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Some macroalgae drift on the ocean and are stranded on coasts, and these stranded brown macroalgae are regarded to be degraded by organisms. Alginate is a major component of brown macroalgae. An uncovering of how carbon is cycled through brown macroalgae is needed to deeply understand coastal ecosystems. In this study, to gain insights into metabolism of brown macroalgae and alginate in the organisms, we initially confirmed that supralittoral talitrid amphipods (beach fleas or sandhoppers collected on the Shibagaki coast in Ishikawa Prefecture, Japan) fed on the brown macroalgae. We then isolated bacteria such as Vibrio sp. with alginate-assimilating capability from the gut of the amphipods. Metagenomic analysis of the gut of amphipods housed in several conditions (e.g. macroalgae or paper as feed, non-sterilized or sterilized environment) showed no condition-dependent compositions of bacteria and fungi, but Vibrio sp. were detected at high frequency, in good agreement with the isolation of Vibrio sp. An intervention study using antibiotics showed that amphipods fed on algae or paper at about the same rate in the presence or absence of antibiotics, and that the antibiotics had no effects on the life span. Moreover, intervention with antibiotics completely killed Vibrio sp. and some other bacteria, and had significant effects on the composition of the flora in the gut, with elimination of the variations observed in the guts of amphipods housed without antibiotics. These data suggest that microbes that were killed by antibiotics, including Vibrio sp., in the gut of talitrid amphipods are not essential for assimilation of brown macroalgae. [ABSTRACT FROM AUTHOR]

People are obtaining more and more information from social media and other online sources, but the spread of misinformation can lead to social disruption. In particular, social networking services (SNSs) can easily spread information of uncertain authenticity and factuality. Although many studies have proposed methods that addressed how to suppress the spread of misinformation on SNSs, few works have examined the impact on society of diffusing both misinformation and its corrective information. This study models the effects of effort to reduce misinformation and the diffusion of corrective information on social disruption, and it clarifies these effects. With the aim of reducing the impact on social disruption, we show that not only misinformation but also corrective information can cause social disruption, and we clarify how to control the spread of the latter to limit its impact. We analyzed the misinformation about a toilet-paper shortage and its correction as well as the social disruption this event caused in Japan during the COVID-19 pandemic in 2020. First, (1) we analyzed the extent to which misinformation and its corrections spread on SNS, and then (2) we created a model to estimate the impact of misinformation and its corrections on the world. Finally, (3) We used our model to analyze the change in this impact when the diffusion of the misinformation and its corrections changed. Based on our analysis results in (1), the corrective information spread much more widely than the misinformation. From the model developed in (2), the corrective information caused excessive purchasing behavior. The analysis results in (3) show that the amount of corrective information required to minimize the societal impact depends on the amount of misinformation diffusion. Most previous studies concentrated on the impact of corrective information on attitudes toward misinformation. On the other hand, the most significant contribution of this study is that it focuses on the impact of corrective information on society and clarifies the appropriate amount of it. [ABSTRACT FROM AUTHOR]

This paper estimated the impact of intervention effects (state of emergency (SOE) or quasi-SOE requirements) and information effects (publicized increases in the number of coronavirus disease 2019 (COVID-19) deaths and fear of infection) on preventive behaviors and telecommuting during the COVID-19 pandemic using the Japan Household Panel Survey. Our results indicated that SOEs and quasi-SOEs had positive effects on the adoption of preventive behaviors among individuals, including handwashing, which indicates that an SOE has a direct effect and an indirect effect. Although SOEs in Japan were less enforceable and more lenient than those in other countries, they still had a certain effect on people's adoption of preventive behaviors. However, the contribution of information effects was much larger than that of intervention effects, suggesting the importance of how and when information should be communicated to the public to prevent the spread of infection. [ABSTRACT FROM AUTHOR]

This paper uses the test proposed by Generalized Supremum Augmented Dickey-Fuller to identify whether there are multiple bubbles in copper price. The empirical results show that base on market fundamentals, there are seven bubbles existed from January 1980 to March 2023. Through analyses, the first two bubbles can be explained by the demand from Japan by the industry concentration and persistent supply constraint. The third to sixth bubbles are mainly negatively impacted by the global financial crisis and growing demand of China. The last bubble is caused by the economic recovery from Covid-19. The logit regression has stated that aluminum price, copper production, all metals index and GDP have a positive impact on copper bubbles, while China's copper imports and precious metals price negatively explains copper bubbles. The main contributions are the investigation of the copper price bubbles, its determinants and the different technique of GSADF to detect copper price bubbles. Furthermore, it provides helpful information for those investors to make reasonable investment decisions and thus, avoid potential price risk. [ABSTRACT FROM AUTHOR]

Academia is becoming more and more competitive, especially for young scientists, so it is important to understand the factors that affect success in academic careers. To survive in academia, it is crucial to obtain research funding. Previous studies have investigated factors that affect the funding success of researchers. In this paper, we focus on research collaboration structure as a factor affecting funding success. More specifically, we investigate the effects of participation in joint research projects, number of joint research projects, and centrality in the collaborative network on the future funding success of junior researchers in Japan. Our results show that participation in joint research projects and the number of such projects significantly affect the future funding success of junior researchers. Furthermore, the median number of years of funding received by researchers involved in joint research projects was found to be about 1.5 times greater than that of researchers not involved in joint research projects, and the average amount of research funding received after 10 years is about 2–4 times more, suggesting that researchers with collaboration ties with other researchers in the early stages of their career tend to be more successful in the future. [ABSTRACT FROM AUTHOR]

Solar PV enables the conversion of solar energy into electricity and has become a clean energy technology for economic development. The advantages and disadvantages of solar photovoltaic vary among CPTPP member nations; nevertheless, since the CPTPP's implementation, fewer researchers have evaluated the member countries' solar photovoltaic goods' level of international competitiveness. In order to correct the flaw that the RCA index can only be studied from trade volume, this study adopts the IRCA index method and the revised CMS model, which integrates a number of variables to analyze the competitiveness of solar photovoltaic in each country. The study's findings indicate that: (1) the structural effect has a significant impact on export growth, particularly during the epidemic period, when Australia's contribution rate reached 106.58%; (2) the competitiveness effect has a lesser impact on export growth, and the epidemic led to a decline in competitiveness, with Japan's contribution rate reaching -262.85%; (3) the second-order effect has a declining trend in its contribution rate of export growth; (4) the export competitiveness of solar PV products differs between CPTPP countries, with power supply products having the most export competitiveness and solar cells having a steady comparative advantage in a weaker state. Apart than Japan, the remaining nations' comparative advantages for PV products are less than 1. Based on the above research findings, this paper puts forward the corresponding policy recommendations. [ABSTRACT FROM AUTHOR]

This paper presents the first case of the successful eradication of a Coleoptera pest species over a wide area using a combination of male annihilation technique (MAT) and sterile insect technique (SIT) application. The sweet potato weevil, Cylas formicarius, is one of the most destructive and widely distributed pests of sweet potato, Ipomoea batatas. A project to eradicate it was launched in 1994 on Kume Island, Okinawa Prefecture, Japan. The MAT application was first used from November 1994 to January 1999 to reduce the density of wild populations. The distribution and densities of weevils were assessed by trapping them and surveying infestation rates in wild hosts and sweet potatoes in the field. The C. formicarius populations were suppressed by approximately 90% and plant infestations were reduced from 9.5% to less than 0.1% by using the MAT. Then, hundreds of thousands to millions of sterile weevils were released each week (ca. 460 million in total from 1999 to 2012). As a result, based on an analysis of 12748 stems and 48749 tubers, no weevil infections were detected in the stems or tubers of sweet potato since 1997. Since 2009, almost no wild weevils were captured in traps, and in wild host and sweet potato surveys no weevils have been found in any of the 580 locations and 8833 samples since October 2011. As of 28 December, 2012, C. formicarius is considered to have been eradicated from Kume Island. This paper describes the process of eradicating C. formicarius using SIT application integrated with MAT application for the first time and discusses some of the main challenges associated with the weevil eradication campaignl. [ABSTRACT FROM AUTHOR]

Testicular torsion is a severe urological emergency caused by the twisting of the spermatic cord. The nationwide incidence of testicular torsion in Japan has not been previously reported. Accordingly, we aimed to estimate the nationwide incidence of testicular torsion using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) and examine the orchiectomy rate. This cross-sectional study was based on data from the NDB. We extracted data of patients aged < 21 years with documented testicular torsion and relevant treatment from January 2018 to December 2020. Testicular torsion was identified based on the Japanese standardized disease codes. The national incidence rate between 2018 and 2020 was calculated and assessed according to age and region of origin. Orchiectomy rates were evaluated according to age. The nationwide incidence rates of testicular torsion were 14.46, 15.09, and 15.88 per 100,000 males aged < 21 years in 2018, 2019, and 2020, respectively. The orchiectomy rate was 7.1%. Testicular torsion was most frequently observed during winter. A similar trend was observed nationwide. To the best of our knowledge, this study is the first to report the nationwide incidence of testicular torsion in Japan. [ABSTRACT FROM AUTHOR]

This study aimed to identify differences in caregiver burden related to toileting assistance, and examine the factors associated with the most burdensome aspects of providing toileting assistance. In 2019, a self-administered postal survey was conducted with 743 caregivers of older adults who received subsidies for continence products in Komatsu City, Japan. Both family caregivers and nursing home staff answered questions regarding older adults' urinary/fecal symptoms, toileting assistance, and perceived caregiver burden. Older adults living at home had less need for toileting assistance than those in nursing homes. However, family caregivers experienced more burden than nursing home staff. The most frequent physical burden associated with toileting assistance for family caregivers was urinary/fecal leakage from absorbent incontinence products. This burden was linked to family caregivers providing care at home, using a combination of urinary pads and diapers, and symptoms that caused burdens on caregivers including urinary/fecal incontinence, nocturia, and no desire to urinate. These results suggest that leakage caused by the inappropriate use of urinary pads combined with diapers is a source of caregiver burden. Continence care experts should provide guidance to family caregivers of older adults, particularly those who are underweight and frail, regarding the selection and fitting of absorbent incontinence products. [ABSTRACT FROM AUTHOR]

Objective: To examine the benefits of full-time hospital facility dogs (HFDs) working with qualified nurse handlers for inpatients in a pediatric medical facility. Methods: A questionnaire survey on the evaluation of HFD activities was conducted in a hospital that had introduced HFDs for the first time in Japan and has been using them for 9 years. Of the 626 full-time medical staff, 431 responded, of which 270 who observed HFD activities were included in the analysis. The Questionnaire contained 20 questions, and nine questions were selected for presentation in this paper because they focused on the situations in which HFD activities were thought to have a strong impact on inpatients. A comparison of the respondents' evaluations for each question was made, and differences in the respondents' attributes (such as profession, length of clinical experience and experience of dog ownership) for those items were examined. Results: The impact of HFDs in terminal care was ranked highest among the respondents. Similarly, HFDs increased patient cooperation for clinical procedures. The responses to these two items did not differ statistically depending on the respondents' attributes. The results imply that patients were more cooperative even for highly invasive examinations and procedures with the support of HFD activities. Conclusions: Healthcare providers considered that HFDs were useful, especially for providing support during the terminal phase and for gaining patients' cooperation for procedures. The fact that the handler was a nurse and the HFD team worked full-time may have enhanced the effectiveness of the program. [ABSTRACT FROM AUTHOR]

Since the financial system has illustrated an increasingly prominent characteristic of inextricable connections, information theory is gradually utilized to study the financial system. By collecting the daily data of industry index (2005-2020) and region index (2012-2020) listed in China as samples, this paper applies an innovative measure named partial mutual information on mixed embedding to generate directed networks. Based on the analysis of nonlinear relationships among sectors, this paper realizes the accurate construction of "time-varying" financial network from the perspective of risk spillover. The results are presented as follow: (1) interactions can be better understood through the nonlinear networks among distinct sectors, and sectors in the networks could be classified into different types according to their topological properties connected to risk spillover; (2) in the rising stage, information is transmitted rapidly in the network, so the risk is fast diffused and absorbed; (3) in the declining stage, the network topology is more complex and panic sentiments have long term impact leading to more connections; (4) The US market, Japan market and Hongkong market have significant affect on China's market. The results suggest that this nonlinear measure is an effective approach to develop financial networks and explore the mechanism of risk spillover. [ABSTRACT FROM AUTHOR]

Background: In the global aging, the coronavirus disease 2019 (COVID-19) pandemic may have affected the place of death (PoD) in Japan, where hospital deaths have dominated for decades. We analyzed the PoD trends before and during the COVID-19 pandemic in Japan. Methods: This nationwide observational study used vital statistics based on death certificates from Japan between 1951 and 2021. The proportion of PoD; deaths at home, hospitals, and nursing homes; and annual percentage change (APC) were estimated using joinpoint regression analysis. Analyses were stratified by age groups and causes of death. Results: After 2019, home deaths exhibited upward trends, while hospital death turned into downward trends. By age, no significant trend change was seen in the 0–19 age group, while hospital deaths decreased in the 20–64 age group in 2019. The trend change in home death in the ≥65 age group significantly increased since 2019 with an APC of 12.3% (95% confidence interval [CI]: 9.0 to 15.7), while their hospital death trends decreased by −4.0% (95% CI: −4.9 to −3.1) in 2019−2021. By cause of death, home death due to cancer and the old age increased since 2019 with an APC of 29.3% (95% CI: 25.4 to 33.2) and 8.8% (95% CI: 5.5 to 12.2), respectively. Conclusion: PoD has shifted from hospital to home during the COVID-19 pandemic in Japan. The majority of whom were older population with cancer or old age. [ABSTRACT FROM AUTHOR]

This study investigated the leftover rate of side dishes in school lunches provided by communal kitchens in Japan's Chugoku region, with a focus on vegetable dishes supplied in containers and three types of menu items served daily to 20 elementary and junior high schools in communal kitchen A for 116 days. First, the leftovers in the containers that were returned to the communal kitchen were weighed and combined. The study then compared outside temperature, distance from communal kitchen A, school type, number of students per class, assignment of nutrition teachers, and time elapsed after cooking. Finally, we examined the relationship between these factors and the leftover rate using multiple regression analysis. The median leftover rate was 20.1% (0–96.9) for 250 side dishes with a high leftover rate; however, this was widely distributed. The number of students per class, assignment of nutrition teachers, and time elapsed after cooking were strongly related to the leftover rate; the adjusted coefficient of determination, R2, was 0.236. The regression results indicated that regarding the side dish leftover rate, the standardized coefficient, β, was 0.414, 0.215, 0.107, 0.093, and 0.094 for the number of students per class, assignment of nutrition teacher, the time elapsed after the end of cooking, distance from communal kitchen A, and presence of seaweed, respectively (p<0.001). Dietary education by homeroom and nutrition teachers and reducing the time elapsed after cooking impacts students' awareness and preferences, which may decrease the leftover rate. [ABSTRACT FROM AUTHOR]

Digital advancements can reduce the burden of recording clinical information. This intra-subject experimental study compared the time and error rates for recording vital signs and prescriptions between an optical character reader (OCR) and manual typing. This study was conducted at three community hospitals and two fire departments in Japan. Thirty-eight volunteers (15 paramedics, 10 nurses, and 13 physicians) participated in the study. We prepared six sample pictures: three ambulance monitors for vital signs (normal, abnormal, and shock) and three pharmacy notebooks that provided prescriptions (two, four, or six medications). The participants recorded the data for each picture using an OCR or by manually typing on a smartphone. The outcomes were recording time and error rate defined as the number of characters with omissions or misrecognitions/misspellings of the total number of characters. Data were analyzed using paired Wilcoxon signed-rank sum and McNemar's tests. The recording times for vital signs were similar between groups (normal state, 21 s [interquartile range (IQR), 17–26 s] for OCR vs. 23 s [IQR, 18–31 s] for manual typing). In contrast, prescription recording was faster with the OCR (e.g., six-medication list, 18 s [IQR, 14–21 s] for OCR vs. 144 s [IQR, 112–187 s] for manual typing). The OCR had fewer errors than manual typing for both vital signs and prescriptions (0/1056 [0%] vs. 14/1056 [1.32%]; p<0.001 and 30/4814 [0.62%] vs. 53/4814 [1.10%], respectively). In conclusion, the developed OCR reduced the recording time for prescriptions but not vital signs. The OCR showed lower error rates than manual typing for both vital signs and prescription data. [ABSTRACT FROM AUTHOR]

The importance of salt intake in preventing heat-related illness (HRI) is well established, however, the specific method of ingestion has not been sufficiently studied. This study, therefore, aimed to investigate the optimal timing of salt intake to prevent HRI during hot outdoor work. We recruited 28 healthy male firefighters working at a fire department in Japan. They were provided a questionnaire to complete before and after receiving training in the summer season. We assessed their salt intake as before, during, and after training or none. In addition, they completed a brief self-administered diet history questionnaire to evaluate their daily salt and alcohol intake. HRI was determined through subjective and objective symptoms listed in the questionnaire, and environmental data were obtained from a national database. Subsequently, factors related to HRI were determined using a logistic regression model. The mean age of the participants was 31.0 ± 7.7 years. The study was performed within 250 working days, and we detected 28 HRI symptoms (11.2%). The median alcohol intake was 25.6 g/day when calculated according to the actual work system. Logistic mixed effect model analysis revealed that salt intake before training (OR: 5.893, 95% CI: 1.407–24.675), and salt intake before and during training (OR: 22.889, 95% CI: 4.276–122.516) were positively associated with HRI symptoms. The results indicate that inappropriate timing of salt intake increases the risks of HRI. Thus, a timely intake of salt in adequate amounts may be important in preventing these risks. [ABSTRACT FROM AUTHOR]

Background: In Japan, as elsewhere, physicians meet with and receive gifts from pharmaceutical representatives (PRs). This study aimed to clarify the Japanese public perceptions of physicians' relationships with PRs, examine the association between these perceptions and their trust in physicians, and compare the public's and physicians' awareness, acceptance, and perceptions of the influence of physician-PR relationships. Methods: A cross-sectional, self-administered, anonymous, internet-panel survey was conducted involving 1,000 participants from the general public. The survey implementation was contracted to Cross Marketing Inc. Results: The mean age of the 1000 participants was 44.8 years (standard deviation 18.3). Forty-eight percent were female. Many of our participants were unaware of certain physician-PR relationships. The public was more acceptable with physicians' receiving stationery and/or medical textbooks and attending promotional drug seminars at their workplaces compared with receiving meals at restaurants. Many thought that physicians' involvement in promotional activities influenced their prescribing habits and estimated that the majority of physicians received office stationery and meals from PRs. They were divided as to whether they would like to know about their physicians' relationships with the industry. Factors associated with higher trust in physicians included participants being 65 years or older, having a primary care physician, being in better health, the belief that physicians' involvement in promotional activities is acceptable, and their high estimate that physicians are not receiving gifts from PRs. Compared to the physicians, the public had lower awareness of and was more accepting of physicians' involvement in promotional activities. Meanwhile, the public believed that physician-PR relationships influenced physicians' prescribing habits more than the physicians themselves. Conclusion: Our survey provided insights into Japanese public perceptions of physician-pharmaceutical industry relationships and their impact on trust in physicians. Physicians should be aware of these perceptions and carefully consider how to foster appropriate relationships with the industry. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of the novel coronavirus disease of 2019 (COVID-19) has led to huge disruptions in the medical field and society. The significance of training and education for experts has been increasingly acknowledged in Japan, where the number of infectious disease (ID) specialists is reportedly insufficient. In this paper, we report the results of a web-based survey that was conducted to reveal the ways in which the COVID-19 pandemic has influenced medical students' awareness of ID specialists and future career choices. Method: This cross-sectional descriptive study was conducted in March 2021 and targeted 717 medical students belonging to Medical School of Okayama University, Japan. The questionnaire consisted of four questions meant to assess students' knowledge and future intentions of becoming ID specialists. Results: We obtained 328 eligible questionnaires (response rate: 45.7%). Of 227 (69.2%) students who were aware of ID specialists, 99 (43.6%) answered that they came to know about them only after the pandemic, 12 (3.7%) answered that their interest in being an ID specialist arose during the pandemic, while 36 (11.0%) responded that they would rather not become ID specialists. At the time of the survey, 5 students (1.5%) were aiming to become ID specialists. Conclusion: We observed a very low rate of interest to be an ID specialist among medical students. The experience of the pandemic does not seem to have influenced Japanese medical students to choose ID as a specialty for their careers. Continuous efforts to increase the number of ID specialists are necessary in Japan as a countermeasure against the coming pandemic. [ABSTRACT FROM AUTHOR]

This paper examines whether the COVID-19-induced employment shocks are associated with increases in suicides and safety net use in the second and third quarters of 2020. We exploit plausibly exogenous regional variation in the magnitude of the employment shocks in Japan and adopt a difference-in-differences research design to examine and control for possible confounders. Our preferred point estimates suggest that a one-percentage-point increase in the unemployment rate in the second quarter of 2020 is associated with, approximately, an additional 0.52 suicides, 28 unemployment benefit recipients, 88 recipients of a temporary loan program, and 10 recipients of public assistance per 100,000 population per month. A simple calculation based on these estimates suggests that if a region experienced a one-percentage-point increase in the unemployment rate caused by the COVID-19 crisis in the second quarter of 2020, which is roughly equivalent to the third-highest regional employment shock, this would be associated with 37.4%, 60.5%, and 26.5% increases in the total, female, and male suicide rates respectively in July 2020 compared with July 2019. These results are primarily correlational rather than causal due to the limitation of our data and research design, but our baseline findings are robust to several different model specifications. [ABSTRACT FROM AUTHOR]

This study documents a rare case of mummified human remains from Japan, dating to the late Heian period, 12th Century AD. The remains have only been scientifically investigated once in 1950 so far. The results of this investigation were translated, analyzed, and interpreted using methods of the 21st century. The remains have been traditionally identified as the four ruling generations of the Ōshū Fujiwara clan, who built a cultural and economic center in Hiraizumi. Accordingly, this paper will first examine the historical and cultural significance of Hiraizumi and its ruling class before re-evaluating the findings of the 1950 investigation. This study is the first in the Western scientific literature to provide a comprehensive historical, cultural, and medical evaluation of these mummies. [ABSTRACT FROM AUTHOR]

Oral care for critically ill patients helps provide comfort and prevent ventilator-associated pneumonia. However, a standardized protocol for oral care in intensive care units is currently unavailable. Thus, this study aimed to determine the overall oral care practices, including those for intubated patients, in Japanese intensive care units. We also discuss the differences in oral care methods between Japanese ICUs and ICUs in other countries. This study included all Japanese intensive care units meeting the authorities' standard set criteria, with a minimum of 0.5 nurses per patient at all times and admission of adult patients requiring mechanical ventilation. An online survey was used to collect data. Survey responses were obtained from one representative nurse per intensive care unit. Frequency analysis was performed, and the percentage of each response was calculated. A total of 609 hospitals and 717 intensive care units nationwide participated; among these, responses were collected from 247 intensive care units (34.4%). Of these, 215 (87.0%) and 32 (13.0%) reported standardized and non-standardized oral care, respectively. Subsequently, the data from 215 intensive care units that provided standardized oral care were analyzed in detail. The most common frequency of practicing oral care was three times a day (68.8%). Moreover, many intensive care units provided care at unequal intervals (79.5%), mainly in the morning, daytime, and evening. Regarding oral care methods, 96 (44.7%) respondents used only a toothbrush, while 116 (54.0%) used both a toothbrush and a non-brushing method. The findings of our study reveal current oral care practices in ICUs in Japan. In particular, most ICUs provide oral care three times a day at unequal intervals, and almost all use toothbrushes as a common tool for oral care. The results suggest that some oral care practices in Japanese ICUs differ from those in ICUs in other countries. [ABSTRACT FROM AUTHOR]

Background: In Japan, rituximab (RTX) for adult-onset frequently relapsing (FR)/steroid-dependent (SD) minimal change disease (MCD) is not explicitly reimbursed by insurance, and its standard regimen has not been established. Methods: We conducted a cross-sectional web-based survey between November and December 2021. The participants were nephrologists certified by the Japanese Society of Nephrology and answered 7 items about RTX for adult MCD. Factors related to the experience of RTX administration at their facilities were estimated by generalized estimating equations. Results: Of 380 respondents, 181 (47.6%) reported the experience of RTX use for adult MCD at their current facilities. Those who worked at university hospitals (vs. non-university hospitals, proportion difference 13.7%) and at facilities with frequent kidney biopsies (vs. 0 cases/year, 19.2% for 1–40 cases/year; 37.9% for 41–80 cases/year; 51.9% for ≥ 81 cases/year) used RTX more frequently. Of 181 respondents, 28 (15.5%) answered that there was no insurance coverage for RTX treatment. Of 327 respondents who had the opportunity to treat MCD, which was a possible indication for RTX, 178 (54.4%) indicated withholding of RTX administration. The most common reason was the cost due to lack of insurance coverage (141, 79.2%). Regarding RTX regimens for FR/SD MCD, introduction treatment with a single body surface area-based dose of 375 mg/m2 and maintenance treatment with a 6-month interval were the most common. Conclusion: This survey revealed the nephrologists' characteristics associated with RTX use, the barriers to RTX use, and the variation in the regimens for adult MCD in Japan. [ABSTRACT FROM AUTHOR]

Introduction: Bronchopulmonary dysplasia (BPD) poses a substantial global health burden. Individualized treatment strategies based on early prediction of the development of BPD can mitigate preterm birth complications; however, previously suggested predictive models lack early postnatal applicability. We aimed to develop predictive models for BPD and mortality based on immediate postnatal clinical data. Methods: Clinical information on very preterm and very low birth weight infants born between 2008 and 2018 was extracted from a nationwide Japanese database. The gradient boosting decision trees (GBDT) algorithm was adopted to predict BPD and mortality, using predictors within the first 6 h postpartum. We assessed the temporal validity and evaluated model adequacy using Shapley additive explanations (SHAP) values. Results: We developed three predictive models using data from 39,488, 39,096, and 40,291 infants to predict "death or BPD," "death or severe BPD," and "death before discharge," respectively. These well-calibrated models achieved areas under the receiver operating characteristic curve of 0.828 (95% CI: 0.828–0.828), 0.873 (0.873–0.873), and 0.887 (0.887–0.888), respectively, outperforming the multivariable logistic regression models. SHAP value analysis identified predictors of BPD, including gestational age, size at birth, male sex, and persistent pulmonary hypertension. In SHAP value-based case clustering, the "death or BPD" prediction model stratified infants by gestational age and persistent pulmonary hypertension, whereas the other models for "death or severe BPD" and "death before discharge" commonly formed clusters of low mortality, extreme prematurity, low Apgar scores, and persistent pulmonary hypertension of the newborn. Conclusions: GBDT models for predicting BPD and mortality, designed for use within 6 h postpartum, demonstrated superior prognostic performance. SHAP value-based clustering, a data-driven approach, formed clusters of clinical relevance. These findings suggest the efficacy of a GBDT algorithm for the early postnatal prediction of BPD. [ABSTRACT FROM AUTHOR]

Some countries have reported a post-pandemic resurgence in syphilis prevalence, but trend data in the World Health Organization Western Pacific Region (WHO-WPRO), including Japan, are severely lacking. Thus, the present study compares the number of syphilis cases before and after the COVID-19 pandemic in some WHO-WPRO countries. In addition, temporal trends in the number of syphilis cases in Japan pre- and post-pandemic are described. Annual numbers of syphilis cases during the study periods from China, New Zealand, Australia and Japan were compared. Annual trends of the numbers of syphilis cases during the same study periods were examined in Japan. In 2020, the number of syphilis-positive cases decreased in all four countries. In 2021, though, China, Australia and Japan all showed an increase in the numbers of syphilis cases. However, the rate of increase in China (+2.8%) and Australia (+4.8%) was low compared to Japan (+36.0%). The number of syphilis cases in New Zealand in 2021 was 12.6% lower than in 2020. In 2022, the number of cases of syphilis in China was 7.4% lower than in 2021. The increase of syphilis-positive cases was approximately 6.3-fold higher in Japan compared to Australia (+66.2% vs. +10.5%) in 2022. In conclusion, post-pandemic resurgence of syphilis occurred in Australia and Japan, but not in China and New Zealand. The reason for the substantial increase in syphilis-positive cases in Japan remains unclear. Post-pandemic, prevention and control of sexually transmitted infections still require attention. [ABSTRACT FROM AUTHOR]

Collective rituals, particularly those characterized by synchrony and pain, have been shown to yield positive social and emotional outcomes. The question arises as to whether these findings extend to low-arousal, family-centered rituals and how spiritual beliefs factor into these communal practices. This study set out to examine the interplay between belief, ritual participation, and their effects on anxiety, social cohesion, and prosocial behavior during a low-arousal collective ritual in Mikasa, Japan. Drawing upon a sample of 183 festival participants, we measured belief in ancestors using a novel scale, identifying significant and consistent associations between these beliefs and measures of social cohesion across multiple targets. Moreover, active participation as a festival dancer displayed a positive relationship with feelings of social cohesion, particularly towards other festival attendees and at the national level. On measures of prosocial behavior, ancestral beliefs were positively associated with generosity shown within the festival setting, whereas observers were less generous towards community members than a non-attending control group. Anxiety outcomes displayed a negative relationship with ancestral beliefs and ritual observation but not participation as seen in previous research, suggesting a complex interplay between rituals, emotions, and individual states. These findings provide novel insights into the importance of belief systems and active participation in shaping social bonds and behaviors in the context of collective rituals. [ABSTRACT FROM AUTHOR]

Ixodid ticks, such as Ixodes ovatus and Haemaphysalis flava, are important vectors of tick-borne diseases in Japan, such as Japanese spotted fever caused by Rickettsia japonica. This study describes the Rickettsia infection rates influenced by the population genetic structure of I.ovatus and H. flava along an altitudinal gradient. A total of 346 adult I. ovatus and 243 H. flava were analyzed for the presence of Rickettsia by nested PCR targeting the 17kDA, gltA, rOmpA, and rOmpB genes. The population genetic structure was analyzed utilizing the mitochondrial cytochrome oxidase 1 (cox1) marker. The Rickettsia infection rates were 13.26% in I. ovatus and 6.17% in H. flava. For I. ovatus, the global FST value revealed significant genetic differentiation among the different populations, whereas H. flava showed non-significant genetic differentiation. The cox1 I. ovatus cluster dendrogram showed two cluster groups, while the haplotype network and phylogenetic tree showed three genetic groups. A significant difference was observed in Rickettsia infection rates and mean altitude per group between the two cluster groups and the three genetic groups identified within I. ovatus. No significant differences were found in the mean altitude or Rickettsia infection rates of H. flava. Our results suggest a potential correlation between the low gene flow in I. ovatus populations and the spatially heterogeneous Rickettsia infection rates observed along the altitudinal gradient. This information can be used in understanding the relationship between the tick vector, its pathogen, and environmental factors, such as altitude, and for the control of tick-borne diseases in Japan. [ABSTRACT FROM AUTHOR]

There are cases in which CKD progression is difficult to evaluate, because the changes in estimated glomerular filtration rate (eGFR) and proteinuria sometimes show opposite directions as CKD progresses. Indices and models that enable the easy and accurate risk prediction of end-stage-kidney disease (ESKD) are indispensable to CKD therapy. In this study, we investigated whether a CKD stage coordinate transformed into a vector field (CKD potential model) accurately predicts ESKD risk. Meta-analysis of large-scale cohort studies of CKD patients in PubMed was conducted to develop the model. The distance from CKD stage G2 A1 to a patient's data on eGFR and proteinuria was defined as r. We developed the CKD potential model on the basis of the data from the meta-analysis of three previous cohort studies: ESKD risk = exp(r). Then, the model was validated using data from a cohort study of CKD patients in Japan followed up for three years (n = 1,564). Moreover, the directional derivative of the model was developed as an index of CKD progression velocity. For ESKD prediction in three years, areas under the receiver operating characteristic curves (AUCs) were adjusted for baseline characteristics. Cox proportional hazards models with spline terms showed the exponential association between r and ESKD risk (p<0.0001). The CKD potential model more accurately predicted ESKD with an adjusted AUC of 0.81 (95% CI 0.76, 0.87) than eGFR (p<0.0001). Moreover, the directional derivative of the model showed a larger adjusted AUC for the prediction of ESKD than the percent eGFR change and eGFR slope (p<0.0001). Then, a chart of the transformed CKD stage was developed for implementation in clinical settings. This study indicated that the transformed CKD stage as a vector field enables the easy and accurate estimation of ESKD risk and CKD progression and suggested that vector analysis is a useful tool for clinical studies of CKD and its related diseases. [ABSTRACT FROM AUTHOR]

Patient profiles suitable for long-term lenvatinib treatment for unresectable hepatocellular carcinoma (uHCC) are yet to be fully understood. This post-hoc analysis aimed to identify such patient characteristics and explore the impact of treatment duration and relative dose intensity (RDI) on treatment outcomes. The data were obtained from 703 patients in a multicenter, prospective cohort study in Japan. Lenvatinib-naïve patients with uHCC were enrolled between July 2018 and January 2019 and were followed up for 12 months. Moreover, patients were dichotomized using the median treatment duration into the longer- (≥177 days; n = 352) or shorter-treatment (<177 days; n = 351) groups. The longer-treatment group often had better performance status, lower Child-Pugh score and better modified albumin-bilirubin grade than the shorter treatment group (p<0.05 for all). The objective response rate (47.6% vs. 28.2%; p<0.001) and disease control rate (92.4% vs. 60.2%; p<0.001) were both significantly higher in the longer-treatment groups than in the shorter-treatment groups. The proportion of patients with any adverse drug reactions was generally similar between the two treatment groups. Within the longer-treatment group, the disease control rate was high regardless of dose modification (i.e., RDI <100% vs. ≥100% during the initial 177 days) (91.2% vs. 98.0%). In conclusion, patients with longer treatment tended to have better overall conditions. Lenvatinib dose modifications at the physician's discretion, considering the balance between effectiveness and safety, may contribute to the long-term treatment. [ABSTRACT FROM AUTHOR]

The nitrogen isotopic composition of nitrogen oxide (NOx) is useful for estimating its sources and sinks. Several methods have been developed to convert atmospheric nitric oxide (NO) and/or nitrogen dioxide (NO2) to nitrites and/or nitrates for collection. However, the collection efficiency and blanks are poorly evaluated for many collection methods. Here, we present a method for collecting ambient NOx (NO and NO2 simultaneously) with over 90% efficiency collection of NOx and low blank (approximately 0.5 μM) using a 3 wt% hydrogen peroxide (H2O2) and 0.5 M sodium hydride (NaOH) solution. The 1σ uncertainty of the nitrogen isotopic composition was ± 1.2 ‰. The advantages of this method include its portability, simplicity, and the ability to collect the required amount of sample to analyze the nitrogen isotopic composition of ambient NOx in a short period of time. Using this method, we observed the nitrogen isotopic compositions of NOx at the Tsukuba and Yoyogi sites in Japan. The averaged δ15N(NOx) value and standard deviation (1σ) in the Yoyogi site was (−2.7 ± 1.8) ‰ and in the Tsukuba site was (−1.7 ± 0.9) ‰ during the sampling period. The main NOx source appears to be the vehicle exhaust in the two sites. [ABSTRACT FROM AUTHOR]

Social isolation exacerbates physical frailty and is associated with subjective well-being. Even those with high levels of social isolation may have different health statuses depending on the type of isolation and their subjective well-being. However, the effect of subjective well-being on the relationship between social isolation and physical frailty remains unclear. This study examined whether the risk of physical frailty was the same for individuals with social isolation according to high and low subjective well-being. The study participants included 1,953 middle-aged Japanese adults aged 45 years and older. Physical frailty was assessed using a modified version of the Fried phenotype criteria. Probabilistic Latent Semantic Analysis was used to classify participants according to social isolation indicators. Subsequently, we focused on the groups with high social isolation and classified them according to whether their subjective well-being was high or low. Subjective well-being was evaluated using the Shiawase and Ikigai scales, which are concepts used in Japan. Finally, we used survival time analysis to examine the relationship between Shiawase or Ikigai and physical frailty in groups with high social isolation. The participants were classified into four groups based on their social isolation status. The physical frailty rate of the high social isolation class was 37.0%, which was significantly higher than that of the other classes. Survival time analysis revealed that among people with high social isolation, those with high Shiawase and Ikigai had a significantly lower risk of physical frailty than those with low Shiawase and Ikigai. All individuals with high social isolation are not at a high risk of physical frailty. The findings reveal that even those with high level of social isolation may have a lower risk of physical frailty if their subjective well-being is high. These results will contribute to promoting the prevention of frailty in middle-aged and older adults. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic has put a strain on the healthcare system, and sudden changes in disease status during home treatment have become a serious issue. Therefore, prediction of disease severity and allocation of sufficient medical resources, including high-flow nasal cannula (HFNC), to patients in need are important. We aimed to determine risk factors for the need of HFNC use in COVID-19. Methods: This was a single-center retrospective observational cohort study including all eligible hospitalized adult patients aged ≥18 years diagnosed with COVID-19 between April 14, 2020 and August 5, 2021 who were treated in the study hospital. The primary outcome is the need for HFNC. Nineteen potential predictive variables, including patient characteristics at hospital admission, were screened using least absolute shrinkage and selection operator and logistic regression to construct a predictive risk score. Accuracy of the risk score was determined using area under the receiver operating characteristic curve. Results: The study cohort included 148 patients. The rate of the need for HFNC was 22.9%. Among the 19 potential variables, percutaneous oxygen saturation (SpO2) <92% (odds ratio [OR] 7.50, 95% confidence interval [CI] 2.806–20.82) and IL-6 (OR 1.021, 95% CI 1.010–1.033) were included in developing the risk score, which was termed interleukin (IL)-6-based COVID-19 severity (IBC-S) score. Conclusions: The IBC-S score, an easy-to-use risk score based on parameters available at the time of hospital admission, predicted the need for HFNC in patients with COVID-19. The IBC-S score based on interleukin-6 and SpO2 might aid in determining patients who should be transported to a tertiary medical institution or an isolation facility. [ABSTRACT FROM AUTHOR]

Background: There has been a recent decrease in the prevalence of infectious diseases in children worldwide due to the usage of vaccines. However, the association between cesarean delivery and infectious diseases remains unclear. Here, we aimed to clarify the association between cesarean delivery and the development of infectious diseases. Methods: This study is a cross-sectional study. We used data from the Japan Environment and Children's Study, which is a prospective, nationwide, government-funded birth cohort study. The data of 104,065 records were included. Information about the mode of delivery, central nervous system infection (CNSI), otitis media (OM), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), gastrointestinal infection (GI), and urinary tract infection (UTI) was obtained from questionnaires and medical records transcripts. Multiple logistic regression analysis was used to assess the association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI risk. Results: We included a total of 74,477 subjects in this study, of which 18.4% underwent cesarean deliveries. After adjusting for the perinatal, socioeconomic, and postnatal confounding factors, children born by cesarean delivery did not have an increased risk of developing CNSI (95% confidence interval [CI] 0.46–1.35), OM (95% CI 0.99–1.12), URTI (95% CI 0.97–1.06), LRTI (95% CI 0.98–1.15), GI (95% CI 0.98–1.11), or UTI (95% CI 0.95–1.45). Conclusions: This nationwide cohort study did not find an association between cesarean delivery and CNSI, OM, URTI, LRTI, GI, and UTI. However, further studies are needed to evaluate the role of cesarean delivery in the development of infectious diseases. [ABSTRACT FROM AUTHOR]

The emergence of macrolide-resistant Bordetella pertussis (MRBP) is a significant problem because it reduces treatment options for pertussis and exacerbates the severity and spread of the disease. MRBP has been widely prevalent in mainland China since the 2010s and has been sporadically detected in other Asian countries. In Japan, two MRBP clinical strains were first isolated in Tokyo and Osaka between June and July 2018. The isolates BP616 in Osaka and BP625 in Tokyo harbored the same virulence-associated allelic genes (including ptxP1, ptxA1, prn1, fim3A, and fhaB3) and MT195 genotype and exhibited similar antimicrobial susceptibility profiles. However, despite their simultaneous occurrence, a distinguishable epidemiological link between these isolates could not be established. To gain further insight into the genetic relationship between these isolates in this study, we performed whole-genome analyses. Phylogenetic analysis based on genome-wide single-nucleotide polymorphisms revealed that the isolates belonged to one of the three clades of Chinese MRBP isolates, but there were 11 single-nucleotide polymorphism differences between BP616 and BP625. Genome structure analysis revealed two large inversions (202 and 523 kbp) and one small transposition (3.8 kbp) between the genomes. These findings indicate that the two Japanese MRBP isolates are closely related to Chinese MRBP isolates but are genomically distinct, suggesting that they were introduced into Japan from mainland China through different transmission routes. [ABSTRACT FROM AUTHOR]

Understanding the genetic diversity of inbred lines is vital for development of superior F1 varieties. The present study aimed to analyze Japanese maize parental inbred lines and determine their genetic diversity for future breeding. Genetic analyses were conducted using multiple methods. Principal component analysis (PCA), phylogenetic trees, and Bayesian clustering reflected borders between heterotic groups according to the derivation of each inbred line. A self-pollinated line derived from a classic F1 variety and another line from an open-pollinated population from the same derivation were classified as separate components by PCA and Bayesian clustering. The result suggests that open pollination could be essential in modern breeding. Of those classified as dent or flint based on their derivation, some had a combination of all components or clusters. Therefore, the classification of inbred lines should be based on their derivation and DNA markers. The findings will be valuable for breeding and genetic studies in Japan. Additionally, these techniques may be used to obtain a more significant number of SNPs and related phenotypic data. [ABSTRACT FROM AUTHOR]

Objectives: To examine spatial effects in neonatal care, we conducted a retrospective cohort study to investigate the geographical distribution of antimicrobial exposure among very preterm and very low birth weight infants in Japan. Study design: We utilized a nationwide claims database in Japan to extract prescriptions of injectable antimicrobials for 41,423 very preterm and very low birth weight infants admitted within the first two days of life from April 2010 to March 2021. We identified frequently prescribed antimicrobials, revealed early neonatal exposure and neonatal exposure to each antimicrobial agent by 47 prefectures in Japan, and evaluated their spatial autocorrelation using global and local Moran's I statistics. We then scrutinized regional disparities in antimicrobial drug prescriptions. Results: The top 10 antimicrobials prescribed to very preterm and very low birth weight infants in Japan were ampicillin, amikacin, gentamicin, cefotaxime, fluconazole, ampicillin combination, micafungin, cefmetazole, cefazolin, and vancomycin. We identified northern cold spots for fluconazole exposure and southern hot spots for ampicillin, amikacin, gentamicin, and cefmetazole exposure. Geographical heterogeneity in the selection of antibacterial and antimycotic agents was observed. Conclusion: Our study revealed the geographical distribution of antimicrobial exposure among very preterm and very low birth weight infants in Japan, thus disclosing its spatial effects. Further research addressing the spatial effects of neonatal care is needed to understand how drug exposure affects the outcomes of preterm infants. [ABSTRACT FROM AUTHOR]

The number of plants unpalatable to deer increases with increasing deer numbers. In the Kyushu Mountain area of Southern Japan, Pieris japonica (Ericaceae), an unpalatable shrub, has become the monodominant vegetation under evergreen conifer and deciduous broad-leaved tree stands. The monodominance of unpalatable plants in the understory has potential advantages and drawbacks; however, the effects of Pieris dominance are not well understood. To assess the effects of P. japonica dominances on forest environments and ecosystems, we investigated understory environments and soil microbiomes in Pieris-dominant sites. Under the deciduous broad-leaved trees, Pieris dominance leads to considerable Pieris leaf litter and humus weights and low soil bulk density and canopy openness. In the soil fungal community and fungal functional groups, the relative abundance of symbiotrophic fungi, particularly ectomycorrhizal fungi in Pieris-dominant sites were lower than in other-vegetation understory sites and saprotrophic fungi vice versa. Because few seedlings and saplings were found under Pieris shrubs, Pieris dominance in the understory might exclude other plant species. The results of this study will contribute to the Pieris population and forest management following deer overgrazing. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the factors that cause differences in competition level based on the competition performance structure among university student decathletes in Japan. The results of factor analysis using the maximum likelihood method (Oblimin rotation), assuming a five-factor structure estimated from parallel analysis and the information criterion, revealed the following competitive performance structures: "running speed and body projection," "running endurance," "rotational throwing power," "translational throwing power," and "vertical leaping power." Some of these were similar to the competitive performance structures of the world's top athletes, but they were found to have a unique structure: two throwing powers. The analysis results using latent rank theory allowed us to evaluate them on a seven-point scale. The calculated item reference profile, difficulty index, and discrimination index for each rank indicated that shot put and 100 and 400 m performance formed the basis of decathlon performance. In addition, high jump and pole vault, which fall under the category of "vertical leaping power," retained high difficulty and discrimination and were revealed to affect the stage of achievement of overall performance in the decathlon. [ABSTRACT FROM AUTHOR]

In this retrospective study, we aimed to investigate the frequency, trend, and nature of non-infectious diseases (non-IDs) as the final diagnosis for patients during an infectious disease (ID) consultation in an acute care hospital in Japan. This study included adult inpatients who underwent ID consultations between October 2016 and March 2018. The demographic data, clinical manifestations, and final non-ID diagnoses of cases were explored. Among the 502 patients who underwent ID consultations, 45 (9.0%) were diagnosed with non-IDs. The most common diagnoses were tumors (22.2%, n = 10), connective tissue and collagen vascular diseases (13.3%, n = 6), other inflammatory diseases (8.9%, n = 4), and drug-induced fever (8.9%, n = 4). Multiple logistic regression analysis showed that the presence of consultations for diagnosis (odds ratio [OR], 22.0; 95% confidence interval [CI], 10.1–48.2; p<0.01), consultations from the internal medicine department (OR, 2.5; 95% CI, 1.2–5.2; p = 0.02), and non-bacteremia cases (OR, 5.2; 95% CI, 1.4–19.3; p = 0.01) were independently associated with diagnosed non-IDs. Non-IDs after ID consultations were mainly tumor-related, inflammatory diseases, and drug fever. The presence of consultations for diagnosis, consultations from the internal medicine department and non-bacteremia cases were related to non-IDs among ID consultations. Further research is needed to explore the frequency and pattern of non-IDs to improve the quality of ID consultations in daily practice. [ABSTRACT FROM AUTHOR]

Objectives: To describe inpatient and outpatient cardiac rehabilitation (CR) utilization patterns over time and by subgroups among patients admitted for acute heart failure (AHF) in Japan. Background: Cardiac rehabilitation (CR) is a crucial secondary prevention strategy for patients with heart failure. While the number of older patients with AHF continues to rise, trends in inpatient and outpatient CR participation following AHF in Japan have not been described to date. Methods: We conducted a retrospective cohort study of adult patients hospitalized for AHF in Japan between April 2008 and December 2020. Using data from the Medical Data Vision database, we measured trends in inpatient and outpatient CR participation following AHF. Descriptive analyses and summary statistics for AHF patients by CR participation status were reported. Results: The analytic cohort included 88,052 patients. Among these patients, 37,810 (42.9%) participated in inpatient and/or outpatient CR. Of those, 36,431 (96.4%) participated in inpatient CR only and 1,277 (3.4%) participated in both inpatient and outpatient CR. Rates of inpatient CR rose more than 6-fold over the study period, from 9% in 2009 to 55% in 2020, whereas rates of outpatient CR were consistently low. Conclusions: The rate of inpatient CR participation among AHF patients in Japan rose dramatically over a 12-year period, whereas outpatient CR following AHF was vastly underutilized. Further study is needed to assess the clinical effectiveness of inpatient CR and to create infrastructure and incentives to support and encourage outpatient CR. [ABSTRACT FROM AUTHOR]

This study simulates how the disruption of imports from various regions affects the total production of the importer economy. We particularly incorporate the propagation of the economic effect through domestic supply chains using data on more than one million firms and four million supply chain ties in Japan. Our findings are summarized as follows. First, the negative effect of the disruption of intermediate imports grows exponentially as its duration and strength increase due to downstream propagation. Second, the propagation of the economic effect is substantially affected by the network topology of importers, such as the number of importers (affected nodes) and their degree of upstreamness in supply chains, whereas the effect of their degree centrality is heterogeneous depending on their degree of upstreamness. Finally, the negative effect of import disruption can be mitigated by the reorganization of domestic supply chains, even when conducted only among network neighbors. Our findings provide important policy and managerial implications for the achievement of more robust and resilient global supply chains. [ABSTRACT FROM AUTHOR]

Long-term high-fat feeding results in intramyocellular lipid accumulation, leading to insulin resistance. Intramyocellular lipid accumulation is related to an energy imbalance between excess fat intake and fatty acid consumption. Alternating current electromagnetic field exposure has been shown to enhance mitochondrial metabolism in the liver and sperm. Therefore, we hypothesized that alternating current electromagnetic field exposure would ameliorate high-fat diet-induced intramyocellular lipid accumulation via activation of fatty acid consumption. C57BL/6J mice were either fed a normal diet (ND), a normal diet and exposed to an alternating current electromagnetic field (ND+EMF), a high-fat diet (HFD), or a high-fat diet and exposed to an alternating current electromagnetic field (HFD+EMF). Electromagnetic field exposure was administered 8 hrs/day for 16 weeks using an alternating current electromagnetic field device (max.180 mT, Hokoen, Utatsu, Japan). Tibialis anterior muscles were collected for measurement of intramyocellular lipids, AMPK phosphorylation, FAT/CD-36, and carnitine palmitoyltransferase (CPT)-1b protein expression levels. Intramyocellular lipid levels were lower in the HFD + EMF than in the HFD group. The levels of AMPK phosphorylation, FAT/CD-36, and CPT-1b protein levels were higher in the HFD + EMF than in the HFD group. These results indicate that alternating current electromagnetic field exposure decreases intramyocellular lipid accumulation via increased fat consumption. [ABSTRACT FROM AUTHOR]

Background: The division of the Korean peninsula involved many neighbouring countries in the Korean War. The relations with those countries have since been reorganised due to active exchange. This study examined how the quantity and quality of contact with traditional alliance (US and Japan) and strategic partner (China and Russia) countries affected their national images. Methods: To this end, this study analyzed the relation with the national image by measuring the quantity and quality of contact of an individual with each country. The quantity of contact included an evaluation of the individual's subjective amount of contact, contact path, and contact status, and the quality of contact was measured as an evaluation for the pleasure, competitiveness, intimacy, spontaneity, and necessity when contacting each country's culture. A total of 387 participants were divided into two groups based on the presence of direct contact and the quantity and quality of their contact and national images were examined. The participants were followed by a completion of the self-questionnaires including the Culture Experience Questionnaire, National Image Questionnaire, and demographic information questionnaire. Results: The results of this study are as follow: first, regardless of the type of country, the national image was highly correlated with the degree of subjective contact evaluated by individuals, but there was a weak tendency with contact quality. Second, there was no significant interaction between the country type and contact status for national image, however, different national images for each country were detected. In other word, for contact quantity, contact groups showed more positive national images compared to non-contact groups in Russia, but not Japan, China, and the US. For contact quality, the positive contact experience group showed more positive national images compared to the negative contact experience group, but only in traditional alliance countries. Conclusion: This study highlights the importance of implementing different strategies for countries to maintain peaceful international relations. [ABSTRACT FROM AUTHOR]

Background: Long-term cancer prognosis after initial surgical procedures is an unlikely endpoint for clinical trials. Medical claim databases may aid in addressing this issue regardless of limited information on disease and patient background. However, the long-term prognosis (especially regarding long-term care needs) following surgical procedures remains unclear. This study aimed to assess whether long-term outcomes, such as the exacerbation of long-term care needs and mortality, differ with surgical methods. Methods: Using a longitudinal study with linkage between medical claim and long-term care database, patients with primary colorectal cancer who underwent initial colonoscopies were identified through anonymized data in Japan (Shizuoka Kokuho Database, 2012–2018). Odds ratios (ORs) for long-term outcomes (long-term care needs and all-cause mortality during a 6.5-year follow-up period) were analyzed using logistic regression to compare laparoscopy and endoscopic surgery to laparotomy. Results: Overall, 3,744 primary colorectal cancer cases (822 laparotomies, 705 laparoscopies, and 2,217 endoscopic surgeries) were included. Compared to the laparotomy group, the crude OR for exacerbation of long-term care needs in the laparoscopic surgery group was 0.376 (95% confidence interval, 0.227, 0.624), while the OR for all-cause mortality was 0.22 (0.329, 0.532). Conclusion: This is the first study to analyze long-term prognosis after surgery for patients with colorectal cancer to combine medical and long-term needs data. As the national health insurance claim database rarely includes information on cancer stage and comorbidities, better prognosis on endoscopic surgery may need careful interpretation. Therefore, laparoscopy has superior outcomes in terms of long-term care needs and mortality compared to those of laparotomy. [ABSTRACT FROM AUTHOR]

Prolonged symptoms that occur after COVID-19 (long-COVID) vary from mild, which do not interfere with daily life, to severe, which require long-term social support. This study assessed the secular trend in online searches on long-COVID in Japan. We conducted an observational study using data provided by Yahoo! JAPAN on the monthly search volume of query terms related to long-COVID from January 2020 to December 2022, including the search volume of the query "コロナ後遺症" (long-COVID in Japanese). The number of new cases of COVID-19 by month was used as a control for search trends, and the symptoms retrieved in conjunction with long-COVID were compared. Trends in online searches for each symptom of long-COVID were analyzed. The symptoms of long-COVID were classified according to "Component 1—Symptoms and Complaints" of the International Classification of Primary Care, 2nd edition (ICPC-2). Interest in long-COVID increased in response to peaks in the number of new cases of COVID-19 in Japan. The most frequent symptom searches with long-COVID were hair loss/baldness (3,530, 21,400, and 33,600 searches in 2020, 2021, and 2022, respectively), cough (340, 7,900 and 138,910 searches in 2020, 2021, and 2022, respectively), disturbance of smell/taste (230, 13,340, and 44,160 searches in 2020, 2021, and 2022, respectively), and headache (580, 6,180, and 42,870 searches in 2020, 2021, and 2022, respectively). In addition, the ranking of interest in "weakness/tiredness, general" in long-COVID increased each year (not in the top 10 in 2020, seventh in 2021, and second in 2022), and the absolute number of searches also increased. To our knowledge, this is the first study to investigate secular trends in online interest in long-COVID in the world. Continued monitoring of online interest in long-COVID is necessary to prepare for a possible increase in the number of patients with long-COVID. [ABSTRACT FROM AUTHOR]

Low-back pain is common among school-aged children. Decreased trunk flexibility in childhood influences low-back pain in adulthood. Previous studies examining the association between low-back pain and trunk flexibility in children are insufficient. Examining this association among elementary school children may help to better understand trunk flexibility in children with low-back pain and to modify the management of inflexibility. Therefore, this study aimed to identify the prevalence of low-back pain and its relationship with physical function among elementary school students. School-aged children aged 6–12 years were recruited in Japan between May 2018 and March 2023. Fingertip-to-floor distance, back muscle strength, pelvic tilt angle during gait, and the visual analog scale for low-back pain were measured. In addition, factors independently related to low-back pain were determined through logistic regression analysis. Low-back pain was reported in 9.6% of the 394 participants (boys, 191; girls, 203). All children with low-back pain presented with back pain when they moved; however, the pain was non-specific. Logistic regression analysis showed that the fingertip-to-floor distance was an independent risk factor for low-back pain (odds ratio, 0.921; p = 0.007). The odds ratios calculated in the logistic regression analysis confirmed that low-back pain frequency increased as the fingertip-to-floor distance decreased. The risk of low-back pain was associated with inflexibility, regardless of sex and muscle strength. These findings suggest that children with low-back pain must increase their trunk and lower extremity flexibility. [ABSTRACT FROM AUTHOR]

Background: Physical therapy (PT) is beneficial for critically ill patients, but the extent of its application in the intensive care unit (ICU) differs between countries. Here, we compared the extent of PT intervention in the ICU in Japan, the Philippines, and Taiwan by evaluating the sociodemographic and ICU-related profiles of ICU physical therapists. Materials and methods: In this cross-sectional study, a semistructured nationwide online survey was distributed to ICU physical therapists in the three countries. Results: We analyzed the responses of 164 physical therapists from Japan, Philippines, and Taiwan. Significant differences were observed between the countries in all sociodemographic variables and the following ICU-related profiles of physical therapists: ICU work experience, duration of the ICU posting, number of hours per day spent in the ICU, on-call ICU PT service engagement, source of ICU patient referral, therapist–patient ratio, and ICU-related PT training participation (p < 0.05). Medical, surgical, and neurologic ICUs were the most common ICU workplaces of the ICU physical therapists, but only surgical and neurologic ICUs exhibited significant differences between the countries (p < 0.05). Standard PT techniques in the ICU were passive and active-assisted range of motion, positioning, and breathing exercises but were implemented with significantly different frequencies between the countries (p < 0.05). The most common challenge faced in ICU PT service delivery by respondents from all three countries was lack of training prior to ICU duty, and lack of training was even bigger challenge in Japan than in other two countries after adjustment of age, highest educational attainment, and work experience. Conclusion: The differences in the health-care system between Japan, the Philippines, and Taiwan were related to differences in the compliance with internationally recommended PT practice standards in the ICU, differences in the type of PT intervention prioritized, and the challenges encountered in ICU PT service delivery. [ABSTRACT FROM AUTHOR]

Introduction: On March 11, 2011, the Great East Japan Earthquake occurred in Japan, with a nuclear accident subsequently occurring at the Fukushima Daiichi Nuclear Power Plant. The disaster forced many evacuees to change particular aspects of their lifestyles. However, the effect of evacuation on the new-onset of hyperuricemia have not been sufficiently elucidated. This study assessed the association between evacuation and new-onset hyperuricemia after the earthquake based on the Fukushima Health Management Survey from a lifestyle and socio-psychological perspective. Materials and methods: This is a 7-year prospective longitudinal study included 18,140 residents (6,961 men and 11,179 women) with non-hyperuricemia who underwent both the Comprehensive Health Check and the Mental Health and Lifestyle Survey in fiscal year 2011. Associations between new-onset hyperuricemia and lifestyle- and disaster-related factors, including evacuation, were estimated using a Cox proportional hazards regression model analysis. Hyperuricemia was defined as uric acid levels > 7.0 mg/dL for men and > 6.0 mg/dL for women. Results: During a median follow-up of 4.3 years, 2,996 participants (1,608 men, 23.1%, 1,388 women, 12.4%) newly developed hyperuricemia. Significant associations were observed between evacuation and onset of hyperuricemia in women (adjusted hazard ratio 1.18, 95% confidence interval, 1.05–1.32, p = 0.007), but not in men (adjusted hazard ratio 1.11, 95% confidence interval, 0.99–1.24, p = 0.067). Discussion: Evacuation after a natural disaster is an independent risk factor for the new-onset of hyperuricemia in women. The possibility of hyperuricemia developing in response to natural disasters should be considered. [ABSTRACT FROM AUTHOR]

This study aimed to determine the optimal conditions to measure the percentage of the area considered as pneumonia (pneumonia volume ratio [PVR]) and the computed tomography (CT) score due to coronavirus disease 2019 (COVID-19) using the Ziostation2 image analysis software (Z2; Ziosoft, Tokyo, Japan), which is popular in Japan, and to evaluate its usefulness for assessing the clinical severity. We included 53 patients (41 men and 12 women, mean age: 61.3 years) diagnosed with COVID-19 using polymerase chain reaction who had undergone chest CT and were hospitalized between January 2020 and January 2021. Based on the COVID-19 infection severity, the patients were classified as mild (n = 38) or severe (n = 15). For 10 randomly selected samples, the PVR and CT scores by Z2 under different conditions and the visual simple PVR and CT scores were compared. The conditions with the highest statistical agreement were determined. The usefulness of the clinical severity assessment based on the PVR and CT scores using Z2 under the determined conditions was statistically evaluated. The best agreement with the visual measurement was achieved by the Z2 measurement condition of ≥–600 HU. The areas under the receiver operating characteristic curves, Youden's index, and the sensitivity, specificity, and p-values of the PVR and CT scores by Z2 were as follows: PVR: 0.881, 18.69, 66.7, 94.7, and <0.001; CT score: 0.77, 7.5, 40, 74, and 0.002, respectively. We determined the optimal condition for assessing the PVR of COVID-19 pneumonia using Z2 and demonstrated that the AUC of the PVR was higher than that of CT scores in the assessment of clinical severity. The introduction of new technologies is time-consuming and expensive; our method has high clinical utility and can be promptly used in any facility where Z2 has been introduced. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the distribution of board-certified infectious disease (ID) specialists at medical schools and Designated Medical Institutions (DMIs) in Japan. Methods: Data on the number of board-certified ID specialists was extracted by gender, prefecture, and hospital from the Japanese Association for Infectious Diseases database. The numbers and types of Japanese university hospitals that have a Faculty of Medicine, as well as the DMIs legally determined by the Infectious Diseases Control Law, were collected from the database of the Ministry of Health, Labour, and Welfare of Japan. Results: As of November 2022, there were 1,688 board-certified ID specialists in Japan, with 510 employed at 82 university hospitals. Two medical schools had no ID specialists, and six had only one ID specialist. There was no ID specialists in 14.3% of Class I DMIs and 66.7% of Class II DMIs. Additionally, 14.9% of prefectures had no ID specialists at all in their Class II DMIs. The percentage of female doctors among ID specialists was 12.7%, approximately half of the overall male-to-female ratio of medical doctors in Japan. Conclusion: The allocation of Japanese ID specialists to medical schools and legally designated healthcare institutes is inadequate and skewed. Female physicians are expected to play a more active role in this increasing demand. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the relationship between night shifts and snacking behaviors during pregnancy using Japanese maternal-infant longitudinal data from a large-scale study. Methods: This study used the Japan Environment and Children's Study dataset jecs-ta-20190930, released in October 2019. After simple analysis using analysis of variance and multiple comparisons, crude odds ratios (cOR) and adjusted odds ratios (aORs) were calculated. To evaluate eating habits, we examined habitual fast food and snacks (e.g., potato chips, corn puffs and tortilla chips) consumption, midnight snacks, and regular missing breakfast. Results: There was no significant association between inappropriate weight gain during pregnancy and night shift work in early pregnancy. The aOR for consuming snacks more than once a week after noticing pregnancy for shift workers was 1.34 (95% confidence interval 1.27–1.41; p < 0.001) compared with worker without night shiftwork. The aOR for shift workers consuming fast food more than three times a week during pregnancy was 1.40 (95% confidence interval 0.79–2.33; p > 0.05). Conclusions: Pregnant night shift workers did not show excessive weight gain but had an increased frequency of consumption of snack foods compared with pregnant dayshift workers. [ABSTRACT FROM AUTHOR]

Background: The government of Japan has spent a significant amount on dental healthcare, but it remains unknown how the spending varies across age, type of service, and time. This study describes trends in dental expenditures in Japan. Methods: This descriptive study used two national data sources: Estimates of National Medical Care Expenditure and Survey on Economic Conditions in Health Care. We obtained annual total and average per capita dental expenditures by age in Japan from 1984 to 2020 and estimated the proportions of types of service from 1996 to 2021. All costs were adjusted for the 2020 Consumer Price Index (1 US dollar ≈ 100 yen in 2020). Results: Total dental expenditures increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020. In particular, total and average per capita dental spending for older persons showed a rapid increase (total: from 185 billion yen in 1984 to 1.18 trillion yen in 2020; average per capita: from 15,500 yen in 1984 to 32,800 yen in 2020), contributing to the total amount increase. The crown restoration and prosthesis category amounted to 50.3% of the total expenditure in 1996, and this proportion declined to 32.4% by 2021. In 0–14 years persons, expenses on the crown restoration and prosthesis category decreased while the medical management category (mainly including fees for a management plan for oral diseases or oral functions) increased. In persons aged 65 years or older, expenses on the crown restoration and prosthesis category decreased, with increasing expenses in the medical management and at-home treatment categories. Conclusion: The amount of dental spending in Japan substantially increased from 1.96 trillion yen in 1984 to 3.00 trillion yen in 2020), a 1.53-fold increase. The observed changes in annual dental spending varied across age groups and types of service. [ABSTRACT FROM AUTHOR]