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Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P<.001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P<.001 and P = . 001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR. [ABSTRACT FROM AUTHOR]

Introduction: This study identifies the patient population that may benefit from interprofessional collaboration in the support of patients with cerebrovascular diseases. Method: This study involved 170 patients who received treatment in Japan's recovery rehabilitation wards in December 2019–June 2020. Participants were categorized into three groups based on their functional independence measure (FIM) scores at admission, distinguishing between complete dependence, modified dependence, and independence groups. They were classified into the group with higher collaborative practice (HCP) and the group with lower collaborative practice (LCP) based on the median value of the therapist collaborative practice scale (TCPS). The primary outcomes measured were FIM efficiency and FIM effectiveness. The main effects and interactions of the level of independence with activities of daily living (ADL) and collaboration were examined using a two-way analysis of variance and Bonferroni multiple comparison tests. Results: The level of independence with ADL and collaboration had an interaction effect related to FIM effectiveness (F (2, 164) = 3.191, p = 0.044). Within the independence group, HCP and LCP differed significantly (F (1, 164) = 15.562, p < 0.001). Conclusion: Interprofessional collaboration may improve ADL in patients with high ADL independence at admission. Furthermore, the interprofessional collaboration quality impacted patients' ADL improvement. [ABSTRACT FROM AUTHOR]

Background: This study aimed to: (1) identify assessment methods that can detect greater ankle dorsiflexion range of motion (DROM) limitation in the injured limb; (2) determine whether differences in weightbearing measurements exist even in the absence of DROM limitations in the injured limb according to non-weightbearing measurements; and (3) examine associations between DROM in the weightbearing and non-weightbearing positions and compare those between a patient group with foot and ankle injuries and a healthy group. Methods: Eighty-two patients with foot and ankle injuries (e.g., fractures, ligament and tendon injuries) and 49 healthy individuals participated in this study. Non-weightbearing DROM was measured under two different conditions: prone position with knee extended and prone position with knee flexed. Weightbearing DROM was measured as the tibia inclination angle (weightbearing angle) and distance between the big toe and wall (weightbearing distance) at maximum dorsiflexion. The effects of side (injured, uninjured) and measurement method on DROM in the patient groups were assessed using two-way repeated-measures ANOVA and t-tests. Pearson correlations between measurements were assessed. In addition, we analyzed whether patients without non-weightbearing DROM limitation (≤ 3 degrees) showed limitations in weightbearing DROM using t-tests with Bonferroni correction. Results: DROM in patient groups differed significantly between legs with all measurement methods (all: P < 0.001), with the largest effect size for weightbearing angle (d = 0.95). Patients without non-weightbearing DROM limitation (n = 37) displayed significantly smaller weightbearing angle and weightbearing distance on the injured side than on the uninjured side (P < 0.001 each), with large effect sizes (d = 0.97–1.06). Correlation coefficients between DROM in non-weightbearing and weightbearing positions were very weak (R = 0.17, P = 0.123) to moderate (R = 0.26–0.49, P < 0.05) for the patient group, and moderate to strong for the healthy group (R = 0.51–0.69, P < 0.05). Conclusions: DROM limitations due to foot and ankle injuries may be overlooked if measurements are only taken in the non-weightbearing position and should also be measured in the weightbearing position. Furthermore, DROM measurements in non-weightbearing and weightbearing positions may assess different characteristics, particularly in patient group. Level of evidence: Level IV, cross-sectional study. [ABSTRACT FROM AUTHOR]

Aim: The gut microbiota has emerged as a new intervention target for sarcopenia. Prior studies in humans have focused on the association between gut microbiota and skeletal muscle quantity, while the evidence on muscle function and quality is lacking. This study aimed to identify gut microbiota genera associated with skeletal muscle function, quantity, and quality in a general population of Japanese adults. Methods: This cross‐sectional study included 164 participants aged 35–80 years, women and men recruited from urban areas of Japan. Fecal samples were collected and analyzed using 16S rRNA gene amplicon sequencing. Skeletal muscle function was measured using handgrip strength and leg extension power (LEP), while skeletal muscle mass was estimated using bioelectrical impedance analysis. Phase angle was used as a measure of skeletal muscle quality. Multivariate linear regression analysis stratified by age group was used to examine the association between the dominant genera of the gut microbiota and skeletal muscle variables. Results: A significant association was found between Bacteroides and Prevotella 9 with LEP only in the ≥60 years group. When both Bacteroides and Prevotella 9 were included in the same regression model, only Bacteroides remained consistently and significantly associated with LEP. No significant associations were observed between skeletal muscle mass, handgrip strength, and phase angle and major gut microbiota genera. Conclusions: In this study, we observed a significant positive association between Bacteroides and leg muscle function in older adults. Further studies are required to elucidate the underlying mechanisms linking Bacteroides to lower‐extremity muscle function. Geriatr Gerontol Int 2024; 24: 53–60. [ABSTRACT FROM AUTHOR]

Simple Summary: Cancer-associated fibroblasts (CAFs) are a major component of the stroma in oral squamous cell carcinoma (OSCC) and are considered important therapeutic targets. In this study, we demonstrated that aortic carboxypeptidase-like protein (ACLP) is highly expressed in CAFs of OSCC, thereby activating them. Cancer cells induce ACLP expression in CAFs through the TGF-β1 signaling pathway, and CAF-derived ACLP enhances the migration and infiltration of cancer cells. Furthermore, ACLP co-expresses with collagen and shows an inverse correlation with tumor infiltration of CD8+ T lymphocytes. Our data suggest that targeting ACLP could be a potential approach for stromal-targeted therapy and a novel target for cancer immunotherapy. We previously showed that upregulation of adipocyte enhancer-binding protein 1 (AEBP1) in vascular endothelial cells promotes tumor angiogenesis. In the present study, we aimed to clarify the role of stromal AEBP1/ACLP expression in oral squamous cell carcinoma (OSCC). Immunohistochemical analysis showed that ACLP is abundantly expressed in cancer-associated fibroblasts (CAFs) in primary OSCC tissues and that upregulated expression of ACLP is associated with disease progression. Analysis using CAFs obtained from surgically resected OSCCs showed that the expression of AEBP1/ACLP in CAFs is upregulated by co-culture with OSCC cells or treatment with TGF-β1, suggesting cancer-cell-derived TGF-β1 induces AEBP1/ACLP in CAFs. Collagen gel contraction assays showed that ACLP contributes to the activation of CAFs. In addition, CAF-derived ACLP promotes migration, invasion, and in vivo tumor formation by OSCC cells. Notably, tumor stromal ACLP expression correlated positively with collagen expression and correlated inversely with CD8+ T cell infiltration into primary OSCC tumors. Boyden chamber assays suggested that ACLP in CAFs may attenuate CD8+ T cell migration. Our results suggest that stromal ACLP contributes to the development of OSCCs, and that ACLP is a potential therapeutic target. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is a non-pharmacological therapy used clinically for mood disorders. Relief of physical symptoms with acupuncture treatment may lead to relief of depressive symptoms and improvement of quality of life (QoL). Few studies have examined the effect of acupuncture on the physical symptoms and QoL of patients with mood disorders. Objectives: To examine the effect of acupuncture on physical symptoms and QoL of patients with treatment-resistant major depressive disorder (MDD) and bipolar disorder (BD). Methods: This prospective, single-arm, longitudinal study included patients with MDD and BD from an outpatient psychiatric clinic. Acupuncture was performed weekly for 12 weeks in combination with regular treatment, with fixed acupoints and individualized treatment for each patient. Psychiatric symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS). Physical symptoms such as physical pain, gastrointestinal symptoms, and sleep disorders were evaluated using the Japanese version of the Somatic Symptom Scale-8 (SSS-8) and Visual Analog Scale (VAS). QoL was evaluated using the 8-item Short-Form (SF-8) Health Survey. Results: A total of 36 patients (15 MDD and 21 BD patients) were analyzed. After 12 weeks of acupuncture, HSDS and HSAS scores significantly decreased (p < 0.05). Physical symptoms evaluated using SSS-8 and VAS scores also significantly improved (p < 0.05). In particular, neck pain and insomnia improved at an early stage. Among the SF-8 subscales, scores of bodily pain, general health perception, role limitations due to emotional problems, and mental health significantly increased (p < 0.05). Conclusion: Acupuncture may improve not only psychiatric symptoms but also physical symptoms and QoL in patients with treatment-resistant mood disorders. Further studies are required for confirmation of the preliminary data collected thus far. [ABSTRACT FROM AUTHOR]

Background Walkable neighbourhoods promote physical activity and prevent obesity, but there is limited evidence to inform urban planning strategies for public health within the context of rural Japan. This study describes associations between neighbourhood walkability and obesity in Toyama, a regional municipality in Japan. Methods A cross-sectional analysis of the Toyama Prefecture National Health Insurance data (n  = 3454) in 2016 using Analysis of Covariance (ANCOVA) and binary logistic regression. Walk Score® was used to estimate neighbourhood walkability. Results Residents from highly walkable neighbourhoods generally had lower mean body mass index (BMI), but significant associations between neighbourhood walkability and BMI and prevalence of obesity were only observed in women (adjusted OR: 0.46, 95% CI: 0.26–0.80). Men below 65 years old had higher obesity prevalence (adjusted OR: 1.76, 95% CI: 1.34–2.30). Daily alcohol consumption was associated with lower odds of being obese among men (adjusted OR: 0.72, 95% CI: 0.55–0.95). Hypertension, diabetes mellitus and dyslipidaemia were associated with higher obesity prevalence among residents, regardless of gender. Conclusions Walkable environment may improve health outcomes for rural communities in Japan. Further studies are required to create equitable and inclusive living spaces for men and women to access healthier lifestyle choices. [ABSTRACT FROM AUTHOR]

Aim: This observational study aimed to describe the rate and degree of difficult experiences with COVID‐19 pandemic‐related changes (DE) during pregnancy, clarify the relationship between DE and self‐compassion of women postnatally, and investigate the influence of compassion from a partner (CP) and compassion from the woman's mother (CM) on this relationship. Methods: Data from 46 1‐month postnatal women in Japan were collected through a self‐report questionnaire from October to December 2020. Self‐compassion was measured using the Japanese version of the Self‐Compassion Scale; DE, CP, and CM were measured using original questions based on prior studies. Results: Almost all participants (97.8%) experienced more than one DE during pregnancy. Data analyses revealed that DE in maternity hospitals (d = 0.76), DE in social support (d = 0.53), and CM (d = 0.64) were associated with self‐compassion. A two‐way analysis of variance suggested that CM moderated the relationship between self‐compassion and DE in preparation for the baby (η2 = 0.11) and the birth plan (η2 = 0.11), whereas CP moderated the relationship between self‐compassion and DE in social support (η2 = 0.07). Conclusions: Our findings suggest that self‐compassion negatively correlates with DE in maternity hospitals and social support. Additionally, CM may buffer the influence of DE in preparation for the baby and the birth plan on self‐compassion; moreover, CP may buffer the influence of DE in social support on self‐compassion. This study highlights the importance of supporting perinatal women to adapt to COVID‐19‐related changes through cooperation with their families, which may increase self‐compassion. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of the Comprehensive Violence Prevention and Protection Program (CVPPP) training for managing patient aggression in 95 participants who attended the FY 2019 program using a single-group pretest–posttest design. The comparison of findings before and 1 month after the training showed a significant improvement in staff anger (p < 0.01) and their negative (p < 0.01) and positive attitudes (p < 0.01) toward psychiatric inpatient aggression and confidence (p < 0.01). Staff with controlling and self-affirming traits provided more effective care and demonstrated a positive attitude toward inpatient aggression (p < 0.05). Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1999542. [ABSTRACT FROM AUTHOR]

Background/aims High-intensity static stretching is assumed to increase the range of motion and/or decrease muscle stiffness; however, the effects of high-intensity static stretching on the quadriceps muscle have been debated. Hot pack application before high-intensity static stretching was assumed to decrease stretching pain, which is the main problem in high-intensity static stretching, and decrease quadriceps muscle stiffness. This study aimed to examine hot pack application before high-intensity static stretching on stretching pain, knee flexion range of motion, and quadriceps muscle stiffness. Methods In total, 21 healthy sedentary male participants randomly performed two interventions: high-intensity static stretching and hot pack application before stretching. Static stretching was performed at three 60-second stretching interventions with a 30-second interval. Then, a 20-minute hot pack was applied before high-intensity static stretching. The knee flexion range of motion and shear elastic modulus of the quadriceps muscle were measured by ultrasonic shear-wave elastography before and after the static stretching intervention. Results Stretching pain after hot pack application before stretching was lower than high-intensity static stretching alone. Significant increases were also found in knee flexion range of motion after both stretching interventions, but no significant difference was noted in the increase in the knee flexion range of motion with or without hot pack application. No significant change was found in quadriceps muscle stiffness in either intervention. conclusions The results suggest that hot pack application before high-intensity static stretching could decrease stretching pain, but no significant difference in knee flexion range of motion increase was found. [ABSTRACT FROM AUTHOR]

Introduction: We have been developing a closed-circuit cardiopulmonary bypass (CPB) system ("Dihead CPB") for application during coronary artery bypass grafting (CABG) and valve surgery. To strive for minimal hemolysis during Dihead CPB, we compared the hemolysis caused by three different suction systems and performed a clinical study with the newly applied suction system. Materials & Methods: We evaluated the hemolysis caused by roller-pump suction, the SmartSuction® Harmony® and wall suction systems with respect to suction speed and compared the systems by means of in vitro studies. A clinical study was also performed on 15 volunteers to assess hemolysis and the adequacy of the newly applied suction system with Dihead CPB. Results: Pressure inside the suction cannula was −22.5 ± 0.1 mmHg at a maximum flow of 1.5 L/min for roller-pump suction and −43.4 ± 0.1 mmHg at −150 mmHg of the set vacuum pressure of wall suction. With the SmartSuction, the pressure inside the cannula varied from −76.3 ± 1.0 to −130.3 ± 1.5 mmHg, depending on suctioning conditions. Suction speed (to suction 50 ml of blood) was fastest with the SmartSuction (69.7 ± 3.58 s) whereas, with roller suction, it was 117.3 ± 8.47 s and with wall suction 96.9 ± 7.10 s. The SmartSuction had the highest hemolysis rate (2.00 ± 0.33%) vs. 0.61 ± 0.10% for roller suction and 0.41 ± 0.11% for wall suction (p<0.001). The clinical study with wall suction showed no significant increase in plasma free hemoglobin during or after CPB compared with before surgery. Conclusions: Wall suction had less hemolysis than roller suction or the SmartSuction in the in vitro study and the clinical study with wall suction showed efficient suction speed and acceptable hemolysis, suggesting that Dihead CPB with wall suction is feasible for CABG. [ABSTRACT FROM AUTHOR]

Aim To evaluate the long-term effectiveness of modified brief assertiveness training (with cognitive techniques) for nurses. Background Most assertiveness training takes a long time to conduct; thus, briefer training is required for universal on-the-job training in the workplace. Methods In this single-group study, nurses received two 90-min training sessions with a 1-month interval between sessions. The degree of assertiveness was assessed by using the Rathus Assertiveness Schedule as the primary outcome, at four time points: pre- and post-training, 3-month follow-up and 6-month follow-up. Results A total of 33 nurses received the training, and the mean Rathus Assertiveness Schedule score improved from −14.2 ( SD = 16.5) pre-training to −10.5 ( SD = 18.0) post-training ( p < .05). These improvements were maintained until the 6-month follow-up. The pre-post effect size of 0.22 (indicating small effect) was larger than the effect sizes ranging from −0.56 to 0.17 (no effect) reported in previous studies that used brief training. Conclusions Modified brief assertiveness training seems feasible and may achieve long-term favourable outcomes in improving assertiveness among nurses. Implications for Nursing Management The ease of implementation of assertiveness training is important because creating an open environment for communication leads to improved job satisfaction, improved nursing care and increased patient safety. [ABSTRACT FROM AUTHOR]

Objective: A majority of menstruating women experience some degree of regular recurrences of diverse symptoms-commonly known as premenstrual syndrome (PMS)-during the days before menstruation. Given the multifactorial etiology of PMS, no single treatment is universally recognized as effective, and many women turn to alternative modalities, including aromatherapy. The present study investigated therapeutic effects on premenstrual symptoms using fragrance from yuzu, a Japanese citrus fruit ( Citrus junos Sieb. ex Tanaka), and aromatherapy, from the perspective of autonomic nervous system function. Subjects: Seventeen women in their 20s with subjective premenstrual symptoms. Design: A single-blind randomized crossover study. Settings/Location: This study was performed at a laboratory in a university in Osaka, Japan. Subjects were examined on two separate occasions in the luteal phase. Outcome measures: Using two aromatic stimulation sources (yuzu and lavender used as the control), this experiment measured heart rate variability (HRV) reflecting autonomic nerve activity and the Profile of Mood States (POMS) as a psychologic index before and after aromatic stimulation. Results: A scant 10-min inhalation of the yuzu scent significantly decreased heart rate and increased high-frequency power of HRV, reflecting parasympathetic nerve activity, in the luteal phase. Additionally, POMS tests demonstrated that inhalation of the yuzu essential oil significantly decreased three negative subscales: tension-anxiety, anger-hostility, and fatigue-common premenstrual symptoms, together with a total mood disturbance as a global measure of affective state, as long as 35 min after the aroma stimulation. These premenstrual psychoneurophysiologic effects of yuzu fragrance did not differ from those of the effects of lavender. Conclusions: The present study indicated that short-term inhalation of yuzu fragrance could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that yuzu fragrance aromatherapy might serve as an anti-PMS modality, given its comparable psychoneurophysiologic effects to those of lavender, a representative relaxing scent. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate and compare muscle and tendon stiffness under active conditions in sprinters and untrained participants. In total, 14 sprinters and 24 untrained men participated in this study. Active muscle stiffness in the medial gastrocnemius muscle was calculated based on changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Tendon stiffness was determined during isometric plantar flexion using ultrasonography. No significant differences were observed in active muscle stiffness between sprinters and untrained men at any torque levels. Furthermore, no significant difference was noted in tendon stiffness between the two groups. These results suggest that muscle and tendon mechanical properties in the plantar flexors under active conditions are similar in sprinters and untrained participants. [ABSTRACT FROM PUBLISHER]

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

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While more women with breast cancer survive because of advances in cancer treatment including hormonal therapy, they are at a risk of menopausal symptoms, which can threaten their psychological wellbeing. We examined the effect of menopausal symptoms on women's psychological wellbeing during three different phases of breast cancer: short-term (0-1 years since diagnosis), medium-term (2-5 years), and long-term (more than 5 years). In this cross-sectional study, 425 survivors treated with hormonal therapy were recruited from a convenience sample in Japan and completed an anonymous self-administered questionnaire. Multiple regression analysis revealed that menopausal symptoms significantly contributed to psychological wellbeing in all phases. In long-term survivors, menopausal symptoms were significantly milder; however, the negative effect was prolonged. One in three to four survivors was suspected to have poor psychological wellbeing, irrespective of time. Although the effect of menopausal symptoms on psychological wellbeing has been described in short-term survivors, little is known about the long-term effect. This study examines the effect of menopausal symptoms on psychological wellbeing, thereby providing useful information regarding long-term quality of life. [ABSTRACT FROM AUTHOR]

Background. This study aimed to investigate whether a lifestyle-based physical activity program could contribute to reduced medical expenditure. Methods. The study participants were 60 adults aged 63.1 (standard deviation, 4.4) years in the intervention group; the case-control group consisted of 300 adults who were randomly selected from Japan’s national health insurance system. This community-based retrospective study incorporated a 3-year follow-up. Results. The total and outpatient medical expenditure in the intervention group were significantly lower than in the control group: total expenditure, $US640.4/year; outpatient expenditure, $369.1/year. The odds ratio for outpatient visiting was 6.47-fold higher in the control than in the intervention group. Conclusion. Our study suggests that a health program to promote physical activity can result in reduced total medical expenditure, outpatient medical expenditure, and possibly also inpatient medical expenditure. [ABSTRACT FROM AUTHOR]

Background: The Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE) assesses the extent to which an individual has the characteristics, capabilities, and attitudes required for self-directed learning. This study aimed to validate the Japanese version of the SDLRSNE with graduate-level nursing students. Method: Confirmatory factor analyses, using data from a cross-sectional online survey of 376 nursing students, were conducted to examine construct validity. Relationships with potential related factors were analyzed to evaluate construct validity. Reliability was evaluated with item analysis and Cronbach's alpha. Results: Factor analyses revealed that three-factor and individual subscale models had a moderate-to-poor fit. No meaningful relationship with potential related factors was noted. Reliability measurements indicated a moderate fit to data. Conclusion: This study could not confirm that the Japanese version of the SDLRSNE had acceptable levels of reliability and validity when tested with graduatelevel nursing students. Further research is needed to examine the psychometric properties of the Japanese version of the SDLRSNE with other adult nursing learners or with graduate-level nursing students in other countries. [ABSTRACT FROM AUTHOR]

Objective Progranulin is a growth factor that is active in wound repair and is an antagonist of tumor necrosis factor (TNF) receptors, regulating fibroblast activation, angiogenesis, and inflammation. Because long-standing activation of gene programs related to wound healing is a hallmark of systemic sclerosis (SSc), we sought to investigate the role of progranulin in SSc. Methods Progranulin expression levels in human and murine skin samples were determined by immunohistochemical analysis and quantitative reverse transcription-polymerase chain reaction. The role of progranulin in fibroblast activation was examined using a gene-silencing technique. Progranulin levels in serum obtained from 60 patients with SSc and 16 healthy control subjects were determined by enzyme-linked immunosorbent assay. Results Progranulin expression was increased in SSc dermal fibroblasts compared with normal dermal fibroblasts, both in vivo and in vitro. Transcription factor Fli-1, a deficiency of which is involved in the activation of SSc dermal fibroblasts, served as a potent repressor of the progranulin gene, and Fli-1+/− mice and bleomycin-treated wild-type mice exhibited up-regulated expression of progranulin in dermal fibroblasts. SSc dermal fibroblasts were resistant to the antifibrotic effect of TNF, but this resistance was reversed by gene silencing of progranulin. Serum progranulin levels were elevated in patients with early diffuse cutaneous SSc (dcSSc), especially in those with inflammatory skin symptoms, and were positively correlated with the C-reactive protein level. Conclusion Progranulin overproduction due to Fli-1 deficiency may contribute to the constitutive activation of SSc dermal fibroblasts by antagonizing the antifibrotic effect of TNF. Progranulin may also be involved in the inflammatory process associated with progressive skin sclerosis in early dcSSc. [ABSTRACT FROM AUTHOR]

Background Alcohol-dependent patients are known to be generally more unfairness sensitive. The ultimatum game ( UG) is an experimental task designed to provoke feelings of perceived unfairness. A previous study using the UG has reported more unfairness sensitivity in patients with alcohol dependence than in a nondependent control group; it has been speculated that this increased sensitivity might be due to a difficulty in impulse control. However, the mechanism of this relationship has not been clarified. Therefore, the relationship between unfairness sensitivity in interpersonal relationships and impulsivity was investigated using UG and delay discounting ( DD) paradigms. Methods Subjects were 32 individuals with alcohol dependency and 36 healthy control individuals; both groups performed UG and DD tasks. Results Participants with alcohol dependence rejected monetary offers deemed unfair at a significantly higher rate than did control participants. Moreover, the proportion of accepting unfairness was negatively correlated with impulsivity in patients with alcohol dependence. Conclusions Perceived unfairness is related to impulsivity in patients with alcohol dependence. These results provide insights concerning the psychopathology of alcohol dependence. [ABSTRACT FROM AUTHOR]

Objective Interleukin-17 (IL-17)-producing T cells (Th17 cells) play critical roles in the pathogenesis of immune-related diseases, including systemic lupus erythematosus. However, the fundamental mechanism regulating Th17 cell differentiation is not fully understood. Recently, we demonstrated that plasma levels of CD147/basigin (Bsg) in patients with lupus nephritis (LN) were closely associated with disease activity. but the molecular mechanism involving Bsg has been elusive. Here, we addressed the role of Bsg in the pathogenesis of LN. Methods Injections of pristane (2,6,10,14-tetramethylpentadecane [TMPD]) were administered to Bsg−/− or Bsg+/+ mice to induce LN. The mice were killed 6 months after being injected, for histologic and biochemical analyses of the kidneys and spleens. Results Pristane induced LN more strikingly in Bsg−/− mice than in Bsg+/+ mice, even though humoral autoimmunity was similarly increased in both genotypes. The increased number of Th17, but not Th1, Treg cells, was augmented in Bsg−/− mice. The expression of IL-17 was also increased in the kidneys of Bsg−/− mice, in proportion to LN disease activity. Furthermore, treatment with anti-IL-17 antibody reduced LN disease activity in Bsg−/− mice. Complementary to these phenotypes of Bsg−/− mice, Bsg expression was enhanced in activated CD4+ T cells in vivo and in vitro. Bsg deficiency selectively augmented in vitro differentiation of naive CD4+ T cells to Th17 cells and STAT-3 phosphorylation during this differentiation. Moreover, STAT-3 phosphorylation was suppressed by crosslinking of Bsg with its antibody. Conclusion Bsg plays an indispensable role in Th17 cell differentiation as a negative regulator by suppressing the IL-6/STAT-3 pathway. [ABSTRACT FROM AUTHOR]

Objective. B cells play an important role in the pathogenesis of autoimmune diseases. The role of Bruton's tyrosine kinase (Btk) in cytokine-induced human B cell differentiation and class-switch recombination remains incompletely defined. This study analysed the effect of Btk on human activated B cells. Methods. Purified B cells from healthy subjects were stimulated with B cell receptor (BCR) and other stimuli with or without a Btk inhibitor and gene expression was measured. The B cell line BJAB was used to assess Btk-associated signalling cascades. Phosphorylated Btk (p-Btk) in peripheral blood B cells obtained from 10 healthy subjects and 41 patients with RA was measured by flow cytometry and compared with patient backgrounds. Results. IL-21 signalling, in concert with BCR, CD40 and BAFF signals, led to robust expression of differentiation- and class-switch DNA recombination-related genes and IgG production in human B cells, all of which were significantly suppressed by the Btk inhibitor. Although phosphorylation of STAT1 and STAT3 was induced by co-stimulation with IL-21, BCR and CD40, STAT1 phosphorylation in the nucleus, but not in the cytoplasm, was exclusively impaired by Btk blockade. High levels of p-Btk were noted in B cells of RA patients compared with controls and they correlated significantly with titres of RF among RF-positive patients. Conclusion. The findings elucidate a model in which Btk not only plays a fundamental role in the regulation of BCR signalling, but may also mediate crosstalk with cytokine signalling pathways through regulation of IL-21-induced phosphorylation of STAT1 in the nuclei of human B cells. Btk appears to have pathological relevance in RA. [ABSTRACT FROM AUTHOR]

LA Wall Thickness, LA Electrogram, and Dormant PV Conduction Introduction Atrial remodeling plays a key role in development of the substrate for atrial fibrillation (AF). Whether the wall thicknesses of the left atrium (LA) and pulmonary vein (PV)-LA junction affect remodeling and AF ablation is unknown. We investigated the relationship between wall thicknesses, electrogram characteristics, and adenosine triphosphate (ATP)-provoked dormant PV conduction as they pertain to AF. Methods In 50 patients with AF and 25 patients without AF, wall thicknesses of the LA and PV-LA junction were measured on 320-slice computed tomography images. For the AF patients, NavX-based voltage maps generated during sinus rhythm were obtained, and ATP-provoked dormant PV conduction after PV isolation was evaluated. Results Walls of the LA and PV-LA junction were significantly thicker in the AF patients than in the control patients (1.83 ± 0.29 mm vs. 1.59 ± 0.28 mm, respectively; P = 0.0010; and 0.88 ± 0.14 mm vs. 0.65 ± 0.11 mm, P<0.0001, respectively). Wall thickness at the PV-LA junction was independently associated with AF (β = 0.40, P = 0.0002). In AF patients, the walls of the PV-LA junction showed stepwise thickening across bipolar voltages indicative of severe (bipolar voltage <33rd percentile) to moderate (33rd-66th percentiles) to mild fibrosis/scarring (≥66th percentile). Walls of the PV-LA junction with dormant PV conduction were significantly thicker than those without it (0.94 ± 0.19 mm vs. 0.86 ± 0.21 mm, respectively; P = 0.0025). Conclusions Together, the association between thickened PV-LA junction walls and AF and the increased bipolar voltage suggests that such wall thickening increases PV electrical activities, leading to initiation and maintenance of AF and perhaps to ATP-provoked dormant PV conduction. [ABSTRACT FROM AUTHOR]

Background and Objective Epithelial cells are recognized as the first line of defense against bacterial infection and environmental harmful stimuli such as cigarette smoke ( CS). Although previous studies explored the effects of nicotine on host cells, mechanisms by which CS affects cellular functions remain uncertain. The present study investigated the effects of CS condensate ( CSC) on in vitro wound closure of gingival epithelial cells and their potential interactions with a major periodontal pathogen, Porphyromonas gingivalis. Material and Methods Human gingival epithelial cells (Ca9-22) were treated with CSC for 24 h. Cell proliferation was determined using a WST-1 assay. Cell migration was assessed using a wound closure model. The expression of integrins was analyzed by confocal scanning laser microscopy and real-time PCR. Intracellular invasion of P. gingivalis was evaluated by confocal scanning laser microscopy and an antibiotic protection assay. Results Low concentrations (1-10 μg/mL) of CSC showed no significant effect on cell proliferation. CSC demonstrated dual effects on epithelial wound closure of Ca9-22 cells: high concentrations (i.e. 250 μg/mL) significantly inhibited the wound closure whereas low concentrations (i.e. 10 μg/mL) promoted it ( p < 0.01). CSC induced distinct changes in cytoskeleton. When CSC-exposed cells were infected with P. gingivalis for 2 h, a significant inhibition of wound closure was observed concurrent with a decrease in integrin α3 expression near the wound area. A significantly increased P. gingivalis invasion into Ca9-22 was observed when exposed to low concentrations of CSC. Conclusion Low concentrations of CSC increased invasion of human gingival epithelial cells by P. gingivalis and induced changes in cytoskeleton and integrin expression, thereby modulating the cell migration. [ABSTRACT FROM AUTHOR]

Objective It is generally accepted that blockade of endothelin receptors has potentially beneficial effects on vasculopathy associated with systemic sclerosis (SSc). The aim of this study was to clarify the molecular mechanism underlying these effects using endothelial cell-specific Fli-1-knockout (Fli-1 ECKO) mice, an animal model of SSc vasculopathy. Methods Levels of messenger RNA for target genes and the expression and phosphorylation levels of target proteins were determined in human and murine dermal microvascular endothelial cells by real-time quantitative reverse transcription-polymerase chain reaction and immunoblotting, respectively. The binding of Fli-1 to the target gene promoters was evaluated using chromatin immunoprecipitation. Expression levels of Fli-1 and α-smooth muscle actin in murine skin were evaluated using immunohistochemistry. Vascular structure and permeability were evaluated in mice injected with fluorescein isothiocyanate-dextran and Evans blue dye, respectively. Results In human dermal microvascular endothelial cells, endothelin 1 induced phosphorylation of Fli-1 at Thr312 through the sequential activation of c-Abl and protein kinase Cδ, leading to a decrease in Fli-1 protein levels as well as a decrease in binding of Fli-1 to the target gene promoters, whereas bosentan treatment reversed those effects. In Fli-1 ECKO mice, 4 weeks of treatment with bosentan increased endothelial Fli-1 expression, resulting in vascular stabilization and the restoration of impaired leaky vessels. Conclusion The vascular fragility of Fli-1 ECKO mice was improved by bosentan through the normalization of Fli-1 protein levels and activity in endothelial cells, which may explain, in part, the mechanism underlying the beneficial effects of endothelin receptor blockade on SSc vasculopathy. [ABSTRACT FROM AUTHOR]

Background: A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods: We studied people aged 18-59 years old, n = 4,328 (the “General” group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the “Triers” group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results: The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact “at school”, and around 65% first learned it “through mass media” or “via the Internet”. More than 30% of the respondents first learned it “less than 5 years before” the survey. Conclusions: Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effectiveness of brief intervention (BI) conducted in the workplace for heavy drinkers. Methods: A randomized controlled trial was conducted at six companies in Japan. Participants were heavy drinkers who met the inclusion criteria and were randomized into three groups: the BI group, BI with diary group and a control group. Outcomes (total drinks, binge drinking episodes and alcohol-free days) were evaluated at 3 and 12 months. Results: The 304 participants recruited were allocated to the three groups and 277 participated in all follow-up evaluations. Dropout rates in the respective groups were 7.0, 14.9 and 5.5%. Some improvements were observed in all the groups. In particular, alcohol-free days in the BI group were significantly increased by 93.0% at 12 months. Total drinks at 12 months were reduced by 41 g per week in the BI group compared with the control group, although the intergroup difference was not significant. Conclusion: BI in the workplace is effective for increasing the number of alcohol-free days. However, the effectiveness on decreasing alcohol consumption was unclear, which could be explained by alcohol screening itself causing a reduction in drinking. [ABSTRACT FROM PUBLISHER]

Background A recent survey of 79 countries showed that fertility knowledge was lower in Japan than in any other developed country. Given the fertility decline in Japan and the importance of fertility knowledge, we conducted an online survey to examine fertility knowledge and the related factors for effective public education. Methods We studied people aged 18-59 years old, n = 4,328 (the "General" group), and also people who had been trying to conceive for at least six months, 18-50 years old, n = 618 (the "Triers" group). Fertility knowledge was assessed using the Japanese version of the 13-item Cardiff Fertility Knowledge Scale (CFKS-J). All participants provided socio-demographic and fertility information. Participants also completed a 14-item health literacy scale and an 11-item health numeracy scale. We asked participants who were aware of age-related decline in fertility when and where they first acquired that knowledge. Results The average percentages of CFKS-J items answered correctly were 53.1% in the Triers group and 44.4% in the General group (p < 0.001). Multivariate linear regression models showed in the Triers group greater fertility knowledge was associated with greater health literacy and prior medical consultation regarding their fertility. In the General group greater fertility knowledge was associated with being female, younger, university educated, currently trying to conceive, non-smoking, having higher household income, having higher health literacy and having higher health numeracy. Of those who were aware of the age-related decline in fertility, around 3% first learned the fact "at school," and around 65% first learned it "through mass media" or "via the Internet." More than 30% of the respondents first learned it "less than 5 years before" the survey. Conclusions Although fertility knowledge had improved since a previous study, possibly due to recent media coverage of age-related infertility, it was still low. Educational interventions, both in schools and in the community, may be needed to increase fertility knowledge in the general population because most people obtain fertility knowledge from mass media, which has been shown to often present distorted and inaccurate fertility information. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to investigate the effects of wearing a compression garment (CG) for 24 h on changes in muscular strength and blood parameters over time after resistance exercise. METHODS: Nine trained men conducted resistance exercises (10 repetitions of 3-5 sets at 70% of one-repetition maximum (1RM) for nine exercises) in two trials, wearing either a CG or a normal garment (CON) for 24 h after exercise. Recovery of muscular strength, blood parameters, muscle soreness, and upper arm and thigh circumference were compared between the trials. RESULTS: Both trials showed decreases in maximal strength after the exercise (P < 0.05). However, the CG trial showed faster recovery of one-repetition maximum for the chest press from 3 to 8 h after exercise (P < 0.05). Recovery of maximal knee extension strength was also improved in the CG trial 24 h after exercise (P < 0.05). The CG trial was associated with lower muscle soreness and subjective fatigue scores the following morning (P < 0.05). The upper arm and thigh circumferences were significantly higher during the recovery period in the CON trial, whereas no change was observed in the CG trial. Blood lactate, insulin like growth factor-1, free testosterone, myoglobin, creatine kinase, interleukin 6, and interleukin 1 receptor antagonist concentrations for 24 h after exercise were similar in both trials. CONCLUSIONS: Wearing a CG after resistance exercise facilitates the recovery of muscular strength. Recovery for upper body muscles significantly improved within 3-8 h after exercise. However, facilitation of recovery of lower limb muscles by wearing the CG took a longer time. [ABSTRACT FROM AUTHOR]

Aims and objectives. To assess psychosocial profiles of children with achondroplasia using a nationwide survey. Background. Achondroplasia, showing short stature and disproportionately short limbs, causes physical inconvenience such as difficulty in reaching high objects. It is, however, still controversial whether the condition is associated with psychological problems, especially in childhood. Design. A cross-sectional descriptive design was employed. Methods. To evaluate psychosocial profiles and adaptation processes in children with achondroplasia, we developed an inventory of scales based on the psychological stress model of which conceptual framework was comprised of stressor, coping process, coping resource and adaptation outcome domains. Participants were recruited nationwide through the largest advocacy support group for achondroplasia in Japan. Of the 130 group members, 73 X-ray-diagnosed patients, aged 8-18 years, completed the inventory of questionnaires to be analysed. Results. As for the stressor domain, patients experienced short stature-related unpleasant experiences more frequently (z-score: +1.3 in average, +3.9 in physical inconvenience). Nevertheless, these experiences had little effect on the coping process (threat appraisal: -0.2, control appraisal: +0.1) and the adaptation outcome (stress response: +0.3, self-concept: 0.0). Interestingly, self-efficacy in the coping resource domain was noticeably increased (+3.1) and was strongly correlated with most variables in the coping process and in adaptation outcome domains. Conclusions. Although the children with achondroplasia experienced more short stature-related stressors, there was no evidence of any psychosocial maladaptation. This finding suggests that coping process as well as coping resources such as self-efficacy could be important targets for promoting psychological adjustment in children with achondroplasia. Relevance to clinical practice. To help children with achondroplasia adapt socially, nurses and other healthcare providers should routinely assess their psychological adaptation process, especially cognitive appraisal and self-efficacy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nurses with higher levels of work engagement tend to be highly efficient in their work and more willing to keep working and to provide patient-centred care. However, whether more engaged nurses provide end-of-life care more proactively has not been examined in the home-care setting. AIM: This study aimed to examine work engagement among home-visiting nurses in Japan and its relationship with their attitudes toward caring for dying patients and their families. METHODS: A total of 343 nurses working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. The authors performed multiple regression analysis to explore the relationships between home-visiting nurses' work engagement and attitudes. RESULTS: Data from 184 nurses (53.6%) was analysed. Work engagement was significantly positively related to the nurses' attitudes toward caring for dying patients and their families. CONCLUSION: As more engaged nurses tend to have more positive attitudes toward caring for dying patients and their families, further research is needed to identify the factors that might help nursing managers to enhance their staff's engagement and perhaps thereby improve their attitudes, with the ultimate aim of achieving better outcomes for patients and families. [ABSTRACT FROM AUTHOR]

Objective. The mechanisms of ectopic calcification in inflammatory diseases are poorly understood. We investigated the effects of inflammatory cytokines on the mechanisms of calcification in human adipose tissue-derived mesenchymal stem cells (hADSCs).Methods. The effects of inflammatory cytokines were evaluated using hADSCs cultured in osteoblast induction medium. mRNA expression was measured by real-time PCR and protein levels were measured by western blotting. Cell mineralization was evaluated by Alizarin Red S staining.Results. In hADSCs, administration of IL-6/soluble IL-6 receptor (sIL-6R), TNF or IL-1β accelerated calcification through enhanced expression of an osteoblast differentiation marker, runt-related transcription factor 2 (RUNX2). IL-6/sIL-6R had the greatest effect. The transcription of mRNA for receptor tyrosine kinase-like orphan receptor 2 (ROR2), involved in the non-canonical wingless-type (WNT) MMTV integration site pathway, was increased, while β-catenin expression, an essential factor in the canonical WNT signalling pathway for osteoblast differentiation, did not change. Suppression of signal transducer and activator of transcription 3 (STAT3), but not STAT1, by small interfering RNA (siRNA) exerted a strong inhibitory effect on RUNX2 and ROR2 expression, and inhibited accelerated calcification.Conclusion. IL-6/sIL-6R stimulation accelerated the ROR2/WNT5A pathway in hADSCs in a STAT3-dependent manner, resulting in augmented calcification. These results suggest that the mechanisms of ectopic calcification accelerated by IL-6 in hADSCs may be involved in chronic inflammatory tissues and that IL-6 inhibitors may be beneficial in the treatment of ectopic calcification in inflammatory diseases. [ABSTRACT FROM PUBLISHER]

BACKGROUND: The 3-dimensional (3D) distances of specific points on the chest and abdominal wall are useful for assessing the characteristics of breathing movement. This study aimed to determine whether the 3D distances on the chest and abdominal wall during deep breathing (DB) could be estimated using a newly developed breathing movement-measuring device (BMMD). METHODS: Breathing movement distances on the chest (bilateral third and eighth ribs) and abdomen (upper abdomen) of 10 healthy young males were measured using a pen-sized mechanical BMMD and a 3D motion analysis system during DB. DB was controlled and based on the distances targeted by the BMMD (ie, 1, 2, and 3 cm), which was placed on the observation points and fixed on a tripod. Simultaneously, the 3D distances of reflective markers on the observation points were measured. The obtained data were statistically analyzed using a paired t test, repeated measures analysis of variance with multiple comparisons tests, and linear regression with mixed effects. RESULTS: All the BMMD distances were less than the 3D distances. The differences between the 3D and BMMD distances on the chest and abdomen, except for the left lower chest (eighth rib), were significantly greater at a target distance of 3 cm than that of 1 cm. The coefficients of determination ranged from 0.98 to 0.99. CONCLUSIONS: Linear regression equations provided adequate estimates of the 3D distances of markers on the chest and abdominal wall during DB. The results suggest that this BMMD is useful for quantitatively assessing DB movement of the chest and abdominal wall in healthy young males. [ABSTRACT FROM AUTHOR]

Background Adiponectin secreted from adipose tissue is assumed to mediate protective effects on development of metabolic syndrome (MetS) and MetS-related diseases such as cardiovascular diseases and cancer. Relationship between alcohol intake and circulating adiponectin levels is not consistent among the several previous studies. In the present study, we investigated effects of alcohol intake and the alcohol-related polymorphisms on serum adiponectin levels among Japanese male workers. Methods We conducted a cross-sectional design study with 541 male workers aged 51.5 ± 5.9 (mean ± SD) years in a Japanese plant. Information on alcohol intake and other lifestyles was obtained by a self-administered questionnaire. Serum total adiponectin (T-Ad), high-molecular-weight adiponectin ( HMW-Ad), medium-molecular-weight adiponectin ( MMW-Ad), and low-molecular-weight adiponectin ( LMW-Ad) levels were measured by the enzyme-linked immune assay system kit. Two genotypes in the alcohol dehydrogenase-1B ( ADH1B) and aldehyde dehydrogenase-2 ( ALDH2) genes were determined using blood sample. In multivariate regression analyses, we adjusted for age, body mass index, smoking, and physical exercise. Results Among all subjects, high alcohol consumption of 12 units (1 unit contains 22.9 g of ethanol) a week or more was negatively associated with T-Ad levels in the multivariate model, although not significant. When we performed analyses separately for each genotype, high alcohol consumption was negatively associated with T-Ad, HMW-Ad, and LMW-Ad levels only in those with ADH1B *2/*2. Such relationships were not observed in each ALDH2 genotype group. Conclusions High alcohol consumption was inversely associated with T-Ad, HMW-Ad, and LMW-Ad levels in those with ADH1B *2/*2 genotype, but not in those with the other ADH1B genotypes. To our knowledge, this is the first study that reports combined effects of the alcohol-related polymorphisms and alcohol intake on serum adiponectin levels. Additional studies are required to confirm the present finding. [ABSTRACT FROM AUTHOR]

American and Japanese children's evaluations of the reporting of peers' transgressions to authority figures were investigated. Seven-, 9-, and 11-year-old children (N = 160) and adults (N = 62) were presented with vignettes and were asked to evaluate the decisions of child observers who reported their friend's either major or relatively minor transgression to a teacher. The results showed that, in both countries, participants across all age groups considered it appropriate to report major transgressions. However, compared with older participants, the youngest children thought it was appropriate to tattle (i.e., to report more minor transgressions). The results also showed a cross-cultural difference: Japanese compared with American participants considered it appropriate to report minor transgressions. The age-related findings are discussed with reference to children's social experience and improving cognition. The cross-cultural findings are discussed with reference to potential differences in the emphases placed on respecting authority relationships, empathy, and social interdependence by the 2 cultures. [ABSTRACT FROM AUTHOR]

Purpose: Weight retention during the postpartum period is critical for the later development of obesity in women. Traditional physical activity is frequently discontinued because of incompatibility with mothers' agenda (i.e., baby care). In the present study, active video games (AVG) are proposed for postpartum women to improve their body composition. Methods: Thirty-four postpartum women (body mass index = 24.5 ± 3.4 kg•m) were randomized to an AVG group or a control group. Subjects assigned to the AVG group were given a Wii Nintendo console with the game Wii Fit Plus for 40 d. The two groups were tested for weight, body mass index, body fat mass, waist and hip circumferences, and other anthropometric parameters. Physical fitness, energy expenditure, energy intake, and adverse events were also investigated. Results: The AVG group lost more weight than the control group (-2.2 ± 0.9 vs. -0.5 ± 0.7 kg, P < 0.001). They also exhibited more important reductions of BMI, waist and hip circumferences, and body fat (P < 0.05). During the 40-d period, subjects expended an estimated 4682 ± 2874 kcal just by playing AVG. Daily energy intake was reduced by 206 ± 559 kcal. There were significant positive correlations between playing frequency, total playing time, total energy expenditure during the 40-d period, and decrease in daily energy intake respectively, and weight loss (P < 0.05). Playing time data suggested no conflict with baby care activities. Conclusions: AVGs could represent an interesting spare physical activity for postpartum women. In the present study, these games promoted physical activity, induced a reduction of energy intake, and subsequently minimized weight retention. [ABSTRACT FROM AUTHOR]

Background:A close relationship between upper and lower respiratory tract diseases has been reported. However, little is known about pulmonary function in patients with upper respiratory tract diseases.Methods:Pulmonary function was measured in: 68 patients with chronic rhinosinusitis without nasal polyps, 135 patients with chronic rhinosinusitis with nasal polyps, 89 patients with allergic rhinitis and 100 normal control subjects. The relationships between pulmonary function and clinical parameters were assessed. These parameters included radiographic severity of chronic rhinosinusitis, serum total immunoglobulin E levels, concentrations of cytokines in nasal secretions and exhaled nitric oxide levels.Results:The pulmonary function of patients with chronic rhinosinusitis was significantly affected. The level of interleukin-5 in nasal secretions was significantly correlated with pulmonary function in patients with chronic rhinosinusitis.Conclusion:The findings indicated latent obstructive lung function changes in chronic rhinosinusitis patients. The cytokines in nasal secretions might be related to obstructive lung function changes in chronic rhinosinusitis. [ABSTRACT FROM PUBLISHER]

Objectives To determine the association between protein intake and risk of higher-level functional decline in older community-dwelling adults. Design Prospective. Setting Ohasama Town, Japan. Participants Residents (N = 1,007; mean age 67.4 ± 5.5) free of functional decline at baseline; follow-up was conducted for 7 years. Measurements Nutrient and food intakes were determined using a validated 141-item food frequency questionnaire. Participants were divided into quartiles according to intake levels of total, animal, and plant protein. Subscales of the Tokyo Metropolitan Institute of Gerontology Index of Competence subscales were used to assess higher-level functional decline. Logistic regression analysis was used to examine the future risk of higher-level functional decline in relation to protein intake, with lowest protein intake as reference. Results During the study period, 24.4% of eligible participants reported declines in higher-level functional capacity. After adjustment for putative confounding factors, men in the highest quartile of animal protein intake had significantly lower risk of higher-level functional decline than those in the lowest quartile (odds ratio ( OR) = 0.41, 95% confidence interval ( CI) = 0.20-0.83; P for trend .01). These associations were not seen in women ( OR = 0.76, 95% CI = 0.41-1.34; P for trend .37). No consistent association was observed between plant protein intake and future higher-level functional decline in either sex. Conclusion Higher protein, particularly animal protein, was associated with lower risk of decline in higher-level functional capacity in older men. Animal protein intake may be a modifiable indicator for early detection and prevention of higher-level functional decline in elderly adults. [ABSTRACT FROM AUTHOR]

The article focuses on a study concerning the acute effects of self-myofascial release utilizing foam rollers has on arterial function and stiffness. It states that a randomized controlled crossover fashion was used on ten young adults performing self-myofascial release and control trials on separate days, with blood pressure, heart rate, plasma nitric oxide concentrations, and Brachial-ankle pulse wave velocity measured.

The purpose of this study was to assess the effect of short-term priming in perceptual anticipation tasks involving point-light biological motions. After the production or the observation of a relevant or an irrelevant movement (action vs. observation priming), 11 right-handed volunteers were asked to anticipate, as quickly and accurately as possible, the end point of a pointing movement after the stimulus vanished upon completion of 60% of the total movement. Our results indicate that perceptual accuracy is significantly affected only with relevant observation priming. This suggests that perceptual anticipation tasks' involving point-light biological motions implies specific perceptual competencies. [ABSTRACT FROM AUTHOR]

The present study compared the accuracy of triaxial accelerometry and the doubly labelled water (DLW) method for measuring physical activity (PA) in Japanese adolescents. A total of sixty adolescents aged 12–15 years were analysed. The total energy expenditure (TEE) was measured over 7 d by the DLW method and with an EW4800P triaxial accelerometer (Panasonic Corporation). The measured (RMRm) and predicted RMR (RMRp) were 5·7 (sd 0·9) and 6·0 (sd 1·0) MJ/d, respectively. TEE measured by the DLW method and accelerometry using RMRm or RMRp were 11·0 (sd 2·6), 10·3 (sd 1·9), and 10·7 (sd 2·1) MJ/d, respectively. The PA levels (PAL) measured by the DLW method using RMRm or RMRp were 1·97 (sd 0·31) and 1·94 (sd 0·31) in subjects who exercised, and 1·85 (sd 0·27) and 1·74 (sd 0·29) in subjects who did not exercise. The percentage of body fat correlated significantly with the percentage difference between RMRmv. RMRp, TEE, PA energy expenditure (PAEE) and PAL using RMRp, and PAL using RMRm assessed by the DLW method and accelerometry. The present data showed that while accelerometry estimated TEE accurately, it did not provide the precise measurement of PAEE and PAL. The error in accelerometry was attributed to the prediction error of RMR and assessment in exercise. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to compare the effects of Nordic walking with conventional walking and band-based resistance exercise on functional fitness, static balance and dynamic balance in older adults. Volunteers (n = 65) were divided into four groups: Nordic walking (NW), conventional walking (CW), resistance (RES), and control. Each group performed activity 50-70 min·day-1 (warm-up 10-15 min, main exercise 30-40, and cool down 10-15 min), 3 days·week-1 (NW and CW) or 2 day·week-1 (RES) for 12 wks. Upper-body strength improved (p < 0.05) in the RES (22.3%) and the NW (11.6%) groups compared to the CW and control groups. Cardio-respiratory fitness improved more in the NW (10.9%) and CW (10.6%) groups compared to the RES and control groups. Upper- and lowerbody flexibility also improved in all exercise groups compared to the control group. There were no improvements in balance measures in any group. While all modes of exercise improved various components of fitness, Nordic walking provided the best well-rounded benefits by improving upper-body strength, cardiovascular endurance, and flexibility. Therefore, Nordic walking is recommended as an effective and efficient mode of concurrent exercise to improve overall functional fitness in older adults. [ABSTRACT FROM AUTHOR]

Background Several studies have suggested that i.v. atropine has a potential role in treating infantile hypertrophic pyloric stenosis ( IHPS). It remains unclear, however, whether surgery can be replaced by i.v. therapy. Methods Data were extracted on infants with IHPS who were treated with atropine and/or surgery, from a nationwide administrative database through 2006-2008. Patient demographic data, treatment effects and length of hospital stay were analyzed in each treatment group. Results A total of 585 infants met the criteria for IHPS; 188 patients (32%) were initially treated with atropine ( i.v. form, n = 180; oral form, n = 8), while 397 were treated with surgery as a first-line therapy. Of the 180 infants receiving i.v. atropine, 38 were withdrawn from medical management and subsequently underwent surgery. Thus, the overall success rate of i.v. atropine was 78.9% (142/180). Surgery had a success rate of 100%, and postoperative complications were found in 2.8% of patients (12/435). Medical management required longer hospital stay than surgery (mean, 13.5 days vs 8.0 days; P < 0.001). Conclusion Surgery remains the suitable standard management option for IHPS, with its high success rate, minimal complications and shorter hospital stay compared with i.v. atropine therapy. [ABSTRACT FROM AUTHOR]

Background Appropriate nutrition during childhood is important for preventing future development of lifestyle-related diseases. The effect of feeding choice on infant growth in Japan is not known. Methods Data from 204 healthy schoolchildren (age, 6-9 years) were obtained retrospectively from their parents by questionnaires. Breast-fed ( BF) and formula-fed ( FF) groups were defined as those fed only breast milk or formula milk at 4 months of age, respectively. There were 71 children (M/F, 31/40) in BF and 30 (M/F, 19/11) in FF. Anthropometric data at birth, and at 1, 4, 7, 10, 18, and 36 months of age in male and female infants were compared between the groups. Results In male infants, height was significantly lower at 4 months, bodyweight was lower from 4 to 18 months, and body mass index ( BMI) was lower from 10 to 36 months in BF than in FF. The standard deviation scores ( SDS) for height, weight and BMI had a similar pattern. No significant differences were observed for these variables for female infants in BF compared with FF. Multiple regression analysis showed that birthweight, mother's pre-pregnancy weight, and infant feeding choice were significant factors associated with weight- SDS at 18 and 36 months. Feeding choice was the only factor associated with BMI-SDS at 18 months. Conclusions Infant feeding choice had a gender-associated effect on growth during infancy. When evaluating infant growth, not only birthweight and mother's pre-pregnancy weight, but also infant feeding choice and gender should be considered. [ABSTRACT FROM AUTHOR]

Purpose: Omeprazole has ( R)- and ( S)-enantiomers, which exhibit different pharmacokinetics (PK) among patients with cytochrome P450 (CYP) 2C19 genotype groups. The aim of this study was to investigate whether the 1-point, 4-h postdose ( R)-omeprazole hydroxylation index (HI) of racemic omeprazole reflects the three CYP2C19 genotype groups in Japanese individuals. Methods: Ninety healthy Japanese individuals were enrolled and classified into the three different CYP2C19 genotype groups: homozygous extensive metabolizers (hmEMs; n = 34), heterozygous EMs (htEMs; n = 44), and poor metabolizers (PMs; n = 12). Blood samples were drawn 4 h after the intake of an oral dose of omeprazole 40 mg, and plasma levels of omeprazole and its metabolites were analyzed by high-performance liquid chromatography (HPLC) using a chiral column. Results: Mean plasma concentrations of ( R)- and ( S)-omeprazole in PMs were significantly higher than those in hmEMs and htEMs, and similar results were obtained in the case of omeprazole sulfone. Additionally, there was a significant difference in plasma concentrations of ( R)-5-hydroxyomeprazole among CYP2C19 genotype groups, whereas no significant differences were observed in that of ( S)-5-hydroxyomeprazole. Similarly, ( R)-omeprazole HI in hmEMs, htEMs, and PMs were 5.6, 3.1, and 0.3, respectively, which were significantly different, but no significant difference was present in the ( S)-omeprazole HI. Conclusion: Our findings demonstrate that ( R)-omeprazole HI correlated better with CYP2C19 genotype groups than racemic-omeprazole HI, and these results may be useful for classification among patients in CYP2C19 genotype groups prior to omeprazole treatment. [ABSTRACT FROM AUTHOR]

Objective: This study is a pharmacogenetic clinical trial designed to clarify whether the N-acetyltransferase 2 gene ( NAT2) genotype-guided dosing of isoniazid improves the tolerability and efficacy of the 6-month four-drug standard regimen for newly diagnosed pulmonary tuberculosis. Methods: In a multicenter, parallel, randomized, and controlled trial with a PROBE design, patients were assigned to either conventional standard treatment (STD-treatment: approx. 5 mg/kg of isoniazid for all) or NAT2 genotype-guided treatment (PGx-treatment: approx. 7.5 mg/kg for patients homozygous for NAT2*4: rapid acetylators; 5 mg/kg, patients heterozygous for NAT2*4: intermediate acetylators; 2.5 mg/kg, patients without NAT2*4: slow acetylators). The primary outcome included incidences of 1) isoniazid-related liver injury (INH-DILI) during the first 8 weeks of therapy, and 2) early treatment failure as indicated by a persistent positive culture or no improvement in chest radiographs at the8th week. Results: One hundred and seventy-two Japanese patients (slow acetylators, 9.3 %; rapid acetylators, 53.5 %) were enrolled in this trial. In the intention-to-treat (ITT) analysis, INH-DILI occurred in 78 % of the slow acetylators in the STD-treatment, while none of the slow acetylators in the PGx-treatment experienced either INH-DILI or early treatment failure. Among the rapid acetylators, early treatment failure was observed with a significantly lower incidence rate in the PGx-treatment than in the STD-treatment (15.0 % vs. 38 %). Thus, the NAT2 genotype-guided regimen resulted in much lower incidences of unfavorable events, INH-DILI or early treatment failure, than the conventional standard regimen. Conclusion: Our results clearly indicate a great potential of the NAT2 genotype-guided dosing stratification of isoniazid in chemotherapy for tuberculosis. [ABSTRACT FROM AUTHOR]

Studies of physician-nurse relationships have focused mainly on nurses' perceptions. Few studies have explored physicians' perceptions and related factors. This study had two aims: to describe physicians' perceptions of physician-nurse collaboration in Japan by focusing on attitudes toward collaboration and collaborative practice and to examine the effect of physicians' experiences related to collaboration on their perceptions of collaboration. A cross-sectional survey was conducted. Of the 520 physicians from four hospitals, 248 completed the survey. The survey included the Jefferson Scale of attitudes toward physician-nurse collaboration, the collaborative practice scales, learning experiences related to collaboration with nurses and experiences of joint activities with nurses. Multiple regression analysis revealed that learning experiences in undergraduate and out-of-hospital education and experiences of joint committee work were significantly associated with higher collaborative practice scores. Although participants' attitude scores had a strong association with practice scores, there were no variables significantly associated with the attitude score. This study supported the importance of education in undergraduate courses and suggested that it should be ongoing after qualification. Joint activities other than daily practice, such as continuous quality improvement, might also be effective. Factors that improve physicians' attitudes toward collaboration should be further explored. [ABSTRACT FROM AUTHOR]