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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]

This research provides a review of seated shot put alongside new data from the Tokyo 2020 Paralympic Games with the aim to understand the latest trends in equipment within a recently established rule set and how key equipment variables may impact performance for athletes in different classifications. First, a review of the literature found that the throwing pole is a key equipment aid that is not well understood, in part due to limitations in testing design. New data from the 2020 Paralympic Games showed inconsistent trends for the use of the throwing pole among athletes, particularly in transitionary classes (F33–34 and F54–55). A two-way analysis of variance found a main effect of classification on performance (p <.001), as well as an interaction effect between pole use and classification on performance (p <.05). Notably, pole users are seen to perform better than non–pole users in Class F32 (p <.05). [ABSTRACT FROM AUTHOR]

Late emerging adulthood is pivotal for identity exploration and development and is interrelated with life satisfaction. In the development of identity and life satisfaction, it is important to have a stable employment status that supports the foundation of life. However, the interrelationships among identity, life satisfaction, and employment status in late emerging adulthood are unclear. Using a two-wave longitudinal survey, this study examined identity development and whether the relationship between identity and life satisfaction varies by employment status. Participants included 875 Japanese emerging adults (65.5% women, Mage = 24.74, SDage = 0.44). Multivariate analysis of variance showed that identity synthesis decreased for those who lost their jobs or those who changed from being full-time to part-time employment. Additionally, individuals with full-time employment had higher identity synthesis and lower confusion than those with part-time or no employment. Multi-group path analysis indicated that identity synthesis was positively associated with life satisfaction and confusion was negatively associated, and these relationships did not differ by employment status. These findings suggest that identity development in late emerging adulthood varies by employment status and that the association between identity and life satisfaction may not be moderated by employment status. Overall, this study contributes to elucidating the characteristics of identity development along employment status and its relationship to life satisfaction in late emerging adulthood. [ABSTRACT FROM AUTHOR]

Background: Motor skills have been linked to executive functions (EFs) in children with developmental coordination disorder (DCD). However, the traits of other neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder and autism spectrum disorder, remain overlooked. Therefore, this study explored the association between motor skills, occupational performance, and mental health in older kindergarten children with DCD and other NDDs. Overall, 95 participants aged 5–6 years were included in this study and divided into four groups: DCD traits (DCD-t), DCD-t + NDD traits (DCD-t + NDD-t), NDD-t-only, and typically developing children. Motor skills, EFs, and mental health were assessed using the DCD Questionnaire (DCDQ-J) and Movement Assessment Battery for Children—Second Edition, School Assessment of Motor and Process Skills (S-AMPS), and the Strengths and Difficulties Questionnaire (SDQ), respectively. The DCD-t + NDD-t group exhibited a strong correlation between the S-AMPS motor skill score and the DCDQ-J fine motor skill score (r = 0.88, p < 0.001) and between the total DCDQ-J score and the SDQ Total Difficulties Score (r = −0.94, p < 0.001). The findings indicate that children with DCD-t and NDD-t are more likely to experience EF and mental health problems than those with DCD-t only. [ABSTRACT FROM AUTHOR]

Objective: Mentoring programs can improve nurses' mental health. This study examined the effects of a staff training program based on cognitive behavior therapy for burnout in which mentors provided intervention to their mentees. Methods: The principal investigator served as a facilitator and conducted staff training in cognitive behavior therapy. An original cognitive behavior therapy manual was presented to trained nurses (mentors), and lectures were provided on using the manual, ways of implementing cognitive behavior therapy, and other important points. The study participants included 35 mid-career nurses (mentors) and 34 young nurses in their first to third year (mentees) working in acute care hospitals. Groups of five mentees were formed in which two mentors provided cognitive behavior therapy based on the manual. Changes in mentees' stress, burnout, and turnover intention at pre-intervention, post-intervention, and follow-up (3 months after the intervention) were objectively evaluated using an evaluation index. Results: The intervention significantly reduced the following evaluation indicators: total strain, conflict with other nursing staff, nursing role conflict, qualitative workload, quantitative workload, conflict with patients, problem avoidance due to irrational beliefs, escape-avoidance, emotional exhaustion of burnout, desire to change hospitals or departments, and turnover intention. Conclusion: Implementation of cognitive behavior therapy by mentors effectively reduced mentees' stress, burnout, and turnover. [ABSTRACT FROM AUTHOR]

Background: Yokukansan, a traditional Japanese medicine (Kampo), has been widely used to treat neurosis, dementia, and chronic pain. Previous in vitro studies have suggested that Yokukansan acts as a partial agonist of the 5-HT1A receptor, resulting in amelioration of chronic pain through inhibition of nociceptive neuronal activity. However, its effectiveness for treating postoperative pain remains unknown, although its analgesic mechanism of action has been suggested to involve serotonin and glutamatergic neurotransmission. This study aimed to investigate the effect of Yokukansan on postoperative pain in an animal model. Methods: A mouse model of postoperative pain was created by plantar incision, and Yokukansan was administered orally the day after paw incision. Pain thresholds for mechanical and heat stimuli were examined in a behavioral experiment. In addition, to clarify the involvement of the serotonergic nervous system, we examined the analgesic effects of Yokukansan in mice that were serotonin-depleted by para-chlorophenylalanine (PCPA) treatment and intrathecal administration of NAN-190, 5-HT1A receptor antagonist. Results: Orally administered Yokukansan increased the pain threshold dose-dependent in postoperative pain model mice. Pretreatment of para-chlorophenylalanine dramatically suppressed serotonin immunoreactivity in the spinal dorsal horn without changing the pain threshold after the paw incision. The analgesic effect of Yokukansan tended to be attenuated by para-chlorophenylalanine pretreatment and significantly attenuated by intrathecal administration of 2.5 µg of NAN-190 compared to that in postoperative pain model mice without para-chlorophenylalanine treatment and NAN-190 administration. Conclusion: This study demonstrated that oral administration of Yokukansan has acute analgesic effects in postoperative pain model mice. Behavioral experiments using serotonin-depleted mice and mice intrathecally administered with a 5-HT1A receptor antagonist suggested that Yokukansan acts as an agonist at the 5-HT1A receptor, one of the serotonin receptors, to produce analgesia. [ABSTRACT FROM AUTHOR]

Background: There has been a significant increase in scientific investigations of the hearing‐dementia association among the research on potentially modifiable risk factors for cognitive impairment. We tested two clinical questions. Analysis 1: does persistent hearing aid (HA) use decrease the decline in cognitive function caused by ageing? Analysis 2: does cognitive function at the time of HA fitting predict future persistent HA use? Methods: This case–control study performed at two referral centres reported data obtained over a 4.5‐year period. We recruited a group of patients with cognitive decline, aged 65 or older with or without hearing loss. The intervention consisted of the use of HAs. The primary outcome measures were adherence to continuous HA use and cognitive function measured using the Japanese version of the Mini‐Mental State Examination Test and the Reading Cognitive Test Kyoto. Results: Eighteen HA users and 18 controls were included in the first analysis. HA use was associated with a deceleration of cognitive decline 12 months later. In the second analysis, 11 participants with good adherence to HA use were compared with 12 participants who showed poor adherence to HA use. Among the variables employed in this study, cognitive function measured using the Reading Cognitive Test Kyoto was significantly lower in participants with poor adherence to HA. Conclusions: HA use in cognitively impaired individuals with hearing loss can slow age‐related cognitive decline. Cognitively impaired people with hearing loss who fail to commit to HA use tend to have lower cognitive measurement scores before HA fitting. HA use is generally more challenging as people age and their cognitive abilities decline. Therefore, it is desirable that HAs be used when hearing loss and dementia are in their early stages. [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]

We assessed whether the impact of cabotegravir plus rilpivirine on inflammation reduction differs from that of oral antiretrovirals, using real-world data. Inflammatory biomarkers and lipid profiles were followed from baseline to 8 months after switching. Seventy-eight participants were analyzed. The CD4/CD8 ratio and C-reactive protein did not change. There were transient decreases in CD8 and CD4 counts in the group that switched from the dolutegravir-based regimen, but not in the tenofovir alafenamide-based regimen group. High-density lipoprotein (HDL) cholesterol increased, resulting in a decrease in the total-cholesterol to HDL cholesterol ratio, whereas there was no significant change in low-density lipoprotein cholesterol. [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]

This study investigated the characteristics of physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty. In this study, 29 participants with subacute stroke and walking difficulty were enrolled and classified into two groups: participants who successfully completed three items (i.e., sit-to-stand, standing, and stand-to-sit) of the Functional Balance Scale (independent group, n = 13) and those who showed incomplete scores on any of the three items (dependent group, n = 16). Light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) were measured using an accelerometer at three periods (i.e. daytime, therapy time, and non-therapy time) for a week. Two-way analysis of variance (groups × physical activity intensity) demonstrated a significant interaction in each period. Post-hoc tests showed significantly more LIPAs and MVPAs in the independent group in all periods, except for MVPA in the non-therapy time. Particularly, LIPA showed significant between-group differences in each period. Among individuals with subacute stroke and walking difficulty, those who could completely perform sit-to-stand, standing, and stand-to-sit could perform more LIPAs. Increasing sit-to-stand, standing, and stand-to-sit abilities could be an important factor in increasing the opportunity to perform LIPAs. [ABSTRACT FROM AUTHOR]

Context: Each hamstring muscle is subdivided into several regions by multiple motor nerve branches, which implies each region has different muscle activation properties. However, little is known about the muscle activation of each region with a change in the knee joint angle. Understanding of regional activation of the hamstrings could be helpful for designing rehabilitation and training programs targeted at strengthening a specific region. Objective: To investigate the effect of knee joint angle on the activity level of several regions within the individual hamstring muscles during isometric knee-flexion exercise with maximal effort (MVCKF). Design: Within-subjects repeated measures. Setting: University laboratory. Participants: Sixteen young males with previous participation in sports competition and resistance training experience. Intervention: The participants performed 2 MVCKF trials at each knee joint angle of 30°, 60°, and 90°. Outcome Measures: Surface electromyography was used to measure muscle activity in the proximal, middle, and distal regions of the biceps femoris long head (BFlh), semitendinosus, and semimembranosus of hamstrings at 30°, 60°, and 90° of knee flexion during MVCKF. Results: Muscle activity levels in the proximal and middle regions of the BFlh were higher at 30° and 60° of knee flexion than at 90° during MVCKF (all: P <.05). Meanwhile, the activity levels in the distal region of the BFlh were not different among all of the evaluated knee joint angles. In semitendinosus and semimembranosus, the activity levels were higher at 30° and 60° than at 90°, regardless of region (all: P <.05). Conclusion: These findings suggest that the effect of knee joint angle on muscle activity level differs between regions of the BFlh, whereas that is similar among regions of semitendinosus and semimembranosus during MVCKF. [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: As the human population ages, there is an urgent need to find new fall prevention strategies that differ from the conventional strategy of improving physical motor functions. Therefore, this study aimed to investigate the mechanism of falling during a dual task based on eye movements and frontal blood flow in the elderly. Methods: Thirteen healthy elderly women participants performed the following tasks while walking on the spot: stepping at a normal walking speed (single task), stepping at a normal walking speed while solving mathematical problems (dual task), and stepping at a normal walking speed while looking carefully at an image in front of them (control task). Eye movements, stepping state (number of steps and toe height), and frontal blood flow of the participants were measured. Results: The participants’ eye movements were significantly greater during the dual task than during the single and control tasks. However, the number of steps was not significantly different while performing the dual and single tasks. Toe height was significantly lower during the dual task than during the single task. Finally, frontal blood flow increased while performing the dual task compared with while the single task. Conclusion: This study clarified the mechanism by which fall occurs in elderly participants. Eye movements increased during dual task walking; however, the additional task involving “thinking” required focus, the visual search became sparse, and the toe height was reduced. These factors increased the risk of “stumbling,” which is considered the primary mechanism of falls. [ABSTRACT FROM AUTHOR]

BACKGROUND: COPD is characterized by progressive and irreversible air flow limitations. Single-inhaler therapies (SITTs) incorporating an inhaled corticosteroid, a long-acting muscarinic antagonist, and a long-acting β2-agonist have been shown to effectively alleviate symptoms and improve lung function. Fluticasone-furoate/umeclidinium/vilanterol (F/U/V) and budesonide/glyco-pyrronium/formoterol (B/G/F) are available as SITT in Japan. However, the clinical differences between these 2 combinations and the predictors of their proper use have not been established. This study aimed to identify the subject characteristics that could predict the effectiveness of inhaler therapy. METHODS: We assessed the pulmonary function test results of subjects with COPD before and one month after using F/U/V and B/G/F as SITT. Subjects with a difference of 100 mL or more in the FEV1 after treatment with pre-SITT were extracted and divided into the F/U/V effect and no-effect group and B/G/F effect and no-effect group to examine the factors associated with positive outcomes with each inhaler. RESULTS: F/U/V and B/G/F significantly improved the inspiratory capacity (IC), %IC, FVC, and %FEV1 when compared to pre-inter-vention values (P < .001, P = .001, P = .007, P = .009, respectively, for F/U/V; and P = .006, P = .008, P = .038, P = .005, respectively, for B/G/F). Factors associated with FEV1 improvement in F/U/V included lower %IC (odds ratio 0.97 [95% CI 0.94-0.99], P = .03) and a higher modified Medical Research Council (mMRC) dyspnea score (2.36 [1.27-4.70], P < .01). In addition, a higher %IC (1.03 [1.00-1.06], P = .02) and lower mMRC dyspnea score (0.55 [0.28-0.99], P = .041) were predictors for the effectiveness of B/G/F. CONCLUSIONS: Our results showed that SITT significantly improved the IC, %IC, FVC, and %FEV1 when compared to pre-inter-vention and that F/U/V was more effective in subjects with severe symptoms, whereas B/G/F was more effective in subjects with mild symptoms. [ABSTRACT FROM AUTHOR]

Objectives: A high rate of preterm birth has been reported in Okinawa Prefecture, the southernmost island prefecture of Japan. Hence, this study aimed to identify the risk factors for preterm birth in this prefecture. Methods: This retrospective study included data from January 2013 to December 2019 from three facilities in Okinawa Prefecture. Of 13,468 cases of preterm birth at ≥ 22 weeks of gestation, 11,868 were included in this study. Stillbirth and multiparity cases were excluded. First, we compared the overall preterm and full-term birth groups by categorizing the patient background, obstetric, and fetal risk factors. Further, we categorized preterm births into three groups (22–27, 28–33, and 34–36 weeks of gestation) and examined patient background factors to identify potential risk factors for the occurrence of preterm birth in each group. Results: Preterm births accounted for 21.2% (2,521 cases) of all cases, with the rates of 2.6% (317 cases), 6.7% (800 cases), and 11.8% (1,404 cases) at 22–27, 28–33, and 34–36 weeks of gestation, respectively. To prevent preterm birth in Okinawa Prefecture, the present study specifically focused on patient background characteristics. In the multinomial logistic regression, the risk factors for preterm birth at 22–27 weeks of gestation were previous preterm birth (P < 0.0001) and lower age (P = 0.026); at 28–33 weeks of gestation, the risk factors were previous preterm birth (P < 0.0001) and history of cervical conization (P = 0.009); and at 34–36 weeks of gestation, only previous preterm birth (P < 0.0001) was a risk factor. Conclusions for practice: Previous preterm birth, younger age, and history of cervical conization were risk factors for Preterm birth in Okinawa. To reduce premature births in Okinawa Prefecture, it is important to pick up women with these risk factors and provide them with appropriate guidance and education on an ongoing basis. Significance: What is already known about this subject? Previous studies have shown that smoking and short stature increase the rate of preterm birth in Okinawa Prefecture. What does this study add? Previous preterm birth, younger age, and history of cervical conization were risk factors for preterm birth in Okinawa Prefecture. [ABSTRACT FROM AUTHOR]

Background: Problematic Internet use (PIU) remains a significant social concern in Japan and across the globe. Numerous studies have been conducted to examine the prevalence of PIU, and its association with lifestyle habits and mental health status. To the best of our knowledge, few studies have examined the association between parental attachment and PIU in Japan. Furthermore, preventive measures in Japan have primarily targeted adolescents via education. Therefore, in this study we explored the association between PIU and attachment styles among adolescents to seek a new approach for the development of appropriate, effective measures. Methods: A self‐administered survey was conducted at one private (in 2018) and two public junior high schools (in 2020) in Kagawa Prefecture, western Japan. We used the Internet Addiction Test (IAT), the Experiences in Close Relationships–Relationship Structures (ECR–RS) questionnaire, and the Birleson Depression Self‐Rating Scale for Children (DSRS‐C). Multiple regression analysis was performed to examine the association between IAT scores and attachment styles. Results: Of 1,413 participants (grades 7–9; 700 boys and 713 girls), 39% of the students showed possible PIU and 3% showed PIU. Students with PIU tended to sleep for shorter durations, access the Internet for long hours, and have a poor mental health status (p < 0.01). PIU was significantly associated with insecure attachment (p < 0.0001). Conclusions: The findings of our study imply that improving attachment styles and developing secure attachment between the child and parent might help mitigate and/or prevent PIU. [ABSTRACT FROM AUTHOR]

This study aimed to examine the interaction effect between the presence of heart failure and the degree of frailty on skeletal muscle mass index (SMI), handgrip strength, and 5 times sit-to-stand (5STS). This study revealed a significant interaction effect between the presence of heart failure and the degree of frailty on SMI, handgrip strength, and 5STS. The study results revealed that the combination of heart failure and frailty has synergistic negative effects on SMI and upper and lower limb muscle strength. [ABSTRACT FROM AUTHOR]

Assessment-oriented group action (AGA) could be used to empower community-dwelling older adults to maintain their health by groups. AGA can be implemented with the support of a health professional to provide feedback to older adults on physical and cognitive function. To evaluate the effects of AGA. For this feasibility study, we enrolled 23 and 20 participants in the intervention and control groups, respectively. Thοse in the intervention group received feedback of their assessments and devised exercise plans with professional support. The participants performed their exercises over 12 weeks; the follow-up examination was conducted at 40 weeks. The control group only received feedback. The change in health-related consciousness and behavior was evaluated. Muscle strength and mass were measured and the timed up and go test, and the Brief-balance evaluation system test (BESTest) were performed. There were no significant differences in consciousness or behavior between the groups. The score was higher in the intervention than in the control group at 40 weeks in Section-I of the Brief-BESTest, indicating that the muscle strength contributed to balance function. AGA did not show positive changes in consciousness or behaviors but demonstrated significant improvements and lasting effects in balance function. [ABSTRACT FROM AUTHOR]

We investigated whether expression of social meaning operationalized as individual gender identitity and politeness moderated pitch range in the two languages of female and male Japanese-English sequential bilinguals. The bilinguals were resident in either London (UK) or Tokyo (Japan) and read sentences to imagined addressees who varied in formality and sex. Results indicated significant differences in the pitch range of the two languages of the bilinguals, and this was confirmed for female and male bilinguals in London and Tokyo, with the language differences being more extreme in the London bilinguals than in the Tokyo bilinguals. Interestingly, self-attribution of masculine gender traits patterned with within-language variation in the English pitch level of the female bilinguals, whereas self-attribution of feminine gender traits patterned with within-language variation in the English pitch level of the male bilinguals. In addition, female and male bilinguals significantly varied their pitch range in Japanese, but not in English, as a function of the imagined addressees. Findings confirmed that bilinguals produce pitch range differently in their languages and suggest that expression of social meaning may affect pitch range of the two languages of female and male bilinguals differently. [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]

Although there are clear moral components to traffic violations and risky and aggressive driving behavior, few studies have examined the relationship between moral values and risky driving. This study aimed to examine the relationship between moral views of driving behavior and brain activity. Twenty healthy drivers participated in this study. A questionnaire regarding their moral values concerning driving behavior was administered to the participants. Brain activity was measured using near-infrared spectroscopy while eliciting moral emotions. Based on the results of the questionnaire, the participants were divided into two groups: one with high moral values and the other with low moral values. Brain activity was statistically compared between the two groups. Both groups had significantly lower activity in the prefrontal cortex during the self-risky driving task. The low moral group had significantly lower activity in the left dorsolateral prefrontal cortex than the high moral group, while it had lower activity in the right dorsolateral prefrontal cortex in the self-risky driving task than in the safe driving task. Regardless of their moral values, the participants were less susceptible to moral emotions during risky driving. Furthermore, our findings suggest that drivers with lower moral values may be even less susceptible to moral emotions. [ABSTRACT FROM AUTHOR]

Context: A recent review or article reported that thermal agents (TA) or physical activity (PA) can increase range of motion (ROM) and that the combination of TA with stretching is superior to performing stretching only. However, since ROM is affected by the psychological factors, it is questionable whether these studies measured the effect of these interventions on muscle flexibility. By measuring muscle stiffness, the authors attempted to evaluate the effect these interventions on muscle flexibility. Objective: To compare the individual effects of TA and PA on muscle flexibility, as well as their effectiveness when combined with static stretching (SS). Design: Crossover trial. Setting: University research laboratory. Participants: 15 healthy men without a history of orthopedic disease in their lower limbs. Interventions: 15 minutes of 3 different conditions: hot pack as TA, pedaling exercise as PA, and the control group with no TA or PA intervention, followed by 3 min of SS for the hamstrings. Main Outcome Measures: Joint angle and passive torque of the knee during passive elongation were obtained prior to interventions, after 3 kinds of intervention, and after SS. From these data, muscle-tendon-unit (MTU) stiffness of the hamstrings was calculated. Results: Although knee-joint ROM increased with both TA and PA (P < .05), there were no significant differences in MTU stiffness between pre- and postintervention measurements for either of the interventions (TA, P = .477; PA, P = .377; control, P = .388). However, there were similar significant decreases in MTU stiffness between postintervention and post-SS for all conditions (P < .01). Conclusions: TA and PA did not decrease MTU stiffness, and combining these interventions with SS did not provide additional decreases in MTU stiffness compared with performing SS alone. [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]

Foam rolling is a self-applied massage using a foam roller that has gained popularity for treatment of muscle soreness. However, its efficacy for improving hip pain in patients with hip osteoarthritis remains unclear. To investigate the effects of foam rolling on hip pain in patients with hip osteoarthritis. In this retrospective propensity-matched cohort study, medical records of outpatients between January 2017 and March 2019 were reviewed. Of these, 115 patients with hip osteoarthritis were divided into foam rolling or non-foam rolling groups based on home exercises. Both groups were propensity-score matched (1:1) for age, sex, body mass index, Kellgren and Lawrence grade, and visual analog scale (VAS) of hip pain at baseline. The primary outcome was the hip pain-VAS. Effects of interventions on the hip pain-VAS were examined using a split-plot design variance analysis. After matching, both groups comprised 37 patients each. No significant differences were observed in baseline characteristics and outcome measurements between the matched groups. A statistically significant interaction was seen between the effects of time and group for hip pain-VAS (F [1, 72] = 31.874, interaction: P <.001, η2 = 0.307). Hip pain-VAS was improved more effectively in the foam rolling group than those in the non-foam rolling group (P <.001). Thirty-four (92%) patients in the foam rolling group, compared to 15 (41%) in the non-foam rolling group, showed a ≥ 32% (minimal clinically important difference) improvement in hip pain-VAS. These results suggested that foam rolling was an effective intervention for improving hip pain in patients with hip osteoarthritis. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the progression and stability in the performance of world-ranked swimmers from 2015 to 2020, and the impairment induced by the COVID-19 lockdown. An observational retrospective design over five consecutive competitive seasons was selected. FINA´s male Top-50 who were qualified for the Tokyo Olympic Games were considered in freestyle, backstroke, backstroke, and butterfly events. A total of 515 male swimmers and 2060 season-best performances were analyzed. All data was retrieved from two open-access and public websites (Swimrankings and Swimcloud). Repeated measures ANOVA followed by the Bonferroni post-hoc test was performed to analyze the variation between seasons. Stabilization in performance was assessed using spearman correlation coefficients. A significant improvement in performance ≈0.5-2.5% was found in most of the strokes and race distances until the 2018-2019 season. The 2020 lockdown impaired the performance by 1-2%. Moderate to high associations were found in the 2017-2018 season when considering the 2019-2020 performance. The breaststroke was the only stroke with a moderate-high stability (r > 0.40) in all race distances considering the overall time period. It can be concluded that world-ranked swimmers' performance was impaired by 1-2% due to the COVID-19 lockdown, returning to levels that were reached two years earlier. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of foot progression angle on the reduction in knee adduction moment caused by a lateral wedged insole during walking. Twenty healthy, young volunteers walked 10 m at their comfortable velocity wearing a lateral wedged insole or control flat insole in 3 foot progression angle conditions: natural, toe-out, and toe-in. A 3-dimensional rigid link model was used to calculate the external knee adduction moment, the moment arm of ground reaction force to knee joint center, and the reduction ratio of knee adduction moment and moment arm. The result indicated that the toe-out condition and lateral wedged insole decreased the knee adduction moment in the whole stance phase. The reduction ratio of the knee adduction moment and the moment arm exhibited a close relationship. Lateral wedged insoles decreased the knee adduction moment in various foot progression angle conditions due to decrease of the moment arm of the ground reaction force. Moreover, the knee adduction moment during the toe-out gait with lateral wedged insole was the smallest due to the synergistic effect of the lateral wedged insole and foot progression angle. Lateral wedged insoles may be a valid intervention for patients with knee osteoarthritis regardless of the foot progression angle. [ABSTRACT FROM AUTHOR]

Although there have been many investigations of the beneficial effects of both exercise and amino acids (AAs), little is known about their combined effects on the single-dose ingestion of AAs for lipid metabolism during exercise. We hypothesize that taking a specific combination of AAs implicated in glucagon secretion during exercise may increase fat metabolism. We recently developed a new mixture, d-AA mixture (D-mix), that contains arginine, alanine, and phenylalanine to investigate fat oxidation. In a double-blind, placebo-controlled crossover study, 10 healthy male volunteers were randomized to ingest either D-mix (3 g/dose) or placebo. Subjects in each condition subsequently performed a physical task that included workload trials on a cycle ergometer at 50% of maximal oxygen consumption for 1 hr. After oral intake of D-mix, maximum serum concentrations of glycerol (9.32 ± 6.29 mg/L and 5.22 ± 2.22 mg/L, respectively; p = .028), free fatty acid level (0.77 ± 0.26 mEq/L and 0.63 ± 0.28 mEq/L, respectively; p = .022), and acetoacetic acid levels (37.9 ± 17.7 µmol/L and 30.3 ± 13.9 µmol/L, respectively; p = .040) were significantly higher than in the placebo groups. The area under the curve for glucagon during recovery was numerically higher than placebo (6.61 ± 1.33 µg/L ⋅ min and 6.06 ± 1.23 µg/L ⋅ min, respectively;p = .099). These results suggest thatpreexercise ingestion of D-mix may stimulate fat metabolism. Combined with exercise, the administration of AA mixtures could prove to be a useful nutritional strategy to maximize fat metabolism. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether a lateral wedge insole reduces the external knee adduction moment during slope walking. Twenty young, healthy subjects participated in this study. Subjects walked up and down a slope using 2 different insoles: a control flat insole and a 7° lateral wedge insole. A three-dimensional motion analysis system and force plate were used to examine the knee adduction moment, the ankle valgus moment, and the moment arm of the ground reaction force to the knee joint center in the frontal plane. The lateral wedge insole significantly decreased the moment arm of the ground reaction force, resulting in a reduction of the knee adduction moment during slope walking, similar to level walking. The reduction ratio of knee adduction moment by the lateral wedge insole during the early stance of up-slope walking was larger than that of level walking. Conversely, the lateral wedge insole increased the ankle valgus moment during slope walking, especially during the early stance phase of up-slope walking. Clinicians should examine the utilization of a lateral wedge insole for knee osteoarthritis patients who perform inclined walking during daily activity, in consideration of the load on the ankle joint. [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]

Advances in patient care for pressure injuries (PIs) have reduced the prevalence of PIs in Japan, although not in recent years. Several single‐nucleotide polymorphisms (SNPs) have been identified in genes potentially associated with PIs. However, individual variance among PI risks require targeted investigations that may lead to the identification of PI susceptibilities or preventive care options that directly influence PI development pathways. This cross‐sectional study examined the association between PIs and SNPs in genes related to tissue tolerance in patients in a long‐term care hospital in Japan. A total of 178 participants (130 control, 20 with superficial PI history, and 28 with deep PI history) were enrolled in this study of eight SNPs in hypoxia inducible factor 1 subunit alpha (HIF1A), vascular endothelial growth factor C (VEGFC), heat shock protein 90 alpha family class A member 1 (HSP90AA1), myostatin (MSTN), and vitamin D receptor (VDR). The primary outcome was a history of superficial and deep PIs in the last 6 months. SNPs were examined by real‐time polymerase chain reaction, followed by multivariate logistic regression analyses of the associations between the SNPs and PI history. The results showed a significant association between VEGFC rs1485766 and the history of superficial PIs (odds ratio = 2.95; 95% confidence interval = 1.07–8.11; p = 0.04). Stratified analysis using the Braden Scale (≤14) indicated a significant association between HIF1A rs11549465 and deep PIs (p = 0.04). Our study demonstrated that VEGFC rs1485766 and HIF1A rs11549465 were associated with superficial and deep PI susceptibilities, respectively. [ABSTRACT FROM AUTHOR]

Aim: To examine factors of a hypothetical model related to stressors, burnout and turnover in nurses from developed and developing countries—Canada, Japan, the United States, Malaysia and Thailand. Design: A cross‐sectional questionnaire‐based study. Methods: Conducted between April 2016 and October 2017, the Maslach Burnout Inventory, Intention to Leave Scale, and Nursing Stress Scale collected data from acute care hospital nurses in Canada (n = 309), Japan (n = 319), Malaysia (n = 242), Thailand (n = 211) and the United States (n = 194). Results: Compared to other countries, burnout "exhaustion" was the highest in Japan and "cynicism" and intention to leave the job were the highest in Malaysia. Thailand had lower burnouts and turnover than other countries and higher professional efficacy than Japan and Malaysia. In all countries, reducing stressors is important for reducing burnout and intention to leave jobs, especially as they relate to "lack of support." [ABSTRACT FROM AUTHOR]

Context: Posterior ankle impingement syndrome is a common disorder in soccer players and ballet dancers. In soccer players, it is caused by the repetitive stress of ankle plantar flexion due to instep kicking. Protective ankle dorsiflexion taping is recommended with the belief that it prevents posterior ankle impingement. However, the relationship between ankle taping and ball-kicking performance remains unclear. Objective: To demonstrate the relationship between the restrictions of ankle taping and performance of an instep kick in soccer. Design: Laboratory-hased repeated-measures. Setting: University laboratory. Participants: 11 male university soccer players. Intervention: The subjects' ankle plantar flexion was limited by taping. Four angles of planter flexion (0°, 15°, 30°, and without taping) were formed by gradation limitation. The subjects performed maximal instep kicks at each angle. Main Outcome Measures: The movements o f the kicking legs and the ball were captured using 3 high-speed cameras at 200 Hz. The direct linear-transformation method was used to obtain 3-dimensional coordinates using a digitizing system. Passive ankle plantar-flexion angle, maximal plantar-flexion angle at ball impact, ball velocity, and foot velocity were measured. The data were compared among 4 conditions using repeated-measures ANOVA, and the correlations between ball velocity and foot velocity and between ball velocity and toe velocity were calculated. Results: Ankle dorsiflexion taping could gradually limit both passive plantar flexion and plantar flexion at the impact. Furthermore, limitation of 0° and 15° reduced the ball velocity generated by instep kicks. Conclusion: Plantar-flexion-limiting taping at 30° has a potential to prevent posterior ankle impingement without decreasing the ball velocity generated by soccer instep kicks. [ABSTRACT FROM AUTHOR]

Context: Abnormal scapular kinematics during throwing motion in baseball players with shoulder disorders has not yet been clarified, although altered scapular position has been suggested to be associated with shoulder disorder. Objective: To determine if the shoulders of baseball players with throwing disorders demonstrate abnormal scapular kinematics during the simulated arm-cocking phase of throwing activity. Design: Cross-sectional study. Setting: Laboratory. Participants: Eleven baseball players (age 21.1 ± 1.2 y) with a unilateral shoulder disorder volunteered to participate, including 9 players at the college level and 2 at the adult level. The mean playing experience was 12.1 ± 2.7 y. Main Outcome Measures: Scapular upward/downward rotation, anteroposterior tilting, and external/internal rotation during simulated arm-cocking motion were analyzed using a 3-to-2-dimensional registration technique. Results: Scapular external rotation in the throwing shoulder was significantly smaller by 2.0--6.0° than that of the contralateral shoulder. There were no detectable differences in scapular upward/downward rotation or anteroposterior tilting between the throwing and contralateral shoulders. Conclusions: Compared with that in the contralateral shoulder, scapular external rotation was smaller in the throwing shoulder, which would increase glenohumeral horizontal abduction during the arm-cocking phase and be related to the throwing-shoulder disorder. [ABSTRACT FROM AUTHOR]

Purpose: To describe cross-sectional age differences in change-of-direction performance (CODp) in female football players and investigate the relationship between CODp and linear-sprint speed, muscle power, and body size. Methods: A sample of 135 well-trained female football players was divided into 8 age groups. Anthropometry (height, body mass, and lean body mass) and athletic performance (10-m sprint speed, 10-m x 5-CODp, and 5-step bounding distance) were compared to determine interage differences using ANOVA. Then, the participants were divided into 3 age groups: 12- to 14-y-olds, 15- to 17-y-olds, and =18 y-olds. Simple- and multiple-regression analyses were conducted to determine the correlation between CODp and the other measurement variables in each age group. Results: Age-related differences were found for CODp (F = 10.41, P < .01), sprint speed (F = 3.27, P < .01), and bounding distance (F = 4.20, P < .01). Post hoc analysis revealed that the CODp of 17-y-old players was faster than that of 16-y-old players (P < .01), with no interage differences in sprint speed and bounding distance. Sprint speed and bounding distance were weakly correlated with CODp in 15- to =18-y-old players, but only sprint speed was correlated with CODp in 12- to 14-y-old players. Conclusions: CODp improves from 16 to 17 y of age in female players. Linear-sprint speed, muscle power, and body size were weakly correlated with the age differences in CODp. [ABSTRACT FROM AUTHOR]

Background Cartilage conduction hearing aids (CCHAs) were newly devised and spread fast in Japan since their launch in 2017. However, little knowledge is available for this new device. Purpose The aim of this study was to establish the knowledge of CCHAs and suggest their indication. Research Design Correlational study. Study Sample A total 256 patients were registered. Data Collection and Analysis The fitting of CCHAs was surveyed in nine institutions. The outcomes were assessed by audiometric tests. The patients were classified into seven groups, depending on the ear conditions. The clinical characteristics, assessment results, and purchase rates were compared among the groups. The assessment results of CCHAs were also compared with those of previously used hearing aids. Results Most patients who used CCHAs were classified into the bilateral closed (aural atresia or severe stenosis) ear (n=65) or unilateral closed ear (n=124) groups. The patients in these groups achieved good benefits that resulted in a high purchase rate. The bilateral continuous otorrhea group also supported a high purchase rate, although the benefits of CCHAs were not always excellent. In contrast, the purchase rate was poor in the patients who could use air conduction hearing aids (ACHAs) without absolute problems. As for using a CCHA as a contralateral routing of signals hearing aid, the benefits depended on the patients. Conclusions CCHAs are considered as a great option not only to the patients with closed ears but also to those who had difficulties in ACHAs usage. [ABSTRACT FROM AUTHOR]

Background: This study explored visiting nurses' knowledge and beliefs regarding pain management in community-dwelling older adults with moderate-to-severe dementia. Methods: A cross-sectional study design was used to collect data in 2019. A questionnaire was mailed to nursing managers at 1037 home-visiting nursing stations in Japan. Findings: The final analysis included 230 responses. The mean score on the knowledge and belief statements was 14 out of a possible 18, and respondents with more pain management training obtained a higher total score on knowledge than those without such training (p<.001). More than 95% indicated that they needed training on pain management for older adults with dementia. Conclusion: Visiting nurses in Japan require training in pain management for older adults with moderate-to-severe dementia. Despite its usefulness, the current pain management training programme should be improved to enable visiting nurses to manage dementia patients' pain more confidently. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to compare the effects of acupuncture treatment on arterial blood pressure (BP) and heart rate (HR) in patients with mild hypertension with high sympathetic tone with those of normotensive patients and to examine the effects on cardiac sympathetic nerve activity (CSNA) and vagal activity using heart rate variability (HRV) analysis. Design: Eight male patients with prehypertension or stage I hypertension and eight normotensive age-matched patients were included in this study. All patients had their systolic BP (SBP), diastolic BP (DBP), HR, and HRV measured. In addition, the ratio of low-frequency (LF) to high-frequency (HF) HRV and the power of the HF of the HRV were recorded. The study was conducted at Kansai University of Health Sciences in Japan. Interventions: Each patient underwent a single, 15-min-long acupuncture session. Acupuncture was applied to PC6, LI4, ST36, LR3 on both sides, and GV20. Results: SBP and HR decreased significantly in the hypertensive group during and after acupuncture compared with the baseline SBP and HR (p < 0.05). LF/HF was significantly reduced during acupuncture (p < 0.05), and HF was significantly increased after acupuncture in the hypertensive group (p < 0.05). However, there were no significant changes in LF/HF or HF in the control group. Conclusions: Acupuncture may reduce the BP and HR in patients with mild hypertension. An HRV analysis suggests that acupuncture may suppress the enhanced basal CSNA activity and increase the vagal nerve activity in patients with mild hypertension. Clinical Trial Registration number: UMIN000041249. [ABSTRACT FROM AUTHOR]

Perceptual epenthesis is the perception of illusory vowels in consonantal sequences that violate native phonotactics. The consensus has been that each language has a single, predictable candidate for perceptual epenthesis, that vowel which is most minimal (i.e., shortest and/or quietest). However, recent studies have shown that alternate epenthetic vowels can be perceived when the perceptual epenthesis of the minimal vowel would violate native co-occurrence restrictions. We propose a potential explanation for these observed patterns: speech perception, and thus also vowel perceptual epenthesis, is modulated by transitional probability whereby epenthetic vowels must conform to the language specific expectations of the listener. To test this explanation, we present two experiments examining perceptual epenthesis of two Japanese vowels—/u/ and /i/—against their transitional probability in CV sequences. In Experiment 1, Japanese listeners assigned VCCV tokens to VCuCV and VCiCV categories. In Experiment 2, participants discriminated VCCV tokens from VCuCV and VCiCV tokens. The results show that sequences where /i/ is transitionally probable are more likely to elicit /i/ perceptual epenthesis. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the relevance of hip joint angles to the production of the pelvic rotation torque in fast-pitch softball hitting and to examine the effect of ball height on this production. Thirteen advanced female softball players hit stationary balls at three different heights: high, middle, and low. The pelvic rotation torque, defined as the torque acting on the pelvis through the hip joints about the pelvic superior–inferior axis, was determined from the kinematic and force plate data using inverse dynamics. Irrespective of the ball heights, the rear hip extension, rear hip external rotation, front hip adduction, and front hip flexion torques contributed to the production of pelvic rotation torque. Although the contributions of the adduction and external rotation torques at each hip joint were significantly different among the ball heights, the contributions of the front and rear hip joint torques were similar among the three ball heights owing to cancelation of the two torque components. The timings of the peaks of the hip joint torque components were significantly different, suggesting that softball hitters may need to adjust the timings of the torque exertions fairly precisely to rotate the upper body effectively. [ABSTRACT FROM AUTHOR]

The evaluation of hip hop dancers presently lacks clearly defined criteria and is often dependent on the subjective impressions of judges. Our study objective was to extract hidden motion characteristics that could potentially distinguish the skill levels of hip hop dancers and to examine the relationship between performance kinematics and judging scores. Eleven expert, six nonexpert, and nine novice dancers participated in the study, where each performed the "wave" motion as an experimental task. The movements of their upper extremities were captured by a motion capture system, and several kinematic parameters including the propagation velocity of the wave were calculated. Twelve judges evaluated the performances of the dancers, and we compared the kinematic parameters of the three groups and examined the relationship between the judging scores and the kinematic parameters. We found the coefficient of variation of the propagation velocity to be significantly different among the groups (P < .01) and highly correlated with the judging scores (r = -0.800, P < .01). This revealed that the variation of propagation velocity was the most dominant variable representing the skill level of the dancers and that the smooth propagation of the wave was most closely related to the evaluation by judges. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the morphological and mechanical properties of the human patellar tendon among elementary school children (prepubertal), junior high school students (pubertal), and adults. Twenty-one elementary school children, 18 junior high school students, and 22 adults participated in this study. The maximal strain, stiffness, Young's modulus, hysteresis, and cross-sectional area of the patellar tendon were measured using ultrasonography. No significant difference was observed in the relative length (to thigh length) or cross-sectional area (to body mass2/3) of the patellar tendon among the three groups. Stiffness and Young's modulus were significantly lower in elementary school children than in the other groups, while no significant differences were observed between junior high school students and adults. No significant differences were observed in maximal strain or hysteresis among the three groups. These results suggest that the material property (Young's modulus) of the patellar tendons of elementary school children was lower than that of the other groups, whereas that of junior high school students was already similar to that of adults. In addition, no significant differences were observed in the extensibility (maximal strain) or viscosity (hysteresis) of the patellar tendon among the three groups. [ABSTRACT FROM AUTHOR]

Purpose: Intravenous (IV) sedation is commonly used in dentistry. However, no report has yet been published regarding age, hypertension, and antihypertensive drugs during implant surgery and their relationship with changes in blood pressure (BP) and heart rate in implant surgery under IV sedation with propofol and midazolam. Materials and Methods: Medical records of 252 patients who underwent implant surgery were retrospectively analyzed. Patients were classified into four groups according to their age (in years) and hypertension status: A = ≤ 64, no hypertension; B = ≥ 65, no hypertension; C = ≤ 64, hypertension; or D = ≥ 65, hypertension. Hypertensive patients were further characterized by their antihypertensive medications: E = calcium channel blockers (CCBs), F = angiotensin II receptor blockers (ARBs), G = CCBs+ARBs, or H = no medication. IV sedation was administered in two stages. After midazolam injection to prevent angialgia, propofol was infused at the rate of 4 mg/kg/h, followed by a dose reduction. Systolic and diastolic BP and heart rate were recorded before, during, and after surgery. Results: Systolic BP increased significantly after patients were draped in groups A, C, and D, with group D showing the most pronounced increase. Sedatives decreased BP in all groups. Diastolic BP in group F decreased significantly compared to group H after induction and before infiltration of local anesthetic. After infiltration, systolic BP decreased more significantly in group G than in group H. Intraoperative hypotension was observed in 25% of patients. The incidence of intraoperative hypertension in group D was markedly higher than in group A (23% vs 4%). Conclusion: IV sedation using midazolam and propofol reduces hypertensive risks during implant surgery. Nevertheless, care must be taken, especially in older hypertensive patients and in hypertensive patients on ARBs or ARBs+CCBs. [ABSTRACT FROM AUTHOR]

Background: Two issues in clinical trials with multiple endpoints were surveyed: (1) the terminology of multiple endpoints, the relationship between rare events and endpoints, and the differences in multiplicity adjustment between regions, and (2) the current practice on multiplicity adjustment and sample size calculation. This article summarizes the results of the survey on the second issue. Methods: Eligible trials for this survey fulfilled the following conditions: (1) confirmatory phase 3 trial; (2) use of multiple primary endpoints, co-primary endpoints, key secondary endpoint(s) or composite endpoint(s); (3) inclusion of Japanese participants; and (4) protocols created in 2010 or later. The survey was conducted at member companies of the Japan Pharmaceutical Manufacturers Association from October 2017 to November 2017. Results: Useable responses were obtained from 78 trials in 13 companies based in Japan and 9 companies based in other countries. The Bonferroni procedure was mostly used in clinical trials with multiple primary endpoints, while multiple testing procedures that consider a hierarchy of endpoints or a structure of hypotheses were used in clinical trials with key secondary endpoint(s). In sample size calculation, we can consider the probability of study success, such as the probability of statistical significance in at least one comparison of primary endpoints; however, other probabilities were also considered. This survey reveals that multiplicity adjustment and the correlation of endpoints were not always considered in sample size calculation. Conclusions: In clinical trials with multiple endpoints, clinical importance was considered when determining multiple testing procedures. Challenges remain with the definition of power, the consideration of multiple testing procedures and the correlation between endpoints in sample size calculation. [ABSTRACT FROM AUTHOR]

Aims: To evaluate how a structured interactive two‐day education programme for clinical nurses on end‐of‐life (EOL) care for older people affects nurses' attitudes and knowledge. Design: Non‐randomised controlled trial. Methods: Nurses were recruited separately for intervention and control groups. The intervention group assisted older patients with EOL care and recruited patients for the programme. To prevent sampling bias, control group nurses were recruited from a facility with numerous EOL care opportunities. The intervention was a two‐day educational programme. Using valid and reliable scales, we evaluated the attitudes (total score range: 26–130) and knowledge (total score range: 0–51) of the intervention group four times (pretraining, post‐training, 3 months, 6 months) and the control group three times (baseline, 3 months, 6 months) between January 2016 and April 2017. Analysis of covariance examined both groups' score changes at 3 and 6 months while adjusting for confounding factors. Results: Participants were 338 nurses caring primarily for older people (intervention group: 164; control group: 174); 142 responded at all measurement points. The change in mean value of the attitude scale from baseline to 3 months (differences in the groups' attitude scores = 7.33; 95% CI = 2.43–12.24; p =.004) and 6 months (differences in groups' attitude scores = 5.77; 95% CI = 0.17–11.37; p =.044) was greater in the intervention group. Moreover, the mean knowledge scale score change from baseline to 3 months was greater in the intervention group (differences in groups' knowledge scores = 5.74; 95% CI = 4.07 to 7.39; p <.001). There was no evidence of a change in this score between baseline and 6 months. Conclusion: The programme improved nurses' medium‐ to long‐term attitudes and knowledge. Thus, it may help nurses enhance the quality of care they provide. Implications for practice: A two‐day educational program improves nurses' medium‐ to long‐term attitudes and knowledge on end‐oflife care. For quality end‐of‐life care for older people, a structured and evidence‐based educational program should be provided to nursing staff. [ABSTRACT FROM AUTHOR]

Background: A recent study revealed that whole-body vibration (WBV) tends to decrease spasticity in stroke-related hemiplegic legs. However, acute changes in cortical activation after WBV are unclear. Objective: To examine whether WBV induces acute changes in sensorimotor cortical activation in patients with stroke-related hemiplegic legs. Methods: Eleven stroke patients (mean age 52.6 [SD 15.4] years; median time after stroke 3 [25th and 75th percentiles; 3 and 10.5, respectively] months) participated in a comparative before-and-after intervention trial. Six healthy adults were also studied. WBV at 30 Hz was applied for 5 min to the hamstrings, gastrocnemius, and soleus muscles. Spasticity was assessed according to the modified Ashworth scale (MAS). Active and passive range of motion (A-ROM and P-ROM, respectively) were also measured. Change in Oxy-Hb concentration in bilateral sensorimotor cortex associated with voluntary ankle dorsiflexion of the affected limb was assessed via functional near-infrared spectroscopy (fNIRS) before and immediately after WBV. Results: MAS score, A-ROM, and P-ROM improved immediately after WBV. In the patients, while there was no significant interaction between effects of region (ipsilesional and contralesional sensorimotor cortex) and the WBV intervention (before and immediately after WBV) (F1,10 = 0.702, p =.422), there was a significant main effect of the WBV intervention (F1,10 = 6.971, p =.025). In the healthy participants, there was no association with the WBV intervention or region. Conclusions: In patients with stroke-related spastic-hemiplegic legs, WBV might result not only in clinical improvement but also in acute increase in sensorimotor cortical activation. [ABSTRACT FROM AUTHOR]

Background: Thirst is a distressing symptom and influences quality of life of patients with heart failure (HF). Knowledge about thirst in HF is insufficient; therefore, the aim of this study was to describe factors related to thirst, self-reported reasons for thirst, and interventions to relieve thirst in 3 different countries. Methods: A cross-sectional study was conducted in Sweden, the Netherlands, and Japan. Patients were recruited at the HF clinic or during HF hospitalization. Thirst was assessed by a visual analog scale (0-100); reasons for thirst and interventions to relieve thirst were assessed by an open-ended questionnaire. Patients were divided into low and high thirst based on the first and third tertiles of the visual analog scale. Results: Two hundred sixty-nine patients participated in the study (age, 72 ± 12 years). Mean thirst intensity was 24 ± 24, with a mean thirst of 53 ± 15 in the highest tertile. No significant differences in thirst among the 3 countries were found. Multivariable logistic regression analysis showed that a higher dose of loop diuretics (odds ratio, 3.47; 95%confidence interval, 1.49-8.06) and fluid restriction (odds ratio, 2.21; 95%confidence interval, 1.08-4.32) were related to thirst. The most reported reasons for thirst were salty/spicy food (20%) and low fluid intake (18%). Most of the patients (56%) drank more in case of thirst; 20%only drank a little bit, probably related to a fluid restriction. Conclusions: Thirst in patients with HF was related to a higher dose of loop diuretics and fluid restriction. Healthcare providers should realize that it is important to assess thirst regularly and reconsider the need of a fluid restriction and the amount of loop diuretics in case of thirst [ABSTRACT FROM AUTHOR]

This study examines the perception of Mandarin lexical tones by native speakers of Burmese who use lexical tones in their first language (L1) but are naïve to Mandarin. Unlike Mandarin tones, which are primarily cued by pitch, Burmese tones are cued by phonation type as well as pitch. The question of interest is whether Burmese listeners can utilize their L1 experience in processing unfamiliar Mandarin tones. Burmese listeners' discrimination accuracy was compared with that of Mandarin listeners and Australian English listeners. The Australian English group was included as a control group with a non-tonal background. Accuracy of perception of six tone pairs (T1-T2, T1-T3, T1-T4, T2-T3, T2-T4, T3-T4) was assessed in a discrimination test. Our main findings are 1) Mandarin listeners were more accurate than non-native listeners in discriminating all tone pairs, 2) Australian English listeners naïve to Mandarin were more accurate than similarly naïve Burmese listeners in discriminating all tone pairs except for T2-T4, and 3) Burmese listeners had the greatest trouble discriminating T2-T3 and T1-T2. Taken together, the results suggest that merely possessing lexical tones in L1 may not necessarily facilitate the perception of non-native tones, and that the active use of phonation type in encoding L1 tones may have played a role in Burmese listeners' less than optimal perception of Mandarin tones. [ABSTRACT FROM AUTHOR]

Context: Walking in water has been included in rehabilitation programs. However, there is a dearth of information regarding the influence of a water current on physiological responses, rating of perceived exertion (RPE), and stride characteristics of subjects while they walk in water. Objective: To compare physiological responses, RPE, and stride characteristics of subjects walking in water (with and without a current) with those of subjects walking on dry land. Design: Repeated measures. Setting: University laboratory. Participants: 7 male adults (mean age = 21.6 y). Intervention: Subjects walked on a treadmill on dry land and on an underwater treadmill immersed to the level of the xiphoid process. The walking speeds in water were set to be half of that on dry land. Main Outcome Measures: Oxygen consumption (VO2), respiratory-exchange ratio (RER), heart rate (HR), minute ventilation (VE), RPE (for breathing and legs, RPE-Br and RPE-Legs, respectively), systolic (SBP) and diastolic (DBP) blood pressures, and stride frequency (SF) were measured. In addition, stride length (SL) was calculated. Results: There was no significant difference in the VO2, RER, HR, VE, RPE-Br, and RPE-Legs while walking in water with a current compared with walking on dry land (P > .05). Furthermore, VO2, RER, HR, VE, RPE-Br, RPE-Legs, SF, and SBP while walking in water were significantly higher with a water current than without (P < .05). Conclusions: These observations suggest that half the speed should be required to work at the similar metabolic costs and RPE while walking in water with a current, compared with walking on dry land. Furthermore, it was suggested that the physiological responses and RPE would be higher while walking in water with a current than without. [ABSTRACT FROM AUTHOR]

Aims: To clarify the subgroups of overtime work motivations and to determine how fatigue, mental status, and work engagement differ among the subgroups. Design: Cross‐sectional. Methods: Questionnaires were distributed to 1,075 full‐time nurses working in four hospitals in Japan from October 2015 ‐ February 2016. Nurses were categorized into subgroups of overtime work motivation by latent class analysis. An analysis of covariance was conducted to examine how fatigue, mental status, and work engagement differ among subgroups. Results/Findings: We identified five types of overtime workers differing greatly in fatigue, mental status, and work engagement. Conclusions: Even when nurses worked approximately the same work hours, the difference in motivation corresponded to different degrees of fatigue, mental status, and work engagement. When introducing policies to reduce overtime work, managers should consider the different groups of overtime workers, as effective measures may differ. [ABSTRACT FROM AUTHOR]