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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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

To investigate the psychometric properties of the Test d'Evaluation des Membres Suprieurs de Personnes Agres (TEMPA) for the affected upper extremity in a population of Japanese patients with stroke. A prospective, cross-sectional, single-center study involving 30 patients with stroke was conducted. The inter-rater reliability, the validity, and the internal consistency were assessed. The Fugl-Meyer Assessment (FMA), the Action Research Arm Test (ARAT), the Motor Activity Log, and the Box-and-Block Test were employed for assessing the validity. The English TEMPA instructions were successfully translated in accordance with the accepted principles of translation. The weighted Kappa coefficients for the functional rating scores were 0.87, 0.93, and 0.91 for combined total score, unilateral total score, and bilateral total scores. No statistically significant systematic disagreement was seen in the combined scores. The Spearman's rho values were higher than 0.70 regarding the gold standard tools (the FMA-UE motor domain and the ARAT). The Cronbach's alpha was 0.940 in the functional rating scale and 0.998 in the task analysis scale. The most aspects of the Japanese TEMPA showed acceptable levels of inter-rater reliability and validity in patients with affected upper extremities after stroke. The TEMPA is reliable and valid in measuring activity capacity of upper extremity in patients with stroke. The functional rating score of the TEMPA is recommended to assess activities related to daily living, especially when users need to focus on bimanual activities. The TEMPA may help guide intervention that improve bimanual activity as well as the affected arm activity. [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]

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]

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]

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]

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]

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]

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]

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]

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]

Purpose: Working memory (WM) deficits are implicated in various communication disorders, including stuttering. The reading span test (RST) measures WM capacity with the dual task of reading sentences aloud and remembering target words. This study demonstrates a difference in strategy between people who stutter (PWS) and people who do not stutter (PWNS) in performing the RST. The impact of the effective strategy and the stuttering-like disfluencies during the RST were investigated. Method: Twenty-six PWS and 24 people who do not stutter performed the RST and a simple reading aloud task. After the RST, they were asked which strategy ("imagery" or "rehearsal") they had used in order to remember the target words during the task. Results: The proportion of those who used an "imagery" strategy during the RST was significantly smaller in the PWS group. However, the RST scores of those who used an "imagery" strategy were significantly higher than the RST scores of those who used a "rehearsal" strategy in both groups. The "rehearsal" users were asked to undertake one more RST with an "imagery" strategy, which resulted in an increased score for both groups. The disfluency frequency of the PWS group was significantly reduced during the RST than during the oral reading task, irrespective of the employed strategy. Conclusions: PWS tended to use the less effective verbal "rehearsal" strategy during the RST. The differential effects of switching strategies on the measured WM capacity and on the disfluency rate suggest that the enhanced fluency during the RST would be mostly attributable to the reduced attention to speech motor control. Therefore, the use of the "imagery" strategy and focusing on the contents of communication, away from speech motor control, should help PWS communicate better in daily conversation. [ABSTRACT FROM AUTHOR]

Aim: Identifying the relationship between burnout status and hospital size and workplace environment among hospital nursing directors. Background: Although the demands on nursing staff and managers are increasing, nursing directors' burnout is an under‐researched topic. Methods: An anonymous survey was conducted with 205 nursing directors across all 654 hospitals in Tokyo, Japan. The survey instruments were the Japanese version of the Burnout Scale, the Organizational Justice Questionnaire, the Nursing Work Empowerment Scale and the Workplace Support Scale. Results: Nursing directors who were close to burnout were from smaller rather than large hospitals. Correlations were found between emotional exhaustion and interactional justice, age, resources, moral support from hospital executives, and self‐reflection support from subordinates. Regarding depersonalization, correlations were found with interactional justice, age and work support from subordinates. Regarding participants' personal accomplishment, correlations were found with procedural justice, interactional justice and opportunities. Conclusions: Nursing directors of smaller hospitals tend to experience greater burnout. The impact of work environment on burnout is greater than that of facility and individual characteristics. Implications for Nursing Management: To mitigate burnout, hospitals should ensure high organizational justice, provide access to resources and opportunities, and encourage moral support from executives and work support from subordinates. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to develop a scale that can comprehensively measure public health nurses'(PHNs) career development and to verify the validity and reliability of that scale. Design and samples: This study is a cross‐sectional investigation. The participants were 1,009 PHNs working in a government facility in Japan. A total of 586 participants who had been working for more than 3 years as PHNs were analyzed. Measurements: Anonymous self‐response questionnaires included items on professional awareness, practical competency, and job satisfaction. We conducted exploratory factor analysis and confirmatory factor analysis to clarify the construct validity of the scale. The reliability was examined by the Cronbach's α coefficient. The validity was examined by an external reference relevant validity and the known‐group method. Results: The scale was structured with 32 items covering three factors: "community activities, policy, and management," "PHN identity," and "foundations as a PHN." The Cronbach's α coefficients were all greater than 0.9. In confirmatory factor analysis, the scale showed acceptable goodness of fit. Conclusions: The comprehensive career development scale for PHNs proved its reliability and validity. This scale may be useful to promote PHN identity and competency comprehensively in basic education and in‐charge education. [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]

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]

Aims and Objectives: To explore the differences in clinical practice activities and work‐related burden between nurses with past work experience other than nursing (second career nurses: SCNs) and nurses without any past work experience (nonsecond career nurses: NSCNs). Background: The number of SCNs is increasing. Some studies note that SCNs must perform additional clinical practice activities and experience more work‐related burden than NSCNs. However, there are no quantitative studies exploring SCNs' clinical practice and work‐related burden. Design: A cross‐sectional survey. Methods: Research was conducted according to the STROBE statement. Participants were 2,013 nurses working at 56 hospitals in Japan. A 30‐item questionnaire was developed to capture clinical practice activities using clinical ladders, asking about the types of clinical practice activities participants had practiced. Every practiced activity received a score of 1. The total count of each clinical practice activity was then summed. The quantitative workload (QW) scale score was used to investigate levels of QW. Higher QW scores indicated higher levels of work‐related burden. These variables were then compared between SCNs and NSCNs, and the factors that were associated with high QW among SCNs were examined. Results: Altogether, 961 participants (328 SCNs and 633 NSCNs) were included in the analyses. No significant differences were shown in clinical practice activities between the groups; however, SCNs' QW was significantly higher than was NSCNs' after controlling for demographic variables. SCNs' high QW was associated with the following variables: unmarried marital status, not having role model nurses and previous employment as a care worker. Conclusions: Quantitative workload was significantly higher among SCNs than among NSCNs. Tailored support for SCNs' high QW based on their specific needs should be considered. Relevance to clinical practice: These results can help nurse managers reduce SCNs' work‐related burden and illustrate future research directions for this minority group. [ABSTRACT FROM AUTHOR]

Research in Western countries has indicated that the cognitive distortions of sexual offenders play an etiological and maintenance role in offending. The present study examines whether the cognitive distortions hypothesized by previous Western studies can be found in Japanese sexual offenders against women. This study used the questionnaire administered by probation officers in the special cognitive-behavioral treatment programs for sexual offenders, which have been implemented since 2006 in Japan. Participants in the offender group were 80 Japanese male probationers and parolees (more than 19 years old, M age = 34.6, SD = 8.8) convicted of rape (n = 39) or indecent assault (n = 41). All of them attended special treatment programs at probation offices. The non-offender comparison group consisted of 95 Japanese male probation officers and police officers (M age = 35.5, SD = 11.4). A factor analysis of the questionnaire responses extracted three factors: Blaming the Victim, Minimization, and Avoidance of Responsibility. The data analyses showed that sexual offenders scored significantly higher than non-offender participants on the three subscales. No significant differences were found among four sexual offender groups classified as rapists or indecent assaulters and with or without previous convictions for sexual offenses. In conclusion, the results of this study indicate that rapists and indecent assaulters placed on probation or parole in Japan hold cognitive distortions concerning sexual assaults against women than the control group of probation and police officers. The findings of this study also suggest that cognitive distortions exhibited by sexual offenders against women transcend cultural divides. [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]

Shiitake (Lentinula edodes) extract, eritadenine, has been shown to reduce cholesterol levels, and its hypocholesterolemic actions are involved in the metabolism of methionine. However, the mechanisms by which eritadenine affects cholesterol metabolism in animals fed a high-fat diet containing different sources of lipids have not yet been elucidated in detail. This study was conducted to investigate the effects of shiitake supplementation on serum lipid concentrations in rats fed a diet including a high amount of a plant oil (HO [high oil] and HOS [high oil with shiitake] groups), animal fat (HF [high fat] and HFS [high fat with shiitake] groups), or MCT- (medium-chain triglyceride-) rich plant oil (HM [high MCT] and HMS [high MCT with shiitake] groups). Rats in the HOS, HFS, and HMS groups were fed shiitake. When rats were fed a diet containing shiitake, serum triglyceride, cholesterol levels, and LCAT (lecithin-cholesterol acyltransferase) activities were lower in rats given MCT-rich plant oil than in those that consumed lard. The lipid type in the diet with shiitake also affected serum cholesterol levels and LCAT activities. The diet containing MCT-rich plant oil showed the greatest rates of decrease in all serum lipid profiles and LCAT activities. These results suggest that shiitake and MCT-rich plant oil work together to reduce lipid profiles and LCAT activity in serum. [ABSTRACT FROM AUTHOR]

The aim of the present study was to clarify the structural relationship between health-related habits and psychosocial factors during adolescence/early adulthood. An anonymous, self-administered questionnaire was provided to 1141 third- and fourth-year students at eight academic departments from six universities in regional Japanese cities. Surveys included items addressing participants' demographic characteristics, psychosocial factors (individual-level social capital, self-efficacy, mental health (from health-related quality of life SF-36v2), and sense of coherence (SOC)), and health-related habits. A multiple indicator analysis based on structural equation modeling was conducted to examine the structural relationship between health-related habits and these factors. Valid responses were obtained from 952 participants. The final model demonstrated a high level of goodness of fit. While the path from SOC to health-related habits was significant, those from self-efficacy to health-related habits and from mental health to health-related habits were not significant. The path coefficient from SOC to health-related habits was greater than the path coefficient from background characteristics. In the multiple population comparison that considered gender, a nearly identical model was supported for men and women. Psychosocial factors related to health-related habits were social capital, self-efficacy, mental health, and SOC. Furthermore, it was suggested that SOC functions as an intervening factor for maintaining a healthy lifestyle. It was observed that individual psychosocial factors influence health-related habits more than their background characteristics. Findings highlight that supporting the building of social relationships and social environments is essential to promote a healthy lifestyle among university students. [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]

Adolescent depression is a significant public health concern. Although skipping breakfast is associated with depressive symptoms in adolescents, the effects of dietary patterns on their depressive symptoms remain unknown. Therefore, this study aims to determine whether dietary patterns are associated with depressive symptoms among junior and senior high school students in Japan. A total of 441 junior high school students and 417 senior high school students participated in this study. The Center for Epidemiologic Studies Depression scale (CES-D) was used to measure the participants’ depressive symptoms. We surveyed the participants’ breakfast consumption pattern, as well as their general dietary patterns (meat, fish, green and yellow vegetables, milk and dairy products, and fruits), using a self-report questionnaire. The results indicated that the senior high school students had a significantly higher CES-D score than the junior high school students. We found negative and significant partial correlations between regular consumption of breakfast and depressive symptoms, and between regular consumption of green and yellow vegetables and depressive symptoms in both junior and senior high school students, after controlling for age, sex, and sleep duration. Furthermore, a one-way analysis of covariance (ANCOVA) revealed that adolescents who consumed green and yellow vegetables every day (one or more times per day) had significantly lower depressive symptoms than those from the “Never/1–2 times a week” group. The findings of this study reveal that the regular consumption of green and yellow vegetables is associated with lower depressive symptoms in adolescents, that is, the consumption of green and yellow vegetables may be vital in the context of adolescents’ mental health. [ABSTRACT FROM AUTHOR]

Aim and objective: To explore the accuracy with which nursing students can identify the fundamentals of care. Background: A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. Design: Cross‐sectional descriptive design. Methods: A total of 398 nursing students (pre‐ and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. Results: The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre‐ and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. Conclusions: Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. Relevance to clinical practice: To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients. [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. The aim of this randomized controlled study was to investigate the effects of insoles with a toe-grip bar on toe function and standing balance in healthy young women. Methods. Thirty female subjects were randomly assigned to an intervention group or a control group. The intervention group wore shoes with insoles with a toe-grip bar. The control group wore shoes with general insoles. Both groups wore the shoes for 4 weeks, 5 times per week, 9 hours per day. Toe-grip strength, toe flexibility, static balance (total trajectory length and envelope area of the center of pressure), and dynamic balance (functional reach test) were measured before and after the intervention. Results. Significant interactions were observed for toe-grip strength and toe flexibility (F=12.53, p<0.01; F=5.84, p<0.05, resp.), with significant improvement in the intervention group compared with that in the control group. Post hoc comparisons revealed that both groups showed significant improvement in toe-grip strength (p<0.01 and p<0.05, resp.), with higher benefits observed for the intervention group (p<0.01). Conversely, no significant interaction was observed in the total trajectory length, envelope area, and functional reach test. Conclusions. This study suggests that insoles with a toe-grip bar contribute to improvements in toe-grip strength and toe flexibility in healthy young women. [ABSTRACT FROM AUTHOR]

Background: Approximately 30% of patients with Crohn disease (CD) are unresponsive to biologies. No previous study has focused on a plant-based diet in an induction phase of CD treatment. Objective: To investigate the remission rate of infliximab combined with a plant-based diet as first-line (IPF) therapy for CD. Methods: This was a prospective single-group trial conducted at tertiary hospitals. Subjects included consecutive adults with a new diagnosis (n = 26), children with a new diagnosis (n = 11), and relapsing adults (n = 9) with CD who were naive to treatment with biologics. Patients were admitted and administered a standard induction therapy with infliximab (5 mg/kg; 3 infusions at 0, 2, and 6 weeks). Additionally, they received a lacto-ovo-semivegetarian diet. The primary end point was remission, defined as the disappearance of active CD symptoms at week 6. Secondary end points were Crohn Disease Activity Index (CDAI) score, C-reactive protein (CRP) concentration, and mucosal healing. Results: Two adults with a new diagnosis were withdrawn from the treatment protocol because of intestinal obstruction. The remission rates by the intention-to-treat and per-protocol analyses were 96% (44/46) and 100% (44/44), respectively. Mean CDAI score (314) on admission decreased to 63 at week 6 (p < 0.0001). Mean CRP level on admission (5.3 mg/dL) decreased to 0.2 (p < 0.0001). Mucosal healing was achieved in 46% (19/41) of cases. Conclusion: IPF therapy can induce remission in most patients with CD who are naive to biologics regardless of age or whether they have a new diagnosis or relapse. (The study ID number is UMIN000019061, UMIN000020335: Registration at www. umin.ac.jp). [ABSTRACT FROM AUTHOR]

Although self-efficacy has been used extensively in the field of nursing (e.g., as an outcome measure of nursing interventions), its underlying nature is poorly understood. Investigation of the relationship between self-efficacy and brain activation will help explain the fundamental nature of self-efficacy. In this study, we compared prefrontal activation measured with near-infrared spectroscopy (NIRS) across 89 undergraduate students categorized into three groups based on their General Self-Efficacy Scale scores: low self-efficacy (n = 59), moderate self-efficacy (n = 17), and high self-efficacy (n = 13). Changes in the hemoglobin levels of the prefrontal cortex (PFC) during a verbal fluency task were assessed using two-channel NIRS. Significant differences in the oxygenated hemoglobin (oxy-Hb) level of the left PFC (LPFC) were observed via analysis of variance. Post hoc Tukey’s test showed a significant difference only between low self-efficacy and moderate self-efficacy groups. We found a medium between-group effect size in the moderate self-efficacy group versus the low self-efficacy group for the changes in oxy-Hb levels of the LPFC (d = .78; 95% confidence interval for effect size [0.22, 1.33]). No significant between-group differences were observed with respect to changes in the oxy-Hb in the right PFC. The results indicate less left prefrontal activation in the low self-efficacy group than in the moderate self-efficacy group. These findings provide evidence to support the fundamental nature of self-efficacy. [ABSTRACT FROM AUTHOR]

This longitudinal descriptive study examined whether rectal cancer patients report changes in health-related quality of life ( HRQOL) over a 6-month period after different types of sphincter-saving surgery ( SSS): intersphincteric resection ( ISR), ultra-low anterior resection ( ULAR) and low anterior resection ( LAR). It also compares HRQOL among the three groups of patients. Seventy-three patients from two hospitals in Japan completed questionnaires on HRQOL and defecation symptoms immediately before surgery and 1 and 6 months afterwards. Results showed that ISR patients had significantly worse HRQOL scores than ULAR and LAR patients and more defecation symptoms that persisted during the 6 months post- SSS. Thus, patients undergoing ISR require psychological and social support, including skills in competent self-management, during the early post-operative period. Furthermore, defecation problems substantially influence HRQOL. The first month post- SSS is particularly challenging. The assumption that HRQOL is better after SSS compared to living with a permanent stoma might not be valid. [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]

Background: Vascular CD34+ cells in anterior cruciate ligament (ACL) tissue have the potential for high proliferation and multilineage differentiation that can accelerate tendon-bone healing. While patient characteristics, such as age, can affect tendon-bone healing, the influence of elapsed time after injury on the healing process is unclear. Hypothesis: Cells obtained during the early phase after injury will exhibit a greater tendon-bone healing potential compared with chronic phase counterparts when applied to an immunodeficient rat model of ACL reconstruction. Study Design: Controlled laboratory study. Methods: Adult human ACL-ruptured tissue was harvested from patients undergoing arthroscopic primary ACL reconstruction and classified into 2 groups based on the time elapsed between injury and surgery: (1) early group (≤3 months from injury) and (2) chronic group (>3 months from injury). In addition, 76 ten-week-old female immunodeficient rats underwent ACL reconstruction, followed by intracapsular administration of one of the following: (1) ACL-derived cells from the early group (n = 5), (2) ACL-derived cells from the chronic group (n = 5), or (3) phosphate-buffered saline (PBS) only (n = 5). During the 8 weeks after surgery, histological (weeks 2, 4, 8), immunohistochemical (week 2), radiographic (weeks 0, 2, 4, 8), and biomechanical (week 8) analyses were performed to evaluate tendon-bone healing. Results: In the early group, the histological evaluation showed early healing, induction of endochondral ossification–like integration, and mature bone ingrowth. Micro–computed tomography showed that the tibial bone tunnels at week 4 and week 8 were significantly reduced in the early group compared with those in the chronic group and PBS group (P < .05). Moreover, biomechanical tensile strength was significantly greater in the early group than in the other groups (P < .05). An accelerated healing potential in the early group was further demonstrated by the enhancement of intrinsic angiogenesis/osteogenesis and human-derived vasculogenesis/osteogenesis. Conclusion: Compared with human ACL-derived cells obtained during the chronic phase, cells obtained during the early phase after injury have a greater tendon-bone healing potential when used in an immunodeficient rat model of ACL reconstruction. Clinical Relevance: During ACL reconstruction surgery, transplanting ACL remnant tissue in the early phase after injury could accelerate and enhance tendon-bone healing. [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]