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This study aimed to assess the fertility knowledge of Japanese education undergraduates who plan to become schoolteachers and examine related factors. A cross-sectional questionnaire survey was conducted with 252 first-year education undergraduates at a Japanese university. The Cardiff Fertility Knowledge Scale (CFKS) was used to measure fertility knowledge, and other items inquiring about basic reproductive knowledge were included. We assessed the relationship between fertility knowledge and gender and the experience of future life planning, among other factors. We found that fertility knowledge varied. Participants possessed a relatively good knowledge of the relationships between fertility and female ageing, and smoking, but limited knowledge about the effect of sexually transmitted infections on fertility. Male participants answered more correctly than female participants (p < 0.01) regarding 'sperm production'; however, female respondents answered more accurately than male respondents (p < 0.01) regarding 'timing of menopause. In Japan, the national curriculum standard for upper secondary schools was revised in 2018, and fertility was added to the Health and Physical Education curriculum. The study results suggested that it is important to include fertility in a sex education teaching curriculum for education undergraduates to enable them to deliver fertility education as teachers in the future.

The menarche age in girls with intellectual disability and high support needs (HSN) is approximately the same as in girls with typical development. However, there is no clear teaching procedure for menstrual hygiene management (MHM) skills before menarche. This study examined whether a menstrual education program that focuses on visual support affects the MHM skills of girls with intellectual disability/HSN. The study comprised 11 preadolescent girls with intellectual disability/HSN in their pre-menarche age. They were asked to change napkins on a doll three times: before, immediately following, and one month after attending the program. Fifteen MHM items were measured. The participants' scores were significantly higher after attending the program. There was no significant difference in the mean scores for each of the 15 items among the levels of intellectual disability. The program that utilized visual materials was effective, and the effect was not influenced by age or intellectual level.

In order to examine whether syntactic processing is a necessary prerequisite for semantic integration in Japanese, cortical activation was monitored while participants engaged in silent reading task. Congruous sentences (CON), semantic violation sentences (V-SEM), and syntactic violation sentences (V-SYN) were presented in the experiment. The participants' oxygenated hemoglobin concentration changes during the reading task were measured using functional near-infrared spectroscopy. The results suggest that the CON sentences did not require additional cognitive load on syntactic processing or semantic processing. The V-SEM sentences demanded great cognitive load on semantic processing. Besides, it also elicited great cognitive load on syntactic processing. The V-SYN sentences induced great cognitive load on syntactic processing, but it did not induce additional load on semantic processing. These evidence demonstrates that, in Japanese language processing, the difficultness of semantic processing could influence the difficultness of syntactic processing, while the difficultness of syntactic processing would not influence the difficultness of semantic processing. Our findings are suggestive of the possibility that in Japanese language reading, semantic processing precedes syntactic processing, or semantic processing and syntactic processing are in parallel.

Children with severe motor and intellectual disabilities (CSMID) face challenges in the transition from childhood to adult life after graduation, including changing health conditions caused by the acceleration of secondary disabilities, transition from paediatric to adult health care, and transition to places where they spend time after graduation from high school. However, no conceptual framework is currently available to explore this issue from a multifaceted perspective. This literature review aimed to fill this gap using the International Classification of Functioning, Disability and Health: Children & Youth version (ICF-CY) coding system. Through a descriptive analysis, ICF-CY codes were compared with the factors identified as relevant to CSMID by previous studies. The related ICF-CY codes were then extracted. Several codes within the ICF-CY domains of Body Functions and Body Structures, Activities, Participation, and Environmental Factors were thought to be important to understand CSMID. Some relevant Personal Factors were identified as well. Using the newly created conceptual framework, the support for CSMID can be more effective, allowing them to live a more fulfiling life.

Purpose: The aim of this study was to investigate a structured approach for effective speech therapy (ST) for dysarthria and speech-related quality of life in patients with sporadic spinocerebellar degeneration (SCD), including cerebellar-type multiple-system atrophy and cerebellar cortical atrophy. Method: Twenty-two patients with SCD (cerebellar-type multiple system atrophy, 15 patients; cerebellar cortical atrophy, seven patients) who underwent intensive ST were examined. Dysarthria was evaluated using the Scale for Assessment and Rating of Ataxia Speech Dysfunction, Assessment of Motor Speech for Dysarthria Articulation, oral diadochokinesis (OD), and Voice Handicap Index-10 (VHI-10). Respiratory muscle strength (inspiratory and expiratory pressure) and respiratory-phonatory coordination (maximum phonation time) were measured. Cognitive function was evaluated using the Montréal Cognitive Assessment and the word fluency test. Mood was evaluated using the Hospital Anxiety and Depression Scale. The relationships between dysarthria scales (particularly, VHI-10) and clinical data were analyzed using stepwise regression. The differences in outcomes after intensive ST were analyzed using the Wilcoxon signed-rank test. The alpha level (p) for statistical significance was set at 0.0125 by Bonferroni correction. Results: For both pre- and post-ST, the patient's OD (p = 0.002) and maximum phonation time (p = 0.002) significantly improved, except for Speech Dysfunction scores of the Scale for Assessment and Rating of Ataxia (p = 0.705) and the VHI-10 (p = 0.018). The Assessment of Motor Speech for Dysarthria Articulation, OD, and inspiratory pressure were identified as independent variables of VHI-10 (adjusted R[subscript 2] = 0.820) for speech-related quality of life; no correlations among the Montréal Cognitive Assessment, word fluency test, and Hospital Anxiety and Depression Scale scores were observed. Conclusion: OD and VHI-10 showed improvements due to changes in speech function and respiratory-phonatory coordination, justifying intensive ST treatment for dysarthria in patients with SCD.

This study aims to find out how students prepared for a flipped classroom and to examine what type of instruction could effectively guide students to do pre-class preparation. We conducted case studies for over two years in a physiology class at a Japanese university. In a survey performed in 2017, students were asked to participate in a questionnaire and an interview. Their responses in the questionnaire indicated that there was a clear and positive correlation between their class preparation time and individual grades, while class preparation of some students was proven not so productive or efficient. By the same token, the student interview made clear that students were not well informed of what to focus on or how to prepare appropriately for the flipped classes. Based on the 2017 findings, we started to share learning objectives with students for their pre-class preparation in the 2018 course. Amid and after the 2018 spring semester, questionnaires were administered to examine the effectiveness of instructions for preparation, and of sharing learning objectives to measure the level of students' metacognition. As a result, the students who continuously review the learning objectives achieved significantly higher grades than the students who did not. We also found that the level of students' metacognition exerted a stronger influence on their grades than the amount of effort invested in reviewing the learning objectives for pre-class preparation. In conclusion, our study suggests that instructors should design a comprehensive flipped class model which maximizes the benefit of pre-class preparation time by envisioning that students' preparation would be more sustainable and effective with proper guidance.

Job interviews are significant barriers for individuals with autism spectrum disorder because these individuals lack good nonverbal communication skills. We developed a job interview training program using an android robot. The job interview training program using an android robot consists the following three stages: (1) tele-operating an android robot and conversing with others through the android robot, (2) a face-to-face mock job interview with the android robot, and (3) feedback based on the mock job interview and nonverbal communication exercises using the android robot. The participants were randomly assigned to the following two groups: one group received a combined intervention with "interview guidance by teachers and job interview training program using an android robot" (n = 13), and the other group received an intervention with interview guidance by teachers alone (n = 16). Before and after the intervention, the participants in both groups underwent a mock job interview with a human interviewer, who provided outcome measurements of nonverbal communication, self-confidence, and salivary cortisol. After the training sessions, the participants who received the combined interview guidance by teachers and the job interview training program using an android robot intervention displayed improved nonverbal communication skills and self-confidence and had significantly lower levels of salivary cortisol than the participants who only received interview guidance by teachers. The job interview training program using an android robot improved various measures of job interview skills in individuals with autism spectrum disorder.

The objective of this study was to investigate relationships between caregiver-reported sensory processing abnormalities, and the physiological index of auditory over-responsiveness evaluated using acoustic startle response measures, in children with autism spectrum disorders and typical development. Mean acoustic startle response magnitudes in response to 65-105 dB stimuli, in increments of 10 dB, were analyzed in children with autism spectrum disorders and with typical development. Average peak startle latency was also examined. We examined the relationship of these acoustic startle response measures to parent-reported behavioral sensory processing patterns in everyday situations, assessed using the Sensory Profile for all participants. Low-threshold scores on the Sensory Profile auditory section were related to acoustic startle response magnitudes at 75 and 85 dB, but not to the lower intensities of 65 dB. The peak startle latency and acoustic startle response magnitudes at low-stimuli intensities of 65 and 75 dB were significantly related to the low-threshold quadrants (sensory sensitivity and sensation avoiding) scores and to the high-threshold quadrant of sensation seeking. Our results suggest that physiological assessment provides further information regarding auditory over-responsiveness to less-intense stimuli and its relationship to caregiver-observed sensory processing abnormalities in everyday situations.

This paper aims to determine via responses to three questionnaire surveys how sexuality education programs are conducted at junior high schools in Japan. Study 1 examined the practice of sexuality education in schools, Study 2 investigated junior high school students' (age 12-13 and 14-15 years) knowledge of sexuality, and Study 3 examined parents'/guardians' views on sexuality education. For Study 1, 703 principals of 5158 junior high schools returned an original questionnaire (13.6% recovery rate), and for Studies 2 and 3, 9492 students and 5374 parents returned questionnaires (86.2% and 60.3% recovery rate, respectively). In Study 1, an average of 9.19 hours of instruction was allocated to sexuality education over three grades. In Study 2, the average correct response rate was as low as 34.5% for boys and 39.4% for girls, with many answering "I don't know." Approximately one-half of the boys indicated there was nothing in particular they wanted to know about sex and no-one they wanted to consult. In Study 3, parents viewed school as a more appropriate setting than home for teaching physiological aspects of sexuality and providing accurate information. From the results of the three studies, we discuss the current situation and future challenges for sexuality education in Japan. (Contains 9 tables.)

We investigated changes in movement kinematics and attentional focus when expert and novice golfers performed a golf-putting task under pressure. Six male professional golfers and five male novice golfers performed 100 acquisition trials, followed by 10 trials in the pressure condition with a performance-contingent cash reward and small audience. After the 10 trials in the pressure condition, participants answered a questionnaire concerning attentional focus during both types of trial, including such aspects as conscious control of movements and the effects of distraction. A pressure manipulation check revealed a modest increase in physiological arousal, in that heart rate increased by about 10 bpm although state anxiety did not increase. A two-dimensional analysis of movement kinematics revealed that the amplitudes of arm and club movements decreased on the backswing in the pressure condition. Arm and club movement speed decreased on the foreswing in both experts and novices. Furthermore, neither experts nor novices changed their attentional focus in the pressure condition. Whereas previous studies of "choking under pressure" focused on attentional changes, the kinematic changes found in the present study were possibly caused by the influences of strategy modification and/or emotional response. Choking phenomena can be explained by attentional changes, along with the influences of strategy modification and/or emotional response under pressure. (Contains 4 tables and 1 figure.)

Lemna aequinoctialis Welw. is a widely spread species that has diverse physiological and molecular properties. Flower characteristics are important factors in deducing taxonomical status; however, owing to the rarity of flowering observations in Lemna, studying them has been a prolonged challenge. In this study, physiological and morphological analyses were conducted by inducing flowering, and molecular analysis was done based on the two chloroplast DNA loci (matK, atpF−atpH intergeneric spacer) of L. aequinoctialis sensu Landolt (1986) from 70 strains found in 70 localities in Japan, Korea, Thailand, and the US. In total, 752 flowering fronds from 13 strains were observed based on axenic conditions. Two different trends in flower organ development—protogyny and adichogamy—were detected in these strains. Their physiological traits were divided into two groups, showing different morphological features based on frond thickness, root cap, and anther sizes. Molecular analysis showed two lineages corresponding to two physiological groups. These were identified as L. aequinoctialis sensu Beppu et al. (1985) and L. aoukikusa Beppu et Murata based on the description of the nomenclature of L. aoukikusa. These were concluded as independent taxa and can be treated as different species. Furthermore, the distribution of L. aoukikusa is not only limited to Japan. [ABSTRACT FROM AUTHOR]

Dialysis treatment has improved the survival of patients with kidney failure. However, the hospitalization and mortality rates remain alarmingly high, primarily due to incomplete uremic toxin elimination. High-volume hemodiafiltration (HDF) has emerged as a promising approach that significantly improves patient outcomes by effectively eliminating medium and large uremic toxins, which explains its increasing adoption, particularly in Europe and Japan. Interest in this therapy has grown following the findings of the recently published CONVINCE study, as well as the need to understand the mechanisms behind the benefits. This comprehensive review aims to enhance the scientific understanding by explaining the underlying physiological mechanisms that contribute to the positive effects of HDF in terms of short-term benefits, like hemodynamic tolerance and cardiovascular disease. Additionally, it explores the rationale behind the medium-term clinical benefits, including phosphorus removal, the modulation of inflammation and oxidative stress, anemia management, immune response modulation, nutritional effects, the mitigation of bone disorders, neuropathy relief, and amyloidosis reduction. This review also analyzes the impact of HDF on patient-reported outcomes and mortality. Considering the importance of applying personalized uremic toxin removal strategies tailored to the unique needs of each patient, high-volume HDF appears to be the most effective treatment to date for patients with renal failure. This justifies the need to prioritize its application in clinical practice, initially focusing on the groups with the greatest potential benefits and subsequently extending its use to a larger number of patients. [ABSTRACT FROM AUTHOR]

Toyotamaphimeia is an extinct crocodylian lineage whose name is derived from a mythological Japanese princess. Here, we re-examine the type specimens of a long-forgotten species: Tomistoma taiwanicus from the Pleistocene of Tainan (Taiwan) and revise its taxonomic status to Toyotamaphimeia taiwanicus n. comb., leading to the first recognized species of Toyotamaphimeia outside Japan. Our phylogenetic analyses also support this taxonomic assignment and, more interestingly, further suggest an East Asian lineage. In addition, Toyotamaphimeia taiwanicus n. comb. represents a tropical species, resolving a long-standing puzzle of why Toyotamaphimeia only inhabited a much higher latitudinal area (Japan). Given the large body size of Toyotamaphimeia taiwanicus n. comb. (~7 m) and the fact that it is geologically older than Toyotamaphimeia machikanensis from Japan, we propose a novel evolutionary scenario: the genus Toyotamaphimeia originated in Taiwan and evolved to a large body size with gigantothermic physiology, which resulted in migration out of Taiwan and dispersal farther north to Japan. Our taxonomic identification shows the presence of an extinct endemic crocodylian species from the Pleistocene of Taiwan with large-scale paleogeographic implications. This study, with our recent progress in vertebrate paleontology in Taiwan, should provoke more in-depth paleontological research on the Pleistocene extinction. [ABSTRACT FROM AUTHOR]

Consecutive sexual maturation (CSM), an abnormal reproductive phenomenon of a marine snail, Reishia clavigera, has occurred since 2017 in the vicinity of the Fukushima Daiichi Nuclear Power Plant after the nuclear disaster there. We hypothesized that alterations in animal physiology mediated through genetic/epigenetic changes could sensitively reflect environmental pollution. Understanding the mechanism of this rapid biological response should enable us to quantitatively evaluate long-lasting effects of the nuclear disaster. To determine the molecular basis for CSM, we conducted transcriptome profiling in the ganglia of normal and CSM snails. We assembled the short-read cDNA sequences obtained by Illumina sequencing, and succeeded in characterizing more than 60,000 gene models that include 88 kinds of neuropeptide precursors by BLAST search and experimental curation. GO-enrichment analysis of the differentially expressed genes demonstrated that severe downregulation of neuropeptide-related genes occurred concomitantly with CSM. In particular, significant decreases of the transcripts of 37 genes among 88 neuropeptide precursor genes, including those for myomodulin, PentaFVamide, maturation-associated peptide-5A and conopressin, were commonly observed in female and male CSM snails. By contrast, microseminoprotein precursor was the only exceptional case where the expression was increased in CSM snails. These results indicate that down-regulation of neuropeptide precursors is a remarkable feature of CSM. We also found that factors involved in epigenetic modification rather than transcription factors showed altered patterns of expression upon CSM. Comprehensive expression panels of snail neuropeptide precursors made in this study will be useful tools for environmental assessment as well as for studying marine reproductive biology. [ABSTRACT FROM AUTHOR]

The objective of this study was to holistically examine the impact of long-haul transmeridian travel (LHTT) on perceptual, mood, sleep and physiological markers in Olympic team support staff travelling to Japan for the 2020 Summer Olympic Games. An observational descriptive study design was used. Nine support staff members of the Irish Olympic team (2 M/7 F; age 34.3 ± 8.3 y (mean ±SD)) embarked on a long-haul (LH) eastward flight across eight time-zones from Ireland to Japan (approx. 24 h total travel time), to work at the Irish Team's 2020 Summer pre-Olympic Games camp, postponed to July 2021 due to Covid-19 pandemic. Perceived jet lag and travel fatigue symptoms, mood states and salivary markers for circadian rhythm and stress were assessed in the morning and evening during the week prior to travel as baseline (BL) measures and on days 1 to 8 (C1-C8) and day 15 (C15) post-travel. Night-time sleep (duration and quality) was monitored via actigraphy monitors and self-report sleep diaries. Participants perceived themselves to be significantly jet lagged for six days post-travel (p <.05). Morning sCort decreased by 66% on C1 and remained significantly lower than BL until C6 (p ≤.03). On arrival participants perceived sleep to be worse than BL on arrival (C1, C2, C4, C5; p ≤.04), with significantly shorter sleep duration (C2, C3, C6; p ≤.01) and lower sleep efficiency (C2, C6; p ≤.04) recorded by actigraphy, all normalizing by C7. Negative changes in mood states were evident in the evening time following LHTT, with significant elevations in confusion (C2, C3, p ≤.02), fatigue (C2, C3; p ≤.03) and depression (C3, C7; p <.05) and reduction in vigour (C2, C6, C7; p <.05). Following LHTT in an eastward direction across eight time-zones, it took seven days for perceived jet lag, physiological markers for circadian rhythm and sleep to normalize in Olympic team support staff. Despite alleviation of jet lag and fatigue and return of sleep to normal by C15, vigor remained low, indicating a "submerged" mood profile in these Olympic team support staff. These findings highlight the need to put strategies in place before and after LHTT for the Olympic Games to assist Olympic team support staff to maximize sleep, minimize stress and assist with expediating recovery from jet lag and travel fatigue, allowing them to perform optimally in supporting Olympic athletes in their final preparations for the Games. [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]

Background: The Report Card on Physical Activity for Children and Youth aims to consolidate existing evidence, encourage greater evidence-informed physical activity, and improve surveillance of physical activity. Methods: The Japan report card followed the methodology of the Canadian and Scottish report cards, but was adapted to reflect the Japanese context. Nationally representative data were used to score each of the respective indicators. Results: The 2016 Japan Report Card on Physical Activity for Children and Youth consists of Health Behaviors and Outcomes (7 indicators), and Influences on Health Behaviors (4 indicators). Three Health Behaviors and Outcomes received C grades (Participation in Sport; Sedentary Behavior; Recreational Screen Time; Physical Fitness), while 2 indicators could not be graded (Overall Physical Activity, and Active Play). The indicators Active Transportation (B) and Weight Status were favorable (A). In the Influences domain, Family Influence and Community and the Built Environment were graded as D, while School and Government Strategies and Investments were favorable (B). Conclusions: The Japan report card illustrated some favorable health behaviors, health outcomes, and influences. There is a need for more evidence especially on overall physical activity levels, active play, and community and the built environment. [ABSTRACT FROM AUTHOR]

The effects of climate change on forest ecosystems take on increasing importance more than ever. Information on plant traits is a powerful predictor of ecosystem dynamics and functioning. We reviewed the major ecological traits, such as foliar gas exchange and nutrients, xylem morphology and drought tolerance, of Cryptomeria japonica and Chamaecyparis obtusa, which are major timber species in East Asia, especially in Japan, by using a recently developed functional trait database for both species (SugiHinokiDB). Empirically, C. obtusa has been planted under drier conditions, whereas C. japonica, which grows faster but thought to be less drought tolerant, has been planted under wetter conditions. Our analysis generally support the empirical knowledge: The maximum photosynthetic rate, stomatal conductance, foliar nutrient content and soil-to-foliage hydraulic conductance were higher in C. japonica than in C. obtusa. In contrast, the foliar turgor loss point and xylem pressure corresponding to 50% conductivity, which indicate drought tolerance, were lower in C. obtusa and are consistent with the drier habitat of C. obtusa. Ontogenetic shifts were also observed; as the age and height of the trees increased, foliar nutrient concentrations, foliar minimum midday water potential and specific leaf area decreased in C. japonica, suggesting that nutrient and water limitation occurs with the growth. In C. obtusa, the ontogenetic shits of these foliar traits were less pronounced. Among the Cupressaceae worldwide, the drought tolerance of C. obtusa, as well as C. japonica, was not as high. This may be related to the fact that the Japanese archipelago has historically not been subjected to strong dryness. The maximum photosynthetic rate showed intermediate values within the family, indicating that C. japonica and C. obtusa exhibit relatively high growth rates in the Cupressaceae family, and this is thought to be the reason why they have been selected as economically suitable timber species in Japanese forestry. This study clearly demonstrated that the plant trait database provides us a promising opportunity to verify out empirical knowledge of plantation management and helps us to understand effect of climate change on plantation forests by using trait-based modelling. [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]

Lumbar spinal stenosis is one of the most commonly diagnosed spinal disorders worldwide and remains a major cause for surgery in older adults. Lumbar spinal stenosis is clinically defined as a progressive degenerative disorder with low back pain and associated neurogenic intermittent claudication. Conservative and surgical management of lumbar spinal stenosis has been shown to be minimally effective on its symptoms. A treatment option that has not been investigated in the United States is the utilization of prostaglandin E1 analogs, which have been used primarily in Japan for the treatment of lumbar spinal stenosis since the 1980s. The vasodilatory and antiplatelet aggregation effects of prostaglandin E1 presumably improve symptoms of lumbar spinal stenosis by increasing blood flow to the spinal nerve roots. This brief report examines the potential vascular pathology of lumbar spinal stenosis, reviews evidence on the use of prostaglandin E1 analog limaprost in Japan for lumbar spinal stenosis, and briefly discusses misoprostol as a possible alternative in the United States. The studies summarized in this report suggest that prostaglandin E1 analogs may provide benefit as a conservative treatment option for patients with lumbar spinal stenosis. However, higher-quality studies conducted in the United States and comparison with other currently used conservative treatments are required before it can be recommended for routine clinical use. [ABSTRACT FROM AUTHOR]

A macrourid, Coryphaenoides yaquinae sp. inc., was observed to be attracted to bait and exhibiting normal foraging behaviour during a period of 80 min within view of a baited video camera on the sea floor at 7259 m - the deepest ever observation of a fish species with a swim bladder. The buoyancy provided by an oxygen-filled swim bladder at 74.4 MPa pressure was estimated to be 0.164 N, at a theoretical energy cost of 20 kJ, 200 times less than the cost of equivalent lipid buoyancy. During normal metabolism, 192 days would be required to fill the swimbladder. At these depths, oxygen is very incompressible, so changes in volume during ascent or descent are small. However, swimbladder function is crucially dependent on a very low rate of diffusion of oxygen across the swimbladder wall. The oxygen in the swimbladder could theoretically sustain aerobic metabolism for over 1 year but is unlikely to be used as a reserve., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2024. Published by The Company of Biologists Ltd.)

• Japanese adults have low CRP and IL-6 when compared to American and Europeans. • Low levels of inflammatory activity are associated in part with less obesity. • Consuming tea, fish, vegetables and bathing were predictive of lower CRP and IL-6. Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly – among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan. [ABSTRACT FROM AUTHOR]

The low bath bicarbonate concentration ([ HCO3- ]) used by a nephrology group in Japan (25.5 mEq/L), coupled with a bath [acetate] of 8 mEq/L, provided an opportunity to study the acid-base events occurring during hemodialysis when HCO3- flux is from the patient to the bath. We used an analytic tool that allows calculation of HCO3- delivery during hemodialysis and the physiological response to it in 17 Japanese outpatients with an average pre-dialysis blood [ HCO3- ] of 25 mEq/L. Our analysis demonstrates that HCO3- addition is markedly reduced and that all of it comes from acetate metabolism. The HCO3- added to the extracellular fluid during treatment (19.5 mEq) was completely consumed by H+ mobilization from body buffers. In contrast to patients dialyzing with higher bath [ HCO3- ] values in the US and Europe, organic acid production was suppressed rather than stimulated. Dietary analysis indicates that these patients are in acid balance due to the alkaline nature of their diet. In a larger group of patients using the same bath solution, pre-dialysis blood [ HCO3- ] was lower, 22.2 mEq/L, but still in an acceptable range. Our studies indicate that a low bath [ HCO3- ] is well tolerated and can prevent stimulation of organic acid production. [ABSTRACT FROM AUTHOR]

Truffle species indigenous to Japan include a white-colored truffle Tuber japonicum and two black-colored truffles, T. himalayense and T. longispinosum. As the fruiting bodies of these Tuber species are promising edible, studies on the artificial cultivation for these truffles are currently underway in Japan. In the present study, we investigated the influence of pH on in vitro mycelial growth in these Tuber species to determine the optimal pH conditions for the cultivation of these truffles. Mycelia of five strains from each species were cultured in modified Melin–Norkrans liquid medium at different pH values. Tuber japonicum grew well at pH 5.0 and 6.0, whereas T. himalayense and T. longispinosum grew well at pH 7.0. This results suggest that the optimal pH for mycelial growth varies among Tuber species. The growth data collected in this study can be used to design optimal pH conditions for artificial cultivation of these Japanese truffles. • The optimal pH for mycelial growth varies among truffle species. • Tuber japonicum grows well at pH 5.0 and 6.0. • Tuber himalayense and T. longispinosum grow well at pH 7.0. [ABSTRACT FROM AUTHOR]

Hypophosphatasia (HPP) is a rare and intractable metabolic bone disease caused by mutations in the ALPL gene. Here, we undertook a nationwide survey of HPP in Japan, specifically regarding the prominent genetic and dental manifestations of odonto (n = 16 cases) and other (termed "non-odonto") (n = 36 cases) types. Mean serum alkaline phosphatase (ALP) values in odonto-type patients were significantly greater than those of non-odonto-type patients (P<0.05). Autosomal dominant and autosomal recessive inheritance patterns were detected, respectively, in 89% of odonto-type and 96% of non-odonto-type patients. The ALPL "c.1559delT" mutation, associated with extremely low ALP activity, was found in approximately 70% of cases. Regarding dental manifestations, all patients classified as odonto-type showed early exfoliation of the primary teeth significantly more frequently than patients classified as non-odonto-type (100% vs. 56%; P<0.05). Tooth hypomineralisation was detected in 42% of non-odonto-type patients, but not in any odonto-type patients (0%; P<0.05). Collectively, these results suggest that genetic and dental manifestations of patients with odonto-type and non-odonto-type HPP are significantly different, and these differences should be considered during clinical treatment of patients with HPP. [ABSTRACT FROM AUTHOR]

Background: The extent of medication adherence in patients with type 2 diabetes mellitus (T2DM) several years after starting treatment with hypoglycemic agents remains unknown. Most previous work on medication adherence targeting this group of patients has been undertaken across a single year or is questionnaire based. This study aimed to determine medication adherence status and factors affecting adherence 3 years after initiation of hypoglycemic agents, using a nationwide medical claim-based database in Japan. Methods: This retrospective study was conducted on data from 884 subjects with T2DM to better understand medication adherence, the effects of polypharmacy, and other factors. We also investigated the effects of medication nonadherence on hemoglobin A1c levels. Proportion of days covered was defined as the number of days for which a hypoglycemic agent was prescribed and in the patient’s possession to the number of days in the observation period. A proportion of days covered ≥0.8 were considered adherent, and those with a value <0.8 as nonadherence. Polypharmacy was defined as taking ≥5 medications. Results: Of the 884 patients investigated, 440 were considered adherent during the study period. Significant factors related to adherence included number of medications (3 or 4, or ≥5), male sex, age 50–<60 years, and total number of visits ≥17. Medication adherence was also a factor related to patients with hemoglobin A1c values < 7.0% at the end of the observation period. Conclusions: We surveyed medication adherence for 3 years with post medication initiation, and found that subjects aged 50–<60 years, those with ≥3 concomitant medications, and those with a total number of visits ≥17 were more likely to be adherent and persistent, and more likely to continue their hypoglycemic agents. A high degree of medication adherence was found to have a positive influence on hemoglobin A1c levels. [ABSTRACT FROM AUTHOR]

Background: Evidence indicates that human circadian rhythm is affected by the intestinal microbiota, and establishment of the circadian rhythm begins during fetal development. However, the relationship between maternal fermented food intake and infant sleep duration has not been previously investigated. In this study, we examined whether dietary consumption of fermented food during pregnancy is associated with infant sleep duration at 1 year of age. Methods: This birth cohort study used data from a nationwide government-funded study called The Japan Environment and Children’s Study (JECS). After exclusions from a dataset comprising 104,065 JECS records, we evaluated 72,624 mother-child pairs where the child was 1 year old. We investigated the association between dietary intake of fermented foods during pregnancy and infant sleep duration of less than 11 h at 1 year of age. Results: Multivariable logistic regression showed that maternal intake of fermented food, especially miso, during the pregnancy was independently associated with reduced risk of infant sleep duration of less than 11 h. Conclusions: Further research, including interventional studies, is warranted to confirm the association between consumption of fermented foods during pregnancy and sufficient infant sleep duration. Trial registration: . [ABSTRACT FROM AUTHOR]

Design: Randomized controlled study. Setting: Laboratory. Participants: 26 healthy swimmers randomly assigned to an exercise (n = 13; Ex) or control group (n = 13; Cont). Intervention: The Ex group performed respiratory-muscle exercises for 10 min thrice a week for 4 wk. Context: Respiratory-muscle exercises are used not only in the rehabilitation of patients with respiratory disease but also in endurance training for athletes. Respiration involves the back and abdominal muscles. These muscles are 1 of the elements responsible for posture control, which is integral to injury prevention and physical performance. However, the effects of respiratory-muscle exercise on posture remain unclear. Objective: To examine the potential of respiratory-muscle exercise for improving posture. Main Outcome Measures: Spinal curvature, pulmonary function, and trunk-muscle strength were measured for both the groups at baseline and after 4 wk. The data were compared between the Ex and Cont groups with Mann-Whitney U test and preintervention and postintervention within groups with a Wilcoxon signed rank-sum test. Results and Conclusion: The spinal curvature was significantly different in the Ex group, indicating a decrease in the thoracic (-13.1%, P < .01) and lumbar (-17.7%, P < .05) angles. The Ex group presented with lower thoracic (-8.6%) and lumbar (-20.9%) angles at postexercise than the Cont group (P < .05). With respect to trunk-muscle strength, only trunk-flexion strength significantly increased from pretest to posttest in the Ex group (P < .05). For pulmonary function, forced vital capacity and forced expiratory volume in 1.0 s were significantly increased after 4 wk in the Ex group (P < .05). The results suggest that respiratory-muscle exercise straightened the spine, leading to good posture control, possibly because of contraction of abdominal muscles. [ABSTRACT FROM AUTHOR]

The article examines the metabolic responses during water walking (WW) in Japanese men and women from younger age to elderly. Results of the study suggest that exercise intensity is higher in women than in men. The study finds out that absolute intensity was similar in both genders due to the walking speed during WW. It also suggests that metabolic equivalent (MET) references with rating of perceived exertion (RPE) at some WW speeds.

Purpose: The aim of this study was to evaluate human osteoblast activity on thin hydroxyapatite (HA)-coated three-dimensional scaffolds made of titanium fiber web. Materials and Methods: A thin HA film was coated on a titanium fiber web by the molecular precursor method. Human osteoblasts were disseminated onto the uncoated and HA-coated titanium fiber web, and osteoblast activity was observed at days 3, 7, 14, and 21 of culture. Results: Proliferation activities of osteoblasts were significantly higher in the uncoated titanium fiber web. Osteoblasts in the uncoated titanium fiber web showed a typical expression pattern, but those in the HA-coated titanium fiber web showed rapid osteocalcin expression and calcification at an early stage of culture. Moreover, osteocalcin expression per osteoblast was significantly higher in the HA-coated group. Conclusion: These results suggest that HA coating with the molecular precursor method accelerated osteoblast functional activity. [ABSTRACT FROM AUTHOR]

Rice ratooning is the practice of harvesting a second crop grown from the main crop's stubble. The rice–ratoon-rice system is an emerging alternative to a conventional single rice crop in warm-temperate regions (25°N to 30°N). Central Japan (35°N to 36°N) has a favorable growing season of 190–200 d yr−1 for rice, and is considered to represent the northern limit (based on climate and growing season length) for growing a ratoon crop. The objective of this study was to determine the feasibility of the rice–ratoon-rice system in central Japan. Two short-duration japonica cultivars ('Akihikari' and 'Akitakomachi') were grown in a rice–ratoon-rice system and two long-duration and high-yielding japonica cultivars ('Yamadawara' and 'Togo 3′) in a single rice crop system at Tokyo in 2019 and 2020. The annual productivity of the rice–ratoon-rice system (7.6–7.9 t ha−1 yr−1) was 7–25 % lower than that of the single-crop system using high-yielding rice cultivars (8.5–10.2 t ha−1 yr−1), although it was higher than the national average (6.7 t ha−1 yr−1). The aboveground biomass in the ratoon rice crop was 12–33 % of that in the main rice crop. The mean fraction of radiation intercepted by ratoon rice (0.24–0.33) was significantly lower than that of the main rice crop (0.45–0.47). Among the yield components, the number of spikelets m−2 was the most striking factor; it decreased the ratoon rice yield (2600–8400 spikelets m−2) compared with the main rice crop (27,200–42,400 spikelets m−2). Overall, the rice–ratoon-rice system in central Japan is inefficient under the current temperature regime unless high-value premium japonica rice with high ratooning ability can be identified. Future research needs to identify the physiological and morphological mechanisms that limit the yield of ratoon rice in popular short-duration japonica rice accessions, with an emphasis on quick shoot regrowth and tiller regeneration after the first harvest. • Rice–ratoon-rice system was tested in its northern limit (central Japan; 35°N). • Short-duration japonica rice was able to produce 7.6–7.9 t ha−1 yr−1 of grain yield. • A conventional single-crop system produced 8.5–10.2 t ha−1 yr−1 using long-duration rice. • Limited ratooning was suggested to be the main constraint in the rice–ratoon-rice system. [ABSTRACT FROM AUTHOR]

Japanese eel (Anguilla japonica) recruitment to Japan was very low during the early 2017−2018 recruitment season when most glass eels are usually caught, but catches increased in the late recruitment season when recruitment usually decreases. Concurrently, the Kuroshio meander south of Japan had formed again after the previous event ended in 2005. The role of the large meander and ocean circulation features such as the North Equatorial Current (NEC) in the unusual 2017−2018 Japanese eel recruitment timing-pattern was investigated using a three-dimensional particle tracking model that simulated swimming behaviors of virtual larvae (v-larvae) in addition to their drift in ocean currents. Four recruitment seasons were selected for when the Kuroshio large meander was present (2004−2005, 2017−2018) or absent (2009−2010, 2015−2016), and when NEC was shifted north (2004−2005, 2015−2016) or south (2009−2010, 2017−2018). The simulated recruitment timing-patterns were similar to the actual recent-year recruitment, with no early recruitment period v-larvae arrival to southern Japan and increased late period recruitment occurring. Rather than being related to the presence of the Kuroshio large meander, the late arrival appeared to be caused by a southward shifted, weak North Equatorial Current near the spawning area, a longer Subtropical Countercurrent eddy region retention time, and a weak Kuroshio during the early migration and recruitment period of those years. In the late recruitment period, the Kuroshio was stronger than other selected years near the East China Sea and south of Japan and v-larvae were transported more rapidly. The Kuroshio large meander may influence local eel recruitment in Japan, and the recirculation formed by the large meander could potentially enhance recruitment to the Tokai region. Oriented (northwestward) swimming v-larvae were less affected by the large meander, and showed higher recruitment success than those using along-current swimming. Although the Kuroshio large meander did not seem to be responsible for the unusual recruitment pattern in 2018, how Japanese eel larvae and glass eels actually cross out of the Kuroshio and reach coastal waters in Japan remains to be explored. [ABSTRACT FROM AUTHOR]

Background: Though mass evacuation may increase the need for long-term care (LTC) services, how the need for LTC services increases and how the public LTC system affects it is not well understood. We evaluated changes in public LTC benefits for the people living in the mandatory evacuation areas established after the 2011 Fukushima nuclear disaster and examined the roles of the universal LTC insurance system in Japan. Methods: In order to evaluate the effect of the mandatory evacuation on LTC benefits, we examined the trends of LTC benefits in the Fukushima evacuation group and the nationwide non-evacuation group. We first decomposed per-elderly-individual benefits at the municipality level into the LTC certification rate and per-certified-individual benefits, and then implemented difference-in-differences analysis using these variables as outcomes. Results: Per-elderly-individual benefits significantly increased from 2012 onward in the evacuation group, and this was explained by an increase in the certification rate rather than in per-certified-individual benefits. Increases in per-elderly-individual benefits and the certification rate in the post-disaster period were observed in all but the highest care level, and the corresponding outcomes for the highest care level decreased immediately after the disaster. We also found that the increase in the certification rate had been mostly realized by an increase in the number of certified individuals. Conclusions: The increase in LTC benefits can be associated with the impact of the increase in the number of people newly certified to receive LTC benefits after the mandatory evacuation. In order to cope with the increase in utilization of long-term care and associated costs after disasters in aging societies, both formal long-term care services and social support for informal care for evacuees should be considered important. [ABSTRACT FROM AUTHOR]

Brown adipose tissue (BAT) is responsible for non-shivering thermogenesis and is an attractive therapeutic target for combating obesity and related diseases. Human BAT activity has been evaluated by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18FDG-PET/CT) under acute cold exposure, but the method has some serious limitations, including radiation exposure. Infrared thermography (IRT) may be a simple and less-invasive alternative to evaluate BAT activity. In the present study, to establish an optimal condition for IRT, using a thermal imaging camera, skin temperature was measured in the supraclavicular region close to BAT depots (Tscv) and the control chest region (Tc) in 24 young healthy volunteers. Their BAT activity was assessed as the maximal standardized uptake value (SUVmax) by 18FDG-PET/CT. Under a warm condition at 24–27°C, no significant correlation was found between the IRT parameters (Tscv, Tc,, and the difference between Tscv and Tc,, Δtemp) and SUVmax, but 30–120 min after cold exposure at 19°C, Tscv and Δtemp were significantly correlated with SUVmax (r = 0.40–0.48 and r = 0.68–0.76). Δtemp after cold exposure was not affected by mean body temperature, body fatness, and skin blood flow. A lower correlation (r = 0.43) of Δtemp with SUVmax was also obtained when the participant’s hands were immersed in water at 18°C for 5 min. Receiver operating characteristic analysis revealed that Δtemp after 30–60 min cold exposure can be used as an index for BAT evaluation with 74% sensitivity, 92% specificity, and 79% diagnostic accuracy. Thus, IRT may be useful as a simple and less-invasive method for evaluating BAT, particularly for large-scale screening and longitudinal repeat studies. [ABSTRACT FROM AUTHOR]

Objective: To investigate the cost differences between magnetic resonance-guided focussed ultrasound (MRgFUS) and unilateral deep brain stimulation (DBS) for the treatment of medication-refractory essential tremor (ET) in Japan using a cost-minimisation model. Methods: A cost-minimisation model estimated total costs for MRgFUS and unilateral DBS by summing the pre-procedure, procedure, and post-procedure costs over a 12-month time horizon, using data from published sources and expert clinical opinion. The model base case considered medical costs from fee-for-service tariffs. Scenario analyses investigated the use of Diagnosis Procedure Combination tariffs, a diagnosis-related group-based fixed-payment system, and the addition of healthcare professional labour costs healthcare professionals using tariffs from the Japanese Health Insurance Federation for Surgery. One-way sensitivity analyses altered costs associated with tremor recurrence after MRgFUS, the extraction rate following unilateral DBS, the length of hospitalisation for unilateral DBS and the procedure duration for MRgFUS. The impact of uncertainty in model parameters on the model results was further explored using probabilistic sensitivity analysis. Results: Compared to unilateral DBS, MRgFUS was cost saving in the base case and Diagnosis Procedure Combination cost scenario, with total savings of JPY400,380 and JPY414,691, respectively. The majority of savings were accrued at the procedural stage. Including labour costs further increased the cost differences between MRgFUS and unilateral DBS. Cost savings were maintained in each sensitivity analysis and the probabilistic sensitivity analysis, demonstrating that the model results are highly robust. Conclusions: In the Japanese healthcare setting, MRgFUS could be a cost saving option versus unilateral DBS for treating medication-refractory ET. The model results may even be conservative, as the cost of multiple follow-ups for unilateral DBS and treatment costs for adverse events associated with each procedure were not included. This model is also consistent with the results of other economic analyses of MRgFUS versus DBS in various settings worldwide. [ABSTRACT FROM AUTHOR]

Long working hours and a lack of sleep have been suggested to negatively affect the safety of workers. Here, we examined the association between long working hours/sleep-related problems and near-misses/injuries in industrial settings using a nationally representative sample of workers in Japan. Based on the composition ratio of workers by industry, sex, and age in Japan, data from a web-based cross-sectional survey for 18,682 participant full-time workers (7,098 female and 11,584 male; mean age, 43.7 [standard deviation 11.1] years) were analyzed. Nearly 30% and 5% of participants reported any types of near-misses during the past six months and injuries during the past year, respectively. For all types of near-misses and some types of injuries, a significant difference in frequency distribution was observed by industry. After adjustment for demographic, job-, and life-related variables, participants who worked long hours (i.e., more than 51 hours per week) were more likely to report job-related near-misses/injuries than those who worked 35–40 hours per week. The presence of sleep-related problems was also significantly related to near-misses and injuries. However, while sleep-related problems were significantly associated with near-misses/injuries in all industries, the association between long working hours and near-misses/injuries differed by industry. Odds ratios for near-misses/injuries were strongly significant in the “transport/postal services” industry for those who worked more than 51 hours per week compared to those who worked 35–40 hours per week. Comprehensive protective measures for workers, including (1) reducing total hours of service/job-related fatigue, (2) maintaining sufficient sleep hours/good sleep, and (3) increasing awareness about the impact of overwork/long working hours and sleep-related problems on workers’ safety among employers, workers, clients/customers, and the general public might be effective for preventing near-misses and injuries in industrial settings among workers, especially those who work long hours in the “transport/postal services” industry. [ABSTRACT FROM AUTHOR]

Background: There are few reports that objectively show actual health conditions among the homeless or diagnoses of non-communicable diseases based on blood tests. This report discloses the actual data from blood tests and non-communicable diseases among the participants. Furthermore, associations between the test values for lifestyle-related disease and mental disorder/intellectual disability, as well as personal backgrounds of homeless people, were analyzed from the data gathered in the survey. Methods: This study was performed in a rented meeting room close to Nagoya Station on November 2, 2014. Blood samples, physical measurements, blood pressure measurements intellectual faculties were measured. Physical/mental diseases were diagnosed by doctors. Fisher’s exact test was performed to compare between subgroups (by participants’ socio-demographic data or the presence of mental illness/cognitive disability) according to non-communicable disease test values, and to calculate the odds ratio. Results: Abnormalities among participants in test values for non-communicable disease were as follows: hypoalbuminemia in one participant (0.9%), abnormalities in liver function in 22 participants (19.3%), decreased renal function in two participants (1.8%), dyslipidemia in 67 participants (58.8%), "a person whose impaired glucose tolerance cannot be ruled out" in 20 participants (17.5%), obesity in 33 participants (28.9%), thinness in five participants (4.3%), and hypertension in 60 participants (52.6%). Compared to the National health and nutrition survey 2015, non-communicable diseases of the homeless people were similar or slightly better than in the general population in Japan. Participants aged 20–39 years had a significant positive tendency of having liver function abnormality compared to ≥60 years old participants. There was no significant tendency with socio-demographic characteristics in dyslipidemia and “impaired glucose tolerance”. Conclusion: It was found that the percentage of homeless people in Nagoya who showed abnormalities of lifestyle-related disease was similar or better than that of general population in Japan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate how cardiovascular diseases harm labor force participation (LFP) among the Japanese population and verify the validity of plasma biomarkers as instrumental variables of cardiovascular diseases after adjusting for a broad set of confounders including dietary intake. Design: Using nationally representative repeated cross-sectional surveys in Japan, the Comprehensive Survey of Living Conditions and National Health and Nutrition Survey, with plasma biomarkers as instrumental variables for quasi-randomization. Setting: Onset of cardiovascular diseases in those receiving regular treatment for hypertension, intracerebral hemorrhage, intracerebral infarction, angina pectoris, myocardial infarction, or other types of cardiovascular diseases. Participants: A total of 65,615 persons aged ≥ 20 years (35,037 women and 30,578 men) who completed a survey conducted every three years from 1995 through 2013. Main outcome measures: Respondent employment and weekly working hours during each survey year. Results: Cardiovascular diseases significantly and remarkably reduced the probability of working by 15.4% (95% CI: -30.6% to -0.2%). The reduction in working probability was detected for women only. Respondents aged ≥ 40 years were less likely to work once diagnosed and the reduction was enlarged for those aged ≥ 65 years, while those aged < 40 years appeared to be unaffected. Probability of engaging in manual labor significantly decreased once diagnosed; however, no impact was found for cognitive occupations. Among employed respondents, the adverse effects of cardiovascular diseases decreased working hours by five hours per week. Validity of the biomarker instrumental variables was generally verified. Conclusions: A vicious circle is suggested between LFP and unfavorable health. However, the effects vary across age, sex, and occupation type, even after adjusting for causal effects, which could cause a downward bias in LFP impact. Attributes: cardiovascular disease, labor force participation, instrumental variable method as quasi-randomization, plasma biomarker, Comprehensive Survey of Living Conditions, National Health and Nutrition Survey. [ABSTRACT FROM AUTHOR]

Pertussis is a human respiratory infection caused by the gram-negative bacterium, Bordetella pertussis. To evaluate the pertussis burden and vaccine efficacy, diagnosis and epidemiological surveillance should be based on accurate and valid diagnostic methods. Recently, the serodiagnostic tests Novagnost Bordetella pertussis IgA and IgM were approved in Japan for pertussis diagnostics. Although the anti-pertussis toxin (PT) IgG assay has been used for pertussis diagnosis worldwide, little is known about the anti-B. pertussis IgA and IgM assays. In this study, serum samples from 460 healthy donors were examined to determine the seroprevalence of anti-B. pertussis IgA and IgM in a Japanese population, and its correlation with donor age. Our data demonstrated that anti-B. pertussis IgA and IgM are positively and negatively correlated with age (r = 0.27, r = -0.37; P < 0.001, respectively). Age-specific analysis revealed high titers of anti-B. pertussis IgA in adults (46–50 years), while anti-B. pertussis IgM titers were high in schoolchildren (6–10, 11–15 years). When applying the arbitrary cut-off values for these ages, 17.6% and 39.5% of healthy donors were interpreted as pertussis-positive or indeterminate with anti-B. pertussis IgA (46–50 years) and IgM (11–15 years) titers, respectively. Overall, our findings indicated that the Novagnost Bordetella pertussis IgA and IgM testing could be greatly affected by subject age, limiting its value for pertussis diagnosis. [ABSTRACT FROM AUTHOR]

We compared the current prevalence of and obstetric outcomes in underweight Japanese women with data from 16 years ago. We reviewed the obstetric records of singleton pregnant Japanese women who delivered at our institute at ≥ 22 weeks’ gestation from 2000 through 2002 and those from 2016 through 2018. From 2000–2002 to 2016–2018, numbers of pregnant women in their twenties decreased and pregnant women in their forties increased significantly (p < 0.01). There were no significant changes in the prevalence of underweight pregnant women between the 2 periods. The prevalence of women whose weight gain during pregnancy was less than optimal increased (p = 0.049). There was no difference in obstetric outcomes between the 2 periods. Based on the current results, we cannot judge the necessity of further education to curb the increasing trend of Japanese women who desire slimness. Maternal weight may not have a high priority as an indicator of the gestational nutritional status associated with obstetric outcomes in Japan. [ABSTRACT FROM AUTHOR]

To investigate how changes in eGFR can affect medical costs, a regional cohort of national health insurance beneficiaries in Japan was developed from a nationwide database system (Kokuho database, KDB), and non-individualized data were obtained. From 105,661 people, subjects on chronic dialysis and subjects without consecutive medical checkups were excluded. Finally, medical costs in the follow-up year categorized by annual changes in eGFR between baseline and the next year were longitudinally examined in 70,627 people ranging in age from 40 to 74 years. Global mean costs for subjects with a rapid decrease in eGFR (≤-30%/year) were the highest among all ΔeGFR categories. In men, the cost was 1.42 times that for a stable eGFR. A total of 6,268 (19.4%) men and 5,381 (14.0%) women with eGFR <60 ml/min/1.73 m2 were identified in the baseline year. The mean cost was higher with a low eGFR than without a low eGFR, and there were also higher proportions newly initiating dialysis in 2014 (low eGFR with rapid decrease in eGFR vs. with stable eGFR: 9.61% vs. 0.02% in women, P<0.001). Moreover, the costs for low eGFR subjects with a rapid decrease in eGFR were more than twice those of non-low eGFR subjects with a rapid decrease in eGFR and also compared to low eGFR subjects with a stable eGFR. Moreover, initiating chronic dialysis was considered one of the major causes of high medical costs in women with rapid eGFR decline. To the best of our knowledge, this is the first study of renal disease using a cohort developed from the KDB system recently established in Japan. [ABSTRACT FROM AUTHOR]

Long-term stock decline in the Japanese eel (Anguilla japonica) is a serious issue. To reduce natural resource utilization in Japan, artificial hormonal induction of maturation and fertilization in the Japanese eel has been intensively studied. Recent experiment on feminized (by feeding a commercial diet containing estradiol-17β for first half year) cultured female eels have shown ovulation problems, which is seldom observed in captured wild female eels. Therefore, the aim of this study is to try to investigate causes of ovulation problem frequently seen in cultured female eels by comparative trans-omics analyses. The omics data showed low growth hormone and luteinizing hormone transcription levels in the brain and low sex hormone–binding globulin transcription levels in the liver of the cultured female eels. In addition, it was found that high accumulation of glucose-6-phosphate and, maltose in the liver of the cultured female eel. It was also found that docosahexaenoic (DHA) acid, eicosapentaenoic acid (EPA) and arachidonic acid (ARA) ratios in cultured female eels were quite different from wild female eels. The data suggested that ovulation problem in cultured female eels was possibly resulted from prolonged intake of a high-carbohydrate diet and/or suboptimal DHA/EPA/ARA ratios in a diet. [ABSTRACT FROM AUTHOR]

Background: In the current meta-analysis, we aimed to systematically review and summarize the eligible studies evaluating the association between dietary acid load in terms of potential renal acid load (PRAL) and net-endogenous acid production (NEAP) with anthropometric parameters and serum lipids in adult population. Methods: In a systematic search from PubMed, Scopus, Web of Sciences and Cochrane electronic databases up to December 2018, relevant studies were included. Cross-sectional, case control or cohort studies evaluating the association between PRAL and NEAP with the mean values of body mass index (BMI), waist circumference (WC), low and high density lipoprotein cholesterol (LDL, HDL), triglyceride (TG), total cholesterol (TC) and the prevalence of obesity were included. Results: According to our results, having higher dietary acid load content in terms of high PRAL scores was associated with higher triglyceride concentrations (weighted mean difference (WMD): 3.468; confidence interval (CI): -0.231, 7.166, P = 0.04) and higher obesity prevalence (30% and 27% in highest versus lowest categories). Accordingly, being in the highest category of NEAP was associated with higher prevalence of obesity (25% and 22% in highest versus lowest category). In subgroup analysis, higher PRAL scores was associated with higher BMI in women (WMD: 0.122; CI: -0.001, 0.245; P = 0.049) and higher NEAP in men (WMD: 0.890; CI: 0.430, 1.350; P < 0.001). There was no association between dietary acid load and other studied parameters. Conclusions: In the current meta-analysis, high dietary acid load content was associated with higher serum triglyceride concentrations and higher obesity prevalence. Reducing dietary acid load content might be a useful preventive strategy against obesity and metabolic disorders. [ABSTRACT FROM AUTHOR]

Introduction: The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. There is currently no validated laboratory test which can predict severe complications of DI. The Atypical lymphocyte count (ALC) is a research parameter generated at no extra cost when an automated Full Blood Count (FBC) is performed. The purpose of this study was to assess the association of ALC with the severity of DI. Methods: We prospectively collected data on patients admitted to Nawaloka Hospital Sri Lanka (NH) with DI between December 2016 and November 2017. DI was diagnosed based on a positive Non-structural antigen 1 (NS1) or dengue IgM antibody. ALC (absolute ALC and percentage) data were extracted from the Sysmex XS500i automated full blood count (FBC) analyzer (Sysmex Corporation Kobe, Japan). Clinical data was recorded from medical records and the computerized data base maintained by NH. Results: 530 patients were enrolled. Patients with clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. Patients who presented with respiratory compromise had statistically significantly higher AL% compared to those without. (AL%; 8.65±12.09 vs 2.17±4.25 [p = 0.01]). Similarly, patients who developed hypotension had higher AL% compared to those who did not suffered from shock (AL%; 8.40±1.26 vs 2.18±4.25 [p = 0.001]). The AL% of dengue patients presenting with bleeding, at 4.07%, is also higher than those without bleeding complications, at 2.15%. There was a significant negative association between platelet count and AL% (p = 0.04). Conclusions: Clinical manifestations of severe dengue have a significantly higher AL % compared to dengue without warning signs. AL % at presentation may be predictive of severe DI and future larger prospective longitudinal studies should be done to determine if AL % on admission is predictive of the complications of DI. [ABSTRACT FROM AUTHOR]

Background: Based on non-clinical data, it is expected that azilsartan, an angiotensin II receptor blocker, will help improve insulin resistance in addition to its hypotensive action. The present study is aimed to explore the effect of azilsartan compared to telmisartan on insulin sensitivity in hypertensive patients in the clinical setting. Methods: This multicenter, randomized, open-label, parallel-group exploratory study was conducted in Japan. We randomized adult patients (≥20 years old) with grade I or II essential hypertension and coexisting type 2 diabetes (1:1) to receive either oral azilsartan (20 mg/day;17 patients) or telmisartan (40 mg/day;16 patients) for 12 weeks. The primary endpoint was the change in the homeostasis model assessment ratio of insulin resistance (HOMA-R) from the baseline at the end of the treatment period. We also evaluated its safety and efficacy on other diabetes-related variables and blood pressure. Findings: The mean changes in HOMA-R at the end of treatment were 0.22 (95% CI, −1.09–1.52) in the azilsartan group and −0.23 (95% CI, −0.72–0.27) in the telmisartan group. We found no clinically remarkable changes between the groups in diabetes-related variables such as fasting blood glucose, fasting insulin, HbA1c (NGSP), HOMA-β, or 1,5-anhydroglucitol. Reductions in clinic systolic and diastolic blood pressure were observed at week 4 and the reduced levels were maintained throughout the treatment period in both groups. No serious treatment-emergent adverse events (TEAEs) were observed. Only one drug-related TEAE (mild decrease in blood pressure) was reported in one patient in the azilsartan group. Conclusion: Neither azilsartan nor telmisartan had any clinically remarkable effects on insulin resistance parameters when administered for 12 weeks to patients with grade I or II essential hypertension and coexisting type 2 diabetes mellitus. Azilsartan (20 mg/day) and telmisartan (40 mg/day) exerted comparable antihypertensive effects. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the running pace and step characteristics among various competitive-level 400-m hurdlers through inter-group and intra-athlete comparisons. We analysed spatiotemporal data involving the split time, mean step length (SL) and mean step frequency (SF) for 13 male world-class and 14 male national-level 400-m hurdlers. We analysed 16.5 ± 3.9 races for each world-class hurdler and 19.8 ± 6.0 races for each national-level hurdler (the total number of analysed runs was 491) using publicly available television and internet broadcasts. Inter-group comparisons showed that both first- and latter-halves split times of the world-class hurdlers were significantly shorter than those of the national-level hurdlers. In the latter-half phase, no significant differences of SL and SF were observed between the world-class and national level hurdlers. Intra-athlete comparisons showed that no athletes favoured only first-half phase in terms of running speed in short finish times. In contrast, finish times of all hurdlers were sensitive to running speed in the latter-half phase. In the latter half of the race, 18 of the 27 hurdlers were identified as being SF reliant during speed enhancements; running speed of the other 9 hurdlers were also sensitive to high SF. In conclusions, important findings regarding high performance in inter-group comparisons do not always corresponded with those in intra-athlete comparisons. All athletes and coaches should first prioritize maintaining high running speeds in the latter half of 400-m hurdles rather than in the first half of the race. [ABSTRACT FROM AUTHOR]

Background: The crushed-tablet rivaroxaban concentration has been previously reported to be lower than the non-crushed concentration. However, the rivaroxaban concentration of fine granules has not yet been investigated. The anticoagulation intensity of rivaroxaban with fine granules, tablets, and crushed tablets was compared in acute stroke patients to assess the efficacy of each form. Methods and findings: Hospitalized patients over 75 years old with acute stroke who started taking rivaroxaban from April 2012 to September 2017 were included. Blood samples were drawn just before and 4 hours after taking rivaroxaban on a median of 5 days after treatment initiation for concentration measurements (C0h, C4h) based on an anti-factor Xa chromogenic assay. Of 114 patients (49 female, 83±5 years old), 97 had ischemic strokes, 9 had transient ischemic attacks, and 8 had intracerebral hemorrhages. Rivaroxaban was administered a median of 7 days after onset. Of these, 38 patients were given the 15 mg dose, and 76 were given the 10 mg dose. In the 15 mg dose group, C0h was significantly higher in the fine granule group than in the crushed tablet group, with no significant difference compared to the tablet group [C0h: 27.6±6.8 vs 4.0±4.1 (P = 0.01) vs. 33.3±25.2 ng/ml, (P = 0.51), respectively], as was C4h [223.0±66.6 vs 103.0±79.5 (P = 0.02) vs. 229.5±121.6 ng/ml (P = 0.88)]. In the 10 mg dose group, C0h was significantly higher in the fine granule group than in the crushed tablet group and comparable to that in the tablet group [23.2±7.9 vs 7.5±6.2 (P<0.01) vs 19.0±15.8 ng/ml, (P = 0.35)], as was C4h [150.7±85.4 vs 85.1±46.8 (P<0.01) vs 189.8±92.7 ng/ml (P = 0.18)]. Conclusions: The rivaroxaban concentration with fine granules was consistent with that in the tablet group and higher than that in the crushed tablet group. [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]

Anthropogenic effects have created various risks for wild animals. Boat traffic is one of the most fatal risks for marine mammals. Individual behavioral responses of cetaceans, including diving behavior such as changing swimming direction and lengthing inter-breath interval, to passing boats is relatively well known; however, the social function of cetacean responses to boat traffic in a natural setting remains poorly understood. We focused on describing the behavioral responses of single and aggregated finless porpoises to boats passing at Misumi West Port, Ariake Sound, Japan, by using a drone characterized with a high-precision bird’s-eye angle. During the study period, we collected 25 episodes of finless porpoise responses to boats passing by. A mean (± SEM) of 5.1 ± 1.0 individuals were observed for each episode. The primary response to passing boats was avoidance by dive, which implies boat traffic is a substantial disturbance to finless porpoises that travel along the seawater surface daily. The diving duration decreased significantly with an increase in the number of aggregated individuals. The diving and floating reaction times were 10.9 ± 2.3 s and 18.7 ± 5.0 s, respectively. There was no significant difference between the reaction times indicating that each individual was motivated to keep the group cohesion consistent when floating even after the risk had dissolved, which is comparable to the behavior of porpoises that dive when riskier conditions are present, such as when a boat approaches an aggregation. Our findings provide new insights on the sociality of finless porpoises even though there were limitations, like an inability to identify a specific individual. The drone enabled us to observe the social behavior of finless porpoises and other cetaceans at an unprecedented resolution, which may lead to a better understanding of the evolutionary diversity of intelligence and sociality and the bridge to human evolution. [ABSTRACT FROM AUTHOR]