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The influence of sugar consumption on the risk of colorectal cancer (CRC) remains controversial. Prospective cohort studies focusing on total and specific types of sugar intake among the Asian population who have different patterns of sugar intake sources than American and European populations are scarce. We intended to examine the association of sugar intake with CRC risk among middle‐aged adults in a Japanese large‐scale population‐based cohort study. The participants (42,405 men and 48,600 women) who were 45–74 years old and answered the questionnaire in 1995–1999 in the Japan Public Health Center‐based Prospective Study were followed up until December 2013. Total sugars, total fructose, and specific types of sugar intake were estimated using a validated 147‐item food frequency questionnaire and divided into quintiles (Q1–Q5). We used Cox proportional hazard regression models adjusted for potential confounders to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During the follow‐up, 2118 CRC cases (1226 men and 892 women) were identified. We did not observe any clear association between all types of sugar intake and an increased risk of CRC. Analyses by tumor sites yielded a positive association of total sugar consumption with rectal cancer in women (1.75 [1.07–2.87] for Q1 vs. Q5; plinear trend = 0.03), but no statistically significant trend was detected among men. Sugar intake was not associated with CRC risk in middle‐aged Japanese adults. However, for rectal cancer, the probability of an increased risk among women with a higher total sugar intake cannot be excluded. [ABSTRACT FROM AUTHOR]

In this study, the viability and stability of probiotics (Lactobacillus casei and Bifidobacterium animalis) encapsulated in a resistant starch medium through freeze‐drying is evaluated. Particle size, SEM, and color analysis are done on the microcapsules. The encapsulation yield after freeze‐drying is between 81.55% and 88.78%, with viability of the microcapsules analyzed in simulated gastric juice (SGJ) and simulated intestinal juice (SIJ) as well as in apple juice store at 4 °C over 28 days. The microencapsulated probiotics in this study has a substantial final count for SGJ and SIJ between 7.30–7.98 Log colony‐forming unit (CFU) mL‐1 and 7.26–7.89 Log CFU mL‐1, respectively. The Log CFU mL‐1 for free cells are significantly lower than the microcapsules. The final viability for microcapsules in the juice at the end of 28 days for resistant starch + L. casei (RSL), resistant starch + B. animalis (RSB), and resistant starch + L. casei + B. animalis(RSLB) are 7.53, 6.98, and 7.46 Log CFU mL‐1. This confirms that microencapsulation enhance the survival of L. casei and B. animalis in fruit juice under cold storage. Results from this study show that resistant starch has potential as an encapsulating material as it protected the probiotic cells in conditions such as freeze‐drying, simulated gastrointestinal digestion and low pH environments during beverage application. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the displacement of tooth arrangement in dentures fabricated by additive manufacturing (AM) and heat curing. Methods: Three‐dimensional (3D) scanning was performed for edentulous jaw models. After the teeth were arranged, 3D scanning for the wax denture was performed. Heat‐cured dentures were fabricated with heat‐cure polymer resin. Based on data obtained by subtracting the model data from wax denture data, AM dentures were fabricated from ultraviolet‐cured acrylic resin. Accuracy was verified by superimposing heat‐cured and AM dentures on the tooth region data from the wax dentures and measuring displacement of the tooth arrangement. Results: In the maxillary dentures, the amount of tooth displacement for the heat‐cured dentures and for the AM dentures ranged from −0.08 to +0.06 mm and from −0.25 to +0.06 mm respectively. A significant difference was observed between two dentures. In the mandibular dentures, the amount of tooth displacement for the heat‐cured dentures and for the AM dentures ranged from −0.09 to +0.07 mm and from −0.03 to +0.07 mm respectively. No significant difference was observed between two dentures. Conclusions: The artificial teeth of the maxillary dentures fabricated by AM showed a greater displacement compared to those by heat curing. [ABSTRACT FROM AUTHOR]

Cowpea [Vigna unguiculata (L.) Walp.] is a valuable crop for subsistence farmers in sub‐Saharan Africa. Characterization and evaluation of cowpea germplasm collections based on seed yield for genotype × environment (GE) interactions can assist in improving the adaptability and stability across environments. The objectives of this study were to determine genetic variability in the germplasm collection, to determine the magnitude of GE interactions, to identify superior genotypes across environments, and to determine the phenotypic correlations among the seed yield and related traits. Seventy‐five cowpea genotypes were planted in three different locations during the 2017–2018 and 2018–2019 cropping seasons, and data were collected for seed yield and its components. Highly significant (P <.001) genotype effect for seed yield traits suggested great genetic differences among the tested populations. Significant (P <.05) genotype × location interaction (GL), genotype × season interaction (GS), and genotype × location × season interaction (GLS) effects were observed for seed yield traits, indicating the presence of complex GE interactions. The GLS effect was more than the GL and GS effects for seed yield, 100‐seed weight, number of pods, and pod width, highlighting the difficulty in genetic improvement of these traits. Cowpea genotypes 6 (ARC006), 49 (ARC049), 63 (IT90K‐76), and 57 (PAN311) showed high yield, wide adaptation, and stability. Genotype 58 (NGOII) and 1 (ARC001) showed high yield, instability, and specific adaptation. No clear mega‐environments were identified. Significant (P <.05) correlations were observed among most of the traits evaluated. The results obtained can serve as a guide and basis of germplasm management and improvement of cowpea seed yield. [ABSTRACT FROM AUTHOR]

Summary: Projected mortalities from cancer are expected to continue escalating, with conventional chemotherapeutic regimens having extensive side effects, hence the need for therapeutics capable of terminating cancer cells selectively, through apoptosis. Therapeutic protein isolates bind specifically to target proteins inducing cell death in vitro and in vivo in various cancer cells. Therefore, this study aimed at observing the antioxidant and anticancer potential of protein isolates from five cowpea cultivars (Glenda, Embu buff, Makhatini, Veg Cowpea 2 and Veg Cowpea 3). Cytotoxicity was conducted on cancerous and non‐cancerous cell lines. Apoptosis was quantified using flow cytometry, and caspase‐3/7 activity was determined. Cytotoxicity assays revealed that Embu buff was the pre‐eminent inhibitor of cancerous cells, while also acting as a protecting mediator in a stressed non‐cancerous cell line by causing a reversal in apoptotic activity. Therefore, cowpea isolates show high potential as candidates for the therapeutic intrusion of cancer. [ABSTRACT FROM AUTHOR]

Summary: There has been growing interest in the use of resistant starch (RS) as a prebiotic for physiological benefits and to reduce the risk of chronic diseases. In this study, RS was isolated from samples of five cowpea cultivars (DT129‐4,TVU 11424,PAN 311, Fahari and Bechuana White) seeds to determine their potential prebiotic effects, and proximate and mineral composition. Results obtained showed samples of five cowpea cultivars to be high in protein (18.0–28.7%) and carbohydrates (54.9–66.0%) and low in fat (0.6–3.7%). The RS from cowpea samples ranged between 9.3 and 12.1% with cultivar DT129‐4 having the highest amount. Fermentation of RS using mixed and pure cultures was done, and bacterial growth was monitored over a 24‐h period. Resistant starch isolated from all cowpea samples fulfilled the criteria to be classified as a prebiotic which have a wide range of beneficial effects on the host, with cultivar DT129‐4 showing the most prebiotic potential amongst cowpea samples tested. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The aim of this study was to assess the effectiveness of improving the attitude of dental students towards the use of a full‐body patient simulation system (SIMROID) compared to the traditional mannequin (CLINSIM) for dental clinical education. Materials and methods: The participants were 10 male undergraduate dental students who had finished clinical training in the university hospital 1 year before this study started. They performed a crown preparation on an upper pre‐molar tooth using SIMROID and CLINSIM as the practical clinical trials. The elapsed time for preparation was recorded. The taper of the abutment teeth was measured using a 3‐dimensional shape‐measuring device after this trial. In addition, a self‐reported questionnaire was collected that included physical pain, treatment safety and maintaining a clean area for each simulator. Qualitative data analysis of a free format report about SIMROID was performed using text mining analysis. This trial was performed twice at 1‐month intervals. Results: The students considered physical pain, treatment safety and a clean area for SIMROID significantly better than that for CLINSIM (P < .01). The elapsed time of preparation in the second practical clinical trial was significantly lower than in the first for SIMROID and CLINSIM (P < .01). However, there were no significant differences between the abutment tapers for both systems. For the text mining analysis, most of the students wrote that SIMROID was similar to real patients. Conclusion: The use of SIMROID was proven to be effective in improving the attitude of students towards patients, thereby giving importance to considerations for actual patients during dental treatment. [ABSTRACT FROM AUTHOR]

We conducted a systematic review and meta-analysis of population-based cohort studies of maternal body mass index ( BMI) and risk of adverse birth and health outcomes in low- and middle-income countries. Pub Med, Embase, CINAHL and the British Nursing Index were searched from inception to February 2014. Forty-two studies were included. Our study found that maternal underweight was significantly associated with higher risk of preterm birth (odds ratio [ OR], 1.13; 95% confidence interval [ CI], 1.01-1.27), low birthweight ( OR, 1.66; 95% CI, 1.50-1.84) and small for gestational age ( OR, 1.85; 95% CI, 1.69-2.02). Compared with mothers with normal BMI, overweight or obese mothers were at increased odds of gestational diabetes, pregnancy-induced hypertension, pre-eclampsia, caesarean delivery and post-partum haemorrhage. The population-attributable risk ( PAR) indicated that if women were entirely unexposed to overweight or obesity during the pre-pregnancy or early pregnancy period, 14% to 35% fewer women would develop gestational diabetes, pre-eclampsia or pregnancy-induced hypertension in Brazil, China, India, Iran or Thailand. The highest PAR of low birthweight attributable to maternal underweight was found in Iran (20%), followed by India (18%), Thailand (10%) and China (8%). Treatment and prevention of maternal underweight, overweight or obesity may help reduce the burden on maternal and child health in developing countries. [ABSTRACT FROM AUTHOR]

Natural hybrids between the boreal species Hexagrammos octogrammus and two temperate species Hexagrammos agrammus and Hexagrammos otakii were observed frequently in southern Hokkaido, Japan. Previous studies revealed that H. octogrammus is a maternal ancestor of both hybrids; the hybrids are all fertile females and they frequently breed with paternal species. Although such rampant hybridization occurs, species boundaries have been maintained in the hybrid zone. Possible explanations for the absence of introgressions, despite the frequent backcrossing, might include clonal reproduction: parthenogenesis, gynogenesis and hybridogenesis. The natural hybrids produced haploid eggs that contained only the H. octogrammus genome (maternal ancestor) with discarded paternal genome and generated F1‐hybrid type offspring by fertilization with the haploid sperm of H. agrammus or H. otakii (paternal ancestor). This reproductive mode was found in an artificial backcross hybrid between the natural hybrid and a male of the paternal ancestor. These findings indicate that the natural hybrids adopt hybridogenesis with high possibility and produce successive generations through hybridogenesis by backcrossing with the paternal ancestor. These hybrids of Hexagrammos represent the first hybridogenetic system found from marine fishes that widely inhabit the North Pacific Ocean. In contrast with other hybridogenetic systems, these Hexagrammos hybrids coexist with all three ancestral species in the hybrid zone. The coexistence mechanism is also discussed. [ABSTRACT FROM AUTHOR]

Background: Patients with acute ischemic stroke and active cancer have more severe neurological symptoms, elevated risks of stroke recurrence, and death compared with the general population. We examined whether von Willebrand factor (vWF) antigen levels at stroke onset were associated with the poor outcomes of patients with stroke and cancer., Methods and Results: Using data from 90 patients with acute ischemic stroke and active cancer who were registered in the SCAN (Ischemic Stroke in Patients With Cancer and Neoplasia) study, a prospective multicenter, observational study in Japan, we divided patients into 2 groups according to their median vWF antigen levels (high, n=46; or low, n=44). The high-vWF group had a significantly higher initial National Institutes of Health Stroke Scale score (median, 7 [interquartile range, 3-11.25] versus 3 [interquartile range, 1-8.5]; P <0.05) and a significantly higher incidence of cryptogenic stroke (32 [70%] versus 16 [36%]; P <0.01) and venous thromboembolism (7 [15%] versus 0 [0%]; P <0.01), as well as multiple lesions (28 [62%] versus 12 [27%]; P <0.001), than the low-vWF group. We observed no significant difference in the rate of stroke recurrence within 1 year between the groups. However, increased vWF levels were an independent predictor of death within 1 year of stroke onset, after adjusting for potential confounders (odds ratio, 6.77 [95% CI, 1.49-30.78]; P <0.05)., Conclusions: Elevated vWF antigen levels were associated with adverse outcomes in patients with cancer-associated stroke and may represent a useful biomarker to guide future therapeutic interventions.

Introduction: This study aimed to evaluate and validate the educational effectiveness of a job shadowing class as a dental teaching programme for preclinical dental students through a questionnaire that assessed related student perceptions., Materials and Methods: A total of 124 preclinical (second year) dental students at Tokushima University participated in job shadowing placements from 2017 to 2019. Each student observed dental practice or surgery for 1 day in the university hospital. After shadowing, the students were requested to fill out a nine-item questionnaire based on a five-point scale. The first analysis was performed to calculate the correlation for each item. Furthermore, regression analysis for the categorical data was performed to show the relationship between eight questions (Items 1-8) and one question (Item 9: comprehensive evaluation). Next, factor analysis was performed to determine students' perceptions regarding the shadowing class., Results: Ninety-eight students (response rate: 79%) completed the questionnaire. There was a strong relationship amongst Items 1, 8 and 9 ("interested in dentistry as a job," "learning motivation" and "comprehensive evaluation" respectively) based on the results of the correlation and regression analysis. The factor analysis led to three student perceptions as latent factors, namely, "Interesting," "Self-awareness" and "Future Goal," which had a relatively close inter-factor correlation (0.465-0.772)., Conclusion: The finding suggests that job shadowing may increase a students' interest in a dentistry career at an early stage of their education and learning motivation, along with generating self-awareness. This programme may present possible educational effectiveness in dental education., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background Limited data exist on the prognostic factors for patients with ischemic stroke and active cancer. Methods and Results We conducted a prospective, multicenter, observational study in Japan, including patients with acute ischemic stroke and active cancer, to investigate the prognostic factors. We followed up the patients for 1 year after stroke onset. The patients were divided into 2 groups according to cryptogenic stroke and known causes (small-vessel occlusion, large-artery atherosclerosis, cardioembolism, and other determined cause), and survival was compared. The hazard ratios (HRs) and 95% CIs for mortality were calculated using Cox regression models. We identified 135 eligible patients (39% women; median age, 75 years). Of these patients, 51% had distant metastasis. A total of 65 (48%) and 70 (52%) patients had cryptogenic stroke and known causes, respectively. Patients with cryptogenic stroke had significantly shorter survival than those with known causes (HR [95% CI], 3.11 [1.82-5.32]). The multivariable Cox regression analysis revealed that distant metastasis, plasma D-dimer levels, venous thromboembolism (either deep venous thrombosis or pulmonary embolism) complications at stroke onset were independent predictors of mortality after adjusting for potential confounders. Cryptogenic stroke was associated with prognosis in univariable analysis but was not significant in multivariable analysis. The plasma D-dimer levels stratified the prognosis of patients with ischemic stroke and active cancer. Conclusions The prognosis of patients with acute ischemic stroke and active cancer varied considerably depending on stroke mechanism, distant metastasis, and coagulation abnormalities. The present study confirmed that coagulation abnormalities were crucial in determining the prognosis of such patients.

Background We aimed to clarify which time-to-maximum of the tissue residue function (Tmax) mismatch ratio is useful in predicting anterior intracranial atherosclerotic stenosis (ICAS)-related large-vessel occlusion (LVO) before endovascular therapy. Methods and Results Patients with ischemic stroke who underwent perfusion-weighted imaging before endovascular therapy for anterior intracranial LVO were divided into those with ICAS-related LVO and those with embolic LVO. Tmax ratios of >10 s/>8 s, >10 s/>6 s, >10 s/>4 s, >8 s/>6 s, >8 s/>4 s, and >6 s/>4 s were considered Tmax mismatch ratios. Binominal logistic regression was used to identify ICAS-related LVO, and the adjusted odds ratio (aOR) and 95% CI for each Tmax mismatch ratio increase of 0.1 were calculated. A similar analysis was performed for ICAS-related LVO with and without embolic sources, using embolic LVO as the reference. Of 213 patients (90 women [42.0%]; median age, 79 years), 39 (18.3%) had ICAS-related LVO. The aOR (95% CI) per 0.1 increase in Tmax mismatch ratio in ICAS-related LVO with embolic LVO as reference was lowest with Tmax mismatch ratio >10 s/>6 s (0.56 [0.43-0.73]). Multinomial logistic regression analysis also showed the lowest aOR (95% CI) per 0.1 increase in Tmax mismatch ratio with Tmax >10 s/>6 s (ICAS-related LVO without embolic source: 0.60 [0.42-0.85]; ICAS-related LVO with embolic source: 0.55 [0.38-0.79]). Conclusions A Tmax mismatch ratio of >10 s/>6 s was the optimal predictor of ICAS-related LVO compared with other Tmax profiles, with or without an embolic source before endovascular therapy. Registration clinicaltrials.gov. Identifier NCT02251665.

Background The prognostic impact of benzodiazepines has been unclear in patients with heart failure (HF). Methods and Results This was a historical observational cohort study. A total of 826 patients who had been hospitalized for HF and were being treated for insomnia with either benzodiazepines or Z-drugs (zolpidem, zopiclone, or eszopiclone), were enrolled and divided on the basis of their hypnotics: benzodiazepine group (n=488 [59.1%]) and Z group (n=338 [40.9%]). We compared the patient characteristics and postdischarge prognosis between the groups. The primary end points were rehospitalization for HF and cardiac death. The benzodiazepine group was older (age, 72.0 versus 69.0 years; P =0.010), had a higher prevalence of depression (17.4% versus 8.9%; P <0.001), and showed a higher use of loop diuretics (77.9% versus 67.8%; P =0.001). In the laboratory data, the benzodiazepine group demonstrated lower levels of hemoglobin (12.3 versus 13.0 g/dL; P =0.001), sodium (139.0 versus 140.0 mEq/L; P =0.018), and albumin (3.7 versus 3.9 g/dL; P =0.003). Kaplan-Meier analysis showed that both end points were higher in the benzodiazepine group (rehospitalization for HF, log-rank P =0.001; cardiac death, log-rank P =0.043). Multiple Cox proportional hazard analysis revealed that the use of benzodiazepines was an independent predictor of rehospitalization for HF (hazard ratio, 1.530; 95% CI, 1.025-2.284; P =0.038). Furthermore, rehospitalization for HF was higher in the benzodiazepine group after propensity score matching (log-rank P =0.036). Conclusions Benzodiazepine is associated with higher risk of rehospitalization for HF compared with Z-drugs in patients with HF.

Background & Aims: Hepatitis C virus (HCV) infection has been known to cause various extrahepatic autoimmune disorders. The prevalence of platelet-associated immunoglobulin G (PA-IgG) has been high in patients with HCV infection. Because thrombocytopenia in HCV-related liver diseases is a notable problem, we performed prospective study on the effect of direct-acting antivirals (DAAs) treatment on PA-IgG and platelet count., Methods: A total of 215 patients with HCV-related liver disease were enrolled in this study. The patients who discontinued DAAs or did not undergo adequate laboratory examinations and who did not achieve sustained virologic response were excluded and finally a total of 187 patients were investigated., Results: A total of 171 patients (91.4%) were PA-IgG positive (>46 ng/10 7 cells) before starting DAAs (baseline). The PA-IgG level elevation was significantly correlated with higher liver inflammation and fibrosis markers (P < 0.05) and lower platelet count (P = 0.000019). The platelet count of the patients with low PA-IgG titer tended to be higher at baseline, end of treatment (EOT), and at 12 and 24 weeks after EOT. The platelet count increased at EOT (P < 0.05) and 24 weeks after EOT (P < 0.01). The PA-IgG levels were significantly decreased at EOT, 12 and 24 weeks after EOT (P < 0.01). Multiple regression analysis found that only platelet count at baseline was closely associated with negative conversion of PA-IgG at 24 weeks after EOT (P = 0.004)., Conclusions: Eradication of HCV by DAAs treatment successfully decreased PA-IgG level and increased platelet count., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objectives: The aim of this study was to investigate activity-induced effects from bone geometric properties of the proximal femur in athletic vs nonathletic healthy females by statistically controlling for variation in body size, lower limb isometric, and dynamic muscle strength, and cross-sectional area of Musculus gluteus maximus., Methods: The material consists of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in either high jump, triple jump, soccer, squash, powerlifting, endurance running or swimming, and a group of physically active nonathletic women (N = 20). Cross-sectional bone geometric properties were calculated for the lesser trochanter, sub-trochanter, and mid-shaft of the femur regions. Bone geometric properties were analyzed using a general linear model that included body size, muscle size, and muscle strength as covariates., Results: Body size and isometric muscle strength were positively associated with bone geometric properties at all three cross-sectional levels of the femur, while muscle size was positively associated with bone properties only at the femur mid-shaft. When athletes were compared to nonathletic females, triple jump, soccer, and squash resulted in greater values in all studied cross-sections; high jump and endurance running resulted in greater values at the femoral mid-shaft cross-section; and swimming resulted in lower values at sub-trochanter and femur mid-shaft cross-sections., Conclusions: Activity effects from ground impact loading were associated with higher bone geometric values, especially at the femur mid-shaft, but also at lesser and sub-trochanter cross-sections. Bone geometric properties along the femur can be used to assess the mechanical stimuli experienced, where ground impact loading seems to be more important than muscle loading., (© 2019 Wiley Periodicals, Inc.)

Background The Get With the Guidelines-Heart Failure ( GWTG - HF ) risk score was developed using American Heart Association GWTG - HF program data and predicts in-hospital mortality in patients with acute heart failure (HF). We aimed to clarify the prognostic impacts of the GWTG - HF risk score in patients with HF after discharge. Methods and Results We examined the GWTG - HF score in 1452 patients with HF, who were admitted to our hospital and discharged after treatment, by calculating 7 predetermined variables. We divided all subjects into 3 groups according to the GWTG - HF risk score (low, moderate, and high score groups). The plasma B-type natriuretic peptide level significantly increased with increasing GWTG - HF risk score severity (median values of B-type natriuretic peptide: 167.0 in low, 260.7 in moderate, and 418.2 pg/mL in high score groups). We followed up all subjects after discharge, and there were 347 (23.9%) all-cause deaths and 407 (28.0%) cardiac events in follow-up periods. A Kaplan-Meier survival curve demonstrated that event rates of all-cause death and cardiovascular events, including worsening HF and cardiac death, significantly increased with increasing GWTG - HF risk score severity in all subjects, and also in 749 patients with HF with preserved ejection fraction (ejection fraction ≥50%) and 703 patients with HF with reduced ejection fraction (ejection fraction <50%) patients. The multivariable Cox proportional hazard regression analysis demonstrated that the GWTG - HF risk score was one of the significant predictors of all-cause mortality and cardiac events (all-cause mortality: hazard ratio, 1.537, 95% confidence interval, 1.172-2.023; cardiac events: hazard ratio, 1.584, 95% confidence interval, 1.344-1.860, per 10-point increase of GWTG - HF score). Conclusions The GWTG - HF risk score is a useful multivariable score model for several years after hospitalization in patients with HF in a Japanese population.

Objectives: We investigated the relationship between loading history and bone biomechanical properties used in physical activity reconstructions. These bone properties included bone bending and torsional strength (J), cortical area (CA), the direction of the major axis (theta angle), and element shape ratios determined from cross sections of standardized bone length. In addition, we explored the applicability of anatomically determined cross sections., Methods: Our material consisted of hip and proximal thigh magnetic resonance images of Finnish female athletes (N = 91) engaged in high-jump, triple-jump, endurance running, swimming, power-lifting, soccer and squash; along with a group of active non-athlete individuals (N = 20). We used regression analysis for size-adjustment, and the extracted residuals were then used to compare differences in the bone properties between groups., Results: We found that triple-jumpers, soccer players, and squash players had the greatest values in CA and J, swimmers and non-athletes had the smallest, whereas high-jumpers, power-lifters, and endurance runners exhibited interim values. No between-the-group differences in element shape ratios or theta angles were found. We found that influences of activity were similar regardless of whether standardized length or anatomically determined cross sections were used., Conclusions: Extreme (triple-jump) and directionally inconsistent loading (soccer and squash) necessitate a more robust skeleton compared to directionally consistent loading (high-jump, power-lifting, and endurance running) or non-impact loading (swimming and non-athletes). However, not all of these relationships were statistically significant. Thus, information gained about physical activity using bone properties is informative but limited. Accounting for the limitations, the method is applicable on fragmented skeletal material as anatomically determined cross sections can be used., (© 2017 Wiley Periodicals, Inc.)

Background: It has been recently reported that histamine H 2 receptor antagonists (H2RAs) are associated with impairment of ventricular remodeling and incident heart failure. In addition, favorable pleiotropic effects and adverse effects of proton pump inhibitors (PPIs) on cardiovascular disease have also been reported. We examined the associations of acid suppressive therapy using H2RAs or PPIs with cardiac mortality in patients with heart failure., Methods and Results: In total, 1191 consecutive heart failure patients were divided into 3 groups: a non-acid suppressive therapy group (n=363), an H2RA group (n=164), and a PPI group (n=664). In the follow-up period (mean 995 days), 169 cardiac deaths occurred. In the Kaplan-Meier analysis, cardiac mortality was significantly lower in the PPI group than in the H2RA and non-acid suppressive therapy groups (11.0% versus 21.3% and 16.8%, respectively; log-rank P =0.004). In the multivariable Cox proportional hazards analysis, use of PPIs, but not H2RAs, was found to be an independent predictor of cardiac mortality (PPIs: hazard ratio 0.488, P =0.002; H2RAs: hazard ratio 0.855, P =0.579). The propensity-matched 1:1 cohort was assessed based on propensity score (H2RAs, n=164; PPIs, n=164). Cardiac mortality was significantly lower in the PPI group than in the H2RA group in the postmatched cohort (log-rank P =0.025). In the Cox proportional hazards analysis, the use of PPIs was a predictor of cardiac mortality in the postmatched cohort (hazard ratio 0.528, P =0.028)., Conclusions: PPIs may be associated with better outcome in patients with heart failure., (© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Raw egg white undergoes sol-gel transition by heat treatment, which changes it to an elastic gel. Here, protease treatment to render a new texture to heated egg white gel was applied. Protease-treated gels exhibited ductile flow without obvious rupture points. Transmission electron microscopy analysis showed that in protease-treated gels, protein aggregates were distributed more homogeneously compared with that observed in the untreated control, probably because ovalbumin was digested into small peptides as revealed by SDS-PAGE. The properties of the gel were evaluated by sensory tests and by measuring the movement of the masseter muscle, using surface electromyography. Results showed that maximum bite force and mastication duration were decreased for the protease-treated gels, which were evaluated as being softer, smoother, less elastic and better textured. Overall, our results indicate that protease-treated egg white gel has superior qualities and is easier to swallow than the untreated gel., Practical Applications: In the food industry, the use of egg white is limited compared with that of egg yolk and whole eggs. In this study, we performed protease treatment to generate a new food material with smoother and softer texture compared with heat treated egg white. Our findings may expand the consumption of egg white, which can be consumed by people with mastication and swallowing disorders, and reduce the waste of egg white as a surplus product.

Objective: Recent evidence suggests that human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is a separate HNSCC subgroup with distinct epidemiology, histopathological characteristics, therapeutic response to chemotherapy and radiation, and clinical outcome. This study aimed to investigate the role of HPV infection in oral squamous cell carcinoma (OSCC) and the correlation between HPV infection, tumor suppressor protein p16 expression, and clinicopathological features in Japanese patients., Methods: In total, 174 OSCC specimens were examined for p16 levels by immunohistochemistry, and p16-positive OSCCs were analyzed for HPV DNA by in situ hybridization (ISH) and HPV genotypes by real-time PCR. The results were evaluated for the association with clinicopathological characteristics of OSCC patients., Results: Twenty-four OSCC samples were found positive for p16 expression; all of them were well-differentiated tumors. P16 immunoreactivity was significantly associated with the invasion depth and tended to correlate with sex, site in the oral cavity, stromal reaction, TNM stage, and survival. HPV DNA was detected in 13 of 24 (54%) p16-positive OSCC by real-time PCR; HPV 16, 18, and other high-risk genotypes were the most prevalent. However, ISH failed to detect HPV DNA in p16-positive OSCCs., Conclusion: P16 immunoreactivity and HPV genotyping by real-time PCR may be useful markers of HPV infection in OSCC. However, although HPV-related OSCC showed good outcomes, HPV infection may have a minor role in oral oncogenesis in Japanese patients., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of this study was to develop and evaluate a dental implant surgery simulator that allows learners to experience the drilling forces necessary to perform an osteotomy in the posterior mandibular bone. The simulator contains a force-sensing device that receives input and counteracts this force, which is felt as resistance by the user. The device consists of an actuator, a load cell, and a control unit. A mandibular bone model was fabricated in which the predicted forces necessary to drill the cortical and trabecular bone were determined via micro CT image-based 3D finite element analysis. The simulator was evaluated by five dentists from the Department of Implantology at Tokyo Dental College. The ability of the evaluators to distinguish the drilling resistance through different regions of the mandibular bone was investigated. Of the five dentists, four sensed the change in resistance when the drill perforated the upper cortical bone. All five dentists were able to detect when the drill made contact with lingual cortical bone and when the lingual bone was perforated. This project successfully developed a dental implant surgery simulator that allows users to experience the forces necessary to drill through types of bone encountered during osteotomy. Furthermore, the researchers were able to build a device by which excessive drilling simulates a situation in which the lingual cortical bone is perforated--a situation that could lead to negative repercussions in a clinical setting. The simulator was found to be useful to train users to recognize the differences in resistance when drilling through the mandibular bone.

Poor adherence to medication is a major public health challenge. Here, we aimed to determine the adherence to oral and topical medications and to analyze underlying associated factors using the translated Japanese version of Morisky Medication Adherence Scale-8 regarding urticaria treatment. Web-based questionnaires were performed for 3096 registered dermatological patients, along with a subanalysis of 751 registered urticaria patients in this study. The adherence to oral medication was significantly associated with the frequency of hospital visits. Variables that affected the adherence to topical medication included age and experience of drug effectiveness. The rate of responses that "It felt like the symptoms had improved" varied significantly among the dermatological diseases treated with oral medications. Dermatologists should be aware that adherence to the treatment of urticaria is quite low. Regular visits and active education for patients with urticaria are mandatory in order to achieve a good therapeutic outcome by increasing the adherence., (© 2015 The Authors. The Journal of Dermatology published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Dermatological Association.)

Controlling the flow rate in an implantable rotary blood pump based on the physiological demand made by the body is important. Even though various methods to estimate the flow rate without using a flow meter have been proposed, no adequate method for measuring the blood viscosity, which is necessary for an accurate estimate of the flow rate, without using additional sensors or mechanisms in a noninvasive way, has yet been realized. We have developed a sensorless method for measuring viscosity in magnetically levitated rotary blood pumps, which requires no additional sensors or mechanisms. By applying vibrational excitation to the impeller using a magnetic bearing, we measured the viscosity of the working fluid by measuring the phase difference between the current in the magnetic bearing and the displacement of the impeller. The measured viscosity showed a high correlation (R(2)  > 0.992) with respect to a reference viscosity. The mean absolute deviation of the measured viscosity was 0.12 mPa·s for several working fluids with viscosities ranging from 1.18 to 5.12 mPa·s. The proposed sensorless measurement method has the possibility of being utilized for estimating flow rate., (Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.)

Previously we assessed the medication adherence for oral and topical remedies by a translated Japanese version of the Morisky Medication Adherence Scale-8 (MMAS-8) together with socioeconomic backgrounds in 3096 Japanese dermatological patients, and found the medication adherence, especially to topical drugs, was poor in these patients. In order to elucidate the disease-specific sociomedical factors, we further sub-analyzed the medication adherence in 237 psoriasis patients and compared it with that in other dermatological diseases such as atopic dermatitis, urticaria or tinea. This study was conducted among patients registered in monitoring system and 3096 eligible patients were enrolled. Our web-based questionnaire included the following items such as age, sex, annual income, main health-care institution, experience of effectiveness by oral or topical medication, overall satisfaction with treatment, and MMAS-8 for oral or topical medication. Mean adherence score by MMAS-8 was 5.2 for oral and 4.3 for topical medication. More patients with psoriasis used a university hospital and fewer used a private clinic compared with those with the other skin disease patients. Experience of drug effectiveness by oral medication and overall satisfaction with treatment was lower in psoriasis patients than in other patients. In oral medication, significantly better adherence was observed in those of higher age and with higher annual income. The adherence to medication, especially to topical drugs, was poor in 237 psoriasis patients. We speculated that some severe psoriasis patients were not sufficiently treated systemically and were resistant to topical therapy, leading to poor adherence., (© 2015 Japanese Dermatological Association.)