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Background: Parosmia symptoms are difficult to quantify due to their heterogeneity among patients, and thus a clinical challenge. This study aimed to assess parosmia with Self-Administered Odor Questionnaire for Parosmia (SAOQ-P), a modification of the widely used SAOQ in Japan. The primary objective was to assess the effectiveness of SAOQ-P in identifying parosmia symptoms and its potential integration into the clinical assessment process. The study also explored traditional olfactory test differences between patients with and without parosmia., Methods: Patients at Jikei Smell Clinic that presented between May 2022 and November 2022 were recruited and administered the SAOQ-P, which had an added question about changes in the perception of 20 daily odors compared to the original SAOQ. Traditional olfactory tests utilized T&T olfactometry and Open Essence., Results: Of 279 patients, 81 had parosmia, while 198 did not exhibit parosmic symptoms. Parosmia prevalence was influenced by the cause of olfactory dysfunction, with post-infectious and post-COVID-19 patients showing higher parosmia rates. Among parosmia patients, 87% reported changes in their perception of at least one odor assessed by SAOQ-P, with coffee, stool, and perfume most commonly affected. Traditional olfactory tests showed no significant differences between parosmia and non-parosmia groups. The number of odors causing parosmia was negatively correlated with age., Conclusion: SAOQ-P offers a promising approach to assess and quantify parosmia symptoms, seamlessly integrating into clinical assessments. SAOQ-P identified parosmia in 87% of patients and revealed insights into triggering factors. Traditional olfactory tests' limitations underscore the need for more accurate, patient-centric diagnostic approaches for parosmia.

An overwhelming surge of information regarding preparedness for postvaccination side effects had caused widespread confusion approximately since April 2021, when the coronavirus disease 2019 (COVID-19) vaccination had started for the general population in Japan. Notably, this resulted in a remarkably increased shortage of OTC acetaminophen formulations. The aim of this study was to elucidate the actual responses of the public in such an environment, how individuals acquired and understood information related to the management of postvaccination side effects, and how they obtained and used antipyretic analgesics before and after COVID-19 vaccination. We conducted a web-based survey in January 2022, targeting 400 individuals aged ≥20 years, who had received two COVID-19 vaccine doses, and excluded qualified professionals such as physicians and pharmacists. The results revealed that 67% of the respondents had obtained antipyretic analgesics in anticipation of adverse effects after vaccination, whereas 38% had taken these medicines before and/or after the second vaccination. Possible misappropriation of medicines from others, preventive administration, and lack of dosage and administration confirmation are the problems identified in medication acquisition and usage. Additionally, avoidance of antipyretic analgesics based on information without scientific evidence was observed. This study revealed no small amount of inappropriate use of medicines in situations, such as the COVID-19 pandemic, where there is an "infodemic" of mixed-quality information. Pharmacists, as experts in medication, should play a crucial role in promoting appropriate medication usage by consistently staying updated with the latest scientific evidence and proactively supporting OTC drug selection and counseling medication.

Objectives: Poor medication adherence among older adults is a global concern as it causes adverse drug interactions and inappropriate dosing. This study aimed to assess the association between family pharmacy and medication adherence among older adults., Methods: The Japan Gerontological Evaluation Study was a cross-sectional study of 18,792 people aged ≥65 years living in 61 municipalities in 25 prefectures who participated in a survey conducted in 2019 and did not require long-term care. Self-reported questionnaires were administered to evaluate whether the participants "always received medicines from the same pharmacy" and whether they had unused medicines. Modified Poisson regression was used to examine the association after adjusting for confounders., Results: Unused medicines were present in 89.9% of the "have group" (individuals who always received their medicines from the same pharmacy). This group had a lower prevalence of unused medicines (prevalence ratio [PR] = 0.87, 95% confidence interval [CI]: 0.82-0.92) than the "none group" (individuals who did not always receive their medicines from the same pharmacy). In the stratified analysis by education level, the prevalence of unused medicines was lower among those with low levels of education (≤9 years: PR = 0.82, 95% CI: 0.71-0.96; 10-12 years: PR = 0.81, 95% CI: 0.74-0.88)., Discussion: Older adults who "always received medicines from the same pharmacy" had a lower prevalence of unused medicines, especially those with low levels of education. Thus, "always receiving medicines from the same pharmacy" may be effective in reducing the proportion of unused medicines and improving medication adherence., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Providing standardized, high-quality rehabilitation for critically ill patients is a crucial issue. In 2017, the Japanese Society of Intensive Care Medicine (JSICM) promulgated the "Evidence-Based Expert Consensus for Early Rehabilitation in the Intensive Care Unit" to advocate for the early initiation of rehabilitations in Japanese intensive care settings. Building upon this seminal work, JSICM has recently conducted a rigorous systematic review utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. This endeavor resulted in the formulation of Clinical Practice Guidelines (CPGs), designed to elucidate best practices in early ICU rehabilitation. The primary objective of this guideline is to augment clinical understanding and thereby facilitate evidence-based decision-making, ultimately contributing to the enhancement of patient outcomes in critical care settings. No previous CPGs in the world has focused specifically on rehabilitation of critically ill patients, using the GRADE approach. Multidisciplinary collaboration is extremely important in rehabilitation. Thus, the CPGs were developed by 73 members of a Guideline Development Group consisting of a working group, a systematic review group, and an academic guideline promotion group, with the Committee for the Clinical Practice Guidelines of Early Mobilization and Rehabilitation in Intensive Care of the JSICM at its core. Many members contributed to the development of the guideline, including physicians and healthcare professionals with multiple and diverse specialties, as well as a person who had been patients in ICU. Based on discussions among the group members, eight important clinical areas of focus for this CPG were identified. Fourteen important clinical questions (CQs) were then developed for each area. The public was invited to comment twice, and the answers to the CQs were presented in the form of 10 GRADE recommendations and commentary on the four background questions. In addition, information for each CQ has been created as a visual clinical flow to ensure that the positioning of each CQ can be easily understood. We hope that the CPGs will be a useful tool in the rehabilitation of critically ill patients for multiple professions., (© 2023. The Author(s).)

Background: A pharmacist's work has shifted from non-personal to in-person services; especially in a super-aging society, further collaboration with other professions is needed. Communication has become an essential skill for pharmacists. However, there is limited public awareness about the work of pharmacists, and their perception among high school students is unclear. Medical dramas have been reported as educational tools for students, including their role in influencing the career choices of health professionals., Objective: This study aimed to evaluate the impact of a TV drama featuring a hospital pharmacist on perceptions of pharmacists among high school students and guardians., Methods: An online survey involving 300 high school students and 300 guardians with their own high school children was conducted before the drama aired, and a post-survey conducted after it finished airing. Regular viewing was defined as exposure in this study. A difference-in-differences approach was used to compare the change in perceptions toward pharmacists' work, required knowledge, aptitude, and communication needs., Results: Comparing before and after they viewed the drama, high school students had significant differences in their perceptions of pharmacist duties such as "one-dose package dispensing" and "health consultation other than medicine," while guardians had different perceptions of "collaboration with health care professionals" and "information sharing about medication therapy." Regarding pharmacist aptitude, only guardians showed significant differences in their perceptions of skills such as "precision," "cooperativeness," and "decisiveness." There were no significant differences in the perceived level of communication required for pharmacists., Conclusions: The results indicated that the portrayal of the pharmacist in the drama may have had some impact on high school students and guardians and was considered useful as an opportunity to learn about pharmacists. However, it was suggested that pharmacists should make the public understand that their work requires real-world communication skills., Competing Interests: All authors are members of an endowed laboratory funded by companies including Ain Pharmaciez Inc., I & H Co., Ltd., Medical Ikkou Co., Ltd., Toho Holdings Co., Ltd., Tomod's, and Wakaba Co. The companies are not directly involved in this study., (© 2023 The Authors.)

Purpose: Measuring health-related quality of life (HRQOL) in various health conditions in different countries is important given the regional differences. This study employed large-scale nationwide data targeting older adults in Japan to estimate the HRQOL in the key health conditions that are the major causes of disability., Methods: Our data were derived from two survey waves (2016 and 2019 surveys) of cross-sectional data from the Japan Gerontological Evaluation Study, an ongoing nationwide study targeting functionally independent older adults in Japan. A total of 28,345 individuals from 27 of the 47 Japanese provinces were analyzed. The EuroQoL 5-dimension 5-level instrument (EQ-5D-5L) was employed to assess the HRQOL utility scores. The targeted minimum loss-based estimator with sampling weighting methods was applied to estimate the utility score in eight major health conditions, including sensory organ disease, musculoskeletal disease, oral disorders, and depressive disorders., Results: The estimated HRQOL utility score for those with the poorest health conditions in self-rated health, hearing loss, vision loss, number of remaining teeth (e.g., no teeth with no denture use), oral dysfunction, depressive symptoms, chronic low back pain, and chronic knee pain was 0.576 (95% confidence interval (CI) 0.555-0.598), 0.768 (95% CI 0.737-0.800), 0.680 (95% CI 0.662-0.699), 0.809 (95% CI 0.796-0.821), 0.776 (95% CI 0.764-0.788), 0.723 (95% CI 0.710-0.737), 0.715 (95% CI 0.690-0.739), and 0.742 (95% CI 0.722-0.763), respectively., Conclusion: We successfully provided a catalog for the HRQOL utility score in key health conditions that are the leading causes of disability among older adults., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Janus-type triskelion-shaped fluorophores comprising coumarins bearing various electron-donating substituents ( 1aad , 1add , 1ccd , and 1cdd ) were successfully synthesized via an intramolecular Ullmann coupling. Density functional theory (DFT) calculations indicated that all the compounds presented two different molecular surfaces, similar to Janus-type molecules. The absorption and fluorescence spectra of asymmetrical derivatives 1aad , 1add , 1ccd , and 1cdd exhibited a bathochromic shift due to their narrow highest occupied molecular orbital (HOMO) -lowest unoccupied molecular orbital (LUMO) gap. Natural transition orbital (NTO) analysis indicated that the excited state orbital overlaps differ among the C 3 symmetrical and asymmetrical dyes. These triskelion-shaped fluorophores were found to form molecular nanoaggregates in THF/H 2 O mixtures and demonstrated aggregation-induced emission (AIE) enhancement characteristics as a result of restricting their molecular inversion. These results indicate that Janus-type AIE fluorophores are potentially applicable as solid-state fluorescent chiral materials, which can be optimized by controlling their molecular rearrangement in the solid state.

Xenopus laevis tadpoles possess regenerative capacity in their hindlimb buds at early developmental stages (stages ~52-54); they can regenerate complete hindlimbs with digits after limb bud amputation. However, they gradually lose their regenerative capacity as metamorphosis proceeds. Tadpoles in late developmental stages regenerate fewer digits (stage ~56), or only form cartilaginous spike without digits or joints (stage ~58 or later) after amputation. Previous studies have shown that administration of fibroblast growth factor 10 (FGF10) in late-stage (stage 56) tadpole hindlimb buds after amputation can improve their regenerative capacity, which means that the cells responding to FGF10 signaling play an important role in limb bud regeneration. In this study, we performed single-cell RNA sequencing (scRNA-seq) of hindlimb buds that were amputated and administered FGF10 by implanting FGF10-soaked beads at a late stage (stage 56), and explored cell clusters exhibiting a differential gene expression pattern compared with that in controls treated with phosphate-buffered saline. The scRNA-seq data showed expansion of fgf8-expressing cells in the cluster of the apical epidermal cap of FGF10-treated hindlimb buds, which was reported previously, indicating that the administration of FGF10 was successful. On analysis, in addition to the epidermal cluster, a subset of myeloid cells and a newly identified cluster of steap4-expressing cells showed remarkable differences in their gene expression profiles between the FGF10- or phosphate-buffered saline-treatment conditions, suggesting a possible role of these clusters in improving the regenerative capacity of hindlimbs via FGF10 administration., (© 2022 Japanese Society of Developmental Biologists.)

Background: Low skeletal muscle area or density, such as myosteatosis, identified on computed tomography (CT) is associated with poor prognosis in patients with cardiovascular diseases. However, there is a lack of evidence regarding the clinical process of skeletal muscle decline as a short-term change during acute care settings. This study focused on the use of routine CT imaging for aortic disease management and investigated the changes in skeletal muscle before and after acute care., Methods: This prospective study included 123 patients who underwent abdominal CT before and after acute care. The all-abdominal and each abdominal muscle areas were divided into eight parts (e.g. rectus abdominis, psoas, and erector spine), and their areas and densities were measured at the third lumbar vertebra level after the patients were discharged and de-identified with blinding to avoid measurement bias. Short physical performance battery (SPPB) was measured at the start and end of in-hospital cardiac rehabilitation. A generalized linear model with patients as random effects was made to investigate skeletal muscle loss during acute care. Multivariate linear regression analysis was also used to assess the relationship between the change in skeletal muscle during acute care and SPPB during in-hospital cardiac rehabilitation., Results: The median age of the patients was 70 (interquartile: 58-77) years, and 69.9% (86/123) were men. The median day between acute care from the day of surgery or hospital admission and follow-up CT was 7 (interquartile: 3-8) days. Overall muscle density declined after acute care (estimate value: -3.640, 95% confidence interval [CI]: -4.538 to -2.741), and each abdominal muscle density consistently declined (interaction: F value = 0.099, P = 0.998). In contrast, there was no significant change in the overall muscle area (estimate value: -0.863, 95% CI: -2.925 to 1.200). Changes in the muscle area were different for each skeletal muscle (interaction: F value = 2.142, P = 0.037), and only the erector spine muscle significantly declined (estimate value: -1.836, 95% CI: -2.507 to -1.165). After adjusting for confounding factors, a greater decline in muscle density was associated with lower recovery score on SPPB (β = 0.296, 95% CI: 0.066 to 0.400)., Conclusions: Muscle density consistently declined after acute care, especially the erector spine muscles, which also significantly decreased in size. A higher decline in muscle density was associated with a slower recovery of physical function during in-hospital cardiac rehabilitation in patients with aortic diseases., (© 2022 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.)

Aims: High-sensitivity cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) are associated with prognosis and severity in patients with heart failure (HF); however, their association with physical function is unclear. This study aimed to investigate whether hs-cTnT and BNP levels are associated with physical function in patients with HF., Methods and Results: Hs-cTnT, BNP, and physical function (maximal quadriceps isometric strength [QIS], usual gait speed, and 6-min walk distance [6MWD]) were evaluated in 363 consecutive patients with HF (median age, 70 [60-78] years). Patients were divided into four groups according to their median hs-cTnT and BNP levels. After adjusting for demographic characteristics, laboratory levels, and HF severity, higher hs-cTnT and BNP levels were significantly associated with lower physical function (log hs-cTnT, β = -0.162, P = 0.001, for maximal QIS; β = -0.175, P = 0.002, for usual gait speed, and β = -0.129, P = 0.004, for 6MWD; log BNP, β = -0.090, P = 0.092, for maximal QIS, β = 0.038, P = 0.516, for usual gait speed, and β = -0.108, P = 0.023, for 6MWD). In addition, the high hs-cTnT and high BNP group had significantly lower physical function (all P < 0.05) than the low hs-cTnT and low BNP group., Conclusions: Higher hs-cTnT and BNP levels are both associated with lower physical function in patients with HF, but hs-cTnT levels showed a more consistent association. The combination of hs-cTnT and BNP may be effective for the stratification of physical function in patients with HF., (© 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)