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Earthquake swarms are most commonly composed of small‐magnitude earthquakes. However, a recent study by Yoshida, Uchida, et al. (2023, https://doi.org/10.1029/2023GL106023) analyzed a swarm beneath the Noto Peninsula in Japan that, after more than two years of moderate‐magnitude seismicity, triggered the moment magnitude (Mw) 6.2 Suzu mainshock in May 2023. Based on high‐precision earthquake locations and a slip inversion of the mainshock, these authors found that the Mw 6.2 Suzu earthquake occurred on the updip extension of a fault that was active during the swarm, likely driven by increased fluid pressure. After publication of that paper, a much larger and more destructive Mw 7.5 event occurred nearby on 1 January 2024. These events underscore the potential for swarms to be precursors to large, damaging earthquakes. Forecasting the eventual evolution of swarms is currently very challenging but could be aided in the future by new observations and models. Plain Language Summary: Although earthquake swarms often only contain small earthquakes, occasionally they can trigger large, damaging earthquakes. Yoshida, Uchida, et al. (2023, https://doi.org/10.1029/2023GL106023) examined the triggering of a magnitude 6.2 earthquake in Japan, which caused extensive damage, following two years of smaller earthquakes. This sequence, like many swarms, may have been driven by elevated fluid pressure migrating upwards within the crust. After publication of that paper, a much larger and more destructive Mw 7.5 event occurred nearby. Forecasting the eventual evolution of ongoing swarms is currently very challenging but could be aided in the future by new observations and models. Key Points: Earthquake swarms can be precursors to damaging earthquakes, including the 1 January 2024, Mw 7.5 Noto Peninsula, Japan eventFluid pressure changes often drive swarm activity, and their degree of confinement may influence swarm evolutionDirect observations of fluids in fault zones combined with numerical modeling may aid swarm forecasting in the future [ABSTRACT FROM AUTHOR]

Our research activities would be better served if they were communicated in a manner that is openly accessible to the public and all researchers. The research we share is often limited to representative data included in research papers—science would be much more efficient if all reproducible research data were shared alongside detailed methods and protocols, in the paradigm called Open Science. On the other hand, one primary function of research journals is to select manuscripts of good quality, verify the authenticity of the data and its impact, and deliver to the appropriate audience for critical evaluation and verification. In the current paradigm, where publication in a subset of journals is intimately linked to research evaluation, a hypercompetitive "market" has emerged where authors compete to access a limited number of top‐tier journals, leading to high rejection rates. Competition among publishers and scientific journals for market dominance resulted in an increase in both the number of journals and the cost of publishing and accessing scientific papers. Here we summarize the current problems and potential solutions from the development of AI technology discussed in the seminar at the 46th Annual Meeting of the Molecular Biology Society of Japan. [ABSTRACT FROM AUTHOR]

Aim: To clarify whether the Whitney Comorbidity Index (WCI) is useful in Asian adults with cerebral palsy (CP) and whether aspiration pneumonia and pressure ulcers improved the prognostic significance of the WCI. Method: This cohort study evaluated individuals aged at least 18 years with CP in Japan. We used Cox proportional hazards regression to analyse 2‐year mortality rates. The predictive performance of the Charlson Comorbidity Index, Elixhauser Comorbidity Index, and WCI were compared as comorbidity assessment criteria. Aspiration pneumonia and pressure ulcers were added to the Cox models, and their impact on hazard ratios was determined. Results: Of the 2232 adults with CP, 72 died during the 2 years. The model with a previously reported weighted WCI with aspiration pneumonia and pressure ulcers produced the best fit. Additionally, the hazard risk of 2‐year mortality for an unweighted WCI score of at least 4 was 2.56; when CP‐specific comorbidities were added, it increased to 8.94. Interpretation: This study showed that the WCI can be used in Asian adults with CP. Furthermore, assessing patient age, aspiration pneumonia, and pressure ulcers in addition to the WCI increased the predictive value for mortality. Our findings indicate that the WCI can promote valid comparisons between international populations. What this paper adds: The Whitney Comorbidity Index (WCI) is useful among adults with cerebral palsy, irrespective of ethnic differences.Assessment of aspiration pneumonia and pressure ulcers increased the WCI predictive value.The WCI helps identify adults with cerebral palsy at risk of adverse outcomes. What this paper adds: The Whitney Comorbidity Index (WCI) is useful among adults with cerebral palsy, irrespective of ethnic differences.Assessment of aspiration pneumonia and pressure ulcers increased the WCI predictive value.The WCI helps identify adults with cerebral palsy at risk of adverse outcomes. This article's abstract has been translated into Japanese. Follow the links from the abstract to view the translations. [ABSTRACT FROM AUTHOR]

Accurate traffic volume prediction plays a crucial role in urban traffic control by relieving congestion through improved regulation of traffic volume. Network‐level traffic volume prediction and detector failure have rarely been considered in the literature. This paper proposes a framework based on long short‐term memory and the multilayer perceptron that can predict network‐level traffic volumes even with detector failure. A profile model learns the profile of the detector's signature (traffic pattern). Detectors with similar profiles are considered to have similar traffic patterns and are grouped into a cluster. Failed detectors can obtain reference information from similar detectors in the same cluster without additional information. A predictive model is developed for each cluster. The proposed method is validated using Japan Road Traffic Information Center data for three cities. The computational results indicate that the proposed method performs well both on typical days and atypical days (the COVID‐19 lockdown period and the 2021 Tokyo Olympics). Further, it considers detector reliability: the increase in mean absolute error is less than 1 veh/5 min when the probability of detector failure increases to 20%. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to illustrate the changing diversity patterns of native freshwater fish in the past two centuries and to identify priority locations for native fish conservation to counter future degradation. Location: Japanese archipelago. Methods: We used the published native fish fauna data in 39 lakes across Japan, analysing historical and current diversity and projecting future distribution patterns based on the Japanese Red List. We assessed fish assemblages' taxonomic, phylogenetic, and functional alpha and beta diversity across different periods. Additionally, we proposed a cumulative diversity index that incorporated taxonomic, phylogenetic and functional facets, and then examined its relationship with the latitudinal positioning of the lakes across periods. Results: We observed a significant decrease in the richness of native freshwater fish since historical periods. Accompanying this decline were significant reductions in both phylogenetic relatedness and functional redundancy. Fish beta diversity increased from the past to the present and is predicted to decline drastically, indicating an ongoing homogenization process. Using the cumulative diversity index, we identified Hokkaido and Kyushu as crucial habitats for endemic fishes. These islands, with unique biogeographical backgrounds, contributed substantially to the national dissimilarity patterns of native fish assemblages in the historical period. However, the contribution is diminishing due to the ongoing decline in fish endemism. Main Conclusions: The conservation priority of native freshwater fish in Japan should be assigned to Hokkaido and Kyushu due to the inhabited endemic species. The proposed framework for assessing the cumulative diversity of biotic communities presented the potential to aid macroecological explorations that underpin biodiversity conservation. [ABSTRACT FROM AUTHOR]

Background: Few epidemiological studies on respiratory medicine and the relationship between clinical signs and various respiratory diseases in cats have been reported. Objectives: This retrospective study aimed to investigate the prevalence and breed predisposition to feline respiratory diseases in Japan and determine the association between clinical signs, duration and type of respiratory diseases. Methods: The medical records of cats with feline respiratory diseases were examined to obtain information on age, sex, breed, final diagnosis, clinical signs and duration. The odds ratios (ORs) and 95% confidence intervals were calculated to evaluate breed predispositions. Mann–Whitney U, Kruskal–Wallis and Dunn's tests were used to assess the duration of clinical signs. Results: This study included 540 cats with 615 respiratory diagnoses. The American Shorthair breed was predisposed to bronchopneumonia (BP; OR: 5.0) and pulmonary tumour (PT; OR: 3.6), while the Russian Blue breed exhibited a predisposition to inflammatory lower airway diseases (OR: 3.4), BP (OR: 6.1) and interstitial lung diseases (OR: 11.1). Similarly, the Scottish Fold breed displayed predisposition to PTs (OR: 5.8). The duration of clinical signs among nasal diseases, nasopharyngeal diseases and lower tracheal/bronchial and pulmonary diseases differed significantly (p = 0.001, p = 0.012, p < 0.0001, respectively). Conclusions: The results suggest that some popular breeds in Japan are predisposed to feline respiratory diseases, especially the American Shorthair, Russian Blue and Scottish Fold breeds. The characteristics of occurrence, clinical signs and duration of each disease will aid in diagnosing, treating, preventing and elucidating the pathophysiology of feline respiratory disease. [ABSTRACT FROM AUTHOR]

Aim: Possible negative effects of the COVID‐19 pandemic on short‐term postoperative outcomes for colorectal perforation in Japan were examined in this study. Methods: The National Clinical Database (NCD) is a large‐scale database including more than 95% of surgical cases in Japan. We analyzed 13 107 cases of colorectal perforation from 2019 to 2021. National data were analyzed, and subgroup analyses were conducted for subjects in prefectures with high infection levels (HILs) and metropolitan areas (Tokyo Met. and Osaka Pref.). Postoperative 30‐day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) does not contain 1. Results: In the NCD, postoperative 30‐day mortality occurred in 1371 subjects (10.5%), surgical mortality in 1805 (13.8%), and postoperative complications in 3950 (30.1%). Significantly higher SMRs were found for 30‐day mortality in November 2020 (14.6%, 1.39 [95% CI: 1.04–1.83]) and February 2021 (14.6%, 1.48 [95% CI: 1.10–1.96]), and for postoperative complications in June 2020 (37.3%, 1.28 [95% CI: 1.08–1.52]) and November 2020 (36.4%, 1.21 [95% CI: 1.01–1.44]). The SMRs for surgical mortality were not significantly high in any month. In prefectures with HILs and large metropolitan areas, there were few months with significantly higher SMRs. Conclusions: The COVID‐19 pandemic had limited negative effects on postoperative outcomes in patients with colorectal perforation. These findings suggest that the emergency system for colorectal perforation in Japan was generally maintained during the pandemic. [ABSTRACT FROM AUTHOR]

This study investigated the relative influences of environmental, spatial, and historical factors, including the island‐specific history of land connectivity, on bat assemblages in the Japanese Archipelago. We collected bat distribution data from 1408 studies and assigned them to Japan's First Standard Grid (approximately 6400 km2). Japanese bat assemblages were analyzed at two scales: the entire Japanese Archipelago comprised 16 islands and exclusively the four main islands. At first, we calculated taxonomic and functional total beta diversity (βtotal) by Jaccard pairwise dissimilarity and then divided this into turnover (βrepl) and richness‐difference (βrich) components. We conducted hierarchical clustering of taxonomic beta diversity to examine the influence of the two representative sea straits, Tsugaru and Tokara, which are considered biogeographical borders. Variation partitioning was conducted to evaluate the relative effects of the three factors on the beta diversity. Clustering revealed that the Tokara Strait bordered the two major clades; however, the Tsugaru Strait did not act as a biogeographical border for bats. In the variation partitioning, shared fraction between spatial and historical factors significantly explained taxonomic and functional βtotal and taxonomic βrepl at the entire archipelago scale, but not at the four main islands scale extending only Tsugaru Strait but not Tokara Strait. Pure environmental factors significantly explained functional βtotal at both scales and taxonomic βtotal only at the four main islands scale. These results suggest that spatial and historical factors are more pronounced in biogeographical borders, primarily structuring assemblage composition at the entire archipelago scale, especially in taxonomic dimension. However, current environmental factors primarily shape the assemblage composition of Japanese bats at the main island scale. The difference in results between the two scales highlights that the primary processes governing assemblages of both dimensions depend on the quality of the dispersal barriers between terrestrial and aquatic barriers for bats. [ABSTRACT FROM AUTHOR]

Background: Poly (ADP‐ribose) polymerase (PARP) inhibitors have been increasingly used in the treatment of ovarian cancer, with BRCA positivity and homologous recombination deficiency (HRD) being common biomarkers used for predicting their efficacy. However, given the limitations of these biomarkers, new ones need to be explored. Methods: This retrospective study included 181 ovarian cancer patients who received olaparib or niraparib at two independent hospitals in Japan between May 2018 and December 2022. Clinical information and blood sampling data were collected. Patient characteristics, treatment history, and predictability of treatment duration based on blood data before treatment initiation were examined. Results: High‐grade serous carcinoma, BRCA positivity, HRD, and maintenance therapy after recurrence treatment were observed more frequently in the olaparib group than in the niraparib group. The most common reasons for treatment interruption were anemia, fatigue, and nausea in the olaparib group and thrombocytopenia in the niraparib group. Regarding response to olaparib treatment, complete response to the most recent treatment, maintenance therapy after the first chemotherapy, high‐grade serous carcinoma, and germline BRCA positivity were observed significantly more frequently among responders than among non‐responders. Furthermore, neutrophil counts were significantly higher among responders than among non‐responders. Conclusions: Inflammation‐related blood data, such as neutrophil count, obtained at the initial pre‐treatment visit might serve as potential predictors for prolonged olaparib treatment. While this study offers valuable insights into potential indicators for prolonged olaparib treatment, it underscores the need for more expansive research to strengthen our understanding of PARP inhibitors and optimize treatment strategies in ovarian cancer. [ABSTRACT FROM AUTHOR]

Objective: Multisystem proteinopathy (MSP) is an inherited disorder in which protein aggregates with TAR DNA‐binding protein of 43 kDa form in multiple organs. Mutations in VCP, HNRNPA2B1, HNRNPA1, SQSTM1, MATR3, and ANXA11 are causative for MSP. This study aimed to conduct a nationwide epidemiological survey based on the diagnostic criteria established by the Japan MSP study group. Methods: We conducted a nationwide epidemiological survey by administering primary and secondary questionnaires among 6235 specialists of the Japanese Society of Neurology. Results: In the primary survey, 47 patients with MSP were identified. In the secondary survey of 27 patients, inclusion body myopathy was the most common initial symptom (74.1%), followed by motor neuron disease (11.1%), frontotemporal dementia (FTD, 7.4%), and Paget's disease of bone (PDB, 7.4%), with no cases of parkinsonism. Inclusion body myopathy occurred most frequently during the entire course of the disease (81.5%), followed by motor neuron disease (25.9%), PDB (18.5%), FTD (14.8%), and parkinsonism (3.7%). Laboratory findings showed a high frequency of elevated serum creatine kinase levels and abnormalities on needle electromyography, muscle histology, brain magnetic resonance imaging, and perfusion single‐photon emission computed tomography. Interpretation: The low frequency of FTD and PDB may suggest that FTD and PDB may be widely underdiagnosed and undertreated in clinical practice. [ABSTRACT FROM AUTHOR]

The difference in observed atmospheric anomalies over the Northern Hemisphere winter between 2021–22 and 2020–21 La Niña years indicated a tripole pattern consisting of a Japan cyclone, a Bering Sea anticyclone, and a cyclone over the North American continent. This feature, however, was not replicated in the North American Multi‐Model Ensemble (NMME) forecasts. A set of model sensitivity experiments was performed to better understand the cause of this discrepancy. The results revealed the possible role of the influence of sea surface temperature (SST) anomalies, particularly over the Indian Ocean, on the observed circulation differences that was further modulated by internal atmospheric variability. The failure in predicting circulation changes in NMME was next attributed to the errors in SST predictions over the Indian Ocean and highlights the need for improvements in SST forecasts over this region. Plain Language Summary: The tropical SST anomalies associated with the El Niño‐Southern Oscillation (ENSO) are known to influence the global atmospheric circulation and are the major source of skill in U.S. seasonal predictions. As the cold phase of ENSO, La Niña features below‐normal SST anomalies and suppressed convection over the equatorial central and eastern Pacific. Such a tropical heating distribution favors the formation of the atmospheric circulation pattern that has a roughly opposite effect on U.S. surface climate compared to El Niño, the warm phase of ENSO, although the effect is not strictly symmetric. For the recent two La Niña boreal winters of 2020–21 and 2021–22, the observed circulation patterns differed, but dynamical seasonal prediction failed to replicate this feature. Understanding the cause for the discrepancy of circulation changes between prediction and observations is of fundamental importance for the improvement of seasonal forecasts. Toward this, we designed numerical experiments that are forced with observed and predicted SST anomalies over different ocean basins. The results show that it is the errors in SST prediction over the Indian Ocean that contributed to the failure in the prediction of circulation changes, highlighting the importance of skillful prediction of SST over this region. Key Points: The difference in observed atmospheric anomalies for 2022 versus 2021 La Niña boreal winters featured a Northern Hemisphere tripole patternIndian Ocean SST contributed to the formation of observed tripole pattern, with internal atmospheric variability modulating its magnitudeErrors in SST predictions over the Indian Ocean led to the failure in predictions of the circulation changes in NMME forecasts [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has impacted healthcare behaviors, leading to fewer pediatric visits in Japan and potentially fewer visits by adult patients. However, existing Japanese studies on treatment interruptions have generally relied on questionnaire‐based methods. In this study, we assessed the impact of the pandemic on antihypertensive treatment interruption using real‐world prescription data. Methods: We conducted an interrupted time series analysis using the National Health Insurance Database in Okayama Prefecture, Japan. Participants included individuals aged 40–69 years with at least one antihypertensive prescription between 2018 and 2020. Treatment interruption was defined as a 3‐month or longer gap in prescriptions after medication depletion. We used segmented Poisson regression with models unadjusted and adjusted for seasonality and over‐dispersion to assess monthly treatment interruptions before and after Japan's April 2020 emergency. Results: During the study period, 23.0% of 55,431 participants experienced treatment interruptions. Cyclical fluctuations in interruptions were observed. The crude analysis indicated a 1.2‐fold increase in treatment interruptions following the pandemic; however, the adjusted models showed no significant changes. Even among higher‐risk groups, such as women, younger adults, and those with shorter prescriptions, no significant alterations were observed. Conclusion: We found no significant impact of the COVID‐19 pandemic on antihypertensive treatment interruption in Okayama Prefecture. The less severe outbreak in the area or increased use of telemedicine and extended prescriptions may have contributed to treatment continuity. Further research is needed using a more stable and comprehensive database, broader regional data, and detailed prescription records to validate and extend our findings. [ABSTRACT FROM AUTHOR]

Aim: We explored institutional factors in Japan associated with lower operative mortality and failure‐to‐rescue (FTR) rates for eight major gastrointestinal procedures. Methods: A 22‐item online questionnaire was sent to 2119 institutional departments (IDs) to examine the association between institutional factors and operative mortality and FTR rates. IDs were classified according to the number of annual surgeries, board certification status, and locality. In addition, the top 20% and bottom 20% of IDs were identified based on FTR rates and matched with the results of the questionnaire survey. Factors associated with operative mortality were selected by multivariate analysis. Results: Of the 1083 IDs that responded to the questionnaire, 568 (213 382 patients) were included in the analysis. Operative morbidity, operative mortality, and FTR rates in the top 20% and bottom 20% of IDs were 13.1% and 8.4% (p < 0.001), 0.52% and 4.3% (p < 0.001), and 4.0% and 51.2% (p < 0.001), respectively. Based on the patients' background characteristics, the top 20% of IDs handled more advanced cases. No significant difference in locality was seen between better or worse hospital FTR rates, but fewer esophagectomies, hepatectomies, and pancreatoduodenectomies were performed in depopulated areas. Six items were found to be associated with operative mortality by multivariate logistic analysis. Only 50 (8.8%) IDs met all five factors related to better FTR rates. Conclusions: The present findings indicate that several hospital factors surrounding surgical treatment, characterized by abundant human resources, are closely related to better postoperative recovery from severe complications. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to verify the clinical feasibility of tele‐proctoring using our ultra‐low latency communication system with shared internet access. Methods: Connections between two multiple remote locations at various distances were established through the TELEPRO® tele‐proctoring system. The server records the latency between the two locations for tele‐proctoring using the annotations. Questionnaires were administered to the surgeons, assistants, and medical staff. Respondents rated the quickness and quality of communication in terms of latency and disturbances in the audio, video, and usefulness of the live telestrations with annotation. Results: Seven hospitals tele‐proctored with Sapporo Medical University between January 2021 and September 2022. The median latency of annotation between the two locations ranged from 24.5 to 48.5 ms. No major technological problems occurred, such as streaming interruption, loss of video or audio, poor resolution. The video encoding time was 10 ms, and its decoding time was 0.8 ms. The total latency positively correlated with the distance between two locations (R = 0.55, p < 0.01). The quality of communication regarding latency, disturbance, and surgical education with intraoperative annotative instructions showed similar trends, with perfectly fine being the most common response. No significant differences in surgical quality, educational effect, or social impact were observed between the latency ≥30 and <30 ms groups for whether the size of latency affects surgical education. Conclusion: The feasibility of the tele‐proctoring system is expected to be a sustainable approach to help education for young surgeons and surgical supports in rural areas, thereby reducing disparities in health care. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate probable maximum precipitation (PMP) estimated using surface dew points (SDP) or actual precipitable water obtained from upper‐air data (UAD) in the moisture‐maximization method with the help of sufficient extreme precipitation events using large‐scale climate ensemble simulation data (d4PDF). The deviations between the PMP variables estimated by the SDP and UAD approaches were analyzed for southern and northern areas of Japan to consider the regional characteristics of the deviations. We found that the deviations were high in northern areas where the SDPs are relatively low during precipitation events. The PMPs estimated using each approach were also compared to the extreme‐scale reference precipitation proposed in this study. The SDP approach overestimated the PMPs by over 20% compared to the reference precipitation in the northern region. However, the UAD approach showed very low average errors in all southern and northern areas. This tendency of the SDP approach was significantly related to the regional climatic characteristics of the SDP, which indicated that the SDP approach may estimate an uncertain PMP value depending on each regional climatic characteristic compared to the UAD approach. Regional climatic characteristics should be considered when using the SDP approach to estimate the PMP. [ABSTRACT FROM AUTHOR]

Aim: Interview quality is an important factor in the success of clinical trials for major depressive disorder (MDD). There is a substantial need to establish a reliable, remote clinical assessment interview system that can replace traditional in‐person interviews. Methods: We conducted a multicenter, randomized, unblinded, prospective, cross‐sectional study to assess the reliability of remote interviews in patients with MDD (UMIN000041839). Eligible patients with MDD underwent remote and in‐person sessions of the Montgomery‐Åsberg Depression Rating Scale (MADRS) assessment performed by different raters within 28 days of providing consent. Patients were randomized to a group first assessed using in‐person interviews and secondarily using remote interviews (in‐person‐first group) or a group first assessed by remote interviews and secondarily using in‐person interviews (remote‐first group). Nineteen trained people (15 clinical psychologists, 3 nurses, and 1 clinical laboratory technologist) performed interviews. Results: Of 59 patients (in‐person‐first group, n = 32; remote‐first group, n = 27) who completed both remote and in‐person interviews, 51% (n = 30) were women; the mean age was 41.6 years (range, 21–64 years). There was a strong association between remote and in‐person MADRS scores (r = 0.891, kappa = 0.901). An overall intraclass correlation coefficient (ICC) of 0.886 (95% confidence interval, 0.877–0.952) indicated good consistency between MADRS scores in remote and in‐person interviews. The ICC decreased as the severity of depression increased. Conclusion: Our results suggest remote interviews are a feasible alternative option to in‐person interviews in assessing symptom severity in MDD patients and could promote clinical trials in Japan. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and frequentist network meta‐analysis used random‐effects models is conducted to determine whether there are differences in the efficacy, acceptability, tolerability, and safety profiles of brexpiprazole (BRE) and aripiprazole (ARI) for Japanese with major depressive disorder (MDD) who were inadequately responsive to antidepressants. Methods: Outcome measures were scores on the Montgomery Åsberg Depression Rating Scale (primary), the Clinical Global Impression severity scale, and social functioning scale; the non‐response rate; the non‐remission rate; all‐cause discontinuation; discontinuation due to adverse events (DAE); at least one adverse event (1AE); serious adverse event, akathisia; tremor; weight gain. Results: A literature search identified three double‐blind, randomized, placebo‐controlled trials. These comprised one BRE study (with a 1 mg/day [BRE1] and a 2 mg/day [BRE2]) and two ARI studies (with a 3 mg/day arm and a flexible‐dose arm[within the dosage range approved in Japan]) (n = 1736). Both BRE and ARI demonstrated better efficacy than the placebo. BRE but not ARI had a higher DAE than the placebo. ARI but not BRE had a higher 1AE than the placebo. BRE and ARI had a higher risk of akathisia and weight gain than the placebo. There were no significant differences between BRE and ARI for any of the outcomes. Although BRE1 had good efficacy, it carried risk of weight gain. Although BRE2 also had efficacy, it carried risks of DAE, akathisia, and weight gain. However, the risk of akathisia in BRE2 was reduced by an initial dose of 0.5 mg/day rather than 1.0 mg/day. Conclusions: Overall BRE showed similar utility to ARI and a good risk–benefit balance. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID‐19) pandemic and government regulations have affected the daily lives and mental health of individuals worldwide. This study aimed to determine how much the change in time spent on exercise (exercise time), outdoor activities ("going‐out" time), and screen usage (screen time) before and after the COVID‐19 pandemic has affected mental health (depression, anxiety, and insomnia). In June 2021, during the third wave of the COVID‐19 pandemic, a web‐based, cross‐sectional survey was conducted in Japan through an online research company. A total of 824 workers participated in this study. Depression, anxiety, and insomnia were assessed using the Patient Health Questionnaire‐9, General Anxiety Disorder‐7, and Insomnia Severity Index, respectively. The symptoms of depression were associated with age and decreased exercise time. Symptoms of anxiety were associated with not decreased going‐out time. Symptoms of insomnia were associated with reduced exercise time. The results indicated that during the COVID‐19 pandemic, an increase in exercise time could have prevented depression and insomnia. Similarly, a decrease in going‐out time could have prevented anxiety. Furthermore, in the event of future outbreaks of unpredictable infections, such as COVID‐19, decreased going out and increased exercise may help maintain mental health. [ABSTRACT FROM AUTHOR]

Aims: In Japan, the daily dosage of hypnotic drugs for insomnia treatment is increasing year by year, and over‐dependence on treatment with hypnotic drugs is a major problem. This study aimed to examine the factors related to the elimination of prescriptions of three or more hypnotic drugs within 1 year in our clinic. Methods: We conducted two surveys. Survey ① assessed the frequency of prescriptions of three or more hypnotic drugs by retrospectively reviewing the medical records of all patients who visited general and psychiatric outpatient clinics from January 2013 to March 2019. Survey ② assessed changes in prescriptions of hypnotic and psychotropic drugs within the subsequent year by retrospectively reviewing the medical records of all patients prescribed three or more hypnotic drugs who visited neuropsychiatric outpatient clinics multiple times between April 2013 and March 2019. Results: The frequency of prescribing three or more hypnotic drugs was six to nine times higher in psychiatry than in other departments. Flunitrazepam and brotizolam were the most common drugs prescribed and had the second lowest discontinuation rate after zolpidem. Conversely, eszopiclone, zopiclone, and suvorexant had the highest discontinuation rates. The success factors for drug reduction were age (odds ratio [OR]: 0.97, p < 0.0037), trazodone addition (OR: 12.86, p < 0.0194) and number of years of psychiatric experience. Conclusions: The characteristics and success factors in relation to drug reduction in patients with multiple prescriptions of hypnotic drugs identified in this study may contribute to solving the problem of multiple prescriptions of hypnotic drugs. [ABSTRACT FROM AUTHOR]

Introduction: The question remains to be elucidated: "Is treatment with antidepressants at doses approved in Japan effective for Japanese patients with MDD?" It is crucial to confirm this in order to provide appropriate treatments for Japanese patients with major depressive disorder (MDD). Therefore, we conducted a systematic review and random‐effects pairwise meta‐analysis including these nine double‐blind, randomized, placebo‐controlled trials. Methods: We calculated the standardized mean difference (SMD) and risk ratio (RR) with a 95% confidence interval (95% CI). Results: Pooled newer antidepressants outperformed placebo regarding improvement of depressive symptom scale scores [SMD (95% CI) = −0.20 (−0.27, −0.12), p < 0.00001], response to treatment [RR (95% CI) = 1.23 (1.13, 1.32), p < 0.00001], and remission rate [RR (95% CI) = 1.30 (1.16, 1.45), p < 0.00001]. Although all‐cause discontinuation was not significantly different between the treatment groups, the pooled antidepressant group showed a higher discontinuation rate due to adverse event [RR (95% CI) = 1.60 (1.13, 2.26), p = 0.007] and a higher incidence of at least one adverse event than the placebo group [RR (95% CI) = 1.13 (1.08, 1.18), p < 0.00001]. Discussion: We concluded that newer antidepressants are effective for Japanese adults with MDD although the clinicians must monitor the health conditions of these individuals. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the prevalence and characteristics of diabetic symmetric sensorimotor polyneuropathy (DSPN) in patients with type 2 diabetes registered in the Japan Diabetes Complication and its Prevention Prospective study. In the study, 6,338 patients with diabetes who had been treated by diabetes specialists were registered in 2007–2009. Of these, patients with type 2 diabetes who could be evaluated for DSPN were analyzed using the t‐test, χ2‐test and logistic regression analyses. DSPN was diagnosed using the Simple Diagnostic Criteria for Diabetic Polyneuropathy proposed by the Diabetic Neuropathy Study Group in Japan. Of the total participants, 5,451 patients (mean age 61.4 years, duration of diabetes 10.8 years) were analyzed. Based on the criteria, 35.8% of patients were diagnosed with DSPN. The prevalence of sensory symptoms was 25.8%. The following factors increased the risk for DSPN: age (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.42–1.73), duration of diabetes (OR 1.32, 95% CI 1.21–1.43), body mass index (OR 1.19, 95% CI 1.09–1.30), systolic blood pressure (OR 1.06, 95% CI 1.01–1.10), hemoglobin A1c (OR 1.15, 95% CI 1.09–1.22), biguanides (OR 1.22, 95% CI 1.06–1.39) and insulin therapy (OR 1.59, 95% CI 1.36–1.84). The following factors decreased the risk for DSPN: total cholesterol (OR 0.98, 95% CI 0.96–1.00) and exercise therapy (OR 0.85, 95% CI 0.73–0.98). The baseline survey clarified the prevalence and characteristics of DSPN in Japanese patients with type 2 diabetes. The survey also showed the risk factors of DSPN. [ABSTRACT FROM AUTHOR]

Measurements of surface heat flux from boreholes of the NIED Hi‐net network of seismometers are used to determine temperature and shear stress on the plate interface beneath northern Honshu. At the maximum depth of thrust‐faulting earthquakes, about 60 km, the temperature is 660 ± 240°C and the average shear stress during slip on the interface is 100 ± 45 MPa. The equivalent quantities from the oceanic setting of the Kermadec trench are 630 ± 140°C and 115 ± 25 MPa. The shear stresses are substantially higher than commonly assumed in models of convergent plate interfaces, but are consistent with measurements made above other convergent plate interfaces where heat flux data are more sparse. They are also consistent with the level of shear stress required to explain measurements of pressure and temperature from high‐pressure‐low‐temperature terrains that experienced metamorphism on subduction interfaces, in particular those from the Cretaceous Sanbagawa belt of SW Japan. Plain Language Summary: The temperatures and stresses under which most of the world's great earthquakes nucleate are poorly known because they take place at depths of tens of kilometers, where conditions cannot be directly observed. Measurements of surface heat flux above plate interfaces provide the strongest indirect constraints, but those measurements are sparse. We use a dense set of heat flux measurements to determine shear stress and temperature on the plate interface of northern Honshu, on which the 2011 Tōhoku earthquake occurred. The shear stress, 100 ± 45 MPa, and temperature, 660 ± 240°C, are significantly higher than previous estimates, but are supported by analysis of heat flux above the Kermadec plate interface—the only location where a comparable density of heat flux measurements has been used to estimate shear stress. Shear stresses of ∼100 MPa can also account for the conditions of temperature and pressure recorded in rocks of the Sanbagawa belt of SW Japan, which are the exhumed remnants of an approximately 90‐million‐year‐old plate interface. This concordance supports arguments that the Sanbagawa, and similar terrains around the world, record physical and chemical conditions relevant to the generation of earthquakes on present‐day plate interfaces. Key Points: Surface heat flux measurements constrain temperature (660 ± 240°C) and shear stress (100 ± 45 MPa) at ∼60 km on the plate interface in N HonshuThese values are supported by estimates from dense heat flux measurements at the Kermadec plate boundary (630 ± 140°C) and (115 ± 25 MPa)Metamorphic temperatures in an exhumed plate interface, the Sanbagawa belt of SW Japan, are also explained by this level of shear stress [ABSTRACT FROM AUTHOR]

Non‐inertial afterslip has been inferred to occur following large earthquakes. An explanation for this slow slip phenomenon is that coseismically generated stresses induce sliding on parts of a fault surface with velocity‐strengthening frictional properties. Here we develop an alternative mesoscale heuristic explanation for afterslip based on the idea that afterslip may occur on any portion of a fault that exhibits positive residual geometric moment following an earthquake, including sections that ruptured coseismically. Following a large earthquake, this model exhibits exponential time decay of afterslip and allows for variable sensitivity to coseismic event magnitude and residual geometric moment. This model provides a partial explanation for the spatial relationship of co‐ and post‐seismic slip associated with the 2011 MW = 9 Tohoku‐oki earthquake. Plain Language Summary: Afterslip is slow slip that occurs after large earthquakes. Some geodetic inferences of afterslip suggest that regions experiencing afterslip may have also slipped coeismically. This spatially coincident behavior is poorly explained by classical stress‐driven afterslip models. Here, we develop a motion‐based model to explain this possible spatial relationship. The model predicts faster afterslip rates in regions that have an excess of accumulated slip to be released following a large earthquake. This model may be used to describe the spatial relationship of co‐ and post‐seismic slip associated with the 2011 Great Japan earthquake. Key Points: We develop a geometric moment based model for time‐dependent afterslipThe model exhibits and exponential time decay of afterslip ratesThis model provides a kinematic explanation for overlapping co‐ and post‐seismic slip proximal to the 2011 great Japan earthquake [ABSTRACT FROM AUTHOR]

Background: Many countries are experiencing rapid population aging, and the provision of support for older adults with diseases or disabilities to continue living in their communities is a major global challenge. Japan has established multifunctional long‐term care in small group homes and home‐visit nursing (MLSH) as a service category that integrates medical and care services. These services focus on nursing functions to support continuous, long‐term home, and end‐of‐life care for older adults with high levels of medical care dependency. This study aimed to clarify the relationship between nurses' perceptions of nursing benefits/challenges and the degree of interprofessional collaboration in the context of MLSH. Methods: We conducted a mail questionnaire survey of MLSH facilities throughout Japan. All facilities in Japan that had been operating for at least 1 year were included. We analyzed 182 responses (response rate: 36.0%; valid response rate: 98.3%). Results: Comparison of scores representing the degree of interprofessional collaboration perceived by nurses showed the highest score was for colleague nurses (3.9 ± 0.5) and the lowest was for external care managers (2.5 ± 0.9). Compared with the weak collaboration group, the strong collaboration group had higher perceptions of the benefits of nursing and lower perceptions of the challenges. Conclusions: The results of this study suggest that strong collaboration allows teams to achieve sufficient effects of care while reducing related challenges. It may be necessary to promote collaboration with external professionals to appropriately manage service users' worsened conditions and improve the quality of care. [ABSTRACT FROM AUTHOR]

Background: Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID‐19 pandemic in Japan. Methods: Thirty‐three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID‐19 pandemic and whether or not COVID‐19 caused acute asthma exacerbation were investigated. Results: From fiscal years 2010–2019, the median number of acute asthma hospitalizations per year was 3524 (2462–4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3‐ to 6‐year group. SARS‐CoV‐2 was evaluated in 2094 patients from fiscal years 2020–2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS‐CoV‐2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long‐term control medications before admission despite the severity of bronchial asthma. Conclusion: SARS‐CoV‐2 was hardly detected in children with acute asthma hospitalization during the COVID‐19 pandemic. This result indicated that SARS‐CoV‐2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long‐term control medications is a major problem that should be addressed. [ABSTRACT FROM AUTHOR]

Background: Allergic bronchopulmonary mycosis (ABPM) is an allergic disease caused by type I and type III hypersensitivity to environmental fungi. Schizophyllum commune, a basidiomycete fungus, is one of the most common fungi that causes non‐Aspergillus ABPM. Objective: Herein, we attempted to clarify the clinical characteristics of ABPM caused by S. commune (ABPM‐Sc) compared with those of allergic bronchopulmonary aspergillosis (ABPA). Methods: Patients with ABPM‐Sc or ABPA were recruited from a nationwide survey in Japan, a multicenter cohort, and a fungal database at the Medical Mycology Research Center of Chiba University. The definition of culture‐positive ABPM‐Sc/ABPA is as follows: (1) fulfills five or more of the 10 diagnostic criteria for ABPM proposed by Asano et al., and (2) positive culture of S. commune/Aspergillus spp. in sputum, bronchial lavage fluid, or mucus plugs in the bronchi. Results: Thirty patients with ABPM‐Sc and 46 with ABPA were recruited. Patients with ABPM‐Sc exhibited less severe asthma and presented with better pulmonary function than those with ABPA (p = 0.008–0.03). Central bronchiectasis was more common in ABPM‐Sc than that in ABPA, whereas peripheral lung lesions, including infiltrates/ground‐glass opacities or fibrotic/cystic changes, were less frequent in ABPM‐Sc. Aspergillus fumigatus‐specific immunoglobulin (Ig)E was negative in 10 patients (34%) with ABPM‐Sc, who demonstrated a lower prevalence of asthma and levels of total serum IgE than those with ABPM‐Sc positive for A. fumigatus‐specific IgE or ABPA. Conclusions: Clinical characteristics of ABPM‐Sc, especially those negative for A. fumigatus‐specific IgE, differed from those of ABPA. [ABSTRACT FROM AUTHOR]

Estimating interseismic deformation in subduction fault zones can offer insights into the frequency and magnitude of megathrust earthquakes. Diffusive mass transfer is a significant mechanism of strain during interseismic periods along the plate interface, observed through the pervasive scaly fabrics and mineral veins in tectonic mélanges of ancient accretionary prisms. The dissolution of fluid‐mobile elements (e.g., Si and Large‐Ion Lithophile Elements) along scaly folia and subsequent reprecipitation as veins lead to the enrichment of fluid‐immobile elements (e.g., Ti and High Field Strength Elements) in scaly fabrics. The kinetics of dissolution‐precipitation is temperature‐dependent, suggesting depth‐dependent mass transfer along subduction interfaces. Here, we evaluate the magnitudes of volume strain in a suite of mélange samples that span peak metamorphic temperatures of 130–340°C. Micro‐chemical analysis shows that the depletion of fluid‐mobile elements and enrichment of fluid‐immobile elements in scaly fabrics increases with temperature. Assuming the conservation of Ti, we apply mass balance constraints to calculate the volumetric strain in scaly fabrics. Results indicate average volumetric strain of 28% and 95% in the individual scaly fabrics of the Lower Mugi and Makimine mélanges in Japan, which record temperatures near the updip and downdip isotherms bounding the seismogenic zone, respectively. To determine the total volume strain within an area of interest, we integrate the amount of volume loss along individual microstructures across the network using image analyses, which ranges from 3% to 14% for the mélanges. Our approach demonstrates the potential to fully describe the deformation related to mass transfer by connecting characterization in different scales with geochemical analyses. Plain Language Summary: Estimating how subduction fault zones deform between major earthquakes provides information about the frequency and magnitude of those earthquakes. One significant way in which deformation occurs is through the movement of substances within fault zones. We observe the evidence in rocks from ancient subduction fault zones, where substances in specific rock fabrics dissolve in fluids and reprecipitate in mineral‐filled cracks. The process by which material redistributes at depth within subduction fault zones is dependent on temperature; therefore, we analyze a collection of rock samples that experienced varying temperatures. Through the examination of rock chemistry, we discover that elements carried by fluid are depleted in specific rock fabrics, while other immobile elements become enriched depending on temperature. We combine the chemistry with mathematical calculations to estimate the amount of deformation in terms of changes in rock volume. Our results reveal variations in volume loss in fabrics of rocks that experienced the lowest and highest temperatures among our samples. To obtain a comprehensive understanding of the deformation in our area of interest, we integrate the results with an analysis of rock images. Our study demonstrates how we can gain insights into the deformation occurring during these periods by combining different analytical approaches. Key Points: Mass‐balance analysis quantifies strain in a microstructure. Coupling with image analysis integrates strain over the area of interestDegrees of mass transfer vary with temperature observed in tectonic mélangesSingle scaly fabrics exhibit >60% average volume loss, while mélanges show <20% total volume strain [ABSTRACT FROM AUTHOR]