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Anatomical education is very important in understanding the internal structure of the body and the mechanism of life, especially for the medical profession, including nursing. However, in Japan, students have a few opportunities of getting anatomical education using animals before they enter university. The different step-by-step anatomical curriculum needs to be created for elementary school, junior high school, high school, and university students. However, it is difficult to perform anatomical education widely, particularly with bioethics problems and students who often have an aversion to dissected animals. Therefore, it is considered very useful to introduce anatomical education using marine products, which are more familiar. In particular, fish have the same basic structure as vertebrates, so they are useful for understanding the bodies of vertebrate animals, including the human body. Also, the use of marine products other than fish can deepen students' understanding of the structure of organisms of various systems. Therefore, in this study, we conducted anatomical lectures from functional morphology and ecological point of view, using marine products as teaching materials for elementary school children. To prevent students' aversion, the marine products were wrapped, which also reduced the smell. Students actively learned the internal structure of fishes, cephalopods, and shellfish, without aversion. According to our questionnaire survey, most participants reported that their impression and comprehension of the course was excellent or good. The use of "seafood" as teaching material for young learners was found to be very useful for anatomical education.

From the early 19th century until the most recent two decades, open-space and satellite museums featuring anatomy and pathology collections (collectively referred to as "medical museums") had leading roles in medical education. However, many factors have caused these roles to diminish dramatically in recent years. Chief among these are the great advances in information technology and web-based learning that are currently at play in every level of medical training. Some medical schools have abandoned their museums while others have gradually given away their museums' contents to devote former museum space to new classrooms, lecture halls, and laboratories. These trends have accelerated as medical school enrollment has increased and as increasing interest in biological and biomedical research activities have caused medical schools to convert museum space into research facilities. A few medical schools, however, have considered the contents of their museums as irreplaceable resources for modern medicine and medical education and the space these occupy as great environments for independent and self-directed learning. Consequently, some medical schools have updated their medical museums and equipped them with new technologies. The Anatomical Museum of Leiden University Medical Center in The Netherlands and the Medical Museum of Kawasaki Medical School in Kurashiki, Okayama, Japan, are two examples of such upgraded museums. Student surveys at Leiden University have indicated that all students (100%) found audio-guided museum tours to be useful for learning and majorities of them found guided tours to be clinically relevant (87%). However, 69% of students felt that museum visits should be optional rather than compulsory within the medical training curriculum.

At Chiba University, gross anatomy laboratory sessions ("laboratories") are required for physical therapy students. Though most physical therapy schools require their students to participate in laboratories so that they will better understand the structure of the human body, few data exist on the value of these laboratories specifically for physical therapy students. We administered questionnaires to physical therapy undergraduate students both before and after they participated in laboratories. Questionnaire items focused on student attitudes toward the laboratories and on human life and dignity. Data from 83 students were analyzed, with the following results: (1) 74.7% of students had a positive attitude about attending laboratories before doing so; (2) with few exceptions, students' attitudes about upcoming laboratories grew more positive after experiencing the laboratory work (P less than 0.001); (3) laboratories caused students to contemplate the topics of human life and dignity; and (4) 83.1% of students hoped to participate in laboratories at least four times. These results indicate that laboratories reinforce physical therapy students' positive attitudes about laboratory learning and promote student reflection on human life and dignity. This study provides support for the implementation of multiple laboratory sessions using cadavers into a uniform curriculum for physical therapy students in Japan. (Contains 4 tables and 2 figures.)

Bamboo belongs to the grass family and is an important non-timber forest product in tropic and sub-tropic countries. The global trade of bamboo products is worth billions of dollars and is mainly dominant with monopodial bamboo grown in sub-tropic countries such as China and Japan. Many researchers globally discuss that in addition to species and region, bamboo quality can differ based on its rhizome types because the physiology is different for both monopodial and sympodial bamboo. However, there is a massive competition within the yearly forest products due to the challenges posed by underground root system in agroforestry. This review studied the properties of bamboo with regards to their differences in terms of monopodial and sympodial types of rhizomes. It was found that most of the structural, chemical organic, and mechanical properties are higher in monopodial bamboo, but there is a greater fibre morphology and decay resistance in the sympodial bamboo. [ABSTRACT FROM AUTHOR]

Ribbon worms (phylum Nemertea) are found in oceans worldwide; however, only a few inhabit terrestrial, semiterrestrial and freshwater environments. In our study, we describe Acteonemertes orientalis sp. nov., a new species of Plectonemertidae Gibson, 1990 and the first plectonemertid discovered in Japan. The species was found in the supralittoral zone, from which nemerteans have rarely been reported and inhabits areas under rocks, wave-dissipating concrete blocks, and fallen leaves and stocks, along the coast of the Sea of Japan. Multi-locus phylogenetic analyses based on two mitochondrial (16S rRNA and cytochrome c oxidase subunit I) and two nuclear gene markers (18S rRNA and 28S rRNA) revealed that A. orientalis sp. nov. formed a clade with Leptonemertes cf. chalicophora collected from Florida. Although the external and internal morphology of A. orientalis sp. nov. is largely consistent with the generic diagnosis, this species differs in having a large proboscis. Based on the molecular and morphological data, we propose to amend the diagnosis of Acteonemertes by excluding proboscis size. ZooBank: urn:lsid:zoobank.org:pub:BBBE9549-5DCE-424F-9A39-930F8243C28B We discovered a new species of ribbon worm, Acteonemertes orientalis sp. nov. that belongs to the family Plectonemertidae. The species was found inhabiting the supratidal zone under rocks, wave-dissipating concrete blocks and fallen leaves, where nemerteans are rarely observed. Our molecular phylogeny suggested that this species forms a clade with Leptonemerte s cf. chalicophora from Florida, USA. Although the feeding habits of the genus remain unknown, we observed that A. orientalis feeds on isopods that occur sympatrically in the natural habitat. [ABSTRACT FROM AUTHOR]

Context: Periodic assessment of knee extensor muscle strength and size is important for all ages to evaluate the functional status of individuals and to identify and treat those at risk for mobility problems and frailty; however, it is not fully understood whether these field-based simplified approaches correspond to evaluation in knee extensor muscle strength or size. Objective: To examine the relationship between field-based simplified evaluation approaches and knee extensor muscle strength or size in young women. Design: Experimental. Setting: University research laboratory. Subjects: A total of 62 university freshmen women volunteered to participate in this study. Main Outcome Measures: Knee extensor muscle thickness was measured at the anterior half of thigh length; muscle strength was measured when subjects performed knee extension. Field-based simplified approaches (sit-to-stand, standing long jump, handgrip, and upper leg 50% [thigh] girth) were also measured. Results: Maximal strength was correlated with thigh girth, handgrip, and standing long jump, but not with the sit-to-stand test. Muscle thickness was correlated with thigh girth and handgrip, but not with standing long jump or the sit-to-stand test. A stepwise multiple-regression analysis was calculated using the predictor thigh girth and standing long jump to predict knee extensor maximal strength (R2 =.295). To predict knee extensor muscle thickness, the predictor thigh girth was calculated (R2 =.202). Conclusions: Knee extensor muscle strength and size could be evaluated by the field-based simplified approaches, in particular by the thigh girth measurement, which may be a major determinant to maintain activities of daily living for healthy young women. However, the 4 field-based simplified approaches appear to be still not of high impact. [ABSTRACT FROM AUTHOR]

Among over 20,000 species of Annelida, only two branching species with a highly modified body-pattern are known until now: the Syllidae Syllis ramosa McIntosh, 1879, and Ramisyllis multicaudata Glasby et al. (Zoological Journal of the Linnean Society, 164, 481–497, 2012). Both have unusual ramified bodies with one head and multiple branches and live inside the canals of host sponges. Using an integrative approach (combining morphology, internal anatomy, ecology, phylogeny, genetic divergence, and the complete mitochondrial genome), we describe a new branching species from Japan, Ramisyllis kingghidorahi n. sp., inhabiting an undescribed species of Petrosia (Porifera: Demospongiae) from shallow waters. We compare the new species with its closest relative, R. multicaudata; emend the diagnosis of Ramisyllis; and discuss previous reports of S. ramosa. This study suggests a much higher diversity of branching syllids than currently known. Finally, we discuss possible explanations for the feeding behaviour in the new species in relation to its highly ciliated wall of the digestive tubes (especially at the distal branches and anus), and provide a hypothesis for the evolution of branching body patterns as the result of an adaptation to the host sponge labyrinthic canal system. [ABSTRACT FROM AUTHOR]

Purpose: The inferior sagittal sinus (ISS) and its tributaries have received little attention because of its inconspicuous appearance, and its anatomical variations are also unknown. This study aimed to evaluate the morphological variations of the ISS. Materials and methods: We retrospectively reviewed 518 patients in whom cerebral angiography was clinically indicated. The detailed angioarchitecture of the cerebral venous system, including the ISS and their tributaries, and the morphological variations of the ISS were evaluated. Abnormalities of the rostral third superior sagittal sinus (SSS) were also evaluated. Results: The ISS was visualized in 270 (52.1%) patients. We proposed an angiographic ISS classification according to the venous drainage patterns: Type 0, not visualized; Type 1, small ISS with faint tributaries; Type 2, moderate ISS with developed tributaries; and Type 3: large ISS with well-developed tributaries, which are responsible for the venous drainage of the anterior frontal lobe. The frequency of each ISS type was as follows: Type 0, 248 (47.9%); Type 1, 211 (40.7%); Type 2, 44 (8.5%); and Type 3, 15 (2.9%). The mean ISS size was significantly larger with an increase in the type of ISS (p < 0.0001). The rostral third SSS hypoplasia was observed in all cases of Type 3. The hypoplasia of the rostral third SSS and development of the ISS were strongly correlated and complementary to each other. Conclusion: This study provided the angiographic ISS classification, and our proposed angiographic ISS classification could be helpful in better understanding of the ISS anatomy and its venous drainage pattern. [ABSTRACT FROM AUTHOR]

Ikeda taenioides (Ikeda, 1904) (Annelida: Thalassematidae: Bonelliinae) is the world􀁠s longest spoon worm species, which possesses an extremely long tape-like proboscis with a striped color pattern and a large brownish red trunk. This species is endemic to the Japanese Islands and inhabits a deep vertical burrow in intertidal and subtidal sand flats. Their proboscis, which extends from its small burrow opening, has been frequently observed around Japanese coasts. However, sampling of the main body (i.e., trunk) has been extremely rare because it always stays within a deep part of the burrow. Here, we report the success of the sampling of two specimens of I. taenioides with trunks in two different localities of the Seto Inland Sea (i.e., Ohmishima and Hachi), Japan, in 2019 and 2020 using a yabby pump. This is the first sampling of the trunk of I. taenioides in 88 years after its last collection in Onomichi Bay in 1931. We described the trunk color and morphological characteristics of the two specimens, including the internal anatomy. The trunks of the two specimens showed different colors, that is, pale brown (Ohmishima) and deep brownish red (Hachi). However, they were not distinguished to the species level by the comparison of partial COI sequences, suggesting that I. taenioides has an intraspecific variation in trunk color. Despite the difference in the sampling seasons (Ohmishima: June, Hachi: February), both specimens included numerous ripe eggs. According to previous studies, those collected in November and December also included numerous ripe eggs. Taken together, I. taenioides may be reproductive throughout the year or have multiple reproductive seasons per year. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether bone regeneration can be accelerated by using a conditioned medium (CM) and guided bone regeneration (GBR) technique. Materials and Methods: CM was harvested from rat bone marrow stromal cells (BMSCs). The components of CM were immobilized using a polylactide-co-glycolide (PLGA) membrane treated with and without 0.5 mol/L sodium hydroxide (NaOH) to elevate the hydrophilicity. Four experimental groups were prepared: PLGA membrane treated with (1) phosphate-buffered saline (PBS; PBS-M), (2) PBS and 0.5 mol/L NaOH (hydrophilic treatment; PBS-HM), (3) CM (CM-M), and (4) CM and 0.5 mol/L NaOH (CM-HM). These experimental membranes were observed using scanning electron microscopy. Proteins derived from BMSCs immobilized on the PLGA membrane were detected with liquid chromatography-tandem mass spectrometry (LC/MS/MS). Cell proliferation and alkaline phosphatase (ALP) activity were measured to analyze the effect of CM on the BMSCs. Experimental membranes were transplanted into a rat calvarial bone defect model. Microcomputed tomography and histologic analyses were performed 4 and 8 weeks after transplantation. Results: The CM derived from BMSCs can be immobilized on the PLGA membrane. Hydrophilic treatment of the PLGA membrane enhanced the amount of CM immobilization. LC/MS/MS analysis showed that the immobilized proteins on the surface of PLGA membrane were extracellular matrix, such as collagen, decorin, and fibronectin. The proteins in the CM, which were released from the PLGA membrane, enhanced cell proliferation and ALP activity in rat BMSCs. Newly formed bone area at the bone defects that had been treated with CM-HM was significantly high compared with those at bone defects treated with the other membranes. Conclusion: The PLGA membrane treated with 0.5 mol/L NaOH and CM promoted bone regeneration in this rat calvarial defect model. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the morphological and mechanical properties of the human patellar tendon among elementary school children (prepubertal), junior high school students (pubertal), and adults. Twenty-one elementary school children, 18 junior high school students, and 22 adults participated in this study. The maximal strain, stiffness, Young's modulus, hysteresis, and cross-sectional area of the patellar tendon were measured using ultrasonography. No significant difference was observed in the relative length (to thigh length) or cross-sectional area (to body mass2/3) of the patellar tendon among the three groups. Stiffness and Young's modulus were significantly lower in elementary school children than in the other groups, while no significant differences were observed between junior high school students and adults. No significant differences were observed in maximal strain or hysteresis among the three groups. These results suggest that the material property (Young's modulus) of the patellar tendons of elementary school children was lower than that of the other groups, whereas that of junior high school students was already similar to that of adults. In addition, no significant differences were observed in the extensibility (maximal strain) or viscosity (hysteresis) of the patellar tendon among the three groups. [ABSTRACT FROM AUTHOR]

Objectives: The current study used a three-dimensional (3D) surface homologous modeling to analyze the structure of maxillary first premolar (P 1 ) and second premolar (P 2 ) crowns, to identify any morphological differences between them, particularly in their cuspal structures., Methods: The study sample comprised 27 male elementary and junior high school students from Chiba Prefecture, Japan. Plaster casts were collected and the 3D coordinates were used to measure the crown structures. Thereafter, principal component (PC) analysis was carried out using the 3D coordinates of the homologous models, containing 4498 anatomical data points, including 9 landmarks., Results: The findings indicated that P 1 was significantly larger than P 2 , despite both teeth exhibiting similar intercuspal distances. The homologous model analysis revealed that 61.5 % of the total variance could be explained up to the fourth PC. Overall size and shape in the mesiodistal and buccolingual directions were estimated using PC1 and PC2, respectively. Both components highlighted a shape factor, indicating that the buccal cusp was more well-developed than the lingual cusp in P 1 compared to P 2 ., Conclusions: The variations in the size of the mesial and distal premolar teeth and the relationships between the cusps in the completed tooth crowns can be explained using molecular biology developmental models., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Endoscopic treatment for malignant biliary obstruction (MBO) in patients bearing surgically altered anatomy (SAA) is not well-established. Although endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a new treatment option for MBO, limited data are available regarding the efficacy and safety of EUS-BD in patients with SAA. We conducted a multicenter prospective registration study to evaluate the efficacy and safety of EUS-BD in this population. Methods: This study involved 10 referral centers in Japan. Patients with SAA who were scheduled to receive EUS-BD for unresectable MBO between May 2016 and September 2018 were prospectively registered. The primary endpoint was technical success and the secondary outcomes were clinical success, procedure time, procedure-related adverse events (AEs), stent patency, and overall survival. Results: In total, 40 patients were prospectively enrolled. The surgical reconstruction methods were gastrectomy with Roux-en-Y reconstruction (47.5%), gastrectomy with Billroth-II reconstruction (15%), pancreaticoduodenectomy (27.5%), and hepaticojejunostomy with Roux-en-Y reconstruction (10%). EUS-BD was performed for primary biliary drainage in 31 patients and for rescue biliary drainage in nine patients. Transmural stenting alone (60%), antegrade stenting alone (5%), and a combination of the two techniques (35%) were selected for patients treated with EUS-BD. Technical and clinical success rates were 100% (95% confidence interval, 91.2-100.0%) and 95% (95% confidence interval, 83.1-99.4%), respectively. Mean procedure time was 36.5 min. Early AEs were noted in six patients (15%): three self-limited bile leak, one bile peritonitis, and two pneumoperitonea. Late AEs occurred in six patients (15%): one jejunal ulcer and five stent occlusions. Stent patency rate after 3 months of survival was 95.7% (22/23). Median overall survival was 96 days. Conclusion: EUS-BD for MBO in patients with SAA appears to be effective and safe not only as a rescue drainage technique after failed endoscopic retrograde cholangiography but also as a primary drainage technique. Clinical Trial Registration: UMIN000022101 [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to measure the detailed morphology of the femoral anterior cruciate ligament (ACL) footprint. The correlation and the comparison between the measured area and the area which mathematically calculated as elliptical were also evaluated. Materials and Methods: Thirty nine nonpaired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch. The ACL was carefully dissected, and the periphery of the ACL insertion site was outlined on both the whole footprint and the midsubstance insertion. Lateral view of the femoral condyle was photographed with a digital camera, and the images were downloaded to a personal computer. The area, length, and width of the femoral ACL footprint were measured with Image J software (National Institution of Health). Using the length and width of the femoral ACL footprint, the elliptical area was calculated as 0.25 π (length × width). Statistical analysis was performed to reveal the correlation and the comparison of the measured and elliptically calculated area. Results: The sizes of the whole and midsubstance femoral ACL footprints were 127.6 ± 41.7 mm[2] and 61 ± 20.2 mm[2], respectively. The sizes of the elliptically calculated whole and midsubstance femoral ACL footprints were 113.9 ± 4.5 mm[2] and 58.4 ± 3 mm[2], respectively. Significant difference was observed between the measured and the elliptically calculated area. In the midsubstance insertion, significant correlation was observed between the measured and the elliptically calculated area (Pearson's correlation coefficient = 0.603, P= 0.001). However, no correlation was observed in the whole ACL insertion area. Conclusion: The morphology of the femoral ACL insertion resembles an elliptical shape. However, due to the wide variation in morphology, the femoral ACL insertion cannot be considered mathematically elliptical. [ABSTRACT FROM AUTHOR]

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

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

Background: Transcatheter aortic valve implantation (TAVI) is criticized by some as an expensive treatment in super-elder patients with limited life expectancy. However, there is a knowledge gap regarding the magnitude of clinical benefit provided by TAVI in comparison with conservative management in patients with severe aortic stenosis (AS) in real clinical practice, which would be important in the decision making for TAVI. Methods: We combined two independent registries, namely CURRENT AS and K-TAVI registries. CURRENT AS was a multicenter registry enrolling 3815 consecutive patients with severe AS irrespective to treatment modalities between January 2003 and December 2011. K-TAVI was a multicenter, prospective registry including 449 consecutive patients with severe AS, who underwent TAVI with SAPIEN XT balloon-expandable valves between October 2013 and June 2016. In these 2 registries, 449 patients received TAVI and 894 patients were managed with conservative strategy. We conducted propensity score matching and finally obtained a cohort of 556 patients (278 patients for each group) for the analysis. The primary outcome measures were all-cause death and heart failure (HF) hospitalization at 2-year. Results: The cumulative 2-year incidences of all-cause death and HF hospitalization were significantly lower in the TAVI group than in the conservative group (16.8% versus 36.6%, P<0.001, and 10.7% versus 37.2%, P<0.001). After adjusting the residual confounders, TAVI reduced the risks of all-cause death (HR, 0.46; 95%CI, 0.32–0.69; P = 0.0001) and HF hospitalizations (HR, 0.25; 95%CI, 0.16–0.40; P<0.0001) compared with conservative strategy. There was no difference in the cumulative incidence of non-cardiovascular death between the 2 groups. Conclusions: TAVI in the early Japanese experience was associated with striking risk reduction for all-cause death as well as HF hospitalization as compared with the historical cohort of patients with severe AS who were managed conservatively just before introduction of TAVI in Japan. [ABSTRACT FROM AUTHOR]

The genus Amphitetranychus Oudemans (Tetranychidae) consists of only three species, A. quercivorus (Ehara & Gotoh), A. savenkoae (Reck) and A. viennensis (Zacher). The original description of A. savenkoae was extremely simple and had no drawing of the aedeagus; however, a subsequent study described only the aedeagus. The present study investigated all three species in detail using a combination of morphological traits, crossbreeding experiments, esterase zymograms and the mitochondrial cytochrome c oxidase subunit I (COI) gene. Morphological differences in the peritremes and male aedeagi were observed among the three species. Complete reproductive isolation was confirmed in the reciprocal crosses between the morphologically similar A. savenkoae and A. quercivorus (no female offspring were produced). Esterase zymograms differed interspecifically, but not intraspecifically (among individuals in a given species). All three species formed clearly separate clades with 100% bootstrap values in the COI tree, and A. savenkoae was more closely related to A. quercivorus than to A. viennensis, which corresponded to the morphological similarity of their aedeagi and setal counts on tarsi IV. A key to Amphitetranychus species is provided. [ABSTRACT FROM AUTHOR]

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

Background and purpose: Moyamoya disease (MMD) is a progressive cerebrovascular disease with unknown etiology. Growing evidence suggest its involvement of autoimmune and genetic mechanisms in the pathogenesis of MMD. This study aims to clarify the association between HLA allele and MMD. Methods: Case-control study: the DNA of 136 MMD patients in Japan was extracted and the genotype of human leukocyte antigen (HLA) from this DNA was determined by super-high-resolution single-molecule sequence-based typing using next-generation sequencing. Next, the frequency of each HLA allele (HLA-A, HLA-B, HLA-C, HLA-DRB1, HLA-DQB1, and HLA-DPB1) was compared with those in the Japanese control database. In addition, haplotype estimation was performed using the expectation maximization algorithm. Results: The frequencies of the HLA-DRB1*04:10 allele (4.77% vs. 1.47% in the control group; P = 1.7 × 10−3; odds ratio [OR] = 3.35) and of the HLA-DRB1*04:10–HLA-DQB1*04:02 haplotype (haplotype frequency 4.41% vs. 1.35% in the control group; P = 2.0 × 10−3; OR = 3.37) significantly increased. The frequency of thyroid diseases, such as Graves’ disease and Hashimoto thyroiditis, increased in HLA-DRB1*04:10-positive MMD patients compared with that in HLA-DRB1*04:10-negative MMD patients. Conclusions: HLA-DRB1*04:10 is a risk allele and HLA-DRB1*04:10–HLA-DQB1*04:02 a risk haplotype for MMD. In addition, HLA-DRB1*04:10 is associated with thyroid disease in MMD patients. [ABSTRACT FROM AUTHOR]

Background: Because of the increased number of diagnosed cases of endometriosis or adenomyosis resulting in infertility, many women require assisted reproductive technology (ART) to become pregnant. However, incidences of obstetric complications are increased for women who conceive using ART. There has been no prospective cohort study examining the influence of endometriosis and adenomyosis on obstetric outcomes after adjusting for the confounding influence of ART therapy. Objective: This study evaluated the impact of endometriosis and adenomyosis on the incidence of adverse pregnancy outcomes. Study design: Data were obtained from a prospective cohort study, known as the Japan Environment and Children’s Study (JECS), of the incidence of obstetric complications for women with endometriosis and adenomyosis. The data of 103,099 pregnancies that resulted in live birth or stillbirth or that were terminated through abortion between February 2011 and July 2014 in Japan were included. Results: Women with endometriosis or adenomyosis were at increased risk for complications during pregnancy compared to those without a medical history of endometriosis (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.23 to 1.41) or adenomyosis (OR, 1.72; 95% CI, 1.37 to 2.16). Our analysis showed that the adjusted ORs for obstetric complications of pregnant women who conceived naturally or after infertility treatment that did not involve ART therapy were 1.26 (CI, 1.17 to 1.35) for pregnant women with a history of endometriosis and 1.52 (CI, 1.19 to 1.94) for those with a history of adenomyosis. Conclusions: The presence of endometriosis and adenomyosis significantly increased the prevalence of obstetric complications after adjusting for the influence of ART outcomes. [ABSTRACT FROM AUTHOR]

Background: Prenatal psychological stress may increase the risk of placental abruption (PA). This study aimed to clarify the effects of psychological distress during pregnancy and exposure to stressful life events in the year before or during pregnancy on the occurrence of PA in Japanese women. Methods: Using a nationwide prospective birth cohort study, we obtained data from 103,099 women between January 2011 and March 2014. Information on exposure to 14 stressful life events and psychological distress (Kessler 6 scale) was collected using a self-administered questionnaire during pregnancy. Clinical diagnoses of PA were obtained from medical records. A total of 80,799 women with singleton births were analyzed using logistic regression models that adjusted for possible confounders. Results: PA was diagnosed in 335 (0.4%) women. There was no significant difference in the Kessler 6 score during pregnancy between the PA group and non-PA group. Exposure to the death of a child in the year before or during pregnancy was significantly associated with PA in multigravid women (adjusted odds ratio [aOR] 3.57; 95% confidence interval [CI] 1.50–8.34). A spouse’s loss of employment was significantly associated with PA in parous women (aOR 3.25; 95% CI 1.40–7.56). Conclusions: This study identified the possible effects of exposure to the death of a child on PA occurrence that adjusted for important confounding factors. [ABSTRACT FROM AUTHOR]

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

Aim: Sorafenib is used as a first-line treatment for advanced hepatocellular carcinoma (HCC). However, hepatic arterial infusion chemotherapy (HAIC) has also gained acceptance, but only in Japan. We explored the role of body composition as a factor affecting the survival benefit of HAIC compared to sorafenib for the treatment of advanced HCC. Methods: We conducted a retrospective study using the clinical records of 133 patients with advanced HCC treated either with HAIC or sorafenib. Prior to treatment induction, skeletal muscle index and visceral fat area (VFA) were measured at the third lumbar vertebral and umbilical levels, respectively, using computed tomography. Muscle depletion and high-VFA (H-VFA) were defined using published cut-offs. We analyzed clinical parameters, including body composition as prognostic factors. Results: In the HAIC group, multivariate analysis identified a positive response to HAIC (hazard ratio [HR], 0.438; p = 0.022), and conversion from HAIC to sorafenib (HR, 0.374; p = 0.008) as favorable prognostic factors for survival. In contrast, tumor number < 7 (HR, 0.475; p = 0.008), absence of extra-hepatic spread (HR, 0.511; p = 0.015), absence of muscle depletion (HR, 0.555; p = 0.044), and H-VFA (HR, 0.483; p = 0.015) were studied in the sorafenib group. Conclusions: Body composition was identified as a prognostic factor for patient survival after treatment with sorafenib, but not for HAIC, and may be used as a biomarker when selecting between HAIC or sorafenib treatment of patients with advanced HCC. Additionally, conversion to sorafenib in patients receiving HAIC could improve survival regardless of response status. [ABSTRACT FROM AUTHOR]

Purpose: To determine the early signs of posterior staphylomas in highly myopic eyes of younger subjects by swept-source ultra-widefield optical coherence tomography (WF-OCT). Methods: This was an observational case series study. Highly myopic subjects younger than 20 years old who were examined consecutively by prototype WF-OCT were studied. High myopia was defined according to the Ministry of Health and Welfare, Japan classification. A posterior displacement of the sclera and two OCT features indicating the staphyloma edges were used as markers of a staphyloma. Results: Fifty-five eyes of 30 patients with the mean age of 12.3 years, and the mean axial length of 27.9 mm were studied. Seven of the 55 eyes (12.7%) had a posterior displacement of the sclera and were diagnosed as having a staphyloma. Among the two OCT features of the staphyloma edges, a gradual thinning of the choroid toward the staphyloma edge and gradual re-thickening of choroid from the staphyloma edge toward the posterior pole were found in these 7 eyes. However, the other feature of an inward protrusion of the sclera at the staphyloma edge, was obvious in only 2 eyes. The subfoveal choroid and choroid nasal to the optic disc were significantly thinner in eyes with a staphyloma than those without it. Conclusions: The changes of the choroidal thickness toward the staphyloma edge with the posterior displacement of the sclera were considered an early sign which precedes an inward protrusion of sclera at the staphyloma edge. [ABSTRACT FROM AUTHOR]

Introduction: Only a few, large population-based studies, have reported on whiplash-associated disorder (WAD). However, none of them have investigated the influence of crash severity on WAD outcome. In the present study, we aimed to determine whether crash severity predicts outcomes among patients with no-fault government insurance for acute WAD. Methods: We utilized data from a compulsory, no-fault government automobile liability insurance agency in Japan. Individuals involved in a car accident between April 2001 and June 2015 with residual disabilities reported at the end of the treatment between October 2014 and September 2015 were included. Crash severity was assessed based on property damage costs, size of the other vehicle (large car, medium car, small car, or two-wheeled vehicles), and collision types (rear-end collision, contact with vehicle moving in the same direction, or in the opposite direction). Outcomes included the time to claim closure and the number of treatment visits. Results: We analyzed data for a total of 52,251 individuals (28,571 male and 23,680 female) with a median age of 44 years (range: 2–95 years). The median time to claim closure was 220 days (range: 1–4,938 days), and the median number of treatment visits was 102 (range: 1–2,492). There was no significant association between outcomes and property damage costs or size of the other vehicle. Collision types exhibited no consistent association with outcomes. However, older age and affected body parts, in addition to the neck, were independent risk factors for delayed claim closure and a large number of visits, although, all odds ratios were low (often less than 2.0). Conclusions: There was no obvious association of outcomes with property damage costs, size of the other vehicle, or collision types in acute WAD patients. Further studies should investigate the influence of psychological factors, compensation systems, and cultural conditions. [ABSTRACT FROM AUTHOR]

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

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

Imaging methods are essential for the correct identification of root canal anatomy, which is a key factor for successful endodontic therapy. This study aimed to evaluate the performance of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in identifying the apical delta (AD) using micro-computed tomographic imaging as the gold standard. PR and CBCT images of 110 human premolars (120 root canals) were obtained using the VistaScan digital intraoral system (Durr Dental, Beitigheim-Bissinger, Germany) and the 3D Accuitomo CBCT unit (J Morita, Kyoto, Japan), respectively. Two oral radiologists assessed the PR and CBCT images for the presence of ADs using a 5-point scale. Additionally, in the CBCT images, the number of apical foramina was also evaluated. The gold standard was established by means of micro–computed tomographic imaging. The diagnostic values related to PR and CBCT imaging were compared using the McNemar test. The detection of the number of foramina was compared using the paired t test (α ≤ 0.05). ADs were present in 40 root canals (33.3%). Both PR and CBCT images differed significantly from the gold standard (P <.05) in the detection of ADs. CBCT imaging showed higher values than PR for all diagnostic tests (P <.05). Despite the moderate accuracy of PR (0.62) and CBCT imaging (0.73), these methods presented very low sensitivity values (0.07 and 0.35 for PR and CBCT, respectively). CBCT imaging had a tendency of underestimating the number of foramina (P <.05). CBCT imaging showed better performance than PR in the detection of ADs; both imaging modalities underestimate its presence when compared with the gold standard. In general, the number of apical foramina cannot be reliably assessed using CBCT imaging. • Periapical radiography and cone-beam computed tomographic (CBCT) imaging showed moderate accuracy for apical delta detection. • Radiography and CBCT imaging underestimated the presence of deltas compared with micro–computed tomographic imaging. • CBCT imaging performed better than periapical radiography in the detection of apical deltas. • The number of apical foramina cannot be reliably assessed using CBCT imaging. • Additional attention should be taken when prescribing and interpreting CBCT imaging. [ABSTRACT FROM AUTHOR]

Sonography is a simple, inexpensive, and non-invasive diagnostic modality. Although tissues behind bony structures and deep tissues are not delineated, sonography can depict superficial soft tissues very clearly. In the head and neck region, however, it has not yet been used widely, as the anatomical structures are complicated, and considerable experience is needed both to perform an examination and to make a diagnosis. To perform examinations efficiently, operators must be familiar with the sonographic system in use, and take images at standard planes. To make a correct diagnosis, operators require knowledge of the sonographic anatomy on standard planes, representative sonographic signs and artifacts, and common diseases and their typical sonographic findings. In this paper, we have explained the sonographic anatomy on standard planes, and the sonographic findings of common diseases in the oral and maxillofacial region. [ABSTRACT FROM AUTHOR]

Purpose: To examine the foveal structure and vasculature in eyes with an idiopathic epiretinal membrane (ERM). Methods: Forty-nine eyes of 48 patients with an idiopathic ERM were studied. The superficial foveal avascular zone (FAZ) was measured by optical coherence tomography angiography (OCTA; RTVue XR Avanti, Optovue Inc., Fremont, CA), and the central foveal thickness (CFT) was measured by swept source OCT (DRI-OCT, Topcon, Japan). Twenty eyes underwent vitrectomy with internal limiting membrane (ILM) peeling, and the FAZ and CFT were evaluated pre- and postoperatively. Forty-nine eyes of 49 age-matched healthy subjects were also examined as control. Results: The FAZ in eyes with an ERM was significantly smaller than that of the control eyes (0.188±0.16 mm2 vs 0.328±0.14 mm2, P<0.01). The CFT in eyes with an ERM was significantly thicker than that of control eyes (315±0.14 μm vs 193±0.14 μm, P<0.01). The size of the FAZ was strongly correlated with the CFT (ERM, R = -0.753; control, R = -0.61, both P<0.01). The postoperative size of the FAZ was not significantly different from the preoperative size (0.115 mm2 vs 0.128 mm2, P = 0.17) but the CFT was significantly thinner (370 μm vs 288 μm, P<0.01) after the vitrectomy with ILM peeling in 20 eyes. Conclusions: The results indicate that an ERM might affect the morphology and vasculature of not only the inner but also the outer retina before and after vitrectomy with ILM peeling. The FAZ area might have been affected by the ILM peeling. [ABSTRACT FROM AUTHOR]

Introduction: Patients with chronic kidney disease (CKD) depend on advice from healthcare professionals to avoid using unsuitable over-the-counter (OTC) drugs. Recently, qualified, registered nonpharmacist salespersons became licensed to sell OTC drugs in Japan. However, registered salespersons' knowledge and awareness of precautions regarding unsuitable OTC drugs for use in patients with CKD are unclear. Objectives: This study aimed to clarify the awareness, knowledge, and implementation of precautions by registered salespersons regarding OTC drugs used by patients with CKD. Additionally, we evaluated the change of registered salespersons' knowledge and awareness of this topic generated by a pharmacist intervention. Methods: A questionnaire survey and pharmacist intervention were applied to 175 registered salespersons. The intervention comprised a 50-minute lecture imparted by a pharmacist who was trained in nephrology. The knowledge, awareness, and implementation of precautions by participants with respect to nonsteroidal anti-inflammatory drugs (NSAIDs) and antacids were evaluated before and after the intervention. Results: Approximately half of the registered salespersons reported previous experience with selling OTC drugs that were inappropriate for patients with CKD (NSAIDs, 48.0%; antacids, 39.7%). Few participants recognized the need to check renal function when selling those drugs to such patients (NSAIDs, 25.7%; antacids, 47.5%). The registered salespersons' awareness and knowledge were significantly higher after the intervention than before it. Conclusion: The results indicate that before the intervention, the registered salespersons had low levels of awareness and knowledge regarding OTC drug use in patients with CKD despite having prior experience selling unsuitable OTC drugs. However, the pharmacist intervention improved the registered salespersons' awareness and knowledge. The educational program for registered salespersons might be necessary to prevent inappropriate OTC drug use by patients with CKD. [ABSTRACT FROM AUTHOR]

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

Purpose: Abnormal fundus autofluorescence (FAF) potentially precedes onset of late age-related macular degeneration (AMD) in Caucasian patients. Many differences exist between Asian and Caucasian patients regarding AMD types and severity, gender, and genetic backgrounds. We investigated the characteristics of abnormal FAF and retinal sensitivity in the fellow eyes of Japanese patients with unilateral neovascular AMD. Methods: Sixty-six patients with unilateral neovascular AMD and abnormal FAF in the fellow eye were enrolled in this multicenter, prospective, observational study. The best-corrected visual acuity, fundus photographs, FAF images, and retinal sensitivity on microperimetry were measured periodically for 12 months. The FAF images were classified into eight patterns based on the International Fundus Autofluorescence Classification Group. The points measured by microperimetry were superimposed onto the FAF images and fundus photographs and classified as “within,” “close,” and “distant,” based on the distance from the abnormal FAF and other findings. The relationship between the location of the baseline abnormal FAF and retinal sensitivity was investigated. Results: In Japanese patients, patchy (33.3%) and focally increased (30.3%) patterns predominated in the abnormal FAF. Intermediate-to-large drusen was associated predominantly with hyperfluorescence and hypofluorescence. Neovascular AMD developed within 1 year in six (9.1%) eyes, the mean baseline retinal sensitivity of which was 12.8 ± 4.7 dB, significantly (p<0.002) lower than the other eyes. In 44 of the other 60 eyes, microperimetry was measurable at baseline and month 12 and the mean retinal sensitivity improved significantly from 13.5 ± 4.4 to 13.9 ± 4.8 dB (p<0.001), possibly associated with lifestyle changes (e.g., smoking cessation, antioxidant and zinc supplementation). The mean retinal sensitivities of points within and close to the abnormal FAF were 9.9 and 11.7 dB, respectively, which were significantly lower than the 14.0 dB of the points distant from the abnormal FAF. Conclusion: In Japanese patients, patchy and focally increased patterns predominated in the abnormal FAF. The retinal sensitivity was lower close to/within the abnormal FAF. FAF and microperimetry are useful to assess macular function before development of neovascular AMD or geographic atrophy. [ABSTRACT FROM AUTHOR]

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

Highlights • Homologous model created from 3D CT enabled quantitative analysis of the coxal bone. • Sex of 94% of the samples was correctly assigned by measuring point-to-point distances. • Age-dependent principal components (PC) were detected with PC analysis of the models. • Age-dependent morphological changes of the coxal bone were visualized by shifting PCs. • Morphological disparity between right and left coxal bone was measured and visualized. Abstract Sexual dimorphisms and age-dependent morphological features of the human coxal bone were quantitatively analyzed using homologous models created from three-dimensional (3D) computed tomography images of the pelvis (male: 514 samples, female: 388 samples, age 16–100). Bilateral average coxal images of each sex and age decade were generated separately through principle component analyses (PCA). By measuring average point-to-point distances of 8472 corresponding points (average corresponding point differences [ACPDs]) between each homologous coxal image and the average images, the sex of more than 93% of the samples was correctly assigned. Some principal components (PCs) detected in PCA of the homologous models of the samples correlated fairly well with age and are affected by features of the curvature of the iliac crest, the arcuate line and the greater sciatic notch. Moreover, separate PCA using the average images of each age decade successfully detected the first PCs, which were strongly correlated with age. However, neither multiple regression analysis using PCs related to age nor comparison of ACPDs with the average images of each age decade could produce accurate results for age decade assignment of unknown (blind) samples. Therefore, more detailed analysis of age-dependent morphological features would be necessary for actual age estimation. In addition, some laterality or left and right shape difference of the coxal bone images was also elucidated, and was more significant in females. Analysis of 3D structures using homologous models and PCA appears to be a potential technique to detect subsistent morphological changes of bones. [ABSTRACT FROM AUTHOR]

Introduction: A recent development in minimally invasive surgery (MIS) is single-port surgery, where a single large multiport trocar is placed in the umbilicus. All medical schools require that students complete an anatomy course as part of the medical curriculum. However, there is limited instruction regarding the detailed parts of the "umbilicus." In several famous anatomy atlases, the umbilicus is not dissected at all and is merely represented as a button. Until now, the true nature of the umbilicus has not been anatomically demonstrated.Methods: Five cadavers were obtained from the Osaka Medical College medical student anatomy class. The umbilicus was dissected in the anatomy laboratory, to demonstrate all the layers. A detailed dissection was performed, focusing on the exact center of the umbilicus, in order to ascertain whether there exists a "natural orifice" or a fascial defect.Results: In all cadavers, a small defect of fascia was identified just below the center of the umbilicus. Yellow fatty tissue was present just below the skin in the exact center of the umbilicus. A probe placed exactly in the middle of this defect passes easily through into the abdominal cavity.Conclusions: With the widespread use of MIS, umbilical incision is commonly used to reduce pain and improve cosmetic results. This study consistently revealed a natural defect of fascia in the center of the umbilicus. Therefore, the umbilicus can be called a concealed "natural orifice." It is important to recognize and utilize this defect effectively to minimize unnecessary tissue trauma during MIS. [ABSTRACT FROM AUTHOR]

Glandularity has a marked impact on the incidence of breast cancer and the missed lesion rate of mammography. The aim of this study was to develop a novel model for predicting glandularity and patient radiation dose using physical factors that are easily determined prior to mammography. Data regarding glandularity and mean glandular dose were obtained from 331 mammograms. A stepwise multiple regression analysis model was developed to predict glandularity using age, compressed breast thickness and body mass index (BMI), while a model to predict mean glandular dose was created using quantified glandularity, age, compressed breast thickness, height and body weight. The most significant factor for predicting glandularity was age, the influence of which was 1.8 times that of BMI. The most significant factor for predicting mean glandular dose was compressed breast thickness, the influence of which was 1.4 times that of glandularity, 3.5 times that of age and 6.1 times that of height. Both models were statistically significant (both p < 0.0001). Easily determined physical factors were able to explain 42.8% of the total variance in glandularity and 62.4% of the variance in mean glandular dose. Graphical abstract Validation results of the above prediction model made using physical factors in Japanese women. The plotted points of actual vs. prediction glandularity shown in a are distributed in the vicinity of the diagonal line, and the residual plot for predicted glandularity shows an almost random distribution as shown in b. These distributions indicate the appropriateness of the prediction model. [ABSTRACT FROM AUTHOR]

Background: Studies identifying modifiable lifestyle risk factors related to open-angle glaucoma (OAG) are limited, especially from Asian countries. This study aimed to identify lifestyle risk factors for OAG in a Japanese population. Methods and findings: This population-based, cross-sectional study recruited Japanese participants aged 40 years or older from January 2013 to March 2015. We took fundus photographs for OAG screening, determined lifestyle and health characteristics through a questionnaire and performed physical examinations. The participants who had suspect findings in the fundus photographs were sent for a detailed ophthalmic examination to diagnose OAG. Lifestyle and heath characteristics were statistically compared between the OAG and non-OAG participants. A total of 1583 participants were included in the study, of which 42 had OAG and 1541 did not have OAG. The number of days per week that the female participants consumed meat (mean±SD; OAG: 1.7±1.2 days, non-OAG: 2.7±1.5 days) was negatively associated with OAG (OR = 0.61; 95% CI: 0.43–0.88; p = 0.007). Higher intraocular pressure was positively associated with OAG in men (OR = 1.20; 95% CI: 1.05–1.38, p = 0.009). No significant difference between participants with and without OAG was observed for a range of other lifestyle factors and health criteria including self-report of diabetes, number of family living together, body mass index, blood pressure, pulse rate, coffee drinking, tea drinking, alcohol drinking, number of fruits consumed per day and days of fish consumption per week. Conclusions: A higher weekly consumption of meat appears to be negatively associated with OAG in Japanese women. Increasing the dietary intake of meat can contribute to reducing the risk of developing OAG. [ABSTRACT FROM AUTHOR]

Competing Interests: Declaration of Competing Interest The authors declare that there are no relevant conflicts of interest.

Summary: During childhood, perioral muscle function is closely associated with malocclusion. To clarify the effects of tongue function on maxillofacial morphology in children, tongue pressure and maximum lip‐closing force (LCF) were measured and the relationship between perioral muscle function and maxillofacial morphology was evaluated according to the skeletal classification. Maximum tongue pressure (MTP) and swallowing tongue pressure (STP) were measured on the anterior palatine rugae in 100 children (Hellman's dental stages IIIA‐IIIC) using a balloon‐type tongue pressure measurement device. Lip‐closing force was measured using an LCF measurement device. Lateral cephalograms were examined to classify subjects into skeletal (S)‐I, S‐II and S‐III groups. Correlations of skeletal classification with tongue pressure and LCF were examined. Correlations of lateral cephalometric measurements with palatal volume (PV), measured using a three‐dimensional optical scanner, were evaluated. Maximum tongue pressure was significantly lower in the S‐II group than in other groups. Swallowing tongue pressure was significantly lower in the S‐II group than in the S‐III group. Lip‐closing force was significantly higher in the S‐III group than in other groups. Swallowing tongue pressure was positively correlated with MTP and PV. Correlations between tongue pressure and anteroposterior skeletal classification indicated the importance of quantitative tongue function assessment. [ABSTRACT FROM AUTHOR]

The aim is to investigate the relationship between a positive outcome on rehabilitation after hip fracture and behavioral psychological symptoms of dementia (BPSD) transition during rehabilitation. This study is a retrospective cohort study based on the Japan Rehabilitation Database. We recruited 756 subjects 65 years of age or older from 31 hospitals in the database. All subjects were in the hospital as patients undergoing rehabilitation for hip fracture. Functional independence measure (FIM), walking ability, Mini-Mental State Examination (MMSE), and BPSD were measured both at the beginning and at the end of rehabilitation. MMSE for 23 or under was defined as the cognitive-impaired group. MMSE for 24 or over was used as the cognitively intact group. Cognitive impaired participants were divided into four groups: participants presented no BPSD both at the beginning of rehabilitation and at the end of rehabilitation (Group (-/-)), participants presented BPSD at the beginning of rehabilitation but resolved at the end of rehabilitation (Group (+/-)), participants had no BPSD at the beginning of rehabilitation but appeared at the end of rehabilitation (Group (-/+)) and participants had sign of BPSD both at the beginning of rehabilitation and at the end of rehabilitation (Group (+/+)). The endpoints were waking ability, FIM gain. As results, one hundred thirty-seven cognitive-impaired older people patients out of 471 (29.1%) suffered from BPSD at the beginning of rehabilitation. FIM gains in cognitively intact group, Group (-/-), Group (+/-), Group (-/+) and Group (+/+) were 24.8 ± 18.7, 17.5 ± 16.9, 27.3 ± 19.7, 17.8 ± 12.2 and 12.2 ± 17.2, respectively. The Group (+/-) was significantly connected to a positive outcome for rehabilitation. The present study suggested that the management of BPSD can lead to better functional recovery during rehabilitation. [ABSTRACT FROM AUTHOR]

Background: There has been confusion in the anatomical recognition when performing inguinal hernia operations in Japan. From now on, a paradigm shift from the concept of two-dimensional layer structure to the three-dimensional space recognition is necessary to promote an understanding of anatomy.Anatomy and Embryology: Along with the formation of the abdominal wall, the extraperitoneal space is formed by the transversalis fascia and preperitoneal space. The transversalis fascia is a somatic vascular fascia originating from an arteriovenous fascia. It is a dense areolar tissue layer at the outermost of the extraperitoneal space that runs under the diaphragm and widely lines the body wall muscle. The umbilical funiculus is taken into the abdominal wall and transformed into the preperitoneal space that is a local three-dimensional cavity enveloping preperitoneal fasciae composed of the renal fascia, vesicohypogastric fascia, and testiculoeferential fascia. The Retzius' space is an artificial cavity formed at the boundary between the transversalis fascia and preperitoneal space. In the underlay mesh repair, the mesh expands in the range spanning across the Retzius' space and preperitoneal space. [ABSTRACT FROM AUTHOR]

Summary: Although dysphagia is a life‐threatening problem in patients with Parkinson's disease (PD), the pathophysiology of oropharyngeal dysphagia is yet to be understood. This study investigated the tongue motor function during swallowing in relation to dysphagia and the severity of PD. Thirty patients with PD (14 males and 16 females; average age, 69.4 years), Hoehn and Yahr stage II‐IV, in Osaka University Hospital are participated in this study. During swallowing 5 ml of water, tongue pressure on the hard palate was measured using a sensor sheet with 5 measuring points. The maximal tongue pressure at each measuring point during swallowing was compared between patients with PD and healthy controls. Subjective assessment of oropharyngeal dysphagia was performed using Swallowing Disturbance Questionnaire‐Japanese. The maximal tongue pressure at each measuring point was significantly lower in patients with PD than in healthy controls (8 males and 12 females; average age, 71.6 years). Furthermore, the maximal tongue pressure was significantly lower in dysphagic PD patients than non‐dysphagic PD patients. Loss of tongue pressure production at the anterior part of the hard palate was strongly related to dysphagia in the oral phase as well as in the pharyngeal phase. An abnormal pattern of tongue pressure production was more frequently observed in dysphagic PD patients than in non‐dysphagic PD patients. The results suggest that tongue pressure measurement might be useful for early and quantitative detection of tongue motor disability during swallowing in patients with PD. [ABSTRACT FROM AUTHOR]

Spawning ground of Japanese eel (Anguilla japonica) is located near the West Mariana Ridge seamount. The species travels through the North Equatorial Current (NEC) and then enters the Kuroshio Current (KC) on the migration toward East Asian growth habitats. Therefore, El Niño–Southern Oscillation (ENSO) events serve as the potentially important drivers of interannual variability across the equatorial Pacific. Because the NEC bifurcation and salinity profiles are related to ENSO events, we investigated the influence of locations of the NEC bifurcation and salinity front on the success of larval entry to the KC by numerically modeling particle transport in ocean currents from 1972 to 2013 and possible effects on the size of glass eels at continental recruitment and, via otolithometry on the duration of larval migration. Circulation and hydrography used for particle tracking were obtained from the results of the Model for Interdisciplinary Research on Climate (MIROC) high-resolution forecasting experiment. Our results demonstrated that during El Niño years, (1) the southward movement of the salinity front might cause the larvae to experience slower currents and (2) the northward movement of the NEC bifurcation might broaden the separation between their spawning ground and NEC bifurcation, thus prolonging the time needed for the larvae to enter the KC from their spawning ground, because of which the duration of entrainment in the water column and body size increase when eels reach estuarine waters. In addition, this might cause more water to flow into the Mindanao Current (MC), leading to a decline in the rate at which larvae get entrained into the KC. [ABSTRACT FROM AUTHOR]

Urinary type IV collagen (U-Col4) and albumin excretion is evaluated to monitor the development of diabetic kidney disease. However, U-Col4 excretion in the general population without diabetes has not yet been fully elucidated. In this study, 1067 participants without diabetes and with urinary albumin-creatinine ratio <300 mg/gCr (normo- or microalbuminuria) who underwent an annual health examination in 2004 were enrolled and observed for 5 years. They were divided according to the amount of U-Col4 or urinary albumin excreted. The decline in estimated glomerular filtration rate (eGFR) was calculated. In participants with eGFR ≥80 mL/min, abnormal U-Col4 excretion was indicated as a significant independent risk factor for 10% eGFR change per year, which is one of the prognostic factors for the development of end-stage kidney disease. Moreover, in contrast to urinary albumin excretion, U-Col4 excretion was not related to age or kidney function, suggesting that some individuals with abnormal U-Col4 excretion can have an independent hidden risk for the development of kidney dysfunction. In conclusion, it is important to measure U-Col4 excretion in the general population without diabetes to determine changes in renal features in every individual and help detect future complications such as diabetic kidney disease. If U-Col4 excretion is abnormal, kidney manifestation should be carefully followed up, even if the kidney function and urinalysis findings are normal. [ABSTRACT FROM AUTHOR]

Objective: To understand the actual condition of orthodontic treatment in team care for patients with syndromic craniosynostosis (SCS) in Japan. Design: A nationwide collaborative survey. Setting: Twenty-four orthodontic clinics in Japan. Patients: A total of 246 patients with SCS. Main Outcome Measure: Treatment history was examined based on orthodontic records using common survey sheets. Results: Most patients first visited the orthodontic clinic in the deciduous or mixed dentition phase. Midface advancement was performed without visiting the orthodontic clinic in about a quarter of the patients, and more than a half of the patients underwent "surgery-first" midface advancement. First-phase orthodontic treatment was carried out in about a half of the patients, and maxillary expansion and protraction were performed. Tooth extraction was required in about two-thirds of patients, and the extraction of maxillary teeth was required in most patients. Tooth abnormalities were found in 37.8% of patients, and abnormalities of maxillary molars were frequently (58.3%) found in patients who had undergone midface surgery below the age of 6 years. Conclusions: Many patients underwent "surgery-first" midface advancement, and visiting the orthodontic clinic at least before advancement was considered desirable. First-phase orthodontic treatment should be performed considering the burden of care. Midface advancement below the age of 6 years had a high risk of injury to the maxillary molars. This survey is considered useful for improving orthodontic treatment in team care of patients with SCS. [ABSTRACT FROM AUTHOR]

Background and Objective: Single nucleotide polymorphisms (SNPs) of paraoxonase 1 (PON1) are known to be associated with the pathogenesis of osteoporosis and periodontitis. However, the effects of PON1 on the osteoblastic differentiation of periodontal ligament (PDL) cells are unclear. In this study, we examined the effects of PON1 on the osteoblastic differentiation of PDL cells, and analysed the role of PON1 SNPs on the pathogenesis of aggressive periodontitis (AgP) in the Japanese population. Material and Methods: Human PDL (HPDL) cells were exposed to the PON1 plasmid and PON1 inhibitor, 2‐hydroxyquinoline, and cultured in mineralization medium. Expression of calcification‐related genes and calcified nodule formation were assessed by real‐time PCR, an alkaline phosphatase (ALPase) activity assay and Alizarin red staining. Sanger sequencing was performed to evaluate whether PON1 SNPs are associated with the pathogenesis of AgP in Japanese people. Results: During osteoblastic differentiation of HPDL cells, expression of PON1 mRNA increased in a time‐dependent manner. PON1 stimulated an increase in expression of mRNA for calcification‐related genes, as well as ALPase activity. In contrast, 2‐hydroxyquinoline clearly inhibited the expression of calcification‐related genes, ALPase activity and calcified nodule formation in HPDL cells. Moreover, there was a statistically significant difference in the minor allele frequency of PON1 SNP rs854560 between the Japanese control database and patients with AgP in the Japanese population (P = .0190). Conclusion: PON1 induced cytodifferentiation and mineralization of HPDL cells, and PON1 SNP rs854560 may be associated with the pathogenesis of AgP in the Japanese population. [ABSTRACT FROM AUTHOR]