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Abstract Functional constipation is the most common gastrointestinal disorder during childhood. Oral stimulation (mastication and toothbrushing) reportedly improves bowel movements, but the association between daily toothbrushing behavior and functional constipation remains unknown. Data (n = 83,660) from fetal records (n = 104,059) in the Japan Environment and Children’s Study, an ongoing prospective birth cohort, were analyzed to investigate the impact of daily toothbrushing frequency on functional constipation during childhood, using ROME III diagnostic criteria. After multiple imputations of data acquired from self-reported questionnaires, a multivariable binomial logistic regression analysis was used with adjustments for several maternal and child-related variables. Functional constipation was observed in 10,123 (12.1%) and 8,820 (10.5%) participants at 3 and 4 years postpartum, respectively. Using the appropriate frequency of daily toothbrushing (twice or more) as a reference, the odds of functional constipation increased with decreasing daily toothbrushing frequency after covariate adjustments involving daily feeding frequency. The adjusted odds ratio (OR) for functional constipation in participants without daily toothbrushing behavior (less than once a day) at 4 years postpartum was 1.87 (95% confidence interval [CI] 1.34–2.61). Similarly, the adjusted OR (95% CI) for chronic functional constipation (at both 3 and 4 years postpartum) in participants without daily toothbrushing behavior (less than once a day) at 2 years postpartum was 1.62 (1.14–2.31). Functional constipation during childhood was associated with decreased daily toothbrushing frequency. Although the underlying mechanism of daily toothbrushing behavior in prompting bowel movements remains unclear, it is a major basis of self-health management in children that plays an important role in managing functional constipation.

Abstract It has been suggested that non-fasting triglyceride (TG) concentrations may be useful in predicting various diseases. However, current epidemiological evidence focuses mainly on the effects of fasting TG concentrations. The aim of this study was to investigate the effect of fasting and non-fasting TG levels on new-onset hyperuricemia (HUA) in the general Japanese population. This is a population-based retrospective cohort study (ISSA-CKD study); it included 5,576 participants without HUA at baseline between 2008 and 2019. Participants were categorized into gender-specific tertile groups of serum TG levels: group 1 ( 7 mg/dL [0.42 mmol/l]). During the 5.4-year follow-up period, 552 male and 146 female participants developed new-onset HUA. Incidence rates (per 1,000 person-years) of HUA were 18.2 in group 1, 21.9 in group 2 and 31.0 in group 3 among male, and 2.1 in group 1, 4.0 in group 2 and 7.4 group 3 among female. These associations remained significant after adjustment for confounders (p trend

Abstract The level of dynamic mechanical instability between the bony parts of the ankle joint provides important information on biomechanical function. However, the dynamics of the distance between the talus and lateral malleolus during gait remain unclear. This study aimed to compare the distance between the talus and lateral malleolus and the ankle joint angles during the stance phase of gait between individuals with chronic ankle instability (CAI) and healthy adults. The comparison was conducted using a synchronized ultrasound (US) imaging with a three-dimensional motion analysis (MA) system. This cross-sectional study included 12 participants (5 males, 7 females; age, 20.5 ± 1.8 years; height, 166.6 ± 9.4 cm; body weight, 60.2 ± 5.3 kg; body mass index, 21.7 ± 2.0 kg/m2; 16 feet) with CAI and 10 healthy controls (4 males, 6 females; age, 21.2 ± 1.6 years; height, 164.6 ± 10.5 cm; body weight, 56.8 ± 11.3 kg; body mass index, 20.8 ± 2.6 kg/m2; 20 feet). The distance between the talus and lateral malleolus during gait was significantly increased in the CAI group compared with that in the control group throughout the stance phase. The ankle dorsiflexion angle was smaller in the CAI group during the middle and terminal stance phases. Additionally, the ankle inversion angle was greater in the CAI group than in the control group. Our findings show the application of the synchronized US and MA system in the assessment of mechanical instability in CAI group, which may be used to determine treatment efficacy.

Study Design A retrospective cohort study. Purpose To investigate the sagittal plane configuration of the entire spine and its association with the risk of adjacent segment degeneration (ASD) after posterior lumbar interbody fusion (PLIF). Overview of Literature Although PLIF has demonstrated satisfactory clinical outcomes, it is associated with ASD. However, the geometric mechanical changes that contribute to the occurrence of ASD are not well characterized. Methods Radiological parameters were extracted from the whole lateral radiographs. Patients were divided into two groups: the ASD group (segmental kyphosis of ≥10º, and/or a ≥50% loss of disc height, and/or ≥3 mm of anteroposterior translation) and the non-ASD group. Results All 112 included patients underwent PLIF for lumbar degenerative diseases. The minimum follow-up period was 2 years, with an average follow-up time of 63.6 months. Fifty-two patients (46.4%) were classified into the ASD group and of these, 13 required reoperation due to failure of conservative treatment. Patients with ASD exhibited significantly more caudal and posterior inflection vertebrae (IV), while the lumbar apical vertebra was significantly more caudal immediately after surgery. The IV position was identified as a significant risk factor for ASD, and the ASD incidence was significantly higher in the group where IV ≤5 (L1 vertebral body) than in the group where IV ≥5.5 (T12–L1 disc) (69.0% vs. 38.6%). Conclusions The IV position is a significant risk factor for ASD development. Although it is difficult to control intraoperative IV levels, we note a high risk of ASD in patients with IV lower than T12–L1.

Abstract This study aimed to translate a web-based hamstring outcome score (HaOS) questionnaire to the Japanese context. First, the validity and reliability of the translated questionnaires were examined among Japanese athletes. Second, the association between the previous history of hamstring strain and HaOS was examined. The translation was performed according to internationally recognized methodologies. A total of 233 athletes were asked to complete the HaOS questionnaire, and four questions were added to examine the content validity of the questionnaire. Intraclass correlation coefficient (ICC) was calculated to evaluate the test–retest reliability. Internal consistency was determined by calculating Cronbach’s alpha values. The translated questionnaires had high acceptance and compliance rates, with a response rate of 84.4%. The ICC for each scale ranged from 0.80 to 0.93, and Cronbach's α from 0.72 to 0.96, confirming good reliability and high internal consistency. HaOS of the previous injury group (93.4 [78.9, 100]) was significantly lower than that of the healthy group (86.2 [68.1, 100]) (p

Objectives This study aimed to investigate the association and population-attributable fraction (PAF) of maternal smoking and secondhand smoke (SHS) exposure during pregnancy with placental abruption.Design Prospective cohort study.Setting 15 regional centres in Japan.Participants Pregnant women registered between January 2011 and March 2014 from the Japan Environment and Children’s Study.Outcome measures Data were transcribed from medical records and two self-administered questionnaires. The outcome measure was the incidence of placental abruption. Maternal smoking exposure during pregnancy was categorised based on the number of cigarettes smoked (≤10 or ≥11 cigarettes per day). SHS exposure during pregnancy was evaluated by frequency and duration (almost never or never, 1–3 days/week and/or

Objectives Japanese people are known to get the least amount of sleep in the world, and in particular, the increase in sleep deprived young women is a serious problem. Sleep deprivation is considered to be associated with depression, but the factors involved in this problem are unclear. This study aimed to examine the association between sociodemographic factors, lifestyle choices, sleep-related characteristics and depressive symptoms in young Japanese women.Design Web-based cross-sectional study.Participants We distributed an online survey aiming to recruit young Japanese women ages 18 to 29 from 8 November 2022 to 2 February 2023.Primary and secondary outcome measures Sociodemographic, lifestyle, health, and sleep characteristics were compared among participants according to the presence or absence of depressive symptoms, as assessed by the Patient Health Questionnaire 2 (Cut-off value: 3 points).Results Overall, 540 participants aged between 19 and 29 years were enrolled in the study. The overall prevalence of depressive symptoms was 15.6%. The group with depressive symptoms had a higher rate of current smoking status at 38.5% (unadjusted OR 3.716, 95% CI 1.624 to 8.502). Multiple logistic analyses revealed that depressive symptoms were associated with increased sleep onset latency (β=0.282; p=0.048; OR, 1.325; 95% CI, 1.003 to 1.752) and daytime dysfunction (β=0.550; p

Objectives To investigate the relationship between sleep quality and perimenstrual symptoms among Japanese female students.Design Observational, cross-sectional, online surveySetting We used an online questionnaire to collate responses from Japanese female students on sleep quality and perimenstrual symptoms.Participants A total of 298 female students aged 18–25 years in Japan were included in this study.Primary and secondary outcome measures The Menstrual Distress Questionnaire (MDQ) was used to assess the severity of perimenstrual symptoms for three periods—premenstrual, menstrual and postmenstrual—and the Japanese version of the Pittsburgh Sleep Quality Index was used to assess sleep quality. The MDQ scores were compared between two groups (normal-sleep quality and low-sleep quality) using Mann-Whitney U test. In addition, multiple logistic regression analysis was performed, and the MDQ subscales that showed significant differences between the groups were used as independent variables. The MDQ subscale that was strongly associated with sleep quality was calculated.Results Of the female students, 160 were classified into the normal-sleep quality group and 138 into the low-sleep quality group. The total MDQ scores were significantly higher in the low-sleep quality group at all phases of the menstrual cycle (respectively p

The joint Simon effect refers to inhibitory responses to spatially competing stimuli during a complementary task. This effect has been considered to be influenced by the social factors of a partner: sharing stimulus-action representation. According to this account, virtual interactions through their avatars would produce the joint Simon effect even when the partner did not physically exist in the same space because the avatars are intentional agents. To investigate this, we conducted two joint experiments in which participants controlled avatars as their agents in immersive virtual environments. In Experiment 1, participants were asked to touch a virtual button through their avatars when a target color of an object was presented. The target position was manipulated to be compatible with the button (compatible stimulus) or incompatible with the button (incompatible stimulus). In Experiment 2, the task was identical to that in Experiment 1 except that participants' gaze position was either visualized or not during the task. We hypothesized that visualizing the partner's gaze would enhance the joint Simon effect because gaze is a cue to mentalize others' internal states. The results showed that avatar-based interactions more significantly delayed responses for the incompatible than for the compatible stimulus. However, inconsistent with our hypothesis, visualizing the partner's gaze position did not influence responses for spatially competing stimuli. These results suggest that virtual interactions through avatar agents can produce the joint Simon effect even when the partner does not physically exist in the same space.

Abstract The forced turnout has a perceived risk of development of hallux valgus (HV) in ballet dancers. We determined how the forced turnout affects the sagittal mobility of the first tarsometatarsal (TMT) joint, which is one of the pathogenic factors of HV development. Seventeen female ballet dancers (body mass index: 18.2 ± 1.8 kg/m2) were included and performed demi-plié in control, functional turnout, and forced turnout conditions. Ultrasound imaging synchronized with a three-dimensional motion analysis system was used for measuring the vertical locations of the first metatarsal and medial cuneiform (MC) to evaluate the first TMT joint mobility. Plantar displacement of MC and the first TMT joint mobility in the forced turnout were the greatest among the 3 conditions. Multiple regression analysis indicated that the greater extent of the forcing angle might increase the displacement of MC and the first TMT joint mobility. Evaluating the sagittal mobility of the first TMT joint in the forced turnout can assist in understanding the association between inappropriate techniques including the forced turnout and HV development in ballet dancers. Since the excessive mobility of the first TMT joint is a factor in HV development, the acquirement of adequate active turnout may have the potential to prevent HV development in ballet dancers.

Abstract Time-resolved X-ray magnetic circular dichroism under the effects of ferromagnetic resonance (FMR), known as X-ray ferromagnetic resonance (XFMR) measurements, enables direct detection of precession dynamics of magnetic moment. Here we demonstrated XFMR measurements and Bayesian analyses as a quantitative probe for the precession of spin and orbital magnetic moments under the FMR effect. Magnetization precessions in two different Pt/Ni-Fe thin film samples were directly detected. Furthermore, the ratio of dynamical spin and orbital magnetic moments was evaluated quantitatively by Bayesian analyses for XFMR energy spectra around the Ni $$L_{2,3}$$ L 2 , 3 absorption edges. Our study paves the way for a microscopic investigation of the contribution of the orbital magnetic moment to magnetization dynamics.

Abstract Although fast eating speed has been associated with cardiovascular risk factors, no studies have reported an association between fast eating speed and atherosclerosis as evaluated by carotid intima–media thickness (CIMT). Rapid glucose ingestion is known to cause glucose spikes, which may accelerate atherogenesis and increase levels of growth differentiation factor 15 (GDF-15). Therefore, GDF-15 levels may influence the association between fast eating speed and atherosclerosis. To evaluate the association between eating speed and atherosclerosis in relation to GDF-15, this cross-sectional study analyzed 742 Japanese aged 60–69 years. They were required to have normal thyroid hormone levels, because both GDF-15 levels and atherosclerosis (CIMT ≥ 1.1 mm) can be influenced by thyroid dysfunction. Participants were stratified by the median GDF-15 level. A significant positive association was observed between fast eating speed and atherosclerosis, but only among participants with a high GDF-15 level: the sex- and age-adjusted odds ratios (95% confidence intervals) were 1.95 (1.09, 3.48) in participants with a high GDF-15 level, and 0.83 (0.37, 1.88) in those with a low GDF-15 level. This association remained even after further adjustment for thyroid function and metabolic factors. Serum concentrations of GDF-15 may mediate the association between fast eating speed and atherosclerosis.

Abstract This study aimed to compare second-line treatment outcomes for patients with unresectable pancreatic cancer previously treated with gemcitabine plus nab–paclitaxel (GnP) therapy. We conducted an integrated analysis of two retrospective studies included 318 patients receiving nanoliposomal irinotecan + 5-fluorouracil/folinic acid (NFF) (n = 102), S-1 (n = 57), or FOLFIRINOX (n = 14) as second-line treatment. Median overall survival (OS) in the NFF group was 9.08 months, significantly better than S-1 (4.90 months, P = 0.002). FOLFIRINOX had a median OS of 4.77 months, not statistically different from NFF. Subgroup analyses of OS indicated NFF was generally superior, however, a statistical interaction was observed between the treatment regimen in serum Alb

Abstract Arsenic contamination not only complicates mineral processing but also poses environmental and health risks. To address these challenges, this research investigates the feasibility of utilizing Hyperspectral imaging combined with machine learning techniques for the identification of arsenic-containing minerals in copper ore samples, with a focus on practical application in sorting and processing operations. Through experimentation with various copper sulfide ores, Neighborhood Component Analysis (NCA) was employed to select essential wavelength bands from Hyperspectral data, subsequently used as inputs for machine learning algorithms to identify arsenic concentrations. Results demonstrate that by selecting a subset of informative bands using NCA, accurate mineral identification can be achieved with a significantly reduced the size of dataset, enabling efficient processing and analysis. Comparison with other wavelength selection methods highlights the superiority of NCA in optimizing classification accuracy. Specifically, the identification accuracy showed 91.9% or more when utilizing 8 or more bands selected by NCA and was comparable to hyperspectral data analysis with 204 bands. The findings suggest potential for cost-effective implementation of multispectral cameras in mineral processing operations. Future research directions include refining machine learning algorithms, exploring broader applications across diverse ore types, and integrating hyperspectral imaging with emerging sensor technologies for enhanced mineral processing capabilities.

Abstract Nanoliposomal irinotecan with fluorouracil and folinic acid (NFF) is a standard regimen after gemcitabine-based therapy for patients with unresectable or recurrent pancreatic cancer. However, there are limited clinical data on its efficacy and safety in the real-world. We therefore initiated a retrospective and prospective observational study (NAPOLEON-2). The results of the retrospective part were reported herein. In this retrospective study, we evaluated 161 consecutive patients who received NFF as second-or-later-line regimen. The main endpoint was overall survival (OS), and the other endpoints were response rate, disease control rate, progression-free survival (PFS), dose intensity, and adverse events (AEs). The median age was 67 years (range, 38–85 years). The median OS and PFS were 8.1 and 3.4 months, respectively. The objective response and disease control rates were 5% and 52%, respectively. The median relative dose intensity was 81.6% for nanoliposomal irinotecan and 82.9% for fluorouracil. Grade 3 or 4 hematological and nonhematological AEs occurred in 47 and 42 patients, respectively. Common grade 3 or 4 AEs included neutropenia (24%), anorexia (12%), and leukocytopenia (12%). Subanalysis of patients treated with second-line and third-or-later-line demonstrated no statistical significant difference in OS (7.6 months vs. 9.1 months, respectively; hazard ratio, 0.92; 95% confidence interval, 0.64–1.35; p = 0.68). In conclusion, NFF has acceptable efficacy and safety profile even in real-world clinical settings. The prospective study is in progress to validate these findings.

Abstract Alkaline burns to the cornea lead to loss of corneal transparency, which is essential for normal vision. We used a rat corneal alkaline burn model to investigate the effect of ophthalmic trimebutine solution on healing wounds caused by alkaline burns. Trimebutine, an inhibitor of the high-mobility group box 1-receptor for advanced glycation end products, when topically applied to the burned cornea, suppressed macrophage infiltration in the early phase and neutrophil infiltration in the late phase at the wound site. It also inhibited neovascularization and myofibroblast development in the late phase. Furthermore, trimebutine effectively inhibited interleukin-1β expression in the injured cornea. It reduced scar formation by decreasing the expression of type III collagen. These findings suggest that trimebutine may represent a novel therapeutic strategy for corneal wounds, not only through its anti-inflammatory effects but also by preventing neovascularization.

Abstract Atherosclerosis and height loss are each reportedly associated with cardiovascular disease. However, no studies have found an association between atherosclerosis and height loss. A retrospective study of 2435 individuals aged 60–89 years who underwent annual health check-ups was conducted. Atherosclerosis was defined as carotid intima-media thickness (CIMT) ≥ 1.1 mm. Height loss was defined as being in the highest quintile of height decrease per year, as in our previous studies. Among study participants, 555 were diagnosed as having atherosclerosis. Independent of known cardiovascular risk factors, atherosclerosis was positively associated with height loss. The adjusted odds ratio (OR) was 1.46 (95% confidence interval, 1.15, 1.83). Essentially the same associations were observed for men and women. The adjusted OR (95% CI) was 1.43 (1.01, 2.04) for men and 1.46 (1.07, 1.99) for women. Among older individuals, atherosclerosis is associated with height loss. This result can help clarify the mechanism underlying the association between height loss and cardiovascular disease.

Abstract The length of telomeres located at the ends of chromosomes has attracted attention as an indicator of cellular and individual aging. Various diseases or stresses cause telomere shortening, and it has been reported that alcohol use disorder patients actually have shorter telomeres than healthy patients. However, the factors that contribute to the reduction in telomere length among alcohol use disorder patients have not been clarified in detail. Therefore, in this study, we explored the factors that reduce telomere length in alcohol use disorder patients. A questionnaire survey and a measurement of leukocyte telomere length were conducted among alcohol use disorder patients. The mean telomere length of leukocyte was measured by ∆∆Ct analysis using a real-time PCR. We compared the telomere length between alcohol use disorder patients and the control group (Japanese special health check-up examinee). Moreover, we searched for factors associated with telomere length from drinking/smoking characteristics and history of comorbidities. A total of 74 subjects had alcohol use disorder, and 68 were in the control group. Compared to the control group, alcohol use disorder patients had significantly shorter telomere lengths (p

Abstract In this study, we aimed to separately evaluate the relationship between waist circumference and the incidence of hyperuricemia in men and women in the general Japanese population. We performed a population-based longitudinal study using data from the annual health examination of residents of Iki City, Japan. A total of 5567 participants without hyperuricemia at baseline were included in the analysis. The men and women were placed into groups according to the tertile of waist circumference. The outcome was incident hyperuricemia (uric acid > 416 µmol/L [7.0 mg/dL]). The relationship between waist circumference and the incidence of hyperuricemia was investigated using Cox proportional hazards models. During the follow-up period, hyperuricemia developed in 697 people (551 men and 146 women). The incidence (per 1000 person-years) of hyperuricemia increased with increasing waist circumference in the men (34.9 for tertile 1, 49.9 for tertile 2 and 63.3 for tertile 3; P trend

Abstract Osteosarcoma is rare but is the most common bone tumor. Diagnostic tools such as magnetic resonance imaging development of chemotherapeutic agents have increased the survival rate in osteosarcoma patients, although 5-year survival has plateaued at 70%. Thus, development of new treatment approaches is needed. Here, we report that IL-17, a proinflammatory cytokine, increases osteosarcoma mortality in a mouse model with AX osteosarcoma cells. AX cell transplantation into wild-type mice resulted in 100% mortality due to ectopic ossification and multi-organ metastasis. However, AX cell transplantation into IL-17-deficient mice significantly prolonged survival relative to controls. CD4-positive cells adjacent to osteosarcoma cells express IL-17, while osteosarcoma cells express the IL-17 receptor IL-17RA. Although AX cells can undergo osteoblast differentiation, as can patient osteosarcoma cells, IL-17 significantly inhibited that differentiation, indicating that IL-17 maintains AX cells in the undifferentiated state seen in malignant tumors. By contrast, IL-17RA-deficient mice transplanted with AX cells showed survival comparable to wild-type mice transplanted with AX cells. Biopsy specimens collected from osteosarcoma patients showed higher expression of IL-17RA compared to IL-17. These findings suggest that IL-17 is essential to maintain osteosarcoma cells in an undifferentiated state and could be a therapeutic target for suppressing tumorigenesis.

Abstract First-line chemotherapy for patients with metastatic pancreatic cancer (MPC) includes gemcitabine plus nab-paclitaxel (GnP) and FOLFIRINOX (FFX). However, the efficacy of second-line chemotherapy and the role of combination chemotherapy in clinical practice is still unknown. Data was gathered from 14 hospitals in the Kyushu area of Japan from December 2013 to March 2017. The median overall survival (mOS) from second-line treatment was contrasted between patients who received second-line chemotherapy (CT group) and those who received the best supportive care (BSC group). Furthermore, the mOS of combination chemotherapy was compared to mono chemotherapy in the CT group. To control possible bias in the selection of treatment, we performed a propensity score-adjusted analysis. A total of 255 patients received GnP or FFX as first-line chemotherapy. There were 156 in the CT group and 77 in the BSC group of these. The CT group had a significantly longer mOS than the BSC group (5.2 vs. 2.6 months; adjusted hazard ratio (HR) 0.38; 95% CI 0.27–0.54). In the CT group, 89 patients received combination chemotherapy while 67 received mono chemotherapy. The mOS did not differ significantly between the combination and mono chemotherapy groups (5.5 vs. 4.8 months; adjusted HR 0.88; 95% CI 0.58–1.33). Among patients with MPC receiving second-line treatment, the CT group had a significantly longer mOS than the BSC group, but combination chemotherapy conferred no improvement in survival compared to mono chemotherapy.

Abstract Lumbar spinal stenosis (LSS) is a degenerative disease characterized by intermittent claudication and numbness in the lower extremities. These symptoms are caused by the compression of nerve tissue in the lumbar spinal canal. Ligamentum flavum (LF) hypertrophy and spinal epidural lipomatosis in the spinal canal are known to contribute to stenosis of the spinal canal: however, detailed mechanisms underlying LSS are still not fully understood. Here, we show that surgically harvested LFs from LSS patients exhibited significantly increased thickness when transthyretin (TTR), the protein responsible for amyloidosis, was deposited in LFs, compared to those without TTR deposition. Multiple regression analysis, which considered age and BMI, revealed a significant association between LF hypertrophy and TTR deposition in LFs. Moreover, TTR deposition in LF was also significantly correlated with epidural fat (EF) thickness based on multiple regression analyses. Mesenchymal cell differentiation into adipocytes was significantly stimulated by TTR in vitro. These results suggest that TTR deposition in LFs is significantly associated with increased LF hypertrophy and EF thickness, and that TTR promotes adipogenesis of mesenchymal cells. Therapeutic agents to prevent TTR deposition in tissues are currently available or under development, and targeting TTR could be a potential therapeutic approach to inhibit LSS development and progression.

Abstract A simple method for measuring bioelectric signals of fish in seawater is expected for managing the health of farmed fish and clarifying the ecophysiology of natural fish. We previously proposed a simple and unique method for measuring bioelectric signals of fish by inserting only one special internal electrode (which can be isolated from seawater) into the fish’s body and by sinking an external electrode in seawater (for utilizing the conductivity of seawater). However, the proposed method could not obtain fish electrocardiograms (ECGs) with reliable R-waves in the same manner as the conventional method. In this study, we thus experimentally investigated whether the R-waves of ECGs could be observed by optimizing the insertion position of the internal electrode into the fish’s body. The results of the experiment show that for four species of fish (each slightly longer than 10 cm) with different body shapes, reliable R-waves could be observed by inserting the internal electrode near the heart. We also investigated the possibility of simultaneously measuring ECGs of multiple fish by the proposed method. The results of the investigation show that the fish ECGs with R-waves of three fish could be observed simultaneously even when one single common external electrode replaced multiple external electrodes. This result indicates the advantage of the proposed method in reducing the total number of bioelectrodes compared to the conventional method for ECG measurements of multiple fish.

Objective In Tokyo 2020 Paralympic Games, there were the rule and goal size changes at the blind football competition. This study aimed to compare the scoring and head impact characteristics during blind football competition between the Rio 2016 and Tokyo 2020 Paralympic Games using the official videos.Design Video-based observational study.Participants In total, 36 blind football (men’s football 5-a-side) game videos were obtained from the official International Paralympic Committee.Primary and secondary outcome measures Head impact was defined as the sudden contact of any object with the head. Videos were analysed to assess the number of scores and head impacts along with their corresponding details (ie, round, playing phase, scoring situation, impact situation, occurrence area, impact object, head impact site, fall and foul).Results The total number of goals scored at the Tokyo 2020 Paralympic Games was nearly double that at the Rio 2016 Paralympic Games. Regarding head impacts, a total of 2036 cases (Rio 2016, n=1105; Tokyo 2020, n=931) were evaluated. Significant differences were observed in head impact characteristics between the Rio 2016 and Tokyo 2020 Paralympic Games among seven outcomes (round, scoring situation, impact situation, occurrence area, impact object, site of head impact and fall).Conclusions Compared with the Rio 2016 Paralympic Games, the Tokyo 2020 Paralympic Games showed an increase in the number of points scored and different head impact characteristics.

Background Altered gut microbiota may contribute to COPD development or progression. Herein, we investigated the association of gut microorganisms with COPD, taking into account the impact of smoking status. Methods This cross-sectional observational study was a part of the Shiga Epidemiological Study of Subclinical Atherosclerosis, a population-based cohort study of Japanese men aged 46–76 years, conducted from 2010 to 2016. The gut microbiome, determined using 16S rRNA gene sequencing, was compared among 99 never-smokers, 306 non-COPD ever-smokers and 76 patients with COPD while adjusting for age, body mass index, ethanol consumption and treatment for type 2 diabetes mellitus. Results The abundance of phylum Firmicutes was comparable between patients with COPD and non-COPD ever-smokers but tended to be higher in never-smokers. Similarly, the α- and β-diversity analysis showed similarity between patients with COPD and non-COPD ever-smokers, which tended to differ from never-smokers. Discriminant analysis identified the genus [Prevotella] to be more prevalent in patients with COPD than in never-smokers or non-COPD ever-smokers. Post hoc analysis confirmed similarity of gut microbiome between COPD Global Initiative for Chronic Obstructive Lung Disease (GOLD) I and non-COPD ever-smokers, which was different from GOLD II. Conclusion Smoking may alter the overall gut microbial composition, but gut microbial composition itself may not play a role in the development of COPD. Rather, specific gut bacteria, such as [Prevotella], could be a risk factor for the development of COPD; this may be a potential therapeutic target.

Background: Increasing physical activity may prevent cognitive decline. Previous studies primarily focused on older adults and used self-reported questionnaires to assess physical activity. We examined the relationship between step count, an objective measure of physical activity, and cognitive function in community-based middle-aged and older Japanese men. Methods: The Shiga Epidemiological Study of Subclinical Atherosclerosis randomly recruited community-dwelling healthy men aged 40–79 years from Shiga, Japan, and measured their step counts over 7 consecutive days using a pedometer at baseline (2006–2008). Among men who returned for follow-up (2009–2014), we assessed their cognitive function using the Cognitive Abilities Screening Instrument (CASI) score. We restricted our analyses to those with valid 7-day average step counts at baseline and those who remained free of stroke at follow-up (n = 676). Using analysis of covariance, we calculated the adjusted means of the CASI score according to the quartiles of the average step counts. Results: The mean (standard deviation) of age and unadjusted CASI score were 63.8 (9.1) years and 90.8 (5.8), respectively. The CASI score was elevated in higher quartiles of step counts (90.2, 90.4, 90.6, and 91.8 from the lowest to the highest quartile, respectively, [p for trend = 0.004]) in a model adjusted for age and education. Further adjustment for smoking, drinking, and other cardiovascular risk factors resulted in a similar pattern of association (p for trend = 0.005). Conclusion: In apparently healthy middle-aged and older Japanese men, a greater 7-day average step count at baseline was associated with significantly higher cognitive function score.

Bruxism, the involuntary activity of masticatory muscles, is common among individuals with autism spectrum disorders (ASD). Although bruxism is bidirectionally associated with sleep issues, whether an infant's sleep duration contributes to the development of bruxism remains unknown. In this study, a dataset (n = 83,720) obtained from the Japan Environment and Children's Study, a nationwide birth cohort study, was subjected to multiple imputations using logistic regression analysis with adjustments for several maternal and child-related variables. The aim of this study was to assess whether shorter sleep duration in the neonatal period additively affected the high prevalence of parent-reported bruxism (PRB) among children with ASD. The prevalences of ASD and PRB in the participants were 1.2% and 7.2%, respectively, and the odds ratio of the increased risk of PRB prevalence in individuals with ASD (95% confidence interval) was 1.59 (1.31-1.94) after covariate adjustments. Importantly, shorter sleep duration in the neonatal period (at one month of age) was significantly associated with an increased risk of PRB prevalence in individuals with ASD. The increased occurrence of bruxism, known to be highly prevalent among children with ASD, is associated with shorter sleep duration, particularly in the neonatal stage. Based on our results, a better understanding of the development of bruxism in individuals with ASD would provide valuable information for the prevention of oral diseases.

Circulating CD34-positive cell count is inversely associated with height loss. It acts as an indicator of endothelial repair activity. In conjunction with CD34-positive cells, platelets contribute to endothelial repair. The presence of hypertension increases the demand for endothelial repair. Therefore, platelet count could be associated with height loss among individuals with hypertension. A retrospective study of 2,343 individuals aged 40 to 79 years was conducted. Height loss was defined as being in the highest quartile of annual height decrease (1.6 mm/year for men and 2.0 mm/year for women). A significant inverse association between platelet count and height loss was observed only among participants with hypertension. After adjusting for known cardiovascular risk factors, the odds ratio (95% confidence interval) for height loss per 1 standard deviation increment in platelet count (5.09×104/μL for men and 5.03×104/μL for women) was 0.83 (0.70, 0.98) for participants with hypertension and 1.02 (0.90, 1.16) for participants without hypertension. Independent of known cardiovascular risk factors, platelets could prevent accelerated height loss among individuals with hypertension. Unlike CD34-positive cell count, platelet count and blood pressure, which are easy to assess in daily clinical practice, influence height loss.

Introduction: Exercise tolerance, an important factor affecting life prognosis and rehospitalization in patients with chronic heart failure, is a major outcome of cardiac rehabilitation. Heart failure with preserved ejection fraction (HFpEF) from reduced diastolic capacity has recently increased among patients with chronic heart failure. This study evaluated and clarified the factors indicating exercise tolerance in patients with HFpEF from various perspectives, including cardiac and skeletal muscle functions. Material and Methods: The subjects were 31 patients with HFpEF who underwent cardiac rehabilitation. Exercise tolerance was assessed using a 6-minute walking test. Physical function, physical activity, body composition test, baseline characteristics, blood data, and echocardiography results were extracted from medical records to identify the indicators of exercise tolerance. Results: Gait speed was significantly different in exercise tolerance for HFpEF patients (β=0.75, p

Abstract Atrial fibrillation (AF) and heart failure (HF) contribute to about 45% of all cardiovascular disease (CVD) deaths in the USA and around the globe. Due to the complex nature, progression, inherent genetic makeup, and heterogeneity of CVDs, personalized treatments are believed to be critical. To improve the deciphering of CVD mechanisms, we need to deeply investigate well-known and identify novel genes that are responsible for CVD development. With the advancements in sequencing technologies, genomic data have been generated at an unprecedented pace to foster translational research. Correct application of bioinformatics using genomic data holds the potential to reveal the genetic underpinnings of various health conditions. It can help in the identification of causal variants for AF, HF, and other CVDs by moving beyond the one-gene one-disease model through the integration of common and rare variant association, the expressed genome, and characterization of comorbidities and phenotypic traits derived from the clinical information. In this study, we examined and discussed variable genomic approaches investigating genes associated with AF, HF, and other CVDs. We collected, reviewed, and compared high-quality scientific literature published between 2009 and 2022 and accessible through PubMed/NCBI. While selecting relevant literature, we mainly focused on identifying genomic approaches involving the integration of genomic data; analysis of common and rare genetic variants; metadata and phenotypic details; and multi-ethnic studies including individuals from ethnic minorities, and European, Asian, and American ancestries. We found 190 genes associated with AF and 26 genes linked to HF. Seven genes had implications in both AF and HF, which are SYNPO2L, TTN, MTSS1, SCN5A, PITX2, KLHL3, and AGAP5. We listed our conclusion, which include detailed information about genes and SNPs associated with AF and HF.

Abstract To investigate the relationship between white blood cell (WBC) count and incidence of hyper-low-density lipoprotein (LDL) cholesterolemia in a population-based longitudinal study. This is a retrospective study using data of annual health check-ups for residents of Iki City, Japan. A total of 3312 residents (≥ 30 years) without hyper-LDL cholesterolemia at baseline were included in this analysis. Primary outcome was incidence of hyper-LDL cholesterolemia (LDL cholesterol levels ≥ 3.62 mmol/L and/or use of lipid lowering drugs). During follow-up (average 4.6 years), 698 participants development of hyper-LDL cholesterolemia (incidence 46.8 per 1000 person-years). Higher incidence of hyper-LDL cholesterolemia was observed among participants with higher leukocyte count (1st quartile group: 38.5, 2nd quartile group: 47.7, 3rd quartile group: 47.3, and 4th quartile group: 52.4 per 1,000 person-years, P = 0.012 for trend). Statistically significant relation was observed even after adjustment for age, gender, smoking, alcohol intake, leisure-time exercise, obesity, hypertension and diabetes: hazard ratio 1.24 (95% confidence interval 0.99 to 1.54) for 2nd quartile group, 1.29 (1.03–1.62) for 3rd quartile group and 1.39 (1.10–1.75) for 4th quartile group, compared with 1st quartile group (P for trend = 0.006). Increased WBC count was related to incidence of hyper-LDL cholesterolemia in general Japanese population.

Abstract There are limited absolute biomarkers for determining the prognosis before first- and second-line palliative chemotherapy in unresectable pancreatic cancer (urPC) patients. To find the best prognostic inflammatory marker, we investigated relationships between overall survival (OS) and six inflammatory markers; C-reactive protein/albumin ratio (CAR), neutrophil–lymphocyte ratio (NLR), prognostic nutrition index (PNI), platelet–lymphocyte ratio (PLR), Glasgow prognostic score (GPS), and prognostic index (PI). We examined 255 patients who received gemcitabine + nab-paclitaxel or FOLFIRINOX as first-line chemotherapy and 159 patients who subsequently underwent second-line chemotherapy. First-line patients with lower CAR had better OS compared to those with a higher CAR (hazard ratio 0.57; 95% confidential index 0.42–77; P

Abstract Hyperglycemia impairs immune response; however, it remains unknown whether the anti-tumor effects of anti-programmed cell death-1 antibody (PD-1-Ab) treatment are changed in hyperglycemic conditions. We analyzed the effect of PD-1-Ab on tumor growth in streptozotocin-induced diabetic mice (STZ-mice) subcutaneously inoculated with MC38 (a colon carcinoma cell line). Furthermore, we assessed the expression of chemokines by polymerase chain reaction (PCR) array in tumor-draining lymph nodes (dLNs) of these mice and MC38 cells cultured in different glucose concentrations. The suppressive effect of PD-1-Ab on tumor growth was attenuated. This was accompanied by fewer tumor-infiltrating CD8+ T cells, and STZ-mice had fewer tumor-infiltrating CD11c+ dendritic cells (DCs) than normoglycemic mice. mRNA expression levels of CXCL9, a chemokine recruiting CD8+ T cells, were lower in dLNs of STZ-mice than in normoglycemic mice after PD-1-Ab treatment, and its protein was expressed in DCs. In MC38 cells cultured with 25 mM glucose, mRNA expression of CCL7, a chemokine recruiting DCs, was decreased compared to cells cultured with 5 mM glucose. These results suggest that the STZ-induced hyperglycemia impairs the effect of PD-1-Ab treatment on MC38 tumor growth, and is accompanied by reduced infiltration of DCs and CD8+ T cells and decreased expression of CCL7 and CXCL9.

Study Design A retrospective cohort study. Purpose Our aim is to investigate the relationship between degenerative lumbar scoliosis (DLS), and whole-body alignment, including spinopelvic and lower extremity alignments. Overview of Literature DLS is a deformity commonly associated with aging. However, the correlation between whole-body alignment and DLS remains controversial. Methods Adult volunteers aged over 50 years were included in the study after participating in the screening program. Characteristic data and standing radiographic parameters were assessed. A propensity score model was established with adjustments for age and sex after a preliminary analysis, and cases were divided into DLS (Cobb angle >10°) and non-DLS (Cobb angle ≤10°) groups. Results There were significant differences in age, sex, C2 sagittal vertical axis (C2-SVA), C7-SVA, T1 pelvic angle (TPA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), PI minus LL (PI–LL), knee angle, ankle angle, pelvic shift, C7-center sacral vertical line, L4 tilt, femur-tibia angle, and hip-knee-ankle angle (all p

Study Design Cohort study. Purpose There is currently no published study that focuses on the spinal corrective surgery effects with cranial parameters in adult spinal deformity (ASD) patients. It is an important factor to measure since it plays a critical role in maintaining the line of sight. The objective is to determine the change in cranial parameters using the slope of McGregor’s line (McGS) after ASD surgery after 2 years of follow-up. Overview of Literature A study concluded that cervical spine alignment (C2–C7 lordosis) is strongly affected by thoracic kyphosis (TK). Another study showed that patients with ascending gaze had significantly more thoracolumbar malalignment. Methods This retrospective study includes 295 corrective surgery patients with ASD. Subjects were divided into two groups after propensity age matching analysis: cranial malalignment (McGS 13) and normal cranial alignment (−8≤ McGS ≤13). Lumbar lordosis (LL), pelvic tilt (PT), TK, cervical lordosis (CL), and sagittal vertical axis (SVA) were evaluated between the two groups. Results SVA (95–56 mm) and PT (34°–25°) decreased and LL (19°–41°) increased 2 years after surgery (p

To determine the effects of age and variants of concern on transmission of SARS-CoV-2, we analyzed infection rates among close contacts over 4 periods in Toyama Prefecture, Japan. Among household contacts, odds of infection were 6.2 times higher during the period of the Omicron variant than during previous periods, particularly among children and adolescents.

Study Design This is a retrospective study. Purpose This study aimed to investigate the incidence of and risk factors for postoperative shoulder imbalance (PSI) in patients with Lenke type 1. Overview of Literature PSI is a complication resulting in poor self-image and satisfaction in adolescent idiopathic scoliosis (AIS) patients. Methods We examined the data of AIS patients with Lenke type 1 curves who underwent posterior fusion surgery in a retrospective manner. PSI was defined as a 2-year postoperative absolute radiographic shoulder height (RSH) of ≥2 cm. Patients were divided into two groups based on the presence of PSI and the level of their upper instrumented vertebra (UIV) (UIV at T2 or T3 [U-UIV] or UIV below T3 [L-UIV]). The radiographic parameters and clinical outcomes were compared, and the cutoff values of risk factors were identified by multivariate analysis. Results Of 104 patients, 21 (20.2%) had left shoulder elevation PSI. The PSI group had a significantly greater preoperative RSH (−5.1 mm vs. −14.3 mm) and main thoracic (MT) curve correction rate (77.3% vs. 69.1%) than the non-PSI group. The PSI incidence did not differ between the U-UIV and L-UIV groups. Multivariate analysis identified preoperative RSH and the MT curve correction rate as independent risk factors for PSI. The receiver operating characteristic curve analysis identified the preoperative RSH cutoff value as −6.5 mm and MT curve correction rate cutoff value as 76.9%. Conclusions Even in AIS patients with Lenke type 1 curves, the incidence of PSI was relatively high (20.2%). Patients with preoperative lower right shoulder elevation (i.e., RSH >−6.5 mm) had a higher risk of PSI regardless of UIV level when the MT curve showed a higher correction rate (i.e., correction rate >76.9%).

Abstract Recently, c-axis negative thermal expansion (NTE) was observed in a CoZr2 superconductor and related transition-metal zirconides. Here, we investigated the structural, electronic, and superconducting properties of Co1−x Ni x Zr2 to achieve systematic control of c-axis NTE and switching from NTE to positive thermal expansion (PTE) by Ni substitution. At x ≤ 0.3, c-axis NTE was observed, and the thermal expansion constant α c approached zero with increasing x. At x = 0.4–0.6, c-axis thermal expansion close to zero thermal expansion (ZTE) was observed, and PTE appeared for x ≥ 0.7. On the superconducting properties, we observed bulk superconductivity for x ≤ 0.6, and bulk nature of superconductivity is suppressed by Ni heavy doping (x ≥ 0.7). For x ≤ 0.6, the evolution of the electronic density of states well explains the change in the superconducting transition temperature (T c), which suggests conventional phonon-mediated superconductivity in the system. By analyzing the c/a ratio, we observed a possible collapsed transition in the tetragonal lattice at around x = 0.6–0.8. The lattice collapse would be the cause of the suppression of superconductivity in Ni-rich Co1−x Ni x Zr2 and the switching from NTE to PTE.

Abstract Objective: Resting energy expenditure (REE) decreases if there is reduced energy intake and body weight (BW). The decrease in REE could make it difficult for patients with obesity to maintain decreased BW. This study aimed to investigate the correlation among changes in REE, energy intake, and BW during the weight loss process in patients with obesity. Materials and methods: We conducted a retrospective cohort study of patients hospitalized for the treatment of obesity in Japan. Patients received fully controlled diet during hospitalization and performed exercises if able. REE was measured once a week using a hand-held indirect calorimetry. Energy intake was determined by actual dietary intake. Results: Of 44 inpatients with obesity, 17 were included in the analysis. Their BW decreased significantly after 1 week (−4.7 ± 2.0 kg, P < 0.001) and 2 weeks (−5.7 ± 2.2 kg, P < 0.001). The change in REE after 1 and 2 weeks was positively correlated with the energy intake/energy expenditure ratio (r = 0.66, P = 0.004 at 1 week, r = 0.71, P = 0.002 at 2 weeks). Using a regression equation (y = 0.5257x – 43.579), if the energy intake/energy expenditure ratio within the second week was 82.9%, the REE after 2 weeks was similar to the baseline level. There was no significant correlation between the change in REE and BW. Conclusions: Our data suggest that changes in REE depend on energy intake/energy expenditure ratio and that the decrease in REE can be minimized by matching energy intake to energy expenditure, even during the weight loss process.

Abstract Familial neurohypophyseal diabetes insipidus (FNDI) is a degenerative disease of vasopressin (AVP) neurons. Studies in mouse in vivo models indicate that accumulation of mutant AVP prehormone is associated with FNDI pathology. However, studying human FNDI pathology in vivo is technically challenging. Therefore, an in vitro human model needs to be developed. When exogenous signals are minimized in the early phase of differentiation in vitro, mouse embryonic stem cells (ESCs)/induced pluripotent stem cells (iPSCs) differentiate into AVP neurons, whereas human ESCs/iPSCs die. Human ESCs/iPSCs are generally more similar to mouse epiblast stem cells (mEpiSCs) compared to mouse ESCs. In this study, we converted human FNDI-specific iPSCs by the naive conversion kit. Although the conversion was partial, we found improved cell survival under minimal exogenous signals and differentiation into rostral hypothalamic organoids. Overall, this method provides a simple and straightforward differentiation direction, which may improve the efficiency of hypothalamic differentiation.

Study Design Single-center retrospective case series. Purpose We aimed to evaluate the clinical results of revision surgery for a rod fracture using a posterior-only approach and determine the best procedure to prevent refracture in patients with adult spinal deformity (ASD). Overview of Literature ASD affects the thoracolumbar spine and often requires surgical correction. However, surgery for extensive spinal fusion causes rod fracture, a major mechanical complication. Few studies have described the treatment methods for rod fractures. Furthermore, the clinical outcomes of revision surgery for rod fractures in patients with ASD are currently unclear. Methods We retrospectively reviewed the medical records of 404 patients who underwent corrective fusion surgery for ASD with a minimum 2-year follow-up. We studied cases of reoperation for postoperative rod fractures and investigated surgical procedure, intraoperative findings, clinical course, and rod refracture following revision surgery. Results Rod fracture was observed in 88 patients (21.8%). Fifty-three patients (average age, 68.3 years; average blood loss, 502.2 mL [% estimated blood volume=16.4%]; and operation time, 203.3 minutes) who suffered from a rod fracture at an average of 28.3 months after the primary operation underwent reoperation. Surgical invasiveness had no significant differences in total or partial rod replacement; however, the procedures with and without an anterior bone graft significantly differed. The replaced rod refractured at an average of 35.3 months after the revision surgery of five patients. The rod also refractured at a level outside multiple rods in two patients and with traumatic episodes in three patients. Three patients had bone grafts in the anterior column. Conclusions Revision surgery involving a multirod with a posterior-only approach for a rod fracture that occurred after ASD was performed successfully. Bone grafting in the anterior column is unnecessary for patients without massive bone defects.

Coronary arteries are a critical part of the vascular system and provide nourishment to the heart. In humans, even minor defects in coronary arteries can be lethal, emphasizing their importance for survival. However, some teleosts survive without coronary arteries, suggesting that there may have been some evolutionary changes in the morphology and function of coronary arteries in the tetrapod lineage. Here, we propose that the true ventricular coronary arteries were newly established during amniote evolution through remodeling of the ancestral coronary vasculature. In mouse (Mus musculus) and Japanese quail (Coturnix japonica) embryos, the coronary arteries unique to amniotes are established by the reconstitution of transient vascular plexuses: aortic subepicardial vessels (ASVs) in the outflow tract and the primitive coronary plexus on the ventricle. In contrast, amphibians (Hyla japonica, Lithobates catesbeianus, Xenopus laevis, and Cynops pyrrhogaster) retain the ASV-like vasculature as truncal coronary arteries throughout their lives and have no primitive coronary plexus. The anatomy and development of zebrafish (Danio rerio) and chondrichthyans suggest that their hypobranchial arteries are ASV-like structures serving as the root of the coronary vasculature throughout their lives. Thus, the ventricular coronary artery of adult amniotes is a novel structure that has acquired a new remodeling process, while the ASVs, which occur transiently during embryonic development, are remnants of the ancestral coronary vessels. This evolutionary change may be related to the modification of branchial arteries, indicating considerable morphological changes underlying the physiological transition during amniote evolution.

Haploidentical-related donor transplantation using posttransplant cyclophosphamide (PTCy-haplo) and cord blood transplantation (CBT) are valid alternatives for patients with hematological malignancies when HLA-matched donor transplantation (MDT) is unavailable. However, the effects of graft-versus-host disease (GVHD) on outcomes after these transplants have not been fully elucidated. Therefore, we evaluated the effects of acute and chronic GVHD on transplant outcomes after PTCy-haplo transplants and compared them with CBT and MDT. We included a total of 914 adult patients with hematological malignancies in the Kyoto Stem Cell Transplantation Group registry who received PTCy-haplo (N = 120), CBT (N = 402), and MDT (N = 392), and achieved neutrophil engraftment. A multivariate analysis revealed that grade I–II acute GVHD improved of overall survival (OS) after PTCy-haplo [hazard ratio (HR) = 0.39, P = 0.018] and CBT (HR = 0.48, P < 0.001), but not after MDT (HR = 0.80, P = 0.267) compared with patients without acute GVHD. Grade I–II acute GVHD had a trend toward reducing the risk of nonrelapse mortality (NRM) after PTCy-haplo (HR = 0.13, P = 0.060) and this positive effect was significant after CBT (HR = 0.39, P = 0.003). A negative impact of grade III–IV acute GVHD on NRM was observed after CBT and MDT, but not after PTCy-haplo. Limited chronic GVHD had a positive impact on OS after CBT and MDT, but not after PTCy-haplo. In conclusion, mild acute GVHD improved outcomes after PTCy-haplo and CBT, and limited chronic GVHD improved outcomes after CBT and MDT. These data indicated that the effects of GVHD on transplant outcomes depended on transplant platforms.

Objective We aimed to clarify the relationship between serum alanine transaminase (ALT) levels and incidence of new-onset diabetes in a Japanese general population.Setting Population-based retrospective cohort study using annual health check-up data for residents of Iki City, Nagasaki Prefecture, Japan.Participants A total of 5330 Japanese individuals (≥30 years old) without diabetes at baseline were analysed.Primary and secondary outcome measures Serum ALT levels were determined using an enzymatic method and were classified into gender-specific quartile groups as follows: group 1 (3–16 U/L in men and 3–13 U/L in women), group 2 (17–21 U/L in men and 14–16 U/L in women), group 3 (22–29 U/L in men and 17–22 U/L in women) and group 4 (30–428 U/L in men and 23–268 U/L in women). The study outcome was the incidence of diabetes (fasting glucose ≥7.0 mmol/L, non-fasting glucose ≥11.1 mmol/L, glycated haemoglobin ≥6.5% or use of glucose-lowering therapies).Results After an average follow-up period of 5.0 years, 279 individuals developed diabetes. The incidence rate of diabetes increased with elevation of serum ALT levels (0.7% per 100 person-years in group 1, 0.9% in group 2, 0.9% in group 3 and 1.7% in group 4) (p

Abstract Extremely low alanine aminotransferase (ALT) may reflect aging, frailty, sarcopenia, and malnutrition in several cardiovascular diseases, but the association between low ALT and patient characteristics, cardiovascular and all-cause mortality is not well investigated in the population with atrial fibrillation. We conducted a post hoc analysis of a prospective, observational multicenter study. Patients with nonvalvular AF in the SAKURA AF Registry (n = 3156) were classified into 3 tertiles according to baseline ALT: first (ALT ≤ 15 U/L, n = 1098), second (15

Study Design Single-center prospective study. Purpose To investigate anterior spinal artery (ASA) status using preoperative selective angiography in patients undergoing surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL). Overview of Literature Surgery for T-OPLL has a high risk of neurological complications, which might be associated with insufficient spinal cord blood flow. Methods This study prospectively examined nine T-OPLL patients who underwent posterior thoracic decompression with kyphosis correction and instrumented fusion at Hamamatsu University School of Medicine between 2017 and 2019. All underwent preoperative selective angiography to detect and evaluate the Adamkiewicz artery and ASA. Intraoperative neuromonitoring and Doppler ultrasonography were performed to analyze neurological complications and spinal cord blood flow. Results All nine patients showed ASA stenosis in the area of T-OPLL. In all patients, the Adamkiewicz artery was located between T7 and L2 and the area of ASA stenosis corresponded to the level of T-OPLL and greatest spinal cord compression; intraoperative Doppler ultrasonography confirmed the ASA defect at the same spinal level. The number of spinal levels from the Adamkiewicz artery to the most compressive OPLL lesion was greater in the two patients who developed postoperative neurological deficit compared to those who did not (5.5 vs. 2.3, p=0.014). Conclusions This is the first study to report detection of ASA stenosis in patients with T-OPLL. Maintaining spinal cord blood flow is important in these patients to avoid neurological deterioration.

Abstract We determined how the in vivo mobility of the first tarsometatarsal (TMT) joint can be quantified during gait. Twenty-five healthy participants (12 females) with no history of foot disorders were included. Non-invasive ultrasound (US) with a three-dimensional motion analysis (MA) system was used to evaluate the kinematic characteristics of first TMT joint during stance phase of gait. US probe was positioned longitudinally above the first TMT joint and adjusted to its proximal dorsal prominence. Gait analysis was conducted by the MA system starting with the activation of B-mode US video at 80 frames per second and 60-mm depth for simultaneous capture. During stance phase, the first metatarsal was translated dorsally with respect to the medial cuneiform, returning to a neutral level at toe-off in all subjects. During middle stance phase, the medial cuneiform was stable in males but displaced in the plantar direction in females and was the primary contributor to the differences in sagittal mobility observed between groups. Quantitatively measuring sagittal mobility of the first TMT joint could be useful for the early detection of foot abnormalities. The dynamic characteristics of the medial cuneiform during gait in healthy females may be associated with a high prevalence of hallux valgus.

Abstract Angiogenesis inhibition therapy causes hypertension by increasing peripheral vascular resistance. Vasa vasorum angiogenesis plays a crucial role in the development of atherosclerosis. Since vascular endothelial growth factor (VEGF), which contributes to the progress of angiogenesis, is reported to be inversely associated with the minor allele of polymorphism rs3025039, the minor allele of rs3025039 could be inversely associated with atherosclerosis among individuals with hypertension. A cross-sectional study of 1793 older Japanese adults aged 60–89 years with hypertension who participated in general health check-ups was conducted. Atherosclerosis was defined as carotid intima-media thickness (CIMT) ≥ 1.1 mm. The minor allele of polymorphism rs3025020 was positively associated with VEGF. Therefore, in addition to known cardiovascular risk factors, rs3025020 genotype acted as a confounding factor in the present study. Independent of known confounding factors, the minor allele of rs3025039 was inversely associated with atherosclerosis among older Japanese adults with hypertension. The fully adjusted odds ratio (OR) and 95% confidence interval (CI) for atherosclerosis with the minor allele of rs3025039 was 0.78 (0.64, 0.96). The angiogenesis-related polymorphism rs3025039 was associated with the development of atherosclerosis among older Japanese individuals. This study indicates that the development of atherosclerosis among older individuals might partly indicate a capacity for angiogenesis.