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Background: We explore an optimized approach for increasing lesion size using a novel ablation catheter with a surface thermocouple and efficient irrigation in a temperature-control setting. Methods: We conducted radiofrequency applications at various power levels (35 W, 40 W, and 45 W), contact forces (CFs, 10 g/20 g), and durations (60 s/120 s/180 s) in perpendicular/parallel catheter orientations, with normal saline irrigation (NS-irrigation) and Half NS-irrigation (HNS-irrigation) in an ex-vivo model (Step 1). In addition, we performed applications (35 W/40 W/45 W for 60 s/120 s/180 s in NS-irrigation and 35 W/40 W for 60 s/120 s/180 s in HNS-irrigation) in four swine (Step 2), evaluating lesion characteristics and the occurrence of steam pops. Results: In Step 1, out of 288 lesions, we observed 47 (16.3%) steam pops, with 13 in NS-irrigation and 34 in HNS-irrigation (p = .001). Although steam pops were mostly observed with the most aggressive setting (45 W/180 s, 54%) with NS-irrigation, they happened in less aggressive settings with HNS irrigation. Lesion size significantly increased with longer-duration ablation but not with HNS-irrigation. The optimal %impedance-drop cutoff to predict steam pops was 20% with a negative-predictive-value (NPV) = 95.1% including NS- and HNS-irrigation groups, and 22% with an NPV = 96.1% in NS-irrigation group. In Step 2, similar to the ex-vivo model, lesion size significantly increased with longer-duration ablation but not with HNS-irrigation. Steam pops were absent with NS-irrigation (0/35) even with the largest %impedance-drop reaching 31% at 45 W/180 s. All steam pops were observed with HNS-irrigation (6/21, 29%). The optimal %impedance-drop cutoff predicting steam pops was 24% with an NPV = 96.3% including both NS- and HNS-irrigation groups. Conclusions: Rather than using HNS-irrigation, very long-duration of radiofrequency applications up to 45 W/180 s may be recommended to safely and effectively increase lesion dimensions using this catheter with NS-irrigation. [ABSTRACT FROM AUTHOR]

Companion diagnostic (CDx) tests play important roles in identifying oncogenic driver genes and tailoring effective molecularly targeted therapies for lung cancer patients. In Japan, the Oncomine Dx target test (ODxTT) and the AmoyDx pan lung cancer PCR panel (AmoyDx) are prominent CDx tests and only one of these tests is covered by the domestic insurance system. However, these CDx tests cover different target regions and apply different technologies (ODxTT is amplicon-based next-generation sequencing and AmoyDx is multiplex PCR-based assay), which may lead to missing of actionable mutations affecting patient prognosis. Here, we performed a direct comparison analysis of 1059 genetic alterations of eight driver genes from 131 samples and evaluated the concordance between two CDx tests for detecting actionable variants and fusions. When excluding the eight uncovered variants (ODxTT: two variants, AmoyDx: six variants), the overall percent agreement was 97.6% (1026/1051) with 89.0% of overall positive percent agreement (89/100) and 98.5% of overall negative percent agreement (937/951). Of the 25 discordant genetic alterations, two were undetected despite being covered in the AmoyDx (one EGFR variant and one ROS1 fusion). Furthermore, there were potential false positives in the ODxTT (nine MET exon 14 skippings) and in the AmoyDx (five variants, six ROS1 and three RET fusions). These potential false positives in the AmoyDx likely due to non-specific amplification, which was validated by the unique molecular barcoding sequencing. The ODxTT missed two uncovered EGFR rare variants, which was visually confirmed in the raw sequencing data. Our study provides insights into real-world performance of CDx tests for lung cancer and ensures reliability to advance precision medicine. [ABSTRACT FROM AUTHOR]

Ethical behavior towards the environment includes valuing nature, living sustainably in harmony within nature, and respecting the autonomy of all living things. This paper describes a study of Japanese high school students' attitudes with regard to environmental ethics. Findings suggest that students who value environmental conservation tend to abandon ideas of anthropocentrism. (Contains 16 references.) (WRM)

Background: Disaster-related relocation is associated with depression and post-traumatic stress disorder, especially in older adults. Disaster-related relocation often deprives survivors of opportunities for social group participation, potentially deteriorating their mental health. On the contrary, the relocation could also be an opportunity for optimizing social relationships, ending/reducing unwanted participation. This study examined the potential mediation effects of changing participation for the link of disaster-related relocation to mental health. Methods: We analyzed a pre-post disaster dataset of functionally independent older adults from the Japan Gerontological Evaluation Study. Following the 2013 survey, a follow-up survey was conducted seven months after the 2016 Kumamoto earthquake (n = 828). Results: The causal mediation analyses indicated that compared to no relocation, the relative risk for experiencing major depressive episodes among those relocating to temporary housing was 3.79 [95% confidence interval: 1.70–6.64] (natural direct effect). By contrast, the relative risk for those renewing (either ceased or started) group participation was 0.60 [95% CI: 0.34–0.94] (natural indirect effect). Conclusions: Optimization of social ties according to a renewal of group participation status might have protected older adults in temporary housing against depression. [ABSTRACT FROM AUTHOR]

Purpose/Background: City-specific temporal analysis has been commonly used to investigate the impact of COVID-19-related behavioural regulation policies on crime. However, these previous studies fail to consider differences in the intensity of intervention among cities and the impact of these behavioural regulation policies on crime trends nationwide. This study performs panel data analyses to examine how the declaration of a state of emergency (SoE) affected ambient population and crime in Japan, taking advantage of the fact that the SoE was implemented at different times in different prefectures. Methods: The current study uses two sets of panel data of 47 prefectures for 22 weeks from February to July 2020: (1) the data on ambient population in five types of locations provided by the Google Mobility Reports, and (2) official crime data of six types of crime: residential burglary, commercial burglary, theft of/from vehicle, bicycle theft, sexual assault, and violence and injury. Firstly, an ordinary least squares regression analysis was performed to examine the impact of the SoE on the ambient population. Then a negative binomial model with fixed effects was adopted to examine the effect of the ambient population on the crime trends. Findings: The SoE declaration was found to increase the ambient population in 'residential', and decrease that in other settings including 'workplaces', 'transit stations', and 'retail and recreation' in targeted prefectures. Spill-over effects of the SoE were observed on the ambient population of non-SoE prefectures. The ambient population have impacted five out of the six types of crime examined, except for sexual assault. After controlling for the ambient population, we observed an increase in commercial burglary and theft of/from the vehicle in all prefectures during the SoE weeks, compared to the weeks when the SoE was not declared. Conclusions: The declaration of the SoE during the COVID-19 pandemic changed the ambient population in the SoE-prefectures, resulting the changes in crime levels as well. In addition, the implementation of the SoE in specific prefectures was found to have a contextual impact on national-level crime trends. Furthermore, the implementation of the SoE caused changes in some crime types that could not be explained by the changes in the ambient population, suggesting that the implementation of the SoE affected offenders' decision-making. It is also worth noting that the changes in ambient population and crime trends during the pandemic were observed in Japan where the behavioural regulation policy without law enforcement was introduced. [ABSTRACT FROM AUTHOR]

Japanese government initially enforced restrictions on outpatient attendances among febrile individuals suspected of having COVID-19, asking everyone to remain at home for at least 4 days from the onset of fever. This restriction was cancelled on 8 May 2020, and a new antiviral, remdesivir, was approved from 7 May 2020. To investigate how this policy change influenced the prognosis of people with COVID-19, we estimated the case fatality risk as a function of the date of illness onset from April to June 2020. We used an interrupted time-series analysis model with an intervention date of 8 May 2020, and estimated time-dependent case fatality risk by age group. The case fatality risk showed a decreasing trend in all groups, and models were favored accounting for an abrupt causal effect, i.e., immediate decline in fatality risk. The trend was estimated at − 1.1% (95% CI [confidence interval]: − 3.9, 3.0) among people aged 60–69 years, − 7.2% (95% CI − 11.2, − 2.4) among those aged 70–79 years, − 7.4% (95% CI − 14.2, 0.2) among those aged 80–89 years, and − 10.3% (95% CI − 21.1, 2.7) among those aged 90 and over. Early diagnosis and treatment greatly contributed to reducing the case fatality risk. [ABSTRACT FROM AUTHOR]

Street greenness visibility (SGV) is associated with various health benefits and positively influences perceptions of landscape. Lowering the barriers to SGV assessments and measuring the values accurately is crucial for applying this critical landscape information. However, the verified available street view imagery (SVI) data for SGV assessments are limited to the traditional top-down data, which are generally used with download and usage restrictions. In this study, we explored volunteered street view imagery (VSVI) as a potential data source for SGV assessments. To improve the image quality of the crowdsourced dataset, which may affect the accuracy of the survey results, we developed an image filtering method with XGBoost using images from the Mapillary platform and conducted an accuracy evaluation by comparing the results with official data in Shinjuku, Japan. We found that the original VSVI is well suited for SGV assessments after data processing, and the filtered data have higher accuracy. The discussion on VSVI data applications can help expand useful data for urban audit surveys, and this full-free open data may promote the democratization of urban audit surveys using big data. [ABSTRACT FROM AUTHOR]

Background: The annual rabies vaccination coverage in dogs among 47 prefectures in Japan has been reported to range from 42.3% to 92.4%, and the overall coverage has been steadily declining. Given the presence of unregistered dogs and the small number of stray dogs, the true vaccination coverage is likely to be even lower. Methods: We conducted a cross-sectional survey of dog owners to identify the owner characteristics associated with dog rabies vaccination. People in Japan who currently own dogs were recruited and answered a questionnaire consisting of four sections: (i) demographic characteristics, (ii) education history associated with medicine, (iii) factors related to veterinary services, and (iv) dog characteristics. Results: A total of 534 dog owners covering 629 dogs were surveyed. Vaccination within the prior 12 months was the major outcome (56.1%). The associated variables were (a) owner education level, (b) knowledge about mandatory vaccination, (c) having a family veterinary clinic, (d) frequency of visiting a veterinary clinic, and (e) having ever been advised to vaccinate their dog. Conclusions: Although causality cannot be implied, our findings indicate improving owners' knowledge about mandatory vaccination, facilitating attachment to a veterinary clinic, and veterinarians providing vaccination advice might increase the uptake of dog rabies vaccination. The finding in Japan did not deviate from Asian and African countries with rabies, and the sample estimate of annual vaccination coverage was lower than the reported estimate among registered dogs. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to examine the association between security cameras in public spaces in Japan with residents' perceived neighborhood social cohesion and trust. Methods: The present study used a postal questionnaire mailed to randomly sampled residents aged 20 and 74 years, residing in Ichikawa City, in Chiba Prefecture, Japan. Data from 618 respondents in 39 neighborhoods were used. We used the instrumental variable method in our analyses to strengthen our causal inference. Using probit models, we examined the association between instrumented security camera awareness and perceived neighborhood social cohesion and trust. Results: Security camera awareness was negatively related to perceived neighborhood cohesion and positively associated with trust in others. Conclusions: This study demonstrated the potential causal relationship between security cameras and perceptions of communal society; i.e., a positive effect on trust in others and a negative effect on perceived social cohesion. These findings suggest the importance of considering positive and negative social aspects when implementing security camera policies. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has circulated worldwide and causes coronavirus disease 2019 (COVID-19). At the onset of the COVID-19 pandemic, infection control measures were taken, such as hand washing, mask wearing, and behavioral restrictions. However, it is not fully clear how the effects of these non-pharmaceutical interventions changed the prevalence of other pathogens associated with respiratory infections. In this study, we collected 3,508 nasopharyngeal swab samples from 3,249 patients who visited the Yamanashi Central Hospital in Japan from March 1, 2020 to February 28, 2021. We performed multiplex polymerase chain reaction (PCR) using the FilmArray Respiratory Panel and singleplex quantitative reverse transcription PCR targeting SARS-CoV-2 to detect respiratory disease-associated pathogens. At least one pathogen was detected in 246 (7.0%) of the 3,508 samples. Eleven types of pathogens were detected in the samples collected from March–May 2020, during which non-pharmaceutical interventions were not well implemented. In contrast, after non-pharmaceutical interventions were thoroughly implemented, only five types of pathogens were detected, and the majority were SARS-CoV-2, adenoviruses, or human rhinoviruses / enteroviruses. The 0–9 year age group had a higher prevalence of infection with adenoviruses and human rhinoviruses / enteroviruses compared with those 10 years and older, while those 10 years and older had a higher prevalence of infection with SARS-CoV-2 and other pathogens. These results indicated that non-pharmaceutical interventions likely reduced the diversity of circulating pathogens. Moreover, differences in the prevalence of pathogens were observed among the different age groups. [ABSTRACT FROM AUTHOR]

Background: There is increasing international interest in clinical practice and research related to mental health in the international sports society. The athlete-specific psychological distress assessment tool that addresses potential mental health needs can help promote early detection and recovery of mental illness, as well as physical illnesses. Currently, little is known about the applicability of the useful assessment tool for Japanese elite athletes. The Athlete Psychological Strain Questionnaire (APSQ) is a brief, effective and reliable screening tool to identify early signs of athlete-specific distress and potential mental health symptoms. We examined the applicability and reliability of a Japanese version of the APSQ (APSQ-J) in a Japanese elite athlete context. Further, we examined the construct validity of the APSQ-J. Methods: We collected web-based anonymous self-report data from 219 currently competing Japanese professional male rugby players. A two-stage process was conducted to validate the factor structure of the APSQ-J using exploratory factor analysis (EFA) in a randomly partitioned calibration sample and confirmatory factor analysis (CFA) in a separate validation sample. Cronbach's alpha is used to assess internal consistency. Pearson product-moment correlation coefficients were calculated to determine if the APSQ-J was significantly associated with measures of psychological distress and well-being using Kessler-6 (K6) and the WHO-5 Well-Being Index, respectively. Results: We identified a one-factor structure for the APSQ-J. Confirmatory factor analysis supports this one-factor model, revealing good model fit indices. The standardized path coefficients for each of the items were β = 0.41–0.83 (p < 0.001). A Cronbach's alpha of 0.84 was obtained for the APSQ-J. The APSQ-J demonstrated significant correlations with the K-6 (r = 0.80, p < 0.001) and WHO-5 (r = −0.58, p < 0.001). Conclusion: The APSQ-J can be an appropriate and psychometrically robust measure for identifying athlete-specific distress in elite athletes in Japan. Widely disseminating and utilizing this scale in Japanese sports society may support athletes' mental health via early detection of symptoms of psychological distress. [ABSTRACT FROM AUTHOR]

There is an abundance of woody biomass in Japan. However, its economic feasibility is limited. There have been several discussions on whether generation of heat or electrical power is more suitable for woody biomass. In this study, we clarified the feasibility of generating heat and electricity from the viewpoint of biomass unit price and biomass productivity based on actual operation data for the first time. It was determined that heat production is feasible for a small-scale biomass energy use of 2,660 t/year or more. Electrical power generation is feasible only for a large-scale biomass energy use of 13,100 t/year or more, but it allows use of woody biomass with a higher unit price. [ABSTRACT FROM AUTHOR]

Background: Rurality can reflect many aspects of the community, including community characteristics that may be associated with mental health. In this study, we focused on geographical units to address multiple layers of a rural environment. By evaluating rurality at both the municipality and neighborhood (i.e., a smaller unit within a municipality) levels in Japan, we aimed to elucidate the relationship between depression and rurality. To explore the mechanisms linking rurality and depression, we examined how the association between rurality and depression can be explained by community social capital according to geographical units. Methods: We used cross-sectional data from the 2016 wave of the Japan Gerontological Evaluation Study involving 144,822 respondents aged 65 years or older residing in 937 neighborhoods across 39 municipalities. The population density quintile for municipality-level rurality and the quintile for the time required to reach densely inhabited districts for neighborhood-level rurality were used. We calculated the prevalence ratios of depressive symptoms by gender using a three-level (individual, neighborhood, and municipality) Poisson regression. Community social capital was assessed using three components: civic participation, social cohesion, and reciprocity. Results: The prevalence of depressive symptoms was higher in municipalities with lower population density than those with the highest population density; the ratios were 1.22 (95% confidence intervals: 1.15, 1.30) for men and 1.22 (1.13, 1.31) for women. In contrast, when evaluating rurality at the neighborhood level, the prevalence of depressive symptoms was 0.9 times lower for men in rural areas; no such association was observed for women. In rural municipalities, community civic participation was associated with an increased risk of depressive symptoms. In rural neighborhoods, community social cohesion and reciprocity were linked to a lower risk of depressive symptoms. Conclusions: The association between rurality and depression varied according to geographical unit. In rural municipalities, the risk of depression may be higher for both men and women, and the presence of an environment conducive to civic participation may contribute to a higher risk of depression, as observed in this study. The risk of depression in men may be lower in rural neighborhoods in Japan, which may be related to high social cohesion and reciprocity. [ABSTRACT FROM AUTHOR]

This study aimed to reveal how the COVID-19 stay-at-home period has affected the quality of life (QOL) of children with neurodevelopmental disorders and their parents and to identify possible factors that enabled them to maintain their QOL. We enrolled 136 school-aged children (intellectual quotient ≥ 50) and their parents and administered QOL questionnaires to assess the maladaptive behavior of the children; depression, anxiety, and stress of the parents; and activities of their daily lives. The relationship between their QOL and clinical features was examined. The decrease in QOL of children and parents was associated with the mother's limited job flexibility. Decreased QOL was also associated with changes in the sleep rhythms of the children. Maladaptive behaviors in children were associated with parental stress. However, maintained QOL of some families who faced these same conditions of job stress and sleep disorders was associated with less parental stress, less parental depression and anxiety, and milder maladaptive behavior in children. Both mothers with limited job flexibility and changes in the sleep rhythm of children were associated with reduced QOL of children and their parents. Low parental stress was associated with decreased maladaptive behavior in children and with maintained QOL of the family. [ABSTRACT FROM AUTHOR]

Background: The Oral Care BC-trial reported that professional oral care (POC) reduces the incidence and severity of oral mucositis in patients receiving everolimus (EVE) and exemestane (EXE). However, the effect of POC on clinical response among patients receiving EVE and EXE was not established. We compared outcomes for estrogen receptor-positive metastatic breast cancer patients who received POC to those who had not, and evaluated clinical prognostic factors. All patients simultaneously received EVE and EXE.Methods: Between May 2015 and Dec 2017, 174 eligible patients were enrolled in the Oral Care-BC trial. The primary endpoint was the comparative incidence of grade 1 or worse oral mucositis, as evaluated for both the groups over 8 weeks by an oncologist. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Data were collected after a follow-up period of 13.9 months.Results: There were no significant differences in PFS between the POC and Control Groups (P = 0.801). A BMI <  25 mg/m2 and non-visceral metastasis were associated with longer PFS (P = 0.018 and P = 0.003, respectively) and the use of bone modifying agents (BMA) was associated with shorter PFS (P = 0.028). The PFS and OS between the POC and control groups were not significantly different in the Oral-Care BC trial.Conclusions: POC did not influence the prognosis of estrogen receptor-positive metastatic breast cancer patients. Patients with non-visceral metastasis, a BMI <  25 mg/m2, and who did not receive BMA while receiving EVE and EXE may have better prognoses.Trial Registration: The study protocol was registered online at the University Hospital Medical Information Network (UMIN), Japan (protocol ID 000016109), on January 5, 2015 and at ClinicalTrials.gov ( NCT02376985 ). [ABSTRACT FROM AUTHOR]

Aim: To clarify the prevalence and degree of maternal microchimerism in Japanese children with type 1 diabetes, as well as its effect on phenotypic variation. Methods: We studied 153 Japanese children with type 1 diabetes, including 124 children positive for β‐cell autoantibodies, and their 71 unaffected siblings. The number of circulating microchimeric cells per 105 host cells was estimated by the use of quantitative‐polymerase chain reaction targeting non‐transmitted maternal human leukocyte antigen alleles. The results were compared to previous data from white European people. Phenotypic comparison was performed between maternal microchimerism carriers and non‐carriers with diabetes. Results: Maternal microchimerism was detected in 15% of children with autoantibody‐positive type 1 diabetes, 28% of children with autoantibody‐negative type 1 diabetes, and 16% of unaffected siblings. There were no differences in the prevalence or levels of maternal microchimerism among the three groups or between the children with type 1 diabetes and their unaffected siblings. Furthermore, maternal microchimerism carriers and non‐carriers exhibited similar phenotypes. Conclusions: Maternal microchimerism appears to be less common in Japanese children with type 1 diabetes than in white European people. Our data indicate that maternal microchimerism is unlikely to be a major trigger or a phenotypic determinant of type 1 diabetes in Japanese children and that the biological significance of maternal microchimerism in type 1 diabetes may differ among ethnic groups. What's new?: Maternal microchimerism appears to be less common in Japanese children with type 1 diabetes than in white European people with this condition.Circulating microchimeric cells are unlikely to be a major trigger or a phenotypic determinant of type 1 diabetes in Japanese children.The biological significance of maternal microchimerism in type 1 diabetes may differ among ethnic groups. [ABSTRACT FROM AUTHOR]

Prolonged second stage of labor is a common abnormality of labor progression. Very little research exists regarding the relationship between prolonged second stage of labor and antepartum sonographic fetal head biometry parameters, especially fetal biparietal diameter (BPD). Fetal BPD assessment is essential for estimating fetal weight, and these measurements are readily available to Japanese obstetricians. We conducted a retrospective observational cohort study to evaluate the association between BPD fetal Z-score and prolonged second stage of labor in a Japanese cohort. Individual BPD data measured using a GE Voluson 730 expert ultrasound system (GE, Healthcare Japan, Tokyo, Japan) were converted to Z-scores for a particular gestational age. After excluding patients with multiple pregnancies and emergency or elective cesarean sections, a total of 2,711 (nulliparity, n = 1341) Japanese women who delivered at term were included. We analyzed the incidence of prolonged second stage of labor and the association between BPD Z-score measured <7 days before delivery and prolonged second stage of labor by parity. The overall incidence of prolonged second stage of labor was 18.3% (246/1,341) in nulliparous women and 4.6% (63/1,370) in multiparous women. In nulliparous women, multivariable analysis indicated that BPD Z-score was significantly associated with prolonged second stage of labor (adjusted odds ratio, 1.18; 95% confidence interval, 1.02–1.37). Kaplan-Meier survival analysis showed that at each time point during the second stage of labor, the percentage of women who had not yet delivered was higher among those who delivered neonates with large BPD Z-scores than among those who delivered neonates with smaller BPD Z-scores. On the contrary, in multiparous women, BPD Z-score was not statistically associated with prolonged second stage of labor. Our results suggest that considering BPD Z-score is helpful in the management of nulliparous women who are at risk of developing a prolonged second stage of labor. [ABSTRACT FROM AUTHOR]

Levels of social capital can change after a natural disaster; thus far, no study has examined how changes in social capital affect the mental health of disaster victims. In this study, we examined how predisaster social capital and its changes after a disaster were associated with the onset of mental disorders. In October 2013, we mailed a questionnaire to participants in the Japan Gerontological Evaluation Study living in Mifune, a town in Kumamoto Prefecture, Japan, and measured predisaster social capital. In April 2016, the Kumamoto earthquake struck the region. Three years after the baseline survey, postdisaster social capital and symptoms of mental disorders were measured using the Screening Questionnaire for Disaster Mental Health (n  = 828). Multiple Poisson regression indicated that a 1-standard-deviation change in predisaster social cohesion at the community level reduced the risk of depression among women (relative risk = 0.44, 95% confidence interval: 0.24, 0.78); a decline in social capital after the disaster elevated the risk (relative risk = 2.44, 95% confidence interval: 1.33, 4.47). In contrast to social cohesion, high levels of social participation at the community level were positively associated with the risk of depression among women. Policy-makers should pay attention to sex differences and types of social capital when leveraging social capital for recovery from disasters. [ABSTRACT FROM AUTHOR]

Objective: We evaluated the characteristics of patients with diverticular bleeding in whom emergency endoscopy should be proactively performed and those in whom it is unnecessary for spontaneous hemostasis following conservative treatment. Methods: This study involved 132 patients in whom diverticular bleeding was diagnosed on lower gastrointestinal endoscopy. We evaluated the rate of identification of the bleeding diverticulum during endoscopy and the rate of spontaneous hemostasis following conservative treatment. Results: In 26 patients (20%), bleeding diverticulum was identified during endoscopy. Extravasation or fluid collection on CT imaging was an important factor of successful identification of the bleeding source on endoscopy. Of the 104 patients in the conservative treatment group, 91 (87%) were able to be discharged after spontaneous hemostasis. Univariate analysis revealed a high rate of spontaneous hemostasis in patients without extravasation and fluid collection on CT imaging, those without adhesion of blood during endoscopy, those without diabetes, and those with a hemoglobin level ≥10 g/dL. Conclusion: In patients with colonic diverticular bleeding, extravasation or fluid collection on CT is an important factor related to the identification of the bleeding diverticulum. Patients without characteristic CT findings had a high rate of spontaneous hemostasis after conservative treatment. Background: Diverticular bleeding is the most frequent cause of lower gastrointestinal bleeding accounting for 20%–40% of all cases in Japan and 20%–48% of all those in the Western countries[1, 2]. The prevalence of colonic diverticula tends to increase with age; thus, the overall prevalence of diverticular bleeding is expected to increase in the future. In Japan, the Japanese Gastroenterological Association published guidelines on colonic diverticulitis in 2017; these guidelines recommend the performance of lower gastrointestinal endoscopic examination within 24 h in patients with lower gastrointestinal bleeding suspected to be diverticular bleeding[3]. It has been reported that, for patients with lower gastrointestinal bleeding, urgent endoscopy helps avoid embolotherapy, colectomy, massive blood transfusion, and repeat bleeding[1, 4, 5]. However, it is often difficult to identify the bleeding point [6]; further, there are many challenging cases wherein it is difficult to decide whether urgent endoscopy should be performed in situations where there is insufficient medical staff, such as during nighttime and on holidays. Bleeding is reported to stop spontaneously with conservative treatment alone in 70% of diverticular bleeding cases[7, 8]. In particular, when determining the treatment policy for diverticular bleeding and in the case of patients at high risk of complications following endoscopy, such as older patients, those with poor performance status or cardiovascular disease, and those in whom spontaneous hemostasis can be expected, urgent endoscopy should be avoided, and elective endoscopy should be selected. Therefore, the type of cases wherein urgent endoscopy is effective and the type wherein it is unnecessary need to be clarified. Thus far, there have been very few reports of the characteristics of patients with diverticular bleeding in whom spontaneous hemostasis was achieved. We aimed to assess the characteristics of patients in whom emergency endoscopy should be proactively performed and those for whom it is unnecessary. Thus, we retrospectively analyzed the identification rate for the responsible diverticulum in patients with diverticular bleeding and the rate of spontaneous hemostasis following conservative treatment. [ABSTRACT FROM AUTHOR]

This study aimed to examine the effects of yoga on attention control (AC) and mood states in graduate students with high and low sensory processing sensitivity (SPS) in a physical education course setting. Participants included 20 master's students in Japan who attended a yoga course for a semester and completed the Japanese version of the Highly Sensitive Person Scale, the AC subscale, and Profile of Mood States before and after the yoga course. The high SPS group students had lower AC and higher negative mood states before the course. Significant improvement in scores was observed, although differences between the two groups after the yoga course were not statistically significant. Although a positive correlation was found between SPS and variation in AC, there was a negative correlation between variation in AC and mood states. The results suggest that yoga in physical education for graduate students with high SPS promoted AC and improved mood states. [ABSTRACT FROM AUTHOR]

Stereocaulon sorediiferum is expected to be a Cu-hyperaccumulator lichen and has fluorescent substances. To clarify the relationship between the fluorescence (FL) of the lichen and its Cu concentration, we collected S. sorediiferum samples at Cu-contaminated and uncontaminated sites in Japan, determined the concentration of Cu, K, Mg, Al, Ca, Mn, Fe, Zn, chlorophyll a,b, and total carotenoids in them, analyzed lichen secondary metabolites and fluorescent substances extracted from them, and measured the FL of them and their extracts. We found that the FL intensity of S. sorediiferum samples is significantly negatively correlated with their Cu concentration. The application of its FL for Cu monitoring may allow a new nondestructive quantitative method for assessing Cu contamination. The spectroscopic and chromatographic analysis shows that the fluorescent substances negatively correlated with Cu concentration are not major lichen secondary metabolites (lobaric acid and atranorin) and remain after immersion in acetone. The correlation analysis and the comparison with the causal relationship between Cu concentration and the chlorophyll a/b ratio suggest that the reason for the decrease in FL intensity with increasing Cu concentration is a structural change of the fluorescent substances by accumulated Cu. These findings lead to a better understanding of the relationship between the FL of S. sorediiferum and its Cu concentration and provide new insights into fluorescent lichen substances. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence suggests an impact of childhood disadvantage on late-life functional impairment in Western countries. However, the processes by which childhood disadvantage affects functional capacity are influenced by several factors unique to particular societies. We examined the impact of childhood disadvantage on functional decline among older Japanese, using a large-scale prospective cohort study.Methods: Data came from surveys conducted in 2010 and 2013 as part of the Japan Gerontological Evaluation Study (JAGES), a nationwide cohort study targeting community-dwelling people aged 65 years and over. Childhood disadvantage included subjective childhood socioeconomic status (SES), body height, and educational level. The sample was stratified by age at baseline (65-69, 70-74, 75-79, and ≥ 80 years).Results: A total of 11,601 respondents were analyzed. In the 65-69-year group, lower childhood SES was associated with functional decline but this association was mediated by adult SES. In contrast, childhood SES was independently associated with functional decline in the older cohort. In the 75-79-year group, lower childhood SES was associated with functional decline. However, in the ≥ 80-year group, people with higher childhood SES were more likely to experience functional decline. Shorter height was associated with functional decline in the 70-74-year group. Higher education was related to functional decline in all age groups except the ≥ 80-year group.Conclusions: These findings suggest that childhood disadvantage affects functional decline but its effect varies by age cohort. The mechanisms underlying the association between childhood disadvantage and functional decline may be influenced by social and historical context. [ABSTRACT FROM AUTHOR]

Background: A life-course perspective is essential in understanding the determinants of higher-level functional limitations. We examine the impact of adverse childhood experiences (ACEs) on higher-level functional limitations in older people.Methods: Data were from the Japan Gerontological Evaluation Study 2013, a population-based cohort of independent people aged 65 years or older across Japan (n = 19,220). ACEs before the age of 18 were assessed in terms of seven adversities: parental death, parental divorce, parental mental illness, family violence, physical abuse, psychological neglect, and psychological abuse. Associations between the cumulative number of ACEs and higher-level functional limitations were investigated by multivariate Poisson regression with robust error variances, adjusted for age, gender, childhood disadvantage, adult sociodemographics, adult health behaviors, and health status.Results: Of the older people, 36.3% reported at least one ACE. Older people who had experienced two or more ACEs showed significantly greater higher-level functional limitations than those with no ACE in a crude model (prevalence ratio, PR = 1.61, 95% confidence interval, CI = 1.51-1.71). After adjusting the covariates, this association remained (PR = 1.19, 95% CI = 1.12-1.27).Conclusions: ACEs showed robust independent effects on higher-level functional limitations among older Japanese without disabilities, even after adjusting for potential covariates in childhood and adulthood. The current findings may help in understanding the impact of the latent effects of ACEs on functional limitations in older people. [ABSTRACT FROM AUTHOR]

Here, we demonstrate an accurate terahertz (THz) power calibration toward tens of nanowatt levels at room temperature. A power reference standard based on a calorimeter with extremely low noise is realized by introducing vacuum insulation panels utilized for thermal insulation. The standard provides a measurement capability of 26.7 nW with the expanded uncertainty of 4.2% (k = 2) at 1 THz. The direct‐comparison calibration of a commercially available power meter is performed by considering its detectable power levels using the standard. A thermopile‐type power meter is used as the device under test, and its calibration factors are determined at 1 and 1.5 THz over a power‐level range of 0.66–1.56 µW. We evaluate the measurement uncertainties of the calibration and find a relative expanded uncertainty of 4.8–9.0% (k = 2). © 2019 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]

Although previous studies have referred to the spatiotemporal patterns of burglaries called "repeat victimization" (RV) and "near repeat" (NR), only a few have explicitly dealt with multifamily housing, and none of them have distinguished among RV of a dwelling-unit, victimization of another unit in the same building, and NR in a nearby building. This work examined the spatiotemporal patterns of burglaries in multifamily housing in Fukuoka City, Japan, at both the building and dwelling-unit levels. The data were provided by the Fukuoka Prefectural Police of 8845 cases that occurred between 2005 and 2014. The number of burglary incidents in previously burgled multifamily buildings and in previously burgled dwelling units accounted for 31% and 8.4% of all incidents, respectively. The results of the building-level analysis showed NR patterns in nearby buildings, even after excluding victimization of other units in the same building, in a spatiotemporal range of 200 m and 60 days. The results of the dwelling-unit-level analysis verified a significantly high risk of RV of a unit in 160 days and around twice as high a risk of victimization of other units in the same building in almost 80 days. Thus, this study showed the risk of RV and NR in multifamily housing, which would contribute to the literature in that it expanded the scope of the RV/NR model in detached housing that has been proposed in previous studies. Finally, recommended measures against RV and NR of burglaries in the Japanese context and the research limitations are discussed. Unlabelled Image • Spatiotemporal patterns of burglaries on urban multifamily housing were examined. • A third of all burglary incidents occurred in once-burgled multifamily buildings. • Incidents were spatiotemporally concentrated in burgled buildings' neighborhoods. • Nearly one in ten burglaries occurred in once-burgled dwelling units. • Incidents were temporally concentrated in burgled buildings' units. [ABSTRACT FROM AUTHOR]

In recent years, the field of crime prediction has drawn increasing attention in Japan. However, predicting crime in Japan is especially challenging because the crime rate is considerably lower than that of other developed countries, making the development of a statistical model for crime prediction quite difficult. Risk terrain modeling (RTM) may be the most suitable method, as it depends mainly on the environmental factors associated with crime and does not require past crime data. In this study, we applied RTM to cases of theft from vehicles in Fukuoka, Japan, in 2014 and evaluated the predictive performance (hit rate and predictive accuracy index) in comparison to other crime prediction techniques, including KDE, ProMap, and SEPP, which use past crime occurrences to predict future crime. RTM was approximately twice as effective as the other techniques. Based on the results, we discuss the merits of and drawbacks to using RTM in Japan. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To evaluate comprehensively the use of the glycated albumin to HbA1c ratio for estimation of glycaemic control in the previous month. Methods: A total of 306 children with Type 1 diabetes mellitus underwent ≥10 simultaneous measurements of glycated albumin and HbA1c. Correlation and concordance rates were examined between HbA1c measurements taken 1 month apart (ΔHbA1c) and glycated albumin/HbA1c ratio fluctuations were calculated as Z‐scores from the cohort value at enrolment of this study cohort (method A) or the percent difference from the individual mean over time (method B). Results: Fluctuations in glycated albumin/HbA1c ratio (using both methods) were weakly but significantly correlated with ΔHbA1c, whereas concordance rates were significant for glycaemic deterioration but not for glycaemic improvement. Concordance rates were higher using method B than method A. Conclusions: The glycated albumin/HbA1c ratio was able to estimate glycaemic deterioration in the previous month, while estimation of glycaemic improvement in the preceding month was limited. Because method B provided a better estimate of recent glycaemic control than method A, the individual mean of several measurements of the glycated albumin/HbA1c ratio over time may also identify individuals with high or low haemoglobin glycation phenotypes in a given population, such as Japanese children with Type 1 diabetes, thereby allowing more effective diabetes management. [ABSTRACT FROM AUTHOR]

Background: Mutations in causative genes for neonatal diabetes or maturity‐onset diabetes of the young have been identified in multiple patients with autoantibody‐negative type 1 diabetes (T1D). Objectives: We aimed to clarify the prevalence and phenotypic characteristics of monogenic abnormalities among 89 children with autoantibody‐negative insulin‐requiring T1D. Methods: Mutations in 30 genes were screened using next‐generation sequencing, and copy‐number alterations of 4 major causative genes were examined using multiplex‐ligation‐dependent probe amplification. We compared the clinical characteristics between mutation carriers and non‐carriers. Results: We identified 11 probable pathogenic substitutions (6 in INS , 2 in HNF1A , 2 in HNF4A , and 1 in HNF1B ) in 11 cases, but no copy‐number abnormalities. Only 2 mutation carriers had affected parents. De novo occurrence was confirmed for 3 mutations. The non‐carrier group, but not the carrier group, was enriched with susceptible HLA alleles. Mutation carriers exhibited comparable phenotypes to those of non‐carriers, except for a relatively normal body mass index (BMI) at diagnosis. Conclusions: This study demonstrated significant genetic overlap between autoantibody‐negative T1D and monogenic diabetes. Mutations in INS and HNF genes, but not those in GCK and other monogenic diabetes genes, likely play critical roles in children with insulin‐requiring T1D. This study also suggests the relatively high de novo rates of INS and HNF mutations, and the etiological link between autoimmune abnormalities and T1D in the non‐carrier group. Carriers of monogenic mutations show non‐specific phenotypes among all T1D cases, although they are more likely to have a normal BMI at diagnosis than non‐carriers. [ABSTRACT FROM AUTHOR]

Aim To examine the contribution of PTPN2 coding variants to the risk of childhood-onset Type 1A diabetes. Methods PTPN2 mutation analysis was carried out for 169 unrelated Japanese people with childhood-onset Type 1A diabetes. We searched for coding variants that were absent or extremely rare in the general population and were scored as damaging by multiple in silico programs. We performed mRNA analysis and three-dimensional structural prediction of the detected variants, when possible. We also examined possible physical links between these variants and previously reported risk SNPs as well as clinical information from variant-positive children. Results One frameshift variant (p.Q286Yfs*24) and two probably damaging missense substitutions (p.C232W and p.R350Q) were identified in one child each. Of these, p.Q286Yfs*24 and p.C232W were hitherto unreported, while p.R350Q accounted for 2/121,122 alleles of the exome datasets. The p.Q286Yfs*24 variant did not encode stable mRNA, and p.C232W appeared to affect the structure of the tyrosine-protein phosphatase domain. The three variants were physically unrelated to known risk SNPs. The variant-positive children manifested Type 1A diabetes without additional clinical features and invariably carried risk human leukocyte antigen alleles. Conclusions The results provide the first indication that PTPN2 variants contribute to the risk of Type 1A diabetes, independently of known risk SNPs. PTPN2 coding variants possibly induce non-specific Type 1A diabetes phenotypes in individuals with human leukocyte antigen-mediated disease susceptibility. Our findings warrant further validation. [ABSTRACT FROM AUTHOR]

Aims A majority of children with Type 1 diabetes in Japan are registered with the government-subsidized Specified Pediatric Chronic Disease Treatment Research Projects ( SPCDTRP). In this study, the incidence and prevalence of childhood-onset (< 15 years) Type 1 diabetes in Japan were estimated by drawing on SPCDTRP data. Methods Data available for 2005-2012 from the SPCDTRP and Statistics Bureau, Ministry of Internal Affairs and Communications were used to estimate the incidence of Type 1 diabetes for 2005-2010, adjusted to cover those registered within 3 years of disease onset and stratified by sex, age at onset and period of onset. Results The incidence of Type 1 diabetes for 2005-2010 was 2.25/100,000 persons [95% confidence intervals (95% CI), 2.14-2.36] (boys: 1.91, 95% CI, 1.83-1.98; girls: 2.52, 95% CI, 2.34-2.69), with that for the age brackets 0-4, 5-9 and 10-14 years being 1.48 (95% CI, 1.29-1.66), 2.27 (95% CI, 2.08-2.47) and 3.00 (95% CI, 2.74-3.25), respectively. The onset of disease was shown to peak at age 13 among boys (3.28, 95% CI, 3.02-3.55) and at age 10 among girls (3.28, 95% CI, 3.02-3.55). The peak periods of disease onset were April/May and December. The number of children aged < 15 years with Type 1 diabetes for 2005-2012 was estimated to be 2326 (95% CI, 2202-2450) with the prevalence estimated as 13.53/100,000 persons (95% CI, 12.63-14.43). Conclusions Study findings demonstrated no increase in the incidence of Type 1 diabetes, although suggesting, in agreement with earlier reports, that the onset of disease peaks in adolescence with a female predominance. In addition, the incidence of childhood-onset diabetes exhibited an annual bimodal pattern in this study. [ABSTRACT FROM AUTHOR]

Previous studies have found an association between neighborhood characteristics (i.e., aspects of the physical and social environment) and the incidence of cardiovascular disease (CVD) and elevated CVD risk. This study investigated the relationship between neighborhood characteristics and CVD risk among older people in Japan where research on this association is scarce. Data came from the Japan Gerontological Evaluation Study project; questionnaire data collected from 3,810 people aged 65 years or older living in 20 primary school districts in Aichi prefecture, Japan, was linked to a computed composite CVD risk score based on biomarker data (i.e., hemoglobin A1c, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and estimated glomerular filtration rate). A sex-stratified multilevel linear regression analysis revealed that for male participants, living in neighborhoods with a higher perceived occurrence of traffic accidents and reduced personal safety was associated with an elevated CVD risk (coefficient = 1.08 per interquartile range increase, 95% confidence interval [CI] = 0.30 to 1.86) whereas males living in neighborhoods with a higher perceived proximity of exercise facilities had a lower risk (coefficient = −1.00, 95% CI = −1.78 to −0.21). For females, there was no statistically significant association between neighborhood characteristics and CVD risk. This study suggests that aspects of the neighborhood environment might be important for CVD morbidity and mortality in Japan, particularly among men. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether maternal intimate partner violence (IPV) victimization during pregnancy is associated with abusive behavior by the mother towards infants at 4 months of age. A population-based sample of 6590 mothers with 4-month-old infants participated in this study in Japan. Abusive behavior was assessed via questionnaire and defined as frequency of shaking and smothering during the preceding month. Both verbal and physical IPV during pregnancy were assessed retrospectively. Multiple logistic regression analysis was used, adjusting for types of IPV and potential covariates, specifically postpartum depression. Maternal exposure to verbal and physical IPV during pregnancy was reported by 10.9% and 1.2% of women, respectively. In the adjusted model, women exposed to verbal IPV alone were significantly more likely to abuse offspring (odds ratio: 1.59, 95% confidence interval: 1.17–2.16) while exposure to physical IPV did not have an additive effect for abusive behavior. Maternal victimization by verbal, but not physical IPV was associated with maternal abusive behavior towards their 4-month-old infant. Screening for verbal abuse during pregnancy might be an efficient approach to identify high-risk mothers of infant abuse. [ABSTRACT FROM AUTHOR]

This study aimed to provide a basis for appropriate home care for cancer patients by clarifying the usefulness of home visits in a collaboration program between visiting and certified hospital nurses. This was a mixed-methods study. (1) A quantitative study was conducted, involving all patients referred to the palliative care team, and (2) a questionnaire survey was conducted, involving 40 visiting nurses. In the study (1), the subjects were all patients who were referred to a palliative care team before (October 2010 to March 2012; control group) and after (April 2012 to September 2013; collaborative home visit group) the initiation of collaborative home visits. After the patients underwent observation through December 2013, their data from charts, as of January 2014, were obtained. The proportion of home deaths increased by 3.8%, from 58.3% (n = 14) to 62.1% (n = 18), after the initiation of collaborative home visits; this increase was not significant (P = .78). However, in the survey (2), visiting nurses' sense of difficulty in providing palliative home care was significantly reduced in comparison between those with and without experience of such visits (P= .013).Visiting nurses' reduced sense of difficulty in providing palliative home care after collaboration during home visits suggests the usefulness of such collaboration for them. This program may contribute to increases in the proportion of home deaths by increasing the numbers of nurses newly engaged in palliative home care. [ABSTRACT FROM AUTHOR]

The article discusses a study focusing on the BRCA1 and BRCA2 deleterious mutations in Japanese patients with breast cancer. Topics discussed include the family histories of BRCA1/2 mutation carriers, the role of breast and ovarian cancers as indicators of BRCA1/2 mutations, and the BRCA1/2 mutation's role in the carcinogenesis of breast cancer.

Background: Many patients wish to stay at home during the terminal stage of cancer. However, there is concern that medical care provided at home may negatively affect survival. This study therefore explored whether the survival duration differed between cancer patients who received inpatient care and those who received home care. Methods: We retrospectively investigated the place of care/death and survival duration of 190 cancer patients after their referral to a palliative care consultation team in a Japanese general hospital between 2007 and 2012. The patients were classified into a hospital care group consisting of those who received palliative care in the hospital until death, and a home care group including patients who received palliative care at home from doctors in collaboration with the palliative care consultation team. Details of the place of care, survival duration, and patient characteristics (primary site, gender, age, history of chemotherapy, and performance status) were obtained from electronic medical records, and analyzed after propensity score matching in the place of care. Results: Median survival adjusted for propensity score was significantly longer in the home care group (67.0 days, n = 69) than in the hospital care group (33.0 days, n = 69; P = 0.0013). Cox's proportional hazard analysis revealed that the place of care was a significant factor for survival following adjustment for covariates including performance status. Conclusions: This study suggests that the general concern that home care shortens the survival duration of patients is not based on evidence. A cohort study including more known prognostic factors is necessary to confirm the results. [ABSTRACT FROM AUTHOR]

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Background Although mitochondrial respiratory chain disorders ( MRCD) are one of the most common congenital metabolic diseases, there is no cumulative data on enzymatic diagnosis and clinical manifestation for MRCD in Japan and Asia. Methods We evaluated 675 Japanese patients having profound lactic acidemia, or patients having symptoms or signs of multiple-organ origin simultaneously without lactic acidemia on respiratory chain enzyme activity assay and blue native polyacrylamide gel electrophoresis. Quantitative polymerase chain reaction was used to diagnose mitochondrial DNA depletion syndrome ( MTDPS). Mutation analysis of several genes responsible for MTDPS was also performed. Results A total of 232 patients were diagnosed with a probable or definite MRCD. MRCD are common, afflicting one in every several thousand people in Japan. More than one in 10 of the patients diagnosed lacked lactic acidemia. A subsequent analysis of the causative genes of MTDPS identified novel mutations in six of the patients. A 335 bp deletion in deoxyguanosine kinase ( DGUOK; g.11692_12026del335 (p. A48fsX90)) was noted in two unrelated families, and may therefore be a common mutation in Japanese people. The proportion of all patients with MTDPS, and particularly those with recessive DNA polymerase γ ( POLG) mutations, appears to be lower in Japan than in other studies. This is most likely due to the relatively high prevalence of ancient European POLG mutations in Caucasian populations. No other significant differences were identified in a comparison of the enzymatic diagnoses, disease classifications or prognoses in Japanese and Caucasian patients with MRCD. Conclusion MTDPS and other MRCD are common, but serious, diseases that occur across all races. [ABSTRACT FROM AUTHOR]

Based on quantification and qualification of bacterial 16S rDNA, we verified the bacterial ecological characteristics of surface sediments of Lakes Shinji and Nakaumi, which are representative of coastal lagoons in Japan. Quantification and qualification of the 16S rDNA sequences was carried out using real time polymerase chain reaction and polymerase chain reaction denaturing gradient gel electrophoresis and non-metric multidimensional scaling, respectively. The results revealed that the copy number per gram of sediment ranged from 8.33 × 10 (Lake Nakaumi) to 1.69 × 10 (Honjo area), suggesting that bacterial carbon contributed only 0.05-9.64 % of the total carbon content in the samples. Compared with other aquatic environments, these results indicate that sedimentary bacteria are not likely to be important transporters of nutrients to higher trophic levels, or to act as carbon sinks in the lagoons. The bacterial compositions of Lake Shinji and Lake Nakaumi and the Honjo area were primarily influenced by sediment grain sizes and salinity, respectively. Statistical comparisons of the environmental properties suggested that the areas that were oxygen-abundant (Lake Shinji) and at a higher temperature (Honjo area) presented efficient organic matter degradation. The 16S rDNA copy number per gram of carbon and nitrogen showed the same tendency. Consequently, the primary roles of bacteria were degradation and preservation of organic materials, and this was affected by oxygen and temperature. These roles were supported by the bacterial diversity rather than the differences in the community compositions of the sedimentary bacteria in these coastal lagoons. [ABSTRACT FROM AUTHOR]

Background The etiology of type 1 diabetes ( T1D) is heterogeneous and is according to presence or absence of pancreatic autoantibodies divided into two subtypes: type 1A (autoimmune-mediated) and type 1B (non-autoimmune-mediated). Although several genes have been linked to type 1A diabetes, the genetic cause of type 1B diabetes in Japanese individuals is far from understood. Objective The aim of this study was to test for monogenic forms of diabetes in auto antibody-negative Japanese children with T1D. Methods Thirty four (19 males and 15 female) unrelated Japanese children with glutamate decarboxylase ( GAD) 65 antibodies and/or IA-2A-negative T1D and diabetes diagnosed at < 5 yr of age were recruited from 17 unrelated hospitals participating in the Japanese Study Group of Insulin Therapy for children and adolescent diabetes ( JSGIT). We screened the INS gene and the KCNJ11 gene which encode the ATP-sensitive potassium cannel by direct sequencing in 34 Japanese children with T1D. Results We identified three novel ( C31Y, C96R, and C109F) mutations and one previously reported mutation ( R89C) in the INS gene in five children, in addition to one mutation in the KCNJ11 gene ( H46R) in one child. These mutations are most likely pathogenic and therefore the cause of diabetes in carriers. Conclusion Our results suggest that monogenic forms of diabetes, particularly INS gene mutations, can be detected in Japanese patients classified with type 1B. Mutation screening, at least of the INS gene, is recommended for Japanese patients diagnosed as autoantibody negative at <5 yr of age. [ABSTRACT FROM AUTHOR]

Background: This multicenter observational study was conducted to investigate the efficacy and safety of insulin detemir (detemir) for diabetes management in Japanese children and adolescents. Methods: Data from the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes database were analyzed. Ninety children (32 boys, 58 girls; mean age, 11.9 ± 3.8 years) who transferred from a neutral protamine Hagedorn insulin or insulin glargine basal-bolus regimen to detemir basal-bolus therapy and who were observed for at least 12 months were identified. Clinical data obtained at 0, 3, 6, and 12 months were analyzed to determine the type of bolus insulin used, number and timing of detemir injections, detemir dose as a proportion of the total insulin dose, hemoglobin A1c (HbA1c), fasting blood glucose (FBG) and frequency of severe hypoglycemia. Results: Twelve months after switching to detemir, the detemir dose represented 39.8% of the total insulin dose, and 37.8% of patients were being treated with twice-daily injections. HbA1c and FBG were significantly reduced from baseline at 3 and 6 months but not at 12 months. Considering the seasonal HbA1c variation in the Japanese population, a separate analysis was performed using data for 65 children (21 boys, 44 girls; mean age, 11.6 ± 2.9 years) who switched to detemir during the winter. Subset analysis showed significant HbA1c reductions from baseline at all specified times. The incidence of severe hypoglycemia during detemir treatment was 4.4 episodes per 100 patient-years. Conclusions: Detemir is an effective and safe basal insulin for diabetes management in Japanese children and adolescents. [ABSTRACT FROM AUTHOR]

Although the problem of a lack of an adequate denominator of crime rates has been widely recognized, relatively few solutions have been found. This paper proposes a sophisticated method of analyzing crime hot spots using global positioning system (GPS) tracking data and agent-based simulation modeling. The goal of the proposed analysis technique is to estimate a population at risk across time and space at the micro-level, such as streets and locations (e.g. parks and playgrounds). In order to create valid estimates of a population at risk and to illustrate how the estimated population at risk can be used in crime analysis, this paper presents a series of three sub-studies. First, GPS tracking data were obtained for two weeks for 80 children in the second and fifth grades from one school located in a suburb of Tokyo, Japan. GIS software was used to analyze the GPS data in order to identify streets and places that the children frequented. Second, agent-based simulation modeling was developed to extend the proposed analysis method to school districts that had not participated in the GPS sub-study. In the process of developing a simulation algorithm, the validity of simulation modeling was checked by comparing the simulation results with the GPS tracking data. Third, victimization surveys with maps were conducted in six schools (including the school that participated in the GPS sub-study) that identified locations of crime incidents. Victimization survey results were overlaid with the analysis results of GPS data and agent-based simulation modeling in order to examine crime hot spots. The proposed technique of agent-based modeling produces an accurate denominator of crime rates at the micro-level which can then be used to analyze crime hot spots properly. In particular, this paper discusses how crime analysts can identify different types of hot spots, such as crime generators and crime attractors, by examining the number of crime incidents and the magnitude of crime rate. This paper argues intervention strategies need to be tailored for each type of crime hot spots, as these crime hot spots develop through different mechanisms. Finally, this paper discusses limitations of the proposed technique and the direction of future research. [ABSTRACT FROM AUTHOR]

Rot diseases of hydroponically cultured leaf lettuce, coriander, and chervil were found in Chiba Prefecture, Japan. Stems and petioles of the three diseased plants became brown or black with a soft rot, and vascular parts of the stems became discolored. Seemingly similar fungi were isolated from the diseased plants. Pathogenicity of these fungal isolates to each plant was demonstrated by inoculation tests. The fungi were identified as Plectosphaerella pauciseptata based on morphological and cultural characters. This identification was supported by phylogenetic analysis with rDNA ITS1-5.8S-ITS2 regions. The diseases were named Plectosphaerella rot (Plectosphaerella huhai-byo in Japanese) of lettuce, coriander, and chervil. [ABSTRACT FROM AUTHOR]

Although wilt diseases of various plants by Verticillium dahliae occur worldwide, Verticillium wilt of lettuce is relatively new and rare. In 2009, this disease appeared suddenly in commercial fields in Ibaraki Prefecture, Japan. To investigate the cause of the disease, we characterized each lettuce isolate for pathogenicity, mating types, and genetic characteristics and found two types of V. dahliae. A population that included at least two types of V. dahliae was the putative infection source of the disease. Effective management systems against V. dahliae isolates of different races and having different host ranges are necessary. [ABSTRACT FROM AUTHOR]

Carbon contamination of optics is a serious issue in all soft X-ray beamlines because it decreases the quality of experimental data, such as near-edge X-ray absorption fine structure, resonant photoemission and resonant soft X-ray emission spectra in the carbon K-edge region. Here an in situ method involving the use of oxygen activated by zeroth-order synchrotron radiation was used to clean the optics in a vacuum ultraviolet and soft X-ray undulator beamline, BL-13A at the Photon Factory in Tsukuba, Japan. The carbon contamination of the optics was removed by exposing them to oxygen at a pressure of 10−1-10−4 Pa for 17-20 h and simultaneously irradiating them with zeroth-order synchrotron radiation. After the cleaning, the decrease in the photon intensity in the carbon K-edge region reduced to 2-5%. The base pressure of the beamline recovered to 10−7-10−8 Pa in one day without baking. The beamline can be used without additional commissioning. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The prevalence of diabetes mellitus is increasing rapidly in Japan, and diabetic neuropathy is a major factor decreasing diabetic patients' quality of life, as well as a risk factor for sudden death. The present study aimed to determine the prevalence of diabetic neuropathy and raise awareness about it among patients and their physicians. Materials and Methods: Diabetic outpatients ( N = 5077) at 249 medical institutions within Kanagawa Prefecture, Japan, were surveyed by questionnaire and underwent foot examinations. The questionnaire included 10 questions about sensory abnormalities of both feet, muscle cramps and autonomic symptoms. Foot examinations included testing for vibratory perception of the medial malleolus, Achilles tendon reflexes and touch sensation of the bottom of the great toe using tissue paper. Results: Of the 5077 patients surveyed, 70.4% reported symptoms. Overall, 75.4% of the patients underwent vibratory perception testing, of whom 44.9% had abnormal thresholds (≤10 s). On the tissue paper touch test, performed in 94.6% of patients, 11.9% had no touch sensation. Of the 2803 type 2 diabetic patients with known background factors who underwent foot examinations, 49.4% had diabetic neuropathy. There was a high prevalence of diabetic neuropathy (36.1%) in patients with <5-year history. Of the patients with no touch sensation on the tissue paper test, 81.3% had diabetic neuropathy. Conclusions: The present study identified the prevalence of diabetic neuropathy in Kanagawa Prefecture. The tissue paper test is a simple and excellent method of evaluating decreased superficial sensation that can help evaluate the severity of diabetic neuropathy. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00174.x, 2011) [ABSTRACT FROM AUTHOR]

A rapid approach based on two-dimensional DNA gel electrophroesis (2-DGE) mapping with selective primer pairs was employed to analyze bacterial community structure in sediments from upstream, midstream and downstream of Sagami River in Japan. The 2-DGE maps indicated that Alpha- and Delta-proteobacteria were major bacterial populations in the upstream and midstream sediments. Further bacterial community structure analysis showed that richness proportion of Alpha- and Delta-proteobacterial groups reflected a trend toward decreasing from the upstream to downstream sediments. The biomass proportion of bacterial populations in the midstream sediment showed a significantly difference from that in the other sediments, suggesting that there may be an environmental pressure on the midstream bacterial community. Lorenz curves, together with Gini coefficients were successfully applied to the 2-DGE mapping data for resolving evenness of bacterial populations, and showed that the plotted curve from high-resolution 2-DGE mapping became less linear and more an exponential function than that of the 1-DGE methods such as chain length analysis and denaturing gradient gel electrophoresis, suggesting that the 2-DGE mapping may achieve a more detailed evaluation of bacterial community. In conclusion, the 2-DGE mapping combined with the selective primer pairs enables bacterial community structure analysis in river sediment and thus it can also monitor sediment pollution based on the change of bacterial community structure. [ABSTRACT FROM AUTHOR]

High temperature superconducting (HTS) cables achieve large power capacity and low-loss power transmission in a compact package. In a new Japanese national project, Sumitomo Electric Industries, Ltd. is working to develop a 66 kV–5 kArms HTS cable with REBCO wires. One of the important technical targets is to reduce AC loss to less than 2 W/m/ph at 5 kArms. To investigate the effect of wire width on the AC losses in multi-layer cable conductors, 30-mm-wide REBCO tapes were divided into 4-mm-wide or 2-mm-wide strips, and two 4-layer cable conductors were manufactured with these strips. The measured AC loss characteristics of the two cable conductors were comparable. The measured AC loss in the cable conductor with 4-mm-wide wire was in good agreement with numerical calculations. However, the AC loss in the cable conductor with 2-mm-wide wires was larger than the numerical prediction. The difference may be due to the wires' non-uniform Jc distribution in the width direction, because the AC losses in cable conductors with narrow wires are strongly influenced by the Jc profiles of the wires. AC loss simulations assuming that the wire's Ic will be higher show that a 14000 A-Ic class cable with 4-mm-wide wires is expected to achieve the AC loss target. For cables with 2-mm-wide wires, the improvement of Jc distribution in the width direction will reduce the AC loss level, and the goal will be achieved with lower Ic wires. [ABSTRACT FROM AUTHOR]

Repeat hepatic resection for recurrent hepatocellular carcinoma (HCC) is effective in improving long-term outcome in selected patients. In the present study, we attempted to identify the prognostic factors influencing overall and recurrence-free survival after the second hepatic resection. From 1 September 1997 to 30 September 2009, 329 consecutive patients with HCC underwent surgical exploration at Yamanashi University Hospital, Japan. Of these, 35 patients underwent curative, second hepatic resection. The survival results in the 35 patients were analyzed retrospectively, and prognostic factors were determined. The univariate analysis revealed that Child-Pugh B, a Lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3) value more than 15%, and multiple tumors, were associated with significantly worse overall survival ( P = 0.010, P = 0.0003, and P = 0.037, respectively) and only AFP-L3 >15% was associated with significantly worse recurrence-free survival after the second hepatic resection ( P = 0.008). By multivariate analysis, only AFP-L3 >15% was an independent predictor of adverse overall survival. The 1-, 3-, and 5-year survival rates after the second hepatic resection of 27 HCC patients with low AFP-L3 (≤15%) were 100%, 100%, and 91.7%, respectively, whereas the corresponding survival rates of eight HCC patients with high AFP-L3 (>15%) were 100%, 47.6%, and 23.8%, respectively. The preoperative AFP-L3 level was a useful prognostic biomarker for survival after repeat hepatic resection. [ABSTRACT FROM AUTHOR]

Background: The prevalence of childhood-onset type 2 diabetes mellitus (T2DM) has increased dramatically over the past two to three decades in Japan, but epidemiological and clinical data remain limited. Several epidemiological studies stress the importance of elucidating the pathophysiology of prenatal nutrition and other intra-uterine environmental factors and the risk of T2DM in each of the different populations. We examined the associations of weight at birth, weight at diagnosis of T2DM, and clinical characteristics of childhood-onset T2DM. Methods: Clinical data sheets were sent to councillors of the Japanese Society for Pediatric Endocrinology (JSPE) and members of the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes (JSGIT) in June 2003. Clinical data on 259 children (9–17 yr of age) categorized as T2DM by pediatric endocrinologists, who are members of the JSPE and/or JSGIT, using 1999 Japan Diabetes Society criteria were analyzed. Degree of overweight was assessed by percent overweight and standard deviation score-body mass index. Results: The age (mean ± SD) of the 259 patients recruited (121 boys and 138 girls) was 11.9 ± 2.1 yr at diagnosis and 14.4 ± 2.0 yr at the time of the survey. Sixty-nine percent of all patients were obese (percent overweight ≥20%) at the time of diagnosis. Obese patients were older at the time of diagnosis and had a higher level of hemoglobin A1c (HbA1c) at diagnosis than non-obese patients (p < 0.05), and there were fewer girls than boys. Twenty two (11.3%) of 195 patients had low birth weights (<2500 g) and 19 (9.7%) had high birth weights (≥4000 g). The frequencies of low and high birth weights were higher among patients with T2DM than among a control group, producing a U-shaped distribution (p < 0.05). The frequency of a family history of diabetes was lower among low-birth weight patients. In contrast, high-birth weight patients had a higher prevalence of diabetic mothers and medication including insulin therapy (p < 0.05). Conclusions: Obesity was shown to be a major risk factor for childhood-onset T2DM in Japan. The frequencies of low and high birth weights were higher among patients with T2DM, and differences in clinical characteristics, such as family history of diabetes, were recognized among patients with T2DM with low, normal, and high birth weights. [ABSTRACT FROM AUTHOR]