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This study aimed to identify the professional structure required by teachers working in primary schools for deaf students in Japan. Ten university teachers training in education for deaf students at Japanese universities participated in semi-structured interviews. Data were analysed using the KJ method of qualitative analysis based on similarity, with 409 codes, 12 categories and 99 sub-categories extracted. The results were aggregated into teaching skills and knowledge and collaborative skills categories, clarifying the specific structure of expertise required for teachers of deaf students. Teaching skills and knowledge have already been integrated into teacher training programmes; however, curriculum development for collaborative skills is required. The results of this study suggest that teachers need to acquire a wide range of professional skills to educate children with hearing impairment. We recommend improving social mechanisms for training these teachers in the future.

Today, the necessity of marine education is being stated. Especially raising awareness about biodiversity is important in marine education. Museums not only house exhibits but also have the function of storing specimens. They hold specimens not available to the public daily that can be used for educational and research purposes. Samples of creatures that are difficult to keep and of unusual organisms are often stored in museums. Also, since immersion specimens do not move, they are suitable for observation. The forms of fish are especially diverse. Observations of fish of various forms facilitate the understanding of fish morphology and awareness of biodiversity. Therefore, we conducted a marine biology course using museum fish specimens. In that course, in order to encourage learners' activeness, we implemented quizzes and organized sessions with story nature. Before the lecture, the awareness of the morphology of the fish was low. The lecture was able to make the diversity of fish form understanding. Learners actively attended, observed and deepened their understanding. Also, we were able to tell learners about the function of the museum. It was found that the use of museum specimens is beneficial for observing precious biological specimens.

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

Objective: Cognitive remediation therapy (CRT) can be used as an adjunct treatment for adolescents with severe and complex anorexia nervosa (AN) requiring inpatient treatment. However, there has been only one study on CRT for adolescents with AN in Japan. This study explored group CRT as an adjunct to inpatient treatment for Japanese adolescents with severe and complex AN requiring inpatient care. Methods: Thirty-one adolescents with AN underwent group CRT. Neuropsychological (set-shifting and central coherence) and psychological assessments (motivation, self-esteem, and depressive symptoms) were measured before and after the intervention. Weight and AN symptoms were measured before and after the intervention and at follow-up, and the adolescents completed post-intervention and follow-up questionnaires. Results: Set-shifting led to medium to large effect size improvements. Medium effect size improvements in central coherence and depressive symptoms were also observed. The feedback from the adolescents was mainly positive, and the treatment completion rate was high. The patients also reported that the skills learned through group CRT could be applied in daily life. Conclusion: Group CRT may be beneficial for adolescents with severe and complex AN who require inpatient care. Plain language summary: Why was this study done? Cognitive remediation therapy (CRT) can be used as an adjunct treatment for adolescents with severe and complex anorexia nervosa (AN) requiring inpatient treatment. However, there has been only one study on CRT for adolescents with AN in Japan. This study explored group CRT as an additional inpatient treatment for adolescents with severe and complex AN requiring inpatient care in Japan. What did the researchers do? A total of 31 adolescents with AN underwent group CRT. Cognitive function and psychological parameters (motivation, self-efficacy, and depressive symptoms) were measured before and after group CRT. Body mass index and AN symptoms were evaluated before and after group CRT and at follow-up. The adolescents completed post-therapy and follow-up questionnaires. What did the researchers find? Cognitive function and depressive symptoms improved after group CRT. The feedback from the adolescents was mostly positive, and 29 of the 31 adolescents completed group CRT. Many adolescents also reported that they used the skills learned through group CRT in their daily lives. What do the findings mean? Group CRT may be beneficial for adolescents with severe and complex AN who require inpatient care. [ABSTRACT FROM AUTHOR]

Background: Naldemedine, a peripherally acting opioid μ receptor antagonist, is effective for prevention of opioid-induced constipation (OIC); however, evidence on its use in children is limited. Objective: To evaluate the efficacy and safety of naldemedine in pediatric patients with OIC. Design, Setting/Subjects: Retrospective analysis of 32 pediatric patients with OIC treated with naldemedine in a single institution in Japan from June 2017 to March 2021. Measurements: Efficacy was evaluated in 13 evaluable patients with bowel movement (BM) response, defined as those with at least three BMs in the first 7 days after naldemedine initiation and an increase of at least one BM from baseline. Safety was evaluated by examining adverse events (AEs) based on the Common Terminology Criteria for AEs (v5.0). Results: BM response was recorded in 11 of the 13 patients (85%), and the number BMs per day significantly increased from 0.43 before naldemedine to 1.00 after naldemedine (p = 0.025). The most common AE was diarrhea, observed in 16 of the 32 patients (50%), and all instances were grade 1 or 2. In three of the 16 patients, naldemedine was discontinued owing to worsening diarrhea. Conclusions: In pediatric patients, naldemedine resulted in a high rate of BM response and increased the BM frequency, indicating its efficacy. In some patients, grade 2 diarrhea required naldemedine discontinuation, suggesting that it should be used with caution in pediatric patients. Further studies are warranted to determine the optimal naldemedine dose in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: The population of people living with dementia (PLwD) continues to grow in Japan where advance care planning (ACP) for PLwD is relatively new. Our aim was to evaluate the feasibility and cultural acceptability of a dementia‐specific ACP communication skills toolkit for Japanese primary care clinicians. Methods: We delivered 13 training sessions in primary care clinics across central Japan and conducted a post‐training survey to assess whether the toolkit increased confidence in dementia‐specific ACP communication skills and the acceptability of the toolkit with the following four statements: (1) The language in the sessions was clear, (2) The sessions took an appropriate amount of time to complete, (3) The design of the sessions was an effective educational method, and (4) The sessions were culturally appropriate for communication with Japanese patients with dementia and their family members. We asked participants to respond using a 5‐point Likert scale from strongly agree to strongly disagree. Results: All participants were Japanese and included 80 physicians (mean age 39.8 years), 33 nurses (mean age 45.7 years), and 58 other participants (mean age 42.9 years), who were 30.0%, 87.9%, and 55.2% female, respectively. Most participants practiced in rural settings. In pre‐ post‐comparisons, participant confidence increased in determining capacity, understanding dementia prognosis, goals of care, eliciting surrogates, recommending self‐care practices to families, and leading family meetings (all p < 0.001). Most participants strongly agreed or agreed that the toolkit was an effective method (96.9%), took an appropriate amount of time (94.5%), contained clear language (89.8%), and was culturally appropriate (73.6%). Conclusions: Dementia‐specific ACP communication skills toolkit can be delivered in Japan. Japanese primary care clinicians generally felt the dementia‐specific ACP toolkit increased their confidence in ACP communication skills and was acceptable. The language, time, and design were well received, though further work is needed to improve the cultural appropriateness of the toolkit. [ABSTRACT FROM AUTHOR]

This study analyzed the factors required for a researcher to become a professor in the humanities and sociology, science and engineering, medicine and biology, and general studies fields. The study focuses on research productivity and analyzes the impact of hiatuses in research production on promotion in universities as well as the time at which such hiatuses have the least impact on promotions. I divided the factors required for promotion into three categories: academic performance (the number of published articles, books, and competitive grants and funding sources acquired), social elements (gender), and elements related to the duration of periods with no research output and their timing. The results show that the probability of promotion to professorship increases as the number of papers in Scopus, the number of books published, and the amount of acquired competitive funds increase. As expected, longer declines in research productivity reduce the probability of promotion. However, it is not always necessary for researchers to publish continuously throughout their careers; the results show that a decline in research productivity other than during the first five years and the period from 20 to 30 years after the start of the research career has no influence on academic promotions.

During their blood-feeding process, ticks are known to transmit various viruses to vertebrates, including humans. Recent viral metagenomic analyses using next-generation sequencing (NGS) have revealed that blood-feeding arthropods like ticks harbor a large diversity of viruses. However, many of these viruses have not been isolated or cultured, and their basic characteristics remain unknown. This study aimed to present the identification of a difficult-to- culture virus in ticks using NGS and to understand its epidemic dynamics using molecular biology techniques. During routine tick-borne virus surveillance in Japan, an unknown flaviviral sequence was detected via virome analysis of host-questing ticks. Similar viral sequences have been detected in the sera of sika deer and wild boars in Japan, and this virus was tentatively named the Saruyama virus (SAYAV). Because SAYAV did not propagate in any cultured cells tested, single-round infectious virus particles (SRIP) were generated based on its structural protein gene sequence utilizing a yellow fever virus-based replicon system to understand its nationwide endemic status. Seroepidemiological studies using SRIP as antigens have demonstrated the presence of neutralizing antibodies against SAYAV in sika deer and wild boar captured at several locations in Japan, suggesting that SAYAV is endemic throughout Japan. Phylogenetic analyses have revealed that SAYAV forms a sister clade with the Orthoflavivirus genus, which includes important mosquito-and tick-borne pathogenic viruses. This shows that SAYAV evolved into a lineage independent of the known orthoflaviviruses. This study demonstrates a unique approach for understanding the epidemiology of uncultured viruses by combining viral metagenomics and pseudoinfectious viral particles. [ABSTRACT FROM AUTHOR]

Background: The transmission of influenza virus in households, especially by children, is a major route of infection. Prior studies suggest that timely antiviral treatment of ill cases may reduce infection in household contacts. The aim of the study was to compare the effects of oseltamivir (OTV) and baloxavir marboxil (BXM) treatment of index cases on the secondary attack rate (SAR) of influenza within household. Methods: A post hoc analysis was done in BLOCKSTONE trial—a placebo‐controlled, double‐blinded post‐exposure prophylaxis of BXM. Data were derived from the laboratory‐confirmed index cases' household contacts who received placebo in the trial and also from household members who did not participate in the trial but completed illness questionnaires. To assess the SAR of household members, multivariate analyses adjusted for factors including age, vaccination status, and household size were performed and compared between contacts of index cases treated with BXM or OTV. Results: In total, 185 index cases (116 treated with BXM and 69 treated with OTV) and 410 household contacts (201 from trial, 209 by questionnaire) were included. The Poisson regression modeling showed that the SAR in household contacts of index cases treated with BXM and OTV was 10.8% and 18.5%, respectively; the adjusted relative reduction in SAR was 41.8% (95% confidence interval: 1.0%–65.7%, p = 0.0456) greater with BXM than OTV. Similar reductions were found in contacts from the trial and those included by questionnaire. Conclusion: BXM treatment of index cases appeared to result in a greater reduction in secondary household transmission than OTV treatment. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) is the most common disease among patients requiring dialysis for the first time in Japan. Multidisciplinary care (MDC) may prevent the progression of kidney failure. However, the effectiveness and timing of MDC to preserve kidney function in patients with DKD is unclear. Therefore, the aim of this study was to investigate whether MDC for patients with DKD affects the preservation of kidney function as well as the timing of MDC in clinical practice. Methods: In this retrospective cohort study, we identified patients with type 2 diabetes mellitus and DKD from April 2012 to January 2020 using a nationwide Japanese healthcare record database. The fee code for medical guidance to prevent dialysis in patients with diabetes was used to distinguish between the MDC and non-MDC groups. The primary outcome was a 40% decline in the estimated glomerular filtration rate, and secondary outcomes were death, hospitalization, permanent dialysis, kidney failure with replacement therapy, and emergency temporary catheterization. Propensity score matching was performed, and Kaplan–Meier and multivariable Cox regression analyses were performed. Results: Overall, 9,804 eligible patients met the inclusion criteria, of whom 5,614 were matched for the main analysis: 1,039 in the MDC group, and 4,575 in the non-MDC group. The primary outcome did not differ between the groups (hazard ratio: 1.18, [95% confidence interval: 0.99–1.41], P = 0.07). The groups also did not differ in terms of the secondary outcomes. Most patients with DKD received their first MDC guidance within 1 month of diagnosis, but most received guidance only once per year. Conclusions: Although we could not demonstrate the effectiveness of MDC on kidney function in patients with DKD, we clarified the characteristics of such patients assigned the fee code for medical guidance to prevent dialysis related to diabetes. [ABSTRACT FROM AUTHOR]

This article proposes an approach to explicit grammar instruction that seeks to develop metalinguistic knowledge of the L2 and raise L2 learners' awareness of their L1, which is crucial for the success of second language acquisition (Ellis 1997, 2002). If explicit instruction is more effective than implicit instruction (Norris and Ortega 2000), the question is what is to be taught explicitly. Research in theoretical linguistics enables us to define what specific metalinguistic knowledge underlies certain lexical items and grammar constructions. The present study illustrates this by using simple sentential constructions that are regarded as A2 grammatical features according to Hawkins and Filipovic (2012). B1-level Japanese learners of English tend to omit objects (Objs) of different types, when producing simple A2-level sentences. We attribute this problem to two linguistic factors. First, verbal argument structure that defines what elements, e.g., subject (Sbj), Obj and other obligatory sentential elements, are required to appear with a given verb. Second, English and Japanese differ with respect to the omission of required element(s). This study claims that metalinguistic knowledge of argument structure and overt versus covert realization of arguments in the two languages should be explicitly taught through structure-based tasks. We propose two different sets of such tasks: (i) instruction that focuses on lexical properties by presenting verbal argument structure and then requiring students to engage in grammaticality judgment and controlled written production tasks; (ii) instruction that focuses on language-particular features by giving students consciousness-raising tasks in L1, consciousness-raising tasks that compare and contrast L1 and L2, controlled-writing tasks, and free-writing tasks with corrective feedback.

Background: Sleep on the first night in a sleep laboratory is characterized by a lower sleep quality and frequency of rhythmic masticatory muscle activity (RMMA) than that on the second night in moderate to severe sleep bruxism (SB) patients. Objective: The aims of this study was to clarify the physiological factors contributing to the first night effect on oromotor activity during sleep and investigate whether physiological factors involved in the first night effect differed between rhythmic and non‐rhythmic oromotor activities. Methods: Polysomnographic data collected on two consecutive nights from 15 moderate to severe SB subjects (F 7: M 8; age: 23.2 ± 1.3 [mean ± SD] years) were retrospectively analysed. Sleep variables, RMMA and non‐specific masticatory muscle activity (NSMA) were scored in relation to episode types (i.e. phasic or tonic and cluster or isolated), sleep architecture and transient arousals. The relationships between nightly differences in oromotor and sleep variables were assessed. The distribution of oromotor events, arousals, cortical electroencephalographic power, RR intervals and heart rate variability were examined in relation to sleep cycle changes. These variables were compared between the first and second nights and between RMMA and NSMA. Results: Sleep variables showed a lower sleep quality on Night 1 than on Night 2. In comparisons with Night 1, the RMMA index increased by 18.8% (p <.001, the Wilcoxon signed‐rank test) on Night 2, while the NSMA index decreased by 17.9% (p =.041). Changes in the RMMA index did not correlate with those in sleep variables, while changes in the NSMA index correlated with those in arousal‐related variables (p <.001, Spearman's rank correlation). An increase in the RMMA index on Night 2 was found for the cluster type and stage N1 related to sleep cyclic fluctuations in cortical and cardiac activities. In contrast, the decrease in the NSMA index was associated with increases in the isolated type and the occurrence of stage N2 and wakefulness regardless of the sleep cycle. Conclusion: Discrepancies in first night effect on the occurrence of RMMA and NSMA represent unique sleep‐related processes in the genesis of oromotor phenotypes in SB subjects. [ABSTRACT FROM AUTHOR]

Study Objective: The effects of the sodium‐dependent glucose transporter‐2 inhibitor ipragliflozin were compared with metformin in a previous study, which revealed that ipragliflozin reduced visceral fat content by 12%; however, the underlying mechanism was unclear. Therefore, this sub‐analysis aimed to compare metabolomic changes associated with ipragliflozin and metformin that may contribute to their biological effects. Design: A sub‐analysis of a randomized controlled study. Setting: Chiba University Hospital and ten hospitals in Japan. Patients: Fifteen patients with type 2 diabetes in the ipragliflozin group and 15 patients with type 2 diabetes in the metformin group with matching characteristics, such as age, sex, baseline A1C, baseline visceral fat area, smoking status, and concomitant medication. Interventions: Ipragliflozin 50 mg or metformin 1000 mg daily. Measurements: The clinical data were reanalyzed, and metabolomic analysis of serum samples collected before and 24 weeks after drug administration was performed using capillary electrophoresis time‐of‐flight mass spectrometry. Main Results: The reduction in the mean visceral fat area after 24 weeks of treatment was significantly larger (p = 0.002) in the ipragliflozin group (−19.8%) than in the metformin group (−2.5%), as were the subcutaneous fat area and body weight. The A1C and blood glucose levels decreased in both groups. Glutamic pyruvic oxaloacetic transaminase, γ‐glutamyl transferase, uric acid, and triglyceride levels decreased in the ipragliflozin group. Low‐density lipoprotein cholesterol levels decreased in the metformin group. After ipragliflozin administration, N2‐phenylacetylglutamine, inosine, guanosine, and 1‐methyladenosine levels increased, whereas galactosamine, glucosamine, 11‐aminoundecanoic acid, morpholine, and choline levels decreased. After metformin administration, metformin, hypotaurine, methionine, methyl‐2‐oxovaleric acid, 3‐nitrotyrosine, and cyclohexylamine levels increased, whereas citrulline, octanoic acid, indole‐3‐acetaldehyde, and hexanoic acid levels decreased. Conclusions: Metabolites that may affect visceral fat reduction were detected in the ipragliflozin group. Studies are required to further elucidate the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Estimation of the population size is essential for understanding population dynamics. Estimating animal density using multiple methods and/or multiple attempts is required for accurate estimations. Raccoon dog Nyctereutes procyonoides is native to East Asia, including Japan, and has become an invasive species in Europe. Information on raccoon dog density in their native range is important to understand their invasion; however, relatively few studies have been conducted on raccoon dog density in their native range. In this study, we extracted DNA from fecal samples of raccoon dogs inhabiting a small island in Japan and conducted density estimation over two periods using DNA capture‐recapture methods: CAPWIRE and SECR. We also investigated sex ratio using genetic sex identification. Density estimates using SECR were approximately threefold different between the two study periods: 17.2 individuals per km2 in 2018 and 49.0 individuals per km2 in 2020. In contrast, estimates using CAPWIRE were relatively stable: 21.7 individuals per km2 in 2018 and 24.3 individuals per km2 in 2020. A drastic increase or decrease is not expected during the study period, and thus, density estimates using CAPWIRE are more reasonable than those using SECR. The small number of samples per individual might result in low accuracy of density estimates by SECR. The density estimated by CAPWIRE was similar to that in the main island in Japan and higher than that in Europe. Feeding competition with other omnivorous carnivores and/or predation risk by wolves might maintain the low density in Europe. The sex ratio of raccoon dogs was 1:1, which was similar to the values in invasive raccoon dogs and other canids. Further genetic census, including sex identification in various landscapes in their native and invasive range, will enable us to understand not only the ecology of raccoon dogs but also their adaptations to their invading areas. [ABSTRACT FROM AUTHOR]

This article sets out to show how to contextualize CEFR descriptors to fit remedial English reading courses at Japanese tertiary institutions. The courses target incoming students who are typically accepted in the fall of their final high school year, and are offered between the time of acceptance and enrolment in the following April. The paper details steps for contextualizing CEFR descriptors and explains how we specify the descriptors for the remedial course. The adaptation of the CEFR comprises two steps. The first is to select CEFR descriptors relevant to the course. The selection is based on the purposes of the course and the proficiency level of the target learners. The second step is to expand on the selected descriptors in terms of reading tasks, text types, and text features. Text types associated with the reading tasks defined in the selected descriptors are identified, and text features are specified based on a close examination of the target level. Reading tasks are particularized according to text types and the actual texts assigned in each lesson. The resultant contextualization, varying in degree of specification, supports the different purposes of the course.

Glaucoma is the most common cause of blindness, which significantly reduces quality of life. Most glaucoma cases are primary glaucoma; nevertheless, many patients suffer from glaucoma caused by drugs, such as corticosteroids. A comprehensive review of the risks associated with corticosteroid-induced glaucoma is limited. Therefore, we used the Japanese Adverse Drug Event Reporting Database (JADER) published by the Pharmaceuticals and Medical Devices Agency (PMDA) to analyze the risk factors associated with glaucoma and the trends and characteristics of corticosteroid-induced glaucoma. We did not find sex or age differences associated with the onset of glaucoma. Hierarchical clustering and principal component analysis revealed that triamcinolone acetonide and betamethasone sodium phosphate, which are used around the eyes in Japan, are more likely to induce intraocular pressure (IOP) elevation compared with other corticosteroids. Increased IOP is a direct cause of glaucoma. Based on these findings, it may be necessary to limit or avoid the use of these corticosteroids. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to clarify the characteristics and their mortality‐related factors in very low birthweight infants with Down syndrome (DS) in Japan. Methods: This retrospective case–control study enrolled newborns with DS weighing <1500 g admitted to neonatal intensive care unit (NICU) of the perinatal centre registered with the Neonatal Research Network of Japan (NRNJ) database from 2008 to 2019. The clinical characteristics and their mortality‐related factors were compared among the Dead group (newborns with DS who died in the NICU), the Survival group (newborns with DS who were alive from the NICU) and the Control group (newborns without congenital or chromosomal condition). Results: A total of 53 656 newborns weighing <1500 g were registered in the NRNJ database for 12 years. Of these, 310 (0.6%) were diagnosed with DS: 62 newborns in the Dead group, 248 in the Survival group and 49 786 in the Control group without chromosomal condition. Logistic analysis revealed that there was a significant difference in the mortality‐related factors in congenital anomalies, pulmonary haemorrhage and persistent pulmonary hypertension of the newborn; the adjusted odds ratios were 8.6, 121 and 9.5, respectively. Newborns with DS weighing <1000 g showed the earliest death in the NICU on the Kaplan–Meier survival curve (P < 0.01). Conclusion: The mortality rate for newborns with DS weighing <1500 g was 20% (5% in the Control group). The mortality‐related factors were complications of congenital anomalies, pulmonary haemorrhage and persistent pulmonary hypertension of the newborn. [ABSTRACT FROM AUTHOR]

Introduction: Groin pain is one of the prevalent injuries in soccer players.1 Since groin pain takes time to heal and affects the performance of the players, it is necessary to monitor the groin condition regularly to prevent its onset and reccurence. The Groin Injury Screening Questionnaire (GISQ) was developed in Norway to evaluate the groin condition for soccer players.2 GISQ has already been translated in several language, but not into Japanese. Objectives: To develop the Japanese version of the GISQ (GISQ-J), and to examine its validity and reliability. Moreover, to investigate the relationship between a history of groin pain and GISQ-J scores. Study design: Cross-sectional study Methods: The GISQ-J, translated with permission from the original author, was distributed twice to 114 Japanese high school and university soccer players by Google Forms. The second response was given within 72 hours of the first 79 80 response, recalling the condition of the groin at the time of the first response. The GISQ-J is a 100-point scale, with a higher score indicating better groin conditions. Cronbach's α was calculated to assess the validity of each GISQ-J scale, and the intraclass correlation coefficient (ICC) was calculated to evaluate the reliability. In addition, an unpaired t-test was used to compare GISQ-J scores by the presence or absence of a history of groin pain. Results: A total of 60 soccer players (52.6%) responded. Cronbach's α for each scale ranged from 0.71 to 0.97, and the ICC from 0.72 to 0.86. Those with a history of groin pain (n=14) had significantly lower GISQ-J scores than those without (n=46)(p<0.05). Conclusions: The GISQ-J showed good validity and reliability on each scale. The GISQ-J scores were poor with a history of groin pain, suggesting that the GISQ-J may be useful in the evaluation of groin conditions in Japanese soccer players. [ABSTRACT FROM AUTHOR]

Introduction: Blind football is a para-sport played by athletes with severe visual impairments, and ranked second highest of the five levels for concussion risk rate in para-sports competition.1 In Tokyo 2020 Paralympic Games, there were game time and goal size changes at the blind football competition. It is possible that this may have also changed the head impact characteristics in Tokyo 2020, but this has not been examined. Objectives: To compare the head impact characteristics during blind football competition between Rio 2016 and Tokyo 2020 Paralympic Games using the official videos. Study design: Cross-sectional study Methods: All 36 official game videos from the national blind football teams participating in the Rio 2016 and Tokyo 2020 summer Paralympic Games were obtained from the International Paralympic Committee's official website channel YouTube (https://www.youtube.com/c/paralympics). The duration of the match was 50 minutes for Rio 2016 and 40 minutes for Tokyo 2020. Eight teams participated in each Paralympic Game, which consisted of 12 preliminary games and six ranking and final games. The videos were analyzed to assess the number of scores, number of head impacts, and their details (round, playing phase, scoring situation, impact situation, occurrence area, impact object, site of head impact, fall, and foul). Results: The total number of goals scored at the Rio 2016 and Tokyo 2020 were 23 and 45, respectively. The number of head impacts was 1,105 and 931 for Rio 2016 and Tokyo 2020, respectively. Significant differences were observed in head impact characteristics between the Rio 2016 and Tokyo 2020 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. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether adolescents' leisure screen time differed during the coronavirus disease 2019 (COVID-19) pandemic compared to before the pandemic, and to identify factors that affect leisure screen time among Japanese high school students. The Health Behavior in School Children questionnaire was used to investigate differences in eating habits and physical and mental health. The results showed that the leisure screen time of Japanese high school students was 2.6 h (SD = 1.4) before the pandemic, and 3.2 h (SD = 1.5) during the pandemic. The factors that increased leisure screen time were found to differ between boys and girls. No significant deterioration in physical and mental health was observed. The impact of the pandemic on eating habits differed in boys and girls. Boys reported "not feeling great about life" as a factor that increased leisure screen time during the pandemic, suggesting that negative emotions influenced the increase in leisure screen time. The pandemic had a significant impact on girls' leisure screen time. Longer screen time should be carefully monitored because it can lead to sleep disturbances, worsening of mental health, and obesity. Compared with before the pandemic, the health status of boys and girls changed little. Eating habits tended to improve for both boys and girls. [ABSTRACT FROM AUTHOR]

Objectives: The coronavirus disease 2019 pandemic has affected cancer management worldwide. For upper tract urothelial carcinomas, delays in treatments are not recommended even during the pandemic. We investigated the impact of the pandemic on patients with these carcinomas who underwent radical nephroureterectomy (RNU) and adjuvant systematic therapy before and after COVID‐19 spread in Japan. Methods: This multicenter retrospective study included 304 patients who underwent RNU for upper tract urothelial carcinomas between May 1, 2019, and December 31, 2021, in Aichi, Japan. The patients were categorized into three groups based on whether they underwent surgery in the prepandemic (before infection spread in Japan), early pandemic (between confirmation of the first case and vaccination initiation), and late pandemic (after the start of vaccination in Japan) phases. The patient characteristics, diagnostic methods, pathological findings, and postoperative therapy were compared among the three phases. Results: Overall, 74, 152, and 78 patients underwent RNU in the prepandemic, early pandemic, and late pandemic phases, respectively. The number of patients who underwent preoperative ureteroscopy decreased significantly from the prepandemic phase to the late pandemic phase due to pandemic‐related restrictions (p = 0.016). There was no difference in the time to the first visit or pathological findings. Among patients classified as high‐risk according to existing clinical trials, the proportion receiving adjuvant systematic therapy after RNU decreased significantly from 52.3% to 19% (p = 0.003). Conclusions: There was no difference in the pathological findings. The number of patients receiving appropriate adjuvant systematic therapy decreased during the pandemic. [ABSTRACT FROM AUTHOR]

Positive expressive writing may improve willingness to engage in expressive writing. An individual, three-day, homework-style experiment was conducted with 42 Japanese undergraduate students who completed a writing task about their feelings regarding a stressful experience. Participants were assigned sequentially to positive, negative, or standard prompt groups. ANOVAs were performed to compare students' willingness to engage in expressive writing across groups and revealed a relative increase in the positive prompt group's willingness from baseline to follow-up. In that group, students' willingness significantly increased from pre-session to post-session. The positive prompt helped maintain higher levels of continued expressive writing and promoted participants' willingness to engage in expressive writing, causing fewer interruptions during writing sessions. Expressive writing may be an early stress intervention strategy. [ABSTRACT FROM AUTHOR]

Background: Part 1 of the DORA study, a 2019 international clinical trial of glecaprevir and pibrentasvir (G/P) treatment in adolescents with chronic hepatitis C virus (HCV) infection, demonstrated high efficacy and safety. However, few reports have considered real-world experience with G/P treatment in adolescents with chronic HCV. The present prospective multicenter study assessed real-world efficacy and safety of G/P treatment in Japanese adolescents with chronic HCV. Methods: Subjects between 12 and 17 years old who were treatment-naïve or previously managed with interferon-based regimens were prospectively enrolled and treated with G/P (300 mg/120 mg) once daily for 8 or 12 weeks. The primary efficacy endpoint was sustained virologic response at 12 weeks after treatment completion (SVR12). Adverse effects and laboratory abnormalities were assessed. Results: Twenty-five Japanese patients (15 female) were enrolled from 13 pediatric centers in Japan. Median age was 13 years (range 12–17). Numbers of patients with genotypes 1b, 2a, 2b, and 2b/1b were 6, 12, 6, and 1, respectively. Twenty-two were treatment-naïve, while three had experienced interferon-based treatments. All patients completed G/P treatment (24 for 8 weeks and 1 for 12). Twenty-four achieved SVR12 (96%). Most adverse events were mild. None were serious. G/P significantly decreased serum alanine aminotransferase, γ‐glutamyltransferase, and Wisteria floribunda agglutinin-positive Mac-2-binding protein concentrations. No negative effects on growth or maturation were apparent at 12 weeks. Conclusions: Under real-world conditions, G/P treatment of Japanese adolescents with chronic HCV was highly efficacious and well tolerated. [ABSTRACT FROM AUTHOR]

There is a rich beech fossil record in Japan dating from the Paleogene to the Holocene, which allows for the continuous tracing of the evolutionary history of the genus and allows us to understand the environmental background that facilitated the genus to obtain a dominant state in present‐day forests. In addition to the temperate climate, the oceanic climate was an important factor in controlling beech distribution and dominance in the forests in Japan. With the cooling climate, beech species began expanding their distribution in the Northern Hemisphere in the middle Eocene and appeared in Japan in the late middle Eocene. Beech species became dominant in forests in Japan during the Miocene along with the development of the oceanic climate by the opening of the Sea of Japan and with the strengthening of the monsoon. Fagus crenata appeared until the Late Pliocene and became dominant in forests in central Japan in the late Early Pleistocene coinciding with the onsetting inflow of the Tsushima Warm Current to the Sea of Japan in interglacial stages. During the full‐glacial stages since the late Middle Pleistocene, the cold and dry climate caused by the strong winter monsoon limited the distribution of beeches into refugia at humid places, including the inland. During the deglaciation since ca 19 ka, the beech population began to grow and its distribution expanded, controlled by the development of the Tsushima Warm Current, as well as latitudinal and altitudinal temperature clines. [ABSTRACT FROM AUTHOR]

Reportedly, antibiotics, which are frequently prescribed in children, have long-term effects owing to gut microbiota dysregulation. Tosufloxacin tosilate hydrate (TFLX) is the first orally administered new quinolone with high efficacy and broad-spectrum action approved as an antibacterial agent for pediatric use in Japan. However, studies on the effects of its early-stage administration are limited. Therefore, we aimed to analyze the later effects of its developmental administration by monitoring growth rate, neurobehavior, and gut microbiota in mice. The TFLX was administered via drinking water at a dose of up to 300 mg/kg for two consecutive weeks during the developmental period (4-6 weeks of age) or adulthood (8-10 weeks of age). Thereafter, the body weights of the mice were measured weekly to monitor growth rate. Behavioral tests were also conducted on 11-12-week-old mice to examine the neurobehavioral effects of the treatment. Further, to examine the effects of the treatment on microbiota, fecal samples were collected from the rectum of mice dissected at 12 weeks of age, and 16s rRNA analysis was conducted. Our results showed increased body weights after TFLX administration, without any long-term effects. Behavioral analysis suggested alterations in anxiety-like behaviors and memory recall dysregulation, and gut microbiota analysis revealed significant differences in bacterial composition. These findings indicated that TFLX administration during the developmental period affects mice growth rate, neurobehavior, and gut microbiota structure. This is the first study to report that TFLX is potentially associated with the risk of long effects. [ABSTRACT FROM AUTHOR]

Limited resources intensify interspecific competition and constrain the survival and distribution of species. A restricted, spatially isolated, small island can also pronounce this effect, as predicted in the island biogeography. This study compared the summer diets of sympatric carnivores, red foxes, raccoon dogs, Japanese martens, and Japanese weasels on the small island Izushima and evaluated niche partitioning, especially focusing on their insectivory. The results showed that insects were the main summer food source for all four species, with a significant overlap in their diets. However, in-depth investigation on insectivory down to the level of species and genera revealed that the species differences were more pronounced. Raccoon dogs frequently fed on ground-dwelling beetles, and Japanese martens fed on several arboreal beetles, while red foxes were less dependent on insects and more biased toward larger prey such as mammals and birds, and Japanese weasels foraged more on smaller prey, thereby reflecting niche partitioning between these species owing to differences in foraging ecology under the constrains of their body sizes. [ABSTRACT FROM AUTHOR]

Drug pricing methods vary extensively across countries. Japan calculates drug prices using cost accounting and based on the efficacy of similar drugs. This study investigated the relationship between drug prices and their clinical efficacy and usefulness using public information on anticancer drugs reimbursed by the National Health Insurance price listing between January 2009 and March 2020. We investigated drug characteristics, prices, and clinical benefits based on overall survival (OS) and progression-free survival (PFS). Eighty anticancer drugs were approved in Japan during the study period. The largest number (28 drugs, 35.0%) was approved based on PFS, 18 (22.5%) were approved based on OS, and 13 (16.3%) based on the response rate. The mean (±SD) drug price was JPY 88,416.2 (±148,974.7), while the median drug price (with quartiles) was JPY 21,694 (JPY 4855.0–JPY 93,396.8). Drug prices were significantly higher for PFS than for OS, while cost index—the drug price to extend PFS or OS by one day—did not differ significantly between PFS and OS. The relationship between the 46 drugs approved based on OS or PFS and their prices was examined. A correlation was found between drug prices and their clinical usefulness in terms of OS but not PFS. [ABSTRACT FROM AUTHOR]

The effects of long-term fasting on the prognosis and hospital economy of hospitalised patient have not been established. To clarify the effects of long-term fasting on the prognosis and hospital economy of hospitalised patients, we conducted a prospective observational study on the length of hospital stay of patients hospitalised at thrity-one private university hospitals in Japan. We conducted a prospective observational study on the effects of fasting period length on the length of hospital stay and outcome of patients hospitalised for 3 months in those hospitals. Of the 14 172 cases of hospitalised patients during the target period on the reference day, 770 cases (median 71 years old) were eligible to fast for the study. The length of hospital stay for fasting patients was 33 (4–387) days, which was about 2·4 times longer than the average length of hospital stay for all patients. A comparative study showed the length of hospital stay was significantly longer in the long-term-fasting (fasting period > 10 d; n 386) group than in the medium-term-fasting (< 10 d; n 384) group (median 21 v. 50; P < 0·0001). Although the discharge to home rate was significantly higher in the medium-term-fasting group (71·4 % v. 36·5 %; P < 0·0001), the mortality rate was significantly higher in the long-term fasting group (10·8 % v. 25·8 %; P < 0·0001). It was verified that the longer the fasting period during hospitalisation, the longer the length of hospital stay and lower home discharge rate, thus indicating that patient quality of life and hospital economy may be seriously dameged. [ABSTRACT FROM AUTHOR]

Objective: The ideal vaginal environment is maintained by Lactobacillus species, which keep the vagina clean and free of infections, boost fertility and immunity. Age-related decline in estrogen affects Lactobacillus population, leading to dominance of nonoptimal species and increased diversity in vaginal microbiota. In this study, we compared the differences between the vaginal microbiota of pre- and postmenopausal women. We also examined the relationships between vaginal and gut microbiota, their relationships with sex hormones and equol-producing ability. Materials and Methods: This was a cross-sectional study of 35 premenopausal and 35 postmenopausal women (age range: 27–76 years). We compared parameters such as the composition of the gut and vaginal microbiota, vaginal pH, estradiol, follicular stimulating hormone, and urinary equol concentration. Results: In the vaginal microbiota of premenopausal women, Lactobacillus species constituted ∼71.98%, and nonoptimal species constituted ∼16.87%. They were 10.08% and 26.78%, respectively, in the vaginal microbiota of postmenopausal women. The proportion of Lactobacillus was significantly low, whereas microbial diversity and vaginal pH were significantly high (p < 0.0001) in postmenopausal women. The compositions of the vaginal microbiota were significantly different in pre- and postmenopausal women. However, such differences were not noticeable in the gut microbiota. Urinary equol production had no significant correlation with vaginal microbiota, although it had significant relationships with gut microbiota in postmenopausal women. In both groups, the proportions of vaginal Lactobacillus were inversely correlated with vaginal microbial diversity and vaginal pH. Conclusion: Postmenopausal women had significantly low Lactobacillus and high nonoptimal species in their vaginal flora, whereas such age-related differences were not identified in gut microbiota. Urinary equol concentration had significant correlation with gut microbiota in postmenopausal women only. This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (Trial registration No.: UMIN000043944). [ABSTRACT FROM AUTHOR]

The article presents a study which described the translation and cultural adaptation of a toolkit to increase its relevance to the Japanese primary care clinician. Topics discussed include categories of reasons for adaptations to the dementia-specific advance care planning training toolkit, most common challenges requiring adaptation of the original training content, and examples of adaptation process from English to Japanese.

Background: Diet-induced inflammation may be associated with sarcopenia; however, few reports have examined this relationship. Aim: To examine the association between the dietary inflammatory index (DII) and sarcopenia in older adults who visited a frailty clinic in Japan. Methods: This cross-sectional study used outpatient data from the Frailty Registry Study. The DII is an index of diet-induced inflammation, and a dietary assessment was performed using a brief self-administered diet history questionnaire to calculate the DII score. We classified DII scores by quartiles (Q1–Q4), and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression analyses for sarcopenia were performed. Age, sex, comorbidities, and physical activity were entered as confounding factors (Model 1) and Models 2, 3, and 4 with BMI, protein intake, and energy intake added to Model 1. Results: We included 304 patients in the analysis (mean age, 77.6 ± 6.3 years; female, 67.4%). The prevalence of sarcopenia was 14.5%. Logistic regression analyses showed that DII scores were significantly associated with sarcopenia in Model 1 and 2 (Model 1, reference: Q1, Q4: OR 3.10, P = 0.020; Model 2, Q4: OR 3.40, P = 0,022) but not in Model 3 and 4. Discussion: Diet-induced inflammation is associated with a higher likelihood of sarcopenia; however, this association disappeared after confounding for protein and energy intake. Conclusions: The results demonstrated that dietary protein and energy parameters were the main drivers for muscle health in medical patients. [ABSTRACT FROM AUTHOR]

In the current coronavirus infection 2019 (COVID-19) pandemic, the messenger RNA vaccines have been shown to help protect high-risk groups from COVID-19. Among healthcare workers vaccinated with Pfizer-BioNTech COVID-19 vaccine, a survey was conducted to analyze the relationship between the incidence and severity of adverse reactions after vaccination. We conducted a prospective self-reported survey of adverse reactions among healthcare workers vaccinated with the Pfizer-BioNTech COVID-19 vaccine (Comirnaty®) in Japan. After the first and second dose of vaccine, local and systemic reactions for 8 days after vaccination were reported by volunteer participants using a website. After receiving vaccination, 374 respondents participated in this matched-pair study. Both the incidence and severity of adverse reactions tended to be higher after the second vaccine dose than after the first dose. However, the incidence and numeric rating scale (NRS) score of muscle and skin pain were nearly the same after the first and second doses. In a comparison by sex, women had significantly higher incidence and NRS scores for adverse reactions such as headache, skin pain, erythema, and itching. The results also showed that younger age groups had higher incidence rates and NRS scores for all adverse reactions investigated, except for muscle pain, compared with older age groups. Some adverse reactions to the Pfizer-BioNTech Comirnaty® COVID-19 vaccine showed gender and age differences. However, generally speaking, all side reactions disappear within a week. Therefore, these side reactions are not a significant concern in recommending vaccination. [ABSTRACT FROM AUTHOR]

Aim: Some autoimmune hepatitis (AIH) patients experience relapse during their clinical course, and some risk factors for relapse have been identified previously using a relatively small sample size. The aim of the present study was to identify the risk factors for relapse in recently diagnosed AIH patients using a nationwide survey in Japan. Methods: The nationwide survey performed in Japan in 2018 of AIH patients diagnosed between 2014 and 2017 was re‐evaluated. A total of 614 patients who received corticosteroids were enrolled in the present study. Associations between relapse and patients' characteristics at diagnosis were evaluated using logistic regression analysis. Results: Relapse was identified in 143 (23.3%) patients after remission. At the time of diagnosis of the disease, there were significant differences in the γ‐glutamyl transpeptidase (γ‐GTP) level, prevalence of liver cirrhosis, and degree of liver fibrosis. Multivariable logistic regression analysis showed that γ‐GTP elevation and liver cirrhosis were significantly associated with relapse. Conclusion: The γ‐GTP level at diagnosis could help identify AIH patients at higher risk of relapse. [ABSTRACT FROM AUTHOR]

The Intractable Hepato‐Biliary Disease Study Group of Japan, sponsored by the Ministry of Health, Labor and Wealth, proposed in 2018 that patients with cirrhosis and a Child‐Pugh score of 5–9 should be diagnosed as having acute‐on‐chronic liver failure (ACLF) when a deterioration of liver function ("serum bilirubin level of 5.0 mg/dl or more" and "prothrombin time value of 40% or less of the standardized values and/or international normalization rates of 1.5 or more") caused by severe liver damage develops within 28 days after an acute insult, including alcohol abuse, bacterial infection, gastrointestinal bleeding, and the exacerbation of underlying liver diseases. Disease severity can be classified into 4 grades depending on the extent of the deterioration in organ functions, including liver, kidney, cerebral, blood coagulation, circulatory and respiratory functions. The Study Group has since performed an annual nationwide survey of patients with ACLF diagnosed according to the proposed diagnostic criteria as well as those with disease conditions related to ACLF. A total of 501 patients, including 183 patients diagnosed as having ACLF, seen between 2017 and 2019 were enrolled, and univariate and multivariate analyses revealed that the proposed diagnostic criteria were useful for identifying cirrhotic patients with an unfavorable outcome following an acute insult. Consequently, the Study Group determined that the proposed diagnostic criteria should be used in both clinical practice and clinical research as formal diagnostic criteria. [ABSTRACT FROM AUTHOR]

Rationale: Epidemiological evidence indicates that ambient exposure to particulate matter ⩽2.5 μm in aerodynamic diameter (PM2.5) has adverse effects on lung function growth in children, but it is not actually clear whether exposure to low-level PM2.5 results in long-term decrements in lung function growth in pre- to early-adolescent schoolchildren. Objectives: To examine long-term effects of PM2.5 within the 4-year average concentration range of 10-19 μg/m3 on lung function growth with repeated measurements of lung function tests. Methods: Longitudinal analysis of 6,233 lung function measurements in 1,466 participants aged 8-12 years from 16 school communities in 10 cities around Japan, covering a broad area of the country to represent concentration ranges of PM2.5, was done with a multilevel linear regression model. Forced expiratory volume in 1 second, forced vital capacity (FVC), and maximal expiratory flow at 50% of FVC were used as lung function indicators to examine the effects of 10-μg/m3 increases in the PM2.5 concentration on relative growth per each 10-cm increase in height. Results: The overall annual mean PM2.5 level was 13.5 μg/m3 (range, 10.4-19.0 μg/m3). We found no association between any of the lung function growth indicators and increases in PM2.5 levels in children of either sex, even after controlling for potential confounders. Analysis with two-pollutant models with O3 or NO2 did not change the null results. Conclusions: This nationwide longitudinal study suggests that concurrent, long-term exposure to PM2.5 at concentrations ranging from 10.4 to 19.0 μg/m3 has little effect on lung function growth in preadolescent boys or pre- to early-adolescent girls. [ABSTRACT FROM AUTHOR]

Lycorma delicatula has expanded its distribution from China to Japan, Korea, and the USA, causing significant economic damage to vineyards in the latter two countries. However, in Japan, L. delicatula has long been limited to the Hokuriku region, central Japan, and no significant damage to crops has been reported since it was first reported there in 2009. Manipulation experiments and field observations in the Hokuriku region, where winter precipitation is extremely high, revealed that egg numbers and hatchability were significantly reduced in exposed places, especially when wax was excluded from the egg mass. Phylogenetic analysis showed that the population in Japan could be divided into at least two groups. Most L. delicatula samples from Hokuriku formed a clade with those from northwestern China. Samples from Okayama, where the distribution of L. delicatula was recently confirmed, had the same haplotype as those from central China, Korea, and the USA. These results suggest that environmental factors and genetic characteristics of L. delicatula are involved in the relatively slow expansion of its distribution in Hokuriku. Conversely, in Okayama, where precipitation is relatively low, the rapidly increasing haplotype in Korea and the USA was detected, leading to concerns that its distribution will expand further. [ABSTRACT FROM AUTHOR]

Background: The relationships between developmental strategies for additional indications and drug price revisions have not been thoroughly studied. Here, we investigated the price revisions for anticancer drugs approved in Japan.Methods: The study was based on published information on anticancer drugs approved between January 2009 and March 2020 in Japan. We investigated the relationships between the pharmacological and regulatory characteristics of anticancer drugs and occurrence/non-occurrence of the Japanese National Health Insurance (NHI) price revisions.Results: Eighty-one new anticancer drugs were given NHI price listings during the survey. On April 1, 2020, the prices of 23 anticancer drugs had been revised from the initial pricing, the prices were reduced for 21 drugs (91.3%). Several parameters showed the relationships between drug characteristics and NHI price revisions. The achievement of additional indications and compound type were identified as explanatory factors for these relationships. Additional indication profiles were defined to assess the relationships between the methods for additional indication achievement and price revisions. When the type of additional indication was "Expansion", the percentage of drugs received NHI price revisions was the highest (P<0.001).Conclusions: NHI price revision was significantly related to the achievement of additional indications and compound type. The strategy for additional indications was found to affect the occurrence/non-occurrence of NHI price revisions. [ABSTRACT FROM AUTHOR]

Objective. The study investigated the effect of weather and day of the week on the daily circulation numbers in two public libraries in Japan. Method. Datasets on library circulation were collected from one library in an urban area, and another in a rural area. The data were then divided according to rainy day and other days, holiday and workday, and day of the week, and the presence or absence of significant differences in daily circulation was analyzed. Automatic linear modeling was performed to analyze the effect of weather, day of the week, and holiday on daily circulation. Results. The results revealed that day of the week have a considerable impact on daily circulation for both libraries. However, weather exerted a significant impact in the urban area only. Automatic linear modeling explained the daily circulation based on day of the week and holiday with an accuracy of 71.5% for the rural library, and explained the circulation numbers based on day of the week, holiday, and precipitation amount with an accuracy of 81% for the urban library. [ABSTRACT FROM AUTHOR]

Aim: This study is to investigate the role of amniocentesis for prenatal diagnosis before and after the beginning of noninvasive prenatal testing (NIPT) in Japan. Methods: We performed a retrospective analysis of genetic amniocentesis at mid‐trimester (15–20 gestational weeks) for fetal karyotype analysis at Nagoya City University between April 2006 and March 2020. The indications, test results, and the detection rate of fetal abnormal karyotype were compared before (phase 1, P1) and after (phase 2, P2) beginning of NIPT at April 2013. Results: A total of 2458 (P1: 1132, P2: 1326) amniocentesis were enrolled in this study. The most frequent indication was advanced maternal age in both phases (P1: 78.2% %, P2: 81.1%). In P2, 110 patients (8.3%) received amniocentesis after positive or nonreportable NIPT results. Other indications were fetal abnormal findings by ultrasounds (P1: 15.4%, P2: 17.7%), abnormal maternal serum screening results (P1: 8.0%, P2: 10%), previous child with fetal chromosome aberration (P1: 6.5%, P2: 3.5%), and translocation of either partner (P1:1.5%, P2: 2.1%). The detection rate for fetal chromosomal aberrations including all indications was significantly increased in P2 (15.9%, 95% CI 14.0–18.0) as compared to P1 (9.0%, 7.4–10.8). However, if the indication was only advanced maternal age, the positive detection rate kept low in both phases (P1: 5.2%, 3.7–7.1, P2: 4.2%, 2.9–5.9). Conclusion: Since the initiation of NIPT, the detection rate of fetal chromosomal abnormalities was higher in this study, suggesting that amniocentesis cannot be strongly recommended for advanced maternal age alone. [ABSTRACT FROM AUTHOR]

Objective: The number of pregnant and delivery cases in systemic lupus erythematosus (SLE) patients are increasing due to the advances in therapies. However, there are many problems such as the exacerbation of SLE during pregnancy and the risk of fetal complications. We investigated the impact of both pregnancy on lupus and lupus on pregnancy in Japanese patients. Methods: We retrospectively analyzed 64 pregnancies in 39 cases of lupus patients at Kyushu University Hospital, Japan, from October 2002 to July 2018 and then assessed the clinical profiles and maternal and fetal outcomes. Results: In terms of the impact of pregnancy on SLE, 29.7% of patients had lupus flare during pregnancy. Multivariate analysis showed that flare rates were significantly higher in patients who discontinued the immunosuppressants when pregnancy was detected or before pregnancy. Pregnancy results were 25.0% for preterm birth, 39.1% for low birth weight infants, and 31.3% for small-for-gestational-age infants. Regarding the effect of SLE on fetal death, the rates of stillbirth were significantly higher in cases whose C3 value at 12 weeks of gestation was lower than before conception. Preterm birth was associated with disease duration and lupus flare during pregnancy. Conclusions: Discontinuation of immunosuppressive drugs was a predictive factor for lupus flare during pregnancy. Further, the decrease of C3 levels at 12 weeks of gestation from baseline was a predictive factor for fetal loss. It is essential for lupus pregnant patients to prevent flares, even with the use of immunosuppressive medications. [ABSTRACT FROM AUTHOR]

Purpose: Nine bladder cancer (BCa) cases were reported among aromatic amine-exposed male workers at a factory manufacturing organic dye/pigment intermediates in Japan. We aimed to evaluate the characteristics of aromatic amine-exposed workers by cross-sectional observation, and the risk of BCa by assessing the standardized incidence ratio (SIR). Methods: In the cross-sectional study, our subjects were: 9 BCa patients, 36 aromatic amine-exposed non-patients, and 79 non-exposed workers from 3 factories. We evaluated the subjects' medical history, urinalysis, qualitative determination of nuclear matrix protein 22, and urinary cytology. For SIR assessment, 98 aromatic amine-exposed workers from 1 factory were included, and the Japanese general male population was used as a referent population. Since no direct aromatic amine-exposure data were available, we calculated surrogate exposure levels using information on job sites, exposure potency, and duration. Results: Coexistent aromatic amines were ortho-toluidine (OT), aniline, para-toluidine, ortho-anisidine, 2,4-xylidine, and ortho-chloroaniline. The prevalence rates of cystitis and bladder lesion-related symptoms in both BCa patients and aromatic amine-exposed non-patient workers were significantly higher than those of non-exposed workers. Overall, the SIR for BCa in OT-exposed workers was 56.8 (95% CI 27.7–104.3) and apparent dose–response relationships were revealed between the SIR and the surrogate exposure level in the 0–10-year lagged analyses. Overall, SIRs in other aromatic amine-exposed workers were also significantly high but no or unclear dose–response relationships were observed. Conclusions: We conclude that OT may be responsible for the increased risk of BCa. Regular monitoring of bladder lesion-related symptoms is essential for the early identification of BCa. [ABSTRACT FROM AUTHOR]

Dissociation has been reported to be associated with emotive‐relational and behavioral difficulties; however, the temporal relationship between dissociation and these difficulties is unclear. Accordingly, this study investigated whether dissociation predicts difficulties (including emotional symptoms, conduct problems, hyperactivity, and peer problems) in adolescents. A two‐wave cross‐lagged panel study (Time 1: September–November 2016, Time 2: February–March 2017) was conducted among 1,773 Japanese junior high and high school students at two private schools (995 boys and 778 girls; Mage = 14.79 years at Time 1 and 15.09 years at Time 2). Dissociation was assessed using the Japanese version of the Adolescent Dissociative Experiences Scale and perceived difficulties were assessed via the Strengths and Difficulties Questionnaire. A cross‐lagged effects model analysis indicated that high dissociation scores at Time 1 predicted high difficulties scores at Time 2. These findings suggest that dissociation could effectively predict difficulties in junior high and high school students. This study expands the field's understanding of the temporal relationship between behavioral problems and dissociation, which could help prevent problem behaviors. [ABSTRACT FROM AUTHOR]

Eel movement patterns have been frequently studied to learn about their movements within the fresh- and brackish waters of the same river before their spawning migrations. Although otolith microchemistry analyses estimated that the eels used fresh-, brackish, and marine water habitats, inter-river movements of Japanese eels via the sea have not been observed. In previous studies silver eels appear to migrate for spawning in October-December, and so eels that migrate to the sea during this period have been considered as migrating for spawning. In the progress of our acoustic telemetry study on eel movement patterns, we found the first evidence that Japanese eels move between distant rivers via the sea. During the study in the Akugawa River, Wakayama Prefecture, Japan, we released 15 acoustically tagged yellow-phase eels on 8 April 2019. Three of the 15 tagged eels released into the Akugawa River were later caught in the ~ 15 km distant Hidari-Aizu River by a local angler during early mid-July 2020. This showed that 2 of 3 tagged eels migrated seaward in October and December. The other tagged eel had been detected only at a releasing point until 30 June 2019 and due to an unknown reason was never detected again before capture in the Hidari-Aizu River. The remaining 12 tagged eels stayed in the Akugawa River during the study period. These findings indicate that Japanese eels may migrate seaward for purposes other than just spawning. This information is valuable for understanding the eels' life-history diversity and for future conservation plans. [ABSTRACT FROM AUTHOR]

Histopathology is essential for the diagnosis and evaluation of disease activity of autoimmune hepatitis (AIH). We aimed to elucidate the characteristics of AIH from the localization of inflammation. We re-evaluated a nationwide survey that was performed in Japan in 2018 of AIH patients diagnosed between 2014 and 2017. A total of 303 patients were enrolled, and the clinical and treatment characteristics were compared between the patients with predominantly portal inflammation (230 patients) or lobular inflammation (73 patients). AIH patients with lobular inflammation had a higher probability of being diagnosed with acute hepatitis than those with portal inflammation. Liver enzyme levels were higher in patients with lobular inflammation, whereas immunoglobulin G levels were higher in patients with portal inflammation. The prevalence of an alanine aminotransferase level < 30 U/L after 6 months of treatment was significantly higher in patients with lobular inflammation than in those with portal inflammation (81.7% vs. 67.3%, P = 0.046). The localization of inflammation may be useful for evaluating the onset of AIH. [ABSTRACT FROM AUTHOR]

Matsumoto, Takenaka, and Takaya (2003) developed the Self-determined Motivation Scale for Exercise (SMSE) based on the self-determination theory (SDT: Deci & Ryan, 2002; Ryan & Deci, 2017) to assess behavioral regulation of exercise. The SMSE evaluates external, introjected, and identified regulations, intrinsic motivation, and amotivation. The SMSE's usefulness has been established in several studies. However, one limitation of the scale is the absence of a subscale assessing integrated regulation, which embodies the most self-determined form of extrinsic motivation in the SDT's continuum. Previous studies on exercise motivation conducted in Japan have been unclear about the consequences of integrated regulation of exercise. This study evaluated the validity and reliability of a revised SMSE (SMSE-2), which includes items assessing integrated regulation. Undergraduates (n=995) completed the SMSE-2. The results of confirmatory factor analysis of their responses supported the six-factor SMSE-2 model (Χ²(194)=1077.59, p<.01; CFI=.92, NNFI=.90, RMSEA=.07, 90% CI=.06-.07). Moreover, the acceptable internal consistency, test-retest reliability, predictive validity, and invariance of the scale between gender was demonstrated. These results supported the usefulness of the revised scale for both genders. [ABSTRACT FROM AUTHOR]

Laboratory tests of adolescents are often interpreted by using reference intervals derived from adults, even though these populations differ in their physical and physiologic characteristics and disease susceptibility. Therefore, to examine the distribution of laboratory values specific for adolescents, we analyzed hematologic and biochemical measurements obtained from 12,023 healthy Japanese adolescents (ages 15 through 18 years; male, 9165; female, 2858) during 2009 through 2018. Distributions were shown as medians with 95% (2.5th and 97.5th percentiles) of values and were compared with those from previous studies that examined similar Asian populations. There were some differences between hematologic parameters, serum creatinine and uric acid concentration, and lipid levels of Japanese adults and adolescents. In comparison with other Asian populations, the distributions of serum uric acid and high-density–lipoprotein cholesterol in the present study were slightly higher than those in the other studies. Although further research is need, the distributions of hematologic and biochemical tests in adolescents may have the potential to facilitate the early identification and management of disease in this population. [ABSTRACT FROM AUTHOR]

Aim: To clarify the outcome and predictive factors in patients with acute liver failure (ALF) awaiting deceased donor liver transplantation (DDLT) in Japan. Methods: Of the DDLT candidates in Japan between 2007 and 2016, 264 adult patients with ALF were retrospectively enrolled in this study. Factors associated with DDLT and waiting‐list mortality were assessed using the Cox proportional hazard model. The DDLT and transplant‐free survival probabilities were evaluated using Kaplan–Meier analysis and the log–rank test. Results: The waiting‐list registration year after the Transplant Law revision in 2010 was a significant factor associated with DDLT. The adjusted hazard ratio indicated that DDLT probability after 2010 was four times higher than that before, and the 28‐day cumulative DDLT probability was more than 35%. The median survival time of the entire cohort was 40 days. Multivariate analysis identified the following three factors associated with waiting‐list mortality: age, coma grade, and international normalized ratio. The transplant‐free survival probabilities were significantly stratified by the number of risks, and patients with all three risks showed extremely poor short‐term prognosis (median survival time = 23 days). Conclusions: The DDLT probability of ALF patients increased after the law revision in 2010; however, patients at high risk of short‐term waiting‐list mortality might need emergent living donor transplantation. [ABSTRACT FROM AUTHOR]

Aims: Personal agency is a variable which potentially facilitates personal recovery in people with serious mental illness. This study aimed to develop a new brief measure for subjective personal agency that can be completed by people with serious mental illness. Methods: Two focus group interviews were first conducted with 11 people with schizophrenia to understand the fundamental components of subjective personal agency for people with serious mental illness living in the community. One group comprised six people with schizophrenia living in the community, while the other consisted of five people with schizophrenia working as peer-support workers. We then developed scale items through collaboration with people with schizophrenia and qualitative analysis (stage 1). A cross-sectional survey was then conducted to test the psychometric properties of the new scale among service users with schizophrenia in 18 assertive community treatment teams (stage 2). Factor validity was tested via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We evaluated convergent validity with the Boston University Empowerment Scale (BUES), divergent validity with the global assessment of functioning (GAF), internal consistency, and test–retest reliability. Results: Seven items were included in the scale at stage 1. In stage 2, 195 participants completed this scale. EFA revealed a one-factor model with five items. CFA indicated good model fit (χ2 statistics [CMIN] = 8.445, df = 5 (CMIN/df = 1.689), p = 0.133, comparative fit index = 0.974, Tucker–Lewis fit index = 0.949, root mean square error of approximation = 0.077 and standardised root mean squared residual = 0.042). The new scale was significantly correlated with total BUES score (r = 0.526, p < 0.001), but not with GAF score. Cronbach's α for internal consistency was 0.79, and intra-class correlation coefficient for test–retest reliability was 0.70. Conclusion: We developed a new, five-item Subjective Personal Agency scale (SPA-5) that can be completed by people with serious mental illness. Further studies are needed to confirm the results outside Japan. [ABSTRACT FROM AUTHOR]