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Mood, emotions, and alcohol use motives are risk factors for hazardous alcohol use among young people, but relevant research about students in Asia is scarce. In addition, it is necessary to identify risk factors not only in students who are already drinking dangerously, but also in students who are in the preliminary stages of dangerous drinking, but few studies have pursued risk factors for these different degrees of hazardous drinking. Therefore, the present study aimed to measure the risk-level-specific factors in Japanese college students. 1,067 college students were categorized by the risk level of their drinking habits, and the risk-level-specific factors for hazardous drinking were examined. Students who engaged in high-risk drinking, and those who were suspected of being alcohol-dependent, were predominantly males. These students' motives for alcohol consumption and expressions of anger were significantly stronger. In addition, they resorted to avoidant, accepting responsibility and emotion-focused strategies for coping with stress. The interesting findings are that positive mood states such as vigor and friendliness tended to be specifically higher in the risky drinking group. These results suggest that emotions such as anger and stress coping skills may be potential targets for preventive interventions against hazardous drinking. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mood and adjustment disorders are two major causes of long-term sick leave among employees, leading to large social losses. Therefore, a return to work (RTW) intervention was attempted, targeting patients with mood and adjustment disorders. OBJECTIVE: This study aimed to investigate the outcome of an interdisciplinary RTW intervention including occupational therapy implemented within the Japanese healthcare framework. METHODS: An interdisciplinary RTW intervention including occupational therapy was conducted five times a week for approximately three months, targeting individuals with mood and adjustment disorders who took a leave of absence. Their mental symptoms, cognitive functioning, job performance, temperament, social adaptation, psychosocial state, and readiness to RTW before and after the intervention were evaluated. Full-time RTW ratios at 3, 6, 12, 18, and 24 months from baseline were followed up and compared with those of prior studies. RESULTS: A total of 30 individuals completed the intervention. After the intervention, participants' psychological symptoms, cognitive function, vocational aptitude, temperament, social adaptation, psychosocial state, and readiness to RTW improved (p≤0.001–0.0279). The ratios of RTW at 3, 6, 12, 18, and 24 months from the baseline were 6.7%, 46.7%, 73.3%, 77.8%, and 82.6%, respectively, reflecting a higher pattern than prior reports. CONCLUSIONS: The interdisciplinary RTW intervention including occupational therapy has the potential to improve not only depressive symptoms but also cognitive functioning, job performance, social adaptation, and readiness to RTW. They can also raise RTW ratios. [ABSTRACT FROM AUTHOR]

Background: Strong eosinophil infiltration in chronic rhinosinusitis with nasal polyp (CRSwNP) is highly associated with recalcitrance and higher nasal polyp recurrence rate after surgery. The prevalence of eosinophilic CRSwNP (ECRS) is increasing in Asian countries including Japan. Benralizumab is a humanized anti-IL-5R alpha monoclonal antibody that depletes eosinophils by antibody-dependent cell-mediated cytotoxicity. Objective: To assess the efficacy and safety of benralizumab in patients with ECRS. Methods: This phase II, randomized, double-blind, placebo-controlled study was conducted in Japan. Patients were randomized 1:2:2 to placebo, a single administration of benralizumab 30 mg, or benralizumab 30 mg every 4 weeks (q4w) for a total of three doses. The primary endpoint was the change in nasal polyp score from baseline at Week 12. Results: Overall, 56 patients were enrolled (placebo, n = 11; benralizumab single dose, n = 22; benralizumab q4w, n = 23). Although the mean total nasal polyp score began to decrease after the initiation of benralizumab treatment, there were no statistically significant differences in change in nasal polyp score from baseline at Week 12 between benralizumab and placebo (placebo, −0.5 ± 0.8; benralizumab single, −0.3 ± 0.8; benralizumab q4w, −0.5 ± 1.5). Post-hoc analysis showed that the administration of benralizumab decreased nasal polyp scores ≥2 points in 42.2% of ECRS patients and that patients with high blood eosinophil levels had a greater tendency to respond to benralizumab treatment. The safety profile was similar to that in previous studies and no unexpected adverse events were noted. Conclusion: Although benralizumab did not meet the primary efficacy endpoint, reductions of nasal polyp scores were seen in the benralizumab group compared with the placebo group over the whole study period, especially in patients with high levels of blood eosinophils. [ABSTRACT FROM AUTHOR]

The individualized occupational therapy (IOT) program is a psychosocial program that we developed to facilitate proactive participation in treatment and improve cognitive functioning and other outcomes for inpatients with acute schizophrenia. The program consists of motivational interviewing, self-monitoring, individualized visits, handicraft activities, individualized psychoeducation, and discharge planning. This multicenter, open-labeled, blinded-endpoint, randomized controlled trial evaluated the impact of adding IOT to a group OT (GOT) program as usual for outcomes in recently hospitalized patients with schizophrenia in Japanese psychiatric hospitals setting compared with GOT alone. Patients with schizophrenia were randomly assigned to the GOT+IOT group or the GOT alone group. Among 136 randomized patients, 129 were included in the intent-to-treat population: 66 in the GOT+IOT and 63 in the GOT alone groups. Outcomes were administered at baseline and discharge or 3 months following hospitalization including the Brief Assessment of Cognition in Schizophrenia Japanese version (BACS-J), the Schizophrenia Cognition Rating Scale Japanese version, the Social Functioning Scale Japanese version, the Global Assessment of Functioning scale, the Intrinsic Motivation Inventory Japanese version (IMI-J), the Morisky Medication Adherence Scale-8 (MMAS-8), the Positive and Negative Syndrome Scale (PANSS), and the Japanese version of Client Satisfaction Questionnaire-8 (CSQ-8J). Results of linear mixed effects models indicated that the IOT+GOT showed significant improvements in verbal memory (p <0.01), working memory (p = 0.02), verbal fluency (p < 0.01), attention (p < 0.01), and composite score (p < 0.01) on the BACS-J; interest/enjoyment (p < 0.01), value/usefulness (p < 0.01), perceived choice (p < 0.01), and IMI-J total (p < 0.01) on the IMI-J; MMAS-8 score (p < 0.01) compared with the GOT alone. Patients in the GOT+IOT demonstrated significant improvements on the CSQ-8J compared with the GOT alone (p < 0.01). The present findings provide support for the feasibility in implementing an IOT program and its effectiveness for improving cognitive impairment and other outcomes in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

The article focuses on a research related to development of an individualized occupational therapy programme and its effects on the neurocognition, symptoms and social functioning of patients with schizophrenia. It discusses use of Brief Assessment of Cognition in Schizophrenia—Japanese version (BACS-J), the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale. It concludes improvement in cognitive impairment and symptoms in patients with schizophrenia.

About 10% of all the onions harvested are disposed of or cheaply treated in a market as worthless onions every year in Japan because they failed to meet the quality standards required for marketing to the customer. Therefore, in order to allow both value additions and the effective reuses of worthless onions, a biological approach combining vinegar fermentation and composting was investigated. Onions were pressed in a mechanical juicer and separated to give onion juice (60 wt.%) and onion residues (40 wt.%). The juice was converted to onion vinegar by a two-step fermentation system. Nutritional analysis revealed that the onion vinegar contained the various minerals, amino acids and organic acids, which is expected to be a new valuable product from onions. The onion residues were then utilized as a source of composting, and found to be successfully composted within a week. Based on these investigations, it became possible to establish the scheme so that the worthless onions can be totally recycled as onion vinegar and fertilizer (compost). [Copyright &y& Elsevier]

This study aimed to evaluate the feasibility and efficacy of individualized occupational therapy (IOT) plus group occupational therapy (GOT) as standard care for cognition compared to GOT alone, and to determine which IOT component has the greatest effect on cognitive outcome in patients with schizophrenia. This study was conducted at 14 clinical sites across Japan and enrolled recently hospitalized patients with schizophrenia. The IOT consisted of motivational interview, self-monitoring, individualized visits, craft activities, individualized psychoeducation, and discharge planning. Among the 68 patients who were randomized to the GOT + IOT group (n = 34) and GOT alone group (n = 34), 67 completed the trial (GOT + IOT group, n = 34; GOT alone group, n = 33). There were significant improvements in change from baseline to post-treatment between the groups in verbal memory, working memory, verbal fluency, attention, executive function domains, and the composite score of the Brief Assessment of Cognition in Schizophrenia (BACS). The BACS composite score was significantly associated with the number of craft activity sessions. The addition of IOT to GOT has a favorable feasibility profile and efficacy for cognition in schizophrenia. Craft activity is the most effective IOT component in improving cognition. • Cognition is impaired in schizophrenia. • IOT provides individualized treatment including multiple psychosocial components. • Large multi-site randomized controlled trial of IOT for schizophrenia. • IOT is a feasible and effective add-on intervention to improve cognition. • Craft activity is the most effective IOT component for improving cognition. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to illustrate the safety and utility of the endoscopic endonasal approach (EEA) for the treatment of esthesioneuroblastomas (ENB).Methods: We retrospectively reviewed patients with a diagnosis of ENB between March 2008 and February 2016 at 10 tertiary referral hospitals in Japan, and assessed demographic data, stage of disease, surgical approach, outcomes and postoperative complications.Results: A total of 22 patients (10 males and 12 females; mean age at presentation, 49.0 years) underwent endoscopic endonasal resection of newly diagnosed ENBs. Dulguerov staging at presentation was T1, 6 patients; T2, 9 patients; T3, 5 patients; and T4, 2 patients. As surgical procedures, unilateral resection via EEA was performed in 12 patients aiming preservation of the contralateral olfactory system, and bilateral resection via EEA was done in 10 patients. Post-operative radiotherapy was done in 20 patients. Pathological margin studies revealed margin-free resections in 21 patients (95.5%). The mean period of follow-up was 44 months. Local recurrence was observed in one T2 patient 12 months after bilateral resection. All patients were alive at the last follow-up, and 21 patients showed no evidence of disease. No post-operative complications including bleeding, CSF leak and meningitis were identified. Preservation of olfactory function was achieved in 11 patients (91.7%).Conclusion: The results of the present study indicate the safety and utility of multilayer resection using EEA for treatment of ENBs. [ABSTRACT FROM AUTHOR]

• A largest cohort including 49 of NSCLC patients with pre-exiting ILD. • The clinical outcomes showed no statistical difference between ILD and Non-ILD group. • Checkpoint inhibitor pneumonitis was more frequently observed in ILD group. • NSCLC patients with ILD could be probable candidates for ICI. The efficacy of immune checkpoint inhibitors (ICIs) in non-small-cell lung cancer (NSCLC) patients with pre-existing interstitial lung disease (ILD) is unclear. Retrospective medical data from advanced or recurrent NSCLC patients who were treated with nivolumab or pembrolizumab at ten institutions in Japan between January 2016 and September 2018 were analyzed. Eligible patients were divided into two groups according to the presence of pre-existing ILD. A total of 461 NSCLC patients were enrolled, 412 without ILD (Non-ILD group) and 49 with ILD (ILD group). The response rate (RR) and disease control rate (DCR) of the ILD group were not inferior to those of the Non-ILD group [RR: 49.0 % (24/49) vs. 30.1 % (124/412), P < 0.01 and DCR: 69.4 % (34/49) vs. 51.2 % (211/412), P = 0.016, respectively]. Non-inferior outcomes were also observed with respect to progression-free survival (PFS) and overall survival (OS) (median PFS: 5.9 months vs. 3.5 months, P = 0.14 and median OS: 27.8 months vs. 25.2 months, P = 0.74 in the ILD and Non-ILD groups, respectively). Among immune-related adverse effects (irAEs), checkpoint inhibitor pneumonitis (CIP) was more frequently observed among NSCLC patients in the ILD group [30.6 % (15/49) vs. 9.5 % (39/412), P < 0.01]. The frequency of irAEs other than CIP and infusion reactions was not significantly different between the ILD group and the Non-ILD group. These results suggest that the clinical outcomes of ICIs are not significantly affected by pre-existing ILD despite the increased frequency of CIP. NSCLC patients with ILD are therefore probable candidates for ICIs. [ABSTRACT FROM AUTHOR]

Background Adjuvant therapy for colorectal cancer (CRC) in patients aged ≥75 years is supported by inadequate evidence, although such patients are increasing in number worldwide. Patients and methods We assessed the influence of age and comorbidities on the prognosis of CRC in elderly patients using pooled data by the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer. In total, 4598 patients (3304 with colon cancer and 1294 with rectal cancer) who underwent curative surgery from 2004 to 2006 were analysed with respect to age, Charlson comorbidity score (CS), tumour marker positivity, adjuvant therapy and prognosis. Results The number of patients aged <64, 65–74 and >75 years was 2007 (44%), 1614 (35%) and 977 (21%), respectively. Tumour location, tumour marker positivity, clinical stage, performance of adjuvant therapy, CS and overall survival (OS) were significantly different among these age groups ( P < 0.0001). Among patients aged ≥75 years with stage III CRC, 35% with colon cancer and 21% with rectal cancer received adjuvant therapy; these proportions were much lower than those in younger patients. Application of adjuvant therapy was dependent on the CS in patients aged ≤74 years, but not in older patients. Sex, the carcinoembryonic antigen concentration and adjuvant therapy were significantly associated with OS in elderly patients with stage III CRC. Conclusion Age and comorbidities worsened the OS of patients with CRC who underwent curative surgery. However, patients aged ≥75 years were undertreated regardless of their CS despite the possibility of OS improvement by adjuvant therapy. [ABSTRACT FROM AUTHOR]

Background: No comprehensive analysis of the pulmonary sequelae of coronavirus disease 2019 (COVID-19) in Japan based on respiratory function tests and chest computed tomography (CT) has been reported. We evaluated post-COVID-19 conditions, especially focusing on pulmonary sequelae assessed by pulmonary function tests and chest CT., Methods: For this prospective cohort study, we enrolled 1069 patients who presented pneumonia at the time of admission in 55 hospitals from February 2020 to September 2021. Disease severity was classified as moderateⅠ, moderate II, and severe, defined primarily according to the degree of respiratory failure. The data on post-COVID-19 conditions over 12 months, pulmonary function, and chest CT findings at 3 months were evaluated in this study. Additionally, the impact of COVID-19 severity on pulmonary sequelae, such as impaired diffusion capacity, restrictive pattern, and CT abnormalities, was also evaluated., Results: The most frequently reported post-COVID-19 conditions at 3 months after COVID-19 were muscle weakness, dyspnea, and fatigue (48.4%, 29.0%, and 24.7%, respectively). The frequency of symptoms gradually decreased over subsequent months. In pulmonary function tests at 3 months, the incidence of impaired diffusion capacity and restrictive pattern increased depending on disease severity. There also were differences in the presence of chest CT abnormalities at the 3 months, which was markedly correlated with the severity., Conclusion: We reported a comprehensive analysis of post-COVID-19 condition, pulmonary function, and chest CT abnormalities in Japanese patients with COVID-19. The findings of this study will serve as valuable reference data for future post-COVID-19 condition research in Japan., Competing Interests: Declaration of Competing interest The authors have no conflicts of interest., (Copyright © 2024. Published by Elsevier B.V.)

Objective: To provide an evidence-based recommendation for the management of olfactory dysfunction in accordance with the consensus reached by the Subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction in the Japanese Rhinologic Society., Methods: Seven clinical questions (CQs) regarding the management of olfactory dysfunction were formulated by the subcommittee of the Japanese Clinical Practice Guideline for olfactory dysfunction. We searched the literature published between April 1990 and September 2014 using PubMed, the Cochrane Library, and Ichushi Web databases. The main search terms were "smell disorder," "olfactory dysfunction," "olfactory loss," "olfactory disturbance," "olfactory impairments," "olfaction disorder," "smell disorder," "anosmia," "cacosmia," and "dysosmia." Based on the results of the literature review and the expert opinion of the Subcommittee, 4 levels of recommendation, from A-strongly recommended to D-not recommended, were adopted for the management of olfactory dysfunction., Results: Both oral and locally administered corticosteroids have been strongly recommended for patients with olfactory dysfunction due to chronic rhinosinusitis. Nasal steroid spray and antihistamine drugs have been moderately recommended for patients with allergic rhinitis. Although no drugs have been deemed to be truly effective for post-viral olfactory dysfunction by randomized-controlled trials (RCTs) or placebo-controlled trials, olfactory training using odorants has been reported to be effective for improving olfactory function. There is considerable evidence that olfactory testing is useful for differential diagnosis, prediction of disease progression, and early detection of cognitive decline in neurodegenerative diseases., Conclusion: The Clinical Practice Guideline has developed recommendations for the management of various aspects of olfactory dysfunction., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Anisakiasis is a parasitic disease caused primarily by Anisakis spp. larvae in Asia and in Western countries. The aim of this study was to investigate the genotype of Anisakis larvae endoscopically removed from Middle Eastern Japanese patients and to determine whether mucosal atrophy affects the risk of penetration in gastric anisakiasis., Methods: In this study, 57 larvae collected from 44 patients with anisakiasis (42 gastric and 2 colonic anisakiasis) were analyzed retrospectively. Genotyping was confirmed by restriction fragment length polymorphism (RFLP) analysis of ITS regions and by sequencing the mitochondrial small subunit (SSU) region. In the cases of gastric anisakiasis, correlation analyses were conducted between the frequency of larval penetration in normal/atrophic area and the manifestation of clinical symptoms., Results: Nearly all larvae were A. simplex seusu stricto (s.s.) (99%), and one larva displayed a hybrid genotype. The A. simplex larvae penetrated normal mucosa more frequently than atrophic area (p = 0.005). Finally, patients with normal mucosa infection were more likely to exhibit clinical symptoms than those with atrophic mucosa infection (odds ratio, 6.96; 95% confidence interval, 1.52-31.8)., Conclusions: In Japan, A. simplex s.s. is the main etiological agent of human anisakiasis and tends to penetrate normal gastric mucosa. Careful endoscopic examination of normal gastric mucosa, particularly in the greater curvature of the stomach will improve the detection of Anisakis larvae.

Background: The University of Pennsylvania Smell Identification Test (UPSIT) is a popular olfactory function test used throughout the world. In Japan, however, it is not widely used because it is written in English and some of the test odorants are unfamiliar to the Japanese population. Recently, a cross-culturally modified UPSIT was developed. This study was designed to determine if the Japanese version of the UPSIT (UPSIT-J) is effective in Japanese populations., Methods: We administered the UPSIT-J to 50 normosmic Japanese subjects and 54 Japanese patients with known olfactory dysfunction. Subjects were also administered the Japanese standard olfactory threshold test (T&T olfactometry), the Odor Stick Identification Test for Japanese (OSIT-J) and i.v. olfactometry (the Alinamin test). Test results from the UPSIT-J and subjects' opinions were compared with the standard Japanese tests of olfactory function., Results: Most subjects reported that the UPSIT-J was easy and interesting compared with OSIT-J and easier and more interesting than the T&T olfactometry and Alinamin test. Identification rates for nine of the UPSIT-J odorants were found to be <80% for normal subjects. UPSIT-J scores correlated with subjects' self-reported levels of olfactory function (r(s) = 0.85), OSIT-J score (r(s) = 0.86), recognition threshold of the T&T olfactometry (r(s) = 0.80), and Alinamin test results (r(s) = 0.38 for latency; r(s) = 0.52 for duration time)., Conclusion: Although a cultural bias was detected for some test odorants, this study indicates that the UPSIT-J is effective for use in the clinic to assess olfactory function in the Japanese population.

This report describes psychiatric occupational therapy practice and collaboration between occupational therapists and psychiatrists at Shinshu University Hospital. Collaboration with psychiatrists enables us to provide the following occupational therapy programs. (1) Individual occupational therapy approaches for patients at the early recovery stage in the psychiatric ward. (2) Psychoeducational interventions by a multi-disciplinary team (MDs, nurses, OTRs, PSWs, CPs). (3) Occupational therapy approaches used in combination with m-ECT for severe psychiatric disorders. (4) Recovery support programs for psychiatric outpatients. It is suggested that occupational therapists should collaborate with psychiatrists in order to facilitate rehabilitation services for people with psychiatric disorders.

Background: The Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM), which consists of a physiological score (PS) and an operative severity score, is useful in determining the risk profile for patients with abdominal aortic aneurysms in Western countries, but no information is available on the use of this method in Japan., Methods and Results: A retrospective cohort study involving 225 patients was performed, and the prognostic factors for morbidity and in-hospital mortality including POSSUM were investigated. The morbidity rate was 26%. On univariate analysis age, renal disease, hemoglobin, albumin, operation time, blood loss and PS were significantly different. On multivariate analysis PS was significantly different. Using receiver operating characteristic (ROC) analysis, PS had an area under the curve (AUC) of 0.712 and the best cut-off point was 18. The in-hospital mortality rate was 2.2%. On univariate analysis renal disease, albumin and PS were significantly different, and on multivariate analysis PS was significantly different. On ROC analysis PS had an AUC of 0.921 and the best cut-off point was 22., Conclusions: PS was the only independent risk factor for morbidity and in-hospital mortality. Further studies may be required to develop a risk-scoring system.

Purpose: In Japan, the incidence of venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), has been relatively low; however, the incidence has recently been increasing. Since April 2004, we have developed an original computer-linked VTE prophylaxis in order to decrease the incidence of in-hospital VTE. Our objective has been to evaluate the efficacy of the VTE prophylaxis guideline., Methods: A retrospective pre- and postintervention study was conducted (preintervention phase, n = 17 854; postintervention phase, n = 26 831). Data were obtained from the clinical records of patients who underwent vascular surgery and were screened for DVT at our institution., Results: The frequency of patients screened for DVT increased significantly from 70 (0.4%) to 209 (0.8%) after the establishment of a guideline (P < 0.001). Asymptomatic DVT patients increased from 5 (12.5%) in the control group to 33 (50.0%) in the intervention group (P < 0.0001), while symptomatic DVT events with leg swelling decreased from 29 (72.5%) to 16 (24.2%) (P < 0.0001). Furthermore, shock and massive PE events were significantly lower (from 31.3% to 0%; P < 0.05)., Conclusion: Our VTE prophylaxis guidelines are considered to be useful for the detection of asymptomatic DVT patients during hospitalization, thus leading to a significantly lower incidence of postoperative VTE.

A mass screening of subjects for prostate specific antigen (PSA) was conducted to investigate whether this method is effective in detection of early stage prostate cancer. From 2001 to 2005, 1022 patients in Yokosuka City with pathologically diagnosed prostate cancer by using prostate needle biopsy were divided into screened (S: 276 patients) and non-screened (NS: 746 patients) groups. Clinical factors (mean age, PSA at diagnosis, clinical stage, Gleason score, WHO classification, cases of radical prostatectomy) were evaluated and analyzed. Statistical significance was analyzed by Mann-Whitney's U-test. The mean age was 70.7 and 72.7 (p<0.0001) in the S group and NS group, respectively; mean PSA at diagnosis was 10.5 and 18.6 ng/ml (P=0.0139); percentage of organ-confined disease (T2b or lower clinical stage), 75 and 55 (p<0.0001); percentage of non-metastatic diseases was 92 and 77 (p<0.001) and percentage of pathologically poor-risk cancer (8 or more Gleason score) was 22 and 38 (p=0.0004), respectively. In conclusion, PSA mass screening was found useful to detect early stage prostate cancer in Yokosuka City. Further studies should be conducted to determine whether PSA mass screening will be able to decrease mortality of prostate cancer.

Since Buerger's disease was first described by Leo Buerger in 1908, many authors have discussed whether it indeed exists and, if so, is a definite clinical entity. Today, Buerger's disease is accepted as a definite vascular disease with a typical clinical picture, natural history, and histopathology; however, the diagnosis of Buerger's disease has been controversial, and the etiology of this vascular occlusive disease has remained unknown because many authors in different countries have their own criteria. Besides, patients with this disease have decreased in number even in Japan, while there has been no change in the number of arteriosclerosis obliterans patients. Currently, only one or two new patients per year are encountered at our outpatient clinic. The purpose of this review is to examine the current epidemiological, pathological, and clinical aspects of Buerger's disease in Japan based on the 222 patient files of our department between 1980 and 2000 and to discuss the pathogenesis, clinical presentation, and various treatment modalities.