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To place β-FeSi2 as a 3rd generation Kankyo (Environmentally Friendly) Semiconductor after GaAs, one should demonstrate its superior features by fabricating practical devices. One has to prepare high-quality β-FeSi2 films with (1) precisely controlled Fe/Si ratio (1:2), (2) flat and cracks-free surface, (3) pinhole-free surface and interfaces, (4) flat interfaces, (5) well-controlled electron or hole concentration with residual carrier concentration as low as ∼10 16 cm-3. One should accordingly explore novel thin film manufacturing technologies by considering specific properties of constituent Fe and Si atoms. Conventional growth methods used for III–V and II–VI compound semiconductor films are not suited for β-FeSi2. Here we summarize the current status of film preparation technologies and describe their advantages and drawbacks. To explore the possibility of β-FeSi2 for low cost and high conversion efficiency solar cells, high quality β-FeSi2 films have been formed on Si substrates by molecular beam epitaxy (MBE) and sputtering methods. The critical feature about the device structure is an optimized thin β-FeSi2 template buffer layer on Si(111) substrate. The template served as a substrate for epitaxial growth of single crystal β-FeSi2 film and restrains the Fe diffusion into Si at β-FeSi2/Si interface. For n-β-FeSi2/p-Si structure under air mass 1.5, an energy conversion efficiency of 3.7% was obtained, showing that β-FeSi2 is practically a promising semiconductor for making solar cells. [Copyright &y& Elsevier]

Introduction: Behavioral Activation (BA) is a short-term cognitive behavioral therapy modality that stimulates activities that increase patients' reinforcement experiences. Recent research verified the effect of brief BA. However, despite the short intervention time per session, BA is difficult to implement during hospitalization due to its long implementation period., Objectives: To evaluate the clinical effectiveness of a brief BA program for people with depression in an inpatient setting., Methods: This study employed a single-group pre-post design. Fifteen patients who met the inclusion criteria participated in the trial after providing oral and written informed consent. In addition to their usual care, participants received four weekly sessions administered by a nurse. The primary outcome measures included the Beck Depression Inventory (BDI-II), which indicated patients' subjective depression severity. Clinical outcomes were measured at preintervention, immediate postintervention, and one-month postintervention., Results: Fourteen participants completed the BA program and were receptive to treatment. For the primary endpoint, BDI-II, there was an improvement in scores (25.60 to 22.73 to 22.06) between the baseline, postintervention, and 1-month postassessment, but not a significant change. For EQ VAS score, there was no significant change, but there was an improvement in EQ VAS score (51.53 to 52.20 to 55.13) between the baseline, postintervention, and 1-month postassessment. The mean total Global Assessment of Functioning score increased from 40.20 to 57.00 across the pre- and postassessment points ( p  < .0001)., Conclusion: The study comprised a brief BA intervention, with results suggesting that participants could complete the program without feeling burdened. Although there was no significant improvement in the general outcome, depression levels, and other outcomes improved. Thus, while there is a need to rethink BA intervention, this program may be a practical approach to improving depression and other outcomes., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

It is known that some endangered species have persisted for thousands of years despite their very small effective population sizes and low levels of genetic polymorphisms. To understand the genetic mechanisms of long-term persistence in threatened species, we determined the whole genome sequences of akame (Lates japonicus), which has survived for a long time with extremely low genetic variations. Genome-wide heterozygosity in akame was estimated to be 3.3 to 3.4 × 10-4/bp, one of the smallest values in teleost fishes. Analysis of demographic history revealed that the effective population size in akame was around 1,000 from 30,000 years ago to the recent past. The relatively high ratio of nonsynonymous to synonymous heterozygosity in akame indicated an increased genetic load. However, a detailed analysis of genetic diversity in the akame genome revealed that multiple genomic regions, including genes involved in immunity, synaptic development, and olfactory sensory systems, have retained relatively high nucleotide polymorphisms. This implies that the akame genome has preserved the functional genetic variations by balancing selection, to avoid a reduction in viability and loss of adaptive potential. Analysis of synonymous and nonsynonymous nucleotide substitution rates has detected signs of positive selection in many akame genes, suggesting adaptive evolution to temperate waters after the speciation of akame and its close relative, barramundi (Lates calcarifer). Our results indicate that the functional genetic diversity likely contributed to the long-term persistence of this species by avoiding the harmful effects of the population size reduction., Competing Interests: Conflict of Interest The authors declare that there is no conflict of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of Society for Molecular Biology and Evolution.)

Background: Cognitive therapy for social anxiety disorder (CT-SAD) has extensive empirical support and is recommended in several national guidelines. However, ensuring access to evidence-based psychological therapies such as CT-SAD remains a global challenge. An internet-delivered version of this treatment protocol (iCT-SAD) has recently been developed in the UK as a way to overcome this challenge, demonstrating comparable outcomes to face-to-face CT-SAD whilst requiring less therapist time per client. Initial findings also suggest its cross-cultural transferability, but the previous studies in other cultural settings used the English language programme and only included English-fluent participants as a second language. It is not yet known what outcomes can be achieved once the programme has been translated and adapted for a different cultural context. Therefore, this trial aims to evaluate the clinical efficacy of Japanese iCT-SAD when combined with treatment as usual (TAU) in clients with SAD., Methods: This two-arm, parallel-group, superiority randomised controlled trial will recruit 60 Japanese participants with SAD, randomly assigning them to either Japanese iCT-SAD + TAU or TAU alone at a ratio of 1:1. The primary outcome measure is the self-report Liebowitz Social Anxiety Scale, and secondary.outcomes include other measures of social anxiety symptoms and processes, general mood and functioning, and response to treatment. We will also assess treatment acceptability and gather participant feedback. Assessments will take place at baseline (week 0), mid-treatment (week 8), and post-treatment (week 15), with a further 3-month follow-up (week 27) for the iCT-SAD + TAU arm. The primary analyses will be conducted on an intent-to-treat basis, comparing the primary and secondary outcome measures between groups using linear mixed-effect models, along with additional mediation analysis., Discussion: Investigating the efficacy of translated and culturally adapted iCT-SAD in different cultural contexts is an important step in evaluating the global reach of internet interventions. This trial will provide valuable insights into the effects of iCT-SAD combined with usual care, and how this treatment could be delivered in routine clinical settings in Japan., Trial Registration: International Standard Randomized Controlled Trials (ISRCTN), ISRCTN82859645, registered on January 19, 2024. UMIN Clinical Trials Registry (UMIN-CTR), UMIN000052702, registered on November 6, 2023., (© 2024. The Author(s).)

The importance of nurses integrating effective psychological techniques into their clinical practice is widely recognized. Nevertheless, further evidence from real-world settings is needed to establish nurse-led cognitive behavioural therapy (CBT) as an effective approach in clinical practice. This study aimed to examine the clinical effectiveness and predictors of individual CBT for mental disorders delivered by nurses in various routine clinical settings. This pragmatic retrospective cohort study collected data from participants who received nurse-led individual CBT at four institutions from different prefectures in Japan between April 2015 and March 2023. During the study period, 280 clients were referred to nurses for CBT, 240 of whom received nurse-led individual CBT of at least one session. The common primary diagnoses among participants were major depressive disorder (33.8%), social phobia (12.9%), and obsessive-compulsive disorder (10.0%). Of these, 23 participants were ongoing cases at the end of the observation period, and 217 who had completed the course of therapy or discontinued/dropped out from the therapy were included in the analysis (173 completed and 44 discontinued/dropped out (i.e., dropout rate = 20.3%)). Based on the clinical significance definition (primary outcome), 62.4% of the participants who completed the therapy were judged to demonstrate positive clinical significance (recovered or improved), with only a few participants (6.9%) demonstrating deterioration. Significant improvements were observed before and after nurse-led individual CBT across all secondary outcomes, including depression and anxiety symptoms, health-related quality of life, and functional disability (all ps ≤ 0.001). Univariate logistic regression revealed that clients with higher baseline severity of depression and anxiety symptoms were less likely to achieve positive clinical significance following nurse-led individual CBT. The real-world evidence gained through this study will encourage frontline nurses and motivate institutional/organizational leaders and policymakers to employ nurse-led individual CBT, especially for depression and anxiety-related disorders.

Strengths-Based Nursing and Healthcare (SBNH) has garnered attention in the field of psychiatric nursing in Japan, yet its adoption in other nursing sectors remains limited. Japan is currently facing the formidable challenge of a rapidly aging population and growing demand for healthcare and welfare services. To address these issues, a shift from hospital-based care to comprehensive community care is underway, underscoring the importance of nurses in community settings, where focusing on client strengths is essential. Therefore, this paper aims to present research and practical examples to advocate for the broader dissemination of SBNH in Japan., (Copyright © 2024 Longwoods Publishing.)

Introduction: The Nepean Beliefs Scale by Brakoulias et al. is an interview-based multidimensional instrument that measures pathological beliefs in various psychiatric disorders. This study examined the reliability and validity of Nepean Beliefs Scale (NBS) for delusions and overvalued ideas in patients with chronic-phase schizophrenia. Methods: Multiple raters at two healthcare settings examined the beliefs of 28 individuals with schizophrenia using the NBS. Concurrently, PANSS, PDI-21, BCIS, PHQ-9 and GAD-7 were administered., Results: The NBS had high reliability and correlation with relevant scales., Discussion: The NBS was found to have sufficient reliability and validity for assessing the pathological beliefs of patients with chronic schizophrenia. Although NBS is an easy-to-instruct instrument, it should be noted that appropriate explanations and examples should be added to instructions to obtain reliable responses from patients with chronic schizophrenia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ishigaki, Shimada, Tanoue, Yoshinaga, Nishiguchi, Ishikawa and Hosono.)

Background: Internet-delivered cognitive therapy for social anxiety disorder (iCT-SAD), which is a therapist-guided modular web-based treatment, has shown strong efficacy and acceptability in English-language randomized controlled trials in the United Kingdom and Hong Kong. However, it is not yet known whether iCT-SAD can retain its efficacy following linguistic translation and cultural adaptation of treatment contents and implementation in other countries such as Japan., Objective: This study aimed to examine the preliminary efficacy and acceptability of the translated and culturally adapted iCT-SAD in Japanese clinical settings., Methods: This multicenter, single-arm trial recruited 15 participants with social anxiety disorder. At the time of recruitment, participants were receiving usual psychiatric care but had not shown improvement in their social anxiety and required additional treatment. iCT-SAD was provided in combination with usual psychiatric care for 14 weeks (treatment phase) and for a subsequent 3-month follow-up phase that included up to 3 booster sessions. The primary outcome measure was the self-report version of the Liebowitz Social Anxiety Scale. The secondary outcome measures examined social anxiety-related psychological processes, taijin kyofusho (the fear of offending others), depression, generalized anxiety, and general functioning. The assessment points for the outcome measures were baseline (week 0), midtreatment (week 8), posttreatment (week 15; primary assessment point), and follow-up (week 26). Acceptability was measured using the dropout rate from the treatment, the level of engagement with the program (the rate of module completion), and participants' feedback about their experience with the iCT-SAD., Results: Evaluation of the outcome measures data showed that iCT-SAD led to significant improvements in social anxiety symptoms during the treatment phase (P<.001; Cohen d=3.66), and these improvements were maintained during the follow-up phase. Similar results were observed for the secondary outcome measures. At the end of the treatment phase, 80% (12/15) of participants demonstrated reliable improvement, and 60% (9/15) of participants demonstrated remission from social anxiety. Moreover, 7% (1/15) of participants dropped out during treatment, and 7% (1/15) of participants declined to undergo the follow-up phase after completing the treatment. No serious adverse events occurred. On average, participants completed 94% of the modules released to them. Participant feedback was positive and highlighted areas of strength in treatment, and it included further suggestions to improve suitability for Japanese settings., Conclusions: Translated and culturally adapted iCT-SAD demonstrated promising initial efficacy and acceptability for Japanese clients with social anxiety disorder. A randomized controlled trial is required to examine this more robustly., (©Naoki Yoshinaga, Graham R Thew, Yuta Hayashi, Jun Matsuoka, Hiroki Tanoue, Rieko Takanashi, Mutsumi Araki, Yoshihiro Kanai, Alisha Smith, Sophie H L Grant, David M Clark. Originally published in JMIR Formative Research (https://formative.jmir.org), 05.05.2023.)

Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and mild encephalopathy associated with excitotoxicity (MEEX) are the most frequent acute encephalopathies in pediatric patients in Japan. AESD typically presents with biphasic seizures and delayed reduced diffusion in the subcortical area, called bright tree appearance (BTA), on radiological examination. In patients with AESD, arterial spin labeling (ASL) shows decreased cerebral blood flow (CBF) in the hyperacute stage and increased CBF in the acute stage, suggesting the usefulness of ASL for the early diagnosis of AESD. Additionally, proton magnetic resonance spectroscopy (MRS) shows elevated glutamate (Glu) and glutamine (Gln) in AESD. MEEX is a group of mild encephalopathies with transient elevation of Gln on MRS similar to that in AESD; however, MEEX does not include any clinical biphasic course or abnormalities, including BTA on diffusion-weighted imaging. Although the usefulness of ASL for AESD has been reported, there are no reports for patients with MEEX. In this study, we report our experience with a 4-year-old girl diagnosed with MEEX who showed unique findings on ASL., Case Presentation: The patient was a 4-year-old girl admitted to the emergency room with febrile status epilepticus. Considering the possibility of AESD, vitamin therapy was initiated. ASL-MR imaging (MRI) of the brain performed on the second day showed increased blood flow in the frontal, temporal, and occipital regions with spared central sulcus, which indicated AESD with central sparing. The patient was diagnosed with AESD, and the treatment included pulse steroid therapy and immunoglobulin therapy from day 3. The patient remained mildly unconscious but gradually became conscious by day 7 with no seizures. Brain MRI performed on day 8 did not show any characteristic AESD findings, such as BTA. Furthermore, MRS showed elevated Gln, which, along with the clinical course, led to the diagnosis of MEEX. The patient was discharged on day 16 without obvious sequelae., Conclusions: ASL may be useful in the early diagnosis of MEEX as well as AESD, facilitating early intervention., (© 2022. The Author(s).)

This study aimed to investigate the clinical effectiveness of nurse-led cognitive/behavioral therapy (CBT) in Japanese routine outpatient care. We retrospectively collected data from 100 cases with mental disorders who had received nurse-led CBT. Results demonstrated that CBT provided by nurses led to significant improvements in quality of life and other clinical outcomes during the intervention period (all p < 0.001). Among participants who received optional follow-up, these improvements were well-maintained. This real-world evidence of nurse-led CBT bridges the research-practice gap, and will encourage frontline nurses and motivate institutional/organizational leaders, academic/professional societies, and policymakers to employ empirically-supported psychotherapeutic techniques in routine nursing care., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To retrospectively review the efficacy of combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate as treatment for dogs with degenerative lumbosacral stenosis (DLSS)., Animals: 21 client owned dogs diagnosed with DLSS and treated surgically., Procedures: Based on clinical records, signalments, clinical signs, findings from orthopedic and neurological examinations, imaging findings, and postoperative complications were evaluated at the following time points: preoperatively, postoperatively, and 3, 6, 12, 24, and 36 months after surgery., Results: In all 21 cases, clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period. Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%). There was no case with major complications., Clinical Relevance: Combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate is a useful treatment that can improve long-term clinical signs in dogs with DLSS.

Introduction: Despite the recent global mental health movement of the transition from hospital-centred to integrated community-based services, comprehensive evidence of psychosocial interventions focusing on community-dwelling individuals with schizophrenia is still lacking. To overcome this gap in the current knowledge, we will conduct a systematic review and meta-analysis to assess the efficacy of all types of psychosocial interventions for community-dwelling (non-hospitalised) individuals with schizophrenia when compared with non-active control conditions (eg, treatment as usual)., Methods and Analysis: This study protocol has been developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. By March 2022, the following sources will have been searched, without restrictions for language or publication period: Embase, PubMed, PsycINFO, CINAHL, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. We will also try to identify other potentially eligible studies by searching the reference lists of included studies, other relevant systematic reviews and grey literature. All relevant randomised controlled trials from both high-income and low-income to middle-income countries will be allowed. Two independent reviewers will conduct the selection/screening of studies, data extraction and methodological quality assessment of included studies. The primary outcomes are quality of life and psychiatric hospital admission. Standard pairwise meta-analyses with a random-effects model will be conducted. Subgroup and sensitivity analyses will be performed to assess the robustness of the findings. Risk of bias will be assessed with the Revised Cochrane Risk-of-Bias Tool for Randomised Trials. The Grades of Recommendation Assessment, Development and Evaluation approach will be used to assess the quality of evidence., Ethics and Dissemination: Ethics approval is not required for this study. The study findings will be disseminated through conference presentations as well as peer-reviewed publications., Prospero Registration Number: CRD42021266187., Competing Interests: Competing interests: HI has received consulting fees from Mitsubishi-Tanabe Pharma; honoraria for lectures from Mochida Pharmaceutical, Otsuka Pharmaceutical and Kyowa Pharmaceutical. TG has received honorarium for writing from Igaku-Shoin. AT has received honoraria for lectures from Mitsubishi-Tanabe Pharma, Sumitomo Dainippon Pharma and Otsuka Pharmaceutical. HS has received honoraria for lectures/presentations from Pfizer, Sanofi, Alexion Pharmaceuticals, Novo Nordisk Pharma, Sumitomo Dainippon Pharma, JCR Pharmaceuticals, Miyazaki City and Country Medical Association, Children’s Cancer Association of Japan and Miyazaki Health Promotion Association; payment for expert testimony from Kyushu Conference for School Physical Examination, Miyazaki City and Country Medical Association and Miyazaki Prefectural Health Foundation; he is a leader of Committee for Growth Charts at School of Miyazaki City and Country Medical Association and Specialist Committee on Newborn Screening Tests of Miyazaki Prefectural Health Foundation. YI has received contracts from Tsumura; honoraria for lectures from Otsuka Pharmaceutical, Sumitomo Dainippon Pharma, Meiji Seika Pharma, Tsumura, Yoshitomiyakuhin Corporation, Takeda Pharmaceutical, Eisai, Mochida Pharmaceutical, Kyowa Kirin, MSD and Towa Pharmaceutical. NY has received a book royalty from Medical Friend; honoraria for lectures from Gakken Medical Support, Eisai, Meiji Seika Pharma, Mitsubishi-Tanabe Pharma and Mochida Pharmaceutical; honoraria for writings from Igaku-Shoin, Nikkei Business Publications and Maruzen Publishing; he is a Diplomate of the Academy of Cognitive and Behavioral Therapies, Secretary Board Member of the Japanese Association for Cognitive Therapy and Member of the Japan Clinical Guideline Development Group for Anxiety Disorders and Obsessive-Compulsive Disorder., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

[Purpose] Limited studies exist on the impact of sustained work at a visual display terminal (VDT) on the position and motion of the pelvis and lumbar spine. We evaluated the changes in movement of the lumbar column and pelvis during VDT work. [Participants and Methods] We evaluated the sitting posture of 20 healthy adults while they performed VDT work. The effects of the sitting posture on lumbo-pelvic position and motion were captured using a three-dimensional accelerometer. Between-posture effects of VDT work were evaluated using an analysis of variance (ANOVA). A two-way ANOVA was used to assess the root mean square (RMS) values of the 80-min VDT work period for each posture. A one-way ANOVA was used to evaluate pre- and post-work changes in RMS values during the finger floor distance test (FFD). [Results] People in the dynamic sitting balance chair (DSBC)-based posture demonstrated significantly higher pelvic RMS values than those in reclining and upright sitting postures. The DSBC-based posture was also associated with significantly higher pre- and post-work lumbar and pelvic RMS values during the FFD than in the reclining and upright sitting postures. [Conclusion] The dynamic balance chair may be an effective method of establishing a pattern of spinal exercise during prolonged sitting., Competing Interests: The authors state there are no conflicts of interest to declare., (2021©by the Society of Physical Therapy Science. Published by IPEC Inc.)

Aim: To evaluate the clinical effectiveness of metacognitive training (MCT) as a transdiagnostic program, on a diverse population with mental disorders in routine Japanese day-care settings., Methods: This study employed a prospective, multicenter, single-group pre-post design. Participants diagnosed with various mental disorders received 10 MCT group sessions. We set transdiagnostic outcomes to assess quality of life, global functioning, cognitive insight, and depressive symptoms. At the end of the MCT, we also evaluated participants' satisfaction with treatment. Assessments were conducted at baseline (Pre), Week 5 (Mid), Week 10 (Post), and Week 14 (follow-up: FU)., Results: Thirty-four participants enrolled in the study and received MCT (schizophrenia = 22, non-schizophrenia = 12). Intent-to-treat analyses revealed significant improvements in quality of life/global functioning during the intervention period, and further improvements were observed during the follow-up (all p < .05). The Pre-FU treatment effect sizes for quality of life and global functioning were small (Hedge's g = 0.44 and 0.47, respectively). Significant improvements were also found in depressive symptoms during both the intervention and follow-up periods (all p < .05), but not in cognitive insight. Overall, participants were highly satisfied with the MCT content and format. Scores on almost all outcomes (except for depression) at each assessment point were not significantly different between the schizophrenic and non-schizophrenic sub-groups., Conclusions: Despite several limitations, mainly due to small sample size and having no control conditions, our results suggest that MCT for a diverse population with mental disorders is a potentially effective approach in improving quality of life/global functioning and other clinical outcomes in routine day-care settings., (© 2020 Japan Academy of Nursing Science.)

Objectives: To clarify the dissemination status of cognitive behavioural therapy (CBT) in Japan under the national health insurance scheme., Design: Retrospective observational study., Setting: National Database of Health Insurance Claims and Specific Health Checkups of Japan., Participants: Patients who received CBT under the national health insurance scheme from fiscal years (FY) 2010 to 2015., Primary and Secondary Outcome Measures: We estimated the change rate and the standardised claim ratio (SCR) for the number of patients receiving CBT and analysed the association between the CBT status and several regional factors., Results: We found that (a) a total of 60 304 patients received CBT during the study period; (b) the number of patients receiving CBT was highest in the first year (-1.8% from FY2010 to FY2015); (c) the number of patients who received CBT per 100 000 population decreased (or remained at zero) in most prefectures (32 out of 47); (d) there was a maximum 424.7-fold difference between prefectures in the standardised claim ratio for CBT and (e) the number of registered CBT institutions was significantly associated with the number of patients who received CBT., Conclusions: The provision of CBT did not increase in the first 6 years (FY2010-2015) after its coverage in Japan's national health insurance scheme. Further studies including a questionnaire survey of registered CBT institutions are required to get more detailed information on the dissemination of CBT in Japan., Competing Interests: Competing interests: NY has received a speaking honorarium from Gakken Medical Support, and writing honoraria from Igaku Shoin, Nihon-Hyouronsha, Sogensha, and Medical Friend. The other authors declare that they have no conflicts of interest., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To investigate the effects of intervertebral distraction screw (IDS) fixation of the lumbosacral joint (LSJ) on the intervertebral foraminal area (IFA) and intervertebral stabilization of the LSJ and adjacent lumbar segments in dogs., Animals: 7 healthy Beagles., Procedures: Dorsal laminectomy was performed at the LSJ in each dog to expose the intervertebral disk. The IDS was then inserted into the L7-S1 disk. Computed tomography was performed before and after laminectomy and after IDS insertion (intact, laminectomy, and IDS conditions, respectively) to measure the intervertebral range of motion (ROM) and intervertebral distance (ID) at L7-S1, L6-7, and L5-6 with the LSJ in a flexed and extended position. The intervertebral foramina stenosis rate was calculated from the intervertebral foramina area in entrance, middle, and exit zones. Results were compared among conditions., Results: The ROM at L7-S1 after IDS insertion was lower than that observed before and after laminectomy; no other differences were identified among conditions. With the LSJ in the flexed position, the ID at L7-S1 was larger after IDS insertion than before and after laminectomy; no other differences in ID were identified. In all evaluated zones, the stenosis rate was lower after IDS insertion than before and after laminectomy. No differences in ROM, ID, and stenosis rate were identified among conditions at L6-7 or L5-6., Conclusions and Clinical Relevance: Results suggested that IDS fixation of the LSJ restricted lumbosacral ROM and prevented decreases in lumbosacral ID and IFA in healthy dogs. There were no changes at L6-7 and L5-6.

This study investigated the efficacy of 10-module metacognitive training (MCT) among Japanese patients with schizophrenia by conducting a multicenter randomized controlled trial to test the influence of the most recent and extended version of MCT on positive symptoms. A six-center, randomized, assessor-blind, controlled trial between "treatment as usual" (TAU) and TAU + MCT was conducted. Fifty inpatients and outpatients with schizophrenia, schizotypal, and delusional disorders (ICD 10) were enrolled, then randomly assigned to TAU (n = 26) or TAU + MCT (n = 24). Assessments were made at baseline, after six weeks, immediately posttreatment, and 1-month post-treatment. The primary outcome was positive symptom score, as measured by the Positive and Negative Syndrome Scale (PANSS). General assessment of functioning (GAF) and measures of cognitive biases were secondary outcomes. Completion at post-treatment (10 weeks later) and 1-month follow-up was high-TAU + MCT, n = 22 (91.67%) and TAU, n = 23 (88.46%). The severity of PANSS positive symptoms declined significantly in the TAU + MCT treatment group compared with the TAU group. GAF also showed significantly greater improvement in the TAU + MCT group compared with the TAU group. There was also a trend for greater efficacy of MCT on cognitive biases. In conclusion, this study provides support for the efficacy of 10 module MCT concerning positive symptomatology (especially, delusion) and general functioning., Competing Interests: Declaration of competing interest None., (Copyright © 2019 Elsevier B.V. All rights reserved.)

SP7/Osterix (OSX) is a master regulatory transcription factor that activates a variety of genes during differentiation of osteoblasts. However, the influence of post-translational modifications on the regulation of its transactivation activity is largely unknown. Here, we report that sirtuins, which are NAD(+)-dependent deacylases, regulate lysine deacylation-mediated transactivation of OSX. Germline Sirt7 knockout mice develop severe osteopenia characterized by decreased bone formation and an increase of osteoclasts. Similarly, osteoblast-specific Sirt7 knockout mice showed attenuated bone formation. Interaction of SIRT7 with OSX leads to the activation of transactivation by OSX without altering its protein expression. Deacylation of lysine (K) 368 in the C-terminal region of OSX by SIRT7 promote its N-terminal transactivation activity. In addition, SIRT7-mediated deacylation of K368 also facilitates depropionylation of OSX by SIRT1, thereby increasing OSX transactivation activity. In conclusion, our findings suggest that SIRT7 has a critical role in bone formation by regulating acylation of OSX.

A highly dense polymer brush was previously fabricated by the spontaneous segregation of amphiphilic diblock copolymers in an elastomer matrix into water and a hydrophobic polymer interface and named a 'dynamic polymer brush'. We fabricated a lower critical solution temperature (LCST)-type thermoresponsive dynamic polymer brush by mixing polyisoprene-b-poly[tri(ethylene glycol)methyl ether methacrylate] (PI-b-PME3MA) into a polystyrene-b-polyisoprene-b-polystyrene (SIS) elastomer. The LCST of PME3MA in water is 52 °C. The structure of the polymer brush was determined at several different temperatures using neutron reflectivity. With increasing temperature, the brush thickness of the LCST-type thermoresponsive dynamic polymer brush decreases, similar to the conventional fixed brush with the LCST-type thermoresponse. However, the graft density of the dynamic polymer brush surprisingly increases with increasing temperature. The change of the brush density of the conventional fixed polymer brush is not allowed. However, we observed for the first time that dynamic polymer brushes uniquely respond to increasing temperature with increasing brush densities.

Objectives: The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide. Since April 2016, Japanese national health insurance has covered nurse-administered cognitive behavioral therapy (CBT) for mood disorders. However, empirical support for nurse-led CBT for depression in Asian countries, especially in Japan, is still lacking. This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression., Methods: In this single-arm study, we evaluated the effects of a 6-week group CBT, led by trained nurses, on patients with major depression. The primary outcome was the Beck Depression Inventory-II (BDI-II). Assessments were conducted at the beginning and end of the intervention., Results: Of 25 participants screened, 23 were eligible for the study (of these, three dropped out during the trial but were included in the analysis). Nurse-led group CBT led to significant improvements in the severity of depression (BDI-II, P  < 0.001). The mean total BDI-II score improved from 23.1 ( SD  = 7.56) to 12.4 ( SD  = 8.57), and the pre-to post-effect size was large (Cohen's d  = 1.33). After CBT, 45% of the participants were judged to be treatment responders, and 34% met the remission criteria., Conclusions: Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting. The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice. Further controlled trials that address the limitations of this study are required.

The tumor microenvironment promotes epigenetic changes in tumor cells associated with tumor aggressiveness. Here we report that in primary tumor cells, increased interleukin-6 (IL-6) expression brought on by DNA demethylation of its promoter by ten-eleven translocation 2 (TET2) promotes lung metastasis in osteosarcoma (OS). Xenograft experiments show increased IL-6 expression and decreased methylation of its promoter in OS cells after implantation relative to before implantation. In addition, changes in IL-6 methylation and expression seen in OS cells at the primary site were maintained at the metastatic site. TET2 knockdown in OS cells suppressed upregulation of IL-6 and demethylation of its promoter in xenograft tumors and decreased tumor metastasis. We also present evidence showing that tumor cell-derived IL-6 facilitates glycolytic metabolism in tumor cells by activating the MEK/ERK1/2/hypoxia-inducible transcription factor-1α (HIF-1α) pathway and increases lung colonization by OS cells by upregulating expression of intercellular adhesion molecule-1 (ICAM-1), enhancing tumor metastasis. Blocking IL-6 signaling with a humanized monoclonal antibody against the IL-6 receptor reduced lung metastasis and prolonged survival of xenografted mice. These findings suggest that TET2-dependent IL-6 induction enables acquisition of aggressive phenotypes in OS cells via the tumor microenvironment and that blocking IL-6 signaling could be serve as a potential therapy to antagonize metastasis.

Sirtuins (SIRT1-7) are NAD + -dependent deacetylase/deacylases that regulate a wide variety of biological functions. Although the roles of sirtuins in cartilage homeostasis and cartilage diseases have been well studied, there is no information on the contribution of SIRT7 to cartilage homeostasis and osteoarthritis (OA) pathologies. Here, we demonstrate that Sirt7 knockout mice are resistant to the development of aging-associated OA and forced exercise-induced OA. Attenuation of Sirt7 in the murine chondrogenic cell line ATDC5 increased the deposition of a glycosaminoglycan-rich extracellular matrix and the mRNA expression of extracellular matrix components such as Col2a1 and Acan. Mechanistically, we found that SIRT7 suppressed the transcriptional activity of SOX9, which is an important transcription factor in chondrocytes, and that the enzymatic activity of SIRT7 was required for its function. Our results indicate that SIRT7 is a novel important regulator of cartilage homeostasis and OA development., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objective: Chondrocyte differentiation is crucial for long bone growth. Many cartilage extracellular matrix (ECM) proteins reportedly contribute to chondrocyte differentiation, indicating that mechanisms underlying chondrocyte differentiation are likely more complex than previously appreciated. Angiopoietin-like protein 2 (ANGPTL2) is a secreted factor normally abundantly produced in mesenchymal lineage cells such as adipocytes and fibroblasts, but its loss contributes to the pathogenesis of lifestyle- or aging-related diseases. However, the function of ANGPTL2 in chondrocytes, which are also differentiated from mesenchymal stem cells, remains unclear. Here, we investigate whether ANGPTL2 is expressed in or functions in chondrocytes., Methods: First, we evaluated Angptl2 expression during chondrocyte differentiation using chondrogenic ATDC5 cells and wild-type epiphyseal cartilage of newborn mice. We next assessed ANGPTL2 function in chondrogenic differentiation and associated signaling using Angptl2 knockdown ATDC5 cells and Angptl2 knockout mice., Results: ANGPTL2 is expressed in chondrocytes, particularly those located in resting and proliferative zones, and accumulates in ECM surrounding chondrocytes. Interestingly, long bone growth was retarded in Angptl2 knockout mice from neonatal to adult stages via attenuation of chondrocyte differentiation. Both in vivo and in vitro experiments show that changes in ANGPTL2 expression can also alter p38 mitogen-activated protein kinase (MAPK) activity mediated by integrin α5β1., Conclusion: ANGPTL2 contributes to chondrocyte differentiation and subsequent endochondral ossification through α5β1 integrin and p38 MAPK signaling during bone growth. Our findings provide insight into molecular mechanisms governing communication between chondrocytes and surrounding ECM components in bone growth activities., (Copyright © 2017. Published by Elsevier Ltd.)

Aim: To evaluate the long-term effectiveness of modified brief assertiveness training (with cognitive techniques) for nurses., Background: Most assertiveness training takes a long time to conduct; thus, briefer training is required for universal on-the-job training in the workplace., Methods: In this single-group study, nurses received two 90-min training sessions with a 1-month interval between sessions. The degree of assertiveness was assessed by using the Rathus Assertiveness Schedule as the primary outcome, at four time points: pre- and post-training, 3-month follow-up and 6-month follow-up., Results: A total of 33 nurses received the training, and the mean Rathus Assertiveness Schedule score improved from -14.2 (SD = 16.5) pre-training to -10.5 (SD = 18.0) post-training (p < .05). These improvements were maintained until the 6-month follow-up. The pre-post effect size of 0.22 (indicating small effect) was larger than the effect sizes ranging from -0.56 to 0.17 (no effect) reported in previous studies that used brief training., Conclusions: Modified brief assertiveness training seems feasible and may achieve long-term favourable outcomes in improving assertiveness among nurses., Implications for Nursing Management: The ease of implementation of assertiveness training is important because creating an open environment for communication leads to improved job satisfaction, improved nursing care and increased patient safety., (© 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.)

Background: Effective communication has a great impact on nurses' job satisfaction, team relationships, as well as patient care/safety. Previous studies have highlighted the various beneficial effects of enhancing communication through assertiveness training programs for nurses. However, most programs take a long time to implement; thus, briefer programs are urgently required for universal on-the-job-training in the workplace. The purpose of this feasibility study was to develop and evaluate a modified brief assertiveness training program (with cognitive techniques) for nurses in the workplace., Methods: This study was carried out as a single-group, open trial (pre-post comparison without a control group). Registered nurses and assistant nurses, working at two private psychiatric hospitals in Miyazaki Prefecture in Japan, were recruited. After enrolling in the study, participants received a program of two 90-min sessions with a 1-month interval between sessions. The primary outcome was the Rathus Assertiveness Schedule (RAS), with secondary measurements using the Brief Version of the Fear of Negative Evaluation Scale (BFNE) and the Brief Job Stress Questionnaire (BJSQ). Assessments were conducted at baseline and after a 1-month interval (pre- and post-intervention)., Results: A total of 22 participants enrolled in the study and completed the program. The mean total score on the primary outcome (RAS) significantly improved from -12.9 (SD = 17.2) to -8.6 (SD = 18.6) ( p  = 0.01). The within-group effect size at the post-intervention was Cohen's d = 0.24; this corresponds to the small effect of the program. Regarding secondary outcomes, there were no statistically significant effects on the BFNE or any of the BJSQ subscales (job-stressors, psychological distress, physical distress, worksite support, and satisfaction)., Conclusions: This single-group feasibility study demonstrated that our modified brief assertiveness training for nurses seems feasible and may achieve a favorable outcome in improving their assertiveness. Further controlled trials with longer follow-up periods are required in order to address the limitations of this study.

Background: We analyzed muscular activity for different computer mouse positions during the completion of a timed computer task and determined whether the different mouse positions could affect muscular activity, productivity and perceived fatigue., Methods: The subjects were nine healthy young men. Two mouse positions were studied: the distal position (DP), with the forearm rested on the desk; the proximal position (PP), with only the wrist rested on the desk. The subjects performed a 16-min task in each position. Surface electromyography data were recorded for the upper back and shoulder muscles. Work productivity and muscular activity were measured for each mouse position. A visual analog scale was used to assess subjective fatigue., Results: Muscular activity was higher in muscle (m.) deltoideus (posterior) for the DP, while it was significantly higher in m. inferior infraspinatus for the PP. The visual analog scale score was significantly higher and work productivity was lower in the PP., Conclusions: We found that using a mouse in the DP rather than the PP leads to less activity of the external rotators, less perceived fatigue and more productivity. This suggests that the DP is preferable to the PP for computer work involving a mouse.

Polymer brush formation kinetics was measured by quartz crystal microbalance (QCM). In the QCM measurement anomalous complex frequency shift as a function of graft density was observed: dissipation rate shift ΔΓ first increased, showed a peak, and then decreased despite the graft density of the polymer brush was increasing monotonically. We calculated the shear modulus of the brush layer from the measured complex frequency shift and revealed that the peak of ΔΓ described the crossover from a viscous brush layer to elastic brush layer. The crossover for the poly(ethylene glycol) with a molecular weight of 2000 occurs at around the characteristic graft density of 0.17 chains/nm 2 which was revealed from the structure analysis by surface plasmon resonance (SPR) and neutron reflectivity (NR).

Macrophages play crucial roles in combatting infectious disease by promoting inflammation and phagocytosis. Angiopoietin-like protein 2 (ANGPTL2) is a secreted factor that induces tissue inflammation by attracting and activating macrophages to produce inflammatory cytokines in chronic inflammation-associated diseases such as obesity-associated metabolic syndrome, atherosclerosis, and rheumatoid arthritis. Here, we asked whether and how ANGPTL2 activates macrophages in the innate immune response. ANGPTL2 was predominantly expressed in proinflammatory mouse bone marrow-derived differentiated macrophages (GM-BMMs) following GM-CSF treatment relative to anti-inflammatory cells (M-BMMs) established by M-CSF treatment. Expression of the proinflammatory markers IL-1β, IL-12p35, and IL-12p40 significantly decreased in GM-BMMs from Angptl2-deficient compared with wild-type (WT) mice, suggestive of attenuated proinflammatory activity. We also report that ANGPTL2 inflammatory signaling is transduced through integrin α5β1 rather than through paired immunoglobulin-like receptor B. Interestingly, Angptl2-deficient mice were more susceptible to infection with Salmonella enterica serovar Typhimurium than were WT mice. Moreover, nitric oxide (NO) production by Angptl2-deficient GM-BMMs was significantly lower than in WT GM-BMMs. Collectively, our findings suggest that macrophage-derived ANGPTL2 promotes an innate immune response in those cells by enhancing proinflammatory activity and NO production required to fight infection., (© 2016 by The American Society for Biochemistry and Molecular Biology, Inc.)

[Purpose] Working while sitting for long periods can cause lumbar pain, fatigue, and reduced work efficiency. How a dynamic chair with a seat that moves three-dimensionally affects pelvic mobility before and after work, work efficiency, and post-work fatigue were examined. [Subjects and Methods] Subjects were 17 healthy adults (10 males, 7 females, mean age 21.8 ± 2.7 years). Subjects performed a 30-min Kraepelin test under two conditions: sitting in a standard office chair and sitting in a dynamic sitting balance chair. Root mean square (RMS) values of pelvic movement measured by a triaxial accelerometer during 30 minutes of work, finger-floor distance before and after work, lumbar fatigue, and pelvic movement RMS values during finger-floor distance measurement were used as outcome measures. [Results] Pelvic movement RMS values collected every 5 minutes during 30 minutes of work were significantly higher while sitting in the dynamic balance chair. Changes in pelvic movement RMS values during finger-floor distance measurement after work and amount of work performed during 30 minutes were significantly higher and lumbar fatigue was significantly lower for the dynamic balance chair. [Conclusion] Dynamic sitting maintained or increased pelvic flexibility. The dynamic balance chair may effectively help workers work continuously in seated postures with little fatigue.

Bone metastasis of breast cancer cells is a major concern, as it causes increased morbidity and mortality in patients. Bone tissue-derived CXCL12 preferentially recruits breast cancer cells expressing CXCR4 to bone metastatic sites. Thus, understanding how CXCR4 expression is regulated in breast cancer cells could suggest approaches to decrease bone metastasis of breast tumor cells. Here, we show that tumor cell-derived angiopoietin-like protein 2 (ANGPTL2) increases responsiveness of breast cancer cells to CXCL12 by promoting up-regulation of CXCR4 in those cells. In addition, we used a xenograft mouse model established by intracardiac injection of tumor cells to show that ANGPTL2 knockdown in breast cancer cells attenuates tumor cell responsiveness to CXCL12 by decreasing CXCR4 expression in those cells, thereby decreasing bone metastasis. Finally, we found that ANGPTL2 and CXCR4 expression levels within primary tumor tissues from breast cancer patients are positively correlated. We conclude that tumor cell-derived ANGPTL2 may increase bone metastasis by enhancing breast tumor cell responsiveness to CXCL12 signaling through up-regulation of tumor cell CXCR4 expression. These findings may suggest novel therapeutic approaches to treat metastatic breast cancer.

Psychiatric nurses have played a significant role in disseminating cognitive behavioral therapy (CBT) in Western countries; however, in Japan, the application, practice, efficiency, and quality control of CBT in the psychiatric nursing field are unclear. This study conducted a literature review to assess the current status of CBT practice and research in psychiatric nursing in Japan. Three English databases (MEDLINE, CINAHL, and PsycINFO) and two Japanese databases (Ichushi-Web and CiNii) were searched with predetermined keywords. Fifty-five articles met eligibility criteria: 46 case studies and 9 comparative studies. It was found that CBT took place primarily in inpatient settings and targeted schizophrenia and mood disorders. Although there were only a few comparative studies, each concluded that CBT was effective. However, CBT recipients and outcome measures were diverse, and nurses were not the only CBT practitioners in most reports. Only a few articles included the description of CBT training and supervision. This literature review clarified the current status of CBT in psychiatric nursing in Japan and identified important implications for future practice and research: performing CBT in a variety of settings and for a wide range of psychiatric disorders, conducting randomized controlled trials, and establishing pre- and postqualification training system.

Angiopoietin-like protein 2 (ANGPTL2) plays an important role in inflammatory carcinogenesis and tumor metastasis by activating tumor angiogenesis and tumor cell chemotaxis and invasiveness. However, it is unclear whether ANGPTL2 expression has an effect on tumor cell survival. Here, we explored that possibility by determining whether ANGPTL2 expression altered survival of human colorectal cancer cell lines treated with antineoplastic drugs. To do so, we generated SW480 cells expressing ANGPTL2 (SW480/ANGPTL2) and control (SW480/Ctrl) cells. Apoptosis induced by antineoplastic drug treatment was significantly decreased in SW480/ANGPTL2 compared to control cells. Expression of anti-apoptotic BCL-2 family genes was upregulated in SW480/ANGPTL2 compared to SW480/Ctrl cells. To assess signaling downstream of ANGPTL2 underlying this effect, we carried out RNA sequencing analysis of SW480/ANGPTL2 and SW480/Ctrl cells. That analysis, combined with in vitro experiments, indicated that Syk-PI3K signaling induced expression of BCL-2 family genes in SW480/ANGPTL2 cells. Furthermore, ANGPTL2 increased its own expression in a feedback loop by activating the spleen tyrosine kinase-nuclear factor of activated T cells (Syk-NFAT) pathway. Finally, we observed a correlation between higher ANGPTL2 expression in primary unresectable tumors from colorectal cancer patients who underwent chemotherapy with a lower objective response rate. These findings suggest that attenuating ANGPTL2 signaling in tumor cells may block tumor cell resistance to antineoplastic therapies., (© 2014 The Authors. Cancer Science published by Wiley Publishing Asia Pty Ltd on behalf of Japanese Cancer Association.)

Global warming effects on seaweed beds are already perceptible. Their geographical distributions greatly depend on water temperatures. To predict future geographical distributions of brown alga, Sargassum horneri, forming large beds in the northwestern Pacific, we referred to future monthly surface water temperatures at about 1.1° of longitude and 0.6° of latitude in February and August in 2050 and 2100 simulated by 12 organizations under an A2 scenario of global warming. The southern limit of S. horneri distribution is expected to keep moving northward such that it may broadly disappear from Honshu Island, the Chinese coast, and Korean Peninsula in 2100, when tropical Sargassum species such as Sargassum tenuifolium may not completely replace S. horneri. Thus, their forests in 2100 do not substitute those of S. horneri in 2000. Fishes using the beds and seaweed rafts consisting of S. horneri in East China Sea suffer these disappearances., (Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study investigated the association between task-induced stress and fatigue by examining the cardiovascular responses of subjects using different mouse positions while operating a computer under time constraints., Material and Methods: The study was participated by 16 young, healthy men and examined the use of optical mouse devices affixed to laptop computers. Two mouse positions were investigated: (1) the distal position (DP), in which the subjects place their forearms on the desk accompanied by the abduction and flexion of their shoulder joints, and (2) the proximal position (PP), in which the subjects place only their wrists on the desk without using an armrest. The subjects continued each task for 16 min. We assessed differences in several characteristics according to mouse position, including expired gas values, autonomic nerve activities (based on cardiorespiratory responses), operating efficiencies (based on word counts), and fatigue levels (based on the visual analog scale - VAS)., Results: Oxygen consumption (VO(2)), the ratio of inspiration time to respiration time (T(i)/T(total)), respiratory rate (RR), minute ventilation (VE), and the ratio of expiration to inspiration (Te/T(i)) were significantly lower when the participants were performing the task in the DP than those obtained in the PP. Tidal volume (VT), carbon dioxide output rates (VCO(2)/VE), and oxygen extraction fractions (VO(2)/VE) were significantly higher for the DP than they were for the PP. No significant difference in VAS was observed between the positions; however, as the task progressed, autonomic nerve activities were lower and operating efficiencies were significantly higher for the DP than they were for the PP., Conclusions: Our results suggest that the DP has fewer effects on cardiorespiratory functions, causes lower levels of sympathetic nerve activity and mental stress, and produces a higher total workload than the PP. This suggests that the DP is preferable to the PP when operating a computer.

Objective: To investigate the efficacy of urine alkalization therapy using citrates in patients with hypersensitive bladder syndrome., Methods: A total of 76 patients with urinary frequency were assessed for their symptoms using a 2-day voiding diary as well as the urine pH at each voiding during the screening period. Their symptoms were also assessed by pain score, King's health questionnaire, and O'Leary-Sant symptom and problem index scores. Finally, 50 patients were evaluated for changes in symptoms after oral treatment with citrates for 2-4 weeks after the screening period., Results: After the treatment, significant increases in the urine pH (from 5.8 ± 0.4 to 6.3 ± 0.4; increment of 0.5 ± 0.4; P < 0.01), and significant decreases in the number of micturitions per day (from 14.5 ± 6.5 to 13.5 ± 5.9; P = 0.02) and the number of episodes of pain/discomfort per day (from 7.8 ± 6.8 to 6.1 ± 7.1; P = 0.02) were observed. In the King's health questionnaire, the sleep/energy domain score was significantly improved (from 60.0 ± 25.0 to 50.3 ± 29.6; P < 0.01). In a subgroup analysis based on urine pH (urine pH <6.2 and ≥6.2), significant improvements in the voiding symptoms, the sleep/energy domain score and the O'Leary-Sant problem index were observed in the group with urine pH of ≥6.2. There were statistically significant differences between the subgroups in the volume per voiding, maximum volume per voiding and the problem index. In addition, the subgroup, in which patients had pain in the screening period, showed statistically significant improvements in the number of micturitions per day, episodes of pain/discomfort per day, the sleep/energy domain score and the problem index., Conclusions: Urine alkalization therapy is likely to be effective in the treatment for hypersensitive bladder syndrome., (© 2013 The Japanese Urological Association.)

Typically, conventional transrectal ultrasound (TRUS) imaging of the cancer tissue is hypoechoic in echo texture. However, TRUS does not reliably distinguish between cancerous and non-cancerous tissue in the prostate. In the present study, sound speed of prostate needle biopsy specimens were measured by ultrasound speed microscope (USM) to construct a database for interpreting clinical TRUS images. Biopsy specimens were formalin-fixed and sectioned approximately 5 µm in thickness. They were mounted on glass slides without cover slips. The ultrasonic transducer with the central frequency of 120 MHz was mechanically scanned over the specimen to measure sound speed distribution. Echo intensity of TRUS images were qualitatively classified into three categories; hyperechoic, iso-echoic and hypoechoic areas. Sound speed was 1596.9 ± 28.2 m/s in hyperechoic, 1571.2 ± 35.8 m/s in iso-echoic and 1562.6 ± 35.1 m/s in hypoechoic area, respectively. However, echo intensity showed no significant relationship to malignancy of prostatic tissue. Echo intensity of TRUS is significantly affected with tissue components and USM findings would provide important information for interpretation of TRUS images.

Ultrasound speed microscope was developed for quantitative measurement of ultrasonic parameters of soft tissues. The system can measure the ultrasonic attenuation and sound speed in the tissue using fast Fourier transform of a single pulsed wave instead of burst waves used in conventional acoustic microscopy. Prostate biopsy tissues were formalin-fixed and sectioned approximately 5-6 μm in thickness. They were mounted on glass slides without cover slips. The ultrasonic transducer was mechanically scanned over the specimen. Attenuation was 1.42 ± 0.08 dB/mm and the sound speed was 1584 ± 12 m/s in prostatic cancer while both values were 1.86 ± 0.14 dB/mm and 1614 ± 30 m/s in normal prostate. The basic measurements of ultrasonic properties would help understanding the interpretation of clinical echography in diagnosis of prostate cancer.

Objectives: Diagnosing the bladder lesions associated with interstitial cystitis/painful bladder syndrome (IC/PBS) is sometimes difficult for general urologists. We therefore aimed to develop an IC/PBS diagnosis method using a cystoscope with a narrow-band imaging (NBI) system that can detect mucosal angiogenic lesions., Methods: Fifty-two subjects suspected of having IC between October 2006 and June 2007 were included in this study. There were 49 women and three men, ranging in age from 19 through 85 with an average age of 59. First, conventional cystoscopy under spinal anesthesia was performed to examine the ulcerative lesions by a urological specialist. Then, other health care professionals made a separate observation of capillary-rich areas of the superficial layer of the bladder mucosa by cystoscopy with the NBI system., Results: Among the 52 patients, 37 cases were found to have ulcers by conventional cystoscopy, which were also recognized as capillary-rich brownish areas using the NBI system (100% accuracy); 13 cases were found to have NBI-positive areas without ulcer, which were coincided with those with petechial hemorrhages and glomerulations following subsequent hydrodistention; and two cases of normal mucosa were detected. Furthermore, six cases of bladder cancer (carcinoma in situ) were detected by biopsies that were obtained from the ulcerative lesions positively identified by NBI cystoscopy., Conclusions: Examining the urinary bladder mucosa with a flexible cystoscope with the NBI system makes it possible to easily detect ulcers of bladder mucosa and areas with angiogenesis. Therefore, it is considered that the use of a flexible cystoscope with the NBI system is highly practical for the IC/PBS diagnosis.

The Men's Outpatient Health Care Unit was established in April 2006 in Kyoto City Hospital. In this outpatient unit, medical services are provided to males of all ages and with any category of complaints. For patients' privacy, the unit is situated on a different floor from the other outpatient ward, and all-male staff handles from reservation to examination. Furthermore, each patient is given 30 minutes to provide enough time for counseling and examination. To our knowledge, this system was established for the first time in Japan. During the first one year, a total of 106 new patients visited this ward with a large variety of chief complaints : sexual dysfunction, urinary disorder, consultation for aging male, consultation for size and shape of the penis, and so forth. Over 25% of patients disinclined against visiting the conventional urological ward. Furthermore, over 25% of patients revealed that they were hesitant to see female staffs including clerks and nurses. Although more facilities in Japan are recently providing gender-specific medical services, most of them are directed to the female gender. Our experience of this health care system suggested that male-specific gender medicine should become more widespread and cover various categories of diseases.

We discovered the directly acting mutagenicity of the tobacco-specific nitrosamine, 4-(N-methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), with UVA light (320-400nm) in Ames bacteria and phage M13mp2 in the absence of metabolic activation. We have investigated the spectrum of mutations caused by UVA-activated NNK. The majority (57%) of induced sequence changes were comprised of GC to CG, GC to TA and GC to AT. This suggested that modification of guanine residues was responsible for these mutations. Hence, we explored the formation of 7,8-dihydro-8-oxo-2'-deoxyguanosine (8-oxodG) and O(6)-methylguanine (O(6)meG) in the DNA. When calf thymus DNA was treated with NNK and UVA, the amount of 8-oxodG/dG and O(6)meG/G in the DNA increased up to 20-fold and 100-fold, respectively, compared with the untreated control. DNA strand breaks were observed following NNK and UVA treatment, and the strand breaks were suppressed in the presence of scavengers for oxygen and NO radical. The formation of NO was also observed in NNK solutions irradiated with UVA. We analyzed the photodynamic spectrum of mutation induction, 8-oxodG formation and NO formation using monochromatic radiation. The patterns of the action spectra were comparable to the absorption spectrum of NNK. We conclude that NNK may act as a photosensitizer in response to UVA to produce NO and other oxidative and alkylative intermediates following the formation of 8-oxodG and O(6)meG in DNA, which may lead to mutations and DNA strand breaks.