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Abstract Background Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic. Methods This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants’ response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates. Results A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017). Conclusions This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study’s findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics. Trial registration Clinicaltrials.gov, NCT04352634.

Abstract Background This study aimed to examine whether online interactive communication education using video materials was as effective as face-to-face education among healthcare college students. Methods The participants were healthcare college students who were enrolled in study programs to obtain national medical licenses. They participated in lectures and exercises on healthcare communication, both online (n = 139) and face-to-face (n = 132). Listening skills, understanding, and confidence in healthcare communication were assessed using a self-assessed tool. Results From the two-way ANOVA result, the interaction effects between group (online, face-to-face) and time (Time 1, Time 2, Time 3) were not statistically significant. The main effect of time increased significantly from Time1 to Time 3 on understanding of communication with patients (Hedges’g = 0.51, 95%CI 0.27–0.75), confidence in communication with patients (g = 0.40, 95%CI 0.16–0.64), and confidence in clinical practice (g = 0.49, 95%CI 0.25, 0.73), while the score of listening skills had no significant change (Hedges’g = 0.09, 95%CI − 0.03 to 0.45). Conclusions The results show that online communication education with video materials and active exercises is as effective in improving students’ confidence as face-to-face. It will be necessary to modify the content of this educational program to improve skills as well as confidence in communication. Trial registration Not Applicable.

Abstract Background The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT). Methods The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden. Results Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = − 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = − 2.12, 95% CI = − 7.80 to 3.56, p = 0.45, d = 0.11). Conclusions The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden. Trial registration The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.

Abstract The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14–9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50–64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21–27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged.

Abstract Results are presented for the medium-induced, soft coherent radiation spectrum for all 2 → 2 partonic channels in QCD, at leading-order in α s but beyond leading logarithmic accuracy. The general formula is valid in the full kinematic range of the underlying process, and reduces to previous results in special cases. The soft gluon radiation spectrum is expressed in terms of the color density matrix specific to each channel, quantifying the entanglement between the color components of the 2 → 2 production amplitude. Beyond the leading logarithm, the spectrum depends explicitly on the off-diagonal elements of this matrix, owing to the soft gluon’s ability to probe the internal color structure of the parton pair.

Abstract Background Well-being is an important issue in workplace. One of these assessment tools of well-being, Workplace PERMA Profiler, is based on Seligman’s five dimensions well-being. Prolonged fatigue may last for a long time, leading a great impact on both employees and enterprises. However, rare studies about the association between well-being and fatigue had been investigated. Our aim is to establish the Chinese version Profiler, and to discovery the association between workplace well-being and fatigue. Methods The Chinese version was established according to International Society of Pharmacoeconomics and Outcomes Research (ISPOR) task force guidelines. In the study, researchers employed simple random sampling by approaching individuals undergoing health checkups or receiving workplace health services, inviting them to participate in a questionnaire-based interview. Prolonged Fatigue was evaluated by Checklist Individual Strength (CIS). The reliability was evaluated by Cronbach’s alphas, Intra-class Correlation Coefficients (ICCs), and measurement errors. Moreover, confirmatory factor analysis and correlational analyses were assessed for the validity. Results The analyses included 312 Chinese workers. Cronbach’s alphas of the Chinese version ranged from 0.69 to 0.93, while the ICC ranged from 0.70 to 0.92. The 5-factor model of confirmatory factor analysis revealed a nearly appropriate fit (χ2 (82) = 346.560, Comparative Fit Index [CFI] = 0.887, Tucker-Lewis Index [TLI] = 0.855, Root Mean Square Error of Approximation [RMSEA] = 0.114, Standardized Root Mean Square Residual [SRMR] = 0.060). Moreover, the CIS and its four dimensions were significantly and negatively associated with the Positive Emotion, while they are positively associated with Engagement dimension except CIS-Motivation dimension. Conclusion The Chinese version Workplace PERMA-Profiler indicate nice reliability and validity. Furthermore, all CIS dimensions were negatively influenced by Positive Emotion, while commonly positively associated with Engagement.

Abstract The study aimed to identify prognostic factors for patients with acute lower gastrointestinal bleeding and to develop a high-accuracy prediction tool. The analysis included 8254 cases of acute hematochezia patients who were admitted urgently based on the judgment of emergency physicians or gastroenterology consultants (from the CODE BLUE J-study). Patients were randomly assigned to a derivation cohort and a validation cohort in a 2:1 ratio using a random number table. Assuming that factors present at the time of admission are involved in mortality within 30 days of admission, and adding management factors during hospitalization to the factors at the time of admission for mortality within 1 year, prognostic factors were established. Multivariate analysis was conducted, and scores were assigned to each factor using regression coefficients, summing these to measure the score. The newly created score (CACHEXIA score) became a tool capable of measuring both mortality within 30 days (ROC-AUC 0.93) and within 1 year (C-index, 0.88). The 1-year mortality rates for patients classified as low, medium, and high risk by the CACHEXIA score were 1.0%, 13.4%, and 54.3% respectively (all P

BackgroundDuring the COVID-19 pandemic, health care professionals experienced high levels of depression. However, extant research has not highlighted effective internet-based psychological interventions to improve the mental health in this population during the pandemic. It remains unclear whether self-guided, internet-based cognitive behavioral therapy (iCBT) programs are effective in improving the mental health of health care workers during the COVID-19 pandemic. ObjectiveThe aim of this study was to evaluate the effectiveness of a smartphone-based iCBT stress management program for reducing the depression experienced by nurses in Vietnam and Thailand. MethodsFrom March to April 2022, a 2-arm, parallel-group randomized controlled trial was implemented. One arm offered a 7-week self-guided iCBT program, and the other offered treatment as usual as a control arm. Full-time nurses were recruited from 6 hospitals: 2 hospitals in Vietnam and 4 hospitals in Thailand. The primary outcome of this program was the severity of depression measured by the Depression Anxiety Stress Scale-21 items. Follow-up surveys were conducted to measure the change in depression severity at 3 months (July-August 2022) and at 6 months (October-November 2022) after baseline. Mixed modeling for repeated measures was used to test the effects of the intervention compared with the control for the follow-up. ResultsA total of 1203 nurses were included in this study: 602 in the intervention group and 601 in the control group. The follow-up rate at 3 and 6 months ranged from 85.7% (515/601) to 87.5% (527/602). The completion rate for the program was 68.1% (410/602). The group difference in depression was significant at the 3-month follow-up (coefficient=–0.92, 95% CI –1.66 to –0.18; P=.02) and nonsignificant at the 6-month follow-up (coefficient=–0.33, 95% CI –1.11 to 0.45; P=.41). The estimated effect sizes were –0.15 and –0.06 at the 3- and 6-month follow-ups, respectively. ConclusionsOur study shows that the smartphone-based iCBT program was effective in reducing depression at the 3-month follow-up among hospital nurses in Vietnam and Thailand during the COVID-19 pandemic. However, the effect size was small, and therefore, these results may not be clinically meaningful. Trial RegistrationUMIN Clinical Trials Registry UMIN000044145; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050128 International Registered Report Identifier (IRRID)RR2-10.20944/preprints202303.0450.v1

Abstract Background Depression and anxiety are the most common mental health issues experienced by workers. Although organizational intervention has been extensively evaluated as a primary prevention of depression and anxiety, the corresponding scientific evidence remains limited because of the lack of cluster randomized controlled trials (cRCT) and failure to detect organizational-level effects. Therefore, the present study aims to assess the preventive effects of four types of interventions on depression and anxiety among workers in an open, five-arm, parallel-group cRCT. Methods Overall, 140 worksites and 18,200 nested employees will be recruited from September 2023. The eligible worksites will be randomly assigned to each of the five arms, and programs will be offered for 6–12 months. The five arms are 1) psychoeducation for workers, 2) psychoeducation for supervisors, 3) work environment improvement, 4) physical activity promotion, and 5) active control. The primary outcomes of interest are depression and anxiety. We will also assess psychosocial factors at work, work engagement, health-related quality of life, well-being, economic outcomes, physiological outcomes of health checkups, cortisol levels extracted from fingernails, and indices representing the process and implementation outcomes, including program completion rates. Follow-up surveys will be conducted at 6, 12, and 18 months from baseline, and the primary endpoint is set at the 6-month follow-up. Repeated-measures multi-level mixed modeling will be used to evaluate the effect of each intervention compared with the control. Ethics and dissemination The study protocol was approved by the Research Ethics Committee of the Kitasato University Medical Ethics Organization (C22-082). The results and findings of this study will be published in a scientific journal and disseminated to companies that participate in the study. Trial registration number UMIN000050949.

Abstract Background Team-level job crafting has been put forward as a method to promote nurses' mental health. However, a longitudinal association is unclear. Therefore, the objective of this study was to investigate the association between team job crafting at baseline and work engagement, work performance, psychological distress, and intention to leave at three-month and six-month follow-ups among Japanese hospital nurses. Also, whether an increase in the team job crafting during 3 or 6 months was associated with an increase in the work engagement during 3 or 6 months of individual nurses was examined. Methods A multilevel prospective cohort study was conducted. Data were collected from nurses of five hospitals in Japan at baseline (T1) and follow-ups at 3-months (T2) and 6-months (T3). A total of 2,478 nurses were included. The team job crafting scale for nurses and its three subscales were measured for the independent variables. Ward-means were used as ward-level variables. The dependent variables were work engagement, work performance, psychological distress, and intention to leave. Hierarchical Linear Modeling (HLM) was used to examine the multilevel association. The study protocol was registered at the UMIN Clinical Trials Registry (ID = UMIN000047810) (May 22, 2022). Results A total of 460 nurses completed the T1 survey (response rate = 18.6%), and data from 391 nurses nested in 30 wards were included in the analyses. The intraclass correlation coefficients (ICCs) at T1 were 0.02 for work engagement and 0.07 for team job crafting. The HLM revealed that ward-level team job crafting at T1 was not significantly associated with work engagement, work performance, psychological distress, and intention to leave at T2 or T3. The ward-level change (T3-T1) of “crafting for the task considering the team’s growth” (subscale for team job crafting) was significantly and positively associated with the change (T3-T1) in work engagement. Conclusions Ward-level team job crafting at baseline did not predict nurses' work engagement, work performance, psychological distress, or intention to leave at a three-month or six-month follow-up. The impact of ward-level team job crafting may attenuate over several months.

ABSTRACTGround rolling delays spikelet initiation and thus would be expected to reduce frost injury in early-sown spring wheat. To characterize the relationship between the timing of rolling and the delay of spikelet initiation, we investigated apical development of early-sown spring wheat plants (Triticum aestivum L. cv. ‘Ayahikari’) rolled at the 1-, 2-, 3-, or 4-leaf stage in three years. All rollings delayed apical development. The delay was largest in plants treated at the 1- or 2-leaf stage: spikelet initiation by 5.0 days, the start of internode elongation by 5.5 days, and jointing by 3.5 days relative to the control. Our results and recent meteorological data suggest that in early cropping of spring wheat in the Tokai region of Japan, the earliest sowing date to avoid frost injury can be advanced by 3 days by rolling.

BackgroundPhysical activity effectively prevents depression and anxiety. Although mobile health (mHealth) technologies offer promising results in promoting physical activity and improving mental health, conflicting evidence exists on their effectiveness, and employees face barriers to using mHealth services. To address these problems, we recently developed a smartphone app named ASHARE to prevent depression and anxiety in the working population; it uses a deep learning model for passive monitoring of depression and anxiety from information about physical activity. ObjectiveThis study aimed to preliminarily investigate (1) the effectiveness of the developed app in improving physical activity and reducing depression and anxiety and (2) the app’s implementation outcomes (ie, its acceptability, appropriateness, feasibility, satisfaction, and potential harm). MethodsWe conducted a single-arm interventional study. From March to April 2023, employees aged ≥18 years who were not absent were recruited. The participants were asked to install and use the app for 1 month. The ideal usage of the app was for the participants to take about 5 minutes every day to open the app, check the physical activity patterns and results of an estimated score of psychological distress, and increase their physical activity. Self-reported physical activity (using the Global Physical Activity Questionnaire, version 2) and psychological distress (using the 6-item Kessler Psychological Distress Scale) were measured at baseline and after 1 month. The duration of physical activity was also recorded digitally. Paired t tests (two-tailed) and chi-square tests were performed to evaluate changes in these variables. Implementation Outcome Scales for Digital Mental Health were also measured for acceptability, appropriateness, feasibility, satisfaction, and harm. These average scores were assessed by comparing them with those reported in previous studies. ResultsThis study included 24 employees. On average, the app was used for 12.54 days (44.8% of this study’s period). After using the app, no significant change was observed in physical activity (–12.59 metabolic equivalent hours per week, P=.31) or psychological distress (–0.43 metabolic equivalent hours per week, P=.93). However, the number of participants with severe psychological distress decreased significantly (P=.01). The digitally recorded duration of physical activity increased during the intervention period (+0.60 minutes per day, P=.08). The scores for acceptability, appropriateness, and satisfaction were lower than those in previous mHealth studies, whereas those for feasibility and harm were better. ConclusionsThe ASHARE app was insufficient in promoting physical activity or improving psychological distress. At this stage, the app has many issues that are to be addressed in terms of both implementation and effectiveness. The main reason for this low effectiveness might be the poor evaluation of the implementation outcomes by app users. Improving acceptability, appropriateness, and satisfaction are identified as key issues to be addressed in future implementation. Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry UMIN000050430; https://tinyurl.com/mrx5ntcmrecptno=R000057438

Abstract Background To date, no clinical studies have investigated the relationship between positioning pain and orientation of the lateral decubitus position for hip fracture surgery. The aim of the present study was to test the hypothesis that performing spinal anesthesia in the lateral decubitus position with the fracture side up or down does not affect positioning pain in patients with a femoral neck fracture. Methods This single-center, prospective, randomized non-inferiority trial examined 78 patients who received surgery for a femoral neck fracture under spinal anesthesia. By performing spinal anesthesia in the left lateral decubitus position in all patients, the positioning of the fracture up or down was randomized. Pain score during spinal anesthesia was evaluated objectively (0, calm; 1, facial grimacing; 2, moaning; 3, screaming; or 4, unable to proceed because of restlessness or agitation). Results The data from 66 patients (fracture side down [n = 35] and up [n = 31]) were analyzed. There were no significant differences between the fracture side down and fracture side up groups regarding the percentage of patients who were assessed to have intense pain (score ≥ 3) when changing position from the supine to lateral position (13/35 [37%] vs 12/31 [39%]; 95% confidence interval [95% CI] for the difference of the percentage of patients of intense pain between the groups − 25.0 to 2.2; p = 1.000). Conclusions There were no significant differences in the percentage of patients experiencing severe pain between the two groups. The 95% CI exceeded the preliminarily set a margin of inferiority of 20%; thus, the present study could not demonstrate the non-inferiority of the fractured side down group in terms of pain score.

Abstract Background Friction irritation by wiping increases the risk of skin problems. In bed baths with cotton towels, wiping three times with weak pressure (10–20 mmHg ≈ 1333–2666 Pa) can remove dirt while maintaining skin barrier function. However, few studies have examined the appropriate frictional irritation with disposable towels. This study aimed to analyse the wiping pressure and number of wipes currently applied by nurses when using disposable towels during bed baths and propose the minimum values for removing dirt from the skin. Methods This multi-study approach consisted of cross-sectional and crossover design components. In Study 1, 101 nurses in two hospitals were observed by recording the wiping pressure and number of wipes when using both disposable (nonwoven) and cotton (woven) towels. Wiping pressure and number of wipes by towel materials were analysed using a linear mixed model. In Study 2, 50 adults received oily and aqueous dirt on their forearms, which were wiped six-times with disposable towels, applying randomly assigned pressure categories. We used colour image analysis and a linear mixed model to estimate the dirt removal rate for each combination of wiping pressure and number of wipes. Results Study 1 showed that although wiping pressure did not differ by towel material, the number of wipes was significantly higher for disposable wipes than cotton wipes. Approximately 5% of nurses applied strong wiping pressure or wiped too often. In Study 2, wiping three times with disposable towels at least 5–10 mmHg achieved dirt removal rates of ≥80%. Conclusions Some nurses excessively wiped using disposable towels, which might cause skin problems. However, excessive wiping is not required to adequately remove dirt, regardless of the towel material used in various clinical situations. We recommend wiping at 10–20 mmHg of pressure (just like stroking gently) at least three times to improve the quality of bed baths. These findings highlight the need to develop skin-friendly bed bath educational programmes, particularly using appropriate frictional irritation to reduce the risk of skin problems.

Abstract Background Cannabis is used by adolescents worldwide. Adolescents are more susceptible to the psychological effects of cannabis because their brains are still developing. Cannabis use in adolescents has been reportedly associated with later onset of bipolar disorder. Aims The purpose of this study is to systematically review and analyze longitudinal prospective cohort studies of cannabis use during adolescence and evaluate the risk of developing bipolar disorder. Methods We defined the participants, exposures, comparisons, and outcomes (PECO) as follows: (P) adolescents in the 10–19‐year age group at the baseline survey; (E) cannabis use at least once during lifetime; (C) never‐used cannabis over lifetime; and (O) the onset of bipolar disorder. A systematic search for published prospective cohort studies will be conducted by using the following electronic databases: PubMed, EMBASE, PsycINFO, and Japan Medical Abstracts Society. The quality assessment will be performed by using Risk Of Bias In Non‐randomized Studies – of Interventions. Meta‐analysis will be done if the included studies that exist are more than three. Heterogeneity will be assessed using Cochran's Q test and I2. Funnel plots and Egger's test will be done to assess publication bias. Discussion This study will clarify the association between adolescent cannabis use and the subsequent development of bipolar disorder, which could be useful for future research directions and policy making.

ABSTRACTFrost injury is a concern in early-sown spring wheat (Triticum aestivum) in the Tokai region of Japan. To assess the efficacy of ground rolling as a technique for avoiding frost injury, we investigated its effects on the apical development and yield of ‘Ayahikari’ spring wheat. In both 2018–19 and 2019–20, rolling delayed spikelet initiation by 4–5 days, the start of internode elongation by 5–12 days, and jointing by 3–9 days, but did not affect the apical development rate, which depended on the thermal time. Ground rolling prevented frost injury in 2018–19 but not in 2019–20, probably because the warmer-than-average winter promoted earlier jointing, and so plants were exposed to later low temperatures in February. These results suggest that ground rolling is an effective method for avoiding frost injury in spring wheat during cold winters.

Article Summary Strength and limitations of this study • This systematic review and a meta-analysis will investigate the associations between psychosocial factors at work and menstrual abnormalities or fertility. • This review will include only the literature that has utilized a longitudinal design. • Various outcomes related to reproductive health in female workers will be examined (e.g., fertility, premenstrual symptoms, cycle disorders, menopausal symptoms).

Since the last IAEA-FEC in 2021, significant progress on the development of long pulse steady state scenario and its related key physics and technologies have been achieved, including the reproducible 403 s long-pulse steady-state H-mode plasma with pure radio frequency (RF) power heating. A thousand-second time scale (∼1056 s) fully non-inductive plasma with high injected energy up to 1.73 GJ has also been achieved. The EAST operational regime of high β _P has been significantly extended ( H _98y2 > 1.3, β _P ∼ 4.0, β _N ∼ 2.4 and n _e / n _GW ∼ 1.0) using RF and neutral beam injection (NBI). The full edge localized mode suppression using the n = 4 resonant magnetic perturbations has been achieved in ITER-like standard type-I ELMy H-mode plasmas with q _95 ≈ 3.1 on EAST, extrapolating favorably to the ITER baseline scenario. The sustained large ELM control and stable partial detachment have been achieved with Ne seeding. The underlying physics of plasma-beta effect for error field penetration, where toroidal effect dominates, is disclosed by comparing the results in cylindrical theory and MARS-Q simulation in EAST. Breakdown and plasma initiation at low toroidal electric fields (

Fiber-optic CO _2 sensors are free of electromagnetic interference and highly resistant to corrosion but often require expensive measurement systems or sophisticated preparation procedures. To address this challenge, we developed a CO _2 sensor comprising a hetero-core fiber-optic surface plasmon resonance sensor coated with an ionic liquid (IL) gel as a cost-effective CO _2 sensing system. Among the various sensors tested, the sensor using ethyl-3-methylimidazolium tetrafluoroborate ([EMIM][BF _4 ]) as the IL, prepared at a pull-up speed of 4.5 mm s ^−1 , showed the best CO _2 sensing performance. A hybrid membrane of [EMIM][BF _4 ] and a CO _2 -absorbing polymer (monoethanolamine) demonstrated higher sensitivity for CO _2 concentrations ranging from 0 to 100%. The highlight of the proposed system is its low-cost configuration comprising an 850 nm-wavelength LED and a photodiode as the light source and signal detection device, respectively. Along with facile preparation and low-cost system configuration, the proposed system exhibited significant potential for CO _2 sensing in various fields.

Objectives: This study explored the perceptions of workers regarding mobile health (mHealth) services for physical activity and mental health. Methods: Single, online, one-on-one, 60-minute semi-structured interviews were conducted with workers living or working in Tokyo, Japan. The transcribed text corpus of the interviews was used as data to explore their perceptions. The top 200 nouns in the utterances were extracted and modeled using a bag of words (BoW) and embedded into a two-dimensional space. Results: The interviews extracted 476 utterances with 1,294 nouns from the 12 workers (7 males and 5 females). A total of 10 themes were estimated from the top 200 nouns. The participants mostly agreed that physical activity was effective in improving their mental health. They needed individualized, attractive, and easy mHealth services. Other estimated themes were: limited effects of non-leisure physical activity on mental health, lower priority on physical activity rather than sleep and rest, reluctance to share the data within the groups, and difficulties in wearing the devices to measure physical activity due to work rules. Conclusion: Workers’ perceptions of mHealth services were consistent with previous findings: the need for individualization, attraction, and ease of use. In the working population, mHealth services for physical activity and mental health should consider working conditions and focus on leisure-time physical activity. Social sharing might not be a mandatory technique because of the private topics and variety of associations between physical activity and mental health.

Abstract Background The prevalence of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) has been increasing rapidly worldwide. However, guidelines or clinical studies do not provide sufficient data on ECPR practice. The aim of this study was to provide real-world data on ECPR for patients with OHCA, including details of complications. Methods We did a retrospective database analysis of observational multicenter cohort study in Japan. Adult patients with OHCA of presumed cardiac etiology who received ECPR between 2013 and 2018 were included. The primary outcome was favorable neurological outcome at hospital discharge, defined as a cerebral performance category of 1 or 2. Results A total of 1644 patients with OHCA were included in this study. The patient age was 18–93 years (median: 60 years). Shockable rhythm in the initial cardiac rhythm at the scene was 69.4%. The median estimated low flow time was 55 min (interquartile range: 45–66 min). Favorable neurological outcome at hospital discharge was observed in 14.1% of patients, and the rate of survival to hospital discharge was 27.2%. The proportions of favorable neurological outcome at hospital discharge in terms of shockable rhythm, pulseless electrical activity, and asystole were 16.7%, 9.2%, and 3.9%, respectively. Complications were observed during ECPR in 32.7% of patients, and the most common complication was bleeding, with the rates of cannulation site bleeding and other types of hemorrhage at 16.4% and 8.5%, respectively. Conclusions In this large cohort, data on the ECPR of 1644 patients with OHCA show that the proportion of favorable neurological outcomes at hospital discharge was 14.1%, survival rate at hospital discharge was 27.2%, and complications were observed during ECPR in 32.7%.

Aim: This study aimed to investigate the relationship between transient return of spontaneous circulation (ROSC) before extracorporeal membrane oxygenation (ECMO) initiation and outcomes in out-of-hospital cardiac arrest (OHCA) patients, who were resuscitated with extracorporeal cardiopulmonary resuscitation (ECPR). Methods: This study was a secondary analysis of the SAVE-J II study, which was a retrospective multicentre registry study involving 36 participating institutions in Japan. We classified patients into two groups according to the presence or absence of transient ROSC before ECMO initiation. Transient ROSC was defined as any palpable pulse of ≥1 min before ECMO initiation. The primary outcome was favourable neurological outcomes (cerebral performance categories 1–2). Results: Of 2,157 patients registered in the SAVE-J II study, 1,501 met the study inclusion criteria; 328 (22%) experienced transient ROSC before ECMO initiation. Patients with transient ROSC had better outcomes than those without ROSC (favourable neurological outcome, 26% vs 12%, P

Abstract Outcomes of acute lower gastrointestinal bleeding have not been compared according to hospital capacity. We aimed to perform a propensity score-matched cohort study with path and mediation analyses for acute hematochezia patients. Hospitals were divided into high- versus low-volume hospitals for emergency medical services. Rebleeding and death within 30 days were compared. Computed tomography, early colonoscopy (colonoscopy performed within 24 h), and endoscopic therapies were included as mediators. A total of 2644 matched pairs were yielded. The rebleeding rate within 30 days was not significant between high- and low-volume hospitals (16% vs. 17%, P = 0.44). The mortality rate within 30 days was significantly higher in the high-volume cohort than in the low-volume cohort (1.7% vs. 0.8%, P = 0.003). Treatment at high-volume hospitals was not a significant factor for rebleeding (odds ratio [OR] = 0.91; 95% confidence interval [CI], 0.79–1.06; P = 0.23), but was significant for death within 30 days (OR = 2.03; 95% CI, 1.17–3.52; P = 0.012) on multivariate logistic regression after adjusting for patients’ characteristics. Mediation effects were not observed, except for rebleeding within 30 days in high-volume hospitals through early colonoscopy. However, the direct effect of high-volume hospitals on rebleeding was not significant. High-volume hospitals did not improve the outcomes of acute hematochezia patients.

Abstract Background Although sedentary behavior is associated with the onset of major depressive disorder, it remains unclear whether sedentary behavior at work increases the risk of depression. The present study used the Bayesian approach to investigate the association between sitting time at work and the onset of major depressive episode (MDE). Methods A 1-year prospective cohort study was conducted among 233 Japanese workers without MDE (response rate: 4.3%). MDE onset was assessed using the self-reported WHO Composite International Diagnostic Interview version 3.0. A Bayesian Cox proportional hazard model was used to estimate the hazard ratio (HR) between long sitting time at work and MDE onset. Results A total of 231 workers were included in the analysis. During the follow-up, 1621 person-months were observed, and six participants experienced MDE onset. Incident rates per months were 0.34, 0.11, and 1.02% in short (

BackgroundDigital data on physical activity are useful for self-monitoring and preventing depression and anxiety. Although previous studies have reported machine or deep learning models that use physical activity for passive monitoring of depression and anxiety, there are no models for workers. The working population has different physical activity patterns from other populations, which is based on commuting, holiday patterns, physical demands, occupations, and industries. These working conditions are useful in optimizing the model used in predicting depression and anxiety. Further, recurrent neural networks increase predictive accuracy by using previous inputs on physical activity, depression, and anxiety. ObjectiveThis study evaluated the performance of a deep learning model optimized for predicting depression and anxiety in workers. Psychological distress was considered a depression and anxiety indicator. MethodsA 2-week longitudinal study was conducted with workers in urban areas in Japan. Absent workers were excluded. In a daily survey, psychological distress was measured using a self-reported questionnaire. As features, activity time by intensity was determined using the Google Fit application. Additionally, we measured age, gender, occupations, employment status, work shift types, working hours, and whether the response date was a working or nonworking day. A deep learning model, using long short-term memory, was developed and validated to predict psychological distress the next day, using features of the previous day. Further, a 5-fold cross-validation method was used to evaluate the performance of the aforementioned model. As the primary indicator of performance, classification accuracy for the severity of the psychological distress (light, subthreshold, and severe) was considered. ResultsA total of 1661 days of supervised data were obtained from 236 workers, who were aged between 20 and 69 years. The overall classification accuracy for psychological distress was 76.3% (SD 0.04%). The classification accuracy for severe-, subthreshold-, and light-level psychological distress was 51.1% (SD 0.05%), 60.6% (SD 0.05%), and 81.6% (SD 0.04%), respectively. The model predicted a light-level psychological distress the next day after the participants had been involved in 3 peaks of activity (in the morning, noon, and evening) on the previous day. Lower activity levels were predicted as subthreshold- and severe-level psychological distress. Different predictive results were observed on the basis of occupations and whether the previous day was a working or nonworking day. ConclusionsThe developed deep learning model showed a similar performance as in previous studies and, in particular, high accuracy for light-level psychological distress. Working conditions and long short-term memory were useful in maintaining the model performance for monitoring depression and anxiety, using digitally recorded physical activity in workers. The developed model can be implemented in mobile apps and may further be practically used by workers to self-monitor and maintain their mental health state.

Abstract Aim Some studies have examined the relationship between premenstrual syndrome (PMS) and antenatal depression. However, retrospective designs were used to obtain the PMS experiences. Different from such earlier research, this study aims to investigate the association between PMS before pregnancy and antenatal depression with a prospective design. Method This is a secondary analysis of a randomized controlled trial (RCT) conducted among pregnant women. Premenstrual symptoms before pregnancy of the participants were obtained prospectively via a period tracking app. At the baseline of the RCT, 5073 women participated. Of those, 3004 had one or more symptom records related to menstruation 1 year before pregnancy. The outcome, antenatal depression, was assessed using the Edinburgh Postnatal Depression Scale (EPDS) at the RCT baseline, and the cut‐off value was set at 11. For covariates, age, education, planned pregnancy, and the number of children were also measured at the same time. Multiple logistic regression analyses were employed to estimate the odds ratio (OR) of having antenatal depression, adjusting for the covariates. Results A total of 366 individuals who had three or more cycles of menstrual‐related symptom records were included in the analyses, and of those 52 were applicable to PMS before pregnancy. There was no significant association between PMS and antenatal depression (adjusted OR = 1.28, P = 0.61). Conclusion The present study was the first study to utilize a prospective design to obtain premenstrual symptoms. Future research should consider using a validated and objective measure of PMS diagnosis and a larger sample.

Abstract Background Antimesenteric cutback end‐to‐end isoperistaltic anastomosis (Sasaki‐Watanabe anastomosis; Sasaki‐W anastomosis), which was developed in our department, is a novel hand‐sewn anastomotic technique for Crohn's disease intended to prevent anastomotic stenosis and preserve the peripheral circulation. Aim The aim of the present study is to present the surgical technique of Sasaki‐W anastomosis and to assess the safety and the early results of the surgical anastomotic recurrence of Sasaki‐W anastomosis. Patients and Methods The present study was a single‐center retrospective cohort study. As an early‐period group, 13 patients with Crohn's disease, who were mainly selected from cases considered to be at high risk of recurrence, underwent 15 Sasaki‐W anastomoses from August 2009 to January 2012. As a late‐period group, 36 patients with Crohn's disease, who were selected regardless of risk factors, underwent 37 Sasaki‐W anastomoses from September 2016 to March 2020. The medical data including patient characteristics, surgical records, postoperative details, and surgical recurrences were assessed. Results There were no intraoperative complications. With a median follow‐up of 107 mo, surgical recurrence occurred in one patient at 106 mo after surgery in the early‐period group. The cumulative surgical recurrence‐free rate in the early‐period group was 100% at 5 y and 86% at 10 y after surgery. No patients required reoperation in the late‐period group. Conclusion Sasaki‐W anastomosis is safe and feasible. Although long‐term study is needed, this anastomotic technique can be a reasonable operative option for Crohn's disease.

Periodontal disease (PD) is the most common oral disease that is caused by infection with periodontal-disease-associated bacteria (PDAB) such as Porphyromonas gulae and Porphyromonas macacae in dogs as well as in humans. Unlike humans, most dogs do not follow daily oral hygiene routine, and this results in many dogs being affected by PD. Thus, to prevent PD, it is important to control PDAB. Xylitol is a sugar alcohol that inhibits the growth of oral bacteria in humans. However, xylitol is poisonous to dogs and can lead to hypoglycemia and hepatic failure. Herein, we show the inhibitory effect of erythritol, a sugar alcohol that can be used safely in dogs, on the growth of PDAB isolated from dogs with PD. Oral bacteria were isolated from the oral cavities of dogs with PD, and the distribution of PDAB was evaluated. Interestingly, Porphyromonas gingivalis, a bacterium typically responsible for PD in humans, was not isolated from dog samples. The bacteriostatic effect of erythritol supplementation was investigated on isolated PDAB in vitro. Our results show that erythritol exert bacteriostatic effects on PDAB comparable to xylitol. Thus, application of erythritol can be suggested to control PDAB in dogs in the future.

Abstract There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen’s d was − 0.18 (95% CI − 0.34 to − 0.02) and 0.03 (95% CI − 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost. Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796

Abstract Aims This systematic review aimed to evaluate randomized controlled trials (RCTs) to examine the effect of maternal and infant sleep intervention during women's pregnancy for the purpose of preventing perinatal depression. Method A systematic search (from inception to January 28, 2019) for RCTs using five electronic databases—the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed, PsycINFO, and Ichushi Web (Japan Medical Abstracts Society)—was conducted. Twelve investigators independently conducted initial screenings based on title and abstract, and then, two researchers performed full‐text reviews one by one. A meta‐analysis would be conducted if at least three studies were found. However, only two articles that met inclusion criteria, and narrative data synthesis was conducted for these two articles. The study protocol has been registered at PROSPERO (CRD42019119999). Result A total of 13 654 studies were initially searched. After removing duplicates, 10 547 studies were screened, and finally, two studies met the inclusion criteria. In both studies, the intervention was a one‐time face‐to‐face session during pregnancy to deliver the behavioral knowledge and skills for optimizing sleep hygiene for both infant and mother. Effectiveness of the intervention in improving maternal mood was not significant in one study. In the other, there was a significant difference in maternal mood between the intervention and control group. No mood comparison was made between baseline and postintervention. Conclusion This study found limited evidence to support the effectiveness of sleep intervention for all pregnant women, which means “universal intervention,” to protect maternal mental health. Further well‐designed RCTs are needed to confirm these findings.

Abstract Background Work engagement is one of the most important outcomes for both employees and employers. Although the findings to date, integrated 40 intervention studies aiming to improve work engagement, consistent results have not yet been produced, suggesting the importance of further intervention studies. This study aims to investigate the effects of gratitude intervention programs focused on two important work engagement factors among Japanese workers: personal and job resources. Methods This study will be a two-arm, parallel-group cluster (organization) randomized control trial. Japanese organizations and nested employees will be recruited through the first author’s acquaintances using snowball sampling. Organizations that meet the inclusion criteria will be randomly allocated to intervention or control groups in a 1:1 ratio within the company unit. The intervention groups will be provided with a 1-month long gratitude intervention program, which aims to promote reciprocal gratitude exchanges within the same organization. The program consists of psychoeducation, gratitude lists, and behavioral gratitude expression. The control groups will not receive any intervention. The primary outcome will be work engagement measured by the Japanese version of the Utrecht Work Engagement Scale at baseline and after 1 (immediate post-survey), 3, and 6 months. Multilevel latent growth modeling will be conducted to examine the effectiveness of the intervention program. Discussion This study will be the first cluster randomized controlled trial applied to the investigation of gratitude intervention aimed at improving work engagement among Japanese workers; to promote reciprocal gratitude exchanges within a given organization; and to include both gratitude lists and behavioral gratitude expression. Gratitude interventions have several strengths in terms of implementation: the objectives of the exercises are easy to understand and implement; it does not require much time or expense; they tend to have lower dropout rates; and they do not require experts in psychology. Although implementation difficulties have been common in previous interventions targeting work engagement, gratitude intervention may be suitable even for workers who have limited time to devote to the tasks. Trial registration: This study was registered at the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR, ID=UMIN000042546): https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000048566 on November 25, 2020.

Abstract For studying small-x gluon saturation in forward dijet production in high-energy dilute-dense collisions, the improved TMD (ITMD) factorization formula was recently proposed. In the Color Glass Condensate (CGC) framework, it represents the leading term of an expansion in inverse powers of the hard scale. It contains the leading-twist TMD factorization formula relevant for small gluon’s transverse momentum k t , but also incorporates an all-order resummation of kinematical twists, resulting in a proper matching to high-energy factorization at large k t . In this paper, we evaluate the accuracy of the ITMD formula quantitatively, for the case of quark dijet production in high-energy proton-proton(p+p) and proton-nucleus (p+A) collisions at LHC energies. We do so by comparing the quark-antiquark azimuthal angle ∆ϕ distribution to that obtained with the CGC formula. For a dijet with each quark momentum p t much larger than the target saturation scale, Q s , the ITMD formula is a good approximation to the CGC formula in a wide range of azimuthal angle. It becomes less accurate as the jet p t ’s are lowered, as expected, due to the presence of genuine higher-twists contributions in the CGC framework, which represent multi-body scattering effects absent in the ITMD formula. We find that, as the hard jet momenta are lowered, the accuracy of ITMD start by deteriorating at small angles, in the high-energy-factorization regime, while in the TMD regime near ∆ϕ = π, very low values of p t are needed to see differences between the CGC and the ITMD formula. In addition, the genuine twists corrections to ITMD become visible for higher values of p t in p + A collisions, compared to p+p collisions, signaling that they are enhanced by the target saturation scale.

Background The association between female sex and poor outcomes following surgery for type A acute aortic dissection has been reported; however, sex‐related differences in clinical features and in‐hospital outcomes of type B acute aortic dissection, including classic aortic dissection and intramural hematoma, remain to be elucidated. Methods and Results We studied 2372 patients with type B acute aortic dissection who were enrolled in the Tokyo Acute Aortic Super‐Network Registry. There were fewer and older women than men (median age [interquartile range]: 76 years [66–84 years], n=695 versus 68 years [57–77 years], n=1677; P

BackgroundThe prolonged COVID-19 pandemic has affected mental health among workers. Psychoeducational intervention via a website could be effective for primary prevention of mental illness among workers in the current COVID-19 pandemic. ObjectiveThe aim of this randomized controlled trial is to examine the effect of a newly developed online psychoeducational website named Imacoco Care on reducing psychological distress and fear about COVID-19 infection among workers. MethodsParticipants in the study were recruited from registered members of a web survey company in Japan. Participants who fulfilled the eligibility criteria were randomly allocated to the intervention or control group. Participants in the intervention group were invited to access the Imacoco Care program within a month after the baseline survey. The Kessler Psychological Distress Scale (K6) and the Fear of COVID-19 Scale (FCV-19S) scores were obtained at baseline and at 1- and 3-month follow-ups. ResultsA total of 1200 workers were randomly allocated to the intervention and control groups (n=600 [50%] per group). The Imacoco Care intervention group showed a significant favorable effect on K6 scores (P=.03) with a small effect size (ES; Cohen d=–0.14) and an adverse effect on FCV-19S scores (P=.01) with a small ES (Cohen d=0.16) at 3-month follow-up. In the per protocol analysis (including only participants who had read the Imacoco Care content at least 1 time), the Imacoco Care intervention group also showed a significant favorable effect on reducing K6 scores (P=.03), while an adverse effect on FCV-19S scores was not significant (P=.06) in the intervention group at 3-month follow-up. ConclusionsA web-based psychoeducation approach may be effective for improving psychological distress among workers; however, it may be important not only to distribute information but also to encourage active engagement with the content of the program to prevent adverse effects of psychoeducational intervention. Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000042556; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000048548

Abstract Background Left ventricular assist devices (LVADs) currently play an important role in the treatment of patients with end-stage heart failure who require a bridge to heart transplantation or destination therapy. With the development and improvement of the LVADs, the morbidity and mortality rates are declining and life expectancies increasing, and the number of patients with LVADs requiring non-cardiac surgery is likely to increase. We present the case of a patient with implantable LVAD who underwent laparoscopic right hemicolectomy for ascending colon cancer. Case description The patient was a 66-year-old man who underwent LVAD implantation as a BTT 3 years prior. He suffered from severe anemia at follow-up, and a colonoscopy revealed ascending colon cancer. The LVAD pump was implanted in the epigastrium. The long C-shaped subfascial driveline tunnel was made, and driveline exit site was located on the left lateral abdominal wall. We assessed the positional relationship between the tumor and the driveline using X-ray and three-dimensional computed tomography (3D CT) images. 3D CT image allowed us to easily identify the location of the driveline, and we determined to perform laparoscopic right hemicolectomy. The port sites were decided upon carefully to avoid the driveline injury, and the driveline was marked on the skin before surgery. There were no adhesions in the abdominal cavity, and both the LVAD and the driveline were observable. The trocars were in nearly the same positions as in a standard laparoscopic right hemicolectomy. During the operation, the LVAD and the driveline did not interfere with the trocars. We successfully completed a standard laparoscopic right hemicolectomy despite hemorrhagic tendency. The patient was discharged without any bleeding complications during the postoperative course. Conclusion Laparoscopic surgery is feasible and safe for patients with LVADs with intensive preoperative simulation and perioperative prevention of infection.

Abstract Background Removal of an airway foreign body is challenging to anesthesiologists. We report successful removal of an extremely rare foreign body between a tracheal tube and the trachea in patients under tracheal intubation. Case presentation A 57-year-old male received total aortic arch replacement and postoperative mechanical ventilation. An airway foreign body was detected just below the glottis, outside the tracheal tube during mechanical ventilation after surgery in the intensive care unit. Before the removal procedure, we planned multiple strategies to cope with unexpected airway and breathing troubles. As a result, the foreign body was successfully removed orally by using a bronchial fiber, without extubation of the tracheal tube, under general anesthesia with dexmedetomidine and ketamine. Conclusions We reported the successful removal of a foreign body in the subglottic airway of a patient under tracheal intubation.

Abstract Background Personal values, which are formed in early life, can have an impact on health outcome later in life. Objective The aim of this study is to investigate the relation between personal values in adolescence and bio-indicators related to metabolic syndrome (MetS) in adulthood. Participants and Methods The longitudinal data used was from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Personal values in adolescence were retrospectively obtained in 2017 from a self-reporting questionnaire, composed of value priorities and commitment to the values. Venous samples were collected in 2012 for low and high-density lipoprotein (LDL, HDL) cholesterol and hemoglobin A1c (HbA1c). Body mass index (BMI), waist circumference and systolic and diastolic blood pressure (SBP, DBP) were also measured. The associations of each variable were examined by partial correlation analysis. In addition, multiple linear regression analysis was conducted to examine overall associations between personal values and the sum of standardized scores (Z-score) of the biomarkers as a proxy of MetS. Results The total population (n = 668) included 261 men and 407 women. For men, the personal value priority of “Having influence on society” was associated with high HDL cholesterol (0.133, p = 0.032) and “Cherishing familiar people” with low waist circumference (r = -0.129, p = 0.049), low SBP, and high DBP (r = -0.135, p = 0.039; r = 0.134, p = 0.041). For women, “Not bothering others” was associated with high SBP and low DBP (r = 0.125, p = 0.015; r = -0.123, p = 0.017). "Economically succeeding" was associated with a worse outcome (β = 0.162, p = 0.042) in men. Conclusions Although some significant associations were found between personal values in adolescence and MetS-related markers in adulthood, the overall associations were not strong. Culturally prevailing values were likely to be associated with a good outcome of metabolic health.

Abstract Aims The purpose of this study is to retrospectively examine the association between personal values in adolescence and sense of coherence (SOC) in adulthood. Methods J‐SHINE data from wave 1 (2010) and wave 3 (2017) were used in this study. We retrospectively measured personal values at age 15 in 2017 in two ways: (a) value priorities developed from Schwartz's theory of basic values; and (b) the commitment to values measured by Personal Values Questionnaire II (PVQ‐II). Multiple regression analysis was used to estimate the association. Results Having a value priority of belief, pursuing one's interest, enduring active challenges, cherishing family and friends, and having a commitment to values in adolescence were significantly and positively associated, while avoiding causing trouble was significantly and negatively associated with SOC in adulthood. Conclusions Personal values in adolescence may be associated with SOC in adulthood. Research of personal values in adolescence could contribute to the understanding the development of SOC.

Abstract Background Bonding disorders happen as parents cannot build an affective relationship with children and are associated with their psychological and social conditions. Personal values impact well-being and psychological outcomes; however, how personal values influence bonding relationships is unknown. The purpose of the study was to investigate the relationship between personal values in adolescence recalled by adult participants and impaired bonding using a community-representative database. Methods We conducted a retrospective study using cross-sectional data of adults living with children in Japan. Personal values were evaluated by value priorities measured by 11 items from Personal Value Questionnaires, and commitment to values measured by a Japanese version of the Personal Values Questionnaires II. Impaired bonding was evaluated by five items from a Japanese-version of the Mother-to-Infant Bonding Scale. Odds ratios of value priorities and commitment to values for impaired bonding relationships were calculated after adjusting covariates. Results Of 13,920 people selected by probability proportionate sampling, 466 participants with children under 6 years old were selected for analysis. Personal values on improving society, graduating from school, positive evaluation from others, and pursuing one’s interest were negatively associated with impaired bonding relationship, while personal values on financial success were positively associated with impaired bonding relationship. Commitment to values were negatively associated with bonding problems. Conclusions While a future longitudinal study is needed, the present findings may indicate that personal values in adolescence are associated with their bonding relationship with children.

Abstract Background This case report presents a case of a patient with global cerebral infarction of uncertain etiology following an emergency surgery for acute type A aortic dissection. As a result, factor XII deficiency was revealed postoperatively. To date, there have been several reports of cardiovascular surgery in patients with factor XII deficiency. However, all previous reports were of patients whose factor XII deficiency had been detected preoperatively; therefore, before this, there had been no reports of complications associated with factor XII deficiency following cardiovascular surgery. Case presentation We report a case of emergency aortic arch replacement surgery for acute type A aortic dissection in a 57-year-old Japanese man. A blood test prior to the surgery showed coagulopathy, a platelet count of 117 × 109/L, a prothrombin time–international normalized ratio of 1.78, an activated partial thromboplastin time of 69.7 seconds, and fibrinogen 999 seconds). After the heparin administration, the activated clotting time, measured every 30–60 minutes, remained unchanged (> 999 seconds); therefore, additional heparin was not administered during the surgery, and there was no clinical problem during cardiopulmonary bypass. However, a diagnosis of global cerebral infarction was made on the first postoperative day. An additional blood coagulation test performed on postoperative day 9 revealed factor XII deficiency (8.0%). Regarding the reason that global cerebral infarction occurred in the present case, two reasons were considered: One was factor XII deficiency itself, and the other was low-dose heparin administration during the cardiopulmonary bypass due to excessively prolonged activated clotting time caused by factor XII deficiency. Conclusions Factor XII deficiency should be considered in patients with prolonged activated clotting time and spontaneous thrombosis in vascular surgeries. Moreover, the present case emphasizes that management of heparin during cardiopulmonary bypass should not be performed on the basis of activated clotting time monitoring alone, especially in a case with prolonged activated clotting time.

Background and Aim The T‐cell receptor (TCR) repertoire was assessed in response to various antigens and was considered to be associated with the pathogenesis of inflammatory bowel disease (IBD). Thus, we performed TCR repertoire analysis to examine the pathology of IBD from changes in the TCR repertoire of memory T cells in the intestinal lamina propria mononuclear cells (LPMCs) and peripheral blood mononuclear cells (PBMCs) of patients with IBD. Methods LPMCs in the surgical specimens and PBMCs were isolated from 12 patients with IBD (5 patients with ulcerative colitis [UC] and 7 patients with Crohn's disease [CD]). PBMCs were collected from 10 healthy individuals as controls. Comprehensive TCR sequence analyses of adaptor‐ligation polymerase chain reaction (PCR) products were performed using MiSeq. Results The diversity of TCR‐α and TCR‐β in PBMCs was significantly lower in patients with IBD than that in controls (P = 0.00084 and 0.0013, respectively). Comparisons of TCR diversity in LPMCs and PBMCs between CD and UC showed that the diversity in LPMC was not affected by diseases, whereas that in PBMCs was significantly lower in CD than in UC (P = 0.045 and 0.049, respectively). Some TCR clones may have shown a specific increase or decrease in CD and UC, and many clones were common to both LPMCs and PBMCs in the same patients. Conclusion The diversity of TCR clones in LPMCs and PBMCs in patients with IBD was significantly lower than that of PBMCs in controls. TCR diversity in PBMCs was particularly low in patients with CD.

Abstract Objective This study aimed to investigate the association between time preference (i.e., time discounting and hyperbolic time discounting) and personal values (the areas of priority values and commitment to value) in a sample of adult community residents in Japan. Methods Data from respondents (N = 2787) who completed the wave 1 and 3 surveys of a three-wave panel study of adult community residents in municipalities in Tokyo and suburban areas spanning 2010–2017 were analysed. Time discount rate and hyperbolic discount were measured using a three-item choice-based scale at the wave 1. Areas of priority value at present and at age 15 were measured by 11 questions for different value areas at the wave 3; the commitment to value at present and age 15 was measured by the Personal Value Questionnaire-II (PVQ-II) at the wave 3. Linear regression analyses were conducted of priority areas of values and commitment to value on time preference indicators, adjusting for sociodemographic variables and childhood socioeconomic status. Results After excluding those with missing responses, data from 1880 and 1958 respondents were subject to analyses on time discounting and hyperbolic time discounting, respectively. Time discount rate was significantly and negatively associated with the value area of maintaining a stable life at present. Hyperbolic time discounting was significantly and negatively associated with the commitment to value at age 15. Conclusion There may be an association between time preference and personal values. Time discounting and hyperbolic time discounting may be associated with different aspects of personal values, i.e., area of priority values and commitment to value, respectively.

Abstract Background The aim of this study was to examine the internal consistency, structural validity, and convergent/known-group validity of the Japanese version of the 42-item Psychological Well-Being Scale (PWBS-42). Methods The PWBS-42 includes six 7-item subscales designed to measure the following dimensions of eudaimonic psychological well-being: 1) autonomy, 2) environmental mastery, 3) personal growth, 4) positive relations with others, 5) purpose in life, and 6) self-acceptance. A questionnaire was administered to 2102 community residents in Tokyo aged 30 or over as a part of the Midlife in Japan (MIDJA) survey, in 2008. The internal consistency reliability was tested using Cronbach’s α. Structural validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations of the Japanese PWBS-42 subscales with life satisfaction, negative affect, negative adjectives, positive affect, positive adjectives, self-esteem, and perceived stress scales. Results Data from 1027 respondents (505 males and 522 females) were analyzed (valid response rate = 56.2%). Cronbach’s α values ranged from 0.70 to 0.78 for five of the subscales, while that for purpose in life was lower (0.57). EFA yielded a five-factor structure: The first two factors consisted of negative and positive items mostly from the environmental mastery, purpose in life, and self-acceptance subscales. The third, fourth, and fifth factors consisted mostly of items from the positive relations with others, autonomy, and personal growth subscales, respectively. As hypothesized, the scores for life satisfaction, negative and positive affect/adjectives, self-esteem and perceived stress were significantly correlated with all subscales of the Japanese PWBS-42. Conclusion The subscales of the Japanese version of the PWBS-42 showed accep. levels of reliability and support for convergent validity in the Japanese population. The factor structure was slightly different from the theoretical 6-factor model: items of three subscales (environmental mastery, purpose in life, and self-acceptance) loaded together on two factors. This finding may be interpreted in light of the interdependent self construal found in Japan in which these three components could be closely linked.

Abstract Background For promoting mental health and well-being of individuals, it is important to investigate its association with personal values. However, in Eastern Asian countries, no study has yet investigated the association between personal values in adolescence and mental health and well-being in adulthood. To fill that research gap, we conducted a cross-sectional study based on two online surveys of working populations in Japan and the United States. Methods A total of 516 workers from each of the two countries, aged 30–49 years, completed a questionnaire that measured personal values in adolescence, current psychological distress, health-related quality of life, and subjective well-being (satisfaction and happiness). Personal values were measured by items based on Schwartz’s theory of basic values and people’s commitment to those ten values. Multiple group path analysis was performed to examine the associations between personal values in adolescence and health-related outcomes, grouped by country. Results Care, graduating from school, and commitment to values were associated with better mental health and well-being in Japanese participants. Belief and challenging were associated with better mental health and well-being in US participants. On the other hand, financial success was associated with poor mental health and well-being in Japanese participants. Avoiding causing trouble and positive evaluation were associated with poor mental health and well-being in the US participants. Conclusions Certain personal values and commitment to those values in adolescence may be associated with mental health and well-being in adulthood. To address the limitations of this study, future studies should use a longitudinal design and investigate the interactions among the types of personal values and commitment to the values.

Applications of metasurfaces for optoelectronic devices require wiring to each isolated antenna for biasing and current flow. Here, the authors report optimal wire interconnects design for controlling the optical properties and present antenna-enhanced mid-infrared photodetection incorporating a single quantum well.

We developed a wearable swallowing assessment device using a hetero-core fiber-optic pressure sensor for the detection of laryngeal movement during swallowing. The proposed pressure sensor (comfortably attached to the skin of the neck) demonstrated a high sensitivity of 0.592 dB/kPa and a linearity of R2 = 0.995 within a 14 kPa pressure band, which is a suitable pressure for the detection of laryngeal movement. In addition, since the fabricated hetero-core fiber-optic pressure sensor maintains appreciable sensitivity over the surface of the sensor, the proposed wearable swallowing assessment device can accurately track the subtle pressure changes induced by laryngeal movements during the swallowing process. Sixteen male subjects and one female subject were evaluated in a variety of age groups ranging from 30 to 60 years old. For all subjects, characteristic swallowing waveforms (with two valleys based on laryngeal movements consisting of upward, forward, backward, and downward displacements) were acquired using the proposed wearable swallowing assessment device. Since the denoted time of the first valley in the acquired waveform determines the “aging effect”, significant differences in swallowing functions among the different age groups were ultimately determined based on the time of the first valley. Additionally, by analyzing each age group using the proposed device, due to p-values being consistently less than 0.05, swallowing times were found to exhibit statistically significant differences within the same groups.

Abstract Background Prevention of antenatal and postnatal depression is crucial, given its high prevalence and severe consequences. Although several systematic reviews and meta-analyses have examined the effects of psychological interventions on the population at risk for perinatal depression, few studies have focused on universal prevention and none have focused specifically on universal prevention in pregnancy. The aim of this study is to examine the effects of psychological interventions with a universal prevention focus on perinatal depression during pregnancy by performing a systematic review and meta-analysis based on both the latest articles and a broader literature search. Methods The literature search will be conducted using the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed and PsycINFO, from inception onwards. Randomized controlled trials that examined the association between psychological interventions and universal prevention of antenatal and postnatal depression among pregnant women will be included. Study selection, data collection, quality assessment, and statistical syntheses will be conducted following a priori defined methods in the protocol. Discussion The findings of this systematic review and meta-analysis will have both clinical and political importance in the context of perinatal mental health. In addition, this study will promote future studies and clarify the direction of research on universal prevention of perinatal depression. Systematic review registration PROSPERO CRD42019118041