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Keita Kawai,1 Kunihiro Iwamoto,1 Seiko Miyata,1 Ippei Okada,1 Motoo Ando,1 Hiroshige Fujishiro,1 Akiko Noda,2 Norio Ozaki1 1Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan; 2Department of Biomedical Sciences, Chubu University Graduate School of Life and Health Sciences, Kasugai, JapanCorrespondence: Kunihiro Iwamoto, Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan, Tel +81-52-744-2282, Fax +81-52-744-2293, Email iwamoto@med.nagoya-u.ac.jpPurpose: Sleep state misperception, which is the discrepancy between subjective and objective sleep, is often observed in patients with depression. This phenomenon may delay the remission of depression. Previous studies have focused on the total sleep time (TST) misperception, with many of these studies using actigraphy. Thus, our study investigated depressed patients with the exploratory aim of clarifying factors associated with the sleep state misperception including the wake after sleep onset (WASO) misperception, with their objective sleep additionally evaluated by polysomnography (PSG).Patients and Methods: We conducted a cross-sectional study. Before undergoing overnight PSG monitoring, 40 patients with depression completed questionnaires that included the Beck Depression Inventory (BDI), Epworth sleepiness scale, Temperament and Character Inventory, and the Pittsburgh sleep quality index. Patients were also asked to estimate their subjective sleep duration after they woke up in the morning. Based on this data, we calculated the misperception using the following formula: subjective sleep duration minus objective sleep duration. We compared each factor between negative and positive misperception groups and the multiple regression analysis was performed for TST and WASO misperception, respectively.Results: Although sleep architectures, age, severity of depression and obstructive sleep apnea (OSA) exhibited differences in underestimating or overestimating the WASO, only sex differences were associated with underestimating or overestimating their total sleep time (TST). Moreover, BDI, the severity of OSA, sleep architectures (N1% and N2%), and benzodiazepine (BZD) use were significantly correlated with WASO misperception, whereas only OSA severity was significantly correlated with TST misperception. A subsequent multiple regression analysis demonstrated the BDI was independently correlated with the WASO misperception (β=0.341, p=0.049).Conclusion: In clinical practice, interventions especially for OSA, and the reduction of depressive symptoms are an important method for improving patient sleep perception. Moreover, current results suggest that BZD prescriptions should be avoided as well.Keywords: insomnia, personality, sleep architectures, discrepancy, sleep disorders

Background There are long-standing controversies about the transplant indications for alcoholic liver disease (ALD), because of the recognition that ALD is fundamentally self-inflicted. However, it is unclear whether psychosocial characteristics of ALD are different from that of non-alcoholic liver disease (NALD) in the selection of liver transplantation (LT) recipients. We aimed to clarify the psychosocial characteristics of ALD recipients (ALD-R)/ALD recipient candidates (ALD-RC) and NALD recipients (NALD-R)/ NALD recipient candidates (NALD-RC). Methods From 2011 to 2019, 75 patients were enrolled in this prospective observational study (ALD-RC, n = 19; NALD-RC, n = 56), LT were carried out as follow; ALD-R, n = 6; NALD-R, n = 52. We evaluated psychosocial characteristics in the preoperative period and 3, 12 months after LT (ALD-R, n = 3/3; NALD-R, n = 28/25). The following scales were used to evaluate psychosocial characteristics: Visual Analogue Scale, Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Brief Evaluation of Medication Influences and Beliefs, Social Support Questionnaire (SSQ), Temperament and Character Inventory, Parental Bonding Instrument (PBI), the Short Form Health Survey (SF-36). Results When evaluating on the basis of abstinence rule, a comparison of ALD-RC and NALD-RC in the preoperative period identified similar patterns of psychosocial characteristics, except that the NALD-RC scored higher on the PBI item “overprotection from mother” (P Conclusion The psychosocial characteristics of ALD-RC and NALD-RC may be similar when evaluated on the basis of Japan’s abstinence rule. This result also imply that the psychosocial characteristics of ALD-RC may differ from the previously reported psychosocial characteristics of alcohol dependent patients. These findings have the potential to provide helpful information for the evaluation of ALD-RC.

Background: While the suicide rate in Japan has recently declined, it is still high from a global perspective. Recently, suicides related to unemployment caused by COVID-19 have increased. In addition, because of increases in karoshi and industrial accidents, mental health measures for workers have become an urgent issue. We previously conducted a study that tested whether screening for mood disorders, which were strongly associated with suicide-related behavior, helps prevent suicide in small and medium-size enterprise workers, where mental health support was insufficient. The current study builds on 2 the previous study’s findings that mental illness screening helps identify mood disorders and may provide a primary prevention method for suicide. Methods: A total of 1,411 consenting workers were surveyed using the Mini-International Neuropsychiatric Interview (MINI). A representative module of each disease item was extracted and analyzed. The Center for Epidemiological Studies-Depression (CES-D), Bipolar Spectrum Diagnostic Scale (BSDS), Liebowitz Social Anxiety Scale (LSAS-J), and the Sheehan Disability Scale (SDISS) were used as secondary assessments. We compared individuals with depression, bipolar disorder, dysthymia, and mood disorders with a control group. In addition, we conducted multivariate analyses to investigate items that identified individuals with depression, mood dysregulation, bipolar disorder, or all-inclusive mood disorders. Results The adjusted odds ratios in the anxiety disorders groups were 3.2 for panic disorder, 2.6 for social anxiety disorder, 2.1 for agoraphobia, and 1.8 for generalized anxiety disorder; 2.1 for obsessive compulsive disorders; and 2.8 for the bulimia nervosa group. These results show a significant correlation with mental illnesses that are referred to as neuroses in a conventional diagnosis. Conclusion: The study found that screening for anxiety disorders, obsessive-compulsive disorders and eating disorders contributes to preventing mood disorders among workers. We hope that our findings will indirectly contribute to preventing workers’ suicides.

Spermatogenesis is a complex process that produces functional sperm by establishing male germline stem cells (mGSCs) in adult testes. To study Drosophila spermatogenesis in vitro, we examined various culture conditions of spermatogonia. Spermatogonia from larval testes began to differentiate soon after culture, whereas mGSCs did not undergo self-renewal division. Strikingly, 16-cell spermatogonia from early and late larval testes differentiated into motile spermatids autonomously. Furthermore, individual spermatogonia developed into motile spermatids even after mechanical dissociation from encapsulating cyst cells. This is the first study to report that spermatogonia in larval testes retain the ability to differentiate into spermatids in the absence of gonadal tissue. Our in vitro system should provide an excellent opportunity to study spermatogenesis in detail and apply genetic manipulation.

Here, we introduce our method of combined use of magnetic resonance angiography/multidetector-row computed tomography (MRA/MDCTA), Doppler sonography, and indocyanine green (ICG) fluorescence angiography to identify the locations of the perforator vessels of the flaps. This method can be used to accurately confirm perforator vessel location on pre- or intraoperative images. If a detectable perforator is obtained using preoperative MRA/MDCTA and Doppler sonography, we use the term “freestyle perforator-based flap” for propeller or V-Y advancement flaps. In some cases, aggressive perforator dissection is necessary to free these flaps from adhesions and evenly distribute the torsion, and the intraoperative identification of perforator vessels detected by Doppler sonography and ICG fluorescence angiography makes it possible to select perforators of larger caliber and stronger pulsatility without fear of anatomic inconsistencies; furthermore, such identification facilitates the surgical mechanics and shortens the operation time.