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BackgroundThe global obesity epidemic is a significant public health issue, often leading to metabolic disorders such as diabetes and cardiovascular diseases. Collagen peptides (CP) and their bioactive component, Prolyl-hydroxyproline (Pro-Hyp), have shown potential in reducing adipocyte size, with unclear mechanisms concerning brown adipocyte differentiation.MethodsWe investigated the effects of Pro-Hyp on the differentiation of brown adipocytes in C3H10T1/2 mesenchymal stem cells, focusing on its impact on adipocyte size, gene expression related to brown fat function, and mitochondrial activity.ResultsPro-Hyp treatment decreased adipocyte size and upregulated brown fat-specific genes, including C/EBPα, PGC-1α, and UCP-1. Remarkably, it did not alter PPARγ expression. Pro-Hyp also elevated mitochondrial activity, suggesting enhanced brown adipocyte functionality. A Pro-Hyp responsive element was identified in the PGC-1α gene promoter, which facilitated the binding of the Foxg1 transcription factor, indicating a novel regulatory mechanism.ConclusionPro-Hyp promotes brown adipocyte differentiation, potentially offering a therapeutic strategy for obesity management. This study provides a molecular basis for the anti-obesity effects of CP, although further in vivo studies are needed to confirm these findings and to investigate the potential impact on beige adipocyte differentiation.

Abstract Background While the dimensional alteration of alveolar bone following tooth extraction have been extensively descripted in the literature, no information is available regarding potential hard and soft tissues changes following implant explantation. Aim To evaluate the radiographic bone healing and the horizontal and vertical soft tissue dimensional alterations at implant extraction alveoli, 6 months following implant explantation. Material and Methods Data from 31 patients scheduled for extraction of one implant with persisting peri‐implantitis despite treatment were analysed. Bone crest level changes and the extent of bone healing at the apical aspect of the implant socket were assessed on the radiographs prior and 6 months following explantation. Regression analyses assessed the impact of various predictors (e.g., bone crest level, presence/absence of buccal bone) on bone level changes. Fisher's exact probability test was applied to assess the difference in probability to have mucosa recession of ≥2 mm in the presence or absence of alveolar buccal bone. Results A vertical bone loss of 0.8 mm (standard deviation [SD] = 1.3) of the peri‐implant bone crest and a gain of 0.8 mm (SD = 1.1) from the bottom of the peri‐implant defect were recorded. Complete healing was noted in the intact implant extraction socket (i.e., the part of the implant not affected by peri‐implantitis). A reduction of 0.4 mm (SD = 0.7) of the alveolar mucosa height was recorded in concomitant with a decrease of 0.7 mm (SD = 0.8) of the mucosa width. These alterations were more pronounced in the absence of the alveolar buccal bone. Conclusion The results of the present explorative study indicated a decrease in the height and width of the alveolar soft and hard tissues following explantation of peri‐implantitis affected implants, and these changes were more pronounced in the absence of the buccal bone wall. Nevertheless, the apical portion of the implant alveolus (the intact implant socket) tend to heal with no further bone loss.

In breast cancer surgery, some medical facilities lack the necessary resources to conduct sentinel lymph node biopsy and its intraoperative frozen section consultation. In the coastal rural area of Fukushima, Japan, which has suffered from physician undersupply following the 2011 triple disaster of earthquake, tsunami and nuclear disaster, we explored the feasibility of telepathology by evaluating the diagnostic accuracy in remote intraoperative frozen section consultation of sentinel lymph node biopsy and its required time. Although examination time has room for improvement, telepathology can be one possible solution in resource-limited areas.

Key Clinical Message During disasters, multiple factors can cause significant delays in medical visits. Regular patient monitoring, high‐risk individual alerts, and telemedicine enhancements can potentially alleviate these issues and ensure timely interventions. Abstract During the COVID‐19 pandemic, a Japanese woman in her 70s delayed her regular breast cancer checkup for over 2 years. During disasters, health priorities tend to decline, necessitating proactive measures from healthcare providers, such as augmenting collaboration among healthcare professionals and identifying high‐risk individuals.

Abstract Background The extensive loss of teeth and surrounding tissues due to mandibulectomy for an oral tumor not only impacts negatively on appearance, but also often causes various functional disorders, decreasing quality of life (QOL). In the present case, reconstruction with a scapular flap was carried out along with segmental mandibulectomy, aiming for functional restoration through restoration-driven implant treatment. A good outcome was obtained, with improvement of masticatory function and QOL following the prosthetic treatment. Case presentation The patient was a 37-year-old woman diagnosed with ossifying fibroma in the left side of the mandible. Segmental mandibulectomy and reconstruction with a scapular flap were carried out. Implant diagnostic simulation was performed, and based on the result, secondary reconstruction using a particulate cancellous bone and marrow graft was carried out by an oral surgeon. After wound healing was complete, implant placement was performed twice, and the final prosthodontic treatment was completed. Masticatory performance and maximum bite force, which are indices of masticatory function, were improved from before to after prosthetic treatment. In addition, oral health-related QOL was improved from before to after prosthetic treatment. Conclusion In the present case, restoration-driven implant treatment was performed in a patient following segmental mandibulectomy for a mandibular tumor, with a good outcome. Planning the treatment measures with a focus on the final prosthetic vision can lead to improvement of oral function in patients with extensive mandibular defects.

Abstract Purpose Japan, with an increasing number of elderly people needing long-term care in a super-aged society, urgent needs to develop the clinical guidelines on implant maintenance for elderly people with declining independence. The purpose is to categorize the troubles encountered in the care of patients with dental implants and to indicate actual practices and points of note. Methods From the members of the Japanese Society of Oral Implantology, 12 expert panelists who were experienced with many problems of implant maintenance during dental visits and were familiar with their solutions were selected. Through repeated discussions in the many panel meetings, the problems of implant maintenance during dental visits were distilled. Results During a dental visit, the oral cavity, general conditions, and background of elderly patients who cannot orally care for themselves must be grasped, and medical staff, care managers, and patients should understand the changes in these factors as time goes by. The solutions and responses that can be made differ greatly depending on the medical care facilities, the environment, differences in the experience of medical staff, and the patient’s background. Thus, it is necessary to select safe treatments appropriate to each situation. Conclusions This paper features many opinions based on clinical experiences. However, clinical guidelines on implant management during dental visits should be formulated in the future based on the accumulation of evidence through the implementation of clinical research.

Peri-implant diseases are known as undesirable conditions that can occur after implant therapy. Although several risk indicators are becoming clear, the causes of peri-implant diseases have not been completely investigated. The purpose of this review was to summarize the prevalence and risk indicators for peri-implant diseases by referring to current papers from various angles. Many studies have reported the varied prevalence of peri-implant mucositis (23.9%–88.0% at the patient level and 9.7%–81.0% at the implant level) and peri-implantitis (8.9%–45% at the patient level and 4.8%–23.0% at the implant level). Additionally, several studies concluded that poor oral hygiene and lack of regular maintenance were strongly correlated with the development of both peri-implant mucositis and peri-implantitis. Diabetes and a history of periodontitis were revealed as risk indicators for peri-implantitis. However, there was no definitive conclusion about the correlations between peri-implant diseases and other factors such as smoking, the shape of the implant superstructure, and the condition of the keratinized mucosa. Further studies useful for evidence-based decision-making are needed for predictable implant therapy in the long term.

Abstract Little is known about how the psychological stress of having experienced a natural disaster affects cancer patients. We experienced a patient who was treated with breast cancer after having been stricken by a typhoon, which resulted in significant psychological damage. Treatment strategies should incorporate patients' mental health appropriately after disasters.

Abstract We experienced the case of a patient with advanced breast cancer who failed to receive comprehensive care despite regular video conferencing with her physician during the COVID‐19 pandemic, resulting in delayed detection of liver metastasis. Inter‐hospital collaboration is required to provide uninterrupted cancer care to those disproportionately affected by crises.

Abstract The purpose of this retrospective cohort study was to create a model for predicting the onset of peri-implantitis by using machine learning methods and to clarify interactions between risk indicators. This study evaluated 254 implants, 127 with and 127 without peri-implantitis, from among 1408 implants with at least 4 years in function. Demographic data and parameters known to be risk factors for the development of peri-implantitis were analyzed with three models: logistic regression, support vector machines, and random forests (RF). As the results, RF had the highest performance in predicting the onset of peri-implantitis (AUC: 0.71, accuracy: 0.70, precision: 0.72, recall: 0.66, and f1-score: 0.69). The factor that had the most influence on prediction was implant functional time, followed by oral hygiene. In addition, PCR of more than 50% to 60%, smoking more than 3 cigarettes/day, KMW less than 2 mm, and the presence of less than two occlusal supports tended to be associated with an increased risk of peri-implantitis. Moreover, these risk indicators were not independent and had complex effects on each other. The results of this study suggest that peri-implantitis onset was predicted in 70% of cases, by RF which allows consideration of nonlinear relational data with complex interactions.

Background Dental implant therapy is a well-established method of prosthetic rehabilitation of missing teeth. To maintain the health of the surrounding tissue, management of risk factors/indicators and daily maintenance are important. It still remains controversial whether a certain amount of keratinized mucosal width is essential for maintaining the health of peri-implant tissue. The purpose of this multicenter retrospective study was to assess the correlation between bone loss around dental implant and the amount of keratinized tissue width. Methods A total of 1,644 implants were evaluated. Data was collected about participants’ general and dental history, as well as implant details. Bone resorption around implant was calculated from intra-oral radiographs taken after 1 year and more than 3 years of function. Implants were classified into three groups; received free gingival graft or apically repositioned flap surgery for increasing the keratinized mucosa ≥2 mm width (group A), keratinized mucosa width ≥2 mm (group B), and keratinized mucosa width

Abstract Little is known on how different types of disasters interact in their impacts on patient care. We experienced a breast cancer patient whose initial presentation was delayed for 2 years due to the COVID‐19 pandemic and Typhoon Hagibis. Increasing awareness is needed on the combined impacts of disasters on breast cancer management.

Abstract Background In some cases, a dentist cannot solve the difficulties a patient has with an implant because the implant system is unknown. Therefore, there is a need for a system for identifying the implant system of a patient from limited data that does not depend on the dentist’s knowledge and experience. The purpose of this study was to identify dental implant systems using a deep learning method. Methods A dataset of 1282 panoramic radiograph images with implants were used for deep learning. An object detection algorithm (Yolov3) was used to identify the six implant systems by three manufactures. To implement the algorithm, TensorFlow and Keras deep-learning libraries were used. After training was complete, the true positive (TP) ratio and average precision (AP) of each implant system as well as the mean AP (mAP), and mean intersection over union (mIoU) were calculated to evaluate the performance of the model. Results The number of each implant system varied from 240 to 1919. The TP ratio and AP of each implant system varied from 0.50 to 0.82 and from 0.51 to 0.85, respectively. The mAP and mIoU of this model were 0.71 and 0.72, respectively. Conclusions The results of this study suggest that implants can be identified from panoramic radiographic images using deep learning-based object detection. This identification system could help dentists as well as patients suffering from implant problems. However, more images of other implant systems will be necessary to increase the learning performance to apply this system in clinical practice.

Abstract Background Excessive loading from the occlusion is known as a major pathological factor in implant failure. The force applied to the implant varies depending on the positional relationship to an opposing tooth in clinical cases. However, no studies have clarified the relationship between the discrepancy and mechanical complications. Materials and methods The study enrolled patients whose mandibular first molar was missing and was opposed by a natural maxillary first molar. The horizontal and vertical distance between the residual ridge and the occlusal surface of the maxillary first molar were measured from computerized tomograms. Subsequently, four finite element models were constructed in combinations of horizontal and vertical discrepancies. Additionally, the effect of inclined implantation and angled abutments were examined in a large clearance model. Maximum von Mises stress values generated in abutments under 90° or 60° loading vectors were compared with a three-dimensional finite element method. Results Data from 123 subjects (39 males and 84 females, average age 55.2 ± 11.4 (SD) years) were collected for the analyses. Under all conditions, the stress on the load side (the buccal side) was concentrated on the platform, and the stress on the opposite side (the lingual side) was concentrated on the top of the abutment tube inserted into the implant. In comparison to 90° loading vectors, the maximum von Mises stresses of each model were 1.20 to 2.67 times under 60° loading vectors. For inclined implantation, the maximum stress was 8.4% less at a 90° load and 9.7% less at a 60° load compared with vertical implantation. With angled abutments, the maximum stress was 15.7% less at a 90° load and 30.0% less at a 60° load compared with vertical implantation. Conclusion In cases of progressive alveolar resorption with a large clearance between the implant and the opposing teeth, a higher stress concentration was observed at the joint between the implant and the abutment. Our findings also showed that stress concentration around this area can be reduced by the use of inclined implantation and angled abutments under the condition of a horizontal offset between the implant and opposing teeth.

Abstract Background To evaluate the effect of several representative decontamination methods of oral biofilms on different implant surfaces. Material and methods Eleven participants wore a hard resin splint carrying 6 rough (GC Aadva® implant; 3.3-mm diameter, 8-mm length) or machined (not commercially available) surface implants for 4 days to accumulate dental plaque naturally on the titanium surfaces of the implants. Apart from surface roughness, the morphology of all implants was identical. After detaching the implants from the splints, the ability of the following decontamination methods—gauze soaked in saline (G), ultrasonic scaler (US), air abrasive (Air), rotary stainless steel instrument (Rot), and Er:YAG laser (Las)—to cleanse the contaminated implant surface for 1 min extra-orally was tested. The control (Cont) group did not receive any decontamination. Scanning electron microscopic (SEM) investigation of one participant’s samples was employed to examine the post-instrumented implant surface for qualitative analysis, and bacterial culture of the remaining 10 participants’ samples was performed to count the number of colony-forming units (CFU) for quantitative analysis. The experimental sequence was initially performed for the rough surface implants and then similarly repeated for the machined surface implants. Bacterial CFU counts among the six groups were analyzed using the Steel-Dwass test, and differences between rough and machined surface implants were determined using the Mann-Whitney U test. Results G and Rot eliminated most biofilms on machined surface implants according to SEM analysis. G, Air, and Rot removed significantly more of the biofilms on rough and machined surface implants compared with US according to CFU counts. Moreover, G significantly reduced more biofilms than Las on machined surface implants. The analysis between rough and machined surface implants showed that Cont, G, and US were better able to cleanse biofilms on machined surface implants compared with rough surface implants. Conclusions Gauze soaked in saline and rotary stainless steel instruments may be advantageous for cleansing contaminated implant surfaces based on the qualitative and quantitative analyses. In contrast, air abrasives were not shown to be preferable in the qualitative analyses. Additionally, apart from the Er:YAG laser, the reduction of biofilms assessed in both qualitative and quantitative analyses demonstrated that all decontamination methods were better at cleansing machined surface implants compared with rough surface implants.

Abstract Recognition of Individual and environmental risks is crucial to alleviate damage inflicted by disasters. In particular, an awareness of floods and their health risks in patients’ residences is important for patients and their healthcare professionals.

Endogenous polyamines such as putrescine (Put), spermidine (Spd), and spermine (Spm) affect adipocyte differentiation. In this study, we investigated the effect of exogenously supplemented polyamines on mouse adipocyte differentiation and anti-obesity actions in vitro and in vivo. The preadipocyte cell line, 3T3-L1, was cultured with Put, Spd, or Spm, and lipid accumulation in the cells was measured by Oil Red O staining. Lipid accumulation was significantly suppressed by Spm. Suppression of CCAAT/enhancer binding protein α mRNA by Spm suggested that the decreased lipid accumulation was due to delaying the cell differentiation. The body weight and fat of obese mice induced with a high-fat diet were reduced by oral ingestion of Spm. In conclusion, oral supplementation of Spm has the ability to prevent obesity through inhibition of adipocyte differentiation.

Abstract Background Eribulin mesylate is currently indicated as a sequential monotherapy to be administered after two chemotherapeutic regimens, including anthracycline and taxane treatments, for treatment of metastatic breast cancer. This open-label, multicenter phase II study was designed to evaluate the efficacy and safety of eribulin as a first- or second-line treatment for patients with metastatic breast cancer. Methods The primary objective was to determine the overall response rate. Secondary objectives were to evaluate progression-free survival and the safety profile. Patients were scheduled to receive eribulin mesylate 1.4 mg/m2 intravenously on days 1 and 8 of a 21-day cycle. Patients received the study treatment unless disease progression, unacceptable toxicity, or a request to discontinue from the patient and/or investigator eventuated. Results Between December 2012 and September 2015, 32 patients with metastatic breast cancer were enrolled at 10 participating clinical institutions in Japan, and toxicity and response rates were evaluated. The overall response rate was 43.8% (95% confidence interval [CI] 26.5–61.0). The clinical benefit and tumor control rates were 56.3% (95% CI 39.0–73.5) and 78.1% (95% CI 63.8–92.5), respectively. Median progression-free survival was 8.3 months (95% CI 7.1–9.4). A subgroup analysis did not identify any factors affecting the efficacy of eribulin. The most common adverse events were neutropenia (71.9%), alopecia (68.7%), and peripheral neuropathy (46.9%). As a first- or second-line therapy, eribulin showed sufficient efficacy for metastatic breast cancer compared with taxane and capecitabine treatment in previous clinical trials. The safety profile of eribulin was acceptable. Conclusions Eribulin may be another option for first-line chemotherapeutic regimens for metastatic breast cancer. Trial registrations This trial was retrospectively registered at the University Hospital Medical Information Network (UMIN) Clinical Trial Registry (ID number: UMIN000010334). Date of trial registration: April 1st, 2013.

Abstract A literature review of finite element analysis (FEA) studies of dental implants with their model validation process was performed to establish the criteria for evaluating validation methods with respect to their similarity to biological behavior. An electronic literature search of PubMed was conducted up to January 2017 using the Medical Subject Headings “dental implants” and “finite element analysis.” After accessing the full texts, the context of each article was searched using the words “valid” and “validation” and articles in which these words appeared were read to determine whether they met the inclusion criteria for the review. Of 601 articles published from 1997 to 2016, 48 that met the eligibility criteria were selected. The articles were categorized according to their validation method as follows: in vivo experiments in humans (n = 1) and other animals (n = 3), model experiments (n = 32), others’ clinical data and past literature (n = 9), and other software (n = 2). Validation techniques with a high level of sufficiency and efficiency are still rare in FEA studies of dental implants. High-level validation, especially using in vivo experiments tied to an accurate finite element method, needs to become an established part of FEA studies. The recognition of a validation process should be considered when judging the practicality of an FEA study.

Abstract Prolyl-hydroxyproline (Pro-Hyp) is one of the major constituents of collagen-derived dipeptides. We previously reported that Pro-Hyp promotes the differentiation of osteoblasts by increasing Runx2, osterix and Col1α1 mRNA expression levels. Here, to elucidate the mechanism of Pro-Hyp promotion of osteoblast differentiation, we focus on the involvement of Foxo1 in osteoblast differentiation via Runx2 regulation and the role of Foxg1 in Foxo1 regulation. The addition of Pro-Hyp had no effect on MC3T3-E1 cell proliferation in Foxo1- or Foxg1-knockdown cells. In Foxo1-knockdown cells, the addition of Pro-Hyp increased ALP activity, but in Foxg1-knockdown cells, it had no effect on ALP activity. An enhancing effect of Pro-Hyp on the Runx2 and osterix expression levels was observed in Foxo1-knockdown cells. However, no enhancing effect of Pro-Hyp on osteoblastic gene expression was observed when Foxg1 was knocked down. These results demonstrate that Pro-Hyp promotes osteoblastic MC3T3-E1 cell differentiation and upregulation of osteogenic genes via Foxg1 expression.

Objectives: In 2014, immediately prior to the revision of Article 25-2 of the Pharmacists’ Act, we conducted a survey on pharmacists’ and patients’ perceptions of pharmacists’ roles. A role discrepancy between the two was identified. The objective was to examine changes in role perceptions and awareness of pharmacists as medication specialists following revision to the Pharmacists’ Act. Methods: The survey was conducted using an Internet-based questionnaire. A total of 469 patients and 354 pharmacists responded to 12 questions about the perceived roles of pharmacists. Results: Analysis revealed that the only evaluation that changed as a result of revisions was pharmacists’ role as “family or regular pharmacist,” with scores dropping by about half. As in 2014, the high rating rate for pharmacists surpassed the high rating of patients for all other items. The greatest discrepancy in role perception was observed for the same three items (“Understanding the effects of the drugs the patients are taking,” “Understanding the health changes caused by the drugs dispensed to the patients,” and “Consciously protecting patients from the adverse effects of drugs”) as 2014. Conclusion: A major role discrepancy continues to exist between patients and pharmacists, and it is necessary for pharmacists to take on a more advanced role in patient care. Results suggest that pharmacists must monitor changes in patients’ lifestyles and provide clear explanations for patients to rate them highly as medication specialists.

Background and study aims Colonoscopy is the gold standard for detecting colorectal adenomas and cancers. Endoscopic surveillance has been shown to be effective for preventing colorectal cancer. Although detection of colorectal polyps at an early stage is important, endoscopic visualization of early neoplasia can be difficult. The Endocuff is a new device that can be attached to the tip of the colonoscope to hold the colonic folds away from the field of view during withdrawal. The aim of this study was to compare the adenoma detection rate (ADR) and the mean number of adenomas detected per patient (MAP) achieved using Endocuff-assisted colonoscopy (EAC) and standard colonoscopy (SC). Patients and methods This randomized prospective study was conducted at two academic endoscopy departments in Japan. A total of 447 patients underwent a complete colonoscopic examination between April 2015 and September 2015. The EAC group included 239 patients. The cecal intubation rate, insertion time, withdrawal time, pain score, complications, polyp detection rate (PDR), ADR, the mean number of polyps detected per patient (MPP), and the MAP were assessed. Results There were no differences between the EAC and SC groups in terms of cecal intubation rate, insertion time, withdrawal time, or pain scores. The PDR in patients increased by about 12 % (61.9 % vs. 49.2 %, P = 0.013) and ADR increased by 15 % (52.5 % vs. 39.2 %, P = 0.001) with the use of the Endocuff. The advanced ADR was higher in the EAC group but no statistically significant difference was found (7.7 % vs. 4.6 %, P = 0.17). Both MPP and MAP were also higher in the EAC group (mean ± SD: 1.33 ± 1.43 vs. 0.83 ± 0.99 per patient; P

Patient's condition is distinctly different among individuals especially in the elderly. Dental implant failure seems to be a multi-factorial problem; therefore, it is unclear that aging itself is a risk factor for the placement of implants. This review reorders and discusses age-related risk factors for the success of dental implants. In dental implant treatment, chronological age by itself is suggested as one of the risk factors for success, but it would not be a contraindication. In general, reserved capacity of bone and soft tissue make it possible to establish osseointegration in the long run. Rather than aging itself, the specific nature of the disease process, such as osteoporosis or diabetes, and local bone quality and quantity at the implant site, mostly related to aging, are more important for successful dental implant treatment. This review revealed a shortage of published data for the survival and success of dental implants in older patients. More studies useful for evidence-based decision making are needed to assess the survival and success of dental implants for aged patients with a compromised condition.

Purpose: To evaluate the reproducibility and reliability of a novel electromyogram (EMG) device with a flexible sheet sensor for measuring muscle activity related to mastication and swallowing. Methods: We developed a new EMG device made of elastic sheet electrodes to measure the masseter and digastric muscle activities for evaluating mastication and swallowing. To examine the measurement reproducibility of the new EMG device, masseter muscle activity was analyzed using the intraclass correlation coefficient (ICC). Further, we measured the maximum amplitude, duration, integrated value, and signal-to-noise ratio (SNR) using the new EMG device and conventional EMG devices and evaluated the reliability using ICC and Bland-Altman analysis. Results: We confirmed high ICC (1,1) and ICC (2,1) scores (0.92 and 0.88, respectively) while measuring the reproducibility of the new EMG device. When compared to the active electrode EMG device, we found a high correlation for the maximum amplitude (0.90), duration (0.99), integrated values (0.90), and SNR (0.75), with no observation of significant fixed errors. Moreover, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed. Compared with the passive electrode EMG device, the maximum amplitude and duration were highly correlated (0.73 and 0.89). In addition, the SNR exhibited a significant fixed error. In contrast, the regression coefficient was not significant for any of the evaluation items and no proportional error was observed. Conclusions: Our results suggest that the new EMG device can be used to reliably and reproducibly evaluate muscle activity during mastication and swallowing. [ABSTRACT FROM AUTHOR]

Background/Aim: Disasters can jeopardize breast cancer care and Japan's triple disaster in 2011 (earthquake, tsunami, and nuclear accident) is no exception. However, detailed information is lacking regarding the care of breast cancer related lymphedema (BCRL) following the disaster. We aimed to explore the process by which local patients become aware of BCRL, the problems faced, and the support they require. We also aimed to clarify the effects of the 2011 disaster on experiences related to lymphedema in the target population. Patients and Methods: Patients who developed BCRL after breast cancer treatment were recruited from Iwaki city, a municipality located in the southern coastal region of Fukushima (N=16). In-depth, semi-structured, face-to-face interviews were conducted, and the obtained data were appraised using thematic analysis. Results: Five themes related to BCRL were identified: 1) the process of becoming aware of BCRL, 2) troubles or worries/concerns due to BCRL, 3) information sources regarding BCRL management, 4) strategies to cope with BCRL, and 5) the adverse impacts of the 2011 disaster on BCRL management. Conclusion: Except for the disaster context, the themes are in line with those of previous studies conducted in the nondisaster context. Nonetheless, there were limited but nonnegligible adverse effects of the 2011 disaster on long-term local BCRL management. The findings of this study demonstrate the necessity for individualizing coping strategies against BCRL among healthcare professionals in the Fukushima coastal area and beyond. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of sub-mucosal mechanical instrumentation following supra-mucosal plaque removal in the treatment of peri-implant mucositis. Materials and methods: A total of 44 patients, 27 from a specialist clinic in Sweden, and 17 from a Japanese one, were included. The 44 patients had a total of 175 implants of which 84 (48%) had clinical signs of mucositis (bleeding on probing [BoP]) and no radiographic bone loss. At baseline, the 44 patients received professional supra-mucosal plaque removal and oral hygiene instruction and motivation. Following the 1-month examination, sub-mucosal instrumentation was initiated using ultrasonic and hand instruments. Patients were then examined at 4 and 7 months. Presence of plaque, marginal bleeding, BoP and probing pocket depth (PPD) changes were recorded at each examination in an unblinded manner. Results: One month following supra-mucosal plaque removal, the number of treated implants with BoP was reduced from 84 to 44 (48% reduction) with a concomitant decrease of the mean PPD of 0.6 mm (95% CI: -0.5 to -0.7), from 4.4 ± 1.0 mm (mean ± SD) to 3.8 ± 1.0 mm, P < 0.0001. Following sub-mucosal instrumentation, a further reduction of 9% (from 44% to 36%) of BoP was recorded, with a concomitant reduction of the mean PPD of 0.3 mm (95% CI: -0.1 to -0.4) at the 7-month examination. Conclusions: The improvement of the clinical condition (absence of marginal bleeding, BoP and PPD reduction at treated implants) following non-surgical treatment of mucositis appeared to be in great part because of supra-mucosal plaque removal, while the sub-mucosal instrumentation seemed to have only a minor additional effect. Deep implant position compared to neighbouring teeth/implant was associated with persisting mucositis following treatment. The presence of deep pockets following treatment was associated with BoP, screw-retained prostheses without abutment and sub-mucosal crown margins. [ABSTRACT FROM AUTHOR]