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Background This study aimed to develop a simplified version of the 25-item Ganbatta Scale (i.e., Ganbatta Scale-Short Form to objectively assess behaviors associated with “ganbatta” (“I did my best/I pushed myself/I tried hard”) in children aged 3–7 years who undergo blood sampling and vaccination. Methods A cross-sectional survey was conducted among 1143 nurses working in pediatric or outpatient clinics using a questionnaire with 11 items on the respondents' demographics and 25 items on behaviors associated with the “ganbatta” concept in children undergoing needle procedures. Data factor analysis was performed using the principal factor extraction method with promax rotation. Results Overall, 3 factors containing 16 items were extracted from the survey results. The three factors were a “Sense of relief and joy after needle removal” (seven items), “Proactive participation” (six items), and “Negative emotional expression” (three items). Reliability analysis revealed coefficients of 0.927 for all 16 items and 0.904, 0.893, and 0.912 for Factors 1, 2, and 3, respectively. We compared the “ganbatta” concept to the three factors; it encompassed various meanings, such as children’s post-procedure sense of joy associated with their successful efforts, as characterized by Factor 1. The children's positive behavior aimed to overcome their existing condition through a change of attitude, as characterized by Factor 2, and their behavior highlighted “perseverance” as a prerequisite skill associated with the “ganbatta” concept, as characterized by Factor 3. Conclusions This simplified version of the scale can be used in clinical practice owing to its reduced number of items (16). Trial registration: Not applicable

This study was conducted to determine how skilled nurses perceive the independence of children with congenital heart disease. A questionnaire survey was administered to elicit responses to questions such as whether the skilled nurses noticed problems with the independence of children with congenital heart disease, and whether they thought that support from adults close to the children was needed to foster independence. More than 60% of the 84 nurses perceived problems regarding the independence of children with congenital heart disease. Situations in which skilled nurses noticed problems, in addition to difficulties and limitations in understanding of the disease, included instances of family members making decisions and answering questions and of the child being unable to communicate easily. Nearly all of the skilled nurses felt that support from adults close to children with congenital heart disease was needed to foster their independence.

GANBATTA ("Well done!") is a term used frequently in Japan to praise children in medical settings when they have worked hard or made a courageous attempt. Therefore, the aim of this study was to clarify the factor structure of behaviors associated with ganbatta in young children (age 3-7 years) undergoing blood sampling or vaccine injection. A cross-sectional questionnaire survey was carried out on 150 selected pediatric nursing educators holding a nursing license (age ≥20 years). An exploratory factor analysis was then conducted using the principal factor method with promax rotation to confirm the construct validity. Cronbach's α coefficients were calculated for each identified factor to verify the internal consistency of the item. The mean (standard deviation) lengths of pediatric nursing and pediatric nursing education experience were 7.8 (4.7) and 9.9 (8.1) years, respectively. The cumulative contribution rate was 70.4%. The KMO measure of sampling adequacy was 0.927. The p value of Bartlett's test of sphericity was

Tricholoma bakamatsutake, which forms its fruit body in oak forests, is similar to T. matsutake in shape and odor; therefore, it is expected to have a high economic value similar to T. matsutake. Recently, the fruit bodies of T. bakamatsutake were produced after planting of a Quercus phillyraeoides sapling with a pure culture of the fungal mycelia. This fungus forms pigmented thick-walled spores (chlamydospores [CSs]) terminally on the hyphae in culture and in the field settings. Abundant CS production in vitro seems to be advantageous for cultivating mycorrhizal trees inoculated with T. bakamatsutake CSs. We investigated the effects of adding 16 different nitrogen (N) compounds (three inorganic and 13 organic) to a culture medium on vegetative hyphal growth and CS formation. The growth of T. bakamatsutake was reduced by many of the N sources used. Conversely, the rate of CS formation was improved by the addition of valine or glutamine.

An important factor controlling tree species diversity is conspecific density dependence (CDD). Adult trees associated with arbuscular mycorrhiza (AM) and ectomycorrhiza (ECM) can exhibit negative and positive CDD effects on conspecific recruitment, respectively. However, the extent to which these mycorrhizal associations affect spatial distributions of individual trees and their relative abundances within forests through CDD remains uncertain. We analysed changes in spatial correlations between adults and conspecific juveniles at different growth stages of five hardwood species in a 6-ha plot of an old-growth forest using a point pattern analysis. The clump sizes of large individuals were also evaluated using the Iδ index (a measure of individual dispersion) in 24 species. In two AM-associated species, juveniles were distributed at greater distances with increasing size or were always distributed at a distance from adults, resulting in small clumps of adults. In contrast, juveniles of two ECM-associated species were distributed close to adults during early or late growth stage, resulting in large clumps of adults. Juveniles of an ECM-associated species disappeared with increasing size, probably due to shade intolerance. In 24 tree species with large numbers of individuals within a plot, the relative basal area was related to both mycorrhizal type and maximum diameter, suggesting that the relative abundance of a species is largely related to its mycorrhizal associations and maximum plant size. This study strongly demonstrated that mycorrhizal associations play an important role in determining the spatial distribution patterns and community structure of tree species through CDD.

Conspecific negative distance dependent seedling mortality and negative density-dependent seedling survival (CNDD) are among the most important mechanisms of species diversity maintenance. Recent research has demonstrated that CNDD is greater for species with abundant seeds, due mainly to attack by density-dependent pathogens. If seed number were correlated negatively with seed size, species with smaller seeds would exhibit much greater negative CNDD. We explored whether CNDD is affected by seed size. We evaluated the strength of CNDD as a log response ratio of the probability of mortality among seedlings at conspecific and heterospecific sites and at high and low densities as functions of distance and density, respectively, in a seed-sowing experiment using eight hardwood species in a temperate forest in northern Japan. As a function of distance, CNDD attributable to pathogens was correlated positively with seed mass at low density, but not at high density, whereas seed mass was not correlated with CNDD attributable to invertebrate or vertebrate herbivores. As a function of density, seed mass was not correlated with CNDD attributable to pathogens or invertebrate or vertebrate herbivores. The ability of large-seeded species to better tolerate CNDD suggests a novel mechanism through which seed size may contribute to CNDD variation and promote species coexistence due to distance-dependent attack by pathogens, particularly those bearing leaf diseases.

To evaluate the extent to which landslides affect community dynamics and consequent species diversity in a beech-dominated forest, differences in the composition and size structure of tree species were compared between landslide and adjacent stable (control) stands. Demography and changes in size were compared between the two stands over a 5-year period about 60 years after a landslide. In the control stand, replacement occurred even amongst late-successional species, with beech (Fagus crenata)—the most dominant species—increasing in relative abundance. In the landslide stand, very few large individuals of late-successional species occurred, whereas large individuals of early-successional species occurred only in the landslide stand. The traits indicate that the landslide strongly facilitated species diversity, not only by reducing the dominance of late-successional species, but also by promoting recruitment of early-successional species. However, new recruitment of early-successional species was inhibited in the landslide stand, although we observed succeeding regeneration and subsequent population growth of late-successional species there. As a result, the relative dominance of late-successional species increased with succession after the landslide, thus decreasing future species diversity. In beech-dominant forest landscapes in Japan that include communities with different developmental stages, the mosaic of serial stages may facilitate species diversity after a landslide.

Tricholoma matsutake (S. Ito & S. Imai) Singer and its allied species are referred to as matsutake worldwide and are the most economically important edible mushrooms in Japan. They are widely distributed in the northern hemisphere and established an ectomycorrhizal relationship with conifer and broadleaf trees. To clarify relationships among T. matsutake and its allies, and to delimit phylogenetic species, we analyzed multilocus datasets (ITS, megB1, tef, gpd) with samples that were correctly identified based on morphological characteristics. Phylogenetic analyses clearly identified four major groups: matsutake, T. bakamatsutake, T. fulvocasta- neum and T. caligatum; the latter three species were outside the matsutake group. The haplotype analyses and median-joining haplotype network analyses showed that the matsutake group included four closely related but clearly distinct taxa (T. matsutake, T. anatolicum, Tricholoma sp. from Mexico and T. magnivelare) from different geographical regions; these were considered to be distinct phylogenetic species.

To evaluate the role of thinning intensity in increasing hardwood diversity in managed coniferous forests, we investigated the effects of environmental changes caused by thinning on the seedling demography (i.e. seedling emergence, survival, and growth) of hardwood species for 5 years after thinning in 67% thinned (Intensive), 33% thinned (Weak), and unthinned treatments (Control) in a Cryptomeria japonica plantation in northern Japan. Intensive thinning strongly increased light and soil temperature but reduced litter accumulation, thus facilitating seed germination, seedling emergence, and seedling survival of primarily early- and mid-successional species compared to late-successional species. As a result, more early- and mid-successional species were observed in Intensive compared to Weak and Control, whereas the number of late-successional species did not differ among thinning intensities. Thus, the number of species was greatest in Intensive but lowest in Control throughout the 5 years. However, Shannon’s diversity index (H′) did not strongly differ among thinning intensities, largely due to the predominance of the mid-successional species Cornus controversa, particularly in Intensive. In Control and Weak, both seedling survival and height were often greater for advance regeneration than for seedlings newly emerged in the year following thinning, whereas neither variable differed between advance regeneration and seedlings newly emerged in Intensive, mainly due to selective predation of advance regeneration by mammalian herbivores. These results suggest that the future composition of hardwoods can be roughly predicted by the composition of advance regeneration in Weak but by the composition of both advance regeneration and seedlings newly emerged in Intensive. When comparing large individuals (height >1.5 m), the number of species was greatest in Intensive in 2008, 5 years post-thinning, primarily due to rapid vertical growth regardless of successional status. These results suggest that within a C. japonica plantation, a canopy-level mixed conifer-hardwood forest would be more probable and occur more rapidly in Intensive compared to Weak. In Weak, enhanced species diversity would likely be restricted to the understorey layer because of the slower growth rate and lower survival rate of hardwood seedlings caused by the more rapid deterioration of favourable environmental conditions.

Summary 1. In forest communities, the Janzen–Connell (J–C) model proposes that species diversity is maintained by noncompetitive distance- or density-dependent seedling mortality caused by host-specific natural enemies. Host specificity, however, has not been fully elucidated. 2. We conducted a cross-inoculation experiment to evaluate the host specificity of a pathogenic fungus, Colletotrichum anthrisci. The fungus was isolated from seedlings of four tree species (Prunus grayana, Fraxinus lanuginosa, Cornus controversa and Magnolia obovata), all of which were killed by damping-off disease beneath conspecific adults. Each fungal isolate was then inoculated into seedlings of P. grayana and F. lanuginosa. Molecular identification [internal transcribed spacer (ITS) sequences] also confirmed that all isolates (strains) showed 99–100% similarity with C. anthrisci, irrespective of their origin. 3. In both P. grayana and F. lanuginosa seedlings, all isolates of the pathogen caused damage, irrespective of origin, but the damage was more severe with the isolate from conspecifics rather than from any of the three heterospecifics. 4. In response to infection, callose papillae were deposited on the inner side of the leaf cell wall of seedlings in P. grayana; then, circular abscission layers formed between two layers of leaf cells surrounding the locus of infection. The central area of the infection was completely cut off from the rest of the leaf. In F. lanuginosa, infected leaves of seedlings were shed immediately after inoculation. This defensive behaviour, which may prevent further pathogen invasion, was more frequent in seedlings inoculated with isolates from conspecifics than from heterospecifics in both species. 5. Synthesis. Although the pathogenic fungus C. anthrisci is ubiquitous and attacks a wide range of host species, virulence was much stronger for strains derived from conspecifics rather than from heterospecifics, suggesting local adaptation and development of host specificity. If host specificity is common for several pathogens within a microbial community in a given area occupied by an adult, and the trait is also common for multiple tree species co-occurring within a forest community, the J–C model would be applicable to explain tree species diversity.

Tricholoma matsutake is the most commercially important edible mushroom in pine forests in Japan. Tricholoma bakamatsutake and T. fulvocastaneum, species closely related to T. matsutake, occur in Fagaceae forests. We examined ectomycorrhizal (EM) formation by these Tricholoma species by in vitro synthesis among seven strains (two of T. matsutake, four of T. bakamatsutake, one of T. fulvocastaneum) and axenic plants of pine (Pinus densiflora) and oak (Quercus serrata, Q. phillyraeoides). All strains, except for one of T. matsutake, formed EM associations with both pine and oak. Plant growth and mycelial development were differently affected by EM formation depending on the plant-fungus combination.

Anomalous junction of pancreaticobiliary duct (AJPBD) patients has an increased risk of gallbladder and bile duct carcinomas. However, the relevance of carcinoma with AJPBD is not fully clarified. We performed analysis of loss of heterozygosity (LOH) at p53 locus and immunohistochemistry of p53 and K-ras gene mutation in five cases of gallbladder carcinoma associated with AJPBD. LOH of p53 locus and overexpression of p53 were detected in two out of five (40%) and five out of five (100%), respectively, in the present study. K-ras gene mutation at codon 12 and 13 was not detected (0%, 0/5). These results suggest that aberrations of p53 are involved in carcinogenesis of gallbladder carcinoma associated with AJPBD. Next, in order to find the genetic events besides K-ras mutation and overexpression of mutant p53 in this disease, LOH analysis was performed using 72 microsatellite markers. High frequency of allelic loss (> 50%) was found on 2p (81.8%), 4p (50%), 4q (50%), 8q (60%), 9q (50%), 10p (50%), 14p (60%), 14q (50%), 16p (60%), 19p (50%), 21p (50%) and Xp (66.6%). The highest deletion regions on chromosome 2p24 (3/3, 100%), 14q22 (3/4, 75%) and 21q22 (3/4, 75%) were found. The present study suggests that gallbladder carcinoma associated with AJPBD has high frequent allelic loss and has two new regions which may harbor putative tumor suppressor genes.

Lens culinaris agglutinin-reactive fraction of α-fetoprotein (AFP-L3) is a specific marker used to detect hepatocellular carcinoma (HCC). However, its clinical utility is not sufficient in patients with low total AFP concentrations because of limitations in instrument sensitivity. Recent advances have led to the introduction of a highly sensitive AFP-L3% assay (sensitive AFP-L3%), provided by a novel on-chip, liquid-phase binding assay. This cross-sectional study was conducted to evaluate the clinical significance of the sensitive AFP-L3% in determining HCC recurrence in patients with low total AFP concentrations.A total of 370 consecutive patients with HCC were screened within 1-3 months of locoregional treatment, and 215 of the 370 patients showed serum AFP20 ng/ml. Total AFP, sensitive AFP-L3%, and des-gamma-carboxy prothrombin (DCP) were measured in those 215 patients and HCC recurrence was evaluated by radiological findings. Optimal cutoff values of the markers for detecting HCC recurrence were obtained on the basis of receiver operating characteristic (ROC) curve.The area under the ROC curve of the total AFP, sensitive AFP-L3%, and DCP in HCC patients with serum AFP20 ng/ml were 0.638, 0.724, and 0.779, respectively. The diagnostic accuracies of the total AFP, sensitive AFP-L3%, and DCP were 60.9% (cutoff value 5 ng/ml), 67.7% (cutoff value 7%), and 64.6% (cutoff value 40 ng/ml), respectively.The new sensitive AFP-L3% assay provides great utility in determining HCC recurrence in patients with low AFP concentrations. Further studies focusing on the combinatorial use of the markers (total AFP, sensitive AFP-L3%, and DCP) are required.

Hokkaido Prefecture of Japan covers a vast geographical area. The uneven distribution of medical personnel in Hokkaido is accountable for the scarcity of medical services in certain areas. As a result, the anxiety of the population living in those underserved areas increases, thereby posing a serious social concern. The interprofessional education (IPE) program was proposed as a response to a concern about community health care. This program was meant to systematize various practical experience training programs and restructure them into one joint curriculum for community health care, in addition to expanding the residential community internship program. This enables the entire university to undertake consistent education on community health. The residential community and team-based training programs aim at producing professionals who will serve in the community. These programs encourage students to have an interest in community health as professionals through practice training during their initial school years. Furthermore, the residential joint curriculum (team-based residential community health care internship) provides students with an opportunity to interact not only with medical professionals but also patients and their families and health care staff. This leads to opening their eyes to disease prevention specifically and more widely to community issues. Through IPE, students are expected to: (1) strengthen their interest in community health care, which they have had even upon entry to the university; (2) deepen their understanding of the community, particularly community health care; (3) obtain an appreciation toward and a sense of empowerment within community health care; and (4) develop a sense of mission and deep commitment to community health care.