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Aim: We aimed to elucidate the present clinical situation, future challenges, and potential need for diagnostic support software in Kampo medicine. Methods: We conducted an online survey (comprising 28 questions) of Japanese physicians from the 23 to 24 January 2024 via MedPeer. The participants' responses were stratified according to their age distribution. Results: We evaluated data for 652 respondents. The most common respondent age groups were those in their 30s and 40s. The most common specialty of respondents was internal medicine (43.7%). Only 33.7% of respondents had received education on Kampo medicine at university. Most respondents (90.0%) were not licensed as certified physicians or members of the Japan Society for Oriental Medicine. Most respondents (86.7%) currently prescribed Kampo formulas (current users); only 3.8% had no experience in prescribing Kampo formulas. The conditions for which Kampo formulas were frequently prescribed were muscle cramps, constipation, medically unexplained symptoms/menopausal syndrome, appetite loss/malnutrition, and fatigue. However, 48.3% of current users did not use traditional Kampo patterns (sho). The most frequent issues reported by respondents were the lack of scientific evidence and standardization of diagnostic methods in Kampo medicine. Respondents indicated the need for postgraduate education and implementation of diagnostic support software for using Kampo patterns by non‐specialists in Kampo medicine. Conclusion: There was a discrepancy between the high frequency of Kampo formula prescriptions and the low use of traditional Kampo patterns in Japan. Diagnostic support software is likely to become a useful method of improving appropriate Kampo formula prescriptions by non‐specialists. [ABSTRACT FROM AUTHOR]

This article discusses the use of Zokumeito (ZMT), a traditional medicine, for the rapid recovery of consciousness and physical function in a patient with cerebral infarction. ZMT is a combination of various herbs and is not available as an extract, so the authors prescribed similar medicines that contained some of the same ingredients. The patient, a 91-year-old male, showed significant improvement in his condition after starting the treatment, including increased vocalizations, the ability to sit in a wheelchair, and eventually being able to eat and drink without assistance. The authors note that further research is needed to fully understand the effects of ZMT in stroke patients. [Extracted from the article]

Background: The source of ninjin'yoeito (NYT) is considered the 'Formulary of Bureau of Taiping People's Welfare Pharmacy', written around 1241–52 AD. NYT is used to treat patients with chronic fatigue, malaise with qi deficiency, and exhaustion of all five parenchymatous viscera with difficulty in recovering. Key Findings: NYT formula consists of 12 crude drugs. NYT extract for medical use is covered by the National Health Insurance system of Japan for convalescence after recovery from diseases, fatigue and malaise, anorexia, perspiration during sleep, cold limbs, and anemia. Studies have shown clinical effects of NYT: treatment of anemia, cancer treatment support, frailty, cognitive dysfunction, apathy, fatigue/malaise, anorexia, and lung diseases. Preclinical studies support clinical studies; activating ghrelin‐neuropeptide Y pathway‐mediated appetite‐enhancing effects, inhibiting muscle volume loss through the Akt/mTOR pathway‐mediated hyperphosphorylation of 4E‐BP1 and FoxO1‐mediated Atrogin‐1, suppressing the hypothalamic–pituitary–adrenal axis by downregulating the sympathetic‐adrenal‐medullary axis and GABA neurons for improving sociability, promoting recovery from skeletal muscle atrophy through the activation of PGC‐1α, hematopoiesis‐promoting effects, and increasing the number of immune cells in immunocompromised models. The incidence of adverse events of NYT was reported as 3.09 or 2.03%. The most significant adverse effects of NYT are gastrointestinal disorders. Conclusion: Recently, NYT has been widely used to treat several symptoms and conditions under the National Health Insurance System of Japan. Clinical studies showed the efficacy of NYT to treat anemia, frailty, cognitive dysfunction, anorexia, apathy, and fatigue/malaise, as well as for long‐term cancer treatment support. The pharmacological mechanisms supporting its effects are also being reported. [ABSTRACT FROM AUTHOR]

Background: The origin of hangekobokuto (HKT) is from Jin Gui Yao Lue (Kinkiyōryaku in Japanese), and it has been indicated for treating throat discomfort in women. Key Findings: HKT consists of five crude drugs. Clinical studies have shown that HKT can improve the swallowing reflex by increasing the substance P level in saliva; improve the cough reflex; reduce pneumonia in patients with dementia, cerebrovascular disease, Alzheimer's disease, or Parkinson's disease; reduce postoperative aspiration pneumonia in patients who undergo cardiovascular surgery; and improve depression and anxiety scores in patients with globus hystericus. Furthermore, HKT has been reported to increase serotonin (5‐HT) and noradrenaline levels in the hypothalamus, and dopamine (DA) levels in the striatum in a healthy rodent model; improve 5‐HT levels in the striatum and hippocampus, and ameliorate 5‐HT and DA reductions in the whole brain in an acute stress model; improve 5‐HT levels in the striatum, and ameliorate 5‐HT and DA reductions in the prefrontal cortex in a chronic stress model; and decrease corticosterone and corticotropin‐releasing factor levels in a chronic stress model. Reported adverse events of HKT include interstitial pneumonia (0.38 per 100 000 cases) and liver damage (0.89 per 100 000 cases), which are rare. Conclusion: HKT is widely used and shows a low rate of adverse events. Several clinical studies have reported its effects in reducing aspiration pneumonia and improving depression and anxiety, some of which may be explained by the regulation of monoamines and stress hormones in the brain and substance P levels in the oral cavity. [ABSTRACT FROM AUTHOR]

The well-established notion that the frequency of self-interested unethical behavior increases among anonymous people was reexamined employing a more strict definition of anonymity, voluntary unethical behavior, and adult individuals. Anonymity was defined as nonassociability of the participant's traits with respect to unethical behavior. The participant's identity and a monetary reward were manipulated as the independent variables, while cheating behavior was observed as the dependent variable. A sample of 143 undergraduate students were randomly assigned to 1 of 4 conditions (nonidentifiable-reward, identifiable-reward, nonidentifiable-nonreward, or identifiable-nonreward condition) to flip a coin twice in the experimental assignment. Results indicated that participants behaved differently depending on anonymity status and reward status. Implications for unethical behavior among anonymous individuals are discussed. (Contains 3 tables and 1 figure.)

The present study examined association between anonymity and antisocial individual behavior without any influence from the presence of others. Anonymity was operationally defined as consisting of two components, nonidentifiability and nonaccountability. Antisocial behavior was defined as rule-breaking behavior seeking a monetary reward. It was hypothesized that anonymity would increase antisocial behavior among individuals. Undergraduate students (20 men, 50 women) were recruited from two psychology classes and were randomly assigned to four experimental conditions (Anonymous, Nonidentifiable, Nonaccountable, and Nonanonymous) to examine whether they would violate game rules to obtain the monetary reward through anonymity. Only participants in the Anonymous condition violated the rules to obtain the reward. Implications for the effects of anonymity on antisocial individual behavior are discussed.

Aim: We present the study protocol of a multicenter, retrospective observational study that aims to investigate the efficacy of the actual treatment (the efficacy of conventional and Kampo medicines) of patients with mild to moderate or suspected coronavirus disease (COVID‐19). Methods: This study is designed as a multicenter, retrospective observational study. Outpatients and inpatients will be recruited from Japanese hospitals. The inclusion criteria are as follows: having or suspected to have COVID‐19, mild to moderate COVID‐19, symptomatic, ≥20 years of age, male or female, able to communicate in Japanese, and treated with conventional and Kampo medicine. The exclusion criteria are: unable to provide informed consent due to dementia, psychosis, or psychiatric symptoms, severe COVID‐19, or determined unsuitable for this study. The sample size is set at 1000, as this number of people can be treated at the collaborating medical institutions during the study period. Results: The main outcome is the number of days without fever, with a body temperature of less than 37°C. The secondary outcome is set at common cold‐like symptoms other than fever (fatigue, cough, shortness of breath, sputum, diarrhea) and severity of illness and hospitalization up to 14 days after the visit. Trial registration: The trial was registered in the University Hospital Medical Information Network (Reservation No. UMIN000041301) on August 4, 2020. Conclusion: Our study will explore the contribution of conventional and Kampo medicine in the treatment of patients with mild and moderate COVID‐19. [ABSTRACT FROM AUTHOR]

Context: In Japan, many patients who cannot consume food orally are managed using external tube feeding over long periods. Although helpful in nutritional management, tube feeding significantly reduces a patient's quality of life. Aims: We examined the factors that affected the transition from tube to oral feeding in elderly people. Settings and Design: Single-center, retrospective, pilot study conducted from January 1, 2018 to December 28, 2019. Methods and Materials: We recruited patients who attempted to return to oral intake following tube feeding for >12 months at Miyama Hospital. Fourteen participants (male-to-female ratio = 6:8; age = 83.9 ± 2.6 years) attempted to resume oral feeding. We investigated patient diagnoses, duration of tube feeding, sex, swallowing reflex time, and Kohnan consciousness score. Patients with a swallowing reflex >4 s were administered banxia houpu tang. Results: Of the 14 patients, seven managed to resume oral feeding (group 1), while the remaining seven failed (group 2). The two groups of patients showed no significant difference in terms of mean age, duration of tube feeding, swallowing reflex time, and sex. However, the consciousness level of group 1 was significantly higher than that of group 2. Conclusions: Higher consciousness level in patients who successfully resumed oral feeding suggests that oral feeding should be considered in patients with adequate consciousness. [ABSTRACT FROM AUTHOR]

The present study was designed to shed light on the origin of disaster myths, such as panic, looting, crime, and psychological shock in postdisaster situations, by examining effects of secondhand information and the moderating effect of anxiety on such negative misconceptions. It was hypothesized that secondhand information on disaster behaviour, such as media reports and word‐of‐mouth rumours, and trait anxiety would increase the degrees to which people gave credit to four popular disaster myths. Also, trait anxiety was predicted to moderate the association between information sources and disaster myths. Questionnaire data obtained from 1,500 Japanese participants indicated that people relying on secondhand information gave more credit to all the four misconceptions than those relying on firsthand information such as direct disaster experience. However, trait anxiety was not found to significantly affect the degrees of the disaster myths. Furthermore, the moderating effect of trait anxiety on the association between the information sources and the disaster myths was not observed in any of the four myths. The present results imply that although reliance on secondhand information increases the degree of disaster myths to some extent, there should be other causes from which disaster myths originate. [ABSTRACT FROM AUTHOR]