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Akemi Sawai,1,* Bryan J Mathis,2,* Hiroaki Natsui,3 Alexander Zaboronok,2 Risa Mitsuhashi,1 Yuki Warashina,4 Noboru Mesaki,4 Hitoshi Shiraki,4 Koichi Watanabe4 1Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 2Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; 3Faculty of Sports and Health Sciences, Japan Women’s College of Physical Education, Setagaya-ku, Tokyo, Japan; 4Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan *These authors contributed equally to this work Introduction: Menstrual dysfunction, musculoskeletal injury, and poor nutrition combine to form the female athlete triad (FAT), which results in serious health consequences for affected athletes. To this point, the risk factors of this phenomenon have not been fully explored in Japanese female college athletes. Additionally, the effect of competitive level on FAT risk factors has also not been reported. Therefore, we aimed to examine FAT risk factors in Japanese female athletes of various sports as well as examine the impact of competitive level on FAT.Methods: A Japanese-language survey was completed by 531 athletes and 20 nonathletes at two Japanese universities and answers with regard to menstrual status, musculoskeletal injury, nutrition, and other variables were analyzed based on classification of the sports into nine distinct groups based on activity type. Sport intensity, training volume, and competitive levels were used to further classify each sport. One-way ANOVA and the Bonferroni post hoc test using SPSS were carried out to analyze significance for relationships between sport intensity and FAT risk factors. Additionally, the relationship between competitive level and FAT risk factors was analyzed by ANOVA and Bonferroni post hoc tests.Results: Sport intensity was positively correlated with a delay in menarche as well as dysmenorrhea and poor nutrition while musculoskeletal injury was correlated with repetitive, high-training volume sports. Lower competitive levels increased dysmenorrhea but did not impact injury status or nutrition.Conclusion: Sport intensity and training volume, but not competitive level, are the critical factors affecting FAT risk in Japanese female college athletes. Keywords: athletes, dysmenorrhea, FAT, female, Japanese, triad

Cancers rely on multiple, heterogeneous processes at different scales, pertaining to many biomedical fields. Therefore, understanding cancer is necessarily an interdisciplinary task that requires placing specialised experimental and clinical research into a broader conceptual, theoretical, and methodological framework. Without such a framework, oncology will collect piecemeal results, with scant dialogue between the different scientific communities studying cancer. We argue that one important way forward in service of a more successful dialogue is through greater integration of applied sciences (experimental and clinical) with conceptual and theoretical approaches, informed by philosophical methods. By way of illustration, we explore six central themes: (i) the role of mutations in cancer; (ii) the clonal evolution of cancer cells; (iii) the relationship between cancer and multicellularity; (iv) the tumour microenvironment; (v) the immune system; and (vi) stem cells. In each case, we examine open questions in the scientific literature through a philosophical methodology and show the benefit of such a synergy for the scientific and medical understanding of cancer.

Abstract The objective of the present study was to evaluate the risk factors and outcomes associated with hyponatremia in patients with Guillain-Barré syndrome (GBS). We retrospectively studied 80 consecutive patients with GBS who visited our hospital and compared clinical, laboratory, and electrophysiological findings of patients with and without hyponatremia. Disability was evaluated using the Hughes grading system. Of the 80 patients, 18 (23%) had hyponatremia. Hyponatremia was significantly associated with older age (P = 0.003), urinary retention (P

Objective We previously reported that CD14+ dendritic‐shaped cells exhibit a dendritic morphology, engage in pseudo‐emperipolesis with lymphocytes, and express CD90 in the perivascular areas of rheumatoid arthritis (RA) synovial tissues. However, it remains unclear whether these CD14highCD90intermediate(int) cells function as dendritic cells. In this study, we investigated the dendritic cell–differentiation potential of CD14highCD90int cells. Methods The localization and number of CD14highCD90int cells in RA synovial tissues and peripheral blood were examined. The dendritic cell–differentiation potential of CD14highCD90int cells was examined by measuring interleukin‐6 and tumor necrosis factor‐α levels in the supernatant and CD83 and human leukocyte antigen (HLA)‐DR expression in the cells after induction of dendritic cell differentiation. Synovial cells were co‐cultured with lymphocytes, and the activation of these cells was examined. Results CD14highCD90int cells were abundant in RA synovial tissues, including the sublining layer and the pannus areas. Patients with untreated and active RA had significantly higher percentages of CD14highCD90int cells in the peripheral blood and synovial tissues. In RA synovial cells, inflammatory cytokine levels increased with dendritic cell–differentiation culture, but CD83 and HLA‐DR expression were significantly increased in the CD14highCD90int cell group. When co‐cultured with lymphocytes, cell numbers and inflammatory cytokine levels significantly increased in both groups of synovial cells after dendritic cell induction. Conclusion CD14+ cells migrate and spread from the circulating blood to RA synovial tissues while expressing CD90, and CD14highCD90int cells in contact with lymphocytes differentiate into HLA‐DR+ dendritic cells, which contribute to chronic inflammation in RA.

Sechang Oh,1 Takashi Shida,1 Akemi Sawai,1 Tsuyoshi Maruyama,2 Kiyoshi Eguchi,2 Tomonori Isobe,1 Yoshikazu Okamoto,3 Noriko Someya,4 Kiyoji Tanaka,4 Emi Arai,1 Akiko Tozawa,5 Junichi Shoda1 1Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, 2Department of Rehabilitation, Tsukuba University Hospital, 3Department of Diagnostic Radiology, 4Department of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 5Protea Japan Co Ltd, Chiyoda, Tokyo, Japan Background: While aerobic training is generally recommended as therapeutic exercise in guidelines, the effectiveness of resistance training has recently been reported in the management of nonalcoholic fatty liver disease (NAFLD). Acceleration training (AT) is a new training method that provides a physical stimulation effect on skeletal muscles by increasing gravitational acceleration with vibration. AT has recently been indicated as a component of medicine. In this study, we evaluated the effectiveness of AT in the management of NAFLD in obese subjects.Methods: A total of 18 obese patients with NAFLD who had no improvement in liver function test abnormalities and/or steatosis grade after 12 weeks of lifestyle counseling were enrolled in an AT program. These patients attended a 20-minute session of AT twice a week for 12 consecutive weeks.Results: During the AT program, the NAFLD patients showed a modest increase in the strength (+12.6%) and cross-sectional area (+3.1%) of the quadriceps, coupled with a significant reduction in intramyocellular lipids (−26.4%). Notably, they showed a modest reduction in body weight (−1.9%), abdominal visceral fat area (−3.4%), and hepatic fat content (−8.7%), coupled with a significant reduction in levels of aminotransferase (−15.7%), γ-glutamyltransferase (−14.4%), leptin (−9.7%), interleukin-6 (−26.8%), and tumor necrosis factor-α (−17.9%), and a significant increase of adiponectin (+8.7%). On a health-related quality of life survey, the patients showed an improvement in physical functioning (+17.3%), physical role (+9.7%), general health (+22.1), and social functioning (+6.0%).Conclusion: AT reduced hepatic and intramyocellular fat contents and ameliorated liver function test abnormalities in obese patients with NAFLD, which was coupled with improved physical function and body adiposity. AT is clinically beneficial for the management of NAFLD. Keywords: whole-body vibration, obesity, liver steatosis, adipokine, quality of life

This study aimed to develop a method to evaluate the quality of bovine in vitro fertilized (IVF) embryos based on gene expression profiling via whole-transcriptome amplification. The expression of 11 developmentally important genes in individual bovine in vivo-derived (IVD) and IVF embryos were examined. Gene expression profiling was conducted by classifying the expression level of each gene in individual embryos as low, medium, or high. The IVF group had a higher (P < 0.01) proportion of embryos with low expression of SOX2, NANOG, and FGF4. In addition, a correlation analysis between the expression levels of each gene in individual embryos demonstrated that the relationship between gene expression differed with respect to IVD and IVF embryos. Our results suggest that the expression profiling of developmentally important genes using IVD embryos as normal controls could be a useful indicator for evaluating the quality of bovine IVF embryos.

Abstract Objectives Thoracoscopy under local anaesthesia is widely performed to diagnose malignancies and infectious diseases. However, few reports have described the use of this procedure for diagnosing and treating intrathoracic infections. This study aimed to evaluate the safety and efficacy of thoracoscopy under local anaesthesia for the management of intrathoracic infections. Results Data from patients who underwent thoracoscopy procedures performed by chest physicians under local anaesthesia at our hospital between January 2018 and December 2023 were retrospectively reviewed. We analysed their demographic factors, reasons for the examinations, diseases targeted, examination lengths, anaesthetic methods used, diagnostic and treatment success rates, as well as any adverse events. Thirty patients were included. Of these, 12 (40%) had thoracoscopies to diagnose infections, and 18 (60%) had them to treat pyothorax. In terms of diagnosing pleurisy, the causative microorganism of origin was identified via thoracoscopy in only three of 12 (25.0%) patients. For diagnosing pyothorax, the causative microorganism was identified in 7 of 18 (38.9%) patients. Methicillin-resistant Staphylococcus aureus was the most common causative microorganism identified. The treatment success rates were very high, ranging between 94.4 and 100%, whereas the identification rate of the causative microorganisms behind infections was low, ranging between 25.0 and 38.9%. The most frequent adverse events included perioperative hypoxaemia and pain. There were two (6.7%) serious adverse events of grade ≥ 3, but none resulted in death. Conclusions The efficacy of managing intrathoracic infections through thoracoscopy under local anaesthesia is commendable. Nonetheless, the diagnostic accuracy of the procedure, regarding the precise identification of the causative microorganisms responsible for intrathoracic infections, persists at a notably low level, presenting a substantial clinical hurdle.

Abstract Background Pembrolizumab (PEM), an immune checkpoint inhibitor (ICI), is often used for triple-negative breast cancer, but can also be used to treat solid tumors that exhibit high microsatellite instability (MSI-High). However, patients with breast cancer rarely have MSI-High, the use of PEM in such cases in clinical practice is uncertain due to lack of sufficient supporting data. Here, we report the case of a premenopausal woman in who received PEM for MSI-High luminal-type breast cancer. Case presentation A 40-year-old premenopausal Asian woman was diagnosed with stage IIA (T2N0M0) breast cancer and had an Oncotype DX recurrence score of 38. After surgery, she received 4 courses of chemotherapy with docetaxel and cyclophosphamide. After 3 months of tamoxifen therapy, the patient complained of abdominal pain due to right iliac metastasis, and biopsy of the metastatic lesion showed of luminal type; she was sequentially treated with fulvestrant, a CDK4/6 inhibitor, and an anticancer drug (TS1), but over the next year, metastasis to the bone and para-aortic lymph nodes increased. Tumor was MSI-High; PEM was started, and after three courses, bone metastases were reduced, para-aortic lymph node metastases resolved, opioids were discontinued, and the patient returned to society; PEM was administered for 1 year with no worsening of bone metastases on imaging. Asymptomatic brain metastasis less than 1 cm was detected and gamma knife was performed. Six months after completion of PEM, the patient is working with no new lesions. Conclusion We report a case of luminal-type breast cancer with bone metastases and MSI-High, which was treated with PEM and showed a rapid therapeutic response.

Abstract The social amoeba Dictyostelium discoideum switches between solitary growth and social fruitification depending on nutrient availability. Under starvation, cells aggregate and form fruiting bodies consisting of spores and altruistic stalk cells. Once cells socially committed, they complete fruitification, even if a new source of nutrients becomes available. This social commitment is puzzling because it hinders individual cells from resuming solitary growth quickly. One idea posits that traits that facilitate premature de-commitment are hindered from being selected. We studied outcomes of the premature de-commitment through forced refeeding. Our results show that when refed cells interacted with non-refed cells, some of them became solitary, whereas a fraction was redirected to the altruistic stalk, regardless of their original fate. The refed cells exhibited reduced cohesiveness and were sorted out during morphogenesis. Our findings provide an insight into a division of labor of the social amoeba, in which less cohesive individuals become altruists.

A new mathematical model can estimate the number of precursor cells that contribute to regenerating blood cells in mice.

SIGNIFICANCE: Myopia holds significant public health concern given its social, ocular disease and economic burdens. Although environmental factors are primarily to blame for the rapid rise in prevalence, key risk factors remain unresolved. PURPOSE: The aim of this study was to objectively characterize, using a wearable technology, the temporal indoor and outdoor behavioral patterns and associated environmental lighting characteristics of young myopic and nonmyopic University students. METHODS: Participants were recruited to continuously wear an Actiwatch for 3 weeks, during either or both academic and non-academic periods. The device allows continuous recording of activity and incident light. Recorded illuminance levels were used as a proxy for outdoors (>1,000 lux), with the dynamics (interval frequency and duration) of indoor and outdoor activities, as well as lighting characteristics derived. In addition, participant input regarding near work was obtained daily. Participants were classified by both myopia and axial length status (based on collected refractive error and biometry data) for the purpose of data analysis. RESULT: A total of 55 students, aged 18 to 25 years of age, participated. Overall, the dosing of indoor and outdoor activities was similar across participants, regardless of myopia status, during the academic period. Nonetheless, an apparent difference in the timing of outdoor activities was noted with myopes going outdoors later in the day, particularly during the weekend (p = 0.03). While a trend was observed between increased lighting levels experienced outdoors and shorter axial lengths, there was no significant relationship with myopia status. Noteworthy, participants generally significantly overestimated time spent outdoors, compared to Actiwatch-derived estimates of the same. CONCLUSION: While the findings from this cohort of young adult students did not reveal substantial myopia-related differences in behavior, the power of a more objective and dynamic approach to quantifying behavior cannot be understated, providing argument for general adoption of wearable technologies in future clinical myopia studies.