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Aim: To elucidate the effects of ultra‐processed foods (UPFs) on body weight and ad libitum energy intake compared with non‐UPFs. Materials and Methods: In this randomized, open‐label crossover study conducted at the University of Tokyo Hospital, overweight/obese Japanese male participants were randomly assigned (1:1) to start the study with consumption of either UPFs or non‐UPFs for 1 week, followed by a 2‐week washout period, before crossing over to the alternate food diet for 1 week. Individuals with diabetes, hypertension or any other medical conditions who visited a hospital regularly were excluded. The meals were designed to be matched for the total energy and macronutrient levels. The primary outcome was the difference in the body weight change between the UPF and non‐UPF periods. The differences in the average daily energy intake and chewing frequency were assessed as one of the prespecified secondary outcomes. Results: Nine eligible participants were randomly assigned to start the study with either UPFs or non‐UPFs. All participants completed the study. During the UPF period, participants gained 1.1 kg more weight (95% confidence interval 0.2 to 2.0; P =.021) and consumed 813.5 kcal more per day (342.4 to 1284.7; P =.0041) compared with during the non‐UPF period. Regarding the chewing frequency, the number of chews per calorie was significantly lower during the UPF period (P =.016). Conclusions: Consumption of UPFs causes significant weight gain. Medical nutritional therapy focused on reducing the consumption of UPFs could be an effective strategy for preventing obesity. [ABSTRACT FROM AUTHOR]

Keloid scars tend to occur in high‐tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid‐predilection sites and sebaceous gland‐dense and acne‐prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne‐susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin‐mechanical properties, and their changes in a three‐dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck. [ABSTRACT FROM AUTHOR]

Background: Understanding the etiology of psychosis is essential to the development of preventive interventions. The COVID‐19 pandemic provides a rare natural experiment that can expand our understanding of the role of social factors in the trajectories and etiology of psychosis across adolescence, particularly in Tokyo where the prevalence of actual COVID‐19 infection remained low. We hypothesized that the likelihood of self‐reporting psychotic experiences (PEs) would increase following the onset of the COVID‐19 pandemic. Methods: The Tokyo Teen Cohort (TTC) is a prospective cohort study of adolescents in the general population of the Tokyo metropolitan area, followed from age 10 to 16 years. We used multi‐level linear regression models to test the associations between the phase of the COVID‐19 pandemic and self‐reported PEs. Results: Among 1935 adolescents included in the analysis, a rapid increase in PEs occurred at the onset of the COVID‐19 pandemic, following approximately 6 years of steady decline across prior waves. This association was more pronounced for boys compared to girls. This increase became more pronounced as the pandemic moved into later phases, defined based on contemporaneous sociopolitical changes in Tokyo (i.e. changes to school closure, social distancing guidelines, and the state of emergency status). Conclusions: The steady decline in PEs across adolescence was halted and reversed concurrent with the COVID‐19 pandemic onset, despite very low rates of COVID‐19 infection. This implicates COVID‐19 related socioenvironmental factors as contributory etiological factors in the development of PEs in this adolescent cohort. [ABSTRACT FROM AUTHOR]

Objectives: Cognitive impairment, pain and depressive symptoms are common and interrelated factors in older adults. However, the directionality and specificity of their association remains unclarified. This study explored whether these factors prospectively increase reciprocal risk and examined the longitudinal association between these factors and quality of life (QoL). Methods: This study used longitudinal data from The Older Persons and Informal Caregivers Survey Minimal Data Set (TOPICS‐MDS; the Netherlands). Older adults self‐reported cognitive impairment, pain, depressive symptoms and QoL at baseline and after 6 and 12 months of follow‐up. The Random Intercept Cross‐Lagged Panel Model was used to assess the prospective association between the three factors, while a multilevel linear regression analysis in a two‐level random intercept model was used to examine the longitudinal associations between the three factors and QoL at the within‐person level. Results: The data of 11,582 home‐dwelling older adults with or without subjective cognitive impairment were analysed. At the within‐person level, pain at 6 months was associated with subsequent depressive symptoms (β = 0.04, p = 0.024). The reverse association from depression to pain, and longitudinal associations between pain and subjective cognitive impairment and between depressive symptoms and subjective cognitive impairment were non‐significant. Pain, depressive symptoms and subjective cognitive impairment showed a significant association with poor QoL 6 months later. Conclusions: A directional relationship was observed from pain to depressive symptoms. Pain reduction holds a potential benefit in the prevention of depressive symptoms, ultimately optimising the QoL of older adults. Key points: Older adults have multiple chronic conditions, and subjective cognitive impairment, pain and depressive symptoms are common and interrelated factors which affect the quality of life.Home‐dwelling older adults experiencing pain were more likely to report later depressive symptoms.Pain, depressive symptoms and subjective cognitive impairment were associated with subsequent poor quality of life.Pain reduction may help prevent depressive symptoms and poor quality of life. [ABSTRACT FROM AUTHOR]

Background: Little information is available on the association between gender nonconformity during adolescence and subsequent mental health. While the distress related to gender nonconformity may be socially produced rather than attributed to individual-level factors, further research is needed to better understand the role of psychosocial factors in this context. Method: We analyzed data from the Tokyo Teen Cohort, obtained through random sampling of adolescents born between 2002 and 2004. We used inverse probability weighting to examine the association of gender nonconformity at ages 12 and 14 as a time-varying variable with subsequent mental health at age 16, while accounting for time-fixed and time-varying confounders. Furthermore, we used a weighting approach to investigate the mediating role of modifiable psychosocial factors in this association, addressing exposure-mediator and mediator–mediator interactions. Results: A total of 3171 participants were analyzed. Persistent gender nonconforming behavior at ages 12 and 14 was associated with subsequent depression (β = 2.02, 95% confidence interval [CI] 0.85 to 3.19) and psychotic experiences (β = 0.33, 95% CI 0.14 to 0.52) at age 16. The results remained robust in sensitivity analyses. Approximately 30% of the association between gender nonconformity and depression was consistently mediated by a set of psychosocial factors, namely loneliness, bullying victimization, and relationships with mother, father, and friends. Conclusions: Persistent gender nonconformity during adolescence is associated with subsequent mental health. Psychosocial factors play a vital mediating role in this association, highlighting the essential need for social intervention and change to reduce stigmatization and ameliorate mental health challenges. [ABSTRACT FROM AUTHOR]

Objectives Aneurysmal dermatofibroma (ADF) and hemosiderotic dermatofibroma (HDF) are rare variants of dermatofibroma (DF) characterized by distinct histologic features. While HDF is traditionally considered a precursor to ADF, supporting evidence is limited, and the etiology remains unclear. A retrospective analysis of 2128 DF cases (2016-2019) was conducted to investigate the clinicopathologic characteristics of ADF, HDF, and other DFs. Methods Histopathologically diagnosed DF cases were examined for ADF and HDF. Univariate analyses were performed to compare clinicopathologic features. Results Among the cases, 168 (7.9%) were ADF and 29 (1.4%) were HDF. Aneurysmal dermatofibroma and HDF shared several common characteristics, including lower occurrence in females, larger size, and increased cellularity (all P <.0001). Notably, 29% of ADFs lacked hemosiderin deposition. Aneurysmal dermatofibroma primarily manifested on exposed areas (face and forearm, both P <.001). In contrast, 41% of HDFs occurred on the lower leg (P =.018), and all lower leg HDFs exhibited signs of venous stasis, distinguishing them from other HDFs (P <.0001). Conclusions Our findings indicate a potential close relationship between ADF and HDF. Contrary to conventional beliefs, we also presented the possibility of ADF progressing into HDFs. Physical trauma may induce ADF, and HDFs may emerge from ADFs in conjunction with venous stasis in the lower extremities. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the efficacy of ulnar superficial slip resection (USSR) for improving hand function after unfavourable results after triggering finger release using a minimally invasive approach. Methods: We evaluated 17 consecutive fingers of 16 patients who complained of unfavourable outcomes after primary trigger finger release. The chief complaints of the two index and 15 middle fingers were proximal interphalangeal (PIP) joint pain during movement, flexion contracture of the PIP joint and snapping at the A2 pulley in eight, seven and two fingers, respectively. The joint arc of the active range of motion and extension loss of the PIP joint, grip strength, visual analogue score (VAS) of PIP joint pain and Quick Disability of the Arm, Shoulder and Hand were evaluated before and after surgery. Results: Thirteen fingers could release joint contracture and snapping by the USSR procedure. However, four fingers of three patients required total flexor digitorum superficialis resection to resolve the unsatisfactory conditions of the intraoperative decision. The joint arc of active range of motion and extension loss of the PIP joint, grip strength and VAS score significantly improved (mean of 16.1 months follow-up). Finally, 15 patients (88.2%) were satisfied with the symptom relief outcomes. Conclusions: USSR is an effective and satisfactory procedure for unfavourable conditions after trigger finger release, including PIP joint pain, joint contracture and snapping at the A2 pulley. Level of Evidence: Level IV (Therapeutic) [ABSTRACT FROM AUTHOR]

Behavioral science researchers have shown strong interest in disaggregating within-person relations from between-person differences (stable traits) using longitudinal data. In this paper, we propose a method of within-person variability score-based causal inference for estimating joint effects of time-varying continuous treatments by controlling for stable traits of persons. After explaining the assumed data-generating process and providing formal definitions of stable trait factors, within-person variability scores, and joint effects of time-varying treatments at the within-person level, we introduce the proposed method, which consists of a two-step analysis. Within-person variability scores for each person, which are disaggregated from stable traits of that person, are first calculated using weights based on a best linear correlation preserving predictor through structural equation modeling (SEM). Causal parameters are then estimated via a potential outcome approach, either marginal structural models (MSMs) or structural nested mean models (SNMMs), using calculated within-person variability scores. Unlike the approach that relies entirely on SEM, the present method does not assume linearity for observed time-varying confounders at the within-person level. We emphasize the use of SNMMs with G-estimation because of its property of being doubly robust to model misspecifications in how observed time-varying confounders are functionally related to treatments/predictors and outcomes at the within-person level. Through simulation, we show that the proposed method can recover causal parameters well and that causal estimates might be severely biased if one does not properly account for stable traits. An empirical application using data regarding sleep habits and mental health status from the Tokyo Teen Cohort study is also provided. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the outcomes of reverse digital artery island flap (RDAIF) in primary and secondary reconstruction after failed replantation or composite graft method. Methods: This study retrospectively analyzed 42 patients that underwent RDAIF (18 primary and 24 secondary). Preoperative details (demographics, injury details, and waiting days) and postoperative outcomes (active arc of proximal interphalangeal [PIP] and distal interphalangeal (DIP) joints, extension loss of PIP, flexion arc of metacarpophalangeal joint, total active motion, flap sensation, the presence of numbness, Tinel's sign and cold intolerance) were evaluated. Quick Disabilities of the Arm, Shoulder, and Hand score (Quick-DASH) and patient satisfaction were also statistically compared between the 2 groups. Results: There was no significant difference in patient demographics between the 2 groups in sex, age, smoking and diabetic history, affected hand and finger, injury type and level, and flap area. The only difference was in waiting days. Similar sensory recovery and patient satisfaction were found in both groups. Range of motion in the DIP and PIP joints, extension loss of PIP, total active motion, and Quick-DASH were superior in the primary coverage group. Increasing age, subzone III injury, and secondary reconstruction were found to be the factors that adversely affected the postoperative range of motion. Conclusions: Secondary reconstruction was more likely to result in joint contracture. In the event of a damaged fingertip amputation in older patients, primary flap reconstruction should be considered as the initial treatment of choice, with regard to the ultimate range of motion. [ABSTRACT FROM AUTHOR]

Aim: To investigate the impact of the COVID‐19 pandemic and its preventive measures on the glycemic and lipid control in people with diabetes mellitus (DM). Materials and methods: We conducted this retrospective cohort study from April 2019 to March 2021; we termed the period from April 2019 to March 2020 as the pre‐COVID‐19 period, and the period from April 2020 to March 2021 as the COVID‐19 period, and divided each of these two periods into four quarters. Results: In the 1st quarter of the COVID period, when the Japanese government declared the first public health emergency, 3,465 people with diabetes mellitus were receiving treatment, which was 10.4% lower than that in the pre‐COVID period. The annual mean HbA1c level was significantly elevated in the COVID‐19 period. The annual mean total cholesterol (TC) and triglyceride (TG) levels were also significantly higher in the COVID‐19 period. Although there were no significant differences in the glycemic control or annual medication between the two periods in people with type 1 diabetes mellitus, the annual mean HbA1c, TC, and TG levels were significantly higher in the COVID‐19 period in people with type 2 diabetes mellitus. Furthermore, a significant increase in the percentage of prescriptions for glinides, biguanides, sodium‐glucose cotransporter 2 inhibitors, and glucagon‐like peptide‐1 receptor agonists for people with type 2 diabetes mellitus was observed in the COVID period. Conclusions: It appears from our study that COVID‐19 and its preventive measures had a negative impact on the glycemic and lipid control in people with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β =.118, P <.001; 14–16y: β =.086, P =.012). The reverse SIB->AHs relationship was non-significant at 12–14y (β =.047, P =.112) but emerged from 14y to 16y as the primary direction of influence (β =.243, P <.001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To evaluate the impact of the COVID‐19 pandemic on the glycemic control, eating habits, and body composition of people with diabetes mellitus; to identify the determinants of worsening glycemic control in people with diabetes mellitus. Materials and methods: This retrospective, longitudinal observational study was performed in outpatients with diabetes mellitus who visited our hospital between April 2019 and March 2020 (pre‐COVID‐19 period) and continued for follow up from April 2020 to March 2021 (COVID‐19 period). We compared the glycemic control, nutritional intakes, and body composition of people with diabetes mellitus between the two periods. The changes in the HbA1c values (ΔHbA1c) and other study variables were compared between the two periods. Logistic regression analysis was performed to identify the factors associated with the increase of HbA1c levels. Results: A significant increase of HbA1c was observed during the COVID‐19 period. The percent fat mass (FM) also increased, while the percent skeletal muscle mass (SMM) decreased during the COVID‐19 period. After adjustments for age and sex, the ΔBMI (OR:2.33), ΔFM (OR:1.45), and ΔSMM (OR:0.51) were identified as being associated with elevated levels of HbA1c. Conclusions: The COVID‐19 pandemic had a negative impact on the glycemic control and body composition of people with diabetes mellitus. The increased body weight and FM and decreased SMM observed during the pandemic were associated with poor glycemic control in people with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Adolescent loneliness is a growing public health issue owing to its adverse health impact. Although adolescent loneliness is common, its trajectories can show distinct patterns over time. However, there is limited knowledge regarding their determinants, particularly for chronic loneliness. We aimed to determine the predictors of loneliness trajectories across early-to-mid adolescence and examine their association with later suicidality. Methods: Data were collected from 3165 participants from the population-based Tokyo Teen Cohort. Participants reported their loneliness at 10, 12, 14, and 16 years. Loneliness trajectories were identified using latent class growth analysis. We examined the predictive role of bullying victimization and parental psychological distress at age 10 via a multinomial logistic regression. Sociodemographic and child-related factors (i.e., chronic health conditions and cognitive delay) were included as covariates. The association between the trajectories, self-harm, and suicidal ideation by age 16 was investigated using Poisson regression. Results: Four trajectories were identified: "consistently low" (2448, 77.3%), "moderate–decreasing" (185, 5.8%), "moderate–increasing" (508, 16.1%), and "consistently high" (24, 0.8%). Taking "consistently low" as a reference, experiences of bullying victimization predicted all the remaining trajectories [adjusted relative risk ratio 1.64, 95% confidence interval (CI) 1.18–2.28 for "moderate–decreasing," 1.88, 1.52–2.33 for "moderate–increasing," and 4.57, 1.97–10.59 for "consistently high"]. Parental psychological distress predicted the "moderate–increasing" (1.84, 1.25–2.71) and "consistently high" (5.07, 1.78–14.42) trajectories. The "consistently high" trajectory showed the greatest risk for self-harm and suicidal ideation (adjusted relative risk ratio 6.01, 95% CI 4.40–8.22; 2.48, 1.82–3.37, respectively); however, the "moderate–increasing" and "moderate–decreasing" trajectories were also at increased risk (moderate–increasing: 2.71, 2.23–3.30 for self-harm, 1.93, 1.69–2.19 for suicidal ideation; moderate–decreasing: 2.49, 1.91–3.26 for self-harm, 1.59, 1.33–1.91 for suicidal ideation). Conclusions: Bullying victimization and parental psychological distress at age 10 were independent determinants of increased and chronic loneliness trajectories across early-to-mid adolescence. Compared with "consistently low," all other loneliness trajectories were associated with an increased risk of adolescent suicidality. Interventions targeting adolescent loneliness should include approaches to mitigate bullying and parental psychological distress. These strategies may help prevent adolescent suicidality. [ABSTRACT FROM AUTHOR]

Introduction: Most lipomas are readily dissected and removed. However, some cases can pose surgical difficulties. This retrospective study sought to identify clinical and radiological risk factors that predict difficult lipoma resection and can be used in a clinically useful scoring system that predicts difficulty preoperatively. Methods: The study cohort consisted of all consecutive patients who underwent resection of pathology-confirmed lipoma during 2016–2018 at a tertiary care referral center in Tokyo, Japan. Surgical difficulty was defined as difficulty separating some/all of the tumor from the surrounding tissue by hand and inability to extract the tumor in one piece. Descriptive, univariate, and multivariate logistic regression analyses were conducted to identify predictive factors. The predictive accuracy of the scoring system that included these factors was assessed by tenfold cross-validation analysis. Receiver-operating curve (ROC) analysis was conducted to identify the optimal cutoff score for predicting surgical difficulty. Results: Of the 86 cases, 36% involved surgical difficulty. Multivariate analysis showed that subfascial intramuscular location (odds ratio 42.7, 95% confidence interval 3.0–608.0), broad touching of underlying structures (46.5, 3.7–586.0), in-flowing blood vessels (9.3, 1.1–78.5), and unclear boundaries (109.0, 1.1–1110.0) significantly predicted surgical difficulty. These factors were used to construct a 0–4 point scoring system (with one point per variable). On cross-validation, the accuracy of the scoring system was 82.4% (Cohen's kappa of 0.57). ROC analysis showed that scores ≥ 2 predicted surgical difficulty with sensitivity and specificity of 55% and 98%, respectively. Conclusions: Our scoring system accurately predicted lipoma resection difficulty and may help operators prepare, thereby facilitating surgery. [ABSTRACT FROM AUTHOR]

Reports describing the treatment of non-union of the distal phalanx of the thumb are limited. We present the case of a 45-year-old man who developed a symptomatic non-union after an open fracture of the distal phalanx of the thumb. He was treated with a reverse dorso-ulnar vascularised fascial metacarpal bone flap. Bone union was achieved 3 months post surgery, and he was well at 7 months post surgery. The reverse dorso-ulnar fascial metacarpal bone flap is an alternative to consider in patients with non-union of the distal phalanx of the thumb. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Background: Problematic alcohol use (PAU) after natural disasters is an unignorable public health issue. However, the long‐term trajectory and course of PAU after an earthquake disaster remain unknown. Methods: The Higashi‐Matsushima cohort study was conducted between 2012 (time 1) and 2019 (time 8) in areas affected by the Great East Japan Earthquake in 2011. In the annual health checks, participants responded to self‐report questionnaires on PAU, traumatic experiences (e.g., house damage), resources (e.g., social support), and other covariates (e.g., gender, psychological distress). The trajectory and course of PAU were estimated by latent growth model and latent class analyses. Risk factors for the long‐term course of PAU were calculated by multinomial logistic regression analysis with multiple imputation. The analytical sample comprised 8929 residents who participated in at least one survey across the eight time points. Results: The trajectory of PAU showed a sustained trend (slope <0.001). Three potential courses of PAU (No PAU course: 84.3%, Subthreshold PAU course: 12.4%, and Persistent PAU course: 3.4%) were estimated. The long‐term course of PAU, especially the persistent PAU course, was predicted by house damage (OR = 1.43, 95% CI 1.06 to 1.92), less social support (OR = 0.71, 95% CI 0.53 to 0.96), gender (male) (OR = 16.86, 95% CI 9.42 to 30.20), and psychological distress (OR = 1.15, 95% CI 1.09 to 1.20). Conclusions: Long‐term support is needed after an earthquake disaster, especially for residents who in early phases of the disaster suffer from PAU, males, and those in vulnerable situations resulting from conditions such as severe house damage, low social support, or high psychological distress. [ABSTRACT FROM AUTHOR]

Parents of children with 22q11.2 deletion syndrome (22q11DS) experience distress not only due to multimorbidity in the patients, but also due to professionals' lack of understanding about 22q11DS and insufficient support systems. This study investigated relationships between medical, welfare, and educational challenges and parental psychological distress. A cross‐sectional survey was conducted on primary caregivers of children with 22q11DS. Participants included 125 parents (114 mothers, 91.2%; average age = 44.3 years) who reported their challenges, psychological distress, and child's comorbidities of 22q11DS. Results showed that the difficulty in going to multiple medical institutions (β = 0.181, p < 0.05) and lack of understanding by welfare staff and insufficient welfare support systems for 22q11DS (β = 0.220–0.316, all p < 0.05) were associated with parental psychological distress, even after adjusting for child's comorbidities. In the subsample of parents whose child attended an educational institution, inadequate management in classroom and mismatch between service and users in educational settings were associated with psychological distress (β = 0.222–0.296, all p < 0.05). This study reveals the importance of assessing not only severity of comorbidities in 22q11DS, but also the medical, welfare, and educational challenges for parental mental health. [ABSTRACT FROM AUTHOR]

Advanced glycation end products play a key role in the pathophysiology of schizophrenia. Cognitive impairment is one of the central features of schizophrenia; however, the association between advanced glycation end products and cognitive impairment remains unknown. This study investigated whether advanced glycation end products affect the cognitive domain in patients with schizophrenia. A total of 58 patients with chronic schizophrenia were included in this cross-sectional study. Plasma advanced glycation end products were measured using high-performance liquid chromatography (HPLC). Neuropsychological and cognitive functions were assessed using the Wechsler Adult Intelligence Scale, Third Version, and the Wisconsin Card Sorting Test Keio-FS version. Multiple regression analysis adjusted for age, sex, body mass index, educational years, daily dose of antipsychotics, and psychotic symptoms revealed that processing speed was significantly associated with plasma pentosidine, a representative advanced glycation end product (standardized β = -0.425; p = 0.009). Processing speed is the cognitive domain affected by advanced glycation end products. Considering preceding evidence that impaired processing speed is related to poor functional outcome, interventions targeted at reducing advanced glycation end products may contribute to promoting recovery of patients with schizophrenia as well as cognitive function improvement. [ABSTRACT FROM AUTHOR]

Many methods have been developed to infer reciprocal relations between longitudinally observed variables. Among them, the general cross-lagged panel model (GCLM) is the most recent development as a variant of the cross-lagged panel model (CLPM), while the random-intercept CLPM (RI-CLPM) has rapidly become a popular approach. In this article, we describe how common factors and cross-lagged parameters included in these models can be interpreted, using a unified framework that was recently developed. Because common factors are modeled with lagged effects in the GCLM, they have both direct and indirect influences on observed scores, unlike stable trait factors included in the RI-CLPM. This indicates that the GCLM does not control for stable traits as the RI-CLPM does, and that there are interpretative differences in cross-lagged parameters between these models. We also explain that including such common factors as well as moving-average terms in the GCLM makes this interpretation very complicated. [ABSTRACT FROM AUTHOR]

Cultural values can be considered as important factors that impact parents' social cognitions and parenting practices. However, few studies compare specific cultural values of parents and the relationships between cultural values and parenting processes in eastern and western contexts. This study examined the ethnicity differences in mothers' cultural values, parental social cognitions (child-rearing ideologies and goals), and parenting practices between Mainland Chinese and European American contexts. Predictors of parenting goals and parenting practices were also investigated. Mothers of 4–6 years old children from the western United States (N = 78) and Shanghai/China (N = 96) participated in this study. The results suggested that mothers from Shanghai/China were both more collectivistic and individualistic than mothers from the western United States. Chinese mothers more strongly endorsed training and collectivistic parenting goals, while European American mothers more strongly endorsed individualistic parenting goals for their children. However, no significant difference was found in parenting practices for both groups of mothers. For both ethnic groups, in general, mothers' cultural values have small but significant impact on their parenting processes. The prediction of cultural values and parenting goals on parenting practices were also different for both ethnicity groups. Although Chinese mothers were higher on both individualism and collectivism, their collectivistic values were more important in predicting parental social cognitions. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To prevent diabetic complications, strict glucose control and frequent monitoring of blood glucose levels with invasive methods are necessary. We considered the monitoring of tear glucose levels might be a possible method for non‐invasive glucose monitoring. To develop tear glucose monitoring for clinical application, we investigated the precise correlation between the blood and tear glucose concentrations. Materials and Methods: A total of 10 participants and 20 participants with diabetes were admitted, and blood and tear samples were collected. Before statistical analysis, we eliminated tear samples contaminated with blood. We observed the daily blood and tear glucose dynamics, and carried out a random intercept model analysis to examine the association between the blood and tear glucose concentrations. Results: Tear occult blood tests showed that the tear glucose concentrations and their variation increased in both participants with and without diabetes as contamination of blood increased. In both participants with and without diabetes, fluctuations of the plasma glucose concentrations were observed depending on the timing of collection of the samples, and the dynamics of the tear glucose concentrations paralleled those of the plasma glucose concentrations. The random intercept model analysis showed a significant association between the plasma and tear glucose concentrations in participants with diabetes (P < 0.001). This association still existed even after adjusting for the glycated hemoglobin levels and the prandial state (P < 0.001). Conclusions: It is important to eliminate the tear samples contaminated with blood. Tear glucose monitoring might be a reliable and non‐invasive substitute method for monitoring the blood glucose concentrations for diabetes patients, irrespective of glycated hemoglobin levels and timing of sample collection. [ABSTRACT FROM AUTHOR]

Background: The aim of our study was to evaluate the influence of changes of nutritional status and body composition on the results of comprehensive geriatric assessment (CGA) in inpatients of a geriatric ward. Sex differences in these relationships were also investigated. Methods: A total of 212 elderly patients (>65 years old) admitted to the geriatric ward at the University of Tokyo hospital between 2012 and 2019 were enrolled in this study. CGA (ADL, IADL, MMSE, GDS, Vitality Index) was performed, along with assessment of body compositions (appendicular muscle mass, abdominal muscle mass, body fat mass) and blood malnutrition biomarkers (serum albumin, pre-albumin, 25-hydroxy vitamin D, zinc, hemoglobin concentrations). Results: Multiple linear regression analysis showed that upper, lower limbs and abdominal muscle masses were significantly associated with the score on ADL in men. On the other hand, abdominal muscle mass was negatively associated with the scores on GDS. Body fat mass was also negatively associated with the score on IADL. In contrast, in women, multiple linear regression analysis failed to show any significant associations between body composition parameters and scores on any domains of CGA. Unlike in men, however, blood malnutrition biomarkers were significantly associated with ADL, IADL, MMSE, and Vitality Index in women. Conclusions: Our study findings revealed that the association of the nutritional status and body composition with the functional status in the elderly differs by sex. These results suggest that intensification of exercise in men and improvement of the nutritional status in women are particularly useful to maintain the functional status. [ABSTRACT FROM AUTHOR]

The use of hierarchical data (also called multilevel data or clustered data) is common in behavioural and psychological research when data of lower‐level units (e.g., students, clients, repeated measures) are nested within clusters or higher‐level units (e.g., classes, hospitals, individuals). Over the past 25 years we have seen great advances in methods for computing the sample sizes needed to obtain the desired statistical properties for such data in experimental evaluations. The present research provides closed‐form and iterative formulas for sample size determination that can be used to ensure the desired width of confidence intervals for hierarchical data. Formulas are provided for a four‐level hierarchical linear model that assumes slope variances and inclusion of covariates under both balanced and unbalanced designs. In addition, we address several mathematical properties relating to sample size determination for hierarchical data via the standard errors of experimental effect estimates. These include the relative impact of several indices (e.g., random intercept or slope variance at each level) on standard errors, asymptotic standard errors, minimum required values at the highest level, and generalized expressions of standard errors for designs with any‐level randomization under any number of levels. In particular, information on the minimum required values will help researchers to minimize the risk of conducting experiments that are statistically unlikely to show the presence of an experimental effect. [ABSTRACT FROM AUTHOR]

Factor Score Regression (FSR) methods have received increased interest in the quantitative literature, with Croon's bias-correcting method gaining particular traction. By fixing measurement parameters in place in an initial step, FSR methods aim to stymie the proliferation of bias in larger structural models that may contain misspecification. Although Croon's approach was originally derived for factor models exhibiting simple structure and conditionally independent unique factors, Hayes and Usami recently extended this method to connected measurement models featuring correlated uniquenesses. In this article, we demonstrate that their formulas also correct bias in models that feature cross-loadings. We begin by discussing bias in SEMs that incorrectly impose simple structure. We then describe Croon's approach in connected measurement models featuring cross-loadings and compare its performance to two other state-of-the-art FSR approaches both analytically and via a simulated demonstration. [ABSTRACT FROM AUTHOR]

We present outcomes of using a perforator-based ulnar parametacarpal flap in 25 patients for digital pulp defects. These included 17 free transfers to the thumb, index, middle and ring fingers and eight reverse pedicled transfers to the little fingers. This flap includes a dorsal sensory branch of the ulnar nerve, which was sutured to the digital nerve in all transfers. Each flap had one to three reliable perforators (mean 0.44 mm diameter) to the ulnar parametacarpal region and contained at least one perforator within 2 cm proximal to the palmar digital crease. All the 25 flaps survived completely. Twenty-two patients were followed for 15 months (range 12 to 24), and three were lost to follow-up. The mean static and moving two-point discrimination of the flap was 7 mm and 5 mm, respectively. At the donor site, sensory reinnervation was acceptable. We conclude that ulnar parametacarpal perforator flaps offer sensate, thick and glabrous skin for finger pulp repair, all in a single operative field. Level of evidence: IV [ABSTRACT FROM AUTHOR]

Recently, quantitative researchers have shown increased interest in two-step factor score regression (FSR) approaches to structural model estimation. A particularly promising approach proposed by Croon involves first extracting factor scores for each latent factor in a larger model, then correcting the variance−covariance matrix of the factor scores for bias before using this matrix as input data in a subsequent regression analysis or path model. Although not immediately obvious, Croon's bias correction formulas are predicated upon the standard assumption of conditionally independent uniquenesses (measurement residuals). To our knowledge, the method's performance has never been evaluated under conditions in which this assumption is violated. In the present research, we rederive Croon's formulas for the case of correlated uniqueness and present the results of two Monte Carlo simulations comparing the method's performance with standard methods when the unique factors were correlated in the population model. In our simulations, our proposed Croon FSR approaches outperformed methods that blindly assumed conditionally independent uniquenesses (e.g., uncorrected FSR, traditional Croon FSR, structural equation modeling [SEM] using standard specification), performed comparably to a correctly specified SEM, and outperformed SEMs that correctly specified the unique factor covariances but misspecified the structural model. We discuss the implications of our results for substantive researchers. [ABSTRACT FROM AUTHOR]

Objective: Desire for slimness (DS) is a well‐established risk factor for eating disorders among adolescents, particularly girls. It is known that exposure to traditional media such as television can increase DS. However, the association between DS and the use of new media, such as social networking sites (SNS), adjusting for relevant potential confounders, has not been examined to‐date. In this study, we assessed the relationship between DS and SNS use among early adolescent girls and boys, adjusting for body mass index (BMI), time spent watching television, and Internet use. Method: DS, SNS use, and confounding variables were assessed using self‐report questionnaires and face‐to‐face interviews from a cross‐sectional population‐based survey of 4,478 10‐year‐old Japanese adolescents (2,100 girls and 2,378 boys). Results: After adjusting for confounding variables, SNS use was associated with increased risk of DS among girls (odds ratio [OR] = 1.93; 95% confidence interval [CI], 1.17–3.18, p =.010), but not among boys (OR = 1.07; 95% CI, 0.64–1.80, p =.786). Discussion: Exposure to SNS was associated with an increased risk of DS among early adolescents, especially girls. Targeting SNS use in early adolescence seems a promising approach to prevention of DS and subsequent eating problems, particularly among girls. [ABSTRACT FROM AUTHOR]

Background: Idiopathic osteonecrosis of the capitate is rare condition with few reports of treatment using vascularized bone graft. Methods: A case of a 45-year-old woman with idiopathic necrosis of the capitate who underwent surgical treatment with a vascularized bone graft from the base of the second metacarpal bone is reported. Results: At 14 months postoperatively, the range of motion of her wrist was maintained, and localized wrist pain was relieved. Conclusions: This bone graft, which has a reliable pedicle with few anomalies, offers sufficient cancellous bone for the capitate, and can be harvested in the same operative field, is desirable for the treatment of osteonecrosis of the capitate. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Within-Person Variability Score-Based Causal Inference: A Two-Step Estimation for Joint Effects of Time-Varying Treatments" published in the journal Psychometrika. The notice acknowledges errors in the original version of the article and provides corrected equations. The publisher, Springer Nature, maintains a neutral stance on jurisdictional claims and institutional affiliations. The correction was reported by Satoshi Usami. [Extracted from the article]

Longitudinal designs provide a strong inferential basis for uncovering reciprocal effects or causality between variables. For this analytic purpose, a cross-lagged panel model (CLPM) has been widely used in medical research, but the use of the CLPM has recently been criticized in methodological literature because parameter estimates in the CLPM conflate between-person and within-person processes. The aim of this study is to present some alternative models of the CLPM that can be used to examine reciprocal effects, and to illustrate potential consequences of ignoring the issue. A literature search, case studies, and simulation studies are used for this purpose. We examined more than 300 medical papers published since 2009 that applied cross-lagged longitudinal models, finding that in all studies only a single model (typically the CLPM) was performed and potential alternative models were not considered to test reciprocal effects. In 49% of the studies, only two time points were used, which makes it impossible to test alternative models. Case studies and simulation studies showed that the CLPM and alternative models often produce different (or even inconsistent) parameter estimates for reciprocal effects, suggesting that research that relies only on the CLPM may draw erroneous conclusions about the presence, predominance, and sign of reciprocal effects. Simulation studies also showed that alternative models are sometimes susceptible to improper solutions, even when reseachers do not misspecify the model. [ABSTRACT FROM AUTHOR]

Aim: A concise teacher‐led program for mental health literacy (MHL), suitable for schools with tight schedules was developed, and its effects were examined in pre‐teens. Methods: Participants comprised 662 grade 5 to 6 students from nine Japanese elementary schools. The program consisted of a 45‐minute session, delivered by school teachers using a 10‐minute animated film. Program focuses included: mental health problems are common, can be associated with lifestyle and that seeking help from reliable adults is a key to finding solutions. Participants filled out self‐report questionnaires before, immediately after and 3 months post‐intervention. Changes in MHL were analyzed using multilevel models. Results: Knowledge about mental health/illnesses, recognition of mental health state and intention to help peers/seek help when suffering from mental health problems, were significantly improved immediately and 3 months post‐intervention. Conclusions: Concise teacher‐led programs administered in schools can have positive and lasting effects on MHL in pre‐teens. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the effect of age relative to school (i.e., class or grade level) peers on emotional well-being and the role of possible mediators of this effect in early adolescence using a large set of individual-level data from a community survey. Methods: A large community-based survey of 10-year-old children and their primary parents was conducted in Tokyo, where the school entry cutoff date is fixed. Emotional well-being was assessed by the WHO (Five) Well-Being Index (WHO-5). Academic performance and the experience of being bullied at school were also evaluated as potential mediators of the effect of relative age. Results: A total of 4,478 children participated in the study. In a univariate linear regression analysis, the relative birthdate (continuous variable starting from the school entry date and ending at the last date of the academic grade) was negatively associated with emotional well-being (β = -0.043, p = .005). The path analyses suggested that academic performance and bullying mediated the relationship between the relative birthdate and emotional well-being (both p < .01). Conclusions: Among a sample of 10-year-olds, children who were younger compared to class peers had lower levels of emotional well-being. Academic performance and victimization by peers mediated the relationship. [ABSTRACT FROM AUTHOR]

Behavioral researchers have shown growing interest in structural equation model trees (SEM Trees), a new recursive partitioning-based technique for detecting population heterogeneity. In the present research, we conducted a large-scale simulation to investigate the performance of latent growth curve model (LGCM)-based SEM Trees for uncovering between-individual differences in patterns of within-individual change. Simulation results showed that the correct estimation rates of the number of classes are most strongly related to the agreement rate of the covariate with its true latent profile, and the number of true classes also has a serious negative impact on correct estimation rates of the number of classes. SEM Trees is not always sensitive to the influence of model misspecification, and its impact differs according to a complex function of the types of misspecification as well as the statistical properties of the template model. On the whole, LGCM-based SEM Trees is a robust and stable approach under possible model misspecifications. [ABSTRACT FROM AUTHOR]

Growth curve modeling (GCM) has been one of the most popular statistical methods to examine participants' growth trajectories using longitudinal data. In spite of the popularity of GCM, little attention has been paid to the possible influence of time-specific errors, which influence all participants at each timepoint. In this article, we demonstrate that the failure to take into account such time-specific errors in GCM produces considerable inflation of type-1 error rates in statistical tests of fixed effects (e.g., coefficients for the linear and quadratic terms). We propose a GCM that appropriately incorporates time-specific errors using mixed-effects models to address the problem. We also provide an applied example to illustrate that GCM with and without time-specific errors would lead to different substantive conclusions about the true growth trajectories. Comparisons with other models in longitudinal data analysis and potential issues of model misspecification are discussed. [ABSTRACT FROM AUTHOR]

Aim The aim of this clinical trial was to obtain proof of concept for high-dose pyridoxamine as a novel treatment for schizophrenia with enhanced carbonyl stress. Methods Ten Japanese schizophrenia patients with high plasma pentosidine, which is a representative biomarker of enhanced carbonyl stress, were recruited in a 24-week, open trial in which high-dose pyridoxamine (ranging from 1200 to 2400 mg/day) was administered using a conventional antipsychotic regimen. Main outcomes were the total change in Positive and Negative Syndrome Scale score and the Brief Psychiatric Rating Scale score from baseline to end of treatment at week 24 (or at withdrawal). Results Decreased plasma pentosidine levels were observed in eight patients. Two patients showed marked improvement in their psychological symptoms. A patient who harbors a frameshift mutation in the Glyoxalase 1 gene also showed considerable reduction in psychosis accompanied with a moderate decrease in plasma pentosidine levels. A reduction of greater than 20% in the assessment scale of drug-induced Parkinsonism occurred in four patients. Although there was no severe suicide-related ideation or behavior, Wernicke's encephalopathy-like adverse drug reactions occurred in two patients and were completely suppressed by thiamine supplementation. Conclusion High-dose pyridoxamine add-on treatment was, in part, effective for a subpopulation of schizophrenia patients with enhanced carbonyl stress. Further randomized, placebo-controlled trials with careful monitoring will be required to validate the efficacy of high-dose pyridoxamine for these patients. [ABSTRACT FROM AUTHOR]

When conducting longitudinal research, the investigation of between-individual differences in patterns of within-individual change can provide important insights. In this article, we use simulation methods to investigate the performance of a model-based exploratory data mining technique—structural equation model trees (SEM trees; Brandmaier, Oertzen, McArdle, & Lindenberger, 2013)—as a tool for detecting population heterogeneity. We use a latent-change score model as a data generation model and manipulate the precision of the information provided by a covariate about the true latent profile as well as other factors, including sample size, under the possible influences of model misspecifications. Simulation results show that, compared with latent growth curve mixture models, SEM trees might be very sensitive to model misspecification in estimating the number of classes. This can be attributed to the lower statistical power in identifying classes, resulting from smaller differences of parameters prescribed by the template model between classes. [ABSTRACT FROM AUTHOR]

Objective:Many skin flaps have been described for fingertip reconstruction; however, they have not been compared histologically. The aim of this study is to compare the histological features of common insensate flaps that are used for fingertip reconstruction. Method:Skin from fingertips and common flap donor sites on the hand and forearm of cadavers were harvested. This study investigated four histological characteristics, namely thickness of the epidermis and dermis; the ratio of collagen to elastic fibres (C/E ratio) in subdermal tissues, and distribution densities of Merkel cells and Meissner’s corpuscles. It then compared the values obtained to determine which flap donor site best matched the fingertip. Results:Epidermal thickness of the reverse digital artery island flap, thenar flap, and hypothenar flap was similar to that of fingertip tissue; dermal thickness of the hypothenar flap was similar to that of fingertip tissue. The C/E ratio of the reverse digital artery island flap was similar to that of fingertip tissue. Merkel cells were abundant in the reverse digital artery island flap, but Meissner’s corpuscles were few in each of the flaps compared with fingertip tissue. Conclusion:The flap donor site with histological properties most similar to fingertip tissue was the palmar lateral aspect at the finger base, representative of the reverse digital artery island flap with respect to epidermal thickness, C/E ratio, and presence of Merkel cells. The thenar and hypothenar flaps also showed similar properties. [ABSTRACT FROM AUTHOR]