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A complication of teacher education policy in Japan is rooted in a gap between an image of teachers, which is held by society as a whole, and includes various character traits and the reality of Japanese university education. On the other hand, the expansion of an "open system" and lack of nationwide standard are making individual universities that provide teacher education programs in Japan to "narrow down." The enforcement of the current approval system is deficient as a quality assurance measure, and therefore has many harmful effects. Accordingly, it is desirable to recognize the realities of teacher education and respect the independence of individual universities when considering teacher education reform in the future. [This article was translated by Ai Omori.]

Objective: The novel morpholino antisense oligonucleotide viltolarsen targets exon 53 of the dystrophin gene, and could be an effective treatment for patients with Duchenne muscular dystrophy (DMD). We investigated viltolarsen's ability to induce dystrophin expression and examined its safety in DMD patients. Methods: In this open‐label, multicenter, parallel‐group, phase 1/2, exploratory study, 16 ambulant and nonambulant males aged 5–12 years with DMD received viltolarsen 40 or 80 mg/kg/week via intravenous infusion for 24 weeks. Primary endpoints were dystrophin expression and exon 53 skipping levels. Results: In western blot analysis, mean changes in dystrophin expression (% normal) from baseline to Weeks 12 and 24 were − 1.21 (P = 0.5136) and 1.46 (P = 0.1636), respectively, in the 40 mg/kg group, and 0.76 (P = 0.2367) and 4.81 (P = 0.0536), respectively, in the 80 mg/kg group. The increase in mean dystrophin level at Weeks 12 and 24 was significant in the 80 mg/kg group (2.78%; P = 0.0364). Patients receiving 80 mg/kg showed a higher mean exon 53 skipping level (42.4%) than those receiving 40 mg/kg (21.8%). All adverse events were judged to be mild or moderate in intensity and none led to study discontinuation. Interpretation: Treatment with viltolarsen 40 or 80 mg/kg elicited an increasing trend in dystrophin expression and exon 53 skipping levels, and was safe and well tolerated. The decline in motor function appeared less marked in patients with higher dystrophin levels; this may warrant further investigation. This study supports the potential clinical benefit of viltolarsen. [ABSTRACT FROM AUTHOR]

Objective: Duchenne muscular dystrophy (DMD) is a progressive muscular disease characterized by chronic cycles of inflammatory and necrotic processes. Prostaglandin D2 (PGD2) is produced by hematopoietic PGD synthase (HPGDS), which is pathologically implicated in muscle necrosis. This randomized, double‐blind, placebo‐controlled early phase 2 study (NCT02752048) aimed to assess the efficacy and safety of the novel selective HPGDS inhibitor, TAS‐205, with exploratory measures in male DMD patients aged ≥5 years. Methods: Patients were randomized 1:1:1 to receive low‐dose TAS‐205 (6.67–13.33 mg/kg/dose), high‐dose TAS‐205 (13.33–26.67 mg/kg/dose), or placebo. The primary endpoint was the change from baseline in a 6‐minute walk distance (6MWD) at Week 24. Results: Thirty‐six patients were enrolled, of whom 35 patients were analysed for safety. The mean (standard error) changes from baseline to Week 24 in 6MWD were −17.0 (17.6) m in the placebo group (n = 10), −3.5 (20.3) m in the TAS‐205 low‐dose group (n = 11), and −7.5 (11.2) m in the TAS‐205 high‐dose group (n = 11). The mean (95% confidence interval) difference from the placebo group was 13.5 (−43.3 to 70.2) m in the TAS‐205 low‐dose group and 9.5 (−33.3 to 52.4) m in the TAS‐205 high‐dose group. No obvious differences were observed in the incidences of adverse events between treatment groups. No adverse drug reactions specific to TAS‐205 treatment were observed. Interpretation: The HPGDS inhibitor TAS‐205 showed a favorable safety profile in DMD patients. Further research is required to examine the effectiveness of TAS‐205 in a larger trial. [ABSTRACT FROM AUTHOR]

The authors investigated the effect of an auditory cue on the choice of the initial swing leg in gait initiation. Healthy humans initiated a gait in response to a monaural or binaural auditory cue. When the auditory cue was given in the ear ipsilateral to the preferred leg side, the participants consistently initiated their gait with the preferred leg. In the session in which the side of the monaural auditory cue was altered trial by trial randomly, the probability of initiating the gait with the nonpreferred leg increased when the auditory cue was given in the ear contralateral to the preferred leg side. The probability of choosing the nonpreferred leg did not increase significantly when the auditory cue was given in the ear contralateral to the preferred leg side in the session in which the auditory cue was constantly given in the ear contralateral to the preferred leg side. The reaction time of anticipatory postural adjustment was shortened, but the probability of choosing the nonpreferred leg was not significantly increased when the gait was initiated in response to a binaural auditory cue. An auditory cue in the ear contralateral to the preferred leg side weakens the preference for choosing the preferred leg as the initial swing leg in gait initiation when the side of the auditory cue is unpredictable. [ABSTRACT FROM AUTHOR]

We investigated the effect of advance information about the sequence of a to-be-signaled motor response on corticospinal excitability during the foreperiod in healthy humans. Advance information about the sequence of a to-be-signaled motor response was provided by a precue signal 600 ms before a response signal during a warned choice reaction task. The precue signal indicated the sequence of one of three to-be-signaled motor responses: simple, repetitive, or sequential motor responses. The amplitude of the motor-evoked potential (MEP) decreased significantly 100 ms before the response signal in both the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) muscles, but a significant decrease was present only in the APB muscle 300 ms before the response signal. The decrease in the MEP amplitude 100 ms before the response signal induced by the precue signal indicating the repetitive motor response was significantly smaller than that induced by the precue signal indicating the simple or sequential motor response in the FDI muscle, and was significantly smaller than that induced by the precue signal indicating the sequential motor response in the APB muscle. The decrease in corticospinal excitability in the middle foreperiod is larger when the advance information about a to-be-signaled motor response is unrelated to the muscle tested, and the decrease in the late foreperiod is affected by advance information about the sequence of a to-be-signaled motor response. [ABSTRACT FROM AUTHOR]

The quantum efficiency (QE) of Er3+-doped silicate, tellurite, phosphate and fluoride glasses have been examined under simulated sunlight excitation. The maximum of total QE, the sum of QE of 4S3/2, 4I11/2, 4I13/2→4I15/2 and 4S3/2→4I13/2 transition, is 75% and the maximum of QE1530, the QE of the 4I13/2→4I15/2 transition at 1530 nm, is 34% for 5.47×1019 cm-3 Er3+-doped fluoride glass. The figure of merit as laser media στ of silicate glass is 1.00×10-22 cm2sec, which is the highest in 4 glasses. Although QE1530 of silicate is lower than fluoride, it is possible to compensate the low quantum efficiency to optimize the fiber laser design. Therefore Er3+-doped fluoride and silicate glasses are expected to be promising candidates as solar-pumped glass laser (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [ABSTRACT FROM AUTHOR]

This study investigated whether the motor execution process of one finger movement in response to a start cue is influenced by the participation of another finger movement and whether the process of the finger movement is dependent on the movement direction. The participants performed a simple reaction time (RT) task, the abduction or flexion of one (index or little finger) or two fingers (index and little fingers). The RT of the prime mover for the finger abduction was significantly longer than that for the flexion, indicating that the time taken for the motor execution of the finger response is dependent on the movement direction. The RT of the prime mover was prolonged when the abduction of another finger, whose RT was longer than the flexion, was added. This caused closer RTs between the prime movers for a two-finger response compared with the RTs for a one finger response. The absolute difference in the RT between the index and little finger responses became smaller when two fingers responded together compared with one finger response. Those results are well explained by a view that the common motor drive triggers the prime movers when two fingers move together in response to a start cue. [ABSTRACT FROM AUTHOR]

Quantitative or semiquantitative outcome measures for patients with Duchenne muscular dystrophy (DMD) are important, as they can be objective indicators of the natural history of DMD; these measures also aid in the evaluation of the efficacy of various treatments. However, the most widely used standard outcome measures in patients with DMD, such as the North Star Ambulatory Assessment and the 6-min walk test, cannot be applied after patients have become nonambulatory. We evaluated the utility and reliability of accelerometric analysis of motor activity in nonambulatory patients with DMD. We measured the motor activity of the upper extremity in 7 nonambulatory patients with DMD, by using an accelerometer attached at the wrist of the dominant arm. To eliminate gravitational acceleration, we measured the changes in acceleration between measurements. The root of the sum of squared values of the changes per unit time in the 3 axes of the accelerometer was defined as a jerk. The total sum of the jerk values obtained at a measurement frequency of 15.625 Hz for 8 h was defined as the cumulative sum of jerks (Cj). The Cj values had significant and very strong or strong correlations with the Brooke Upper Extremity Scale (r s = −0.973; p = 0.00023) and the arm function scores for the DMD Functional Ability Self-Assessment Tool (r s = 0.810, p = 0.027). The values also had a very strong or strong correlation with the elbow flexion strength (nondominant arm: r = 0.931, p = 0.002; dominant arm: r = 0.750, p = 0.052). Cj assessment is a useful method to evaluate motor activities in nonambulatory patients with DMD. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the outcomes of the early introduction of a standing program for patients with Duchenne muscular dystrophy (DMD)., Methods: This was a retrospective observational study of 41 outpatients with DMD aged 15-20 years. We introduced the standing program using knee-ankle-foot orthoses (KAFO) to slow the progression of scoliosis when ankle dorsiflexion became less than 0° in the ambulatory period., Results: Thirty-two patients with DMD were offered the standing program with KAFO; 12 continued the program until the age of 15 years (complete group) and 20 discontinued the program before the age of 15 years (incomplete group). The non-standing program group included 9 patients. The standing program with KAFO was significantly associated with the Cobb angle at the age of 15 years after adjustment for the duration of corticosteroid use and DMD mutation type (P=0.0004). At the age of 15 years, significant correlations were found between the ankle dorsiflexion range of motion (ROM) and non-ambulatory period (P=0.0010), non-ambulatory period and Cobb angle (P<0.0001), Cobb angle and percent predicted forced vital capacity (P=0.0004), and ankle dorsiflexion ROM and Cobb angle (P=0.0066). In the complete group, the age at ambulation loss (log-rank P=0.0015), scoliosis progression (log-rank P=0.0032), and pulmonary dysfunction (log-rank P=0.0006) were significantly higher than in the non-standing program group., Conclusions: The early introduction of a standing program for DMD patients may prolong the ambulation period and slow the progression of scoliosis and pulmonary dysfunction., Competing Interests: CONFLICTS OF INTEREST: Outside the scope of this study, Hirofumi Komaki has received support from Nippon Shinyaku Co., Ltd. and has received grants from Taiho Pharmaceutical Co., Ltd., Sarepta Therapeutics, Inc., and Pfizer, Inc. The authors declare no conflict of interest., (2023 The Japanese Association of Rehabilitation Medicine.)

The present study investigated whether the long-interval interhemispheric inhibition (LIHI) is induced by the transcranial magnetic stimulation over the primary sensory area (S1-TMS) without activation of the conditioning side of the primary motor area (M1) contributing to the contralateral motor evoked potential (MEP), whether the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and whether the pathways mediating the LIHI are different from those mediating the M1-TMS-induced LIHI. In order to give the TMS over the S1 without eliciting the MEP, the intensity of the S1-TMS was adjusted to be the sub-motor-threshold level and the trials with the MEP response elicited by the S1-TMS were discarded online. The LIHI was induced by the S1-TMS given 40 ms before the test TMS in the participants with the attenuation of the tactile perception of the digit stimulation (TPDS) induced by the S1-TMS, indicating that the LIHI is induced by the S1-TMS without activation of the conditioning side of the M1 contributing to the contralateral MEP in the participants in which the pathways mediating the TPDS is sensitive to the S1-TMS. The S1-TMS-induced LIHI was positively correlated with the attenuation of the TPDS induced by the S1-TMS, indicating that the S1-TMS-induced LIHI is dependent on the effect of the S1-TMS on the pathways mediating the TPDS at the S1. In another experiment, the effect of the digit stimulation given before the conditioning TMS on the S1- or M1-TMS-induced LIHI was examined. The digit stimulation produces tactile input to the S1 causing change in the status of the S1. The S1-TMS-induced LIHI was enhanced when the S1-TMS was given in the period in which the tactile afferent volley produced by the digit stimulation just arrived at the S1, while the LIHI induced by above-motor-threshold TMS over the contralateral M1 was not enhanced by the tactile input. Thus, the S1-TMS-induced LIHI is dependent on the status of the S1 modulated by the tactile input, and the pathways mediating the sub-motor-threshold S1-TMS-induced LIHI are not the same as the pathways mediating the above-motor-threshold M1-TMS-induced LIHI.