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Awareness about Open Educational Resources (OERs) and the purposes for offering and adopting OERs and Massive Open Online Courses (MOOCs) were analyzed using a detailed survey of higher education across Japan, which was conducted in 2015. A comparison with a similar study conducted in 2013 revealed that awareness of OERs has increased slightly and the number of MOOCs offered has increased significantly in the intervening two years. The increase of offerings and adoption was low for OERs but high for MOOCs. OERs are used to improve the learning environment for students, while MOOCs aim to promote lifelong learning. Only one-fifth of the institutions surveyed in 2013 offered MOOCs or advanced their plans to offer them in 2015, and institutions that did offer MOOCs or advance such plans to offer them after the previous survey tended to provide MOOCs for society and for promotional purposes, not only for themselves because Japanese institutions are self-sustainable in terms of open education activities, operating without the support of the government or foundations. [This paper was presented at the 2017 Open Education Consortium Global Conference, held in Cape Town (South Africa) in March 8th-10th 2017.]

Simple Summary: We evaluated the efficacy of bevacizumab (BEV) in first-line chemotherapy for clear cell carcinoma (CCC). We categorized patients with advanced clear cell carcinoma (CCC) who received platinum-based first-line chemotherapy into a non-BEV group and a BEV group, and compared the progression-free survival (PFS), overall survival (OS), response rates, adverse events, and platinum agent-resistant recurrence rates. The PFS was improved and response rates were higher in the BEV group. One patient in the BEV group had grade 4 gastrointestinal perforation, although no treatment-related death was reported. First-line chemotherapy with BEV in advanced CCC showed the potential for high response rates and an improved PFS. Objective: The usefulness of bevacizumab (BEV) as first-line chemotherapy for advanced ovarian clear cell carcinoma (CCC) was retrospectively evaluated at Tohoku Gynecologic Cancer Unit institutions. Patients and Methods: A total of 81 patients (52 patients without BEV and 29 with BEV) with advanced ovarian CCC who received initial platinum-based chemotherapy were enrolled. We selected 26 patients each without and with BEV according to propensity score matching methods, and compared the platinum-resistant recurrence rate, response rate, progression-free survival (PFS), overall survival (OS), and adverse events between the two groups. Results: The objective response rates for the patients with measurable disease in the non-BEV and BEV groups were 60.0% and 95.5%, respectively (p = 0.007). The recurrence of platinum-resistant patients was observed in 50.0% of the non-BEV group and 23.1% of the BEV group (p = 0.117). The median PFS was 12 and 22 months, respectively (p = 0.034), and the median OS was 32 and 47 months, respectively (p = 0.223). In the BEV group, grade 3 hypertension and proteinuria occurred in two patients, and thrombosis and carboplatin hypersensitivity occurred in one patient. Grade 4 gastrointestinal perforation occurred in one patient. Conclusions: First-line chemotherapy with BEV in advanced CCC showed the potential for high response rates and improved PFS. [ABSTRACT FROM AUTHOR]

Background: Atezolizumab, one of the immune checkpoint inhibitors, has been approved as an adjuvant treatment following resection and platinum‐based chemotherapy in patients with stage II–IIIA non‐small cell lung cancer with 1% or more programmed death ligand‐1 (PD‐L1) expression. The Food and Drug Administration (FDA) has approved SP263 as a companion diagnostic assay for adjuvant treatment with atezolizumab; however, in clinical practice, the 22C3 assay is most commonly used for advanced non‐small cell lung cancer. Therefore, our study aimed to compare two PD‐L1 assays, SP263 and 22C3, to evaluate whether 22C3 could replace SP263 when deciding whether to administer adjuvant atezolizumab. Methods: We retrospectively and prospectively analyzed 98 patients who underwent surgical resection at Kanagawa Cancer Center (Japan). An immunohistochemistry assay was performed for all the cases with both SP263 and 22C3. We statistically analyzed the concordance of PD‐L1 expression between SP263 and 22C3 assays. Results: The concordance between the two assays using Cohen's kappa was κ = 0.670 (95% CI: 0.522–0.818) at the 1% cutoff and κ = 0.796 (95% CI: 0.639–0.954) at the 50% cutoff. The Spearman correlation coefficient of 0.874 (p < 0.01) indicated high concordance. PD‐L1 expression with 22C3 resulted slightly higher than that with SP263. Conclusions: This study showed a high concordance of PD‐L1 expression with the SP263 and 22C3 assays. Further studies examining the therapeutic effects of adjuvant atezolizumab are required. [ABSTRACT FROM AUTHOR]

Background: We explore an optimized approach for increasing lesion size using a novel ablation catheter with a surface thermocouple and efficient irrigation in a temperature-control setting. Methods: We conducted radiofrequency applications at various power levels (35 W, 40 W, and 45 W), contact forces (CFs, 10 g/20 g), and durations (60 s/120 s/180 s) in perpendicular/parallel catheter orientations, with normal saline irrigation (NS-irrigation) and Half NS-irrigation (HNS-irrigation) in an ex-vivo model (Step 1). In addition, we performed applications (35 W/40 W/45 W for 60 s/120 s/180 s in NS-irrigation and 35 W/40 W for 60 s/120 s/180 s in HNS-irrigation) in four swine (Step 2), evaluating lesion characteristics and the occurrence of steam pops. Results: In Step 1, out of 288 lesions, we observed 47 (16.3%) steam pops, with 13 in NS-irrigation and 34 in HNS-irrigation (p = .001). Although steam pops were mostly observed with the most aggressive setting (45 W/180 s, 54%) with NS-irrigation, they happened in less aggressive settings with HNS irrigation. Lesion size significantly increased with longer-duration ablation but not with HNS-irrigation. The optimal %impedance-drop cutoff to predict steam pops was 20% with a negative-predictive-value (NPV) = 95.1% including NS- and HNS-irrigation groups, and 22% with an NPV = 96.1% in NS-irrigation group. In Step 2, similar to the ex-vivo model, lesion size significantly increased with longer-duration ablation but not with HNS-irrigation. Steam pops were absent with NS-irrigation (0/35) even with the largest %impedance-drop reaching 31% at 45 W/180 s. All steam pops were observed with HNS-irrigation (6/21, 29%). The optimal %impedance-drop cutoff predicting steam pops was 24% with an NPV = 96.3% including both NS- and HNS-irrigation groups. Conclusions: Rather than using HNS-irrigation, very long-duration of radiofrequency applications up to 45 W/180 s may be recommended to safely and effectively increase lesion dimensions using this catheter with NS-irrigation. [ABSTRACT FROM AUTHOR]

Background: Docetaxel (DTX) is commonly used as a primary chemotherapy, and cabazitaxel (CBZ) has shown efficacy in patients who are DTX resistant. Primary prophylactic granulocyte colony stimulating factor (G-CSF) therapy is currently used with CBZ treatment in routine clinical care in Japan. Methods: In this study, we performed a systematic review following the Minds guidelines to investigate the effectiveness and safety of primary prophylaxis with G-CSF during chemotherapy for prostate cancer and to construct G-CSF guidelines for primary prophylaxis use during chemotherapy. A comprehensive literature search of various electronic databases (PubMed, Cochrane Library, and Ichushi) was performed on January 10, 2020, to identify studies published between January 1990 and December 31, 2019 that investigate the impact of primary prophylaxis with G-CSF during CBZ administration on clinical outcomes. Results: Ultimately, nine articles were included in the qualitative systematic review. Primary G-CSF prophylaxis during CBZ administration for metastatic castration-resistant prostate cancer was difficult to assess in terms of correlation with overall survival, mortality from infection, and patients' quality of life. These difficulties were owing to the lack of randomized controlled trials comparing patients with and without primary prophylaxis of G-CSF during CBZ administration. However, some retrospective studies have suggested that it may reduce the incidence of febrile neutropenia. Conclusion: G-CSF may be beneficial as primary prophylaxis during CBZ administration for metastatic castration resistant prostate cancer, and we made a "weak recommendation to perform" with an annotation of the relevant regimen. [ABSTRACT FROM AUTHOR]

Background/Objectives: We aimed to determine the trends over time and current status of early Helicobacter pylori-uninfected gastric cancer (HpUIGC) treatment in a region with an aging population. Methods: This retrospective, multi-center observational study was conducted at seven major general hospitals in Kagoshima Prefecture. From January 2009 to July 2022, 2091 patients who received endoscopic resection (ER) for early gastric cancer (EGC) were retrospectively enrolled, of which 35 were identified as early HpUIGC cases. Results: The number of ERs for EGC demonstrated a significant increasing trend from 2010 to 2021 (p = 0.01 for trend). Furthermore, the 12-year period from 2010 to 2021 was divided into an early and late phase every 6 years. In the early phase, there were 5 cases (0.7%) of early HpUIGC, while in the late phase, there were 25 cases (2.1%), indicating a significant increase in the proportion of ERs for early HpUIGC cases in the late phase (p = 0.02). Conclusions: The proportion of ERs for early HpUIGC, which are more common in relatively young patients, may be increasing as a proportion of all ERs for GC, even in areas of Japan with an aging population. [ABSTRACT FROM AUTHOR]

Background: The terminology for lung cancer diagnosis in small biopsies was adopted in the 2015 World Health Organization classification. If non‐small cell lung cancer (NSCLC) has no clear adenocarcinoma (AD) or squamous cell carcinoma morphology, the tumor is further classified based on mucin or immunohistochemical staining as NSCLC favor AD (NFAD), NSCLC favor squamous cell carcinoma, or NSCLC not otherwise specified. Since this new term was defined, the difference between AD and NFAD has not yet been fully explored. This study aimed to examine the differences in clinical background, gene alteration frequency, and programmed death ligand 1 (PD‐L1) expression. Methods: We included patients diagnosed with AD or NFAD with small samples, and who underwent testing with the Oncomine Dx target test between August 2019 and April 2023 in Kanagawa Cancer Center. Results: This study comprised 268 patients. A total of 96 patients underwent surgery after AD or NFAD diagnosis. The clinical stage was more advanced and pathological N0 was lower in NFAD than in AD. The pathology of the surgical specimens revealed that solid predominant AD was significantly more common in NFAD than in AD (p < 0.001). In both AD and NFAD, EGFR mutation was the most frequent gene alteration, followed by KRAS mutation. The frequency of EGFR mutations was significantly higher in AD than in NFAD. PD‐L1 expression was significantly higher in NFAD than in AD (p < 0.001). Conclusion: This study shows a clear difference between AD and NFAD in terms of cancer progression, pathological features of the main tumor, genetic characteristics, and PD‐L1 expression. [ABSTRACT FROM AUTHOR]

Introduction: Cryoballoon ablation (CBA) of the left atrial (LA) roof in addition to a pulmonary vein isolation has been expected to improve the clinical outcomes post‐atrial fibrillation (AF) ablation. We demonstrated the characteristics and efficacy of CBA of the LA roof through our experience with a large volume of procedures. Methods: Among 1036 AF ablation procedures with CBA of the LA roof, 834 patients who underwent a de novo ablation were analyzed. Results: Complete LA roof line conduction block was obtained in 767 patients (92.0%) solely by CBA (Group A). Compared with the other patients (Group B), the mean nadir balloon temperature during CBA of the LA roof (−44.5 ± 5.6°C for Group A vs. −40.5 ± 7.5°C for Group B, p <.01) and number of cryoballoon applications during the LA roof ablation with a circular mapping catheter located in the left superior pulmonary vein (1.3 ± 0.8 for Group A vs. 1.6 ± 1.0 for Group B, p =.02) were significantly lower in Group A. A multivariate analysis revealed that those were predictors of a complete LA roof conduction block after only CBA. The 1‐year Kaplan–Meier atrial arrhythmia free rate estimates were 80.6% for Group A and 59.0% for Group B (p <.01). Conclusion: Complete LA roof line conduction block could be obtained with a cryoballoon without touch‐up ablation in most cases. The LA roof CBA with a circular mapping catheter located in the right superior pulmonary vein was preferable to obtaining complete LA roof conduction block, which was important with regard to the clinical outcomes. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to reveal risk factors for incident of frontotemporal dementia (FTD) compared with Alzheimer disease (AD) in Japan. Method: Fifty consecutive subjects diagnosed with FTD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‐5) under 75 years old were included retrospectively. As a control group, 48 subjects who were diagnosed with AD according to the DSM‐5 and matched by age, sex, educational history, and Mini‐Mental State Examination were also included. In order to examine the distinctive risk factors of FTD, we compared the relationship between symptomatologic features, Clinical Dementia Rating, clinical factors, and sociopsychological factors in the two groups. Result: Patients with FTD were more likely than patients with AD to have meticulous premorbid personality and less likely to have a history of diabetes than patients with AD. Although the regression analysis was not significant, a history of psychiatric disorders tends to affect the incidence of FTD. Conclusions: These findings regarding the risk of FTD are expected to lead to early diagnosis and care of FTD. Geriatr Gerontol Int 2023; 23: 932–937. [ABSTRACT FROM AUTHOR]

Background: tert-Butyl hydroperoxide (TBHP; CAS 75–91-2), a hydroperoxide, is mainly used as a polymerization initiator to produce polyethylene, polyvinyl chloride, and unsaturated polyester. It is a high-production chemical, widely used in industrial countries, including Japan. TBHP is also used as an additive for the manufacturing of food utensils, containers, and packaging (UCP). Therefore, there could be consumer exposure through oral intake of TBHP eluted from UCPs. TBHP was investigated in various in vitro and in vivo genotoxicity assays. In Ames tests, some positive results were reported with and/or without metabolic activation. As for the mouse lymphoma assay, the positive result was reported, regardless of the presence or absence of metabolic activation enzymes. The results of some chromosomal aberrations test and comet assay in vitro also demonstrated the genotoxic positive results. On the other hand, in in vivo tests, there are negative results in the bone marrow micronucleus test of TBHP-administered mice by single intravenous injection and the bone marrow chromosomal aberration test using rats exposed to TBHP for 5 days by inhalation. Also, about dominant lethal tests, the genotoxic positive results appeared. In contrast, there is little information about in vivo mutagenicity and no information about carcinogenicity by oral exposure. Results: We conducted in vivo gene mutation assay using MutaMice according to the OECD Guidelines for the Testing of Chemicals No. 488 to investigate in vivo mutagenicity of TBHP through oral exposure. After repeated dosing for 28 days, there were no significant differences in the mutant frequencies (MFs) of the liver and glandular stomach up to 300 mg/kg/day (close to the maximum tolerable dose (MTD)). The positive and negative controls produced the expected responses. Conclusions: These findings show that orally administrated TBHP is not mutagenic in the mouse liver and glandular stomach under these experimental conditions. [ABSTRACT FROM AUTHOR]

Background: Endometrial cancer (EMC) is the most common female genital tract malignancy with an increasing prevalence in many countries including Japan, a fact that renders early detection and treatment necessary to protect health and fertility. Although early detection and treatment are necessary to further improve the prognosis of women with endometrial cancer, biomarkers that accurately reflect the pathophysiology of EMC patients are still unclear. Therefore, it is clinically critical to identify biomarkers to assess diagnosis and treatment efficacy to facilitate appropriate treatment and development of new therapies for EMC. Methods: In this study, wide-targeted plasma metabolome analysis was performed to identify biomarkers for EMC diagnosis and the prediction of treatment responses. The absolute quantification of 628 metabolites in plasma samples from 142 patients with EMC was performed using ultra-high-performance liquid chromatography with tandem mass spectrometry. Results: The concentrations of 111 metabolites increased significantly, while the concentrations of 148 metabolites decreased significantly in patients with EMC compared to healthy controls. Specifically, LysoPC and TGs, including unsaturated fatty acids, were reduced in patients with stage IA EMC compared to healthy controls, indicating that these metabolic profiles could be used as early diagnostic markers of EMC. In contrast, blood levels of amino acids such as histidine and tryptophan decreased as the risk of recurrence increased and the stages of EMC advanced. Furthermore, a marked increase in total TG and a decrease in specific TGs and free fatty acids including polyunsaturated fatty acids levels were observed in patients with EMC. These results suggest that the polyunsaturated fatty acids in patients with EMC are crucial for disease progression. Conclusions: Our data identified specific metabolite profiles that reflect the pathogenesis of EMC and showed that these metabolites correlate with the risk of recurrence and disease stage. Analysis of changes in plasma metabolite profiles could be applied for the early diagnosis and monitoring of the course of treatment of EMC patients. [ABSTRACT FROM AUTHOR]

Aim: Uterine cervical cancer (UCC) is the fourth most common cancer in women, responsible for more than 300 000 deaths worldwide. Its early detection, by cervical cytology, and prevention, by vaccinating against human papilloma virus, greatly contribute to reducing cervical cancer mortality in women. However, penetration of the effective prevention of UCC in Japan remains low. Plasma metabolome analysis is widely used for biomarker discovery and the identification of cancer‐specific metabolic pathways. Here, we aimed to identify predictive biomarkers for the diagnosis and radiation sensitivity of UCC using wide‐targeted plasma metabolomics. Methods: We analyzed 628 metabolites in plasma samples obtained from 45 patients with UCC using ultra‐high‐performance liquid chromatography with tandem mass spectrometry. Results: The levels of 47 metabolites were significantly increased and those of 75 metabolites were significantly decreased in patients with UCC relative to healthy controls. Increased levels of arginine and ceramides, and decreased levels of tryptophan, ornithine, glycosylceramides, lysophosphatidylcholine, and phosphatidylcholine were characteristic of patients with UCC. Comparison of metabolite profiles in groups susceptible and non‐susceptible to radiation therapy, a treatment for UCC, revealed marked variations in polyunsaturated fatty acid, nucleic acid, and arginine metabolism in the group not susceptible to treatment. Conclusions: Our findings suggest that the metabolite profile of patients with UCC may be an important indicator for distinguishing these patients from healthy cohorts, and may also be useful for predicting sensitivity to radiotherapy. [ABSTRACT FROM AUTHOR]

The incidence of medication-related osteonecrosis of the jaw is increasing worldwide, mostly due to the use of antiresorptive agents (ARAs) such as bisphosphonate (BP) and denosumab (Dmab). However, the proportion of BP-related osteonecrosis of the jaw (BRONJ) and Dmab-related osteonecrosis of the jaw (DRONJ) among all ARA-related osteonecrosis of the jaw (ARONJ) cases is not clear; this hinders appropriate treatment, recurrence-prevention planning, and avoidance of unnecessary Dmab withdrawal. Moreover, the causative drug administered at each disease stage remains unknown. Therefore, we conducted a retrospective study of patients with ARONJ who visited oral and maxillofacial surgery departments at hospitals in Hyogo Prefecture, Japan, over 3 years to classify and compare patient characteristics with those having BRONJ and DRONJ. We sought to identify the proportion of DRONJ in ARONJ. After excluding stage 0 patients, 1021 patients were included (471 high-dose; 560 low-dose). ARA treatment for bone metastases of malignant tumors and multiple myeloma was considered high dose, while that for cancer treatment-induced bone loss and osteoporosis was low dose. Low doses of BP and Dmab accounted for >50% patients; the results differed from those in other countries. DRONJ accounted for 58% and 35% of high-dose and low-dose cases, respectively. Stage 3 ARONJ cases comprised 92 (19.5%) low-dose BRONJ, 39 (20.1%) high-dose BRONJ, 24 (30%) low-dose DRONJ, and 68 (24.5%) high-dose DRONJ. Eighty-nine patients who received switch therapy were divided into BRONJ or DRONJ, but there was no difference in the ratio of each stage compared to the non-switch therapy. To the best of our knowledge, this is the first study to clarify the proportion of BRONJ and DRONJ cases, causative drug, and its doses by disease stages. DRONJ accounted for approximately 30% of the ARONJ, approximately 60% of which was due to high doses. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the magnitude and trends in personal payments from pharmaceutical companies to urologists in Japan. Methods: This cross-sectional study examined the personal payments made to urologists by the major pharmaceutical companies in Japan between 2016 and 2019. Descriptive analyses were performed on the payment data. All urologists board-certified by the Japanese Urological Association as of March 2022 were included in this study. Trends in personal payments were assessed using the population-averaged generalized estimating equations with panel data of per-physician personal payments. Results: Among 7016 active board-certified urologists, 4962 (70.7%) accepted 53,070 payments totaling $36,424,239 for reimbursement of lecturing, writing, and consulting compensations from 66 pharmaceutical companies between 2016 and 2019. The median payments per urologist receiving payments were $1714 [interquartile range(IQR): $700–$4583] in payment amounts and 4.0 (IQR: 2.0–10.0) in the number of payments. Only 1%, 5%, 10%, and 25% of top-paid urologists accepted 36.2%, 64.8%, 75.8%, and 90.1% of overall payments respectively. The payments per urologist and the number of payment contracts had annually increased over this period by 4.1% (95% CI: 2.3%–6.0%, p < 0.001) and 2.4% (95% CI: 1.2%–3.7%, p < 0.001), but there was no significant change in the number of urologists receiving payments, with a relative average annual change of 0.7% (95% CI: -0.15%–1.6%, p = 0.10) between 2016 and 2019. Conclusion: Most urologists received personal payments for lecturing, consulting, and writing compensations from pharmaceutical companies in Japan. The payments from pharmaceutical companies had been increasing over the 4-year period. These payments were substantially concentrated on a small number of urologists. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to clarify the accuracy of pregnant women's knowledge and understanding regarding infectious disease screening in early pregnancy and clarify the roles that should be played by health care providers in promoting the health of pregnant women and their children. Methods: A cross-sectional questionnaire survey was conducted in 25 hospitals across Japan from May 2018 to September 2019. We compared the agreement rates regarding screening results for hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis, human T-cell leukemia virus-1 (HTLV-1), and cervical cytology in the medical records and understanding of their results by pregnant women. We then investigated whether participants had knowledge regarding the risk of mother-to child transmission in these diseases and factors associated with their knowledge. Results: We enrolled 2,838 respondents in this study. The rates of agreement for HBV and cervical cancer screening related to human papillomavirus infection were "substantial," those for syphilis was "moderate," and those for HCV and HTLV-1 were "fair," according to the Kappa coefficient. The rate of knowledge regarding mother-to-child transmission of syphilis was highest (37.0%); this rate for the other items was approximately 30%. Increased knowledge was associated with higher educational level and higher annual income. Conclusions for Practice: Pregnant women in Japan had generally good levels of understanding regarding their results in early-pregnancy infectious disease screening. However, they had insufficient knowledge regarding mother-to-child transmission of these diseases. Health care providers should raise awareness in infectious disease prevention among pregnant women and the general public, providing appropriate measures and implementing effective perinatal checkups and follow-ups for infectious diseases. Significance: A previous study reported biases in knowledge about mother-to-child disease transmission among pregnant women. However, there are no reports on the accuracy of pregnant women's understanding and their backgrounds related to knowledge about infectious diseases. In this report, Japanese pregnant women had generally good understanding of their results in infectious disease screening. However, they had insufficient knowledge regarding mother-to-child transmission of infectious diseases. It is crucial for health care providers to raise awareness in infectious disease prevention and provide appropriate measures for pregnant women and the general public, such as implementing effective perinatal checkups and follow-ups. [ABSTRACT FROM AUTHOR]

Understanding the structure of human sexual contact networks is vital in a broad range of disciplines, including sociology, biology, public health, and anthropology. However, sexual contact networks are yet to be understood because technical and privacy issues make it difficult to conduct accurate, large-scale surveys. In this study, we surveyed data openly available on one of the largest adult entertainment websites in Japan, where male clients (MCs) can write online customer reviews of female commercial sex workers (FCSWs). In particular, our investigation focused on a type of establishment called "soapland," the only type of sex industry in Japan where sexual intercourse is publicly permitted. Soaplands are scattered throughout Japan, and the study website covers approximately 66% of them. Using such a vast amount of data on a nationwide scale, we clarified the network structure of commercial sex, characterized by small-world, scale-free, and disassortative mating properties. To study geographical characteristics, we compared the resulting network with three different artificially generated networks via the random rewiring of links. Moreover, we considered a simple epidemic model on the resulting network, and investigated whether it would be more effective to provide infection control measures to FCSWs or MCs. We determined that active FCSWs constitute an important pathway of infection propagation in commercial sex networks, but MCs also play an essential role as weak ties. [ABSTRACT FROM AUTHOR]

Background: The pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH) is considered to be associated with chronic inflammation; however, the underlying mechanism remains unclear. Recently, altered gut microbiota were found in patients with pulmonary arterial hypertension (PAH) and in experimental PAH models. The aim of this study was to characterize the gut microbiota in patients with CTEPH and assess the relationship between gut dysbiosis and inflammation in CTEPH.Methods: In this observational study, fecal samples were collected from 11 patients with CTEPH and 22 healthy participants. The abundance of gut microbiota in these fecal samples was assessed using 16S ribosomal ribonucleic acid (rRNA) gene sequencing. Inflammatory cytokine and endotoxin levels were also assessed in patients with CTEPH and control participants.Results: The levels of serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-8, and macrophage inflammatory protein (MIP)-1α were elevated in patients with CTEPH. Plasma endotoxin levels were significantly increased in patients with CTEPH (P < 0.001), and were positively correlated with TNF-α, IL-6, IL-8, and MIP-1α levels. The 16S rRNA gene sequencing and the principal coordinate analysis revealed the distinction in the gut microbiota between patients with CTEPH (P < 0.01) and control participants as well as the decreased bacterial alpha-diversity in patients with CTEPH. A random forest analysis for predicting the distinction in gut microbiota revealed an accuracy of 80.3%.Conclusion: The composition of the gut microbiota in patients with CTEPH was distinct from that of healthy participants, which may be associated with the elevated inflammatory cytokines and endotoxins in CTEPH. [ABSTRACT FROM AUTHOR]

Ozegahara Mire is the largest alpine mire in Japan, and it has been preserved as the precious peatland ecosystem under oligotrophic condition. However, after the late 20 century, the mire has been exposed to ecosystem disturbance by invaded Sika deer. Browsing and digging of the mire vegetation by Sika deer have given considerable impacts on not only vegetation but also biochemical property of the peat soil, resulting in the changes in microbiological activities and nutrient dynamics. However, little information has been provided about the effect of deer disturbance on nitrogen (N) dynamics in the mire. This study aims to provide information about the effects of deer disturbance on nitrogen dynamic including N2 fixation and denitrification in Ozegahara Mire. Soil samples were collected at 6 plots on 2 sites with and without mire disturbance by Sika deer at eastern Naka-Tashiro of Ozegahara mire in July 2018. Mineral N contents and other physicochemical properties of the soil samples were measured. N2 fixation and denitrification activities of the soil samples were also measured at different incubation temperatures (15, 20 or 25°C) under either aerobic or anaerobic conditions by acetylene reduction activity (ARA) and inhibition methods, respectively. As results, the ARA in the disturbed sites were lower than those in the undisturbed sites and also lower under aerobic condition than anaerobic condition. Negative correlation was found between ARA and ammonium N in the soil (R2 = 0.353, p< 0.05), suggesting that mechanical disturbance of the peat soils by deer enhanced mineralization of organic N to suppress N2 fixation. ARA was increased by elevated incubation temperature in the undisturbed sites, while no change in the disturbed sites. Denitrification activities was not affected by the disturbance by Sika deer, while higher under aerobic condition than in anaerobic condition, and in higher temperature than lower temperature. Multi-regression analysis of ARA affecting factors revealed that ARA was significantly influenced by temperature, ammonium N and disturbance. These results indicate the marked influences of the mire disturbance by Sika deer on N2 fixation and denitrification activities of the peat soils and N dynamics in Ozegahara Mire. [ABSTRACT FROM AUTHOR]

Objectives: Gastrointestinal endoscopy (GIE) is useful for the early detection and treatment of many diseases; however, GIE is considered a high‐risk procedure in the coronavirus disease 2019 (COVID‐19) pandemic era. This study aimed to explore the rate of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) positivity in saliva and gastrointestinal fluids to which endoscopy medical staff are exposed. Methods: The study was a single‐center cross‐sectional study. From June 1 to July 31, 2020, all patients who underwent GIE at Yokohama City University Hospital were registered. All patients provided 3 mL of saliva. For upper GIE, 10 mL of gastric fluid was collected through the endoscope. For lower GIE, 10 mL of intestinal fluid was collected through the endoscope. The primary outcome was the positive rate of SARS‐CoV‐2 in saliva and gastrointestinal fluids. We also analyzed serum‐specific antibodies for SARS‐CoV‐2 and patients' background information. Results: A total of 783 samples (560 upper GIE and 223 lower GIE samples) were analyzed. Polymerase chain reaction (PCR) on saliva samples did not show any positive results in either upper or lower GIE samples. However, 2.0% (16/783) of gastrointestinal fluid samples tested positive for SARS‐CoV‐2. No significant differences in age, sex, purpose of endoscopy, medication, or rate of antibody test positivity were found between PCR positive and PCR negative cases. Conclusions: Asymptomatic patients, even those with no detectable virus in their saliva, had SARS‐CoV‐2 in their gastrointestinal tract. Endoscopy medical staff should be aware of infection when performing procedures. The study was registered as UMIN000040587. [ABSTRACT FROM AUTHOR]

Aims: Patients with severe behavioral and psychological symptoms of dementia (BPSD) are often admitted to mental hospitals, while, inpatient care could also lead to prolonged hospital stay. The present study aims to survey clinical profiles of patients who required inpatient treatment for BPSD, and then establish the criteria for introducing inpatient treatment through assessment by certified psychiatrists. Methods: We performed a prospective survey about clinical characteristics of people with dementia who required treatment of BPSD at 12 mental medical institutions. All patients were assessed by certified psychiatrists to determine the optimal treatment settings: outpatient or inpatient. The multivariate logistic regression analysis was performed to specify factors contributed to the judgement of clinicians. Subsequently, the receiver operating characteristic curve analysis was conducted to explore a score derived from the Neuropsychiatric Inventory to divide patients into outpatient or inpatient groups. Results: The present study included 386 patients, of which 242 were admitted to mental hospitals. BPSD were classified into four domains, and aggressive BPSD was significantly associated with assessment for inpatient treatment; the adjusted odds ratio was approximately 2 regardless of dementia severity. Furthermore, the composite score of agitation, irritability and aberrant behavior showed the highest area under the curve value (=0.706), which differentiated inpatients from outpatients with a sensitivity of 76% and a specificity of 54%. Conclusions: Aggressive BPSD was the risk factor for inpatient treatment. The composite score of the Neuropsychiatric Inventory subdomain‐related aggressive BPSD could be a screening tool to introduce inpatient treatment for BPSD. Geriatr Gerontol Int 2021; 21: 825–829. [ABSTRACT FROM AUTHOR]

Objective: The Japan Society of Gynecologic Oncology published the first guidelines for the treatment of cervical cancer in 2007. The aim of this research was to evaluate the influence of the introduction of the first guideline on clinical trends and outcomes of patients with earlystage cervical cancer who underwent surgery. Methods: This analysis included 9,756 patients who were diagnosed based on the pathological Tumor-Node-Metastasis (pTNM) classification (i.e., pT1b1, pT1b2, pT2b and pN0, pN1, pNX) and received surgery as a primary treatment between 2004 and 2009. Data of these patients were retrospectively reviewed, and clinicopathological trends were assessed. The influence of the introduction of the guideline on survival was determined by using a competing risk model. Results: For surgery cases, the estimated subdistribution hazard ratio (HR) by the competing risk model for the influence of the guideline adjusted for age, year of registration, pT classification, pN classification, histological type, and treatment methods was 1.024 (p=0.864). Following the introduction of the first guideline in 2007, for patients with lymph node metastasis, the use of chemotherapy (CT) as a postsurgical therapy increased, whereas that of concurrent chemoradiotherapy (CCRT)/radiotherapy (RT) decreased (p<0.010). For pN1 cases, the estimated subdistribution HR by the competing risk model for the influence of the guideline was 1.094 (p=0.634). There was no significance in the postsurgical therapy between CT and CCRT/RT (p=0.078). Conclusions: Survival of surgical cases was not improved by the introduction of the guidelines. It is necessary to consider more effective postsurgical therapy for high-risk earlystage cervical cancer. [ABSTRACT FROM AUTHOR]

The Japan Society of Gynecologic Oncology published its first clinical guidelines for uterine cervical cancer in 2007 which has been revised twice in 2011 and 2017. The aim of this study was to investigate the influence of the first guideline publication on the therapeutic trend and patient outcome by analyzing uterine cervical cancer cases registered to the cancer registry organized by the Japan Society of Obstetrics and Gynecology. Data of uterine cervical cancer cases registered to the cancer registry from 2000 to 2012 were provided. Epidemiological and clinical trend were analyzed by the Chi-squared test with subsequent standardized residual analysis. Overall survival among the patients registered between 2004 and 2009 was analyzed using the Fine and Gray competing risk model. 68,707 cases were registered during the study period. A trend analysis revealed that the guideline publication may have led to a decrease in neoadjuvant chemotherapy in parallel with an increase in radiation therapy mainly in stage II and III patients undergoing primary treatment. A survival analysis indicated that the introduction of the guideline may have improved overall survival among stage III uterine cervical cancer patients, even though a significant difference was not observed in all of the cases. This study demonstrated the potential influence of the guideline publication on the clinical trend and patient outcome. As this is the first assessment of the guideline for uterine cervical cancer in Japan, continuous evaluation is necessary to further comprehend the significance of this guideline. • The first guideline for uterine cervical cancer in Japan was published in 2007. • Influence of the guideline publication was assessed by analyzing clinical data of 68,707 uterine cervical cancer cases. • It was indicated that the guideline led to a decrease in NAC and surgery in parallel with an increased selection of RT. • A Multivariate analysis suggested that the guideline publication possibly improved overall survival in stage III patients. [ABSTRACT FROM AUTHOR]

Background: A previous comparative study in Japan has demonstrated that the two consecutive UroVysion tests are useful tools to detect the presence of bladder cancer during follow-up after transurethral resection, but they also presented their high rates of false-positive results. Here, we aimed to evaluate the relationship between the UroVysion tests and subsequent intravesical recurrence. Methods: In the previous study, patients without bladder cancer during the first analysis showed the same examination set repeated 3 months later as the second analysis. In this follow-up study, 326 patients showed negative findings confirmed on cystoscopy during the second UroVysion test. Recurrence-free survival was assessed using a median follow-up of 27 months. Results: In the two consecutive UroVysion tests, 214 patients (65.6%) showed negative UroVysion results in both tests, whereas 91 presented a positive result on either tests and 21 patients presented positive results in both tests. During the follow-up, 40 patients (12.3%) had an intravesical recurrence with non-muscle-invasive bladder cancer. The recurrence rates in patients with negative results in both tests, those with one positive result in either tests, and those with positive results in both tests were 8.4%, 16.5%, and 33.3%, respectively. The multivariate analysis indicated that the history of bladder cancer and the consecutive UroVysion test pattern were independent risk factors for recurrence. Conclusions: Our data confirmed the effectiveness of two consecutive UroVysion tests in predicting intravesical recurrence after TURBT. Further prospective studies would help determine an appropriate interval for cystoscopy follow-up. [ABSTRACT FROM AUTHOR]

Aim: In patients with Alzheimer's disease (AD), cognitive impairments cause a progressive reduction in Activities of Daily Living (ADL). Neuropsychiatric symptoms (NPS) also appear in most patients; however, the association between NPS and reductions in ADL remains unclear. The present study evaluated whether NPS influence such reductions using two different ADL measures in patients with AD. Methods: Among 546 consecutive outpatients who visited the memory clinic at the Jikei University Kashiwa Hospital, we recruited 208 patients with AD and investigated the correlations between either the Physical Self‐Maintenance Scale (PSMS) score or the Instrumental ADL (IADL) level, and each of the Behavioral Pathology in AD (Behave‐AD) subscales. To clarify the causal relationships of these correlations, we then verified the associations between statistically significant demographic variables and the Behave‐AD subscales as well as the two ADL scales (PSMS score and IADL percentage) using a general linear model. Results: Neither the PSMS nor the IADL results were significantly influenced by the aberrant motor behaviors score. However, the IADL was significantly influenced by the Mini‐Mental State Exam (MMSE) score. Furthermore, diurnal rhythm disturbances and the interaction between diurnal rhythm disturbances score and the MMSE score significantly influenced the PSMS results. Conclusion: Basic ADL reductions may be influenced by diurnal rhythm disturbances, in addition to cognitive impairments in patients with AD. Furthermore, the interaction between the diurnal rhythm disturbances score and cognitive function may also influence basic ADL. Geriatr Gerontol Int 2020; ••: ••–••. [ABSTRACT FROM AUTHOR]

Changes in the proportions of river‐ and lake‐produced eggs of a landlocked amphidromous fish, ayu (Plecoglossus altivelis altivelis) in the Lake Biwa water system, Japan, were monitored by stable isotope analysis, based on different δ15N and δ13C values of prey organisms between the lake and its tributaries. During the 3 month reproduction season, the δ15N values of spawned eggs decreased with time. This result implies that there was a shift from lake‐produced eggs to river‐produced eggs within a reproductive season, based on the observation that adult fish in the lake had previously been shown to have eggs with distinctly higher δ15N values in their ovaries than those in the tributaries. This explanation was also supported by the change in δ13C values of the spawned eggs. Furthermore, eggs with lower δ15N and higher δ13C values tended to be spawned at less variable depths, suggesting that females spawning river‐produced eggs selected the spawning sites from a narrower range. We conclude that stable isotope ratios of spawned eggs can be indicators of the relative contributions of different food chains and can enable comparisons of reproductive characteristics between types of egg. [ABSTRACT FROM AUTHOR]

In order to realise effective maintenance and enhanced durability of structures, it is important to also reduce corrosion of bridges by airborne sea salt. The objective of this study is to reduce airborne sea salt adhesion amount on steel girder bridges by employing aerodynamic countermeasures. The study bridge is a typical metropolitan highway bridge with 8 I-shaped steel girders located in Japan. Aerodynamic countermeasure devices are employed to change the flow field around the bridge structure in an attempt to reduce wind velocity normal to the bridge girders. Devices existing on urban bridges such as noise barriers, median barriers, and facilities for passage of drainage pipes and electric cables, modelled as horizontal plates, are modified and investigated for their ability to reduce airborne sea salt adhesion amount. As additional devices, vertical plates are installed to change the flow separation and their applicability is also studied. Computational fluid dynamics is employed for flow field simulations and airborne sea salt adhesion amount is estimated by the improved concentration flux method. Findings indicate that horizontal plates and vertical plates significantly reduce airborne sea salt adhesion amount. Noise barriers and median barriers can also reduce airborne sea salt adhesion amount. [ABSTRACT FROM PUBLISHER]

INTRODUCTION: Japan is a developed country with high use of Internet and online platforms for health information. 'Yahoo! Answer Japan' is the most commonly used question-and-answer service in Japan. AIM: To explore the information users seek regarding breast cancer from the 'Yahoo! Answer Japan' web portal. METHODS: The 'Yahoo! Answer Japan' portal was searched for the key word 'breast cancer' and all questions searched for the period of 1 January to 31 December 2014 were obtained. The selected questions related to human breast cancer and were not advertisements or promotional material. The questions were categorized using a coding schema. High and low access of the questions were defined by the number of view-counts. RESULTS: Among the 2392 selected questions, six major categories were identified; (1) suspected breast cancer, (2) breast cancer screening, (3) treatment of breast cancer, (4) life with breast cancer, (5) prevention of breast cancer and (6) others. The highest number of questions were treatment related (28.8%) followed by suspected breast cancer-related questions (23.4%) and screening-related questions (20%). Statistical analysis revealed that the treatment-related questions were more likely to be highly accessed. CONCLUSION: Content analysis of Internet question--answer communities is important, as questions posted on these sites would serve as a rich source of direct reflection regarding the health-related information needs of the general population. [ABSTRACT FROM AUTHOR]

The previous reports suggest that obstructive sleep apnoea ( OSA) is related to metabolic syndrome, mineral metabolism disorders and cardiovascular disease. In addition, a possible relationship between obesity and the calcification of ligaments has been implied. However, the potential link between OSA and the calcification of ligaments has not been directly studied. In this present study, to investigate the potential link between OSA and the calcification of ligaments, we examined the prevalence of the calcification of ligaments in OSA patients and the relationship between these findings and OSA severity. Eighty consecutive patients (60 males, 20 females) diagnosed as OSA or a heavy snorer based on full-night polyso-mnography were retrospectively recruited from May 2006 to July 2008. Each patient underwent cephalometric imaging examination before the arrangement of an oral appliance. One calibrated observer ( YS) reviewed the cephalometric images for the presence of calcification of the nuchal ligament and osteophytes of the cervical spine. The prevalence of calcification of the nuchal ligament in OSA patients and snorers was 46·3% (males: 52%, females: 30%) There was a significant positive correlation between the severity of OSA ( AHI) and the calcification of the nuchal ligament before and after adjusting for BMI. The prevalence of the calcification of the nuchal ligament in OSA subjects and snorers was higher than in previous studies with non- OSA subjects. In addition, it is suggested that the severity of OSA correlates with the presence of calcification of the nuchal ligament. [ABSTRACT FROM AUTHOR]

Aims: It remains inconclusive whether high dietary fiber intake decreases the risk of obesity, hypercholesterolemia or high blood pressure during childhood. Therefore, this study investigated the relationships of dietary fiber intake with weight status and related clinical parameters among Japanese children. Methods: We analyzed the data of 5,600 subjects aged 10-11 years, between 2006 and 2010. Fiber intake was assessed using the Brief-type Diet History Questionnaire. Body height and weight and blood pressure were measured. Serum levels of total cholesterol, low- and high-density lipoprotein cholesterol and triglycerides were analyzed. Fiber intake was categorized into quintiles, and multivariate models were used to adjust for lifestyle factors. Results: Total fiber intake decreased the risks of overweight and high total cholesterol (OR Quintile 5 vs. Quintile 1 overweight: 0.71 for boys, 0.40 for girls; total cholesterol: 0.60 for boys, 0.66 for girls). Water-soluble fiber intake was associated with a lower risk of high blood pressure, although the ORs were not significant. Conclusions: Increasing the dietary fiber intake in Japanese children may have favorable effects on overweight and hypercholesterolemia. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

This study aims to evaluate the microclimate and development of pressure ulcers and superficial skin changes. A prospective cohort study was conducted in an acute care ward in Indonesia. Risk factors for pressure ulcers and superficial skin changes were identified based on the Bergstrom Braden conceptual model. Microclimate data were collected every 3 days for 15 days while the development of pressure ulcers and superficial skin changes was observed every day. Pressure ulcers and superficial skin changes were developed in 20 of the 71 participants. Total mean difference in skin temperature was higher for patients with pressure ulcers and superficial skin changes (0·9 ± 0·6°C) compared with controls (0·6 ± 0·8°C) ( P = 0·071). Binary logistic regression predictor values for pressure ulcers and superficial skin changes were 0·111 for type of sheet and 0·347 for Braden Scale results. In conclusion, difference in skin temperature seems to be a predictor for pressure ulcer development and superficial skin changes, while synthetic fibre sheets are able to maintain a beneficial microclimate. [ABSTRACT FROM AUTHOR]

The Hijikawa-arashi, a gap wind occurring in Ozu City, Ehime Prefecture, Japan, was investigated through in situ observations of horizontal and vertical directions. Analysis of surface air temperature data revealed that the inland Ozu Basin was radiatively cooled on the days on which the Hijikawa-arashi events occurred. This induced a greater difference in air temperature between the basin and the estuary of the Hijikawa River in comparison to days that no basin cooling occurred. In addition, the wind speeds of the Hijikawa-arashi observed at the estuary of the Hijikawa River were strongly proportional to the sea-level pressure difference between the inland Ozu Basin and the estuary. Theoretical calculations indicated that this pressure gradient force was sufficient for driving the strong wind of the Hijikawa-arashi. Moreover, calculation of the Froude number using vertical meteorological data revealed that the Hijikawa-arashi developed as a supercritical flow. That is, the flow was intensified at the exit of the gap, in accordance with the hydraulic theory. The vertical observations detected the inversion layer over the Hijikawa-arashi and suggested an application of the shallow water theory to this gap wind. The Hijikawa-arashi is an interesting gap flow with a strong wind, despite its small-scale geography relative to other gap winds worldwide. There is an important trigger getting higher basin pressure upstream due to the radiative cooling of the atmosphere and formation of a cold pool at the basin. [ABSTRACT FROM AUTHOR]

Copyright of Socio-Economic History / Shakai-Keizai Shigaku is the property of Socio-Economic History Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To provide data required for assessing the environmental health and safety risks of nanocomposites, abrasion-induced particle release from single-wall carbon nanotube (SWCNT)/polymer composites with or without thermal aging were evaluated by a shot blast system. First, overall composite weight loss (i.e., overall particle release) as a result of shot blasting was measured. Incorporating 5 wt% SWCNTs in polystyrene (PS) matrix was observed to reduce overall particle release by approximately 30% compared with pure PS. Heat treatment of the 5 wt% SWCNT/PS composites at 100°C for 10 days induced very slight change in overall particle release due to shot blasting. However, heat treatment at 350°C for 1 hr greatly deteriorated the abrasion resistance of the composites, enhancing overall particle release. Second, to verify the existence and form of SWCNTs released from the composites, released particles were observed by electron microscopy. Micron-sized particles with protruding SWCNTs and submicron-sized SWCNT clusters were observed in the particles released from the composites. Heat treatment of the composites at 350°C for 1 hr enhanced SWCNT release, which mainly formed clusters or rope-like bundles. [ABSTRACT FROM AUTHOR]

Background: Uterine leiomyosarcoma (LMS) and undifferentiated endometrial sarcoma (UES) are rare, aggressive malignancies. Both are treated similarly; however, few chemotherapy agents are effective. Recently, the combination of gemcitabine (900 mg/m, days 1 and 8) plus docetaxel (100 mg/m, day 8) with granulocyte colony-stimulating factor (G-CSF, 150 μg/m, days 9-15) has been shown to have activity in LMS. In Japan, neither prophylactic G-CSF at a dose of 150 μg/m nor docetaxel at a dose of 100 mg/m are approved for use. For this reason, we evaluated the combination of 900 mg/m gemcitabine plus 70 mg/m docetaxel regimen without prophylactic G-CSF support in advanced or recurrent LMS and UES in Japanese patients. Methods: Eligible women with advanced or recurrent LMS and UES were treated with 900 mg/m gemcitabine on days 1 and 8, plus 70 mg/m docetaxel on day 8, every 3 weeks. The primary endpoint was overall response rate, defined as a complete or partial response. Results: Of the eleven women enrolled, 10 were evaluated for a response. One complete response and 2 partial responses were observed (30 %) with an additional 4 (40 %) having stable disease. Mean progression-free survival was 5.4 months (range 1.3-24.8 months), and overall survival was 14 months (range 5.3-38.4 months). Grade 4 neutropenia was the major toxicity (50 %). The median number of cycles was 5 (range 2-18). Twenty-two cycles (44 %) employed G-CSF. Conclusion: The gemcitabine plus docetaxel regimen without prophylactic G-CSF support was tolerable and highly efficacious in Japanese patients with advanced or recurrent LMS and UES. [ABSTRACT FROM AUTHOR]

In this study, the sensitivities of surface air temperatures to anthropogenic heat (AH) were investigated in downtowns of the two Japanese major cities, Tokyo and Osaka. First, meteorological measurements were made with the simultaneous monitoring of electricity demand in a contrastive couple of a downtown commercial area (C-area) and a residential area (R-area) within each city in summer 2007. From the measurements, the areal-mean surface air temperatures were obtained as $$ {\overline{T}}_{\mathrm{C}} $$ and $$ {\overline{T}}_{\mathrm{R}} $$ for each of the C-area and R-area, respectively. Using the actual electricity demand and the estimated motor fuels consumption, their areal total was evaluated as the energy-consumption-basis AH. The estimated C-areas' AH indicated greater values up to 220 W/m on weekdays and remarkable decrease about by half on weekends, whereas that in the R-areas showed less values of 10-20 W/m stably. Then, $$ {\overline{T}}_{\mathrm{C}}-{\overline{T}}_{\mathrm{R}} $$ on calm and fine days were found to be systematically decreased from weekdays to weekends in both cities roughly indicating a proportional relationship with the reductions in the C-areas' AH on weekends. The result suggested a common afternoon sensitivity for both C-areas of around 1.0°C/100 W/m, which indicated an intensity of the AH impact on surface air temperature there. Next, to simulate the observed AH impact, the authors' CM-BEM (a multilayer urban canopy model coupled with a building energy model) was newly implemented in the mesoscale Weather Research and Forecasting (WMF) model. This new system, WRF-CM-BEM, was applied to Tokyo and almost reasonably validated from the aspects of the reproducibility of urban surface air temperature and electricity demand in the observation areas. The simulations also suggested that WRF-CM-BEM underestimated the observed air temperature sensitivity to AH in the Tokyo C-area roughly by half but still in the same order of magnitude. [ABSTRACT FROM AUTHOR]

The article looks at the physiological and appearance characteristics of skin maceration caused by urine and/or faeces. It cites a comparative study involving 69 elderly women with urinary and/or faecal incontinence. It notes the greater stratum corneum and dermis hydration levels in the maceration group compared to the non-maceration group. The use of the erythema index in the precise and easy identification of the condition is also discussed.

Background: A national survey in Japan reported that the prevalence of smoking among high school students has sharply decreased in recent years. However, the survey only considered students who attended regular high schools (RHSs), and Japan offers part-time high schools (PHSs) that are often attended by academically and socioeconomically disadvantaged youth. Purpose: Therefore, we examined the smoking prevalence and smoking-related factors among PHS students. Method: A self-administered questionnaire-based survey was conducted at six PHSs. The subjects included 540 enrolled students aged 15 to 18 years. The questionnaire included items on smoking status, smokers in the family, frequency of convenience store use, lifestyle behaviors, and health awareness. Logistic regression analysis was used to identify factors that were significantly associated with smoking. Results: A total of 45.6 % of students had smoking experience, and 29.3 % were smokers. For males and females, the smoking prevalence was about 3 and 7–12 times higher, respectively, than that reported in the national survey. The factors found to be significantly associated with smoking included having a smoker in the family, experience with drinking alcohol, and using convenience store daily (odds ratio [OR] = 12.5) or sometimes (OR = 3.63). There was a significant dose–response relationship between smoking and convenience store use. Conclusion: The smoking prevalence among PHS students was remarkably higher than that among RHS students. These findings suggest that marginalized and disadvantaged youth should be targeted for tobacco control, and intervention is needed to protect youth from tobacco sales and advertising at convenience stores. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to analyze the outcomes of children added to the waiting list for deceased donor liver transplantation (DDLT) and the results of DDLT in a single Japanese center. Methods: Forty-seven children were listed on the organ allocation system for DDLT. The priority points related to the medical status of each patient were evaluated and stratified into four categories; 10, 8, 6, and 3 points. The clinical data were collected from the medical records, and the outcomes were analyzed. Results: There were 10 priority points in 25 patients, 6 points in 13 and 3 points in 9. Ten recipients (21.3 %); 7 patients with 10 points and 3 patients with 6 points, underwent DDLT. Seven out of the 10 recipients received split/reduced liver grafts. The surgical complications consisted of biliary stricture, hepatic venous outflow obstruction, intraabdominal abscess and intraabdominal bleeding. Two recipients, who were critically-ill before DDLT, died due to sepsis. The one-year graft survival rate was 70.0 %, with a median follow-up period of 6.4 months. Conclusion: The initial experience with pediatric DDLT in our series was satisfactory. Split LT of deceased donor organs may have the potential to resolve the serious organ shortage in Japan. [ABSTRACT FROM AUTHOR]

Background. A new public long-term care (LTC) insurance was launched in 2000 in Japan. However, there have been few studies involving factors that increase LTC costs of demented subjects; no follow-up studies involving the Government-Certified Index (GCI) and requisite costs related to the causes of dementia. Method. An epidemiological survey was conducted in a rural area in Japan in 1999, and 271 subjects were diagnosed as dementia patients. Age, sex, mini-mental state examination, clinical dementia rating, activity of daily living, causes of dementia, and coexisting physical disease were confirmed. After the LTC insurance has been launched, we tracked the GCI stages and payment amounts every month for 8 years. Result. 209 subjects were certified to be eligible for LTC insurance; however, 13 did not receive any payment. Only 49 out of 209 were alive after the follow-up period.The most common cause of dementia was Alzheimer's disease (AD), followed by vascular dementia (VaD). There was no significant difference between the mortality rates of the two groups. VaD subjects required higher costs than AD subjects in the total certified period and in GCI stage 5. Conclusion. Our results indicate that causes of dementia can have an impact on the requisite costs for the LTC insurance. [ABSTRACT FROM AUTHOR]

We investigated relationships between the flowering phenology of Prunus yedoensis 'Somei-yoshino' (cherry blossom) and the local temperatures in Japan. Our observations were carried out across the Okayama Plain, which included Okayama City (about 700,000 inhabitants), from the winter of 2008 to the spring of 2009. Local air temperature (AT) and the globe temperature (GT) were recorded at the tree height. The flowering dates (FDs) of P. yedoensis were earliest in the central commercial area (located at the center of the plain), followed by the north residential area (further inland), and finally the south residential area (seaward). The recorded FDs were related to the period-averaged daily maximum/minimum AT and GT, and the phenologically effective AT and GT defined in this study. Of these parameters, the phenologically effective GTs correlated most with the FDs. Since the GT is determined by AT, solar and infrared radiations, and wind speed, our previous result suggests that a combination of these three components surrounding the tree is more important for budding and flowering than is AT alone. The supposition is supported by the flowering of P. yedoensis being the latest at the coastal region of the Okayama Plain where the AT were higher than at the inland region, excluding the urban area; it is probably caused by stronger winds there than at the other sites. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Field Ornithology is the property of Resilience Alliance and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this study was to estimate the Coniacian latitudinal thermal gradient in the Northern Hemisphere. Both hemipelagic (ammonoids) and benthic (brachiopods and bivalves) δO and δC records were used. They originated from Coniacian shallow-water sequences across a wide range of paleolatitudes, from the Koryak upland (northern Kamchatka, Russian Far East) in the north, to Hokkaido (Japan) in the south. Among Coniacian ammonoids, both migrants from Hokkaido living in high latitudes (Kamchatka) and endemic forms dwelling in middle-low latitudes (Hokkaido) indicate seemingly close optimal growth temperatures. Nevertheless, certain differences in climatic conditions, prevailing during high-latitude coldest seasons, undoubtedly provoked growth cessation in some groups of ammonites. Our isotopic study suggests latitudinal temperature changes of only 0.12 °C per degree of latitude for the Northern Hemisphere in Coniacian times, while the average annual temperature in North Kamchatka seems about 3.3 °C lower than that in Hokkaido. [ABSTRACT FROM AUTHOR]

Background: The rate of influenza vaccination in Japan has declined over the past several decades. It is essential to identify community-specific factors that affect attitudes toward vaccination, but such parameters have not yet been fully determined in Japan. The present study used the Health Belief Model (HBM) to identify perceptions of influenza vaccination in a rural Japanese community. Methods: All subjects were residents of a rural town in the southern part of Kyoto, Japan. An anonymous selfadministered questionnaire was mailed to 846 randomly chosen households (containing 2,665 subjects). The survey explored gender, age, history of influenza, and factors associated with obtaining influenza vaccination, based on the HBM. Results: A total of 1,182 valid responses (response rate, 44.4%) were received. Sources of information that were associated with vaccination decisions were medical facilities for children (OR = 4.21; 95% CI: 1.17-15.1), workplaces for adults (OR = 2.40; 95% CI: 1.22-4.75), medical facilities, town office and family for elderly subjects (OR = 6.18; 95% CI: 2.42-15.7, OR = 5.59; 95% CI: 2.26-13.8 and OR = 3.29; 95%CI: 1.01-10.6). Subjects, in all age groups, who strongly agreed that the vaccine was effective were significantly more likely to be vaccinated (OR = 10.5; 95%CI: 2.68-41.7 for children; OR = 8.85; 95%CI: 4.61-16.9 for adults; OR = 19.9; 95%CI: 8.28-48.0 for the elderly). The vaccination rate of elderly subjects who expressed concerns regarding adverse vaccine effects (OR = 0.34, 95% CI: 0.15-0.78) or who were worried about practical barriers to the vaccination process (OR = 0.13; 95% CI: 0.05-0.31) was significantly lower than in other populations. Conclusions: Our results indicate that vaccination coverage can be increased if accurate information on personal risk, severity of influenza illness, and efficacy of vaccination are provided by responsible information sources that are easily accessible. Such sources include medical facilities and municipal offices. In addition, barriers and inconveniences associated with vaccination should be removed, especially if they impact on elderly people. [ABSTRACT FROM AUTHOR]

This paper focuses on ongoing work on comprehensive revision of Japan's City Planning Law (CPL). The basic framework of the current CPL was established in 1968. During the 1960s, rapid population growth and population concentration in urban areas took place, and sporadic developments on the urban fringe were encroaching on farm and forest lands. One of major purposes of enacting the CPL was to prevent disorderly urbanisation of such lands from expanding. The background which existed when the current CPL was enacted has been completely changed, however. A low birth rate and ageing population are a serious problem, and the population is expected to begin a perceptible decline around 2010 in Japan. To respond to such changes in socio-economic circumstances, the Japanese government has started a comprehensive study for revision of the CPL. The main issues it is exploring for a new framework are: how to achieve integrated land use and development control of urban and farmland to prevent suburban sprawl, how to refine regulations on building construction to achieve desirable land use (particularly in urban areas), and how to introduce a time-management system in planning and developing public facilities such as roads and parks. This paper introduces interesting phenomena happening in the city planning field and shows new proposals to solve the above-mentioned problems. It is expected that this paper will show people in the city planning field challenging work on a new city planning scheme to respond to population decrease, especially in developed countries. [ABSTRACT FROM AUTHOR]

Primary open-angle glaucoma (POAG) is the major type of glaucoma. To discover genetic markers associated with POAG. we examined a total of 1,575 Japanese subjects in a genome-wide association study (stage 1) and a subsequent study (stage 2). Both studies were carried out at a single institution. In the stage 1 association study, we compared SNPs between 418 POAG patients and 300 control subjects. First, low-quality data were eliminated by a stringent filter, and 331,838 autosomal SNPs were selected for analysis. Poorly clustered SNPs were eliminated by a visual assessment, leaving 255 that showed a significant deviation (P < 0.001) in the allele frequency comparison. In the stage 2 analysis, we tested these 255 SNPs for association in DNA samples from a separate group of 409 POAG and 448 control subjects. High-quality genotype data were selected and used to calculate the combined P values of stages 1 and 2 by the Mantel-Haenszel test. These analyses yielded 6 SNPs with P < 0.0001. All 6 SNPs showed a significant association (P < 0.05) in stage 2, demonstrating a confirmed association with POAG. Although we could not link the SNPs to the annotated gene(s), it turned out that we have identified 3 genetic loci probably associated with POAG. These findings would provide the foundation for future studies to build on, such as for the metaanalysis, to reveal the molecular mechanism of the POAG pathogenesis. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study is to identify the related factors of skin lesions found in the surrounding environment of absorbent pads by clinical investigation. Background. Most older patients with incontinence use absorbent products, therefore causing many patients to have skin lesion in the absorbent pad area. To prevent these skin lesions from occurring, it is necessary to examine the absorbent pad environment of clinical patients since there are many contributing factors that complicate the pathophysiology in this area. Design. A cross-sectional design was used. Methods. One hundred older Japanese patients with faecal and/or urinary incontinence using diapers and absorbent pads participated. Excluding blanchable erythema, the presence of skin lesions in the absorbent pad area was confirmed. Skin pH, hydration level and bacterial cultures were used to assess the skin property. Absorbent pad environment and patient demographics were also investigated. Results. The overall prevalence of skin lesions was 36%. Forty percent of the skin lesions were contact dermatitis. Multivariate logistic regression analysis revealed that only the presence of diarrhoea independently affected contact dermatitis. Conclusion. There was a significant relationship between contact dermatitis and the use of absorbent pads when the patient had diarrhoea. Although the factors related to skin lesions in the absorbent pad area are complexly intertwined, this study was the first to be able to determine diarrhoea as one specific factor in clinical setting. Relevance to clinical practice. This finding suggests that the presence of diarrhoea is significantly related with contact dermatitis. Therefore, when a patient has diarrhoea, health-care professionals should immediately implement a preventative care program which includes careful skin observation and improved skin care. It is also necessary to develop a more effective absorbent pad to protect the skin of incontinent patients who suffer from the irritating effects of liquid stool. [ABSTRACT FROM AUTHOR]

We estimated wet-bulb globe temperature (WBGT) using measured meteorological data to understand the bioclimates of human living spaces during the summer season. Our research focused on commercial and residential areas of Okayama City, Japan (population ∼700,000). The commercial spaces (CO) mainly consisted of multi-story office buildings, whereas the residential spaces (RE) consisted of one- or two-story residential buildings. On a fine day with southeast winds, the spatially averaged WBGT measured in the CO was higher than that in the RE. The difference was statistically significant and would have caused noticeable discomfort and a high risk of heat disorder for occupants of the CO over the long term. For instance, at 1900 Japan Standard Time (JST), the maximum difference in the WBGT between the CO and RE sites was 2.0°C (23.5°C for the CO and 21.5°C for the RE). From 1800 to 1900 JST, the wet-bulb temperature in the CO was still 1.5–2.0°C higher than that in the RE, even though both areas had the same dry-bulb temperature. This indicates that the CO retained greater amounts of water vapor for longer periods compared to the RE. The wet-bulb temperature in the CO increased rapidly at most observation points when the southeast sea breeze arrived. In contrast, in the RE, the wet-bulb temperature decreased until evening. This difference was caused by moist air transported from a river about 1 km upwind from the CO. The moist air forced an increase in the WBGT and elevated the risk of heat disorder in the CO. The spatially averaged globe temperature of the CO at 1500 JST was 6.2°C lower than that at the RE, causing the WBGT of the CO to decrease. The results suggest that the higher WBGT in the CO was caused by higher wet-bulb temperatures. On a day with southwest winds, the CO and RE showed no difference in WBGT because the river was not included in the upwind source area. [ABSTRACT FROM AUTHOR]

Since the human papillomavirus (HPV) vaccination program for Japanese girls aged 12–16 years began in 2010, vaccination uptake has been low in women born before 1993 but high (approximately 70%) in those born during 1994–1999. We previously compared the prevalence of vaccine types HPV16 and HPV18 in cervical intraepithelial neoplasia grade 1–3 (CIN1–3) or adenocarcinoma in situ (AIS) between vaccinated and unvaccinated cohorts and found direct protection effects among vaccinated women in Japan. In this study, we focused on changes in HPV16/18 prevalence among "unvaccinated" cohorts with CIN/AIS. We analyzed HPV16/18 prevalence among 5051 unvaccinated women aged <40 years, newly diagnosed with CIN/AIS during 2012–2021 for time trends. Declining trends in HPV16/18 prevalence over 9 years were observed in CIN1 (36.0–10.0%, Ptrend = 0.03) and CIN2–3/AIS (62.5–36.4%, Ptrend = 0.07) among women aged <25 years. HPV16/18 prevalence in CIN1 and CIN2–3/AIS diagnosed at age 20–24 years was lower in 1994–1999 birth cohorts compared with 1988–1993 birth cohorts (4.5% vs. 25.7% for CIN1 and 40.0% vs. 58.1% for CIN2–3/AIS, both p = 0.04). Significant reduction in HPV16/18 prevalence among young unvaccinated women with CIN1 and CIN2–3/AIS suggests herd effects of HPV vaccination in Japan. [ABSTRACT FROM AUTHOR]

Background: Since the 1980s, the number of foreign residents in Japan has continuously been on the rise. In order to improve the foreign resident support services infrastructure and effectiveness, a survey was conducted at a national level from February to August 2002. The survey was done via a mailed questionnaire to all municipalities in Japan. Methods: For the purpose of the study, municipalities were divided into four groups based on level of urbanization and numbers of foreign residents in the area. The situation of the foreign maternal and child support programs were compared and the municipal administrations were evaluated. In addition, the attribution analysis and evaluation of the foreigner support program was conducted in each municipality group. Results: The evaluation of the current service support program for foreigner was not judged positively in the majority (95%) of the municipalities. In the non-urbanized municipalities with a low composition of foreigners, the foreigner mother and child support program were not functional compared with other regions. Additionally, various factors were highlighted based on attribution analysis among each group. Although most of the municipalities recognized the importance of the foreign resident support program, the evaluations showed a wide gap between intention and reality. Conclusion: It is recommended that the barriers as identified in the research results are rectified, and the current situation improved based on municipality characteristics, local demands and the needs of the population. The efficient use of limited fiscal and human resources is also advocated by strengthening of cooperation with other official bodies and also employing foreign residents to work in public offices for facilitating the foreign residents support programs. [ABSTRACT FROM AUTHOR]

We examined the influence of nursery soil cover on germination of Thujopsis dolabrata var. hondai. Seeds were sown under seeding bed conditions: (1) nursery soil (andosol) without soil cover, (2) Kanuma pumice without soil cover, (3) nursery soil with nursery soil cover, and (4) nursery soil with sterilized sand cover. Germination percentages were compared between these conditions. The germination percentage (8.8%) at 10 weeks after sowing under condition 3 was significantly lower than under conditions 1, 2, and 4 (56.8%, 52.0%, and 47.2%, respectively). Of the nongerminated seeds under condition 3, 75.0% were decayed and several fungi were isolated from decayed seeds. An inoculation test of isolated fungi Cylindrocarpon tenue, Cylindrocarpon sp., Fusarium oxysporum, and Botrytis sp. to seeds showed that these fungi caused seed decay. Our results indicated that nursery soil cover may not be suitable for T. dolabrata var. hondai seeds sown in nursery soil because of seed decay by pathogens. [ABSTRACT FROM AUTHOR]