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Summary: Background: Insufficient information is available on the relationship between obesity and outcome of paediatric patients with acute pancreatitis. Objectives: This study aimed to investigate the effect of obesity on outcomes of paediatric patients with acute pancreatitis based on a national administrative database. Methods: A total of 500 cases in 416 paediatric patients with acute pancreatitis (aged 5–17 years) were referred from 260 hospitals between 2010 and 2012 in Japan. Patients were divided into two groups according to the presence of obesity: with obesity (n = 65) and without obesity (n = 435). Patient data were collected from the administrative database to compare the prevalence of severe acute pancreatitis, in‐hospital mortality, length of stay (LOS) and medical costs between the groups. Results: Both prevalence of severe acute pancreatitis and in‐hospital mortality were significantly higher in paediatric patients with obesity than those without (36.9% vs. 16.3% and 3.1% vs. 0.0%; P < 0.001, respectively). Longer LOS and higher medical costs were also observed in paediatric patients with obesity (25.7 vs. 15.2 days, P < 0.001 and 14 169.5 vs. 7457.7 US dollars, P < 0.001, respectively). Conclusion: This study demonstrated that obesity significantly influenced the outcomes of paediatric acute pancreatitis. [ABSTRACT FROM AUTHOR]

Background Recent studies in the USA have shown a lower postoperative mortality rate in mildly obese patients, described as the 'obesity paradox'. The results from the relatively obese population in Western countries may not be generalizable to Asian countries, prompting the present study to investigate the relationship between body mass index ( BMI) and outcomes after gastrointestinal surgery. Methods Patients who underwent gastrectomy or colorectal resection for stage I- III cancer between July and December 2010 were identified from a nationwide inpatient database in Japan. Multivariable logistic regression models for in-hospital mortality and postoperative complications, and a linear regression model for total costs were established, with adjustment for age, sex, co-morbidities, cancer stage and BMI. Restricted cubic spline functions were used to consider potential non-linear associations between BMI and the outcomes. Results Among 30 765 eligible patients, associations between BMI and the outcomes were U-shaped, with the lowest mortality, morbidity and total costs in patients with a BMI of around 23·0 kg/m2. A BMI of 18·5 kg/m2 was associated with significantly greater mortality (odds ratio ( OR) 2·04, 95 per cent confidence interval 1·64 to 2·55), postoperative complications ( OR 1·10, 1·03 to 1·18) and total costs (difference €1389, 1139 to 1640) compared with a BMI of 23·0 kg/m2. Patients with a BMI exceeding 30·0 kg/m2 had significantly higher rates of postoperative complications and total costs than those with a BMI of 23·0 kg/m2, but no significant association was evident between a BMI of more than 23·0 kg/m2 and in-hospital death. Conclusion Unlike previous studies in the USA, in the present national Japanese cohort of patients undergoing surgery for gastrointestinal cancer, those who were either underweight or overweight had more postoperative complications and greater perioperative costs than those of normal weight. [ABSTRACT FROM AUTHOR]

Abstract: The balloon-borne experiment with a superconducting spectrometer (BESS) has performed cosmic-ray observations as a US–Japan cooperative space science program, and has provided fundamental data on cosmic rays to study elementary particle phenomena in the early Universe. The BESS experiment has measured the energy spectra of cosmic-ray antiprotons to investigate signatures of possible exotic origins such as dark matter candidates or primordial black holes, and searched for heavier antinuclei that might reach Earth from antimatter domains formed in the early Universe. The apex of the BESS program was reached with the Antarctic flight of BESS-Polar II, during the 2007–2008 Austral Summer, that obtained over 4.7billion cosmic-ray events from 24.5days of observation. The flight took place at the expected solar minimum, when the sensitivity of the low-energy antiproton measurements to a primary source is greatest. Here, we report the scientific results, focusing on the long-duration flights of BESS-Polar I (2004) and BESS-Polar II (2007–2008). [Copyright &y& Elsevier]

For patients with non-traumatic osteonecrosis of the femoral head (ONFH), core decompression (CD) and bone grafts (BG) are mainly performed in the West, while osteotomy is found to be predominant in Japan. It is not well recognized how the surgical procedures for joint preservation in patients with ONFH are completely different between the United States and Japan. This paper identifies the contexts and the differences in treatment strategies for ONFH between the two countries. We compared the surgical trends of the two countries over three periods, 1997-2001, 2002-2006, and 2007-2011 (the US data for the third period was 2007-2008), based on a 2014 US paper and a 2013 national publication in Japan. We compared the details of surgery for non-traumatic ONFH under the same conditions in the two reports. For the period 1997-2001, the rates of surgeries for ONFH in the US were as follows: total hip arthroplasty (THA), 86%; CD, 10%; and osteotomy, 0.4%. In Japan, THA was 61%, osteotomy 38%, and CD 0%. For the recent period, 2007-2011 (US 2007-2008), the rate of THA was 91%, CD 6%, and osteotomy 0.1%, in the US, compared to a THA rate of 73%, CD 0%, and osteotomy 26% in Japan. The results for the interim period (2002-2006) were between the old and new data. The use of joint-preserving surgery for ONFH differs greatly between the US and Japan. The first-line joint-preserving surgery was CD in the US and osteotomy in Japan. Each procedure was rarely done in the other country. From about 2000 to 2010, the percentage of THA increased in both countries. The proportion of joint-preserving surgery (CD in the US and osteotomy in Japan) declined. The decrease in joint-preserving procedures may be largely attributed to improved long-term outcomes of THA due to technological advances. There is also a reluctance for young ONFH patients to undergo joint-preserving procedures, such as osteotomy, that require long-term hospitalization., (© 2021 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.)

Purpose: This study investigated the effects of clotrimazole troche on the risk of transplant rejection and the pharmacokinetics of tacrolimus., Methods: The data mining approach was used to investigate whether the use of clotrimazole increased the risk of transplant rejection in patients receiving tacrolimus therapy. Patient data were acquired from the US Food and Drug Administration's Adverse Event Reporting System (FAERS) from the first quarter of 2004 to the end of 2017. Next, we retrospectively investigated the effect of clotrimazole troche on tacrolimus pharmacokinetics in seven patients who underwent heart transplantation between March and December 2017., Results: The FAERS subset data indicated a significant association between transplant rejection and tacrolimus with clotrimazole [reporting odds ratio 1.92, 95% two-sided confidence interval (95% CI) 1.43-2.58, information component 0.81, 95% CI 0.40-1.23]. The pharmacokinetic study demonstrated a significant correlation between trough concentration (C 0 ) and area under the concentration-time curve of tacrolimus after discontinuation of clotrimazole (R 2 = 0.60, P < 0.05) but not before its discontinuation. Furthermore, the median clearance/bioavailability of tacrolimus after discontinuation of clotrimazole was 2.2-fold greater than that before its discontinuation (0.27 vs. 0.59 L/h/kg, P < 0.05). The median C 0 decreased from 10.7 ng/mL on the day after discontinuation of clotrimazole to 6.5 ng/mL at 1 day and 5.3 ng/mL at 2 days after its discontinuation., Conclusion: Immediate dose adjustments of tacrolimus may be beneficial to avoid transplant rejection when clotrimazole troche is added or discontinued.

The basic principle of Diagnosis Related Groups (DRG) is to classify patients according to the combination of diagnosis and procedures. The first DRG developed by research at Yale University was adopted for the per-case-payment American Medicare scheme for hospital fees under a DRG/PPS (prospective payment system). This scheme has been refined continuously and adopted as payment systems in other countries. The DPC-based reimbursement scheme in Japan consists of two components; a DPC component and a Fee-For-Service (FFS) component. The DPC component corresponds to the "so-called" hospital fee, includes the hospital basic charge, the pharmaceuticals and supplies used in wards, lab-test, radiological examination, and any procedures costing less than 10,000 yen. The FFS component corresponds to the charges for surgical procedures, pharmaceuticals and supplies used in operation rooms, and procedures costing more than 10,000 yen. For the DPC component, a per diem payment schedule is set for each DPC group. One of the most important objectives in introducing the DPC scheme is to ameliorate the transparency of hospital activities in Japan. The DPC system is expected to make hospital services measurable, and then to provide a common ground for discussion among interest groups over the optimal policy to maintain a sustainable Japanese medical care system. However, in order to keep DPC more reliable, much must be done to refine the DPC version 3. For example, development of CCP (Co-morbidity-Complication-Procedure) matrix is now ongoing to more properly describe the resource consumption of each DPC group. It is also important how to evaluate nursing services, ICU services and expensive drugs and materials within the DPC sheme.

Although the word "mentor"has traditionally been used to describe a relationship between an older adult and a younger person, recent work has extended its usage to relationships with peers and groups rather than with individuals and uncoupled the instrumental and affective qualities of the role. This paper examines (a) the extent to which adolescents' relationships with significant others in different social roles are characterized by mentoring and (b) the extent to which mentoring and other relationship functions covary. Adolescents' naturally occurring social relationships are explored in two very different contexts-Japan and the United States-that differ in the norms and patterning of social interactions. College students (N = 365) used questionnaires to describe the extent to which relations with significant others were characterized by mentoring. Results indicate striking similarity in the patterning of results in the two countries and support the traditional view of mentoring. Mentoring is most likely to occur in relationships with adults (especially parents), rather than with peers, and with same-gender, rather than other-gender associates. Mentoring by parents appears to covary with other aspects of positive relationships, but be more independent in relationships with unrelated adults or peers. Although more of the variability in experienced mentoring is attributed to differences between associates than to differences between adolescents in both the United States and Japan, this is especially true of the United States. Results suggest that although "classic" mentoring is most common in both countries, mentoring is somewhat less constrained by social role differences in Japan than is in the United States.

A T-cell (KH-2) from a Japanese T-cell leukemia patient with hypercalcemia has been characterized and shown to be similar in its properties to Human T-cell leukemia virus (HTLV)-positive T-cell lines from T-cell leukemia patients from different parts of the world. The HTLV isolated from the Japanese T-cell leukemia patient with hypercalcemia belongs to the HTLV family and has properties similar to HTLV from T-cell leukemia patients from the United States, Israel, and the Caribbean.