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We have observed charge-ordering-induced polar domains and domain walls (DWs) in a bilayered manganite Pr(Sr0.15Ca0.85)2Mn2O7 using second-harmonic-generation microscopy. Around the transition temperature TC∼306 K, a nucleation process of the domains with spontaneous polarization is clearly observed. Well below TC, the characteristic band-shaped dark patterns are identified in the second-harmonic images. On the analogy of the nucleation feature, they can be assigned to the DWs separating antiparallel polar domains. The anisotropy in the DW is governed by the geometrical constraint of the charge and orbital ordering, not by the electrostatic stability as in conventional ferroelectric DWs. [ABSTRACT FROM AUTHOR]

A correlated electron interface between paramagnetic CaRuO3 and antiferromagnetic CaMnO3 has been characterized with optical magnetoelectric (OME) effect as an interface-selective probe for spin and charge states. To detect the OME effect, i.e., nonreciprocal directional dichroism for visible or near-infrared light, we have constructed a “tricolor” superlattice with artificially broken inversion symmetry by stacking CaRuO3, CaMnO3, and CaTiO3, and patterned a grating structure with 4 μm period on the superlattice. The observed intensity modulation (0.3% at 50 K) in the Bragg diffraction verifies a charge transfer and concomitant ferromagnetism at the CaRuO3–CaMnO3 interface. [ABSTRACT FROM AUTHOR]

We have observed charge-ordering-induced polar domains and domain walls (DWs) in a bilayered manganite Pr(Sr0.15Ca0.85)2Mn2O7 using second-harmonic-generation microscopy. Around the transition temperature TC∼306 K, a nucleation process of the domains with spontaneous polarization is clearly observed. Well below TC, the characteristic band-shaped dark patterns are identified in the second-harmonic images. On the analogy of the nucleation feature, they can be assigned to the DWs separating antiparallel polar domains. The anisotropy in the DW is governed by the geometrical constraint of the charge and orbital ordering, not by the electrostatic stability as in conventional ferroelectric DWs. [ABSTRACT FROM AUTHOR]

The article explores the excitonic effect by electroreflectance spectroscopy using terahertz electric field pulses in undoped cuprates amd analyses the spectral changes of reflectivity under electric fields reveal that the splitting of odd-parity and even-parity excitons. The study supports the s-wave symmetry of the doublon-holon pair in contrast to the d-wave Cooper pair in doped cuprates. Also discussed is its effect in two-dimensional (2D) Mott insulator and Coulomb interaction.

Industrial physical therapy (IPT) interventions by physical therapists can enhance labor productivity. However, in Japan, there is a scarcity of case studies involving corporate visits, questionnaire-based data, and insights into corporate demands. Addressing this gap is vital for improving presenteeism related to chronic pain and increasing employees' health literacy, thereby advancing corporate health management. This case study evaluates the effectiveness of a workshop aimed at preventing and reducing chronic pain among employees in the Development Department of Company A, an information technology (IT) firm. The research employed pre- and post-survey questionnaires, workshop interventions, and meetings with corporate management to assess the current state of musculoskeletal chronic pain and productivity losses and to verify the intervention's effectiveness. Approximately 50 participants attended the workshop in person, while around 30 participated online, totaling 80 attendees. A total of 56 (51 men and 5 women) individuals responded to the pre-workshop questionnaire, and 28 responded to the post-workshop questionnaire. The age distribution of the 56 pre-survey respondents was as follows: 9 in their twenties, 13 in their thirties, 22 in their forties, and 12 aged 50 and older. Preliminary survey results showed that 55.4% of participants experienced chronic pain in at least one body part. The average presenteeism value was 82.8% (standard deviation = 16.8). It was also found that literacy regarding appropriate pain management strategies was low. An independent t -test comparing literacy scores based on the presence or absence of pain showed no significant differences ( p = 0.34). Additionally, a one-way ANOVA conducted to examine differences across four age groups revealed no significant differences (F = 0.934, p = 0.431). Results from the post-workshop questionnaires indicated that more than 70% of the employees experienced an increase in understanding and satisfaction, with positive feedback on the improvement of knowledge about chronic pain mechanisms and posture. However, there were also requests for more interactive communication and a desire to learn more about specific care methods, suggesting the need to provide interventions tailored to appropriate stages of preventive medicine.

Background/objectives: The active straight leg raise requires intricate coordination between the hip, knee, pelvis, and spine. Despite its complexity, limited research has explored the relationship between lower limb raising velocity and trunk muscle motor control during an active straight leg raise in healthy individuals. This study aimed to explore the potential effects of increased lower limb raising velocity on core muscle contractions during active straight leg raises., Methods: Six healthy adult men (mean age: 24.5 ± 2.5 years) participated in this study. Electromyography signals were recorded using surface electrodes placed on the rectus abdominis, external oblique, and internal oblique/transverse abdominis muscles. The participants performed active straight leg raises at three different velocities: 3 s, 2 s, and as fast as possible (max). The electromyography data were analyzed from 250 ms before to 1000 ms after movement initiation, with muscle activity expressed as a percentage of the maximal voluntary isometric contraction. Statistical analyses were conducted using non-parametric tests, including the Friedman test for overall differences, followed by pairwise Wilcoxon signed-rank tests with Bonferroni correction for multiple comparisons ( p < 0.05)., Results: During the 250 ms before movement initiation, the internal oblique/transverse abdominis, external oblique, and rectus abdominis muscles showed greater activity in the max condition compared to the 3 s and 2 s conditions (Friedman test, p < 0.05), but no significant differences were found in pairwise comparisons (Wilcoxon test, p > 0.05). Similarly, during the 500 ms after movement initiation, internal oblique/transverse abdominis activity was higher in the max condition, with no significant pairwise differences observed., Conclusions: Faster lower limb raising velocities during active straight leg raise may enhance core stability by activating anticipatory and sustained internal oblique/transverse abdominis, external oblique, and rectus abdominis activity on the raised limb side. Training to promote this activation could improve dynamic stability in rapid or asymmetric movements.

Sprint performance plays a crucial role in various sports. Short sprints vary depending on the size of the court/playing field and on competitive characteristics, but are common in many sports. Although the relationship between age and muscle strength has been explored in short sprints, there is limited understanding of how various physical factors interact, particularly concerning differences in the acceleration phase. This study examined the relationship between sprint times at 0-2.5 m, 2.5-5 m, and 5-10 m intervals and various factors (body composition, flexibility, muscle strength, physical fitness) in junior athletes (13 boys; 13 girls; average age 11.37 ± 1.30 years; 7 in badminton, 8 in fencing, 5 in rowing, and 6 in climbing). The sprint time was measured using four timing lights at 0 m (start point), 2.5 m, 5 m, and 10 m (finish point). The results indicated that sprint times increased with age, and is correlated with muscle strength and flexibility. A partial correlation analysis showed that faster times in the 0-2.5 m interval were associated with higher hip flexibility (right: r = -0.42, p = 0.035; left: r = -0.60, p = 0.001); in the 2.5-5 m interval, faster times were associated with higher core flexibility (right: r = -0.34, p = 0.091; left: r = -0.40, p = 0.046); and in the 5-10 m interval, a relationship with standing long jump performance was confirmed ( r = -0.56, p = 0.003). Furthermore, a lower fat-free body weight translated to higher performance (0-2.5 m: r = 0.40, p = 0.047; 2.5 m: r = 0.37, p = 0.071; 5-10 m: r = 0.55, p = 0.004). In the acceleration phase of 10 m, flexibility immediately after the start and the subsequent horizontal propulsive force are important factors that are strongly related to performance change in each interval. These results emphasize that even over a short distance such as 10 m, the factors influencing performance can change significantly. This highlights the importance of overall flexibility, propulsive power and body fat regulation in junior short sprinters, as well as the need for daily training carefully tailored to the specific sprint distances required in each sport.

This study aimed to examine prospectively the relationship between the deep squatting test and medial elbow injuries in elementary school baseball players and to determine the usefulness of the lower extremity field test in throwing injuries. The participants were 254 players who had participated in preseason medical checkups in both 2019 and 2020 and had no problems with the 2019 medical checkups. The evaluation parameters included ultrasonography examination, physical examination, and three types of deep squatting tests. The success rate of deep squatting tests was significantly lower in the injured group than in the non-injured group in the medial elbow injuries. By the difficulty level, the backward test in the deep squatting test was more likely to predict medial elbow injuries than the forward and middle tests. Furthermore, there was a significant difference in the squatting test and medial elbow injuries by grades. In conclusion, this is the first prospective study to provide evidence that the deep squatting tests, classified by difficulty level, can predict the risk of subsequent medial elbow injuries in elementary school players. The deep squatting test may be useful as a field test for lower extremity flexibility that can be performed by athletes and instructors, as it can predict the risk of subsequent medial elbow injuries.

Background: Occupational health, grounded in occupational medicine, aims to enhance the well-being and labor productivity of the working population. Within this realm, there has been growing concern over the increasing instances of labor loss due to diminished physical capacity and the rise in musculoskeletal disorders. Chronic pain is also associated with musculoskeletal disorders. Another pressing issue related to chronic musculoskeletal pain was needed assistance services are underutilized, is referred to as a "service gap". Understanding trends based on age and affected regions of the body is indispensable for developing strategies to address chronic musculoskeletal pain in workers. This study aimed to elucidate age-specific trends in the prevalence and number of pain sites in chronic musculoskeletal pain as well as the patterns of treatment during chronic musculoskeletal pain, categorized by age and affected site., Methods: This study was conducted in December 2022 in contract to Cross Marketing Inc. The survey began on December 12, 2022 and ended on December 15, 2022. An online survey was administered to 1,946 participants (973 women and 973 men), and responses were collected, ensuring a roughly equal distribution of samples among men and women across six age groups ranging from their 20 to 70 s. The survey inquired about the presence of chronic pain in each of the eight body parts and the adoption of five different treatments when experiencing pain. Statistical analysis was performed using the chi-square test, with the measurement data categorized by age group and body part., Results: The results indicated a significantly higher prevalence of chronic pain at three or more sites among individuals in their 30 s: the prevalence of pain at each of the eight body sites varied with age. Approximately half of the participants did not engage in specific treatments during episodes of chronic pain. The presence or absence of treatment showed no significant differences according to affected site or age group. This study revealed age- and body part-related relationships with chronic musculoskeletal pain in middle-aged patients and highlighted healthcare service gaps in its management in Japan., Competing Interests: The authors declare that they have no competing interests. None of the authors are employees of Cross Marketing, Inc. Yasumasa Oka is an employee of the Kanazawa Orthopedic and Sports Medicine Clinic. Noriyuki Kida is an employee of the Kyoto Institute of Technology. Michio Wachi and Takumi Jiroumaru is an employee of the Bukkyo University., (© 2024 Oka et al.)

The purpose of this study was to devise a tilt sensation measurement method to evaluate ankle proprioception and to examine its reliability. It was also used to determine the relationship among tilt sensation abilities, physical development, and lower limb injuries in junior athletes. In this study, a step platform created tilt angles. Participants with eye masks answered "yes" or "no" to sensing a tilt, evaluated over nine or seven trials. Experiment 1 involved 22 university students (20.6 ± 0.9 years). The minimum angle at which a tilt could be sensed while standing on both feet was determined, and measurements were taken again to examine reliability. Experiment 2 involved 40 junior athletes (12.3 ± 2.0 years), where the minimum angle for tilt sensation was obtained, and medical checks were conducted to assess injuries in the knee, lower leg, and foot. Reliability studies showed a moderately significant correlation between the first and second sessions ( r = 0.504, p = 0.017), suggesting the reliability of the experimental method. The proportion capable of sensing a tilt of 1.1° and 1.6° was significantly higher in junior high school students than in elementary school students (1.1°; χ 2 = 8.839, p = 0.003. 1.6°; χ 2 = 4.038, p = 0.044). The group unable to sense a tilt of 1.6° and 2.1° had a significantly higher positive rate of knee injuries compared to the sensed group among junior high school students (1.6°; χ 2 = 4.622, p = 0.032. 2.1°; χ 2 = 4.622, p = 0.032). Our findings suggested that a reduced tilt sensation ability was associated with knee injuries in junior high school students. Utilizing our devised tilt sensation assessment could play a crucial role in preventing and detecting early injuries in junior high school students.

Postural assessment is one of the indicators of health status in older adults. Since the number of older adults is on the rise, it is essential to assess simpler methods and automated ones in the future. Therefore, we focused on a visual method (imaging method). The purpose of this study is to determine the degree of agreement between the imaging method and the palpation and visual methods (clinical method). In addition, the influence of differences in the information content of the sagittal plane images on the assessment was also investigated. In this experiment, 28 sagittal photographs of older adults whose posture had already been assessed using the clinical method were used. Furthermore, based on these photographs, 28 gray and silhouette images (G and S images) were generated, respectively. The G and S images were assessed by 28 physical therapists (PTs) using the imaging method. The assessment was based on the Kendall classification, with one of four categories selected for each image: ideal, kyphosis lordosis, sway back, and flat back. Cross-tabulation matrices of the assessments using the clinical method and imaging method were created. In this table, four categories and two categories of ideal and non-ideal (KL, SB, and FB) were created. The agreement was evaluated using the prevalence-adjusted bias-adjusted kappa (PABAK). In addition, sensitivity and specificity were calculated to confirm the reliability. When comparing the clinical and imaging methods in the four posture categories, the PABAK values were -0.14 and -0.29 for the S and G images, respectively. In the case of the two categories, the PABAK values were 0.57 and 0.5 for the S and G images, respectively. The sensitivity and specificity were 86% and 57% for the S images and 76% and 71% for the G images, respectively. The four categories show that the imaging method is difficult to assess regardless of the image processing. However, in the case of the two categories, the same assessment of the clinical method applied to the imaging method for both the S and G images. Therefore, no differences in image processing were observed, suggesting that PTs can identify posture using the visual method.

In the present study, by heating a quartz glass substrate having the dry residue of a 10 μL droplet of a solution of HAuCl 4 and a counter substrate facing to the dry residue from room temperature to one hundred and several tens of degrees Celsius in 20 min in air, highly dense gold nanoparticles were produced on the counter substrate. A gold nanoparticle substrate produced by this simple method was utilized as a substrate for surface-enhanced Raman scattering analysis., (© 2023. The Author(s).)

This study aimed to estimate the factors that cause differences in competition level based on the competition performance structure among university student decathletes in Japan. The results of factor analysis using the maximum likelihood method (Oblimin rotation), assuming a five-factor structure estimated from parallel analysis and the information criterion, revealed the following competitive performance structures: "running speed and body projection," "running endurance," "rotational throwing power," "translational throwing power," and "vertical leaping power." Some of these were similar to the competitive performance structures of the world's top athletes, but they were found to have a unique structure: two throwing powers. The analysis results using latent rank theory allowed us to evaluate them on a seven-point scale. The calculated item reference profile, difficulty index, and discrimination index for each rank indicated that shot put and 100 and 400 m performance formed the basis of decathlon performance. In addition, high jump and pole vault, which fall under the category of "vertical leaping power," retained high difficulty and discrimination and were revealed to affect the stage of achievement of overall performance in the decathlon., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ashino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Estimating the action capability is vital for humans to move their bodies successfully. Researchers have proposed reachability as an overestimation of motor abilities by judging unreachable distances as reachable. The existing literature has mainly investigated the sagittal direction, but multi-directional reachability is unexplored. This study examined the relationship between perception and motor using the reaching of the lower limbs in multiple directions. We asked 16 adults to reach targets projected onto the floor at 21 locations (seven directions and three distances) to estimate the reaching time. We found that the reaching time slowed as the direction increased toward the contralateral side, but the subjective reaching time did not change with direction. Multiple regression analysis showed that the subjective reaching time could be calculated accurately, mainly using the duration from the toe leaving the ground to movement completion. These results suggest that changes in direction may not be perceived precisely by the motor system of the lower limbs and that the subjective reaching time was strongly affected by the time after the toe left the ground. Our findings provide novel insights into the relationship between motor and perception in multiple directions, which may provide a new strategy for the maximal performance of lower-limb movement., (© 2023. Springer Nature Limited.)

Efficient body movement is required in our daily lives, as it facilitates responding to the external environment and producing movements in various directions and distances. While numerous studies have reported on goal-directed movements in the frontal direction during gait initiation, there is limited research on the efficient movement of the lower limbs in multiple directions and distances. Therefore, we aimed to examine changes in the kinematics of lower-limb reaching movements to determine skilled motor ability in terms of direction and distance. Sixteen adults (10 male participants) were requested to reach targets projected on the floor in seven directions and at three distances for a total of 21 points. The reaching time slowed down for the contralateral side (right foot to left-sided target) and was caused by a slower start of the toe movement. To identify the cause of this delay, we analyzed the onset of movement at each joint and found that movement to the contralateral side starts from the hip, followed by the knee, and subsequently the toe. The time-to-peak velocity was also calculated, and the motion required to reach the target in the shortest time varied depending on direction and distance. These results suggested that movement kinematics vary with direction and distance, resulting in a slower reaching time on the contralateral side. The results of our study hold promise for potential applications in sports and rehabilitation., Competing Interests: No authors have competing interests., (Copyright: © 2023 Oku et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: To examine whether the Areal Deprivation Index (ADI), an indicator of the socioeconomic status of the community the patient resides in, is associated with delayed arrival at the hospital and poor outcomes in patients with acute ischaemic stroke from a prefecture-wide stroke database in Japan., Design: Retrospective study., Setting: Twenty-nine acute stroke hospitals in Kochi prefecture, Japan., Participants: Nine thousand and six hundred fifty-one patients with acute ischaemic stroke who were urgently hospitalised, identified using the Kochi Acute Stroke Survey of Onset registry. Capital and non-capital areas were analysed separately., Primary and Secondary Outcome Measures: Prehospital delay defined as hospital arrival ≥4-hour after stroke onset, poor hospital outcomes (in-hospital mortality and discharge to a nursing facility) and the opportunities of intravenous recombinant tissue plasminogen activator (rt-PA) and endovascular reperfusion therapy., Results: In the overall cohort, prehospital delay was observed in 6373 (66%) patients. Among individuals residing in non-capital areas, those living in municipalities with higher ADI (more deprived) carried a significantly higher risk of prehospital delay (per one-point increase, OR (95% CI) 1.45 (1.26 to 1.66)) by multivariable logistic regression analysis. In-hospital mortality (1.45 (1.02 to 2.06)), discharge to a nursing facility (1.31 (1.03 to 1.66)), and delayed candidate arrival ≥2-hour of intravenous rt-PA (2.04 (1.30 to 3.26)) and endovascular reperfusion therapy (2.27 (1.06 to 5.00)), were more likely to be observed in the deprived areas with higher ADI. In the capital areas, postal-code-ADI was not associated with prehospital delay (0.97 (0.66 to 1.41))., Conclusions: Living in socioeconomically disadvantaged municipalities was associated with prehospital delays of acute ischaemic stroke in non-capital areas in Kochi prefecture, Japan. Poorer outcomes of those patients may be caused by delayed treatment of intravenous rt-PA and endovascular reperfusion therapy. Further studies are necessary to determine social risk factors in the capital areas., Trial Registration Number: This article is linked to a clinical trial to UMIN000050189, No.: R000057166 and relates to its Result stage., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: We herein report the anesthetic management for extracardiac conduit-total cavopulmonary connection (EC-TCPC) for weaning from an extracorporeal right ventricular assist device (RVAD) in a patient with an implantable left ventricular assist device (LVAD) for fulminant cardiomyopathy., Case Presentation: A 24-year-old man developed fulminant cardiomyopathy and was placed on a biventricular assist device (BiVAD) comprising an implantable LVAD and an extracorporeal RVAD. The Fontan procedure was performed to wean the patient from the RVAD and allow him to be discharged home. Atrial septal defect creation, right ventricular suture, and tricuspid valve closure were then simultaneously performed to ensure sufficient left ventricular preload to drive the LVAD. Furthermore, to keep the central venous pressure lower, the inflow cannula of the LVAD was oriented in the correct direction., Conclusion: This is the first report of anesthetic management of the Fontan procedure in a patient with a BiVAD., (© 2023. The Author(s).)

Background: Spinal alignment evaluation is commonly performed in the clinical setting during rehabilitation. However, there is no simple method for its quantitative measurement. Recently, the depth cameras in Kinect sensors have been employed in various commercial and research projects in the healthcare field. We hypothesized that the time-of-flight technology of the Kinect sensor could be applied to quantitatively evaluate spinal alignment. The purpose of this study was to develop a simple and noninvasive evaluation for spinal alignment using the Kinect sensor and to investigate its validity., Methods: Twenty-four healthy men participated in the study. Measurement outcomes were the thoracic kyphosis and lumbar lordosis angles in the standing position, using a Spinal Mouse, the validity of which has been previously reported, and the Kinect sensor. In the measurement by the Kinect sensor, a program was created to obtain the three-dimensional coordinates of each point within an area marked on the monitor, and the sums of the angles at each vertebral level were calculated for the thoracic and lumbar areas. Pearson's correlation coefficient was used to analyze the relationship between the Kinect sensor and Spinal Mouse measurements of thoracic kyphosis and lumbar lordosis angles., Results: There was a significant positive and moderate correlation between the thoracic kyphosis measurements taken by each device. Contrarily, there was no significant correlation in the lordosis angle between measurements using the Kinect sensor and Spinal Mouse., Conclusions: Our results demonstrated the validity of measuring the thoracic kyphosis angle using the Kinect sensor. This indicates that the depth camera in the Kinect sensor is able to perform accurate thoracic alignment measurements quickly and noninvasively., (© 2023. The Author(s).)

The changes in lumbar lordosis angle (LL) and sacral slope angle (SS) related to upper limb elevation and thoracic kyphosis angle (TK) in baseball players with spondylolysis remain unclear. Herein, we investigated baseball players with spondylolysis and those without low back pain, comparing LL and SS with upper limb elevation within and between groups and TK between groups. Baseball players with spondylolysis were enrolled as subjects, and baseball players without low back pain were enrolled as controls (n = 8 each). X-rays were obtained in the standing position and with maximal elevation position of the upper limb (elevation position). LL and SS were measured in the standing and elevated positions, and TK was measured in the standing position. LL was significantly larger in individuals with spondylolysis than controls. The SS of the control group was significantly larger in the elevated position than in the standing position, while the SS of the spondylolysis group was not significantly different between positions. SS was significantly larger in the spondylolysis group than in the control group, only in the standing position. Physical therapy for spondylolysis should focus on hyperlordosis alignment in the standing and maximal elevation positions of both upper limbs, sacral hyper-slope alignment in the standing position, and decreased sacral slope motion.

The endometrium undergoes repeated proliferation and shedding during the menstrual cycle. Significant changes to this environment include fluctuations in the partial pressure of oxygen, exposure to a high-cytokine environment associated with intrauterine infection, and inflammation. Chronic endometritis is a condition wherein mild inflammation persists in the endometrium and is one of the causes of implantation failure and miscarriage in early pregnancy. It is thought that the invasion of embryos into the endometrium requires epithelial-mesenchymal transition (EMT)-associated changes in the endometrial epithelium. However, the effects of inflammation on the endometrium remain poorly understood. In this study, we investigated the effects of the intrauterine oxygen environment, hypoxia-inducible factor (HIF), and inflammation on the differentiation and function of endometrial epithelial cells. We elucidated the ways in which inflammatory cytokines affect HIF activity and EMT in an immortalized cell line (EM-E6/E7/TERT) derived from endometrial epithelium. Pro-inflammatory cytokines caused significant accumulation of HIF-1α protein, increased HIF-1α mRNA levels, and enhanced hypoxia-induced accumulation of HIF-1α protein. The combined effect of inflammatory cytokines and hypoxia increased the expression of EMT-inducing factors and upregulated cell migration. Our findings indicate that pro-inflammatory factors, including cytokines and LPS, work synergistically with hypoxia to activate HIF-1 and promote EMT in endometrial epithelial cells.

Background: Excessive elbow valgus stress can often cause pitching elbow injuries, and rehabilitation is usually required before an athlete can resume playing. However, there is a lack of information on the partial load rehabilitation of pitching elbow injuries caused by valgus extension overload based on elbow valgus stress. The purpose of this study was to clarify how quantitative partial elbow valgus stress while pitching affects ball velocity and subjective pitch-effort., Methods: Forty-six male baseball pitchers participated in this study. Each player wore a wearable device on the elbow that collected their pitch parameters. Ball velocity was measured using a radar gun. Each elbow valgus stress was measured while each player was instructed to throw 5 fastballs at full effort. Then, based on the average stress of the 5 throws (100% partial valgus stress), the 75% and 50% stresses were calculated (75% and 50% partial valgus stress, respectively). Each pitcher continued to pitch until the number of pitches thrown at the targeted elbow stress reached 5. Each player was asked about their subjective pitch-effort after completing each type of partial valgus stress pitch. Outcomes were statistically evaluated using either a 1-way repeated measures analysis of variance or 2-way analysis of variance., Results: The ball velocity was 72% (95% confidence interval [CI], 69%-75%) and 58% (95% CI, 55%-61%) during the 75% and 50% partial valgus stress, respectively (P < .001). Subjective pitch-effort was 41% (95% CI, 38%-44%) and 19% (95% CI, 16%-22%) while pitching at 75% and 50% partial valgus stress, respectively (P < .001)., Conclusions: It may be desirable to instruct pitchers to throw at less than 20% subjective pitch-effort of the max if they want to pitch at 50% partial valgus stress. Elbow valgus stress might correlate with ball velocity at 75% partial valgus stress pitch. These results could enable clinicians and coaches to perform safer return-to-throwing programs and prevent excessive load on the elbow., (Copyright © 2022 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined., Methods: This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared., Results: The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. -1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles., Conclusions: In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.

Objectives: Spondylolysis occurs bilaterally or unilaterally and bilateral spondylolysis increases the risk of developing isthmic spondylolisthesis. The characteristics of the lumbar lordosis angle (LLA), sacral slope angle (SSA), and spondylolysis fracture angle (SFA) in bilateral spondylolysis compared with those in unilateral spondylolysis have not been clarified. The purpose of this study was to compare the LLA, SSA, and SFA of bilateral and unilateral spondylolysis., Materials and Methods: Thirty-eight patients with lumbar spondylolysis who visited our clinic for an initial visit and 15 age-matched patients with a chief complaint of low back pain were included as controls. Computed tomography films were used to classify all spondylolysis patients into two groups: those with bilateral fractures (bilateral) and those with unilateral fractures (unilateral). The LLA and SSA were measured using lateral X-ray films and the SFA was measured using computed tomography films., Results: The LLA was significantly higher in all spondylolysis patients than in the control group (p = .026). There was no significant difference in SSA between the spondylolysis and control groups (p = .28). The LLA was significantly higher in the bilateral group than in the unilateral group (p = .018). There was no significant difference in SSA between the bilateral and unilateral groups (p = .15). The SFA was significantly lower in the bilateral group than in the unilateral group (p = .024)., Conclusions: This study suggests that physical therapy for spondylolysis may be considered bilaterally and unilaterally., Competing Interests: The authors declare that no competing interests exist.

Background: Flow diverter (FD) placement is generally effective for intractable internal carotid artery (ICA) aneurysms. However, salvage treatment for the aneurysm enlarging even after FD placement remains to be elucidated. Additional overlapping FD placement is considered the first-line treatment for residual or recurrent aneurysms. However, it is unclear whether overlapping FD is also effective for enlarging giant aneurysms that are considered impending rupture status. Although parent artery occlusion is a promising option, treatment strategy must be optimized, especially when a critical perforating artery is involved., Case Description: A 74-year-old woman experienced rapid symptomatic growth of her giant supraclinoid ICA aneurysm 10 months after FD placement. We assumed that reinforcement of flow diverting effect alone would be less effective for this extremely intractable aneurysm with more aggressive clinical feature so that surgical bailout by parent artery occlusion was planned. Complete ICA obliteration underneath the aneurysm was unavailable due to the presence of anterior choroidal artery. Thus, we took a flow alteration strategy, where we created minimal retrograde flow through the parent artery by a combination of an extracranial-intracranial bypass and targeted endovascular proximal parent artery obliteration, resulting in prevention of aneurysmal rupture and further growth., Conclusion: Impending rupture of the intracranial giant aneurysm after FD placement may be controllable with a tailor-made parent artery occlusion strategy even when a critical perforating artery is involved., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Surgical Neurology International.)

The physical causes of organ malformation remain largely unclear in most cases due to a lack of information on tissue/cell dynamics. Here, we address this issue by considering onset of cyclopia in sonic hedgehog (SHH)-inhibited chick embryos. We show that ventral forebrain-specific self-organization ability driven by SHH-dependent polarized patterns in cell shape, phosphorylated myosin localization, and collective cell motion promotes optic vesicle elongation during normal development. Stress loading tests revealed that these polarized dynamics result from mechanical responses. In particular, stress and active tissue deformation satisfy orthogonality, defining an SHH-regulated morphogenetic law. Without SHH signaling, cells cannot detect the direction of stress and move randomly, leading to insufficient optic vesicle elongation and consequently a cyclopia phenotype. Since polarized tissue/cell dynamics are common in organogenesis, cell disorientation caused by loss of mechanosensation could be a pathogenic mechanism for other malformations.

Purpose: The purpose of this study was to investigate the relationship between the standing trunk extension angle and medial elbow injuries. Subjects and methods: The study participants were 90 male baseball pitchers (10−12 years) belonging to youth baseball teams. Pitching elbow injuries were evaluated by an orthopedic surgeon using ultrasound scans and physical examination findings. A single optical three-dimensional motion analysis system was used for the trunk extension measurements, with three-dimensional coordinates captured. The overall, upper, and lower trunk angles were then analyzed. Results: Trunk extension angle during standing trunk extension was significantly smaller among participants who were positive for medial elbow injuries on ultrasound scans (positive: 71.4° ± 10.3°; negative: 75.7° ± 9.2°; t = 2.05, p < 0.05). The upper trunk extension angle was significantly smaller than the lower trunk extension angle among participants who were positive for medial elbow injuries on physical examination (upper: 33.0° ± 6.9°; lower: 41.2° ± 8.2°; t = −2.42, p < 0.05). Conclusions: Trunk extension angle during standing trunk extension is associated with medial elbow injuries. Evaluating the trunk extension angle as multiple segments rather than a single rigid body is valuable.

[Purpose] This study aimed to compare the muscle activity around the foot and ankle joints, notably of the abductor digiti minimi, between affected and unaffected sides of individuals with chronic ankle instability. [Participants and Methods] Twelve adult males with chronic ankle instability in one ankle (age, 27.7 ± 5.4 years; height, 172.5 ± 8.1 cm; weight, 67.5 ± 8.1 kg) were included and underwent surface electromyography assessments in multiple positions on both affected and unaffected sides. Measurements were obtained for eight muscles including the abductor digiti minimi. Each measurement included a 5-s segment of the stable waveform, with the root mean square-processed and normalized to the resting position set to 1. [Results] Abductor digiti minimi activity on the affected side was significantly reduced during maximal toe extension/abduction with both ankle dorsiflexion and plantarflexion. Peroneus longus activity on the affected side was significantly greater during maximal toe extension/abduction with ankle plantarflexion; peroneus longus and tibialis anterior muscle activities were significantly greater on the affected side during maximal toe extension/abduction with ankle dorsiflexion. [Conclusion] In the absence of load, muscle imbalance in the intrinsic and extrinsic muscles of the foot was suggested. However, no significant differences were observed under loading conditions., (2022©by the Society of Physical Therapy Science. Published by IPEC Inc.)

A specific DMPO-OH adduct signal (1:2:2:1)related to hydroxyl radical generation in a longterm stored improved iodide formulation, tentatively designated as the distilled KMT reagent which prepared from a pH 0.3 solution containing FeCl 3 , EDTA, KI and ethanol termed the KMT reagent, was detected by electron spin resonance (ESR) spectroscopy.Although the color intensities of N,N,N,N-tetramethyl-p-phenylenediamine (TMPD) and N,N-diethyl-p-phenylenediamine (DPD) differ, the mixture of the long-term stored distilled KMT reagent and TMPD exhibited a purple color similar to Wurster's blue, and the mixture of the long-term stored distilled KMT reagent and DPD exhibited a pink color similar to Wurster's red. There is a possibility that the long-term stored distilled KMT reagent may possess with the ability to generate a hydroxyl radical.

Background: Cancer is an important comorbidity that can affect survival in dialysis patients. However, it is unclear if dialysis patients who develop cancer are disadvantaged by later detection and poorer prognosis. This study comparatively examined the stage at diagnosis and prognosis of several common cancer types in dialysis and nondialysis patients., Methods: In this retrospective cohort study, cancer registry data were linked with administrative data to identify dialysis and nondialysis patients with any new diagnosis of cancer between 2010 and 2015 at 36 hospitals in Osaka Prefecture, Japan. In these patients, we identified the cancer stage at diagnosis for patients with colorectal, stomach, lung, liver, kidney, and bladder cancers. The association between dialysis and survival time (up to 3 years of follow-up) was examined for each cancer type using Cox proportional hazards models that adjusted for age, sex, and cancer stage., Results: We analyzed 2,161 dialysis patients and 158,964 nondialysis patients with cancer. Dialysis patients had a higher prevalence of colorectal, liver, and kidney cancers than nondialysis patients. Colorectal, stomach, lung, liver, and kidney cancers were diagnosed earlier in dialysis patients, whereas bladder cancer was diagnosed at an advanced stage. The Cox proportional hazards models revealed that mortality was significantly higher in dialysis patients with colorectal, stomach, lung, and bladder cancers than in nondialysis patients (all p < 0.05)., Conclusions: Dialysis patients had higher mortality for several common cancers despite their earlier detection. This poorer prognosis may be influenced by the unavailability and complications of cancer treatment for these patients., (© 2022 S. Karger AG, Basel.)

Purpose: The purpose of this study was to compare pitching motion of the professional female baseball pitchers with the male university baseball pitchers focused on the pelvic and thoracic movements., Subjects and Methods: The participants were 15 healthy professional female baseball pitchers (11 right-handers and 4 left-handers; age, 21.7 ± 3.2 years; height, 162.5 ± 5.1 cm; weight, 59.0 ± 6.6 kg) and 14 healthy male university baseball pitchers (12 right-handers and 2 left-handers; age, 19.9 ± 0.8 years; height, 176.4 ± 3.0 cm; body mass, 73.1 ± 3.0 kg). Throwing motion was captured by three-dimensional motion analysis system. Kinematic data of the lead hip, pelvis, thorax, and dominant shoulder were collected and the joint angle at maximum external rotation phase and ball release phase were compared., Results: The female baseball pitchers rotated pelvis and thorax more than the male at the maximum external rotation phase and ball release phase ( p < 0.05). At the same, the pelvis and thorax of the female baseball pitchers were tilted significantly closer to horizontal plane than the male ( p < 0.05). The pelvis and thorax of the male baseball pitchers was tilted to non-dominant lateral side., Conclusions: The results of this study indicate that the pelvic and thoracic movements of the professional female baseball pitchers was different from male university pitchers.

Granulocyte colony-stimulating factor (G-CSF) is a cytokine that mobilizes bone marrow-derived cells (BMDCs) to peripheral blood and has been clinically used to treat neutropenia. Previously, we reported that BMDCs migrated into the rotator cuff repair site via peripheral blood in the healing process. However, techniques to accelerate the healing process using the peripheral blood pathway have not been established. We evaluated whether G-CSF has a noteworthy effect on improving rotator cuff healing by enhancing the influx of BMDCs into the peripheral blood. We used Sprague-Dawley rats and chimeric rats, selectively expressing green fluorescent protein (GFP) in BMDCs. Their bilateral supraspinatus tendons were resected and sutured to the greater tuberosity of the humerus using the Masson-Allen technique, and G-CSF was subcutaneously injected for 5 days after surgery. Several GFP-positive cells were observed around the enthesis in the G-CSF-treated group compared with that in the Control group. Histological analysis revealed that the tendon-to-bone maturing scores and the Safranin O-stained cartilaginous areas were significantly higher in G-CSF-injected rats than in the control rats at weeks 4 and 8 after surgery. Consistently, the ultimate force to failure in the G-CSF-treated group significantly increased compared with the Control group at weeks 4 and 8 after surgery. These results suggest that BMDCs mobilized into the peripheral blood after G-CSF administration migrated to the rotator cuff repair area and effectively enhanced rotator cuff healing by promoting tenocyte and cartilage matrix production. In conclusion, the BMDC mobilization technique by G-CSF treatment via peripheral blood will provide a potential therapeutic approach for rotator cuff healing with clinically relevant applications. Impact statement As the retear rate following rotator cuff repair is high, new methods to aid its healing are required. Granulocyte colony-stimulating factor (G-CSF) has been used clinically and may represent a novel approach to treating rotator cuff tear. Herein, using a rat model, we elucidate the kinetics of bone marrow-derived mesenchymal stem cells at the repair site following G-CSF administration and describe the underlying mechanism by which G-CSF can help promote the repair of the rotator cuff.

[Purpose] To quantitatively analyze the characteristics of movements evoked by certain motor instruction words on the basis of measurements of ankle elevation and related body movements in step-over motion tasks. [Participants and Methods] Sixty-one healthy adult participants were presented with motor instructions and asked to step over an obstacle in accordance with the instructions. The motor instructions were as follows: "Raise your XX (body part) up YY (expression)" in four combinations using "thigh" and "knee" for body part and "high" and "firmly" for expression. Using Kinect to analyze movements, ankle elevation, trunk-anteversion angle, hip-flexion angle, and knee-flexion angle were measured and statistically processed. [Results] With respect to body part, there was no significant difference in the mean and standard deviation (individual variation) values for ankle elevation. With respect to expression, hip joint and knee joint were bent significantly more for "high" than for "firmly", and although the mean value for ankle elevation was high, ankle elevation standard deviation (individual variation) values were significantly lower for "firmly" than for "high". [Conclusion] Explicit motor instruction words such as "high" may be effective in improving performance, while ambiguous motor instruction words like "firmly" may be effective in stabilizing movements., (2021©by the Society of Physical Therapy Science. Published by IPEC Inc.)

[Purpose] The external and internal abdominal muscles may be related to gait speed; however, this has not yet been elucidated. In this study, we aimed to clarify the relationship between gait speed and trunk muscle thickness in elderly individuals. [Participants and Methods] The participants were 12 elderly individuals (4 males and 8 females, mean age 83.4 years old, SD ± 0.5) that attend a day service center. We measured the 5 m free gait speed, the 5 m fastest gait speed, and the thickness of five trunk muscles (the rectus abdominis [divided into three parts: upper, central, and lower], external oblique, internal oblique, transverse abdominis, and iliopsoas muscles). [Results] There were positive correlations between the free gait speed and the thickness of the lower rectus abdominis, internal oblique, and transverse abdominis muscles. There were also positive correlations between the fastest gait speed and the thickness of the lower rectus abdominis, internal oblique, and transverse abdominis muscles. [Conclusion] Incorporating muscle strength training of the lower rectus abdominis, internal oblique, and transverse abdominis muscles into existing lower limb muscle training protocols is important to effectively maintain the gait speed of elderly individuals., (2021©by the Society of Physical Therapy Science. Published by IPEC Inc.)

Ultrafast electronic-phase change in solids by light, called photoinduced phase transition, is a central issue in the field of non-equilibrium quantum physics, which has been developed very recently. In most of those phenomena, charge or spin orders in an original phase are melted by photocarrier generations, while an ordered state is usually difficult to be created from a non-ordered state by a photoexcitation. Here, we demonstrate that a strong terahertz electric-field pulse changes a Mott insulator of an organic molecular compound in κ-(ET) 2 Cu[N(CN) 2 ]Cl (ET = bis(ethylenedithio)tetrathiafulvalene), to a macroscopically polarized charge-order state; herein, electronic ferroelectricity is induced by the collective intermolecular charge transfers in each dimer. In contrast, in an isostructural compound, κ-(ET) 2 Cu 2 (CN) 3 , which shows the spin-liquid state at low temperatures, a similar polar charge order is not stabilized by the same terahertz pulse. From the comparative studies of terahertz-field-induced second-harmonic-generation and reflectivity changes in the two compounds, we suggest the possibility that a coupling of charge and spin degrees of freedom would play important roles in the stabilization of polar charge order.

Purpose: To elucidate the effects of cigarette smoking on human endometrial maturation for reproductive function, the authors examined the in vitro effects of cigarette smoke extract (CSE) on angiogenesis and decidualization in primary human endometrial stromal cells (ESCs)., Methods: Endometrial stromal cells were cultured with CSE and/or estradiol-17β (E 2 ) and medroxyprogesterone acetate (MPA). The mRNA, protein levels, and protein secretion of the angiogenic factors and decidual specific factors were assessed using real-time polymerase chain reaction, Western blot analysis, and enzyme-linked immunosorbent assay, respectively. Decidualization was also monitored by the changes in cellular morphology., Results: Endometrial stromal cell proliferation substantially decreased after dose-dependent treatments with CSE at concentrations above 1%, whereas cell death was induced at treatment concentrations above 1% CSE. Treatments above 0.025% CSE led to increased vascular endothelial growth factor mRNA through hypoxia-inducible factor-1α accumulation. CSE concentrations at 0.01% and 0.025% increased the prolactin expression levels after treatment with E 2 and MPA, whereas 0.1% and 0.25% CSE concentrations suppressed prolactin. Similar tendencies were observed in cellular morphology and other decidual specific factors., Conclusion: These results suggest that exposure to cigarette smoke affects endometrial appropriate maturation including the processes of angiogenesis and decidualization in the reproductive system., Competing Interests: The authors declare no conflict of interest., (© 2021 The Authors. Reproductive Medicine and Biology published by John Wiley & Sons Australia, Ltd on behalf of Japan Society for Reproductive Medicine.)