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Objective: The effects of four toothpastes on the color stability of in-office bleached tooth specimens were determined., Materials and Methods: We evaluated an experimental toothpaste (EXP) and three commercially available toothpastes: Colgate Optic White (OPW), Aquafresh White & Protect (AWP), and Crest 3D White (CDW). OPW, AWP, and CDW contained inorganic abrasives, whereas EXP and AWP contained sodium polyphosphate. Forty-eight randomly selected human-extracted maxillary central incisors were bleached and brushed twice daily over 30 days. We analyzed the final color difference (ΔE*ab, ΔE 00 , ΔWI D ), arithmetic average surface roughness (Ra) of the enamel measured on days 0 and 30, and scanning electron microscopy images of enamel surfaces and toothpastes. ΔE*ab, ΔE 00 , ΔWI D , and Ra were analyzed using one-way analysis of variance and Tukey's test (α = 0.05)., Results: ΔE*ab and ΔE 00 values were significantly lower after toothbrushing with EXP, OPW, and CDW than with AWP. OPW induced the greatest positive ΔWI D . Ra was significantly increased by OPW and CDW, but slightly increased by AWP, with cube-like particles, and EXP, with no particle-like structures., Conclusions: Only EXP stabilized the color of bleached teeth without increasing the enamel surface roughness. Sodium polyphosphate with approximately 10 phosphate groups was effective at removing stains., Clinical Significance: The effect of toothpaste on the color stability of bleached teeth depends on the constituting abrasives and chemical components. Polyphosphoric acid has different stain-removal effects depending on its degree of polymerization. Additionally, although certain types of abrasives may be effective for color stability, they also increase the surface roughness of the enamel., (© 2023 Wiley Periodicals LLC.)

Background: Undernutrition is a negative predictor of adverse outcomes in patients with heart failure (HF). Despite the survival advantage of elevated body mass index (BMI) in patients with HF, BMI does not necessarily reflect a favorable nutritional status. In the present study, we investigated the clinical impact of nutritional screening in patients with HF and overweight/obesity., Methods: We examined the data from 170 patients with overweight or obesity status (defined as BMI ≥ 25 kg/m 2 ) who admitted for acute HF. Their controlling nutritional status (CONUT) score was calculated on admission. The CONUT score is regarded as an index of the nutritional status., Results: The median duration of follow-up was 1096 days (interquartile range, 805-1096 days). Undernutrition was identified in 66.5% of the patients. Kaplan-Meier survival analysis demonstrated that patients with undernutrition had a higher incidence of all-cause death and readmission due to HF than those without undernutrition. Multivariate Cox regression analysis revealed that the CONUT score, but not BMI and the geriatric nutritional risk index, was independently correlated with poor prognosis., Conclusions: Undernutrition is highly prevalent and independently predicts poor outcomes in patients with overweight/obesity and acute HF., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The causal relationship of lipoprotein(a) with cardiovascular disease has been established. However, clinical impacts of lipoprotein(a) levels on adverse vascular events in patients with established coronary artery disease who are undergoing statin treatment have not been fully elucidated. We measured lipoprotein(a) levels of 668 consecutive patients with ST-elevated myocardial infarction upon admission and reevaluated lipoprotein(a) of 189 of these patients during statin treatment at least 6 months later than the date of index ST-elevated myocardial infarction. Changes in lipoprotein(a) and associations between lipoprotein(a) levels and the incidence of major adverse cardiac and cerebrovascular event for 3 years were examined. Lipoprotein(a) at baseline was an independent predictor of 3-year major adverse cardiac and cerebrovascular event after ST-elevated myocardial infarction. Levels of lipoprotein(a) at follow-up were slightly but significantly elevated despite improvements in other lipid parameters due to statin treatment. Furthermore, higher levels of lipoprotein(a) achieved with statin treatment were also associated with the subsequent incidence of major adverse cardiac and cerebrovascular event over 3 years, regardless of whether or not the LDL-cholesterol levels were below 100 mg/dl. In conclusion, lipoprotein(a) levels during lipid management by statin are also predictive of adverse vascular events in Japanese patients with ST-elevated myocardial infarction.

Neointimal calcification after stent implantation has been reported as one of the forms of neoatherosclerosis. There are a few patients with in-stent restenosis (ISR) and an undilatable calcified neointima who require rotational atherectomy to achieve sufficient acute gain in lumen diameter. However, the clinical outcomes of rotational atherectomy for undilatable calcified ISR have not been fully elucidated. Therefore, we investigated the safety and efficacy of rotational atherectomy for treating calcified ISR. This retrospective study included 17 patients (20 lesions) who had undergone percutaneous coronary intervention including rotational atherectomy to treat ISR with severely calcified neointima. Kaplan-Meier analysis was used to analyze the data. The mean age of the enrolled patients was 67±18 years, and 71% were men. The patients had highly atherogenic characteristics: 65% had diabetes mellitus and 53% were receiving hemodialysis. Procedural success was obtained in 19 (95%) patients, and the acute gain in lumen diameter was acceptable (1.7±0.6 mm). However, during a median follow-up of 571 days, the incidences of major adverse cardiac and cerebrovascular events per patient and clinical-driven target lesion revascularizations per lesion were relatively high. There were no differences in clinical outcomes according to the baseline characteristics, type of restenotic stents, and therapeutic strategy. In conclusion, clinical outcomes of rotational atherectomy for severely calcified ISR were unfavorable despite a high success rate and acceptable acute gain in lumen diameter., Competing Interests: Y.U. received lecture fees from Otsuka Pharma Ltd. H.I. received lecture fees from Astellas Pharma Inc., Daiichi-Sankyo Pharma Inc., and Otsuka Pharma Inc. T.M. received lecture fees from Bayel Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi-aventis K.K., and Takeda Pharmaceutical Co., Ltd. T.M. received unrestricted research grants for the Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofi-aventis K.K., Takeda Pharmaceutical Co., Ltd., and Teijin Pharma Ltd.

Serum bilirubin measurement is necessary to accurately distinguish jaundice from carotenemia. A 59.8-y old Japanese male showed symptoms of yellow skin pigmentation as a result of β-carotenemia. Diagnostic laboratory results indicated elevated levels of serum muscle enzymes (aspartate aminotransferase, lactate dehydrogenase, and creatine kinase), but normal levels in liver function tests (alanine aminotransferase and direct bilirubin). The laboratory results indicated hypothyroid myopathy. Moreover, although the patient did not show significant abnormalities in liver function tests, the serum level of total bilirubin (TBIL) measured by bilirubin oxidase method was markedly increased beyond the upper limit of normal. Fundamental experiments revealed that the bilirubin oxidase method had a positive interference by β-carotene. These findings suggested that hyper β-carotenemia could have caused the falsely elevated serum TBIL levels in the patient.

Background: Hospitalization for heart failure (HF) carries a risk of impairment in physical activity. We assessed the association between changes in Barthel index (BI) during hospitalization and prognosis in patients with acute HF. Methods and Results: We evaluated the BI in 256 patients with acute HF at the time of hospital admission (pre-BI) and at discharge (post-BI). All patients were followed for 1 year after discharge. BI significantly decreased during hospitalization in enrolled patients. Patients with a post-BI <60 had longer hospital stays and higher rates of non-home discharge, and had a lower 1-year survival rate than those with a post-BI ≥60. Multivariate Cox regression analysis revealed that post-BI, not pre-BI or changes in BI, significantly correlated with all-cause death and the composite of all-cause death or rehospitalization for HF for 1 year after discharge. Patients with decreasing BI during hospitalization had significantly lower all-cause death- or HF readmission-free survival following acute HF than those having a pre-BI ≥60 and changes in BI ≥0., Conclusions: Results demonstrate that low BI at discharge and decreased BI during hospitalization predicted poor outcomes in Japanese patients with acute HF. A comprehensive approach, beginning in the acute phase, aiming to maintain patients' ability to perform activities of daily living could provide better management of HF.

Background: The prognostic impact of red blood cell distribution width (RDW) on adverse outcomes in patients with heart failure with preserved ejection fraction (HFpEF) is unclear. We investigated the association between RDW values at admission and long-term prognosis in patients with acute decompensated HFpEF., Methods: The present study enrolled 278 consecutive patients with acute decompensated HFpEF, whose RDW levels were measured at admission. We divided enrolled patients into 2 groups according to RDW value and investigated the association between RDW and patients' mortality., Results: A Kaplan-Meier analysis demonstrated that patients with higher RDW levels had significantly higher all-cause and non-cardiac mortality, but not cardiac-based mortality, than did patients with lower RDW levels. A multivariate Cox regression analysis revealed that RDW levels were independently correlated with all-cause and non-cardiac mortality after adjusting for other risk factors, including age, brain natriuretic peptide, hemoglobin, and Charlson comorbidity index score. In a receiver-operating curve analysis, the cut-off value to maximize the prognostic impact of RDW on mortality was 15.2%. The evaluation of RDW and other prognostic factors improved their predictive value for both all-cause and non-cardiac mortality., Conclusions: The current study demonstrated that RDW levels at admission independently predict poor outcomes because of non-cardiac events in patients with acute decompensated HFpEF. Evaluation of RDW could provide useful information for the long-term prognosis of HFpEF., (Copyright © 2017. Published by Elsevier Ltd.)

In addition to BRCA1 and BRCA2, RAD51C, PALB2 and BRIP1 are known as breast cancer susceptibility genes. However, the mutation status of these genes in Japanese familial breast cancer cases has not yet been evaluated. To this end, we analyzed the exon sequence and genomic rearrangement of RAD51C, PALB2 and BRIP1 in 100 Japanese patients diagnosed with familial breast and ovarian cancer and without BRCA1 and BRCA2 mutations. We detected a large deletion from exons 6 to 9 in RAD51C, 4 novel BRIP1 missense variants containing 3 novel non-synonymous variants, c.89A>C, c.736A>G and c.2131A>G, and a splice donor site variant c.918+2T>C. No deleterious variant of PALB2 was detected. The results of pedigree analysis showed that the proband with a large deletion on RAD51C had a family history of both breast and ovarian cancer, and the families of probands with novel BRIP1 missense variants included a male patient with breast cancer or many patients with breast cancer within the second-degree relatives. We showed that the mutation frequency of RAD51C in Japanese familial breast cancer cases was similar to that in Western countries and that the prevalence of deleterious mutation of PALB2 was possibly lower. Furthermore, our results suggested that BRIP1 mutation frequency in Japan might differ from that in Western countries., (© 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)

Background: We assessed the long-term safety and efficacy of tolvaptan in 102 patients with heart failure (HF) and chronic kidney disease (CKD). Median follow-up duration was 1.6 years (1.0-4.4 years).Methods and Results:One patient discontinued tolvaptan because of hypernatremia. There were no changes in renal function or electrolytes during the 1-year follow-up. The cardiac-related death-free or HF-related hospitalization-free survival rate was significantly higher in patients receiving tolvaptan than in propensity score-matched patients who did not receive tolvaptan., Conclusions: In patients with HF and CKD, long-term administration of tolvaptan was well-tolerated, relatively safe and effective, suggesting its utility for long-term management of these conditions.

Intramyocardial dissecting hematoma is a rare but potentially fatal complication of myocardial infarction. The decision to adopt a surgical or conservative strategy may depend on the clinical and hemodynamic stability of patients. Regardless, the precise and temporal assessment of the structure of hematoma is imperative. We herein report the first case of a patient with early spontaneous remission of intramyocardial dissecting hematoma successfully managed by a conservative approach with multimodality imaging.

Lipoprotein(a) [Lp(a)], which is genetically determined, has been reported as an independent risk factor for atherosclerotic vascular disease. However, the prognostic value of Lp(a) for secondary vascular events in patients after coronary artery disease has not been fully elucidated. This 3-year observational study included a total of 176 patients with ST-elevated myocardial infarction (STEMI), whose Lp(a) levels were measured within 24 h after primary percutaneous coronary intervention. We divided enrolled patients into two groups according to Lp(a) level and investigated the association between Lp(a) and the incidence of major adverse cardiac and cerebrovascular events (MACCE). A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of MACCE than those with lower Lp(a) levels (log-rank P = 0.034). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the occurrence of MACCE after adjusting for other classical risk factors of atherosclerotic vascular diseases (hazard ratio 1.030, 95 % confidence interval: 1.011-1.048, P = 0.002). In receiver-operating curve analysis, the cutoff value to maximize the predictive power of Lp(a) was 19.0 mg/dl (area under the curve = 0.674, sensitivity 69.2 %, specificity 62.0 %). Evaluation of Lp(a) in addition to the established coronary risk factors improved their predictive value for the occurrence of MACCE. In conclusion, Lp(a) levels at admission independently predict secondary vascular events in patients with STEMI. Lp(a) might provide useful information for the development of secondary prevention strategies in patients with myocardial infarction.

Autism spectrum disorder (ASD) is characterized by problems with reciprocal social interaction, repetitive behaviours/narrow interests, and impairments in the social cognition and emotional processing necessary for intention-based moral judgements. The aim of this study was to examine the information used by early adolescents with and without ASD when they judge story protagonists as good or bad. We predicted that adolescents with ASD would use protagonists' behaviour, while typically developing (TD) adolescents would use protagonists' characteristics when making the judgements. In Experiment 1, we measured sentence by sentence reading times and percentages for good or bad judgements. In Experiment 2, two story protagonists were presented and the participants determined which protagonist was better or worse. Experiment 1 results showed that the adolescents with ASD used protagonist behaviours and outcomes, whereas the TD adolescents used protagonist characteristics, behaviours, and outcomes. In Experiment 2, TD adolescents used characteristics information when making "bad" judgements. Taken together, in situations in which participants cannot go back and assess (Experiment 1), and in comparable situations in which all information is available (Experiment 2), adolescents with ASD do not rely on information about individual characteristics when making moral judgements.

Tolvaptan, a vasopressin type 2 receptor antagonist, has an aquaretic effect without affecting renal function. The effects of long-term tolvaptan administration in heart failure patients with renal dysfunction have not been clarified. Here, we assessed the clinical benefit of tolvaptan during a 6-month follow-up in acute decompensated heart failure (ADHF) patients with severe chronic kidney disease (CKD; estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m(2)). We compared 33 patients with ADHF and severe CKD who were administered tolvaptan in addition to loop diuretics (TLV group), with 36 patients with ADHF and severe CKD who were administered high-dose loop diuretics (≥40 mg) alone (LD group). Alterations in serum creatinine and eGFR levels from the time of hospital discharge to 6-month follow-up were significantly different between the groups, with those in the TLV group being more favorable. Furthermore, Kaplan-Meier analysis revealed that rehospitalization for heart failure (HF) was significantly lower in the TLV group compared with the LD group. In ADHF patients with severe CKD, tolvaptan use for 6 months reduced worsening of renal function and rehospitalization rates for HF when compared with conventional diuretic therapy. In conclusion, tolvaptan could be a safe and effective agent for long-term management of HF and CKD.

Background: Increased red blood cell distribution width (RDW) is associated with adverse outcomes in heart failure. In the present study, we assessed the association between changes in RDW values during hospitalization and long-term prognosis in patients with acute decompensated heart failure (ADHF)., Methods: We measured the RDW value in 229 consecutive patients with ADHF. Blood samples were obtained at the time of hospital admission and at discharge. Changes in RDW were calculated as the mean difference between RDW values on admission and those at the time of hospital discharge., Results: Patients were followed up for a median of 692 days. A Kaplan-Meier survival analysis demonstrated that patients whose RDW levels increased during hospitalization had significantly higher all-cause and cardiac-based mortality following heart failure than did patients whose RDW levels decreased during hospitalization. A multivariate Cox regression analysis revealed that change in RDW values during hospitalization, but not the values of RDW and hemoglobin on admission, was independently correlated with all-cause and cardiac-based mortality after adjusting for other risk factors in patients with ADHF., Conclusions: These data document that the change in RDW values during hospitalization independently predicts poor outcomes in patients with ADHF. Continuous follow-up of RDW values could provide useful information for long-term prognosis after heart failure., (Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Emotional competence has recently, become a widespread concern in schools and workplaces, both which deeplyinvolve laypersons. While academic researchers have discussed the status of emotional competence comparedto the traditional intelligence, it is very important to elucidate how laypersons regard emotional competencecompared to traditional intelligence as well. The present study investigated the position of emotional competencein the multiple intelligences theory by assessing laypersons' self-estimates of their abilities and their rating ofthe importance of emotional competence for thriving in society. Participants (N = 584) answered a questionnaireonline. Results showed that laypersons regarded emotional competence as a distinct construct, and most stronglyrelated it to personal intelligence. Moreover, their ratings of the importance of emotional competence and personalintelligence for thriving in society were higher than that of traditional intelligence.

Researchers have repeatedly argued that it is important to determine whether the psychometric properties of an emotional competence measure hold in Eastern populations because there may be cultural variability in abilities linked with emotional competence. However, few studies have examined potential differences in an emotional competence measure in Eastern cultures. To fill this gap, we investigated the applicability of the Profile of Emotional Competence to a Japanese population. Results demonstrated measurement and structural invariance across our Japanese and the original Belgian data sets. As was found in the Belgian sample, this measure showed adequate convergent and criterion validity in the Japanese sample. Furthermore, the scores on this measure were stronger predictors of subjective health and happiness in the Japanese than Belgian population. This measure also showed incremental validity. Our results suggest that the Profile of Emotional Competence is applicable to the Japanese population, an Eastern society., (© The Author(s) 2015.)

Emotional competence refers to individual differences in the ability to appropriately identity, understand, express, regulate, and utilize one's own emotions and those of others. This study developed a Japanese version of a short form of the Profile of Emotional Competence, a measure that allows the comprehensive assessment of intra- and interpersonal emotional competence with shorter items, and investigated its reliability and validity. In Study 1, we selected items for a short version and compared it with the full scale in terms of scores, internal consistency, and validity. In Study 2, we examined the short form's test-retest reliability. Results supported the original two-factor model and the measure had adequate reliability and validity. We discuss the construct validity and practical applicability of the short form of the Profile of Emotional Competence.

In this commentary on 'Friendlessness and theory of mind: A prospective longitudinal study' by Fink, Begeer, Peterson, Slaughter, and de Rosnay (Brit. J. Dev. Psychol, 2015; 33, 1-17) we reconsider the link between early mastery of theory of mind (ToM) and social relationships by focusing on connections with other related areas of socio-cognitive ability such as emotional competence, ToM development across age, and the effect of interventions., (© 2014 The British Psychological Society.)

Sitagliptin has been widely used for the treatment of diabetes and shown recently to have beneficial pleiotropic outcomes on cardiovascular systems in experimental studies. However, little is known about the influence of sitagliptin on atherosclerosis-related cardiovascular diseases in a clinical setting. This study examined the effect of sitagliptin on carotid intima-media thickness (IMT). A total of 76 patients with clinically stable and documented coronary artery disease, who were newly diagnosed with impaired glucose tolerance or mild type 2 diabetes mellitus, were allocated, randomly, to receive either sitagliptin 100 mg/day or the placebo control. Common carotid IMT, glucose profiles, glycosylated hemoglobin (HbA1c), and lipid profiles were measured at baseline and repeated at 12 months. Sitagliptin-treated patients showed less IMT progression than the control group (p = 0.02). In addition, the sitagliptin group showed greater reductions in body weight (2.2%), 2-hour glucose levels on the 75-g oral glucose tolerance test (17.3%), HbA1c (4.7%), and low-density lipoprotein cholesterol levels (7.9%) from that at baseline. In conclusion, treatment with sitagliptin for 12 months was associated with a beneficial effect in the prevention of carotid IMT progression, compared with the diet control., (Copyright © 2014 Elsevier Inc. All rights reserved.)

The present study examined the effects of role-play experience on children's mindreading ability. Forty-one primary school children (20 boys, 21 girls, mean age: 9.37 years, range: 8-11 years) were introduced to a communication task in which the use of mindreading was essential. During each trial, participants viewed a shelf, presented on a laptop, which contained several familiar objects, and they were instructed to touch an object on the shelf following an order issued by a "manager" who stood at the opposite side of the shelf. There were two managers: one was a monkey manager with normal color vision, and the other was a dog manager with restricted color vision. The monkey manager could see all the objects in the same colors as the participants, whereas the dog manager saw some objects in different colors. Participants were required to respond according to the manager's instruction. In the restricted color vision condition, the dog manager saw the colors of objects differently; thus, participants had to work out his intentions, according to his different perspective. In the normal color vision condition, all objects were in the same colors as those seen by the monkey manager. Before the test phase, participants in the role-play group were provided a role-play experience in which they assumed the role of the dog manager with restricted color vision. The experimental data were analyzed using a 2 × 2 mixed-design ANOVA (role-play condition × communication partner condition) to examine differences in the error rate. Both main effects and its interaction were significant. According to the post-hoc analyses, participants in the no-role-play condition made significantly more errors in the restricted color vision condition than in the normal color vision condition, whereas no such difference was found among participants in the role-play condition. These results suggest that role-play experience could facilitate mindreading of characters with restricted color vision.

Polyphosphate is a phosphate polymer which is effective for stain removal and prevention of stain deposition. Ultraphosphate belongs to the polyphosphate group and has a highly branched mesh-like structure. To evaluate stain control ability of ultraphosphate, we used HAP powder, glass-ionomer cement and detached human teeth for models of in vitro stain control experiments. When using HAP powder, the stain removal ability of ultraphosphate was the highest among common chelating agents. In addition, ultraphosphate efficiently removed stain and prevented stain deposition on glass-ionomer cement at 20°C and 37°C. Finally, ultraphosphate removed coffee stain from human teeth surface efficiently and the color difference (ΔE*ab) before and after ultraphosphate treatment was changed dramatically from 59.4 to 8.3. Similarly, the ΔE*ab value of human teeth treated with ultraphosphate before coffee treatment was only 9.9, while the value without ultraphosphate pre-treatment was 21.2. These results indicate that ultraphosphate is a potent agent for stain control.

Background: Regulation of emotions in others is distinct from other activities related to trait emotional intelligence in that only such behavior can directly change other people's psychological states. Although emotional intelligence has generally been associated with prosociality, emotionally intelligent people may manipulate others' behaviors to suit their own interests using high-level capabilities to read and manage the emotions of others. This study investigated how trait emotional intelligence was related to interacting with ostracized others who attempt retaliation., Method: We experimentally manipulated whether two people were simultaneously ostracized or not by using an online ball-tossing game called Cyberball. Eighty university students participated in Cyberball for manipulating ostracism and a "recommendation game," a variation of the ultimatum game for assessing how to interact with others who attempt retaliation, with four participants. After the recommendation game, participants rated their intention to retaliate during the game., Results: People with higher interpersonal emotional intelligence were more likely to recommend that the ostracized other should inhibit retaliation and maximize additional rewards when they have a weaker intention to retaliate. However, they were more likely to recommend that the ostracized other should retaliate against the ostracizers when they have a stronger intention to retaliate., Conclusion: This is the first laboratory study that empirically reveals that people with high interpersonal emotional intelligence influence others' emotions based on their own goals contrary to the general view. Trait emotional intelligence itself is neither positive nor negative, but it can facilitate interpersonal behaviors for achieving goals. Our study offers valuable contributions for the refinement of the trait emotional intelligence concept in the respect of its social function.

The present study examined effects of role-play experience on reading the mind of people with different perception. It is normally difficult but very important in daily life to understand people with different characteristics, including those with restricted color vision. We explored the mechanisms of reading the mind of people with different perception. Forty university students were introduced to a communication task in which the use of mindreading was essential. During each trial, participants viewed a shelf, presented on a laptop computer, which contained several familiar objects, and they were instructed to touch an object on the shelf following an instruction issued by a partner who stood at the opposite side of the shelf. There were two partners: one was a monkey with normal color vision and the other was a dog with restricted color vision. The monkey could see all the objects in the same colors as the participants, whereas the dog saw some objects in different colors (e.g., he saw as yellow objects that the participants saw as red). Participants were required to respond according to the partner's instruction. In the restricted color vision condition, the dog saw the colors of objects differently; thus, participants had to work out his intentions (i.e., mind read), according to his different perspective. In the normal color vision condition, all objects were in the same colors as those seen by the monkey. Before the test phase, the role-play group had a role-play experience in which participants assumed the role of people with restricted color vision. No-role-play participants made significantly more errors in the restricted color vision condition than in the normal color vision condition, whereas among role-play participants, there was no difference between conditions. These results suggest that role-play experience facilitates reading the mind of people with perceptual experiences different from our own.

This study investigated the development of "mindreading" in young adults. Forty university students were divided into two groups (role-play group and no-role-play group). Then they participated in a perspective-taking task in which the use of mindreading is essential. The participants viewed a computer display of eight familiar objects in different compartments of a wall divider with four rows of four compartments. Some of the compartments were open to see through, while others had back panels and thus which, if any, object was present could only be seen from the participant's side. They were instructed to touch the display corresponding to an object in a compartment in accord with the instructions of a "manager" who stood behind the divider and thus could not see into all of the compartments. The no-role-play group made more errors than the role-play group, and took longer to respond. The effects of role play lasted during five successive task blocks. These results suggest that experience with role play activates mindreading in this perspective-taking task.

Background: Oxidized low-density lipoprotein (LDL) cholesterol is a sensitive lipid marker for predicting atherosclerosis. Ezetimibe and statins are reported to decrease both LDL cholesterol and oxidized LDL cholesterol. This prospective randomized open-label crossover study compared combination therapy with atorvastatin plus ezetimibe versus high-dose atorvastatin monotherapy. Changes in serum lipids, including malondialdehyde-modified LDL (MDA-LDL) as a representative form of oxidized LDL cholesterol, and glucose metabolism were assessed., Methods and Results: The subjects were 39 Japanese patients with coronary artery disease and type 2 diabetes or impaired glucose tolerance who were taking 10 mg/day of atorvastatin (30 men and 9 women with a mean age of 67.8 years). They were randomized to a group that first received add-on ezetimibe (10 mg/day) or a group that first received atorvastatin monotherapy at a higher dose of 20 mg/day. Both treatments were given for 12 weeks each in a crossover fashion. Add-on ezetimibe significantly decreased MDA-LDL (109.0 ± 31.9 mg/dl to 87.7 ± 29.4 mg/dl, p=0.0009), while up-titration of atorvastatin did not. The decrease with add-on ezetimibe was significantly greater than with up-titration of atorvastatin (p=0.0006). Total cholesterol and LDL cholesterol were significantly decreased by both treatments, but the percent reduction with add-on ezetimibe was significantly greater (p<0.05). High-density lipoprotein cholesterol was significantly increased by both treatments and there was no significant difference between them. The apolipoprotein B/apolipoprotein A-I ratio and remnant-like particle cholesterol were only significantly decreased by add-on ezetimibe. Both treatments caused similar elevation of hemoglobin A(1c)., Conclusion: In Japanese patients with type 2 diabetes or impaired glucose tolerance and coronary artery disease, adding ezetimibe (10 mg/day) to atorvastatin (10 mg/day) significantly improved the lipid profile compared with atorvastatin monotherapy at 20 mg/day., (Copyright © 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.)

Objective: This study examined the effect of acarbose therapy on carotid intima-media thickness (IMT) in patients with established coronary artery disease (CAD) who had been newly diagnosed with impaired glucose tolerance (IGT) or mild type 2 diabetes mellitus (T2DM)., Methods: This was a 1-year, prospective, randomized, open-label, parallel-group study in patients with established CAD (≥50% stenosis on quantitative coronary angiography) who were newly diagnosed with IGT or mild T2DM. IGT was defined as 2-hour glucose concentrations of 140 to 199 mg/dL on the 75-g oral glucose tolerance test (OGTT). Mild T2DM was defined as a fasting plasma glucose concentration <126 mg/dL, 2-hour plasma glucose concentration on OGTT >200 mg/dL, and glycosylated hemoglobin (HbA(1c)) <6.5%. On the day after undergoing coronary angiography, patients were randomly allocated to receive either acarbose 150 mg/d or control (no treatment). Carotid IMT was measured by ultrasonography at baseline and at 12 months of follow-up. The changes in glucose profiles (75-g OGTT), HbA(1c), and lipid profiles were also compared between baseline and follow-up. At visits every 2 months, data on adverse events, drug adherence, and changes in medication were collected. Adverse events were recorded based on spontaneous reports and questioning by the investigator. Clinical follow-up data on outcomes of interest were obtained from patients' hospital charts or from telephone interviews; these outcomes were the incidence of mortality, nonfatal myocardial infarction, repeat percutaneous coronary intervention for a treated coronary artery, and stroke., Results: Ninety Japanese patients were enrolled in the study (45 in each group). Two patients in the acarbose group discontinued therapy due to drug-related diarrhea, and 1 patient in each group was discontinued because of a newly diagnosed malignancy. Three patients in the control group were discontinued because they initiated treatment with fibrates, and 2 patients in the control group were lost to follow-up. Thus, complete baseline and follow-up data were available for 42 patients in the acarbose group and 39 in the control group. These 81 patients were predominantly male (74 [91.4%]), with a mean (SD) age of 66.3 (9.0) years, mean body weight of 65.9 (10.5) kg, and mean HbA(1c) of 5.57% (0.38%). Baseline characteristics appeared to be comparable between the 2 groups. In the acarbose group, IMT increased from a mean of 1.28 (0.53) mm at baseline to 1.30 (0.52) mm at 12-month follow-up (mean change, 0.02 [0.29] mm; P = NS), whereas in the control group, it increased from a mean of 1.15 (0.37) mm to 1.32 (0.46) mm (mean change, 0.17 [0.25] mm; P < 0.001 ). The difference between groups was statistically significant (P = 0.01). In addition, the acarbose group had significant reductions from baseline in 2-hour glucose concentrations on the 75-g OGTT (mean change, -24.8 [45.2] mg/dL; P = 0.001), fasting total cholesterol (mean change, -11.26 [26.1] mg/dL; P = 0.009), and fasting triglyceride concentrations (mean change, -30.4 [62.7] mg/dL; P = 0.003), whereas the corresponding changes were not significant in the control group (mean change, -8.5 [39.4], -6.22 [26.7], and -1.05 [74.2] mg/dL, respectively). Cardiovascular events requiring hospitalization occurred in 4 patients (9.5%) in the acarbose group and 4 patients (10.3%) in the control group. No deaths, nonfatal myocardial infarctions, or strokes occurred in either group over the follow-up period., Conclusion: In this small, open-label study in patients with established CAD who were newly diagnosed with IGT or mild T2DM, 12 months of treatment with acarbose was associated with a beneficial effect in terms of preventing the progression of carotid IMT compared with control, although it was not associated with a significant decrease in IMT from baseline. UMIN (University Hospital Medical Information Network) Clinical Trials Registry identifier: UMIN000000544., (Copyright © 2010 Excerpta Medica Inc. All rights reserved.)

This study investigated the perceptual and cognitive characteristics of metaphoric and onomatopoeic descriptions of physical pain. Ninety-eight Japanese pain descriptors were identified from previous pain studies and the World Wide Web. Four hundred and thirty-six Japanese undergraduates were asked to indicate for each descriptor: (a) body locations; (b) temporal (duration, interval repetition, and frequency), spatial (movement, depth, area, volume) and magnitude (strength) levels; and (c) ratings on seven semantic differential scales for cognitive evaluation. Correspondent analysis and principal component analysis indicated good correspondence between the perceptual and cognitive characteristics. Cluster analysis revealed that the 98 descriptors fall into eleven clusters that appear to be associated with different underlying metaphors for pain (e.g., the body as a container that experiences pain as the result of damage from an object or weapon). These results are discussed in terms of the relationship between the metaphors people use to describe their pain experience and the potential for bodily-basis conceptualization of pain.

Much of the evidence from the West has shown links between children's developing self-control (executive function), their social experiences, and their social understanding (Carpendale & Lewis, 2006, chapters 5 and 6), across a range of cultures including China. This chapter describes four studies conducted in three Oriental cultures, suggesting that the relationships among social interaction, executive function, and social understanding are different in these cultures, implying that social and executive skills are underpinned by key cultural processes.

Objective: To evaluate the effectiveness of restricting weight gain during pregnancy to reduce perinatal complications., Study Design: The study was conducted in the Tokyo metropolitan area, and reviewed 3071 mothers and their infants born from singleton pregnancies retrospectively. To examine the influence of increased maternal weight gain on perinatal complications, we performed five-category stratification for weight gain: less than 8.0, 8.0-10.0, 10.1-12.0, 12.1-14.0 and over 14.0 kg., Results: Total weight gains less than 8.0 kg significantly increased the risk of low birth weight (LBW) and small for gestational age (SGA) infants (OR=2.19, 95% CI; 1.36-3.52, OR=1.76, 95% CI; 1.23-2.51) and total weight gain over 14.0 kg significantly increased the risk of large for gestational age (LGA) infants and pregnancy induced hypertension (PIH) (OR=3.06, 95% CI; 1.88-4.98, OR=2.87, 95% CI; 1.86-4.42, respectively), compared with women with weight gain of 10.1-12.0 kg. The groups with weight gains of 8.0-10.0 kg and 12.1-14.0 kg did not show adverse perinatal outcomes, including gestational diabetes (GDM), cesarean delivery, postpartum hemorrhage and laceration, significantly different from the 10.1 to 12.0 kg gain group., Conclusion: Strict restriction of weight gain during pregnancy is not effective in reducing perinatal complications.

Background: Insulin resistance and hyperinsulinemia are important risk factors for coronary artery disease (CAD) and cardiovascular event (CVE). However, their independent relationship to new CVE in patients with normal glucose tolerance (NGT) and CAD is not known., Methods and Results: Subjects of this 3-year observational study were 102 patients with CAD. Plasma glucose and insulin concentrations were determined at 2 time points (baseline and post oral glucose tolerance test [OGTT]. The fasting plasma glucose <110 mg/dl and post-OGTT <140 mg/dl was diagnosed as NGT (World Health Organization criteria). Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR). Of the 102 patients, 23 had onset of new CVE, including 19 with new CAD. They had significantly higher fasting and post-OGTT insulin levels and HOMA-IR than those without new CVE (P<0.01, 0.031 and <0.01, respectively). Using the univariate Cox proportional hazards model, fasting and post-OGTT insulin values, HOMA-IR and high density lipoprotein (HDL) cholesterol differed significantly between the 2 groups. The multivariate Cox model showed that the effect of fasting plasma insulin and HOMA-IR remained significant and independent of HDL cholesterol., Conclusion: Fasting hyperinsulinemia and high insulin resistance increased the risk of new CVE in patients with NGT and CAD.

Among the naturally occurring toxins that are known to have specific inhibitory effects on type-1 and type-2A protein phosphatases (PP1 and PP2A), tautomycin (TM) is unique in that it exhibits significantly higher affinity to PP1 than to PP2A. The ratio of the dissociation constant for the PP1-TM interaction to that for the PP2A-TM interaction (the PP1/PP2A ratio) is 0.01-0.03. The aim of the present study was to evaluate the possible contributions of the C-1-C-16 segment of TM to the affinity characteristics of the toxin. The relatively hydrophobic segment contains a spiroketal motif whose enantiomeric form is present in okadaic acid (OA), which exhibits exceedingly higher affinity to PP2A than to PP1. We therefore synthesized two TM analogues: TM1 in which the side chains of the spiroketal motif of TM were removed but its absolute configuration was retained, and TM2 in which the spiroketal motif of TM1 was replaced with its enantiomeric form. The effects of TM, TM1 and TM2 on the activities of the native catalytic subunits of PP1 (PP1C) and PP2A and a recombinant gamma isoform of PP1 (PP1gamma) were examined. The PP1/PP2A ratio determined thereby was 0.2-0.5 for TM1 and 5-10 for TM2. Both the presence of the side chains and the stereochemistry of the spiroketal moieties may be major determining factors for the affinity characteristics of TM. We also show that a monoclonal antibody raised against OA binds to TM2 albeit with much lower affinity than to OA, whereas it exhibits no measurable affinities to TM and TM1.

This study was part of a series investigating lay attributions for the cure of psychological problems. Three groups of students--Japanese students in Japan, Japanese students studying in England, and British students--completed a questionnaire and rated the perceived efficacy of 24 different strategies for overcoming each of 5 psychological problems: agoraphobia, depression, smoking cessation, lack of confidence, and obesity. Factor analysis of the curative strategies revealed 5 interpretable factors, the first 3 of which were Professional Help, Inner Control, and Understanding. There were numerous cultural differences between the British group and both Japanese groups in their written ratings of strategies, particularly professional help, for each psychological problem.

The concept "theory of mind", first proposed by Premack and Woodruff (1978), has drastically changed our view of the mind. In the first half of this paper, the concept's history and recent developments were reviewed. Included were studies of non-human primates, normal children, and autistic children, in addition to some philosophical discussions. The "false belief" paradigm has been successful in understanding children older than 4 years and in characterizing children with high-functioning autism. But with the paradigm alone, it is difficult to explain the "mind" of most non-human primates, younger children, and a large part of autistic children. In the second half, a theoretical discussion was made to understand early developments of mind. The theory theory and competing theories of modularity, simulation, and intersubjectivity were compared concerning the observability of mind (of self and others), the basic mechanisms for understanding the mind, the indispensability of theorizing the mind, and the need for metarepresentation in pretend plays.