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To control spoilage by lactic acid bacteria (Leuconostoc spp.) in cooked deli food, various combinations of environmental and/or intrinsic factors have been employed based on hurdle technology. Since many factors and their combinations greatly influence Leuconostoc spp. growth, this study aimed to develop a machine learning model based on the experimentally obtained growth kinetic data using extreme gradient boosting tree algorithm to quantitatively and flexibly predict Leuconostoc spp. growth. In particular, the effects of sodium acetate (0–1.5%) and glycine (0–1.5%), which are frequently used food additives in the Japanese food industry, on the growth of Leuconostoc spp. in cooked deli foods were examined with a combination of temperature (5–25 °C) and pH (5.0–6.0) conditions. The developed machine learning model to predict the number of Leuconostoc spp. over time successfully demonstrates comparable accuracy in culture media to the conventional Baranyi model-based prediction. Furthermore, while the accuracy of the prediction by the machine learning model for cooked deli foods such as potato salad, Japanese simmered hijiki, and unohana evaluated by the proportion of relative error within the acceptable prediction range was 98%, the accuracy of the conventional Baranyi model-based prediction was 89%. The developed machine learning model successfully and flexibly predicted the growth of Leuconostoc spp. in various cooked deli foods incorporating the effect of food additives, with an accuracy comparable to or better than that of the conventional kinetic-based model.

Background: Although accurately assessing self-efficacy for self-management is crucial in chronic illness care, important, there is a scarcity of validated psychometric properties in Japan. This study aimed to validate a Japanese version of the Self-Efficacy for Managing Chronic Disease (SEMCD-J) scale. Methods: Individuals with self-reported chronic diseases, symptoms, or conditions for over one year were recruited online. The SEMCD-J was translated through translation, back translation, and cognitive interviews with 15 participants. Patient Health Questionnaire-9 (PHQ-9) and Center for Disease Control and Prevention Healthy Days Core Module-4 (CDC-HRQOL-4) were used to evaluate the scale's validity. Test-retest reliability was assessed two weeks after the initial measurement. Results: Of 500 participants, 494 were analyzed and 149 were analyzed for test-retest reliability. The mean item score was 5.54 ± 2.12. Confirmatory factor analysis (CFA) with a 1-factor model showed good fit (CFI = 0.94, TLI = 0.90, RMSEA = 0.23, SRMR = 0.04). CFA with a 2-factor model showed better fit (CFI = 0.99, TLI = 0.98, RMSEA = 0.11, SRMR = 0.01). Cronbach's α of the total, Factor 1, and Factor 2 were 0.97, 0.97, and 0.92. Their item-total correlations ranged from 0.88 to 0.95, 0.93 to 0.97, and 0.92 to 0.93, respectively. Their interclass correlation coefficients were 0.63, 0.58, and 0.66, respectively. The minimum detectable change was 3.56. Pearson's correlation analyses indicated that SEMCD-J was significantly associated with PHQ-9 (r = −0.57, p

Abstract Aim This pilot examined the effect of online peer support on mental health problems among individuals with post‐acute sequelae of COVID‐2019 (PASC). Methods A single‐arm pre‐post design of online peer‐support design consisting of eight sessions of 1 h per week with three to six participants and two facilitators per group was performed. Participants were recruited from online communities, social media, and medical clinics for the PASC between May and August 2023. The degrees of depression, anxiety, loneliness, social withdrawal, and self‐esteem were measured pre‐ and post‐intervention. Participants' statements during the sessions were analyzed using thematic analyses. Results Of the 18 participants, three dropped out of the interventions, and 17 (including two participants who dropped out) completed the pre‐ and post‐intervention questionnaires. Depression severity significantly decreased in the paired t‐test and linear mixed model. The following interactions were extracted: conveying the same feelings, dealing with difficulties, showing empathy, enhancing the atmosphere, and adapting to suit health conditions. Impressions extracted from participating in the interventions included feelings of emotional support, a sense of bonding, changes in perspective, changes in behaviors or new actions through participation, inadequacy during sessions, and adverse effects associated with participation. Conclusion Online peer support may be helpful in treating depression in individuals with PASC.

Abstract The psychological distress experienced by coronavirus disease of 2019 (COVID-19) survivors after recovery from the illness is amplified by discrimination endured because of their infection status. However, the difference in the risk of facing discrimination and risk of experiencing psychological distress in the early and late waves of the COVID-19 pandemic remain unclear. This study aimed to investigate whether the risk of facing discrimination because of infection status was lower in the early or late waves and whether risk of discrimination on psychological distress was more serious in later, rather than earlier waves. We conducted two online surveys to collect data from survivors divided into two groups. The participants with scores of five or more on the Kessler Psychological Distress Scale were identified as having experienced psychological distress. The participants were identified as having experienced discrimination based on infection status if they had endured being blamed, some type of discrimination, or having themselves or their families maligned. The timing of infection was split into infected during early waves of the pandemic for 2021 participants and infected during later waves of the pandemic for 2022 participants. Modified Poisson regression analyses were performed using experiences of discrimination as criteria and timing of infection as predictors. Modified Poisson regression analyses were further performed using the presence of psychological distress as a criteria and experiences of discrimination and timing of infection as the criteria, in addition to interaction effect of these es. The data of 6010 participants who were infected in early waves and 5344 participants who were infected in later waves were analyzed. The risks of being blamed, some forms of discrimination, and participants and their families being maligned were significantly lower in the group who were infected in later waves than those infected in earlier waves. Experiences of discrimination were highly associated with psychological distress in those infected in later waves than those infected in earlier waves, while only being blamed showed a significant association. Risk of discrimination was found to be lower in those infected in later waves, whereas risk of discrimination on psychological distress was shown to be more serious in those infected in later waves. Therefore, we submit that it is more important to support COVID-19 survivors who face discrimination, than it is to attempt to decrease the current discriminatory climate caused by the COVID-19 pandemic.

Abstract Aim The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health‐related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants. Methods The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6‐month follow‐up (T3). A mixed model for repeated‐measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's d. Results The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [t = 3.20, p = 0.001]; intended behavior [t = 8.04, p

Abstract Objective Robust instruments to evaluate the ability of trauma-informed care among healthcare workers need to be developed, as this would help the implementation of trauma-informed care to prevent re-traumatization of patients. This study aims to assess the reliability and validity of the Japanese version of the Trauma-Informed Care (TIC) Provider Survey. A total of 794 healthcare workers were surveyed using a self-administered questionnaire, including the TIC Provider Survey, and six measures that were considered to be correlated with it. We calculated the Cronbach’s alpha coefficient to investigate the internal consistency of each category of the TIC Provider Survey (knowledge, opinions, self-rated competence, practices, and barriers). Spearman’s rank correlation coefficients were used to investigate the correlation between each category of the TIC Provider Survey, and other measures of construct validity. Results Cronbach’s alpha coefficients of each category of the TIC Provider Survey were 0.40 (Knowledge), 0.63 (Opinions), 0.92 (Self-rated competence), 0.93 (Practices), and 0.87 (Barriers). The Spearman’s rank correlation coefficients were small. We confirmed the reliability of the acceptable levels and examined the validity of modest or unacceptable levels of the Japanese version of the TIC provider survey among Japanese workers in a healthcare setting.

Abstract Evidence demonstrating the association of preexisting psychiatric disorders with post-COVID-19 is limited. We aim to investigate the association using larger sample sizes and more extended postinfection periods than previous studies. A total of 6015 (response rate = 77.5%) COVID-19 survivors were surveyed using a self-administered questionnaire from July to September 2021. Poisson regression analysis with robust error variance was performed to estimate post-COVID-19 prevalence ratios (PRs) with or without preexisting psychiatric disorders. Participants with preexisting psychiatric disorders numbered 1067 (17.7%), and with post-COVID-19 were 2149 (35.7%). Post-COVID-19 PR with preexisting psychiatric disorders was 1.09 (95% CI 1.02–1.18, p = 0.013). The interaction between preexisting psychiatric disorders and postinfection periods was significant (p for interaction

Abstract Background Although negative attitudes are known to develop with experiences of COVID-19 infection, it remains unclear whether such attitudes contribute to depression and anxiety as sequelae of COVID-19. We aimed to investigate the relationships between attitude towards COVID-19 infection and post-COVID-19 depression and anxiety. Methods A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following attitude strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings. Results A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading infection to others and depression or anxiety. Conclusion Negative attitudes, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Further studies confirming whether countermeasures for preventing or decreasing the negative attitude towards COVID-19 infection mitigate these symptoms are needed.

Abstract Spinal and bulbar muscular atrophy (SBMA) is a polyglutamine‐mediated neuromuscular disease caused by a CAG repeat expansion in the androgen receptor (AR) gene. While transcriptional dysregulation is known to play a critical role in the pathogenesis of SBMA, the underlying molecular pathomechanisms remain unclear. DNA methylation is a fundamental epigenetic modification that silences the transcription of various genes that have a CpG‐rich promoter. Here, we showed that DNA methyltransferase 1 (Dnmt1) is highly expressed in the spinal motor neurons of an SBMA mouse model and in patients with SBMA. Both genetic Dnmt1 depletion and treatment with RG108, a DNA methylation inhibitor, ameliorated the viability of SBMA model cells. Furthermore, a continuous intracerebroventricular injection of RG108 mitigated the phenotype of SBMA mice. DNA methylation array analysis identified hairy and enhancer of split 5 (Hes5) as having a CpG island with hyper‐methylation in the promoter region, and the Hes5 expression was strongly silenced in SBMA. Moreover, Hes5 over‐expression rescued the SBMA cells possibly by inducing Smad2 phosphorylation. Our findings suggest DNA hyper‐methylation underlies the neurodegeneration in SBMA.

Objectives: This study aimed to investigate workplace measures implemented in response to COVID-19 during the outbreak in Japan from T1 (March 2020) to T2 (May 2020), focusing on the disparities by company size and industry. Methods: A longitudinal study was conducted using a cohort of full-time employees, starting with the baseline online survey on March 19–22, 2020 (T1). An online follow-up survey was conducted on May 22–26, 2020 (T2). The McNemar test was used to assess differences between T1 and T2 in the proportion of implemented measurements. Analysis of covariance was performed to compare the differences in the number of implemented measures across groups classified by company size or industry, adjusting for sex and age. Results: A total of 1,032 participants (response rate: 72.6%) completed the follow-up questionnaire. The final analytic sample comprised n=987. The workplace measures involving the delivery of information on COVID-19 were 88.4% at T2, which significantly increased from T1 (increased 8.6%, p

On a mid-summer day, a middle-aged man with severe pectus excavatum died unexpectedly in his bed one to two weeks after the onset of dyspnea, which had been followed by bedrest and restricted drinking and eating. Computed tomography (CT) and autopsy demonstrated an eccentrically hypertrophied heart (weight 600 g), which was displaced, rotated, and occupied a large space in the left thoracic cavity due to a deeply depressed sternum. The pulmonary artery was bent and extended across the left thoracic cavity to the right hilum. Anatomical abnormalities in the heart and pulmonary artery obstructed the right ventricular outflow, dilated the right ventricle, and induced restrictive hemodynamics. The left lung was atelectatic due to compression by the heart, while the right lung was enlarged and partly expanded to the left upper thoracic cavity. Histology confirmed pulmonary infarctions at different stages in the upper and middle lobes of the right lung. Restrictive hemodynamics promoted right ventricular dilation, causing spatial limitation of the left thoracic cavity. It is presumed that diastolic right ventricular dysfunction would have rapidly progressed along with pericardial effusion (150 mL), and intra-cardiac thrombi were formed due to stagnation, arrhythmia, bedrest, and dehydration. Consequently, the thrombi would be repetitively embolized in the right lung, thereby aggravating respiratory dysfunction and right-sided heart failure. This is the first autopsy report on the unexpected death of an untreated adult patient of pectus excavatum, with systematic pathophysiological analyses on the basis of the postmortem CT, macroscopic, and microscopic findings.

A middle-aged woman with unrepaired congenital heart disease died suddenly from asphyxia due to hemoptysis. Postmortem computed tomography, autopsy, and histological examinations revealed the presence of an aneurysm and dissection of the right main pulmonary artery with intraluminal thrombus. The observed congenital heart diseases included patent ductus arteriosus, ventricular septal defect, and right-sided aorta. These anomalies predisposed her to left to right shunt, resulting not only in pulmonary artery hypertension and right ventricular hypertrophy, but also pulmonary artery aneurysm and dissection. Histological examinations confirmed the presence of medial degeneration and elastic fiber disruption, as well as muscular hyperplasia of the vasa vasorum and follicular infiltration of the lymphocytes and plasma cells in the main pulmonary artery. These changes may have contributed to the pathogenesis of the aneurysm and dissection through the induction of arterial wall fragility. Histology demonstrated, in addition to findings of pulmonary hypertension, such as plexiform lesions, medial-intimal hyperplasia, and veno-occlusive lesion, unique findings related to multiple dissections of the intra-pulmonary elastic arteries, which may have caused the lethal hemoptysis.

Introduction: Arachnoid cyst, a congenital extra-axial lesion, has been implicated in osteolytic lesion and subdural hematoma. Cerebral venous thrombosis occasionally induces subdural hematoma. Case report: A man in his mid-forties with congenital bone defects was found dead after recumbency for months. Autopsy disclosed acute subdural hemorrhage and intracranial hemorrhage that infiltrated to the right neck through large occipital bone defects. CT demonstrateda high density area in the supratentorial venous sinuses and an infratentorial low-density mass adjacent to the bone defects, suggesting cerebral venous thrombosis and arachnoid cysts, respectively. Conclusion: This is the first report on death due to nontraumatic extracranial and subdural hemorrhage derived from cerebral venous sinuses and possibly associated with arachnoid cysts and cerebral venous thrombosis.

Background: Trauma-informed care is recommended to avoid the inadvertent retraumatization of patients by health care providers. Psychometric evaluation of trauma-informed care instruments is needed. The Japanese version of the Attitudes Related to Trauma-Informed Care (ARTIC-10) Scale has not yet been psychometrically validated., Objective: The study's objective was to examine the reliability and validity of the ARTIC-10., Methods: This psychometric study of the ARTIC-10 compared with five other scales associated with attitudes related to trauma-informed care used a cross-sectional survey design conducted in November 2020 with a convenience sample of Japanese physicians and nurses recruited from an internet research agency. Participants completed self-administered questionnaires including the (a) ARTIC-10; (b) the Japanese version of the Moral Sensitivity Questionnaire 2018; (c) Patient Health Questionnaire-9; (d) Generalized Anxiety Disorder-7; (e) Stress Underestimation Beliefs; and (f) Negative Acts Questionnaire-Revised. Cronbach's α measured reliability internal consistency, and construct validity was measured by Spearman's rank., Results: A total of 794 physicians and nurses completed the surveys. Cronbach's α value of ARTIC-10 was 0.56. Higher scores of ARTIC-10 were positively and significantly correlated with Moral Sensitivity Questionnaire 2018 and negatively and significantly correlated with other scales (r =-.12 to .30)., Conclusion: This study found only modest internal consistency and construct validity of the Japanese version of ARTIC-10 in physicians and nurses. Further study is needed to identify factors that affect the reliability and validity of this Japanese scale to improve its psychometric properties., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Trauma Nurses.)