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BackgroundDuring the COVID-19 pandemic, many people lacked access to group fitness opportunities due to elevated risk of infection, lockdown, and closure of exercise facilities. Additionally, many people experienced higher than average rates of mental health burden (eg, anxiety and stress). To help address these needs, an existing in-person community exercise class, taught by a faculty member from an academic medical center, transitioned to an online synchronous (OS) physical fitness class via the Zoom (Zoom Video Communications) videoconferencing platform. As such, the instructor advertised the OS fitness classes through an existing email list of community members and university faculty, staff, students, or alumni email listservs. This telewellness intervention sought to create a sense of community, build social support, and promote physical and mental wellness during the COVID-19 pandemic.ObjectiveOur aim was to determine the perceived mental and physical health benefits of attending an OS fitness class for community members, including health care workers. We also assessed the use and functionality of related technologies necessary for delivering and attending the fitness classes.MethodsAn online survey questionnaire was created and tested to collect quantitative and qualitative data for an exploratory study. Data were collected to evaluate the fitness class, motivation, perceived health benefits, and related technologies. A convenience sample of people who had participated in the OS fitness classes was recruited for this study via an emailed recruitment flyer.ResultsA total of 51 participants accessed and completed the survey questionnaire. Survey participants consisted of 28 of 51 (55%) with a university affiliation, 17 of 51 (33%) with no university affiliation, and 6 of 51 (12%) who declined to state. The largest group of participants reporting full-time employment (18/51, 35%) also reported university affiliation with the academic medical center. In this group, 13 of 51 (25%) participants reported full-time employment, university affiliation, and doctoral degrees. High overall exercise class satisfaction was observed in the survey responses (mean 4.0, SD 1). Data analyses revealed significant perceived value of both mental and physical health benefits as motivating factors for participating in the OS fitness class. Challenges were identified as not being able to receive individual feedback from the instructor and the inability of some participants to see if they were in sync with the rest of the class.ConclusionsResults provide preliminary support for the use of online videoconferencing fitness platforms to promote wellness and facilitate group exercise in the community during times of high infection risk. Future studies should continue to explore perceived benefits, mental and physical wellness, best practices, and the design of related technologies.

Rhabdoid tumor of the kidney (RTK) is a rare but aggressive cancer that occurs in infancy and early childhood.[1] Current treatment protocols for RTK included a combination of surgery, radiation therapy, and chemotherapy, however the prognosis remains poor with a 5-year survival between 20-25%.[1] Therefore, the need to develop therapeutic strategies to treat RTK is still greatly unmet. High dependence on glycolysis by cancer cells, known as the Warburg effect [2], demonstrates a weakness that can be harnessed to target cancer cells and provides rationale for exploring antiglycolytic approaches for targeting cancer cells. Glyceraldehye-3-phosphate dehydrogenase (GAPDH) is an essential enzyme within the glycolysis pathway (Figure 1) making GAPDH a potential therapeutic target for inhibiting tumor growth and progression [3]. Aspergillus oryzae is a probiotic fungus that is used in the production of Japanese fermented food, including soybean paste and soy sauce. Heptelidic acid (HA) is a sesquiterpene lactone derived from A. oryzae and has recently been shown to exert antitumor effects against multiple cancers including pancreatic and extraintestinal melanomas. [4,5] HA is a specific and irreversible inhibitor of GAPDH.[6] Its GAPDH inhibition activity is shown to contribute to its antitumor effects. [4,5]. The purpose of this study is to assess the therapeutic potential of HA on RTK. This study gives the first evidence that HA shows cytotoxicity in RTK and provides rationale to ultimately develop a therapy using HA for RTK.

Abstract Studies on the compounds of aromatic oils and their effects on psychophysiological changes in humans are often conducted separately. To obtain better validation, a suitable protocol is needed that can be extrapolated to large-scale olfactory stimulation experiments. Unfortunately, this type of study is still rarely performed. In this situation, we propose a randomized crossover pilot study on olfactory stimulation with aromatic oils in relation to changes in psychophysiological activity by focusing on white musk aromatic oil due to its popularity in the community. Chemical profiling by TDU-GC-MS (thermal desorption gas chromatography/mass spectrometry) was performed to understand the compounds of the aromatic oils presented. To understand the changes in the participants’ impressions and mood states, POMS 2 (Profile of Mood States 2nd Edition) and VAS (Visual analogue scale) were performed in addition to physiological evaluation by using EEG (electroencephalogram), ECG (electrocardiogram) and salivary amylase measurements. The proposed pilot study showed “gorgeous”, “sweet”, and “like” impression toward white musk aromatic oil under VAS evaluation. Mood evaluation under POMS 2 variables such as Fatigue-Inertia (FI), Tension-anxiety (TA) and TMD (total mood disturbance) were significantly decreased under white musk aromatic oil inhalation. Under current protocol, we can also see the changes in autonomic activity and brain activity during olfactory stimulation. This pilot study could be the first step towards a larger sample size experiment on olfactory stimulation. This experiment has been registered to UMIN Clinical Trials Registry with register ID : UMIN000051972 on 24/08/2023.

Abstract To report the efficacy of anamorelin in patients with colorectal and gastric cancer with cachexia and in those receiving systemic chemotherapy. We retrospectively collected real-world data from patients diagnosed with colorectal and gastric cancers experiencing cachexia who were treated with anamorelin. We evaluated the efficacy of treatment by measuring the improvements in appetite and body weight (BW) gain. Between June 2021 and October 2022, 43 cancer patients with cachexia—23 with gastric cancer and 20 with colorectal cancer—were treated with anamorelin. Median observation period was 7.3 months. The participants were 25 males with median age of 71 years and median BMI of 19.7. The ECOG PS distribution was 4, 33, 6 for grades 0, 1, and 2, respectively. Seven patients received supportive care only, while 36 received anamorelin with chemotherapy. Thirty-four had received chemotherapy previously (≤ 2 regimens) and nine had received ≥ 3 regimens. Median anamorelin treatment duration was 2.8 months; overall survival was 7.3 months. After 3 weeks, 24 experienced appetite improvement and 21 gained weight; after 12 weeks, 20 experienced appetite improvement and 15 gained weight. Multivariate analysis showed that anamorelin treatment before second-line chemotherapy and colorectal cancer correlated with appetite improvement and weight gain at 3 weeks. In the univariate analysis, anamorelin treatment before second-line chemotherapy correlated with weight gain at 12 weeks and with improved overall survival in patients with weight gain at 12 weeks. Early anamorelin treatment contributes to appetite improvement and BW gain in colorectal and gastric cancers with cachexia.

Cryptococcal meningitis is one of the most common fungal meningitis in adults and causes disabling morbidity and mortality worldwide. The occurrence of postinfectious inflammatory response syndrome during cryptococcal meningitis treatment presents a diagnostic challenge. This time course seems paradoxical because patients show worsening symptoms and imaging findings. However, laboratory data improve with antifungal treatments. Herein, we present a case of an older woman diagnosed with cryptococcal meningitis who later developed postinfectious inflammatory response syndrome. Despite the initial antifungal treatment and improvements in cerebrospinal fluid analysis results, the patient's neurological condition deteriorated; imaging findings worsened. Magnetic resonance imaging at the time of postinfectious inflammatory response syndrome showed more prominent meningeal enhancement and brain edema, consistent with postinfectious inflammatory response syndrome, combined with negative repeat cerebrospinal fluid cultures for cryptococcal species. This case highlights the importance of considering postinfectious inflammatory response syndrome when patients with cryptococcal meningitis show clinical worsening during treatment. Prompt corticosteroid therapy significantly improves patient outcomes. Radiologists and clinicians should be aware of postinfectious inflammatory response syndrome to provide appropriate therapeutic options and improve prognosis in patients with cryptococcal meningitis.

Postpolypectomy syndrome (PPS), also known as postpolypectomy coagulation syndrome or transmural burn syndrome, is a rare complication following colonic polypectomy characterized by abdominal pain, fever, and leukocytosis. Herein, we present a case of a patient in his 70s who developed abdominal pain and fever after a polypectomy. He was diagnosed with PPS, which rapidly progressed to septic shock necessitating left hemicolectomy. Pathological findings confirmed intestinal necrosis and severe electrocoagulation injury. Despite surgical intervention, the patient succum to multiple complications. While usually mild, approximately 0.07% of PPS cases require hospitalization due to localized peritonitis from electrocautery. Conservative management is effective, though severe complications are rare. Despite its generally favorable prognosis, our case highlights rapid progression to fatal septic shock postsurgery. Recognition of PPS is crucial, particularly in patients with abdominal pain postpolypectomy, as it can lead to life-threatening outcomes.

Societal Impact Statement The iconic Yoshino cherry tree in Japan is experiencing shifts in its blossom timing due to climate warming. To develop a genetically informed predictive model for bud dormancy release, we examined seasonal gene expression in Yoshino cherry trees at three different locations. Our experiments, coupled with the analysis of DORMANCY‐ASSOCIATED MADS‐box (DAM) genes, highlighted DAM4 as the most reliable indicator for the rate of bud dormancy release. Our study demonstrated that seasonal gene expression profiles serve as a valuable indicator for forecasting the timing of dormancy release, benefiting Japanese traditions and providing insights into the biological impacts of climate change. Summary The Yoshino cherry tree Cerasus × yedoensis ‘Somei‐yoshino’ stands out as an iconic springtime symbol in Japan. For the Yoshino cherry trees to bloom in the spring, dormant buds must undergo a period of exposure to low temperatures, allowing them to break dormancy. Key genes related to dormancy release, known as DORMANCY‐ASSOCIATED MADS‐box (DAM), have been extensively studied. However, it remains unclear how these genes function in natural environments to regulate the timing of bud dormancy release. To develop a genetically informed predictive model for bud dormancy release, we explored seasonal changes in genome‐wide gene expression profiles in the Yoshino cherry trees at three distinct sites in Japan. Five distinct genome‐wide transcription profiles, subjectively named as modes—early summer, summer, autumn, winter, and spring—were identified, with the winter and spring modes observed when the daily mean temperature was below approximately 10°C. Our experiments of bud dormancy release, along with the assessment of expression profiles of DAM genes, have revealed that among the six DAM genes, DAM4 expression profile is the most indicative of the rate of bud dormancy break. Our estimates suggest that, on average, the tree needs to be exposed to temperatures below 10.1°C for 61.1 days to suppress DAM4 expression to the threshold required for bud dormancy release. Our projections for the timing of bud dormancy release indicated a delay of approximately 2.3 days per decade from 1990 to 2020. Our study demonstrated that gene expression serves as a valuable indicator for forecasting the timing of dormancy release.

Abstract Aims/Introduction The clinical significance of age‐related biomarkers in patients with diabetes has not been fully elucidated. In this study, we aimed to establish models to predict the progression of aging in patients with diabetes using biomarkers. Materials and Methods This single‐center, retrospective cohort study included 115 Japanese patients with diabetes aged ≥60 years. Age‐related adverse health outcomes were defined as emergency hospitalization, any increase in the level of nursing care certification, admission to a nursing home or death. The associations of age‐related biomarker levels (adiponectin, growth differentiation factor 15 [GDF15], C‐X‐C motif chemokine ligand 9 and apelin) and clinical indicators with age‐related adverse health outcomes were evaluated. Factors that predominantly influenced the occurrence of age‐related adverse health outcomes were explored using the Cox proportional hazards model. Results The mean age of the 115 participants was 73 years, 50.6% were men, the mean body mass index and hemoglobin A1c level were 25.3 kg/m2 and 9.79%, respectively. There were 26 age‐related adverse health outcomes during the study period (median 1.93, range 0–4.65 years). In a model combining clinical indicators and biomarkers, including the Barthel Index, GDF15 and adiponectin, the occurrence of age‐related adverse health outcomes was found to be significantly associated with GDF15 and Barthel Index. The group with both GDF15 and adiponectin levels higher than the median proved to be significantly higher than the group with both lower. Conclusions The measurement of GDF15 and adiponectin levels and the Barthel Index might be useful for predicting age‐related adverse health outcomes in patients with diabetes.

Abstract Background Anorexia of aging (AA) is a condition in older adults that includes loss of appetite and reduced food intake. There is a lack of detailed analysis of the potential influence of educational initiatives in addressing AA. This study aimed to clarify the current state of knowledge and practice regarding AA and its relationship with the availability of continuing education opportunities among Japanese healthcare professionals involved in treating older patients. Methods The Japan Geriatrics Society and the Japanese Association on Sarcopenia and Frailty, in collaboration with the Society on Sarcopenia, Cachexia, and Wasting Disorders, conducted an online questionnaire survey on the knowledge and practices in AA detection and management. Questions were asked in the areas of demographics, screening, definition/diagnosis, treatment, referral, and awareness, with those who ‘participate’ in continuing education and professional development programmes in nutrition for their patients were classified as the ‘education group’ and those who ‘do not participate’ were classified as the ‘non‐education group’. The results for each question were compared. Results The analysis included 870 participants (physicians, 48%; registered dietitians, 16%; rehabilitation therapists, 14%; pharmacists, 12%; nurses, 6%; and other professionals, 5%). The education group (45%) was more likely than the non‐education group (55%) to use the Mini‐Nutritional Assessment Short Form (MNA‐SF) to screen for AA (49% vs. 27%) and less likely not to use a validated tool (33% vs. 47%). More participants used evidence‐based tools and materials for AA care (38% vs. 12%), and fewer used their clinical judgement (23% vs. 35%) or were unaware of the tools and materials (9% vs. 23%). The proportion using a team of professionals experienced in AA care were 47% and 24% of the education and non‐education groups, respectively. By profession, few physicians used specific validated tools and resources for AA screening and treatment. More than half of the dietitians used the MNA‐SF regardless of training opportunity availability. Regarding professional availability and team use, differences in educational opportunities were particularly large among physicians. Conclusions Participation in continuing education programmes on nutrition is associated with responsiveness to AA screening and treatment and the availability of a team of professionals, which may influence the quality of AA treatment. Nutrition education may support the confidence of healthcare professionals working with older adults in AA with complex clinical signs and encourage them to conduct evidence‐based practice.

Objectives: No detailed country-specific cross-sectional studies have been reported on endoscopic plastic surgery. For the first time, the Japan Society of Plastic and Reconstructive Surgery conducted a nationwide survey to ascertain the status of endoscopic procedures in plastic surgery in Japan. This article discusses the current situation based on this survey findings. Methods: A questionnaire survey was conducted among 566 Japan Society of Plastic and Reconstructive Surgery-certified training facilities regarding the status of endoscopic plastic surgery procedures completed between January 2020 and December 2021. Results: Of the 143 institutions, 33 conducted endoscopic plastic surgery operations during the period, for a total of 753 procedures. Two hundred sixty-two procedures were conducted in the craniomaxillofacial region at 19 institutions and 491 in the extremities and trunk region at 19 institutions. Five intraoperative accidents were recorded, but no cases were moved to traditional surgery based on intraoperative choices. Sixteen postoperative problems were reported, but there were no reports of fatalities. Conclusions: The number of endoscopic plastic surgery cases is anticipated to rise, and this nationwide survey will contribute to this by offering useful data and insights.

Abstract Somatic hypermutations (SHMs) in the variable region (VH) of the immunoglobulin heavy chain (IgH) gene are common in diffuse large B‐cell lymphoma (DLBCL). Recently, IgH VH SHMs have become known as immunogenic neoantigens, but few studies have evaluated the prognostic impact of the frequency of VH SHMs in DLBCL. The BIOMED‐2 protocol is the gold standard polymerase chain reaction (PCR) for clonality analysis in lymphoid malignancies, but can produce false negatives due to the presence of IgH VH SHMs. To overcome this problem, three primer sets were designed for the three framework regions (FR1, FR2, and FR3). We evaluated the predictive value of this PCR pattern in patients with DLBCL. To evaluate the prognostic impact of complete detection of the clonal amplifications (VHFR1–JH, VHFR2–JH, and VHFR3–JH) in the BIOMED‐2 protocol, we retrospectively analyzed 301 DLBCL patients who were initially treated with anthracycline‐based immunochemotherapy. Complete detection of the FR1 to FR3 primer‐based IgH VH PCR patterns in the BIOMED‐2 protocol was associated with low frequency of VH SHMs (p