Kinematic and Kinetic Effects of 10-Degree Coronal Wedge Floors on Lower Limb Joints During Static Standing: An Upright Multidetector-Row CT Study.

Background: Coronal wedge insoles are commonly prescribed to mitigate musculoskeletal disorders, yet their static-standing kinematic and kinetic effects on lower extremity joints remain insufficiently understood.

Methods: This cross-sectional experimental study included 15 healthy older adults (mean 64.9 ± 6.

Evaluating Telepsychiatric Assessment Satisfaction in Children and Adolescents With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder and Their Caregivers: Randomized Controlled Trial.

Background: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often face structural and psychological barriers in accessing medical care, including economic costs, long wait times, and stress of attending new medical environments. The COVID-19 pandemic accelerated the adoption of telehealth services to overcome these challenges. However, few studies have assessed the satisfaction levels of children and adolescents diagnosed with neurodevelopmental disorders and their caregivers when they use telepsychiatry, particularly in Japan.

Stereotactic Step-by-step Dissection of the Anterior Transpetrosal Approach: A Three-dimensional Photogrammetry-based Educational Tool for Neurosurgeons.

Skull base surgery requires precise spatial recognition; however, existing educational tools remain limited. To address this issue, we developed a step-by-step stereotactic three-dimensional anatomical model of the anterior transpetrosal approach using digital photogrammetry. Cadaveric dissection was subsequently performed in 17 steps, of which 10 were reconstructed into three-dimensional models.

[Turnover intentions of public health nurses after responding to COVID-19: A comparison with 10 years ago (A report of the Committee on Public Health Nursing 2022/2023 survey)].

Objectives　This study aimed to determine how turnover intentions among public health nurses have changed following their coronavirus disease 2019 (COVID-19) response compared to 10 years ago, using propensity score matching.Methods　As part of the Committee on Public Health Nursing's 2022/2023 activities, we conducted a repeated cross-sectional survey among public health nurses based on the Job Demands-Resources Model, a theoretical framework for turnover intentions. We collected cross-sectional observational data from periods before and after the COVID-19 outbreak.

Hot spring and sauna use for improving blood lipid profiles: A systematic review and expert consensus on efficacy and recommendations.

Objectives: Dyslipidemia is a significant risk factor for cardiovascular disease. Traditional treatments often focus on pharmacological interventions; however, alternative therapies, such as hot spring and sauna use, have recently gained attention because of their potentially beneficial effects on lipid profiles and cardiovascular health.

Design And Setting: This systematic review aimed to synthesize current evidence on the efficacy of hot spring and sauna use, alone or combined with exercise therapy, in improving blood lipid profiles, with a focus on mechanisms, benefits, and limitations.

Age and Health Status Benefits Following Initiation of Atrial Fibrillation-Specific Treatments.

Background: Atrial fibrillation (AF) is managed with various strategies, including rate and rhythm control, to improve patients' health status. Although its incidence increases with age, how age affects health status improvements following AF treatment remains unknown.

Methods: Using data from a multicenter registry for outpatients with newly recognized AF, baseline and 1-year health status was assessed with the Atrial Fibrillation Effect on Quality-of-life quesTionnaire (AFEQT).

The surgical burden score: a novel continuous metric to predict postoperative complications after hepatectomy for hepatocellular carcinoma.

Background: No validated model incorporates surgical parameters for complication risk in hepatocellular carcinoma (HCC) resection. We evaluated a novel Surgical Burden Score (SBS), integrating adjusted blood loss (aBL; mL/kg) and operative time (hours) via a Pythagorean formula, and developed an SBS-based model to predict complications.

Methods: Patients undergoing curative-intent hepatectomy for HCC(2000-2023) were identified from an international database.

Pre-event psychiatric states predict trajectories of event-related distress in Japan.

Background: Recent time-dependent analyses of stress-related disorders have identified heterogeneity of trajectories and their modifying factors. While psychiatric patients are vulnerable to stress events, it is unclear how psychiatric conditions in the general population modulate subsequent event-related distress trajectories.

Methods: Using a longitudinal online survey from before the COVID-19 pandemic to post-pandemic follow-ups (n = 3815 Japanese adults) and a latent growth mixture model, we identified four trajectories of pandemic-related stress symptoms: resilient, chronic, mild chronic, and early response.

To fuse or not to fuse: surgical strategies for recurrent lumbar disc herniation from a 16-nation study.

Objective: Variations exist among surgeons in the treatment of recurrent lumbar disc herniation (LDH), generating major issues in decision-making models. The authors aimed to identify international nuances in surgical treatment patterns, highlight the differences in responses in each country group and different treatment trends across countries, and identify factors that influence surgical decisions.

Methods: An online survey with preformulated answers was submitted to 292 orthopedic surgeons and 223 neurosurgeons from 16 countries regarding 3 clinical vignettes (recurrence without low back pain, recurrence with severe low back pain, and recurrence with 2-level disc disease).

Practical Use of Mixed Reality for Transfacial Pinning in Monobloc Advancement for Syndromic Craniosynostosis.

Mixed reality (MR) enables real-time overlay of virtual anatomic structures in the surgical field and has potential applications in craniofacial surgeries. Although early monobloc advancements have benefited from transfacial pinning, the technique remains challenging owing to the limited safe insertion area and orbital injury risk. The authors processed DICOM-format computed tomography images for bone segmentation and added a rod representing the optimal pin insertion trajectory.

Loss-Prone HLA Class I Alleles Inform Outcomes of Early Hematopoietic Cell Transplantation in Acquired Aplastic Anemia.

HLA class I allele loss in acquired aplastic anemia (AA) represents an immune escape from the T cell-mediated pathogenesis. We investigated the impact of loss-prone HLA alleles on the hematopoietic cell transplantation (HCT) outcomes using registry data of 875 Japanese patients with acquired AA. HLA associations were evident exclusively among 399 patients who received HCT within 1 year of the diagnosis, consistent with the predominance of HLA loss in this group.

Efficacy and Safety of Voretigene Neparvovec in -Retinopathy: Results of a Phase III Trial in Japan.

Purpose: We report the efficacy and safety of voretigene neparvovec (VN) as an adeno-associated viral vector-based gene therapy for Japanese patients with inherited retinal dystrophy caused by biallelic pathogenic variants (-retinopathy).

Design: Open-label, single arm, phase III clinical trial.

Participants: Four subjects were recruited based on the following criteria: (1) a clinical and molecular genetic diagnosis of -retinopathy; (2) age ≥4 years; (3) a best-corrected VA (BCVA) worse than 20/60 or a visual field (VF) <20° by a III4e isopter or equivalent; and (4) sufficient viable retinal cells by OCT or ophthalmoscopy.

Vitreous Hemorrhage Following Blunt Ocular Trauma by a Cat's Forepaw: A Case Report and Literature Review.

Traumatic vitreous hemorrhage is most commonly associated with sports injuries or accidental falls. We report an exceptionally rare case of vitreous hemorrhage presumed to result from blunt trauma inflicted by the forepaw of a domestic cat. A 50-year-old man presented with blurred vision and ocular pain in his right eye after being struck by his pet cat.

Predictors of poor outcomes after posterior decompression surgery in patients with degenerative cervical myelopathy.

Study Design: Retrospective multicenter study.

Objectives: To identify predictors associated with failure of neurological improvement after posterior decompression surgery for degenerative cervical myelopathy (DCM).

Setting: 17 institutions in Japan.

Decentralized pandemic response and health equity: an analysis of socioeconomic disparities in COVID-19 mortality in Japan.

Objectives: Global data often link greater socioeconomic deprivation to higher COVID-19 mortality. However, whether decentralized governance can mitigate this disparity by enabling tailored, equitable local responses remains unclear. We assessed whether Japan's decentralized pandemic response moderated the association between area-level socioeconomic deprivation and COVID-19 mortality across municipalities.

Noise-induced transitions in random Pomeau-Manneville maps.

We introduce randomness to Pomeau-Manneville (PM) maps by incorporating dichotomous multiplicative noise that alternates between dynamics with an attracting and a repelling fixed point. We characterize the dynamical behavior by measuring the separation of two nearby orbits. Controlling the probability of selecting the repelling PM map, we find two noise-induced transitions.

Sodium Polystyrene Sulfonate and Heart Failure Risk: A Comparative Study With Calcium Polystyrene Sulfonate.

Aim: Sodium polystyrene sulfonate (SPS) is one of the classic potassium-binding agents that remains commonly used in the treatment of hyperkalaemia. However, the potential concern about its sodium load has not been fully investigated. In this study, we evaluated the association between SPS initiation and heart failure (HF), compared with calcium polystyrene sulfonate (CPS).

Pareidolic Illusions and Associated Lower Regional Gray Matter Volumes in Community-Dwelling Older Adults Without Dementia: The Arakawa 65+ Study.

Objectives: Pareidolic illusions involve perceiving meaningful objects in ambiguous or visually complex stimuli. Although seen in dementia, their presence and associated neuroanatomical basis in older adults without dementia remain unclear. Investigating these illusions in this population may reveal early neurodegenerative changes preceding overt dementia.

Development of Keap1-Nrf2 Protein-Protein Interaction Inhibitor Activating Intracellular Nrf2 Based on the Naphthalene-2-acetamide Scaffold, and its Anti-Inflammatory Effects.

Nuclear factor erythroid 2-related factor 2 (Nrf2) and Kelch-like ECH-associated protein 1 (Keap1) axis is an attractive therapeutic target for various intractable diseases. Although protein-protein interaction inhibitors against Keap1-Nrf2 have been developed over the past decade, more structural expansion is needed to improve efficacy. In this article, several candidate compounds are designed and synthesized as novel Nrf2 activators and their intracellular Nrf2-activating effects are evaluated.

B cell depletion as a therapeutic strategy for neuromyelitis optica spectrum disorder: rationale, evidence, and challenges.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disorder of the central nervous system that predominantly affects the spinal cord and optic nerves. Aquaporin-4 antibodies have been identified as a distinguishing biomarker of NMOSD, allowing for differentiation from multiple sclerosis and other mimicking neurological conditions. Targeted monoclonal antibody treatments are evolving based on an improved understanding of the pathophysiology underlying NMOSD.

Effectiveness of posaconazole as primary prophylaxis in allogeneic hematopoietic stem cell transplantation.

We retrospectively analyzed the effectiveness of posaconazole (tablet and infusion formulations) and its correlation with blood concentration in preventing invasive fungal infections (IFIs) in 360 patients who underwent allogeneic hematopoietic stem cell transplant (allo-HSCT) between 2010 and 2023. A total of 61 patients received posaconazole, 102 received micafungin, and 197 received fluconazole for primary prophylaxis. By day 100 post-transplant, the cumulative incidence of IFIs was significantly lower with posaconazole (5.

The tale of donanemab: God is in the details.

Alzheimer's disease is a major cause of dementia, that affects approximately 7-8% of people aged 65 years and older (according to WHO & Alzheimer's Disease International) and thus is a major concern in public health world-wide. This review chronicles the foundational research and translational trajectory leading to the development of donanemab, a monoclonal antibody targeting pyroglutamyl amyloid-β (Aβ3pE-X) peptides, recently approved for the treatment of early Alzheimer's disease (AD). We trace a 30-year arc from the biochemical identification of Aβ species to the recognition of Aβ3pE-42 as a predominant pathological isoform in AD and Down syndrome brains-a fact still underrecognized among clinicians and researchers.

Memory-induced slow relaxation in the generalized Langevin equation.

We investigate the relaxation dynamics of the generalized Langevin equation (GLE) with an exponential memory kernel. Our analysis reveals that the relaxation time to equilibrium scales inversely with the square of the memory decay rate λ, i.e.