Japanese Society of Toxicology Acta Medica Okayama 0388-1350 51 10 2026 Integration of QSAR modeling and in vitro validation for identification of food-derived Nrf2 activators against arsenic-induced toxicity 533 547 EN Ngo Thanh Huong Laboratory of Toxicology, Division of Pharmaceutical Sciences, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Susumu Kodama Laboratory of Toxicology, Division of Pharmaceutical Sciences, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Atsushi Ono Laboratory of Toxicology, Division of Pharmaceutical Sciences, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Arsenic exposure is a major public health concern due to its toxicity and carcinogenicity, largely mediated by oxidative stress, and activation of the Nrf2 signaling pathway is considered a promising strategy to mitigate such damage. In this study, a quantitative structure–activity relationship (QSAR) model was developed to identify potential Nrf2 activators from food-derived compounds. Machine learning algorithms, including Random Forest (RF), Support Vector Machine (SVM), Linear Discriminant Analysis (LDA), and a stacking model, were developed and optimized. The optimized RF, SVM, and LDA models were subsequently integrated into a stacking framework, which was selected as the final predictive model for virtual screening based on its robust and balanced predictive performance. The stacking model achieved the highest accuracy during five-fold cross-validation (0.77) and demonstrated competitive performance on the independent test set (0.742 �} 0.040), with balanced precision, sensitivity, and F-measure. Consequently, the stacking model was selected as the final model for virtual screening. A total of 70,926 compounds retrieved from a food-derived database were filtered based on physicochemical criteria, and QSAR-based virtual screening predicted 920 compounds as potential activators of the Nrf2 signaling pathway, from which 5,7-Dimethylchrysin (FooDB ID: FDB015537) and Demethylvestitol (FooDB ID: FDB012218) were selected for experimental validation. In vitro assays using HepG2 cells demonstrated that 5,7-Dimethylchrysin significantly enhanced cell viability against sodium arsenite (150 ƒÊM)-induced cytotoxicity, with an effective concentration (EC50) of 0.54 ƒÊM, whereas Demethylvestitol exhibited only limited protective effects. Furthermore, luciferase reporter assays confirmed that 5,7-Dimethylchrysin activated antioxidant response element (ARE)-driven transcription in a concentration-dependent manner, producing a 1.5 to 2.4-fold increase at concentrations ranging from 0.78 to 6.25 ƒÊM. Overall, these findings highlight the effectiveness of integrating QSAR modeling with experimental validation to identify food-derived compounds with protective potential against arsenic-induced toxicity, with 5,7-Dimethylchrysin emerging as a promising candidate for further investigation. No potential conflict of interest relevant to this article was reported.

Frontiers Media SA Acta Medica Okayama 2297-7775 11 2026 Navigating inherited �gintensive surveillance�h within Japan's structural norms of autonomy: maternal identity negotiation among long-term Peruvian migrant mothers (1990–2025) 1944754 EN Katia Sara Huaman Palomino Graduate School of Humanities and Social Sciences, Okayama University Yoshitsugu Hirata Faculty of Education, Okayama University Introduction: This study examines how Peruvian mothers who have settled in Japan for decades rework their identities as mothers. These women were raised with the belief that being a good mother means constantly watching over and protecting their children. But in Japan, child-rearing pushes children toward independence from a young age. This study asks: What happens when these two different approaches of mothering meet?<br> Methods: We interviewed 21 Peruvian mothers who had lived in Japan for 17–35 years.<br> Results: The analysis identified four identity positions to this cultural friction. The first is holding firmly to Peruvian maternal scripts (�gIdeological Retention�h). The second is following Japanese conventions in public while keeping Peruvian ways at home (�gCompartmentalization�h). The third is moving away from inherited protective scripts and adopting Japanese norms of independence (�gAssimilation�h). The fourth is blending elements of both into a maternal self that is �gneither the one nor the other�h (a �gThird Space�h).<br> Discussion: This study helps us understand that migrant mothers do not simply choose between their home and new cultures. Instead, they actively work to create a way of mothering through a process we call Reflexive Continuity that makes sense for their unique situations. No potential conflict of interest relevant to this article was reported.

Japanese Circulation Society Acta Medica Okayama 1346-9843 89 6 2025 Clinical Impact of Genetic Testing for Long QT Syndrome�@�\ Evidence From a Nationwide LQTS Registry in Japan �\ 835 844 EN Takeshi Aiba Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC) Seiko Ohno Medical Genome Center, National Cerebral and Cardiovascular Center (NCVC) Misa Takegami Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center (NCVC) Yoshiaki Kato Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center (NCVC) Heima Sakaguchi Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center (NCVC) Keiko Shimamoto Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC) Keiko Sonoda Medical Genome Center, National Cerebral and Cardiovascular Center (NCVC) Kazufumi Ida Division of Counseling for Medical Genetics, National Cerebral and Cardiovascular Center (NCVC) Naokata Sumitomo Department of Pediatric Cardiology, Saitama Medical University International Medical Center Taisuke Nabeshima Department of Pediatric Cardiology, Saitama Medical University International Medical Center Takashi Murakami Department of Child Health, Institution of Medicine, University of Tsukuba Yumiko Ninomiya Department of Pediatrics, National Hospital Organization Kagoshima Medical Center Koichi Kato Department of Cardiovascular Medicine, Shiga University of Medical Science Megumi Fukuyama Department of Cardiovascular Medicine, Shiga University of Medical Science Takeru Makiyama Department of Cardiology, Kyoto University Kenshi Hayashi Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences Kunio Ohta Department of Medical Education, Institute of Medical, Pharmaceutical, and Health Sciences, Kanazawa University Graduate School of Medical Sciences Hiroshi Morita Okayama University Graduate School of Medicine Tadashi Nakajima Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine Yoshiaki Kaneko Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine Nobue Yagihara Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences Sou Otsuki Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences Tomoki Kosho Department of Medical Genetics, Shinshu University School of Medicine Yoko Yoshida Osaka City General Hospital Motoki Takamuro Hokkaido Children�fs Hospital Michihiko Ueno Department of Pediatrics, Teine-Keijinkai Hospital Tatsunori Takahashi Department of Pediatrics, Yamagata University Faculty of Medicine Yasuya Inden Department of Cardiology, Nagoya University Graduate School of Medicine Yasunobu Hayabuchi Department of Pediatrics, Tokushima University Shota Muraji Fukuoka Children�fs Hospital Shigeo Watanabe Yokohama City University Kunihiro Nishimura Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center (NCVC) Yoshihiro Asano Department of Genomic Medicine, National Cerebral and Cardiovascular Center (NCVC) Hitoshi Horigome Department of Child Health, Institution of Medicine, University of Tsukuba Masao Yoshinaga Department of Pediatrics, National Hospital Organization Kagoshima Medical Center Minoru Horie Department of Cardiovascular Medicine, Shiga University of Medical Science Wataru Shimizu Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC) Kengo Kusano Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center (NCVC) Background: Genetic testing for long QT syndrome (LQTS) is useful for diagnosis, risk stratification, and therapeutic strategies. This study investigated the clinical impact of genetic testing for LQTS patients.<br> Methods and Results: Total 3,851 patients (proband: 2,316 [60%]; female: 2,283 [59%]; median age: 14 years [interquartile range 9–36 years]) diagnosed with LQTS (LQTS score ≥3.5, QTc ≥500 ms, pathogenic variants in LQTS-associated genes, or unexplored syncope with QTc 480–499 ms) were enrolled in this study. Of these patients, 1,146 (29.8%) experienced syncope and 322 (8.5%) experienced ventricular fibrillation (VF) or cardiopulmonary arrest (CPA) at ≤70 years of age. Genetic testing using a next-generation sequencing panel and/or Sanger sequencing was performed for 3,770 (98%) patients, genotype was then identified in the following LQTS-associated genes: KCNQ1 (45%), KCNH2 (34%), SCN5A (8%), KCNE1 (0.1%), KCNE2 (0.03%), KCNJ2 (2.7%), CACNA1C (1.2%), and CALM1,2 (0.3%). Forty-seven (1.2%) patients had double or compound heterozygous variants in LQTS-associated genes, whereas the genotype remained unknown in 220 (5.8%) patients. When comparing phenotype with genotype, QTc was significantly longer in CALM1,2 patients than in others except for CACNA1C, whereas QTc was almost normal in KCNJ2 patients. The incidence of the first cardiac event (syncope, VF/CPA) differed among the genotypes, and prognosis was significantly worse for CALM1,2 patients.<br> Conclusions: Comprehensive genetic testing, including non-major LQTS genes, is important for diagnosis and risk stratification of LQTS. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2662-4435 7 1 2026 Rapid fluvial response to meter-scale coseismic coastal uplift during the 2024 Noto Peninsula earthquake 742 EN Takayuki Takahashi International Research Institute of Disaster Science, Tohoku University Takuro Ogura Graduate School of Social Sciences, Hitotsubashi University Kotaro Iizuka Center for Spatial Information Science, The University of Tokyo Yoshiya Iwasa Faculty of Education, University of Teacher Education Fukuoka Yuichi S. Hayakawa Center for Spatial Information Science, The University of Tokyo Tatsuto Aoki Institute of Human and Social Sciences, Kanazawa University Nobuhisa Matta Graduate School of Education, Okayama University The response of river profiles to relative base-level change is a key topic in earth surface processes, but observations capturing these changes on unconsolidated deposits at a 1–10 years timescales are scarce. We monitored geomorphic changes at the Hakka River mouth after the 3.5-meter base-level fall caused by coseismic uplift of the 2024 Noto Peninsula earthquake, Japan. Utilizing uncrewed aerial vehicle surveys, we documented a maximum vertical riverbed lowering of 2 m and knickpoint upstream migration of 770-m within the first-year post-earthquake, primarily triggered by erosion during major floods that followed the earthquake. Our findings demonstrate that fluvial terraces can develop within a year or less, following co-seismic coastal uplift. However, the river has not yet reached a renewed graded stage because riverbed armoring resulting from sediment sorting during incision currently inhibits further incision. We suggest that the abandonment of alluvial plains and lowering and widening of the riverbed in the lower 10-km segment will continue over the next decade. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0308-8146 526 2026 Flavor encapsulation capacities of amphiphilic polyvinylpyrrolidone as a carrier for amorphous solid dispersions 150819 EN Haruna Sato Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nao Honda Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Takato Hasegawa Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Chika Araga Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Hiroyuki Imanaka Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Naoyuki Ishida Department of Chemical Engineering and Material Sciences, Faculty of Science and Engineering, Doshisha University Koreyoshi Imamura Division of Applied Chemistry, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University This study investigates the characteristics of amorphous solid dispersions (ASDs) formed using an amphiphilic carrier polymer, focusing on the effects of source solution conditions on flavor retention. Cinnamaldehyde and polyvinylpyrrolidone (PVP) were dissolved as flavor and carrier components in methanol or ethanol under different conditions and subsequently spray-dried into fine powders. The amount of cinnamaldehyde retained in the spray-dried ASDs was quantified to assess the impact of solution conditions. The results indicate that cinnamaldehyde molecules were physically entrapped within the entangled PVP chains during the spray-drying process. The flavor encapsulation capacity of PVP reached a maximum of approximately 4 mmol/g-PVP under specific conditions. This maximum capacity implies that each cinnamaldehyde molecule is associated with approximately two PVP monomer units, which is higher than those reported for selected cyclodextrin-based systems in comparable contexts of cinnamaldehyde encapsulation. Additionally, the dissipation of cinnamaldehyde from the ASD samples during storage under vacuum was examined. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0021-8820 2026 Amino acid mapping–guided scaffold selection and hit identification of histidine kinase inhibitors from a virtual library of over 12 million compounds EN Teruhiko Ishikawa Graduate School of Education, Okayama University Yoko Eguchi Department of Science and Technology on Food Safety, Faculty of Biology-Oriented Science and Technology, Kindai University Toshihide Okajima SANKEN, The University of Osaka Masayuki Igarashi Institute of Microbial Chemistry (BIKAKEN) Shino Ohira Analysis Technology Center, FUJIFILM Corporation Kyosuke Tsumura Analysis Technology Center, FUJIFILM Corporation Kazumasa Sakurai High Pressure Protein Research Center, Institute of Advanced Technology, Kindai University Yoshimasa Ishizaki Institute of Microbial Chemistry (BIKAKEN) Chigusa Hayashi Institute of Microbial Chemistry (BIKAKEN) Shammi Akter Laboratory of Microbial Technology, Division of Systems Bioengineering, Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School, Kyushu University Jiro Nakayama Laboratory of Microbial Technology, Division of Systems Bioengineering, Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School, Kyushu University Chie Kohayakawa Department of Lead Exploration Units, Graduate School of Pharmaceutical Sciences, The University of Osaka Akiyoshi Tani Department of Lead Exploration Units, Graduate School of Pharmaceutical Sciences, The University of Osaka Naoki Sawa Graduate School of Education, Okayama University Takaomi Katsumoto Graduate School of Education, Okayama University Fumiya Matsumoto Graduate School of Education, Okayama University Jun-Ichi Haruta Department of Lead Exploration Units, Graduate School of Pharmaceutical Sciences, The University of Osaka Ryutaro Utsumi SANKEN, The University of Osaka Waldiomycin is a natural product originally isolated from actinomycete extracts. It inhibits histidine kinases (HKs), which are essential components of bacterial two-component signal transduction systems, by targeting the conserved H-box region and suppressing autophosphorylation. Here, we identified novel HK inhibitors using amino acid mapping (AAM)-based virtual screening. We compared the AAM descriptor of the naphthoquinone moiety of waldiomycin, which directly interacts with the H-box region, with those of approximately 12 million commercially available compounds and identified 714 candidates with similar descriptor values. From these candidates, we selected 9-hydroxy-4H-pyrido[1,2-a]pyrimidin-4-one as a promising and structurally distinct scaffold and synthesized 15 derivatives. The inhibitory activities of these derivatives were evaluated against the HKs WalK, VicK, and EnvZ. Three 4H-pyrido[1,2-a]pyrimidin-4-one derivatives (FF-054, FF-055, and FF-060) exhibited potent inhibitory activity, with IC50 values ranging from 4.39 to 259 µM. Notably, the IC50 values of these compounds increased three- to six-fold against the EnvZ S242A mutant, in which the conserved H-box residue is substituted. Furthermore, nuclear magnetic resonance (NMR) analysis using the EnvZ DHp domain (residues 223–289, encompassing the H-box region) confirmed direct interaction with this domain. Taken together, these results demonstrate that pyrido[1,2-a]pyrimidin-4-one derivatives FF-054, FF-055, and FF-060 are novel HK inhibitors that target the H-box region. This study represents the first successful application of AAM-based screening to identify HK inhibitors targeting this highly conserved region. No potential conflict of interest relevant to this article was reported.

Japanese Society of Preventive Medicine Acta Medica Okayama 2758-7916 2 3 2024 Relationship between food security and dietary habits and subjective sense of health and subjective sense of well-being among residents of large-scale housing complexes in Japan 45 56 EN Keiko Wakimoto School of Food Sciences and Nutrition, Mukogawa Women�fs University Miyuki Yokoro-Hisanari Faculty of Education, Okayama University Akira Ohtsubo Community Liaison Division for Education and Research, Mukogawa Women�fs University Tatsuya Fujii School of Education, Mukogawa Women�fs University Jotaro Kato School of Letters, Mukogawa Women�fs University Hitoshi Ogasawara School of Nursing, Mukogawa Women�fs University Daisuke Kudo School of Nursing Science, Meiji University of Integrative Medicine Minae Fukui Ichikan Nursing Development center for Diversity, Kobe City College of Nursing Yuichi Fujita School of Nursing, Mukogawa Women�fs University Background: This study aimed to determine the relationship between food security and dietary habits and subjective health and subjective well-being among residents of a large-scale housing complex in Japan. Methods: This study used a cross-sectional design through a self-administered questionnaire survey. The study subjects were residents of Mukogawa Danchi in Nishinomiya City, Hyogo Prefecture, Japan, and data from 515 households out of 6,857 total dwelling units were used for the analysis. Food security status (HFSSM), dietary diversity score (HDDS), diet, eating behavior, subjective sense of health, and subjective sense of well-being were examined using logistic regression analysis. Results: Food insecurity was negatively associated with household dietary diversity scores (OR [95%CI]:0.49 [0.24–0.98] p = 0.044). Similarly, food insecurity was negatively associated with having a nutritionally balanced diet and having a satisfactory amount of food. There was also a negative association with family meals. There was a negative association between food insecurity and a subjective sense of health and a negative association (0.35 [0.15–0.78] p = 0.011) with a subjective sense of well-being among those aged 65 and older. Conclusions: In a large-scale housing complex in Japan, inadequate dietary intake was observed in food-insecure households; they ate meals less frequently with their families. Additionally, residents experiencing food insecurity tended to have lower subjective health and subjective well-being, depending on their age. No potential conflict of interest relevant to this article was reported.

EpiSmart Science Vector Ltd Acta Medica Okayama 2476-762X 26 1 2025 Preoperative Nutritional Status Influences Enteral Nutrition Weaning 6 Months Post-Surgery in Patients with Esophageal Cancer 263 267 EN Mika Sonoi Department of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin University Yasuhiro Shirakawa Department of Surgery, Hiroshima City Hiroshima Citizens Hospital Norihiro Sonoi Center for Education in Medicine and Health Sciences, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kazuhiro Noma Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shunsuke Tanabe Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Naoaki Maeda Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hiroshi Morimatsu Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objective: This study aimed to clarify whether nutritional status at admission affects enteral nutrition weaning 6 months after surgery in patients with esophageal cancer. Methods: This was a retrospective study of 81 patients who underwent subtotal esophageal cancer resection between April 2014 and February 2016. The survey items were as follows: 1) sex, 2) age, 3) presence or absence of family members living together, 4) clinical stage, 5) surgical procedure, 6) reconstructed organs, 7) nutritional status at admission, 8) presence or absence of postoperative complications (anastomotic leakage, chylothorax, and recurrent laryngeal nerve paralysis), and 9) presence or absence of treatment other than surgery (chemo- or radiotherapy). Results: The enteral nutrition withdrawal rate after 6 months was 15.5% in the malnutrition group and 84.5% in the normal nutrition group (p = 0.007). In a comparison between groups with and without enteral nutrition after 6 months, a significant association was observed with surgical procedure, nutritional status at admission, and postoperative complications (p < 0.05). Logistic regression analysis showed that the odds of discontinuing enteral nutrition 6 months later were 5.692 (hazard ratio: 1.545–20.962) for malnutrition on admission and 11.921 (hazard ratio: 3.449–41.207) for complications. Conclusion: Regardless of the presence or absence of treatment other than surgery, preoperative nutritional improvement is beneficial for increasing postoperative oral intake. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2079-6382 14 3 2025 Influence of Educational Films on Antiviral Prescription for COVID-19: Insights from Web-Based Survey in Japan 276 EN Kosaku Komiya Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine Akihiko Hagiwara Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine Yuichiro Shindo Department of Respiratory Medicine, Nagoya University Graduate School of Medicine Kazufumi Takamatsu Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University Naoki Nishimura Department of Respiratory Medicine, National Center for Global Health and Medicine Yukako Takechi Iki-iki Clinic Eiki Ichihara Center for Clinical Oncology, Okayama University Hospital Takahiro Takazono Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences Shinyu Izumi Department of Respiratory Medicine, National Center for Global Health and Medicine Shimpei Gotoh Department of Clinical Application, Center for iPS Cell, Research and Application, Kyoto University Seiichiro Sakao Department of Pulmonary Medicine, School of Medicine, International University of Health and Welfare Takehiro Izumo Department of Respiratory Medicine, Japanese Red Cross Medical Center Kazuko Yamamoto Division of Infectious, Respiratory, and Digestive Medicine, First Department of Internal Medicine, University of the Ryukyus Graduate School of Medicine Kazuhiro Yatera Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan Hiroshi Kakeya Department of Infection Control Science, Osaka Metropolitan University Graduate School of Medicine Yoko Shibata Department of Pulmonary Medicine, Fukushima Medical University School of Medicine Keisuke Tomii Department of Respiratory Medicine, Kobe City Medical Center General Hospital Hironori Sagara Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine Yuka Sasaki Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital Toyohiro Hirai Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University Akihito Yokoyama Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University Hiroshi Mukae Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences Takashi Ogura Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center Background: Prescribing antiviral agents for severe acute respiratory syndrome coronavirus 2 requires careful consideration based on the patient�fs risk factors for severe disease progression and their vaccination status. However, effective interventions ensuring the appropriate use of antiviral agents by physicians have yet to be fully established. Thus, this study evaluated the impact of an educational film on antiviral prescription rates for coronavirus disease 2019 (COVID-19). Methods: This prospective, nationwide, web-based survey enrolled 1500 physicians. They were instructed to view a short educational film and assess the necessity of prescribing antiviral agents in 16 fictitious scenarios featuring adult patients with COVID-19 with varying risk factors for severe disease and vaccination statuses. We compared the antiviral prescription rates before and after viewing the educational film. Results: There was a significant increase in the antiviral prescription rates after viewing the educational film, particularly nirmatrelvir/ritonavir prescribed in cases involving immunocompromised patients (from 31.3% to 49.4%) and those with obesity (from 15.1% to 33.7%) who were unvaccinated and had no risk of drug interactions. However, viewing the educational film made little to no impact on the prescription rates for the patients with hypertension and hyperlipidemia or those with no underlying conditions. Conclusions: Short educational films may promote the appropriate use of antiviral agents for COVID-19. However, their impact on altering prescription behavior appears limited and varies according to the clinical context. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 0031-9007 137 9 2026 Strain-Tuned Nodal Superconductivity in the Charge-Ordered Kagome Metal CsV3⁢Sb5 096003 EN Yusuke Takeuchi Department of Physics, Okayama University Akito Kobayashi Department of Physics, Okayama University Saki Uchida Department of Physics, Okayama University Takumi Nagao Department of Physics, Okayama University Seigo Ogawa Department of Physics, Okayama University Rui Zhou Institute of Physics, Chinese Academy of Sciences, and Beijing National Laboratory for Condensed Matter Physics Shinji Kawasaki Department of Physics, Okayama University Fei Song Fujian Provincial Collaborative Innovation Center for Advanced High-Field Superconducting Materials and Engineering, College of Physics and Energy, Fujian Normal University Hao Ni Fujian Provincial Collaborative Innovation Center for Advanced High-Field Superconducting Materials and Engineering, College of Physics and Energy, Fujian Normal University Yong Zhao Fujian Provincial Collaborative Innovation Center for Advanced High-Field Superconducting Materials and Engineering, College of Physics and Energy, Fujian Normal University Guo-qing Zheng Department of Physics, Okayama University The nature of the superconducting pairing symmetry in the kagome metal CsV3⁢Sb5 and its relationship with the charge density wave (CDW) order are central unresolved issues. Here, we investigate the evolution of superconductivity in CsV3⁢Sb5 under in situ uniaxial pressure using 121Sb nuclear quadrupole resonance (NQR). We find that tensile strain significantly enhances the superconducting transition temperature, 𝑇c, while the CDW remains unchanged, demonstrating that superconductivity can be tuned independently of the bulk charge order. At a tensile strain of 𝜖 =+0.90%, the nuclear spin-lattice relaxation rate reveals a remarkable double transition: an upper transition at 𝑇c⁢1=3.6  K to a nodal gap state, and a lower one at 𝑇c⁢2=3.0  K characterized by a nodeless gap. These results evidence degenerate superconducting states with different gap symmetry in the kagome metal at ambient pressure which split under strain. Our Letter demonstrates a high tunability of superconductivity by uniaxial pressure. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2212-5345 63 3 2025 Practical Guidelines for Asthma Management (PGAM): Digest edition 405 421 EN Jun Tamaoki Department of Respiratory Medicine, Tokyo Women's Medical University Hiroyuki Nagase Division of Respiratory Medicine and Allergology, Department of Medicine, Teikyo University School of Medicine Hiroyuki Sano Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine Takeshi Kaneko Department of Pulmonology, Yokohama City University Graduate School of Medicine Yasuhiro Gon Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine Nobuaki Miyahara Department of Allergy and Respiratory Medicine, Okayama University Hospital Hironori Sagara Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University Akihiko Tanaka Department of Medicine, Division of Allergology and Respiratory Medicine, School of Medicine, Showa University Takahiko Horiguchi Department of Respiratory Medicine, Toyota Regional Medical Center Etsuko Tagaya Department of Respiratory Medicine, Tokyo Women's Medical University Tomohiro Akaba Department of Respiratory Medicine, Tokyo Women's Medical University Yuji Tohda Kindai University Hospital The international and national guidelines for asthma management are typically comprehensive and designed for respiratory specialists, making them less practical for primary care physicians who handle most asthma cases. Recognizing the need for more accessible guidelines, the Japan Asthma Society developed the Practical Guidelines for Asthma Management (PGAM). PGAM aims to provide a concise summary of key asthma management principles, increasing awareness, education, and support among nonspecialists and patients alike. It includes user-friendly tables and lists outlining common symptoms, triggers, diagnostic criteria, and basic management strategies, along with frequently encountered treatable traits and comorbidities. These elements are presented through simple, clinically relevant algorithms. A notable feature of PGAM is the �gBasic Roadmap for Asthma Management,�h which outlines a clear sequence for patient assessment, diagnosis, and treatment from initial consultation onward, offering an easy-to-follow visual guide. Additionally, the guidelines include methods for assessing airway inflammation, enabling patient phenotyping and endotyping. This supports a personalized treatment approach, particularly with biologics, aimed at achieving clinical remission. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1362-1017 31 6 2026 Bridging the Awareness–Action Gap in Disaster Preparedness: A Qualitative Study of Immersive Virtual Reality Learning Among Nursing Students e70681 EN Keiko Mori Graduate School of Health Sciences, Okayama University Miina Yamazaki Kobe University Hospital Yoshiyuki Haruna Snowlion. Inc. Background: Disasters increasingly challenge healthcare systems, highlighting the need to strengthen preparedness among future healthcare professionals. Although disaster risk awareness is important, it does not consistently translate into preparedness behaviours, reflecting the awareness–action gap. Immersive virtual reality (VR) may enhance experiential disaster learning, but how it influences preparedness processes remains insufficiently understood, particularly in healthcare and critical care education.<br> Aims: To explore how immersive VR-based disaster simulations influence disaster risk perception and preparedness among nursing students, with particular attention to the awareness–action gap and implications for future healthcare and critical care practice.<br> Study Design: A qualitative descriptive study using immersive VR-based disaster simulations followed by semi-structured interviews. Twelve undergraduate and graduate nursing students in Japan experienced immersive VR simulations depicting floods and landslides. Individual semi-structured interviews explored emotional responses, disaster risk perception, preparedness awareness and anticipated behavioural responses. Data were analysed using Krippendorff's content analysis with researcher triangulation.<br> Results: Five categories were identified: (1) heightened vulnerability and psychological burden through immersion; (2) persistence of the awareness–action gap despite increased risk perception; (3) enhanced risk recognition and preparedness intentions; (4) recognition of the need for social and structural support systems; and (5) emerging responsibility accompanied by perceived limitations. VR transformed abstract disaster risk into emotionally salient experiences, strengthening threat appraisal and preparedness awareness; however, awareness did not consistently translate into preparedness behaviours, reflecting insufficient coping appraisal and self-efficacy.<br> Conclusions: Immersive VR may strengthen disaster risk perception and preparedness awareness, but immersive experiences alone may be insufficient to bridge the awareness–action gap. Combining VR with reflective learning, skills-based training and collaborative simulation may strengthen coping appraisal and preparedness action.<br> Relevance to Clinical Practice: Immersive VR combined with reflective and skills-based learning may support psychological readiness, situational awareness and disaster preparedness competencies among future nurses, including those preparing for critical care practice. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0022-3751 604 18 2026 Integrative simulation analysis of myocardial ischaemia–reperfusion injury 7640 7662 EN Takao Shimayoshi Center for Artificial Intelligence and Mathematical Data Science, Okayama University Ayako Takeuchi Department of Physiology and Biophysics, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Satoshi Matsuoka Department of Integrative and Systems Physiology, Faculty of Medical Sciences, University of Fukui Cardiac ischaemia, reduced coronary blood flow, causes significant damages to the heart, and paradoxically reperfusion, restored flow after ischaemia, often results in more severe injury. Although the mechanisms underlying cardiac ischaemia–reperfusion injury have been intensively investigated, effective therapeutic strategies applicable during reperfusion to mitigate this damage have not been established yet. To obtain more insights into the mechanisms underlying ischaemia–reperfusion injury, and to explore effective methods to relieve reperfusion injury, we developed a comprehensive mathematical model of ventricular myocyte, implementing excitation–contraction (E–C) coupling, cytosolic and mitochondrial pH regulation, pH dependence of major components of E–C coupling and cellular energy metabolism, including mitochondrial oxidative phosphorylation. The mathematical model successfully reproduced experimentally observed findings on cardiac ischaemia–reperfusion injury, such as intracellular and extracellular acidosis, cytosolic Na+ overload, cytosolic Ca2+ overload, mitochondrial dysfunction, action potential shortening and contraction failure. It was found that the reperfusion-induced exacerbation of Na+i, Ca2+i overloads was mainly caused by insufficient production of NADH, which is used in mitochondrial oxidative phosphorylation to synthesize ATP for Na+/K+ pump and sarcoplasmic/endoplasmic reticulum Ca2+ pump (SERCA) to expel accumulated cytosolic Na+ and Ca2+, respectively. It was suggested that the preservation of mitochondrial NADH production, attenuation of ATP consumption via SERCA or contraction for a short period or activation of the Na+/K+ pump during reperfusion mitigates reperfusion injury. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0031-3998 2026 Long-term association between the COVID-19 pandemic and language development at 3 years of age EN Rumi Matsuo Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Naomi Matsumoto Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazue Nakamura Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital Takashi Yorifuji Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background: Few studies have examined the long-term association between the COVID-19 pandemic and language development in preschoolers or its effect modifiers. We therefore examined this association during health checkups of 3-year-olds in Japan.<br> Methods: This repeated cross-sectional study included 40,898 3-year-olds who underwent checkups in Okayama City, Japan. We compared children examined before (2017–2019) and during the pandemic (2020–2023). The primary outcome was physician-determined risk of language difficulties. The secondary outcome was children�fs infrequent questions using words such as �gwhat,�h �gwho,�h and �gwhere.�h Modified Poisson regression estimated RRs adjusted for confounders. Subgroup analyses examined effect modification by sex, childcare setting, and family size.<br> Results: The COVID-19 pandemic was associated with increased risk of language difficulties (RR 1.52, 95% CI 1.35–1.72). The association peaked in fiscal year 2021 and remained elevated throughout the pandemic. Secondary outcome showed elevated risk (RR 1.16, 95% CI 1.05–1.29). Girls and home-care children showed higher RRs than boys and preschool attendees.<br> Conclusions: The COVID-19 pandemic was associated with risk of language difficulties among 3-year-old children, with associations varying by sex and childcare setting. These findings suggest the importance of maintaining social interaction opportunities for young children during public health crises. No potential conflict of interest relevant to this article was reported.

Pharmaceutical Society of Japan Acta Medica Okayama 0918-6158 49 8 2026 Impact of Adjusted Creatinine Clearance on Carboplatin Dosing in Endometrial Cancer: A Retrospective Study 1285 1290 EN Kentaro Katayama Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Makio Imamura Department of Clinical Support, Kurashiki Medical Center Takashi Uehara Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Carboplatin (CBDCA) dosing is commonly determined using the Calvert formula, with creatinine clearance (Ccr) estimated by the Cockcroft–Gault formula. In Japan, where serum creatinine (sCr) is usually measured enzymatically, unadjusted Ccr may overestimate glomerular filtration rate and lead to CBDCA overdosing. We retrospectively compared treatment exposure, hematologic toxicity, and exploratory oncologic outcomes in patients with endometrial cancer who received postoperative paclitaxel plus CBDCA therapy. Patients were grouped according to whether CBDCA dosing was based on the conventional Cockcroft–Gault formula (CG group) or on adjusted Ccr calculated by adding 0.2 mg/dL to sCr (adjusted group). The incidence of Grade ≥3 neutropenia was significantly lower in the adjusted group than in the CG group. The 5-year progression-free survival (PFS) rate was numerically lower in the adjusted group than in the CG group, although no statistically significant difference was observed between the groups. Because the number of PFS events was limited, the effect of adjusted Ccr-based dosing on oncologic outcomes remains uncertain. These findings suggest that adjusted Ccr-based dosing may reduce hematologic toxicity in routine clinical practice. However, given the limited number of PFS events and the wide uncertainty in survival estimates, further studies are needed to clarify its impact on oncologic outcomes. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1866-6299 85 13 2026 Intensity of chemical weathering and its implications for soil erosion across lithological and climatic gradients in the Chemoga watershed, Upper Blue Nile Basin 317 EN Alebachew Tareke Kehali The United Graduate School of Agricultural Sciences, Tottori University Hiroshi Kitagawa Institute for Planetary Materials, Okayama University Nigussie Haregeweyn International Platform for Dryland Research and Education, Tottori University Mitsuru Tsubo International Platform for Dryland Research and Education, Tottori University Zelalem Leyew Anteneh Department of Geology, School of Earth Sciences, Bahir Dar University Belay Tesfa Ayalew Department of Geology, School of Earth Sciences, Bahir Dar University Zena Tessema Terefe The United Graduate School of Agricultural Sciences, Tottori University Ashebir Sewale Belay Department of Geology, School of Earth Sciences, Bahir Dar University Ayele Almaw Fenta Institute for Planetary Materials, Okayama University Atsushi Tsunekawa Institute for Planetary Materials, Okayama University The geochemistry of rocks, regolith/soil, surficial and core sediments, and clay mineral assemblages from these sediments was analyzed to elucidate the transition from fresh to chemically altered materials. These data were used to evaluate the intensity of chemical weathering and its implications for erosion across contrasting lithological and climatic gradients in the Chemoga watershed of the Upper Blue Nile Basin, Ethiopia. Our findings show depletion of Na+, Ca2+, Mg2+, and K+, and enrichment of Al3+, Fe3+, Ti4+, and Mn2+ in the regolith/soil, upper part of surficial sediment, and upper layer of the core sediment (10 m). Chemical Index of Alteration (CIA) values are rocks 35–47, regolith/soil 75–96, surficial river sediments 45–96, and core sediments 50–90. River sediments in the highland area are dominated by kaolinite (39%), illite (34%), and chlorite (27%), while the lower study area has illite (76%), chlorite (11%), and kaolinite (12%). Geochemistry, ternary plots, and clay mineralogy show that the highland region underwent intensive chemical weathering, while the midland experienced intermediate to high weathering, and the lowland had weak weathering. The highlands experience severe weathering due to a humid, bimodal precipitation climate; despite having younger, weathering-resistant rocks (basalt, andesite, trachyte), the lower regions consist of older, more mafic rocks (basalt and trachybasalt). Like the surficial river sediment, core sediment showed intense chemical weathering and kaolinite dominance in the upper layers (0–10 m depth, CIA > 80). Weathering intensity decreased with depth, suggesting changes in weathering and in clay mineral formation that reflect past climate. The high weathering gradient from highland to lowland correlates with erosion, indicating that weathering strongly influences soil erosion variability in the watershed. This work provides a reasonable basis for improving our understanding of the degree of weathering across contrasting environments and its implications for soil erosion by connecting the relationship between parent materials and chemically altered samples with the degree of soil erosion. No potential conflict of interest relevant to this article was reported.

“ú–{Œ’�N‹³ˆçŠw‰ï Acta Medica Okayama 1340-2560 34 2 2026 ’†�E�‚�E‘åŠw�¶‚ÌŒ’�fŒ‹‰ÊŠˆ—p‚Ì‘£�i—vˆö�\ƒwƒ‹ƒXƒŠƒeƒ‰ƒV�[ƒXƒLƒ‹ƒtƒŒ�[ƒ€ƒ��[ƒN‚ð—p‚¢‚½ŒŸ“¢�\ 118 129 EN Hitomi ONISHI The Joint Graduate School (Ph.D. Program) in Science of School Education, Hyogo University of Teacher Education Nobuki NISHIOKA Faculty of Psychology and Collaboration, Kyoto Women�fs University Takehiko ITO Graduate School of Education, Okayama University –Ú“I�FŠw�ZŒ’�N�f’fŒ‹‰ÊŠˆ—p�iˆÈ‰º�CŠˆ—p�j‚ÆŠÖ˜A—vˆö‹y‚Ñ‘ŠŒÝ‚ÌŠÖ˜A�«‚ðƒwƒ‹ƒXƒŠƒeƒ‰ƒV�[ƒXƒLƒ‹ƒtƒŒ�[ƒ€ƒ��[ƒN‚ð—p‚¢‚Ä–¾‚ç‚©‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�D<br> •û–@�F’†Šw�¶493–¼�C�‚�Z�¶360–¼�C‘åŠw1”N�¶297–¼‚ð‘Î�Û‚É–³‹L–¼Ž©‹LŽ®Ž¿–⎆’²�¸‚ð�s‚Á‚½�D’²�¸“à—e‚ÍŠˆ—p‚Æ�CŒ’�N‚Ö‚ÌŠÖ�S�Cƒwƒ‹ƒXƒŠƒeƒ‰ƒV�[�iˆÈ‰º�CHL�j�CŒ’�fŒ‹‰Ê‚ɑ΂·‚é”FŽ¯�CŒ’�fŒ‹‰Ê‚̓ljð—Í�iˆÈ‰º�C“ljð—Í�j�CˆÓŽvŒˆ’èƒoƒ‰ƒ“ƒX‚Æ‚µ‚½�D‚±‚ê‚ç‚ÌŠÖ˜A�«‚ðŽ¦‚·‰¼�àƒ‚ƒfƒ‹‚ð�ZŽí�C�«•Ê‚Ì‘½•ê�W’c“¯ŽžƒpƒX‰ð�Í‚ÅŒŸ�Ø‚µ‚½�D<br> Œ‹‰Ê�F‰¼�àƒ‚ƒfƒ‹‚É4‚‚̃pƒX‚ð’ljÁ‚µ‚½�C�³ƒ‚ƒfƒ‹‚Å�C�ZŽí�C�«•Ê‚¢‚¸‚ê‚É‚¨‚¢‚Ä‚à”z’u•s•Ïƒ‚ƒfƒ‹‚Å—Ç�D‚È“K�‡“x‚𓾂½�DŒ’�fŒ‹‰Ê‚ɑ΂·‚é”FŽ¯‚©‚ç“ljð—Í�C“ljð—Í‚©‚çˆÓŽvŒˆ’èƒoƒ‰ƒ“ƒX�CˆÓŽvŒˆ’èƒoƒ‰ƒ“ƒX‚©‚犈—p�CŒ’�N‚Ö‚ÌŠÖ�S‚©‚ç“ljð—Í�CˆÓŽvŒˆ’èƒoƒ‰ƒ“ƒX�CŠˆ—p‚ւ̃pƒX‹y‚Ñ�CHL‚©‚犈—p‚ւ̃pƒX‚Í‘S‚Ä‚Ì�ZŽí‚É‚¨‚¢‚Ä—LˆÓ‚Å‚ ‚Á‚½�DŒ’�N‚Ö‚ÌŠÖ�S‚ÆŒ‹‰Ê‚ɑ΂·‚é”FŽ¯‚©‚çHL�CHL‚©‚ç“ljð—Í�CˆÓŽvŒˆ’èƒoƒ‰ƒ“ƒX‚ւ̃pƒX‚Í’†�E�‚�Z�¶‚Ì‚Ý‚Å—LˆÓ‚Å‚ ‚Á‚½�D<br> Œ‹˜_�F’†�E�‚�E‘åŠw�¶‚ÌŒ’�fŒ‹‰ÊŠˆ—p‚𑣂·‚½‚ß‚É‚Í�CŒ’�fŒ‹‰Ê‚𕪂©‚è‚â‚·‚­‚·‚邱‚Æ�CŒ’�fŒ‹‰Ê‚̓ljð—Í‹y‚шӎvŒˆ’èƒoƒ‰ƒ“ƒX‚ÌŒü�ã�C‚·‚È‚í‚¿‰¶Œb‚Ì”FŽ¯‚ÌŒü�ã‚Æ�C•‰’S‚Ì”FŽ¯‚ÌŒyŒ¸‚ª—LŒø‚Å‚ ‚è�C‚»‚Ì�Û‚É‘Î�ÛŽÒ‚ÌŒ’�N‚Ö‚ÌŠÖ�S‚ÆHL‚Ì’ö“x‚ð�l—¶‚·‚é•K—v�«‚ªŽ¦�´‚³‚ꂽ�D No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1462-5814 2026 1 2026 Phenotypic Characterization of Porphyromonas gulae Fimbria Mutants 1926696 EN Hiroaki Inaba Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Sho Yoshida Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Naoya Ohara Department of Oral Microbiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ryota Nomura Department of Pediatric Dentistry, Graduate School of Biomedical and Health Sciences, Hiroshima University Kazuhiko Nakano Department of Pediatric Dentistry, Graduate School of Dentistry, The University of Osaka Michiyo Matsumoto-Nakano Department of Pediatric Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Porphyromonas gulae has been established as a pathogen in animal periodontal disease and expresses several virulence factors, including fimbriae, lipopolysaccharide, and proteases. P. gulae fimbriae are classified into three genotypes (A, B, and C) based on the fimbrillin (fimA) gene encoding a fimbrial subunit protein. We previously reported that P. gulae organisms with type C fimbriae were clearly more virulent as compared to those with other fimbria types, though the basic function of this is not fully understood. Here, we investigated the function of fimbriae using fimA-deficient mutants. In the present study, bacterial fimbriae were related to biofilm tenacity, whereas biofilm formation was not. Also, P. gulae fimbriae are involved in bacterial adhesion and entry into gingival epithelial cells. The role of P. gulae fimbriae in bacterial pathogenicity was then determined using fimA-deficient mutants with a silkworm infection model. Additionally, P. gulae infection can induce inflammatory responses in gingival epithelial cells and also inhibit cell migration and proliferation. In contrast, a P. gulae fimA-deficient mutant did not cause several of those cellular responses. Together, the results show that fimbriae contribute to the pathogenicity of P. gulae by affecting bacterial functions and host cell interactions. No potential conflict of interest relevant to this article was reported.

Walter de Gruyter GmbH Acta Medica Okayama 2195-4720 7 3 2013 An Efficient Synthesis of Limipterin [2'-O-(2-Acetamido-2-deoxy-ƒÀ- D-glucopyranosyl) -L- biopterin] via N2 - (N ,N -Dimethylamino )-methylene- 3-[2-(4-nitrophenyl)ethyl]-L-biopterin 110 112 EN Hiroshi Yamamoto Department of Chemistry, Faculty of Science, Okayama University Tadashi Hanaya Department of Chemistry, Faculty of Science, Okayama University Koichiro Harada Department of Chemistry, Faculty of Science, Okayama University Heizan Kawamoto Department of Chemistry, Faculty of Science, Okayama University Wolfgang Pfleiderer Universitat Konstanz, Fakultat fur Chemie No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0953-8194 38 9 2026 Marine flatworms as windows into the evolution of bilaterian neuropeptide signalling e70259 EN Ryo Nakamura Ushimado Marine Institute, Faculty of Science, Okayama University Mayuko Hamada Ushimado Marine Institute, Faculty of Science, Okayama University Xavier Bailly Multicellular Marine Models Team, CNRS – Sorbonne University – Station Biologique de Roscoff Hirotaka Sakamoto Department of Biology, Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tatsuya Sakamoto Ushimado Marine Institute, Faculty of Science, Okayama University The evolutionary origin(s) of neuropeptide signalling is still largely unknown. It has been hypothesised that signal transmission via neuropeptides played a crucial role in the regulation of nervous systems in the bilaterian ancestor. Identification, expression and functional analyses of neuropeptides and their receptors across different taxonomic groups are important for better understanding the origin(s) of bilaterian neuropeptide signalling. An example is flatworms belonging to the Platyhelminthes (spiralian protostomes) and Xenacoelomorpha (sister to all Bilateria or sister to Ambulacraria). Despite their simple morphology (i.e., a body plan lacking a coelom and circulatory system), they often possess brain-like central nervous systems and a number of bilaterian-conserved neuropeptides. This feature makes them useful models for analyses of neuropeptides and their links to nervous systems. Although previous studies have revealed orthologous relationships between vertebrate neuropeptides and those found in both marine Platyhelminthes and Xenacoelomorpha, our work suggests possible ancestral functions of vasopressin/oxytocin (VP/OT) peptides (platytocin) in these groups. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2673-9801 6 3 2026 The Antioxidant Activity of ƒ¿-Tocopherol Metabolites in Comparison with the Parent Compound in Hepatocytes 26 EN Tomoka Nishio Graduate School of Environmental and Life Science, Okayama University Kasumi Amako Graduate School of Environmental and Life Science, Okayama University Daiki Moriya Graduate School of Environmental and Life Science, Okayama University Shintaro Munemasa Graduate School of Environmental and Life Science, Okayama University Yoshiyuki Murata Graduate School of Environmental and Life Science, Okayama University Yoshimasa Nakamura Graduate School of Environmental and Life Science, Okayama University Toshiyuki Nakamura Graduate School of Environmental and Life Science, Okayama University ƒ¿-Tocopherol (ƒ¿T) is the major form of vitamin E. Although it is metabolized in the liver when high levels of ƒ¿T are present, the function of its metabolites has not yet been fully elucidated. This study aimed to evaluate the antioxidant activities of the ƒ¿T metabolites, ƒ¿-carboxyethyl hydroxychroman (ƒ¿CEHC) and ƒ¿-carboxymethylbutyl hydroxychroman (ƒ¿CMBHC), in comparison with their parent compound. The pretreatment with ƒ¿T and its metabolites showed a cytoprotective effect on the cytotoxicity induced by hydrogen peroxide in the mouse hepatoma Hepa1c1c7 cells. To elucidate the mechanism underlying the effect, in vitro assays and assessments of antioxidant-related genes and proteins were conducted. The in vitro assays showed that these compounds showed little scavenging activity against hydrogen peroxide but exhibited scavenging activity against DPPH radicals. On the other hand, assessments of antioxidant-related genes and proteins showed that ƒ¿T and its metabolites significantly upregulated the expression of heme oxygenase-1 (HO-1) possibly through activation of the transcript factor Nrf2. Moreover, the cytoprotective effects of ƒ¿T and its metabolites against hydrogen peroxide were counteracted by HO-1 inhibitors. These results suggest that not only ƒ¿T but also its metabolites are potential cytoprotective factors against oxidative stress-induced cytotoxicity, and that their effects are exerted not through a direct action of scavenging hydrogen peroxide in the body, but rather through the regulation of gene expression. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1078-8174 32 7 2026 Patient-centred communication in radiographer education: A five-country comparative document analysis of curriculum and competency standards 103553 EN Y. Komatsu Division of Radiological Technology, Graduate School of Health Sciences, Okayama University Y. Chikamoto Independent Researcher K. Tsukano Department of Psychosomatic Medicine, Yokohama Rosai Hospital S. Abe Department of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care Sciences S. Tsudou Department of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care Sciences Y. Yamamoto Division of Radiological Technology, Graduate School of Health Sciences, Okayama University Y. Tanabe Division of Radiological Technology, Graduate School of Health Sciences, Okayama University Introduction: Patient-centred communication is fundamental to radiographic practice, particularly when patients experience anxiety or uncertainty during imaging or treatment. However, it remains unclear whether broad communication expectations in radiography education and professional standards are translated into explicit, observable behaviours and integrated into education and assessment. This comparative document analysis examined the representation of patient-centred communication in selected national-level documents from five countries, using listening-related behaviours as an illustrative example.<br> Methods: Selected national-level curriculum, accreditation, registration, capability, and competency documents from the United States, the United Kingdom, Australia, Canada, and Japan were analysed deductively using a predefined extraction framework. The framework assessed communication competence, listening-related behaviours, patient-centred care, patient/family relationships, interprofessional collaboration, education, and assessment.<br> Results: Communication was addressed in all five selected national-level document sets, although institutional framing differed. It was framed as a professional competency or capability in the United Kingdom and Australia, a role-based competency framework in Canada, clinical competency and accreditation requirements in the United States, and primarily as curriculum content in Japan. Explicit observable behavioural expectations, such as listening-related behaviours, were uncommon. Listening was explicitly defined only in the Australian capability standards; elsewhere, it was represented indirectly through broader concepts, such as patient interaction, information gathering, and interpersonal communication.<br> Conclusion: The selected documents differed in the explicitness, structure, and educational integration of communication-related standards, without implying differences in education quality or clinical outcomes. Defining patient-centred communication through observable behaviours may strengthen alignment among professional expectations, learning outcomes, feedback, and assessment.<br> Implications for practice: Operationalising patient-centred communication as observable behaviours may enhance curriculum mapping, feedback, and assessment in radiographer education. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0918-9440 139 2 2026 Knockout of a single aquaporin, OsPIP2;4, decreases root water permeability in rice 255 265 EN Aya Onishi Institute of Plant Science and Resources, Okayama University Tomoaki Horie Division of Applied Biology, Faculty of Textile Science and Technology, Shinshu University Ryo Ishitsuka Institute of Plant Science and Resources, Okayama University Shizuka Sasano Institute of Plant Science and Resources, Okayama University Rie Horie Division of Applied Biology, Faculty of Textile Science and Technology, Shinshu University Yunosuke Mito Division of Applied Biology, Faculty of Textile Science and Technology, Shinshu University Shigeko Utsugi Institute of Plant Science and Resources, Okayama University Junko Ishikawa Institute of Crop Science, NARO Majid Mahdieh Institute of Plant Science and Resources, Okayama University Maki Katsuhara Institute of Plant Science and Resources, Okayama University Aquaporins (AQPs) are membrane proteins that facilitate water transport and are present in nearly all bacterial, animal, and plant cells. In plants, AQPs are classified into four or more subfamilies, with plasma membrane intrinsic proteins (PIPs) playing a key role in root water uptake and cellular water regulation. Previous studies have demonstrated that PIPs contribute to root hydraulic conductivity (Lpr) in various plant species. In this study, we examined the specific role of OsPIP2;4, one of the PIP-type aquaporins among 11 rice (Oryza sativa) PIP2s, in regulating Lpr. Transgenic rice plants, including OsPIP2;4-knockout (KO) and overexpressing (Ox) lines, were used for this investigation. Two independent KO lines, generated via the CRISPR-Cas9 system and T-DNA insertion mutagenesis, respectively, showed significantly lower Lpr compared to wild-type rice plants. The decrease in Lpr in the T-DNA KO line was associated with reduced OsPIP2;4 transcript levels, measured by real-time PCR, and lower OsPIP2;4 protein levels, as shown by immunohistochemical analysis. Conversely, no notable increase in Lpr was observed in the Ox lines. These results suggest that OsPIP2;4 is expressed in appropriate tissues in rice roots and is a key factor influencing Lpr. This research represents a significant step toward further understanding the physiological functions of OsPIP2;4 in rice. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 — •\Ž†�E‰p•¶–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ‰œ•t EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ƒ}ƒbƒg‰^“®‚Ì‘¤•û“|—§‰ñ“]‚ÉŠÖ‚·‚é”FŽ¯‚ÌŽÀ‘Ô �\ ‘f–pŠT”O‚ÉŠî‚­’²�¸‚Æ�lŽ@ �\ 161 169 EN Toru TAKAHASHI Faculty of Education, Okayama University Kousuke SAKAMOTO International Pacific University Ken HIRONO UCHIDA YOKO CO., LTD. 10.18926/bgeou/71152 �@–{Œ¤‹†‚Ì–Ú“I‚Í�C�¬Šw�Z‘̈ç‰È�C‚¨‚æ‚Ñ’†Šw�Z�E�‚“™Šw�Z•ÛŒ’‘̈ç‰È‚ÌŠíŠB‰^“®—̈æ‚ÅŽæ‚舵‚í‚ê‚é�u‘¤•û“|—§‰ñ“]�v‚ÉŠÖ‚·‚é”FŽ¯‚ÌŽÀ‘Ô‚ð‘f–pŠT”O‚ÉŠî‚­’²�¸‚ð’Ê‚µ‚Ä–¾‚ç‚©‚É‚·‚邱‚Æ‚Å‚ ‚Á‚½�B‘f–pŠT”O‚Æ‚ÍŠw�KŽÒ‚ª“ú�í�¶Šˆ‚É‚¨‚¢‚ÄŒoŒ±“I‚ÉŠl“¾‚µ‚½’mŽ¯�C‚à‚µ‚­‚ÍŠw�Z‚ÌŽö‹Æ“™‚ÅŠw�K‚·‚é‰ÈŠw“IŠT”O‚Æ‚Í•K‚¸‚µ‚àˆê’v‚µ‚È‚¢’mŽ¯‚ðŽw‚µŽ¦‚·—pŒê‚Å‚ ‚é�B–{Œ¤‹†‚É‚Ä‘¤•û“|—§‰ñ“]‚Æ‚¢‚¤‹Z‚ðŽæ‚è�ã‚°‚½—�—R‚Æ‚Í�C‰^“®‚ÌŒ`‘Ô�ã4ƒpƒ^�[ƒ“‚ÌŽÀŽ{•û–@‚ª‘¶�Ý‚µ‚Ä‚¢‚é‚É‚àŠÖ‚í‚炸�C�‡—�“I�C‚©‚Â�s‚¢ˆÕ‚¢ŽÀŽ{•û–@‚Í‚»‚Ì‚¤‚¿‚Ì2ƒpƒ^�[ƒ“‚ÉŒÀ’肳‚ê‚é‚Æ‚¢‚¤“ÁŽê�«‚É‚ ‚é�B–{Œ¤‹†‚Å‚Í‘¤•û“|—§‰ñ“]‚ɑ΂·‚é‘f–pŠT”O‚𖾂炩‚É‚·‚邽‚ß‚É�C‚»‚Ì”FŽ¯‚ð–₤‚½‚߂̃Aƒ“ƒP�[ƒg’²�¸‚ðŽÀŽ{‚µ‚½�B’²�¸ŠúŠÔ‚Í2023”N6ŒŽ7ŒŽ�C’²�¸‘Î�Û‚ÍA‘åŠw�¬Šw�Z‹³ˆõ—{�¬‰Û’ö‚É�Ý�Ђ·‚éŠw�¶140–¼‚Å‚ ‚Á‚½�B’²�¸‚ÌŒ‹‰Ê140–¼’†35–¼�CŠ„�‡‚É‚·‚é‚Æ32.1�“‚ªŒë‚Á‚½’mŽ¯‚ð‘f–pŠT”O‚Æ‚µ‚Ä•Û—L‚µ‚Ä‚¢‚½‚Æ‚¢‚¤‚±‚Æ‚ª–¾‚ç‚©‚Æ‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ƒ_ƒ“ƒX‚ð’Ê‚¶‚½‹¤�¶ŽÐ‰ï‚ÌŽÀŒ»‚ÉŒü‚¯‚½’nˆæ‹¦“­ƒvƒ�ƒWƒFƒNƒg �\ ‰ªŽR‚¤‚炶‚á�Õ‚è‚É‚¨‚¯‚éƒCƒ“ƒNƒ‹�[ƒVƒuƒ_ƒ“ƒXŽÀ‘H �\ 147 159 EN Risako YOSHIMURA The Joint Graduate School in Science of School Education, Hyogo University of Teacher Education Aito ODA Resorttrust, Inc. Wing In CHIU The Joint Graduate School in Science of School Education, Hyogo University of Teacher Education Sayaka TANIGAWA The Joint Graduate School in Science of School Education, Hyogo University of Teacher Education Haruko SAKO Faculty of Education, Okayama University 10.18926/bgeou/71151 �@�Ⴊ‚¢ŽÒ‚Ì•¶‰»Œ|�pŠˆ“®‚Å‚Í�C�Ⴊ‚¢ŽÒ‚ª‘n‘¢‚â”­�M‚ÉŽå‘Ì“I‚ÉŠÖ‚í‚邱‚Æ‚ª�dŽ‹‚³‚ê‚Ä‚¢‚é�B‚µ‚©‚µ�C‚»‚̈êŒ`‘Ô‚Å‚ ‚éƒCƒ“ƒNƒ‹�[ƒVƒuƒ_ƒ“ƒX‚ð’nˆæŽÐ‰ï‚ÉŠJ‚©‚ꂽ•¶‰»Šˆ“®‚Ö‚Æ“WŠJ‚·‚鎖—á‚Ì•ª�Í‚Í�\•ª‚Å‚Í‚È‚¢�B‚»‚±‚Å–{�e‚Å‚Í�C‰ªŽRŒ§‚Ì�u‚¤‚炶‚á�v�Õ‚è‚É‚¨‚¢‚Ä”­‘«‚µ‚½ƒCƒ“ƒNƒ‹�[ƒVƒu—x‚è˜A�uˆêŠúˆê‰ï�`—Ö•‘‰·—…�v‚ð‘Î�Û‚É�CƒCƒ“ƒNƒ‹�[ƒVƒu‚¤‚炶‚áƒ_ƒ“ƒX‚ÌŠJ”­‚¨‚æ‚ÑŽÀ‘H‰ß’ö‚ð�®—�‚µ‚½�BŠˆ“®‹L˜^�C‰f‘œ‹L˜^�CŠˆ“®Ž‘—¿‚ð‚à‚Æ‚É•ª�Í‚µ‚½Œ‹‰Ê�C•\Œ»“à—e‚âŽÀŽ{•û–@�C‰‰•‘ŠÂ‹«‚ª�CŽQ‰ÁŽÒ‚Ì�S�g‚Ì“Á�«‚𓥂܂¦‚Ä’iŠK“I‚É’²�®‚³‚ê‚Ä‚¢‚½‚±‚Æ‚ª–¾‚ç‚©‚Æ‚È‚Á‚½�B‚Ü‚½�CŽQ‰ÁŽÒ‚ÌŽåŠÏ“I‰^“®‹­“x‚ÍŽå‚É�uŠy�v‚©‚ç�u‚â‚â‚«‚‚¢�v‚͈̔͂ɕª•z‚µ�CŠˆ“®–ž‘«“x‚à�‚‚¢ŒXŒü‚ðŽ¦‚µ‚½�BˆÈ�ã‚æ‚è�C–{ƒvƒ�ƒWƒFƒNƒg‚Í�C’nˆæ•¶‰»‚ðŠî”Õ‚Æ‚µ‚½ƒCƒ“ƒNƒ‹�[ƒVƒu‚È�g‘Ì•\Œ»Šˆ“®‚ÉŠÖ‚·‚éŠî‘b“I’mŒ©‚ð’ñ‹Ÿ‚·‚é‚à‚Ì‚Å‚ ‚é‚Æ�l‚¦‚ç‚ê‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ‰ªŽR‘åŠw‹³ˆçŠw•”�‰“™‰Æ’ë‰È•K�C‰È–Ú‚ð’Ê‚µ‚½Šw�¶‚Ì‹³‰ÈŠÏ‚Ì�[‰» �\2024-2025”N“x‚̃Aƒ“ƒP�[ƒg’²�¸‚ÌŒ‹‰Ê‚©‚ç�\ 137 146 EN Chiharu MORI Faculty of Education, Okayama University Miyuki HISANARI Faculty of Education, Okayama University Yoko SHINOHARA Faculty of Education, Okayama University Kyoungwon LEE Faculty of Education, Okayama University 10.18926/bgeou/71150 �@–{Œ¤‹†‚Å‚Í�C‰ªŽR‘åŠw‹³ˆçŠw•”�VƒJƒŠƒLƒ…ƒ‰ƒ€‚É‚¨‚¯‚é�C�‰“™‰Æ’ë‰È‚Ì•K�C‰È–Ú�u“à—e�\�¬Šî‘b�v�C�uŽw“±–@Šî‘b�v�C�uŽw“±–@‡T�v‚Ì3‰È–Ú‚ð’Ê‚µ‚Ä�C—š�CŠw�¶‚̉ƒë‰È‚ɑ΂·‚鋳‰ÈŠÏ�iƒCƒ��[ƒW‚â�l‚¦•û�j‚ª‚ǂ̂悤‚ɕω»‚µ‚½‚Ì‚©‚ð�CƒAƒ“ƒP�[ƒg’²�¸‚ð—p‚¢‚Ä–¾‚ç‚©‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�B�uŽw“±‚·‚é—§�ê‚©‚ç�¬Šw�Z‰Æ’ë‰È‚ðŠw�C‚µ‚Ä�C‰Æ’ë‰È‚̃Cƒ��[ƒW‚â�l‚¦•û‚ª•Ï‰»‚µ‚½�v‚ɑ΂·‚é5Œ�–@‚̉ñ“š‚Å‚Í�C�u‚ ‚Ä‚Í‚Ü‚é�v�C�u‚â‚â‚ ‚Ä‚Í‚Ü‚é�v‚ð�‡‚킹‚½�m’è“I‚ȉñ“š‚ÌŠ„�‡‚Í�C�u“à—e�\�¬Šî‘b�v90.1%�C�uŽw“±–@Šî‘b�v88.5%�C�uŽw“±–@‡T�v95.0%‚Æ�C�uŽw“±–@Šî‘b�v‚Å‚â‚≺‚ª‚Á‚½‚à‚Ì‚Ì�C�uŽw“±–@‡T�v‚Å�Å‚à�‚‚¢Š„�‡‚ðŽ¦‚µ‚½�BŽ©—R‹L�q‚̃eƒLƒXƒg•ª�Í‚Å‚Í�C•K�C‰È–Ú‚ÌŠw�C‚ð’Ê‚µ‚½Šw�¶‚Ì‹³‰ÈŠÏ‚Í�C�u‹³‰È‚ÌŠw�K“à—e‚Ì—�‰ð�v�¨�u‹³‰È—�”O‚Ì—�‰ð�v�¨�u‹³‰ÈŽw“±‚Ì—�‰ð�v‚Ì’iŠK‚𓥂ނ±‚Æ‚É‚æ‚è�C�™�X‚É�[‰»‚µ‚½‚Æ�„Ž@‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 �u‘n‘¢�«‚ªŽÐ‰ï‚Æ�o‰ï‚¤”ü�p‹³ˆç�v‚É‚æ‚鋳ˆõ‚ÌŠw‚Ñ‚ÉŠÖ‚·‚éŠî‘bŒ¤‹†‡V �\ ’†Šw�Z”ü�p‰È‹³ˆõ‚ÌŽö‹Æ‹L˜^‚Æ’Ç�ÕƒCƒ“ƒ^ƒrƒ…�[‚ÉŠî‚­Ž–—ጤ‹†�\ 125 135 EN Ai MATSUURA Faculty of Education, Okayama University Yusuke SENOO Okayama Prefectural Tamashima High School Hitoshi KIMURA Shiga University Faculty of Education Elementary School Soichiro TAKEDA Okayama University Junior High School Chande SON Osaka Kyoiku University Tennoji Junior High School Tetsuo KIYOTA Faculty of Education, Okayama University 10.18926/bgeou/71149 �@–{˜_‚Í�CŠw�ZŠO‚Ì‘¼ŽÒ‚Ƃ̑ΘbŒoŒ±‚ª�C’†Šw�Z”ü�p‰È‹³ˆõ‚ÌŽö‹ÆŽÀ‘H‚É‚¨‚¢‚Ăǂ̂悤‚ɈӖ¡‚¯‚ç‚ê‚Ä‚¢‚½‚Ì‚©‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚·‚é�BŽsˆäƒvƒ�ƒWƒFƒNƒg‚ÉŽQ‰Á‚µ‚½‹³—@B‚ð‘Î�Û‚É�CŽsˆäƒCƒ“ƒ^ƒrƒ…�[Œã‚ÉŽÀŽ{‚³‚ꂽ•\Œ»Šˆ“®‚ÌŽö‹Æ‹L˜^‚Æ�CŽö‹ÆŽÀ‘HŒã‚Ì’Ç�ÕƒCƒ“ƒ^ƒrƒ…�[‚ð�Æ�‡‚µ‚½�B‚»‚ÌŒ‹‰Ê�C‹³—@B‚Í�CŠw�ZŠO‚Ì‘¼ŽÒ‚Ƃ̑ΘbŒoŒ±‚ð�CŽö‹Æ•û–@‚Ì’¼�Ú“I‚È•Ï�X‚Æ‚µ‚Ä‚Å‚Í‚È‚­�CŽö‹Æ’†‚Ì”»’f�C�¶“k—�‰ð�C‘è�Þ�E•\Œ»—�‰ð�C�¶ŠˆŽÀ‘H‚Æ‚ÌŠÖŒW‚É‚¨‚¢‚ĈӖ¡‚¯‚Ä‚¢‚½‚±‚Æ‚ªŠm”F‚³‚ꂽ�B“Á‚É�C�¶“k‚Ì�s“®‚â•\Œ»‚ð“��§‚·‚錩•û‚©‚ç�C‚»‚Ì”wŒi‚â�¶�¬‰ß’ö‚ðŒ©Žæ‚錩•û‚ւ̈Ú�s‚ª‚ ‚Á‚½‰Â”\�«‚ª�‚‚¢�BˆÈ�ã‚Ì‚±‚Æ‚©‚ç�C–{˜_‚É‚æ‚苳Žt‚ÌŠw‚Ñ‚ðŠw�Z“à‚ÌŒ¤�C‚⓯—»�«‚ÉŒÀ’肹‚¸Šw�ZŠO‚Ì�¶Šˆ�¢ŠE‚Æ‚ÌŠÖŒW‚©‚瑨‚¦‚éˆÓ‹`‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ’†�‘’n•û�Lˆæ’†�S“sŽs‚É‚¨‚¯‚é�lŒûˆÚ“®‚Ì“®Œü �\‰ªŽRŒ§‰ªŽRŽs‚ÌŽ–—á�\ 109 124 EN Masao NOBE Faculty of Education, Okayama University 10.18926/bgeou/71148 �@–{�e‚Ì–Ú“I‚Í�C2006”N‚©‚ç2025”N‚܂ł̉ªŽRŽs‚É‚¨‚¯‚é�lŒûˆÚ“®‚ð•ª�Í‚µ�C‚»‚Ì“®Œü‚𖾂炩‚É‚·‚邱‚Æ‚Å‚ ‚é�B21�¢‹I‚É“ü‚Á‚ĈÈ�~�C‰ªŽRŽs‚Å‚Í’†�SŽsŠX’n‚Ì�ÄŠJ”­‚╪�÷ƒ}ƒ“ƒVƒ‡ƒ“‹Ÿ‹‹‚ÌŠg‘å‚É‚æ‚è�C“s�S‰ñ‹A‚ª�i“W‚µ‚Ä‚«‚½�B‚Ü‚½�CƒŠ�[ƒ}ƒ“ƒVƒ‡ƒbƒN‚â“Œ“ú–{‘å�k�Ð�C�VŒ^ƒRƒ�ƒiƒEƒCƒ‹ƒXŠ´�õ�Ç‚ÌŠg‘å‚Æ‚¢‚Á‚½�o—ˆŽ–‚à�C�lŒûˆÚ“®‚Ɉê’è‚̉e‹¿‚ð‹y‚Ú‚µ‚½‚Æ�l‚¦‚ç‚ê‚é�B‚µ‚©‚µ�C‚±‚¤‚µ‚½ŠO•”—vˆö‚É‚à‚©‚©‚í‚炸�C�lŒûˆÚ“®‚ÌŠî–{“I‚È�–�¨‚É‘å‚«‚ȕω»‚Í‚Ý‚ç‚ê‚È‚©‚Á‚½�B‚·‚È‚í‚¿�C‰ªŽRŽs‚ÍŒ§“à‚Ì‘å•”•ª‚ÌŒ—ˆæ‚¨‚æ‚ÑŒ§ŠO‚ÌŽü•Ó’nˆæ‚©‚ç�lŒû‚ð‹zŽû‚·‚éˆê•û‚Å�CŽO‘å“sŽsŒ—‚ðŠÜ‚ÞŠÖ“Œ�E‹ß‹E�E’†•”’n•û‚Ö�lŒû‚ð‘—‚è�o‚µ‚Ä‚¢‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ƒEƒB�[ƒ“‘Ì�§‚É‚¨‚¯‚é�¨—ÍŒ— �\1820”N‘ã‚̘IšÒŠÖŒW‚ð’†�S‚É�\ 91 107 EN Hiroaki YAGUCHI Faculty of Education, Okayama University 10.18926/bgeou/71147 �@�‘�Û�­Ž¡�ã�C•p”É‚ÉŒ¾‹y‚³‚ê‚錻�Û‚É‚à‚©‚©‚í‚炸�C�u�¨—ÍŒ—�v‚Æ‚»‚ÌŠT”O‚Í�\•ª‚É�®—�‚³‚ê‚Ä‚¢‚È‚¢�B–{�e‚Å‚Í�C1820”N‘ãƒ�ƒVƒA‚̃Cƒ^ƒŠƒA”¼“‡‚É‚¨‚¯‚éƒI�[ƒXƒgƒŠƒA‚Ì�¨—͔͈͂ɑ΂·‚é”FŽ¯‚ðŽ–—á‚É�C19�¢‹I‘O”¼‚̃ˆ�[ƒ�ƒbƒp�‘�ێЉï‚É‚¨‚¯‚é�¨—ÍŒ—‚Ì‚ ‚è•û‚ðŒŸ“¢‚µ‚½�B‚Æ‚è‚킯ƒ�ƒVƒA‚Í�C1820”N‘ã‚ð’Ê‚¶‚ăoƒ‹ƒJƒ“”¼“‡‚ÅŒp‘±‚µ‚½ƒMƒŠƒVƒA“Æ—§Šv–½‚Ö‚ÌŠ±�‚ð”F‚ß‚³‚¹‚é‚ׂ­�C1820”N‘ã�‰“ª‚̃iƒ|ƒŠ—§Œ›Šv–½‚ð’Áˆ³‚µ‚½ƒI�[ƒXƒgƒŠƒA‚ÌŠ±�‚Ì�æ—á‚ÉŒJ‚è•Ô‚µŒ¾‹y‚µ‚Ä‚¢‚½�B‚»‚ÌŒ‹‰Ê‚Æ‚µ‚ă�ƒVƒA‚Ì�­�ôŒˆ’èŽÒ‚½‚¿‚Í�C1820”N‘ã�‰“ª‚É‚ÍŠ®‘S‚Ɏ󂯓ü‚ê‚Ä‚¢‚È‚©‚Á‚½�CƒCƒ^ƒŠƒA”¼“‡‚É‚¨‚¯‚éƒI�[ƒXƒgƒŠƒA‚Ì“Á•Ê‚È—˜‰v‚Ì‘¶�Ý‚ð”F‚ß‚é‚ÉŽŠ‚Á‚½�B‚»‚µ‚Ä1830”N‚̃tƒ‰ƒ“ƒXŽµŒŽŠv–½‚ÌŒ‹‰Ê‚Æ‚µ‚Ä�C˜IšÒ—¼�‘‚Í�Cƒoƒ‹ƒJƒ“”¼“‡‚ƃCƒ^ƒŠƒA”¼“‡‚É‚¨‚¯‚é‘o•û‚Ì—˜‰v‚Æ�¨—Í”ÍˆÍ‚ð‚¨ŒÝ‚¢‚Ɏ󂯓ü‚ꂽ�B19�¢‹I‘O”¼‚̃EƒB�[ƒ“‘Ì�§Šú‚Ì�¨—ÍŒ—‚Í�C’·Šú“I‚ÈŒð�‚̌J‚è•Ô‚µ‚ÅŒ`�¬�E�\’z‚³‚ê‚é‚à‚Ì‚Å‚ ‚è�C”FŽ¯‚Ì‚·‚è�‡‚킹‚ª�¬Œ÷‚µ‚½�ê�‡‚É‚Í�C‘å�‘ŠÔ‚ÌŠOŒð“I‹¦—Í‚ð‰Â”\‚É‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 –@‚ÉŠî‚­�‰“™ŽÐ‰ï‰È“à—e�\�¬‚ÉŠÖ‚·‚錤‹† �\•Ä�‘–@‹³ˆç‹³�Þ�w–¯ŽåŽå‹`‚ÌŠî‘b(FOUNDATIONS of DEMOCRACY)�x‚ðŽèŠ|‚©‚è‚É‚µ‚Ä�\ 79 90 EN Toshinori KUWABARA Faculty of Education, Okayama University Shinnosuke FUKUNAGA Okayama University Graduate School of Education Master's Course 10.18926/bgeou/71146 �@–{Œ¤‹†‚Í�C–@‚ÉŠî‚¢‚Ä�\�¬‚³‚ê‚é�‰“™‹³ˆç’iŠK‚̎Љï‰È‚Ì“à—e�\�¬Œ´—�‚𖾂炩‚É‚·‚邽‚ß�C•Ä�‘‚Ì�‰“™–@‹³ˆç‹³�Þ�w–¯ŽåŽå‹`‚ÌŠî‘b�iFOUNDATIONS of DEMOCRACY�j�x‚ð•ª�Í‚µ‚½‚à‚Ì‚Å‚ ‚é�B“ú–{‚É‚¨‚¯‚é–@‹³ˆçŒ¤‹†‚Í�C1990”N‘ãŒã”¼‚©‚ç�C•Ä�‘‚Ì–@‹³ˆçŒ¤‹†‚ð�Љ‚éŒ`‚ÅŽn‚Ü‚è�C‚»‚ÌŒã�C�”‘½‚­‚Ì•Ä�‘‚Ì–@ŠÖ˜A‹³ˆç‹³�Þ‚ª“ú–{‚É�Љ‚ê�C‚»‚Ì•ª�Í‚ÉŠî‚­Œ¤‹†�¬‰Ê‚ª’~�Ï‚³‚ê‚Ä‚«‚½�B‚µ‚©‚µ�C‚»‚ê‚ç‚ÌŒ¤‹†‚Ì‘½‚­‚Í�C’†“™‹³ˆç’iŠK‚Ì‚à‚Ì‚Å‚ ‚è�C�‰“™‹³ˆç‚ð‘Î�Û‚Æ‚·‚é–@‹³ˆç‚ÌŒ¤‹†‚Í‘½‚­‚Í‚È‚¢�B–{Œ¤‹†‚Í�C�‰“™ŽÐ‰ï‰È‚Æ‚µ‚Ä‚Ì–@‹³ˆç‚É�Å“_‚ð“–‚Ä�C‚»‚Ì“à—e�\�¬‚𖾂炩‚É‚µ‚悤‚Æ‚·‚é“_‚É“ÆŽ©�«‚ª‚ ‚é�B–{Œ¤‹†‚ÅŽæ‚è�ã‚°‚é�w–¯ŽåŽå‹`‚ÌŠî‘b�x‚Í�C“ú–{‚Å‚à’�–Ú‚³‚ê�C•¡�”‚ÌŒ¤‹†ŽÒ‚É‚æ‚Á‚Ä•ª�Í‚³‚ê‚Ä‚¢‚é�B–{Œ¤‹†‚Å‚Í�C‚»‚ê‚ç‚Ì�æ�sŒ¤‹†‚ð‚Ó‚Ü‚¦‚‚Â�C‚±‚ê‚Ü‚Å‚ÌŒ¤‹†‚Å‚Í�\•ª‰ð–¾‚³‚ê‚Ä‚¢‚È‚©‚Á‚½“à—e�\�¬Œ´—�‚̉𖾂ð–ÚŽw‚·�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 Žq‚Ç‚à‚ÌŽ©ŒÈ‚ª—§‚¿�オ‚é‘¢Œ`�sˆ×‚ɂ‚¢‚Ä‚Ì•¶Œ£Œ¤‹† �\ –Ø‘º•q‚Ì•¶Œ£‚ÉŠî‚¢‚½Žq‚Ç‚à‚ÌŠw‚т𑨂¦‚鎋“_ �\ 69 77 EN Shuya OHIRA Faculty of Education, Okayama University 10.18926/bgeou/71145 �@–{Œ¤‹†‚Å‚Í�C‘¢Œ`�sˆ×‚É‚¨‚¢‚Ä�CŽq‚Ç‚à‚Ì�uŽ©ŒÈ�v‚ª—§‚¿�オ‚邱‚Æ‚ð‚»‚ÌŽq‚Ç‚àŽ©�g‚ÌŠw‚Ñ‚Æ‚µ‚Ä‘¨‚¦‚鎋“_‚ɂ‚¢‚Ä�C–Ø‘º‚Ì•¶Œ£‚ðŽèŠ|‚©‚è‚ÉŒŸ“¢‚µ‚½�B‚Ü‚¸�C�uŽ©‰ä�v�C�u–³ˆÓŽ¯�v�C�uŽ©ŒÈ�v‚ÌŠT”O‚ð�®—�‚µ�C‘¢Œ`�sˆ×‚É‚¨‚¢‚ÄŒÂ�X‚ÌŽq‚Ç‚à‚ÉŒoŒ±‚³‚ê‚éŠw‚Ñ‚ð�lŽ@‚µ‚½�BŽŸ‚É�CŒÂ�X‚ÌŽq‚Ç‚à‚ÉŒoŒ±‚³‚ê‚éŠw‚Ñ‚ª�CŠˆ“®�ê�Š‚â‘¢Œ`�sˆ×‚ð‹¤—L‚·‚鑼‚ÌŽq‚Ç‚à‚Ö‚Æ’m‚ç‚êŽó—e‚³‚ê‚Ä‚¢‚­ŠÖŒW‚ª�C‘¢Œ`�sˆ×‚̉ߒö‚ÅŒ`�¬‚³‚ê‚邱‚Æ‚ð�lŽ@‚µ‚½�B�ÅŒã‚É�C‘¢Œ`�sˆ×‚É‚¨‚¢‚ÄŒ`�¬‚³‚ê‚éŽq‚Ç‚à“¯Žm‚ÌŠÖŒW‚Ö‚ÆŽQ—^‚µ�C“¯‚¶ŒoŒ±‚ð‹¤—L‚µ‚Ä‚¢‚­‚ ‚è•û‚ª�CŽq‚Ç‚à‚Ì�uŽ©ŒÈ�v‚ª—§‚¿�オ‚éŠw‚т𑨂¦‚鎋“_‚»‚Ì‚à‚Ì‚Å‚ ‚邱‚Æ‚ðŽ¦‚µ‚½�B�¡Œã‚Í�CŒ|�p‹³ˆç‚âŒ|�pŽÀ‘H‚ð‘Î�Û‚Æ‚µ‚½Œ¤‹†‚É‚æ‚è�C–{Œ¤‹†‚Ì’mŒ©‚ð�[‚ß‚Ä‚¢‚­�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ‚O�ÎŽ™ƒNƒ‰ƒX‚É‚¨‚¯‚镉‚Ì�î“®’²�®‚ðŽx‚¦‚é•ÛˆçŽÀ‘H‚Ì�\‘¢ �\•ÛˆçŽÒ‚ւ̃Oƒ‹�[ƒvƒCƒ“ƒ^ƒrƒ…�[‚Ì SCAT •ª�Í�\ 53 67 EN Mika KATAYAMA Faculty of Education, Okayama University Sachiyo OKAMURA Tachibanaima Nursery School of the Tachibana Social Welfare Association 10.18926/bgeou/71144 �@–{Œ¤‹†‚Ì–Ú“I‚Í�C‚O�ÎŽ™ƒNƒ‰ƒX‚É‚¨‚¯‚é“ûŽ™‚Ì•‰‚Ì�î“®’²�®‚ðŽx‚¦‚é•ÛˆçŽÀ‘H‚Ì�\‘¢‚𖾂炩‚É‚·‚邱‚Æ‚Å‚ ‚é�B‚O�ÎŽ™ƒNƒ‰ƒX’S“–•ÛˆçŽÒ‚Q–¼‚ð‘Î�ۂɃtƒH�[ƒJƒX�EƒOƒ‹�[ƒv�EƒCƒ“ƒ^ƒrƒ…�[‚ðŽÀŽ{‚µ�C’€Œê˜^‚ðSCAT ‚É‚æ‚蕪�Í‚µ‚½�B‚»‚ÌŒ‹‰Ê�C�yŽó—e“I‹¤“¯’²�®‚É‚æ‚é�î��“IˆÀ‘SŠî’n‚ÌŒ`�¬�z�yŽq‚Ç‚à‚Ì�S�î‚Ì—�‰ð‚ÉŠî‚­Œ©—§‚Ä‚Ì�[‰»�z�yŽq‚Ç‚à‚Ì�S�î‚Ì—\‘ª‚ÉŠî‚­�î“®’²�®�z�y•ÛˆçŽÒŠÔ‹¦“­‚É‚æ‚é�î“®’²�®‚ÌŽÀ‘H‚Ì‹¤—L�z�y�D‚݂╶‰»“I”}‰î‚ðŠˆ—p‚µ‚½�î“®ˆÀ’艻�z‚Ì‚T‚‚̓��‡ƒJƒeƒSƒŠ�[‚ª“±�o‚³‚ꂽ�B•ÛˆçŽÒ‚ªŽq‚Ç‚à‚Ì�S�î•Ï‰»‚ðŒ©Žæ‚è‚È‚ª‚ç�C‘Ò‹@�EŒ©Žç‚è�E�Å�¬ŒÀ‚̉î“ü‚ð’²�®‚·‚é�uŽq‚Ç‚à‚Ì�S�î‚Ì—\‘ª‚ÉŠî‚­�î“®’²�®�v‚ª“Á’¥“I‚Å‚ ‚Á‚½�B�î“®’²�®Žx‰‡‚ª•ÛˆçŽÒŠÔ‚Ì‹¦“­“IŽÀ‘H‚ÅŽx‚¦‚ç‚ê‚Ä‚¢‚邱‚Æ‚à–¾‚ç‚©‚É‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ’®Šo�áŠQŠw�¶Žx‰‡‚Ì‚½‚ß‚Ì�‰ŠwŽÒŒü‚¯‘åŠwƒm�[ƒgƒeƒCƒJ�[‹¤“¯—{�¬Œ¤�C‚ÌŒø‰Ê�E‰Û‘è�E‚ ‚è•û �\‘½—l‚È�l“IƒŠƒ\�[ƒX‚ðŠˆ—p‚µ‚½—{�¬Œ¤�Cƒ‚ƒfƒ‹‚ÌŒŸ“¢�\ 37 51 EN Takeshi SHIMONAKAMURA Faculty of Education, Okayama University Hiroko INOUE Child Consultation Center, Kumamoto city Yuka TAKAGI Student Accessibility Support Room, Kumamoto University Hirofumi SOEJIMA Student Accessibility Support Room, Kumamoto University Noboru FUJISE Kumamoto Prefecture Mental Health Welfare Center 10.18926/bgeou/71143 �@–{Œ¤‹†‚Í�C‘½—l‚È�l“IƒŠƒ\�[ƒX‚ðŠˆ—p‚µ‚½’®Šo�áŠQŠw�¶Žx‰‡‚Ì‚½‚ß‚Ì�‰ŠwŽÒŒü‚¯ƒm�[ƒgƒeƒCƒJ�[‹¤“¯—{�¬Œ¤�C‚ÌŒø‰Ê‚Ɖۑè‚𖾂炩‚É‚µ�C�¡Œã‚Ì‹¤“¯—{�¬Œ¤�C‚Ì‚ ‚è•û‚ɂ‚¢‚ÄŒŸ“¢‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�B‹¤“¯—{�¬Œ¤�C‚ÌŒø‰Ê‚Æ‚µ‚Ä�C�y‘¼‘åŠw‚Ƃ̌𗬂̗LŒø�«�z�C�yŒ¤�C�‡�˜‚Ì—LŒø�«�z�C�yŒ¤�C“à—e‚Ì�[ŽÀ�z‚È‚Ç‚ªŒ©‚ç‚ê�C�¡Œã‚ÌŒ¤�C‚Ì�¶‚©‚µ•û‚Æ‚µ‚Ä�C�yŒ¤èr‚⊈“®Šg‘å�z�C�yŽx‰‡�EŒ¤�C‚Ì�[ŽÀ�z‚È‚Ç‚ª‹“‚°‚ç‚ê‚Ä‚¨‚è�CŒ¤�C‚Ì—LŒø�«‚ª–¾‚ç‚©‚É‚È‚Á‚½�Bˆê•û‚Å�C‹¤“¯—{�¬Œ¤�C‚̉ۑè‚Æ‚µ‚Ä�CŒð—¬ƒvƒ�ƒOƒ‰ƒ€‚Ì–ž‘«“x‚ª‘Š‘ΓI‚É�Å‚à’á‚­�C�yŽžŠÔ•s‘«�z‚ª”wŒi‚É‚ ‚é‚Æ�l‚¦‚ç‚ꂽ�B‚±‚ê‚ç‚Ì‚±‚Ƃ𓥂܂¦‚Ä�C‹¤“¯—{�¬Œ¤�C‚Ì‚ ‚è•û‚Æ‚µ‚Ä�CŠw�¶�E‹³�Eˆõ‚ªŒð—¬‚·‚é�\•ª‚ÈŽžŠÔ‚ÌŠm•Û‚â�CŠe�u‹`ŽžŠÔ‚Ì‘�‰Á‚Ì‚½‚ß‚É�C“®‰æ‚ðŽ‹’®‚·‚éƒIƒ“ƒfƒ}ƒ“ƒhŒ`Ž®‚ðŠî–{‚Æ‚µ‚Ä�CŒð—¬‚≉�K‚È‚Ç‚ð‘ΖÊ�C‚Ü‚½‚̓ŠƒAƒ‹ƒ^ƒCƒ€ƒIƒ“ƒ‰ƒCƒ“‚ÅŽÀŽ{‚·‚é‚È‚Ç‚ÌŒ¤�C•û–@‚ª�l‚¦‚ç‚ê‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 ‘åŠw�¶‚ÌŽåŠÏ“I�K•ŸŠ´�C�K•Ÿ‚Ö‚Ì“®‹@‚¯‚ð‹K’è‚·‚é�S—�“I—vˆö �\–{—ˆŠ´�C‘Î�lŠÖŒW�CƒGƒ“ƒQ�[ƒWƒ�ƒ“ƒg‚É’…–Ú‚µ‚Ä�\ 27 36 EN Tazuko AOKI Faculty of Education, Okayama University Miki HARADA Elementary School teacher in Okayama Prefecture 10.18926/bgeou/71142 �@–{Œ¤‹†‚Í�C‘åŠw�¶‚Ì�K•ŸŠ´‚ð‹K’è‚·‚é�S—�“I—vˆö‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ�CŽåŠÏ“I�K•ŸŠ´�iSHS�j‚¨‚æ‚Ñ�K‚¹‚Ö‚Ì“®‹@‚¯�iHEMA�j‚ð�]‘®•Ï�”‚Æ‚µ‚Ä�C–{—ˆŠ´�C‘Î�lŠÖŒW�i”íŽó—eŠ´�E”í‹‘�⊴�j�CƒGƒ“ƒQ�[ƒWƒ�ƒ“ƒg�iŠ´�î�E”FŽ¯�j‚Æ‚ÌŠÖ˜A‚ðŒŸ“¢‚µ‚½�B‘åŠw�¶139–¼‚ð‘Î�Û‚ÉŽ¿–⎆’²�¸‚ðŽÀŽ{‚µ�C‘ŠŠÖ•ª�Í‚¨‚æ‚Ñ�d‰ñ‹A•ª�Í‚ð�s‚Á‚½�B‚»‚ÌŒ‹‰Ê�CŽåŠÏ“I�K•ŸŠ´‚É‚Í–{—ˆŠ´‚ÆŠ´�îƒGƒ“ƒQ�[ƒWƒ�ƒ“ƒg‚ª�³‚̉e‹¿‚ð�C”í‹‘�⊴‚ª•‰‚̉e‹¿‚ð—^‚¦‚Ä‚¢‚½�B�K‚¹‚Ö‚Ì“®‹@‚¯‚Ì‚¤‚¿�C�K•Ÿ’Ç‹�‚ÆŠì‚Ñ’Ç‹�‚É‚Í–{—ˆŠ´‚ª�³‚̉e‹¿‚ðŽ¦‚µ�C�K•Ÿ’Ç‹�‚É‚ÍŠ´�îƒGƒ“ƒQ�[ƒWƒ�ƒ“ƒg‚Æ”FŽ¯ƒGƒ“ƒQ�[ƒWƒ�ƒ“ƒg‚àŠÖ˜A‚µ‚Ä‚¢‚½�Bˆê•û�C‚­‚‚났’Ç‹�‚É‚Í‚¢‚¸‚ê‚Ì—vˆö‚à—LˆÓ‚ȉe‹¿‚ðŽ¦‚³‚È‚©‚Á‚½�BˆÈ�ã‚æ‚è�C‘åŠw�¶‚Ì�K•ŸŠ´‚Í�CŽ©•ª‚炵‚­�s“®‚Å‚«‚Ä‚¢‚銴Šo‚⊈“®‚Ö‚Ì�Ï‹É“IŠÖ—^‚É‚æ‚Á‚Ä�‚‚Ü‚è�C‘¼ŽÒ‚©‚ç‚Ì‹‘�⊴‚Í�K•ŸŠ´‚ð’ቺ‚³‚¹‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 �W’cŠˆ“®‚Å‚Ì‹¦“­ŒoŒ±‚ð’Ê‚¶‚Ä”|‚í‚ê‚郊�[ƒ_�[ƒVƒbƒvŒø—ÍŠ´ �\ ŒoŒ±‚ð�U‚è•Ô‚é�KŠµ‚ª‚à‚ˆӖ¡ �\ 13 26 EN Ryo MISAWA Faculty of Education, Okayama University Shunta KANEMI Benesse Corporation Naoko HASEGAWA Faculty of Human Sciences, Department of Psychology, Bunkyo University 10.18926/bgeou/71141 �@–{Œ¤‹†‚Å‚Í�C“ú�í“I‚È�W’cŠˆ“®‚Å‚Ì‹¦“­ŒoŒ±‚¨‚æ‚ÑŒoŒ±Šw�K�KŠµ‚ª�CƒŠ�[ƒ_�[ƒVƒbƒvŒø—ÍŠ´‚Ƃǂ̂悤‚ÉŠÖ˜A‚·‚é‚Ì‚©‚ðŒŸ“¢‚µ‚½�B‘åŠw�¶‚ð‘Î�Û‚ÉŽ¿–⎆’²�¸‚ðŽÀŽ{‚µ�C99–¼‚Ì—LŒø‰ñ“š‚ð•ª�Í‘Î�Û‚Æ‚µ‚½�BˆöŽq•ª�Í‚É‚æ‚è�C‹¦“­ŒoŒ±‚ɂ‚¢‚Ä�u‹¦“­“I–â‘è‰ðŒˆ�v�C�u�W’c“à�Ó”C�‹�s�v�C�uˆÓŽvŒˆ’èŽQ‰æ�v‚Ì3ˆöŽq‚ª’Š�o‚³‚ꂽ�BƒŠ�[ƒ_�[ƒVƒbƒvŒø—ÍŠ´�iŒÛ•‘—Í�C•ÏŠv—Í�C‹¤Š´—Í�j‚Æ‚ÌŠÖ˜A‚ðŠK‘w“I�d‰ñ‹A•ª�Í‚ÅŒŸ“¢‚µ‚½Œ‹‰Ê�C�W’c“à�Ó”C�‹�s‚ÌŒoŒ±‚Í•ÏŠv—Í‚Æ�CˆÓŽvŒˆ’èŽQ‰æ‚ÌŒoŒ±‚͌ە‘—Í‚ÆŠÖ˜A‚µ�CŒoŒ±Šw�K�KŠµ‚Í•ÏŠv—Í‚¨‚æ‚Ñ‹¤Š´—Í‚Æ�³‚ÌŠÖ˜A‚ðŽ¦‚µ‚½�B‚Ü‚½�C‹¦“­“I–â‘è‰ðŒˆ‚ÌŒoŒ±‚ª�­‚È‚¢�ê�‡‚É‚Í�CŒoŒ±Šw�K�KŠµ‚ªŒÛ•‘—Í‚Æ•ÏŠv—Í‚ð•âŠ®“I‚É�‚‚ß‚é‰Â”\�«‚ªŽ¦�´‚³‚ꂽ�B“¾‚ç‚ꂽ’mŒ©‚ÉŠî‚«�C‘åŠw�¶‚̃Š�[ƒ_�[ƒVƒbƒvˆç�¬‚É‚¨‚¯‚鋦“­ŒoŒ±‚Ì“à—e‚ɉž‚¶‚½Žx‰‡‚Æ�CŒoŒ±‚ð�ÈŽ@‚·‚é�KŠµŒ`�¬‚Ì�d—v�«‚ð‹c˜_‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 19�¢‹IŒã”¼“ú–{‚É‚¨‚¯‚éˆê�Ä‹³Žö–@‚ÌŽó—e‚̈ê’f–Ê �\ ‹ß�¢�E‹ß‘ã“]Š·Šú‚Ì‹³ˆç�󋵂̎‹–ì �\ 1 12 EN Kazuaki KAJII Faculty of Education, Okayama University 10.18926/bgeou/71140 �@‹ß‘ã“ú–{‚É‚¨‚¯‚é�¼—m‹³ˆç‚Ì“ú–{‹³ˆç‚ւ̉e‹¿‚ð�lŽ@‚µ�C‚Æ‚­‚É�¢ŠE‚Å“`”d‚Ì‚ ‚Á‚½ƒ‚ƒjƒgƒŠƒAƒ‹�EƒVƒXƒeƒ€�i�•‹³–@�j‚Ì“ú–{‹³ˆç‚É‚¨‚¯‚éˆÊ’u‚ðŒŸ“¢‚·‚é�B19�¢‹IŒã”¼‚Í�C‹ß�¢‚ÌŽ›Žq‰®‚ÌŽž‘ã‚©‚ç‹ß‘ã‚Ì�¬Šw�Z‚ÌŽž‘ã‚Ö‚Ì“]Š·Šú‚Å‚ ‚Á‚½�B�‘–¯‹³ˆç‚Ì�ê‚Æ‚µ‚Ä‚Ì�¬Šw�Z‚ª�®‚¢�C’j�—‚ª�AŠw‚·‚é�󋵂̌`�¬‚ª‚ ‚Á‚½�B‚±‚̉ߒö‚É‚¨‚¢‚Ä�C“ú–{‚ªƒAƒ�ƒŠƒJŒo—R‚ÅŽó—e‚µ‚½ˆê�Ä‹³Žö‚Í�C‹³Žt‚ª‹³Žº‚Å‹³Žö‚·‚é•û–@‚Å‚ ‚Á‚½�B�•‹³‚ð—p‚¢‚é•û–@‚Å‚Í‚È‚©‚Á‚½�B–{�e‚Í�C‹ß‘ã“ú–{‚ł̓‚ƒjƒgƒŠƒAƒ‹¥ƒVƒXƒeƒ€‚ðŠî–{“I‚É‚ÍŒoŒ±‚µ‚È‚¢“WŠJ‚Æ�Cˆê�Ä‹³Žö‚ð�s‚¤‹³Žt‚Ì—{�¬‚ª‚ ‚Á‚½‚±‚Æ‚ð˜_‚¶‚é‚à‚Ì‚Å‚ ‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 192 2026 •\Ž†�E–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 1523-7060 28 1 2025 Optimization of the External Directing Group Depending on the Substrates for the Regioselective C–H Alkenylation of Phenyl Ethers 94 99 EN Koki Yano Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Daisuke Sawada Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Using an external directing group (externalDG), we have succeeded in ortho-selective C–H alkenylation of various DG-free phenyl ethers, including bulky silyl ethers. Also, we demonstrated a strategy to develop regioselective C–H activation by optimizing externalDG depending on the substrate. The means for optimizing externalDG include the selection of the precursor, the addition of a Lewis acid, and changing the ratio of the precursor/Pd, to control the reactivity and regioselectivity. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2699-9307 6 6 2026 NUAK2 Inhibition Enhances Macromolecular Drug Delivery in a 3D Fibrotic Model of the Pancreatic Tumor Microenvironment e202500237 EN Misaki Nakamura Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Hiroyoshi Y. Tanaka Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Mayu Ohira Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Haruko Ohta�]Okano Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Reika Nakamura Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Yu Seno Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Saaya Yara Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Sakura Fujita Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Daichi Shibata Department of Pharmaceutical Biomedicine Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Masaya Yamamoto Department of Materials Processing Graduate School of Engineering, Tohoku University Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Kensuke Osada Department of Molecular Imaging and Theranostics Institute for Quantum Medical Science, National Institutes for Quantum Sciences and Technology (QST) Horacio Cabral Department of Bioengineering Graduate School of Engineering, The University of Tokyo Atsushi Masamune Division of Gastroenterology Graduate School of Medicine, Tohoku University Mitsunobu R. Kano Department of Pharmaceutical Biomedicine Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Pancreatic ductal adenocarcinoma (PDAC) features a fibrotic tumor microenvironment that impedes drug delivery and significantly limits the successful clinical application of nanomedicines. Targeting signaling in pancreatic stellate cells (PSCs), which drive fibrosis via excessive secretion of extracellular matrix proteins such as collagen I, may be useful in overcoming this fibrotic barrier. The AMPK-related kinases NUAK1/2 have recently gained interest as promoters of fibrosis, but whether they play a profibrotic role in PSCs remains unknown. Here, patient PSCs are used to assess NUAK1/2 involvement in the PDAC fibrotic barrier. Leveraging a 3D cell culture model of PDAC fibrosis, the effect of targeting NUAK1/2 on the permeability of macromolecular dextrans of various sizes, as well as physiologically relevant macromolecules, albumin and IgG, and clinical nanomedicines, Doxil and Abraxane, is investigated. NUAK1/2 inhibition is shown to diminish collagen I to enhance macromolecular permeability, via a mechanism independent of established pathways involving transforming growth factor-ƒÀ (TGFƒÀ) and yes-associated protein (YAP). Through isoform-specific knockdown, predominant NUAK2 involvement is demonstrated. Mechanistically, actin stress fiber regulation by NUAK2 is shown to be important. Altogether, these results show in vitro that NUAK2 promotes fibrotic signaling in PSCs and may be targeted to enhance macromolecular drug delivery in PDAC. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0960-7412 127 3 2026 AHG1–AFP interaction as a regulatory node in the ABA response during seed germination e71081 EN Noriyuki Nishimura Institute of Agrobiological Sciences, National Agriculture and Food Research Organization Sho Ushiyama Institute of Plant Science and Resources, Okayama University Masato Otagiri Institute of Plant Science and Resources, Okayama University Kouji Satoh Institute of Agrobiological Sciences, National Agriculture and Food Research Organization Nahomi Suzuki Institute of Agrobiological Sciences, National Agriculture and Food Research Organization Tomoko Irisa Institute of Agrobiological Sciences, National Agriculture and Food Research Organization Nobutaka Mitsuda Biomanufacturing Process Research Center, National Institute of Advanced Industrial Science and Technology Taishi Umezawa Graduate School of Advanced Interdisciplinary Science, Tokyo University of Agriculture and Technology Hideki Nishimura Institute of Plant Science and Resources, Okayama University Keiichirou Nemoto Proteo-Science Center, PIAS, Ehime University Wataru Tsuchiya Research Center for Advanced Analysis, National Agriculture and Food Research Organization Ryoichi Yano Research Center for Advanced Analysis, National Agriculture and Food Research Organization Tatsuya Sawasaki Proteo-Science Center, PIAS, Ehime University Toshimasa Yamazaki Research Center for Advanced Analysis National Agriculture and Food Research Organization Tsukuba Ibaraki 305�]8518 Japan Takashi Hirayama Research Center for Advanced Analysis, National Agriculture and Food Research Organization Seed dormancy and germination are tightly regulated by complex signaling networks that integrate internal and external cues, including the endogenous phytohormone abscisic acid (ABA). ABA HYPERSENSITIVE GERMINATION 1 (AHG1), a group A type 2C protein phosphatase (PP2C), is thought to modulate the activity of transcription factors such as ABA INSENSITIVE 5 (ABI5) in seeds and during germination. AHG1 is regulated by DELAY OF GERMINATION 1 (DOG1), a key regulator of seed dormancy, through physical interaction. We previously reported that AHG1 also interacts with ABI FIVE BINDING PROTEIN 2 (AFP2), a member of the AFP family; however, the molecular basis of AHG1–AFP coordination has remained unclear. In this study, we show that AHG1 interacts with all AFP family members and that AFP3 binds AHG1 and ABI5 through adjacent but distinct amino acid residues within its C-domain, allowing simultaneous association with both proteins. In addition, AHG1 modulates the phosphorylation status of AFP3 at Ser60 in a DOG1-dependent manner, suggesting that DOG1–AHG1 regulates AFP3 post-translationally. Transcriptomic analyses of AHG1- or AFP3-overexpressing lines revealed that these factors are associated with the regulation of a shared set of ABA-responsive genes, including AFPs, and that AFP3 overexpression is predominantly associated with altered expression of genes involved in transcriptional regulation. Large-scale protein interaction analyses showed that AFPs interact with multiple classes of transcription factors, suggesting their involvement in diverse regulatory pathways, including ABA signaling. Together, these findings demonstrate that DOG1 regulates ABI5 function and modulates ABA responses, at least in part, by controlling AHG1-mediated dephosphorylation of AFPs. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2077-0383 15 13 2026 Changing Trends in Cardiovascular Disease Burden in North Africa and the Middle East, 1990–2023: A Joinpoint Analysis of GBD 2023 Data 4866 EN Hanane Ouddoud Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Judah Israel Ong Lescano Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Keith Pardillada Belangoy Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Nishimura Division of Hematology and Oncology, Mayo Clinic Ko Harada Division of Hematology and Oncology, Mayo Clinic Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Quynh Thi Vu Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Naohiro Iwata Department of Pharmacy, Okayama University Hospital Tatsuaki Takeda Department of Education and Research Center for Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Okayama University Yoshito Zamami Department of Pharmacy, Okayama University Hospital Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Background/Objectives: Cardiovascular disease (CVD) burden decreased in the North Africa and Middle East (NAME) region between 1990 and 2019. This study used Global Burden of Disease (GBD) 2023 data to examine whether trends in mortality, disability-adjusted life years (DALYs), incidence, and prevalence continued through 2023 across all 21 NAME countries. Methods: We analysed age-standardised CVD mortality, incidence, prevalence, and DALY rates from 1990 to 2023. Joinpoint regression identified changes in temporal trends and calculated the annual percent change (APC) and average annual percent change (AAPC) with 95% confidence intervals (CIs). Results: Age-standardised CVD mortality decreased from 579.6 per 100,000 in 1990 to 358.2 in 2023 (AAPC: �|1.42%; 95% CI: �|1.48 to �|1.35). However, no significant reduction occurred between 2019 and 2023 (APC: �|0.33%; 95% CI: �|1.37 to 1.75). DALY, incidence, and prevalence rates followed similar patterns, with no significant decline in the final years of this study. Egypt was the only country with a long-term increase in CVD mortality, which accelerated after 2020 (APC: +5.20%; 95% CI: 1.20 to 12.87). High systolic blood pressure, dietary risks, lead exposure, and air pollution were the leading modifiable risk factors. Conclusions: The earlier decline in CVD burden in the NAME region did not clearly continue after 2019. The region is currently off track to meet Sustainable Development Goal 3.4 by 2030. Future progress may depend on improved blood pressure control, lipid management, dietary habits, and environmental risk reduction. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1648-9144 62 7 2026 Diabetes Burden in the Middle East and North Africa Region, 1990–2023: An Ecological Time-Trend Analysis of GBD Estimates 1352 EN Hanane Ouddoud Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Judah Israel Ong Lescano Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Keith Pardillada Belangoy Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Nishimura Division of Hematology and Oncology, Mayo Clinic Ko Harada Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Quynh Thi Vu Faculty of Pharmacy, Haiphong University of Medicine and Pharmacy Naohiro Iwata Department of Pharmacy, Okayama University Hospital Tsukasa Higashionna Department of Pharmacy, Okayama University Hospital Tatsuaki Takeda Department of Education and Research Center for Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Okayama University Yoshito Zamami Department of Pharmacy, Okayama University Hospital Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Background and Objectives: The Middle East and North Africa (MENA) region has one of the highest age-standardized diabetes prevalence rates globally, yet all-age, diabetes-specific evidence incorporating GBD 2023 estimates through 2023 remains limited. Materials and Methods: Using Global Burden of Disease (GBD) 2023 estimates for 21 MENA countries from 1990 to 2023, this ecological time-trend analysis quantified 33-year trends in incidence, prevalence, mortality, and disability-adjusted life-years (DALYs); compared pre-2019 and post-2019 trajectories using joinpoint regression; characterized age- and sex-specific burden patterns; and quantified contributions of modifiable risk factors. Results: Age-standardized incidence increased 92%, from 251.7 (95% uncertainty interval [UI]: 231.5 to 272.4) to 482.5 (95% UI: 451.5 to 516.4) per 100,000, and prevalence more than doubled, from 5564 (95% UI: 5088 to 6024) to 11,247 (95% UI: 10,382 to 12,132) per 100,000. In 2023, males exhibited higher DALY rates than females in most adult age groups from age 15 years onward, shifting away from the female-predominant pattern seen in 1990; female rates remained higher at several of the oldest age groups. Children aged 0 to 14 years were the only group with declining DALY rates (�|52% to �|57%). Post-2019 incidence was higher in 15 of 21 countries, and six countries had higher DALY trends with non-overlapping confidence intervals. Because we only have four to five years of data, these short trends are preliminary and require care when evaluating. High body-mass index was the leading modifiable risk factor. Conclusions: These data support country-specific prevention and chronic-care strategies across the MENA region. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0911-6028 2026 Performance of generative artificial intelligence in oral and maxillofacial radiology based on the board-certification examination of Japan EN Yohei Takeshita Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshiyuki Kawazu Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Miki Hisatomi Department of Oral and Maxillofacial Radiology, Medical Development Field, Okayama University Mamiko Fujikura Department of Oral and Maxillofacial Radiology, Medical Development Field, Okayama University Shunsuke Okada Department of Oral and Maxillofacial Radiology, Medical Development Field, Okayama University Akira Shibanuma Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo Yuri Namba Department of Oral and Maxillofacial Radiology, Division of Dentistry, Okayama University Hospital Suzuka Yoshida Department of Oral and Maxillofacial Radiology, Division of Dentistry, Okayama University Hospital Saori Yoshida Preliminary Examination Room, Medical Development Field, Okayama University Yoshihide Nakamura Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshinobu Yanagi Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objective To evaluate the performance and potential utility of generative artificial intelligence (AI) in oral and maxillofacial radiology using the board-certification examination administered by the Japanese Society for Oral and Maxillofacial Radiology (JSOMR).<br> Methods The responses generated by ChatGPT for multiple-choice questions from the board-certification examination of the JSOMR over the three-year period from 2020 to 2022 were assessed. The questions were manually entered individually as prompts for GPT-3.5, GPT-4, and GPT-5, which are the models available from ChatGPT. The accuracy was calculated according to examination year, question format, and level of taxonomy.<br> Results GPT-3.5 achieved an accuracy of 40.3% for the three years (42.9%, 42.0%, and 36.0% for 2020, 2021, and 2022, respectively), that of GPT-4 was 67.8% (67.3%, 74.0%, and 62.0%, respectively), and that of GPT-5 was 76.5% (79.6%, 78.0%, and 72.0%, respectively). GPT-5�fs results exceeded the passing score for each year with the accuracy significantly outperformed that of GPT-3.5 and GPT-4. Regarding performance according to the question format, GPT-5 performed significantly superior to the earlier models, especially on two-answer questions.<br> Conclusions On the board-certification examination of the JSOMR, the performance of GPT-5 was significantly superior to that of GPT-3.5 and GPT-4. This suggests that, given the rapid development of generative AI, GPT-5 has reached a level of text-based knowledge equivalent to that assessed in the board-certification examination of the JSOMR. No potential conflict of interest relevant to this article was reported.

Japanese Society for Lymphoreticular Tissue Research Acta Medica Okayama 1346-4280 66 2 2026 RHOA G17V mutation analysis redirecting diagnosis: nodal T-follicular helper cell lymphoma with classic Hodgkin lymphoma feature 122 129 EN Rio Yamada Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Midori Filiz Nishimura Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Asami Nishikori Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Takuya Fukumi Department of Hematology, Okayama City Hospital Kumiko Ohsawa Department of Pathology, Saitama Medical Center, Saitama Medical University Shuji Momose Department of Pathology, Saitama Medical Center, Saitama Medical University Yasuharu Sato Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Nodal T-follicular helper cell lymphoma (nTFHL) may present with Hodgkin/Reed–Sternberg (HRS)-like cells and can morphologically mimic classic Hodgkin lymphoma (CHL), although these entities are usually distinguishable. We report an unusual case showing marked morphologic and molecular overlap with CHL, creating a diagnostic challenge but ultimately considered biologically consistent with nTFHL.<br> An 81-year-old woman presented with stage IV disease involving the bone marrow and markedly elevated serum soluble interleukin-2 receptor levels. Excisional lymph node biopsy revealed scattered HRS cells in a T-cell–rich background, with strong CD30 and PD-L1 expression and weak PAX5 positivity, findings consistent with CHL. Fluorescence in situ hybridization demonstrated copy-number alterations at the 9p24.1 locus in HRS cells, further supporting molecular features characteristic of CHL.<br> However, the presence of two T-follicular helper markers, detection of the RHOA p.Gly17Val (G17V) mutation, and oligoclonal T-cell receptor rearrangements with shared peaks in lymph node and bone marrow indicated an underlying nTFHL. The differential therapeutic response also supported a diagnosis of nTFHL, which could not have been established on morphology alone.<br> In this case, although the HRS cells displayed morphological, immunophenotypic, and molecular features highly suggestive of CHL, the biological nature of the lesion was consistent with nTFHL. Compared with previously reported cases of nTFHL with HRS-like cells, this case more closely resembled CHL and may represent a distinct subset best described as �gnTFHL with CHL features,�h a concept warranting greater recognition among pathologists and clinicians. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0168-0102 229 2026 Enhanced calcium activity and transcriptomic alterations in iPSC-derived neurons from BAFME patients with repeat expansions 105080 EN Yuki Nagasako Department of Neurology, Graduate School of Medicine, The University of Tokyo Mitsuru Ishikawa Department of Physiology, Keio University School of Medicine Hiroyuki Ishiura Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Sopak Supakul Department of Physiology, Keio University School of Medicine Sumihiro Maeda Department of Physiology, Keio University School of Medicine Tatsushi Toda Department of Neurology, Graduate School of Medicine, The University of Tokyo Shoji Tsuji Department of Neurology, Graduate School of Medicine, The University of Tokyo Hideyuki Okano Department of Physiology, Keio University School of Medicine Benign adult familial myoclonus epilepsy (BAFME) is caused by intronic TTTCA and TTTTA repeat expansions in SAMD12 and other genes; the neuronal basis of cortical hyperexcitability, however, remains unclear. We generated induced pluripotent stem cell (iPSC)-derived glutamatergic and GABAergic neurons from three BAFME1 patients and examined functional and transcriptomic phenotypes. Patient-derived neurons retained the pathogenic repeat expansions and showed a tendency toward upstream intronic RNA accumulation. Calcium imaging revealed increased spontaneous Ca2 + transient frequency in both neuronal subtypes, indicating heightened activity. Pharmacological profiling demonstrated attenuated responses to calcium-permeable ƒ¿-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-type glutamate receptor (CP-AMPAR) blockade and GABAA receptor antagonism in GABAergic neurons, suggesting altered inhibitory signaling. RNA sequencing revealed transcriptomic alterations without differential expression of ion channels and neurotransmitter receptors. In glutamatergic neurons, ATF4-regulated genes, including SLC7A5 encoding LAT1, a Kv1.2 channel modulator, were downregulated. Reduced SLC7A5 expression was validated at both mRNA and protein levels. In GABAergic neurons, synapse-associated genes PTPRD and GPC6 were upregulated. TCERG1L and NLRP2 were suppressed across both neuronal subtypes. These findings suggest subtype-specific alterations may contribute to neuronal hyperexcitability in BAFME and provide a platform for mechanistic studies of repeat expansion-associated epilepsies. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2949-6780 8 2026 Immersion is not enough: Design quality as the key determinant of perceived effectiveness and usage intention in educational virtual reality 100152 EN Achmad Samsudin Universitas Pendidikan Indonesia Muhammad Zahran Okayama University Eki Nugraha Universitas Pendidikan Indonesia Hadi Nasbey Universitas Negeri Jakarta Mustafa Sozbilir Atatürk University Nor Farahwahidah Abdul Rahman Universiti Teknologi Malaysia Takashi Irie Okayama University Immersive technologies such as Virtual Reality (VR) are increasingly used to support conceptual understanding in science education, yet perceived learning benefits depend on the quality of system design rather than immersion alone. This study investigates how four design-quality dimensions�\Visual and Technological Design (VT), Aesthetic Quality (AQ), Curriculum Alignment (CA), and Digital Feasibility (DF)�\influence learners' Perceived Effectiveness (PE) and Intention to Use (IU) the VARIASI VR simulation, which visualizes particle behavior across phase states of matter. Using an explanatory sequential mixed-methods design, quantitative data from 60 participants were analyzed using PLS-SEM, followed by reflexive thematic analysis of open-ended responses. Results show that VT, AQ, CA, and DF each significantly predict PE, demonstrating that learners' perception of effectiveness depends on the coordinated alignment of conceptual clarity, emotional resonance, and system reliability. However, none of these dimensions directly predicted IU, and the PE �¨ IU relationship was positive but marginal, reflecting learners�f need for procedural guidance and comfort to sustain voluntary adoption. Qualitative findings reveal that while VR enhanced conceptual clarity and engagement, continued use depended on familiarity, scaffolding, and physical comfort. The study highlights that effective VR-based science learning experiences emerge when immersive environments are not only well-designed but pedagogically framed to support confidence and sustained use. No potential conflict of interest relevant to this article was reported.

American Society for Microbiology Acta Medica Okayama 2165-0497 2026 Escalation of CTX-M-producing extensively drug-resistant Shigella spp. in Kolkata, India, following the COVID-19 pandemic e02824-25 EN Puja Bose Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Gourab Halder Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Pratanu Kayet Division of Bioinformatics, ICMR-National Institute for Research in Bacterial Infections Goutam Chowdhury Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Surajit Basak Division of Bioinformatics, ICMR-National Institute for Research in Bacterial Infections Deboleena Roy Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Daisuke Imamura Research Center for Intestinal Health Science, Okayama University Shin-ichi Miyoshi Research Center for Intestinal Health Science, Okayama University Masatomo Morita Department of Bacteriology I, National Institute of Infectious Diseases Thandavarayan Ramamurthy Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Hemanta Koley Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Santasabuj Das Division of Clinical Medicine, ICMR-National Institute for Research in Bacterial Infections Asish Kumar Mukhopadhyay Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections Shigella spp. is recognized by the World Health Organization as a high-priority pathogen due to its global prevalence, unique pathogenic mechanisms, and growing antimicrobial resistance (AMR). Nearly half of all Shigella strains worldwide are now multidrug-resistant (MDR), and the emergence of extensively drug-resistant (XDR) variants�\resistant to ciprofloxacin, ceftriaxone, and azithromycin�\has severely limited effective treatment options. The present study is based on prospective laboratory surveillance involving 323 Shigella isolates collected during 2021–2023, with pre-COVID-19 pandemic data included from a previously published study solely for historical comparison. The presence of antibiotic resistance genes (ARGs) was investigated, and whole-genome sequencing (WGS) was performed on representative isolates to assess phylogenetic relatedness with global isolates. Approximately 10% of isolates exhibited resistance to third-generation cephalosporins. While only 3% of Shigella isolates carried the blaCTX-M-15 gene from 2013 to 2019, its prevalence increased to 26% by 2022–2023. Among 38 ceftriaxone-resistant S. sonnei isolates, 33 were also resistant to azithromycin, categorizing them as XDR. These isolates showed 48% clonal similarity and high phylogenetic resemblance to the isolates reported from England. Hybrid genome assembly revealed a plasmid harboring both the blaCTX-M-15 and mphA ARGs. Conjugation experiments and plasmid profiling confirmed the plasmid�fs transferability. We report a rising trend in third-generation cephalosporin resistance among Shigella spp., primarily driven by the spread of extended-spectrum ƒÀ-lactamase-producing S. flexneri and the emergence of XDR S. sonnei. These findings underscore the urgent need for strengthened national AMR containment strategies and enhanced international surveillance of cephalosporin-resistant Shigella to mitigate this growing public health threat. No potential conflict of interest relevant to this article was reported.

Frontiers Media SA Acta Medica Okayama 2296-4185 14 2026 High horizontal force and lateral force transmission induced by the twist of the Achilles tendon 1874501 EN Shota Enomoto Graduate School of Education, Okayama University Kohta Ito Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST) The Achilles tendon�\the largest and strongest of the many tendons in the human body�\consists of subtendons arising from each head of the triceps surae. These subtendons run helically and intertwine to form a twisted three-dimensional structure. More than a century has passed since the twisted structure of the Achilles tendon was first described, and numerous studies have investigated its functional morphology. However, it remains unclear how the presence or degree of twist affects the mechanical function of the lower limbs. Here, using finite element models of the Achilles tendon with and without twist, we show that the presence and degree of twist can modulate the forces transmitted from muscle to skeleton in a complex manner. In contrast to the model without twist, the twisted models clearly exhibit anterolaterally directed horizontal forces at the distal end under a simple proximal tensile load. The lateral and anterior components reach approximately 101 N and 63 N, respectively. Furthermore, the twisted structure induces inter-subtendon force transmission, and the magnitude of the transmitted force increases with increasing degree of twist. These results indicate that the uniaxial contractile force generated by the triceps surae is transformed into triaxial forces by the twisted Achilles tendon and is redistributed in a complex three-dimensional manner through inter-subtendon interactions. No potential conflict of interest relevant to this article was reported.

Royal Society of Chemistry (RSC) Acta Medica Okayama 1463-9262 28 29 2026 Terpolymerization of epoxide, oxetane, and CO2 for the synthesis of polycarbonates with high CO2 contents, physical tunability, and enzymatic degradability 12214 12224 EN Kaito Niki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Chihiro Maeda Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Tadashi Ema Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Although poly(cyclohexene carbonate) (PCHC) synthesized by the copolymerization of cyclohexene oxide (CHO) and CO2 is a promising material, the physical properties of this material need to be altered and tuned for its wider applications. To this end, we employed a terpolymerization strategy increasing the CO2 content in the resulting polymers. Terpolymerization of CHO, oxetane, and CO2 using AlIII porphyrin catalysts with quaternary ammonium halides afforded polycarbonates with high CO2 contents, physical tunability, and enzymatic degradability. The counter anions of the catalysts were crucial factors in the formation of the poly(trimethylene carbonate) (PTMC) unit. 1a with bromide ions preferentially produced trimethylene carbonate (TMC) over PTMC, while 1d with chloride ions suppressed the formation of TMC and produced PCHC–PTMC directly. PCHC–PTMC showed glass transition temperatures (Tg) between 69 �‹C and �|9 �‹C, depending on the PCHC/PTMC ratio. The tensile test revealed that the PTMC unit contributed to the softening of the film materials. For example, a film material with a CO2 content of 38 wt% showed 505% elongation at break with an elastic character, which contrasted starkly with the 1.3% elongation at break of PCHC with a CO2 content of 31 wt%. Moreover, the selective degradation of the PTMC unit in PCHC–PTMC was achieved with lipases, and a gradient character in the sequence structure was suggested. Overall, PCHC–PTMC is an environmentally benign and sustainable CO2-based polycarbonate. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1078-8174 32 6 2026 Students�f perceptions of an electronic one-minute paper in a radiography training programme: An exploratory cross-sectional questionnaire study 103486 EN Y. Komatsu Division of Radiological Technology, Graduate School of Health Sciences, Okayama University S. Abe Department of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care Sciences S. Tsudou Department of Radiological Technology, Faculty of Health Care Sciences, Jikei University of Health Care Sciences Y. Yamamoto Division of Radiological Technology, Graduate School of Health Sciences, Okayama University Y. Tanabe Faculty of Health Sciences, Department of Radiological Technology, Okayama University Medical School, Okayama University Introduction: Formative assessment can support health professions education; however, reports on electronic 1-min papers as classroom feedback and engagement tools in radiography programmes remain limited. This study explored radiography students�f perceptions of an electronic 1-min paper, focusing on in-class reflection, ease of asking questions, and instructor feedback.<br> Methods: An electronic 1-min paper was used in a radiotherapy course across 45 class sessions in the 2024 academic year for third-year students enrolled in a 4-year radiography programme. Each 90-min class comprised a 60-min lecture, 10-min completion of the paper, and 20-min instructor feedback. After the course, a de-identified online questionnaire was administered. Eleven 5-point Likert-scale items were analysed using descriptive statistics and Spearman's rank correlations. Free-text responses were analysed using inductive qualitative content analysis.<br> Results: Of the 77 eligible students, 74 responded (96.1%). Ease of use received the highest rating (mean, 4.76; standard deviation [SD], 0.52), followed by ease of asking questions (mean, 4.32), question resolution (mean, 4.16), and usefulness of instructor feedback (mean, 4.08). Motivation to review after class was lowest (mean, 3.04; SD, 1.16). Active participation showed a strong positive association with in-class concentration (rs = 0.815; P < 0.001). Free-text responses indicated reflection and improved understanding, anonymous sharing of questions, active listening and concentration, and suggestions for improvement.<br> Conclusion: The electronic 1-min paper was widely accepted and perceived to support in-class reflection, question expression, and immediate feedback. However, students�f perceptions of its influence on out-of-class review motivation were limited. The findings indicate perceived value and engagement rather than demonstrated educational effectiveness.<br> Implications for practice: Electronic 1-min papers may help instructors identify students�f questions and respond during class, providing a practical approach to in-class feedback. No potential conflict of interest relevant to this article was reported.

Ceramic Society of Japan Acta Medica Okayama 1348-6535 134 7 2026 Dielectric response modulation in relaxor (Sr,Ba)Nb2O6 via engineered defect 455 460 EN Ryusei Shiota Graduate School of Natural Science and Technology, Okayama University Takashi Teranishi Graduate School of Natural Science and Technology, Okayama University Shinya Kondo Department of Energy Engineering, Nagoya University Akira Kishimoto Graduate School of Natural Science and Technology, Okayama University Defect engineering provides an effective pathway to tune the dielectric response of relaxor ferroelectrics, yet the roles of individual defect species in tungsten bronze (TTB) systems remain unclear. Here, we investigated how engineered Ti–VO•• defect dipoles and native oxygen vacancies introduced through reduction annealing modify the dielectric properties of relaxor (Sr0.5,Ba0.5)Nb2O6 (0.5-SBN). Ti loading forms stable defect dipoles that generate smaller polar nanoregions (PNRs), suppress their overgrowth, and increase the number of dynamically active PNRs at room temperature, leading to enhanced permittivity ƒÃ�Œ while preserving DC-bias stability and breakdown strength (EB). Reduction annealing generates Nb4+-related local polarizations aligned with the external electric field, which strengthen dipole fluctuations and slightly increase ƒÃ�Œ. Electron localization further relaxes the TTB-A2 site disorder–induced random fields, yielding a sharper dielectric peak and promoting more uniform PNR growth. Microwave dielectric spectroscopy combined with electromagnetic simulations revealed that the increases in ƒÃ�Œ for both Ti-loaded and reduced samples (0.5-SBNT and Reduced 0.5-SBN, respectively) originate predominantly from enhanced dipole polarization. Despite grain coarsening in 0.5-SBNT, the EB remained unchanged, indicating that defect dipoles act as pinning centers that inhibit field-induced PNR aggregation. In reduced 0.5-SBN, EB increased up to pO0 = 4.3 �~ 10�|3 atm owing to relaxed random fields, whereas excessive reduction reduced EB through carrier-driven space-charge effects. These results demonstrate that precise control of defect species enables simultaneous optimization of ƒÃ�Œ, DC-bias stability, and EB in TTB-type relaxor ferroelectrics. No potential conflict of interest relevant to this article was reported.

Fuji Technology Press Ltd. Acta Medica Okayama 1883-8030 21 1 2026 Developing and Implementing a Disaster Prevention Game to Enhance Local Understanding 128 135 EN Miri Shirokane Okayama University Airi Yamada Okayama University Ryo Misawa Okayama University Nobuhisa Matta Okayama University This study developed and implemented a local disaster prevention sugoroku-style game to address challenges in preserving and transmitting regional knowledge in areas with high population mobility. Many Japanese communities face both natural and social vulnerabilities, and effective disaster education requires linking hazard knowledge with local characteristics. Conducted at Sonan Junior High School in Okayama, the project combined lectures, workshops, and a community engagement event. Students learned about regional topography, land use, and disaster history and used this knowledge to design quizzes, rules, and disaster scenarios for the game. The final sugoroku set included a map-based board, thematic quiz areas, and preparedness item cards, enabling players to predict damage and consider appropriate actions. After creating the game, students shifted from identifying familiar landmarks to describing concrete disaster impacts such as liquefaction or infrastructure collapse. Interaction with local residents further enriched learning through shared experiences. The model proved feasible in terms of time and cost, and its structure is easily adaptable to other regions by incorporating local information. The findings suggest that this participatory, place-based approach enhances imagination, self-efficacy, and intergenerational knowledge transfer, contributing to community-wide disaster preparedness. Future studies will examine long-term educational impacts and broader regional applications. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 2329-6933 23 5 2026 Global trends in sarcoidosis-associated mortality, 2001–2023: insights from the World Health Organization mortality database 823 827 EN Ko Harada Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai Mariko Fujii Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Nanami Sako Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Quynh Thi Vu Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Nishimura Division of Hematology and Oncology, Mayo Clinic Keith Pardillada Belangoy Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Hanane Ouddoud Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Tatsuaki Takeda Department of Education and Research Centre for Clinical Pharmacy, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Zamami Department of Pharmacy, Okayama University Hospital Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 1022-5536 34 1 2026 Similar functional outcomes but different remodeling patterns: A minimum 5-years radiographic comparison of short fit-and-fill stem and quadrangular taper stem 1 10 EN Yasutaka Masada Department of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tomonori Tetsunaga Department of Musculoskeletal Health Promotion, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuo Fujiwara Department of Orthopaedic Surgery, Okayama City General Medical Center, Okayama City Hospital Kazuki Yamada Department of Orthopaedic Surgery, Okayama University Hospital Tomohiro Inoue Department of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ryuichiro Okuda Department of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tomoko Tetsunaga Department of Sports Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Okazaki Center for Education in Medicine and Health Sciences, Okayama University Toshifumi Ozaki Department of Orthopaedic Surgery, Section of Medicine, Division of Medicine, Dentistry and Pharmaceutical Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Purpose: ACTIS and CORAIL are cementless titanium femoral stems with hydroxyapatite (HA) coating but differing macro-geometries: ACTIS features a variable triple-taper with a medial collar, whereas CORAIL is a straight double-tapered design available with or without a collar. We compared mid-term clinical and radiographic outcomes of these stems with a minimum 5-years follow-up.<br> Methods: We retrospectively reviewed 114 primary total hip arthroplasties using ACTIS (63 hips) or CORAIL (51 hips). Clinical outcomes and standardized radiographic parameters were assessed and compared between groups.<br> Results: The canal-fill ratio (CFR) was significantly greater at the proximal, middle, and distal levels in the ACTIS group. Spot-weld formation was more frequent with ACTIS than with CORAIL (58.7% vs 35.3%). In logistic regression, proximal CFR significantly predicted spot-weld formation for ACTIS, with an optimal cutoff of 66.2% (sensitivity 91.9%, specificity 72.0%). Rates of subsidence, radiolucent lines, and pedestal formation did not differ significantly between groups. No severe stress shielding was observed with ACTIS, whereas three CORAIL hips demonstrated severe stress shielding (0% vs 5.9%). Clinical scores improved significantly in both groups, with no significant between-group differences at final follow-up.<br> Conclusions: Both stems yielded favorable radiographic and clinical mid-term outcomes. In ACTIS, greater proximal canal fill was associated with radiographic osseointegration, suggesting proximal CFR as a probabilistic radiographic marker of stem ingrowth. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1478-6362 27 1 2025 Performance of the modified 2022 ACR/EULAR giant cell arteritis classification criteria without age restriction for discriminating from Takayasu arteritis 19 EN Takahiko Sugihara Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Masayoshi Harigai Division of Rheumatology, Department of Internal Medicine, Tokyo Women�fs Medical University School of Medicine Haruhito A. Uchida Department of Chronic Kidney Disease and Cardiovascular Disease, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine Hajime Yoshifuji Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University Yasuhiro Maejima Department of Cardiovascular Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Jun Ishizaki Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine Yoshiko Watanabe Department of General Medicine, Kawasaki Medical School Hiroaki Dobashi Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University Yoshinori Komagata Department of Nephrology and Rheumatology, Kyorin University School of Medicine Naoto Tamura Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine Yoshikazu Nakaoka Department of Vascular Physiology, National Cerebral and Cardiovascular Center Research Institute Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis (JPVAS) Objective To evaluate the ability to discriminate giant cell arteritis (GCA) from Takayasu arteritis (TAK) according to the modified 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) GCA classification criteria.<br> Methods Patients enrolled in the Japanese nationwide retrospective registry were evaluated using the criteria with partial modification; wall thickening of descending thoracic-abdominal aorta were mainly diagnosed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging instead of evaluating with positron emission tomography (PET)-CT. The discriminability of the criteria was evaluated using C-statistic (> 0.7: good ability).<br> Results Newly diagnosed patients with GCA (n = 139) and TAK (n = 129) were assessed, and 23.3% of TAK were aged 50 years or older at onset. The sensitivity of the modified 2022 ACR/EULAR GCA classification criteria with a score ≥ 6 was 82.0%, 68.5%, and 32.1% in all GCA, GCA with large-vessel involvement, and GCA without cranial arteritis, respectively. The specificity of the modified criteria was 96.1% for the 129 TAK as controls. Five patients with late-onset TAK met the modified criteria, and four had cranial signs and symptoms, two had bilateral axillary artery involvement, and four had descending thoracic-abdominal aorta involvement. The discriminability of the criteria was good (C-statistic: 0.986, 95% confidence interval [CI]: 0.976–0.996) and remained good after excluding age (C-statistic: 0.927, 95% CI: 0.894–0.961). The discriminability of a set of large-vessel lesions (bilateral axillary artery and descending thoracic-abdominal aorta) and inflammatory markers was markedly decreased with poor C-statistic value (C-statistic: 0.598, 95% CI: 0.530–0.667). Discriminability was improved after adding polymyalgia rheumatica (PMR) (C-statistic: 0.757, 95% CI: 0.700–0.813) or age (C-statistic: 0.913, 95%CI: 0.874–0.951) to the set of large-vessel lesions. In GCA patients with a score ≤ 5, 52% had bilateral subclavian and/or axillary artery involvement.<br> Conclusion The modified 2022 ACR/EULAR GCA classification criteria well performed in classifying GCA and TAK without PET-CT in routine clinical practice. A set of items included in the modified GCA classification criteria had good discriminative ability for GCA and TAK, even when age was excluded. However, age restriction or PMR was required to distinguish GCA without cranial lesions from TAK. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 2050-3911 2025 1 2025 Saddle-Point Approximation to the False-Vacuum Decay at Finite Temperature in 1D Quantum Mechanics 013A01 EN Koji Harada Faculty of Arts and Science, Kyushu University Shuichiro Tao Institute of Promotion of Education and Campus Life, Okayama University Qiang Yin Graduate School of Science, Kyushu University We calculate the false-vacuum decay rate in 1D quantum mechanics on the basis of the saddle-point approximation in the Euclidean path integral at finite temperature. The saddle points are the finite-T and shifted bounce solutions, which are finite-period analogs of the (zero-temperature) bounce solution, and the shot solutions. We reexamine the zero-temperature result by Callan and Coleman and compare it with the zero-temperature limit of our results. We also perform some numerical calculations to illustrate the temperature dependence of the decay rate and compare it with the result by Affleck. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2045-2322 16 1 2026 Nitric oxide induces p53-mediated cell death in human nasal epithelial cells 10055 EN Shizuki Kamiuezono Department of Medicinal Pharmacology, Faculty of Pharmaceutical Sciences, Okayama University Sho Kubota Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Tomoki Tsuchida Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Nobumasa Takasugi Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Takashi Uehara Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Nitric oxide (NO) is a key signaling molecule that plays a vital role in maintaining homeostasis of physiological processes such as immune responses and neurotransmission. However, excessive NO production during inflammatory responses to infection can lead to cytotoxicity and tissue damage. The nasal epithelial barrier is a crucial first line of immunological defense against viral infections, and it is likely exposed to excessive NO levels during chronic inflammation. Therefore, clarifying the effects of NO on this barrier is thus critical. In this study, we investigated the biological effects of sustained NO exposure on RPMI2650 human nasal epithelial cells. Post-NO exposure transcriptomic analyses revealed significant upregulation of genes involved in the p53 signaling pathway. RT-qPCR analyses confirmed the temporal upregulation of p53 target genes associated with apoptosis and cell cycle regulation. These gene expression changes downregulated cell proliferation and induced cell death. Our findings suggest that excessive NO exposure induces nasal epithelial cell death via the p53 pathway, which over the long term can result in tissue damage and dysfunction under inflammatory conditions. These results provide new insights into how prolonged NO exposure affects the nasal epithelial cells and may contribute to the progression of chronic infectious diseases. No potential conflict of interest relevant to this article was reported.

Japanese Society of Veterinary Science Acta Medica Okayama 0916-7250 87 6 2025 Effects of heat stress on gene expression associated with antioxidant capacity of bovine early antral follicles 680 684 EN Kohei KAWANO Laboratory of Reproductive Physiology, Faculty of Environmental, Life, Natural Science and Technology, Okayama University Kenichiro SAKAGUCHI Laboratory of Veterinary Theriogenology, Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University Eri FURUKAWA National Institute of Animal Health, National Agriculture and Food Research Organization Nattapong NINPETCH Department of Animal Science, Faculty of Agriculture at Kamphaeng Saen, Kasetsart University Yojiro YANAGAWA Laboratory of Theriogenology, Department of Clinical Sciences, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido University Seiji KATAGIRI Laboratory of Theriogenology, Department of Clinical Sciences, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido University Heat exposure at the physiological level of oocyte-cumulus-granulosa cell complexes (OCGCs) during in vitro growth (IVG) culture decreases the reduced glutathione (GSH) level of oocytes, an antioxidant, but its mechanism has been unclear. We subjected OCGCs to IVG for 4, 8, or 12 days and investigated the effects of heat exposure on the gene expression of cumulus-granulosa cells associated with antioxidant capacity. Heat exposure did not alter the expression of genes related to GSH synthesis or reuse. Conversely, heat exposure increased mRNA expression of superoxide dismutase 2 and decreased that of glutathione peroxidase 1, which are antioxidant enzymes. Ultimately, heat exposure alters the gene expression of antioxidant enzymes in growing follicles, which may indirectly decrease the GSH level of oocytes. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 1347-6947 88 10 2024 Evaluation of quercetin as a potential cytoprotector against acetaldehyde using the cultured hepatocyte model with aldehyde dehydrogenase isozyme deficiency 1199 1202 EN Yuhang Xu Graduate School of Environmental and Life Science, Okayama University Takeshi Sawamoto Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Ruitong Sun Graduate School of Environmental and Life Science, Okayama University Aki Ishikura Graduate School of Environmental and Life Science, Okayama University Shintaro Munemasa Graduate School of Environmental and Life Science, Okayama University Yoshiyuki Murata Graduate School of Environmental and Life Science, Okayama University Ayano Satoh Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Akiko Matsumoto Department of Social and Environmental Medicine, Saga University Toshiyuki Nakamura Graduate School of Environmental and Life Science, Okayama University Yoshimasa Nakamura Graduate School of Environmental and Life Science, Okayama University Protective effect of quercetin against acetaldehyde was evaluated using the cultured hepatocyte models with aldehyde dehydrogenase (ALDH) isozyme deficiency (aldh2-kd and aldh1a1-kd). The quercetin-induced cytoprotection against acetaldehyde in the ALDH1A1-deficient mutant (aldh1a1-kd) was weaker than that in the wild type. Furthermore, quercetin did not enhance the ALDH activity in aldh1a1-kd cells, suggesting that ALDH1A1 is involved in quercetin-induced cytoprotection. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0025-5831 392 1 2025 Global well-posedness and scattering in weighted space for nonlinear Schrödinger equations below the Strauss exponent without gauge-invariance 1051 1097 EN Masaki Kawamoto Research Institute for Interdisciplinary Science, Okayama University Satoshi Masaki Department of Mathematics, Hokkaido University Hayato Miyazaki Teacher Training Courses, Faculty of Education, Kagawa University In this paper, we consider the nonlinear Schrödinger equation (NLS) with a general homogeneous nonlinearity in dimensions up to three. We assume that the degree (i.e., power) of the nonlinearity is such that the equation is mass-subcritical and short-range. We establish global well-posedness (GWP) and scattering for small data in the standard weighted space for a class of homogeneous nonlinearities, including non-gauge-invariant ones. Additionally, we include the case where the degree is less than or equal to the Strauss exponent. When the nonlinearity is not gauge-invariant, the standard Duhamel formulation fails to work effectively in the weighted Sobolev space; for instance, the Duhamel term may not be well-defined as a Bochner integral. To address this issue, we introduce an alternative formulation that allows us to establish GWP and scattering, even in the presence of poor time continuity of the Duhamel term. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 0031-9007 134 24 2025 Acceleration of Positive Muons by a Radio-Frequency Cavity 245001 EN S. Aritome Graduate School of Science, University of Tokyo K. Futatsukawa High Energy Accelerator Research Organization H. Hara Research Institute for Interdisciplinary Science, Okayama University K. Hayasaka Institute of Science and Technology, Niigata University Y. Ibaraki Graduate School of Science, Nagoya University T. Ichikawa Graduate School of Science, Nagoya University T. Iijima Graduate School of Science, Nagoya University H. Iinuma Graduate School of Science and Engineering, Ibaraki University Y. Ikedo High Energy Accelerator Research Organization Y. Imai Research Institute for Interdisciplinary Science, Okayama University K. Inami Graduate School of Science, Nagoya University K. Ishida High Energy Accelerator Research Organization S. Kamal Department of Chemistry, Laboratory for Advanced Spectroscopy and Imaging Research (LASIR), University of British Columbia S. Kamioka High Energy Accelerator Research Organization N. Kawamura High Energy Accelerator Research Organization M. Kimura High Energy Accelerator Research Organization A. Koda High Energy Accelerator Research Organization S. Koji Graduate School of Science, Nagoya University K. Kojima Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University A. Kondo Graduate School of Science, Nagoya University Y. Kondo Japan Atomic Energy Agency (JAEA) M. Kuzuba Graduate School of Science and Engineering, Ibaraki University R. Matsushita Graduate School of Science, University of Tokyo T. Mibe High Energy Accelerator Research Organization Y. Miyamoto Research Institute for Interdisciplinary Science, Okayama University J. G. Nakamura High Energy Accelerator Research Organization Y. Nakazawa Graduate School of Science and Engineering, Ibaraki University S. Ogawa Research Center of Advanced Particle Physics, Kyushu University Y. Okazaki High Energy Accelerator Research Organization A. Olin Department of Physics and Astronomy, University of Victoria M. Otani High Energy Accelerator Research Organization S. Oyama Graduate School of Science, University of Tokyo N. Saito High Energy Accelerator Research Organization H. Sato Graduate School of Science and Engineering, Ibaraki University T. Sato Graduate School of Science, University of Tokyo Y. Sato Institute of Science and Technology, Niigata University K. Shimomura High Energy Accelerator Research Organization Z. Shioya Faculty of Science, Kyushu University P. Strasser High Energy Accelerator Research Organization S. Sugiyama Graduate School of Science, Nagoya University K. Sumi Graduate School of Science, Nagoya University K. Suzuki Kobayashi-Maskawa Institute for the Origin of Particles and the Universe, Nagoya University Y. Takeuchi Faculty of Science, Kyushu University M. Tanida Faculty of Science, Kyushu University J. Tojo Faculty of Science, Kyushu University K. Ueda Graduate School of Science, Nagoya University, Nagoya S. Uetake Research Institute for Interdisciplinary Science, Okayama University X. H. Xie School of Physics, Peking University M. Yamada Faculty of Science, Kyushu University S. Yamamoto Research Institute for Interdisciplinary Science, Okayama University T. Yamazaki High Energy Accelerator Research Organization K. Yamura Institute of Science and Technology, Niigata University M. Yoshida High Energy Accelerator Research Organization T. Yoshioka Research Center of Advanced Particle Physics, Kyushu University M. Yotsuzuka Graduate School of Science, Nagoya University Acceleration of positive muons from thermal energy to 100 keV has been demonstrated. Thermal muons were generated by resonant multiphoton ionization of muonium atoms emitted from a sheet of laser-ablated aerogel. The thermal muons were first electrostatically accelerated to 5.7 keV, followed by further acceleration to 100 keV using a radio-frequency quadrupole with an intensity of 2�~10�|3  𝜇+/pulse. The transverse normalized rms emittance of the accelerated muons in the horizontal and vertical planes were 0.85�}0.25⁢(s⁢t⁢a⁢t)+0.22�|0.13⁢(syst)   ⁢𝜋 mm mrad and 0.32�}0.03⁢(stat)+0.05�|0.02⁢(syst)   𝜋 mm mrad, respectively. The measured emittance values demonstrated phase-space reduction by a factor of 2.0 �~102 (horizontal) and 4.1 �~102 (vertical) allowing good acceleration efficiency. These results pave the way to realize the first-ever muon accelerator for a variety of applications in particle physics, material science, and other fields. No potential conflict of interest relevant to this article was reported.

American Society for Microbiology Acta Medica Okayama 0021-9193 208 5 2026 Knockout of tusA confers cationic antimicrobial resistance via fur and omp genes in Escherichia coli e00103-26 EN Kazuya Ishikawa Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kiho Nakata Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koichiro Yamada Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Mio Uneme Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuyuki Furuta Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Chikara Kaito Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University tRNA 2-thiouridine synthesizing protein A (TusA), a sulfur-carrier protein, plays a crucial role in tRNA sulfur modification. Several studies have reported that tusA deficiency affects iron–sulfur (Fe–S) homeostasis in addition to tRNA sulfur modification, resulting in pleiotropic phenotypes. In this study, we analyzed the phenotype of tusA-deficient Escherichia coli and its underlying mechanisms. Although the Keio tusA knockout strain showed increased swimming motility and flagellar biosynthesis, these phenotypes were not restored by tusA complementation. Genome resequencing of the original Keio tusA knockout strain identified an unintended secondary mutation in lrhA, a transcriptional regulator of flagellar and chemotaxis genes. This secondary mutation impaired lrhA function, contributing to enhanced flagellar synthesis and swimming motility, as well as altered global gene expression. A tusA knockout strain in which the secondary mutation was corrected (ƒ¢tusA) exhibited reduced swimming motility compared with the wild-type strain, despite showing no abnormalities in flagellar formation. Furthermore, ƒ¢tusA displayed increased resistance to cationic antibacterial agents, including cetyltrimethylammonium bromide, cetylpyridinium chloride, and protamine sulfate. The reduced motility caused by tusA deletion was observed independently of Fur, a global regulator of iron homeostasis, whereas resistance to cationic antibacterial agents was abolished in the fur knockout background. In addition, altered expression of outer membrane protein (omp) genes was observed in ƒ¢tusA, and deletion of these omp genes abolished resistance to cationic antibacterial agents. Together, these results indicate that, by disentangling the phenotypic effects of tusA deletion from those of the unintended secondary mutation, loss of tusA confers resistance to cationic antibacterial agents through a Fur-dependent and Omp-dependent mechanism. No potential conflict of interest relevant to this article was reported.

Society for Human Environmental Studies Acta Medica Okayama 1348-5253 24 1 2026 Relationships between awareness of age-related change, subjective well-being, and psychological stress 69 77 EN Natsue Shiraishi Graduate School of Social and Cultural Sciences, Okayama University Allyson Brothers Human Development and Family Studies, Colorado State University Yasuhiro Yamamoto Faculty of Education, Okayama University Takeshi Nakagawa Graduate School of Human Sciences, University of Osaka Takashi Horiuchi Faculty of Humanities and Social Sciences, Okayama University –{Œ¤‹†‚Í�A‰Á—î‚É”º‚¤•Ï‰»‚Ì”FŽ¯�iAwareness of Age-Related Change: AARC�j�AŽåŠÏ“I�K•ŸŠ´�iSubjective Well-Being:SWB�j�A‚¨‚æ‚Ñ�S—�“IƒXƒgƒŒƒX‚Ì�c’f“IŠÖŒW‚ÌŒŸ“¢‚ð�s‚Á‚½�BAARC ‚Í�Aƒ‰ƒCƒtƒXƒpƒ“”­’B—�˜_‚ÉŠî‚«�A�S—�“I“K‰ž‚É�d—v‚È–ðŠ„‚ð‰Ê‚½‚·‚Æ‚³‚ê‚é�B�æ�sŒ¤‹†‚Å‚ÍAARC ‚Æ�K•ŸŠ´‚ÌŠÖ˜A‚ª•ñ��‚³‚ê‚Ä‚¢‚邪�A‘½‚­‚͉¡’fŒ¤‹†‚Å‚ ‚è�AŽžŠÔ“I•ûŒü�«‚ð�l—¶‚µ‚½ŒŸ“¢‚Í•s�\•ª‚Å‚ ‚é�B‚»‚±‚Å–{Œ¤‹†‚Å‚Í�A“ú–{‚Ì40 �ΈÈ�ã‚Ì�¬�l585 –¼‚ð‘Î�Û‚É�AAARC ’Z�k”Å�iAARC-10 SF�j�A�l�¶–ž‘«“xŽÚ“x�iSWLS�j�A�S—�“IƒXƒgƒŒƒXŽÚ“x�iK6�j‚ð—p‚¢‚Ä�A2 Žž“_�i2022 ”N7 ŒŽ�A2023 ”N10 ŒŽ�j‚ŃIƒ“ƒ‰ƒCƒ“’²�¸‚ðŽÀŽ{‚µ‚½�BŒð�·’x‰„Œø‰Êƒ‚ƒfƒ‹‚Ì•ª�Í‚ÌŒ‹‰Ê�AAARC-gains ‚ÆSWLS ‚ÌŠÔ‚É‘o•ûŒü‚ÌŠÖ˜A‚ª”F‚ß‚ç‚ê�AAARC-gains ‚ª�‚‚¢�l‚Ù‚ÇŒã‚ÌŽåŠÏ“I�K•ŸŠ´‚ª�‚‚­�A‚»‚Ì‹t‚à�¬—§‚·‚邱‚Æ‚ªŽ¦‚³‚ꂽ�Bˆê•û�A�S—�“IƒXƒgƒŒƒX‚ÍAARC-losses ‚ɑ΂µ‚Ĉê•ûŒü‚ÌŠÖ˜A‚ªŠm”F‚³‚ê�AƒXƒgƒŒƒX‚ª�‚‚¢�l‚Ù‚ÇŒã‚ÌAARC-losses ‚ª�‚‚¢‚±‚Æ‚ªŽ¦‚³‚ꂽ�B‚±‚ê‚ç‚ÌŒ‹‰Ê‚Í�Aƒ‰ƒCƒtƒXƒpƒ“”­’B—�˜_‚̘g‘g‚Ý‚Æ�®�‡‚µ�A‰Á—î‚É”º‚¤“K‰ž‰ß’ö‚Ì—�‰ð‚ð�[‚ß‚é‚à‚Ì‚Å‚ ‚é�B‰î“ü‚É‚¨‚¢‚Ä‚Í�AAARC-gains ‚ð‘£�i‚µ�K•ŸŠ´‚ð�‚‚߂邱‚Æ‚ª�‚—îŽÒ‚̃TƒNƒZƒXƒtƒ‹�EƒGƒCƒWƒ“ƒO‚ÉŠñ—^‚·‚é‰Â”\�«‚ª‚ ‚é�B No potential conflict of interest relevant to this article was reported.

Microbiology Society Acta Medica Okayama 2057-5858 11 4 2025 Whole-genome-based characterization of Escherichia albertii strains isolated from paediatric diarrhoeal cases in Kolkata, India 001363 EN Goutam Chowdhury Collaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric Diseases Yuki Hoshiko Division of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume University Miki Okuno Division of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume University Kei Kitahara Collaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric Diseases M John Albert Department of Microbiology, College of Medicine, Kuwait University Shin-ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshitoshi Ogura Division of Microbiology, Department of Infectious Medicine, School of Medicine, Kurume University Shanta Dutta Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Thandavarayan Ramamurthy Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Asish K. Mukhopadhyay Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Escherichia albertii is a Gram-negative facultative anaerobic bacterium that causes diarrhoea in humans. This study shows the isolation of E. albertii from hospitalized paediatric diarrhoeal cases and genome-based characteristics with putative virulence factors and antimicrobial resistance. E. albertii isolates were identified by species-specific PCR, targeting the gene encoding cytolethal distending toxin (Ea-cdt). The genome of E. albertii was sequenced to identify (i) genes encoding virulence factors (ii) antibiotic resistance-encoding genes, including the mobile genetic elements and (iii) core gene-based phylogenetic relationships and pan-genome features. A total of 10 (1.2%) E. albertii isolates were isolated from 854 faecal samples, of which 6 (60%) were found as the sole pathogen and the remaining 4 (40%) were identified along with other pathogens, such as enteroaggregative Escherichia coli, rotavirus and adenovirus. Patients from whom E. albertii was isolated presented cholera-like diarrhoea, i.e. with watery stool (60%) with moderate dehydration (100%), fever (20%) and abdominal pain (20%). The antimicrobial susceptibility testing of E. albertii showed that most of the isolates were susceptible or reduced susceptible to most of the antibiotics except resistance to erythromycin (80%), tetracycline (50%), nalidixic acid (40%), ampicillin (40%), doxycycline (30%) and ceftriaxone (20%). In the whole-genome sequence, E. albertii isolates revealed several virulence-encoding genes, namely the intimin (eae, E. coli attaching and effacing), the cytolethal distending toxin type II subunit A (cdt-IIA), adhesion (paa, porcine attaching- and effacing-associated), non-LEE (locus of enterocyte effacement) encoded effector A (nleA) and antimicrobial resistance genes (ARGs) conferring resistance to tetracycline (tetA, tetR), sulphonamides (sul2), fluoroquinolones (qnrS) and beta-lactamases (blaCTX-M, blaTEM). The SNP-based phylogenetic analysis of 647 whole genomes of E. albertii isolates from the National Center for Biotechnology Information databases did not reveal any comparable clustering pattern based on the biological source and place of isolation. The genome of some of the E. albertii was closely related to those of the isolates from China and the United Kingdom. The PFGE patterns revealed that most of the E. albertii isolates were distinct clones. This study reports on the extensive genome analysis of diarrhoea-associated E. albertii harbouring multiple virulence and ARGs. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1880-5981 78 1 2026 Electrical conductivity measurements of rhyolitic glass at high pressure and high temperature 57 EN Yusuke Haraguchi Graduate School of Engineering, The University of Osaka Kiyoshi Fuji-Ta Graduate School of Engineering, The University of Osaka Takashi Yoshino Institute for Planetary Materials, Okayama University Masashi Nakamoto Graduate School of Engineering, The University of Osaka Masanori Suzuki Graduate School of Engineering, The University of Osaka Toshihiro Tanaka Graduate School of Engineering, The University of Osaka We performed electrical conductivity measurements of rhyolite glasses across the glass transition temperature at 1 GPa. Our experimental data show that, in the Arrhenius plot, the conductivity of rhyolite with 0.2 wt% H2O has an inflection point between around 760 K, while for rhyolite with 4.9 wt% H2O the gradient changes between 685 and 825 K. These inflection points correlate with the glass transition temperature, and are compared with results of previous experiments. The degree of welding of clastic and hydrous rock can be constrained by estimating glass transition temperatures of volcanic rocks combined with measurements of electrical conductivity structures obtained from electromagnetic soundings beneath volcanic bodies. This, in turn, can be used to aid predictions of volcanic eruption. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1931-5244 295 2026 A novel spontaneous rat model of chronic kidney disease with mitochondrial dysfunction driven by thioredoxin insufficiency 51 64 EN Iori K. Ohmori Section of Developmental Physiology and Pathology, Faculty of Education, Okayama University Mamoru Ouchida Department of Molecular Oncology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshiko Hada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Haruhito A. Uchida Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shinya Toyokuni Department of Pathology and Biological Responses, Nagoya University Graduate School of Medicine Tomoji Mashimo Division of Animal Genetics, Laboratory Animal Research Center, Institute of Medical Science, The University of Tokyo Background: Chronic kidney disease (CKD) is a global health burden with high prevalence and poor prognosis. Although oxidative stress and mitochondrial dysfunction have been implicated in its pathogenesis, in vivo causal evidence remains limited. Thioredoxin (Trx), encoded by Txn1, is a redox-active protein that plays a central role in controlling oxidative stress and maintaining intracellular redox homeostasis.<br> Methods: To address this gap, we investigated the lifelong phenotypes of Txn1-F54L mutant rats harboring approximately one-third of the normal Trx activity. These rats were generated via N-ethyl-N-nitrosourea mutagenesis and validated by clustered regularly interspaced palindromic repeat (CRISPR)/CRISPR-associated protein 9 genome editing. Comprehensive analyses included biochemical testing, histopathology, immunohistochemistry, transmission electron microscopy, RNA-sequencing, western blotting, and cytokine profiling.<br> Results: Txn1-F54L mutant rats spontaneously developed progressive CKD, with median survival times of 110–119 days for homozygotes and 303–346 days for heterozygotes. Their clinical features�\elevated blood urea nitrogen, hypoalbuminemia, hypercholesterolemia, hypertension, and arterial medial sclerosis�\closely resembled those of human CKD. Histopathological evaluation revealed extensive tubular injury, interstitial fibrosis, and glomerulosclerosis. Transcriptomic profiling identified 3,418 differentially expressed genes significantly enriched in immune activation and fibrosis pathways. Mitochondrial dysfunction was prominent in proximal tubules, accompanied by oxidative stress accumulation and concurrent activation of regulated cell death pathways (apoptosis, necroptosis, and pyroptosis). Elevated serum levels of interleukin-1ƒÀ, interleukin-6, and interferon-ƒÁ indicated systemic inflammation.<br> Conclusions: Our findings demonstrate that lifelong Trx deficiency induces oxidative stress–mediated mitochondrial dysfunction and regulated cell death, leading to inflammation and progressive CKD. This study establishes the Txn1 mutant rat as a valuable spontaneous CKD model, providing translational insights and a platform for developing therapeutic strategies targeting oxidative stress–induced pathways. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 3 2026 Reducing Hesitation in Resuscitation: Educational Effects of a Female-Appearing Simulator in Basic Life Support Training 185 193 EN Takuya Kubo Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kohei Tsukahara Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takashi Hongo Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takafumi Obara Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshinori Kosaki Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tsuyoshi Nojima Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tetsuya Yumoto Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hiromichi Naito Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Atsunori Nakao Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Original Article 10.18926/AMO/70854 Women are less likely than men to receive timely defibrillation during out-of-hospital cardiac arrest. We investigated whether using a simulator that is visually modified to resemble a female affects learners�f attitudes, knowledge, and performance in basic life support (BLS) training. In a BLS simulation training, first-year medical students (n=220) used a standard gender-neutral simulator (control group) or a modified simulator with a female-like appearance (intervention group). Pre- and post-training questionnaires concerning attitudes and knowledge plus a post-training skills evaluation assessed the students�f training outcomes. The intervention group initiated chest compressions significantly faster than the control group (33.1 vs. 39.8 sec, p<0.01) and achieved a significantly higher rate of correct AED pad placement (64.2% vs. 38.5%, p<0.01). While performing the resuscitation on the female-appearing manikin, the intervention group showed significantly greater increases in self-efficacy (p<0.01) and larger decreases in discomfort about removing the patient�fs clothes (p<0.01). They were also significantly more likely to recognize that chest compressions can be performed (p=0.016) and AED pads can be applied (p=0.015) without removing the patient�fs underwear. Using a female-appearing simulator in BLS training was thus associated with faster chest compression initiation, more accurate AED pad placement, and improved gender-sensitive attitudes and knowledge. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 3 2026 Peripheral Blood T-Cell Receptor Repertoire and Host Immune Background in Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy 169 178 EN Yuki Nakamura Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Takayuki Iwamoto Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Yukiko Kajiwara Department of Breast Surgery, Hiroshima City Hiroshima Citizens Hospital Akira Hida Department of Pathology, Matsuyama Shimin Hospital Shogo Nakamoto Department of Breast and Endocrine Surgery, Okayama University Hospital Yuichiro Miyoshi Department of Breast Endocrine Surgery, Kagawa Prefectural Center Hospital Tadahiko Shien Department of Breast and Endocrine Surgery, Okayama University Hospital Masahiko Ikeda Department of Breast and Thyroid Surgery, Fukuyama City Hospital Hiroyoshi Doihara Department of General Surgery, Kawasaki Medical School General Medical Center Ryohei Ogata Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Yoshikazu Koike Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Tsunehisa Nomura Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Katsuhiro Tanaka Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Kazutaka Nakashima Department of General Surgery, Kawasaki Medical School General Medical Center Tomoki Yamatsuji Department of General Surgery, Kawasaki Medical School General Medical Center Naruto Taira Department of Breast and Thyroid Surgery, Kawasaki Medical School Hospital Original Article 10.18926/AMO/70852 The association between peripheral blood T-cell receptor (TCR) repertoire and chemotherapy response remains unclear. We evaluated peripheral blood TCR repertoire and gut microbiota in 21 breast cancer patients receiving neoadjuvant chemotherapy (NAC) who were enrolled in the SBP-14 prospective cohort study between October 2019 and March 2022. We analyzed stool samples obtained pre-NAC and peripheral blood samples obtained pre- and post-NAC. The primary endpoint was the association between baseline peripheral blood TCR repertoire and treatment response. Eleven patients (52%) had hormone receptor-positive breast cancer. All patients received anthracyclines and taxanes, with anti-HER2 therapy for HER2-positive disease. TCR diversity (TCR alpha chain [TRA], p=0.095; TCR beta chain [TRB], p=0.051) and clonality (TRA, p=0.271; TRB, p=0.500) were not significantly associated with treatment response. Gut microbiota diversity was not correlated with TCR diversity (TRA: ƒÏ=0.046, p=0.845; TRB: ƒÏ=0.021, p=0.929); however, three bacterial orders (Erysipelotrichales, Bacillales, and Pasteurellales) were significantly associated with TCR repertoire. Baseline TCR repertoire was not associated with treatment response in this cohort of breast cancer patients. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 3 2026 Self-Reported Adolescent Menstrual Symptoms and Delayed Gynecologic Consultation among Japanese Women with Endometriosis 159 168 EN Tomoko Ikeda Faculty of Health Sciences, Okayama University Mikiya Nakatsuka Faculty of Health Sciences, Okayama University Original Article 10.18926/AMO/70851 Endometriosis symptoms often first appear during adolescence, yet delays in seeking gynecologic consultation remain a persistent challenge worldwide. Despite growing international evidence, the specific patterns of symptom recognition and consultation delay among Japanese women �\ particularly in relation to self-monitoring behaviors and cultural barriers �\ remain poorly understood. This study aimed to provide foundational data to guide menstrual education and preconception care strategies by conducting a cross-sectional online survey with retrospective recall among women with endometriosis to assess menstrual characteristics and symptom patterns from adolescence to initial care seeking. The survey was conducted in Japan in January 2024 and enrolled 166 women with endometriosis and 200 controls. Participants reported current and adolescent menstrual characteristics, symptom recognition, analgesic and low-dose estrogen–progestin use, school/work impact, and age at first gynecologic consultation for menstrual problems. Women with endometriosis reported heavier bleeding, stronger pain, and greater school/work absence than controls, both currently and retrospectively. The median age at first recognition of heavy bleeding or school/work absence was 16 years, whereas consultation occurred at approximately 21-23 years, indicating a consultation delay of 5-6 years. Notably, while self-monitoring of symptoms was more frequent among women with endometriosis, it only modestly shortened consultation delays. This study provides evidence from Japan that consultation delay persists despite active self-monitoring of symptoms, highlighting the influence of educational and cultural barriers on health-seeking behavior. These findings underscore the importance of integrating menstrual education with clinical guidance to promote timely gynecologic consultation. No potential conflict of interest relevant to this article was reported.

American Physiological Society Acta Medica Okayama 0022-3077 135 4 2026 Characteristics of cross-modal negative BOLD responses in the human sensory subcortex and cortex 747 759 EN Toshikazu Miyata Division of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological Sciences Masaki Fukunaga Section of Brain Function Information, National Institute for Physiological Sciences Junxiang Luo Division of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological Sciences Isao Yokoi National Institute for Physiological Sciences Tetsuya Yamamoto Section of Brain Function Information, National Institute for Physiological Sciences Ayumi Yoshioka Section of Brain Function Information, National Institute for Physiological Sciences Jiajia Yang Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Tomoyo Morita Center for Information and Neural Networks (CiNet), Advanced ICT Research Institute, National Institute of Information and Communications Technology (NICT) Hiromasa Takemura Division of Sensory and Cognitive Brain Mapping, Department of System Neuroscience, National Institute for Physiological Sciences Functional magnetic resonance imaging (fMRI) is a noninvasive method for measuring human brain activity based on blood oxygenation level-dependent (BOLD) responses. Although many studies have reported positive BOLD responses evoked by sensory stimuli, others have reported negative BOLD responses (NBRs) in the sensory cortex when stimuli from different sensory modalities are presented (i.e., cross-modal NBRs). We conducted an fMRI experiment to better understand the characteristics of cross-modal NBRs in subcortical and cortical regions. Auditory and visual stimuli were presented unilaterally to one ear and to either the left or right visual field, respectively. The lateral geniculate nucleus and medial geniculate nucleus did not show a significant cross-modal NBR. In contrast, the primary auditory cortex showed a significant cross-modal NBR when visual stimuli were presented in either the contralateral or ipsilateral visual fields. Finally, we found that the cross-modal NBR in the early visual cortex was highly variable across subjects and did not exhibit consistent trends. However, each subject�fs data exhibited considerable split-half reliability. Our results suggest that cross-modal NBR in the auditory cortex likely reflects mechanisms such as interhemispheric suppression, rather than those coordinated within the same hemisphere.<br> NEW & NOTEWORTHY This study demonstrated that the human primary auditory cortex showed a significant cross-modal negative BOLD response bilaterally, regardless of the visual field in which the visual stimuli were presented. This result suggests that the cross-modal negative BOLD response is not an epiphenomenon of visual cortex activation predominantly observed in the contralateral hemisphere, but is more likely to reflect interhemispheric suppression mechanisms. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1574-7891 2026 Stimulator of interferon genes agonist augmented antitumor immunity of osimertinib in <i>Egfr</i> �]mutated lung cancer EN Jun Nishimura Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tadahiro Kuribayashi Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Johannes Brägelmann Department of Translational Genomics Faculty of Medicine and University Hospital Cologne, University of Cologne Germany Sachi Okawa Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masataka Taoka Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shunta Mori Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tomoka Nishimura Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takaaki Tanaka Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Go Makimoto Department of Respiratory Medicine, Okayama University Hospital Kiichiro Ninomiya Center for Comprehensive Genomic Medicine, Okayama University Hospital Kammei Rai Center for Innovative Clinical Medicine, Okayama University Hospital Eiki Ichihara Center for Clinical Oncology, Okayama University Hospital Ryohei Katayama Division of Experimental Chemotherapy, Cancer Chemotherapy Centre, Japanese Foundation for Cancer Research Katsuyuki Hotta Center for Innovative Clinical Medicine, Okayama University Hospital Masahiro Tabata Center for Clinical Oncology, Okayama University Hospital Yosuke Togashi Department of Respiratory Medicine, Okayama University Hospital Yoshinobu Maeda Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Martin L. Sos Department of Translational Genomics Faculty of Medicine and University Hospital Cologne, University of Cologne Germany Katsuyuki Kiura Department of Respiratory Medicine, Okayama University Hospital Kadoaki Ohashi Department of Respiratory Medicine, Okayama University Hospital Epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers (NSCLCs) lack effective immunotherapy due to a noninflamed tumor microenvironment (TME). We previously reported that EGFR tyrosine-kinase-inhibitor (TKI) induced CD8+ T-cell immunity, which was insufficient for tumor eradication. We evaluated the potential of combining EGFR-TKI with stimulator of interferon genes (STING) agonists in activating a systemic antitumor response. Using a syngeneic mouse model of genetically engineered Egfr-mutant NSCLC, we evaluated the antitumor effects of STING agonist ADU-S100, alone and combined with osimertinib. Immunohistochemistry and flow cytometry were used to assess the TME. Osimertinib alone enhanced CD8+ T-cell infiltration but not Natural Killer (NK) cell infiltration. ADU-S100 injection alone modestly suppressed tumor growth with increasing CD8+/NK cell infiltration in the TME, but lacked an abscopal effect. Combining ADU-S100 with osimertinib significantly enhanced the antitumor effects and CD8+/NK cell infiltration. Depletion of either CD8+ or NK cells reduced the combination effect. Crucially, the combination induced an abscopal effect accompanied by PD-1+/CD8+ cell infiltration. Combining osimertinib with a STING agonist augmented innate and adaptive immunity, inducing systemic antitumor responses in EGFR-mutant NSCLC. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2041-1723 17 1 2026 Structural insights into YheS-mediated release of SecM-arrested ribosome 4963 EN Kaishi Iso Department of Biological Sciences, Graduate School of Science, The University of Tokyo Toma Ikeda School of Life Science and Technology, Institute of Science Tokyo Kohei Yamasaki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yushin Ando Department of Biological Sciences, Graduate School of Science, The University of Tokyo Fumiya K. Sano Department of Biological Sciences, Graduate School of Science, The University of Tokyo Tadaomi Furuta School of Life Science and Technology, Institute of Science Tokyo Hideki Taguchi School of Life Science and Technology, Institute of Science Tokyo Osamu Nureki Department of Biological Sciences, Graduate School of Science, The University of Tokyo Yuhei Chadani Faculty of Environmental, Life, Natural Science and Technology, Okayama University Yuzuru Itoh Department of Biological Sciences, Graduate School of Science, The University of Tokyo ATP-binding cassette subfamily F (ABCF) proteins interact with the ribosome to resolve translation defects near the peptidyl transferase center (PTC). In Escherichia coli, four ABCF proteins (EttA, Uup, YbiT, and YheS) selectively promote translation of distinct problematic nascent peptide sequences, but their molecular mechanisms remain unclear. Here, we present a 2.8 Å cryo-EM structure of the ribosome in complex with an ATPase-deficient mutant of YheS and investigate how it releases ribosomes arrested by the SecM nascent chain. YheS binds to the ribosomal E-site via the L1 stalk, and its P-site tRNA-interaction motif (PtIM) extends toward the PTC, displacing the CCA end of the P-site tRNA. Notably, the cryo-EM density corresponding to the SecM nascent chain within the exit tunnel is largely lost upon YheS binding. These observations suggest that YheS relieves peptide sequence-dependent stalling by perturbing nascent chain-tunnel interactions through P-site tRNA relocation. Steered molecular dynamics simulations provide qualitative support for this model. Together, our findings provide mechanistic insight into a mode of arrest release distinct from the translocon-mediated release mechanism. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0012-1592 68 4-5 2026 Computer�]Aided Sperm Analysis Protocol for Evaluating Sperm Motility in Japanese Medaka e70061 EN Miwa Kuroyanagi Department of Advanced Aquaculture Science, Faculty of Marine Bioscience and Technology, Fukui Prefectural University Satoshi Ansai Ushimado Marine Institute, Faculty of Science, Okayama University Keigo Okamoto Laboratory of Aquatic Molecular Developmental Biology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University Ai Kato Interuniversity Bio-Backup Project Center, National Institute for Basic Biology (NIBB) Touko Yamazaki Laboratory of Bioresources, National Institutes of Natural Sciences Yasuhiro Kamei Optics and Bioimaging Facility, NIBB Eiji Watanabe Basic Biology Program, Graduate University for Advanced Studies (SOKENDAI) Kiyoshi Naruse Laboratory of Bioresources, National Institutes of Natural Sciences Yukiko Ogino Laboratory of Aquatic Molecular Developmental Biology, Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University Changes in sperm motility can serve as an early indicator of reproductive effects caused by environmental chemicals or genetic perturbations. However, sperm motility is highly sensitive to external factors such as osmolarity, ionic composition, and the timing of measurement after activation, making it challenging to obtain consistent and reproducible measurements. Here, we present a standardized protocol for assessing sperm motility in Japanese medaka (Oryzias latipes) using a sperm motility analysis system (SMAS), an application for computer-aided sperm motility analysis (CASA). This protocol details the procedures for sperm collection, activation, and quantitative motility assessment, with particular focus on changes in the percentage of motile sperm post activation and the effects of sperm cryopreservation. We demonstrate time-dependent declines in sperm motility and velocity, and highlight the importance of early post-activation measurements to accurately capture peak motility. Notably, cryopreservation significantly accelerated the decline in sperm motility rate without affecting the initial proportion of motile sperm. To enable reliable comparisons among experimental groups, we recommend standardizing the initiation time after sperm activation by using CASA, and show that measurements should be initiated within 1 min after activation to obtain consistent and reliable data. This standardized SMAS-based protocol provides a robust and reproducible framework for sperm motility analysis in medaka and will be valuable not only for studies in reproductive biology, toxicology, and environmental risk assessment but also for applied research, such as breeding of aquacultural fishes. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0753-3322 194 2026 Elucidation of mechanisms underlying the therapeutic effects of cordycepin on pulmonary hypertension, with a focus on cell senescence and gut microbiota 118923 EN Gaopeng Li Department of Cardiovascular Physiology, Faculty of Medicine, Kagawa University Zhixin Zhao Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University Mitsuhiro Machitani Division of Cancer Stem Cell, National Cancer Center Research Institute Ryou Ishikawa Department of Diagnostic Pathology, Kagawa University Hospital Kaori Ishikawa Department of General Medicine, Kagawa University Hospital Naoya Yokota Department of General Thoracic Surgery, Faculty of Medicine, Kagawa University Reiji Haba Department of Diagnostic Pathology, Kagawa University Hospital Kazufumi Nakamura Center for Advanced Heart Failure, Okayama University Hospital Zhihong Sun Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University Lin-Hai Kurahara Department of Cardiovascular Physiology, Faculty of Medicine, Kagawa University Katsuya Hirano Department of Cardiovascular Physiology, Faculty of Medicine, Kagawa University Introduction: Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder characterized by excessive pulmonary vascular remodeling and aberrant proliferation of pulmonary artery smooth muscle cells (PASMCs). Emerging evidence suggests that gut microbiota dysbiosis contributes to PH development. Cordycepin, a natural adenosine analogue derived from Cordyceps militaris, has demonstrated antiproliferative and microbiota-modulating properties; however, its mechanism of action in PH remains unclear.<br> Objective: Elucidate the mechanisms underlying the therapeutic effects of cordycepin on PH, focusing on cellular senescence and gut microbiota.<br> Methods: The effects of cordycepin on PH pathology were investigated by transcriptome analysis of PASMCs from patients, and metagenomic analysis of rodent PH models. Cellular senescence was analyzed in lung tissue from p16Ink4a-CreERT2 reporter mice and in rat bone marrow-derived macrophages (BMDMs).<br> Results: RNA sequencing analysis revealed activation of p53 signaling by cordycepin in PASMCs. Cordycepin suppressed CDK1 expression and TERT phosphorylation at threonine 249. It ameliorated vascular and cardiac remodeling in PH rat and mouse models. Cordycepin induced M1-like macrophage senescence in p16 Ink4a reporter mice lungs and rat BMDMs. Cordycepin significantly reshaped the gut microbiota, increasing beneficial genera (e.g. Alistipes and Acetatifactor) and reducing proinflammatory taxa (e.g., Ruminococcus), with modulating key metabolic pathways, including short-chain fatty acid, tryptophan, and vitamin K2 metabolism.<br> Conclusion: Cordycepin exerts multi-target therapeutic effects in PH by inhibiting PASMC proliferation via the p53–CDK1/pTERT axis, modulating gut microbiota-linked immunometabolism and induces proinflammatory macrophage senescence. These findings support cordycepin as a promising candidate for PH therapies targeting the vascular, immune, and gut–lung axes. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0007-1048 208 6 2026 Decreased renal function predicts severe cytokine release syndrome after CAR-T-cell therapy for large B-cell lymphoma 2124 2133 EN Yasuyuki Arai Department of Hematology, Graduate School of Medicine, Kyoto University Tomoyasu Jo Department of Hematology, Graduate School of Medicine, Kyoto University Takayuki Sato Department of Hematology and Oncology, Kurashiki Central Hospital Masatoshi Sakurai Division of Hematology, Department of Medicine, Keio University School of Medicine Daisuke Kaji Department of Hematology, Toranomon Hospital Toshio Kitawaki Department of Hematology, Graduate School of Medicine, Kyoto University Kazuyuki Shimada Department of Hematology and Oncology, Nagoya University Graduate School of Medicine Tatsu Shimoyama Division of Clinical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Satoshi Yoshihara Department of Hematology, Hyogo Medical University Hospital Shinichi Makita Department of Hematology, National Cancer Center Hospital Nobuharu Fujii Department of Hematology and Oncology, Okayama University Hospital Go Yamamoto Department of Hematology, Toranomon Hospital Keisuke Kataoka Division of Hematology, Department of Medicine, Keio University School of Medicine Emiko Sakaida Department of Hematology, Chiba University Hospital Hideki Goto Department of Hematology, Hokkaido University Hospital Yasuhiro Nakashima Department of Hematology, Osaka Metropolitan University Hospital Akiyo Yoshida Department of Hematology, Kanazawa University Hospital Yoshihiro Umezawa Department of Hematology, Institute of Science Tokyo Hospital Haryoon Kim Division of Hematology, Department of Medicine, Keio University School of Medicine Motohiro Kato Department of Pediatrics, The University of Tokyo Yoshiko Atsuta Japanese Data Center for Hematopoietic Cell Transplantation Koji Kato Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital Cytokine release syndrome (CRS) remains a major toxicity of chimeric antigen receptor (CAR) T-cell therapy in large B-cell lymphoma (LBCL), and robust pre-infusion predictors are needed for risk-adapted management. We retrospectively analysed LBCL patients in the Japanese nationwide registry who underwent CD19 CAR-T-cell therapy between 2019 and 2024. Among 900 patients (median age 62 years), cumulative incidences of CRS within 30 days after infusion were 75.0% for any grade, 20.8% for grade ≥ 2 and 14.0% for grade ≥ 3. In multivariable analysis, lower estimated glomerular filtration rate (eGFR) (adjusted hazard ratio [aHR] 1.108 per 10 mL/min per 1.73 m2 decrease; 95% confidence interval [CI] 1.015–1.209; p = 0.022), higher ferritin (aHR 1.006 per 100 ng/mL; 95% CI 1.001–1.010; p = 0.016), C-reactive protein (CRP) (aHR 1.142 per mg/dL; 95% CI 1.091–1.195; p < 0.001) and lactate dehydrogenase (LDH) (aHR 1.073 per 100 U/L; 95% CI 1.008–1.142; p = 0.028) independently predicted grade ≥ 2 CRS. We then built a four-factor CRS pre-infusion risk evaluation model, cytokine release syndrome-pre-infusion risk evaluation (CRS-PRE), that stratified grade ≥ 2 CRS risk into low, intermediate and high groups with incidences of 2.8%, 26.0% and 50.0% respectively. Decreased eGFR, a surrogate of host renal reserve, with elevated ferritin, CRP and LDH emerged as predictors of high-grade CRS. The CRS-PRE may facilitate risk-adapted monitoring and intervention in clinical practice. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1341-9625 31 6 2026 Barriers and facilitators for online genetic care for hereditary cancer in Japan: findings from surveys of both clients and medical professionals 1063 1074 EN Sayaka Ueno Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yusaku Urakawa Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumino Kato Arisa Ueki Division of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research Keika Kaneko Division of Clinical Genetic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research Koji Matsumoto Division of Clinical Genetics, Hyogo Cancer Center Hiromi Sugawara Division of Clinical Genetics, Hyogo Cancer Center Sayoko Takeuchi Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Reiko Yoshida Department of Medical Genetics and Genomics, Saitama Cancer Center Miho Kakuta Center for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita Hospital Kiwamu Akagi Center for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita Hospital Kazuo Tamura Center for Genomic Diagnosis, International University of Health and Welfare (IUHW) Narita Hospital Akira Hirasawa Department of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background Online genetic care can offer a promising solution to the shortage of qualified medical professionals in genetic medicine, which leads to regional disparities in access. However, despite global adoption, its use in Japan remains limited.<br> Methods Two questionnaire surveys were conducted to investigate potential needs and barriers regarding online genetic care: one involving 858 medical professionals (738 physicians and 120 genetic counselors or nurses), and the other involving 443 clients who received in-person genetic counseling.<br> Results Only 14.0% of the medical professionals had experience with online genetic care, although 85.9% of the professionals engaged in cancer genetics were willing to consider providing it in the future. Notably, a discrepancy was found regarding hospital selection: clients prioritized access to specialized medical care, whereas professionals assumed clients valued accessibility for family members. Professionals expressed greater concerns about adequacy of online communication, client environments and internet security. Among clients, 89.1% estimated they would sufficiently understand and accept total content of counseling session if were conducted online. Older age and infrequent internet use were associated with lower acceptance and higher anxiety regarding online methods. Concerns about ability to use the necessary technology affected clients�f willingness to encourage online care for their relatives.<br> Conclusion Online genetic care shows high potential for client acceptance and can effectively address regional disparities in Japan. To bridge the gap between client needs and professional perceptions and to overcome the digital divide, it is necessary to develop secure, accessible systems and provide education for both patients and healthcare providers. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0916-7005 43 2 2026 Machine learning prediction of the Madden–Julian oscillation using reservoir computing 25 EN Tamaki Suematsu RIKEN Center for Computational Science Kengo Nakai Graduate School of Environmental Life, Natural Science and Technology, Okayama University Tsuyoshi Yoneda Graduate School of Economics, Hitotsubashi University Daisuke Takasuka Department of Geophysics, Tohoku University Takuya Jinno Graduate School of Science, The University of Tokyo Yoshitaka Saiki Graduate School of Business Administration, Hitotsubashi University Hiroaki Miura Graduate School of Science, The University of Tokyo The prediction of the Madden–Julian Oscillation (MJO), a massive tropical weather event with global socio-economic impacts, has been infamously difficult with physics-based weather prediction models. We employ the reservoir computing, a brain-inspired machine-learning technique, to construct a machine learning model that forecasts the real-time multivariate MJO index (RMM), a macroscopic variable that represents the state of the MJO. The training data was refined by development of a novel real-time band-pass filter that extracts the recurrency of MJO signals only from the past raw atmospheric data, and by selection of a suitable time-delay coordinate of the RMM that enhances the recurrency of the input data. The constructed model demonstrated the skill to forecast the time sequence of the RMM for a month from pre-developmental stages of the MJO. Examination of best-performing cases suggested that RMM sequences may be predicted for over two months in some cases. These results imply that inherent predictability limit of the MJO is longer than that has been estimated from physics-based weather prediction models. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0378-3820 288 2026 Hydrogen-lean two-stage upgrading of highly acidic palm acid oil via decoupled acid reduction and deoxygenation 108478 EN Hirofumi Noge Graduate school of education, Okayama university Chiyu Nakano Department of comprehensive technical solutions, Okayama University Yoshie Ueno Department of Food and Nutrition, Faculty of Home Economics, Kyoto Women's University Wira Jazair Yahya Institute for Sustainable Transport HICoE, University Teknologi Malaysia Hasannuddin Abd Kadir Faculty of Mechanical Engineering, Universiti Teknologi MARA Sachi Masunaga Department of comprehensive technical solutions, Okayama University Upgrading highly acidic waste lipids into liquid hydrocarbons under limited hydrogen availability remains challenging due to catalyst deactivation, excessive cracking, and poor process stability. Palm acid oil (PAO), characterized by extremely high free fatty acid content, represents a particularly demanding feedstock. This study proposes a hydrogen-lean two-stage upgrading strategy that decouples acid value (AV) reduction from hydrocarbon formation through staged reactor operation. In the first stage, batch pretreatment under low hydrogen pressure (initial 0.1 MPa) enabled rapid apparent AV reduction. However, increasing temperature promoted thermally driven degradation, highlighting intrinsic limitations of single-stage severity intensification. Methanol-assisted pretreatment further decreased AV mainly through esterification and formation of oxygenated intermediates. In the second stage, hydrogen-free fixed-bed upgrading over oxide-based catalysts exhibited a distinct operating window near 365 �‹C, where stable condensed liquid recoveries of 50–60 wt% were obtained. Deoxygenation proceeded predominantly via decarbonylation/decarboxylation pathways. Among the catalysts investigated, ZrO₂–Co showed superior stability and lower residual AV. Overall, reactor staging enabled AV reductions exceeding 90% within 1.5–2 h while maintaining stable liquid recovery, demonstrating an effective upgrading strategy for highly acidic waste lipids under hydrogen-lean conditions. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2352-4928 51 2026 Optical spectroscopic evaluation on the acquisition of optimal sonication temperature for efficient liquid phase exfoliation of molybdenum disulfide 114910 EN Fatimah Az-Zahra Saravanan binti Abdullah School of Engineering and Physical Sciences, Heriot-Watt University Malaysia Wengnam Lee Foundation Center, Heriot-Watt University Malaysia Patrik Öhberg Institute of Photonics and Quantum Sciences, School of Engineering and Physical Sciences, Heriot-Watt University Boontong Goh Low Dimensional Materials Research Center, Department of Physics, Faculty of Science, University of Malaya Wuyi Chong Photonics Research Center, University of Malaya Harith Ahmad Photonics Research Center, University of Malaya Yasuhiko Hayashi Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Takeshi Nishikawa Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yuenkiat Yap Foundation Center, Heriot-Watt University Malaysia This work investigates how the sonication temperature affects the liquid phase exfoliation of MoS₂ using optical and morphological approach in attempt to acquire an optimal temperature for such process at ambient room conditions. In an ultrasonic bath, exfoliation was carried out at six different temperatures. UV-Vis, FTIR, Raman spectroscopy and SEM characterizations reveal that moderate room temperature range yield excellent results producing well-dispersed flakes with strong excitonic properties with mild oxidation. Higher temperatures cause substantial oxidation, deterioration and restacking while lower temperatures led to insufficient exfoliation and fragmented morphologies because of insufficient cavitation energy. The findings highlight the importance of temperature control in producing high quality nanosheets for scalable applications. No potential conflict of interest relevant to this article was reported.

Institute of Electrical and Electronics Engineers (IEEE) Acta Medica Okayama 2169-3536 14 2026 Programmable Clock Distribution Using Switching Matrices for Field Programmable Gate Arrays 52641 52653 EN Ayumu Ogura Okayama University Minoru Watanabe Okayama University Nobuya Watanabe Okayama University Every digital systems using very large scale integration require clock distributions, for which a dedicated clock tree or a mesh clock is frequently used. Field programmable gate arrays have numerous general-purpose programmable wires based on switching matrices to connect the outputs and inputs of look-up tables and input–output ports. However, field programmable gate arrays never use numerous general-purpose programmable wires for their clock distributions to satisfy the clock skew margin similarly to very large scale integrations. Field programmable gate arrays also use dedicated clock trees, although their programmability is not high. Currently, field programmable gate arrays can support multiple dedicated clock routing or multiple clock trees. Unfortunately, the number of clock trees is fixed. They remain limited to a small number. Even if an application requires many clock distributions, such a clock distribution cannot be supported in current field programmable gate arrays. This paper therefore presents a proposal of a more flexible clock distribution method based on wiring channels and switching matrices. The method uses general-purpose programmable wires. In addition, to resolve clock skew increase difficulties, we have introduced a new flip-flop with a two-phase clock signal. This paper presents simulation results obtained using the proposed clock distribution method on an originally designed field programmable gate array. In addition, experimentally obtained results indicate that the proposed clock distribution method can function correctly on a Cyclone V field programmable gate array. No potential conflict of interest relevant to this article was reported.

Pharmaceutical Society of Japan Acta Medica Okayama 0918-6158 49 3 2026 Bortezomib Induces Apoptosis via Upregulation of Abhd4 in Peripheral Nerve Cells 496 502 EN Yusuke Konishi Department of Pharmacy, Kobe University Hospital Tomohiro Omura Department of Pharmacy, Kobe University Hospital Takeshi Ijichi Department of Pharmacy, Kobe University Hospital Hiroki Nishiguchi Department of Pharmacy, Kobe University Hospital Ryunosuke Hayakawa Education and Research Center for Clinical Pharmacy, Kobe Pharmaceutical University Yumi Kitahiro Department of Pharmacy, Kobe University Hospital Kotaro Itohara Department of Pharmacy, Kobe University Hospital Kazuhiro Yamamoto Department of Integrated Clinical and Basic Pharmaceutical Sciences, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ikuko Yano Department of Pharmacy, Kobe University Hospital Bortezomib, a first-in-class proteasome inhibitor, is widely used to treat multiple myeloma and other hematological malignancies. Despite its therapeutic efficacy, bortezomib causes peripheral neuropathy (PN) in approximately 20–30% of patients, often leading to dose reduction or discontinuation. Preventive or therapeutic approaches to bortezomib-induced PN are currently unavailable, as its precise mechanism remains unclear. In this study, we compared the effects of bortezomib and the second-generation proteasome inhibitor carfilzomib on peripheral nerve cells to identify candidate molecules involved in PN development. Transcriptome profiling of differentiated F11 cells, a hybridoma of a rat embryonic dorsal root ganglion and mouse neuroblastoma cell line N18TG2, revealed that bortezomib selectively upregulated ƒ¿/ƒÀ-hydrolase containing domain 4 (Abhd4), whereas carfilzomib did not. This finding was confirmed by quantitative RT-PCR and immunoblotting, which demonstrated consistent increases in Abhd4 mRNA and protein levels following bortezomib treatment. Functional analysis further revealed that Abhd4 overexpression promoted early apoptosis, suggesting a mechanistic link between bortezomib-induced Abhd4 elevation and neuronal vulnerability. Therefore, these results suggest that Abhd4 represents a candidate molecular signature associated with bortezomib-induced PN. Although further in vivo validation is needed, these findings warrant further investigation of Abhd4 as a potential contributor to bortezomib-induced PN. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1341-8076 52 5 2026 Survey to Document the Adverse Reactions After Human Papillomavirus Vaccination Among Japanese Female Youth at a University e70314 EN Chigusa Higuchi Educational and Research Management Field, Health Management Department, Okayama University Chikako Ogawa Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine Yoshiaki Iwasaki 1Educational and Research Management Field, Health Management Department, Okayama University Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Hisashi Masuyama Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine Aim: Concerns about possible adverse events remain a critical barrier in implementing human papillomavirus (HPV) vaccination among Japanese youth. This study aimed to understand the time course of adverse events experienced by HPV vaccine recipients.<br> Methods: An online questionnaire survey was given to students, faculty, and staff aged 18–26 years, at Okayama University Hospital, who received the HPV vaccine. The survey gathered information on the number of HPV vaccine doses received, prevaccination health conditions, adverse reactions within 2 h and between 2 h and 7 days postvaccination, menstrual irregularities after vaccination, reasons for getting vaccinated, feelings before and after vaccination, and factors providing reassurance during vaccination. Prevalence of symptoms was expressed as numbers and percentages, and analyses were performed using Chi-squared or Fisher's exact tests.<br> Results: Responses were obtained from 299 participants, yielding a 75% response rate. Approximately 60% participants reported local pain, 30% swelling, and 4% fever. Most symptoms resolved on the vaccination day itself or the following day, although some persisted for 3–7 days. Over 80% participants rated their pain between 0 and 3 on numerical rating scale of 0–10. While 60% experienced anxiety before vaccination, 90% reported no anxiety afterward.<br> Conclusions: Our study presents one of the first comprehensive accounts of post-HPV vaccination adverse events and their time course, and underpins the importance of disseminating detailed information about vaccine-associated adverse reactions to encourage greater vaccine uptake. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1471-2458 26 1 2026 Community health worker-supported oral health promotion in low- and middle-income countries: a scoping review of roles, interventions, and outcomes 1612 EN Junko Yasuoka Division of Global Health Sciences, Graduate School of Public Health, St. Luke�fs International University Shunsuke Okada Department of Oral and Maxillofacial Radiology, Medical Development Field, Okayama University Yohei Takeshita Department of Oral and Maxillofacial Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background Oral diseases are among the most prevalent conditions worldwide and disproportionately affect populations in low- and middle-income countries (LMICs). The shortage and maldistribution of the oral health workforce have widened inequalities in prevention and treatment. Task-sharing through community health workers (CHWs) has been promoted as a cost-effective and sustainable strategy for extending services to underserved populations; however, evidence on their roles in oral health promotion in LMICs remains fragmented. This scoping review mapped evidence on CHW-supported oral health promotion and identified common roles, interventions, and system-level challenges.<br> Methods A comprehensive search was conducted in PubMed, CINAHL, CENTRAL, and Google Scholar, using keywords and MeSH terms related to �gcommunity health workers,�h �goral health,�h and LMICs, based on the EPOC LMIC filter of the World Bank�fs classifications. No publication date restrictions were applied, and gray literature was included. The review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Data were charted on CHW characteristics, roles, target populations, oral conditions addressed, and implementation challenges, and synthesized narratively. This protocol was registered on Open Science Forum (https://doi.org/10.17605/OSF.IO/NZPHA).<br> Results Thirty-two studies from 11 LMICs were included, approximately half from India. The evidence mapped a wide range of CHW roles and interventions, most commonly focusing on oral cancer screening, followed by dental caries prevention and periodontal care. CHWs were involved in home visits, education, screening, basic treatment, and referrals. Some programs integrate mobile health (mHealth) tools for remote diagnosis. System-level challenges were variably reported across settings, including inadequate infrastructure, fragmented referral systems, limited supervision, and constrained career development opportunities for CHWs.<br> Conclusions This scoping review highlights the contributions of CHWs to oral health promotion in LMICs, while underscoring health system and workforce constraints. The available evidence is largely descriptive, suggesting the need for strengthened training, supervision, referral linkages, and career development to support CHWs�f integration into oral health services. Family-centered and Continuum of Care approaches warrant further exploration to inform equitable and sustainable oral health within primary health care systems. No potential conflict of interest relevant to this article was reported.

Informa UK Limited Acta Medica Okayama 1098-6065 2026 Proposing an alternative direction for the development of research: a complementary perspective on Schoenfeld�fs approach to generality 1 12 EN Yusuke Uegatani Hiroshima University High School Ippo Ishibashi Faculty of Education, Okayama University The purpose of this paper is to propose a theoretical framework that suggests directions for future research. While Schoenfeld�fs three-axis heuristic framework is well known for this purpose, it primarily points toward increasing generality. Drawing on prior studies on the generalizability of empirical findings in educational research, this paper argues that an alternative research path is possible. Building on the distinction between prevalence and scope, it proposes two types of generality: the generality of a phenomenon within a specified scope and the generality of a theory. Correspondingly, it identifies two directions for research development: delimitation of the scope and generalization of a theory. Finally, the paper argues that research development based on this framework can be understood as progressive in the Lakatosian sense. While Schoenfeld�fs framework suggests directions for individual studies, this framework guides competing research programmes by enabling both to progress through scope delimitation. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0342-1791 53 2 2026 High-pressure spectroscopic investigation of ƒÃ-FeOOH: toward a better understanding of pressure-induced hydrogen-bond symmetrization 18 EN Izumi Mashino Institute for Planetary Materials, Okayama University Shigeru Yamashita Institute for Planetary Materials, Okayama University Takashi Yoshino Institute for Planetary Materials, Okayama University High-pressure spectroscopic measurements of ƒÃ-FeOOH were conducted up to ~ 65 GPa at room temperature in diamond anvil cells. The pressure evolution of the Raman vibrational modes confirms that a hydrogen-bond-symmetrization-induced phase transition from P21nm to Pnnm occurs at ~ 18 GPa. Infrared (IR) spectroscopic measurements suggest that the Pnnm phase has a disordered hydrogen state, and no spectroscopic evidence for fully centered hydrogen bonds is observed within the investigated pressure range. Above ~ 45 GPa, Fe3+ in ƒÃ-FeOOH undergoes a high-spin to low-spin transition as indicated by a reduction of the unit cell volume, together with reductions in IR transmitted and Raman signals. These results demonstrate that ƒÃ‑FeOOH preserves a disordered hydrogen‑bond configuration up to at least 45 GPa, whereas ƒÂ-AlOOH transforms to a centered hydrogen-bond configuration at ~ 18 GPa. This compositional contrast suggests that Fe‑bearing oxyhydroxides follow a distinct evolution of hydrogen bonding under compression, providing insight into hydrogen behavior in deep Earth materials. No potential conflict of interest relevant to this article was reported.

BMJ Acta Medica Okayama 2044-6055 16 3 2026 Protocol for an open-label, randomised, controlled trial to evaluate the efficacy and safety of sotatercept add-on therapy compared with pulmonary vasodilator-based standard of care for pulmonary vasodilator-resistant pulmonary arterial hypertension associated with unrepaired congenital shunts (atrial septal defect, ventricular septal defect or patent ductus arteriosus), including Eisenmenger syndrome: the SuMILE trial e113430 EN Keimei Yoshida Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Kazuya Hosokawa Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Takahiro Hiraide Department of Cardiology, Keio University School of Medicine Satoshi Akagi Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kentaro Ejiri Department of Cardiovascular Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yu Taniguchi Division of Cardiovascular Medicine, Kobe University Hospital Shiro Adachi Department of Cardiology, Nagoya University Hospital Takumi Inami Department of Cardiovascular Medicine, Kyorin University School of Medicine Naohiko Nakanishi Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Masaharu Kataoka The Second Department of Internal Medicine, University of Occupational and Environmental Health Taijyu Satoh Department of Medical Science and Innovation, SiRIUS Institute of Medical Research, Tohoku University Shunsuke Tatebe Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Toshiro Shinke Division of Cardiology, Department of Medicine, Showa Medical University Hospital Hideshi Tomita Periatric Heart Disease and Adult Congenital Heart Disease Center, Showa Medical University Hospital Yusuke Akazawa Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine Takashi Higaki Department of Pediatric and Adolescent Therapeutic and Developmental Education, Ehime University Graduate School of Medicine Koshiro Tagawa Center for Clinical and Translational Research, Kyushu University Hospital Ayako Ishikita Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Soshun Asakawa Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Kohtaro Abe Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University Introduction Eisenmenger syndrome and pulmonary arterial hypertension (PAH) due to unrepaired congenital shunts, including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA), remain life-threatening conditions despite advances in congenital heart disease (CHD) care. In this population, vasodilator-based therapies effective in other forms of PAH have shown limited benefit, and no disease-modifying treatment has been established. Sotatercept, an activin-signalling inhibitor, improved exercise capacity and haemodynamics in phase 2/3 PAH trials; however, patients with unrepaired CHD, including Eisenmenger syndrome, were excluded. The efficacy and safety of sotatercept in this population remain unknown.<br> Methods and analysis The SuMILE trial is a prospective, exploratory, multicentre, open-label, randomised, controlled trial conducted at 11 Japanese tertiary centres. 36 adults with vasodilator-resistant PAH due to unrepaired ASD, VSD or PDA, including Eisenmenger syndrome, will be randomised 2:1 to sotatercept add-on therapy plus vasodilator-based PAH therapy versus vasodilator-based PAH therapy alone. Sotatercept will be administered subcutaneously every 3 weeks in accordance with label-approved dose-modification rules for haemoglobin and platelet changes. The primary endpoint is the change in 6-min walk distance from baseline to week 24. Key clinical events will be independently adjudicated. Secondary endpoints include all-cause mortality or lung transplantation; pulmonary hypertension-related hospitalisation or initiation of parenteral prostacyclin and changes in WHO functional class, N-terminal pro-brain natriuretic peptide and emPHasis-10. Exploratory endpoints include genotype, right heart catheterisation and cardiac MRI parameters. The primary analysis will use ANCOVA, adjusting for baseline 6-min walk distance and randomisation stratum in the intention-to-treat population.<br> Ethics and dissemination The protocol has been reviewed and approved by the certified central review board (Kyushu University Hospital Clinical Ethics Review Board) and participating institutions. Written informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed journals, scientific conferences and trial registries.<br> Trial registration number Japan Registry of Clinical Trials no. 1071250069; ClinicalTrials.gov NCT07356778. Protocol version and date: V.1.3; 23 October 2025 No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 8756-3282 209 2026 PPy-coated wire actuators for micromechanostimulation of cells – identification of immediate-early responsive mechanoregulatory genes in osteoblasts 117914 EN Jiamin Chen Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Amaia B. Ortega-Santos Department of Physics, Chemistry and Biology (IFM), Linköping University Satoru Hayano Department of Orthodontics, Okayama University Hospital Ziyi Wang Department of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jose G. Martinez Department of Physics, Chemistry and Biology (IFM), Linköping University Emilio Satoshi Hara Department of Advanced International and Information Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Edwin W.H. Jager Department of Physics, Chemistry and Biology (IFM), Linköping University Hiroshi Kamioka Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mechanotransduction, i.e., the conversion of mechanical cues into biochemical signals, is essential for bone development, remodeling, and adaptation. Although mechanical loading is known to regulate osteoblast function and bone homeostasis, dissecting the early and sustained mechanotransductive responses at the microscale remains challenging due to limitations of existing in vitro models. Here, we report the development and application of a mechanostimulation system comprising a polypyrrole (PPy)-based wire actuator that expands and contracts (4 ƒÊm in radius) upon electrical actuation and enables precise, localized micromechanical stimulation of a small number of cells within standard culture formats. Using this system, we applied short-term (30 min) cyclic (Cyc30) or static (Stat30), as well as prolonged (120 min) cyclic (Cyc120) stimulations to two osteoblast-like cells (MC3T3-E1 or KUSA-A1). Subsequent transcriptomic profiling and computational network analyses revealed that Cyc30 was not capable of inducing significant changes in mRNA expression, suggesting cellular adaptation to short-term cyclic loading. In contrast, Stat30 induced the upregulation of Fos, Btg2, Egr1, and Fosl1, all known genes associated with mechanotransduction, supporting the validity and reproducibility of our experimental mechanostimulation system. Notably, two long non-coding RNAs (B930036N10Rik and 5430431A17Rik) were identified for the first time as being upregulated in response to Stat30 stimuli. Among the differentially expressed genes (DEGs) upregulated by Cyc120 stimuli, Hmox1, a stress-inducible enzyme known for its roles in maintaining cellular homeostasis and promoting survival, was the only DEG repeatedly observed across the Cyc30/Cyc120 and Stat30/Cyc120 comparisons in both cell types, potentially emerging as a key stress-response gene under prolonged mechanical loading. Collectively, these results establish the PPy-based microactuator as a powerful tool for microscale mechanobiology, and provide molecular insight into immediate-early responsive transcriptional programs underlying osteoblastic mechanoadaptation conserved across different cell types. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2731-5894 2026 Comparative study of Ni–CeO2 catalysts prepared by impregnation and coprecipitation for CO2 methanation EN Nobuko Fukuda Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Shuichi Imano Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nozomi Nakahara Graduate School of Environmental, Life, Natural Science and Technology, Okayama University This study explores how synthesis methods affect the structure and CO2 methanation performance of Ni–CeO2 catalysts prepared by coprecipitation and impregnation under identical conditions. Coprecipitation generated particles below 100 nm with uniform elemental distribution, together with large bulk-like particles exhibiting locally concentrated Ni species, attributed to differences in hydroxide solubility. Impregnation, by contrast, produced very large particles (> 500 nm) with smaller particles attached, while maintaining relatively homogeneous elemental distribution. Coprecipitated catalysts showed slightly higher surface area and oxygen vacancy concentration, resulting in higher apparent turnover frequencies (TOFapp) below 300 �‹C due to enhanced CO2 adsorption and high Ni site density. However, at temperatures above 350 �‹C, impregnated catalysts displayed higher CH4 selectivity and TOFapp, indicating reduced kinetic limitations and more efficient active-site utilization. These results provide insights for rational design of efficient CO2 methanation catalysts. No potential conflict of interest relevant to this article was reported.

American Geophysical Union (AGU) Acta Medica Okayama 1525-2027 27 5 2026 Chemical Geodynamics of Granitoid Magmatism During a Pacific�]Philippine Sea Plate Transition in Southwest Japan e2026GC012945 EN Nghiem V. Dao The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Tsegereda A. Yemer The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Tulibako T. Mwaisuba The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Chie Sakaguchi The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Hiroshi Kitagawa The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Katsura Kobayashi The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Teruyoshi Imaoka Division of Earth Science, Graduate School of Sciences and Technology for Innovation, Yamaguchi University Eizo Nakamura The Pheasant Memorial Laboratory for Geochemistry and Cosmochemistry, Institute for Planetary Materials, Okayama University at Misasa Granitoid magmatism along the western Pacific margin records interactions between subduction dynamics and crust–mantle processes; however, the links between plate reorganization and magma-source evolution remain debated. Here we integrate U–Pb zircon geochronology with Pb–Sr–Nd–Hf isotope systematics to investigate Cretaceous–Paleogene granitoids in Southwest Japan. Zircon U–Pb ages define two discrete magmatic episodes at 110–60 Ma and 45–30 Ma, separated by a magmatic hiatus of ∼10–15 Myr. These granitoid groups exhibit distinct isotopic signatures, indicating derivation from isotopically distinct magma sources linked to the paleo-Pacific (Izanagi) plate and the Philippine Sea plate, respectively. Isotope-based mass-balance modeling indicates higher sediment contributions to the older granitoids, with decreasing sediment input both landward and through time. The magmatic lull at ca. 52–40 Ma coincides with an abrupt isotopic shift and is interpreted to reflect plate reorganization, during which subduction of the paleo-Pacific plate was replaced by a transform or highly oblique plate boundary associated with the northward migration of the proto–Philippine Sea plate. Independent constraints from convergence rates, sediment flux, and accretionary complex development support this interpretation. These results demonstrate that granitoid magmatism in Southwest Japan was fundamentally controlled by temporal changes in subducted lithosphere and sediment flux driven by plate reorganization, highlighting the sensitivity of arc magmatism to transient tectonic regimes. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0924-090X 114 8 2026 Basin boundary metamorphoses due to changes in accessible boundary orbits in passive dynamic walking 595 EN Kota Okamoto Department of Aeronautics and Astronautics, Graduate School of Engineering, Kyoto University Nozomi Akashi Graduate School of Informatics, Kyoto University Ippei Obayashi nterdisciplinary Education and Research Field, Okayama University Hiroshi Kokubu Department of Mathematics, Graduate School of Science, Kyoto University James A. Yorke Departments of Mathematics and Physics, Institute for Physical Science and Technology, University of Maryland Shinya Aoi Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, The University of Osaka Passive dynamic walking is a mechanical system that walks down a shallow slope without any input or control, and is a useful tool for understanding the dynamic properties of walking. This system has a wide variety of periodic solutions through bifurcations depending on the slope angle, resulting in chaotic attractors and fractal basin boundaries. In addition, basin boundary metamorphoses occur at certain slope angles, where the boundaries of the basin of attraction change abruptly, but the mechanism underlying this phenomenon remains largely unclear. A well-known dynamical system, the Hénon map, exhibits similar properties, and its basin boundary metamorphoses have been explained in terms of changes in accessible boundary orbits caused by intersections of manifolds associated with bifurcating solutions. Inspired by this framework, we propose a hypothesis for the mechanism of basin boundary metamorphoses in passive dynamic walking by introducing the concept of accessible boundary orbits and verify it numerically. Our results provide new insights into the governing dynamics of walking and contribute to a deeper understanding of nonlinear phenomena in locomotion systems. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2045-2322 16 1 2026 Explainable analysis of the complex maze magnetic domain structure through extension of the Landau free energy model by adding an entropy feature 12889 EN K. Masuzawa Department of Material Science and Technology, Tokyo University of Science A. L. Foggiatto Department of Material Science and Technology, Tokyo University of Science S. Kunii Department of Material Science and Technology, Tokyo University of Science R. Nagaoka Department of Material Science and Technology, Tokyo University of Science M. Taniwaki Department of Material Science and Technology, Tokyo University of Science T. Yamazaki Department of Material Science and Technology, Tokyo University of Science C. Mitsumata Department of Material Science and Technology, Tokyo University of Science I. Obayashi Interdisciplinary Education and Research Field, Okayama University Y. Hiraoka Kyoto University Institute for Advanced Study, Kyoto University M. Kotsugi Department of Material Science and Technology, Tokyo University of Science Maze magnetic domains exhibit complex, temperature-dependent behavior that impacts energy loss in soft magnets, yet their magnetization reversal mechanisms remain poorly understood due to current model limitations. To address this gap, we develop an entropy-extended Landau free energy model that incorporates thermal effects into the analysis of magnetic domain. We employ a data-driven pipeline combining persistent homology, energy decomposition, and principal component analysis to construct an interpretable model that quantifies structure–property relationships and enables causal analysis of magnetic pattern formation. Using this approach, we trace entropy increases to their origins in initial domain configurations and quantify energy transfer among entropic, demagnetization, and exchange contributions. We also find that domain wall lengthening tracks increasing structural complexity, yielding previously inaccessible insights into magnetization reversal mechanism and enabling automated visualization. Our entropy-augmented model provides an explainable framework to decipher magnetization processes and guide the design of magnetic materials to reduce energy loss. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1471-2334 25 1 2025 Phenotypic and potential virulence features of Salmonella enterica serotypes from cancer patients in Kolkata, India 1263 EN Goutam Chowdhury Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR- NICED Sanjay Bhattacharya Tata Medical Center Gaurav Goel Tata Medical Center Soumyadip Chatterji Tata Medical Center Kei Kitahara Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR- NICED Ayumu Ohno Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR- NICED Melissa Glenda Lewis Division of Biostatistics, ICMR - National Institute for Research in Bacterial Infections Shin-ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Thandavarayan Ramamurthy Division of Bacteriology, ICMR - National Institute for Research in Bacterial Infections Asish K. Mukhopadhyay Division of Bacteriology, ICMR - National Institute for Research in Bacterial Infections Background Salmonella enterica is a leading cause of gastroenteritis and enteric fever. In this study, we sought to investigate the phenotypic and genotypic characteristics of S. enterica isolated from the cancer patients admitted at the Tata Medical Center, Kolkata over a period of eight years (2016–2023).<br> Methods Salmonella enterica isolates were identified by standard biochemical and serotyping. Antimicrobial susceptibility was tested by disk diffusion method and virulence genes were identified by PCR. The genetic relatedness of strains was determined by pulsed-field gel electrophoresis (PFGE) methods.<br> Results A total of 122 S. enterica isolates were identified and classified into 18 different serovars. S. Typhimurium (28.7%), S. Kentucky (22.1%), S. Enteritidis (13.9%), S. Typhi (5.7%) and S. Agona (5.7%) were identified as the common serovars. S. enterica infection was more often detected in adults (77.9%) than in children of 6–18 years old (11.4%) and < 5 years of age (10.6%). The maximum number of S. enterica was isolated from blood (52.4%) followed by those isolated from stool (36.9%) and urine (5.7%). S. enterica infections were detected among patients with chronic myelogenous leukemia (CML)/acute lymphoblastic leukemia (ALL) (24.6%) than Hodgkin lymphoma/non-Hodgkin lymphoma (16.4%), multiple myeloma (9.8%), lung adenocarcinoma (9%), prostate adenocarcinoma (6.6%), and endometrium carcinoma (5.7%). S. Kentucky showed a statistically significant association with hematologic malignancies (p < 0.001), whereas S. Enteritidis was significantly present in Hodgkin lymphoma and acute lymphoblastic leukemia/Chronic myelogenous leukemia cancer types (p = 0.004). Most of the S. enterica isolates displayed resistance to erythromycin (62.9%), nalidixic acid (62.9%) and tetracycline (33.9%). Salmonella pathogenicity island (SPI)-associated genes (orgA, ssaQ, misL, invE/A, spi4D, pipA and ttrc) were uniformly present in majority of the isolates. The hyper invasive locus (hilA), Salmonella enterotoxin (stn), Salmonella outer protein (sopB), virulence plasmid (spvC), and plasmid encoded fimbriae (pefA) genes were present in 76%, 69%, 51%, 32% and 17% of the isolates, respectively. Clonal analysis of the representative homologous serovars using pulsed-field gel electrophoresis revealed specific clusters with 40 to 90% similarity within each serotype.<br> Conclusions Cancer patients are at increased risk of morbidity due to secondary infections, like S. enterica. Continuous monitoring of antimicrobial resistance patterns and virulence gene profiles in S. enterica isolates from this vulnerable group is critical to guide clinical management and treatment strategies. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 2 2026 Revisiting Adrenal Crisis Triggered by Influenza Infection: Lessons from Two Fatal Cases 153 157 EN Yoshiyuki Ueda Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tetsuya Yumoto Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takashi Hongo Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takafumi Obara Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tsuyoshi Nojima Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kohei Tsukahara Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kosei Hasegawa Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Natsuko Futagawa Department of Pediatrics, Okayama University Hospital Hiromichi Naito Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Atsunori Nakao Department of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Case Report 10.18926/AMO/70458 Adrenal crisis is a life-threatening endocrine emergency that can progress within hours despite a prior diagnosis and maintenance therapy. We describe a fatal influenza-triggered adrenal crisis in two patients: a child with panhypopituitarism and an adult with prior pituitary surgery, both presenting in cardiac arrest. Despite resuscitation and intravenous hydrocortisone, a fatal hypoxic-ischemic injury or multiorgan failure occurred. These cases highlight the fulminant course of an adrenal crisis and underscore the importance of early recognition, clinician awareness, prompt parenteral hydrocortisone administration, and reinforcement of education for patients, caregivers, and healthcare providers to improve preparedness and prevent avoidable deaths. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 2 2026 A Mixed-Methods Study on Changes in Interprofessional Education Attitudes and Fundamental Competencies: A Pre–Post Analysis of Clinical Training in Dietetic Students 109 117 EN Mika Sonoi Department of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin University Norihiro Sonoi Center for Education in Medicine and Health Sciences, Okayama University Yoko Koyama Department of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin University Original Article 10.18926/AMO/70453 This study examined the effects of interprofessional education (IPE) on dietetics students during clinical training, focusing on changes in their attitudes toward IPE and their fundamental competencies. Eighty third-year female students (mean age, 21.0 years) at a Japanese women�fs university participated. Self-administered surveys were conducted before and after clinical training to assess attitudes toward IPE using the Readiness for Interprofessional Learning Scale (RIPLS) and the Shakaijin Kisoryoku (SKL; Fundamental Competencies for Working Persons) scale. Quantitative data were analyzed using paired t-tests, chi-squared tests, and cluster analyses. Qualitative data from open-ended responses were analyzed thematically. RIPLS and SKL scores increased significantly, from 65.3 to 68.9, and from 28. 4 to 33. 2, respectively (p<0.001). All 12 SKL items showed significant improvement. In free responses, �ginitiative�h (66 mentions), �gcommunication�h (10), and �gexecution�h (8) were the most frequently cited as improved competencies. Cluster analysis identified three groups: increasing scores (n=25), high baseline (n=30), and minimal change (n=25). No significant correlation was found between changes in RIPLS and SKL scores (r=�|0.108, p=0.355). IPE integrated into clinical training may enhance dietetics students�f attitudes toward interprofessional collaboration and contribute to the development of professional identity. Individualized, phased IPE implementation is recommended to accommodate differences in learner readiness. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0770-3198 45 5 2026 Global trends in systemic sclerosis-related mortality, 2001–2023: an epidemiological analysis using World Health Organization mortality data 2741 2748 EN Keith Pardillada Belangoy Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Nishimura Division of Haematology and Oncology, Mayo Clinic, Rochester Ko Harada Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Quynh Thi Vu Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Hanane Ouddoud Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Judah Israel Ong Lescano Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Michio Yamamoto Graduate School of Human Sciences, The University of Osaka Tatsuaki Takeda Department of Education and Research Center for Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Okayama University Hirofumi Hamano Department of Pharmacy, Okayama University Hospital Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Yoshito Zamami Department of Pharmacy, Okayama University Hospital Objectives This study aimed to evaluate the global trends in systemic sclerosis (SSc)-related mortality by age, sex, and geographic region. SSc is a multisystem autoimmune disease characterized by tissue fibrosis, vascular dysfunction, and multi-organ involvement, which is associated with a high mortality risk.<br> Methods Using the World Health Organization Mortality Database, we examined trends in SSc-related crude mortality rates (SSc-CRs) and age-standardized mortality rates (SSc-ASMR) per 1,000,000 population from 2001 to 2023. Locally weighted regression was applied to visualize long-term patterns, and Joinpoint regression was used to assess the national trends from 2010 to 2023.<br> Results Across 74 countries, 85,291 SSc-related deaths were reported, with 79.41% occurring in females. The SSc-CR steadily increased from 1.97 (95% confidence interval [CI]: 1.71–2.23) in 2001 to 2.34 (95% CI: 2.01–2.68) in 2023, while the SSc-ASMR decreased from 1.58 (95% CI: 1.42–1.74) to 1.29 (95% CI: 1.08–1.50), respectively. Regionally, mortality was the highest in the Western Pacific region and declined in the Americas and Europe, with temporal fluctuations. The SSc-ASMR was highest in countries with a middle sociodemographic index (SDI).<br> Conclusions While overall age-standardized mortality from SSc has declined in many regions, disparities persist. These results underscore the importance of sustaining research and enhancing disease awareness, as well as developing strategies to reduce mortality in high-risk populations and regions. No potential conflict of interest relevant to this article was reported.

Informa UK Limited Acta Medica Okayama 0020-739X 2026 Triangulation in teaching probability: teaching materials for the theoretical foundations of probability in real-world applications EN Yusuke Uegatani Hiroshima University High School Ippo Ishibashi Faculty of Education, Okayama University Aya Sakota Hiroshima University High School This paper proposes using the concept of triangulation with probabilistic models as a means to enhance theoretical inversion for deepening students�f understanding of the nature of probability in real-world contexts. Triangulation refers to the combined application of multiple methodologies to investigate the same phenomenon, particularly in the social sciences. Theoretical inversion refers to a shift in focus from surprising outcomes to the theoretical foundations of probability. The paper introduces three types of problem-solving tasks designed to enhance one of four types of triangulations: theory triangulation. Theoretical inversion is expected to emerge through engaging in these tasks. The characteristics of the problems are as follows. Problem 1 promotes students to compare different probabilistic models of events under similar procedures. Problem 2 provides students with an opportunity to simplify an experiment by omitting steps that add no new information. Problem 3 enhances students�f ability to recognise how subtle differences in the experimental setup can affect the resulting probability. These tasks are designed to encourage students to view probabilistic reasoning as a form of modelling and to appreciate the importance of assumptions, definitions of elementary events, and clarity in procedural descriptions. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠwŽZ�”�E�”Šw‹³ˆçŠw‰ï Acta Medica Okayama 1341-3155 31 2025 ŽZ�”‰È�u•”•ª‚ɑ΂·‚é•”•ª‚ÌŠ„�‡‚É“–‚½‚é‘å‚«‚³�v‚Ì–â‘è‰ðŒˆ‚Ì‚½‚ß‚Ì‘«�ꂪ‚¯ 24 33 EN �@�¬Šw‚T”N�¶Œü‚¯‚̈ꕔ‚ÌŽZ�”‰È‹³‰È�‘‚Å‚Í�C•”•ª‚ɑ΂·‚é•”•ª‚ÌŠ„�‡‚É“–‚½‚é‘å‚«‚³‚ð‹�‚ß‚é–â‘肪ˆµ‚í‚ê‚Ä‚¢‚é�D‚µ‚©‚µ�C‚»‚Ì–â‘è‰ðŒˆ‚Í�¬Šw‚T”N�¶‚É‚Í—eˆÕ‚Å‚Í‚È‚¢‚Æ�l‚¦‚ç‚ê‚é�D‚»‚±‚Å–{�e‚Í�C‚ǂ̂悤‚ÈŽx‰‡‚ª•”•ª‚ɑ΂·‚é•”•ª‚ÌŠ„�‡‚É“–‚½‚é‘å‚«‚³‚ð‹�‚ß‚é–â‘è‰ðŒˆ‚É—LŒø‚Å‚ ‚é‚©‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�D‘«�ꂪ‚¯ (Scaffolding) ‚ð—�˜_“I˜g‘g‚Ý‚Æ‚µ‚Ä�C‹ï‘Ì“I‚È‘«�ꂪ‚¯‚ð�\‘z‚µ�CŽö‹Æ‚ðŽÀ‘H‚µ‚½�D‚»‚ÌŒ‹‰Ê�C�uŠw�KŽÒ‚Ì“ª‚Ì’†‚Å‘ÌŒ±“I‚ɃŠƒAƒ‹‚È–â‘è‚Æ‚È‚é‚悤–â‘è‚ð�H•v‚·‚邱‚Æ�v�C�uŽ™“¶‚ɃAƒCƒfƒA‚̈ꕔ (‚ǂ̂悤‚È�}“I•\Œ»‚ð—p‚¢‚½‚©) ‚ð�Љ‚¹‚邱‚Æ�v�C�u�}“I•\Œ»‚ð—p‚¢‚é‚悤‘£‚·‚±‚Æ�v�C�uŽ™“¶‚Ì•K—vŠ´‚ɉž‚¶‚Ä�CƒyƒA‚â�¬ƒOƒ‹�[ƒv‚Ō݂¢‚Ì–â‘è‰ðŒˆ‚ðŒ©‚¹�‡‚¤‚±‚Æ�v�C�uŽ™“¶‚ª‹³Žº‘S‘Ì‚ÅŽ©�g‚Ì–â‘è‰ðŒˆ‚ð”­•\‚·‚邱‚Æ�v�C�u‹³Žt‚ª–â‘蕶‚Ì‚Ç‚Ì�î•ñ‚É’�–Ú‚·‚ׂ«‚©‚ðŽwŽ¦‚·‚邱‚Æ�v�C�uŽ™“¶‚ª‘¼‚ÌŽ™“¶‚É–â‘è‰ðŒˆ‚Ì’B�¬‚ð–ÚŽw‚µ‚½�à–¾‚ð‚·‚é‚±‚Æ�v‚ª�C—LŒø‚È‘«�ꂪ‚¯‚Å‚ ‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�D‚»‚µ‚Ä�C‚»‚ê‚ç‚Ì‘«�ꂪ‚¯‚Í�CŠÖ‚í‚è�‡‚¢‹@”\‚³‚¹‚邱‚Æ‚ª—LŒø‚È�ê�‡‚à‚ ‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�D No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 — •\Ž†�E‰p•¶–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ‰œ•t EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[Œ´�eŽ·•M—v—Ì EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[‚ÌŠˆ“®�󋵂̊T—v EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ƒXƒN�[ƒ‹ƒJƒEƒ“ƒZƒ‰�[‚Í”­’BŽxŽ�“I�¶“kŽw“±‚Ö‚¢‚©‚É�vŒ£‚Å‚«‚é‚© �\ƒvƒ‰ƒ“ƒjƒ“ƒOƒV�[ƒg‚ÌŠˆ—p‚ð’Ê‚µ‚½Žx‰‡‚ÌŠg�[‚ÉŒü‚¯‚½ŒŸ“¢�\ 253 266 EN Noriyuki HARA Ryo MISAWA Tazuko AOKI 10.18926/CTED/70373 �@2022”N‚ɉü’ù‚³‚ꂽ�u�¶“kŽw“±’ñ—v�v‚Å‚Í�C‚·‚ׂĂ̎™“¶�¶“k‚Ì�¬’·‚ðŽx‰‡‚·‚é”­’BŽxŽ�“I�¶“kŽw“±‚Ì�d—v�«‚ª–¾Šm‚ÉŽ¦‚³‚ê‚Ä‚¢‚é�B‚µ‚©‚µ�C‚»‚Ì’è’…‚É‚Í�C‹³ˆõ‚Ì‘½–Z‰»‚â‘g�D“IŽx‰‡‘Ì�§‚Ì•s�\•ª‚³‚È‚Ç�CŠw�ZŒ»�ê‚É‚¨‚¯‚鑽‚­‚̉ۑ肪Žw“E‚³‚ê‚Ä‚¢‚é�B‚³‚ç‚É�CƒXƒN�[ƒ‹ƒJƒEƒ“ƒZƒ‰�[�iSC�j‚É‚æ‚éŽx‰‡‚à�\•ª‚É“WŠJ‚³‚ê‚Ä‚¢‚é‚Æ‚ÍŒ¾‚¢“ï‚¢�B‚»‚±‚Å–{�e‚Å‚Í�C”­’BŽxŽ�“I�¶“kŽw“±‚É‚¨‚¯‚éSC‚ÌŽx‰‡‚ÌŠg�[‰Â”\�«‚ðŒŸ“¢‚·‚邽‚ß�CŒ»�ó‚Ɖۑè‚ð�®—�‚µ‚½�B‚Ü‚½�Cƒvƒ‰ƒ“ƒjƒ“ƒOƒV�[ƒg‚ðŠˆ—p‚µ‚½ŽÀ‘HŽ–—á�iŒ´‘¼, 2024�j‚Ì�Ä•ª�Í‚ð’Ê‚µ‚Ä�CSC‚ÆŠw�Z‚ª‹³ˆç–Ú•W‚ð‹¤—L‚µ‚È‚ª‚狦“­“I‚ÉŽx‰‡‚ðŒv‰æ‚·‚é˜g‘g‚Ý‚Ì—L—p�«‚ð‹á–¡‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 “Á•ÊŽx‰‡‹³ˆç‚Ö‚Ì“NŠw“IŽv�l“±“ü‚ɂ‚¢‚Ä‚Ì—\”õ“I�lŽ@ Ž�‘±�E�¶�¬•Ï‰»�E‰ñ�Ü‚Ì�l‚¦•û‚ÉŠî‚­•û–@“I˜g‘g‚Ý‚ÌŽŽˆÄ 237 251 EN Yo HAMADA Okayama Prefectural Okayama Seto Special Needs School Miyuki TAKANO Hyogo University of Teacher Education Satoru SATO Faculty of Education, Okayama University 10.18926/CTED/70372 �@–{�e‚Í�CŒ»‘ã‚Ì“Á•ÊŽx‰‡‹³ˆç‚̉ۑ肩‚ç�C“Á•ÊŽx‰‡‹³ˆçŽÀ‘H‚É“NŠw“IŽv�l‚𓱓ü‚·‚邽‚ß‚Ì—�˜_“I�E•û–@“IŒŸ“¢‚ð�s‚¤‚à‚Ì‚Å‚ ‚é�B‚Ü‚¸�C—�˜_Šî”Õ‚Æ‚µ‚Ä�Cƒxƒ‹ƒNƒ\ƒ“‚Ì�u‹L‰¯—�˜_�v�CƒhƒDƒ‹�[ƒY�•ƒKƒ^ƒŠ‚Ì�u�¶�¬•Ï‰»‚Ì“NŠw�v�CBarad‚Ì�u‰ñ�Ü“I•û–@˜_�v�CBlom‚Ì�u‰ñ�Ü“IƒGƒXƒmƒOƒ‰ƒtƒB�[�v‚ɂ‚¢‚ÄŠT�à‚µ‚½�B‚»‚µ‚Ä�C—�˜_Šî”Õ‚ðŠî‚É•û–@“I˜g‘g‚Ý‚Æ‚µ‚Ä�C�u•¨Ž¿�|Œ¾�à“IŽÀ‘H�v�C�uŽ�‘±�v�C�u�¶�¬•Ï‰»�v‚ÌŽO‚‚̎‹“_‚ð‹³ˆçŽÀ‘H‚ð“Ç‚Ý‰ð‚­‚½‚ß‚Ì‘ŠŒÝ•âŠ®“I‚È•ª�ÍŽ‹“_‚Æ‚µ‚Ä�Ì—p‚·‚邱‚Æ‚ð’ñˆÄ‚µ‚½�B‚±‚ê‚ç‚ÌŽ‹“_‚Í�Cƒ|ƒXƒgŽ¿“IŒ¤‹†‚Æ‚µ‚Ä�C�o—ˆŽ–‚ðŠÖŒW“I�E‰ß’ö“I‚É‘¨‚¦‚邱‚Æ‚ð‰Â”\‚É‚·‚é‚à‚Ì‚Å‚ ‚é�B�¡Œã‚̉ۑè‚Æ‚µ‚Ä�CŽO‚‚̃Œƒ“ƒYŠÔ‚Ì—�˜_“I�®—��C‰ñ�Ü“I•û–@˜_‚Ɖñ�Ü“IƒGƒXƒmƒOƒ‰ƒtƒB�[‚Ì�·ˆÙ‰»�C‚¨‚æ‚Ñ•¡�”‚ÌŽÀ‘HƒGƒsƒ\�[ƒh‚ð�Ú‘±‚µ‚Ä•`‚­‚½‚ß‚Ì•ª�ÍŽè–@‚Ì�¸ãk‰»‚ª‹“‚°‚ç‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ‘åŠw‰@‹¤’ʉȖÚ�wƒŠ�[ƒ_�[ƒVƒbƒv‚ÆSDGs�x‚Ì‹³ˆçƒ‚ƒfƒ‹�\’z‚Æ�¬‰Ê•ª�Í —�˜_Šw�K�EƒsƒAƒŒƒrƒ…�[�E�ÈŽ@Šˆ“®‚É‚æ‚郊�[ƒ_�[ƒVƒbƒv‹³ˆç‚Ì�V“WŠJ 221 235 EN Mamoru ISHIDA Faculty of General Education and Global Studies, Okayama University Shinichi OTSUNE Graduate student, Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Takuya NAKAZAWA Graduate student, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University 10.18926/CTED/70371 �@‰ªŽR‘åŠw‘åŠw‰@‚Å‚Í�A”ŽŽm‰Û’ö�l�ނ̃Š�[ƒ_�[ƒVƒbƒvˆç�¬‚ÉŒü‚¯�A‹¤’ʉȖÚ�wƒŠ�[ƒ_�[ƒVƒbƒv‚ÆSDGs�x‚ð�ÝŒv�EŽÀ‘H‚µ‚Ä‚¢‚é�B–{‰È–Ú‚ÍSDGs‚É�vŒ£‚·‚郊�[ƒ_�[ˆç�¬‚ÉŽåŠá‚ð’u‚«�A—�˜_Šw�K�EƒsƒAƒŒƒrƒ…�[�E�ÈŽ@�EƒOƒ‹�[ƒvƒfƒBƒXƒJƒbƒVƒ‡ƒ““™‚ÌŽè–@‚ð‘g‚Ý�‡‚킹�AŠw�¶“¯Žm‚ÌŠw‚Ñ�‡‚¢�EŽ©ŒÈ�¬’·‚Ì‘£�i‚ð–Ú“I‚Æ‚µ‚Ä‚¢‚é�B–{�e‚Å‚Í�AŠw•”�EŒ¤‹†‰È‚²‚Æ‚ÉŠw�K�¬‰Ê‚ð•ª�Í‚µ�A—�˜_‚ÉŠî‚­�ÈŽ@“IŠw‚Ñ‚Æ‹¦“­“I‚È”á•]Šˆ“®‚ªƒŠ�[ƒ_�[ƒVƒbƒv—�‰ð‚â�¬’·‚É—L—p‚Å‚ ‚邱‚Ƃ𖾂炩‚É‚µ‚½�B–{Œ¤‹†‚Í�AŠw�p“I—�˜_‚ÆŽÀ‘H“IŠˆ“®‚ð�D‚èŒð‚º‚½ƒ‚ƒfƒ‹�\’z‚Æ�A‚»‚ÌŒp‘±“I‰ü‘P‚̈Ӌ`‚ðŽ¦‚µ‚Ä‚¢‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ’m“I�áŠQ�‚“™“Á•ÊŽx‰‡Šw�Z‚É‚¨‚¯‚é SWPBS ‘æ‚P‘wŽx‰‡ �\ƒLƒƒƒ“ƒy�[ƒ“•ûŽ®‚Ì“±“ü‚Æ‚»‚ÌŒø‰Ê�\ 205 219 EN Hideaki TOKIMITSU Graduate School of Education (Professional Degree Course), Okayama University Yoshio MIYAZAKI Faculty of Education, Okayama University Madoka KOYAMA Kurashiki Kotoura Special Needs Seni or High School, Okayama Prefecture 10.18926/CTED/70370 �@–{Œ¤‹†‚Í�CŒy“x’m“I�áŠQ‚Ì‚ ‚éŒãŠú’†“™‹³ˆç’iŠK‚ÌŒö—§’m“I�áŠQ�‚“™“Á•ÊŽx‰‡Šw�Z‚É‚¨‚¢‚Ä�CSWPBS ‘æ1‘wŽx‰‡‚Æ‚µ‚ăLƒƒƒ“ƒy�[ƒ“•ûŽ®‚ÌŽx‰‡‚ðŽÀŽ{‚µ�C‚»‚ÌŒø‰ÊŒŸ�Ø‚ð�s‚Á‚½�B•û–@‚Æ‚µ‚Ä‚Í�C‚wŠw”N�¶“k24–¼‚ɑ΂µ‚Ĉ¥ŽA�s“®‚Ì‘£�i‚ð‘_‚Á‚½ƒLƒƒƒ“ƒy�[ƒ“‚ðŽÀŽ{‚µ�C–Ú•W�s“®‚Ì�¶‹N�”‚ɂ‚¢‚ÄABƒtƒHƒ��[ƒAƒbƒvƒfƒUƒCƒ“‚ð—p‚¢‚ÄŒŸ“¢‚µ‚½�B‚Ü‚½�C‚wŠw”N‹³ˆõ6–¼‚ɑ΂µ�CŽÐ‰ï“I‘Ó–�«‚ð•]‰¿‚·‚éƒAƒ“ƒP�[ƒg‚ðŽÀŽ{‚µ‚½�B‚»‚ÌŒ‹‰Ê�CƒLƒƒƒ“ƒy�[ƒ“‚̉î“ü’¼Œã‚É–Ú•W�s“®‚Ì�¶‹N�”‚¨‚æ‚Ñ–Ú•W�s“®‚É�]Ž–‚µ‚½�¶“k‚ÌŠ„�‡‚Ì‘�‰Á‚ªŒ©‚ç‚ê�CƒLƒƒƒ“ƒy�[ƒ“�I—¹Œã‚àƒx�[ƒXƒ‰ƒCƒ“‚Æ”äŠr‚µ‚½‘�‰Á‚ªˆê’èŠúŠÔŠm”F‚³‚ꂽ�B‚Ü‚½�Cˆê’è’ö“x‚̎Љï“I‘Ó–�«‚àŠm”F‚Å‚«‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ’¬‚­‚è‚ð�l‚¦‚éŽÀ‘HŽ–—á‚ÌŒŸ“¢ �\‘��‡“I‚ÈŠw�K‚ÌŽžŠÔ‚ð’Ê‚¶‚½’†Šw�¶‚̈ӎ¯•Ï‰»‚É’…–Ú‚µ‚Ä�\ 191 203 EN Akemi KAMADA Anan City Anan First Junior High School Kazuaki KAJII Faculty of Education, Okayama University 10.18926/CTED/70369 �@–{Œ¤‹†‚Í�C’†Šw�Z‘��‡“I‚ÈŠw�K‚ÌŽžŠÔ‚É‚¨‚¯‚é’¬‚­‚è‚É‚¨‚¢‚Ä�C‘¼ŽÒ‚Æ‚Ì‹¦“­‚â‘ŠŒÝ�ì—p‚ð’Ê‚¶‚Ä’¬‚­‚è‚ð�\‘z‚µ�CŽÀ‘H‚ÌŒ‹‰Ê�¶‚¶‚½Šw�KŽÒ‚̕ω»‚©‚ç‚»‚ÌŒø‰Ê‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚Ä‚¢‚é�B‚Ü‚½�C‘Θb“I‚ÈŠw‚Ñ‚Å�dŽ‹‚³‚ê‚鑼ŽÒ‚Æ‚Ì‘ŠŒÝ�ì—p‚ð�C’†Šw�Z‚ÌŽÀ‘H‚É—Ž‚Æ‚µ�ž‚Ý�C‚»‚Ì‚ ‚è•û‚ɂ‚¢‚Ä‚àŒŸ“¢‚·‚é�B–{ŽÀ‘H‚Ì‚Ë‚ç‚¢‚Í�C‘½—l‚ÈŽ‹“_‚©‚ç’¬‚Ì�«—ˆ‚ÌŽp‚â‚ ‚è•û‚ð�l‚Æ‚ÌŠÖ‚í‚è‚ɂ‚¢‚ēǂ݉ð‚«�CŽ�‘±‰Â”\‚È’¬‚Ì‚ ‚è•û‚ɂ‚¢‚ÄŽ©•ªŽ–‚Ɉø‚«Šñ‚¹‚Ä�l‚¦‚邱‚Æ‚Å�C’¬‚ɑ΂·‚éˆÓŽ¯‚̕ω»‚𑣂·‚±‚Æ‚É‚ ‚é�BŽÀ‘H‚ÌŒ‹‰Ê�CŠw�KŽÒ‚Ì’¬‚ɑ΂·‚錩•û‚â�l‚¦•û‚̈ӎ¯•Ï‰»‚ªˆø‚«‹N‚±‚³‚ê�C’¬‚­‚è‚ÌŽ�‚Â’nˆæ‰Û‘è‚ɂ‚¢‚ÄŽ©•ªŽ–‚Ɉø‚«Šñ‚¹‚ÄŽv�l‚·‚邱‚Æ‚ª‚Å‚«‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 �u�¶–½‚Ì‘¸‚³�v‚ÌŽ©�싳�Þ‚ðŠˆ—p‚µ‚½�¬Šw�Z“¹“¿‰ÈŽö‹Æ‚ÌŽÀ‘H‚Ɖۑè 181 190 EN Shinji YOSHIKAWA Tsurajimakita Elementary School Tsuguyuki IZUMI Faculty of Education, Okayama University 10.18926/CTED/70368 �@–{Œ¤‹†‚Å‚Í�C“à—e�€–Ú�u�¶–½‚Ì‘¸‚³�v‚ÉŠÖ‚·‚鎩�싳�Þ‚ðŠJ”­‚µ�CŽö‹Æ‚ðŽÀŽ{‚·‚邱‚Æ‚É‚æ‚Á‚Ä�CŽq‚Ç‚à‚ª�u�¶–½‚Ì‘¸‚³�v‚ðŽ©•ª‚Æ‚ÌŠÖ‚í‚è‚Å�[‚­�l‚¦‚邱‚Æ‚ª‚Å‚«‚é‚©‚ɂ‚¢‚ÄŒŸ�Ø‚µ‚½�B�¬‰Ê‚Æ‚µ‚Ä�CŽ©�싳�Þ‚ÌŠˆ—p‚É‚æ‚Á‚ÄŽq‚Ç‚à‚ª‹³�Þ‚Ì“o�ê�l•¨‚É‹¤Š´‚µ�C�u�¶–½‚Ì‘¸‚³�v‚Ì“¹“¿“I‰¿’l‚ðŽ©•ª‚Æ‚ÌŠÖ‚í‚è‚Å�[‚­�l‚¦‚é—lŽq‚ªŠm”F‚Å‚«‚½�Bˆê•û�C‰Û‘è‚Æ‚µ‚Ä�CŽ©�싳�Þ‚Ö�ž‚ß‚½Žv‚¢‚Ì‹­‚³‚©‚ç�CŽq‚Ç‚à‚ªŽö‹ÆŽÒ‚̈Ó�}‚ð‘g‚Ý‚È‚ª‚ç”­Œ¾‚·‚éŽp‚ªŒ©‚ç‚ê�CˆÓ�}‚¹‚¸Žq‚Ç‚à‚Ì”­Œ¾‚ð•ûŒü•t‚¯‚½‰Â”\�«‚ªŽ¦‚³‚ꂽ�B�ÅŒã‚É�CŽq‚Ç‚à’†�S‚ÌŽö‹Æ‚ÌŽÀŒ»‚ÉŒü‚¯‚Ä�CŽÀ‘H‚Æ�ÈŽ@‚̉�ŠÒ‚Ì•K—v�«‚ɂ‚¢‚Ä‹c˜_‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 —§Œ›Žå‹`‚ɑ΂·‚é”FŽ¯‚̉ü‘P‚ð–ÚŽw‚µ‚½�‚“™Šw�ZŒö–¯‰È‚ÌŽö‹ÆŠJ”­Œ¤‹† �\•Ä�‘Œö–¯‹³ˆçƒZƒ“ƒ^�[ŠJ”­�w‰ä‚ç�‡�O�‘�l–¯�x‚ðŽè‚ª‚©‚è‚É‚µ‚Ä�\ 167 180 EN Toshinori KUWABARA Faculty of Education, Okayama University Ayuha MIYAMOTO Graduate School of Humanities and Social Sciences, Okayama University 10.18926/CTED/70367 �@–{Œ¤‹†‚Í�AŒ›–@—�‰ð‚ÌŠî–{‚Æ‚µ‚Ä‚Ì—§Œ›Žå‹`‚ɑ΂·‚é”FŽ¯Œ`�¬‚ð–Ú•W‚Æ‚·‚é�A�‚“™Šw�ZŒö–¯‰È‚ÅŽÀ‘H‰Â”\‚ÈŽö‹Æ‚ÌŠJ”­‚ð–ÚŽw‚µ‚½‚à‚Ì‚Å‚ ‚é�B�]—ˆ‚Ì“ú–{‚̎Љï‰È‹³ˆç‚É‚¨‚¢‚Ä‚Í�AŒ›–@—�‰ð‚Í“ú–{�‘Œ›–@‚ÌŠî–{Œ´‘¥‚Å‚ ‚é�‘–¯ŽåŒ �AŠî–{“I�lŒ ‚Ì‘¸�d�A•½˜aŽå‹`‚Ì—�‰ð‚ðŠî–{‚Æ‚µ‚Ä‚¢‚½‚ª�A‹ß”N�A‚»‚à‚»‚àŒ›–@‚Ƃ͉½‚©‚ð—�‰ð‚³‚¹‚邽‚ß‚É�A—§Œ›Žå‹`‚ÌŠT”O‚ª’�–Ú‚³‚ê‚é‚悤‚É‚È‚è�A‹³‰È�‘‚É‚à‹L�q‚³‚ê‚Ä‚¢‚é�B–{Œ¤‹†‚Í�A‚»‚̂悤‚È—§Œ›Žå‹`‚Æ‚¢‚¤ŠT”O‚ɂ‚¢‚Ä�¶“k‚É“K�Ø‚É—�‰ð‚³‚¹‚邱‚Æ‚ð–ÚŽw‚µ‚½Žö‹Æ‚Ì’ñˆÄ‚ð‚µ‚æ‚¤‚Æ‚·‚é‚à‚Ì‚Å‚ ‚é�BŽö‹ÆŒv‰æ�ì�¬‚É‚ ‚½‚Á‚Ä‚Í�A•Ä�‘‚ÌŒö–¯‹³ˆçƒZƒ“ƒ^�[‚ªŠJ”­‚µ�A’·”NŠˆ—p‚³‚ê‚Ä‚¢‚é�w‰ä‚ç�‡�O�‘�l–¯�iŒ´‘è We the People�j�x‚ðŽQ�Æ‚µ�A‚»‚̈ꕔ‚ðŠˆ—p‚µ�A•Ä�‘‚Ì—ðŽj“I”wŒi‚ÉŠî‚¢‚Ä�ì‚ç‚ꂽ‹³�Þ‚ð�A“ú–{‚Ì•¶–¬‚É‚»‚Á‚ĉü•Ï‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ŒY–@‚̈Ӌ`‚𑨂¦‚³‚¹‚éŽÐ‰ï‰È‚É‚¨‚¯‚é–@‹³ˆçŽÀ‘H‚Ì•û–@ �\–Í‹[�Ù”»‚ðŽæ‚è“ü‚ꂽ’†Šw�ZŽÐ‰ï‰È‚ÌŽö‹ÆŠJ”­‚ð’Ê‚µ‚Ä�\ 153 165 EN Ayuha MIYAMOTO Graduate School of Human ities and So cial Sciences, Okayama University Toshinori KUWABARA Faculty of Education, Okayama University 10.18926/CTED/70366 �@–{Œ¤‹†‚Í�AŒY–@‚Ì—�‰ð‚É�Å“_‚ð‚ ‚Ä�A–Í‹[�Ù”»‚ðŽæ‚è“ü‚ꂽ’†Šw�ZŽÐ‰ï‰È‚ÌŽö‹ÆŠJ”­‚ð�s‚È‚¨‚¤‚Æ‚·‚é‚à‚Ì‚Å‚ ‚é�B“ú–{‚̎Љï‰È‚É‚¨‚¯‚é–@‹³ˆç‚Í�A�]—ˆ‚©‚猛–@Šw�K‚ª’†�S‚Æ‚È‚Á‚Ä‚¨‚è�A‚»‚Ì‘¼‚Ì–@—¥‚ɂ‚¢‚ÄŠw‚Ô‹@‰ï‚Í”ñ�í‚É�­‚È‚¢�B‚»‚̂悤‚ÈŒ»�ó‚𓥂܂¦‚Ä�A‹ß”N�A–¯–@‚âŒY–@‚È‚Ç‚ðŽæ‚è�ã‚°‚½–@‹³ˆç‚ÌŽö‹ÆŠJ”­‚ª�s‚í‚ê‚é‚悤‚É‚È‚Á‚½�B‚»‚̈ê•û‚Å�A�Ù”»ˆõ�§“x“±“üˆÈ�~�A–Í‹[�Ù”»‚ðŽæ‚è“ü‚ꂽŽÐ‰ï‰ÈŽö‹Æ‚ÌŠJ”­�EŽÀ‘H‚ª‚æ‚­Œ©‚ç‚ê‚é‚悤‚É‚È‚Á‚Ä‚¨‚è�AŒYŽ–Ž–Œ�‚ªŽÐ‰ï‰ÈŽö‹Æ‚ÅŽæ‚è�ã‚°‚ç‚ê‚邱‚Æ‚à’¿‚µ‚­‚Í‚È‚­‚È‚Á‚½�B‚µ‚©‚µ�A‚»‚̂悤‚ÈŽö‹Æ‚ð’S“–‚·‚鋳ˆõ‚É�AŒY–@“™‚ÉŠÖ‚·‚é’mŽ¯‚ª�\•ª‚Å‚Í‚È‚­�A–Í‹[�Ù”»‚Ì“à—e‚ÆŽÀ�Û‚Ì�Ù”»‚ª˜¨—£‚µ‚Ä‚¢‚é‚Æ‚¢‚¤‰Û‘è‚à‚ ‚é�B–{Œ¤‹†‚Å‚Í�A�]—ˆ‚Ì–Í‹[�Ù”»‚ðŽæ‚è“ü‚ꂽŽö‹Æ‚Ì“ÁŽ¿‚Ɖۑè‚ðŒŸ“¢‚µ‚½‚¤‚¦‚Å�AŒY–@‚̈Ӌ`‚𑨂¦‚³‚¹‚é’†Šw�ZŽÐ‰ï‰È‚ÌŽö‹ÆŠJ”­‚ð–ÚŽw‚·�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 �‰”C•Ûˆç‹³—@‚ÌŒê‚è‚ÉŒ©‚鉀Ž™‚Ì�݉€ŽžŠÔ‚̈Ⴂ‚É‚æ‚éŽÀ‘H�ã‚̉ۑè 139 152 EN Kazuya HASUI Faculty of Health and Welfare�C Kawasaki University of Medical Welfare Mika KATAYAMA Faculty of Education, Graduate School of Science, Okayama University 10.18926/CTED/70365 �@–{˜_‚Å‚Í�C—c•Û˜AŒgŒ^”F’肱‚Ç‚à‰€‚Ì“Á’¥‚Å‚ ‚鉀Ž™‚Ì�݉€ŽžŠÔ‚̈Ⴂ‚É�Å“_‚ð“–‚Ä�C�‰”C•Ûˆç‹³—@‚Ö‚Ì–Ê�Ú’²�¸‚É‚æ‚èŽÀ‘H�ã‚̉ۑè‚ƑΉž‚ɂ‚¢‚ÄŒŸ“¢‚µ‚½�B‚»‚ÌŒ‹‰Ê�C•Ûˆç‹³—@‚ª‚W‚‚̉ۑè‚ð”FŽ¯‚µ‚Ä‚¢‚邱‚Æ‚ª–¾‚ç‚©‚É‚È‚Á‚½�B‚Ü‚½�C�w—c•Û˜AŒgŒ^”F’肱‚Ç‚à‰€‹³ˆç�E•Ûˆç—v—Ì�x‚É‹L�q‚³‚ê‚Ä‚¢‚é�u—V‚т̘A‘±�«‚ð•Û�á‚·‚é•Ûˆç‚Ì“WŠJ�v‚ÉŠÖ‚·‚é‰Û‘è‚ɉÁ‚¦‚Ä�C‹L�q‚³‚ê‚Ä‚¢‚È‚¢�u‘½—l‚È�݉€ŽžŠÔ‚â�¶ŠˆŒ`‘Ô‚ð�l—¶‚µ‚½‰€Ž™—�‰ð�v‚ÉŠÖ‚·‚é�V‚½‚ȉۑ肪Œ©�o‚³‚ꂽ�B”F’è‹æ•ª‚É‚æ‚é�݉€ŽžŠÔ‚̈Ⴂ‚͉€�¶Šˆ‚É‚¨‚¯‚鎞ŠÔ“IƒXƒPƒWƒ…�[ƒ‹‚â�ê�Š�C�W’c‚̈Ⴂ‚ð—]‹V‚È‚­‚³‚ê‚é�B‚»‚Ì‚½‚ß�C•Ûˆç‹³—@‚ª�Ý’è‚·‚é‚Ë‚ç‚¢‚ÉŠî‚¢‚½‰€�¶Šˆ‚ʼn½‚ð‹¤’ÊŒoŒ±‚Æ‚·‚ׂ«“à—e‚Æ‚µ‚Ä�ݒ肵�C‰½‚ðŒoŒ±�·‚Æ‚µ‚ÄŠˆ‚©‚µ�C‚ǂ̂悤‚È•Ûˆç‚ðŽÀ‘H‚·‚é‚©–¾Šm‚É‚·‚ׂ­�C‚±‚ê‚Ü‚Å”F’肱‚Ç‚à‰€‚Å�Ï‚Ý�d‚Ë‚ç‚ê‚Ä‚«‚½�DŽÀ‘H—á‚ð�W�Ï�E�®—�‚µ�CŽw•W‚𖾎¦‚·‚邱‚Æ‚ª�¡Œã‚̉ۑè‚Å‚ ‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ��‘tŠyŠˆ“®‚Ì’nˆæ“WŠJ‚É‚¨‚¯‚éŽs–¯��‘tŠy’c‚ÌŠÖ‚í‚è‚ÉŠÖ‚·‚錤‹† �\Žs–¯��‘tŠy’c‚Í’nˆæ“WŠJ‚Ì’S‚¢Žè‚ɂȂ蓾‚é‚©�\ 123 137 EN Kunihiko MAKINO Center for Teacher Education and Development�AOkayama University 10.18926/CTED/70364 �@��‘tŠyŠˆ“®‚Ì’nˆæ“WŠJ�iˆÈ‰º�A’nˆæ“WŠJ�j‚É‚¨‚¢‚Ä�AŽw“±ŽÒ‚⊈“®�ê�Š‚Ì•s‘«‚Í‹i‹Ù‚̉ۑè‚Å‚ ‚é�B–{Œ¤‹†‚Í�A’nˆæ“WŠJ‚ª�i‚Þ’†‚Å�AŽs–¯��‘tŠy’c‚ª’nˆæ‚ÌŽq‚Ç‚à’B‚Ì��‘tŠyŠˆ“®‚ðŽx‚¦‚é’S‚¢Žè‚ƂȂ蓾‚é‚©‚ð’²�¸�EŒŸ“¢‚µ‚½�B‰ªŽRŒ§“à‚ÌŽs–¯��‘tŠy’c20 ’c‘Ì‚Ö‚Ì•·‚«Žæ‚è’²�¸‚ƃeƒLƒXƒgƒ}ƒCƒjƒ“ƒO•ª�Í‚ÌŒ‹‰Ê�A’nˆæ“WŠJ‚ւ̈ӎ¯‚É‚Í�·‚ª‚Ý‚ç‚ê�A�Ï‹É“I‚È’c‘Ì‚Å‚ÍŽq‚Ç‚à’B‚̉‰‘tŽw“±‚â�‡“¯‚Å‚ÌŠˆ“®‚ð�m’è“I‚É‘¨‚¦‚éŒXŒü‚ªŠm”F‚³‚ꂽ�Bˆê•û‚Å�AŽw“±‹Z�p‚⎞ŠÔ“I�§–ñ�A�Ó”C•‰’S‚Ö‚Ì•sˆÀ‚ª�á•Ç‚Æ‚È‚Á‚Ä‚¢‚é‰Â”\�«‚ªŽ¦�´‚³‚ꂽ�B‚Ü‚½�AŽs–¯��‘tŠy’c‚ª•ø‚¦‚銈“®�ê�Š‚â�à�­“I‚ȉۑè‚ɑ΂µ‚ÄŒö—§Šw�ZŽ{�Ý‚ÌŠˆ—p‚ª‚»‚Ì‰ðŒˆ‚ÉŠñ—^‚µ“¾‚é‰Â”\�«‚ªŽ¦�´‚³‚ꂽ�Bˆê•û‚Å�AŒö—§Šw�Z‚ÌŽ{�ÝŠJ•ú‚ɂ‚¢‚Ä‚Í�AŽÀ�Û‚Ì�§“x‰^—p‚É‚¨‚¢‚ÄŽ©Ž¡‘ÌŠÔ‚ÌŠi�·‚ª‘¶�Ý‚·‚邱‚Æ‚ª–¾‚ç‚©‚Æ‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 “úŠØ‚̉¹Šy•¶‰»Œð—¬‚ð’Ê‚µ‚½’†Šw�Z‰¹Šy‰È‚É‚¨‚¯‚éƒOƒ��[ƒoƒ‹�EƒVƒeƒBƒYƒ“ƒVƒbƒv‹³ˆç‚Ì�\‘z �\APCEIU‚ł̃Cƒ“ƒ^�[ƒ“ƒVƒbƒv‚É‚¨‚¯‚é’²�¸‚Ì�¬‰Ê‚ÉŠî‚¢‚Ä�\ 107 121 EN Hikari KONISHI Graduate School of Education Toshinori KUWABARA Faculty of Education Yumi KONISHI Graduate School of Education 10.18926/CTED/70363 �@–{˜_•¶‚Í�A’†Šw�Z‰¹Šy‰È‚É‚¨‚¢‚Ä�A“ú–{‚ÆŠØ�‘‚̉¹Šy•¶‰»‚ðŽæ‚è�ã‚°‚Ä�AŒÝ‚¢‚Ì•¶‰»‚̈Ⴂ‚⋤’Ê�«‚𑨂¦‚³‚¹‚½‚¤‚¦‚Å‘ŠŒÝ—�‰ð‚ð‘£�i‚·‚é�AƒOƒ‹�[ƒoƒ‹�EƒVƒeƒBƒYƒ“ƒVƒbƒv‹³ˆç�iˆÈ‰º�AGCED ‚Æ•\‹L�jƒvƒ�ƒOƒ‰ƒ€‚ð�\‘z‚µ‚悤‚Æ‚·‚é‚à‚Ì‚Å‚ ‚é�Bƒvƒ�ƒOƒ‰ƒ€‚Ì�\‘z‚Ì�Û‚É‚Í�A•MŽÒ‚Å‚ ‚é�¬�¼‚ª�AŠØ�‘‚̃\ƒEƒ‹‚ÌAPCEIU�iƒAƒWƒA‘¾•½—m�‘�Û—�‰ð‹³ˆçƒZƒ“ƒ^�[�j‚Å�s‚È‚Á‚½–ñˆê‚©ŒŽŠÔ‚̃Cƒ“ƒ^�[ƒ“ƒVƒbƒv‚ÌŠÔ‚ÌŽÀ’n’²�¸‚Å”cˆ¬‚µ‚½�AŠØ�‘‚Å“WŠJ‚³‚ê‚Ä‚¢‚éGCED ‚Ì•û–@‚ðŽQ�l‚É‚µ‚½�BŠJ”­ƒvƒ�ƒOƒ‰ƒ€‚Å‚Í�A“úŠØ—¼�‘‚Ì‘ÅŠyŠí‚ðŽæ‚è�ã‚°‚Ä�A‚»‚Ì”äŠr‚©‚çŒÝ‚¢‚Ì•¶‰»‚̈Ⴂ‚𑨂¦‚³‚¹‚½‚¤‚¦‚Å�Aˆá‚¢‚ðŽó‚¯“ü‚ê‚È‚ª‚ç�A‚»‚ꂼ‚ê‚Ì�‘‚̉¹Šy•¶‰»‚Ì�ª’ê‚É‚ ‚é—ðŽj“I”wŒi‚É‹C‚©‚¹‚½‚¤‚¦‚Å�A•¶‰»‚Ì‘½—l�«‚â—¼�‘‚Ì•¶‰»‚̌ŗL‚̉¿’l‚ɑ΂·‚é—�‰ð‚ð�[‚߂邱‚Æ‚ð–ÚŽw‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ’nˆæŽÐ‰ï‚ƃOƒ��[ƒoƒ‹‚ð‚‚Ȃ®˜aŠyŠí‰¹ŠyŽŸ�¢‘ãˆç�¬‚ÌŽÀ‘HŒ¤‹†�i‚R�j �¬’†Šw�¶‚ÌŽ¿–⎆’²�¸‚ÉŒ©‚é�uˆÙ•¶‰»ŠÔ”\—Í�vˆç�¬‚̉”\�« 91 105 EN Rinko HAYAKAWA Okayama University Yuko BEPPU Kurashiki City College Miho YAMAJI Part-time Lecturer at Okayama University Yoko HANAKUSA Research Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education Noriko TAKESHITA Biwako-Gakuin University Hiromi TAKASU Okayama University Keiko MIYOSHI Research Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education Naoko SHIMIZU Doctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education Chihiro TOSA Yamaha Corporation Ai NAKAMURA Doctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education Aki HIGUCHI Okayama Prefectural School for the Deaf 10.18926/CTED/70362 �@–{Œ¤‹†‚Í�C�u‚¨‚©‚â‚Ü�‘�Û˜aŠyŠíŠw�¶ƒtƒFƒXƒeƒBƒoƒ‹�v‚ÌŽÀ‘H‚É‚¨‚¯‚é�CˆÙ•¶‰»ŠÔ”\—͈ç�¬‚̉”\�«‚ɂ‚¢‚Ä�CŽQ‰Á‚µ‚½�¬’†Šw�¶‚ÌŽ¿–⎆’²�¸Œ‹‰Ê‚©‚猟“¢‚µ‚½�B<br> �@‚»‚ÌŒ‹‰Ê�C‚P�j‘ÌŒ±‚ð’Ê‚µ‚ÄŒ`�¬‚³‚ꂽ�V‚½‚È”FŽ¯‚É‚æ‚è�C˜aŠyŠí‰¹Šy•¶‰»‚ÆŽ©ŒÈ‚Æ‚ÌŠÖŒW�«‚ð�Ä”FŽ¯�E�Ä�\’z‚µ�C˜aŠyŠí‰¹Šy•¶‰»‚Ö‚Ì�Ï‹É“I‚ÈŠÖ—^‚ðŽ¦‚·‰¿’l‚¯�EˆÓ–¡‚¯‚ª�s‚í‚ê�C“à�݉»‚ª‘£‚³‚ꂽ‚±‚Æ�C‚Q�j‰z‹«•¶‰»‚Æ‚µ‚Ă̘aŠyŠí‰¹Šy•¶‰»‚ɑ΂µ‚Ä�CŠJ•ú“I�E‘¸�d“I‘Ô“x‚ðŽ¦‚µ‚Ä‚¢‚½‚ª�CŽ©ŒÈ‚Ì•¶‰»“IƒAƒCƒfƒ“ƒeƒBƒeƒB‚ðˆÓŽ¯‚·‚éŒ_‹@‚Æ‚È‚Á‚½‚±‚Æ�C‚R�j˜aŠyŠí‰¹Šy‚Ì‹¤—L‚ð’Ê‚µ‚Ä�¶‚¶‚½‹¤Š´‚Ì�ã‚É�C‘ŠŒÝ—�‰ð‚⋦“­ŠÖŒW‚ª�\’z‚³‚ê‚Ä‚¢‚½‚±‚Æ�C‚S�j�u•¶‰»‚Ì‹¤—L‚̉”\�«‚ɂ‚¢‚Ä‚Ì”FŽ¯�v‚ªŒ`�¬‚³‚ê‚é‚È‚Ç�CƒtƒFƒXƒeƒBƒoƒ‹‚Å‚ÌŒoŒ±‚ª�C•¶‰»ŠÏ‚ÌŒ`�¬‚ɉe‹¿‚ð—^‚¦‚éŒ_‹@‚Æ‚È‚Á‚Ä‚¢‚½‚±‚Æ�C‚ª–¾‚ç‚©‚É‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ƒhƒCƒc•t‹ß‚̉Ă̋CŒó‚ƃVƒ…�[ƒxƒ‹ƒg‚̉̋È�s�t‚É�t ˆÙŽ¿‚È‘¼ŽÒ‚Æ‚Ì�o‰ï‚¢‚𑣂·‘åŠw‚Å‚ÌŠw�Û“IŽö‹Æ‚Ì•ñ�� 75 89 EN Kuranoshin KATO Faculty of Education, Okayama University Isao NAGAOKA Faculty of Education, Okayama University Haruko KATO Faculty of Education, Gufu Shotoku Gakuen University (Former affiliation) 10.18926/CTED/70361 �@�uˆÙŽ¿‚È‘¼ŽÒ�v‚Ö‚Ì�o‰ï‚¢‚𑣂·Žö‹Æ—á‚Ì�X‚È‚é’~�Ï‚Ì‚½‚ß�CƒhƒCƒc•t‹ß‚Ì�u‰Ä�v‚Ì‹CŒó‚Æ‹G�ߊ´‚É’�–Ú‚µ‚½‹³‰È‰¡’f“I‚ÈŽö‹Æ‚ð‘åŠw‚ÅŽÀ‘H‚µ‚½�BŽö‹Æ‚Å‚Í�CƒhƒCƒc•t‹ß‚Ì‹CŒó‚Æ‹G�߃TƒCƒNƒ‹‚Ì’†‚Å‚Ì�u‰Ä�v‚Ì“Á’¥‚ð”cˆ¬‚·‚é‚Æ‹¤‚É�CƒVƒ…�[ƒxƒ‹ƒg‚̉̋È�s�t‚É�t‚ðŠÓ�Ü‚µ‚½�B�s�t‚É�t‚Ì3 ”Ô‚Ì�u‰Ä‚ÌŠÔ‚¶‚イ�C‚¸‚Á‚Æ�v‚Æ‚¢‚¤‰ÌŽŒ‚ʼn̂í‚ê‚Ä‚¢‚é�îŒi‚â�‚ª�CƒhƒCƒc•t‹ß‚Æ“ú–{•t‹ß‚ð‘z’肵‚½�ê�‡‚É‚Ç‚¤ˆá‚¢“¾‚é‚©�C‚ÉŠÖ‚·‚éŽó�u�¶‚Ì‹L�q‚ð•ª�Í‚µ‚½�B‚»‚ÌŒ‹‰Ê�C“ú–{‚̉ĂÌ�‚‰·‘½Ž¼‚Ȋ‹«‚©‚ç‚ÍŒ´Ž�‚Ì�‚»‚Ì‚à‚Ì‚ª�¬—§‚µ“ï‚¢‚ÆŠ´‚¶‚½Šw�¶‚à‚¢‚é‚È‚Ç�C–{ŽÀ‘H‚Í�CŽ©•ª‚½‚¿‚Ì�u“–‚½‚è‘O�v‚Ƃ͈قȂé‹CŒó‚â‹G�ߊ´‚É‚à–Ú‚ðŒü‚¯‚é‹@‰ï‚ɂȂ蓾‚½‚Æ‚¢‚¦‚é�Bˆê•û�C“ú–{‚Æ‚Í‚©‚È‚èˆá‚¤‹CŒó”wŒi‚Ì’†‚ŃVƒ…�[ƒxƒ‹ƒg‚ªŽv‚¢•`‚¢‚½‚Å‚ ‚낤�îŒi�E�S�î‚ÉŽö‹Æ‚Å�[‚­”—‚邽‚ß‚Ì�C‰¹Šy•\Œ»Ž©‘Ì‚Ö‚Ì“¥‚Ý�ž‚Ý•û‚ɂ‚¢‚Ä‚à�C�¡ŒãŒŸ“¢‚·‚é•K—v�«‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ’†Šw�¶‚ð‘Î�Û‚Æ‚µ‚½ƒTƒbƒJ�[ŽŽ�‡’†‚Ì�g‘ÌŠˆ“®—Ê‚ÉŠÖ‚·‚錤‹† �`ƒ|ƒWƒVƒ‡ƒ“‚Æ�g‘Ì�E‘Ì—Í“Á�«‚É’…–Ú‚µ‚Ä�` 61 73 EN Takaaki NATSUMEDA Graduate School of Education, Okayama University Minoru ADACHI Okayama University Graduate School of Education 10.18926/CTED/70360 �@’†Šw�¶34�l‚ð‘Î�Û‚Æ‚µ�C�g‘Ì�E‘Ì—Í“Á�«‚ƃTƒbƒJ�[ŽŽ�‡’†‚Ì�g‘ÌŠˆ“®—ʂɂ‚¢‚Ä�Cƒ|ƒWƒVƒ‡ƒ“‚É’…–Ú‚µ‚Ä”äŠr�EŒŸ“¢‚µ‚½�D‚»‚ÌŒ‹‰Ê�C�g‘Ì�E‘Ì—Í“Á�«‚ɂ‚¢‚Ă̓|ƒWƒVƒ‡ƒ“ŠÔ‚É—LˆÓ‚È�·‚Í”F‚ß‚ç‚ê‚È‚©‚Á‚½�D•à�”‚ł̓|ƒWƒVƒ‡ƒ“ŠÔ‚Å—LˆÓ�·‚ª”F‚ß‚ç‚ê�Cƒ‰ƒCƒgƒTƒCƒhƒoƒbƒN‚ª�­‚È‚­�CƒZƒ“ƒ^�[ƒ~ƒbƒhƒtƒBƒ‹ƒ_�[‚ª�‚‚©‚Á‚½�D‹­“x•Ê�g‘ÌŠˆ“®—ÊŽžŠÔ‚ÌŠ„�‡‚ł̓|ƒWƒVƒ‡ƒ“ŠÔ‚Å—LˆÓ�·‚ª”F‚ß‚ç‚ê�Cƒ‰ƒCƒgƒTƒCƒhƒoƒbƒN‚ª’á‚­�CƒZƒ“ƒ^�[ƒ~ƒbƒhƒtƒBƒ‹ƒ_�[‚ª�‚‚©‚Á‚½�DˆÈ�ã‚Ì‚±‚Æ‚©‚ç�C–{Œ¤‹†‚Ì‘Î�Û’†Šw�¶‚ł̓|ƒWƒVƒ‡ƒ“ŠÔ‚Å�g‘Ì�E‘Ì—Í“Á�«‚É‚Í—LˆÓ�·‚ª”F‚ß‚ç‚ê‚È‚¢‚ª�CƒTƒbƒJ�[ŽŽ�‡’†‚Ì�g‘ÌŠˆ“®—ʂł̓|ƒWƒVƒ‡ƒ“ŠÔ‚Å�·‚ª�¶‚¶‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�D No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 �¬Šw�¶‚ÌŠw�Z�¶Šˆ‚É‚¨‚¯‚é�g‘ÌŠˆ“®—Ê‚Æ‘Ì—Í‚ÉŠÖ‚·‚錤‹† 45 59 EN Jin YASUNOBE Graduate School of Education, Okayama University Kensaku SASAYAMA Faculty of Education, Mie University Minoru ADACHI Faculty of Education, Okayama University 10.18926/CTED/70359 �@–{Œ¤‹†‚Ì–Ú“I‚Í�C�¬Šw�Z6”N�¶‚ÌŠw�Z�¶Šˆ‚É‚¨‚¯‚銈“®�ê–Ê•Ê‚Ì�g‘ÌŠˆ“®—Ê‚ð‰Á‘¬“xŒv‚ð—p‚¢‚Ä‹qŠÏ“I‚É‘ª’肵�C‚»‚Ì‘Ì—Í‚Æ‚ÌŠÖŒW‚ðŒŸ“¢‚·‚邱‚Æ‚Å‚ ‚é�D‘Î�Û‚Í�¬Šw�ZŽ™“¶85–¼(’jŽq41–¼�C�—Žq44–¼)‚Æ‚µ�C‹x‚ÝŽžŠÔ�C‘̈çŽö‹Æ�CŠw�Z�¶Šˆ‘S‘Ì‚É‚¨‚¯‚é•à�”‚Æ‹­“x•ÊŠˆ“®ŽžŠÔ‚ð•]‰¿‚µ‚½�D‚»‚ÌŒ‹‰Ê�C’j�—‚Æ‚à‚É‘Ì—Í�ãˆÊŒQ‚Í‹x‚ÝŽžŠÔ‚É‚¨‚¢‚Ä•à�”‚ÆMVPA‚ª‘½‚¢ŒXŒü‚ªŽ¦‚³‚ê�C“Á‚É’jŽq‚Í’†‹x‚Ý�C�—Žq‚Í’‹‹x‚Ý‚¨‚æ‚ё̈çŽö‹Æ‚Å—LˆÓ�·‚ª”F‚ß‚ç‚ꂽ�DŠeŠˆ“®�ê–Ê‚ÌMVPA ‚ª�è‚߂銄�‡‚Í‹x‚ÝŽžŠÔ11.3�“�C‘̈çŽö‹Æ15.7�“‚Å‚ ‚è�C�”ŠO�‘‚Æ”äŠr‚µ‚Ä�­‚È‚­�C�‘�Û“I�„�§’l‚É‚à“Í‚©‚È‚©‚Á‚½�D–{Œ¤‹†‚Í�C�¬Šw�Z‚É‚¨‚¯‚é�g‘ÌŠˆ“®—Ê‚ÌŠî‘bƒf�[ƒ^‚ð’ñŽ¦‚·‚é‚Æ‚Æ‚à‚É�CŠw�Z�¶Šˆ�C“Á‚É‹x‚ÝŽžŠÔ‚â‘̈çŽö‹Æ‚É‚¨‚¯‚é�g‘ÌŠˆ“®‹@‰ï‚Ì�[ŽÀ‚ª•K—v‚Å‚ ‚邱‚Æ‚ðŽ¦�´‚µ‚½�D No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 “ʃŒƒ“ƒY‚Ì‘œ‚Ì�¶‰E—�‰ð‚ÉŠÖ‚·‚é�¬—�‚Ì—vˆö•ª�Í ‹³‰È�‘•ª�Í‚Æ‹³ˆõƒAƒ“ƒP�[ƒg‚É‚æ‚é’T‹†“I‚ÈŠw‚Ñ‚Ö‚Ì’ñˆÄ 31 44 EN Kunihiko TANIMOTO Faculty of Education, Okayama University Yoshihiko INADA Faculty of Education, Okayama University 10.18926/CTED/70358 �@–{Œ¤‹†‚Í�A’†Šw�Z—�‰È‚̓ʃŒƒ“ƒYŠw�K‚Å�¶“k‚ª‘œ‚ÌŒü‚«‚É•ø‚­�¬—�‚É’…–Ú‚µ‚½�B‚»‚Ì—vˆö‚ð�AŒõŒ¹�EƒXƒNƒŠ�[ƒ“�EŠÏŽ@�ê�Š‚Æ‚¢‚Á‚½ŽÀŒ±�ðŒ�‚ª�\•ª‚Ɉӎ¯‚³‚ê‚Ä‚±‚È‚©‚Á‚½“_‚É‚ ‚é‚Æ�lŽ@‚µ�AŠw�KŽw“±—v—Ì‚Æ‹³‰È�‘‚Ì•Ï‘J•ª�Í�A‚¨‚æ‚ÑŒ»�E‹³ˆõ‚ւ̃Aƒ“ƒP�[ƒg’²�¸‚ðŽÀŽ{‚µ‚½�B‚»‚ÌŒ‹‰Ê�A‹³‰È�‘‚Ì‹L�q‚ÍŠÏŽ@�ê�Š‚ðŽw’è‚·‚é•ûŒü‚֕ω»‚µ‚Ä‚¢‚é‚à‚Ì‚Ì�AŒ»�ꋳˆõ‚ÌŽw“±–@‚ɂ͂΂ç‚‚«‚ª‚ ‚è�A�¶“k‚Ì�¬—�‚ð�µ‚­ˆêˆö‚Æ‚È‚Á‚Ä‚¢‚邱‚Ƃ𖾂炩‚É‚µ‚½�B‚±‚ê‚ç‚̉ۑè‰ðŒˆ‚Ì‚½‚ß�AŠÏŽ@Ž‹“_‚ðŽ©‘R‚ɌŒè‚Å‚«‚é3D ƒvƒŠƒ“ƒ^�»‹³�Þ‚ðŠJ”­‚µ�A‹³ˆõŒ¤�C‚Å‚»‚Ì—LŒø�«‚ðŒŸ“¢‚µ‚½�B–{‹³�Þ‚Í�¶“k‚Ì’¼Š´“I—�‰ð‚𑣂µ�A’T‹†“I‚ÈŠw‚Ñ‚ðˆø‚«�o‚·�ã‚Å—LŒø‚Å‚ ‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 �à–¾“I•¶�Í‚ÌŽw“±‚É‚¨‚¯‚é�u“à�È�v‚𑣂·”á”»“I“Ç‚Ý �\�‚“™Šw�Z‚P”N�¶‚ð‘Î�Û‚Æ‚µ‚Ä�\ 15 29 EN Yumi SAISHO Graduate School of Education (Professional Degree Corse), Okayama University Masafumi IKEDA Faculty of Education, Okayama University 10.18926/CTED/70357 �@”á”»“I“Ç‚Ý‚Í�CŒ»‘ã‚Å‚ÍŒ‡‚©‚¹‚È‚¢”\—Í‚Å‚ ‚è�CŠw�KŽw“±—v—Ì‚É‚à–¾‹L‚³‚ê‚Ä‚¢‚é�B‹ß”N�C”á”»“I“Ç‚Ý‚ÌŽw“±‚ÉŠÖ‚·‚錤‹†‚ª‚È‚³‚ê‚Ä‚¢‚é‚à‚Ì‚Ì�C“à—e“I‚ȉ¿’l‚ÌŒŸ“¢‚âŽÐ‰ï“I‚È•¶–¬‚Ì‚È‚©‚Å‘¨‚¦‚邱‚Æ‚ªŠó”–‚¾‚Æ‚·‚éŽw“E‚â�C�u”½�È�«�v‚Æ‚¢‚¤ŠÏ“_‚É’…–Ú‚µ‚½”á”»“I“Ç‚Ý‚ð‹�‚ß‚é�º‚à‚ ‚é�B‚»‚±‚Å�C–{�e‚Å‚Í�C•¶�Í‚»‚Ì‚à‚Ì‚ð”á”»“I‚É“Ç‚Þ‚¾‚¯‚Å‚È‚­�CŽ©�g‚ÌŽ�‚Á‚Ä‚¢‚é�l‚¦‚ð‚à”á”»“I‚É‘¨‚¦‚é�i“à�È‚·‚é�j‚±‚Ƃ𑣂·Žö‹Æ‚ðŠJ”­‚µ‚½�B‚»‚ÌŽè—§‚Ä‚Æ‚µ‚Ä�C•¡�”‚̎Љï”FŽ¯‚ª‘¶�Ý‚·‚é“ñ‚‚̋³�Þ‚Ì“Ç‚Ý”ä‚ׂ½‚¤‚¦‚Å�C‘Η§‚·‚é—§�ê‚©‚ç‚̈ӌ©ŒðŠ·‚ð�s‚¤‚±‚Æ‚â�C‹³�ނɑ΂·‚é•]‰¿‚Ì‹L�q�C‚»‚Ì‹L�q�iŽ©ŒÈ‚Ì“Ç‚Ý�j‚ðŠw�KŽÒŽ©�g‚ª•]‰¿‚·‚é‚Æ‚¢‚Á‚½Šˆ“®‚ðŽæ‚è“ü‚ꂽ�BŠw�KŽÒ‚Ì‹L�q‚Ì•ª�Í‚©‚ç‚Í�CˆÓŽ¯“I‚È“à�È‚ÉŽŠ‚ç‚È‚©‚Á‚½Šw�KŽÒ‚àŒ©Žó‚¯‚ç‚ꂽ‚à‚Ì‚Ì�C–ñ‚UŠ„‚ÌŠw�KŽÒ‚Ì‹L�q‚É‚Í•Ï—e‚ªŒ©‚ç‚ê�C—p‚¢‚½Žè—§‚Ä‚ÍŒø‰Ê‚ª‚ ‚Á‚½‚Æ�„‘ª‚Å‚«‚邱‚Æ‚ðŽw“E‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ŠO�‘�l—cŽ™‚Ì�AŠwŽx‰‡‚É‚¨‚¯‚é•ÛˆçŽm‚Ì�H•v‚ÆŽÀ‘H“I‰Û‘è 1 13 EN Yiwen CHEN The Joint Graduate School (Ph.D. Program) in Science of School Education, Hyogo University of Teacher, Hyogo University of Teacher Education Kazuki YANAGISAWA Graduate School of Education, Okayama University Xinyu REN Graduate School of Education, Okayama University Munehisa YOSHITOSHI Faculty of Education, Okayama University 10.18926/CTED/70356 �@–{Œ¤‹†‚Í�CŠO�‘�l—cŽ™‚ª�AŠwŠú‚É’¼–Ê‚·‚é�¢“ï‚ɑΉž‚·‚邽‚ß�C•ÛˆçŽm‚ª�s‚Á‚Ä‚¢‚é‹ï‘Ì“I‚È•ÛˆçŽÀ‘H‚É‚¨‚¯‚éŽx‰‡‚Ì�H•v‚Ɖۑè‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�BŠO�‘�l—cŽ™‚ÌŽx‰‡ŒoŒ±‚ð—L‚·‚é•ÛˆçŽm2 –¼‚É”¼�\‘¢‰»ƒCƒ“ƒ^ƒrƒ…�[‚ð�s‚¢�CSCAT ‚ð—p‚¢‚½Ž¿“I•ª�Í‚É‚æ‚è�C—cŽ™‚¨‚æ‚Ñ•ÛŒìŽÒ‚Ö‚ÌŽx‰‡“à—e‚ð�®—�‚µ‚½�B‚»‚ÌŒ‹‰Ê�CŒ¾Œê–Ê‚Å‚ÍŽ‹Šo“IŽx‰‡‚â‚₳‚µ‚¢“ú–{Œê‚ðŠˆ—p‚µ�C•¶‰»–ʂł͉ƒ땶‰»‚Æ“ú–{‚̉€•¶‰»‚Ì’²�®‚ª�s‚í‚ê‚Ä‚¢‚½�B”­’BŽx‰‡‚É‚¨‚¢‚Ä‚Í�C”ñ”F’m“IƒXƒLƒ‹‚̈ç�¬‚âˆã—Ë@ŠÖ‚Ƃ̘AŒg‚Ì•K—v�«‚ªŽw“E‚³‚ꂽ�B•ÛŒìŽÒŽx‰‡‚Å‚Í�CŽQ‰ÁŒ^‚ÌŠÖ‚í‚è‚â’š”J‚È�à–¾‚ªŽÀ‘H‚³‚ê‚Ä‚¢‚½‚ª�C�§“x�î•ñ‚Ì’ñ‹Ÿ‚â�s�­‚Ƃ̘AŒg‚ɂ͉ۑ肪Žc‚³‚ꂽ�B‚±‚ê‚ç‚ÌŒ‹‰Ê‚𓥂܂¦�C�¡Œã‚Í•ÛˆçŽm‚̌•ʓI“w—͂Ɉˑ¶‚µ‚È‚¢‚½‚ß‚É‚à�C‘½•¶‰»”wŒi‚ð‚à‚‰ƒë‚Ö‚ÌŽx‰‡‚ð�§“x“I‚ÉŽx‚¦‚é’nˆæ˜AŒg‘Ì�§‚Ì�®”õ‚â�C�î•ñ’ñ‹Ÿ‚Ì•W�€‰»�C“ú–{Œê‹³ˆçŽ‘Œ¹‚Æ‚Ì�Ú‘±‚ð�}‚éŽÀ‘H“IŽd‘g‚Ý‚Ì�\’z‚ª‹�‚ß‚ç‚ê‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 •\Ž†�E–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[ Acta Medica Okayama 2186-1323 16 2026 ‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ ‹³Žt‹³ˆçŠJ”­ƒZƒ“ƒ^�[‹I—v ‘æ16�† ‘S•¶�iˆêŠ‡ƒ_ƒEƒ“ƒ��[ƒh—p�j EN No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0309-0167 2026 Clinicopathological and transcriptomic profiles of 101 patients with diffuse large B-cell lymphoma/high-grade B-cell lymphoma with double-hit MYC and BCL2 or BCL6 and triple hit EN Masashi Miyaoka Department of Pathology, School of Medicine, Tokai University Joaquim Carreras Department of Pathology, School of Medicine, Tokai University Yara Yukie Kikuti Department of Pathology, School of Medicine, Tokai University Haruka Ikoma Department of Pathology, School of Medicine, Tokai University Shunsuke Nagase Department of Pathology, School of Medicine, Tokai University Atsushi Ito Department of Pathology, School of Medicine Tokai University Isehara Japan Makoto Orita Department of Pathology, School of Medicine, Tokai University Hiroshi Kawada Department of Hematology, School of Medicine, Tokai University Rika Sakai Department of Medical Oncology, Kanagawa Cancer Center Yasuharu Sato Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Midori Filiz Nishimura Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Kunihiro Tsukasaki Department of Hematology, International Medical Center, Saitama Medical University Shuji Momose Department of Pathology, Saitama Medical Center, Saitama Medical University Yoshihiro Kameoka Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine Masahiro Yoshida Department of Hematology, Osaka City General Hospital Akira Satou Department of Surgical Pathology, Aichi Medical University Hospital Seiichi Kato Center for Clinical Pathology, Fujita Health University Hospital Naoki Oishi Department of Pathology, University of Yamanashi Akio Saito Department of Hematology, NHO Shibukawa Medical Center Ken Sadahira Division of Hematology, Kawasaki Municipal Kawasaki Hospital Yohei Masugi Department of Pathology, School of Medicine, Tokai University Naoya Nakamura Department of Pathology, School of Medicine, Tokai University Aims: Diffuse large B-cell lymphoma/high-grade B-cell lymphoma (DLBCL/HGBCL) with MYC and BCL2 rearrangements (double-hit lymphoma with BCL2, DHL-BCL2) is a mature aggressive B-cell lymphoma that also includes concurrent triple hit with BCL6 translocation (TH). DHL with MYC and BCL6 (DH-BCL6) can also occur. The differences among these three DLBCL/HGBCL subtypes have not yet been definitively determined.<br> Methods and Results: This study characterized the clinicopathological features and transcriptomic profiles of a series of 101 cases of DLBCL/HGBCL that were subclassified according to MYC, BCL2 and BCL6 FISH data, including cell-of-origin (COO)-like, molecular high-grade (MHG)-like and double-hit/dark-zone (DHIT/DZsig)-like signatures. DLBCL/HGBCL-DH-BCL2 was characterized by higher HGBCL morphology, CD10 positivity, GCB Hans's, GCB COO and MHG molecular subtype. DLBCL/HGBCL-TH had higher LDH levels and worse overall survival. DLBCL/HGBCL-DH-BCL6 had higher MUM1 expression, non-GCB Hans', ABC/Unclassified COO, non-MHG and low DHIT/DZ signatures. Transcriptomic analysis showed that DLBCL/HGBCL-DH-BCL2 and DLBCL/HGBCL-TH were close but separated from DLBCL/HGBCL-DH-BCL6. Gene set enrichment analysis (GSEA) revealed different levels of enrichment between the subtypes.<br> Conclusions: DLBCL/HGBCL-DH-BCL6 differs from the DLBCL/HGBCL-DH-BCL2, and the DLBCL/HGBCL-TH is associated with the worst survival. Analysis of all three genes of MYC, BCL2 and BCL6 is recommended in the context of DLBCL/HGBCL diagnosis. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2688-4046 6 3 2026 PPy�]Coated Wire Actuators for the Micromechanostimulation of Cells: Fabrication and Characterization e202500639 EN Amaia B. Ortega�]Santos Sensor and Actuator Systems, Department of Physics Chemistry and Biology (IFM), Linköping University Satoru Hayano Department of Orthodontics, Okayama University Hospital Emilio Satoshi Hara Advanced Research Center for Oral and Craniofacial Sciences Dental School, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jose G. Martínez Sensor and Actuator Systems, Department of Physics Chemistry and Biology (IFM), Linköping University Hiroshi Kamioka Department of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Edwin W. H. Jager Sensor and Actuator Systems, Department of Physics Chemistry and Biology (IFM), Linköping University Cellular mechanotransduction signals play a crucial role in physiological and pathological conditions, including skeletal disorders. Although various systems exist to mechanically stimulate cultured cells, most are constrained by incubator incompatibility, limited physiological relevance, nonuniform stimulation, or complexity. The objective of this article is to develop and validate a compact, incubator-compatible tool capable of delivering localized and physiologically relevant mechanical stimulation to small cell populations. Here, we introduce a polypyrrole-based wire-shaped microactuator designed to induce localized mechanical stress to adjacent cells. These wire-shaped microactuators are biocompatible, easy-to-use, and compact for use within standard in vitro cell culture systems. Using a noncontact optical method, we characterize the actuation of polypyrrole-coated wires in an aqueous NaDBS electrolyte, showing radial expansion of 1.5–8 µm depending on the deposited polypyrrole film thickness, comparable to cellular dimensions. Next, the actuation is confirmed to be robust and stable to use in cell culture media at physiological temperature. To evaluate biological relevance, osteoblastic KUSA-A1 cells are mechanically stimulated inside the incubator and transcriptomic changes are assessed. Mechanical stimulation resulted in upregulation of genes previously associated with mechanotransduction, including Fos and Fosb. Additionally, several uncharacterized long noncoding RNAs are differentially expressed, suggesting potential novel players in the mechanotransduction pathway. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2410-387X 9 4 2025 Role-Based Efficient Proactive Secret Sharing with User Revocation 80 EN Yixuan He Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yuta Kodera Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Interdisciplinary Education and Research Field, Okayama University Proactive secret sharing (PSS), an extension of secret-sharing schemes, safeguards sensitive data in dynamic distributed networks by periodically refreshing shares to counter adversarial attacks. In our previous work, we constructed a non-interactive proactive secret scheme by integrating threshold homomorphic encryption (ThHE) while reducing the communication complexity to 𝑂(𝑛). Not only is refreshing shares important but revoking the shares of users who have left the system is also essential in practical dynamic membership scenarios. However, the previous work was insufficient for supporting explicit user revocation. This study strengthens the description of roles for authorized users and proposes a scheme to achieve non-interactive share refresh and dynamic user management. In each epoch, authorized users are classified into three roles: retain, newly join, and rejoin, and they receive a broadcast of the compact ciphertext encoding both the refresh information and the revocation instructions from the trusted center (dealer). Authorized users independently derive new shares through homomorphic computations, whereas revoked users are unable to generate new shares. Hash functions are used to bind revocation parameters to the cryptographic hashes of valid users in order to guarantee integrity during revocation, allowing for effective verification without compromising non-interactivity. Our new scheme not only extends the revocation structure but also preserves the 𝑂(𝑛) communication complexity. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1424-8220 25 21 2025 Integrated Authentication Server Design for Efficient Kerberos–Blockchain VANET Authentication 6651 EN Maya Rahayu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Md. Biplob Hossain Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Samsul Huda Interdisciplinary Education and Research Field, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Vehicular Ad Hoc Network (VANET) is a fundamental component of the intelligent transportation systems (ITS), providing critical road information to users. However, the volatility of VANETs creates significant vulnerabilities from malicious actors. Thus, verifying joining entities is crucial to maintaining the VANET�fs communication security. Authentication delays must stay below 100 ms to meet VANET requirements, posing a major challenge for security. Our previous research introduced a Kerberos–Blockchain (KBC) authentication system that contains two main components separately: Authentication Server (AS) and Ticket Granting Server (TGS). However, this KBC architecture required an additional server to accommodate increasing vehicle volumes in urban environments, leading to higher infrastructure costs. This paper presents an integrated authentication server that merges AS and TGS into a Combined Server (CBS) while retaining blockchain security. We evaluate it using OMNeT++ with SUMO for traffic simulation and Ganache for blockchain implementation. Results show that CBS removes the need for an extra server while keeping authentication delays under 100 ms. It also improves throughput by 104% and reduces signaling overhead by 45% compared to KBC. By optimizing authentication without compromising security, the integrated server greatly enhances the cost-effectiveness and efficiency of VANET systems. No potential conflict of interest relevant to this article was reported.

BON VIEW PUBLISHING PTE Acta Medica Okayama 2810-9503 5 1 2025 A Study on Zeek IDS Effectiveness for Cybersecurity in Agricultural IoT Networks 133 142 EN Samsul Huda Interdisciplinary Education and Research Field, Okayama University Muhammad Bisri Musthafa Graduate School of Environmental, Life, Natural Science and Technology, Okayama University S. M. Shamim Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yasuyuki Nogami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University As agriculture moves toward Agriculture 4.0, which uses Internet of Things (IoT) devices to collect data in real time and monitor things from a distance, these networks are becoming increasingly vulnerable to cyberattacks. A common method used to protect against these kinds of threats is the use of intrusion detection systems (IDS). However, the agricultural environment is often changing and has limited resources, which makes cybersecurity challenging. Several available IDS tools are not designed to work properly in places with few resources, intermittent access, and unpredictable network conditions. This paper investigates the performance of Zeek, an open-source IDS, in identifying potential threats in agricultural IoT networks. We performed both offline and real-time experiments: offline analysis used pcap files from the Stratosphere Laboratory dataset, and real-time evaluation involved simulated live attack scenarios, focusing on unauthorized access attempts and distributed denial-of-service (DDoS) attacks. Zeek's performance was assessed based on CPU and memory utilization, as well as quality of service (QoS) metrics. From the experimental results, we found that Zeek was quite effective in protecting agricultural IoT networks against typical threats. Memory usage remained stable around 5% during offline analysis and under 20% during active attacks. However, CPU usage was more volatile, peaking at 120% during DDoS events. In terms of QoS, the system maintained a good throughput (1,375 kbits/s) with minimal packet loss (0.000186%). Among the attack types that we tested, brute force attacks, which represent attempts at unauthorized access, had the strongest effect on network performance, increasing delay to 2.159 ms and jitter to 0.793 ms. It seems clear that a heavier traffic load during such attacks can interfere with QoS. On the basis of our observation, we recommend practical deployment strategies for agricultural IoT systems that take these limitations into consideration, aiming to keep networks both secure and efficient under pressure. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆçŠw•”�‘ŒêŒ¤‹†‰ï Acta Medica Okayama 2189-5414 40 2026 že–ì�_ˆê�w�Î�ì‚­‚ñ�x‚ÉŠw‚Ô‰C•¶‚Ì�‘‚«Š·‚¦ �\•¶–@‚ÆŒêœb‚Ì‘I‘ð‚ª‚à‚½‚ç‚·•\Œ»‚Ì‘Î�Æ�«�\ (37) (47) EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆçŠw•”�‘ŒêŒ¤‹†‰ï Acta Medica Okayama 2189-5414 40 2026 ŒP“ÇŠ¿Ž�‚̉¹“ǂɂ‚¢‚Ä �\‰¹“Ç‘ä–{‚Ì‚·‚·‚ß�\ (1) (12) EN No potential conflict of interest relevant to this article was reported.

Japan Society of Mechanical Engineers Acta Medica Okayama 1880-5558 20 1 2025 Numerical analysis validating the standard k-epsilon model for the kinetic energy of turbulence subjected to weak but long-lasting wind tunnel blockage acceleration JFST0004 EN Akira ONO Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Hiroki SUZUKI Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Toshinori KOUCHI Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Kento TANAKA Graduate School of Environmental, Life, Natural Science and Technology, Okayama University The aim of this study is to investigate the effect of weak but prolonged mean flow accelerations, such as those observed in wind tunnel blockage acceleration, on free-stream turbulence. Specifically, this research aims to validate a model previously developed based on the k-epsilon model. To test this model, the study focuses on scenarios where the turbulence under acceleration is steady and isotropic, since the model suggests that this type of acceleration has no effect on the turbulent kinetic energy. To examine this suggestion, the turbulence within a periodic box was analyzed using large-eddy simulation (LES) based on the conventional Smagorinsky model framework. The numerical analysis is based on a method that conserves velocity fluctuation intensities. The results show that while high rate of acceleration deviates turbulent kinetic energy, low rate acceleration has hardly any effect on turbulent kinetic energy, enstrophy, pressure fluctuation, relative pressure fluctuation intensity, and higher-order statistics of a velocity fluctuation. These results validate the accuracy of the model proposed in the previous studies. These results were obtained by focusing on differences in Reynolds numbers and the spatial scale of the forcing. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw—�Šw•”’n‹…‰ÈŠw‰È Acta Medica Okayama 1340-7414 32 1 2026 2018”N7ŒŽ5“ú�`7“ú‚Ì�¼“ú–{�‹‰J‚É‚¨‚¯‚é�Lˆæ�~�…“Á�« 33 44 EN Kuranoshin KATO Faculty of Education, Okayama University Kengo MATSUMOTO Okayama Gakugeikan High School Kazuo OTANI TV Setouchi Broadcasting Co., LTD. 10.18926/ESR/70297 �@Large-scale rainfall characteristics at the heavy rainfall event around the western Japan for 5–7 July 2018 were analyzed with use of the 10-mimute precipitation data at the surface meteorological observation stations of the Japan Meteorological Agency, and so on. In this case, the area with 3 days total precipitation of near or more than 300 mm was distributed widely from northern Kyushu to Shiga and Fukui Prefectures. As in the many heavy rainfall events around Kyushu District in the mature stage of the Baiu season, contribution of the intense rainfall with more than 4 mm/10-minute (24 mm/h) attained about one third of the areal mean total precipitation. However, it is noted that the "not so intense rain" with less than 2 mm/10-minute (12 mm/h) also contributed to about one third of the huge total precipitation in the wide area. In short, this case could be characterized by the mixture of the western Japan type heavy rainfall event and the eastern Japan type one. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw—�Šw•”’n‹…‰ÈŠw‰È Acta Medica Okayama 1340-7414 32 1 2026 10•ªŠÔ�~�…—Ê‚©‚ç‘å‰J‚Ì“Á’¥‚Ì‘½—l�«‚𑨂¦‚é‘åŠw‚Å‚ÌŽö‹Æ‚ÌŽŽ‚Ý�i–h�ЋC�ÛƒŠƒeƒ‰ƒV�[ˆç�¬‚ÖŒü‚¯‚Ä�j 21 31 EN Kuranoshin KATO Faculty of Education, Okayama University 10.18926/ESR/70296 �@In the disaster prevention education on the heavy rainfall around Japan, it is also important to promote the meteorological literacy on the seasonal and regional differences of their rainfall characteristics such as the convective rain or stratiform rain, together with their total amount of precipitation and their occurrence frequency. As the first step toward the above purpose, the present study made a lesson practice for the university students by utilizing the 10-minute precipitation data for the four heavy rainfall events, in which the types of the heavy rainfall (although all the cases examined in the lesson are relating to the deep convective clouds) are rather different from each other, such as the differences of the rainfall intensity at the peak time, short-period variation of the rainfall intensity and the persistency of the rainfall including the "not so intense rainfall". The reports by the students seem to perceive the different features among these events briefly, but the students' attention to how long the intense rainfall with short-period variation or "not so intense rainfall" lasted was not so sufficient. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw�lŒÃŠwŒ¤‹†Žº Acta Medica Okayama 2026 ‰ªŽRŽsŒü�ê�E�•�Z‹u—˂̈â�Õ‘ª—Ê’²�¸ŠT—v•ñ�� EN 10.18926/70272 No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2666-6065 67 2026 Alcohol consumption, smoking, and the implications of their cessations for field carcinogenesis in the esophagus: a 10-year prospective cohort study 101798 EN Chikatoshi Katada Department of Medical Oncology, Kyoto University Graduate School of Medicine Tetsuji Yokoyama Department of Health Promotion, National Institute of Public Health Tomonori Yano Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East Yasuaki Furue Department of Endoscopy, Saitama Cancer Center Haruhisa Suzuki Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine Kenji Ishido Department of Gastroenterology, Kitasato University School of Medicine Keiko Yamamoto Division of Endoscopy, Hokkaido University Hospital Hiroyoshi Nakanishi Department of Gastroenterology, Ishikawa Prefectural Central Hospital Tomoyuki Koike Division of Gastroenterology, Tohoku University Graduate School of Medicine Masashi Tamaoki Department of Medical Oncology, Kyoto University Graduate School of Medicine Noboru Kawata Division of Endoscopy, Shizuoka Cancer Center Motohiro Hirao Department of Surgery, NHO Osaka National Hospital Yoshiro Kawahara Department of Practical Gastrointestinal Endoscopy, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takashi Ogata Department of Gastrointestinal Surgery, Kanagawa Cancer Center Atsushi Katagiri Division of Gastroenterology, Department of Medicine, Showa Medical University Hospital Takenori Yamanouchi Department of Gastroenterology, Kumamoto Regional Medical Center Hirofumi Kiyokawa Department of Gastroenterology, St. Marianna University School of Medicine Hirofumi Kawakubo Maki Konno Department of Gastroenterology, Tochigi Cancer Center Akira Yokoyama Department of Medical Oncology, Kyoto University Graduate School of Medicine Shinya Ohashi Department of Medical Oncology, Kyoto University Graduate School of Medicine Tai Omori Department of Surgery, Kawasaki Municipal Kawasaki Hospital Tadakazu Shimoda Department of Diagnostic Pathology, Shizuoka Cancer Center Atsushi Ochiai Exploratory Oncology Research and Clinicai Trial Center, National Cancer Center Hideki Ishikawa Department of Molecular-Targeting Prevention, Kyoto Prefectural University of Medicine Akira Yokoyama Clinical Research Unit, National Hospital Organization Kurihama Medical and Addiction Center Manabu Muto Department of Medical Oncology, Kyoto University Graduate School of Medicine Background Alcohol and tobacco are established carcinogens, which promote field carcinogenesis for esophageal squamous cell carcinoma (ESCC). This study aimed to evaluate the long-term effects of alcohol and tobacco cessations, and background mucosal status, on risk for metachronous ESCC (mESCC) after endoscopic resection (ER).<br> Methods This was a multicentre prospective cohort study of patients with intramucosal ESCC treated by ER. All participants received structured education on cessation, and underwent regular endoscopic surveillance. Patients were stratified by Lugol-voiding lesion (LVL) grade (A: none, B: 1–9, C: ≥10). The impacts of alcohol and smoking cessation on field carcinogenesis were assessed.<br> Findings Among 331 enrolled patients, the median follow-up was 120 months (range: 1.3–176.9). The cumulative incidences of mESCC were 10.4%, 27.2%, and 61.8% in grades A, B, and C, respectively. An increment of 1 unit (22 g ethanol) of alcohol consumption and higher LVL grade independently increased the risk for mESCC. Alcohol or smoking cessation reduced this risk (hazard ratio [HR] 0.52, 95% confidence interval [CI]: 0.31–0.88; HR 0.44, 95% CI: 0.25–0.78, respectively), and combined cessation had the greatest impact (HR 0.21, 95% CI: 0.07–0.65). Complete cessation, rather than partial reduction, was necessary to achieve meaningful risk reduction.<br> Interpretation Alcohol and tobacco exposure, and a large number of LVL, are major determinants of mESCC. Complete cessation markedly reduces risk, underscoring the importance of behavioural interventions for secondary prevention of field carcinogenesis after ER. No potential conflict of interest relevant to this article was reported.

JMIR Publications Inc. Acta Medica Okayama 2369-3762 12 2026 Prescription Support Practice for Pharmacy Students: Pre-Post Educational Intervention Study e79545 EN Fuka Aizawa Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital Kenta Yagi Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima University Tsukasa Higashionna Department of Pharmacy, Okayama University Hospital Hirofumi Hamano Department of Pharmacy, Okayama University Hospital Shimon Takahashi Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima University Yoshito Zamami Department of Pharmacy, Okayama University Hospital Kazuaki Shinomiya Department of Pharmaceutical Care and Clinical Pharmacy, Tokushima Bunri University Takahiro Niimura Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital Mitsuhiro Goda Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima University Kei Kawada Department of Clinical Pharmacology and Therapeutics, Graduate School of Biomedical Sciences, Tokushima University Keisuke Ishizawa Clinical Research Center for Developmental Therapeutics, Tokushima University Hospital Background: In the field of team-based care, pharmacists are vital for optimizing medication therapy. However, many medical professionals lack the opportunity to learn how to propose prescription changes with precision.<br> Objective: This study aimed to address this knowledge gap by developing and assessing a new educational program for pharmacy students focused on prescription support and interprofessional collaboration.<br> Methods: We recruited 191 fifth-year pharmaceutical students during the 2022�]2024 academic years. The program featured a 7-day intensive curriculum that included learning how to assist with prescriptions, analyzing clinical data, and engaging in role-playing exercises. A web-based questionnaire and a paper test were used to evaluate students�f awareness and knowledge both before and after the program. Statistical analyses were performed to verify the significance of changes; we utilized the Wilcoxon signed-rank test for the ordinal data derived from the specific behavioral objectives and 2-tailed paired t tests for the interval data from the knowledge tests. The magnitude of change was quantified using r for Wilcoxon tests and Cohen dz for 2-tailed t tests, with 95% CI calculated to ensure the stability and reliability of the observed results.<br> Results: Analysis of the primary outcome specific behavioral objectives revealed statistically significant effects across all items (Wilcoxon signed-rank test; P<.001). Effect sizes (r=0.505�]0.835) ranged from moderate to large, with particularly large effects observed in identifying contents issue (r=0.835, 95% CI 0.126-0.330; P<.001). Knowledge test scores showed significant improvement in the following 3 subjects: pharmacology (r=�|0.504, 95% CI –0.215 to 0.127; P<.001), organic chemistry (r=0.254, 95% CI –0.148 to –0.193; P=.004), and communication (r=0.221, 95% CI –0.151 to –0.190; P=.01). No significant changes were observed in pathology or pharmacokinetics.<br> Conclusions: This program provides strong evidence that practical, hands-on learning with hospital pharmacists helps improve pharmacy students�f professional skills and optimize pharmaceutical therapies in interprofessional care. By teaching pharmacists to effectively propose prescription changes, the program equips them to become integral members of interprofessional care, ultimately leading to optimized pharmaceutical care for patients. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0145-305X 165 2025 Local immune response induced by intra-fin antigen injection in Japanese medaka (Oryzias latipes) is a useful model for immunological studies 105344 EN Tsukasa Ryu Graduate School of Bioresource and Bioenvironmental Sciences, Laboratory of Marine Biochemistry, Kyushu University Mizuki Yoshino Graduate School of Bioresource and Bioenvironmental Sciences, Laboratory of Marine Biology, Kyushu University William Ka Fai Tse Graduate School of Bioresource and Bioenvironmental Sciences, Laboratory of Developmental Disorders and Toxicology, Kyushu University Satoshi Ansai Ushimado Marine Institute, Faculty of Science, Okayama University Taisen Iguchi Graduate School of Nanobioscience, Yokohama City University Anu Kumar Commonwealth Scientific and Industrial Research Organisation, CSIRO Environment Tomonori Somamoto Graduate School of Bioresource and Bioenvironmental Sciences, Laboratory of Marine Biochemistry, Kyushu University Miki Nakao Graduate School of Bioresource and Bioenvironmental Sciences, Laboratory of Marine Biochemistry, Kyushu University Yukiko Ogino Center for Promotion of International Education and Research, Faculty of Agriculture, Kyushu University Teleost fishes play a pivotal role in advancing our understanding of immune system evolution because they retain the ancient characteristics of vertebrate immunity, encompassing both innate and adaptive immune systems. Among these, innate immunity plays a critical role in fish as the first line of defense, coordinating rapid responses to pathogen infections. However, the lack of fish-specific immunological methodologies has limited progress in elucidating fish immune mechanisms. To better understand how the innate immune response develops and resolves in fish, detailed observation and integrative analysis of leukocytes at multiple time points is necessary. In the present study, an intra-fin injection method for observing local immune responses in Japanese medaka (Oryzias latipes) was tested and optimized to analyze the progression of zymosan-induced innate immune responses. Zymosan-injected medaka showed a rapid immune response characterized by leukocyte recruitment and phagocytosis. Using TG(FmpxP:mCherry) transgenic medaka with mCherry fluorescence driven by myeloperoxidase (mpx) promoter, granulocyte chemotaxis towards the site of zymosan entry was successfully visualized. The rapid increase in tumor necrosis factor ƒ¿ (tnfa), interleukin-1ƒÀ (il1b), interleukin-6 (il6), and CXC motif chemokine ligand 8 (cxcl8) expressions in zymosan-injected anal fins provided a molecular basis for the visualized tissue-specific cellular response. Our study underscores the dynamic orchestration of immune components during the innate immune response in Japanese medaka and highlights their potential as a promising model for immunological research. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2041-4889 16 1 2025 TRPV2 in muscle satellite cells is crucial for skeletal muscle remodelling 888 EN Yanzhu Chen Department of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kimiaki Katanosaka Department of Biomedical Sciences, College of Life and Health Sciences, Chubu University Makoto Shibuya Department of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yubing Dong Department of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Lidan Zhang Laboratory of Stem Cell Regeneration and Adaptation, Graduate School of Pharmaceutical Sciences, The University of Osaka Motoi Kanagawa Department of Cell Biology and Molecular Medicine, Ehime University Graduate School of Medicine So-ichiro Fukada Laboratory of Stem Cell Regeneration and Adaptation, Graduate School of Pharmaceutical Sciences, The University of Osaka Keiji Naruse Department of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Katanosaka Department of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Skeletal muscle remodelling relies on muscle stem cells (MuSCs) for regeneration after injury and hypertrophy in response to mechanical loading. However, the mechanisms that trigger MuSC activation and proliferation remain unclear. Transient receptor potential vanilloid 2 (TRPV2) ion channels respond to insulin-like growth factor-1 and mechanical stimuli to regulate the biological characteristics of various cells. Using a temporally inducible MuSC-specific conditional knockout (cKO) mouse, we show that TRPV2 regulates MuSC function and is essential for muscle remodelling. In cultured myofibre, MuSCs express TRPV2 and exhibit Ca2+ responses to the TRPV2 agonists 2-aminoethoxydiphenyl borate and probenecid, which are abolished upon TRPV2 deletion. TRPV2-deficient MuSCs exhibit reduced paired box 7 (Pax7) expression and impaired proliferation, suggesting TRPV2 is a factor that regulates the early stage of MuSC function. Myotube formation in MuSCs was enhanced by overexpression of TRPV2 and suppressed by TRPV2 deficiency, suggesting that TRPV2 is a factor that promotes myogenesis. Muscle-administered cardiotoxin promoted muscle regeneration and resulted in the appearance of numerous Pax7-positive MuSCs between myofibres. MuSC-specific TRPV2 cKO mice exhibit substantially impaired muscle regeneration after cardiotoxin-induced injury, drastically reducing Pax7-positive MuSCs between myofibres. In floxed mice, mechanical loading via synergist ablation induces hypertrophy and greatly increases the number of myonuclei per myofibre. In contrast, MuSC-specific TRPV2 cKO mice show no changes in myofibre thickness or nuclear number, either at baseline or after mechanical loading. Mechanical loading of floxed mice increased TRPV2+/Pax7+ double-positive MuSCs, but MuSC-specific TRPV2 cKO mice showed no change. Additionally, MuSCs exhibit Ca2+ responses to hypo-osmotic stimuli, which are suppressed by TRPV2 inhibitors and TRPV2 deletion, suggesting that MuSCs exhibit TRPV2-dependent mechanical responses. These results establish TRPV2 as a critical regulator of MuSC-mediated muscle remodelling, an important finding that may lead to therapeutic strategies for muscle repair and adaptation. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0385-5600 2026 Overexpression of Escherichia coli yaiX Confers Multidrug Resistance and Enhances Virulence in the Silkworm Infection Model EN Kinuka Hongu Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuya Ishikawa Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tomoki Kosaki Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin�]Ichi Miyoshi Research Center for Intestinal Health Science, Okayama University Kazuyuki Furuta Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Chikara Kaito Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The emergence of bacteria with both antimicrobial resistance and high virulence has become a global health concern, underscoring the urgent need to elucidate the molecular basis underlying these traits. Here, we employed the silkworm (Bombyx mori) infection model, which is suitable for high-throughput screening, together with an Escherichia coli library containing plasmid clones of all genes from strain W3110, to identify genes whose overexpression enhances virulence. We found that overexpression of the uncharacterized protein YaiX promoted bacterial proliferation in silkworms and increased host lethality. Compared with the empty-vector control, the YaiX-overexpressing strain exhibited resistance to multiple antimicrobial agents with diverse mechanisms of action, including ƒÀ-lactams, tetracyclines, fluoroquinolones, aminoglycosides, cationic surfactants, and hydrogen peroxide. Sequence analysis revealed that amino acids 18–52 of YaiX contain a transferase hexapeptide domain predicted to form a left-handed parallel ƒÀ-helix. Overexpression of YaiX mutants lacking regions outside this domain conferred ampicillin resistance, whereas deletion of the hexapeptide domain abolished this phenotype. RNA sequencing and GO enrichment analyses further indicated that YaiX overexpression altered the expression of genes encoding RNA-binding proteins and porins. These findings suggest that YaiX overexpression, through its hexapeptide domain, modulates gene expression and contributes to both multidrug resistance and enhanced virulence in E. coli. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 — •\Ž†�E‰p•¶–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ‰œ•t EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ŠT”OŒ^ƒJƒŠƒLƒ…ƒ‰ƒ€‚ÉŠî‚­•½˜a‹³ˆç’PŒ³‚ÌŠJ”­‚ÆŽÀ‘H �\ �º‚ð‚«‚­�C‚‚­‚é�C‚Æ‚Ç‚¯‚é �\ 197 213 EN Yuichi MIYAMOTO Faculty of Education, Okayama University Yudai Makabe Teacher at an International School Shun SATO Educa & Quest Inc. Tomochika OSHIRO Graduate School of Humanities and Social Sciences, Hiroshima University Mika MATSUYAMA Kyodo Public Relations Co., Ltd. 10.18926/bgeou/70208 �@–{�e‚Í,�¶“k‚½‚¿‚ªŽ©ŒÈ‚âŽÐ‰ï‚ɂЂ©‚ꂽ‹«ŠE�ü‚Ö‚Ì—�‰ð‚ð�[‚ß(‹«ŠE�ü‚Ì�u�ã‚É—§‚Â�v),‹«ŠE�ü‚ð�u•Ê—l‚Ɉø‚«’¼‚·�v‰Â”\�«‚ð’Ç‹†‚·‚é‚Æ‚¢‚¤ƒRƒ“ƒZƒvƒg‚Å�ì‚ç‚ꂽƒJƒŠƒLƒ…ƒ‰ƒ€ŠJ”­ƒvƒ�ƒWƒFƒNƒg‚Ì‚¤‚¿�C•½˜a‹³ˆçƒJƒŠƒLƒ…ƒ‰ƒ€‚ÌŠJ”­‚ÆŽÀ‘H‚Ì�¬‰Ê‚ð‚Ü‚Æ‚ß‚½‚à‚Ì‚Å‚ ‚é�B‘¼ŽÒ‘¶�Ý‚Æ‚Ì‹¤�¶‚Æ‹¦’²‚ÉŠÖ‚í‚éŠT”O‚ð�C�u�º�v‚Æ‚¢‚¤ƒ�ƒ^ƒtƒ@�[‚É�W–ñ‚³‚¹‚Ä6‚‘I’肵‚½�B�¶“k‚½‚¿‚ª,�¢ŠE‚Ɉø‚©‚ꂽ‹«ŠE�ü‚ð‚ǂ̂悤‚É—�‰ð‚µ,‚ǂ̂悤‚ÉŽ©‚ç‚Ì�¶Šˆ‚Ì’†‚Ì‹«ŠE�ü‚𑨂¦‚È‚¨‚»‚¤‚Æ‚µ‚½‚©‚ɂ‚¢‚Ä•ª�Í‚µ‚½�BƒJƒŠƒLƒ…ƒ‰ƒ€�\�¬�ã‚̈Ӌ`‚Ɖۑè‚ÉŠÖ‚µ‚Ä�CŠw�K‚µ‚½ŠT”O‚Ì�¶Šˆ”FŽ¯‚Ö‚Ì“]—p‚Ì�¢“–¾‚ç‚©‚Æ‚È‚è,ƒJƒŠƒLƒ…ƒ‰ƒ€‚Ì’†‚ÉŠT”O‚Ì�ÈŽ@‚Æ‹á–¡‚ð�d“_“I‚É�s‚¤Šˆ“®‚ð“ü‚ê‚邱‚Æ‚Ì�d—v�«‚ª–¾‚ç‚©‚Æ‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 �”N‚Ì�m’è“IŽ©ŒÈ—�‰ð‚𑣂·‹­‚݉î“ü‚ÌŽÀ‘H•ñ�� �\ ”­’BŽxŽ�“I‹³ˆç‘Š’k‚É‚æ‚éƒAƒvƒ��[ƒ`‚ð’Ê‚µ‚Ä �\ 187 196 EN Tsuguyuki IZUMI Faculty of Education, Okayama University 10.18926/bgeou/70207 �@–{Œ¤‹†‚Í�C”­’BŽxŽ�“I‹³ˆç‘Š’k‚Æ‚µ‚ÄŽÀŽ{‚µ‚½‹­‚Ý”FŽ¯Žö‹Æ‚ª�C�”N‚ÌŽ©ŒÈ‚Ì‹­‚Ý‘I‘ð‚Ì“ïˆÕ“x‚É‹y‚Ú‚·‰e‹¿‚ð’T�õ“I‚ÉŒŸ“¢‚µ‚½‚à‚Ì‚Å‚ ‚é�BŒ¤‹†‚P‚Å‚Í’†�‘’n•û‚ÌŒö—§’†Šw�Z423–¼‚ð‘Î�ۂɃIƒ“ƒ‰ƒCƒ“‚Å�CŒ¤‹†‚Q‚Å‚Í�ê–åŠw�ZŠw�¶86–¼�C‘åŠw�¶93–¼‚ð‘Î�ۂɑΖʂÅ�C‹­‚Ý”FŽ¯Žö‹Æ‚ðŽÀŽ{‚µ�CŽö‹ÆŒã‚É�CŽ©ŒÈ‚Ì‹­‚Ý‘I‘ð‚Ì“ïˆÕ“x‚𑪒肵‚½�B‚»‚ÌŒ‹‰Ê�C‚·‚ׂĂ̌Q‚Ì‹­‚Ý‘I‘ð‚Ì“ïˆÕ“x‚Ì•]‰¿‚Í�C•½–ì(2019)‚Æ”äŠr‚µ‚Ä�u—eˆÕ‚Å‚ ‚é�v‚Ƃ̉ñ“šŒXŒü‚ðŽ¦‚µ‚½(Mdn = ‚V)�B‚Ü‚½�C‚RŒQ‚Ì‹­‚Ý‘I‘ð‚Ì“ïˆÕ“x‚Ì•ª•z‚É“�Œv“I‚È—LˆÓ�·‚Í”F‚ß‚ç‚ê‚È‚©‚Á‚½(p = .222)�B‚±‚Ì’mŒ©‚Í�C–{Žö‹Æ‚ª‘Î�ÛŽÒ‚Ì”­’B’iŠK‚âŽÀŽ{Œ`Ž®(ƒIƒ“ƒ‰ƒCƒ“�E‘ΖÊ)‚ÉŠÖ‚í‚炸�C•�•Õ“I‚É‹­‚Ý“Á’è‚ðŽx‰‡‚·‚é‹@”\‚ðŽ�‚‰”\�«‚ðŽ¦�´‚·‚é�B�ÅŒã‚É�C‚±‚Ì’mŒ©‚ð‚à‚Æ‚É�CŠw�ZŒ»�ê‚Å‚Ì‹³ˆç‘Š’k‚Ì�V‚½‚È“WŠJ‚ð’ñŒ¾‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 �‚�Z“Á•ÊŽx‰‡‹³ˆçƒR�[ƒfƒBƒl�[ƒ^�[‚É‚¨‚¯‚é�¬Ž™‚ª‚ñŠ³Ž™Žx‰‡‚ÉŠÖ‚·‚鋳ˆçŽ{�ô‚Ö‚Ì—�‰ð‚Æ–ðŠ„ˆÓŽ¯ 177 185 EN Yiwen CHEN The Joint Graduate School (Ph.D. Program) in Science of School Education Hyogo University of Teacher Education Munehisa YOSHITOSHI Faculty of Education, Okayama University 10.18926/bgeou/70206 �@–{Œ¤‹†‚Ì–Ú“I‚Í�C�¬Ž™‚ª‚ñ‚ðŒoŒ±‚µ‚½�‚�Z�¶‚ɑ΂·‚é“Á•ÊŽx‰‡‹³ˆçƒR�[ƒfƒBƒl�[ƒ^�[‚ÌŽx‰‡ˆÓŽ¯‚𖾂炩‚É‚·‚邱‚Æ‚Å‚ ‚é�BŽ©Ž¡‘Ì‚ÌŒ¤�C�u�À‚ÉŽQ‰Á‚µ‚½59–¼‚ð‘Î�Û‚ÉŽ¿–⎆’²�¸‚ðŽÀŽ{‚µ�C23–¼‚©‚ç‰ñ“š‚𓾂½�B—Ê“Iƒf�[ƒ^‚Í’P�ƒ�WŒv�CŽ©—R‹L�q‚ÍŽ¿“I‹L�q“I•ª�Í‚É‚æ‚蕪�Í‚µ‚½�BŒ‹‰Ê‚Æ‚µ‚Ä�C�¬Ž™‚ª‚ñŠ³Ž™‚ÉŠÖ˜A‚·‚é�V‚½‚È‹³ˆçŽ{�ô�C“Á‚É“¯Žž‘o•ûŒüŒ^Žö‹Æ‚ÉŠÖ‚·‚é”F’m“x‚ª’á‚­�C�§“x‚ª�\•ª‚ÉŽü’m‚³‚ê‚Ä‚¢‚È‚¢ŽÀ‘Ô‚ª–¾‚ç‚©‚É‚È‚Á‚½�Bˆã—Ê֌WŽÒ‚Ƃ̘AŒg‚ɂ‚¢‚Ä‚Í�C�‚‚¢–ðŠ„ˆÓŽ¯‚ªŽ¦‚³‚ꂽˆê•û‚Å�C•a‰@–K–â‚Í‚ ‚Ü‚è�dŽ‹‚³‚ê‚Ä‚¢‚È‚©‚Á‚½�B‚Ü‚½�CŠw‹‰’Ê�M‚⋳�Þ�€”õ‚È‚Ç‚Í•K‚¸‚µ‚à“Á•ÊŽx‰‡‹³ˆçƒR�[ƒfƒBƒl�[ƒ^�[‚Ì–ðŠ„‚Æ‚Í”FŽ¯‚³‚ê‚Ä‚¢‚È‚©‚Á‚½�BŽ©—R‹L�q‚©‚ç‚Í�CICT ‚ðŠˆ—p‚µ‚½Žx‰‡‚Ö‚Ì�Ï‹É“I‚ÈŽp�¨‚ªŽ¦‚³‚ꂽ‚à‚Ì‚Ì�C’†Šw�Z‚Ƃ̘AŒg‚É‚¨‚¯‚é�î•ñ‹¤—L‚â‹Æ–±•‰’S‚ÉŠÖ‚·‚é‰Û‘肪‚Ý‚ç‚ꂽ�B�¡Œã�C˜AŒg‚ÉŠÖ‚·‚éƒKƒCƒhƒ‰ƒCƒ“‚Ì�®”õ‚â�î•ñ‹¤—L‚Ì‹­‰»‚ª‹�‚ß‚ç‚ê‚邱‚Æ‚ðŽw“E‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ƒfƒWƒ^ƒ‹ƒ�ƒfƒBƒA�EƒfƒWƒ^ƒ‹ƒfƒoƒCƒX‚ÌŽ©—¥“I‚ÈŽg—p‚ÉŒü‚¯‚Ä�i‚P�j �\ Ž©ŒÈ�§Œä”\—͂ƃCƒ“ƒ^�[ƒlƒbƒgˆË‘¶ŒXŒü‚ÉŠÖ‚·‚錤‹†‚ÌŠTŠÏ‚©‚ç �\ 169 175 EN Motoko MIYAKE Faculty of Education, Okayama University 10.18926/bgeou/70205 �@ƒfƒWƒ^ƒ‹ƒ�ƒfƒBƒA�EƒfƒWƒ^ƒ‹ƒfƒoƒCƒX‚ÌŽg—p‚É‚¨‚¢‚Ä�CŽg—pŠJŽn”N—î‚Ì’á”N—�E’·ŽžŠÔ—˜—p‚ÌŽÀ‘Ô‚ªŽw“E‚³‚ê�C’á”N—î‚ÌŽq‚Ç‚à‚ɂ‚¢‚Ä‚àˆË‘¶“™‚Ì–â‘肪’�–Ú‚³‚ê‚‚‚ ‚é�B–{•ñ��‚Å‚Í�CŽq‚Ç‚àŽ©�g‚É�CƒfƒWƒ^ƒ‹ƒ�ƒfƒBƒA�EƒfƒWƒ^ƒ‹ƒfƒoƒCƒX‚Æ“K�Ø‚É•t‚«�‡‚¤—Í‚ðˆç‚Ă邱‚Æ‚Ì•K—v�«‚ð�dŽ‹‚·‚é—§�ê‚©‚ç�CƒCƒ“ƒ^�[ƒlƒbƒgˆË‘¶ŒXŒü‚Ì—}�§—vˆö‚Ì‚P‚‚ɋ“‚°‚ç‚ê‚鎩ŒÈ�§Œä”\—Í‚É’…–Ú‚µ�C—¼ŽÒ‚ÌŠÖ˜A‚ɂ‚¢‚Ä‚Ì–{–M‚É‚¨‚¯‚錤‹†‚ðŠTŠÏ‚·‚é�B‚»‚µ‚Ä�CŽq‚Ç‚à‚ÌŽ©ŒÈ�§Œä‚Ì”­’B‰ß’ö�CŽ©ŒÈ�§Œä‚Ì”­’B‚É‚¨‚¯‚é‘£�i—vˆö�E—}�§—vˆö‚ð�®—�‚µ‚½�ã‚Å�CƒCƒ“ƒ^�[ƒlƒbƒgˆË‘¶‚Ì—\–h‚Ì‚½‚ß‚ÉŽq‚Ç‚à‚ÌŽ©ŒÈ�§Œä‚Ì”­’B‚ÌŠÏ“_‚©‚瓾‚ç‚ê‚鎦�´‚ɂ‚¢‚ÄŒŸ“¢‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 �u‘n‘¢�«‚ªŽÐ‰ï‚Æ�o‰ï‚¤”ü�p‹³ˆç�v‚É‚æ‚鋳ˆõ‚ÌŠw‚Ñ‚ÉŠÖ‚·‚éŠî‘bŒ¤‹†‡U �\ Žsˆä‚Ì‘¼ŽÒ‚Ƃ̑Θb‚ª‚à‚½‚ç‚·‹³ˆõ‚̈Ӗ¡•Ï—e‚ÉŠÖ‚·‚é�lŽ@ �\ 157 167 EN Ai MATSUURA Faculty of Education, Okayama University Yusuke SENOO Okayama Prefectural Tamashima High School Hitoshi KIMURA Shiga University Faculty of Education Elementary School Soichiro TAKEDA Okayama University Junior High School Chande SON Osaka Kyoiku University Tennoji Junior High School Tetsuo KIYOTA, Faculty of Education, Okayama University 10.18926/bgeou/70204 �@–{Œ¤‹†‚Í�C�´“c“N’j‚Ì—�˜_˜g‘g‚ðŠî”Õ‚Æ‚µ‚Ä�C‹³ˆõ‚ª“ú�í�¶Šˆ‚Å�o‰ï‚¤Žsˆä‚Ì‘¼ŽÒ‚Ƃ̑Θb‚ð’Ê‚¶‚Ä‘n‘¢�«‚âŽö‹ÆŠÏ‚ð•Ï—e‚³‚¹‚éƒvƒ�ƒZƒX‚𖾊m‰»‚µ‚½‚à‚Ì‚Å‚ ‚é�BŽsˆäƒvƒ�ƒWƒFƒNƒg‚ÌŽ¿“I•ª�Í‚É‚æ‚è�C‹³ˆõ‚Í‘¼ŽÒ‚Ì�¶‚«•û‚âŽp�¨‚©‚ç�V‚½‚ȉ¿’l‚ðŽó‚¯Žæ‚è�iŽsˆä‚©‚ç‚Ì‹�Žó‰ß’ö�j�C‚»‚ÌŒoŒ±‚ðŒ_‹@‚É‹³ˆçŠÏ‚ð�Ä•Ò‚µ�i‹³ˆçŠÏ•Ï—e‰ß’ö�j�C‚³‚ç‚ÉŽö‹Æ�\‘z‚É‹ï‘Ì“I•Ï‰»‚ð�¶‚¶‚³‚¹‚邱‚Æ�iŽö‹Æ“à—eŠÖ—^‰ß’ö�j‚ªŠm”F‚³‚ꂽ�B‚Æ‚è‚킯�C�§“x“IŒ¤�C‚Å‚Í“¾‚É‚­‚¢‹ô”­“I‘Θb‚â�¶Šˆ’m‚ÌŽó—e‚ª�C‹³ˆõ‚Ì‘n‘¢�«‚ðŠ«‹N‚µ�C“ú�í‚É�ª‚´‚µ‚½Šw‚Ñ‚Æ‚µ‚Ä‹@”\‚·‚é“_‚ª�¬‰Ê‚Å‚ ‚é�B–{Œ¤‹†‚Í�C‹³ˆõŽ©�g‚ªŠw‚Ô‘n‘¢�«‚Æ‚¢‚¤�V‚½‚ÈŒ¤‹†—̈æ‚ÌŠî”Õ‚ðŒ`�¬‚µ�C”ü�p‹³ˆç‚É‚¨‚¯‚é‘n‘¢�«ˆç�¬‚Ì�V‚½‚ȉ”\�«‚ð’ñŽ¦‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ‰¹Šy•\Œ»‚Ö‚Ì—�‰ð‚ð�[‚ß‚é•ÛˆçŒ¤�Cƒvƒ�ƒOƒ‰ƒ€‚ÌŒŸ“¢ �\ ‰¹‚≹Šy‚ð�L‚­‚Ƃ炦‚鎋“_‚ðˆç‚Þ �\ 147 155 EN Hiromi TAKASU Faculty of Education, Okayama University 10.18926/bgeou/70203 �@•ÛˆçŒ»�ê‚ł͉¹ŠyŠˆ“®‚Ì�d—v�«‚ªŽw“E‚³‚ê‚éˆê•û�C‘½‚­‚Ì•ÛˆçŽÒ‚ª‰¹Šy‚ɑ΂·‚é‹êŽèˆÓŽ¯‚ðŽ�‚Â�B–{Œ¤‹†‚Å‚Í�C‰¹Šy‚ð�ê–å‹Z”\‚ÉŒÀ’肹‚¸�C“ú�í‚̉¹‚â�g‘Ì—V‚Ñ‚àŠÜ‚ß‚Ä‘¨‚¦‚鎋“_‚ð’ñŽ¦‚µ�C‰¹Šy•\Œ»‚Ö‚Ì—�‰ð‚ð�[‚߂錤�Cƒvƒ�ƒOƒ‰ƒ€‚ðŒŸ“¢‚µ‚½�B�u‹`�C‘¦‹»�«‚ðŽæ‚è“ü‚ꂽ—V‚щÌ�C‚í‚ç‚ׂ¤‚½‚ð—p‚¢‚½�g‘Ì•\Œ»‚ÌŽO—v‘f‚©‚ç�¬‚錤�C‚ðŒ»�E•ÛˆçŽÒ36–¼‚ÉŽÀŽ{‚µ‚½�BŒ¤�C‘OŒã‚ÌŽ©ŒÈ•]‰¿‚Í‘S�€–Ú‚Å�ã�¸‚µ�C“Á‚É�g‹ß‚ȉ¹‚ÌŠˆ—p‚â“`�³“I‰¹Šy‚ÌŽÀ‘H‰Â”\�«‚Å‘å‚«‚ȉü‘P‚ªŒ©‚ç‚ꂽ�B•ÛˆçŒoŒ±•Ê‚Ì•ª�Í‚Å‚Í�C�‰”C�E’†Œ˜�E�n—û‚Ì‘S‚Ä‚Å—LˆÓ‚ÈŒü�オŠm”F‚³‚ê�C�n—û•ÛˆçŽÒ‚Å�Å‚à�L‚Ñ•�‚ª‘å‚«‚©‚Á‚½�B�¡Œã‚ÍŽ©—R‹L�q‚ÌŽ¿“I•ª�Í‚âŒp‘±“I‚ÈŒ¤�C‘ÌŒn‚Ì�\’z�CŽq‚Ç‚à‚Ö‚ÌŒø‰Ê‚ÌŒŸ“¢‚ª‰Û‘è‚Å‚ ‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ’nˆæ‚Æ�l�X‚ðŒq‚®‰¹ŠyŠˆ“® �\ ’nˆæŠˆ—͂̉ñ•œ‚ð–ÚŽw‚·ƒRƒ“ƒT�[ƒg‚ÌŠJ�à �\ 131 145 EN Shinsuke OKAMOTO Faculty of Education, Okayama University 10.18926/bgeou/70202 �@–{Œ¤‹†‚Í�C�lŒûŒ¸�­‚É”º‚Á‚Ä�¬’†Šw�Z‚Ì“�”p�‡‚ª�i‚Þ‰ªŽRŒ§‹Ê–ìŽs‚É‚¨‚¢‚Ä�C’nˆæŠˆ—͂̉ñ•œ‚ð�}‚é‹@‰ï‚ð�ì‚è�C‚»‚̂悤‚È‹@‰ï‚ð’nˆæ�Z–¯Ž©‚ç�ì‚è�o‚·‹@‰^‚ð�‚‚߂邱‚Æ‚ð–Ú“I‚Æ‚µ‚Ä‚¢‚é�B–{Œ¤‹†‚Å‚Í�C“ŒŽ™’†Šw�Z‹æ‚ð‘Î�Û‚É�C�Z‰Ì‚ð�Ä�\�¬‚µ‚½�ì•i‚Ì”­•\‚Æ�C’nˆæ�Z–¯‚Æ‹¦“­‚ÅŠé‰æ�C‰^‰c‚ð�s‚¤ƒRƒ“ƒT�[ƒg‚ÌŠJ�ÂƂ¢‚¤“ñ‚‚̎æ‘g‚ð2023�`24”N“x‚É‚©‚¯‚ÄŽÀ‘H‚µ�C�Z–¯“¯Žm‚ÌŒq‚ª‚è‚ð‹­‚ß�C�Z–¯‚炪’nˆæ‚Ö‚ÌŠÖ�S‚ð�[‚ß‚Ä‚¢‚­‚±‚Æ‚ð�}‚Á‚½�B—¼Žæ‘g‚Í�C’nˆæ�Z–¯‚É�DˆÓ“I‚Ɏ󂯓ü‚ê‚ç‚ꂽŒ‹‰Ê‚Æ‚È‚è�C�¡Œã‚ÌŽæ‘g‚Ì“WŠJ‚ÖŒq‚ª‚é�¬‰Ê‚ª“¾‚ç‚ꂽ�B2025”NŒ»�Ý�C—¼Žæ‘g‚ðŽÀ‘H‚µ‚½’nˆæ‚É‚¨‚¢‚Ä�C’nˆæŠˆ�«‰»‚ð�}‚éŒ|�pŠˆ“®’c‘Ì‚ª�V‚½‚ÉŒ‹�¬‚³‚ê�C’nˆæŠˆ—͂̉ñ•œ‚ð–ÚŽw‚·“®‚«‚ª�Z–¯‚Ì’†‚ÅŒ©‚ç‚ê‚Í‚¶‚ß‚Ä‚¢‚邱‚Æ‚©‚ç�C–{’nˆæ‚Ì�¡Œã‚Ì“®Œü‚ª’�–Ú‚³‚ê‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ƒCƒ“ƒh‚Ì�¬�E’†Šw�Z—�‰È‚É‚¨‚¯‚é‹CŒó•Ï“®‚ÉŠÖ‚·‚é“à—e‚ÌŽæ‚舵‚¢ �\ NCERT ”­�s‚Ì‹³‰È�‘‚É’�–Ú‚µ‚Ä �\ 119 130 EN Ken KAWAI Okayama University Graduate School of Humanities and Social Sciences Science Doctoral Course Hiroki FUJII Faculty of Education, Okayama University 10.18926/bgeou/70201 �@–{Œ¤‹†‚Í�CƒCƒ“ƒh‚Ì�‘‰Æ‹³ˆç�­�ô2020‚¨‚æ‚Ñ�‘‰ÆƒJƒŠƒLƒ…ƒ‰ƒ€�EƒtƒŒ�[ƒ€ƒ��[ƒN2023‚ÉŠî‚¢‚Ä�ì�¬‚³‚ꂽ NCERT ”­�s‚ÌŠw�Z‹³‰È�‘�i‘æ3�`8 Šw”N�j‚ð‘Î�Û‚É�C—�‰È“I“à—e‚ðˆµ‚¤‹³‰È‚Ì‹CŒó•Ï“®‚ÉŠÖ‚·‚é“à—e‚ÌŽæ‚舵‚¢‚ÌŒ»�ó‚ð•ª�Í‚µ‚½�B•ª�Í‚Å‚Í UNESCO ‚É‚æ‚é SDGs ‚Ì‚½‚ß‚Ì‹³ˆç‚Æ Kagawa & Selby ‚Ì�u—�‰ð�EŠÉ˜a�E“K‰ž�v‚Ì�l‚¦•û‚ð‚à‚Æ‚ÉŠÏ“_‚ð�Ý‚¯�C‹L�q‚ð’Š�o�E•ª—Þ‚µ‚½�B‚»‚ÌŒ‹‰Ê�C�‰“™‹³ˆç’iŠK‚Ì�uThe World Around Us�v‚Å‚Í�¶Šˆ�¢ŠE‚É�ª‚´‚µ‚½ŠÂ‹«”z—¶‚Ì‘Ô“x‚Æ�s“®‚ÌŠî‘bŒ`�¬‚ª�dŽ‹‚³‚ê�C‘OŠú’†“™‹³ˆç’iŠK‚Ì�uScience�v‚ł͉Ȋw“I‚Ȉö‰ÊŠÖŒW‚â‹CŒó•Ï“®‘Î�ô‚Ì�‘�Û“I˜g‘g‚Ý‚ª“±“ü‚³‚ê‚Ä‚¨‚è’iŠK“I�[‰»‚ªŠm”F‚³‚ꂽ�Bˆê•û‚Å�CŠT”O“±“ü‚Ì’x‚ê�Cˆö‰Ê˜A�½‚Ì•s“�ˆê�C�s“®•Ï—e‚ÉŽŠ‚éŽd‘g‚݂̎コ�CŠw�Û�«‚Ì•s‘«‚âŒêœb‚âŠT”O‚Ì�K“¾‚̃XƒpƒCƒ‰ƒ‹‚ÈŠw�K‚Ì•s‘«‚ª–¾‚ç‚©‚É‚È‚Á‚½�BŒ»�s‹³‰È�‘‚Í�C‘ÌŒn“I‚©‚ÂŽÀŒø“I‚È‹CŒó•Ï“®‹³ˆç‚É‚Í–¢‚¾•s�\•ª‚Å‚ ‚è�C�¡Œã‚̉ü‘P‚ª‹�‚ß‚ç‚ê‚邱‚Æ‚ðŽw“E‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 �t‹@”\‚Ì—�‰ð‚𑣂·‚½‚ß‚Ì‹³�ÞŠJ”­‚Æ’†Šw�Z—�‰È‚É‚¨‚¯‚éŽö‹ÆŽÀ‘H 111 117 EN Motonori ANDO Faculty of Education, Okayama University Risa IKEDA Seishin Junior High School/Seishin Girls�f High School Fukuto TANAKA Seishin Junior High School/Seishin Girls�f High School 10.18926/bgeou/70200 �@–{Œ¤‹†‚Å‚Í�t‘Ÿ‚É‚¨‚¯‚é‚ë‰ßŒã�C‚ë‰t‚Ì�¬•ª‚ª‚ǂ̂悤‚È•¨Ž¿‚Å�\�¬‚³‚ê‚Ä‚¢‚é‚Ì‚©�C‚»‚ÌŒã‚Ì�t‘Ÿ‚Å‚Ì�Ä‹zŽû‰ß’ö‚ðŠÜ‚ß‚Ä�C’†Šw�¶‚Ì�t‹@”\‚Ì—�‰ð‚𑣂·‹³�ÞŠJ”­‚ðŽŽ‚Ý‚½�B‚Ü‚¸�CŽs”̂̉Ê�`‚ðŠÜ‚Þˆù—¿�…‚ðƒ�ƒ“ƒuƒŒƒ“ƒtƒBƒ‹ƒ^�[‚Å‚ë‰ß‚µ�C‚ë‰t‚ª“§–¾‚É‚È‚é‚Ì‚Í•s—n�«•¨Ž¿‚ª�œ‹Ž‚³‚ê‚邽‚ß‚Å‚ ‚邱‚Æ�C‚Ü‚½�C‚ë‰t‚̊³‚©‚ç�…—n�«‚Ì“œ•ª‚Í‚ë‰ß‚³‚ê‚邱‚Æ‚ðŠm”F‚µ‚½�BŠJ”­‚µ‚½�t‘ŸŽ…‹…‘̃‚ƒfƒ‹‚Í�C�t�¬‘Ì‚ÉŒ©—§‚Ä‚½ŠW‚É�E‚ðŠJ‚¯‚½ƒvƒ‰ƒXƒ`ƒbƒN—eŠí�C�ÔŒŒ‹…‚⌌‰t’†‚É‘¶�Ý‚·‚é—l�X‚È•¨Ž¿‚ð–Í‚µ‚½�F‚â‘å‚«‚³‚̈قȂéƒr�[ƒY�C‚©‚ç�\�¬‚³‚ê‚é�B�¶“k‚Í�C‚±‚Ì‹³�Þ‚ð—p‚¢‚½Žö‹ÆŽÀ‘H‚ðŒo‚Ä�CŒŒ‹…ˆÈŠO‚Ì�…—n�«�¬•ª‚Í—v•s—v‚ÉŠÖ‚í‚炸ˆê’U�t�¬‘Ì‚Å‚ë‰ß‚³‚ê‚Ä‚µ‚Ü‚¤‚±‚Æ�C�¶‘Ì‚É•K—v‚ȃuƒhƒE“œ‚Í”A�׊ǂɂ¨‚¢‚Ä”\“®“I‚É�Ä‹zŽû‚³‚ê‚邱‚Æ‚ð—�‰ð‚µ�C�t‘Ÿ‚Ì‚ë‰ß‚Æ�Ä‹zŽû‚ÉŠÖ‚·‚é�V‚µ‚¢�l‚¦•û‚ÆŠÖ˜A‚·‚éŠT”O‚ðŠl“¾‚·‚邱‚Æ‚ª‚Å‚«‚½�C‚Æ�l‚¦‚ç‚ꂽ�B–{Œ¤‹†‚ÅŠJ”­‚µ‚½‹³�Þ‚ð—p‚¢‚邱‚Æ‚É‚æ‚è�C�¶“k‚Ì�t‘Ÿ‚Ì–ðŠ„‚É‚Â‚¢‚Ä‚Ì—�‰ð‚ð�[‰»‚³‚¹‚邱‚Æ�C“¯Žž‚ÉŽ©�g‚ÌŒ’�N‚Ö‚ÌŠÖ�S‚ð�‚‚ß‚³‚¹‚邱‚Æ�C‚ɂ‚¢‚Ä—LŒø‚Å‚ ‚邱‚Æ‚ª•ª‚©‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ’†ŽRŠÔ’nˆæ‚É�Z‚Þ�‚—î�—�«‚ÌŽq‚Ç‚à‚Æ‚Ì“¯‹�ˆÓŒü‚̕ω»‚Æ‚»‚Ì—vˆö �\ ‰ªŽRŒ§‚ÌŽR‘º‚ð‘Î�Û‚Æ‚µ‚½•ª�Í �\ 101 110 EN Masao NOBE Faculty of Education, Okayama University 10.18926/bgeou/70199 �@•MŽÒ‚Í1997‒98”N‚Æ2016‒17”N‚É�A‰ªŽRŒ§‚Ì’†ŽRŠÔ’nˆæ‚É‚ ‚铯ˆê‚ÌŽR‘º‚Å65�ΈÈ�ã80�Ζ¢–ž‚Ì�—�«‚ð‘Î�Û‚É’²�¸‚ðŽÀŽ{‚µ‚½�B–{�e‚Å‚Í�A‚»‚̃f�[ƒ^‚ð—p‚¢‚Ä�A‡@Žq‚Ç‚à�i•v•w�j‚Æ‚Ì“¯‹�‚Ì—L–³�A‡A�«—ˆ‚É‚¨‚¯‚éŽq‚Ç‚à�i•v•w�j‚Æ‚Ì“¯‹�Šó–]�A‡B�«—ˆŠó–]‚·‚é‹��Z�ê�Š�A‚ª–ñ20”NŠÔ‚łǂ̂悤‚ɕω»‚µ‚½‚Ì‚©‚𖾂炩‚É‚·‚é�Bƒf�[ƒ^‚Ì•ª�Í‚©‚ç�AŽŸ‚Ì‚±‚Ƃ𖾂炩‚É‚µ‚½�BŽq‚Ç‚à�i•v•w�j‚Æ“¯‹�‚µ‚Ä‚¢‚È‚©‚Á‚½‚è�A�«—ˆ‚ɂ킽‚Á‚ÄŽq‚Ç‚à�i•v•w�j‚Æ‚Ì“¯‹�‚ð–]‚Ü‚È‚©‚Á‚½‚è‚·‚é�‚—î�—�«‚ª‘�‚¦‚Ä‚¢‚½�B‚Æ‚­‚É�A•Ê‹�‚·‚éŽq‚Ç‚à‚ª‰ªŽRŒ§“à‚É‹��Z‚µ‚Ä‚¢‚é�ê�‡�A“¯‹�‚ð–]‚Ü‚È‚¢ŒXŒü‚ªŒ°’˜‚Å‚ ‚Á‚½�B‚Ü‚½�AŽq‚Ç‚à‚Æ‚Ì“¯‹�‚ðŠó–]‚·‚é�‚—î�—�«‚Å‚ ‚Á‚Ä‚à�A�‚—ÀŽs‚ÌŒ»�Z�Š‚𗣂ê‚邱‚Æ‚É‚Í’ï�RŠ´‚ðŽ¦‚µ‚Ä‚¢‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 �§�ìŽÒ‚Æ‘¢Œ`•¨‚̑Θb‚𑨂¦‚鎋“_‚ÌŒ¤‹† �\ ƒoƒtƒ`ƒ“‚ÉŠî‚­Ž¿“I‚È�lŽ@‚Ì‚½‚ß‚Ì•¶Œ£‚ÌŒŸ“¢ �\ 93 100 EN Shuya OHIRA Faculty of Education, Okayama University 10.18926/bgeou/70198 �@–{Œ¤‹†‚Å‚Í�C�§�ìŽÒ‚ª‘¢Œ`�sˆ×‚̉ߒö‚ÅŽÀ‘H‚·‚é‘¢Œ`•¨‚Ƃ̑Θb‚É’…–Ú‚µ�C‘¢Œ`�sˆ×‚É‚¨‚¢‚Ä�§�ìŽÒ‚ÉŒoŒ±‚³‚ê‚éŠw‚т𑨂¦Ž¿“I‚É�lŽ@‚·‚邽‚ß‚ÌŽ‹“_‚ð�Cƒoƒtƒ`ƒ“(„M„y„‡„p„y„| „M„y„‡„p„z„|„€„r„y„‰ „A„p„‡„„„ý„~)‚̑Θb‚ÌŠT”O‚É—§‚¿ŒŸ“¢‚µ‚½�B‚Ü‚¸�C‘Θb‚̉ߒö‚ł‚­‚ç‚ê‚鎩ŒÈ‚Æ‘¼ŽÒ‚Ì�u‘ŠŒÝ�ì—p�C‘ŠŒÝŠÖŒW�v‚ɂ‚¢‚ÄŒŸ“¢‚µ�C‘Θb‚̉ߒö‚É‚¨‚¢‚ÄŒÂ�X‚Ì�u�¢ŠE�v‚ªŠm—§‚³‚ê‚é‚Æ‹¤‚É�CŠm—§‚³‚ꂽŒÂ�X‚Ì�u�¢ŠE�v‚ªŽ©ŒÈ‚Æ‘¼ŽÒ‚ÌŠÔ‚Å‹¤—L‚³‚ê‚邱‚Æ‚ðŒŸ“¢‚µ‚½�BŽŸ‚É�C‘¢Œ`�sˆ×‚̉ߒö‚Å�C�§�ìŽÒ‚ª‘f�Þ‚ð•Ï‰»‚³‚¹‚Ä‚¢‚­‚ɂ‚ê‚Ä�C‚»‚Ì‘¢Œ`•¨‚È‚¢‚µ�ì•i‚Ì‚à‚ÂŒ`‚â�F‚ª�C‘z‘œ‚Ì�¢ŠE�Cƒ‚ƒ`�[ƒt�C‰½‚ç‚©‚Ì‹K‘¥�«‚È‚Ç‚ð“Z‚Á‚Ä‚¢‚­�C�§�ìŽÒ‚Æ‘¢Œ`•¨‚È‚¢‚µ�ì•i‚Ƃ̑Θb‚ªŽÀ‘H‚³‚ê‚邱‚Æ‚ðŒŸ“¢‚µ‚½�BŒ¤‹†‚Ì�¬‰Ê‚Æ‚µ‚Ä�C‘¢Œ`•¨‚Ƃ̑Θb‚̉ߒö‚Å�§�ìŽÒ‚ÉŒoŒ±‚³‚ê‚éŠw‚т𑨂¦Ž¿“I‚É�lŽ@‚·‚邽‚ß‚ÌŽ‹“_‚Å‚ ‚éŒ|�p“I�sˆ×‚ð’ñŽ¦‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 Utilizing a Preferred Character as a Stimulus Prompt to Teach Table-Wiping Skills to a Student With Autism Spectrum Disorder 79 91 EN Yoshimasa Matsushita The Joint Graduate School in Science of School Education (Doctor�fs Course), Hyogo University of Teacher Education Yoshihisa Ohtake Faculty of Education, Okayama University 10.18926/bgeou/70197 �@This study examined the effectiveness of a preferred character as a stimulus prompt in teaching table-wiping skills to a student with intellectual disability and autism spectrum disorder who had pervasive support needs. A multiple-treatments design was utilized to determine if the projected character prompt strategy was the most effective, followed by the character puppet prompt and the marker prompt. Results indicated that the marker prompt strategy and the projected character strategy were equally effective in helping the student to acquire table-wiping skills and more effective than the character puppet prompt strategy. However, the projected character prompt strategy elicited the most positive expressions and the fewest refusal behaviors. In contrast, the marker prompt strategy induced the fewest positive express ions and the most refusa l behaviors. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 Character Education ‚Ì“®Œü‚ÆŽ™“¶‚Ì“Á�«‚ð�¶‚©‚µ‚½‹³ˆç“I‰î“ü‚̉”\�«‚ɂ‚¢‚Ä �\ Character Education ‚Æ Character Strengths Education ‚ð‹æ•Ê‚µ‚Ä �\ 63 77 EN Minglu LI The Joint Graduate School in Science of School Education, Hyogo University of Teacher Education Tazuko AOKI Faculty of Education, Okayama University 10.18926/bgeou/70196 �@Ž™“¶‚Ì�K•Ÿ‚â�S—�“I well-being ‚ð�‚‚߂錤‹†‚Ì1‚‚ª�C‚æ‚¢ character ‚̈ç�¬‚ð–ÚŽw‚·‹³ˆçŒ¤‹†‚Å‚ ‚é�BLavy�i2020�j‚Í�C‚±‚ê‚É‚Í2‚‚̗¬‚ꂪ‚ ‚é‚Æ‚·‚é�B‚P‚‚ª character education�C‚à‚¤‚P‚Â‚Í character strengths education ‚Å‚ ‚é�B–{�e‚Å‚Í�C‚Ü‚¸‚±‚Ì2‚‚̓Á’¥‚ɂ‚¢‚ĉð�à‚µ‚Ä�¢ŠE‚Ì—¬‚ê‚ðŽ¦‚µ�CŽŸ‚Ƀ|ƒWƒeƒBƒu�S—�Šw‚ÉŠî‚­ character strengths education ‚ÌŒÀŠE“_‚ðŽw“E‚µ‚½�B‹ï‘Ì“I‚É‚Í�C‚»‚ÌŒ´“T‚Æ‚È‚éVIA-IS�iPeterson & Seligman, 2004�j‚ɂ‚¢‚Ä�C“ŒƒAƒWƒA‚É‚¨‚¯‚é‹­‚Ý‚Æ well-being ‚ÌŠÖ˜AŒ¤‹†‚ª‚Ù‚Æ‚ñ‚Ç�¬‚³‚ê‚Ä‚¢‚È‚¢‚±‚Æ�C‰Á‚¦‚ÄŽ™“¶Šú‚Ì‹³ˆç“I‰î“ü‚Ì�¬‰Ê‚ª‚Ù‚Æ‚ñ‚ÇŒ©‚ç‚ê‚È‚¢‚±‚Æ‚ðŽw“E‚µ‚½�B‚±‚ê‚ç‚ÌŒŸ“¢‚ð’Ê‚µ‚Ä�CŽ™“¶Šú‚Ì”F’m“Á�«‚â”­’B’iŠK‚ɉž‚¶‚½�CŽ™“¶‚Ì•‰‰×‚Ì�­‚È‚¢�g‘ÌŠˆ“®—Ê�C�KŠµŒ`�¬‚ÌŽ‹“_‚Å character ‚̈ç�¬‚ð–ÚŽw‚·‹³ˆç“I‰î“ü‚̉”\�«‚ɂ‚¢‚Ä‹c˜_‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ƒ`�[ƒ€‚É‚¨‚¯‚é–Ú•W�ݒ肪•”Šˆ“®“K‰žŠ´‚É‹y‚Ú‚·‰e‹¿ �\ ŒÂ�l–Ú•W‚Æ�W’c–Ú•W‚Ì�®�‡�«‚É’…–Ú‚µ‚Ä �\ 47 61 EN Ryo MISAWA Faculty of Education, Okayama University Eri MORITA Accounting Division, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University 10.18926/bgeou/70195 �@–{Œ¤‹†‚Å‚Í�C‘åŠw•”Šˆ“®‚̃`�[ƒ€‚É‚¨‚¯‚é–Ú•W�ݒ肪•”Šˆ“®“K‰žŠ´‚É‹y‚Ú‚·‰e‹¿‚ɂ‚¢‚Ä�CŒÂ�l–Ú•W‚Æ�W’c–Ú•W‚Ì�®�‡�«‚É’…–Ú‚µ‚ÄŒŸ“¢‚µ‚½�B‘åŠw�¶187 –¼‚ð‘Î�Û‚ÉŽ¿–⎆’²�¸‚ðŽÀŽ{‚µ�CŒÂ�l–Ú•W�E�W’c–Ú•W‚Ì4 —v‘f�i�¢“ï“x�C‹ï‘Ì�«�CŠÖ—^“x�CƒtƒB�[ƒhƒoƒbƒN�j�C–Ú•W‚Ì�®�‡�«�C‚»‚µ‚Ä•”Šˆ“®“K‰žŠ´‚𑪒肵‚½�B�d‰ñ‹A•ª�Í‚ÌŒ‹‰Ê�C–Ú•W‚Ì�®�‡�«‚Í�C�uŠˆ“®‚Ö‚ÌŒX“|�v‚Æ�u‘g�D�E�¬ˆõ‚Ö‚Ì–ž‘«�v‚É�³‚ÌŒø‰Ê‚ðŽ¦‚µ‚½�B‚Ü‚½�C�W’c–Ú•W‚ÌŠÖ—^“x‚à“K‰žŠ´‚ð�‚‚ß‚é—vˆö‚Å‚ ‚Á‚½�B‚³‚ç‚É�C�®�‡�«‚Í–Ú•W—v‘f‚ÌŒø‰Ê‚ð’²�®‚µ‚Ä‚¢‚½�B�®�‡�«‚ª�‚‚¢�ê�‡‚É‚ÍŒÂ�l–Ú•W‚Ö‚ÌŠÖ—^“x‚ª�uŠˆ“®‚Ö‚ÌŒX“|�v‚ð‘£�i‚µ�C’á‚¢�ê�‡‚É‚Í�W’c–Ú•W‚̃tƒB�[ƒhƒoƒbƒN‚ª•âŠ®“I‚É‹@”\‚µ‚Ä‚¢‚½�B‚±‚ê‚ç‚Ì’mŒ©‚©‚ç�C–Ú•W‚Ì�®�‡�«‚ª�CŒÂ�l–Ú•W‚Æ�W’c–Ú•W‚ÌŠ‹“¡‚ðŠÉ˜a‚µ�C•”Šˆ“®‚É‚¨‚¯‚é�S—�“I“K‰ž‚ðŽx‚¦‚é�d—v‚È—vˆö‚Å‚ ‚邱‚Æ‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 Ž©ŒÈ•Ï—e‚ð’Ê‚µ‚Ä‚Ý‚½ƒ}ƒCƒ“ƒhƒ�ƒ“ƒ_ƒŠƒ“ƒO‚Ì‘n‘¢�«‚ɂ‚¢‚Ä �\ Ž©ŒÈŒ™ˆ«�ê–Ê‚Å‚Ì‚S‚Â‚Ì“àŒ¾‚É’…–Ú‚µ‚½ŒŸ“¢ �\ 31 45 EN Tazuko AOKI Faculty of Education, Okayama University Makoto HAGIWARA a public employee Kazuhiro YASUNAGA Faculty of Education, Okayama University 10.18926/bgeou/70194 �@ƒ}ƒCƒ“ƒhƒ�ƒ“ƒ_ƒŠƒ“ƒO(ˆÈ‰ºMW)‚Í�S‚ªŽ©ŒÈ“à‚Ì•¡�”‚̗̈æ‚ð‚³‚Ü‚æ‚¤‚±‚Æ‚Å, �V‚½‚È‹C‚«‚â”­‘z ‚ª�¶‚Ü‚ê‚é“y�ë‚É‚È‚é‚Æ‚³‚ê‚é�B–{�e‚Å‚Í�C‚±‚Ì‘n‘¢�«‚ðŒŸ“¢‚·‚邽‚ß�C�…ŠÔ(2003)‚ðŽQ�l‚É�CŽ©ŒÈŒ™ˆ« �ê–Ê‚Å�¶‹N‚·‚é4 ‚‚̔½‰ž‚ɂ‚¢‚Ä‚ÌŒ¤‹†ƒ‚ƒfƒ‹‚ð—p‚¢‚Ä‚±‚Ì‘n‘¢�«‚ðŒŸ“¢‚µ‚½�B‚»‚Ì�Û�CMW ‚Æ‚»‚Ì ‘¼‚Ì—ÞŽ—‚Ì“à�È‚ð‹æ•Ê‚·‚邽‚ß�CŽ©ŒÈŒ™ˆ«�ê–Ê‚Å�¶‹N‚·‚é“àŒ¾‚Æ‚µ‚ÄŽ©ŒÈ’�–Ú(�ÈŽ@�E”½ä�), Ž©ŒÈ‚Ö‚Ì–v “ü(MW�E‹ó‘z)‚Ì4 ‚‚ð‘z’肵‚½�B‚Ü‚½‚»‚Ì“àŒ¾‚ªŽ©ŒÈ‚Ì�¬’·‚É‚Æ‚Á‚ĈӖ¡‚Ì‚ ‚é“àŒ¾‚©”Û‚©‚ð”»’f‚·‚é Žw•W‚Æ‚µ‚Ä–{—ˆŠ´‚ð—p‚¢‚½�B•ª�Í‚ÌŒ‹‰Ê, –{—ˆŠ´�‚ŒQ‚É‚¨‚¢‚Ä, MW ‚É‚æ‚é�W’†—Í‚ÌŒ‡”@‚ª�l‚ÌŽv�l‚ð ‘½—̈æ‚É‚³‚Ü‚æ‚킹, “à“I‚ÈŒÂ�«‚Ì‘n‘¢‚Æ“à“I‚ÈŒÂ�l‚Ì�¬’·‚𑣂·‚±‚Æ‚ªŽ¦‚³‚ꂽ�B‚Ü‚½’áŒQ‚É‚¨‚¢‚Ä �ÈŽ@‚ÍŽ©•ª‚炵‚³‚ð‹�‚ß•Ï—e‚ð–ÚŽw‚·ˆÓŽ¯‚ª‘£�i‚³‚ê‚邱‚Æ‚ªŽ¦‚³‚ꂽ�B‘¼•û, ”½ä�‚Æ‹ó‘z‚Í‚¢‚¸‚ê‚Ì ”½‰ž—lŽ®‚É‚àŠÖ‚í‚Á‚Ä‚¢‚È‚¢‚±‚Æ‚ª‚í‚©‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 20 �¢‹I�‰“ª‚̃CƒMƒŠƒX‹³ˆõ‚©‚猩‚½ƒwƒ‹ƒoƒ‹ƒgŠw”h �\�wƒwƒ‹ƒoƒ‹ƒg‹³Žö–@‚É‚©‚ñ‚·‚éŽö‹Æƒm�[ƒg�x‚Ì•ª�Í �\ 17 30 EN Yoshitsugu HIRATA Faculty of Education, Okayama University 10.18926/bgeou/70193 �@–{˜_‚Í�CƒWƒƒ�[ƒ}ƒ“�EƒCƒ“ƒpƒNƒg‚ðŽ‹�À‚Æ‚µ‚Ä�C19-20 �¢‹I‚É‚©‚¯‚Ä‹³ˆõ—{�¬‰üŠv‚ª‚¢‚©‚É“WŠJ‚³‚ê‚Ä‚«‚½‚Ì‚©‚ð‰ð–¾‚·‚錤‹†‚̈ꕔ‚ð‚È‚·‚à‚Ì‚Å‚ ‚é�B‚±‚±‚Å‚Í20 �¢‹I�‰“ª‚̃CƒMƒŠƒX‹³ˆõ‚ª‚ǂ̂悤‚Ƀwƒ‹ƒoƒ‹ƒgŠw”h‚Ì‹³ˆçŽv‘z‚ðŽó—e‚µ‚½‚Ì‚©‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ�C�wƒwƒ‹ƒoƒ‹ƒg‹³Žö–@‚É‚©‚ñ‚·‚éŽö‹Æƒm�[ƒg�x‚Ì•ª�Í‚ð�s‚Á‚½�B‚»‚ÌŒ‹‰Ê�CˆÈ‰º‚Ì‹¤’Ê“_‚Æ‘Šˆá“_‚ª–¾‚ç‚©‚Æ‚È‚Á‚½�BŽö‹Æ–`“ª‚É‚¨‚¢‚Ä–Ú“I‚𖾂炩‚É‚µ�CŽö‹Æ‚ÅŠw‚΂ê‚é“à—e‚Ö‚ÆŽq‚Ç‚à‚̈ӎ¯‚ð�W’†‚³‚¹�C�V‚µ‚¢’mŽ¯‚ð‹³Žö‚·‚é‚Æ‚¢‚¤—¬‚ê‚Í�Cƒwƒ‹ƒoƒ‹ƒgŠw”h‚̌ܒiŠK‹³Žö–@‚Æ‹¤’Ê‚µ‚Ä‚¢‚½�B‚¾‚ª�C‘æŽl‚¨‚æ‚Ñ‘æŒÜ’iŠK‚ɂ‚¢‚Ä‚Í‘å’_‚È•Ï�X‚ªŽ{‚³‚ê‚Ä‚¢‚½�B20 �¢‹I�‰“ª‚̃CƒMƒŠƒX‹³ˆõ‚ªƒwƒ‹ƒoƒ‹ƒgŠw”h‚Ì‹³ˆçŽv‘z‚ð�³Šm‚ÉŽó—e‚·‚é‚æ‚è‚à‘I‘ð“I‚ÉŽó—e‚µ‚½‰Â”\�«‚ª‚ ‚邱‚Æ‚ð‰ð–¾‚µ‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 ‹³�EˆõŒ¤�C‚Ì�‚“x‰»‚ɉʂ½‚·‘åŠw‚Ì–ðŠ„‚Æ‰Û‘è �\ NITS ‰ªŽR‘åŠwƒZƒ“ƒ^�[‚ÌŠˆ“®‚ð’Ê‚µ‚Ä �\ 1 16 EN Atsushi TAKASE Faculty of Education, Okayama University Akiko TSURUMI Okayama University Kindergarten Chiyo KUROSUMI Okayama University Kindergarten Tetsuo KIYOTA Faculty of Education, Okayama University Yoshihiko INADA Faculty of Education, Okayama University Ai MATSUURA Faculty of Education, Okayama University Kouji MIYAMOTO Faculty of Education, Okayama University Mutsumi MATSUEDA Faculty of Education, Okayama University Aiko TSUSHIMA Faculty of Education, Okayama University Yoshio MIYAZAKI Faculty of Education, Okayama University Toshiya TAKEMOTO Okayama University School for Special Needs Education Yoko SAWATANI Okayama University School for Special Needs Education Kazuaki KAJII Faculty of Education, Okayama University Makiko KANAGAWA Faculty of Education, Okayama University 10.18926/bgeou/70192 �@–{˜_•¶‚Å‚Í�C�ê–å�E‚Æ‚µ‚Ä‚Ì‹³�Eˆõ‚ÌŠw‚Ñ‚ð•Û�á‚·‚錤�C‚Ì‚ ‚è•û‚ðŒŸ“¢‚µ�C‚Æ‚­‚É‘åŠw‚ª‰Ê‚½‚·–ðŠ„‚Æ‰Û‘è‚ɂ‚¢‚Ä�lŽ@‚·‚é�B‹³�Eˆõ‚ÌŠw‚Ñ‚Í‹³ˆçˆÏˆõ‰ï‚Å‚ÌŒ¤�C�C‹Î–±�Z‰€‚Å‚ÌŒ¤�C�C‹³�E‘åŠw‰@‚Å‚ÌŠw�C�CŒ¤‹†’c‘Ì‚Å‚ÌŒ¤�C‚È‚Ç‚É‚¨‚¢‚Ä“WŠJ‚³‚ê‚é�B‘åŠw‚ªŠJ”­�EŽÀŽ{‚·‚錤�C‚Í‚±‚ê‚ç‚Æ‚Ç‚¤ŠÖ˜A‚µ�C‚ǂ̂悤‚È“Á�F‚ð‚à‚‚©�B“Æ—§�s�­–@�l‹³�EˆõŽx‰‡‹@�\�iˆÈ‰º�CNITS�j‰ªŽR‘åŠwƒZƒ“ƒ^�[‚ÌŠˆ“®‚ð’Ê‚µ‚ÄŒŸ“¢‚·‚é�B‚»‚µ‚Ä�C‘åŠw‚Í‹³�Eˆõ‚ÌŠw‚т̃j�[ƒY‚ɉž‚¦‚鑤‚É‚ ‚邾‚¯‚Å‚È‚­�C‹³�Eˆõ‚ÌŠw‚Ñ‚ð�Ä�\�¬‚µ�CŽ©—¥“I‹¦“­“I‚ÈŠw‚Ñ‚ðŽx‰‡�E‘£�i‚µ‚Ä‚¢‚­‘¤‚Æ‚µ‚Ä‚Ì–ðŠ„‚ð‰Ê‚½‚·‚à‚Ì‚Å‚ ‚邱‚Æ‚ð�lŽ@‚·‚é�B‚Ü‚½�C‘åŠw‚¨‚¯‚éƒAƒEƒgƒJƒ€�dŽ‹‚ÌŒ¤�CŠJ”­‚Ì•K—v�«‚ðŽw“E‚µ�C�¡Œã‚ÌŽæ‘g‚̉ۑè‚Æ‚µ‚ÄŽ¦‚·�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‘åŠw‰@‹³ˆçŠwŒ¤‹†‰È Acta Medica Okayama 1883-2423 191 2026 •\Ž†�E–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

The Japanese Society for Neuroendovascular Therapy Acta Medica Okayama 1882-4072 19 1 2025 The Qualification Examination for Specialists and Instructors in the Japanese Society of Neuroendovascular Therapy: History and Current Status sr.2024-0099 EN Shinichi Yoshimura Department of Neurosurgery, Hyogo Medical University Kenji Sugiu Department of Neurological Surgery, Okayama University Graduate School of Medicine Masaru Hirohata Department of Neurosurgery, Kurume Medical University Yukiko Enomoto Department of Neurosurgery, Gifu University Graduate School of Medicine Hirotoshi Imamura Department of Neurosurgery, National Cerebral and Cardiovascular Center Wataro Tsuruta Department of Endovascular Neurosurgery, Toranomon Hospital Toshiyuki Fujinaka Department of Neurosurgery, National Hospital Organization Osaka National Hospital Hitoshi Hasegawa Department of Neurosurgery, Brain Research Institute, Niigata University Toshio Higashi Department of Neurosurgery, Fukuoka University Chikushi Hospital Takashi Izumi Department of Neurosurgery, Nagoya University of Graduate School of Medicine Hiro Kiyosue Department of Diagnostic Radiology, Kumamoto University Faculty of Life Sciences Yasushi Matsumoto Division of Development and Discovery of Interventional Therapy, Tohoku University Hospital Hidenori Oishi Oishi Neurosurgery Clinic, and Department of Neurosurgery, The Jikei University School of Medicine Tetsu Satow Department of Neurosurgery/Stroke Center, Kindai University Hospital Michihiro Tanaka Department of Neurosurgery and Neuroendovascular Surgery, Kameda Neurocenter, Kameda Medical Center Tomoyuki Tsumoto Department of Neurosurgery, Showa University Fujigaoka Hospital Hiroshi Yamagami Division of Stroke Prevention and Treatment, Institute of Medicine, University of Tsukuba Akira Ishii Department of Neurosurgery, Juntendo University Faculty of Medicine Yuji Matsumaru Department of Neurosurgery, Institute of Medicine, University of Tsukuba Shigeru Miyachi Department of Neurological Surgery, Aichi Medical Univeristy Neuroendovascular therapy is a key treatment for cerebrovascular disorders, driven by advancements in devices and techniques. The Japanese Society for Neuroendovascular Therapy (JSNET) established a certification system in 1997 to ensure operator competence and minimize complications, with the first examination in 2002. JSNET offers 2 main certifications: specialist and instructor. Specialists perform basic procedures, while instructors lead in practice, education, and research. In 2020, the mechanical thrombectomy practitioner qualification was added to promote mechanical thrombectomy. Applicants must have a JSNET membership, relevant certifications, training, and documented experience. The certification process includes rigorous written and practical examinations that now employ non-fluoroscopic models. Certification renewal every 5 years requires conference participation and a continuing education program. Public awareness and integration into stroke center designations have grown. Over 2200 specialists, including more than 500 instructors, have been certified, significantly advancing neuroendovascular therapy in Japan. JSNET aims to continue improving certification and education to maintain high standards. No potential conflict of interest relevant to this article was reported.

Japan Society of Mechanical Engineers Acta Medica Okayama 2187-9745 12 5 2025 Examining OpenFOAM-based LES analysis in terms of inviscid energy conservation and viscous turbulence decay 25-00095 EN Hiroki SUZUKI Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Kento TANAKA Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Toshinori KOUCHI Graduate School of Environmental, Life, Natural Science and Technology, Okayama University The present study examines an OpenFOAM-based LES analysis from the viewpoints of inviscid energy conservation and viscous turbulence decay. The Smagorinsky model is employed as the sub-grid scale (SGS) model, and a two-dimensional periodic analytical solution and a three-dimensional periodic Taylor-Green vortex (TGV) are employed to represent inviscid flows. The analytical relationship for the kinetic energy K, dK/dt = 0, with t as the dimensionless time, is utilized to validate the OpenFOAM results. For the viscous flow case, the TGV flow in a three-dimensional periodic cubic domain is adopted, and its turbulence kinetic energy distribution is compared with that obtained by a spectral method to examine the analysis. The OpenFOAM-based analysis exhibits energy conservation error in flows that should ideally conserve energy. For the two-dimensional flow, this error decreases with increasing grid resolution N. However, in the three-dimensional flow, the error does not improve even with higher N. In the three-dimensional TGV flow, the turbulence kinetic energy predicted by OpenFOAM exhibits a strong agreement with that from the spectral method when a standard constant value of the Smagorinsky model is employed and the mesh is sufficiently refined. Conversely, for a condition of relatively coarse mesh, the decay characteristics of turbulent kinetic energy deviate from those of the spectral method, and a higher constant value of the Smagorinsky model than the default value becomes necessary to reproduce comparable results. These results suggests that even in LES simulations where highly accurate conservation laws are not satisfied, adjusting the model constants so that the predicted values match experimental or numerical reference data can improve the apparent reliability of the turbulent kinetic energy in the decaying turbulence. No potential conflict of interest relevant to this article was reported.

The Carbon Society of Japan Acta Medica Okayama 2436-5831 4 3 2025 Synthesis and applications of porous carbonaceous materials with inherited molecular structural features from the precursor molecules 179 187 EN Koki Chida Institute of Multidisciplinary Research for Advanced Materials, Tohoku University Takeharu Yoshi Institute of Multidisciplinary Research for Advanced Materials, Tohoku University Yuta Nishina Research Institute for Interdisciplinary Science, Okayama University Kazuhide Kamiya Research Center for Solar Energy Chemistry, Graduate School of Engineering Science, The University of Osaka Ryota Sakamoto Department of Chemistry, Graduate School of Science, Tohoku University Fumito Tani Institute for Materials Chemistry and Engineering, Kyushu University Tomoki Ogoshi Department of Synthetic Chemistry and Biological Chemistry, Graduate School of Engineering, Kyoto University Hirotomo Nishihara Institute of Multidisciplinary Research for Advanced Materials, Tohoku University The carbonization of organic crystalline materials, such as metal organic frameworks and covalent organic frameworks, has emerged as a promising approach for producing functional porous carbonaceous materials. However, both the chemically defined long-term ordered structures and the local chemical structures derived from these precursor materials are generally lost, resulting in amorphous carbons. As a result, controlling the molecular-level structure of nanoporous carbons remains a significant challenge. We report a new bottom-up synthesis approach for porous carbons with a molecular-level design, involving the carbonization of well-designed precursor molecules by thermal polymerization. Among the resulting carbons, ordered carbonaceous frameworks, which contain a high-density of regularly aligned single-atomic metal species, have been identified as promising platforms for single-atom catalysts. This approach also enables the synthesis of various three-dimensional porous carbons that reflect the structural features of their precursor molecules. Recent progress in the synthesis and applications of porous carbons derived from molecular precursors is summarized, highlighting their potential for the development of functional materials. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 2752-6542 5 1 2025 Chloroplast heat shock protein cpHsc70-1 interacts with thylakoid membrane remodeling protein VIPP1 C-terminal tail and controls VIPP1 oligomer assembly pgaf393 EN Di Li Institute of Plant Science and Resources, Okayama University Sarah Wanjiru Gachie Institute of Plant Science and Resources, Okayama University Shin-ichiro Ozawa Institute of Plant Science and Resources, Okayama University Martin Scholz Institute of Plant Biology and Biotechnology, University of Münster Michael Hippler Institute of Plant Science and Resources, Okayama University Wataru Sakamoto Institute of Plant Science and Resources, Okayama University Oxygenic photosynthetic organisms depend on the thylakoid membranes (TMs) for light-driven energy conversion. Recent studies on TM homeostasis (thylakostasis) have highlighted the essential role of the TM remodeling protein vesicle-inducing protein in plastid 1 (VIPP1). As a member of the endosomal sorting complexes required for transport-III (ESCRT-III)/phage shock protein A (PspA)/VIPP1 superfamily, VIPP1 forms large ring- and filament-like homo-oligomeric structures that exhibit a membrane remodeling activity. The oligomerization status was proposed to be modulated by the intrinsically disordered C-terminal tail (Vc), whereas its functional role remained unclear. Notably, this Vc region is conserved not only in photosynthetic VIPP1 but also in the PspA proteins of extremophilic species, implicating its role in membrane stress responses. To investigate the role of the Vc region in VIPP1 assembly, we performed coimmunoprecipitation assays in Arabidopsis chloroplasts and identified chloroplast-localized HSP70 proteins (cpHsc70) as major interactors. Among the two isoforms, cpHsc70-1 was found to be specifically required for modulating VIPP1 oligomeric assembly and dynamics in response to heat stress. Genetic analyses revealed that cpHsc70-1 facilitates the disassembly of VIPP1 oligomers, similarly to Vps4 ATPase in ESCRT-III; loss of either the Vc region or cpHsc70-1-impaired VIPP1 disassembly, resulting in more static oligomeric structures. Furthermore, cpHsc70-1 exhibited a broader role in chloroplast proteostasis, as the cphsc70-1 mutant showed impaired accumulation of green fluorescent protein (GFP)-fusion proteins. Together, our findings uncover a crucial crosstalk between proteostasis and thylakostasis in chloroplasts, coordinated by cpHsc70-1 and VIPP1 in response to membrane stress. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1546-0096 24 1 2026 TeMPRA: advancing continuing professional development in pediatric rheumatology in Japan EN Hiroyuki Wakiguchi Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of Medicine Kunio Hashimoto Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences Masato Yashiro Department of Pediatrics, Okayama University Hospital Kenichi Nishimura Department of Pediatrics, Yokohama City University Graduate School of Medicine Takasuke Ebato Department of Pediatrics, Kitasato University Keiji Akamine Department of Nephrology and Rheumatology, Tokyo Metropolitan Children�fs Medical Center Yoji Uejima Division of Infectious Diseases and Immunology, Saitama Children�fs Medical Center Tomomi Sato Clinical Education Center for Physicians, Shiga University of Medical Science Yuichi Yamasaki Department of Pediatrics, Kagoshima University Hospital Junko Yasumura Department of Pediatrics, Hiroshima Prefectural Hospital Organization Futabanosato Prefectural Hospital Fumiko Okazaki Department of Pediatrics, Yamaguchi University Graduate School of Medicine Toshitaka Kizawa Department of Pediatrics, Japan Community Health Care Organization Sapporo Hokushin Hospital Ryuhei Yasuoka Department of Pediatrics, Hamamatsu University School of Medicine Tomoaki Ishikawa Department of Pediatrics, Nara Medical University Takeshi Yamamoto Department of Pediatrics, Chiba University Graduate School of Medicine Yuji Fujita Department of Pediatrics, Dokkyo Medical University Naohiro Itoh Department of Pediatrics, Faculty of Medical Sciences, University of Fukui Asami Takasaki Department of Pediatrics, School of Medicine, University of Toyama Nodoka Sakurai Department of Pediatrics, NTT East Medical Center Sapporo Kazuo Suzuki Suzuki Kids Clinic Tasuku Tamai Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of Medicine Naoki Hirano Department of Public Health and Epidemiology, Faculty of Medicine, Oita University Nami Okamoto Department of Pediatrics, Osaka Rosai Hospital, Japan Organization of Occupational Health and Safety Masaki Shimizu Department of Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo Background In the context of the global shortage of pediatric rheumatologists, mid-career specialists who can play key roles in regional education, research, and clinical practice have become increasingly important. In Japan, the Team of Mid-career Pediatric Rheumatologists Alliance (TeMPRA) was founded in 2014 to support continuing professional development (CPD) and foster collaboration among mid-career pediatric rheumatologists. The aim of this study was to characterize the current status and future perspectives of the TeMPRA members.<br> Methods In 2024, a cross-sectional, web-based survey was conducted among all 37 active members of the TeMPRA across Japan. Data were collected on career trajectories, educational roles, research activities, clinical practices, and international engagement. Categorical variables were compared using appropriate statistical tests, with a significance level of 0.05.<br> Results Responses were obtained from 35 members (response rate: 95%). Most respondents (71%) were affiliated with university hospitals, and 60% had > 10 years of experience in pediatric rheumatology. Compared with those working in community hospitals, respondents affiliated with university hospitals were significantly more likely to be involved in research activities (50% vs. 0%, P = 0.0261) and global professional contributions (88% vs. 0%, P < 0.0001). Overall, 54% of respondents were engaged in teaching students or early-career pediatric rheumatologists, while 43% were involved in clinical or basic research, most commonly focusing on juvenile idiopathic arthritis and systemic lupus erythematosus. Collectively, respondents were responsible for the care of 1,677 children with pediatric rheumatic diseases. While all respondents reported willingness to contribute to pediatric rheumatology at the regional level, 94% and 71% reported willingness to contribute at the national and global levels, respectively.<br> Conclusions This nationwide survey highlights the substantial educational roles, research activities, and clinical practices of mid-career pediatric rheumatologists in Japan and suggests that the TeMPRA framework can serve as a valuable model for supporting CPD and workforce sustainability. Similar alliance-based approaches may be applicable in other countries facing comparable challenges in pediatric rheumatology. No potential conflict of interest relevant to this article was reported.

Informa UK Limited Acta Medica Okayama 1350-4622 2026 Towards place-responsive climate change education: Mongolian primary teachers�f pedagogical judgement across urban and rural contexts EN Shinetsetseg Gerelkhuu Graduate School of Humanities and Social Sciences, Okayama University Khalifatulloh Fiel�fardh Graduate School of Education, Okayama University Hiroki Fujii Graduate School of Education, Okayama University Batchuluun Yembuu Geography Department, Mongolian National University of Education Uuriintuya Dembereldorj Lifelong Learning and Distance Education Department, Mongolian National University of Education Climate change education (CCE) in primary schools is increasingly recognised as essential, yet how teachers interpret and enact CCE across diverse local contexts remains underexplored. This study examines how Mongolian primary school teachers working with students aged 6–11 in urban and rural contexts interpret and teach climate change, with particular attention to the role of place. Drawing on semi-structured interviews with 20 teachers across contrasting contexts, the study explores how environmental, cultural, and institutional conditions shape teachers�f pedagogical interpretations and classroom practices. Data were analysed using reflexive thematic analysis, informed by conceptual frameworks that position place as an active mediator of teaching and learning. Findings show that rural teachers frequently integrated traditional ecological knowledge and lived environmental experience to connect global climate processes with locally observable ecological change, emphasising livelihood impacts and intergenerational ecological memory. Urban teachers, by contrast, framed climate change through anthropogenic pressures such as air pollution, waste, and infrastructure constraints, foregrounding feasible individual actions within everyday school contexts. Across both settings, teachers exercised place-responsive pedagogical judgement by selectively adapting climate content to local realities while navigating curriculum constraints and workload pressures. The study contributes a place-responsive account of teachers�f pedagogical judgement in CCE, demonstrating how place functions not only as context but as a condition shaping pedagogical feasibility. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1435-2451 410 1 2025 Robotic distal pancreatectomy using two-surgeon technique (TAKUMI-4): a technical note and initial outcomes 171 EN Kosei Takagi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Tomokazu Fuji Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kazuya Yasui Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Purpose With the increasing use of minimally invasive distal pancreatectomy, the use of robotic distal pancreatectomy (RDP) is also increasing worldwide. Standardized surgical protocols are essential for safe implementation of RDP. In this study, we present our surgical protocol and initial outcomes of RDP using �gtwo-surgeon technique�h.<br> Methods Our standard RDP protocol included a two-surgeon technique for cooperation, rationality, and education. Short-term outcomes of RDP were also investigated. This retrospective study included 77 consecutive patients who underwent RDP at our institution between April 2021 and January 2025.<br> Results The median operative time, estimated blood loss, and postoperative hospital stay were 214 min (interquartile range [IQR], 176–253), 10 mL (IQR, 0–50), and 9 days (IQR, 8–10), respectively. A textbook outcome was achieved in 84.4% of patients. Moreover, superior outcomes of RDP (n = 77) compared with those of laparoscopic distal pancreatectomy (n = 62) were confirmed in this study.<br> Conclusion Using the two-surgeon technique, we successfully standardized and introduced the RDP program. The two-surgeon technique can contribute to the safe introduction of RDP and expansion of the program. No potential conflict of interest relevant to this article was reported.

IOP Publishing Acta Medica Okayama 1742-6588 3027 1 2025 LES analysis to investigate a random-phase forcing scheme for steadying anisotropic turbulence fields 012009 EN Koki Minami Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Hiroki Suzuki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Toshinori Kouchi Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Kento Tanaka Graduate School of Environmental, Life, Natural Science and Technology, Okayama University The aim of this study is to investigate the effect of phase randomization on forcing mechanisms that stabilize localized turbulence. A trigonometric forcing based on vector potential is combined with uniform random numbers to create a spatially homogeneous forcing field. The analysis is performed using large-eddy simulation (LES) with the Smagorinsky model as the subgrid scale model. The results demonstrate that steady flows are generated regardless of the presence of phase randomization, successfully forming isotropic turbulence. In contrast, for anisotropic turbulent fields, the addition of phase randomization reduces the degree of anisotropy, indicating a smoothing effect on the anisotropy of the flow. No potential conflict of interest relevant to this article was reported.

IOP Publishing Acta Medica Okayama 1742-6588 3027 1 2025 Fundamental examination of coherent structure model prediction using vortex cores in a two-dimensional Taylor�fs analytical solution 012008 EN Xuanyou Gong Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Hiroki Suzuki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Toshinori Kouchi Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Kento Tanaka Graduate School of Environmental, Life, Natural Science and Technology, Okayama University This study focuses on the possibility that flow around vortex tubes in turbulence may resemble laminar flow, and aims to describe the characteristics of turbulent fields using analytical solutions to the governing equations. In the two-dimensional analytical Taylor solution, the velocity and pressure fields are expressed by trigonometric functions, and a structure in which counter-rotating vortices are arranged in a grid pattern is demonstrated. This solution is used to verify the accuracy of numerical analyses and is expected to contribute to a simple yet unambiguous description of turbulent fields based on vortex structures. Predictions of sub-grid scale components and validation of a coherent structure model using invariants of the velocity gradient tensor are also performed. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 — •\Ž†�E‰p•¶–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ‰œ•t EN No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 Teaching and Learning�FJapanese and International Student Collaboration in the Classroom 209 226 EN Alexis PUSINA Junko OTOSHI 10.18926/70122 This practical report introduces three intercultural collaborative trial classes designed to integrate Japanese and international students in first-year EFL classes. Using a CLIL-informed approach, the classes promoted intercultural understanding through culturally grounded activities and small-group communication tasks. Reflection surveys from both Japanese and international participants revealed overall positive experiences, with international students expressing strong enjoyment and Japanese students highlighting both linguistic gains and communication challenges. Analysis indicates that interaction across diverse cultural and linguistic backgrounds fostered intercultural awareness while motivating Japanese learners to further develop their speaking skills. The findings support the value of collaborative, content-based activities for enhancing intercultural understanding. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 �¢ŠEŠÏŒõ—Ï—�Œ›�͂𓥂܂¦‚½ƒAƒNƒZƒVƒuƒ‹ƒAƒEƒgƒhƒAƒc�[ƒŠƒYƒ€‚ÌŒŸ“¢ �\�¢ŠEŽ©‘RˆâŽY’nˆæ‚ł̃AƒEƒgƒhƒAŒ^ŽÔˆÖŽq‚ð—p‚¢‚½ŽÀ‘H‚ð’Ê‚¶‚Ä�\ 195 208 EN Kosuke IKETANI General Education and Global Studies Field, Okayama University Shin HARADA General Education and Global Studies Field, Okayama University Keita KUSUNOKI Institute of Student Support, Bukkyo University 10.18926/70121 ƒAƒNƒZƒVƒuƒ‹ƒAƒEƒgƒhƒAƒc�[ƒŠƒYƒ€‚ð�i‚ß‚Ä‚¢‚­‚½‚ß‚É‚Í�C�u•Û‘S�E•ÛŒì�v‚Æ�uŠJ”­�v‚Ì—¼—§‚ª”ñ�í‚É�d—v‚ÈŠÏ“_‚Æ‚È‚é�B‚»‚±‚Å–{ŽÀ‘H‚Å‚Í�Cˆê�l‚Å‚à‘½‚­‚Ì�l‚ªƒAƒEƒgƒhƒAŠˆ“®‚ÉŽQ‰Á‚Å‚«‚邱‚Æ‚ð–ÚŽw‚µ�C�¢ŠEŽ©‘RˆâŽY’nˆæ‚É‚¨‚¢‚ăAƒEƒgƒhƒAŒ^ŽÔˆÖŽq‚ð—p‚¢‚½ƒcƒA�[‚ªŽÀŒ»‚Å‚«‚é‚©‚Ç‚¤‚©‚ðŒŸ“¢‚·‚邱‚Æ‚Æ‚µ‚½�B�u’N‚ЂƂèŽæ‚èŽc‚³‚È‚¢ŠÏŒõ�v‚Æ‚Í�C�¢ŠEŠÏŒõ—Ï—�Œ›�Í‚Å‚à•WžÔ‚³‚ꂽ–Ú•W‚Å‚ ‚邪�C‚±‚Ì‚±‚Æ‚ðŽÀŒ»‚·‚邽‚ß‚É‚Í�C�¡‰ñŒŸ“¢‚ð�s‚Á‚½‚悤‚Ȉꂈꂂ̎À‘H‚ð�Ï‚Ý�d‚˂邱‚Æ‚É‚æ‚Á‚Ä�C�­‚µ‚¸‚‚ł ‚Á‚Ä‚àƒAƒNƒZƒVƒuƒ‹ƒAƒEƒgƒhƒAƒc�[ƒŠƒYƒ€‚̉”\”͈͂ð�L‚°‚Ä‚¢‚­‚±‚Æ‚ª�C�Å‚àŠmŽÀ‚ÈŽæ‚è‘g‚Ý‚È‚Ì‚Å‚Í‚È‚¢‚©‚Æ�l‚¦‚Ä‚¢‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ƒsƒA�EAI�E‹³ˆõ‚ÌŽOŽÒ‹¦“­ƒtƒB�[ƒhƒoƒbƒN‚É‚æ‚郉ƒCƒeƒBƒ“ƒOŽö‹Æ‚Ì�Ä�ÝŒv �\AI—˜—p‚ÌŽÀ‘H•ñ���| 174 194 EN Mariko Uzuka Institute for Promotion of Education and Campus Life 10.18926/70120 –{�e‚Í�AƒAƒJƒfƒ~ƒbƒN�Eƒ‰ƒCƒeƒBƒ“ƒOŽö‹Æ‚É‚¨‚¯‚éƒsƒA�EAI�E‹³ˆõ‚Ì‚»‚ꂼ‚ê‚Ì–ðŠ„‚Æ—˜—p�‡�˜�iŽ©•ª�¨ƒsƒA�¨AI�¨�i�ÈŽ@�j�¨‹³ˆõ�j‚ð‘g‚Ý�ž‚ñ‚¾ŽOŽÒ‹¦“­ƒ‚ƒfƒ‹‚ð�ÝŒv‚µ�A2024�`2025”N“x‚ÉŽÀ‘H‚µ‚½“à—e‚ð•ñ��‚·‚é�BŽö‹ÆŒã‚ÌŠw�¶ƒAƒ“ƒP�[ƒg‚Å‚Í�AAI‚Ì‘¦Žž�«�E�¸ãk‰»‚ª•]‰¿‚³‚ê‚éˆê•û�AˆË‘¶‚â—LŒø�«‚ÌŒÀŠE‚ÉŠÖ‚·‚錜”O‚à•\–¾‚³‚ꂽ�B�¬�Ñ•ª•z‚É‚¨‚¢‚Ä‚Í�AAI“±“üŒã‚ɉºˆÊ‘w‚ª�k�¬‚µ�AŠw�K�¬‰Ê‚Ì’ê�ã‚°‚ªŽ¦�´‚³‚ꂽ�B‚Ü‚½�AAIŒë—p‚â—”—p‚ð–h‚®‚É‚Í�A‹³Žº“à‚ÅŒš�Ý“I‚È—˜—p–@‚Ì‹ï‘Ì“I‚ÈŽw“±�i—á�F—ᕶ‚æ‚è�f’f“IƒtƒB�[ƒhƒoƒbƒN‚ð�dŽ‹�AAI’ñˆÄ‚Ì�̔ۗ�—R‚̃�ƒ^‹L�q�j‚ªŒø‰Ê“I‚Å‚ ‚Á‚½�B‚±‚ê‚ç‚ÌŒ‹‰Ê‚©‚ç�AAI‚Ì—˜“_‚ðŠˆ‚©‚µ‚‚Â�AŠw�¶‚Ì”»’f‚ð’†�S‚É�˜‚¦‚郉ƒCƒeƒBƒ“ƒOŽö‹Æ�ÝŒv‚Ì—LŒø�«‚Ɖۑè‚ð’ñŽ¦‚·‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ‘åŠw‚É‚¨‚¯‚é’†�‘Œê‘½“Ç‚ÌŽŽ‚Ý 155 173 EN Tomomi ISHII Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70119 �@This study examines the implementation of the instruction for extensive reading in Chinese among 19 learners who completed one year of beginner-level Chinese studies comprising two 100-minute sessions per week. Regarding survey methods, a questionnaire using a five-point Likert scale and open-ended responses was utilized. The findings revealed that learners recognized extensive reading as an effective strategy for improving their reading comprehension and vocabulary. However, some challenges exist, including the lack of suitable books for extensive reading practices and difficulties in sustaining extensive reading habits. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 �u’m‚Ì’TŒ¤�v�~ ‘½•¶‰»‹¤�C �\ƒIƒ“ƒ‰ƒCƒ“Žö‹Æ�Ä�\’z‚ÌŽŽ‚Ý�\ 145 154 EN Yumiko YAMAMOTO Faculty of General and Global Studies (GDP), Okayama University Kha Manh NGUYEN Discovery Program for Global Learners, Okayama University 10.18926/70118 ‰ªŽR‘åŠw‚Å‚Í2025”N4ŒŽ“üŠw�¶‚©‚ç�VƒJƒŠƒLƒ…ƒ‰ƒ€‚ªƒXƒ^�[ƒg‚µ‚½�BŠwŽm‰Û’ö‰üŠv‚̈êŠÂ‚Æ‚µ‚Ä“±“ü‚³‚ꂽ‚Ì‚ª‘SŠw‹¤’Ê�E‰Û‘è’T‹†‰È–Ú�u’m‚Ì’TŒ¤�v‚Å‚ ‚é�B–{�e‚Å‚Í�C�V“ü�¶‘Î�ۉȖڂł ‚é�u’m‚Ì’TŒ¤�v‚ð�CŠCŠO�¶‚ðŠÜ‚ÞƒOƒ��[ƒoƒ‹�EƒfƒBƒXƒJƒoƒŠ�[�Eƒvƒ�ƒOƒ‰ƒ€�¶Œü‚¯‚ɉpŒê‚Å �gInquiries of Knowledge�h ‚Æ‚µ‚ÄŠJ�u‚µ‚½�‰”N“x‚ÌŽæ‚è‘g‚Ý‚ð•ñ��‚·‚é�B‚Æ‚è‚킯ƒIƒ“ƒfƒ}ƒ“ƒhŒ^ƒIƒ“ƒ‰ƒCƒ“Žö‹Æ‚ð, –{Šw‚ª�„�i‚·‚鑽•¶‰»‹¤�C‚ÌŽ‹“_‚Å�Ä�\’z‚·‚é‚É‚ ‚½‚è�C‹³�Þ‚ð’P‚ɉp–ó‚·‚é‚Ì‚Å‚Í‚È‚­, ƒIƒ“ƒ‰ƒCƒ“ŠÂ‹«‚É‚¨‚¢‚Ä‚à‹¦“­Šw�K‚ðŽÀŒ»‚·‚é�H•v‚â�CŒ¾Œê“I�E•¶‰»“I”z—¶‚Ì“��‡‚ª•s‰ÂŒ‡‚Å‚ ‚邱‚Ƃ𖾂炩‚É‚·‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 Šw•”•ÊƒCƒ“ƒ^ƒrƒ…�[‚É‚æ‚éŠw�KŽÒƒiƒ‰ƒeƒBƒu‚ƃIƒŠƒGƒ“ƒe�[ƒVƒ‡ƒ“ŽÀ‘H �\‘åŠw“üŠwŽž‚É‚¨‚¯‚éŠO�‘ŒêŠw�K“®‹@‚¯‘£�i‚ÌŽŽ‚Ý�\ 129 144 EN Azumi YOSHIDA Institute for Promotion of Education and Campus Life, Okayama University Masako TERANISHI Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70117 ‰ªŽR‘åŠw‚Å‚Í�VŠw�KŽw“±—v—ÌŽÀŽ{‚É�‡‚킹�A�uŠw�KŽÒ’†�S‚ÌŠw‚Ñ�v‚ÌŽÀŒ»‚ð–ÚŽw‚·Target2025‚ƌĂ΂ê‚é•û�j‚Ì‚à‚ƉpŒêƒJƒŠƒLƒ…ƒ‰ƒ€‚̉üŠv‚ð�i‚ß‚Ä‚«‚½�B‚±‚̉üŠv‚Å‚Í�A‰pŒêŒn‹³ˆõ‚ÆŠe•”‹Ç‚Æ‚ª–§‚ɘAŒg‚µ‚È‚ª‚ç�AŠwŽm‰Û’ö‘S‘Ì‚ð’Ê‚µ‚½‰pŒêŠw�K‚ð‘SŠw“I‚É“WŠJ‚µ‚Ä‚¢‚­‚±‚Æ‚É�Å“_‚ð“–‚Ä‚Ä‚¢‚é�B‚»‚ÌŽæ‚è‘g‚݂̈êŠÂ‚Æ‚µ‚Ä�AŠe•”‹Ç‚©‚ç�„‘E‚ðŽó‚¯‚½ƒ��[ƒ‹ƒ‚ƒfƒ‹‚Æ‚ÌŠw•”•ÊƒCƒ“ƒ^ƒrƒ…�[‚ðŽÀŽ{‚µ�A‰pŒêŠw�K‚ɂ‚¢‚Ä‚Ì�Ú�ׂ𒮂«Žæ‚Á‚½�B‚Ü‚½�A�V“ü�¶‚Ö‚ÌŒƒ—ã‚̃�ƒbƒZ�[ƒW“®‰æ‚ð�ì�¬‚µ�A‰pŒêŽö‹ÆƒIƒŠƒGƒ“ƒe�[ƒVƒ‡ƒ“‚Å�ã‰f‚µ‚½�B–{�e‚Å‚Í�AƒCƒ“ƒ^ƒrƒ…�[‚Å“¾‚ç‚ꂽƒiƒ‰ƒeƒBƒu‚âƒIƒŠƒGƒ“ƒe�[ƒVƒ‡ƒ“ŽÀŽ{‚ÌŒoˆÜ�A‚Ü‚½�AƒIƒŠƒGƒ“ƒe�[ƒVƒ‡ƒ“Œã‚ÉŽÀŽ{‚µ‚½ƒAƒ“ƒP�[ƒgŒ‹‰Ê‚ɂ‚¢‚Ä•ñ��‚·‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 From The Odyssey to The Zahir�FThe Evolution of Penelopeia Across Time and Tradition 120 128 EN Saida KHALMIRZAEVA Faculty of General Education and Global Studies, Okayama University 10.18926/70116 The story of a man who leaves home and strives to return has become one of the most enduring narrative patterns in world literature and folklore. Across centuries and cultures, it has been retold in myths, epics, folktales, and modern fiction�\the story of the homecoming hero who, after long absence and peril, finds his way back to the place and the person he once called his own. This study explores the persistence and transformation of this universal motif through a comparative reading of Homer�fs The Odyssey and Paulo Coelho�fs The Zahir. It examines the evolving image of the waiting wife�\from Homer�fs Penelopeia, emblem of chastity and endurance, to Coelho�fs Esther, a modern woman of independence and choice. Despite differences in setting, voice, and moral vision, both works embody the same human longing: to return, to be recognized, and to rediscover love that endures time and change. Beneath their differences lies the same truth�\the heart to which every journey, whether physical or spiritual, must ultimately return. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 Developing a Short-form Scale to Assess Learner Beliefs Regarding English Learning Strategies 100 119 EN Hiroshi MORITANI Institute for Promotion of Education and Campus Life, Okayama University Alexis PUSINA Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70115 Questionnaire surveys are a prevalent method in applied linguistics for investigating complex constructs, such as learner beliefs. However, their complex nature often creates overly lengthy instruments, making them impractical for classroom use or for obtaining timely educational insights. This study aimed to develop a simplified, yet robust version of an existing learner belief scale to address these challenges. The authors carefully selected 24 belief-specific items from an initial pool of 78 items from a previous study for use in an online survey, which was completed by 246 participants. The data were subject to exploratory factor analysis. This process resulted in a concise 12-item scale, could offer a more practical tool for language educators. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ”­’B�áŠQ‚ð—L‚·‚é�‚�Z�¶‚Ì•ÛŒìŽÒ‚É‚æ‚é�áŠQŠw�¶Žx‰‡‚Ì”F’m“x 91 99 EN Shin HARADA General Education and Global Studies Field, Okayama University Kosuke Iketani General Education and Global Studies Field, Okayama University Megumi MATSUI General Education and Global Studies Field, Okayama University Naoto MOCHIZUKI Health and Counseling Center, The University of Osaka 10.18926/70114 �@–{Œ¤‹†‚Å‚Í�C”­’B�áŠQ‚ð—L‚·‚é�‚�Z�¶‚Ì•ÛŒìŽÒ‚ª�C�u‘åŠw“™‚É‚¨‚¯‚é�áŠQŠw�¶Žx‰‡‚âŠw�¶‘Š’k‚ð‚Ç‚Ì’ö“x’m‚Á‚Ä‚¢‚é‚©�v�C�u‘åŠw“™‚É‚¨‚¯‚é�áŠQŠw�¶Žx‰‡‚âŠw�¶‘Š’k‚Ì�î•ñ‚ð‚ǂ̂悤‚É“üŽè‚µ‚½‚©�v�C�u‘åŠw“™‚É‚¨‚¯‚é�áŠQŠw�¶Žx‰‡‚âŠw�¶‘Š’k‚Ì�î•ñŽû�W‚ð‚·‚é�ã‚Å�C‘åŠw“™‚ɂǂ̂悤‚È�î•ñ”­�M‚ðŠú‘Ò‚·‚é‚©�v‚ɂ‚¢‚Ä’²�¸‚ð�s‚Á‚½�B‚»‚ÌŒ‹‰Ê�C‚Ü‚¾•ÛŒìŽÒ‚ɑ΂µ�C�\•ª‚É‘åŠw‚ÌŠw�¶Žx‰‡‚Ì�î•ñ‚ª�s‚«“Í‚¢‚Ä‚¢‚È‚¢‚±‚Æ�CŠw�¶Žx‰‡‚ÉŠÖ‚·‚é�î•ñ”­�M‚ð�s‚¤�à–¾‰ï‚â‘Š’k‰ï‚ð�s‚¤‚±‚Æ‚ª•ÛŒìŽÒ‚©‚çŠú‘Ò‚³‚ê‚Ä‚¢‚邱‚Æ�C”­’B�áŠQ‚ð—L‚·‚é�‚�Z�¶‚Ì�‚‘åˆÚ�s‚ð‘£�i‚·‚邽‚ß‚É�C�‚�Z‚Ì�æ�¶•û‚ɑ΂·‚é�î•ñ”­�M‚à�¸—Í“I‚É�s‚Á‚½‚è�C�‚‘å˜AŒg‚ÌŽæ‚è‘g‚Ý‚ð‚æ‚è�s‚¤•K—v‚ª‚ ‚邱‚Æ“™‚ªŒ©�o‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ‹ß‘ãŠØ�‘‚Ì“Ç–{‹³‰È�‘�w�‰“™�¬Šw�x‚Ì’ê–{‚ÉŠÖ‚·‚é�Ä�l 74 90 EN Ankoo LEE Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70113 �@–{�e‚Å‚Í�A‹ß‘ãŠØ�‘‚Ì“Ç–{‹³‰È�‘�w�‰“™�¬Šw�x�i1906�j‚Ì•ÒŽ[‚É‚¨‚¢‚ÄŽQ�Æ‚³‚ꂽ‚ÆŽv‚í‚ê‚é“ú–{‚Ì–¾Ž¡Šú“Ç–{‹³‰È�‘‚ɂ‚¢‚Ä”äŠr�E�lŽ@‚ð�s‚Á‚½�B‚Ü‚¸�A•¶•”�È•ÒŽ[‚ÌŒŸ’è�w�q�í�¬Šw“Ç–{�x�i1887�j‚Æ‘æ1Šú�‘’è�w�q�í�¬Šw“Ç–{�x�i1903�j�A‚³‚ç‚É‹à�`“°�o”Å‚Ì�w�q�í�‘Œê“Ç–{�x�i1900�j‹y‚Ñ�w�‚“™�‘Œê“Ç–{�x�i1900�j‚Æ‚ÌŠÖ˜A�«‚ɂ‚¢‚Ä�A�æ�sŒ¤‹†‚Ì‹c˜_‚ð�ÄŒŸ“¢‚µ‚½�B‚»‚Ì‚¤‚¦‚Å�A�V‚½‚É‹à�`“°‚Ì�w�V‘Ì“Ç–{ �q�í�¬Šw—p�x�i1894�j‚Æ•�‹yŽÉ‚Ì�w�q�í�¬Šw�V“Ç–{�x�i1893�j‚Ì2Ží‚ð’ê–{‚Æ‚µ‚ÄŠm”F‚·‚邱‚Æ‚ª‚Å‚«‚½�B�w�‰“™�¬Šw�x‚É‚¨‚¢‚Ä�Å‚à‘½‚­ŽQ�Æ‚³‚ꂽ–¾Ž¡Šú“Ç–{‹³‰È�‘‚Í‹à�`“°‚Ì�w�q�í�‘Œê“Ç–{�x�i1900�j‚Å‚ ‚è�A�w�‰“™�¬Šw�x‚Í�A‹à�`“°‚Æ•¶•”�È‚Ì”äŠr“I�V‚µ‚¢�q�í�¬Šw—p“Ç–{‹³‰È�‘‚ð—D�æ“I‚ÉŽQ�Æ‚µ‚½‚ÆŽv‚í‚ê‚é�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 —¯Šw�¶Žó‚¯“ü‚ê‚É‚¨‚¯‚鋳ˆõ‚Ì”»’fŠî�€ �\‘½‚­‚Ì—¯Šw�¶‚ðŽó‚¯“ü‚ê‚Ä‚¢‚鋳ˆõ‚ÌŽ‹“_‚©‚ç�\ 57 73 EN Takao INAMORI Faculty of General and Global Studies, Okayama University 10.18926/70112 �@�­Žq‰»‚Í�‘“à‘åŠw‚Ì’èˆõ�[‘«—¦‚É�[��‚ȉe‹¿‚ð—^‚¦‚邱‚Æ‚©‚ç�A—¯Šw�¶‚ÌŽó“ü‘�‚ÉŠú‘Ò‚ªŠñ‚¹‚ç‚ê‚Ä‚¢‚é�B‚µ‚©‚µ�A‘åŠw‰@‹³ˆç‚É‚¨‚¢‚Ä—¯Šw�¶Žó“ü‚É‘OŒü‚«‚È‹³ˆõ‚Æ�A�Á‹É“I‚È‹³ˆõ‚ªŒ©Žó‚¯‚ç‚ê‚é�B–{Œ¤‹†‚Å‚Í�A‚æ‚葽‚­‚Ì—¯Šw�¶‚ðŽó‚¯“ü‚ê‚Ä‚¢‚鋳ˆõ‚ª�A‚ǂ̂悤‚È”»’fŠî�€‚Ŏ󂯓ü‚ê‚ðŒˆ’è‚µ‚Ä‚¢‚é‚Ì‚©‚ð�A”¼�\‘¢‰»ƒCƒ“ƒ^ƒrƒ…�[‚ð’Ê‚¶‚Ä–¾‚ç‚©‚É‚·‚邱‚Æ‚ðŽŽ‚Ý‚½�B‚»‚ÌŒ‹‰Ê�A”»’fŠî�€‚ÉŠÖ‚µ‚Ä‚Í�A‹³ˆõ‚É‚æ‚è•\Œ»‚͈قȂ邪�u�l•¨�v‚Æ�u”\—Í�v‚ðŠm”F‚µ‚Ä‚¢‚邱‚Æ‚ª•ª‚©‚Á‚½�B‚Ü‚½�AŽó‚¯“ü‚ê‚ð‘OŒü‚«‚É�l‚¦‚鋳ˆõ‚Í�A—¯Šw�E�ÝŠOŒ¤‹†ˆõŒoŒ±‚â�A�‰‚߂Ď󂯓ü‚ꂽ—¯Šw�¶Žw“±‚ð’Ê‚¶‚Ä—Ç‚¢ŒoŒ±‚ð‚µ‚½‚±‚Æ“™‚ª�A—¯Šw�¶‚ɑ΂·‚éƒvƒ‰ƒX‚̈ó�Û‚ð‚‚­‚è�A�Ï‹É“I‚Ȏ󂯓ü‚ê‚ɂ‚Ȃª‚Á‚Ä‚¢‚邱‚Æ‚ª–¾‚ç‚©‚É‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 Ž©•ÂƒXƒyƒNƒgƒ‰ƒ€�Ç“Á�«‚Æ�¸�_“IŒ’�N‚ÌŠÖ˜A�FŽ©ŒÈ—�‰ð‚É‚æ‚é”}‰îŒø‰Ê‚ÌŒŸ“¢ 41 56 EN Hiroki NISHIMURA Institute for Promotion of Education and Campus Life, Okayama University Akihiro UCHIDA Okayama Psychiatric Medical Center 10.18926/70111 –{Œ¤‹†‚Í�AŽ©•ÂƒXƒyƒNƒgƒ‰ƒ€�Ç“Á�«‚Æ�¸�_“IŒ’�N‚ÌŠÖ˜A‚É‚¨‚¢‚Ä�AŽ©ŒÈ—�‰ð‚ª‚ǂ̂悤‚È–ðŠ„‚ð‰Ê‚½‚·‚©‚𖾂炩‚É‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚½�B“ú–{‚Ì�¬�l604–¼‚̃f�[ƒ^‚ð—˜—p‚µ‚½“ñŽŸ•ª�Í‚ÌŒ‹‰Ê�AŽ©•ÂƒXƒyƒNƒgƒ‰ƒ€�Ç“Á�«‚Ì�‚‚³‚Æ�¸�_“IŒ’�N‚̈«‰»‚Æ‚ÌŠÔ‚É‚ÍŠÖ˜A‚ª”F‚ß‚ç‚ꂽ�B‚±‚ÌŠÖ˜A‚Í�AŽ©ŒÈ—�‰ð‚Ì�m’è“I‘¤–Ê‚É‚æ‚Á‚Ä•”•ª“I‚É”}‰î‚³‚ê‚邱‚Æ‚ªŽ¦‚³‚ꂽ�B“Á‚É‚±‚ÌŽ©ŒÈ—�‰ð‚Ì•ÛŒì“I‚ÈŒø‰Ê‚Í�A’j�«‚æ‚è‚à�—�«‚É‚¨‚¢‚Ä‚æ‚è‹­‚¢‰Â”\�«‚ªŽ¦�´‚³‚ꂽ�Bˆê•û‚Å�AŽ©ŒÈ—�‰ð‚̔ےè“I‘¤–Ê‚Í”}‰îŒø‰Ê‚ðŽ¦‚³‚È‚©‚Á‚½�B‚±‚ê‚ç‚ÌŒ‹‰Ê‚©‚ç�AŽ©•ÂƒXƒyƒNƒgƒ‰ƒ€�Ç“Á�«‚ðŽ�‚Â�l�X‚Ö‚ÌŽx‰‡‚É‚¨‚¢‚Ä�A�m’è“I‚ÈŽ©ŒÈ—�‰ð‚ð‘£�i‚·‚邱‚Æ‚ª�d—v‚Å‚ ‚è�A�«�·‚ð�l—¶‚µ‚½ƒAƒvƒ��[ƒ`‚Ì•K—v�«‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ƒIƒ“ƒ‰ƒCƒ“‚É‚æ‚éƒ{ƒ‰ƒ“ƒeƒBƒA“ú–{Œê‹³Žº‚É‚¨‚¯‚éŽQ‰ÁŽÒŠÔ‚̃Cƒ“ƒ^�[ƒAƒNƒVƒ‡ƒ“‚Ì•ª�Í �\’nˆæŒ^“ú–{Œê‹³ˆç‚ÌŽÀŒ»‚ÉŒü‚¯‚Ä�\ 31 40 EN Miwa SUESHIGE Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70110 –{Œ¤‹†‚Å‚Í�C’nˆæŒ^“ú–{Œê‹³ˆç‚̃‚ƒfƒ‹�\’z‚ÉŒü‚¯�C’nˆæŒ^‚Ì“Á’¥‚ð—L‚·‚鋳Žº“à‚Å‚ÌŽx‰‡ŽÒ‚¨‚æ‚ÑŽQ‰ÁŽÒ‚Ì”­˜b‚⋳Žö�s“®‚ÌŒXŒü‚𖾂炩‚É‚·‚ׂ­�CŠO�‘Œê‘ŠŒÝ�ì—p•ª�̓VƒXƒeƒ€‚ð—p‚¢�CƒIƒ“ƒ‰ƒCƒ“‚É‚æ‚éƒ{ƒ‰ƒ“ƒeƒBƒA‹³Žº‚É‚¨‚¯‚éƒCƒ“ƒ^�[ƒAƒNƒVƒ‡ƒ“‚Ì•ª�Í‚ð�s‚Á‚½�B•ª�Í‚ÌŒ‹‰Ê�C�i1�jŽx‰‡ŽÒ‚Ì•½‹Ï”­˜b�”‚ªŠw�KŽÒ‚æ‚葽‚¢‚±‚Æ�C�i2�jŽx‰‡ŽÒ‚Ì”­˜b‚É‚¨‚¯‚éŠÔ�Ú“I�s“®‚ÌŠ„�‡‚ª’¼�Ú“I�s“®‚æ‚è‚à‚â‚â�‚‚¢‚±‚Æ‚ªŽ¦‚³‚ꂽ�B�u‚¨‚µ‚á‚ׂèŒ^‚Ì‹³ˆç�v‚Å‚Í�CŠw�KŽÒ‚ª“`‚¦‚½‚¢‚±‚Æ‚ðŒ¾Œê‰»‚µ‚Ä‚¢‚­ƒvƒ�ƒZƒX‚Ì’†‚Å�CŠÔ�Ú“I�s“®‚̉ºˆÊ•ª—Þ‚Ì�uŽ¿–â�v�uŠw�KŽÒ‚̈Ó�}‚Ì—˜—p�v�uŠw�KŽÒ‚̉ñ“š‚ÌŒJ‚è•Ô‚µ�v“™‚ðŽx‰‡ŽÒ‚ª�Ï‹É“I‚ÉŽg—p‚µŽx‰‡‚µ‚Ä‚¢‚邱‚Æ‚ª•ª‚©‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 �S—�—Õ�°‰Æ“¯Žm‚̃Oƒ‹�[ƒv‘ÌŒ±‚É‚¨‚¯‚锽�È“IŽÀ‘H 12 30 EN Ryosuke KOBASHI Institute for Promotion of Education and Campus Life, Okayama University Masashi TANAKA Tokai University Rin MURASE Graduate School of Education and Human Development, Nagoya University 10.18926/70109 �@�S—�—Õ�°‰Æ‚É‚Æ‚Á‚Ä”½�È“IŽÀ‘H‚Í�d—v‚Å‚ ‚è�C‘½—l‚ÈŒ`‘Ԃ̃Oƒ‹�[ƒv‚ÉŽQ‰Á‚ð‚·‚é‚±‚Æ‚É‚æ‚Á‚Ä”½�È“IŽÀ‘H‚ð�s‚Á‚Ä‚¢‚é�B–{Œ¤‹†‚Å‚Í�C‘S”Ê“I‚È�S—�—Õ�°‰Æ“¯Žm‚̃Oƒ‹�[ƒv‚É‚¨‚¯‚é‘ÌŒ±�iŒ¤‹†1�j‚¨‚æ‚ÑŒp‘±“I‚ȃOƒ‹�[ƒv‚É‚¨‚¯‚é‘ÌŒ±�iŒ¤‹†2�j‚ð’T�õ‚·‚邱‚Æ‚ð–Ú“I‚Æ‚µ‚Ä�C�”–¼‚Ì�S—�—Õ�°‰Æ‚É‚æ‚é˜b‚µ�‡‚¢‚ðKJ–@‚ð‰‡—p‚µ‚Ä•ª�Í‚µ‚½�B‚»‚ÌŒ‹‰Ê�C�S—�—Õ�°‰Æ“¯Žm‚̃Oƒ‹�[ƒv‘ÌŒ±‚É‚¨‚¯‚锽�È“IŽÀ‘H‚É‚Í�C�yƒOƒ‹�[ƒv‘ÌŒ±‚ª“à�Ȃɂ‚Ȃª‚é‚©‚Ç‚¤‚©�z‚È‚Ç‚Ì4‚‘¤–Ê‚ª�d—v‚Å‚ ‚邱‚Æ‚ªŽ¦‚³‚ꂽ�B‚Ü‚½�CŒp‘±“I‚ȃOƒ‹�[ƒv‚É‚¨‚¯‚é‘ÌŒ±‚Å‚Í�C�s–{—ˆ‚Ì�l‚Æ‚µ‚Ä‚ÌŠ´Šo‚â—~‹��t‚â�sŽ©•ª‚ð•sŽ©—R‚É‚µ‚Ä‚¢‚é—vˆö�t‚È‚Ç‚Ì�y‰ï‚É‚¨‚¯‚é‹C‚«�z‚ª“¾‚ç‚ê‚邱‚Æ‚ª”½�È“IŽÀ‘H‚Æ‚µ‚Ä—LˆÓ‹`‚Å‚ ‚邱‚Æ‚ª–¾‚ç‚©‚É‚È‚Á‚½�B No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 ƒZƒNƒVƒ…ƒAƒŠƒeƒB‚Ì‚ä‚炬‚Æ”­’B�áŠQ‚ÌADHD‚Æ‚ÌŠÖ˜A 1 11 EN Megumi MATSUI Institute for Promotion of Education and Campus Life, Okayama University 10.18926/70108 �@ƒZƒNƒVƒ…ƒAƒŠƒeƒB‚Ì‚ä‚炬‚Æ”­’B�áŠQ‚ÌADHD‚Æ‚ÌŠÖ˜A‚𖾂炩‚É‚·‚邽‚ß�CWEB‚É‚æ‚é�c’f’²�¸‚ð�s‚Á‚½�B18�ΈÈ�ã‚Ì�¬�l‚ð‘Î�Û‚Æ‚µ�C‘æ1‰ñ–Ú‚Ì’²�¸‚Í11,018�l�C1”NŒã‚Ì‘æ2‰ñ–Ú‚Ì’²�¸‚Å‚Í5,474�l‚©‚ç‰ñ“š‚𓾂½�B�«Ž©”F�C�«“IŽwŒü�C�«•\Œ»‚Ì—l�X‚ȃZƒNƒVƒ…ƒAƒŠƒeƒB‚ɂ‚¢‚Ä�C2‰ñ‚Ì’²�¸‚Å‚ÌŠY“–�E”ñŠY“–‚Å4ŒQ‚É•ª‚¯�CADHD“¾“_‚ɂ‚¢‚Ä1—vˆö‚̔팱ŽÒŠÔ•ªŽU•ª�Í‚ð�s‚Á‚½�B�uƒfƒ~ƒ�ƒ}ƒ“ƒeƒBƒbƒN�v�uƒfƒ~ƒZƒNƒVƒ…ƒAƒ‹�vˆÈŠO‚ÅŒQ‚ÌŽåŒø‰Ê‚ª—LˆÓ‚Å‚ ‚è�C�uˆÙ�«ˆ¤�v�uƒQƒC�v‚ð�œ‚­ƒZƒNƒVƒ…ƒAƒŠƒeƒB‚Å�C2‰ñ‚Æ‚à�u”ñŠY“–�vŒQ‚æ‚è‚à�uŠY“–�¨”ñŠY“–�vŒQ‚ÌADHD“¾“_‚ª—LˆÓ‚É�‚‚©‚Á‚½�B‚±‚ê‚É‚æ‚èƒZƒNƒVƒ…ƒAƒŠƒeƒB‚Ì‚ä‚炬‚ÆADHD‚Æ‚ÌŠÖ˜A‚ªŽ¦�´‚³‚ꂽ�B No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0003-9861 779 2026 Comparison of bioavailability of quercetin and its structural analogs in mice 110775 EN Nozomi Maeda Graduate School of Environmental and Life Science, Okayama University Atsushi Hashimoto Graduate School of Environmental and Life Science, Okayama University Ryosei Morita Graduate School of Environmental and Life Science, Okayama University Shintaro Munemasa Graduate School of Environmental and Life Science, Okayama University Yoshiyuki Murata Graduate School of Environmental and Life Science, Okayama University Yoshimasa Nakamura Graduate School of Environmental and Life Science, Okayama University Toshiyuki Nakamura Graduate School of Environmental and Life Science, Okayama University Flavonoids are thought to provide beneficial effects on health. However, there are still uncertainties regarding their bioavailability. In this study, we investigated the bioavailability of 6 flavonoids, galangin, kaempferol, quercetin, myricetin, fisetin, and luteolin, by oral administration to mice. Analysis of plasma concentrations of free flavonoids after deconjugation by LC-MS/MS revealed that all flavonoids were rapidly absorbed after administration. Among 6 flavonoids, kaempferol and fisetin showed high absorbed amounts in blood plasma. With the LogP value of the two flavonoids as the maximum value, the amount absorbed decreased for both lower and higher LogP values. The results of the tissue distribution of galangin, kaempferol, and quercetin suggested that the order of fastest movement from the stomach to the small intestine was kaempferol > quercetin > galangin. In addition, the amount of kaempferol and quercetin distributed in the liver was greater than that of galangin. These results suggest that the bioavailability of flavonoids varies with the slight structural differences, possibly due to differences in their rapid accessibility to the small intestine that is the primary site of absorption and metabolism within the body. No potential conflict of interest relevant to this article was reported.

‰ªŽR‘åŠw‹³ˆç�„�i‹@�\ Acta Medica Okayama 1881-5952 3 2026 •\Ž†�E–ÚŽŸ EN No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 2050-3911 2026 2 2026 Feedback-Controlled Beam Pattern Measurement Method Using a Power-Variable Calibration Source for Cosmic Microwave Background Telescopes 023F01 EN Haruaki Hirose Department of Physics, Graduate School of Engineering Science, Yokohama National University Masaya Hasegawa Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK) Daisuke Kaneko International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK) Taketo Nagasaki Accelerator Laboratory (ACCL), High Energy Accelerator Research Organization (KEK) Ryota Takaku Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Tijmen de Haan Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK) Satoru Takakura Department of Physics, Faculty of Science, The University of Tokyo Takuro Fujino International Center for Quantum-field Measurement Systems for Studies of the Universe and Particles (WPI-QUP), High Energy Accelerator Research Organization (KEK) We demonstrate a novel beam pattern measurement method for the side lobe characterization of cosmic microwave background telescopes. The method employs a power-variable artificial microwave source under feedback control from the detector under test on the telescope. It enables us to extend the dynamic range of the beam pattern measurement without introducing nonlinearity effects from the detector. We conducted a laboratory-based proof-of-concept experiment, measuring the H-plane beam pattern of a horn antenna coupled to a diode detector at 81 GHz. We gained an additional dynamic range of 60.3 dB attributed to the feedback control. In addition, we verified the measurement by comparing it with other reference measurements obtained using conventional methods. The method is also applicable to general optical measurements requiring a high dynamic range to detect subtle nonidealities in the characteristics of optical devices. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2079-9292 14 24 2025 An AI-Driven System for Learning MQTT Communication Protocols with Python Programming 4967 EN Zihao Zhu Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Htoo Htoo Sandi Kyaw Department of Information and Communication Systems, Okayama University I Nyoman Darma Kotama Department of Information and Communication Systems, Okayama University Anak Agung Surya Pradhana Department of Information and Communication Systems, Okayama University Alfiandi Aulia Rahmadani Department of Information and Communication Systems, Okayama University Noprianto Department of Information and Communication Systems, Okayama University With rapid developments of wireless communication and Internet of Things (IoT) technologies, an increasing number of devices and sensors are interconnected, generating massive amounts of data in real time. Among the underlying protocols, Message Queuing Telemetry Transport (MQTT) has become a widely adopted lightweight publish–subscribe standard due to its simplicity, minimal overhead, and scalability. Then, understanding such protocols is essential for students and engineers engaging in IoT application system designs. However, teaching and learning MQTT remains challenging for them. Its asynchronous architecture, hierarchical topic structure, and constituting concepts such as retained messages, Quality of Service (QoS) levels, and wildcard subscriptions are often difficult for beginners. Moreover, traditional learning resources emphasize theory and provide limited hands-on guidance, leading to a steep learning curve. To address these challenges, we propose an AI-assisted, exercise-based learning platform for MQTT. This platform provides interactive exercises with intelligent feedback to bridge the gap between theory and practice. To lower the barrier for learners, all code examples for executing MQTT communication are implemented in Python for readability, and Docker is used to ensure portable deployments of the MQTT broker and AI assistant. For evaluations, we conducted a usability study using two groups. The first group, who has no prior experience, focused on fundamental concepts with AI-guided exercises. The second group, who has relevant background, engaged in advanced projects to apply and reinforce their knowledge. The results show that the proposed platform supports learners at different levels, reduces frustrations, and improves both engagement and efficiency. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 80 1 2026 Kinesiophobia Is Associated with Disability, Poor Quality of Life, Psychological Morbidity, and Surgery Dissatisfaction in Patients with Lumbar Microdiscetomy: A Cross-Sectional Controlled Study 39 46 EN Nihal Tezel Department of Physical and Rehabilitation Medicine, Health Sciences University Aslı Gençay Can Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Ankara Yıldırım Beyazıt University Original Article 10.18926/AMO/70071 The study aimed to determine the prevalence of kinesiophobia in patients who had undergone lumbar microdiscectomy and to examine its associations with pain intensity, disability, quality of life, depression, anxiety, and satisfaction with surgery. Forty-eight patients with microdiscectomy and 48 healthy controls were enrolled. The Tampa Scale for Kinesiophobia (TSK), Roland-Morris Disability Index (RMDI), Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and Short Form-36 Health Survey (SF-36) were administered to both groups. The scores of TSK, RMDI, HADS-A, and HADS-D were significantly higher and SF-36 scores were significantly lower in the microdiscectomy than the control group (p<0.001 for all). In the microdiscectomy group, median (min-max) RMDI, HADS-A, and HADS-D scores were 19 (4-34), 10 (0-18), and 9 (0-18), respectively, in kinesiophobic patients, and were significantly higher than 6 (2-20), 3 (0-11), 2.5 (0-11) in non-kinesiophobic patients (all p<0.001). The median (min-max) SF-36 PCS, SF-36 MCS, and VAS scores for surgery satisfaction were 36.5 (8.7-75), 52.1 (11-95), 5, 5 (0-10), respectively, in kinesiophobic patients and were significantly lower than 71 (28-95), 85.5 (9-93), 8.5 (3-10) in non-kinesiophobic patients (all p<0.05). TSK scores were significantly correlated with RMDI, HADS-A, HADS-D, SF-36, and surgery satisfaction scores (all p<0.05). Kinesiophobic patients with lumbar microdiscectomy therefore showed greater disability and psychological morbidity, poorer quality of life, and lower satisfaction with surgery. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0022-3492 2026 A retrospective cohort study comparing periodontal regeneration using fibroblast growth factor�]2 versus autologous bone graft EN Toshiki Matsumoto Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin Nakamura Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Ito�]Shinoda Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Mai Sakamoto Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takayuki Ishii Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasuki Nonomura Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hidetaka Ideguchi Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keisuke Okubo Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital Kazu Takeuchi�]Hatanaka Department of Periodontics and Endodontics, Division of Dentistry, Okayama University Hospital Kazuhiro Omori Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tadashi Yamamoto The Center for Graduate Medical Education (Dental Division), Okayama University Hospital Shogo Takashiba Department of Pathophysiology–Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background: Fibroblast growth factor-2 (FGF-2) is a novel agent utilized in periodontal regeneration therapy. However, its clinical efficacy compared with autologous bone graft (ABG), a long-established treatment, remains unclear. This study aimed to compare the clinical outcomes of FGF-2 and ABG and to assess the impact of patient background factors on outcomes when using FGF-2.<br> Methods: We collected the subjects from January 2013 to September 2023. Clinical outcomes included the vertical bone defect improvement rate (VBDIR) and the probing pocket depth improvement (PPDI). Clinical outcomes between the two groups were compared using analysis of covariance (ANCOVA), adjusting for age, sex, smoking history, and hypertension. Additionally, a multilevel linear analysis was performed to assess factors influencing outcomes in FGF-2.<br> Results: A total of 180 sites from 141 patients (FGF-2: 150 sites; ABG: 30 sites) were evaluated. Both VBDIR and PPDI significantly improved postoperatively in both groups. There were no significant differences in clinical outcomes between FGF-2 and ABG. In FGF-2, smoking history was positively associated, while the preoperative bone defect angle (BDA) was negatively associated with clinical outcomes.<br> Conclusions: FGF-2 might exhibit clinical outcomes comparable to those of ABG, suggesting it is a clinically viable alternative for vertical bone defects. When using FGF-2, patient-specific factors such as smoking history and preoperative BDA should be considered carefully.<br> The name in the trial registry: A survey of clinical practice and evaluation of treatment outcomes of periodontal regenerative therapy using REGROTH at Okayama University Hospital No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2059-3635 11 1 2026 Osimertinib inhibits the MYLK4-mediated phosphorylation of CDKAL1 to suppress stemness and chemoresistance in rhabdomyosarcoma 26 EN Takuto Itano Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Rongsheng Huang Department of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Eiji Nakata Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Atsushi Fujimura Department of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1687-8728 2026 1 2026 Experimental Analysis of Automatic Discrimination Performance Between Simulated Bruxism and Non�]Bruxism Under Conscious Conditions Using Electromyography and Machine Learning 7874254 EN Hajime Minakuchi Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mitsuhiro Nagasaki Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo Lộc Hoàng Đình Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Haruna Miki Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ko Omori Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tazuko Nishimura Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo Takuo Kuboki Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nobuaki Minematsu Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo Purpose: This study aimed to evaluate the potential use of machine learning to automatically classify electromyography (EMG) data into bruxism simulated movement with tooth contact (BMwTC), bruxism simulated movement without tooth contact (BMwoTC), and non-bruxism movement (non-BM).<br> Methods: Twelve eligible healthy participants (female/male: 2/10, mean age: 35.3 �} 8.4 years) were asked to perform the simulated movements (all the tasks were performed five times for 5 s each with a 30-s rest interval). The electrodes were placed on the masseter, infrahyoid, inframandibular, and chin muscles. A sound sensor was placed adjacent to the masseter. The EMG and sound data were sampled at 1 and 44.1 kHz, respectively. Single- and multi-stream hidden Markov models (HMMs) were used to automatically discriminate the tested behavior from the others using a hamming window with 100 ms and shift length of 50 ms. The leave-one-out method was used for training and testing the model, with data from 11 participants used for training and one for testing. Each participant was evaluated, and the final performance was measured by averaging the results of 12 classification trials. The validity of the discrimination was assessed by calculating the harmony mean values using six EMG signals and the sound data.<br> Results: The masseter EMG demonstrated significantly higher discrimination accuracy in the single-stream model (p  < 0.05, One-way ANOVA, Tukey HDS). The multi-stream model also demonstrated higher accuracy; however, no significant difference was observed. Notably, the accuracy of BMwoTC was less than 0.5.<br> Conclusion: The machine-learning-based discriminative system accurately discriminates BMwTC from non-BM using masseter EMG. No potential conflict of interest relevant to this article was reported.

BMJ Acta Medica Okayama 2044-6055 15 12 2025 Effectiveness of education programme to increase competency of health cadres in Indonesia: a cluster non-randomised controlled trial e095428 EN Dewie Sulistyorini Graduate School of Biomedical and Health Sciences, Hiroshima University K A T M Ehsanul Huq Graduate School of Biomedical and Health Sciences, Hiroshima University Abdulfatai Olamilekan Babaita Graduate School of Biomedical and Health Sciences, Hiroshima University Sadia A Aivey Graduate School of Biomedical and Health Sciences, Hiroshima University Gao Huiying Graduate School of Biomedical and Health Sciences, Hiroshima University Kana Kazawa Faculty of Health Sciences, Okayama University Yasuko Fukushima Graduate School of Biomedical and Health Sciences, Hiroshima University Mayumi Kako Graduate School of Biomedical and Health Sciences, Hiroshima University Michiko Moriyama Graduate School of Biomedical and Health Sciences, Hiroshima University Objectives Health cadres, who assist midwives in supporting pregnant women in community settings, need to enhance their competencies in identifying risk factors and referring high-risk pregnant women to midwives for further care. Since the capabilities of these health cadres are influenced by maternal complications, an educational programme was implemented to strengthen their skills. Therefore, this study aimed to evaluate the competency of health cadres by providing a researcher-developed educational programme.<br> Design An open-label, cluster non-randomised controlled trial.<br> Setting and participants Health cadres with at least 1 year of work experience were recruited at six public health centres (PHCs) in Banjarnegara Regency, Indonesia.<br> Interventions Six PHCs were selected and allocated into intervention group (IG=3 PHCs) and control group (CG=3 PHCs) groups. A total of 133 female health cadres were enrolled across the selected PHCs. At each PHC, a systematic random sampling method was used to select the participants. The researchers and health professionals provided a 3-week period of theoretical and scenario-based simulations to the IG, while the CG received no education.<br> Outcome measures Researcher-developed questionnaires and checklists were used to assess the knowledge, skills (health assessment, communication, attitude) and confidence. The primary endpoint was competency, a total score of knowledge and skills. The outcome domains were compared between the two groups, and a linear mixed-effect model was used to account for cluster-level variation.<br> Results A total of 130 (97.7%) completed the study (IG:64, CG:66). The competency score showed significant improvement at endline (CG=49.5 and IG=52.5; p=0.002). The median scores for health assessment skills (CG=12 vs IG=14; p<0.001) and communication skills (CG=7 vs IG=8; p<0.001) were increased in the IG compared with the CG. Mixed-effect model indicated that groups (ƒÀ (95% CI) 2.49 (0.57 to 4.41), p=0.012), baseline knowledge (ƒÀ(95% CI) 0.73 (0.54 to 0.92), p<0.001) and midline health assessment skills (ƒÀ (95% CI) 0.54 (0.25 to 0.82), p<0.001) were significant positive predictors, while age was negatively associated with competency (ƒÀ (95% CI) �|0.20 (�|0.30 to �|0.10), p<0.001)).<br> Conclusion Education effectively increased the competency of health cadres. A well-structured education programme is necessary for health cadres to improve and maintain their competencies in monitoring high-risk pregnant women.<br> Trial registration number NCT06134518. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 2211-1247 45 1 2026 Immunopeptidomics combined with full-length transcriptomics uncovers diverse neoantigens 116781 EN Takamasa Ishino Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Tomofumi Watanabe Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Serina Tokita Division of Cancer Immunology, Graduate School of Medical and Dental Sciences, Niigata University Youki Ueda Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Katsushige Kawase Division of Cell Therapy, Chiba Cancer Center Research Institute Yuka Takano Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Yin Min Thu Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Yuta Suzuki Department of Computational Biology and Medical Sciences, The University of Tokyo Chie Owa Department of Computational Biology and Medical Sciences, The University of Tokyo Takashi Inozume Department of Dermatology, Chiba University Graduate School of Medicine Wenhao Zhou Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Joji Nagasaki Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Vitaly Kochin Department of Immunology, Nagoya University Graduate School of Medicine Toshihide Ueno Division of Cellular Signaling, National Cancer Center Research Institute Shinya Kojima Division of Cellular Signaling, National Cancer Center Research Institute Akiko Honobe-Tabuchi Department of Dermatology, University of Yamanashi Tatsuyoshi Kawamura Department of Dermatology, University of Yamanashi Takehiro Ohnuma Department of Dermatology, Kumamoto Kenhoku Hospital Takamitsu Matsuzawa Department of Dermatology, Chiba University Graduate School of Medicine Yu Kawahara Department of Dermatology, Chiba University Graduate School of Medicine Kazuo Yamashita KOTAI Biotechnologies, Inc Jason Lin Division of Cell Therapy, Chiba Cancer Center Research Institute Jun Koseki Division of Systems Biology, Nagoya University Graduate School of Medicine Hiroyoshi Nishikawa Department of Immunology, Nagoya University Graduate School of Medicine Motoo Araki Department of Urology, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Naoya Kato Department of Gastroenterology, Graduate School of Medicine, Chiba University Teppei Shimamura Division of Systems Biology, Nagoya University Graduate School of Medicine Shinichi Morishita Department of Computational Biology and Medical Sciences, The University of Tokyo Yutaka Suzuki Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo Hiroyuki Mano Division of Cellular Signaling, National Cancer Center Research Institute Toshihiko Torigoe Takayuki Kanaseki Division of Cancer Immunology, Graduate School of Medical and Dental Sciences, Niigata University Masahito Kawazu Division of Cell Therapy, Chiba Cancer Center Research Institute Yosuke Togashi Department of Tumor Microenvironment, Okayama University, Graduate School of Medicine Dentistry and Pharmaceutical Sciences Neoantigens are crucial for antitumor immunity and immune checkpoint inhibitor (ICI) efficacy by triggering strong immune responses. However, conventional methods for identifying neoantigens, such as whole-exon sequencing and short-read RNA sequencing (RNA-seq), appear to be insufficient, and the tumor mutational burden cannot sufficiently predict ICI efficacy. In this study, we employed a proteogenomic approach using long-read RNA-seq with Pacific Biosciences Single-Molecule Real-Time Sequencing technology to analyze full-length transcripts in combination with the human leukocyte antigen ligandome. As a result, many neoantigen candidates were identified, which were unregistered in a comprehensive database, including those from non-coding regions. Additionally, we validated the responses of specific T cell receptors (TCRs) to these candidates and identified several pairs of TCRs and neoantigens. These findings highlight the presence of more diverse neoantigens than expected that cannot be identified by conventional methods. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 2328-8957 13 1 2025 Impact of Candida Care Bundle Compliance on the Prognosis of Patients With Candidemia: A Multicenter Retrospective Cohort Study With Propensity Score Matching Analysis (2016–2023) ofaf790 EN Hidemasa Akazawa Department of Infectious Diseases, Okayama University Hospital Shinnosuke Fukushima Department of Infectious Diseases, Okayama University Hospital Toshie Higuchi Department of General Internal Medicine, Okayama Red Cross Hospital Tomoko Miyoshi Center for Medical Education and Internationalization, Kyoto University Graduate School of Medicine Yasuhiro Nakano Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koji Iio Microbiology Division, Clinical Laboratory, Okayama University Hospital Yukinobu Akamatsu Department of General Medicine, Tottori Municipal Hospital Yuto Haruki Department of Pharmacy, Tsuyama Chuo Hospital Yoshitaka Iwamoto Department of General Medicine, NHO Okayama Medical Center Shuichi Tanaka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shun Fujisato Department of Pharmacy, Okayama Rousai Hospital Soichiro Ako Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Background. Candidemia is a life-threatening infection with high mortality, and appropriate management is essential to improve patient outcomes. The Candida Care Bundle aims to standardize hospital management for patients with candidemia and reduce mortality.<br> Methods. This retrospective multicenter cohort study included candidemia cases from 9 hospitals in Japan between 2016 and 2023. Compliance to the Candida Care Bundle was evaluated based on 5 elements: central venous catheter removal within 24 hours, appropriate antifungal therapy, ophthalmologic examination, follow-up blood cultures, and antifungal treatment for ≥2 weeks after clearance. Patients were categorized into high (4–5 items) and low (0–3 items) compliance groups. The primary and secondary outcomes were defined as 30-day survival and the development of endophthalmitis, with propensity score matching used to adjust for potential confounders.<br> Results. Among 230 patients, 160 (69.5%) were classified into the high compliance group, which exhibited significantly lower 30-day mortality than the low compliance group (8.8% vs 57.1%, P < .01). Even after matching, the high compliance group remained independently associated with improved survival (hazard ratio [HR]: 0.15; 95% confidence interval [CI]: .08–.30). C. albicans (HR: 1.95; 95% CI: 1.01–3.52) and central line-associated bloodstream infection (HR: 2.63; 95% CI: 1.35–5.12) were associated with the fatal outcome. Endophthalmitis involved 23.6% of the patients, being associated with C. albicans (odds ratio [OR]: 8.18; 4.46–19.30) and central line-associated bloodstream infection (OR: 2.69; 1.08–6.70).<br> Conclusions. Strict compliance to the Candida Care Bundle significantly improves survival, underscoring its importance in candidemia management. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0029-6473 2026 1 2026 Knowledge and Attitudes Toward Pain Management Among Nurses in University-Affiliated Hospitals in Western Japan: A Cross-Sectional Study 9991157 EN Mengyao Xi Graduate School of Health Sciences, Okayama University, Yuki Kajiwara Faculty of Health Sciences, Okayama University Takako Hiramatsu Department of Nursing, Kawasaki Medical School Hospital Michiko Morimoto Faculty of Health Sciences, Okayama University Background: Pain is a major global concern. Nurses�f knowledge and attitudes toward pain management are critical determinants of pain care quality and patient outcomes, making them essential for effective clinical practice.<br> Objective: This study aimed to assess nurses�f pain management knowledge and attitudes using the Japanese version of the Knowledge and Attitudes Survey Regarding Pain (J-KASRP), applied for the first time in Japan, and to examine how background factors affect these aspects.<br> Methods: A descriptive, cross-sectional survey was conducted with 1589 nurses in three university-affiliated hospitals in Western Japan. Data were collected using a questionnaire capturing sociodemographic information and the J-KASRP. Descriptive statistics, t-tests, one-way ANOVA, and effect size were used to analyze J-KASRP scores and subdomains. Tukey�fs honestly significant difference test was applied for post hoc comparisons across clinical experience patterns.<br> Results: Of 1001 respondents, 856 valid responses (85.5%) were analyzed. The mean age was 30.1 years (SD = 8.3), and the mean total correct response rate for the J-KASRP was 59.8%; only 1.3% scored ≥ 80%. Cancer-related pain had the lowest J-KASRP subdomain score (42.5%, SD = 20.3%). Higher total J-KASRP scores were found for those with a higher level of education, prior clinical pain education, and recent opioid administration experience (all p < 0.001, effect size > 0.2). In an exploratory pattern analysis, regardless of education level, respondents with both education and opioid administering experience had the highest total and pharmacology subdomains�f scores. No significant differences in cancer-related pain subdomain were observed across patterns of clinical experiences.<br> Conclusions: This first application of the J-KASRP in Japan revealed that nurses�f pain management knowledge and attitudes need to be strengthened, especially for cancer-related pain and opioid pharmacology. The study findings highlight the importance of pain management strengthening education and training to enhance nurses�f evidence-based knowledge and clinical competence. No potential conflict of interest relevant to this article was reported.

American Chemical Society (ACS) Acta Medica Okayama 2694-2445 5 6 2025 Electronic Structure of the S1 State Manganese Cluster in Photosystem II Investigated Using Q-Band Selective Hole-Burning 660 671 EN Shinya Kosaki Department of Physics, Graduate School of Science, Nagoya University Naohiko Nakamura Department of Physics, Graduate School of Science, Nagoya University Yoshiki Nakajima Research Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Jian-Ren Shen Research Institute for Interdisciplinary Science, Advanced Research Field, and Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Hiroyuki Mino Department of Physics, Graduate School of Science, Nagoya University The electronic structure of the S1 state of photosystem II (PSII) was investigated using selective hole burning of Q-band pulsed electron paramagnetic resonance. The free induction decay and spin–echo signals of the tyrosine radical YD• in the plant PSII oscillated because of the magnetic dipole–dipole interaction with the S1 state Mn cluster. The initial period was 410 ns (2.44 MHz) and was assigned to the S = 1 spin state. Based on the oscillation analysis, both Mn1 and Mn4 and both Mn2 and Mn3 were assigned as Mn(III) and Mn(IV), respectively, which is consistent with the quantum chemical calculations. The 410 ns period was accounted for in the simplified model using the isotropic spin density distribution ratio [1.6:–1.1:–1.1:1.6] for Mn1–4 ions. This oscillation was identical with that observed in the presence of methanol. The oscillation decreased in PsbP/Q- and PsbO/P/Q-depleted PSII. In Thermosynechococcus vulcanus, two periods, 390 ns (2.56 MHz) and 630 ns (1.59 MHz), were detected, indicating that the cyanobacterial S1 state includes two isomers, S = 1 and S ≥ 2 spins. The S ≥ 2 spin was not detected in PsbO/U/V-depleted PSII without polyethylene glycol. The S ≥ 2 state was consistent with the reported quantum chemical calculation using S = 3. A simplified model accounted for the S = 1 state as the spin density distribution [1.8:–1.3:–1.3:1.8] and for the S ≥ 2 state as the isotropic spin density distribution [�|0.5:0.5:0.5:0.5] for Mn1–4 ions. In combination with quantum chemical calculations, the most probable protonated structure is W1 = H2O, W2 = H2O, O4 = O2–, and O5 = O2– for the S1 state. These results demonstrate that the selective hole burning method is a powerful tool to complement X-ray studies to determine the valence and protonation structure of manganese clusters, not only in the S1 state but also in higher S-states and general metal clusters, which would provide important insights into the water oxidation mechanism. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0301-486X 190 6 2025 Prognostic Value of Serum (1�¨3)-ƒÀ-D-Glucan Levels in Patients with Candidemia Stratified by Compliance with Candida Bundle: A Multicenter Retrospective Cohort Study (2016–2023) 90 EN Hidemasa Akazawa Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinnosuke Fukushima Department of Infectious Diseases, Okayama University Hospital Toshie Higuchi Department of General Internal Medicine, Okayama Red Cross Hospital Tomoko Miyoshi Center for Medical Education and Internationalization, Kyoto University Graduate School of Medicine Yasuhiro Nakano Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koji Iio Microbiology Division, Clinical Laboratory, Okayama University Hospital Yukinobu Akamatsu Department of General Medicine, Tottori Municipal Hospital Yuto Haruki Department of Pharmacy, Tsuyama Chuo Hospital Yoshitaka Iwamoto Department of General Medicine, NHO Okayama Medical Center Shuichi Tanaka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shun Fujisato Department of Pharmacy, Okayama Rousai Hospital Soichiro Ako Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Background Candidemia is a severe systemic infection with a high mortality risk. While ƒÀ-D-glucan (BDG) serves as a diagnostic biomarker, its prognostic value in candidemia, particularly in association with Candida bundle compliance, remains unclear.<br> Methods In this retrospective multicenter cohort study, we evaluated 96 patients with candidemia across nine Japanese hospitals between 2016 and 2023. Candida bundle compliance was assessed using five key components: central venous catheter removal within 24 h of diagnosis, appropriate initial antifungal therapy, ophthalmologic examination, follow-up blood cultures until clearance, and antifungal therapy for at least two weeks post-clearance. Analyses stratified patients by serum BDG status (positive/negative) and compliance with the Candida bundle (high: 4–5 points; low: 0–3 points). The primary outcome was 30-day mortality, and the secondary outcome was defined as endophthalmitis incidence.<br> Results Of 96 eligible patients with candidemia, 70 (72.9%) were BDG-positive and 26 (27.1%) were BDG-negative. The overall 30-day mortality was 17.7%. Among BDG-positive patients, 15 (21.4%) died, while 2 (7.7%) died in BDG-negative cohorts (p = 0.09). Serum BDG positivity demonstrated a statistically significant association with decreased survival rates in the low bundle adherence group (p = 0.02), whereas this correlation was not observed among patients in the high-compliance cohort (p = 0.66). Endophthalmitis occurred in 25.0% of patients, without significant correlation to serum BDG status. C. albicans was associated with a significantly higher incidence of endophthalmitis compared with non-albicans species (45.7% vs. 8.9%).<br> Conclusions Serum BDG positivity potentially correlates with worse survival in candidemia, particularly in patients with low bundle compliance. This emphasizes the importance of adherence to standardized Candida management protocols for optimizing patient outcomes. No potential conflict of interest relevant to this article was reported.

Public Library of Science (PLoS) Acta Medica Okayama 1932-6203 20 9 2025 Impact of COVID-19 on the awareness and interest in infectious disease specialization among Japanese medical students e0329451 EN Naruto Kamada Faculty of Medicine, Wakayama Medical University Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Satoshi Kutsuna Department of Infection Control and Prevention, Graduate School of Medicine, Osaka University Background<br> The SARS-CoV-2 pandemic has highlighted the critical deficiency of infectious disease (ID) specialists, a subspecialty that remains underrepresented among Japanese medical students.<br> Methods<br> This nationwide cross-sectional survey was administered between April and August 2024 via an online questionnaire distributed to medical students throughout Japan. The survey assessed awareness of and interest in ID specialization, categorizing students by academic year: lower (first- and second-year students), middle (third- and fourth-year students), and upper grades (fifth- and sixth-year students).<br> Results<br> Of 502 respondents, data for 492 medical students were eligible, of whom 69.7% demonstrated awareness of ID specialists, with recognition rates increasing proportionally with academic progression. Regarding career aspirations, 9.8% of respondents expressed interest in pursuing ID specialization, with the highest proportion observed among upper-grade students (19.4%). Male students (14.8%) expressed greater interest in ID specialization than female students (5.2%). The pandemic positively influenced 5.5% of students to consider ID specialization as a future career, whereas only 0.6% reported a negative impact.<br> Conclusions<br> These findings underscore the necessity of enhanced educational initiatives to promote ID specialization among medical students, addressing current shortages and future infectious disease preparedness. No potential conflict of interest relevant to this article was reported.