MDPI AG Acta Medica Okayama 2075-1729 16 10 2026 Purification, Structural Characterization, and Genomic Insights of an Anti-MRSA Peptide from Mangrove-Derived Brevibacillus sp. A34 1697 EN Thanyamai Thongin School of Pharmacy, Walailak University Namfa Sermkaew School of Pharmacy, Walailak University Apichart Atipairin School of Pharmacy, Walailak University Sucheewin Krobthong Center of Excellence in Natural Products Chemistry (CENP), Department of Chemistry, Faculty of Science, Chulalongkorn University Chanat Aonbangkhen Center of Excellence in Natural Products Chemistry (CENP), Department of Chemistry, Faculty of Science, Chulalongkorn University Jumpei Uchiyama Department of Infectious Diseases, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan Nuttapon Songnaka School of Pharmacy, Walailak University The widespread prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in community and healthcare settings has driven the urgent search for novel antibacterial agents. Mangrove sediments are an underexplored source of antimicrobial-producing bacteria. This study characterized an antimicrobial fraction and the genome of the mangrove-derived isolate Brevibacillus sp. A34. The active fraction was purified via ammonium sulfate precipitation, cation-exchange chromatography, and reversed-phase chromatography. De novo MS/MS analysis assigned the octapeptide LLLLLLAH (905.19 Da), designated as A34 AMP, which was further confirmed by chemical synthesis. This active peptide inhibited all four tested S. aureus strains, including three MRSA strains, with a minimum inhibitory concentration (MIC) of 62 µg/mL. At 2× and 4× MIC, A34 AMP exhibited a concentration-dependent bactericidal effect within 20 h. Increased SYTOX Green uptake and morphological alterations supported a membrane permeabilization mechanism, and antimicrobial activity was retained following thermal, pH, protease, and surfactant treatments. Genome mining identified 23 putative biosynthetic gene clusters, including an 11-module nonribosomal peptide synthetase (NRPS) cluster linked to A34 AMP through three-dimensional adenylation-domain modeling. Collectively, these findings highlight A34 AMP from Brevibacillus sp. A34 as a promising bioactive anti-staphylococcal peptide scaffold. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0959-8049 248 2026 Molecular characteristics and clinical outcomes of ERBB2-activating mutation-positive non-small cell lung cancer: A Japanese nationwide real-world cohort 117443 EN Masahiro Yamashita Department of Respiratory Medicine, Okayama University Hospital Kiichiro Ninomiya Department of Respiratory Medicine, Okayama University Hospital Shuta Tomida Center for Comprehensive Genomic Medicine, Okayama University Hospital Eiji Nakata Center for Comprehensive Genomic Medicine, Okayama University Hospital Ayako Morita Department of Respiratory Medicine, Okayama University Hospital Naofumi Hara Department of Respiratory Medicine, Okayama University Hospital Kenji Takada Department of Respiratory Medicine, Okayama University Hospital Go Makimoto Department of Respiratory Medicine, Okayama University Hospital Toshio Kubo Department of Respiratory Medicine, Okayama University Hospital Eiki Ichihara Department of Respiratory Medicine, Okayama University Hospital Kadoaki Ohashi Department of Respiratory Medicine, Okayama University Hospital Katsuyuki Hotta Department of Respiratory Medicine, Okayama University Hospital Yosuke Togashi Department of Respiratory Medicine, Okayama University Hospital Yoshinobu Maeda Center for Comprehensive Genomic Medicine, Okayama University Hospital Daisuke Ennishi Center for Comprehensive Genomic Medicine, Okayama University Hospital Background: Erb-b2 receptor tyrosine kinase 2 (ERBB2)-activating mutations are well-documented oncogenic drivers in non-small cell lung cancer (NSCLC), occurring in approximately 1–4% of cases. These alterations include a heterogeneous spectrum of variant subtypes; however, the clinicogenomic characteristics and clinical significance of the individual variants have yet to be elucidated.<br> Methods: We searched the nationwide Center for Cancer Genomics and Advanced Therapeutics database, which integrates comprehensive genome profiling data generated in routine clinical practice across Japan, to investigate the molecular landscape and clinical outcomes of patients with ERBB2-mutated NSCLC.<br> Results: A total of 319 patients with ERBB2-activating mutations were included in this retrospective analysis. Although 74% of the patients harbored canonical tyrosine kinase domain (TKD) in-frame insertions, 26% carried noncanonical variants, including TKD missense (8%), transmembrane/juxtamembrane domain (10%), and extracellular domain (ECD) mutations (8%). Co-occurring oncogenic driver alterations were identified in only 18 cases (5.6%) and were largely restricted to noncanonical variants, whereas no co-occurring driver alterations were detected among patients with TKD in-frame mutations. Noncanonical variants—TKD missense and ECD mutations in particular—were associated with an increased tumor mutational burden. Among 288 patients with available survival data, 78 (27%) received trastuzumab deruxtecan (T-DXd) during their clinical course. After excluding patients who had started treatment with T-DXd before undergoing comprehensive genome profiling testing, time-dependent T-DXd exposure was associated with a reduced risk of death (adjusted hazard ratio, 0.63; 95% confidence interval, 0.39–1.01; P = 0.057).<br> Conclusions: ERBB2-mutated NSCLC exhibited substantial molecular heterogeneity, with canonical TKD in-frame insertions characterized by a low frequency of co-occurring oncogenic driver alterations. Among patients harboring ERBB2-activating mutations, exposure to T-DXd was associated with improved overall survival. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1432-0851 74 3 2025 Novel combination therapy for platinum-eligible patients with locally advanced or metastatic urothelial carcinoma: a systematic review and network meta-analysis 76 EN Takafumi Yanagisawa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Keiichiro Mori Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Akihiro Matsukawa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Tatsushi Kawada Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ekaterina Laukhtina Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Pawel Rajwa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Fahad Quhal Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Wataru Fukuokaya Department of Urology, The Jikei University School of Medicine Kosuke Iwatani Department of Urology, The Jikei University School of Medicine Renate Pichler Department of Urology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck Jeremy Yuen-Chun Teoh S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong Marco Moschini Department of Urology, San Raffaele Hospital and Scientific Institute Wojciech Krajewski Department of Minimally Invasive and Robotic Urology, Wrocław Medical University Jun Miki Department of Urology, The Jikei University School of Medicine Shahrokh F. Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Takahiro Kimura Department of Urology, The Jikei University School of Medicine European Association of Urology–Young Academic Urologists Urothelial Carcinoma Working Group (EAU-YAU) Recent phase 3 randomized controlled trials (RCTs) demonstrate the promising impact of immune checkpoint inhibitor (ICI)-based combination therapies on locally advanced or metastatic urothelial carcinoma (UC). However, comparative data on the efficacy and toxicity of different ICI-based combinations are lacking. This study aims to compare the efficacy of first-line ICI-based combination therapies for locally advanced or metastatic UC using phase 3 RCT data. In November 2023, three databases were searched for RCTs evaluating oncological outcomes in patients with locally advanced or metastatic UC who were treated with first-line ICI-based combination therapies. Network meta-analysis (NMA) was conducted to compare outcomes, including overall survival (OS), progression-free survival (PFS), objective response rates (ORRs), complete response rates (CRRs), and treatment-related adverse events (TRAEs). Subgroup analyses were based on PD-L1 status and cisplatin eligibility. The NMA included five RCTs. Enfortumab vedotin (EV) + pembrolizumab ranked the highest for improving OS (100%), PFS (100%), ORR (96%), and CRR (96%), followed by nivolumab + chemotherapy. EV + pembrolizumab combination superiority held across PD-L1 status and cisplatin eligibility. In patients who are cisplatin-eligible, EV + pembrolizumab significantly improved OS (HR: 0.68, 95%CI 0.47–0.99) and PFS (HR: 0.67, 95%CI 0.49–0.92) compared to nivolumab + chemotherapy. Durvalumab + tremelimumab was the safest combination for severe TRAEs, and EV + pembrolizumab ranked second. Our analyses support EV + pembrolizumab combination as a first-line treatment for locally advanced or metastatic UC. Thus, EV + pembrolizumab may become a guideline-changing standard treatment. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 138 2 2026 自然脱落した子宮原発 DLBCL に対して Pola-R-CHP 療法と CNS 再発予防を行った１例 58 61 EN Hikaru Osada Department of Hematology, Japanese Red Cross Okayama Hospital Maiko Kimura Department of Hematology, Japanese Red Cross Okayama Hospital Manaka Muneishi Department of Hematology, Japanese Red Cross Okayama Hospital Kozo Murayama Department of Hematology, Japanese Red Cross Okayama Hospital Daigo Niiya Department of Hematology, Japanese Red Cross Okayama Hospital Makoto Takeuchi Department of Hematology, Japanese Red Cross Okayama Hospital Soichiro Fujii Department of Hematology, Japanese Red Cross Okayama Hospital 　A 55-year-old woman presented to her local physician with the chief complaint of genital bleeding. A 22×19-mm mass was noted on the patient's cervix, and during the internal examination the mass auto-amputated. The pathological examination of the auto-amputated mass revealed diffuse large B-cell lymphoma (DLBCL). An examination by F-fluorodeoxyglucose-positron emission tomography-computed tomography (FDG-PET-CT) showed FDG uptake at physiological levels in the cervix, with no abnormal uptake in other organs. Cervical tissue was sampled after the spontaneous detachment of the cervical mass, and the biopsy of the cervical mass did not reveal findings suggestive of lymphoma. Six courses of chemotherapy with polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisolone (Pola-R-CHP) plus an intramedually injection of methotrexate, cytarabine, and predonisolone (IT-triple), followed by two courses of high-dose intrathecal methotrexate (HD-MTX) were adiministered, and the patient has remained recurrence-free for the more than 8 months since the completion of this treatment. Primary uterine DLBCL is an extremely rare disease with a high rate of recurrence in the central nervous system and a poor prognosis. Our search of the relevant literature identified very few reports describing the prognoses of cases with spontaneous tumor detachment. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2059-1381 12 1 2026 Duration-stratified effects of exercise therapy on health-related quality of life in hemodialysis patients: a systematic review and meta-analysis 13 EN Yu Honda Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine Daisuke Uchida Department of Internal Medicine, Teikyo University Hospital Mizonokuchi Shigeki Kojima Kojima Kidney and Dialysis Clinic Hiromasa Miyake Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Masatoshi Nishimoto Department of Nephrology, Nara Medical University Akihito Hishikawa Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine Shun Tonomura Department of Endocrinology, Metabolism and Nephrology, Keio University School of Medicine Tadashi Sofue Department of Cardiorenal and Cerebrovascular Medicine, Kagawa University Naohiko Fujii Department of Nephrology, Hyogo Prefectural Nishinomiya Hospital Masakazu Saitoh Department of Physical Therapy, Faculty of Health Science, Juntendo University Ichiei Narita Niigata Institute for Health and Sports Medicine, Niigata Sports Association Kunihiro Yamagata Department of Nephrology, Institute of Medicine, University of Tsukuba Junichi Hoshino Department of Nephrology, Tokyo Women’s Medical University Hiroo Kawarazaki Department of Internal Medicine, Teikyo University Hospital Mizonokuchi Tsutomu Sakurada Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine Background: Patients on maintenance hemodialysis (HD) have reduced health-related quality of life (HRQoL). Structured exercise therapy is recommended, but domain-specific effects and the influence of intervention duration remain uncertain. This study evaluated the impact of structured exercise therapy on multiple HRQoL domains, including fatigue and depression, stratified by intervention duration.<br> Methods: We conducted a systematic review and meta-analysis, searching MEDLINE (PubMed) through November 2024. The protocol was registered in PROSPERO (CRD42025642273). We included trials comparing structured exercise with non-exercise controls in adult HD patients. Primary outcomes were Short Form (SF)-36 Physical and Mental Component Summaries (PCS, MCS), fatigue, pain, general health, and depression (Beck Depression Inventory). Data were synthesized using random-effects models, stratified by intervention duration (≤ 3 versus > 3 months). Risk of bias was assessed using the Cochrane RoB 2 tool.<br> Results: We identified 94 randomized controlled trials (5228 participants); 22 reported HRQoL outcomes and were meta-analyzed. Exercise significantly improved fatigue (mean difference [MD] + 7.27, 95% confidence interval [CI] 4.75–9.80) and reduced depressive symptoms in > 3-month trials (MD −7.62, 95% CI −8.34 to −6.90); no ≤ 3-month depression data were available. In overall analyses, general health (MD + 11.59, 95% CI 6.98–16.21) and PCS (MD + 5.83, 95% CI 0.71–10.94) improved, whereas MCS (MD + 7.60, 95% CI −3.75 to 18.94) and pain (MD + 2.19, 95% CI −4.41 to 8.79) showed no clear benefit. Short-term interventions (≤ 3 months) yielded significant improvements in pain and general health. In longer-term interventions (> 3 months), general health estimates were similar in magnitude but statistically nonsignificant, and pain effects were also nonsignificant with substantial heterogeneity. Fatigue improved in both duration strata.<br> Conclusions: Structured exercise therapy appears to improve fatigue in patients on maintenance HD and may provide additional gains in PCS and general health with interventions longer than 3 months. Improvements in depressive symptoms were observed from limited evidence, and duration-specific effects remain uncertain because no trials assessed depression at ≤ 3 months. Effects on pain and MCS remain uncertain owing to substantial heterogeneity. Larger long-term trials are needed to clarify the sustainability of HRQoL benefits beyond 3 months. No potential conflict of interest relevant to this article was reported.

AME Publishing Company Acta Medica Okayama 2304-3865 13 5 2024 Primary angiosarcoma of the breast: a literature review 68 EN Yidan Zhu Department of Breast Surgery, Liaoning Cancer Hospital & Institute Shogo Nakamoto Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Takahiro Tsukioki Department of Breast and Endocrine Surgery, Okayama University Hospital Yuko Takahashi Department of Breast and Endocrine Surgery, Okayama University Hospital Yoko Iwatani Department of Breast and Endocrine Surgery, Okayama University Hospital Tsuguo Iwatani Department of Breast and Endocrine Surgery, Okayama University Hospital Xinfeng Zhang Department of Breast Surgery, Liaoning Cancer Hospital & Institute Maki Tanioka Department of Clinical AI Human Resources Development Program, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Tadahiko Shien Department of Breast and Endocrine Surgery, Okayama University Hospital Background and Objective: Primary angiosarcoma of the breast (PBA) is an extremely rare and heterogeneous disease. PBA is difficult to diagnose and has a poor prognosis. In order to better understand the disease and provide evidence-based treatment for PBA patients, a review of the published literature in the English language was conducted.<br> Methods: A literature review in agreement with the PRISMA protocol was conducted. Medline and Cochrane databases were searched for English articles on PBA patients in September 2023 with a predetermined strategy. The articles were categorized and assessed based on hierarchical levels of scientific evidence.<br> Key Content and Findings: A total of 255 articles were identified, among these 137 publications which included 1,888 patients met the criteria for inclusion in the final analysis. No prospective, randomized trials exclusive to PBA have been recognized. This article provides an overview of the most current and comprehensive evidence concerning the epidemiology, etiology, genomic features, clinical presentations, diagnosis, treatment, and prognosis of PBA.<br> Conclusions: Despite the fact that current evidence is largely derived from retrospective studies, database analyses, and case reports, we utilized this information to tackle important clinical questions concerning optimal patient management practices for PBA. Complete surgical excision continues to be the mainstay treatment for PBA. However, the effectiveness of adjuvant therapies is still unclear. This narrative review highlights the urgent need for more rigorously designed research to enhance the management and treatment strategies for PBA. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 1439-7595 36 1 2025 Vaccination in paediatric, adolescent, and transitional-age rheumatic diseases: a systematic review 97 112 EN Takuma Ohnishi Department of Pediatrics, Keio University School of Medicine Hiroyuki Wakiguchi Division of General Pediatrics and Emergency Medicine, Department of Pediatrics, Oita University Faculty of Medicine Shingo Ishimori Department of Pediatrics, Kobe University Graduate School of Medicine Naohiro Itoh Faculty of Medical Sciences, Department of Pediatrics, University of Fukui Masato Yashiro Department of Pediatrics, Okayama University Hospital Susumu Yamazaki Department of Pediatrics and Adolescent Medicine, Juntendo University Graduate School of Medicine Ikuo Okafuji Department of Pediatrics, Kobe City Medical Center General Hospital Yoshiyuki Ohtomo Department of Pediatrics, Juntendo University Nerima Hospital Ichiro Kobayashi Center for Pediatric Allergy and Rheumatology, KKR Sapporo Medical Center Objectives: This systematic review evaluated the efficacy and safety of vaccination in patients with paediatric, adolescent, and transitional-age rheumatic diseases as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement.<br> Methods: An independent investigator systematically searched PubMed to identify relevant studies published by September 2022. The search results were divided into vaccines or toxoids for diphtheria, pertussis, tetanus, pneumococcus, influenza virus, hepatitis A virus, hepatitis B virus, human papillomavirus, poliovirus, measles virus, mumps virus, rubella virus, varicella zoster virus, and tuberculosis.<br> Results: A meta-analysis was not feasible due to the lack of randomized controlled trials with standardized patient backgrounds and conditions. Non-live vaccines are generally immunogenic and safe for patients with rheumatic diseases. In contrast, live attenuated vaccines should usually be withheld in patients on immunosuppressants, corticosteroids, biologics, or Janus kinase inhibitors. However, for necessary immunizations against measles, rubella, mumps, or varicella, live attenuated vaccines may be considered for patients receiving low-dose corticosteroids, methotrexate, or tumour necrosis factor inhibitors.<br> Conclusions This review highlights the significant gap in evidence for paediatric populations compared with adults, particularly concerning new biological therapies and Janus kinase inhibitors. Further evidence is needed regarding vaccination in paediatric patients with rheumatic diseases. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 2470-0010 113 5 2026 Analytical study of birefringent cavities for axionlike dark matter search 055009 EN Tadashi Kuramoto Research Institute for Interdisciplinary Science, Okayama University Yasutaka Imai Research Institute for Interdisciplinary Science, Okayama University Takahiko Masuda Research Institute for Interdisciplinary Science, Okayama University Yutaka Shikano Institute of Systems and Information Engineering, University of Tsukuba Sayuri Takatori Research Institute for Interdisciplinary Science, Okayama University Satoshi Uetake Research Institute for Interdisciplinary Science, Okayama University Light polarization plays a crucial role in optical-cavity experiments; however, mirror birefringence presents a significant challenge that must be addressed carefully. In this study, a rigorous, nonperturbative framework is developed to quantify birefringence effects by incorporating variations in reflectance and polarization misalignment. We analyze the impact of this framework on the sensitivity of axionlike particle (ALP) dark matter searches. The results show that both birefringence and misalignment contribute to sensitivity degradation in the low-mass regime; however, the adverse effects of misalignment can be mitigated by selecting a postselection angle greater than the misalignment angle. Furthermore, birefringence produces an additional resonance peak in the high-mass region, which remains largely unaffected by misalignment and postselection variations. This rigorous framework underscores the importance of considering birefringence in high-precision optical-cavity experiments for ALP detection. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1201-9712 166 2026 eConsult in infectious diseases: A narrative review 108524 EN Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Shinnosuke Fukushima Department of Infectious Diseases, Okayama University Hospital Hidemasa Akazawa Department of Infectious Diseases, Okayama University Hospital Kenta Nakamoto Department of Infectious Diseases, Okayama University Hospital Kohei Oguni Department of Infectious Diseases, Okayama University Hospital Objectives: Asynchronous electronic consultation, eConsult, is increasingly applied in infectious diseases (ID) management to improve access to specialty care and reduce unnecessary referrals. We aimed to integrate published studies to provide a comparative perspective and propose future directions for ID eConsult.<br> Methods: To synthesize relevant findings and present a comprehensive overview of ID eConsult, we searched in MEDLINE database and identified 11 studies between 2017 and 2025 on ID eConsult programs. Structured data were extracted on study characteristics, mode of consultation, and outcomes.<br> Results: Nine studies on outpatient ID eConsult demonstrated faster turnaround times, high rates of avoidance of in-person referrals (24-87%), improved antimicrobial optimization, and high provider satisfaction. Two studies on inpatient ID eConsult reported reductions in mortality, readmission rates, and broad-spectrum antibiotic use.<br> Conclusions: Given its affordability and scalability, the ID eConsult model is particularly advantageous in resource-limited environments. Collectively, ID eConsult may replace traditional telephone or face-to-face consultations, reducing the need for informal curbside discussions. 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’s 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 “community health workers,” “oral health,” and LMICs, based on the EPOC LMIC filter of the World Bank’s 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’ 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 1751-2433 2026 Treatment strategies for pulmonary arterial hypertension associated with adult congenital heart diseases EN Satoshi Akagi Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Shingo Kasahara Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kentaro Ejiri Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Kazufumi Nakamura Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Shinsuke Yuasa Department of Cardiovascular Medicine, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Introduction<br> The number of patients with adult congenital heart disease (ACHD) is gradually increasing worldwide due to advances in surgical techniques and pharmacological therapies. ACHD can lead to pulmonary arterial hypertension (PAH), and treatment strategies for PAH associated with ACHD have also evolved.<br> <br> Areas covered<br> Several PAH-targeted drugs including endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, soluble guanylate cyclase stimulators, and prostacyclin analogs are available for treatment of PAH. In this review, we summarized the current evidence regarding the use of PAH-targeted drugs in patients with PAH associated with ACHD. We also propose a ‘treat and repair’ strategy, which involves initial medical treatment to improve PAH followed by surgical or interventional repair of the systemic-to-pulmonary shunt. A PubMed literature search was conducted from 2000 to 2025.<br> <br> Expert opinion<br> In cases of PAH associated with a systemic-to-pulmonary cardiac shunt, advanced PAH-targeted drugs can improve hemodynamics, and reduce the risk of cardiac defect repair and further improvement in PAH. The treat and repair strategy represents a promising therapeutic approach for PAH patients associated with systemic-to-pulmonary shunts. No potential conflict of interest relevant to this article was reported.

American Physical Society (APS) Acta Medica Okayama 3070-2240 1 2026 Cryogenic buffer gas beam source with in situ ablation target replacement 000016 EN Zhen Han Department of Physics, University of Chicago Zack Lasner Department of Physics, Harvard University Collin Diver Center for Fundamental Physics, Northwestern University Peiran Hu Department of Physics, University of Chicago Takahiko Masuda Research Institute for Interdisciplinary Science, Okayama University Xing Wu Facility for Rare Isotope Beams, Michigan State University Ayami Hiramoto Research Institute for Interdisciplinary Science, Okayama University Maya Watts Center for Fundamental Physics, Northwestern University Satoshi Uetake Research Institute for Interdisciplinary Science, Okayama University Koji Yoshimura Research Institute for Interdisciplinary Science, Okayama University Xing Fan Department of Physics, Harvard University Gerald Gabrielse Center for Fundamental Physics, Northwestern University John M. Doyle Department of Physics, Harvard University David DeMille Department of Physics, University of Chicago The design and performance of a cryogenic buffer gas beam source with a load-lock system is presented. The third generation of advanced cold molecule electric dipole moment search (ACME III) uses this source to produce a beam of cold, slow thorium monoxide (ThO) molecules. A feature of the apparatus is the capability of replacing the ablation targets without interrupting the vacuum or cryogenic conditions, thus increasing the average signal in the eEDM search. The beam source produces 1.3×1011 ground-state ThO molecules per pulse on average, with rotational temperature of 4.8K, molecular beam solid angle of 0.31sr, and forward velocity of 200ms−1, parameters that are consistent with the performance of a traditional source (without a load lock) requiring time-consuming thermal cycles for target replacement. Long-term yield improvement of ∼40% is achieved when the load-lock system is employed to replace targets every two weeks. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2475-0328 9 6 2025 Surgery for Older Cancer Patients: Cross‐Organ Review and Good Practice Statement by the Japanese Geriatric Oncology Guideline Committee 1128 1136 EN Chie Tanaka Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine Takashi Ofuchi Department of Surgery, Kyushu University Beppu Hospital Kiichiro Ninomiya Center for Comprehensive Genomic Medicine, Okayama University Hospital Daisuke Inoue Department of Obstetrics and Gynecology, University of Fukui Ken Sugimoto Department of General Geriatric Medicine, Kawasaki Medical School Keiko Murofushi Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Toru Okuyama Department of Psychiatry/Palliative Care Center, Nagoya City University West Medical Center Shigeaki Watanuki National Center for Global Health and Medicine, National College of Nursing Chiyo Imamura Advanced Cancer Translational Research Institute, Showa University Daisuke Sakai Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine Naomi Sakurai Cancer Solutions Co. Ltd Kiyotaka Watanabe Division of Medical Oncology, Department of Medicine, School of Medicine, Teikyo University Kazuo Tamura NPO Clinical Hematology/Oncology Treatment Study Group Toshiaki Saeki Breast Oncology Service, Saitama Medical University International Medical Center Hiroshi Ishiguro Breast Oncology Service, Saitama Medical University International Medical Center Background: Although the number of older people is increasing, there is a lack of evidence and insufficient consensus regarding postoperative complications and survival in older cancer patients. In this study, we conducted a literature search and systematic review focusing on the outcomes after surgery for older cancer patients.<br> Methods: Literature focusing on surgical treatment for older cancer patients was extracted from Japanese clinical practice guidelines for gastric cancer, lung cancer, colorectal cancer, liver cancer, and gynecological cancers (uterine body, uterine cervix, ovary, and external genitalia and vagina). Outcomes were reviewed, and committee members determined the strength of evidence on a four-point scale (A to D), with A being the highest and D being the lowest.<br> Results: Older cancer patients tend to have a higher incidence of postoperative complications and postoperative syndromes, and their expected survival is generally shorter compared to non-older patients. When extensive surgeries such as para-aortic lymph node dissection and/or resection with other organs are performed for older cancer patients, the postoperative mortality rates tend to increase compared to non-older patients.<br> Conclusion: Surgical treatments for older cancer patients tend to result in higher morbidity even when the patients are in good health status. Nevertheless, there is still a possibility that a certain fraction of the patients achieve treatment outcomes comparable to those of non-older patients. Therefore, surgical indication and procedure for older cancer patients should be carefully determined based on surgical invasiveness and patient tolerability. No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 1756-2848 19 2026 Clinical efficacy and safety of endoscopic ultrasound-guided ablation therapies for pancreatic neuroendocrine tumors: a systematic review and meta-analysis EN Kazuyuki Matsumoto Department of Gastroenterology and Hepatology, Okayama University Hospital Yuki Fujii Department of Gastroenterology and Hepatology, Okayama University Hospital Daisuke Uchida Department of Gastroenterology and Hepatology, Okayama University Hospital Yasuto Takeuchi Department of Gastroenterology and Hepatology, Okayama University Hospital Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital Motoyuki Otsuka Department of Gastroenterology and Hepatology, Okayama University Hospital Background: Pancreatic neuroendocrine tumors (pNETs) are rare; however, they are increasingly being detected. Although surgical resection remains the standard treatment, its invasiveness has prompted interest in less invasive alternatives, particularly for small non-functional pNETs (NF-pNETs) and insulinomas.<br> Objectives: To evaluate the clinical efficacy and safety of endoscopic ultrasound-guided ethanol injection (EUS-EI) and radiofrequency ablation (EUS-RFA) for pNETs.<br> Design: A systematic review and meta-analysis.<br> Data sources and methods: A literature search of PubMed, MEDLINE, and Google Scholar was conducted (April 2005–April 2025). Studies were eligible if they reported clinical outcomes of EUS-EI or EUS-RFA in adult patients with insulinomas or NF-pNETs. The primary endpoints were clinical success (short-term symptom resolution or radiological response) and adverse event (AE) rates. Data were pooled using a random-effects model.<br> Results: Twenty-six studies were included in the meta-analysis. For insulinomas, the pooled clinical success rate was 77% (95% confidence interval (CI), 59–88) for EUS-EI and 95% (95% CI, 89–97) for EUS-RFA. The pooled incidence of total AEs was 32% (95% CI, 17–51) for EUS-EI and 25% (95% CI, 15–39) for EUS-RFA. For NF-pNETs, the pooled clinical success rates were 76% (95% CI, 54–90) for EUS-EI and 85% (95% CI, 74–92) for EUS-RFA, and the pooled incidence of total AEs was 27% (95% CI, 20–35) and 26% (95% CI, 17–38), respectively. The most common moderate or severe AEs were pancreatitis in 12 patients (7.6%) after EUS-EI, and pancreatic fluid collection in 4 patients (1.9%) and pancreatic duct stricture in 3 patients (1.4%) after EUS-RFA. One fatal case occurred in a 97-year-old patient following EUS-RFA.<br> Conclusion: Both EUS-EI and EUS-RFA are effective, relatively safe, and minimally invasive treatment options for pNETs. However, severe AE can occur, and careful patient selection and treatment indication are essential.<br> Trial registration: Not registered. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2049-4173 13 4 2025 Identification of New Repeat Expansion Diseases 244 249 EN Hiroyuki Ishiura Department of Neurology, Okayama UniversityGraduate School of Medicine, Dentistry and Pharmaceutical Sciences Through a genetic study of benign adult familial myoclonus epilepsy (BAFME) type 1, TTTCA and TTTTA repeat expansions have been identified in intron 4 of SAMD12. Lengths of expanded repeats inversely correlated with age at onset of epilepsy. Gain-of-toxic function mechanisms are suggested by the presence of UUUCA-repeat-containing RNA foci. From families with BAFME who did not have repeat expansions in SAMD12, we identified expanded TTTCA and TTTTA repeats in TNRC6A and RAPGEF2. These findings indicated a strong correlation between the repeat motif and the phenotype, leading to the identification of other types of BAFME. We then conducted genetic analysis of neuronal intranuclear inclusion disease (NIID), oculopharyngeal myopathy with leukoencephalopathy (OPML), and oculopharyngodistal myopathy (OPDM). From the observation that NIID, OPML, and OPDM, in addition to fragile X-associated tremor/ataxia syndrome, have shared clinical features, a direct search for CGG repeat expansions successfully led to the identification of the causative genes. Here, I review recent studies on repeat expansions. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 79 6 2025 COVID-19 and the Risks of Migraine and Headache: A Mendelian Randomization Study 413 419 EN Zhiyun Jiang Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University Ying Xi Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University Original Article 10.18926/AMO/69843 Several observational studies suggested that migraine headache attacks were associated with coronavirus disease 2019 (COVID-19). We investigated genetic causal links between COVID-19 phenotypes and the development of headache and migraine, including migraine with aura (MA) and migraine without aura (MO). We conducted a two-sample Mendelian randomization (MR) analysis to estimate the genetic association in European populations. The inverse-variance weighted (IVW) method was used as the main approach in the MR analyses, together with weighted median and MR-Egger methods. We also performed a series of sensitivity tests to assess the robustness of the MR results. The MR results demonstrated that COVID-19 severity, hospitalization, and susceptibility had no causal effect on the risks of headache, migraine, MA, or MO. No horizontal pleiotropy was detected, and the results were robust as supported by the sensitivity analysis findings. Our analyses identified no casual effect of COVID-19 severity, hospitalization, or susceptibility on the risks of headache or migraine in European populations. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 1340-2838 32 6 2025 MedakaBase as a unified genomic resource platform for medaka fish biology dsaf030 EN Kenji Morikami Molecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and Systems Yasuhiro Tanizawa Genome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and Systems Masaru Yagura Molecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and Systems Mika Sakamoto Genome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and Systems Shoko Kawamoto Department of Genetics, Sokendai (Graduate University for Advanced Studies) Yasukazu Nakamura Genome Informatics Laboratory, National Institute of Genetics, Research Organization of Information and Systems Katsushi Yamaguchi Trans-Omics Facility, National Institute for Basic Biology Shuji Shigenobu Trans-Omics Facility, National Institute for Basic Biology Kiyoshi Naruse Laboratory of Bioresources, National Institute for Basic Biology, National Institutes of Natural Sciences Satoshi Ansai Ushimado Marine Institute, Okayama University Shigehiro Kuraku Molecular Life History Laboratory, Department of Genomics and Evolutionary Biology, National Institute of Genetics, Research Organization of Information and Systems Medaka, a group of small, mostly freshwater fishes in the teleost order Beloniformes, includes the rice fish Oryzias latipes, a useful model organism studied in diverse biological fields. Chromosome-scale genome sequences of the Hd-rR strain of this species were obtained in 2007, and its improved version has facilitated various genome-wide studies. However, despite its widespread utility, omics data for O. latipes are dispersed across various public databases and lack a unified platform. To address this, the medaka section of the National Bioresource Project (NBRP) of Japan established a genome informatics team in 2022 tasked with providing various in silico solutions for bench biologists. This initiative led to the launch of MedakaBase (https://medakabase.nbrp.jp), a web server that enables gene-oriented analysis including exhaustive sequence similarity searches. MedakaBase also provides on-demand browsing of diverse genome-wide datasets, including tissue-specific transcriptomes and intraspecific genomic variations, integrated with gene models from different sources. Additionally, the platform offers gene models optimized for single-cell transcriptome analysis, which often requires coverage of the 3′ untranslated region (UTR) of transcripts. Currently, MedakaBase provides genome-wide data for seven Oryzias species, including original data for O. mekongensis and O. luzonensis produced by the NBRP team. This article outlines technical details behind the data provided by MedakaBase. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2158-4001 2025 A Linear Search Algorithm for Resource Allocation in Frequency Domain Non-Orthogonal Multiple Access EN Satoshi Denno Faculty of Environmental, Life, Natural Science and Technology, Okayama University Yuto Ohba Faculty of Environmental, Life, Natural Science and Technology, Okayama University Yafei Hou Faculty of Environmental, Life, Natural Science and Technology, Okayama University This paper proposes a linear search algorithm for resource allocation in frequency domain non-orthogonal multiple access based on the low-density signature (LDS). Although the proposed linear search enables the non-orthogonal multiple access to achieve superior transmission performance, the proposed linear search makes the resource allocation implemented with lower and fixed computational complexity. The performance of the non-orthogonal access based on the proposed linear search is evaluated by computer simulation. The proposed linear search algorithm makes the non-orthogonal multiple access achieve a gain of about 6 dB at the BER of 10–5 when the overloading ratio is set to 2. The complexity of the non-orthogonal access based on the proposed linear search algorithm is approximately half as much as that of the conventional low complexity resource allocation when the overloading ratio is 2, if the complexity is evaluated in terms of the number of additions. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1467-7881 26 11 2025 Missing the Target: A Scoping Review of the Use of Percent Weight Loss for Obesity Management e13960 EN Diana Sherifali McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University Megan Racey McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University Donna Fitzpatrick‐Lewis McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University Michelle Greenway McMaster Evidence Review and Synthesis Team; School of Nursing, McMaster University Sanjeev Sockalingam Obesity Canada Jun Wada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Soo Huat Teoh Department of Clinical Medicine, Advanced Medical and Dental Institute, Universiti Sains Malaysia Ian Patton Obesity Canada David Macklin Temerty Faculty of Medicine, University of Toronto Elizabeth F. C. van Rossum Department of Internal Medicine, Division of Endocrinology, and Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam Luca Busetto Department of Medicine, University of Padova Deborah Bade Horn Center of Obesity Medicine and Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School J. D. Patricia Nece Obesity Action Coalition Morgan Emile Gabriel Salmon Leguede ABHispalis Spain, Alianza Hispana de Personas con Obesidad Latin America Nicole Pearce Obesity Canada Carel Le Roux School of Medicine, University College Dublin Jamy Ard School of Medicine, Wake Forest University Angela S. Alberga Department of Health, Kinesiology, and Applied Physiology, Concordia University Lee Kaplan Obesity, Metabolism and Nutrition Institute Massachusetts General Hospital and Harvard Medical School Arya M. Sharma Department of Medicine, University of Alberta Sean Wharton Temerty Faculty of Medicine, University of Toronto Introduction: To co-create comprehensive targets for obesity management, we need to understand the genesis and current use of percent weight loss targets in research. The goals of our scoping review are to (1) synthesize the literature on percent weight loss targets for adults with obesity and (2) discuss the percent weight loss targets in context with their health benefits.<br> Methods: We searched Cochrane, MEDLINE, and EMBASE for English language, pharmaceutical, and/or behavioral intervention studies in adults with obesity where the explicit aim of the study was weight reduction defined as a percent of body weight. Reviewers screened citations and extracted data including study characteristics.<br> Results: From 16,164 abstracts, we included 30 citations which were mostly randomized controlled trials (RCTs) (n = 17) or quasi-experimental studies (n = 12) published between 1992 and 2024. Most of the studies had target weight loss goals between 3% and 10% of body weight (n = 28), while n = 2 had body weight loss goals of 15% or 30%. The proportion of participants who met the percent weight loss target ranged from 5.9% (nutrition only study) to 85% (pharmaceutical study). The studies reported different reasons for targeting a percentage of weight loss such as disease-specific outcomes, reduced risk of disease, or patient-reported outcomes.<br> Conclusion: Percent weight loss targets were based on similar research and were often not feasible nor sustainable for most participants. The design of these interventions and evaluation of obesity management would benefit from more patient-focused parameters which could help to co-design comprehensive targets for research and practice. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 1532-0626 37 27-28 2025 Algebraic Connectivity Maximizing Regular Graphs: Special Case Analysis and Depth‐First Search e70357 EN Masashi Kurahashi Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Najd Salaani Polytech Sorbonne, Sorbonne University Tsuyoshi Migita Faculty of Environmental, Life, Natural Science and Technology, Okayama University Norikazu Takahashi Faculty of Environmental, Life, Natural Science and Technology, Okayama University The algebraic connectivity is an indicator of how well connected a graph is. It also characterizes the convergence speed of some dynamic processes over networks. In this paper, taking into account that homogeneous networks are modeled as regular graphs, we tackle the following problem: given a pair (𝑛, 𝑘) of positive integers such that 𝑘 is less than 𝑛 and kn is an even number, find a 𝑘-regular graph with 𝑛 vertices that have the maximum algebraic connectivity. We first consider some special cases and derive solutions through theoretical analysis. We next present depth-first search algorithms for solving the problem, which reduce the search space by making use of some known properties of the regular graph and the algebraic connectivity.We also show the results of execution of the proposed algorithms for the values of 𝑛 up to 12. No potential conflict of interest relevant to this article was reported.

AVES YAYINCILIK A.Ş. Acta Medica Okayama 2980-1478 50 5 2025 A Systematic Review and Meta-Analysis of Penis Length and Circumference According to WHO Regions: Who has the Biggest One? 291 301 EN Hadi Mostafaei Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Keiichiro Mori Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Satoshi Katayama Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fahad Quhal Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Takafumi Yanagisawa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Ekaterina Laukhtina Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Frederik König Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Reza Sari Motlagh Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Pawel Rajwa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Hanieh Salehi-Pourmehr Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Sakineh Hajebrahimi Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Shahrokh F. Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna This study aimed to perform a systematic review and meta-analysis of stretched, erect, and flaccid penis length as well as circumference according to geographic WHO regions. PubMed, Embase, Scopus, and Cochrane Library were searched for articles published until February 2024. Studies in which a healthcare professional evaluated the penis size were considered eligible. After assessing the risk of bias, a systematic review and meta-analyses were performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement, and the outcomes were grouped based on the WHO regions. A total of 33 studies comprising 36 883 patients were included. The risk of bias in the included studies was moderate/low. A comprehensive systematic review was done and meta-analyses performed for flaccid length [n = 28 201, mean (SE) 9.22 (0.24) cm], stretched length [n = 20 814, mean (SE) 12.84 (0.32) cm], erect length [n = 5669, mean (SE) 13.84 (0.94) cm], flaccid circumference [n = 30 117, mean (SE) 9.10 (0.12) cm], and erect circumference [n = 5168, mean (SE) 11.91 (0.18) cm]. The mean length of the stretched penis was largest in Americans [14.47 (0.90) cm]. The mean length of the flaccid penis was the largest in the Americas [10.98 (0.064) cm]. The mean flaccid penile circumference was largest in Americans [n = 29 714, mean (SE) 10.00 (0.04) cm]. Penis sizes vary across WHO regions, suggesting the need to adjust standards according to geography to better understand councilmen and their partners. These data provide a framework for discussing body image expectations and therapeutic strategies in this sensitive and emotional subject matter. No potential conflict of interest relevant to this article was reported.

SAGE Publications Acta Medica Okayama 2352-3727 11 2 2025 Advancements in systemic therapy for muscle-invasive bladder cancer: A systematic review from the beginning to the latest updates 1 13 EN Takafumi Yanagisawa Department of Urology, The Jikei University School of Medicine Akihiro Matsukawa Department of Urology, The Jikei University School of Medicine Jeremy Yuen-Chun Teoh Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Keiichiro Mori Department of Urology, The Jikei University School of Medicine Tatsushi Kawada Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Paweł Rajwa Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Fahad Quhal Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Marco Moschini Department of Urology, San Raffaele Hospital and Scientific Institute Shahrokh F. Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Jun Miki Department of Urology, The Jikei University School of Medicine Takahiro Kimura Department of Urology, The Jikei University School of Medicine Context: Several phase III randomized controlled trials (RCTs) have shown the importance of perioperative systemic therapy, especially for the efficacy of immune checkpoint inhibitors (ICIs) in both neoadjuvant and adjuvant settings for muscle-invasive bladder cancer (MIBC).<br> Objective: To synthesize the growing evidence on the efficacy and safety of systemic therapies for MIBC utilizing the data from RCTs.<br> Evidence acquisition: Three databases and ClinicalTrials.gov were searched in October 2024 for eligible RCTs evaluating oncologic outcomes in MIBC patients treated with systemic therapy. We evaluated pathological complete response (pCR), disease-free survival (DFS), progression-free survival (PFS), event-free survival (EFS), overall survival (OS), and adverse events (AEs).<br> Evidence synthesis: Thirty-three RCTs (including 14 ongoing trials) were included in this systematic review. Neoadjuvant chemotherapy improved OS compared to radical cystectomy alone. Particularly, the VESPER trial demonstrated that dd-MVAC provided oncological benefits over GC alone in terms of pCR rates, OS (HR: 0.71), and PFS (HR: 0.70). Recently, the NIAGARA trial showed that perioperative durvalumab plus GC outperformed GC alone in terms of pCR rates, OS (HR: 0.75), and EFS (HR: 0.68). Despite the lack of data on overall AE rates in the VESPER trial, differential safety profiles in hematologic toxicity were reported between dd-MVAC and durvalumab plus GC regimens. In the adjuvant setting, no study provided the OS benefit from adjuvant chemotherapy. However, only adjuvant nivolumab had significant DFS and OS benefits compared to placebo.<br> Conclusions: Neoadjuvant chemotherapy remains the current standard of care for MIBC. Durvalumab shed light on the promising impact of ICIs added to neoadjuvant chemotherapy. Nivolumab is the only ICI recommended as adjuvant therapy in patients who harbored adverse pathologic outcomes. Ongoing trials will provide further information on the impact of combination therapy, including chemotherapy, ICIs, and enfortumab vedotin, in both neoadjuvant and adjuvant settings. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 1999-5903 17 5 2025 An Improved Reference Paper Collection System Using Web Scraping with Three Enhancements 195 EN Tresna Maulana Fahrudin Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Komang Candra Brata Department of Information and Communication Systems, Okayama University Inzali Naing Department of Information and Communication Systems, Okayama University Soe Thandar Aung Department of Information and Communication Systems, Okayama University Amri Muhaimin Department of Data Science, Universitas Pembangunan Nasional Veteran Jawa Timur Dwi Arman Prasetya Department of Data Science, Universitas Pembangunan Nasional Veteran Jawa Timur Nowadays, accessibility to academic papers has been significantly improved with electric publications on the internet, where open access has become common. At the same time, it has increased workloads in literature surveys for researchers who usually manually download PDF files and check their contents. To solve this drawback, we have proposed a reference paper collection system using a web scraping technology and natural language models. However, our previous system often finds a limited number of relevant reference papers after taking long time, since it relies on one paper search website and runs on a single thread at a multi-core CPU. In this paper, we present an improved reference paper collection system with three enhancements to solve them: (1) integrating the APIs from multiple paper search web sites, namely, the bulk search endpoint in the Semantic Scholar API, the article search endpoint in the DOAJ API, and the search and fetch endpoint in the PubMed API to retrieve article metadata, (2) running the program on multiple threads for multi-core CPU, and (3) implementing Dynamic URL Redirection, Regex-based URL Parsing, and HTML Scraping with URL Extraction for fast checking of PDF file accessibility, along with sentence embedding to assess relevance based on semantic similarity. For evaluations, we compare the number of obtained reference papers and the response time between the proposal, our previous work, and common literature search tools in five reference paper queries. The results show that the proposal increases the number of relevant reference papers by 64.38% and reduces the time by 59.78% on average compared to our previous work, while outperforming common literature search tools in reference papers. Thus, the effectiveness of the proposed system has been demonstrated in our experiments. No potential conflict of interest relevant to this article was reported.

Frontiers Media SA Acta Medica Okayama 2624-9367 7 2025 Muscle morphological adaptations to resistance training and sports participation in children and adolescents: a scoping review 1646835 EN Shota Enomoto Institute for Promotion of Education and Campus Life, Okayama University Nobuaki Tottori Graduate School of Education, Hyogo University of Teacher Education Introduction: This scoping review aimed to systematically map the existing literature on the effects of resistance training (RT) and sports participation on muscle morphology in children and adolescents.<br> Methods: Herein, a literature search was conducted using three electronic databases: PubMed, Scopus, and Web of Science. The inclusion criteria were as follows: articles that were written in English, which used chronic RT or a combination of RT with other training methods, or investigated the effects of sports participation, and reported muscle morphology as an outcome.<br> Results: This scoping review included 29 studies: 17 cross-sectional studies, 3 prospective observational studies, and 9 interventional studies. The following distribution was obtained after categorizing the included studies according to participant age: aged 6–11 years, 12 articles; aged 12–14 years, 10 articles; and aged 15–17 years, 10 articles. The designs of interventional studies included eight quasi-experimental parallel-group trials and a quasi-experimental crossover trial. However, none of the included interventional studies followed the CONSORT guidelines for conducting randomized controlled trials. Across the included studies, 14 different sports were analyzed for their effects on muscle morphology. Four studies combined players from various sports. In the included studies, 47 different muscles or muscle groups were examined. Our results identified unexplored muscles because our included studies did not examine the volume of lower leg muscles.<br> Conclusion: Future research directions in this field, including experimental design and targeted muscles, are warranted. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2399-3669 7 1 2024 Post-spinel-type AB2O4 high-pressure phases in geochemistry and materials science 189 EN Masaki Akaogi Department of Chemistry, Gakushuin University Takayuki Ishii Institute for Planetary Materials, Okayama University Kazunari Yamaura Research Center for Materials Nanoarchitectonics (MANA), National Institute for Materials Science Post-spinel-type AB2O4 compounds are stable at higher pressures than spinel phases. These compounds have garnered much interest in geo- and materials science for their geochemical importance as well as potential application as high ionic conductors and materials with strongly correlated electrons. Here, large-volume high-pressure syntheses, structural features and properties of post-spinels are reviewed. Prospects are discussed for future searches for post-spinel-type phases by applying advanced large-volume high-pressure technology. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0022-510X 472 2025 Clinical, neuroimaging and genetic findings in the Japanese case series of CLCN2-related leukoencephalopathy 123486 EN Kenta Orimo Department of Neurology, Graduate School of Medicine, The University of Tokyo Takashi Matsukawa Department of Neurology, Graduate School of Medicine, The University of Tokyo Akihiko Mitsutake Department of Neurology, Graduate School of Medicine, The University of Tokyo Takusei Cho Department of Neurology, Graduate School of Medicine, The University of Tokyo Hiroya Naruse Department of Neurology, Graduate School of Medicine, The University of Tokyo Yoshio Sakiyama Division of Neurology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University Kensho Sumi Department of Neurology, Mitsui Memorial Hospital Naohiro Uchio Department of Neurology, Mitsui Memorial Hospital Akane Satake Department of Neurology, Fuefuki Central Hospital Yoshihisa Takiyama Department of Neurology, Fuefuki Central Hospital Takuya Matsushita Department of Neurology, Kochi Medical School, Kochi University Yosuke Omae Genome Medical Science Project, National Center for Global Health and Medicine Yosuke Kawai Genome Medical Science Project, National Center for Global Health and Medicine Katsushi Tokunaga Genome Medical Science Project, National Center for Global Health and Medicine Jun Mitsui Department of Precision Medicine Neurology, Graduate School of Medicine, The University of Tokyo Hiroyuki Ishiura Department of Neurology, Graduate School of Medicine, The University of Tokyo Shoji Tsuji Department of Neurology, Graduate School of Medicine, The University of Tokyo Tatsushi Toda Department of Neurology, Graduate School of Medicine, The University of Tokyo Biallelic loss-of-function variants in CLCN2 lead to CLCN2-related leukoencephalopathy (CC2L), also called leukoencephalopathy with ataxia (LKPAT). CC2L is characterized clinically by a spectrum of clinical presentations including childhood- to adult-onset mild ataxia, spasticity, cognitive decline, and vision loss as well as typical MRI findings of symmetrical high signal intensities on the DWIs/T2WIs of the middle cerebellar peduncles (MCPs). We searched for pathogenic variants of CLCN2 in a case series of undiagnosed leukoencephalopathy accompanied by MCP signs, which led to the identification of four Japanese patients with CC2L. All the patients carried at least one allele of c.61dupC (p.Leu21Profs*27) in CLCN2, including compound heterozygosity with either the novel pathogenic variant c.983 + 2 T > A or the previously reported pathogenic variant c.1828C > T (p.Arg610*). Of note, all the four previously reported cases from Japan also harbored c.61dupC, and no reports of this variant have been documented from outside Japan. The allele frequency of c.61dupC in the Japanese population is 0.002152, raising the possibility of a relatively high prevalence of CC2L in Japan. Patients in this study developed symptoms after the age of 30, and demonstrated neurological signs including cerebellar ataxia, pyramidal signs, and mild cognitive impairment, consistent with previous reports. One male patient had two children, supporting preserved fertility, and another patient had calcifications in the cerebral and cerebellar surfaces. These findings provide valuable insights into the broader clinical and genetic spectra of CC2L in the Japanese population, and emphasize the importance of considering this disease in the differential diagnoses of leukoencephalopathy with MCP signs. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0090-8258 192 2025 Effectiveness of exercise therapy on chemotherapy-induced peripheral neuropathy in patients with ovarian cancer: A scoping review 155 162 EN Masanori Konuma Department of Rehabilitation Medicine, Okayama University Hospital Tomohiro Ikeda Department of Rehabilitation Medicine, Okayama University Hospital Tomohiro Mitoma Department of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Shinsuke Shirakawa Department of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Jota Maki Department of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Yoshimi Katayama Department of Rehabilitation Medicine, Okayama University Hospital Masanori Hamada Department of Rehabilitation Medicine, Okayama University Hospital Shoji Nagao Department of Obstetrics and Gynecology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Toshifumi Ozaki Department of Rehabilitation Medicine, Okayama University Hospital Background & aims. Exercise therapy is a potentially beneficial treatment option for chemotherapy-induced peripheral neuropathy (CIPN). However, there is a lack of consensus on the management of CIPN in patients with ovarian cancer. The purpose of this scoping review was to evaluate the evidence on the effectiveness of exercise therapy in patients with ovarian cancer and explore key physical fitness parameters.<br> Methods. A systematic electronic search was conducted using the MEDLINE, CINAHL, Web of Science, PEDro, and ClinicalTrials.gov databases. Two independent reviewers summarized the features and data from the literature regarding the effectiveness of exercise therapy for CIPN and the association between CIPN and physical fitness parameters.<br> Results. Ten articles involving 3402 participants were reviewed. The study design included one randomized controlled trial, one single-arm trial, one prospective cohort study, five retrospective cohort studies, and two cross-sectional studies. The mean patient age was >60 years in three studies and 50–60 years in six studies. The mean body mass index was >25.0 kg/m2 in six studies and not stated in four studies. In six references, patients received platinum and taxane-based chemotherapy. The effectiveness of an exercise therapy program for CIPN was reported in a randomized controlled trial. Two cross-sectional studies highlighted the association between daily physical inactivity and CIPN; two retrospective cohort studies showed an association between low skeletal muscle density and CIPN; one article demonstrated an association between physical dysfunction and CIPN.<br> Conclusion. This scoping review indicates that although evidence is lacking, exercise intervention programs for CIPN in patients with ovarian cancer have potential benefits, especially when focused on daily physical activity, skeletal muscle density, and physical function. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 2198-4034 10 1 2024 Implant-supported fixed prostheses with cantilever: a systematic review and meta-analysis 57 EN Yusuke Kondo Clinical Guideline Task-Force Members (2018-), Japanese Society of Oral Implantology (JSOI) Kiyoshi Sakai Clinical Guideline Task-Force Members (2018-), Japanese Society of Oral Implantology (JSOI) Hajime Minakuchi Department of Oral Rehabilitation and Implantology, Okayama University Hospital Takuya Horimai The Library, School of Dentistry, Nihon University Takuo Kuboki Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Faculty of Medicine Dentistry and Pharmaceutical Sciences JSOI Clinical Guideline Working Group collaborators Purpose This systematic review (SR) aimed to investigate whether the presence of a cantilever affects the results of implant treatment for partial edentulism, including an analysis of the anterior and posterior regions of the dental arches.<br> Methods An electronic search was performed, and original articles published between 1995 and November 2023 were included. The outcomes were the implant survival rate, patient satisfaction, occurrence of mechanical complications, and marginal bone loss around the implants. Two SR members independently examined the validity of the studies, extracted evidence from the included studies, and performed risk of bias assessment, comprehensive evidence evaluation, and meta-analysis.<br> Results Nine studies met our inclusion criteria. Implant survival rate tended to be lower in the cantilever group, and marginal bone loss tended to be higher in the cantilever group; however, there was no significant difference. There was no significant difference in patient satisfaction based on the presence or absence of a cantilever. Moreover, the incidence of mechanical complications was significantly higher in the cantilever group. According to the analysis of anterior and posterior regions, implant survival rate tended to be lower in the cantilever group of the posterior region, and marginal bone loss around the implants tended to be higher in the cantilever group of the anterior region.<br> Conclusion Implant-supported fixed prostheses with cantilevers did not negatively affect implant survival rate, marginal bone loss, or patient satisfaction. However, the incidence of mechanical complications significantly increased in the cantilever group. No potential conflict of interest relevant to this article was reported.

Oxford University Press (OUP) Acta Medica Okayama 1439-7595 35 4 2025 Telemedicine as an alternative to in-person care in the field of rheumatic diseases: A systematic scoping review 715 721 EN Ken-ei Sada Department of Clinical Epidemiology, Kochi Medical School Shigeru Iwata Department of Rheumatology and Clinical Immunology, Wakayama Medical University Yuzaburo Inoue Department of General Medical Science, Graduate School of Medicine, Chiba University Eiichi Tanaka Department of Rheumatology, Tokyo Women’s Medical University School of Medicine Keiichiro Nishida Locomotive Pain Center, Okayama University Hospital Yutaka Kawahito Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Asami Abe Department of Rheumatology, Niigata Rheumatic Center Atsushi Kawakami Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences Takako Miyamae Department of Pediatric Rheumatology, Institute of Rheumatology, Tokyo Women’s Medical University Objective: The COVID-19 pandemic prompted the widespread adoption of telemedicine as an alternative to in-person care. This systematic scoping review evaluated the effectiveness, cost-efficiency, and challenges of telemedicine for patients with rheumatic diseases.<br> Methods: A comprehensive search of the MEDLINE database was conducted using specific terms related to rheumatoid or juvenile arthritis, and telemedicine. The literature search included studies published up to March, 2024. In this review, we only considered studies assessing telemedicine as an alternative to in-person care.<br> Results: The search, conducted on 15 March 2024, generated 258 references. Eight reports from three randomized controlled trials and three observational studies were included. Randomized controlled trials have shown that the outcomes of telemedicine intervention are comparable to those of in-person care in terms of disease activity, functional status, and quality of life, while enabling fewer outpatient visits and cost-effectiveness. However, the high dropout rates highlight the importance of patient preferences and comprehensive education. Observational studies revealed similar findings but were limited by a high confounding bias.<br> Conclusion: Telemedicine offers economic advantages and maintains clinical outcomes comparable to those of in-person care. Its success depends on structured patient education and alignment with patient preferences. Further research is required, particularly in the context of healthcare in Japan. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2076-2615 15 10 2025 A Canine c-kit Novel Mutation Isolated from a Gastrointestinal Stromal Tumor (GIST) Retains the Ability to Form Dimers but Lacks Autophosphorylation 1444 EN Kei Shimakawa Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University So Doge Laboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Masaki Michishita Laboratory of Veterinary Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Eri Tanabe Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Tsuyoshi Tajima Laboratory of Veterinary Pharmacology, School of Veterinary Science, Nippon Veterinary and Life Science University Masato Kobayashi Laboratory of Veterinary Reproduction, School of Veterinary Science, Nippon Veterinary and Life Science University Makoto Bonkobara Laboratory of Veterinary Clinical Pathology, School of Veterinary Science, Nippon Veterinary and Life Science University Masami Watanabe Laboratory of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuhiko Ochiai Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Yoshikazu Tanaka Laboratory of Veterinary Hygiene, School of Veterinary Science, Nippon Veterinary and Life Science University Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the gastrointestinal tract; KIT mutations are present in both canine and human GISTs. In this study, genomic DNA was extracted from formalin-fixed paraffin-embedded (FFPE) sections of 55 canine GIST cases, and mutation searches were performed for exons 8, 9, and 11. The results revealed novel mutations, A434T and F436S, in exon 8. In contrast to the A434T mutation without functional changes, the F436S mutant retained its dimerization ability, but lost its phosphorylation function and attenuated downstream Akt signaling, which is reflected in wound healing and migration activities. A comparison of the subcellular localization of WT KIT and the F436S mutant revealed no differences. In silico simulations indicated that the F436S mutation alters the structure of the near-membrane region and that its effects may extend to the transmembrane and intracellular domains compared to the WT. F436S is a point mutation that affects the entire molecule because co-mutation with the F436S mutation and the known autophosphorylation mutation reduces the autophosphorylation abilities. No potential conflict of interest relevant to this article was reported.

Microbiology Society Acta Medica Okayama 2057-5858 11 7 2025 Genomic features of three major diarrhoeagenic Escherichia coli pathotypes in India 001430 EN Yuki Hoshiko ​Division of Microbiology, Department of Infectious Medicine, Kurume University School of Medicine Goutam Chowdhury Collaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric Diseases Kei Kitahara Collaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric Diseases Debjani Ghosh Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Debora Satie Nagano ​Division of Microbiology, Department of Infectious Medicine, Kurume University School of Medicine Ayumu Ohno Collaborative Research Centre of Okayama University for Infectious Diseases, ICMR-National Institute of Cholera and Enteric Diseases Shin-ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Miki Okuno ​Division of Microbiology, Department of Infectious Medicine, Kurume University School of Medicine Takeshi Yamamoto ​Division of Microbiology, Department of Infectious Medicine, Kurume University School of Medicine Shanta Dutta ​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 Yoshitoshi Ogura ​Division of Microbiology, Department of Infectious Medicine, Kurume University School of Medicine Background. Diarrhoea remains a major threat to children in developing nations, with diarrhoeagenic Escherichia coli (DEC) being the primary causative agent. Characterizing prevalent DEC strains is crucial, yet comprehensive genomic analyses of major DEC strains, including enteropathogenic E. coli (EPEC), enteroaggregative E. coli (EAEC) and enterotoxigenic E. coli (ETEC), are lacking in India.<br> Methods. We sequenced 24 EAEC and 23 EPEC strains from Indian patients with diarrhoea and conducted an extensive database search for DEC human isolates from India. Detailed phylogenetic analyses, virulence gene subtyping and examinations of accessory virulence and antimicrobial resistance (AMR) genes were performed.<br> Results. The analysed DEC strains included 32 EAEC, 25 EPEC, 32 ETEC and 1 each of the EPEC/ETEC-hybrid and ETEC/EAEC-hybrid pathotypes. These strains were predominantly classified into phylogroups A (35.2%) and B1 (41.8%) and dispersed within these phylogroups without pathotype-specific clustering. One ETEC strain was classified into cryptic clade 1. Subtypes of hallmark virulence genes varied substantially amongst strains in each pathotype, and 31 accessory virulence genes were detected either specifically within certain pathotypes or across multiple pathotypes at varying frequencies, indicating diversification of the virulence gene repertoire within each pathotype. Acquired AMR genes were found in 73.6% of the strains, with frequent identification of AMR genes for aminoglycosides (40.0%), β-lactams (64.8%), sulphonamides (49.5%) and trimethoprim (42.9%). Known quinolone-resistant mutations were found in 74.7% of the strains, whereas AMR genes for macrolide (30.8%), phenicol (11.0%) and tetracycline (27.4%) were less frequent.<br> Conclusions. The diverse virulence potential and trends in AMR gene prevalence amongst major DEC strains in India are highlighted in this study. Continuous monitoring of DEC strain characteristics is essential for the effective control and treatment of DEC infections in India. No potential conflict of interest relevant to this article was reported.

Japanese Society of Preventive Medicine Acta Medica Okayama 2758-7916 3 1 2025 Relationship between media literacy and searching skills on report assignments in nursing students in Japan 11 21 EN Yurii Nagao Department of Nursing, Faculty of Medicine, Okayama University Wakana Yano Department of Nursing, Faculty of Medicine, Okayama University Yoko Takahata Department of Nursing, Faculty of Medicine, Okayama University Objective: This study evaluates the relationship between information access and media literacy attitudes. We also assessed the impact of “Medical Literature Reading” on media literacy among Japanese university students. Methods: A cross-sectional study was conducted from April 2–16 and from August 2–16, 2024. A self-reporting questionnaire, including the school year, was used to determine if participants had taken the “Medical Literature Reading” course and to identify the sources often used for reporting assignments and media literacy. Results: This study included 195 subjects. The differences in media literacy scores between school years were analyzed. The total scores of fourth-year students were significantly higher than those of first-year on the media literacy scale (p = 0.014). The differences in media literacy scores among students enrolled in “Medical Literature Reading” were analyzed. The scores on the media literacy scale (p = 0.006) were significantly higher in participants than in non-participants. The relationships among the three groups by sources used for report assignments, school years (χ2(6) = 42.101, p < 0.0001), and history of taking “Medical Literature Reading” (χ2(2) = 7.048, p = 0.030) were also analyzed. Conclusions: Media literacy improved with schooling. Certain report assignments and subjects related to information literacy were found to have affected media literacy. Combining continuing experience and knowledge can lead to improvements in media literacy. No potential conflict of interest relevant to this article was reported.

Springer Nature Switzerland Acta Medica Okayama 2367-4512 2025 Investigation Towards Detecting Landing Websites for Fake Japanese Shopping Websites 107 119 EN Daigo Michishita Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Satoru Kobayashi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Toshihiro Yamauchi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Recently, the number of victims of fake shopping websites that imitate legitimate ones to defraud people has been increasing. It has been shown that fake shopping websites use legitimate defaced landing websites as their leading paths. Therefore, if the detection of landing websites for fake shopping websites can be achieved, it can assist in addressing these websites and reduce the opportunities for users to be redirected to fake shopping websites. In this study, we collect and investigate existing landing websites that redirect users to fake Japanese shopping websites and identify effective features for detecting them. We identified effective search terms for collecting landing websites for fake Japanese shopping websites and found that using Google searches with queries of top-level domain and product names was effective. We also investigated the conditions for activating analytical evasion functions in the collected landing websites for fake Japanese shopping websites and clarified the differences in search results between crawlers and users. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 14 4 2025 Natural Course and Long-Term Outcomes of Gastric Subepithelial Lesions: A Systematic Review 1055 EN Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hiroyuki Okada Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital Motoyuki Otsuka Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background/Objectives: Gastric subepithelial lesions (SELs) are often incidentally detected during endoscopic examinations, with most patients being asymptomatic and lesions measuring <20 mm. Despite their generally indolent nature, certain SELs, such as gastrointestinal stromal tumors, require resection. Current guidelines recommend periodic surveillance; however, the natural course and long-term outcomes of gastric SELs have not been sufficiently investigated. This systematic review aimed to synthesize evidence on the progression, growth rate, and risk factors associated with gastric SELs to inform clinical management strategies. Methods: A comprehensive search of PubMed was conducted for peer-reviewed studies published between January 2000 and November 2024. Eligible studies included original studies on the follow-up and progression of gastric SELs. Non-English articles, reviews, case reports, and unrelated topics were excluded. In total, 277 articles were screened, with 15 additional articles identified through manual screening. Ultimately, 41 articles were included in the analysis. The study protocol is registered in PROSPERO (CRD42024614865). Results: Large-scale studies reported low growth rates of 2.0-8.5% over 2.0-5.0 years, while smaller studies reported a broader range of growth rates of 5.4-28.4%. The factors contributing to these discrepancies include patient selection, follow-up duration, and growth criteria. Risk factors for lesion size increase include larger initial lesion size, irregular margins, heterogeneous echo patterns, and certain tumor locations. Conclusions: These findings underscore the need for individualized management strategies based on lesion size, imaging characteristics, and risk factors. The close monitoring of high-risk lesions is crucial for timely intervention. Standardized growth criteria and optimized follow-up protocols are essential for improving clinical decision making and patient outcomes. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0361-8609 96 10 2021 Validated international definition of the thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly clinical subtype (TAFRO) of idiopathic multicentric Castleman disease 1241 1252 EN Yoshito Nishimura Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences David C. Fajgenbaum Center for Cytokine Storm Treatment & Laboratory, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania Sheila K. Pierson Center for Cytokine Storm Treatment & Laboratory, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania Noriko Iwaki Hematology/Respiratory Medicine, Kanazawa University Graduate School of Medical Science Asami Nishikori Division of Pathophysiology, Okayama University Graduate School of Health Sciences Mitsuhiro Kawano Department of Rheumatology, Kanazawa University Graduate School of Medical Science Naoya Nakamura Department of Pathology, Tokai University School of Medicine Koji Izutsu Department of Hematology, National Cancer Center Hospital Kengo Takeuchi Department of Pathology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research Midori Filiz Nishimura Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yoshinobu Maeda Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kazuyuki Yoshizaki Department of Organic Fine Chemicals, Institute of Scientific and Industrial Research, Osaka University Eric Oksenhendler Department of Clinical Immunology, Hôpital Saint-Louis Frits van Rhee Myeloma Center, University of Arkansas for Medical Sciences Yasuharu Sato Division of Pathophysiology, Okayama University Graduate School of Health Sciences Thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly (TAFRO) syndrome is a heterogeneous entity manifesting with a constellation of symptoms described above that can occur in the context of idiopathic multicentric Castleman disease (iMCD) as well as infectious diseases, malignancies, and rheumatologic disorders. So, iMCD-TAFRO is an aggressive subtype of iMCD with TAFRO syndrome and often hyper-vascularized lymph nodes. Since we proposed diagnostic criteria of iMCD-TAFRO in 2016, we have accumulated new insights on the disorder and additional cases have been reported worldwide. In this systematic review and cohort analysis, we established and validated a definition for iMCD-TAFRO. First, we searched PubMed and Japan Medical Abstracts Society databases using the keyword “TAFRO” to extract cases. Patients with possible systemic autoimmune diseases and hematologic malignancies were excluded. Our search identified 54 cases from 50 articles. We classified cases into three categories: (1) iMCD-TAFRO (TAFRO syndrome with lymph node histopathology consistent with iMCD), (2) possible iMCD-TAFRO (TAFRO syndrome with no lymph node biopsy performed and no other co-morbidities), and (3) TAFRO without iMCD or other co-morbidities (TAFRO syndrome with lymph node histopathology not consistent with iMCD or other comorbidities). Based on the findings, we propose an international definition requiring four clinical criteria (thrombocytopenia, anasarca, fever/hyperinflammatory status, organomegaly), renal dysfunction or characteristic bone marrow findings, and lymph node features consistent with iMCD. The definition was validated with an external cohort (the ACCELERATE Natural History Registry). The present international definition will facilitate a more precise and comprehensive approach to the diagnosis of iMCD-TAFRO. No potential conflict of interest relevant to this article was reported.

Japanese Society for Lymphoreticular Tissue Research Acta Medica Okayama 1346-4280 64 2 2024 Atypical lymphoplasmacytic and immunoblastic proliferation: A Systematic Review 97 106 EN Midori Filiz Nishimura Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Toshiaki Takahashi Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Kensuke Takaoka Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Sharina Macapagal Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Chalothorn Wannaphut Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Asami Nishikori Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Hiroko Toda Department of Pathology, Chugoku Central Hospital Yoshito Nishimura Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Yasuharu Sato Department of Molecular Hematopathology, Okayama University Graduate School of Health Sciences Atypical lymphoplasmacytic and immunoblastic proliferation (ALPIBP) was first reported in 1984 as characteristic histological findings in lymph nodes associated with autoimmune diseases, but it has not been clearly defined to date. To summarize the histological characteristics and clinical diagnoses associated with ALPIBP, we searched MEDLINE and EMBASE for all peer-reviewed articles using keywords including “atypical lymphoplasmacytic and immunoblastic lymphadenopathy” from their inception to December 27, 2023. We also summarized the courses of three cases with a pathological diagnosis of ALPIBP. Nine articles with 52 cases were included. Among the total of 55 cases, including the three from our institution, the median age of the cases was 63.5 years with a female predominance (69.5%). Lymphadenopathy was generalized in 65.6% and regional in 34.4% of cases. RA (24.4%), SLE (24.4%), and autoimmune hemolytic anemia (20.0%), were common clinical diagnoses. A combination of cytotoxic chemotherapy was used in 15.6% of cases due to the suspicion of malignancy. Nodal T-follicular helper cell lymphoma, angioimmunoblastic type, methotrexate-associated lymphoproliferative disorders, and IgG4-related diseases were listed as important diseases that need to be pathologically differentiated from ALPIBP. This review summarizes the current understanding of the characteristics of ALPIBP. Given that underrecognition of ALPIBP could lead to overdiagnosis of hematological malignancy and unnecessary treatment, increased awareness of the condition in pathologists and clinicians is crucial. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1029-8428 43 1 2025 Differentially Expressed Nedd4-binding Protein Ndfip1 Protects Neurons Against Methamphetamine-induced Neurotoxicity 4 EN Masato Asanuma Department of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ikuko Miyazaki Department of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jean Lud Cadet Molecular Neuropsychiatry Section, Intramural Research Program, NIH/ NIDA To identify factors involved in methamphetamine (METH) neurotoxicity, we comprehensively searched for genes which were differentially expressed in mouse striatum after METH administration using differential display (DD) reverse transcription-PCR method and sequent single-strand conformation polymorphism analysis, and found two DD cDNA fragments later identified as mRNA of Nedd4 (neural precursor cell expressed developmentally downregulated 4) WW domain-binding protein 5 (N4WBP5), later named Nedd4 family-interacting protein 1 (Ndfip1). It is an adaptor protein for the binding between Nedd4 of ubiquitin ligase (E3) and target substrate protein for ubiquitination. Northern blot analysis confirmed drastic increases in Ndfip1 mRNA in the striatum after METH injections, and in situ hybridization histochemistry showed that the mRNA expression was increased in the hippocampus and cerebellum at 2 h-2 days, in the cerebral cortex and striatum at 18 h-2 days after single METH administration. The knockdown of Ndfip1 expression with Ndfip1 siRNA significantly aggravated METH-induced neurotoxicity in the cultured monoaminergic neuronal cells. These results suggest that drastic increases in Ndfip1 mRNA is compensatory reaction to protect neurons against METH-induced neurotoxicity. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1341-321X 31 2 2024 Clinical and microbiological characteristics of high-level daptomycin-resistant Corynebacterium species: A systematic scoping review 102575 EN Shinnosuke Fukushima Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Kazuyoshi Gotoh Department of Medical Laboratory Science, Okayama University Graduate School of Health Sciences Shuma Tsuji Department of Medical Laboratory Science, Okayama University Graduate School of Health Sciences Koji Iio Microbiology Division, Clinical Laboratory, Okayama University Hospital Hidemasa Akazawa Department of Infectious Diseases, Okayama University Hospital Osamu Matsushita Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of Infectious Diseases, Okayama University Hospital Introduction: Corynebacterium species potentially develop high-level daptomycin resistance (HLDR) shortly after daptomycin (DAP) administration. We aimed to investigate the clinical and microbiological characteristics of HLDR Corynebacterium infections.<br> Methods: We first presented a clinical case accompanied by the results of a comprehensive genetic analysis of the isolate, and then performed a systematic scoping review. Based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, we searched for articles with related keywords, including “Corynebacterium”, “Daptomycin", and "Resistance”, in the MEDLINE and Web of Science databases from the database inception to October 25, 2024. Clinical case reports and research articles documenting the isolation of HLDR Corynebacterium species, defined by a minimum inhibitory concentration of DAP at ≥256 μg/mL, were deemed eligible for this review.<br> Results: Of 80 articles screened, seven case reports detailing eight cases of HLDR Corynebacterium infections, as well as five research articles, were included. C. striatum was the most common species (7/9 cases, 77.8 %), and prosthetic device-associated infections accounted for 66.7 % of the cases. Duration of DAP administration before the emergence of HLDR isolates ranged from 5 days to 3 months; three-quarters of the cases developed within 17 days. Three HLDR isolates were genetically confirmed to have an alteration in pgsA2. The majority of the patients were treated with either glycopeptides or linezolid, with favorable outcomes. In vitro experiments confirmed that C. striatum strains acquire the HLDR phenotype at higher rates (71 %–100 %) within 24 h of incubation, compared to other Corynebacterium strains.<br> Conclusion: DAP monotherapy, especially for prosthetic device-associated infections, can result in the development of HLDR Corynebacterium. Additional research is warranted to investigate the clinical implications of this potentially proliferating antimicrobial resistant pathogen. No potential conflict of interest relevant to this article was reported.

Fuji Technology Press Ltd. Acta Medica Okayama 1883-8022 17 5 2023 Effect of Vibration Behavior in Low-Frequency Vibration Cutting on Surface Properties of Workpiece 434 448 EN Hiroyuki Kodama Okayama University Shota Matsuno Okayama University Naoyuki Shibata Okayama University Kazuhito Ohashi Okayama University 　The objective of this study was to determine the effect of vibration behavior on workpiece surface properties in low-frequency vibration cutting. The effects of the parameters that determine vibration behavior on surface roughness were quantitatively evaluated through a comparison with other cutting conditions. Furthermore, by clarifying how the surface properties of the workpiece, such as roughness, roundness, and cross-sectional curves, change depending on the vibration behavior, a search for optimal conditions for low-frequency vibration cutting was conducted. The best surface properties were obtained under the condition of spindle rotation per vibration E=4.5. By using a value close to the minimum possible spindle rotation R=0.5 when the workpiece is retracted, it is expected to be effective in suppressing the variation in surface roughness at each phase angle; this variation is characteristic of low-frequency vibration cutting. Workpieces machined under low-frequency vibration conditions such as (E=2.5, R=1.0) and (E=3.5, R=1.0) were found to form characteristic surface patterns on the workpiece surface owing to a phenomenon in which the depth of the cut to the workpiece changes. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2313-433X 10 10 2024 Searching Method for Three-Dimensional Puncture Route to Support Computed Tomography-Guided Percutaneous Puncture 251 EN Yusuke Gotoh Faculty of Environmental, Life, Natural Science and Technology, Okayama University Aoi Takeda Graduate School of Natural Science and Technology, Okayama University Koji Masui Department of Radiology, Kyoto Prefectural University of Medicine Koji Sakai Department of Radiology, Kyoto Prefectural University of Medicine Manato Fujimoto Graduate School of Informatics, Osaka Metropolitan University In CT-guided percutaneous punctures-an image-guided puncture method using CT images-physicians treat targets such as lung tumors, liver tumors, renal tumors, and intervertebral abscesses by inserting a puncture needle into the body from the exterior while viewing images. By recognizing two-dimensional CT images prior to a procedure, a physician determines the least invasive puncture route for the patient. Therefore, the candidate puncture route is limited to a two-dimensional region along the cross section of the human body. In this paper, we aim to construct a three-dimensional puncture space based on multiple two-dimensional CT images to search for a safer and shorter puncture route for a given patient. If all puncture routes starting from a target in the three-dimensional space were examined from all directions (the brute-force method), the processing time to derive the puncture route would be very long. We propose a more efficient method for three-dimensional puncture route selection in CT-guided percutaneous punctures. The proposed method extends the ray-tracing method, which quickly derives a line segment from a given start point to an end point on a two-dimensional plane, and applies it to three-dimensional space. During actual puncture route selection, a physician can use CT images to derive a three-dimensional puncture route that is safe for the patient and minimizes the puncture time. The main novelty is that we propose a method for deriving a three-dimensional puncture route within the allowed time in an actual puncture. The main goal is for physicians to select the puncture route they will use in the actual surgery from among the multiple three-dimensional puncture route candidates derived using the proposed method. The proposed method derives a three-dimensional puncture route within the allowed time in an actual puncture. Physicians can use the proposed method to derive a new puncture route, reducing the burden on patients and improving physician skills. In the evaluation results of a computer simulation, for a 3D CT image created by combining 170 two-dimensional CT images, the processing time for deriving the puncture route using the proposed method was approximately 59.4 s. The shortest length of the puncture route from the starting point to the target was between 20 mm and 22 mm. The search time for a three-dimensional human body consisting of 15 CT images was 4.77 s for the proposed method and 2599.0 s for a brute-force method. In a questionnaire, physicians who actually perform puncture treatments evaluated the candidate puncture routes derived by the proposed method. We confirmed that physicians could actually use these candidates as a puncture route. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 78 5 2024 Effect of Radon Inhalation on Murine Brain Proteins: Investigation Using Proteomic and Multivariate Analyses 387 399 EN Shota Naoe Graduate School of Health Sciences, Okayama University Ayumi Tanaka Graduate School of Health Sciences, Okayama University Norie Kanzaki Ningyo-toge Environmental Engineering Center, Japan Atomic Energy Agency Reiju Takenaka Graduate School of Health Sciences, Okayama University Akihiro Sakoda Ningyo-toge Environmental Engineering Center, Japan Atomic Energy Agency Takaaki Miyaji Advanced Science Research Center, Okayama University Kiyonori Yamaoka Faculty of Health Sciences, Okayama University Takahiro Kataoka Faculty of Health Sciences, Okayama University Original Article 10.18926/AMO/67663 Radon is a known risk factor for lung cancer; however, it can be used beneficially, such as in radon therapy. We have previously reported the enhancement of antioxidant effects associated with trace amounts of oxidative stress as one of the positive biological effects of radon inhalation. However, the biological effects of radon inhalation are incompletely understood, and more detailed and comprehensive studies are required. Although several studies have used proteomics to investigate the effects of radon inhalation on body proteins, none has focused on brain proteins. In this study, we evaluated the expression status of proteins in murine brains using proteomic and multivariate analyses to identify those whose expressions changed following two days of radon inhalation at a concentration of 1,500 Bq/m3. We found associations of radon inhalation with the expressions of seven proteins related to neurotransmission and heat shock. These proteins may be proposed as biomarkers indicative of radon inhalation. Although further studies are required to obtain the detailed biological significance of these protein alterations, this study contributes to the elucidation of the biological effects of radon inhalation as a low-dose radiation. No potential conflict of interest relevant to this article was reported.

BMJ Publishing Group Acta Medica Okayama 2044-6055 14 10 2024 Decline in and recovery of fertility rates after COVID-19-related state of emergency in Japan e087657 EN Tomohiro Mitoma Department of Obstetric and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Jota Maki Department of Obstetric and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Hikaru Ooba Department of Obstetric and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Hisashi Masuyama Department of Obstetric and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Introduction The COVID-19 pandemic led to a decline in fertility rates worldwide. Although many regions have experienced a temporary drop in fertility rates with the spread of the infection, subsequent recovery has varied across countries. This study aimed to evaluate the impact of COVID-19 infection rates and regional sociodemographic factors on the recovery of fertility rates in Japan following the state of emergency.<br> Methods This study examined prefectural fertility data from before the COVID-19 pandemic to forecast fertility rates up to 2022 using a seasonal autoregressive integrated moving average model. A regression analysis was conducted on fertility rates during the first state of emergency and the subsequent recovery rate with respect to the number of new COVID-19 cases and sociodemographic factors specific to each prefecture.<br> Results During the first state of emergency, the monthly fertility rate decreased by an average of -13.8% (SD: 6.26, min: -28.78, max: 0.15) compared with the previous year. Over the following 22 months, the average fertility recovery rate was +2.31% (SD: 3.57; min: -8.55, max: 19.54). Multivariate analysis of the impact of the pandemic on fertility changes during the first emergency indicated a negative correlation between new COVID-19 cases per capita and the proportion of nuclear households. No significant correlation was found between fertility recovery rate and new COVID-19 cases or emergency duration. When classifying fertility rate fluctuation patterns before and after the emergency into four clusters, variations were noted in the proportion of the elderly population, marriage divorce rate and the number of internet searches related to pregnancy intentions across the clusters.<br> Conclusions No association was found between pregnancy intentions related to the spread of infection, such as the number of new cases and the fertility recovery rate following the first state of emergency. Differences in the patterns of decline and recovery during the pandemic were observed based on population composition and internet searches for infection and pregnancy across different prefectures. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2769-2558 2 2 2023 Effectiveness of psychological first aid in infectious disease pandemics: An overview of systematic reviews e107 EN Masahide Koda Co‐Learning Community Healthcare Re‐Innovation Office, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toru Horinouchi Department of Psychiatry, Hokkaido University Graduate School of Medicine Nozomu Oya Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine Morio Aki Department of Psychiatry, Graduate School of Medicine, Kyoto University Akihisa Iriki Osaka Psychiatric Medical Center Kazufumi Yoshida Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University Yusuke Ogawa Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University Hironori Kuga National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry Tomohiro Nakao Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University There is insufficient research on the usefulness of psychological interventions, such as psychological first aid (PFA), during outbreaks. We searched for and critically appraised systematic reviews that examined the effectiveness of PFA during infectious disease outbreaks, such as the novel coronavirus disease (COVID-19). Systematic reviews that examined the efficacy of PFA in the severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus, Ebola virus disease, and COVID-19 outbreaks were searched through PubMed on February 19, 2021. The three included systematic reviews were critically appraised and assessed using AMSTAR-2. One review's overall confidence in its findings was evaluated as “high,” which suggested that PFA training had a favorable effect on healthcare personnel. Furthermore, the review also demonstrated that PFA was commonly used during outbreaks and could be delivered through multiple methods, such as a phone or video call. Although it was anticipated that PFA would improve subjective well-being, reports showed no evidence of reduced depression or insomnia. Future studies should examine additional numbers of PFA recipients and conduct quasi-experimental studies to better understand the effectiveness of PFA. Evidence on its effectiveness in infectious disease outbreaks is still lacking, along with research and evaluation methods. Quasi-experimental studies, such as comparisons with other psychological interventions, are required to better understand the effectiveness of PFA. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 0271-3586 67 11 2024 Job strain and adverse pregnancy outcomes: A scoping review and meta‐analysis 971 979 EN Kota Nakayama Okayama University Medical School Etsuji Suzuki Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Natalie Slopen Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health Ichiro Kawachi Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health Background: Previous studies have shown that job strain is associated with low birthweight (LBW), preterm birth (PTB), and small for gestational age (SGA). We conducted a scoping review and meta-analysis to assess the association between job strain and adverse pregnancy outcomes.<br> Methods: A literature search was performed on PubMed. We included English-language studies that examined the association between job strain (based on the Karasek demand-control model) and pregnancy outcomes. We excluded letters, posters, reviews, and qualitative studies. Random effects meta-analysis was performed. Heterogeneity was assessed using τ2 and I2 statistics. Potential bias was assessed using standard funnel plots. Asymmetry was evaluated by Egger's test. Leave-one-out analysis was performed for sensitivity analyses.<br> Results: Three eligible studies were found for LBW, seven for PTB, and four for SGA. The number of subjects ranged from 135 to 4889, and the prevalence of high job strain ranged from 6.64% to 33.9%. The pooled odds ratio and 95% confidence interval (CI) for LBW, PTB, and SGA were 1.23 (95% CI: 0.97, 1.56), 1.10 (95% CI: 1.00, 1.22), and 1.16 (95% CI: 0.97, 1.39) respectively, indicating modest associations. Heterogeneity for LBW and PTB may not be important but may be moderate for SGA. No publication bias was detected for LBW and PTB, but possible publication bias exists for SGA.<br> Conclusion: We found a modest association between job strain and PTB. Since job strain is only one of the many aspects of an unhealthy work environment, interventions that improve working conditions more broadly are needed. No potential conflict of interest relevant to this article was reported.

Taylor and Francis Acta Medica Okayama 0883-9514 38 1 2024 Surrogate-Assisted Multi-Objective Optimization for Simultaneous Three-Dimensional Packing and Motion Planning Problems Using the Sequence-Triple Representation 2398895 EN Ziang Liu Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tomoya Kawabe Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tatsushi Nishi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Shun Ito Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tomofumi Fujiwara Faculty of Environmental, Life, Natural Science and Technology, Okayama University Packing problems are classical optimization problems with wide-ranging applications. With the advancement of robotic manipulation, there are growing demands for the automation of packing tasks. However, the simultaneous optimization of packing and the robot's motion planning is challenging because these two decisions are interconnected, and no previous study has addressed this optimization problem. This paper presents a framework to simultaneously determine the robot's motion planning and packing decision to minimize the robot's processing time and the container's volume. This framework comprises three key components: solution encoding, surrogate modeling, and evolutionary computation. The sequence-triple representation encodes complex packing solutions by a sequence of integers. A surrogate model is trained to predict the processing time for a given packing solution to reduce the computational burden. Training data is generated by solving the motion planning problem for a set of packing solutions using the rapidly exploring random tree algorithm. The Non-Dominated Sorting Genetic Algorithm II searches for the Pareto solutions. Experimental evaluations are conducted using a 6-DOF robot manipulator. The experimental results suggest that implementing the surrogate model can reduce the computational time by 91.1%. The proposed surrogate-assisted optimization method can obtain significantly better solutions than the joint angular velocity-based estimation method. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2073-8994 16 8 2024 An Enhanced Active Access-Point Configuration Algorithm Using the Throughput Request Satisfaction Method for an Energy-Efficient Wireless Local-Area Network 1005 EN Bin Wu Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Dezheng Kong Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Xuan Wang Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Taishiro Seto Graduate School of Environmental, Life, Natural Science and Technology, Okayama University Yu-Cheng Fan Department of Electronic Engineering, National Taipei University of Technology Wireless Local-Area Networks (WLANs), as a popular internet access solution, are widely used in numerous places, including enterprises, campuses, and public venues. As the number of devices increases, large-scale deployments will cause the problem of dense wireless networks, including a lot of energy consumption. Thus, the optimization of energy-efficient wireless AP devices has become a focal point of attention. To reduce energy consumption, we have proposed the active access-point (AP) configuration algorithm for WLANs using APs with a dual interface. This uses the greedy algorithm combined with the local search optimization method to find the minimum number of activated APs while satisfying the minimum throughput constraint. However, the previous algorithm basically satisfies only the average throughput among the multiple hosts associated with one AP, wherein some hosts may not reach the required one. In this paper, to overcome this limitation, we propose an enhanced active AP configuration algorithm by incorporating the throughput request satisfaction method that controls the actual throughput at the target value (target throughput) for every host by applying traffic shaping. The target throughput is calculated from the single and concurrent communicating throughput of each host based on channel occupancy time. The minimum throughput constraint will be iteratively adjusted to obtain the required target throughput and achieve the fair throughput allocation. For evaluations, we conducted simulations using the WIMNET simulator and experiments using the testbed system with a Raspberry Pi 4B for APs in four topology cases with five APs and ten hosts. The results show that the proposed method always achieved the required minimum throughput in simulations as well as in experiments, while minimizing the number of active APs. Thus, the validity and effectiveness of our proposal were confirmed. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 13 14 2024 New Delhi Metallo-Beta-Lactamase Inhibitors: A Systematic Scoping Review 4199 EN Lutfun Nahar Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of Infectious Diseases, Okayama University Hospital Kazuyoshi Gotoh Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Md Asaduzzaman Department of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background/Objectives: Among various carbapenemases, New Delhi metallo-beta-lactamases (NDMs) are recognized as the most powerful type capable of hydrolyzing all beta-lactam antibiotics, often conferring multi-drug resistance to the microorganism. The objective of this review is to synthesize current scientific data on NDM inhibitors to facilitate the development of future therapeutics for challenging-to-treat pathogens. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews, we conducted a MEDLINE search for articles with relevant keywords from the beginning of 2009 to December 2022. We employed various generic terms to encompass all the literature ever published on potential NDM inhibitors. Results: Out of the 1760 articles identified through the database search, 91 met the eligibility criteria and were included in our analysis. The fractional inhibitory concentration index was assessed using the checkerboard assay for 47 compounds in 37 articles, which included 8 compounds already approved by the Food and Drug Administration (FDA) of the United States. Time-killing curve assays (14 studies, 25%), kinetic assays (15 studies, 40.5%), molecular investigations (25 studies, 67.6%), in vivo studies (14 studies, 37.8%), and toxicity assays (13 studies, 35.1%) were also conducted to strengthen the laboratory-level evidence of the potential inhibitors. None of them appeared to have been applied to human infections. Conclusions: Ongoing research efforts have identified several potential NDM inhibitors; however, there are currently no clinically applicable drugs. To address this, we must foster interdisciplinary and multifaceted collaborations by broadening our own horizons. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2079-9292 13 14 2024 A Reference Paper Collection System Using Web Scraping 2700 EN Inzali Naing Department of Information and Communication Systems, Okayama University Soe Thandar Aung Department of Information and Communication Systems, Okayama University Khaing Hsu Wai Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Collecting reference papers from the Internet is one of the most important activities for progressing research and writing papers about their results. Unfortunately, the current process using Google Scholar may not be efficient, since a lot of paper files cannot be accessed directly by the user. Even if they are accessible, their effectiveness needs to be checked manually. In this paper, we propose a reference paper collection system using web scraping to automate paper collections from websites. This system can collect or monitor data from the Internet, which is considered as the environment, using Selenium, a popular web scraping software, as the sensor; this examines the similarity against the search target by comparing the keywords using the Bert model. The Bert model is a deep learning model for natural language processing (NLP) that can understand context by analyzing the relationships between words in a sentence bidirectionally. The Python Flask is adopted at the web application server, where Angular is used for data presentations. For the evaluation, we measured the performance, investigated the accuracy, and asked members of our laboratory to use the proposed method and provide their feedback. Their results confirm the method’s effectiveness. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1422-0067 25 13 2024 Genome-Wide Association Study with Three Control Cohorts of Japanese Patients with Esotropia and Exotropia of Comitant Strabismus and Idiopathic Superior Oblique Muscle Palsy 6986 EN Toshihiko Matsuo Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Ichiro Hamasaki Department of Ophthalmology, Okayama University Hospital Yoichiro Kamatani Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo Takahisa Kawaguchi Center for Genomic Medicine, Graduate School of Medicine, Kyoto University Izumi Yamaguchi Center for Genomic Medicine, Graduate School of Medicine, Kyoto University Fumihiko Matsuda Center for Genomic Medicine, Graduate School of Medicine, Kyoto University Akira Saito StaGen Co., Ltd. Kazuyuki Nakazono StaGen Co., Ltd. Shigeo Kamitsuji StaGen Co., Ltd. Esotropia and exotropia in the entity of comitant strabismus are multifactorial diseases with both genetic and environmental backgrounds. Idiopathic superior oblique muscle palsy, as the predominant entity of non-comitant (paralytic) strabismus, also has a genetic background, as evidenced by varying degrees of muscle hypoplasia. A genome-wide association study (GWAS) was conducted of 711 Japanese patients with esotropia (n= 253), exotropia (n = 356), and idiopathic superior oblique muscle palsy (n = 102). The genotypes of single nucleotide polymorphisms (SNPs) were determined by Infinium Asian Screening Array. Three control cohorts from the Japanese population were used: two cohorts from BioBank Japan (BBJ) and the Nagahama Cohort. BBJ (180K) was genotyped by a different array, Illumina Infinium OmniExpressExome or HumanOmniExpress, while BBJ (ASA) and the Nagahama Cohort were genotyped by the same Asian array. After quality control of SNPs and individuals, common SNPs between the case cohort and the control cohort were chosen in the condition of genotyping by different arrays, while all SNPs genotyped by the same array were used for SNP imputation. The SNPs imputed with R-square values ≥ 0.3 were used to compare the case cohort of each entity or the combined entity with the control cohort. In comparison with BBJ (180K), the esotropia group and the exotropia group showed CDCA7 and HLA-F, respectively, as candidate genes at a significant level of p < 5 × 10−8, while the idiopathic superior oblique muscle palsy group showed DAB1 as a candidate gene which is involved in neuronal migration. DAB1 was also detected as a candidate in comparison with BBJ (ASA) and the Nagahama Cohort at a weak level of significance of p < 1 × 10−6. In comparison with BBJ (180K), RARB (retinoic acid receptor-β) was detected as a candidate at a significant level of p < 5 × 10−8 in the combined group of esotropia, exotropia, and idiopathic superior oblique muscle palsy. In conclusion, a series of GWASs with three different control cohorts would be an effective method with which to search for candidate genes for multifactorial diseases such as strabismus. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1341-9625 28 7 2023 Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review 847 859 EN Miho Saiga Department of Plastic Surgery, Okayama University Hospital Ryoko Nakagiri Department of Plastic Surgery, Okayama University Hospital Yuko Mukai Department of Plastic Surgery, Okayama Rosai Hospital Hiroshi Matsumoto Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshihiro Kimata Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Breast reconstruction (BR) aims to improve the satisfaction and quality of life (QOL) of breast cancer survivors. Clinical studies using patient-reported outcomes (PROs) can therefore provide relevant information to the patients and support decision-making. This scoping review was conducted to analyze recent trends in world regions, methods used, and factors investigated. The literature search was conducted in August 2022. Databases of PubMed, MEDLINE, and CINAHL were searched for relevant English-language studies published from 2017 to 2022. Studies involving women with breast cancer who underwent BR after mastectomy and investigated PROs after BR using BR-specific scales were included. Data on the country, publication year, study design, PRO measures (PROMs) used, time points of surveys, and research themes were collected. In total, 147 articles met the inclusion criteria. BREAST-Q was the most widely used, contributing to the increase in the number and diversification of studies in this area. Such research has been conducted mainly in North America and Europe and is still developing in Asia and other regions. The research themes involved a wide range of clinical and patient factors in addition to surgery, which could be influenced by research methods, time since surgery, and even cultural differences. Recent BR-specific PROMs have led to a worldwide development of research on factors that affect satisfaction and QOL after BR. PRO after BR may be influenced by local cultural and social features, and it would be necessary to accumulate data in each region to draw clinically useful conclusion. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1201-9712 141 2024 Vibriosis in South Asia: A systematic review and meta-analysis 106955 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Januka Khatiwada Social Work Institute Shanta Dutta Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives: South Asia remains home to foodborne diseases caused by the Vibrio species. We aimed to compile and update information on the epidemiology of vibriosis in South Asia. <br> Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, EMBASE, and Google Scholar for studies related to vibriosis in South Asia published up to May 2023. A random-effects meta-analysis was used to estimate the pooled isolation rate of non-cholera-causing Vibrio species. <br> Results: In total, 38 studies were included. Seven of these were case reports and 22 were included in the meta-analysis. The reported vibriosis cases were caused by non-O1/non-O139 V. cholerae, V. parahaemolyticus, V. fluvialis, and V. vulnificus. The overall pooled isolation rate was 4.0% (95% confidence interval [CI] 3.0-5.0%) in patients with diarrhea. Heterogeneity was high (I-2 = 98.0%). The isolation rate of non-O1/non-O139 V. cholerae, V. parahaemolyticus, and V. fluvialis were 9.0 (95% CI 7.0-10.0%), 1.0 (95% CI 1.0-2.0%), and 2.0 (95% CI: 1.0-3.0%), respectively. Regarding V. parahaemolyticus, O3:K6 was the most frequently isolated serotype. Cases peaked during summer. Several studies reported antibiotic-resistant strains and those harboring extended-spectrum beta-lactamases genes. <br> Conclusions: This study demonstrates a high burden of infections caused by non-cholera-causing Vibrio species in South Asia. No potential conflict of interest relevant to this article was reported.

Japanese Pharmacological Society Acta Medica Okayama 1347-8613 154 3 2024 Attenuation of protein arginine dimethylation via S-nitrosylation of protein arginine methyltransferase 1 209 217 EN Rikako Taniguchi Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuto Moriya Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Naoshi Dohmae Biomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource Science Takehiro Suzuki Biomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource Science Kengo Nakahara Department of Medicinal Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Sho Kubota 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 Upregulation of nitric oxide (NO) production contributes to the pathogenesis of numerous diseases via S-nitro- sylation, a post-translational modification of proteins. This process occurs due to the oxidative reaction between NO and a cysteine thiol group; however, the extent of this reaction remains unknown. S-Nitrosylation of PRMT1, a major asymmetric arginine methyltransferase of histones and numerous RNA metabolic proteins, was induced by NO donor treatment. We found that nitrosative stress leads to S-nitrosylation of cysteine 119, located near the active site, and attenuates the enzymatic activity of PRMT1. Interestingly, RNA sequencing analysis revealed similarities in the changes in expression elicited by NO and PRMT1 inhibitors or knockdown. A comprehensive search for PRMT1 substrates using the proximity-dependent biotin identification method highlighted many known and new substrates, including RNA-metabolizing enzymes. To validate this result, we selected the RNA helicase DDX3 and demonstrated that arginine methylation of DDX3 is induced by PRMT1 and attenuated by NO treatment. Our results suggest the existence of a novel regulatory system associated with transcription and RNA metabolism via protein S-nitrosylation. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0167-594X 167 1 2024 Midline invasion predicts poor prognosis in diffuse hemispheric glioma, H3 G34-mutant: an individual participant data review 201 210 EN Yasuhito Kegoya Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yoshihiro Otani Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yohei Inoue Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Ryo Mizuta Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Fumiyo Higaki Department of Radiology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Kana Washio Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Shinichiro Koizumi Department of Neurosurgery, Hamamatsu University School of Medicine Kazuhiko Kurozumi Department of Neurosurgery, Hamamatsu University School of Medicine Joji Ishida Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Kentaro Fujii Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Norio Yamamoto Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Yoshihiro Tanaka Division of Epidemiology, Graduate School of Public Health, Shizuoka Graduate University of Public Health Isao Date Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Introduction Diffuse hemispheric glioma, H3 G34-mutant (DHGs), is a newly categorized tumor in pediatric-type diffuse high-grade gliomas, World Health Organization grade 4, with a poor prognosis. Although prognostic factors associated with genetic abnormalities have been reported, few reports have examined the clinical presentation of DHGs, especially from the viewpoint of imaging findings. In this study, we investigated the relationship between clinical factors, including imaging findings, and prognosis in patients with DHGs.<br> Methods We searched Medline through the PubMed database using two search terms: “G34” and “glioma”, between 1 April 2012 and 1 July 2023. We retrieved articles that described imaging findings and overall survival (OS), and added one DHG case from our institution. We defined midline invasion (MI) as invasion to the contralateral cerebrum, brainstem, corpus callosum, thalamus, and basal ganglia on magnetic resonance imaging. The primary outcome was 12-month survival, estimated using Kaplan–Meier curves and logistic regression.<br> Results A total of 96 patients were included in this study. The median age was 22 years, and the proportion of male patients was 48.4%. Lesions were most frequently located in the frontal lobe (52.6%). MI was positive in 39.6% of all patients. The median OS was 14.4 months. Univariate logistic regression analysis revealed that OS was significantly worse in the MI-positive group compared with the MI-negative group. Multivariate logistic regression analysis revealed that MI was an independent prognostic factor in DHGs.<br> Conclusions In this study, MI-positive cases had a worse prognosis compared with MI-negative cases. No potential conflict of interest relevant to this article was reported.

岡山大学教師教育開発センター Acta Medica Okayama 2186-1323 14 2024 男性保育者に関する研究動向と今後の展望 373 387 EN Kyogo KURIHARA Okayama University Graduate School of Education Graduate Student Kazuya HASUI Kawasaki University of Medical Welfare Mika KATAYAMA Faculty of Education, Okayama University 10.18926/CTED/66793 　本研究は、男性保育者を対象とした先行研究から、研究動向を明らかにし今後の課題を展望することを目的とした。対象文献は、CiNii Research を用いて、「男性保育者」をキーワードとして設定し検索したところ、84件が分析対象となった。対象文献を内容ごとに整理した結果、８つに分類することができた。各分類から、男性保育者に対する保育現場及び社会の認識は比較的明らかにされていたが、男性保育者自身の視点に焦点を当てた研究は十分でないことが明らかとなった。今後は、誕生して50年以上が経過した男性保育者を取り巻く周囲の認識の現状を改めて検討するとともに、男性保育者が保育職にやりがいを感じ、長期的なキャリアを築くにあたっての自己認識及び男性保育者が抱える課題の明確化が必要と考えられた。 No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 12 22 2023 Epidemiology and Reporting Characteristics of Systematic Reviews in Orthopedic Journals: A Meta-Epidemiological Study 7031 EN Norio Yamamoto Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shunsuke Taito Scientific Research WorkS Peer Support Group (SRWS-PSG) Takanori Miura Scientific Research WorkS Peer Support Group (SRWS-PSG) Takashi Ariie Scientific Research WorkS Peer Support Group (SRWS-PSG) Yosuke Tomita Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare Hirofumi Ogihara Scientific Research WorkS Peer Support Group (SRWS-PSG) Daijo Shiratsuchi Graduate School of Health Sciences, Kagoshima University Takashi Yorifuji Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasushi Tsujimoto Scientific Research WorkS Peer Support Group (SRWS-PSG) Systematic reviews (SRs) with complete reporting or rigorous methods can lead to less biased recommendations and decisions. A comprehensive analysis of the epidemiological and reporting characteristics of SRs in orthopedics is lacking. We evaluated 360 SRs, including 165 and 195 published in orthopedic journals in 2012 and 2022. According to the established reporting guidelines, we examined these SRs for key epidemiological characteristics, including focus areas, type of meta-analysis (MA), and reporting characteristics. Most SRs (71%) were therapy-related, with a significant proportion originating from authors in the USA, UK, and China. Pairwise MA was performed on half of the SRs. The proportion of protocol registrations improved by 2022 but remained low (33%). Despite a formal declaration of adherence to the reporting guidelines (68%), they were often not used and reported enough. Only 10% of the studies used full search strategies, including trial registries. Publication bias assessments, subgroup analyses, and sensitivity analyses were not even planned. The risk of bias assessment improved in 2022; however, the certainty of the evidence remained largely unassessed (8%). The use and reporting of standard methods in orthopedic SRs have remained suboptimal. Thus, authors, peer reviewers, journal editors, and readers should criticize the results more. No potential conflict of interest relevant to this article was reported.

岡山大学農学部 Acta Medica Okayama 2186-7755 113 2024 四倍体コムギが保有する新規早生遺伝子の探索およびその効率的遺伝解析法の開発 49 54 EN Kazusa Nishimura Course of Applied Plant Science Wheat (Triticum spp.) is one of the world's three major cereals and a staple food for more than 35% of the world's population, and while nearly doubling crop yields is essential to meet the caloric demands of a growing population by 2050, current rates of wheat yield growth are insufficient to meet this demand. Therefore, it is important to promote the improvement of wheat varieties and to increase yields in a stable manner by utilizing all available genetic resources. Here I would like to introduce some research that has been conducted in this regard, using tetraploid wheat (Triticum turgidum L.) as a genetic resource in the search for genes related to flowering time and the research related to the streamlined genetic analysis technique. No potential conflict of interest relevant to this article was reported.

岡山大学農学部 Acta Medica Okayama 2186-7755 113 2024 過剰発現プロファイリングADOPT法を用いたS.cerevisiaeのワイン醸造用ブドウ果汁への適応性評価 1 6 EN Hisao Moriya Course of Agrochemical Bioscience Chiyuki Kohata Ono Course of Agrochemical Bioscience The authors have recently developed the overexpression profiling ADOPT method. In the ADOPT method, yeast strains overexpressing most of the genes in the budding yeast Saccharomyces cerevisiae genome are mixed and competitively cultured, and the genes overexpressed in the enriched strains are systematically identified. Furthermore, the identified genes can be used to identify bottleneck factors that are necessary but lacking for growth of S. cerevisiae under given conditions. In our previous studies, we have identified bottlenecks in artificially created stress environments in the laboratory, but in this study, we used grape juice for winemaking as an example to see if industrial bottlenecks can be identified. ADOPT experiments with sulfite-added grape juice used in conventional winemaking resulted in a strong enrichment of strains overexpressing the sulfite pump SSU1 and its transcription factor FZF1. Since enhancement of SSU1 function is known to occur in wine yeast acclimation, ADOPT was also shown to be useful in the search for industrial bottlenecks. On the other hand, no genes were strongly enriched by ADOPT in grape juice without sulfite addition, suggesting that grape juice is a balanced medium with few bottlenecks for S. cerevisiae growth. No potential conflict of interest relevant to this article was reported.

Wiley Acta Medica Okayama 2052-8817 10 1 2023 Clinical parameter-guided initial resuscitation in adult patients with septic shock: A systematic review and network meta-analysis e914 EN Tetsuya Yumoto Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Tomoki Kuribara School of Nursing, Sapporo City University Kohei Yamada Department of Traumatology and Critical Care Medicine, National Defense Medical College Hospital Takehito Sato Department of Anesthesiology, Nagoya University Hospital Shigeru Koba Department of Critical Care Medicine, Nerima Hikarigaoka Hospital Kenichi Tetsuhara Department of Critical Care Medicine, Fukuoka Children's Hospital Masahiro Kashiura Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University Masaaki Sakuraya Department of Emergency and Intensive Care Medicine, JA Hiroshima General Hospital Aim: To identify the most useful tissue perfusion parameter for initial resuscitation in sepsis/septic shock adults using a network meta-analysis.<br> Methods: We searched major databases until December 2022 for randomized trials comparing four tissue perfusion parameters or against usual care. The primary outcome was short-term mortality up to 90 days. The Confidence in Network Meta-Analysis web application was used to assess the quality of evidence.<br> Results: Seventeen trials were identified. Lactate-guided therapy (risk ratios, 0.59; 95% confidence intervals [0.45–0.76]; high certainty) and capillary refill time-guided therapy (risk ratios, 0.53; 95% confidence intervals [0.33–0.86]; high certainty) were significantly associated with lower short-term mortality compared with usual care, whereas central venous oxygen saturation-guided therapy (risk ratio, 1.50; 95% confidence intervals [1.16–1.94]; moderate certainty) increased the risk of short-term mortality compared with lactate-guided therapy.<br> Conclusions: Lactate or capillary refill time-guided initial resuscitation for sepsis/septic shock patients may decrease short-term mortality. More research is essential to personalize and optimize treatment strategies for septic shock resuscitation. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1368-8375 142 2023 EpEX, the soluble extracellular domain of EpCAM, resists cetuximab treatment of EGFR-high head and neck squamous cell carcinoma 106433 EN Koki Umemori Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kisho Ono Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Takanori Eguchi Department of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hotaka Kawai Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tomoya Nakamura Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Tatsuo Ogawa Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kunihiro Yoshida Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hideka Kanemoto Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kohei Sato Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kyoichi Obata Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shoji Ryumon Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hirokazu Yutori Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Naoki Katase Department of Oral Pathology, Graduate School of Biomedical Sciences, Nagasaki University Tatsuo Okui Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine Hitoshi Nagatsuka Department of Oral Pathology and Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Soichiro Ibaragi Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Objectives: Cetuximab (Cmab) is a molecularly targeted monoclonal antibody drug for head and neck squamous cell carcinoma (HNSC), although cetuximab resistance is a serious challenge. Epithelial cell adhesion molecule (EpCAM) is an established marker for many epithelial tumors, while the soluble EpCAM extracellular domain (EpEX) functions as a ligand for epidermal growth factor receptor (EGFR). We investigated the expression of EpCAM in HNSC, its involvement in Cmab action, and the mechanism by which soluble EpEX activated EGFR and played key roles in Cmab resistance.<br> Materials and methods: We first examined EPCAM expression in HNSCs and its clinical significance by searching gene expression array databases. We then examined the effects of soluble EpEX and Cmab on intracellular signaling and Cmab efficacy in HNSC cell lines (HSC-3 and SAS).<br> Results: EPCAM expression was found to be enhanced in HNSC tumor tissues compared to normal tissues, and the enhancement was correlated with stage progression and prognosis. Soluble EpEX activated the EGFR-ERK signaling pathway and nuclear translocation of EpCAM intracellular domains (EpICDs) in HNSC cells. EpEX resisted the antitumor effect of Cmab in an EGFR expression-dependent manner.<br> Conclusion: Soluble EpEX activates EGFR to increase Cmab resistance in HNSC cells. The EpEX-activated Cmab resistance in HNSC is potentially mediated by the EGFR-ERK signaling pathway and the EpCAM cleavage-induced nuclear translocation of EpICD. High expression and cleavage of EpCAM are potential biomarkers for predicting the clinical efficacy and resistance to Cmab. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2023 Development of Neutron Tagging Algorithm and Search for Supernova Relic Neutrino in SK-Gd Experiment EN Masayuki HARADA Graduate School of Natural Science and Technology, Okayama university No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0196-6553 51 9 2023 Increased evidence for no benefit of contact precautions in preventing extended-spectrum β-lactamases-producing Enterobacteriaceae: Systematic scoping review 1056 1062 EN Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Introduction: Extended-spectrum β-lactamases-producing Enterobacteriaceae (ESBL-E) is a critical antimicrobial resistance pathogen, to which we need to pay the greatest attention. This study was aimed at uncovering the present evidence for the preventive effectiveness of contact precautions for patients colonized or infected with ESBL-E.<br> Methods: According to the Preferred Reporting Items for Systemic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews, we searched MEDLINE for articles with relevant keywords from the beginning of 2010 to October 18, 2022.<br> Results: Of the 355 articles found, 9, including 8 observational studies and 1 randomized controlled trial, were selected. Safety of discontinuing contact precautions was evaluated mainly in acute-care and long-term care hospitals. Consistently, all authors concluded that contact precautions can be safely discontinued in patients colonized or infected with ESBL-E.<br> Conclusion: The clinical impact of discontinuing contact precautions for patients with ESBL-E is minimal and can be safely withdrawn at acute, noncritical, adult care wards. Relevant data from pediatric and geriatric wards, as well as intensive care units, were insufficient and should be investigated in future research. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1867-1071 40 10 2022 Up-to-date evidence on image-guided thermal ablation for metastatic lung tumors: a review 1024 1034 EN Yusuke Matsui Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Koji Tomita Department of Radiology, Okayama University Hospital Mayu Uka Department of Radiology, Okayama University Hospital Noriyuki Umakoshi Department of Radiology, Okayama University Hospital Takahiro Kawabata Department of Radiology, Okayama University Hospital Kazuaki Munetomo Department of Radiology, Okayama University Hospital Shoma Nagata Department of Radiology, Okayama University Hospital Toshihiro Iguchi Department of Radiological Technology, Faculty of Health Sciences, Okayama University Takao Hiraki Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The aim of this review was to summarize the latest evidence on image-guided thermal ablation therapies for lung metastases. PubMed was used to search for relevant articles that reported the oncological outcomes of thermal ablation for metastatic lung tumors, and those published in 2010 or later were selected for review. Ablative therapies were applied for lung metastases from various types of primary tumors, but most commonly colorectal ones. Radiofrequency ablation (RFA) was the most evaluated technique, followed by microwave ablation (MWA). The local control rates of ablative therapies were generally favorable, approximately 80–90% in many studies. Representative studies demonstrated promising overall survival rates of approximately 50% or higher 5 years after ablation for lung metastases from colorectal cancer or mixed types of primary tumors. Nevertheless, the survival outcomes varied depending on the type of primary tumor and background factors of patients such as other metastases and comorbidities. Several studies had aimed to compare the outcomes of various ablative therapies such as RFA, MWA, and cryoablation; however, conclusive data are not yet available to determine the most appropriate ablation modality for lung metastases. Further data accumulation is needed, especially for long-term outcomes and comparisons with other therapies. No potential conflict of interest relevant to this article was reported.

Japan Society of Mechanical Engineers Acta Medica Okayama 1881-3054 16 4 2022 Adaptive heterogeneous particle swarm optimization with comprehensive learning strategy JAMDSM0035 EN Ziang LIU Faculty of Natural Science and Technology, Okayama University Tatsushi NISHI Faculty of Natural Science and Technology, Okayama University This paper proposes an adaptive heterogeneous particle swarm optimization with a comprehensive learning strategy for solving single-objective constrained optimization problems. In this algorithm, particles can use an exploration strategy and an exploitation strategy to update their positions. The historical success rates of the two strategies are used to adaptively control the adoption rates of strategies in the next iteration. The search strategy in the canonical particle swarm optimization algorithm is based on elite solutions. As a result, when no particles can discover better solutions for several generations, this algorithm is likely to fall into stagnation. To respond to this challenge, a new strategy is proposed to explore the neighbors of the elite solutions in this study. Finally, a constraint handling method is equipped to the proposed algorithm to make it be able to solve constrained optimization problems. The proposed algorithm is compared with the canonical particle swarm optimization, differential evolution, and several recently proposed algorithms on the benchmark test suite. The Wilcoxon signed-rank test results show that the proposed algorithm is significantly better on most of the benchmark problems compared with the competitors. The proposed algorithm is also applied to solve two real-world mechanical engineering problems. The experimental results show that the proposed algorithm performs consistently well on these problems. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2005 Novice-oriented human interface for a search and rescue robot system EN Zhixiao Yang No potential conflict of interest relevant to this article was reported.

IOP Publishing Ltd Acta Medica Okayama 2041-8205 951 2 2023 Search for Astrophysical Electron Antineutrinos in Super-Kamiokande with 0.01% Gadolinium-loaded Water L27 EN M. Harada Department of Physics, Okayama University We report the first search result for the flux of astrophysical electron antineutrinos for energies O(10) MeV in the gadolinium-loaded Super-Kamiokande (SK) detector. In 2020 June, gadolinium was introduced to the ultrapure water of the SK detector in order to detect neutrons more efficiently. In this new experimental phase, SK-Gd, we can search for electron antineutrinos via inverse beta decay with efficient background rejection thanks to the high efficiency of the neutron tagging technique. In this paper, we report the result for the initial stage of SK-Gd, during 2020 August 26, and 2022 June 1 with a 22.5 x 552 kton center dot day exposure at 0.01% Gd mass concentration. No significant excess over the expected background in the observed events is found for the neutrino energies below 31.3 MeV. Thus, the flux upper limits are placed at the 90% confidence level. The limits and sensitivities are already comparable with the previous SK result with pure water (22.5 x 2970 kton center dot day) owing to the enhanced neutron tagging. Operation with Gd increased to 0.03% started in 2022 June. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 2199-4536 10 1 2023 Data-driven evolutionary computation for service constrained inventory optimization in multi-echelon supply chains 825 846 EN Ziang Liu Faculty of Environmental, Life, Natural Science and Technology, Okayama University Tatsushi Nishi Faculty of Environmental, Life, Natural Science and Technology, Okayama University Supply chain digital twin has emerged as a powerful tool in studying the behavior of an actual supply chain. However, most studies in the field of supply chain digital twin have only focused on what-if analysis that compares several different scenarios. This study proposes a data-driven evolutionary algorithm to efficiently solve the service constrained inventory optimization problem using historical data that generated by supply chain digital twins. The objective is to minimize the total costs while satisfying the required service level for a supply chain. The random forest algorithm is used to build surrogate models which can be used to estimate the total costs and service level in a supply chain. The surrogate models are optimized by an ensemble approach-based differential evolution algorithm which can adaptively use different search strategies to improve the performance during the computation process. A three-echelon supply chain digital twin on the geographic information system (GIS) map in real-time is used to examine the efficiency of the proposed method. The experimental results indicate that the data-driven evolutionary algorithm can reduce the total costs and maintain the required service level. The finding suggests that our proposed method can learn from the historical data and generate better inventory policies for a supply chain digital twin. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 4 2023 Association of Tumor Necrosis Factor-Alpha with Psychopathology in Patients with Schizophrenia 395 405 EN Marko Pavlovic University Hospital Center Mostar, University of Mostar Dragan Babic University Hospital Center Mostar, University of Mostar Pejana Rastovic University Hospital Center Mostar, University of Mostar Jurica Arapovic University Hospital Center Mostar, University of Mostar Marko Martinac Health Care Center Mostar, University of Mostar Sanja Jakovac University Hospital Center Mostar, University of Mostar Romana Barbaric University Hospital Center Mostar, University of Mostar Original Article 10.18926/AMO/65750 We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=−0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=−0.258, t=−2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=−0.247, p=0.019) and antipsychotic treatment duration (ρ=−0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 77 4 2023 Association between Radon Hot Spring Bathing and Health Conditions: A Cross-Sectional Study in Misasa, Japan 387 394 EN Takahiro Kataoka Department of Radiological Technology, Okayama University Graduate School of Health Sciences Hiroshi Habu Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ayumi Tanaka Department of Radiological Technology, Okayama University Graduate School of Health Sciences Shota Naoe Department of Radiological Technology, Okayama University Graduate School of Health Sciences Kaito Murakami Department of Radiological Technology, Okayama University Graduate School of Health Sciences Yuki Fujimoto Department of Radiological Technology, Okayama University Graduate School of Health Sciences Ryohei Yukimine Department of Radiological Technology, Okayama University Graduate School of Health Sciences Soshi Takao Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumihiro Mitsunobu Department of Longevity and Social Medicine (Geriatrics), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takashi Yorifuji Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kiyonori Yamaoka Department of Radiological Technology, Okayama University Graduate School of Health Sciences Original Article 10.18926/AMO/65749 No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants’ bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 1094-5539 82 2023 Safety and usefulness of nebulized liposomal amphotericin B: Systematic scoping review 102233 EN Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yoshito Nishimura Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Purpose<br> Invasive fungal infections potentially result in fatal outcomes in immunocompromised hosts. Compared to intravenous administration, a nebulization therapy can achieve a high concentration of drug delivered in the respiratory tract, without a systematic absorption. We herein summarized the study findings on the safety and clinical utility of nebulized liposomal amphotericin B therapy.<br> Methods<br> According to the PRISMA Extension for Scoping Reviews, we performed a search on MEDLINE and EMBASE for articles with relevant keywords, including “inhaled liposomal amphotericin B″, “nebulized liposomal amphotericin B″, or “aerosolized liposomal amphotericin B″, from the inception of these databases to August 31, 2022.<br> Results<br> Of the 172 articles found, 27 articles, including 13 case reports, 11 observational studies, and 3 clinical trials, were selected. Generally, findings showed that nebulized liposomal amphotericin B treatment appeared to be safe and without severe adverse effects. We found an accumulated evidence for the safety, tolerability, and effectiveness of nebulized liposomal amphotericin B prophylaxis among lung transplantation recipients; however, a randomized controlled study has yet to be reported. Data on hemato-oncological patients are relatively scarce; however, a randomized controlled study suggested the prophylactic effect of nebulized liposomal amphotericin B on invasive pulmonary aspergillosis. Observational and randomized controlled studies to evaluate therapeutic efficacy of the nebulized liposomal amphotericin B therapy have not been performed.<br> Conclusion<br> In conclusion, we found increasing evidence for the effectiveness of the inhalation therapy among patients after lung transplantation and with hemato-oncological diseases. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 18794068 14 5 2023 Significance of the comprehensive geriatric assessment in the administration of chemotherapy to older adults with cancer: Recommendations by the Japanese Geriatric Oncology Guideline Committee 101485 EN Kiichiro Ninomiya Center for Comprehensive Genomic Medicine, Okayama University Hospital Daisuke Inoue Department of Obstetrics and Gynecology, University of Fukui Ken Sugimoto Department of General Geriatric Medicine, Kawasaki Medical School Chie Tanaka Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine Keiko Murofushi Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Toru Okuyama Department of Psychiatry / Palliative Care Center, Nagoya City University West Medical Center Shigeaki Watanuki National Center for Global Health and Medicine, National College of Nursing Chiyo K. Imamura Advanced Cancer Translational Research Institute, Showa University Daisuke Sakai Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine Naomi Sakurai Cancer Solutions Co.,Ltd Kiyotaka Watanabe Division of Medical Oncology, Department of Medicine, School of Medicine, Teikyo University Kazuo Tamura NPO Clinical Hematology/Oncology Treatment Study Group Toshiaki Saeki Breast Oncology Service, Saitama Medical University International Medical Center Hiroshi Ishiguro Breast Oncology Service, Saitama Medical University International Medical Center Introduction: The number of older patients with cancer is expected to continue to increase owing to the aging population. Recently, the usefulness of geriatric assessment (GA) conducted by multiple staff members from different medical backgrounds has been reported; however, a consensus on the effectiveness of GA has not yet been achieved.<br> Materials and Methods: We, as the Japanese Geriatric Oncology Guideline Committee for elderly patients with cancer, conducted a literature search of randomized controlled trials published before August 2021 that used GA or comprehensive GA (CGA) as an intervention for patients with cancer undergoing chemotherapy. As the key outcomes for answering the clinical question, we focused on survival benefit, adverse events, and quality of life (QOL). After a systematic review of these studies, the expert panel member developed recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.<br> Results: For older patients with cancer, GA or CGA is suggested during or before chemotherapy (weakly recommended). Chemotherapy-induced adverse events were significantly reduced by GA/CGA interventions without any adverse effects on survival. Health-related QOL tended to improve with the GA/CGA interventions.<br> Discussion: Although, in our opinion, GA/CGA does require time and resources, it poses no harm patients. Therefore, we suggest expanding the human resources and educating skills of medical providers for clinical implementation of GA/CGA. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 1477-8939 52 2023 Shigellosis in Southeast Asia: A systematic review and meta-analysis 102554 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Debmalya Mitra Collaborative Research Centre of Okayama University for Infectious Diseases in India at ICMR-NICED Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Januka Khatiwada Social Work Institute Shanta Dutta Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background: Southeast Asia is attractive for tourism. Unfortunately, travelers to this region are at risk of becoming infected with Shigella. We conducted a meta-analysis to provide updates on Shigella prevalence in Southeast Asia, along with their serogroups and serotypes.<br> Methods: We conducted a systematic search using PubMed, EMBASE, and Web of Science for peer-reviewed studies from 2000 to November 2022. We selected studies that detected Shigella in stools by culture or polymerase chain reaction (PCR). Two reviewers extracted the data using a standardized form and performed quality assessments using the Joanna Briggs Institute checklist. The random effects model was used to estimate the pooled prevalence of Shigella.<br> Results: During our search, we identified 4376 studies. 29 studies (from six Southeast Asian countries) were included in the systematic review, 21 each in the meta-analysis of the prevalence of Shigella (Sample size: 109545) and the prevalence of Shigella serogroups.<br> The pooled prevalence of Shigella was 4% (95% CI: 4–5%) among diarrhea cases. Shigella sonnei was the most abundant serogroup in Thailand (74%) and Vietnam (57%), whereas Shigella flexneri was dominant in Indonesia (72%) and Cambodia (71%). Shigella dysenteriae and Shigella boydii were uncommon (pooled prevalence of 1% each). The pooled prevalence of Shigella was 5% (95% CI: 4–6%) in children aged <5 years. The pooled prevalence showed a decreasing trend comparing data collected between 2000–2013 (5%; 95% CI: 4–6%) and between 2014–2022 (3%; 95% CI: 2–4%). Shigella prevalence was 6% in studies that included participants with mixed pathogens versus 3% in those without. Shigella flexneri serotype 2a was the most frequently isolated (33%), followed by 3a (21%), 1b (10%), 2b (3%), and 6 (3%).<br> Conclusions: This study provides compelling evidence for the development of effective Shigella vaccines for residents of endemic regions and travellers to these areas. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学科 Acta Medica Okayama 1340-7414 29 1 2023 2018 年北海道胆振東部地震の初期の破壊過程 49 63 EN Hirofumi KOWARI Department of Earth Sciences, Okayama University Masanao KOMATSU Department of Earth Sciences, Okayama University Hiroshi TAKENAKA Department of Earth Sciences, Okayama University 10.18926/ESR/65481 The rupture process at the beginning stage of the 2018 Hokkaido Eastern Iburi, Japan, earthquake (MJ 6.7) is investigated by analyzing P-wave records from local strong-motion stations. The records show about 3 s of small amplitude arrival (so-called "initial rupture phase") followed by the onset of the main energy release ("main rupture phase"). In this paper we address the issue: where the seismic energy release corresponding to the main rupture phase started at the primary stage of the main rupture, by locating the main rupture onset position. For this aim we applied the 2D and the 3D search methods to estimate the relative location of the onset of the main rupture with respect to the hypocenter, and the time difference between them. The 2D method assumes a plausible initial fault plane and locates the main rupture onset position on the initial fault plane, while the 3D method does not require such assumed fault planes. In the 2D method we employed each of the nodal planes of the first-motion focal mechanism as the initial rupture plane. The 3D method was able to give a better solution than the 2D one. It suggests that the main rupture initiation point might not be on the same fault plane as the hypocenter is. The solution shows that the main rupture onset point is 5.8 km southward and 2.5 km upward from the hypocenter, with the rupture time of 3.3 s from the origin time. It is consistent with the previous studies on the relationship between the magnitude and the initial rupture duration. No potential conflict of interest relevant to this article was reported.

Baishideng Publishing Group Acta Medica Okayama 1007-9327 29 12 2023 Review of lymphoma in the duodenum: An update of diagnosis and management 1852 1862 EN Masaya Iwamuro Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Takehiro Tanaka Department of Pathology, Okayama University Hospital Hiroyuki Okada Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences The presentation, subtype, and macroscopic images of lymphoma vary depending on the site of the tumor within the gastrointestinal tract. We searched PubMed for publications between January 1, 2012 and October 10, 2022, and retrieved 130 articles relating to duodenal lymphoma. A further 22 articles were added based on the manual screening of relevant articles, yielding 152 articles for full-text review. The most predominant primary duodenal lymphoma was follicular lymphoma. In this review, we provide an update of the diagnosis and man-agement of representative lymphoma subtypes occurring in the duodenum: Follicular lymphoma, diffuse large B-cell lymphoma, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, mantle cell lymphoma, and T-cell lymphomas. No potential conflict of interest relevant to this article was reported.

Public Library of Science Acta Medica Okayama 1932-6203 18 3 2023 Knockout of ribosomal protein RpmJ leads to zinc resistance in Escherichia coli EN Riko Shirakawa Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Kazuya Ishikawa 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 Zinc is an essential metal for cells, but excess amounts are toxic. Other than by regulating the intracellular zinc concentration by zinc uptake or efflux, the mechanisms underlying bacterial resistance to excess zinc are unknown. In the present study, we searched for zinc-resistant mutant strains from the Keio collection, a gene knockout library of Escherichia coli, a model gram-negative bacteria. We found that knockout mutant of RpmJ (L36), a 50S ribosomal protein, exhibited zinc resistance. The rpmJ mutant was sensitive to protein synthesis inhibitors and had altered translation fidelity, indicating ribosomal dysfunction. In the rpmJ mutant, the intracellular zinc concentration was decreased under excess zinc conditions. Knockout of ZntA, a zinc efflux pump, abolished the zinc-resistant phenotype of the rpmJ mutant. RNA sequence analysis revealed that the rpmJ mutant exhibited altered gene expression of diverse functional categories, including translation, energy metabolism, and stress response. These findings suggest that knocking out RpmJ alters gene expression patterns and causes zinc resistance by lowering the intracellular zinc concentration. Knockouts of other ribosomal proteins, including RplA, RpmE, RpmI, and RpsT, also led to a zinc-resistant phenotype, suggesting that deletion of ribosomal proteins is closely related to zinc resistance. No potential conflict of interest relevant to this article was reported.

Frontiers Media Acta Medica Okayama 2296-9144 10 2023 Parameter search of a CPG network using a genetic algorithm for a snake robot with tactile sensors moving on a soft floor 1138019 EN Hajime Tamura Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Tetsushi Kamegawa Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University When a snake robot explores a collapsed house as a rescue robot, it needs to move through various obstacles, some of which may be made of soft materials, such as mattresses. In this study, we call mattress-like environment as a soft floor, which deforms when some force is added to it. We focused on the central pattern generator (CPG) network as a control for the snake robot to propel itself on the soft floor and constructed a CPG network that feeds back contact information between the robot and the floor. A genetic algorithm was used to determine the parameters of the CPG network suitable for the soft floor. To verify the obtained parameters, comparative simulations were conducted using the parameters obtained for the soft and hard floor, and the parameters were confirmed to be appropriate for each environment. By observing the difference in snake robot's propulsion depending on the presence or absence of the tactile sensor feedback signal, we confirmed the effectiveness of the tactile sensor considered in the parameter search. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1422-0067 24 6 2023 Stress-Inducible SCAND Factors Suppress the Stress Response and Are Biomarkers for Enhanced Prognosis in Cancers 5168 EN Mona Sheta Department of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kunihiro Yoshida Department of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hideka Kanemoto Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Stuart K. Calderwood Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School Takanori Eguchi Department of Dental Pharmacology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The cell stress response is an essential system present in every cell for responding and adapting to environmental stimulations. A major program for stress response is the heat shock factor (HSF)-heat shock protein (HSP) system that maintains proteostasis in cells and promotes cancer progression. However, less is known about how the cell stress response is regulated by alternative transcription factors. Here, we show that the SCAN domain (SCAND)-containing transcription factors (SCAN-TFs) are involved in repressing the stress response in cancer. SCAND1 and SCAND2 are SCAND-only proteins that can hetero-oligomerize with SCAN-zinc finger transcription factors, such as MZF1(ZSCAN6), for accessing DNA and transcriptionally co-repressing target genes. We found that heat stress induced the expression of SCAND1, SCAND2, and MZF1 bound to HSP90 gene promoter regions in prostate cancer cells. Moreover, heat stress switched the transcript variants' expression from long noncoding RNA (lncRNA-SCAND2P) to protein-coding mRNA of SCAND2, potentially by regulating alternative splicing. High expression of HSP90AA1 correlated with poorer prognoses in several cancer types, although SCAND1 and MZF1 blocked the heat shock responsiveness of HSP90AA1 in prostate cancer cells. Consistent with this, gene expression of SCAND2, SCAND1, and MZF1 was negatively correlated with HSP90 gene expression in prostate adenocarcinoma. By searching databases of patient-derived tumor samples, we found that MZF1 and SCAND2 RNA were more highly expressed in normal tissues than in tumor tissues in several cancer types. Of note, high RNA expression of SCAND2, SCAND1, and MZF1 correlated with enhanced prognoses of pancreatic cancer and head and neck cancers. Additionally, high expression of SCAND2 RNA was correlated with better prognoses of lung adenocarcinoma and sarcoma. These data suggest that the stress-inducible SCAN-TFs can function as a feedback system, suppressing excessive stress response and inhibiting cancers. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 12 5 2023 Serum sCD40L and IL-31 in Association with Early Phase of IgA Nephropathy 2023 EN Keiko Tanaka Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Hitoshi Sugiyama Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Hiroshi Morinaga Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Masashi Kitagawa Department of Nephrology, National Hospital Organization Okayama Medical Center Yuzuki Kano Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Yasuhiro Onishi Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Koki Mise Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Katsuyuki Tanabe Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Haruhito A. Uchida Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Jun Wada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences Background: IgA nephropathy (IgAN) is a major cause of chronic glomerulonephritis worldwide. T cell dysregulation has been reported to contribute to the pathogenesis of IgAN. Methods We measured a broad range of Th1, Th2 and Th17 cytokines in the serum of IgAN patients. We searched for significant cytokines, which were associated with clinical parameters and histological scores in IgAN patients. Results: Among 15 cytokines, the levels of soluble CD40L (sCD40L) and IL-31 were higher in IgAN patients and were significantly associated with a higher estimated glomerular filtration rate (eGFR), a lower urinary protein to creatinine ratio (UPCR), and milder tubulointerstitial lesions (i.e., the early phase of IgAN). Multivariate analysis revealed that serum sCD40L was an independent determinant of a lower UPCR after adjustment for age, eGFR, and mean blood pressure (MBP). CD40, a receptor of sCD40L, has been reported to be upregulated on mesangial cells in IgAN. The sCD40L/CD40 interaction may directly induce inflammation in mesangial areas and may therefore be involved in the development of IgAN. Conclusions: The present study demonstrated the significance of serum sCD40L and IL-31 in the early phase of IgAN. Serum sCD40L may be a marker of the beginning of inflammation in IgAN. No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1472-6831 23 1 2023 Autophagy as a potential mechanism underlying the biological effect of 1,25-Dihydroxyvitamin D3 on periodontitis: a narrative review 90 EN Xiaoting Chen Department of Pathophysiology‑Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Zulema Arias Department of Pathophysiology‑Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kazuhiro Omori Department of Periodontics and Endodontics, Okayama University Hospital Tadashi Yamamoto Department of Pathophysiology‑Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yuki Shinoda-Ito Department of Pathophysiology‑Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shogo Takashiba Department of Pathophysiology‑Periodontal Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The major active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25D3), is known for its wide bioactivity in periodontal tissues. Although the exact mechanisms underlying its protective action against periodontitis remain unclear, recent studies have shown that 1,25D3 regulates autophagy. Autophagy is vital for intracellular pathogen invasion control, inflammation regulation, and bone metabolic balance in periodontal tissue homeostasis, and its regulation could be an interesting pathway for future periodontal studies. Since vitamin D deficiency is a worldwide health problem, its role as a potential regulator of autophagy provides new insights into periodontal diseases. Based on this premise, this narrative literature review aimed to investigate the possible connection between 1,25D3 and autophagy in periodontitis. A comprehensive literature search was conducted on PubMed using the following keywords (e.g., vitamin D, autophagy, periodontitis, pathogens, epithelial cells, immunity, inflammation, and bone loss). In this review, the latest studies on the protective action of 1,25D3 against periodontitis and the regulation of autophagy by 1,25D3 are summarized, and the potential role of 1,25D3-activated autophagy in the pathogenesis of periodontitis is analyzed. 1,25D3 can exert a protective effect against periodontitis through different signaling pathways in the pathogenesis of periodontitis, and at least part of this regulatory effect is achieved through the activation of the autophagic response. This review will help clarify the relationship between 1,25D3 and autophagy in the homeostasis of periodontal tissues and provide perspectives for researchers to optimize prevention and treatment strategies in the future. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2076-3417 13 3 2023 Flexible Route Planning for Multiple Mobile Robots by Combining Q-Learning and Graph Search Algorithm 1879 EN Tomoya Kawabe Graduate School of Natural Science and Technology, Okayama University Tatsushi Nishi Graduate School of Natural Science and Technology, Okayama University Ziang Liu Graduate School of Natural Science and Technology, Okayama University The use of multiple mobile robots has grown significantly over the past few years in logistics, manufacturing and public services. Conflict-free route planning is one of the major research challenges for such mobile robots. Optimization methods such as graph search algorithms are used extensively to solve route planning problems. Those methods can assure the quality of solutions, however, they are not flexible to deal with unexpected situations. In this article, we propose a flexible route planning method that combines the reinforcement learning algorithm and a graph search algorithm for conflict-free route planning problems for multiple robots. In the proposed method, Q-learning, a reinforcement algorithm, is applied to avoid collisions using off-line learning with a limited state space to reduce the total learning time. Each vehicle independently finds the shortest route using the A* algorithm, and Q-learning is used to avoid collisions. The effectiveness of the proposed method is examined by comparing it with conventional methods in terms of computation time and the quality of solutions. Computational results show that for dynamic transportation problems, the proposed method can generate the solutions with approximately 10% of the computation time compared to the conventional Q-learning approach. We found that the required computation time is linearly increased with respect to the number of vehicles and nodes in the problems. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1999-4893 16 1 2023 Three Diverse Applications of General-Purpose Parameter Optimization Algorithm 45 EN Yuanzhi Huo Department of Information and Communication Systems, Okayama University Pradini Puspitaningayu Department of Information and Communication Systems, Okayama University Nobuo Funabiki Department of Information and Communication Systems, Okayama University Kazushi Hamazaki Department of Information and Communication Systems, Okayama University Minoru Kuribayashi Department of Information and Communication Systems, Okayama University Yihan Zhao Department of Mechanical Engineering, Shonan Institute of Technology Kazuyuki Kojima Department of Mechanical Engineering, Shonan Institute of Technology Parameters often take key roles in determining the accuracy of algorithms, logics, and models for practical applications. Previously, we have proposed a general-purpose parameter optimization algorithm, and studied its applications in various practical problems. This algorithm optimizes the parameter values by repeating small changes of them based on a local search method with hill-climbing capabilities. In this paper, we present three diverse applications of this algorithm to show the versatility and effectiveness. The first application is the fingerprint-based indoor localization system using IEEE802.15.4 devices called FILS15.4 that can detect the location of a user in an indoor environment. It is shown that the number of fingerprints for each detection point, the fingerprint values, and the detection interval are optimized together, and the average detection accuracy exceeds 99%. The second application is the human face contour approximation model that is described by a combination of half circles, line segments, and a quadratic curve. It is shown that the simple functions can well approximate the face contour of various persons by optimizing the center coordinates, radii, and coefficients. The third application is the computational fluid dynamic (CFD) simulation to estimate temperature changes in a room. It is shown that the thermal conductivity is optimized to make the average temperature difference between the estimated and measured 0.22 &#8451;. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 2352-3409 44 2022 The dataset of Japanese patents and patents' holding firms in green vehicle powertrains field 108524 EN Jiaming Jiang Graduate School of Humanities and Social Science, Okayama University Kensuke Baba Cyber-Physical Engineering Informatics Research Core, Okayama University Yu Zhao School of Management, Department of Management, Tokyo University of Science Junshi Feng Graduate School of Humanities and Social Science, Okayama University Sou Kumagai Department of Electrical and Communication Engineering, Faculty of Engineering, Okayama University In 2020, the Government of Japan declared "2050 carbon neutral" and launched a long-term strategy to create a "virtuous cycle of economy and environment".(1) Japanese firms possess many technologies that contribute to decarbonization, which is important to expand investment for Green Technology (environmental technology) development. As automobiles are major contributors to greenhouse gas emissions [1], the technological shift towards vehicle powertrain systems is an attempt to lower problems like emissions of carbon dioxide, nitrogen oxides [2]. On the other hand, patent data are the most reliable business performance for applied research and development activities when investigating the knowledge domains or the technology evolution (Wand, 1997). Our paper describes a Japanese patents dataset of the vehicle powertrain systems for hybrid electric vehicle (HEV), battery electric vehicle (BEV) and fuel cell electric vehicles (FCEV). In this paper we create a method of bombinating international patent classification (IPC) and keywords to define "green" patents in vehicle powertrains field, using patent data which were applied to Japan Patent Office recorded on EPO's PATSTAT database during 2010 similar to 2019 year. When analyze patents, it is necessary to consider the social situation of each country including language background, we collect patents description documents (abstracts and titles) not only written in English but also in Japanese. Finally, we build a database includes 6025 green patents' description documents and 266 patents' holding firms. With which we then identify 3756 HEV patents, 1716 BEV patents, and 553 FCEV patents. Data about patent holding firms is also appended. The full dataset may be useful to researchers who would like to do further search like natural language processing and machine learning on patent description documents, statistical data analysis for empirical economics. No potential conflict of interest relevant to this article was reported.

MDPI AG Acta Medica Okayama 2673-6918 2 4 2022 Traditional Chinese Medicines and Prescriptions Brought from China to Japan by a Monk (Jianzhen, Japanese: Ganjin): A Historical Review 267 284 EN Shihui Liu Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Toshihiko Matsuo Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Chie Matsuo Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Takumi Abe Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University (1) Background: Japanese Kampo medicine has its origin in ancient Chinese medicine. In 742, a Tang Dynasty monk named Jianzhen (Ganjin) was invited by Japanese clerics to visit Japan and teach commandments in Buddhism. Because of the dangers of the voyage and also other obstacles, he took 11 years to reach Japan on the sixth voyage and he was blind when he arrived in Japan. He was the first person in China to go to Japan to establish the Buddhism commandments, and he was also the first person in Japan to directly teach traditional Chinese medicine. Until now, there have been few reports in English about the details of the Chinese herbal medicines he brought to Japan, including the types of herbal medicines, pharmacological activities, and formulations. In the review, we systematically and comprehensively summarized Jianzhen’s life from the standpoint of his medical and pharmaceutical knowledge and the types and pharmacological activities of Chinese herbal medicines and prescriptions that were brought to Japan by Jianzhen; <br> (2) Methods: A review was made on the relevant literature written by Chinese, Japanese, and English languages regarding the medical and pharmacological knowledge of Jianzhen, the 36 Chinese herbal medicines brought to Japan by Jianzhen, and the pharmacological and therapeutic effects of these 36 herbal medicines, as well as their formulations; <br> (3) Results: The review of the literature proved that Jianzhen’s prescriptions served as a basis for current herbal medicines (Kampo) in Japan. In the process of the literature search, we found a book entitled Jianshangren (Holy Priest Jianzhen)’s Secret Prescription, which recorded the complete prescription of the 36 traditional Chinese medicines Jianzhen brought to Japan; <br> (4) Conclusions: Jianzhen is one of the ancestors of traditional Chinese medicine/Kampo medicine, and he brought traditional Chinese medicine and medical books to Japan for patients. He made important contributions to the development of traditional Chinese medicine in Japan. No potential conflict of interest relevant to this article was reported.

Springer Nature Acta Medica Okayama 2055-0936 8 1 2022 Colonization with extended-spectrum beta-lactamase-producing Escherichia coli and traveler's diarrhea attack rates among travelers to India: a systematic review and meta-analysis 22 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keinosuke Okamoto Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background India is an attractive destination for travelers. Unfortunately, numerous reports exist on traveler's diarrhea (TD) and fecal colonization with extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) among international travelers visiting India. Here, we systematically reviewed studies published on the acquisition of ESBL-EC and TD attack rates among international visitors to India. Methods Design: Systematic review and meta-analysis. A systematic search was performed using Google Scholar, PubMed, EMBASE, Web of Science, and gray literature from 2000 to December 2021, for studies containing data for ESBL-EC acquisition or TD experience related to a trip to India. Random effects models were used to compute the prevalence of ESBL-EC acquisition and TD attack. Results The literature search yielded a total of 5023 records. Of these, 31 met our inclusion criteria for systematic review and only 17 could be meta-analyzed (9 for TD, and 8 for ESBL-EC). The overall pooled attack rate of TD was 39% (95% confidence interval, CI: 25-53%). In studies where travelers' memory was used to diagnose TD, the pooled attack rate of TD was slightly higher (42%, 95% CI: 21-64%) compared to those where TD was objectively documented (33%, 95% CI: 17-49%). There were significant risks to be colonized with ESBL-EC among the travelers who experienced TD. The pooled rate of ESBL-EC colonization was 72% (CI: 67-78%). Most ESBL-EC produced CTX-M-15 enzyme. Furthermore, most of the travelers who acquired ESBL-EC were from highly industrialized countries recruited from travel clinics: Canada (n = 80), Germany (n = 69), Netherlands (n = 20), Sweden (n = 18), Japan (n = 10), Finland (n = 8), USA (n = 7), Spain (n = 5), and Denmark (n = 3). Conclusions TD pooled attack rate and ESBL-EC acquisition among international travelers visiting India were high in this study. However, we cannot make generalizations based upon this TD pooled attack rate for the current situation, due to a lack of current data. Our study highlights that travelers should be advised on TD to ensure that they do not disregard the risk of contracting TD and be better prepared as a result. It also illustrates the importance of international travel in acquiring antibiotic-resistant Escherichia coli. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1422-0067 23 18 2022 Histidine-Rich Glycoprotein Suppresses the S100A8/A9-Mediated Organotropic Metastasis of Melanoma Cells 10300 EN Nahoko Tomonobu Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Rie Kinoshita Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hidenori Wake Department of Pharmacology, Kindai University Faculty of Medicine Yusuke Inoue Faculty of Science and Technology, Division of Molecular Science, Gunma University I. Made Winarsa Ruma Faculty of Medicine, Udayana University Ken Suzawa Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuma Gohara Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ni Luh Gede Yoni Komalasari Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Fan Jiang Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hitoshi Murata Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Ken-Ichi Yamamoto Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences I. Wayan Sumardika Faculty of Medicine, Udayana University Youyi Chen Department of General Surgery & Bio-Bank of General Surgery, The Fourth Affiliated Hospital of Harbin Medical University Junichiro Futami Department of Interdisciplinary Science and Engineering in Health Systems, Okayama University Akira Yamauchi Department of Biochemistry, Kawasaki Medical School Futoshi Kuribayashi Department of Biochemistry, Kawasaki Medical School Eisaku Kondo Division of Molecular and Cellular Pathology, Niigata University Graduate School of Medical and Dental Sciences Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masahiro Nishibori Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masakiyo Sakaguchi Department of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences The dissection of the complex multistep process of metastasis exposes vulnerabilities that could be exploited to prevent metastasis. To search for possible factors that favor metastatic outgrowth, we have been focusing on secretory S100A8/A9. A heterodimer complex of the S100A8 and S100A9 proteins, S100A8/A9 functions as a strong chemoattractant, growth factor, and immune suppressor, both promoting the cancer milieu at the cancer-onset site and cultivating remote, premetastatic cancer sites. We previously reported that melanoma cells show lung-tropic metastasis owing to the abundant expression of S100A8/A9 in the lung. In the present study, we addressed the question of why melanoma cells are not metastasized into the brain at significant levels in mice despite the marked induction of S100A8/A9 in the brain. We discovered the presence of plasma histidine-rich glycoprotein (HRG), a brain-metastasis suppression factor against S100A8/A9. Using S100A8/A9 as an affinity ligand, we searched for and purified the binding plasma proteins of S100A8/A9 and identified HRG as the major protein on mass spectrometric analysis. HRG prevents the binding of S100A8/A9 to the B16-BL6 melanoma cell surface via the formation of the S100A8/A9 complex. HRG also inhibited the S100A8/A9-induced migration and invasion of A375 melanoma cells. When we knocked down HRG in mice bearing skin melanoma, metastasis to both the brain and lungs was significantly enhanced. The clinical examination of plasma S100A8/A9 and HRG levels showed that lung cancer patients with brain metastasis had higher S100A8/A9 and lower HRG levels than nonmetastatic patients. These results suggest that the plasma protein HRG strongly protects the brain and lungs from the threat of melanoma metastasis. No potential conflict of interest relevant to this article was reported.

Nature Portfolio Acta Medica Okayama 2045-2322 12 1 2022 Impact of the cervical cancer awareness months on public interest in Japan: A Google Trends analysis, 2012-2021 15391 EN Hideharu Hagiya Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Fumio Otsuka Department of General Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The immunization and screening rates for human papillomavirus in Japan are lower than those in other countries. We aimed to evaluate the impact of cervical cancer awareness months on public attention using Google Trends analysis. Between 2012 and 2021, we analyzed the trends in relative search volumes (RSVs) for "Shikyuu-keigan" (cervical cancer in English) in Japan, during the cervical cancer awareness month (CCAM) in January and cervical cancer prevention awareness enhancement month (CCPAEM) in November. We performed a joinpoint regression analysis to identify a statistically significant trend change point. Additionally, we compared the mean RSVs of each awareness month with the rest of the year. Significant trend change points were observed, but none were found in CCAM and CCPAEM periods. Comparison of mean RSVs among CCAM, CCPAEM, and the rest of the months did not suggest any significant increases in RSVs during these awareness periods. In conclusion, CAM and CCPAEM did not raise public interest in cervical cancer in Japan. Although the results are based on internet users, the findings might suggest a need to develop a more effective and attractive approach to achieve the 90-70-90 targets of cervical cancer prevention by 2030. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 4 2022 Efficacy of 0.01% Atropine Eye Drops in Controlling Myopia Progression and Axial Elongation in Children: A Meta-analysis Based on Randomized Controlled Trials 457 463 EN Weiying Sun Department of Ophthalmology 2, Kawasaki Medical School Satoshi Hasebe Department of Ophthalmology 2, Kawasaki Medical School Original Article 10.18926/AMO/63905 To clarify the preventive effects of 0.01% atropine eye drops against myopia progression and axial elongation in children, a meta-analysis was carried out based on data obtained from PubMed and Web of Science as of August 1, 2021. Randomized controlled trials (RCTs) that enrolled myopic children who had received atropine for at least one year were included in this study, Key search terms included myopia, children, and 0.01% or low-dose atropine. Heterogeneity was quantified by I2 statistics, and meta-analyses were performed using the fixed-effect model. Five RCTs involving 809 unique children were analyzed. One trial was excluded because of a poor Jadad score and markedly rapid myopia progression in controls. The mean effect sizes for 12 months in myopia progression and axial elongation synthesized from the remaining 4 RCTs were 0.20 (95% CI: 0.13 to 0.27) D and −0.08 (−0.11 to −0.04) mm, respectively (p<0.0001). The corresponding inhibition ratios were 28% and 19%. I2 statistics were 6% or less. Sensitivity analysis and funnel plots demonstrated the robustness of the estimation. The 0.01% atropine-induced inhibition ratio for myopia progression in Asian children was roughly half of that originally reported and did not reach the minimum requirement for clinical treatment. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 4 2022 Gene Expression Profiling between Patient Groups with High and Low Ki67 Levels after Short-term Preoperative Aromatase Inhibitor Treatment for Breast Cancer 399 408 EN Yukiko Kajiwara Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takayuki Iwamoto Departments of Breast and Endocrine Surgery, Okayama University Hospital Yidan Zhu Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mariko Kochi Departments of Breast and Endocrine Surgery, Okayama University Hospital Tadahiko Shien Departments of Breast and Endocrine Surgery, Okayama University Hospital Naruto Taira Departments of Breast and Endocrine Surgery, Okayama University Hospital Hiroyoshi Doihara Departments of Breast and Endocrine Surgery, Okayama University Hospital Shinichi Toyooka Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Original Article 10.18926/AMO/63894 According to a recent report, a low Ki67 level after short-term preoperative hormone therapy (post-Ki67) might suggest a more favorable prognosis compared with a high post-Ki67 level in patients with hormone receptorpositive/human epidermal growth factor 2-negative (HR+/HER2−) breast cancer with high levels of Ki67. This study aimed to evaluate the pre-treatment genetic differences between these two patient groups. Forty-five luminal B-like patients were stratified into two groups, namely, a group with high (H→H) and one with low (H→L) Ki67 levels after short-term preoperative aromatase inhibitor (AI) treatment. We compared pre-treatmentgene expression profiles between the two groups. In gene level analysis, there was no significant difference between the two groups by the class comparison test. In pathway analysis, five metabolism-related gene sets were significantly upregulated in the H→L group (p≤0.05). In the search for novel targets, five genes (PARP, BRCA2, FLT4, CDK6, and PDCD1LG2) showed significantly higher expression in the H→H group (p≤0.05). Several metabolism-related pathways were associated with sensitivity to AI. In the future, it will be necessary to seek out new therapeutic strategies for the poor prognostic group with high post-Ki67. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 4 2022 Therapeutic Approaches Targeting miRNA in Systemic Lupus Erythematosus 359 371 EN Sumie Hiramatsu-Asano Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jun Wada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Review 10.18926/AMO/63887 Systemic lupus erythematosus (SLE) is a potentially fatal systemic autoimmune disease, and its etiology involves both genetic and environmental factors such as sex hormone imbalance, genetic predisposition, epigenetic regulation, and immunological factors. Dysregulation of microRNA (miRNA) is suggested to be one of the epigenetic factors in SLE. miRNA is a 22-nucleotide single-stranded noncoding RNA that contributes to post-transcriptional modulation of gene expression. miRNA targeting therapy has been suggested to be useful for the treatment of cancers and other diseases. Gene knockout and miRNA targeting therapy have been demonstrated to improve SLE disease activity in mice. However, these approaches have not yet reached the level of clinical application. miRNA targeting therapy is limited by the fact that each miRNA has multiple targets. In addition, the expression of certain miRNAs may differ among cell tissues within a single SLE patient. This limitation can be overcome by targeted delivery and chemical modifications. In the future, further research into miRNA chemical modifications and delivery systems will help us develop novel therapeutic agents for SLE. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 11 16 2022 Association between Immediate Postoperative Radiographic Findings and Failed Internal Fixation for Trochanteric Fractures: Systematic Review and Meta-Analysis 4879 EN Norio Yamamoto Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yasushi Tsujimoto Scientific Research Works Peer Support Group (SRWS-PSG) Suguru Yokoo Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center Koji Demiya Department of Orthopedic Surgery, Tsuyama Chuo Hospital Madoka Inoue Scientific Research Works Peer Support Group (SRWS-PSG) Tomoyuki Noda Department of Orthopedic Surgery and Traumatology, Kawasaki Medical School General Medical Center Toshifumi Ozaki Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science Takashi Yorifuji Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Failed internal fixations for trochanteric fractures have a strong negative impact owing to increased postoperative mortality and high medical costs. However, evidence on the prognostic value of postoperative radiographic findings for failed internal fixations is limited. We aimed to clarify the association between comprehensive immediate postoperative radiographic findings and failed internal fixation using relative and absolute risk measures. We followed the meta-analysis of observational studies in epidemiology guidelines and the Cochrane handbook. We searched specific databases in November 2021. The outcomes of interest were failed internal fixation and cut-out. We pooled the odds ratios and 95% confidence intervals using a random-effects model and calculated the number needed to harm for each outcome. Thirty-six studies involving 8938 patients were included. The certainty of evidence in the association between postoperative radiographic findings and failed internal fixation or cut-out was mainly low or very low except for the association between intramedullary malreduction on the anteromedial cortex and failed internal fixation. Moderate certainty of evidence supported that intramedullary malreduction on the anteromedial cortex was associated with failed internal fixation. Most postoperative radiographic findings on immediate postoperative radiographs for trochanteric fractures were uncertain as prognostic factors for failed internal fixations. No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1471-2458 22 1 2022 Correlation between national surveillance and search engine query data on respiratory syncytial virus infections in Japan 1517 EN Kazuhiro Uda Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science Takashi Yorifuji Department of Epidemiology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Mitsuru Tsuge Department of Pediatrics Acute Diseases, Okayama University Academic Field of Medicine, Dentistry, and Pharmaceutical Masato Yashiro Department of Pediatrics, Okayama University Hospital Hirokazu Tsukahara Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Background The respiratory syncytial virus (RSV) disease burden is significant, especially in infants and children with an underlying disease. Prophylaxis with palivizumab is recommended for these high-risk groups. Early recognition of a RSV epidemic is important for timely administration of palivizumab. We herein aimed to assess the correlation between national surveillance and Google Trends data pertaining to RSV infections in Japan. Methods The present, retrospective survey was performed between January 1, 2018 and November 14, 2021 and evaluated the correlation between national surveillance data and Google Trends data. Joinpoint regression was used to identify the points at which changes in trends occurred. Results A strong correlation was observed every study year (2018 [r = 0.87, p < 0.01], 2019 [r = 0.83, p < 0.01], 2020 [r = 0.83, p < 0.01], and 2021 [r = 0.96, p < 0.01]). The change-points in the Google Trends data indicating the start of the RSV epidemic were observed earlier than by sentinel surveillance in 2018 and 2021 and simultaneously with sentinel surveillance in 2019. No epidemic surge was observed in either the Google Trends or the surveillance data from 2020. Conclusions Our data suggested that Google Trends has the potential to enable the early identification of RSV epidemics. In countries without a national surveillance system, Google Trends may serve as an alternative early warning system. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2075-4418 11 11 2021 Cholera Rapid Diagnostic Tests for the Detection of Vibrio cholerae O1: An Updated Meta-Analysis 2095 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Anusuya Debnath Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keinosuke Okamoto Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University The rapid diagnosis of cholera contributes to adequate outbreak management. This meta-analysis assesses the diagnostic accuracy of cholera rapid tests (RDTs) to detect Vibrio cholerae O1. Methods: Systematic review and meta-analysis. We searched four databases (Medline, EMBASE, Google Scholar, and Web of Science up to 8 September 2021) for studies that evaluated cholera RDTs for the detection of V. cholerae O1 compared with either stool culture or polymerase chain reaction (PCR). We assessed the studies' quality using the QUADAS-2 criteria. In addition, in this update, GRADE approach was used to rate the overall certainty of the evidence. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity of cholera RDTs. Results: Overall, 20 studies were included in this meta-analysis. Studies were from Africa (n = 11), Asia (n = 7), and America (Haiti; n = 2). They evaluated eight RDTs (Crystal VC-O1, Crystal VC, Cholkit, Institut Pasteur cholera dipstick, SD Bioline, Artron, Cholera Smart O1, and Smart II Cholera O1). Using direct specimen testing, sensitivity and specificity of RDTs were 90% (95% CI, 86 to 93) and 86% (95% CI, 81 to 90), respectively. Cholera Sensitivity was higher in studies conducted in Africa [92% (95% CI, 89 to 94)] compared with Asia [82% (95% CI, 77 to 87)]. However, specificity [83% (95% CI, 71 to 91)] was lower in Africa compared with Asia [90% (95% CI, 84 to 94)]. GRADE quality of evidence was estimated as moderate. Conclusions: Against culture or PCR, current cholera RDTs have moderate sensitivity and specificity for detecting Vibrio cholerae O1. No potential conflict of interest relevant to this article was reported.

FRONTIERS MEDIA SA Acta Medica Okayama 2235-2988 12 2022 Mycovirus Hunting Revealed the Presence of Diverse Viruses in a Single Isolate of the Phytopathogenic Fungus Diplodia seriata From Pakistan 913619 EN Haris Ahmed Khan Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Paul Telengech Institute of Plant Science and Resources, Okayama University Hideki Kondo Institute of Plant Science and Resources, Okayama University Muhammad Faraz Bhatti Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University Diplodia seriata in the family Botryosphaeriaceae is a cosmopolitan phytopathogenic fungus and is responsible for causing cankers, fruit rot and leaf spots on economically important plants. In this study, we characterized the virome of a single Pakistani strain (L3) of D. seriata. Several viral-like contig sequences were obtained via a previously conducted next-generation sequencing analysis. Multiple infection of the L3 strain by eight RNA mycoviruses was confirmed through RT-PCR using total RNA samples extracted from this strain; the entire genomes were determined via Sanger sequencing of RT-PCR and RACE clones. A BLAST search and phylogenetic analyses indicated that these eight mycoviruses belong to seven different viral families. Four identified mycoviruses belong to double-stranded RNA viral families, including Polymycoviridae, Chrysoviridae, Totiviridae and Partitiviridae, and the remaining four identified mycoviruses belong to single-stranded RNA viral families, i.e., Botourmiaviridae, and two previously proposed families "Ambiguiviridae" and "Splipalmiviridae". Of the eight, five mycoviruses appear to represent new virus species. A morphological comparison of L3 and partially cured strain L3ht1 suggested that one or more of the three viruses belonging to Polymycoviridae, "Splipalmiviridae" and "Ambiguiviridae" are involved in the irregular colony phenotype of L3. To our knowledge, this is the first report of diverse virome characterization from D. seriata. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1660-4601 19 12 2022 Long-Term Kinetics of Serological Antibodies against Vibrio cholerae Following a Clinical Cholera Case: A Systematic Review and Meta-Analysis 7141 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Debmalya Mitra Collaborative Research Center of Okayama University for Infectious Diseases in India Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Background: Approximately 2.9 million people worldwide suffer from cholera each year, many of whom are destitute. However, understanding of immunity against cholera is still limited. Several studies have reported the duration of antibodies following cholera; however, systematic reviews including a quantitative synthesis are lacking. Objective: To meta-analyze cohort studies that have evaluated vibriocidal, cholera toxin B subunit (CTB), and lipopolysaccharide (LPS) antibody levels following a clinical cholera case. Methods: Design: Systematic review and meta-analysis. We searched PubMed and Web of science for studies assessing antibodies against Vibrio cholerae in cohorts of patients with clinical cholera. Two authors independently extracted data and assessed the quality of included studies. Random effects models were used to pool antibody titers in adults and older children (aged >= 6 years). In sensitivity analysis, studies reporting data on young children (2-5 years) were included. Results: Nine studies met our inclusion criteria for systematic review and seven for meta-analysis. The pooled mean of vibriocidal antibody titers in adults and older children (aged >= 6 years) was 123 on day 2 post-symptom onset, which sharply increased on day 7 (pooled mean = 6956) and gradually waned to 2247 on day 30, 578 on day 90, and 177 on day 360. Anti-CTB IgA antibodies also peaked on day 7 (pooled mean = 49), followed by a rapid decrease on day 30 (pooled mean = 21), and further declined on day 90 (pooled mean = 10), after which it plateaued from day 180 (pooled mean = 8) to 360 (pooled mean = 6). Similarly, anti-CTB IgG antibodies peaked in early convalescence between days 7 (pooled mean = 65) and 30 (pooled mean = 69), then gradually waned on days 90 (pooled mean = 42) and 180 (pooled mean = 30) and returned to baseline on day 360 (pooled mean = 24). Anti-LPS IgA antibodies peaked on day 7 (pooled mean = 124), gradually declined on day 30 (pooled mean = 44), which persisted until day 360 (pooled mean = 10). Anti LPS IgG antibodies peaked on day 7 (pooled mean = 94). Thereafter, they decreased on day 30 (pooled mean = 85), and dropped further on days 90 (pooled mean = 51) and 180 (pooled mean = 47), and returned to baseline on day 360 (pooled mean = 32). Sensitivity analysis including data from young children (aged 2-5 years) showed very similar findings as in the primary analysis. Conclusions: This study confirms that serological antibody (vibriocidal, CTB, and LPS) titers return to baseline levels within 1 year following clinical cholera, i.e., before the protective immunity against subsequent cholera wanes. However, this decay should not be interpreted as waning immunity because immunity conferred by cholera against subsequent disease lasts 3-10 years. Our study provides evidence for surveillance strategies and future research on vaccines and also demonstrates the need for further studies to improve our understanding of immunity against cholera. No potential conflict of interest relevant to this article was reported.

Elsevier Ltd. Acta Medica Okayama 1882-7616 58 2022 Managements of sleep bruxism in adult: A systematic review 124 136 EN Hajime Minakuchi Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masanori Fujisawa Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry Yuka Abe Department of Prosthodontics, School of Dentistry, Showa University Takashi Iida Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo Kyosuke Oki Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University Kazuo Okura Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, Tokushima University Graduate School Norimasa Tanabe Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University Akira Nishiyama General Dentistry, Comprehensive Patient Care, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021. Reference list searches and hand searches were also performed by an external organization. Two reviewers for each therapy independently performed article selection, data extraction, and risk of bias assessment. The reviewers resolved any disagreements concerning the assortment of the articles by discussion. Finally, 11, 3, 14, and 22 articles were selected for each therapy. The results suggested that OAT tended to reduce the number of SB events, although there was no significant difference compared to other types of splints, that the potential benefits of CBT were not well supported, and that BFT, rabeprazole, clonazepam, clonidine, and botulinum toxin type A injection showed significant reductions in specific SB parameters, although several side effects were reported. It can be concluded that more methodologically rigorous randomized large-sample long-term follow-up clinical trials are needed to clarify the efficacy and safety of management for SB. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2072-6694 14 10 2022 Impact of Breast Cancer Awareness Month on Public Interest in the United States between 2012 and 2021: A Google Trends Analysis 2534 EN Yoshito Nishimura Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jared D. Acoba Department of Medicine, John A. Burns School of Medicine, University of Hawai’i Simple Summary In this study, we quantified public awareness regarding breast cancer associated with Breast Cancer Awareness Month (BCAM) in October using Google Trends data and a joinpoint regression analysis. We analyzed the impact of BCAM, Lung Cancer Awareness Month (LCAM), and Prostate Cancer Awareness Month (PCAM) on public awareness of the top three most common cancers in the U.S. from 2012 to 2021 using the relative search volume of Google Trends. The results imply that BCAM has successfully improved the public awareness of breast cancer in the U.S., while LCAM and PCAM had no impact on the awareness of lung and prostate cancers. BCAM could serve as a good example for organizations working on health observances or awareness campaigns. Breast Cancer Awareness Month (BCAM) has a long history of over 30 years, established in 1985 to occur every October, and the National Breast Cancer Foundation now leads the operation. There have been no studies to evaluate the impact of the BCAM on public awareness of breast cancer. We analyzed the impact of BCAM on public awareness of breast cancer in the U.S. from 2012 to 2021 using the relative search volume (RSV) of Google Trends as a surrogate. We also analyzed the impact of Lung Cancer Awareness Month (LCAM) and Prostate Cancer Awareness Month (PCAM) on public awareness of lung and prostate cancer, respectively, to see differences in their effectiveness among the health observances for the top three most common cancers in the U.S. We performed a joinpoint regression analysis to identify statistically significant time points of a change in trend. There were joinpoints around BCAM for "Breast cancer" every year from 2012 to 2021, with a significant increase in the weekly RSVs from 21.9% to 46.7%. Except for 2013 and 2015 for "Lung cancer", when significant increases in the RSV at 1.8% and 1.2% per week were observed around LCAM, no joinpoints were noted around LCAM or PCAM. These results imply that BCAM has successfully improved the public awareness of breast cancer in the U.S. compared to other representative health observances, likely due to the effective involvement of non-medical industries, influencers affected by breast cancer, and an awareness symbol. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1660-4601 19 9 2022 Cholera Outbreaks in India, 2011-2020: A Systematic Review 5738 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Anusuya Debnath Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ayumu Ohno Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keinosuke Okamoto Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Fecal contamination of water sources and open defecation have been linked to cholera outbreaks in India. However, a systematic review on the drivers responsible for these outbreaks has yet to be published. Here, we systematically review the published literature on cholera outbreaks in India between 2011 and 2020. We searched studies in English in three databases (MEDLINE, EMBASE, and Web of Science) and the Integrated Disease Surveillance Program that tracks cholera outbreaks throughout India. Two authors independently extracted data and assessed the quality of the included studies. Quantitative data on the modes of transmission reviewed in this study were assessed for any change over time between 2011-2015 and 2016-2020. Our search retrieved 10823 records initially, out of which 81 full-text studies were assessed for eligibility. Among these 81 studies, 20 were eligible for inclusion in this review. There were 565 reported outbreaks between 2011 and 2020 that led to 45,759 cases and 263 deaths. Outbreaks occurred throughout the year; however, they exploded with monsoons (June through September). In Tamil Nadu, a typical peak of cholera outbreaks was observed from December to January. Seventy-two percent (33,089/45,759) of outbreak-related cases were reported in five states, namely Maharashtra, West Bengal, Punjab, Karnataka, and Madhya Pradesh. Analysis of these outbreaks highlighted the main drivers of cholera including contaminated drinking water and food, inadequate sanitation and hygiene (including open defecation), and direct contact between households. The comparison between 2011-2015 and 2016-2020 showed a decreasing trend in the outbreaks that arose due to damaged water pipelines. Many Indians still struggle with open defecation, sanitation, and clean water access. These issues should be addressed critically. In addition, it is essential to interrupt cholera short-cycle transmission (mediated by households, stored drinking water and foodstuffs) during an outbreak. As cholera is associated with deprivation, socio-economic development is the only long-term solution. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 2433-4146 53 3 2022 ポーランドにおける体制転換以降の政治・経済・社会的変動 －カトリック教会の動向とポピュリズム政治の台頭を中心に－ 21 44 EN Hiroichi Iemoto Masahiro Taguchi 10.18926/OER/63485 This paper describes the doctrinal trends of the Catholic Church and the rise of populist politics by analyzing the political, economic, and social changes that have occurred since the system transformation period.<br> In 1989, Poland became the first socialist country to establish a non-communist government and led the system transformations in Eastern European countries. Politically, Poland has broken the communist dictatorship and introduced political pluralism, economically she has promoted market liberalization, and socially she has achieved democratization and cultural pluralism. However, politicians, while superficially advocating political pluralism, often engaged in a battle of mutual accusations through “lustration,” which refers to policies that limit the participation of former communists, especially informants of the communist secret police, resulting in political chaos. In recent years, under the “Law and Justice” regime, Catholic traditions and conservative national and family values have been honored as values that must be upheld by Poles, while EU skepticism has been propagated, anti-immigrant sentiments have been fanned, and the clampdown on LGBT people has been tightened. Conflicts with the EU have also intensified, including political intervention in the judiciary and the supremacy of domestic law over EU law. Put simply, Law and Justice, while claiming to reintroduce pluralism into a Polish polity dominated by the monolithic technocratic liberalism that was dominant in the early years of the transition, has in fact empowered social groups that felt excluded from the post-1989 reforms to create a more exclusive monism. <br> Thus, while Poland received international attention as a country that led the way in democratization among the former Eastern European countries, even today pluralism has not taken stable root. In Chapter 1, the political and economic situation and changes of doctrine of the Church during the transition period will be analyzed. In Chapter 2, the political changes during the EU accession period and the church’s search for its position will mentioned. The chapter ３ will analyze the rise of populism after 2015 and its relationship to the Catholic Church. No potential conflict of interest relevant to this article was reported.

Nature Portfolio Acta Medica Okayama 2045-2322 12 1 2022 Identification of osteoporosis using ensemble deep learning model with panoramic radiographs and clinical covariates 6088 EN Shintaro Sukegawa Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ai Fujimura Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital Akira Taguchi Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University Norio Yamamoto Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Akira Kitamura Search Space Inc. Ryosuke Goto Search Space Inc. Keisuke Nakano Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kiyofumi Takabatake Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hotaka Kawai Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hitoshi Nagatsuka Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Yoshihiko Furuki Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital Osteoporosis is becoming a global health issue due to increased life expectancy. However, it is difficult to detect in its early stages owing to a lack of discernible symptoms. Hence, screening for osteoporosis with widely used dental panoramic radiographs would be very cost-effective and useful. In this study, we investigate the use of deep learning to classify osteoporosis from dental panoramic radiographs. In addition, the effect of adding clinical covariate data to the radiographic images on the identification performance was assessed. For objective labeling, a dataset containing 778 images was collected from patients who underwent both skeletal-bone-mineral density measurement and dental panoramic radiography at a single general hospital between 2014 and 2020. Osteoporosis was assessed from the dental panoramic radiographs using convolutional neural network (CNN) models, including EfficientNet-b0, -b3, and -b7 and ResNet-18, -50, and -152. An ensemble model was also constructed with clinical covariates added to each CNN. The ensemble model exhibited improved performance on all metrics for all CNNs, especially accuracy and AUC. The results show that deep learning using CNN can accurately classify osteoporosis from dental panoramic radiographs. Furthermore, it was shown that the accuracy can be improved using an ensemble model with patient covariates. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 1660-4601 19 8 2022 Misconceptions and Rumors about Ebola Virus Disease in Sub-Saharan Africa: A Systematic Review 4714 EN Basilua Andre Muzembo Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Ngangu Patrick Ntontolo Department of Family Medicine and Primary Health, Protestant University of Congo Nlandu Roger Ngatu Department of Public Health, Kagawa University Faculty of Medicine Januka Khatiwada Social Work Institute Tomoko Suzuki Department of Public Health, School of Medicine, International University of Health and Welfare Koji Wada Department of Public Health, School of Medicine, International University of Health and Welfare Kei Kitahara Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Shunya Ikeda Department of Public Health, School of Medicine, International University of Health and Welfare Shin-Ichi Miyoshi Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University We sought to summarize knowledge, misconceptions, beliefs, and practices about Ebola that might impede the control of Ebola outbreaks in Africa. We searched Medline, EMBASE, CINAHL, and Google Scholar (through May 2019) for publications reporting on knowledge, attitudes, and practices (KAP) related to Ebola in Africa. In total, 14 of 433 articles were included. Knowledge was evaluated in all 14 articles, and they all highlighted that there are misconceptions and risk behaviors during an Ebola outbreak. Some communities believed that Ebola spreads through the air, mosquito bites, malice from foreign doctors, witchcraft, and houseflies. Because patients believe that Ebola was caused by witchcraft, they sought help from traditional healers. Some people believed that Ebola could be prevented by bathing with salt or hot water. Burial practices where people touch Ebola-infected corpses were common, especially among Muslims. Discriminatory attitudes towards Ebola survivors or their families were also prevalent. Some Ebola survivors were not accepted back in their communities; the possibility of being ostracized from their neighborhoods was high and Ebola survivors had to lead a difficult social life. Most communities affected by Ebola need more comprehensive knowledge on Ebola. Efforts are needed to address misconceptions and risk behaviors surrounding Ebola for future outbreak preparedness in Africa. No potential conflict of interest relevant to this article was reported.

Lippincott Williams & Wilkins Acta Medica Okayama 0025-7974 101 7 2022 Silica-associated systemic lupus erythematosus with lupus nephritis and lupus pneumonitis A case report and a systematic review of the literature e28872 EN Kazuhiko Fukushima Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Haruhito A. Uchida Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yasuko Fuchimoto Department of Respiratory Medicine, Okayama Rosai Hospital Tomoyo Mifune Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Mayu Watanabe Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kenji Tsuji Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Katsuyuki Tanabe Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Masaru Kinomura Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shinji Kitamura Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yosuke Miyamoto Department of Respiratory Medicine, Okayama Rosai Hospital Sae Wada Department of Respiratory Medicine, Okayama Rosai Hospital Taisaku Koyanagi Department of Respiratory Medicine, Okayama Rosai Hospital Hitoshi Sugiyama Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Takumi Kishimoto Department of Respiratory Medicine, Okayama Rosai Hospital Jun Wada Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Introduction Several epidemiological studies have shown that silica exposure triggers the onset of systemic lupus erythematosus (SLE); however, the clinical characteristics of silica-associated SLE have not been well studied. Patient concerns A 67-year-old man with silicosis visited a primary hospital because of a fever and cough. His respiratory condition worsened, regardless of antibiotic medication, and he was referred to our hospital. Diagnosis The patient showed leukopenia, lymphopenia, serum creatinine elevation with proteinuria and hematuria, decreased serum C3 level, and was positive for anti-double stranded DNA antibody, anti-nuclear antibody, and direct Coombs test. He was diagnosed with SLE. Renal biopsy was performed, and the patient was diagnosed with lupus nephritis (class IV-G(A/C) + V defined by the International Society of Nephrology/Renal Pathology Society classification). Computed tomography revealed acute interstitial pneumonitis, bronchoalveolar lavage fluid showed elevation of the lymphocyte fraction, and he was diagnosed with lupus pneumonitis. Interventions Prednisolone (50 mg/day) with intravenous cyclophosphamide (500 mg/body) were initiated. Outcomes The patient showed a favorable response to these therapies. He was discharged from our hospital and received outpatient care with prednisolone slowly tapered off. He had cytomegalovirus and herpes zoster virus infections during treatment, which healed with antiviral therapy. Review: We searched for the literature on sSLE, and selected 11 case reports and 2 population-based studies. The prevalence of SLE manifestations in sSLE patients were comparative to that of general SLE, particularly that of elderly-onset SLE. Our renal biopsy report and previous reports indicate that lupus nephritis of sSLE patients show as various histological patterns as those of general SLE patients. Among the twenty sSLE patients reported in the case articles, three patients developed lupus pneumonitis and two of them died of it. Moreover, two patients died of bacterial pneumonia, one developed aspergillus abscesses, one got pulmonary tuberculosis, and one developed lung cancer. Conclusion Close attention is needed, particularly for respiratory system events and infectious diseases, when treating patients with silica-associated SLE using immunosuppressive therapies. No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 76 2 2022 Clinicopathological Features and Surgical Outcomes of Small Bowel Metastasis from Renal Cell Carcinoma 155 165 EN Jiro Kimura Department of Gastroenterological Surgery, National Center for Global Health and Medicine Takehiro Okabayashi Department of Gastroenterological Surgery, National Center for Global Health and Medicine Kenta Sui Department of Gastroenterological Surgery, National Center for Global Health and Medicine Motoyasu Tabuchi Department of Gastroenterological Surgery, National Center for Global Health and Medicine Jun Iwata Department of Diagnostic Pathology, National Center for Global Health and Medicine Yasuhiro Hata Department of Radiology, National Center for Global Health and Medicine Tatsuo Iiyama Department of Biostatistics, National Center for Global Health and Medicine Noriaki Ono Department of Urology, Kochi Health Sciences Center Original Article 10.18926/AMO/63409 Small bowel metastasis from renal cell carcinoma (RCC) is rare, and its clinicopathological characteristics are unclear; thus, we revisited the concept of this tumor and reviewed its diagnostic and treatment modalities. We filtered MEDLINE searches of articles published in English between 1950 and 2019, and identified 100 patients who had undergone treatment, including 1 patient from our clinic. We extracted patient characteristics, treatment, and prognostic data, resulting in clinicopathological data on 100 patients (83 men, 17 women). Mean age was 63 years (range, 16-86 years). Tumor sites were duodenum, jejunum, ileum, and multiple sites in 30, 37, 25, and 7 patients, respectively. The 1-, 3-, and 5-year overall survival rates after diagnosis were 53.0%, 36.0%, and 36.0%. Curative resection patients showed 62.1% 5-year survival after surgery, vs. 27.5% in noncurative surgical management cases. Good prognoses can be expected if these tumors are identified early for complete removal. Surgery is the only curative option. To determine the best management strategy and improve prognostic accuracy, we continue to collect and analyze epidemiological and pathological data. Although this condition is rare, surgery should be considered if curative resection is expected. Prognosis after curative resection is not poor, but recurrence is not unlikely. No potential conflict of interest relevant to this article was reported.

The Society for Free Radical Research Japan Acta Medica Okayama 0912-0009 70 2 2022 Confirmation of efficacy, elucidation of mechanism, and new search for indications of radon therapy 87 92 EN Kiyonori Yamaoka Health Sciences, Institute of Academic and Research, Okayama University Takahiro Kataoka Health Sciences, Institute of Academic and Research, Okayama University Indications of radon therapy include various diseases related to respiratory, painful, digestive, chronic degenerative, senile, etc. derived from reactive oxygen species, but most are based on empirical prescriptions. For this reason, we have evaluated the relation between the biological response caused by radon and the tissue/organ absorbed dose more quantitatively, and have promoted the elucidation of mechanisms related to the indication and searching newly. As a result, as a mechanism, a series of moderate physiological stimulative effects accompanying a small amount of oxidative stress by radon inhalation are being elucidated. That is, hyperfunction of anti-oxidation/immune regulation/damage repair, promotion of anti-inflammation/circulating metabolism/hormone secretion, induction of apoptosis/heat shock protein, etc. Also, new indications include inflammatory/neuropathic pain, hepatic/renal injury, colitis, type 1 diabetes, complication kidney injury, hyperuricemia, transient cerebral ischemia, and inflammatory edema. Furthermore, we examined the combined antioxidant effect of radon inhalation and antioxidants or therapeutic agents. As a result, it was clear that any combination treatment could enhance the suppression effect of disease. It can be expected that radon therapy can be used effectively by applying it in addition to usual treatment, since reduction in its dosage can also be expected by concomitant use for drugs with strong side effects. No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0168-1702 307 2 2022 A new tetra-segmented splipalmivirus with divided RdRP domains from Cryphonectria naterciae, a fungus found on chestnut and cork oak trees in Europe 198606 EN Yukiyo Sato Institute of Plant Science and Resources, Okayama University Sabitree Shahi Institute of Plant Science and Resources, Okayama University Paul Telengech Institute of Plant Science and Resources, Okayama University Sakae Hisano Institute of Plant Science and Resources, Okayama University Carolina Cornejo Swiss Federal Research Institute WSL, Forest Health & Biotic Interactions Daniel Rigling Swiss Federal Research Institute WSL, Forest Health & Biotic Interactions Hideki Kondo Institute of Plant Science and Resources, Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University Positive-sense (+), single-stranded (ss) RNA viruses with divided RNA-dependent RNA polymerase (RdRP) domains have been reported from diverse filamentous ascomycetes since 2020. These viruses are termed splipalmiviruses or polynarnaviruses and have been characterized largely at the sequence level, but ill-defined biologically. Cryphonectria naterciae, from which only one virus has been reported, is an ascomycetous fungus potentially plant-pathogenic to chestnut and oak trees. We molecularly characterized multiple viruses in a single Portuguese isolate (C0614) of C. naterciae, taking a metatranscriptomic and conventional double-stranded RNA approach. Among them are a novel splipalmivirus (Cryphonectria naterciae splipalmivirus 1, CnSpV1) and a novel fusagravirus (Cryphonectria naterciae fusagravirus 1, CnFGV1). This study focused on the former virus. CnSpV1 has a tetra-segmented, (+)ssRNA genome (RNA1 to RNA4). As observed for other splipalmiviruses reported in 2020 and 2021, the RdRP domain is separately encoded by RNA1 (motifs F, A and B) and RNA2 (motifs C and D). A hypothetical protein encoded by the 5′-proximal open reading frame of RNA3 shows similarity to a counterpart conserved in some splipalmiviruses. The other RNA3-encoded protein and RNA4-encoded protein show no similarity with known proteins in a blastp search. The tetra-segment nature was confirmed by the conserved terminal sequences of the four CnSpV1 segments (RNA1 to RNA4) and their 100% coexistence in over 100 single conidial isolates tested. The experimental introduction of CnSpV1 along with CnFGV1 into a virus free strain C0754 of C. naterciae vegetatively incompatible with C0614 resulted in no phenotypic alteration, suggesting asymptomatic infection. The protoplast fusion assay indicates a considerably narrow host range of CnSpV1, restricted to the species C. naterciae and C. carpinicola. This study contributes to better understanding of the molecular and biological properties of this unique group of viruses. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2077-0383 11 5 2022 Procalcitonin to Predict Severity of Acute Cholangitis and Need for Urgent Biliary Decompression: Systematic Scoping Review 1155 EN Krixie Silangcruz Department of Internal Medicine, University of Hawai’i Yoshito Nishimura Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Torrey Czech Department of Internal Medicine, University of Hawai’i Nobuhiko Kimura Department of Internal Medicine, University of Hawai’i James Yess Department of Internal Medicine, University of Hawai’i Serum procalcitonin (PCT) has been reported as a potential biomarker to predict the severity of acute cholangitis (AC) or the need for urgent biliary decompression. This study aimed to identify and summarize the existing research about serum PCT and the severity of AC, and to find gaps towards which future studies can be targeted. Following the PRISMA extension for scoping reviews, MEDLINE, EMBASE, and Google Scholar were searched for all peer-reviewed articles with relevant keywords including "cholangitis" and "procalcitonin" from their inception to 13 July 2021. We identified six studies. All the studies employed a case-control design and aimed to evaluate the usefulness of serum PCT to predict the severity of AC with key identified outcomes. While the potential cut-off values of serum PCT for severe AC ranged from 1.8-3.1 ng/mL, studies used different severity criteria and the definition of urgent biliary decompression. No studies proposed cut-off PCT values for the need for urgent biliary decompression. This scoping review identified the current level of evidence regarding the usefulness of serum PCT in assessing the severity of AC. Further clinical research is warranted with a focus on standardized outcome measures employing prospective or experimental designs. No potential conflict of interest relevant to this article was reported.

岡山大学全学教育・ 学生支援機構 Acta Medica Okayama 2432-9665 6 2021 海外の大学におけるセクシュアルマイノリティ学生支援 ーウェブサイトから分かるアメリカの大学の支援状況一 136 147 EN 10.18926/63337 アメリカの大学におけるセクシュアルマイノリティ学生への支援状況について，State and territorial universities 623校を対象に、各大学のウェブサイトを参照して調査を行った。セクシュアルマイノリティ学生を専門にサポートするセンター・部署を持つ339校の「センター・部署の名称」「支援・活動内容」を調査したところ、名称で多く使用されている単語や、多くの大学で行われている支援・活動内容が明らかとなった。支援・活動内容は10のグループに分類され、「施設・設備」「カウンセリング・サポート」「LGBT関連」「相互支援」「啓発活動」「各種資料提供」「経済・服」「医療」「性関連」「その他」であった。これらの結果は今後の日本の大学における支援・活動の参考となるものであった。 No potential conflict of interest relevant to this article was reported.

Elsevier BV Acta Medica Okayama 0196-6553 50 2 2022 Impact of the world hand hygiene and global handwashing days on public awareness between 2016 and 2020: Google trends analysis 141 147 EN Yoshito Nishimura Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Hideharu Hagiya Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Koichi Keitoku Department of Medicine, John A. Burns School of Medicine, University of Hawaii Toshihiro Koyama Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University Fumio Otsuka Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Background: Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear. Methods: This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis. Results: Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods. Conclusions: While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0304-8608 167 2022 A novel victorivirus from the phytopathogenic fungus Neofusicoccum parvum 923 929 EN Haris Ahmed Khan Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Yukiyo Sato Institute of Plant Science and Resources, Okayama University Hideki Kondo Institute of Plant Science and Resources, Okayama University Atif Jamal Crop Diseases Research Institute, National Agricultural Research Centre Muhammad Faraz Bhatti Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University Neofusicoccum parvum is an important plant-pathogenic ascomycetous fungus that causes trunk diseases in a variety of plants. A limited number of reports on mycoviruses from this fungus are available. Here, we report the characterization of a novel victorivirus, Neofusicoccum parvum victorivirus 3 (NpVV3). An agarose gel dsRNA profile of a Pakistani strain of N. parvum, NFN, showed a band of similar to 5 kbp that was not detectable in Japanese strains of N. parvum. Taking a high-throughput and Sanger sequencing approach, the complete genome sequence of NpVV3 was determined to be 5226 bp in length with two open reading frames (ORF1 and ORF2) that encode a capsid protein (CP) and an RNA-dependent RNA polymerase (RdRP). The RdRP appears to be translated by a stop/restart mechanism facilitated by the junction sequence AUGucUGA, as is found in some other victoriviruses. BLASTp searches showed that NpVV3 CP and RdRP share the highest amino acid sequence identity (80.5% and 72.4%, respectively) with the corresponding proteins of NpVV1 isolated from a French strain of N. parvum. However, NpVV3 was found to be different from NpVV1 in its terminal sequences and the stop/restart facilitator sequence. NpVV3 particles similar to 35 nm in diameter were partially purified and used to infect an antiviral-RNA-silencing-deficient strain (Delta cl2) of an experimental ascomycetous fungal host, Cryphonectria parasitica. NpVV3 showed symptomless infection in the new host strain. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 2210-2612 90 2022 Acute acalculous cholecystitis caused by SARS-CoV-2 infection: A case report and literature review 106731 EN Hana Futagami Center for Graduate Medical Education, Okayama University Hospital Hiroki Sato Department of Gastroenterological Surgery, Okayama University Hospital Ryuichi Yoshida Department of Gastroenterological Surgery, Okayama University Hospital Kazuya Yasui Department of Gastroenterological Surgery, Okayama University Hospital Takahito Yagi Department of Gastroenterological Surgery, Okayama University Hospital Toshiyoshi Fujiwara Department of Gastroenterological Surgery, Okayama University Hospital Background: Emerging data indicate that gastrointestinal disorders, in addition to pulmonary dysfunction, are also hallmarks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Case presentation: A 42-year-old man with maintenance hemodialysis developed high fever and dyspnea. He was positive for SARS-CoV-2 and was diagnosed with pneumonia. After treatment for SARS-CoV-2, his respiratory condition improved. However, he developed right upper quadrant pain with elevated inflammatory markers (white blood cells, 21,160/mu L; c-reactive protein, 163.9 mg/L) on the 13th day. Abdominal computed tomography revealed acute acalculous cholecystitis. Percutaneous transhepatic gallbladder drainage (PTGBD) was performed together with antibiotic therapy, which resulted in improvement of symptoms. Laparoscopic cholecystectomy was performed 36 days after PTGBD. <br> Conclusion: We report a rare case of acute acalculous cholecystitis (AAC) following pneumonia caused by SARS-CoV-2 infection. We also conducted a literature search to characterize SARS-CoV-2-related cholecystitis. Infection with SARS-CoV-2 is an important trigger for AAC, and appropriate therapeutic alternatives should be cautiously selected according to individual cases. No potential conflict of interest relevant to this article was reported.

Group of Wild Plant Science, Institute of Plant Science and Resources, Okayama University Acta Medica Okayama 2021 Naturalized plants in Japan : Seed-Image database EN Jun Yamashita Institute of Plant Science and Resources, Okayama University 10.48696/63011 Naturalized Plants in Japan Seed-Image database is an image database of naturalized alien plant seeds recorded in Japan. This database contains plant images, information on morphological features of seeds and the name list of naturalized alien plants, as well as seed images. Seeds are categorized into 5 groups based on morphological features such as reticulation (wrinkles or projections), ridges, edges and achene fruit. Users can search seed images by family names, species names and those features. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2021 Development of a polarization modulator for the observation of CMB B-modes in search of primordial gravitational waves with LiteBIRD EN Kunimoto Komatsu Graduate School of Natural Science and Technology, Okayama university No potential conflict of interest relevant to this article was reported.

Okayama University Medical School Acta Medica Okayama 0386-300X 75 5 2021 Use of Highly Accurate Devices for a First Lower Premolar Endodontic Treatment with Multiple Root Canals 641 645 EN Zulema Rosalia Arias Martinez Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Jorge Luis Lopez Videla Montaño Sistema de Radiografías Odontologicas (SIRO) Keisuke Yamashiro Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Yuki Shinoda-Ito Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Tadashi Yamamoto Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Shogo Takashiba Department of Pathophysiology - Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Case Report 10.18926/AMO/62778 This case report highlights the importance of using a dental operating microscope (DOM) and ultrasonic endodontic tips (UETs) to locate all root canals in the lower first premolar. A 53-year-old woman presented to our clinic with pain in the lower right first premolar. After a detailed search using a DOM and UETs, three root canals were found, prepared with rotary HyFlex endodontic files, and obturated using the lateral condensation technique. At the five-year follow-up after treatment, the tooth was completely restored and fulfilling its function, with no signs or symptoms of any post-treatment flare-up. No potential conflict of interest relevant to this article was reported.

岡山大学大学院教育学研究科 Acta Medica Okayama 1883-2423 177 2021 幼児期に育てたい「言葉に対する感覚」の明確化と感覚の豊かさをもたらす教材の探求 1 12 EN Mika Katayama Graduate School of Education, Okayama University Rinko Hayakawa Graduate School of Education, Okayama University 10.18926/bgeou/62426 本稿ではまず，2017 年に改訂（定）された幼稚園教育要領の領域「言葉」に焦点を当て，生涯発達の始点である幼児期に育む言葉の力の変更点とその重要性について整理した。続いて，新たに育成することが求められることとなった「言葉に対する感覚」及び言葉を豊かにすることについて，小学校以降の学習指導要領に用いられている「言語感覚」を検討の手立てとして詳解を試みた。その結果，幼児期に育てたい「言葉に対する感覚」としては，自分が表現する立場と受け取る（理解する）立場の双方で，「言葉の表現の適否」や「言葉のニュアンスを感じ取れる」感覚を育もうとしていることを見出した。最後に，「教職課程コアカリキュラム」に新設された「領域に関する専門的事項」の科目に関連して，「言葉に対する感覚を豊かにする実践」を歌の歌詞を教材とすることの意義と可能性について論述した。 No potential conflict of interest relevant to this article was reported.

Frontiers Media SA Acta Medica Okayama 1664-302X 12 2021 Identification of a Novel Quinvirus in the Family Betaflexiviridae That Infects Winter Wheat 715545 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Naoto Yoshida Agricultural Research Institute, HOKUREN Federation of Agricultural Cooperatives Miki Fujita Institute of Plant Science and Resources (IPSR), Okayama University Kazuyuki Maruyama Institute of Plant Science and Resources (IPSR), Okayama University Kiwamu Hyodo Institute of Plant Science and Resources (IPSR), Okayama University Hiroshi Hisano Institute of Plant Science and Resources (IPSR), Okayama University Tetsuo Tamada Institute of Plant Science and Resources (IPSR), Okayama University Ida Bagus Andika College of Plant Health and Medicine, Qingdao Agricultural University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University Yellow mosaic disease in winter wheat is usually attributed to the infection by bymoviruses or furoviruses; however, there is still limited information on whether other viral agents are also associated with this disease. To investigate the wheat viromes associated with yellow mosaic disease, we carried out de novo RNA sequencing (RNA-seq) analyses of symptomatic and asymptomatic wheat-leaf samples obtained from a field in Hokkaido, Japan, in 2018 and 2019. The analyses revealed the infection by a novel betaflexivirus, which tentatively named wheat virus Q (WVQ), together with wheat yellow mosaic virus (WYMV, a bymovirus) and northern cereal mosaic virus (a cytorhabdovirus). Basic local alignment search tool (BLAST) analyses showed that the WVQ strains (of which there are at least three) were related to the members of the genus Foveavirus in the subfamily Quinvirinae (family Betaflexiviridae). In the phylogenetic tree, they form a clade distant from that of the foveaviruses, suggesting that WVQ is a member of a novel genus in the Quinvirinae. Laboratory tests confirmed that WVQ, like WYMV, is potentially transmitted through the soil to wheat plants. WVQ was also found to infect rye plants grown in the same field. Moreover, WVQ-derived small interfering RNAs accumulated in the infected wheat plants, indicating that WVQ infection induces antiviral RNA silencing responses. Given its common coexistence with WYMV, the impact of WVQ infection on yellow mosaic disease in the field warrants detailed investigation. No potential conflict of interest relevant to this article was reported.

IEEE Acta Medica Okayama 2020 Method of Generating a Blacklist for Mobile Devices by Searching Malicious Websites 20489448 EN Takashi Ishihara Graduate School of Natural Science and Technology, Okayama University Masaya Sato Graduate School of Natural Science and Technology, Okayama University Toshihiro Yamauchi Graduate School of Natural Science and Technology, Okayama University As mobile devices have become more popular, malware and attacks directed at them have significantly increased. One of the methods to attack mobile devices is redirecting a user to unwanted websites by unwanted page transition. One of the countermeasures against such attacks is to generate a blacklist of URLs and hostnames, which can prevent access to malicious websites. To generate a blacklist, first, malicious websites are collected in the web space. Then, URLs and hostnames of the malicious websites are added to the blacklist. However, URLs of the malicious websites are typically changed frequently; thus, it is necessary to keep track of the malicious websites and update the blacklist in a timely manner. In this study, we proposed a method to generate blacklists for mobile devices by searching malicious websites. The method collects many HTML files from the web space using a crawler and searches for HTML files that are highly likely to be malicious using keywords extracted from the known malicious websites to discover the new ones. Thus, new malicious websites can be added to the blacklist in a timely manner. Using the proposed method, we discovered malicious websites that were not detected by Google Safe Browsing. Moreover, the blacklist generated using the method had a high detection rate for certain malicious websites. This paper reports the design process and the results of the evaluation of the new method. No potential conflict of interest relevant to this article was reported.

Hindawi Acta Medica Okayama 2021 2021 Accuracy of Deep Learning Algorithms for the Diagnosis of Retinopathy of Prematurity by Fundus Images: A Systematic Review and Meta-Analysis 8883946 EN Jingjing Zhang Department of Regenerative and Reconstructive Medicine (Ophthalmology), Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Yangyang Liu Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Toshiharu Mitsuhashi Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama University Toshihiko Matsuo Department of Regenerative and Reconstructive Medicine (Ophthalmology), Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Background. Retinopathy of prematurity (ROP) occurs in preterm infants and may contribute to blindness. Deep learning (DL) models have been used for ophthalmologic diagnoses. We performed a systematic review and meta-analysis of published evidence to summarize and evaluate the diagnostic accuracy of DL algorithms for ROP by fundus images. <br> Methods. We searched PubMed, EMBASE, Web of Science, and Institute of Electrical and Electronics Engineers Xplore Digital Library on June 13, 2021, for studies using a DL algorithm to distinguish individuals with ROP of different grades, which provided accuracy measurements. ,e pooled sensitivity and specificity values and the area under the curve (AUC) of summary receiver operating characteristics curves (SROC) summarized overall test performance. ,e performances in validation and test datasets were assessed together and separately. Subgroup analyses were conducted between the definition and grades of ROP. ,reshold and nonthreshold effects were tested to assess biases and evaluate accuracy factors associated with DL models. <br> Results. Nine studies with fifteen classifiers were included in our meta-analysis. A total of 521,586 objects were applied to DL models. For combined validation and test datasets in each study, the pooled sensitivity and specificity were 0.953 (95% confidence intervals (CI): 0.946–0.959) and 0.975 (0.973–0.977), respectively, and the AUC was 0.984 (0.978–0.989). For the validation dataset and test dataset, the AUC was 0.977 (0.968–0.986) and 0.987 (0.982–0.992), respectively. In the subgroup analysis of ROP vs. normal and differentiation of two ROP grades, the AUC was 0.990 (0.944–0.994) and 0.982 (0.964–0.999), respectively. <br> Conclusions. Our study shows that DL models can play an essential role in detecting and grading ROP with high sensitivity, specificity, and repeatability. ,e application of a DL-based automated system may improve ROP screening and diagnosis in the future. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2072-6651 13 7 2021 Serodiagnosis and Bacterial Genome of Helicobacter pylori Infection 467 EN Aina Ichihara Department of Bacteriology, Academic Field of Health Science Okayama University Hinako Ojima Department of Bacteriology, Academic Field of Health Science Okayama University Kazuyoshi Gotoh Department of Bacteriology, Academic Field of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Osamu Matsushita Department of Bacteriology, Academic Field of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Susumu Take Department of Gastroenterology and Hepatology, Kurashiki Central Hospital Hiroyuki Okada Department of Gastroenterology and Hepatology, Academic Field of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Akari Watanabe Department of Oral Health Care and Rehabilitation, Institute of Biomedical Sciences, Tokushima University Graduate School Kenji Yokota Department of Bacteriology, Academic Field of Health Science Okayama University The infection caused by Helicobacter pylori is associated with several diseases, including gastric cancer. Several methods for the diagnosis of H. pylori infection exist, including endoscopy, the urea breath test, and the fecal antigen test, which is the serum antibody titer test that is often used since it is a simple and highly sensitive test. In this context, this study aims to find the association between different antibody reactivities and the organization of bacterial genomes. Next-generation sequences were performed to determine the genome sequences of four strains of antigens with different reactivity. The search was performed on the common genes, with the homology analysis conducted using a genome ring and dot plot analysis. The two antigens of the highly reactive strains showed a high gene homology, and Western blots for CagA and VacA also showed high expression levels of proteins. In the poorly responsive antigen strains, it was found that the inversion occurred around the vacA gene in the genome. The structure of bacterial genomes might contribute to the poor reactivity exhibited by the antibodies of patients. In the future, an accurate serodiagnosis could be performed by using a strain with few gene mutations of the antigen used for the antibody titer test of H. pylori. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 1615-5289 22 1 2021 Effective highlighting modes of graphical user interfaces in visual information search 111 119 EN Toshihisa Doi Okayama University This study discusses the preferred highlighting mode for graphical user interface (GUI) design. The study investigated the effects of different highlighting modes on the search time and accuracy of the element on the screen. The experimental factors were the type of highlighting (color, bold, or color and bold), the target highlighting (highlighted or not highlighted), and the number of elements on GUI (few or many). The participants had to search for a predetermined target on the screen. The evaluation measures were the reaction time and percentage correctly identified. The statistical analysis result shows that bold highlighting had the shortest search time, and color highlighting had the worst accuracy. Under the conditions of this experiment, bold highlighting should contribute to the design of the screen for an easier search of information in terms of both search speed and accuracy. No potential conflict of interest relevant to this article was reported.

Springer Science and Business Media LLC Acta Medica Okayama 0217-4561 39 4 2021 Foreign investment or divestment as a near-term solution to performance shortfalls? The moderating role of vicarious learning 1481 1509 EN Kent Ngan-Cheung Hui School of Management, Xiamen University Yuanyuan Gong Discovery Program for Global Learners, Okayama University Qi Cui Department of Organization and Human Resources, Renmin University Naipeng Jiang Tourism Department, Fudan University Most studies on problemistic search do not pay sufficient attention to how below-aspiration organizations decide what types of strategic actions to use to cope with performance shortfalls. In this study, we examine the preferences of multinational corporations (MNCs) for selecting foreign investment or divestment as a near-term solution to performance shortfalls. We first argue that foreign divestment is generally a more preferred performance solution. Drawing on the literature on vicarious learning, we further argue that MNCs are more likely to engage in foreign investment or foreign divestment to combat large performance shortfalls if peers recently and actively undertook the same type of strategic action. Moreover, they are less likely to undertake the other type of strategic action simultaneously because they adopt the satisficing principle and time constraints deter them from implementing multiple types of strategic action substantially. The analysis of the data about Japanese manufacturing MNCs reveals that vicarious learning influences MNCs’ selection preferences in certain conditions, thereby extending the literature on problemistic search. No potential conflict of interest relevant to this article was reported.

岡山大学大学院ヘルスシステム統合科学研究科 Acta Medica Okayama 2436-3227 1 2021 遠隔での見守りのための機器・サービスの調査と訪問看護での利用を想定した分類 47 63 EN Toshio Sakamoto Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University Akina Hirata Yell Co., Ltd. Mizuki Morita Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University 10.18926/interdisciplinary/61889 This study aims to improve the quality of home nursing care for the elderly. The report presents web-based information about devices and services for remote monitoring and health management using information and communication technology and about how they can improve home care nursing station efficiency in Japan. The search terms "elderly people," "watch over," and "service," plus "sensor" were used to narrow the search. After repeating the search using a chained search for materials and links extracted from those search results, services for home care stations particularly addressing the remote monitoring of elderly people were selected and extracted. Early detection of abnormalities for support by home health nurse responsibilities for observing the general condition of the patient was chosen as the main evaluation index of usefulness. The contractor and service cost were secondary evaluation axes. Results show 9 information communication devices and services for real-time monitoring of the elderly persons’ vital signs in real time for 24 hr, 2 of which are highly useful for early detection of abnormalities and subsequent response. Results suggest that other services might be more useful, depending on how they are used, and that general-purpose services with minimum functions and low cost of introduction and maintenance can provide more opportunities for utilization. Providing these services on a BtoBtoC model and responding to patients’ medical needs can supplement home care nursing station work, increase human resource and time efficiencies, and give patients "the feeling that a nurse is always at their bedside,” even when far away. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 26663643 2 1 2021 Japanese Lung Cancer Society Guidelines for Stage IV NSCLC With EGFR Mutations 100107 EN Kiichiro Ninomiya Department of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Shunsuke Teraoka Internal Medicine III, Wakayama Medical University Yoshitaka Zenke Department of Thoracic Oncology, National Cancer Center Hospital East Hirotsugu Kenmotsu Division of Thoracic Oncology, Shizuoka Cancer Center Yukiko Nakamura Department of Respiratory Medicine, Yokohama Municipal Citizen’s Hospital Yusuke Okuma Department of Thoracic Oncology, National Cancer Center Hospital Akihiro Tamiya Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center Kaname Nosaki Department of Thoracic Oncology, National Cancer Center Hospital East Masahiro Morise Department of Respiratory Medicine, Nagoya University Graduate School of Medicine Keiju Aokage Department of Thoracic Surgery, National Cancer Center Hospital East Yuko Oya Department of Thoracic Oncology, Aichi Cancer Center Hospital Toshiyuki Kozuki Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center Tomohiro Sakamoto Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Tottori University Kentaro Tanaka Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University Hisashi Tanaka Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine Junko Tanizaki Department of Medical Oncology, Kishiwada City Hospital Satoru Miura Department of Internal Medicine, Niigata Cancer Center Hospital Hideaki Mizutani Department of Thoracic Oncology, Saitama Cancer Center Eisaku Miyauchi Department of Respiratory Medicine, Tohoku University Hospital Ou Yamaguchi Department of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center Noriyuki Ebi Department of Respiratory Oncology, Iizuka Hospital Yasushi Goto Department of Thoracic Oncology, National Cancer Center Hospital Takaaki Sasaki Respiratory Center, Asahikawa Medical University Haruko Daga Department of Medical Oncology, Osaka City General Hospital Satoshi Morita Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto University Takeharu Yamanaka Department of Biostatistics, Yokohama City University School of Medicine Shinsuke Amano Japan Federation of Cancer Patient Groups Kazuo Hasegawa Japan Lung Cancer Alliance Chiyo K. Imamura Advanced Cancer Translational Research Institute, Showa University Kenichi Suzuki Division of Applied Pharmaceutical Education and Research, Hoshi University Kazuko Nakajima Department of Nursing and The Division of Stem Cell Transplantation, Shizuoka Cancer Center Hitomi Nishimoto Department of Nursing, Okayama University Hospital Satoshi Oizumi Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center Toyoaki Hida Department of Thoracic Oncology, Aichi Cancer Center Hospital Katsuyuki Hotta Center for Clinical Oncology, Okayama University Hospital Yuichi Takiguchi Department of Medical Oncology, Chiba University Hospital Patients with NSCLC in East Asia, including Japan, frequently contain EGFR mutations. In 2018, we published the latest full clinical practice guidelines on the basis of those provided by the Japanese Lung Cancer Society Guidelines Committee. The purpose of this study was to update those recommendations, especially for the treatment of metastatic or recurrent EGFR-mutated NSCLC. We conducted a literature search of systematic reviews of randomized controlled and nonrandomized trials published between 2018 and 2019 that multiple physicians had reviewed independently. On the basis of those studies and the advice from the Japanese Society of Lung Cancer Expert Panel, we developed updated guidelines according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We also evaluated the benefits of overall and progression-free survival, end points, toxicities, and patients’ reported outcomes. For patients with NSCLC harboring EGFR-activating mutations, the use of EGFR tyrosine kinase inhibitors (EGFR TKIs), especially osimertinib, had the best recommendation as to first-line treatment. We also recommended the combination of EGFR TKI with other agents (platinum-based chemotherapy or antiangiogenic agents); however, it can lead to toxicity. In the presence of EGFR uncommon mutations, except for an exon 20 insertion, we also recommended the EGFR TKI treatment. However, we could not provide recommendations for the treatment of EGFR mutations with immune checkpoint inhibitors, including monotherapy, and its combination with cytotoxic chemotherapy, because of the limited evidence present in the literature. The 2020 Japanese Lung Cancer Society Guidelines can help community-based physicians to determine the most appropriate treatments and adequately provide medical care to their patients. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 24054569 2021 Intravesical Therapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer: A Systematic Review and Network Meta-analysis of Disease Recurrence EN Ekaterina Laukhtina Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Mohammad Abufaraj Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Abdallah Al-Ani Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan Mustafa Rami Ali Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan Keiichiro Mori Department of Urology, The Jikei University School of Medicine Marco Moschini Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Fahad Quhal Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Reza Sari Motlagh Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Victor M. Schuettfort Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Hadi Mostafaei Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nico C. Grossmann Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Harun Fajkovic Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Francesco Soria Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino Dmitry Enikeev Institute for Urology and Reproductive Health, Sechenov University Shahrokh F. Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Context<br/> Patients with intermediate-risk non–muscle-invasive bladder cancer (NMIBC) may pose a clinical dilemma without an agreed evidence-based decision tree for personalized treatment. <br/>Objective<br/> To perform a systematic review and network meta-analysis (NMA) to summarize available evidence on the oncologic outcomes of intravesical therapy in patients with intermediate-risk NMIBC. <br/> Evidence acquisition<br/> The MEDLINE, EMBASE, and ClinicalTrials.gov databases were searched in October 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they reported on oncologic outcomes in patients with intermediate-risk NMIBC treated with transurethral resection of bladder tumor with and without intravesical chemotherapy or bacillus Calmette-Guérin (BCG) immunotherapy. <br/>Evidence synthesis<br/> Twelve studies were included in a qualitative synthesis (systematic review); three were deemed eligible for a quantitative synthesis (NMA). An NMA of five different regimens was conducted for the association of treatment with the 5-yr recurrence risk. Chemotherapy with maintenance was associated with a lower likelihood of 5-yr recurrence than chemotherapy without maintenance (odds ratio [OR] 0.51, 95% credible interval [CI] 0.26–1.03). Immunotherapy, regardless of whether a full- or reduced-dose regimen, was not associated with a significantly lower likelihood of 5-yr recurrence when compared with chemotherapy without maintenance (OR 0.90, 95% CI 0.39–2.11 vs OR 0.93, 95% CI 0.40–2.19). Analysis of the treatment ranking revealed that chemotherapy with maintenance had the lowest 5-yr recurrence risk (P score 0.9666). <br/> Conclusions<br/> Our analysis indicates that chemotherapy with a maintenance regimen confers a superior oncologic benefit in terms of 5-yr recurrence risk compared to chemotherapy without maintenance in patients with intermediate-risk NMIBC. Regardless of the dose regimen, immunotherapy with BCG does not appear to be superior to chemotherapy in patients with intermediate-risk NMIBC in term of disease recurrence. However, owing to the lack of comparative studies, there is an unmet need for well-designed, large-scale trials to validate our findings and generate robust evidence on disease recurrence and progression. <br/>Patient summary<br/> A maintenance schedule of chemotherapy reduces the rate of long-term recurrence of bladder cancer that has not invaded the bladder muscle. Chemotherapy inserted directly into the bladder and immunotherapy without maintenance schedules seem to have limited benefit in preventing cancer recurrence. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 10781439 39 3 2021 Catalog of prognostic tissue-based biomarkers in patients treated with neoadjuvant systemic therapy for urothelial carcinoma of the bladder: a systematic review 180 190 EN Ekaterina Laukhtina Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Keiichiro Mori Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Victor M. Schuettfort Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Fahad Quhal Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Hadi Mostafaei Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Reza Sari Motlangh Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Satoshi Katayama Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Nico C. Grossmann Department of Urology, Comprehensive Cancer Center, Medical University of Vienna Marco Moschini Department of Urology, Luzerner Kantonsspital Dmitry Enikeev Institute for Urology and Reproductive Health, Sechenov University, Shahrokh F. Shariat Department of Urology, Comprehensive Cancer Center, Medical University of Vienna PURPOSE<br/> The present systematic review aimed to identify prognostic values of tissue-based biomarkers in patients treated with neoadjuvant systemic therapy (NAST), including chemotherapy (NAC) and checkpoint inhibitors (NAI) for urothelial carcinoma of the bladder (UCB). <br/> MATERIAL AND METHODS<br/> The PubMed, Web of Science, and Scopus databases were searched in August 2020 according to the PRISMA statement. Studies were deemed eligible if they compared oncologic or pathologic outcomes in patients treated with NAST for UCB with and without detected pretreatment tissue-based biomarkers. <br/> RESULTS<br/> Overall, 44 studies met our eligibility criteria. Twenty-three studies used immunohistochemistry (IHC), 19 – gene expression analysis, three - quantitative polymerase chain reaction (QT PCR), and two – next-generation sequencing (NGS). According to the currently available literature, predictive IHC-assessed biomarkers, such as receptor tyrosine kinases and DNA repair pathway alterations, do not seem to convincingly improve our prediction of pathologic response and oncologic outcomes after NAC. Luminal and basal tumor subtypes based on gene expression analysis showed better NAC response, while claudin-low and luminal-infiltrated tumor subtypes did not. In terms of NAI, PD-L1 seems to maintain value as a predictive biomarker, while the utility of both tumor mutational burden and molecular subtypes remains controversial. Specific genomic alterations in DNA repair genes have been shown to provide significant predictive value in patient treated with NAC. QT PCR quantification of specific genes selected through microarray analysis seems to classify cases regarding their NAC response. <br/> CONCLUSION<br/> We believe that the present systematic review may offer a robust framework that will enable the testing and validation of predictive biomarkers in future prospective clinical trials. NGS has expanded the discovery of molecular markers that are reflective of the mechanisms of the NAST response. No potential conflict of interest relevant to this article was reported.

MDPI Acta Medica Okayama 2218-273X 10 11 2020 Deep Learning for Osteoporosis Classification Using Hip Radiographs and Patient Clinical Covariates 1534 EN Norio Yamamoto Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital Shintaro Sukegawa Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Akira Kitamura Search Space Inc. Ryosuke Goto Search Space Inc. Tomoyuki Noda Department of Musculoskeletal Traumatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Keisuke Nakano Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Kiyofumi Takabatake Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hotaka Kawai Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hitoshi Nagatsuka Department of Oral Pathology and Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Keisuke Kawasaki Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital Yoshihiko Furuki Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital Toshifumi Ozaki Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences This study considers the use of deep learning to diagnose osteoporosis from hip radiographs, and whether adding clinical data improves diagnostic performance over the image mode alone. For objective labeling, we collected a dataset containing 1131 images from patients who underwent both skeletal bone mineral density measurement and hip radiography at a single general hospital between 2014 and 2019. Osteoporosis was assessed from the hip radiographs using five convolutional neural network (CNN) models. We also investigated ensemble models with clinical covariates added to each CNN. The accuracy, precision, recall, specificity, negative predictive value (npv), F1 score, and area under the curve (AUC) score were calculated for each network. In the evaluation of the five CNN models using only hip radiographs, GoogleNet and EfficientNet b3 exhibited the best accuracy, precision, and specificity. Among the five ensemble models, EfficientNet b3 exhibited the best accuracy, recall, npv, F1 score, and AUC score when patient variables were included. The CNN models diagnosed osteoporosis from hip radiographs with high accuracy, and their performance improved further with the addition of clinical covariates from patient records. No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 63 1 2021 Remark on a Paper by Izadi and Baghalaghdam about Cubes and Fifth Powers Sums 53 60 EN Gaku Iokibe Department of Mathematics, Graduate School of Science, Osaka University In this paper, we refine the method introduced by Izadi and Baghalaghdam to search integer solutions to the Diophantine equation<img src="http://www.lib.okayama-u.ac.jp/www/mjou/mjou_63_53.png">. We show that the Diophantine equation has infinitely many positive solutions. No potential conflict of interest relevant to this article was reported.

American Society for Microbiology Acta Medica Okayama 2150-7511 11 3 2020 Hadaka Virus 1: a Capsidless Eleven-Segmented Positive-Sense Single-Stranded RNA Virus from a Phytopathogenic Fungus, Fusarium oxysporum e00450-20 EN Yukiyo Sato Institute of Plant Science and Resources, Okayama University Wajeeha Shamsi Institute of Plant Science and Resources, Okayama University Atif Jamal Crop Diseases Research Institute, National Agricultural Research Centre Muhammad Faraz Bhatti Atta-ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Hideki Kondo Institute of Plant Science and Resources, Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources, Okayama University The search for viruses infecting fungi, or mycoviruses, has extended our knowledge about the diversity of RNA viruses, as exemplified by the discovery of polymycoviruses, a phylogenetic group of multisegmented RNA viruses with unusual forms. The genomic RNAs of known polymycoviruses, which show a phylogenetic affinity for animal positive-sense single-stranded RNA [(+)RNA] viruses such as caliciviruses, are comprised of four conserved segments with an additional zero to four segments. The double-stranded form of polymycovirus genomic RNA is assumed to be associated with a virally encoded protein (proline-alanine-serine-rich protein [PASrp]) in either of two manners: a capsidless colloidal form or a filamentous encapsidated form. Detailed molecular characterizations of polymycoviruses, however, have been conducted for only a few strains. Here, a novel polymyco-related virus named Hadaka virus 1 (HadV1), from the phytopathogenic fungus Fusarium oxysporum, was characterized. The genomic RNA of HadV1 consisted of an 11-segmented positive-sense RNA with highly conserved terminal nucleotide sequences. HadV1 shared the three conserved segments with known polymycoviruses but lacked the PASrp-encoding segment. Unlike the known polymycoviruses and encapsidated viruses, HadV1 was not pelleted by conventional ultracentrifugation, possibly due to the lack of PASrp. This result implied that HadV1 exists only as a soluble form with naked RNA. Nevertheless, the 11 genomic segments of HadV1 have been stably maintained through host subculturing and conidiation. Taken together, the results of this study revealed a virus with a potential novel virus lifestyle, carrying many genomic segments without typical capsids or PASrp-associated forms. IMPORTANCE Fungi collectively host various RNA viruses. Examples include encapsidated double-stranded RNA (dsRNA) viruses with diverse numbers of genomic segments (from 1 to 12) and capsidless viruses with nonsegmented (+)RNA genomes. Recently, viruses with unusual intermediate features of an infectious entity between encapsidated dsRNA viruses and capsidless (+)RNA viruses were found. They are called polymycoviruses, which typically have four to eight dsRNA genomic segments associated with one of the virus-encoded proteins and are phylogenetically distantly related to animal (+)RNA caliciviruses. Here, we identified a novel virus phylogenetically related to polymycoviruses, from the phytopathogenic fungus Fusarium oxysporum. The virus, termed Hadaka virus 1 (HadV1), has 11 (+)RNA genomic segments, the largest number in known (+)RNA viruses. Nevertheless, HadV1 lacked a typical structural protein of polymycoviruses and was not pelleted by standard ultracentrifugation, implying an unusual capsidless nature of HadV1. This study reveals a potential novel lifestyle of multisegmented RNA viruses. No potential conflict of interest relevant to this article was reported.

Japanese Society of Breeding Acta Medica Okayama 1344-7610 70 2 2020 DNA markers based on retrotransposon insertion polymorphisms can detect short DNA fragments for strawberry cultivar identification 231 240 EN Chiharu Hirata Fukuoka Agriculture and Forestry Research Center Takamitsu Waki Tochigi Prefectural Agricultural Experiment Station Katsumi Shimomura Fukuoka Agriculture and Forestry Research Center Takuya Wada Fukuoka Agriculture and Forestry Research Center Seiya Tanaka Graduate School of Bioresource and Bioenvironmental Sciences, Kyushu University Hidetoshi Ikegami Fukuoka Agriculture and Forestry Research Center Yousuke Uchimura Fukuoka Agriculture and Forestry Research Center Keita Hirashima Fukuoka Agriculture and Forestry Research Center Yoshiko Nakazawa Tochigi Prefectural Agricultural Experiment Station Kaori Okada Tochigi Prefectural Agricultural Experiment Station Kiyoshi Namai Tochigi Prefectural Agricultural Experiment Station Makoto Tahara Graduate School of Environmental and Life Science, Okayama University Yuki Monden Graduate School of Environmental and Life Science, Okayama University In this study, DNA markers were developed for discrimination of strawberry (Fragaria × ananassa L.) cultivars based on retrotransposon insertion polymorphisms. We performed a comprehensive genomic search to identify retrotransposon insertion sites and subsequently selected one retrotransposon family, designated CL3, which provided reliable discrimination among strawberry cultivars. Through analyses of 75 strawberry cultivars, we developed eight cultivar-specific markers based on CL3 retrotransposon insertion sites. Used in combination with 10 additional polymorphic markers, we differentiated 35 strawberry cultivars commonly cultivated in Japan. In addition, we demonstrated that the retrotransposon-based markers were effective for PCR detection of DNA extracted from processed food materials, whereas a SSR marker was ineffective. These results indicated that the retrotransposon-based markers are useful for cultivar discrimination for processed food products, such as jams, in which DNA may be fragmented or degraded. No potential conflict of interest relevant to this article was reported.

Wolters Kluwer Acta Medica Okayama 2394-8108 5 3 2019 Cerebral circulation improves with indirect bypass surgery combined with gene therapy 119 123 EN Alex Shear Department of Neurosurgery and Brain Repair, College of Medicine, University of South Florida Morsani Shingo Nishihiro Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Tomohito Hishikawa Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Masafumi Hiramatsu Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Kenji Sugiu Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Takao Yasuhara Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Isao Date Department of Neurological Surgery, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University Angiogenesis involves new blood vessels sprouting from preexisting blood vessels. This process may serve to improve brain circulation. Moyamoya disease (MMD) is a cerebrovascular disorder causing intracranial stenosis which significantly reduces the blood supply to the brain. Mainly stroke is the first symptom of the disorder, so treatments that reduce the risk of stroke are used for patients with MMD. To prevent stroke for those with chronic cerebral hypoperfusion, more blood needs to flow to the brain, which was thought to be achieved by enhancing angiogenesis. Indirect bypass surgery, such as encephalo-myo-synangiosis (EMS), is used for revascularization. However, EMS alone sometimes cannot provide enough circulation to avoid ischemic strokes. The current study examined if EMS combined with high-mobility group box-1 (HMGB1) and vascular endothelial growth factor (VEGF) enhanced angiogenesis and increased cerebral circulation. The results indicated that HMGB1 administered with EMS increased angiogenesis through a VEGF-dependent mechanism. In addition, exercising and stem cell transplantation possess possible means to increase angiogenesis. Overall, EMS with gene therapy, maintaining fitness, and stem cell utilization may prevent or help one recover from stroke by enhancing brain angiogenesis. Thus, these treatments may be applicable for patients with MMD. This paper is a review article. Referred literature in this paper has been listed in the references section. The datasets supporting the conclusions of this article are available online by searching various databases, including PubMed. No potential conflict of interest relevant to this article was reported.

AME Publishing Co. Acta Medica Okayama 2218-676X 9 8 2020 Effect of local surgery on outcomes of stage IV breast cancer 5102 5107 EN Takahiro Tsukioki Department of Breast and Endocrine Surgery, Okayama University Hospital Tadahiko Shien Department of Breast and Endocrine Surgery, Okayama University Hospital Hiroyoshi Doihara Department of Breast and Endocrine Surgery, Okayama University Hospital Metastatic breast cancer (MBC), including de novo stage IV, is regarded as being incurable and the mainstay of clinical management is systemic therapy. Traditionally, locoregional surgery is performed only for local control, such as to prevent ulceration and bleeding. In recent years, however, both retrospective and prospective studies have demonstrated the prognostic efficacy of primary surgery for de novo stage IV patients. Therefore, we conducted a meta-analysis to evaluate whether surgical therapy contributes to overall survival (OS) extension. We searched for clinical trials published in electronic databases (PubMed, Embase, and the Cochrane databases) and performed a meta-analysis of the data collected. There were five prospective randomized controlled phase III trials (RCTs). The results of three have been reported. According to our meta-analysis of these RCTs, primary surgery for de novo stage IV breast cancer patients significantly improves OS. However, the Tata trial showed that systemic therapy does not achieve a sufficient effect. Another trial, conducted in Turkey, had statistical shortcomings and patient randomization was not adequately performed The ABCSG (Austrian Breast and Colorectal Cancer Study Group) trial had too few subjects. Meta-analysis of 12 retrospective studies showed that patients with stage IV breast cancer receiving surgery as the initial treatment experienced longer OS (HR: 0.65, P<0.00001). Based on our meta-analysis of three reported 'RCTs, surgery as the primary treatment does not significantly impact the outcomes of de novo stage IV breast cancer patients. However, these trials had limitations. We await the results of the remaining two ongoing RCTs (ECOG 2108 and JCOG 1017). These trials are anticipated to resolve current controversies and provide many eagerly awaited answers. No potential conflict of interest relevant to this article was reported.

日本耳鼻咽喉科感染症研究会 Acta Medica Okayama 09133976 31 1 2013 耳漏を主訴に来院した扁桃周囲膿瘍の1例 175 178 EN The patient was a 79-year-old woman. Her left ear was being treated with otitis externa at her nearby clinic by eardrop. Her otorrhea did not improve after one week. The otorrhea still kept outflowing during food intake. That is the reason of her visiting our hospital. Her past medical histories were sigmoid colon perforation with stoma placement, rheumatoid arthritis, diabetes mellitus, hypertension, right hip prosthesis placement. At the first visit to our hospita!, She had a remarkable erosion of the left ear canal, fistula was found in front of the ear canal skin. She showed pus leakage due to her chewing. Strongly swelling surrounded the left tonsil and soft palate, and oropharynx had been narrowed. T he CT scan revealed the low density area with a contrast effect from the lower ear to the left tonsil, was diagnosed with left peritonsillar abscess. On admission to our hospital, drainage and the administration of antibiotics were performed. She was discharged in satisfactory progress on day 10. Peritonsillar abscess, but there is a frequently encountered disease, being the chief complaint otorrhea is rare. As reported case seems to be similar as far as we have searched is only reported as "one case of deep neck abscess in the throat and ear canal causing self-destruction" is Tomohiro Anno 1961. We report this case with the literature about peritonsillar abscess. No potential conflict of interest relevant to this article was reported.

Remedy Acta Medica Okayama 2474-1647 5 2020 The Timing for Diagnosis of Anisometropia in Japanese Children with Congenital Eyelid Ptosis 2842 EN Toshihiko Matsuo Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems Purpose: The difference in refractive errors between both eyes, namely, anisometropia, is a known complication in congenital blepharoptosis. This study searched the timing of diagnosis of anisometropia in children with congenital blepharoptosis.</br> Methods: Retrospective review was made on medical records of 20 consecutive patients with congenital blepharoptosis at Okayama University Hospital from 2004 to 2018.</br> Results: T he age at the initial visit ranged from 1 month to 5 years 1 month (median, 5.5 months), and the follow-up period from 1 year 8 months to 13 years 5 months (median, 5 years 5 months). Blepharoptosis was on the right side in 6 patients, on the left side in 10, and on both sides in 4. Four patients underwent levator muscle plication at the age ranging from 3 months to 6 years 2 months: One patient on the right side, 2 on the left side, and one on both sides. Nine patients were found to have anisometropia, defined as hyperopic difference of 2 or more diopters between both eyes, or astigmatic difference of 2 or more diopters between both eyes, and astigmatism of 3 or more diopters in both eyes (ametropia), at the age ranging from 1 year 3 months to 3 years 6 months (median, 3 years). Four of the 9 patients with anisometropia showed unilateral amblyopia as the best-corrected visual acuity in decimals ranging from 0.2 to 0.5. The remaining 11 patients without anisometropia had normal levels of visual acuity in both eyes. Anisometropia was found in 3 of 4 patients with surgery and 6 of 16 patients with no surgery (no significant difference at chi-square test).</br> Conclusion: About a half of children with congenital blepharoptosis was found to have anisometropia at the age of 1 to 3 years. Care must be taken on refraction and glasses prescription at these ages. No potential conflict of interest relevant to this article was reported.

Frontiers Media Acta Medica Okayama 1664-302X 11 2020 Virome Analysis of Aphid Populations That Infest the Barley Field: The Discovery of Two Novel Groups of Nege/Kita-Like Viruses and Other Novel RNA Viruses 509 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Miki Fujita Institute of Plant Science and Resources (IPSR), Okayama University Hiroshi Hisano Institute of Plant Science and Resources (IPSR), Okayama University Kiwamu Hyodo Institute of Plant Science and Resources (IPSR), Okayama University Ida Bagus Andika College of Plant Health and Medicine, Qingdao Agricultural University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University Aphids (order Hemiptera) are important insect pests of crops and are also vectors of many plant viruses. However, little is known about aphid-infecting viruses, particularly their diversity and relationship to plant viruses. To investigate the aphid viromes, we performed deep sequencing analyses of the aphid transcriptomes from infested barley plants in a field in Japan. We discovered virus-like sequences related to nege/kita-, flavi-, tombus-, phenui-, mononega-, narna-, chryso-, partiti-, and luteoviruses. Using RT-PCR and sequence analyses, we determined almost complete sequences of seven nege/kitavirus-like virus genomes; one of which was a variant of the Wuhan house centipede virus (WHCV-1). The other six seem to belong to four novel viruses distantly related to Wuhan insect virus 9 (WhIV-9) or Hubei nege-like virus 4 (HVLV-4). We designated the four viruses as barley aphid RNA virus 1 to 4 (BARV-1 to -4). Moreover, some nege/kitavirus-like sequences were found by searches on the transcriptome shotgun assembly (TSA) libraries of arthropods and plants. Phylogenetic analyses showed that BARV-1 forms a clade with WHCV-1 and HVLV-4, whereas BARV-2 to -4 clustered with WhIV-9 and an aphid virus, Aphis glycines virus 3. Both virus groups (tentatively designated as Centivirus and Aphiglyvirus, respectively), together with arthropod virus-like TSAs, fill the phylogenetic gaps between the negeviruses and kitaviruses lineages. We also characterized the flavi/jingmen-like and tombus-like virus sequences as well as other RNA viruses, including six putative novel viruses, designated as barley aphid RNA viruses 5 to 10. Interestingly, we also discovered that some aphid-associated viruses, including nege/kita-like viruses, were present in different aphid species, raising a speculation that these viruses might be distributed across different aphid species with plants being the reservoirs. This study provides novel information on the diversity and spread of nege/kitavirus-related viruses and other RNA viruses that are associated with aphids. No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 01689002 959 2020 Evaluation of gadolinium’s action on water Cherenkov detector systems with EGADS 163549 EN Ll. Marti Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo M. Ikeda Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Kato Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Kishimoto Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo M. Nakahata Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Nakajima Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Nakano Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo S. Nakayama Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Okajima Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo A. Orii Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo G. Pronost Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo H. Sekiya Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo M. Shiozawa Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo H. Tanaka Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo K. Ueno Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo S. Yamada Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo T. Yano Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo T. Yokozawa Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo M. Murdoch Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study J. Schuemann Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study M.R. Vagins Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study K. Bays Department of Physics and Astronomy, University of California G. Carminati Department of Physics and Astronomy, University of California N.J. Griskevich Department of Physics and Astronomy, University of California W.R. Kropp Department of Physics and Astronomy, University of California S. Locke Department of Physics and Astronomy, University of California A. Renshaw Department of Physics and Astronomy, University of California M.B. Smy Department of Physics and Astronomy, University of California P. Weatherly Department of Physics and Astronomy, University of California S. Ito Department of Physics, Okayama University H. Ishino Department of Physics, Okayama University A. Kibayashi Department of Physics, Okayama University Y. Koshio Department of Physics, Okayama University T. Mori Department of Physics, Okayama University M. Sakuda Department of Physics, Okayama University R. Yamaguchi Department of Physics, Okayama University P. Fernandez Department of Theoretical Physics, University Autonoma Madrid L. Labarga Department of Theoretical Physics, University Autonoma Madrid I. Bandac Laboratorio Subterraneo de Canfranc J. Perez Laboratorio Subterraneo de Canfranc J. Amey Department of Physics, Imperial College London R.P. Litchfield Department of Physics, Imperial College London A. Sztuc Department of Physics, Imperial College London Y. Uchida Department of Physics, Imperial College London W.Y. Ma Department of Physics, Imperial College London A. Goldsack Department of Physics, Oxford University C. Simpson Department of Physics, Oxford University D. Wark Department of Physics, Oxford University L.H.V. Anthony Department of Physics, University of Liverpool N. McCauley Department of Physics, University of Liverpool A. Pritchard Department of Physics, University of Liverpool F. Di Lodovico Department of Physics, King’s College London B. Richards Department of Physics, King’s College London A. Cole Department of Physics and Astronomy, University of Sheffield M. Thiesse Department of Physics and Astronomy, University of Sheffield L. Thompson Department of Physics and Astronomy, University of Sheffield J. Imber Ecole Polytechnique, IN2P3-CNRS, Laboratoire Leprince-Ringuet S.V. Cao High Energy Accelerator Research Organization (KEK) K. Ito Department of Physics, Tokai University Y. Takeuchi Department of Physics, Kobe University R. Akutsu Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo Y. Nishimura Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo K. Okumura Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo S. Hirota Department of Physics, Kyoto University F. Muto Institute for Space-Earth Environmental Research, Nagoya University M. Yokoyama Department of Physics, University of Tokyo Y. Suda Department of Physics, University of Tokyo H. Zhang Department of Engineering Physics, Tsinghua University Used for both proton decay searches and neutrino physics, large water Cherenkov (WC) detectors have been very successful tools in particle physics. They are notable for their large masses and charged particle detection capabilities. While current WC detectors reconstruct charged particle tracks over a wide energy range, they cannot efficiently detect neutrons. Gadolinium (Gd) has the largest thermal neutron capture cross section of all stable nuclei and produces an 8 MeV gamma cascade that can be detected with high efficiency. Because of the many new physics opportunities that neutron tagging with a Gd salt dissolved in water would open up, a large-scale R&D program called EGADS was established to demonstrate this technique’s feasibility. EGADS features all the components of a WC detector, chiefly a 200-ton stainless steel water tank furnished with 240 photo-detectors, DAQ, and a water system that removes all impurities from water while keeping Gd in solution. In this paper we discuss the milestones towards demonstrating the feasibility of this novel technique, and the features of EGADS in detail. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2020 Search for Astronomical Neutrinos from Blazar TXS0506+056 in Super-Kamiokande EN Kaito Hagiwara Graduate School of Natural Science and Technology, Okayama University No potential conflict of interest relevant to this article was reported.

Elsevier Acta Medica Okayama 0370-2693 798 2019 Search for heavy neutrinos in pi > mu nu decay 134980 EN A. Aguilar-Arevalo Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de Mexico M. Aoki Graduate School of Science, Osaka University, M. Blecher Physics Department, Virginia Tech. D.I. Britton School of Physics and Astronomy, University of Glasgow Bruch, D. vom Bruch Department of Physics and Astronomy, University of British Columbia D. A. Bryman Department of Physics and Astronomy, University of British Columbia S. Chen Department of Engineering Physics, Tsinghua University J. Comfort Physics Department, Arizona State University L. Doria TRIUMF, 4004 Wesbrook Mall S. Cuen-Rochin Department of Physics and Astronomy, University of British Columbia P. Gumplinger TRIUMF, 4004 Wesbrook Mall A. Hussein University of Northern British Columbia Y. Igarashi KEK S. Ito Graduate School of Science, Osaka University S. H. Kettell Brookhaven National Laboratory L. Kurchaninov TRIUMF, 4004 Wesbrook Mall L. S. Littenberg Brookhaven National Laboratory C. Malbrunot Department of Physics and Astronomy, University of British Columbia R. E. Mischke TRIUMF, 4004 Wesbrook Mall T. Numao TRIUMF, 4004 Wesbrook Mall D. Protopopescu School of Physics and Astronomy, University of Glasgow A. Sher TRIUMF, 4004 Wesbrook Mall T. Sullivan Department of Physics and Astronomy, University of British Columbia D. Vavilov TRIUMF, 4004 Wesbrook Mall In the present work of the PIENU experiment, heavy neutrinos were sought in pion decays pi(+) -> mu(+)nu at rest by examining the observed muon energy spectrum for extra peaks in addition to the expected peak for a light neutrino. No evidence for heavy neutrinos was observed. Upper limits were set on the neutrino mixing matrix vertical bar U-mu i vertical bar(2) in the neutrino mass region of 15.7-33.8 MeV/c(2), improving on previous results by an order of magnitude. (C) 2019 The Authors. Published by Elsevier B.V. No potential conflict of interest relevant to this article was reported.

岡山大学教師教育開発センター Acta Medica Okayama 2186-1323 10 2020 年長児におけることば遊びとひらがな単語読字の 流暢性との関連 27 37 EN Moe YOKOYAMA Takayuki TANJI 10.18926/CTED/58116 本研究は，年長児のことば遊び，長音表記知識，およびひらがな単語読字の流暢性との関連を明らかにすることを目的とした。年長児40 名を対象に，文字を使ったことば遊びである“ことばのかくれんぼゲーム”，かな読み中後期の発達課題である，ひらがな長音単語の表記知識課題，ひらがな単語速読課題を実施した。各課題の相関から，ひらがな単語速読成績と長音表記選択課題の分節回答成績で有意な関連が認められた。また，ことばのかくれんぼゲーム成績，長音表記選択成績，月齢を独立変数，ひらがな単語速読成績を従属変数とした重回帰分析の結果，ことばのかくれんぼゲームの「部分文字列」成績と月齢が有意な予測変数として抽出された。本研究から，年長児におけるひらがな単語読字の流暢性には，ことばの音韻操作を駆使してことばを見つける力や，有意味な文字列をすばやく見つける力を必要とされるような，ことば遊びが関与することが示唆された。 No potential conflict of interest relevant to this article was reported.

BMC Acta Medica Okayama 1471-230X 19 1 2019 Prognostic significance of the controlling nutritional status (CONUT) score in patients undergoing hepatectomy for hepatocellular carcinoma: a systematic review and meta-analysis 211 EN Kosei Takagi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Piotr Domagala Department of Surgery, Erasmus MC, University Medical Center Rotterdam Wojciech G. Polak Department of Surgery, Erasmus MC, University Medical Center Rotterdam Stefan Buettner Department of Surgery, Erasmus MC, University Medical Center Rotterdam Jan N. M. Ijzermans Department of Surgery, Erasmus MC, University Medical Center Rotterdam Background: The clinical value of the controlling nutritional status (CONUT) score in hepatocellular carcinoma (HCC) has increased. The aim of this meta-analysis was to systematically review the association between the CONUT score and outcomes in patients undergoing hepatectomy for HCC. <br/> Methods: Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, and Google Scholar were systematically searched. Random effects meta-analyses were conducted to examine the prognostic value of the CONUT score in HCC patients. <br/> Results: A total of five studies including 4679 patients were found to be eligible and analyzed in the meta-analysis. The CONUT score was significantly associated with overall survival (HR 1.78, 95%CI = 1.20-2.64, P = 0.004, I-2 = 79%), recurrence-free survival (HR 1.34, 95%CI = 1.17-1.53, P < 0.001, I-2 = 16%) and postoperative major complications (OR 1.85, 95%CI: 1.19-2.87, P = 0.006, I-2 = 72%) in HCC patients. Moreover, the CONUT score was associated with the Child-Pugh classification, liver cirrhosis, ICGR15, and tumor differentiation. However, it was not associated with tumor size, tumor number, and microvascular invasion. <br/> Conclusions: The CONUT score is an independent prognostic indicator of the prognosis and is associated with postoperative major complications and hepatic functional reserve in HCC patients. No potential conflict of interest relevant to this article was reported.

Oxford University Press Acta Medica Okayama 2050-3911 6 2019 Development of a method for measuring rare earth elements in the environment for future experiments with gadolinium-loaded detectors 063H03 EN S. Ito Okayama University, Faculty of Science T. Okada Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Takaku Institute for Environmental Sciences, Department of Radioecology M. Harada Okayama University, Faculty of Science M. Ikeda Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Kishimoto Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Koshio Okayama University, Faculty of Science M. Nakahata Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo Y. Nakajima Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo H. Sekiya Demand to use gadolinium (Gd) in detectors is increasing in the field of elementary particle physics, especially in neutrino measurements and dark matter searches. Large amounts of Gd are used in these experiments. To assess the impact of Gd on the environment it is becoming important to measure the baseline concentrations of Gd. Such measurement, however, is not easy due to interference by other elements. In this paper a method for measuring the concentrations of rare earth elements, including Gd, is proposed. In the method, inductively coupled plasma-mass spectrometry is utilized after collecting the dissolved elements in chelating resin. Results of the ability to detect anomalous concentrations of rare earth elements in river water samples in the Kamioka and Toyama areas are also reported. No potential conflict of interest relevant to this article was reported.

TAYLOR & FRANCIS Acta Medica Okayama 0169-1864 2019 Development of a separable search-and-rescue robot composed of a mobile robot and a snake robot EN Tetsushi Kamegawa Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Taichi Akiyama Graduate School of Natural Science and Technology, Okayama University Satoshi Sakai Graduate School of Natural Science and Technology, Okayama University Kento Fujii Graduate School of Natural Science and Technology, Okayama University Kazushi Une Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Eitou Ou Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Yuto Matsumura Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Toru Kishutani Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Eiji Nose Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Yusuke Yoshizaki Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Akio Gofuku Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, In this study, we propose a new robot system consisting of a mobile robot and a snake robot. The system works not only as a mobile manipulator but also as a multi-agent system by using the snake robot's ability to separate from the mobile robot. Initially, the snake robot is mounted on the mobile robot in the carrying mode. When an operator uses the snake robot as a manipulator, the robot changes to the manipulator mode. The operator can detach the snake robot from the mobile robot and command the snake robot to conduct lateral rolling motions. In this paper, we present the details of our robot and its performance in the World Robot Summit. No potential conflict of interest relevant to this article was reported.

Humana Press Acta Medica Okayama 2014 Detection and analysis of non-retroviral RNA virus-like elements in plant, fungal, and insect genomes. 73 88 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Sotaro Chiba Institute of Plant Science and Resources (IPSR)Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University Endogenous non-retroviral RNA like sequences (NRVSs) have been discovered in the genome of a wide range of eukaryotes. These are considered as fossil RNA viral elements integrated into host genomes by as-yet-known mechanisms, and in many cases, those fossils are estimated to be millions-of-years-old. It is likely that the number of NRVS records will increase rapidly due to the growing availability of whole-genome sequences for many kinds of eukaryotes. Discovery of the novel NRVSs and understanding of their phylogenetic relationship with modern viral relatives provide important information on deep evolutionary history of RNA virus-host interactions. In this chapter, therefore, the common strategies for the identification and characterization of endogenous NRVSs from plants, insects, and fungi are described. No potential conflict of interest relevant to this article was reported.

Springer Acta Medica Okayama 0304-8608 160 8 2015 Cymbidium chlorotic mosaic virus, a new sobemovirus isolated from a spring orchid (Cymbidium goeringii) in Japan. 2099 104 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Shogo Takemoto Institute of Plant Science and Resources (IPSR)Okayama University Kazuyuki Maruyama Institute of Plant Science and Resources (IPSR)Okayama University Sotaro Chiba Institute of Plant Science and Resources (IPSR)Okayama University Ida Bagus Andika Institute of Plant Science and Resources (IPSR)Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University Cymbidium chlorotic mosaic virus (CyCMV), isolated from a spring orchid (Cymbidium goeringii), was characterized molecularly. CyCMV isometric virions comprise a single, positive-strand RNA genome of 4,083 nucleotides and 30-kDa coat protein. The virus genome contains five overlapping open reading frames with a genomic organization similar to that of sobemoviruses. BLAST searches and phylogenetic analysis revealed that CyCMV is most closely related to papaya lethal yellowing virus, a proposed dicot-infecting sobemovirus (58.8 % nucleotide sequence identity), but has a relatively distant relationship to monocot-infecting sobemoviruses, with only modest sequence identities. This suggests that CyCMV is a new monocot-infecting member of the floating genus Sobemovirus. No potential conflict of interest relevant to this article was reported.

Elsevier Science Acta Medica Okayama 01681702 177 1 2013 Characterization of burdock mottle virus, a novel member of the genus Benyvirus, and the identification of benyvirus-related sequences in the plant and insect genomes. 75 86 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Shuichi Hirano Institute of Plant Science and Resources (IPSR), Okayama University Sotaro Chiba Institute of Plant Science and Resources (IPSR), Okayama University Ida Bagus Andika Institute of Virology and Biotechnology, Zhejiang Academy of Agricultural Sciences Makoto Hirai Department of Parasitology, Graduate School of Medicine, Gunma University Takanori Maeda Formerly College of Bioresource Sciences, Nihon University Tetsuo Tamada Institute of Plant Science and Resources (IPSR), Okayama University The complete nucleotide sequence of the burdock mottle virus (BdMoV) isolated from an edible burdock plant (Arctium lappa) in Japan has been determined. BdMoV has a bipartite genome, whose organization is similar to RNA1 and RNA2 of benyviruses, beet necrotic yellow vein virus (BNYVV), beet soil-borne mosaic virus (BSBMV), and rice stripe necrosis virus (RSNV). BdMoV RNA1 (7038 nt) contains a single open reading frame (ORF) encoding a 249-kDa polypeptide that consists of methyl-transferase, helicase, papain-like protease, AlkB-like, and RNA-dependent RNA polymerase domains. The AlkB-like domain sequence is not present in the proteins encoded by other known benyviruses, but is found in replication-associated proteins of viruses mainly belonging to the families Alfaflexiviridae and Betaflexiviridae. BdMoV RNA2 (4315 nt) contains six ORFs that are similar to those of benyviruses: these are coat protein (CP), CP readthrough, triple gene block movement and cysteine-rich proteins. Phylogenetic analyses showed that BdMoV is more closely related to BNYVV and BSBMV than to RSNV. Database searches showed that benyvirus replicase-related sequences are present in the chromosomes of a chickpea plant (Cicer arietinum) and a blood-sucking insect (Rhodnius prolixus). Some other benyvirus-related sequences are found in the transcriptome shotgun libraries of a few species of plants and a bark beetle. Our results show that BdMoV is a distinct species of the genus Benyvirus and that ancestral and extant benyviruses may have infected or currently infect a wide range of hosts, including plants and insects. No potential conflict of interest relevant to this article was reported.

Elsevier Science Acta Medica Okayama 01681702 213 2016 Sequence and phylogenetic analyses of novel totivirus-like double-stranded RNAs from field-collected powdery mildew fungi 353 364 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Sakae Hisano Institute of Plant Science and Resources (IPSR), Okayama University Sotaro Chiba Institute of Plant Science and Resources (IPSR), Okayama University Kazuyuki Maruyama Institute of Plant Science and Resources (IPSR), Okayama University Ida Bagus Andika Institute of Plant Science and Resources (IPSR), Okayama University Kazuhiro Toyoda Graduate School of Environmental and Life Science, Okayama University Fumihiro Fujimori Department of Environmental Education, Tokyo Kasei University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University The identification of mycoviruses contributes greatly to understanding of the diversity and evolutionary aspects of viruses. Powdery mildew fungi are important and widely studied obligate phytopathogenic agents, but there has been no report on mycoviruses infecting these fungi. In this study, we used a deep sequencing approach to analyze the double-stranded RNA (dsRNA) segments isolated from field-collected samples of powdery mildew fungus-infected red clover plants in Japan. Database searches identified the presence of at least ten totivirus (genus Totivirus)-like sequences, termed red clover powdery mildew-associated totiviruses (RPaTVs). The majority of these sequences shared moderate amino acid sequence identity with each other (<44%) and with other known totiviruses (<59%). Nine of these identified sequences (RPaTV1a, 1b and 2-8) resembled the genome of the prototype totivirus, Saccharomyces cerevisiae virus-L-A (ScV-L-A) in that they contained two overlapping open reading frames (ORFs) encoding a putative coat protein (CP) and an RNA dependent RNA polymerase (RdRp), while one sequence (RPaTV9) showed similarity to another totivirus, Ustilago maydis virus H1 (UmV-H1) that encodes a single polyprotein (CP-RdRp fusion). Similar to yeast totiviruses, each ScV-L-A-like RPaTV contains a -1 ribosomal frameshift site downstream of a predicted pseudoknot structure in the overlapping region of these ORFs, suggesting that the RdRp is translated as a CP-RdRp fusion. Moreover, several ScV-L-A-like sequences were also found by searches of the transcriptome shotgun assembly (TSA) libraries from rust fungi, plants and insects. Phylogenetic analyses show that nine ScV-L-A-like RPaTVs along with ScV-L-A-like sequences derived from TSA libraries are clustered with most established members of the genus Totivirus, while one RPaTV forms a new distinct clade with UmV-H1, possibly establishing an additional genus in the family. Taken together, our results indicate the presence of diverse, novel totiviruses in the powdery mildew fungus populations infecting red clover plants in the field. No potential conflict of interest relevant to this article was reported.

Oxford University Press Acta Medica Okayama 00018244 30 6 2019 Artificial selection on walking distance suggests a mobility-sperm competitiveness trade-off 1522 1529 EN Kentarou Matsumura Graduate School of Environmental and Life Science, Okayama University C Ruth Archer Centre for Ecology & Conservation, University of Exeter David J Hosken Centre for Ecology & Conservation, University of Exeter Takahisa Miyatake Graduate School of Environmental and Life Science, Okayama University Securing matings is a key determinant of fitness, and in many species, males are the sex that engages in mate searching. Searching for mates is often associated with increased mobility. This elevated investment in movement is predicted to trade-off with sperm competitiveness, but few studies have directly tested whether this trade-off occurs. Here, we assessed whether artificial selection on mobility affected sperm competitiveness and mating behavior, and if increased mobility was due to increased leg length in red flour beetles (Tribolium castaneum). We found that, in general, males selected for decreased mobility copulated for longer, stimulated females more during mating, and tended to be better sperm competitors. Surprisingly, they also had longer legs. However, how well males performed in sperm competition depended on females. Males with reduced mobility always copulated for longer than males with high mobility, but this only translated into greater fertilization success in females from control populations and not the selection populations (i.e. treatment females). These results are consistent with a mate-searching/mating-duration trade-off and broadly support a trade-off between mobility and sperm competitiveness. No potential conflict of interest relevant to this article was reported.

Elsevier Science Acta Medica Okayama 01681702 262 2019 A novel insect-infecting virga/nege-like virus group and its pervasive endogenization into insect genomes 37 47 EN Hideki Kondo Institute of Plant Science and Resources (IPSR), Okayama University Sotaro Chiba Asian Satellite Campuses Institute, Nagoya University Kazuyuki Maruyama Institute of Plant Science and Resources (IPSR), Okayama University Ida Bagus Andika Institute of Plant Science and Resources (IPSR), Okayama University Nobuhiro Suzuki Institute of Plant Science and Resources (IPSR), Okayama University Insects are the host and vector of diverse viruses including those that infect vertebrates, plants, and fungi. Recent wide-scale transcriptomic analyses have uncovered the existence of a number of novel insect viruses belonging to an alphavirus-like superfamily (virgavirus/negevirus-related lineage). In this study, through an in silico search using publicly available insect transcriptomic data, we found numerous virus-like sequences related to insect virga/nege-like viruses. Phylogenetic analysis showed that these novel viruses and related virus-like sequences fill the major phylogenetic gaps between insect and plant virga/negevirus lineages. Interestingly, one of the phylogenetic clades represents a unique insect-infecting virus group. Its members encode putative coat proteins which contained a conserved domain similar to that usually found in the coat protein of plant viruses in the family Virgaviridae. Furthermore, we discovered endogenous viral elements (EVEs) related to virga/nege-like viruses in the insect genomes, which enhances our understanding on their evolution. Database searches using the sequence of one member from this group revealed the presence of EVEs in a wide range of insect species, suggesting that there has been prevalent infection by this virus group since ancient times. Besides, we present detailed EVE integration profiles of this virus group in some species of the Bombus genus of bee families. A large variation in EVE patterns among Bombus species suggested that while some integration events occurred after the species divergence, others occurred before it. Our analyses support the view that insect and plant virga/nege-related viruses might share common virus origin(s). No potential conflict of interest relevant to this article was reported.

INDERSCIENCE ENTERPRISES Acta Medica Okayama 2044-4893 7 3 2017 A design-aware test code approach for code writing problem in Java programming learning assistant system 145 154 EN Khin Khin Zaw Graduate School of Natural Science and Technology, Okayama University Nobuo Funabiki Graduate School of Natural Science and Technology, Okayama University To advance Java programming educations, we have developed the web-based Java programming learning assistant system (JPLAS) that provides the code writing problem. This problem asks a student to write a source code for a given assignment, where the correctness is verified by running the test code on JUnit. In this paper, we propose a design-aware test code approach for the code writing problem. The design-aware test code tests any important method in the model source code that has the advisable design for the assignment. Thus, by writing a code that can pass it, a student is expected to implement the code with the proper classes/methods in the model code. In evaluations of the proposal, all the students could complete highly qualitative codes for five graph algorithms using the design-aware test codes, where the code quality metrics were measured by metrics plugin for Eclipse. No potential conflict of interest relevant to this article was reported.

岡山大学理学部地球科学教室 Acta Medica Okayama 1340-7414 22 1 2015 焼きなまし法による初動発震機構解の決定 9 23 EN Masanao Komatsu Hiroshi Takenaka 10.18926/ESR/54116 Simulated annealing (SA) is known as one of the efficient methods for global optimization. It allows for getting an optimal solution by jumping out of local minimum. In this paper, we apply the simulated annealing to determination of focal mechanism solution. To investigate the feasibility of the application, we determine focal mechanism solution of the 14 March 2014 Iyo-Nada intermediatedepth earthquake. The computation of SA method is then 1278 times faster than that of the grid search method. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 128 1 2016 メカノセンサー 61 62 EN Ken Takahashi No potential conflict of interest relevant to this article was reported.

IEEE Robotics & Automation Society Acta Medica Okayama 2015 Path Tracking by a Mobile Robot Equipped with Only a Downward Facing Camera 6053 6058 EN Isaku Nagai Keigo Watanabe This paper presents a practical path-tracking method for a mobile robot with only a downward camera facing the passage plane. A unique algorithm for tracking and searching ground images with natural texture is used to localize the robot without a feature-point extraction scheme commonly used in other visual odometry methods. In our tracking algorithm, groups of reference pixels are used to detect the relative translation and rotation between frames. Furthermore, a reference pixel group of another shape is registered both to record a path and to correct errors accumulated during localization. All image processing and robot control operations are carried out with low memory consumption for image registration and fast calculation times for completing the searches on a laptop PC. We also describe experimental results in which a vehicle developed by the proposed method repeatedly performed precise path tracking under indoor and outdoor environments. No potential conflict of interest relevant to this article was reported.

岡山実験動物研究会 Acta Medica Okayama 31 2015 実験動物を用いる実習における3Rs 実践の試み －マウス、ラットの飼育、保定、注射、解剖に向けての予備トレーニング－ 40 49 EN Toshiki Usuda Kayo Furumoto Megumu Kita 広島アニマルケア専門学校では、動物看護コース3 年課程（動物看護師志望者と実験動物技術者志望者が混 在）の3 年次に実施する実験動物学実習に際して、動物福祉の観点から動物に与える苦痛を可能な限り少なく できる実施法を模索してきた。実際に生きた動物を用いる実習を行う前に、いくつかの予備トレーニングを取 り入れた3Rs 実践の試みである。具体的には、ケージ取り扱い練習、先鋭器具取り扱い練習のための雑巾縫 製、保定練習を目的とした軟質ボールによる手指トレーニング、自身の皮膚摘まみ練習、鉛筆や鶏手羽先を用 いた注射器具使用練習、そして餃子の皮、鶏皮、鶏手羽先を用いた解剖器具使用練習などである。これらの取 り組みそれぞれが、果たして効果的であるかどうか検証できているわけではないが、学生の取り組みを間近で 観察した立場から、感覚的には効果を実感している。また、予備トレーニングは、動物に与える苦痛を軽減す ることを最大の目標とするものであるが、一方で、動物を用いた実習に臨む学生の心理的準備を促す効果もあ るように感じている。実験動物技術者や動物看護師養成課程、コースが、大学や専門学校に設けられ、そこに 多くの学生が学んでいる現在、動物を用いた実習のプログラムを動物実験倫理・動物福祉の観点からさらに洗 練させることが望まれる。そのプログラムの一部として、われわれの予備トレーニングの取り組みを紹介した。 No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 127 1 2015 家族性大腸腺腫症（FAP）に合併した同時性５多発大腸癌に対してリンパ節郭清を伴う腹腔鏡下大腸全摘術を施行した１例 25 29 EN Hiroshi Kato Masahiro Oishi Masahito Kodera Masao Yamamura Hideaki Ikeda Kenji Mizuno Yutaka Yamashita 　A 49-year-old Japanese man visited our hospital with chief complaints of difficulty with and bleeding during defecation. After a detailed examination, he was diagnosed with familial adenomatous polyposis (FAP) with multiple (five) colorectal cancers. The tumors were located in the right-sided, left-sided, and sigmoid colon, and the lower rectum. Regional lymph node involvement was observed, but no metastasis to other organs was detected. We, therefore, performed a laparoscopic total colectomy with superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) lymph node dissection. We were able to perform minimally invasive and cosmetically acceptable surgery using laparoscopy instead of highly-invasive open abdominal surgery. Our search of the literature revealed no reported cases of laparoscopic total colectomy with lymph node dissection for FAP with multiple colorectal cancers, making the present case the first to be reported in the literature. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 126 3 2014 Reduced Port Surgeryで切除した高度炎症を伴う虫垂中に発見された潜在性虫垂粘液嚢胞腺腫の１例 223 226 EN Hiromitsu Suzuki Kouji Kimura Sigeki Kinoshita Kazuo Okano Appendicitis is a benign disease for which surgical treatment is widely provided. The complication of neoplastic lesions may be discovered only after resection. However, in some cases, specimens are not submitted to histopathological examination in Japan because of an extreme deficiency of pathologists. We report our experience with one patient who experienced the complication of latent low-grade appendiceal mucinous neoplasm (LAMN) after surgery for appendicitis. Our patient was an 85-year-old woman. Conservative treatment failed to relieve fever and lower abdominal pain and it was decided to treat her surgically. Abdominal computed tomography (CT) showed appendicitis with severe inflammation and suspected adhesion. We decided to explore the abdominal cavity using a reduced-port laparoscopic approach. We found no mucous debouchment or clear tumors in the specimen. Histopathological findings indicated the coexistence of appendicitis and LAMN. At one year and a half after surgery, there was no evidence of the development of pseudomyxoma peritonei. In appendectomy, it is thought that careful perioperative treatment and a postoperative pathological search are important when there are no preoperative findings suggesting a neoplastic lesion. No potential conflict of interest relevant to this article was reported.

Public Library Science Acta Medica Okayama 1932-6203 9 9 2014 Seed Maturation Regulators Are Related to the Control of Seed Dormancy in Wheat (Triticum aestivum L.) EN Kazuhide Rikiishi Masahiko Maekawa In Arabidopsis, the regulation network of the seed maturation program controls the induction of seed dormancy. Wheat EST sequences showing homology with the master regulators of seed maturation, LEAFY COTYLEDON1 (LEC1), LEC2 and FUSCA3 (FUS3), were searched from databases and designated respectively as TaL1L (LEC1-LIKE), TaL2L (LEC2-LIKE), and TaFUS3. TaL1LA, TaL2LA and TaFUS3 mainly expressed in seeds or embryos, with the expression limited to the early stages of seed development. Results show that tissue-specific and developmental-stage-dependent expressions are similar to those of seed maturation regulators in Arabidopsis. In wheat cultivars, the expression level of TaL1LA is correlated significantly with the germination index (GI) of whole seeds at 40 days after pollination (DAP) (r = -0.83**). Expression levels of TaFUS3 and TaL2LA are significantly correlated respectively with GIs at 40 DAP and 50 DAP, except for dormant cultivars. No correlation was found between the expression level of TaVP1, orthologue of ABA INSENSITIVE3 (ABI3), and seed dormancy. DELAY OF GERMINATION1 (DOG1) was identified as a quantitative trait locus (QTL) for the regulation of seed dormancy in Arabidopsis. Its promoter has RY motif, which is a target sequence of LEC2. Significant correlation was found between the expression of TaDOG1 and seed dormancy except for dormant cultivars. These results indicate that TaL1LA, TaL2LA, and TaFUS3 are wheat orthologues of seed maturation regulators. The expressions of these genes affect the level of seed dormancy. Furthermore, the pathways, which involve seed maturation regulators and TaDOG1, are important for regulating seed dormancy in wheat. No potential conflict of interest relevant to this article was reported.

岡山実験動物研究会 Acta Medica Okayama 30 2014 科学研究費補助金によるウズラの研究課題 50 60 EN Katsunori Sato Japanese quails are widely used for experiments are models of birds, such as chickens, and are becoming increasingly important in research fields today. Their experimental usefulness was initially reported in an international journal for academic research by Padgett et al. and Wilson et al. in 1959, and, since then, a large number of researchers in- and outside Japan have conducted surveys and studies to examine their characteristics. In Japan, the first study on Japanese quails with a Grant-in-Aid for Scientific Research was conducted in 1966, followed by a large number of studies examining them. This grant program aims to support original and pioneering research activities, and is also expected to promote studies on Japanese quails in a wide range of research fields, leading to the advancement of all areas. This paper reviews previous studies on Japanese quails, conducted within the 48-year period between 1966 and 2013. They were searched for using the Database of Grants-in-Aid for Scientific Research KAKEN, excluding some research subjects, and are listed chronologically by keyword. Those comparing Japanese quails with other animals or using them as part of the study are also included. No potential conflict of interest relevant to this article was reported.

Biomed Central Ltd Acta Medica Okayama 1471-2164 12 2011 454 sequencing of pooled BAC clones on chromosome 3H of barley EN Kazuhiro Sato Yuka Motoi Nami Yamaji Hideya Yoshida Background: Genome sequencing of barley has been delayed due to its large genome size (ca. 5,000Mbp). Among the fast sequencing systems, 454 liquid phase pyrosequencing provides the longest reads and is the most promising method for BAC clones. Here we report the results of pooled sequencing of BAC clones selected with ESTs genetically mapped to chromosome 3H. Results: We sequenced pooled barley BAC clones using a 454 parallel genome sequencer. A PCR screening system based on primer sets derived from genetically mapped ESTs on chromosome 3H was used for clone selection in a BAC library developed from cultivar "Haruna Nijo". The DNA samples of 10 or 20 BAC clones were pooled and used for shotgun library development. The homology between contig sequences generated in each pooled library and mapped EST sequences was studied. The number of contigs assigned on chromosome 3H was 372. Their lengths ranged from 1,230 bp to 58,322 bp with an average 14,891 bp. Of these contigs, 240 showed homology and colinearity with the genome sequence of rice chromosome 1. A contig annotation browser supplemented with query search by unique sequence or genetic map position was developed. The identified contigs can be annotated with barley cDNAs and reference sequences on the browser. Homology analysis of these contigs with rice genes indicated that 1,239 rice genes can be assigned to barley contigs by the simple comparison of sequence lengths in both species. Of these genes, 492 are assigned to rice chromosome 1. Conclusions: We demonstrate the efficiency of sequencing gene rich regions from barley chromosome 3H, with special reference to syntenic relationships with rice chromosome 1. No potential conflict of interest relevant to this article was reported.

Oxford University Press Acta Medica Okayama 0305-1048 38 2010 NBRP databases: databases of biological resources in Japan D26 D32 EN Yukiko Yamazaki Ryo Akashi Yutaka Banno Takashi Endo Hiroshi Ezura Kaoru Fukami-Kobayashi Kazuo Inaba Tadashi Isa Katsuhiko Kamei Fumie Kasai Masatomo Kobayashi Nori Kurata Makoto Kusaba Tetsuro Matuzawa Shohei Mitani Taro Nakamura Yukio Nakamura Norio Nakatsuji Kiyoshi Naruse Hironori Niki Eiji Nitasaka Yuichi Obata Hitoshi Okamoto Moriya Okuma Kazuhiro Sato Tadao Serikawa Toshihiko Shiroishi Hideaki Sugawara Hideko Urushibara Masatoshi Yamamoto Yoshio Yaoita Atsushi Yoshiki Yuji Kohara The National BioResource Project (NBRP) is a Japanese project that aims to establish a system for collecting, preserving and providing bioresources for use as experimental materials for life science research. It is promoted by 27 core resource facilities, each concerned with a particular group of organisms, and by one information center. The NBRP database is a product of this project. Thirty databases and an integrated database-retrieval system (BioResource World: BRW) have been created and made available through the NBRP home page (http://www.nbrp.jp). The 30 independent databases have individual features which directly reflect the data maintained by each resource facility. The BRW is designed for users who need to search across several resources without moving from one database to another. BRW provides access to a collection of 4.5-million records on bioresources including wild species, inbred lines, mutants, genetically engineered lines, DNA clones and so on. BRW supports summary browsing, keyword searching, and searching by DNA sequences or gene ontology. The results of searches provide links to online requests for distribution of research materials. A circulation system allows users to submit details of papers published on research conducted using NBRP resources. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 0022-2615 61 9 2012 Significant association of the dupA gene of Helicobacter pylori with duodenal ulcer development in a South-east Indian population 1295 1302 EN Jawed Alam Sankar Maiti Prachetash Ghosh Ronita De Abhijit Chowdhury Suryasnata Das Ragini Macaden Harshad Devarbhavi T. Ramamurthy Asish K. Mukhopadhyay A novel virulence factor, duodenal ulcer-promoting gene A (dupA), in Helicobacter pylori has been found to be associated with disease in certain populations but not in others. This study analysed a South-east Indian population as part of the debate about the relevance of dupA for the prediction of clinical outcomes. A total of 140 H. pylori strains isolated from duodenal ulcer (DU) (n=83) and non-ulcer dyspepsia (NUD) patients (n=57) were screened by PCR and dot-blot hybridization to determine the presence of the ORFs jhp0917 and jhp0918. Part of jhp0917-jhp0918 was sequenced to search for the C/T insertion that characterizes dupA and the levels of dupA transcripts were also assessed. The PCR and dot-blot results indicated the presence of jhp0917 and jhp0918 in 37.3% (31/83) and 12.2% (7/57) of H. pylori strains isolated from DU and NUD patients, respectively. Sequencing analysis showed insertion of a C at nt 1386 in the 3' region of jhp0917, forming the dupA gene in 35 strains. RT-PCR analysis detected the dupA transcript in 28 of these 35 strains. The expression level of the dupA transcript varied from strain to strain, as shown by real-time PCR. The results demonstrated that analysis based on PCR only for dupA may produce an erroneous interpretation. The prevalence of dupA was significantly greater among strains isolated from patients with DU than from patients with NUD in this population (P=0.001, odds ratio=4.26, confidence interval=1.60-11.74). Based on these findings, dupA can be considered a biomarker for DU patients in India. The reported discrepancies for this putative virulence marker in different populations may be due to the genome plasticity of H. pylori. No potential conflict of interest relevant to this article was reported.

一般社団法人電子情報通信学会 Acta Medica Okayama 0913-5685 109 390 2010 類似した動作や状況を検索するための意味役割及び動詞語義付与システムの構築(第1回集合知シンポジウム〜言語処理が紡ぎ出す未来〜) 1 6 EN Koichi Takeuchi Suguru Tsuchiyama Masato Moriya Yuuki Moriyasu 本研究では類似した動作や状態を検索するための基礎技術として,動作表現の類似関係を付与する項構造付与システムを構築している.項構造とは動詞と名詞の係り関係まで含めて動作の共通部分を記述するもので,例えば「XがYを逮捕する」「Yを捕まえる」には概念を共通していることを示す.本研究ではすでに,4425語(7473語義)の動詞に対して動詞間の項構造関係をシソーラス形式で整理して公開している.そこでこのオントロジーを基に規則ベースの項構造付与システムの構築を行った.本報告では項構造付与に必要なサブタスクとして,慣用句同定,複合名詞内係関係同定,主動詞探索を取り上げ事例による語義決定法について述べる.また,現状での語義付与精度について簡単な評価実験を行う. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 125 1 2013 遺伝子多型と薬剤感受性 77 78 EN Satoshi Kuroda Toshiaki Sendo No potential conflict of interest relevant to this article was reported.

Oxford University Press Acta Medica Okayama 0022-1503 102 4 2011 Genome-wide deficiency mapping of the regions responsible for temporal canalization of the developmental processes of Drosophila melanogaster 448 457 EN Kazuo H. Takahashi Yasukazu Okada Kouhei Teramura Developmental processes of organisms are programed to proceed in a finely regulated manner and finish within a certain period of time depending on the ambient environmental conditions. Therefore, variation in the developmental period under controlled genetic and environmental conditions indicates innate instability of the developmental process. In this study, we aimed to determine whether a molecular machinery exists that regulates the canalization of the developmental period and, if so, to test whether the same mechanism also stabilizes a morphological trait. To search for regions that influence the instability of the developmental period, we conducted genome-wide deficiency mapping with 441 isogenic deficiency strains covering 65.5% of the Drosophila melanogaster genome. We found that 11 independent deficiencies significantly increased the instability of the developmental period and 5 of these also significantly increased the fluctuating asymmetry of wing shape although there was no significant correlation between the instabilities of developmental period and wing shape in general. These results suggest that canalization processes of the developmental period and morphological traits are at least partially independent. Our findings emphasize the potential importance of temporal variation in development as an indicator of developmental stability and canalization and provide a novel perspective for understanding the regulation of phenotypic variability. No potential conflict of interest relevant to this article was reported.

情報処理学会 Acta Medica Okayama 09196072 2006 94 2006 複合名詞に着目したWeb検索結果のクラスタリング 35 42 EN Kazuki Hirao Koichi Takeuchi 本稿では複合名詞に着目したWeb検索結果のクラスタリング手法を提案する．本手法では検索結果のタイトルと要約を利用し，階層的で一つの検索結果が複数のクラスタに含まれることを認めるクラスタリングを行う．本手法は次の２つの仮説に基づいている．1)複合名詞は固有の概念を表すため，文書を特徴付けやすい．2)複合名詞間の語構成関係を利用して，部分複合による類概念，および上位下位関係のクラスラベルを作成することで見通しの良いＷｅｂ文書の分類ができる．実験の結果，複合名詞の構造は分かりやすいクラスタ構造の形成に利用でき，また自然なラベル付けに有効であった．このことから，複合名詞は検索結果全体を見渡すためのよいインデックスであると言える． No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 36 2 2002 A Study on the Planning and Scheduling of Production System Considering Demand Changes 15 42 EN Ryuji Ohtani Masami Konishi Jun Imai Tatsushi Nishi 10.18926/47023 In this paper, we studied a planning and scheduling of production system considering demand changes. In the proposed system, planning part determines lot-size and amount of jobs in production. On the other hand, scheduling part determines the production sequence of jobs. In order to treat with the demand changes, both planning and scheduling should work well simultaneously. In the proposed system, preset and real time production control system is newly constructed from the view point of adaptive control. In the system, production planning is modified when the difference between production amount and demand becomes large. Moreover, production schedule is regenerated when the determined schedule is deviated from the prospected one. The scheduling system is characterized as the autonomous decentralized optimization system where each job works as agent and agent searches its appropriate starting time of processing. The effectiveness of the proposed system is confirmed by numerical examples. No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 36 1 2001 Automatic Detection of Circular Objects by Ellipse Growing 107 116 EN Kenichi Kanatani Naoya Ohta 10.18926/47004 We present a new method for automatically detecting circular objects in images: we detect an osculating circle to an elliptic arc using a Hough transform, iteratively deforming it into an ellipse, removing outlier pixels, and searching for a separate edge. The voting space is restricted to one and two dimensions for efficiency, and special weighting schemes are introduced to enhance the accuracy. We demonstrate the effectiveness of our method using real images. Finally, we apply our method to the calibration of a turntable for 3-D object shape reconstruction. No potential conflict of interest relevant to this article was reported.

Faculty of Engineering, Okayama University Acta Medica Okayama 0475-0071 37 1 2002 Robust Image Matching under a Large Disparity 25 32 EN Yasushi Kanazawa Kenichi Kanatani 10.18926/46970 We present a new method for detecting point matches between two images without using any combinatorial search. Our strategy is to impose various local and non-local constraints as "soft" constraints by introducing their "confidence" measures via "mean-field approximations". The computation is a cascade of evaluating the confidence values and sorting according to them. In the end, we impose the "hard" epipolar constraint by RANSAC. We also introduce a model selection procedure to test if the image mapping can be regarded as a homography. We demonstrate the effectiveness of our method by real image examples. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 66 7 1954 前立腺肥大症と腎機能に関する実験的研究 第2編 犬の前立腺浸出液による腎臓機能障碍について 1299 1319 EN Shigemichi Ohto 1. After having prepared some extracts, made respectively from a dog's normal prostate, moderately hypertrophied prostate in mixed form, as well as from highly glandular hypertrophied prostate, both of dog, injected them subcutaneously in a dog, in doses of 5-2cc per day, for about 14-16 weeks successively, and examined such as general view, changes occurred to Rest-N, Cl, Ur as well as Ur within blood; moreover, employing some fluid test, and in view to urinal symptoms, has endeavoured to find out those changes that have occurred in kidney functions. 2. Among the cases in which extracts out of dog's normal prostate gland were administered, no important perpetual changes could be recognized. 3. In the case where extracts from the moderate hypertrophied prostate in mixed form were administered, (2nd case), fluid test proved to be utter failure, submitted no results, but probably this may be due to some individual quality of test animals, in the urin of which one could always detect certain spermo. However, during ten-weeks course allotted to this case, loss of body weight, (about minus 7.8%), together with a regular gradual increase on the part of Rest-N, Cl, Ur and Ur in blood, could be detected, whose final values all have exceeded normal area. 4. Among cases in which highly glandular hypertrophied gland were administered, first such symptoms as thirst, then came loss of spirit, followed by anxiety as well as depression, which ended in the appearance of edems in the back limb at the middle of, 11th week; growing higher and higher. 5. The increase of Rest-N, Cl, Ur and Ur within blood has also been clearly seen; above all, the last-mentioned one showed a special increase. 6. Moreover, in fluid test, a clear obstruction of concentration ability could be seen. 7. As for urin, here also appeared changes that have accompanied to general view and fluid test. 8. The dog which supplied the moderately hypertrophied prostate in mixed form employed in 2nd case (7 years), has been verified diagnosed owing to histological search of its kidney, that has given rise to a distinct Nephrose. 9. From the above results obtained by experiments, it is thought most proper for us to consider that the kidney trouble discovered in hypertrophy of prostate is apt to be accompanied with certain poisonous changes of kidney parenchyma, which may be ascribed to the poisoned substance due to hypertrophy of prostate. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 67 5 1955 無「カタラーゼ」血液症の研究 III. 患者血液抽出物に於ける「カタラーゼ」減少作用に就いての検討 905 908 EN Minoru Okita Tetsuya Oishi A toxohormone-like fraction prepared from the blood of acatalasemia patients by the method of Nakahara was tested whether it could decrease the catalase content of liver and blood of the mice or not. Although no decrease of catalase cotent of these tissues was observed, the fraction prepared from the patients could kill the mice. However, the fraction prepared from normal blood had no toxic action on the mice. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 31 4 2000 Toyota dans l'histoire 153 175 EN Koichi Shimizu 10.18926/OER/41516 At the end of the 20th century, the Japanese automobile industry is suffering from the long depression of Japanese economy to such an extent that sorne of Japanese carmakers were not able to survive without cooperating with foreign powerful carmakers. Nissan has been in restructuring under the French managers dispatched by Renault. Suzuki and Isuzu began to reinforce their cooperation with GM, whereas Fuji Heavy Industry (Subaru) and Mitsubishi are searching for their Western partners. It is only Toyota and Honda that seem to be able to compete by themselves on globalized automobile markets. Irony of the history, because until the end of the 1980s all Japanese carmakers were regarded as the most competitive companies of the world by incarnating the 'Lean Production' model whose basic model is the Toyota Production System. This stereotype has to be dismissed, because they have been having neither the same management nor the same strategy. This paper then tries to show the history of Japanese automobile industry from its very beginning to mid-1990 when the majority of carmakers are facing a crisis. In doing so, it presents the specifie characteristics of Toyota by placing it in the historical perspective. No potential conflict of interest relevant to this article was reported.

岡山大学経済学会 Acta Medica Okayama 0386-3069 32 4 2001 産業進化と創業･成長支援策 65 100 EN Mitsllshige Nitta 10.18926/OER/41476 In the latter half in 1990's, the extensive public policies for promoting newly establishment of the enterprise (for example, "Law for facilitating the creation of New Business" enforced in 1999) were introduced in Japan. In this paper, I would like to search the theoretical background of such policy as the policy for promoting evolution of industry that the innovative activities were accompanied by newly establishment and discontinuance ofbusiness of the enterprise. To begin with, I carried out the fact finding on the relation between newly establishment and discontinuance of business using the data of "The 1999 Establishment and Enterprise Census." And I verified some hypotheses on the evolution of industries which Acs and Audretsch (1991) and Audretsch (1995) presented and tried the reexamination of these hypotheses. I set the increasing rate of newly establishment (the number of employee base) and the increasing rate of discontinuance of business (the number of employee base) during 1996-1999 period as main variables. I carried out the regression analysis on manufacturing industries and service industries (industrial classification of 2 and 3 digits), and confirmed that there was the positive correlation between the increasing rate of newly establishment and the increasing rate of discontinuance of business. I examined the ratio of increasing rate of discontinuance of business and increasing rate of newly establishment (D / E ratio) on enterprise scale (by the number of employee base) and industrial sector (industrial classification of 2 digits). As the result, I confirmed that the D / E ratio described the V-shaped curve with the extension of enterprise scale in many industrial sectors. I consider that the base point of this V-shaped curve shows minimum efficient scale. I confirmed that there was the positive correlation between this minimum efficient scale (D / E ratio at V-shaped base point) and employment increasing rate of the industrial sector. Based on these results of analysis, I describe some policy implications on the public policies for the newly establishment of enterprises and the initial support and growth support for the newly-established and smallscale enterprises. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 71 11-1 1959 皮膚疾患に於ける血中並びに皮膚中電解質に関する研究 第1編 各種皮膚疾患に於ける血中電解質量の変動に就いて 7291 7304 EN Kakuzo Kunihara In order to explain the physiological conditions in skin diseases by searching the tendency of metabolism of electrolytes, the contents of sodium, potassium, calcium and chlor in serum were measured in 122 cases of various skin diseases. (1) Comparatively many cases of the numerous skin diseases showed the variation of the contents of electrolytes, but it was not always remarkable and constantly regular. (2) In bullous diseases, acquired pigmentary disturbances, diffuse scleroderma and erythroderma, varied the most remarkably, and especially in the 2 former cases was pointed out the evident tendency. (3) In eczema, dermatitis, inflammatory keratosis, erythematodes and cutaneous tuberculosis were often found abnormal values, but very irregular and complicated. (4) In urticaria, drug eruption and erythema exsudativum multiforme showed slight changes. (5) The auther conceived that the metabolism of electrolytes in vivo was so influenced by the several organs, especially endocrine organs, and by the autonomous nervous system, that such irregularity of this variation was showed. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 71 11-1 1959 実験的廿日鼠肝炎時の血液学的考察 第2編 骨髄像 7143 7154 EN Kiyoshi Oguchi The cellular morphological description was attempted by the investigation of myelogram in 20 of normal mice and the hemogram and myelogram were also observed on the mice with the intraperitoneal inoculation of liver emulsion of ectromelia virus 10(9) LD(50) in the dilution of 10(2) and 10(7) under the control of myelogram in normal mice, and then the mode of bone marrow in the infection of hepatitis virus was observed. comparing the above results with the myelogram of epidemic hepatitis in human and analysing the origin of the significant changes shown on the hemogram. And the results wene as follows. 1. Signifcant change was not observed on the erythroblast system. 2. The myelogram showed a parallel change to the peripheral hemogram in severe cases with remarkable leukocytosis and neutrocytosis on the peripheral blood picture. 3. The monocytosis and the appearance of plasma cells and plasmoid cells in mild cases had no direct relation to the bone marrow and it was thought that the origin of this reaction should be searched on other system, except bone marrow. 4. The myelogram in this experiment was relatively agreed with that of epidemic hepatitis in human, and it was thought that the main change was on the neutrocyte system. No potential conflict of interest relevant to this article was reported.

岡山医学会 Acta Medica Okayama 0030-1558 71 10-2 1959 腎部分剔除術の実験的研究 第2編 単腎部分剔除術後の残腎病理組織学的研究 6703 6713 EN Akira Kishimoto For the pathological studies with single kidney, already partialy nephrectomised, were searched, and the following conclusions were obtained. 1. Healing of wound is about from 35 to 42 days after the operation. Scarline is a few milimeters brest and crealy different from the distant part. 2. Glomerular or tubular degenerations of the distant part are sever in three days after the operation, and two weeks after are not found. 3. Cortical anaemia and medullary hyperemia are most severe in the third day, and the later was searched even in the 8th week. 4. Any time the changes of glomeruls are more slightly than the changes of tubulus, and the regeneration was eminent in the later. 5. The changes in the renal clearance test were certainly parallel to the changes in the pathological study. 6. The degree of glomerular or tubular degenerations was not influenced on account of the volume which had been removed, but on accout of renal ischaemia. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 102 50 2007 A human transporter protein that mediates the final excretion step for toxic organic cations 17923 17928 EN Masato Otsuka Takuya Matsumoto Riyo Morimoto Shigeo Arioka Hiroshi Omote Yoshinori Moriyama <p>In mammals, toxic electrolytes of endogenous and exogenous origin are excreted through the urine and bile. Before excretion, these compounds cross numerous cellular membranes in a transporter-mediated manner. However, the protein transporters involved in the final excretion step are poorly understood. Here, we show that MATE1, a human and mouse orthologue of the multidrug and toxin extrusion (MATE) family conferring multidrug resistance on bacteria, is primarily expressed in the kidney and liver, where it is localized to the luminal membranes of the urinary tubules and bile canaliculi. When expressed in HEK293 cells, MATE1 mediates H+-coupled electroneutral exchange of tetraethylammonium (TEA) and 1-methyl-4-phenylpyridinium (MPP). Its substrate specificity is similar to those of renal and hepatic H+-coupled organic cations (OCs) export. Thus, MATE1 appears to be the long searched for polyspecific OC exporter that directly transports toxic OCs into urine and bile.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 73 5 2006 Search for anomalous couplings in top decay at hadron colliders EN S Tsuno I Nakano R Tanaka <p>We present a quantitative study on sensitivities to the top-decay anomalous couplings, taking into account realistic experimental conditions expected at Tevatron and LHC. A double angular distribution of W and charged lepton in the top-decay is analyzed, using t<(t)<($)over bar> events in the leptons+jets channel. In order to improve sensitivities to the anomalous couplings, we apply two techniques: (i) We use a likelihood fitting method for full kinematical reconstruction of each top event. (ii) We develop a new effective spin reconstruction method for leptonically-decayed top quarks; this method does not require spin information of the antitop side. For simplicity, we neglect couplings of right-handed bottom quark as well as CP violating couplings. The 95% C.L. estimated bound on a ratio of anomalous couplings reads -0.81 < f(2)/f(1)<-0.70, -0.12 < f(2)/f(1)< 0.14 using 1000 reconstructed top events at Tevatron, while -0.74 < f(2)/f(1)<-0.72, -0.01 < f(2)/f(1)< 0.01 is expected with 100 k reconstructed top events at LHC, where only statistical errors are taken into account. A two-fold ambiguity in the allowed range remains when the number of events exceeds a few hundred.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2005 Improvement of zone control induction heating equipment for high-speed processing of semiconductor 1069 1070 EN Daisuke Miyagi Aisya Saitoh Norio Takahashi Naoki Uchida Kazuhiro Ozaki <p>In this paper, the effect of dividing into several small coil groups having different current and frequency on heating characteristics is investigated using FEM (finite element method). The heating characteristics of graphite of each coil is examined, and a useful information for controlling current and frequency, which realize the nearly uniform heating, is obtained.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1999 An open magnetic path type of single sheet tester for measurement of magnetostriction of electrical steel sheet EN Tomoya Nakase Masanori Nakano Koji Fujiwara Norio Takahashi No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2005 Performance Improvement of TCP using Performance Enhancing Proxies — Effect of Premature ACK Transmission Timing on Throughput — 7 12 EN Shigeyuki Osada Tokumi Yokohira Wang Hui Kiyohiko Okayama Nariyoshi Yamai <p>In order to improve TCP performance, a method using a PEP (Perfonnance Enhancing Proxy) is proposed. The PEP operates on a router along a TCP connection. When a data packet arrives at the PEP, it forwards the packet to the destination host, transmits the corresponding ACK (premature ACK) to the source host in behalf of the destination host and stores the copy of the packet into its own buffer (PEP buffer) in case of the retransmission of the packet. In this paper, under the strategy which keeps the number of packets in the PEP buffer for which premature ACKs have been returned being less than or equal to a fixed threshold value (watermark value), we investigate the relation between the watermark value and the maximum throughput. Extensive simulation runs show that the simulation results are roughly classified into two cases. One case is that the maximum throughput becomes larger for larger watermark value and becomes a constant value when the watermark value is over a value. The other case is that though the maximum throughput becomes larger for lager watermark value in the same way, it reversely decreases when the watermark value is over a value. We also show that the latter (former) case is easier to occur as the propagation delay in the input side network ofthe PEP becomes smaller (larger) and the propagation delay in the output side network of the PEP becomes larger (smaller) and the PEP buffer capacity becomes smaller (larger).</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2 1992 A Wideband Microwave Power Divider/Combiner with Multiple-Port Double-Ladder Structure 885 888 EN Atsushi Sanada Kiyoshi Fukui Shigeji Nogi We propose a new microwave power divider/combiner with multiple-port doubleladder structure for use in high power solid-state power amplifiers. Numerical and experimental analysis were carried out at X-band, and the results of the divider/combiner indicated low insertion loss and wide band characteristics in good accordance with the theory. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1998 Measuring system of magnetostriction under AC excitation using optical methods 220 220 EN Tomoya Nakase Masanori Nakano F. Fujiwara N. Takahashi No potential conflict of interest relevant to this article was reported.

IEEE Computer Society Acta Medica Okayama 2003 A proposal of a minimal-state processing search algorithm for isochronous channel reuse problems in DQDB networks 229 232 EN Nobuo Funabiki Ayako Sugano Teruo Higashino The IEEE 802.6 MAC standard protocol defines the distributed-queue dual bus (DQDB) for metropolitan area networks (MANs). The isochronous channel reuse problem (ICRP) has been studied for the efficient use of DQDB. Given a set of established connections and a set of connection requests, the goal of ICRP is to maximize the number of satisfied requests by finding a proper channel assignment, such that no established connection is not only reassigned a channel, but also any pair of active connections does not interfere each other. We propose a minimal-state processing search algorithm for ICRP (MIPS/sub -/ICRP). The simulation results show that MIPS/sub -/ICRP always provides near-optimum solutions. No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2006 A LECCS model parameter optimization algorithm for EMC designs of IC/LSI systems 304 307 EN Nobuo Funabiki Yohei Nomura Jun Kawashima Yuichiro Minamisawa Osami Wada <p>&lt;p&gt;In this paper, we propose a parameter optimization algorithm for EMC macro-modeling of IC/LSI power currents called the LECCS (linear equivalent circuit and current source) model. The unnecessary electro-magnetic wave from a digital electronics device may cause the electromagnetic interference (EMI) to other apparatus. Thus, its reduction has been regarded as one of the highest priority issues in digital electronics device designs. In order to accurately simulate high-frequency currents from power-supply sources that are the primary sources of EMI, the LECCS model has been proposed as a linear macromodel of a power-supply circuit. A LECCS model consists of multiple RLC-series circuits in parallel to represent the equivalent circuit between the voltage source and the ground. Given a set of measured impedances at various frequencies, our proposed algorithm first finds the number of RLC-series circuits corresponding to the number of valleys. Then, it searches optimal values of RLC parameters by a local search method. The effectiveness of our algorithm is verified through applications to a real system, where the accuracy and the required processing time by our algorithm are compared with the conventional method.&lt;/p&gt;</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2005 A Framework for Mobile Agent Systems with the Capability of Preceding and Following Users 89 94 EN Tokumi Yokohira Kiyohiko Okayama Takashi Murakami Kayo Takarako <p>As one of mobile agent applications, many systems which provide continuous service for users moving on a network have been proposed. In these systems, because a movement of mobile agents is performed after a user movement, users must wait for arrival of mobile agents. To reduce users' waiting time, we propose a fundamental framework for mobile agent systems where an agent can move precedently before a user movement. In our frame-work, it is assumed that computers are connected on a network and users with rewritable devices move on the network. The framework supports precedent movement ofmobile agents based on prediction using movement history of users. Because the prediction may be wrong, the framework also provides the following movement of mobile agents. Moreover, the framework provides a recovery method of mobile agents in service in case that mobile agents disappear due to problems such as their bugs. Because we provide some APIs, via which various functions of our framework are accessed, developers of mobile agent systems can easily use our framework using the APIs. We implemented an experimental agent system using the APIs and confirmed that the framework perforned correctly using the experimental system.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 138 5 1991 Current commands for high-efficiency torque control of DC shunt motor 227 232 EN Shigeyuki Funabiki T. Fukushima <p>The current commands for a high-efficiency torque control of a DC shunt motor are described. In the proposed control method, the effect of a magnetic saturation and an armature reaction are taken into account by representing the coefficients of an electromotive force and a torque as a function of the field current, the armature current and the revolving speed. The current commands at which the loss of the motor drive system becomes a minimum are calculated as an optimal problem. The proposed control technique of a motor is implemented on the microprocessor-based control system. The effect of the consideration of the magnetic saturation and the armature reaction on the produced torque and the minimisation of the loss are discussed analytically and experimentally </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1 2003 Modeling of gapped power bus structures for isolation using cavity modes 10 15 EN Zhi Liang Wang Osami Wada Ryuji Koga <p>Power bus resonance characteristics of a gapped power-plane with a slit and a split power-plane with a gap were studied, using a fast algorithm based on a full cavity-mode resonator model and the segmentation method. Inductance and capacitance models were used to account for a field coupling along the slit and across the gap, respectively. Good agreements between the calculated and measured results were found to demonstrate the effectiveness and accuracy of our fast algorithm and the segmentation method, as well as the inductance model for the slit and the capacitance model for the gap. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1999 Improvements of single sheet testers for measurement of 2-D magnetic properties up to high flux density EN Masanori Nakano H. Nishimoto K. Fujiwara N. Takahashi No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2006 A LECCS model parameter optimization algorithm for EMC designs of IC/LSI systems 304 307 EN Nobuo Funabiki Yohei Nomura Jun Kawashima Yuichiro Minamisawa Osami Wada <p>In this paper, we propose a parameter optimization algorithm for EMC macro-modeling of IC/LSI power currents called the LECCS (linear equivalent circuit and current source) model. The unnecessary electro-magnetic wave from a digital electronics device may cause the electromagnetic interference (EMI) to other apparatus. Thus, its reduction has been regarded as one of the highest priority issues in digital electronics device designs. In order to accurately simulate high-frequency currents from power-supply sources that are the primary sources of EMI, the LECCS model has been proposed as a linear macromodel of a power-supply circuit. A LECCS model consists of multiple RLC-series circuits in parallel to represent the equivalent circuit between the voltage source and the ground. Given a set of measured impedances at various frequencies, our proposed algorithm first finds the number of RLC-series circuits corresponding to the number of valleys. Then, it searches optimal values of RLC parameters by a local search method. The effectiveness of our algorithm is verified through applications to a real system, where the accuracy and the required processing time by our algorithm are compared with the conventional method.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2002 Application of segmentation method to analysis of power/ground plane resonance in multilayer PCBs 775 778 EN Zhi Liang Wang Osami Wada Yoshitaka Toyota Ryuji Koga <p>The fast algorithm developed for calculating the resonant characteristics of the power/ground planes in multilayer PCBs, is extended to the case of that the pattern of the power/ground planes consists of several "segments" of rectangles, using the so-called segmentation method. Good agreements between the calculated and measured results have demonstrated the usefulness and accuracy of our fast algorithm and the segmentation method.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1992 Computational acoustics and some applications to electromechanical and electroacoustic transducer design EN Yukio Kagawa No potential conflict of interest relevant to this article was reported.

Department of Mathematics, Faculty of Science, Okayama University Acta Medica Okayama 0030-1566 2 1 1952 On The Spaces With Normal Projective Connexions And Some Imbedding Problem Of Riemannian Spaces II 21 40 EN Tominosuke Otsuki 10.18926/mjou/33175 <p>In the present paper, we shall investigate the conditions under which a given Riemannian space V_n can be imbedded, as a hypersurface, into a Riemannian space V_n+1 which has the following properties I) and II). I) The group of holonomy of the space with a normal projective .connexion corresponding to V_n+1 fixes a hyperquadric and V_n is its image in V_n+1 , that is, the locus of points lying on the parallel displaced hyperquadrics, regarded as points in the tangent projective spaces. If V_n+1 has the property above, there exist a scalar y such that the hypersurface is given by the relation y -= 0. II) The orthogonal trajectories of the family of the hypersurfaces on which y is constant are geodesics in V_n+1. If the group of holonomy of the space with a normal projective eonnexion corresponding to a V_n+1 fixes a hyperquadric, it is projectively equivalent to an Einstein space2 ). In the previous paper, the author have studied the problem of the same kind as this under the conditions I) and II') V_n+1 is an Einstein space. The imbedding problem of V_n into V_n+1 under the only condition I) is very complicated in structure. The purpose of the present paper is also to search for the methods dealing with the problem, as the previous one. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2004 A study of reinforcement learning with knowledge sharing 175 180 EN Kazuyuki Ito Yoshiaki Imoto Hideaki Taguchi Akio Gofuku <p>In this paper, we consider multi-agent system in which every agents have own tasks that differs each other. We propose a method that decreases learning time of reinforcement learning by using the model of environment. In the proposed algorithm, the model is created by sharing the experiences of agents each other. To demonstrate the effectiveness of the proposed method, simulations of a puddle world and experiments of a maze world have been carried out. As a result effective behaviors have been obtained quickly.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 3 2002 Control of hyper-redundant robot using QDSEGA 1499 1504 EN Kazuyuki Ito Fumitoshi Matsuno <p>We consider a flexible autonomous system. To realize the system, we employ a hyper-redundant system (a flexible hardware system) and reinforcement learning controller &#34;QDSEGA&#34; (Q-learning with structuring exploration space based on genetic algorithm) which is a flexible software system. In this paper we apply QDSEGA for controlling of the hyper-redundant robot. To demonstrate the effectiveness, a task of acquisition of locomotion patterns is applied to a multi-legged formation and a snake-like formation, from which an effective locomotion is obtained.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1 2003 Path evaluation for a mobile robot based on a risk of collision 485 490 EN Masahiro Irie Keiji Nagatani Akio Gofuku <p>An odometry system that mobile robot uses for positioning has cumulative error because of wheels' slippage and uneven ground. It causes a risk of collision of obstacles. Therefore, we propose a path evaluation method for a mobile robot based on a risk of collision. To evaluate a robot's path, we define an evaluation value as an integral of a risk of collision along the path. To evaluate the risk of collision at each point, we use an estimated positioning error generated in the odometry system. Using the evaluation method, the robot can plan a path based on a risk of collision, not the shortest path. We also consider sensing points planning for position adjustment of the mobile robot, based on the same approach. Some examples of path evaluation results support a validity of the proposed method.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 3 2003 A study of reinforcement learning with knowledge sharing for distributed autonomous system 1120 1125 EN Kazuyuki Ito Yoshiaki Imoto Akio Gofuku Mitsuo Takeshita <p>Reinforcement learning is one of effective controller for autonomous robots. Because it does not need priori knowledge and behaviors to complete given tasks are obtained automatically be repeating trial and error. However a large number of trials are required to realize complex tasks. So the task that can be obtained using the real robot is restricted to simple ones. Considering these points, various methods that prove the learning cost of reinforcement learning have been proposed. In the method that uses priori knowledge, the methods lose the autonomy that is most important feature of reinforcement learning in applying it to the robots. In the Dyna-Q, that is one of simple and effective reinforcement learning architecture integrating online planning, a model of environment is learned from real experience and by utilizing the model to learn, the learning time is decreased. In this architecture, the autonomy is held, however the model depends on the task, so acquired knowledge of environment cannot be reused to other tasks. In the real world, human beings can learn various behaviors to complete complex tasks without priori knowledge of the tasks. We can try to realize the task in our image without moving our body. After the training in the image, by trying to the real environment, we save time to learn. It means that we have model of environment and we utilize the model to learn. We consider that the key ability that makes the learning process faster is construction of environment model and utilization of it. In this paper, we have proposed a method to obtain an environment model that is independent of the task. And by utilizing the model we have decreased learning time. We consider distributed autonomous agents, and we show that the environment model is constructed quickly by sharing the experience of each agent, even when each agent has own independent task. To demonstrate the effectiveness of the proposed method, we have applied the method to the Q-learning and simulations of a puddle world are carried out. As a result effective behaviors have been obtained quickly. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2004 A combined navigation strategy by a steering 239 244 EN Zhixiao Yang Kazuyuki Ito Kazuhiko Saijo Kazuyuki Hirotsune Akio Gofuku Fumitoshi Matsuno <p>This paper applies our developed novice users oriented force feedback steering wheel interface and mouse interface to navigating a tank type rescue robot. By analyzing merits and limitation of operating each interface, we propose a combined navigation strategy by the two interfaces. The steering wheel interface consists of a force feedback steering control and a six monitors’ wall. Through this interface, users can navigate the tank robot like driving cars, while watching incoming videos. It provides a daily life operation method for novice users to navigate the tank rescue robot. The steering wheel interface is efficient in exploring open areas. For complex disaster fields, this interface requires users have skillful operation experiences, which take them more attention. The mouse-screen interface consists of a mouse and a camera’s view displayed in a computer screen. Through this interface, users can navigate the tank robot just by mouse clicking. Path planning and low-level controlling are realized by system automatically. The mouse-screen interface can realize exact navigation, especially needed in complex structures, without taking much attention. It gives users more time to care incoming information. The two interfaces can shift into each other at any time. The combined navigation strategy adopts merits of the two interfaces and compensates limitation of each of them. It provides an efficient operation method for novice users to navigate rescue robots. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2005 Development of Wrist Rehabilitation Equipment Using Pneumatic Parallel Manipulator 2302 2307 EN Masahiro Takaiwa Toshiro Noritsugu <p>In this study, we aim at developing a mechanical device to support humans rehabilitation motion of their wrist joint instead of or to help a physical therapist. Pneumatic parallel manipulator is introduced as the mechanical equipment from a view that pneumatic actuators bring minute force control property owing to the air compressibility and parallel manipulator’s feature of multiple degrees of freedom is suitable for a complex motion of human wrist joint. Impedance control system is introduced to realize several rehabilitation modes. The validity of the proposed system is confirmed through some experiments.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2 2003 A miniature inspection robot negotiating pipes of widely varying diameter 2735 2740 EN Koichi Suzumori Shuichi Wakimoto Masanori Tanaka <p>The purpose of this research is to realize a small robot which can negotiate pipes whose diameter varies widely during the robot's course. A new in-pipe locomotion mechanism named &#34;snaking drive&#34; is proposed in this paper and its potential and fundamental characteristics are shown with experimental data of the prototype model. First, in the sections 2 to 5, the basic traveling characteristics of the snaking drive mechanism are discussed: a theoretical formula of the fundamental characteristics and control algorithm are derived, the motions of the robot are simulated on a PC, and the prototype model was designed, developed, and tested. Next, in the sections 6 and 7, additional control algorithms for the front link are derived. They are necessary for steering at T-branches and L-bends of pipes, and also for camera view stabilization. Their performances are also shown by software simulation and experiments. The prototype robots moved in pipes whose diameter varies between 55 mm to 331 mm with the maximum speed of 22 mm/s. The paper also shows that the prototype negotiates T-branches and L-bends of pipes with inspection capability through a camera mounted on the robot.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2004 A combined navigation strategy by a steering wheel and a mouse for a tank rescue robot 239 244 EN Zhixiao Yang Kazuyuki Ito Kazuhiko Saijo Kazuyuki Hirotsune Akio Gofuku Fumitoshi Matsuno <p>This paper applies our developed novice users oriented force feedback steering wheel interface and mouse interface to navigating a tank type rescue robot. By analyzing merits and limitation of operating each interface, we propose a combined navigation strategy by the two interfaces. The steering wheel interface consists of a force feedback steering control and a six monitors’ wall. Through this interface, users can navigate the tank robot like driving cars, while watching incoming videos. It provides a daily life operation method for novice users to navigate the tank rescue robot. The steering wheel interface is efficient in exploring open areas. For complex disaster fields, this interface requires users have skillful operation experiences, which take them more attention. The mouse-screen interface consists of a mouse and a camera’s view displayed in a computer screen. Through this interface, users can navigate the tank robot just by mouse clicking. Path planning and low-level controlling are realized by system automatically. The mouse-screen interface can realize exact navigation, especially needed in complex structures, without taking much attention. It gives users more time to care incoming information. The two interfaces can shift into each other at any time. The combined navigation strategy adopts merits of the two interfaces and compensates limitation of each of them. It provides an efficient operation method for novice users to navigate rescue robots.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 1 2003 Extended QDSEGA for Controlling Real Robot : Acquisition of Locomotion Patterns for Snake : like Robot 791 796 EN Kazuyuki Ito Tetsushi Kamegawa Fumitoshi Matsuno <p>Reinforcement learning is very effective for robot learning. It is because it does not need prior knowledge and has higher capability of reactive and adaptive behaviors. In our previous works, we proposed new reinforce learning algorithm: &quot;Q-learning with dynamic structuring of exploration space based on genetic algorithm (QDSEGA)&quot;. It is designed for complicated systems with large action-state space like a robot with many redundant degrees of freedom. However the application of QDSEGA is restricted to static systems. A snake-like robot has many redundant degrees of freedom and the dynamics of the system are very important to complete the locomotion task. So application of usual reinforcement learning is very difficult. In this paper, we extend layered structure of QDSEGA so that it becomes possible to apply it to real robots that have complexities and dynamics. We apply it to acquisition of locomotion pattern of the snake-like robot and demonstrate the effectiveness and the validity of QDSEGA with the extended layered structure by simulation and experiment. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 3 2002 Recognition of elastic characteristic of object using pneumatic parallel manipulator 1724 1727 EN Masahiro Takaiwa Toshiro Noritsugu Kenichi Fujie <p>The goal of this study is to develop a mechanical system that can display elastic characteristic of an object aiming at the application in the field of virtual reality. A pneumatic parallel manipulator is introduced as a driving mechanism, which consequently brings the capability of minute force displaying property owing to the air compressibility. A compliance control system without using force/moment sensor is constructed by introducing a disturbance observer, and a compliance display scheme is proposed. The validity of the proposed scheme is verified experimentally. </p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 2003 A micro snake-like robot for small pipe inspection 303 308 EN Shuichi Wakimoto Jun Nakajima Masanori Tanaka Takefumi Kanda Koichi Suzumori <p>The goal of this research is development of a micro robot which can negotiate pipes whose diameter varies widely. The robot mechanism is based on &#34;snaking drive&#34;. First, in section 1 to 4, basic characteristics of the snaking drive are discussed: the principle of the snaking drive is shown, theoretical fundamental formulas are derived, and the motions of the robot are simulated. Second, in section 5, a micro robot was designed, fabricated and tested. And fundamental experiments of the robot are shown. Third, in section 6, two application experiments are shown: one is a stabilization of camera image, and the other is a robot steering at branches. The robot moved in pipes whose diameter varies between 18 mm to 100 mm with the maximum speed of 36 mm/s. And the robot could negotiate T-branches and L-bends of pipes.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 206 15 2003 Peripheral targets of centrally located putative accessory neurons of MRO in the isopod Ligia exotica 2619 2628 EN Noriyuki Hama Yoshinori Okada Edit Pollák László Molnár Akiyoshi Niida <p>The three centrally located putative accessory neurons of the muscle receptor organ (MRO) of the isopod Ligia exotica were identified to the third segmental nerve (N3) of the thoracic ganglion by backfilling with Lucifer Yellow. These neurons were then studied intracellularly and extracellularly to determine whether they suppressed the stretch-activated responses of thoracic stretch receptors. Intracellular injection of depolarizing currents into these three putative accessory neurons revealed that only neuron #3 had an inhibitory effect, suggesting that it is an inhibitory accessory neuron related to thoracic stretch receptors. We searched for the peripheral targets of neurons #1 and #2 by intracellular filling with Lucifer Yellow or by recording of junctional potentials in extensor muscles, and show that they are motor neurons that innervate the deep extensor and superficial extensor muscles, respectively.</p> No potential conflict of interest relevant to this article was reported.

Acta Medica Okayama 3 2001 Image processing technique for detection of a particular object from motion images 1662 1666 EN Tetsuhiro Sumimoto Kazuoki Kuramoto Saburo Okada Hidekazu Miyauchi Masaaki Imade Hideki Yamamoto Yessy Arvelyna <p>This paper deals with the detection of the rescue target as a particular object from motion images under bad weather conditions. When shipwrecks occur, the searching activities for rescue is done using an airplane. The detection of the rescue target such as life rafts depends on a visual search by human eyes. To detect a small rescue target in a wide sea area, the searching man must monitor motion sights under nasty weather. The human eyes sometimes loses its sight and the ability of detection fails owing to the long flight and the nasty weather. To support the searching activities in the case of a marine casualty, we propose motion image processing techniques using the improved S/N ratio and dynamic range of the image data of the rescue target in the motion images under bad conditions </p> No potential conflict of interest relevant to this article was reported.