Necl-1/CADM3 regulates cone synapse formation in the mouse retina.

In vertebrates, retinal neural circuitry for visual perception is organized in specific layers. The outer plexiform layer is the first synaptic region in the visual pathway, where photoreceptor synaptic terminals connect with bipolar and horizontal cell processes. However, molecular mechanisms underlying cone synapse formation to mediate OFF pathways remain unknown. This study reveals that Necl-1/CADM3 is localized at S- and S/M-opsin-containing cones and dendrites of type 4 OFF cone bipolar cells (CBCs). In Necl-1-/- mouse retina, synapses between cones and type 4 OFF CBCs were dislocated, horizontal cell distribution became abnormal, and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors were dislocated. Necl-1-/- mice exhibited aberrant short-wavelength-light-elicited signal transmission from cones to OFF CBCs, which was rescued by AMPA receptor potentiator. Additionally, Necl-1-/- mice showed impaired optokinetic responses. These findings suggest that Necl-1 regulates cone synapse formation to mediate OFF cone pathways elicited by short-wavelength light in mouse retina.

Variation in antibody titers determined by Abbott and Roche Elecsys SARS-CoV-2 assays in vaccinated healthcare workers.

SARS-CoV-2-specific antibody measurement is important for evaluating COVID-19 vaccine efficacy. We quantified and compared anti-spike (S) antibodies using different commercial immunoassays. We tested serum samples from 70 SARS-CoV-2-naive health care workers 2 weeks after vaccination with a single dose of BNT162b2, 2 and 4 weeks, and 3 months after the second dose of BNT162b2. The following quantitative assays were used: Roche Elecsys Anti-SARS-CoV-2 S (Roche-S), Abbott SARS-CoV-2 IgG II Quant [Abbott-IgG(S)], and Abbott SARS-CoV-2 IgM (Abbott-IgM). All samples tested positive for Roche-S and Abbott-IgG antibodies after the second dose, with 83.6% Abbott-IgM positive rate. Roche-S and Abbott-IgG(S) correlated significantly in all samples (r = 0.920, p < 0.0001), and the Roche-S and Abbott-IgG(S) assay showed a strong correlation with each other at each time point after vaccination. Roche-S and Abbott-IgG(S) antibody titers were correlated with age; their rate of decline was age-dependent in males but not in females. Abbott-IgG(S) antibody titers decreased from 2 weeks after the second dose. Roche-S antibody titers peaked 2 weeks after the second dose in 76.2% of the participants; the titers recovered 3 months post-vaccination after declining at week 4 in 40.7% of the participants. The concordance between Roche-S and Abbott-IgG(S) antibody titers over time was 47.5%. Most participants presented significantly high Roche-S and Abbott-IgG(S) antibody titers after immunization. Some measurements were inconsistent with titer changes between these assays, possibly because of differences in the immunoglobulin-specificity of the kits.

Age-Related Differences in the Limited Range of Motion of the Lower Extremity and Their Relation to Low Back Pain in Young Baseball Players: A Cross-Sectional Study of 1215 Players.

BACKGROUND: Age-related differences in the limited range of motion of the lower extremities and their relationship with low back pain in juvenile athletes have not been well assessed. This study investigated the relationship between low back pain and limited range of motion of the hip and knee in young baseball players during the baseball season. RESULTS: Participants comprised 1215 baseball players (216 pitchers, 999 fielders) aged 6-16 years who underwent medical checkups (self-completed questionnaire and physical examination). Of the 1215 players, 255 (21.0%) experienced seasonal low back pain requiring rest during the previous year. The prevalence of low back pain and a positive Thomas test, straight-leg-raising test, and heel-to-buttock test increased with age. Univariate analysis revealed that a positive heel-to-buttock test in both the throwing and non-throwing arm sides in the 11-12 age group and a positive Thomas test in the throwing arm side in the 13-14 age group were associated with seasonal low back pain (P = 0.0051, P = 0.021, and P = 0.048, respectively). Multivariate analysis, adjusted for factors associated with low back pain, showed significant associations between the positive heel-to-buttock test (odds ratio 1.75, 95% confidence interval 1.11-2.79; P = 0.016) and low back pain in players aged 11-14 years. CONCLUSIONS: A positive heel-to-buttock test is potentially associated with low back pain among juvenile baseball players. Particular attention should be paid to the limited range of motion of the knee joint and tightness of the quadriceps femoris muscle among baseball players with low back pain aged 11-14 years.

Impact of low back pain experience on future occurrence of shoulder pain in adolescent baseball players: A 1-year prospective cohort study.

BACKGROUND: Low back pain can affect musculoskeletal problems of the upper limb in adolescent overhead athletes. However, few epidemiological studies have examined this causal relationship. This prospective cohort study aimed to investigate the relationship between baseline low back pain experience and the occurrence of future shoulder and elbow pain among high school baseball players. METHODS: Participants comprised 383 high school baseball players from 43 high school baseball teams who had undergone baseline medical evaluations (a self-completed questionnaire and physical examination). The occurrence of shoulder and elbow pain during a 1-year follow-up and associations with baseline low back pain (positive subjective symptom during the last year at baseline) adjusted for flexibility of the scapulo-thoracic region, shoulder, and lower extremities, such as straight-leg raise angle (hamstring tightness), Thomas test (iliopsoas tightness), heel-buttock-distance (quadriceps tightness) and passive range of motion of the hip were investigated using multivariable analysis. RESULTS: A total of 307 players (80.2%) participated in the 1-year follow-up survey, with shoulder and elbow pain reported in 75 players (24.4%) and 119 players (38.8%), respectively, during follow-up. After adjusting for factors associated with shoulder pain using logistic regression modeling, significant associations between LBP experienced during the last year at baseline (odds ratio, 2.18; 95% confidence interval, 1.23-3.87; P = 0.0078) and new-onset of shoulder pain were noted. CONCLUSIONS: Baseline low back pain impacted future shoulder pain in high school baseball players during the 1-year follow-up. Management of shoulder pain warrants careful attention to low back pain.

Molecular Weight-Dependent Oxidation and Optoelectronic Properties of Defect-Free Macrocyclic Poly(3-hexylthiophene).

The redox behaviors of macrocyclic molecules with an entirely π-conjugated system are of interest due to their unique optical, electronic, and magnetic properties. In this study, defect-free cyclic P3HT with a degree of polymerization (DPn) from 14 to 43 was synthesized based on our previously established method, and its unique redox behaviors arising from the cyclic topology were investigated. Cyclic voltammetry (CV) showed that the HOMO level of cyclic P3HT decreases from -4.86 eV (14 mer) to -4.89 eV (43 mer), in contrast to the linear counterparts increasing from -4.94 eV (14 mer) to -4.91 eV (43 mer). During the CV measurement, linear P3HT suffered from electro-oxidation at the chain ends, while cyclic P3HT was stable. ESR and UV-Vis-NIR spectroscopy suggested that cyclic P3HT has stronger dicationic properties due to the interactions between the polarons. On the other hand, linear P3HT showed characteristics of polaron pairs with multiple isolated polarons. Moreover, the dicationic properties of cyclic P3HT were more pronounced for the smaller macrocycles.

Immunological responses following the third dose of the BNT162b2 SARS-CoV-2 vaccine among Japanese healthcare workers.

INTRODUCTION: A limited number of studies have shown a decline in antibody titers in healthcare workers beyond six months after the second dose of the BNT162b2 vaccine, and has been insufficiently investigated yet in the respective Asian ethnic groups. METHODS: We conducted a longitudinal observational study on 187 healthcare workers and other personnel and healthy adults at least eight months after vaccination at the International University of Health and Welfare. RESULTS: The baseline (before the third dose of BNT162b2) anti-receptor binding domain (RBD) IgG level was 569[377-943] AU/mL 245[240-250] days after the second dose. The mean antibody titer of participants aged 20-29 years was 4.6 times higher than that of participants aged 70-79 years. After booster vaccination, serum anti-RBD antibody levels were elevated in all participants with a median titer of 23,250[14,612-33,401] AU/mL 21[19-23] days after the third dose. The median post-booster antibody titers in the 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years age groups were 30.6, 33.0, 33.8, 27.4, 50.1, and 90.3 times, respectively, higher than the pre-booster ones. Antibody levels were 15% lower in daily drinkers compared to nondrinkers, suggesting that daily alcohol consumption can prevent antibody levels from increasing after vaccination. Our results show decreased antibody titers after two doses of the vaccine, especially in the elderly; however, the third dose of the vaccine resulted in a significant increase in antibody titers in all age groups. CONCLUSIONS: We provided information on antibody responses following primary and booster doses of the BNT162b2 mRNA COVID-19 vaccine in Japan.

The influence of chronic medial epicondylar apophysitis on medial ulnar collateral ligament insufficiency-: a retrospective cohort study.

Background: This study aimed to investigate the effect of chronic traction apophysitis of the medial epicondyle (MEC) on medial ulnar collateral ligament (MUCL) insufficiency in high school baseball players. Methods: In this retrospective cohort study, 3034 of 6069 high school baseball players were enrolled. A self-reported questionnaire was distributed to investigate past history of elbow pain and elbow pain during the previous season. Physical examinations to assess tenderness on the MUCL and the elbow valgus stress test (EVST) were performed. Ultrasonography was performed to determine the presence of morphological abnormalities of the anteroinferior aspect of the MEC (MEC lesions). Results: Participants with MEC lesions had a significantly higher prevalence of past history of elbow pain, elbow pain during the previous season, MUCL tenderness, and positive EVST than those without MEC lesions (P < .05). Multivariate logistic regression analysis revealed that the participants with the fragmented type had the highest risk of past history of elbow pain (odds ratio [OR] = 3.94), elbow pain during the previous season (OR = 2.27), positive EVST (OR = 3.49), and the second highest risk of MUCL tenderness (OR = 2.01) followed by the irregular type (OR = 2.31). Participants with the hypertrophic type had the lowest risk of past history of elbow pain (OR = 2.08), elbow pain during the previous season (OR = 1.42), MUCL tenderness (OR = 1.09), and positive EVST (OR = 1.47). Conclusion: The presence of chronic non-healed traction apophysitis of the MEC in high school baseball players presented a significantly high risk of elbow pain and MUCL insufficiency.

Discitis due to late-onset mesh infection 14 years after inguinal hernia repair: a case report.

BACKGROUND: Mesh infection after inguinal hernia repair is a very rare complication. The incidence of late-onset mesh infection is approximately 0.1-0.2% of total hernia repair cases and can lead to serious complications if not treated promptly. Here, we report a rare case of discitis due to late-onset mesh infection, occurring 14 years after an inguinal hernia repair. CASE PRESENTATION: An 89-year-old man was brought to our hospital with right-sided abdominal pain and signs of hypoglycemia. He had a history of type 2 diabetes mellitus and had undergone inguinal hernia repair 14 years ago. Upon admission, laboratory tests revealed no elevated inflammatory markers. Computed tomography (CT) revealed a peri-appendicular abscess. Although the patient was administered empiric antibiotics, on day 3 of admission, his white blood cell count and C-reactive protein levels increased to 38,000/µl and 28 mg/dl, respectively. CT-guided drainage was attempted but was not successful. Escherichia coli was detected in both blood culture collections. On day 7 of admission, the patient complained of back pain; CT on day 10 revealed a peri-appendicular abscess with a soft tissue shadow anterior to the thoracic vertebrae at the 8th/9th level. Thoracic discitis, due to bacteremia originating from the mesh abscess, was suspected. We surgically resected the appendix, followed by removal of the plug and mesh abscess. The post-operative course of the patient was uneventful. For treating discitis, it is known that antibiotic therapy is required for a minimum of 6 weeks. Therefore, on the 30th day post-surgery, the patient was transferred to the orthopedic ward for continued treatment. CONCLUSIONS: This report discusses a rare case of late-onset mesh infection leading to thoracic discitis. Since late-onset mesh infection cannot be treated solely with antibiotics, expeditious surgery should be selected when subcutaneous drainage fails. When an immunocompromised patient with bacteremia has a complaint of back pain, purulent spinal discitis should also be suspected.

The prevalence and clinical characteristics of sacroiliac joint dysfunction in adolescent baseball players.

BACKGROUND: Sacroiliac joint (SIJ) dysfunction is a potential source of low back pain (LBP) in baseball players, who are more likely to be affected by loading of the SIJ in the throwing motion. However, the prevalence and characteristics of this condition have not been studied thoroughly. This study aimed to investigate the prevalence and clinical characteristics of SIJ dysfunction among high school baseball players. METHODS: Participants comprised 891 high school baseball players who had undergone annual medical evaluations (a self-completed questionnaire and physical examination). The prevalence of SIJ dysfunction and associations with the measurements of the flexibility of the spine and lower extremities such as finger-floor-distance, straight-leg-raising angle, heel-buttock-distance, Thomas test, and passive range of motion of the hip were investigated. RESULTS: Twenty-two of 891 subjects (2.5%) met our criteria for SIJ dysfunction. Twelve subjects (55%) exhibited throwing arm side symptoms more commonly than in the non-throwing arm side (n = 3, 15%) or bilateral side (n = 7, 32%). Previous episodes of LBP were experienced significantly more frequently among subjects with SIJ dysfunction (n = 19, 86.4%) than among those without (n = 501, 57.7%; P = 0.015). The prevalence of present LBP that interfered with play was significantly higher among subjects with SIJ dysfunction (n = 9, 42.9%) than among those without (n = 118, 21.2%; P = 0.038). The prevalence of SIJ dysfunction as a source of LBP was estimated at 7.1% (9 of 127 subjects). After adjustment for associated factors using a logistic regression model, we observed a significant association between a limitation in hip internal rotation on the throwing arm side and SIJ dysfunction (odds ratio 3.11 [1.30-7.71]; P = 0.0109). CONCLUSIONS: According to our criteria, the estimated prevalence of SIJ dysfunction among high school baseball players is 2.5%. There was a significant association between a limitation in hip internal rotation on the throwing arm side and SIJ dysfunction.

Influences of limited flexibility of the lower extremities and occurrence of low back pain in adolescent baseball players: A prospective cohort study.

BACKGROUND: Limited flexibility of the lower extremities, such as hamstring tightness, has long been suggested as a physical risk factor for low back pain among adolescent athletes. However, few prospective cohort studies have examined the direction of causality for this relationship. This prospective cohort study investigated the relationship between limited flexibility of the lower extremities and the occurrence of low back pain among high school baseball players. METHODS: Participants comprised 335 high school baseball players from 43 high school baseball teams who had undergone baseline medical evaluations (a self-completed questionnaire and physical examination). Occurrence of low back pain during a 1-year follow up, and associations with measurements of flexibility of the lower extremities such as straight-leg-raising angle (hamstring tightness), Thomas test (iliopsoas tightness), heel-buttock-distance (quadriceps tightness), and passive range of motion of the hip were investigated. RESULTS: In total, 296 players (88.4%) participated in the 1-year follow-up survey, with 147 of the 296 players (49.7%) reporting the occurrence of low back pain during follow-up. The number of players with low back pain during follow-up peaked in November, then decreased and was lowest in June. After adjusting for factors associated with low back pain using logistic regression modeling, a significant association between hamstring tightness on the non-throwing arm side and low back pain (odds ratio 2.86, 95% confidence interval 1.17-6.94; P = 0.018) was found. CONCLUSIONS: Hamstring tightness on the non-throwing arm side was identified as a potential risk factor for low back pain in high school baseball players. These results may provide guidance in the development of future prevention programs.

Associations between core stability and low back pain in high school baseball players: A cross-sectional study.

BACKGROUND: Reduced core stability is a potential risk factor for low back pain in athletes. However, the association between core stability and low back pain in high school baseball players has not been thoroughly studied. The purpose of this study was to investigate the relationship between core stability and low back pain and its clinical characteristics in high school baseball players. METHODS: Participants comprised 812 high school baseball players who had undergone annual medical evaluations, comprising a self-completed questionnaire and a physical examination. We investigated the relationships between low back pain during the season and on the day of medical evaluations and core stability using a cross-sectional study design. Core stability was assessed using the Sahrmann core stability test. RESULTS: Reduced core stability was confirmed in 358 (44.1%) of all players, 98 (49.5%) pitchers, and 260 (42.3%) fielders. In total, 352 players (43.3%) reported incidents of seasonal low back pain during the previous year. Thirty-five pitchers (17.7%) and 153 fielders (24.9%) reported low back pain on the day of the medical evaluations. No significant associations were seen between low back pain throughout the season and reduced core stability. After adjusting for confounding factors (total amount of practice per week, hamstring tightness and quadriceps tightness) using logistic regression modeling, a significant association between presence of low back pain during lumbar extension movement and reduced core stability was found (odds ratio, 2.57; 95% confidence interval, 1.08-6.62; P = 0.033) in pitchers. CONCLUSIONS: High school baseball pitchers with reduced core stability showed a higher probability of reporting low back pain during lumbar extension movement. Evaluation of core stability should be considered in high school baseball players, especially in pitchers.

The role of the flexor pronator muscles as dynamic stabilizers against elbow valgus stress in patients with medial ulnar collateral ligament insufficiency.

BACKGROUND: The flexor pronator muscles (FPMs) have been reported to act as dynamic stabilizers against valgus forces in overhead-throwing athletes. Several studies have demonstrated the anatomic, biomechanical, and clinical effects of the FPMs. However, no studies have investigated the in vivo kinematics of the FPMs against the valgus forces on the elbow. This study aimed to clarify the clinical contribution of the FPMs as dynamic stabilizers in medial ulnar collateral ligament (MUCL) insufficiency. METHODS: Eighteen baseball players with MUCL injury participated in this study. The elbow was flexed to 90°, and the forearm was placed in the supinated position. Manual valgus stress was applied to the elbow joint until maximal shoulder external rotation was achieved. The width of the ulnohumeral joint space was measured using ultrasonography, and any changes in medial elbow pain were recorded before and after isometric forearm pronation. RESULTS: All the subjects had MUCL tenderness and felt medial elbow pain when elbow valgus stress was applied. The width of the medial joint space was significantly larger on the injured side than on the healthy side (5.1 ± 1.0 mm vs. 3.2 ± 1.0 mm) with elbow valgus stress. During isometric forearm pronation, the width of the medial joint space was significantly decreased (3.1 ± 0.9 mm vs. 2.6 ± 1.0 mm) and medial elbow pain had completely diminished. CONCLUSION: Isometric forearm pronation reduces valgus stress-induced widening of the medial joint space and medial elbow pain in patients with MUCL insufficiency.

Association Between Musculoskeletal Pain and Psychological Stress Responses in High School Baseball Players: A Cross-sectional Study.

BACKGROUND: Musculoskeletal pain could represent a psychological stressor in adolescent athletes. However, few epidemiological studies have investigated this association. PURPOSE: To assess the relationship between musculoskeletal pain (shoulder, elbow, wrist, and low back) and psychological stress responses in high school baseball players. STUDY DESIGN: Cross-sectional study. METHODS: Participants comprised male Japanese high school baseball players who had completed a questionnaire as part of their annual medical evaluation in 2016. Experiences of shoulder, elbow, wrist, and low back pain during the previous season were investigated. Pain severity was graded as 1 (mild, playing without interference), 2 (moderate, playing with interference), or 3 (severe, could not play because of pain). The Stress Response Scale-18 was used to measure stress response: low, medium, rather high, and high. Prevalence rates of shoulder, elbow, wrist, and low back pain and their association with psychological stress responses were investigated using univariate and multivariable analyses. RESULTS: A total of 944 players (223 pitchers and 721 fielders) were included in this study. Their mean age was 16.1 ± 0.6 years, and 66% were high school juniors, while 33.6% were seniors. In pitchers, the prevalence rates during the previous year of severe (grade 3) interference with playing because of elbow, shoulder, wrist, and low back pain were 21.5% (n = 48), 19.3% (n = 43), 3.6% (n = 8), and 18.4% (n = 41), respectively, whereas in fielders, the respective prevalence rates were 17.1% (n = 123), 17.9% (n = 129), 6.7% (n = 48), and 19.3% (n = 139). After adjusting for confounding factors (playing on a top-performing team, high school grade level, and all other sites of musculoskeletal pain), the authors found significant associations in pitchers between severe experiences of elbow pain and low back pain and medium to high psychological stress responses (odds ratio, 2.64 [95% CI, 1.32-5.39], P = .006 and odds ratio, 2.32 [95% CI, 1.12-4.89], P = .024, respectively). No significant associations were seen between musculoskeletal pain and psychological stress responses in fielders. CONCLUSION: In the current study, elbow and low back pain were associated with stronger psychological stress responses compared with other musculoskeletal pain in high school baseball pitchers.

Arthroscopic Elbow Debridement Using Anterocentral Transbrachialis Portal.

Arthroscopic debridement for elbow osteoarthritis has been widely used as a minimally invasive treatment; however, in some cases, it can be a technically demanding procedure, such as in patients with severe osteoarthritis with large spur formation and severe synovitis. The anterocentral transbrachialis portal is a recently developed portal for elbow arthroscopy, which allows easy and convenient access to the anterior compartment for sufficient debridement. This report describes in detail the anterocentral transbrachialis portal and its usefulness for debridement of the elbow joint in osteoarthritis.

Investigation on the Epoxidation of Piperitenone, and Structure-activity Relationships of Piperitenone Oxide for Differentiation-inducing Activity.

Piperitenone oxide, a major chemical constituent of the essential oil of spearmint, Mentha spicata, induces differentiation in human colon cancer RCM-1 cells. In this study, piperitenone oxide and trans-piperitenone dioxide were prepared as racemic forms by epoxidation of piperitenone. The relative configuration between two epoxides in piperitenone dioxide was determined to be trans by 1H NMR analysis and nuclear Overhauser effect spectroscopy (NOESY) in conjunction with density functional theory (DFT) calculations. Optical resolution of (±)-piperitenone oxide by high-performance liquid chromatography (HPLC) using a chiral stationary phase (CSP) afforded both enantiomers with over 98% enantiomeric excess (ee). Evaluation of the differentiation-inducing activity of the synthetic compounds revealed that the epoxide at C-1 and C-6 in piperitenone oxide is important for the activity, and (+)-piperitenone oxide has stronger activity than (-)-piperitenone oxide. The results obtained in this study provide new information on the application of piperitenone oxide and spearmint for differentiation-inducing therapy. Furthermore, natural piperitenone oxide was isolated from M. spicata. The enantiomeric excess of the isolated natural piperitenone oxide was 66% ee. Epoxidation of piperitenone with hydrogen peroxide proceeded in a phosphate buffer under weak basic conditions to give (±)-piperitenone oxide. These results suggest that the nonenzymatic epoxidation of piperitenone, which causes a decrease in the enantiomeric excess of natural piperitenone oxide, is accompanied by an enzymatic epoxidation in the biosynthesis of piperitenone oxide.

Detection of Gas Drifting Near the Ground by Drone Hovering Over: Using Airflow Generated by Two Connected Quadcopters.

This paper describes the utilization of the downwashes of multicopters for gas-sensing applications. Multirotor drones are an attractive platform for sensing applications. Their high maneuverability enables swift scanning of a target area with onboard sensors. When equipped with a gas sensor and used for gas-sensing applications, however, the strong downwash produced by the rotors poses a problem. When a multicopter is hovering at a low altitude, gas puffs leaked from a gas source on the ground are all blown away. Here, we propose to use two multicopters connected by a rod or a string and place a gas sensor at the midpoint of the rod/string. The downwash generated by each multicopter spreads radially after it impinges on the ground. When two multicopters are connected, the airflows spreading radially along the ground from the two multicopters impinge at the center and are deflected in the upward direction. Gas puffs wafting near the ground surface between the two multicopters are carried by this upward airflow to the gas sensor. Experimental results are presented to show the soundness of the proposed method. The connected quadcopters hovering over an ethanol gas source was able to detect the gas even with a moderate cross-flow.

Acetaminophen combined with tramadol is more effective than acetaminophen or tramadol to reduce neuropathic root pain: an experimental study with application of nucleus pulposus in a rat model.

INTRODUCTION: Various drugs are used to treat patients with neuropathic pain; however, optimal treatment using acetaminophen (A) and/or tramadol (T) remains unclear. The evidence supporting the drug choice and the timing of administration is insufficient. Therefore, the objective of the present study was to investigate the effect of T and/or A on pain-related behavior in a nucleus pulposus (NP) rat model. MATERIALS AND METHODS: Sprague-Dawley rats (n = 180) were divided into NP-A (52 mg/kg), NP-T (6 mg/kg), NP-AT (combined A and T), NP-S (saline), and sham groups (n = 36 per group). The rats received 0.2 mL of treatment solution orally once daily for 7 days after application of NP on the left L5 dorsal root ganglion (DRG). Behavioral testing and immunohistochemistry analysis for some markers' expressions in DRGs and the spinal cord were performed. RESULTS: Pain thresholds in the NP-AT group did not significantly differ from the sham at all time points, while those were significantly lower in the NP-A and in the NP-T groups at D7 and/or D14 (p < 0.05). Tumor necrosis factor-α in the NP-S group was significantly higher at D2 and D7 (p < 0.05). Among the three treatment groups, activating transcriptional factor 3 and growth-associated protein 43 showed a tendency toward an increase at D7-D21. CONCLUSION: Combined administration of acetaminophen and tramadol maintained in the pain threshold in the rat NP model. These findings suggest that the combination of acetaminophen and tramadol might be a potential therapeutic modality for patients with lumbar disc herniation. These slides can be retrieved under Electronic Supplementary Material.

Unified Approach toward Syntheses of Juglomycins and Their Derivatives.

A unified and common intermediate strategy for syntheses of juglomycins and their derivatives is reported. The use of a 1,4-dimethoxynaphthalene derivative as a key intermediate enabled easy access to various juglomycin derivatives. In this study, juglomycins A-D, juglomycin C amide, khatmiamycin and its 4-epimer, and the structure proposed for juglomycin Z were synthesized from this intermediate. The absolute configuration of natural khatmiamycin has been established to be 3R,4R through our synthesis. Unfortunately, the spectroscopic data for synthetic juglomycin Z were not consistent with the data reported for the natural one, strongly suggesting a structural misassignment.

Sufficient duration of off-season decreases elbow disorders in elementary school-aged baseball players.

BACKGROUND: Several guidelines for the prevention of throwing injuries recommend a sufficiently long off-season; however, few studies providing scientific evidence to support these recommendations exist. Our study aimed to clarify the association between off-season duration and throwing elbow injuries among elementary school-aged baseball players. METHODS: This study enrolled 680 elementary school-aged baseball players who underwent medical checkups. The experience with elbow pain and the off-season duration were investigated via the administration of a self-completed questionnaire. Ultrasonographic assessment of the elbow joint was performed on the day of the medical checkup to assess for morphologic abnormalities. RESULTS: The prevalence of elbow pain and morphologic abnormalities of the medial epicondyle (medial epicondyle lesions) was significantly decreased when the subjects' off-season duration was longer. Multivariate analysis revealed that the risk of elbow pain was significantly lower in the group whose off-season lasted 1 to 2 months (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.15-0.62; P = .0006) and in the group whose off-season lasted longer than 2 months (OR, 0.59; 95% CI, 0.37-0.95; P = .0316). The risk of medial epicondyle lesions was also significantly lower in the group whose off-season lasted 1 to 2 months (OR, 0.39; 95% CI, 0.22-0.67; P = .0005) and in the group whose off-season lasted longer than 2 months (OR, 0.36; 95% CI, 0.23-0.56; P < .0001). On the contrary, no significant correlation was found between capitellar osteochondritis dissecans and off-season duration. CONCLUSION: Off-season duration has a significant correlation with elbow pain and morphologic abnormalities of the medial elbow joint in elementary school-aged baseball players.

The prevalence of scapular malalignment in elementally school aged baseball player and its association to shoulder disorder.

BACKGROUND: Various shoulder disorders have been reported to be associated with scapulothoracic joint dysfunction in adult overhead athletes. However, little is known about the prevalence of scapular malalignment and its relationship to shoulder injuries in skeletally immature baseball players. The purpose of the current study was to investigate the prevalence of scapular malalignment in elementary school-aged baseball players, as well as its association with shoulder disorder. METHODS: One hundred sixty-nine baseball players in higher elementary school grades (aged 11-12 years) were enrolled in this study. Shoulder pain experience pain over the previous one year, as well as other individual and environmental factors were surveyed by a self-completed questionnaire. Scapula malalignment was assessed using still images of both arms both at the side and in an elevated position. The relative position of the dominant scapula to the non-dominant side was assessed by two independent examiners. RESULTS: Scapular malalignment was observed in 126 subjects (74.6%), and the dominant scapula tended to deviate inferiorly and medially, as well as tilt anteriorly, compared with the non-dominant side. Forty-four of the 169 subjects (23.8%) experienced shoulder pain over the one year period. The prevalence of shoulder pain was significantly increased with the increasing scapular anterior tilt and the superior shift of the dominant scapula, whereas no significant correlation between shoulder pain and scapular horizontal shift or upward-downward rotation was observed. CONCLUSION: About three-quarters of the elementary school-aged baseball players in the current study presented with scapular malalignment, and those with anterior tilt and superior shift of the dominant scapula were at higher risk of shoulder pain.