Assessment of Surgical Outcomes in Patients with Degenerative Cervical Myelopathy Using the 25-Question Geriatric Locomotive Function Scale: A Longitudinal Observational Study.

Introduction: Locomotive syndrome caused by degenerative musculoskeletal diseases is reported to improve with surgical treatment. However, it is unclear whether surgical treatment is effective for the locomotive syndrome developing in patients with degenerative cervical myelopathy (DCM). Thus, this study primarily aimed to longitudinally assess the change in locomotive syndrome stage before and after cervical spinal surgery for patients with DCM using the 25-question geriatric locomotive function scale (GLFS-25). A secondary objective was to identify factors associated with the postoperative improvement in the locomotive syndrome stage. Methods: We retrospectively reviewed clinical data of patients undergoing cervical spine surgery at our institution from April 2020 to May 2022 who had answered the Japanese Orthopaedic Association Cervical Myelopathy Assessment Questionnaire, visual analog scale, and GLFS-25 preoperatively and at 6 months and 1 year postoperatively. We collected demographic data, medical history, preoperative radiographic parameters, presence or absence of posterior longitudinal ligament ossification, and surgical data. Results: We enrolled 115 patients (78 men and 37 women) in the present study. Preoperatively, using the GLFS-25, 73.9% of patients had stage 3, 10.4% had stage 2, 9.6% had stage 1, 6.1% had no locomotive syndrome. The stage distribution of locomotive syndrome improved significantly at 6-months and 1-year postoperatively. The multivariable Poisson regression analysis revealed that better preoperative lower extremity function (relative risk: 3.0; 95% confidence interval: 1.01-8.8) was significantly associated with postoperative improvement in the locomotive syndrome stage. Conclusions: This is the first study to longitudinally assess the locomotive syndrome stage in patients with DCM using GLFS-25. Our results indicated that patients with DCM experienced significant improvement in the locomotive syndrome stage following cervical spine surgery. Particularly, the preoperative lower extremity function was significant in postoperative improvement in the locomotive syndrome stage.

Health impact assessment of PM2.5-related mitigation scenarios using local risk coefficient estimates in 9 Japanese cities.

Previous studies have highlighted the negative effects of PM2.5 on mortality, expressed in terms of attributable deaths and life years lost. However, there are very few studies assessing the health impacts of air pollution in terms of economic burden/benefits. This study assessed the health impact of two hypothetical interventions among sex- and age-specific risk populations using a robust risk estimation and economic valuation process. We utilized the sex- and age-stratified daily all-cause mortality together with the daily PM2.5 of the 9 Japanese cities from 2002 to 2008 in estimating the relative risks. The estimated risks were then utilized for the economic valuation of co-benefits/burden with respect to the two hypothetical PM2.5-related mitigation scenarios, in comparison to status quo, namely: i) decrease to Japanese standards, and ii) decrease to WHO standards. Impact of these interventions on health were assessed using the following HIA metrics: attributable mortality, attributable years life lost, and environmental health impact. A 10-µg/m3 increase in PM2.5 would increase the risk by 0.52% (95% CI: -0.91% to 1.99%) for all-cause mortality, with varying risk estimates per subgroup. High economic burdens were estimated at status quo, with particularly distinct burden difference for age-specific mortality; 0.40 trillion yen (0-64 y.o.) and 1.50 trillion yen (>64 y.o.). If stricter standards, relative to status quo, were to be enforced, i.e. WHO standard, there is a potential to yield economic benefits in the same risk population; 0.26 trillion yen (0-64 y.o.) and 0.98 trillion yen (>64 y.o.). We did not observe any substantial difference with the burden and benefit related to sex-specific mortality. Using the estimated local risk coefficients complemented with the valuation of the risks, policymaking entities will have the opportunity to operate their own HIA to assess the relevant air pollution-related health impacts.

Baseline Profile of Participants in the Japan Environment and Children's Study (JECS).

BACKGROUND: The Japan Environment and Children's Study (JECS), known as Ecochil-Chosa in Japan, is a nationwide birth cohort study investigating the environmental factors that might affect children's health and development. We report the baseline profiles of the participating mothers, fathers, and their children. METHODS: Fifteen Regional Centres located throughout Japan were responsible for recruiting women in early pregnancy living in their respective recruitment areas. Self-administered questionnaires and medical records were used to obtain such information as demographic factors, lifestyle, socioeconomic status, environmental exposure, medical history, and delivery information. In the period up to delivery, we collected bio-specimens, including blood, urine, hair, and umbilical cord blood. Fathers were also recruited, when accessible, and asked to fill in a questionnaire and to provide blood samples. RESULTS: The total number of pregnancies resulting in delivery was 100,778, of which 51,402 (51.0%) involved program participation by male partners. Discounting pregnancies by the same woman, the study included 95,248 unique mothers and 49,189 unique fathers. The 100,778 pregnancies involved a total of 101,779 fetuses and resulted in 100,148 live births. The coverage of children in 2013 (the number of live births registered in JECS divided by the number of all live births within the study areas) was approximately 45%. Nevertheless, the data on the characteristics of the mothers and children we studied showed marked similarity to those obtained from Japan's 2013 Vital Statistics Survey. CONCLUSIONS: Between 2011 and 2014, we established one of the largest birth cohorts in the world.

Validity of using annual mean particulate matter concentrations as measured at fixed site in assessing personal exposure: an exposure assessment study in Japan.

From 2003 through 2005, we compared annual mean particulate matter (PM) and nitrogen dioxide (NO2) concentrations as measured at fixed-site monitoring stations in 6 Japanese cities with those measured inside and outside subject residences and during personal monitoring. A total of 65 households participated in indoor and outdoor residential exposure monitoring. In summer and autumn, we also performed personal monitoring of one resident of each household. On each day, personal samplers were used to collect 24-h samples of PM and NO2 simultaneously from the fixed sites, indoor and outdoor, and from those undergoing personal monitoring. We found good correlations between the fixed-site and outdoor measurements for annual mean (average of 7-day × 4-season) concentrations of PM2.5, PM10₋2.5, PM10 and NO2 (Spearman's rank correlation coefficients (ρ) ≥ 0.75). However, the correlations between the fixed-site and indoor measurements were moderate to low. In summer and autumn, the correlations between the fixed-site and personal mean concentrations of PM2.5 (ρ = 0.62), PM10 (ρ = 0.58), and NO2 (ρ = 0.70) were acceptable. However, because people spend most of their time indoors, these correlations for annual mean concentrations were not estimated to be high. Our results are important in allowing researchers to estimate the effects of resulting measurement errors of PM and NO2.

Does early orchidopexy prevent morphological changes in undescended testes? A perioperative assessment using ultrasonography.

INTRODUCTION: The aim of this study was to assess the efficacies of early orchidopexy on later morphological changes in the testis using ultrasonography. MATERIALS AND METHODS: The medical records of 23 consecutive patients with unilateral undescended testis operated on in our institution between 1992 and 2001 were reviewed in the historical cohort design. The subjects were divided into two groups according to their age at the time of surgery: group A included the patients who underwent surgery before age 2 (n = 13), and group B included those who were operated on at 2 years of age or older (n = 10). The mean undescended testicular volume and the incidence risk of morphological abnormalities detected by ultrasonography were compared between the two groups. RESULTS: At 5 years after orchidopexy, the difference in the mean volume between the two groups was not statistically significant. The incidence risk of structural abnormalities at 5 years after orchidopexy was lower in group A than in group B (25.0 vs. 83.3%, p = 0.05). CONCLUSIONS: This study thus provides evidence that orchidopexy at a younger age could prevent morphological changes in the undescended testis.