History of pain around the lumbopelvic region during perinatal period: a prospective cohort study.

PURPOSE: Many women experience pain around the low back and pelvic girdle during/after pregnancy. These pains have different risk factors and require independent management strategies. Therefore, an epidemiological database is required to understand when each type of pain occurs, and how serious it could be. Thus, the history of pain in the lumbopelvic region throughout the perinatal period was investigated. METHODS: The information of 170 women recruited at the obstetrics and gynecology clinics in Japan was collected at 12, 24, 30, and 36 weeks of pregnancy, in the early days after childbirth, and one month after childbirth. The presence and severity of sacroiliac joint pain, pubic pain, groin pain, and low back pain were assessed using a numerical rating scale. Descriptive statistics were used to determine changes in the prevalence of pain. In addition, the change in the severity of each type of pain was observed through descriptive statistics, by including only those who had pain. RESULTS: The sacroiliac joint pain showed a twofold increase from 12 to 24 weeks, while the pubic pain suddenly increased after 24 weeks. The severity of pubic and groin pain increased sharply during pregnancy. Regarding low back pain, the change in the severity was lesser than the other pains. The sacroiliac joint pain was the highest among the four pains during pregnancy. CONCLUSION: Each type of pain had a different incidence rate and a different time of onset and aggravation. These results help women and health professionals to manage, and prevent these harmful symptoms.

Biomechanical gait analysis and rehabilitation in a traumatic hallux deficit patient: a case report.

BACKGROUND: The hallux plays a crucial role in maintaining standing balance and facilitating forward and backward movements during gait. CASE PRESENTATION: A 21-year-old Japanese patient, suffering from a traumatic hallux deficit with only a portion of the basal phalanx intact, underwent rehabilitation treatment. The thenar area exhibited instability, leading to impaired balance and walking difficulties. Biomechanical assessment revealed the need for a rehabilitation strategy for the foot, as well as the knee, hip, and trunk. A rehabilitation protocol was designed to enhance medial foot loading during walking and standing, including balance and trunk strength training. After a 12-week rehabilitation period, the patient's gait showed significant improvement. Specifically, the load response and single-support phases of the gait cycle on the affected side increased from 46.9% to 49.3%, while the pre-swing phase decreased from 14.6% to 11.6%. The vertical component of the ground reaction force rose from 599.8 to 647.5 N. The enhanced stability from balance training and increased muscle strength contributed to the patient's improved walking and balance. CONCLUSION: A patient with a traumatic hallux deficit underwent conservative treatment through strategic rehabilitation according to biomechanical assessment. This case report underscores the value of biomechanical gait analysis in the conservative management of similar conditions.

A Case of Successful Rehabilitation for Controlling Chronic Pain Following Osteonecrosis of the Femoral Head in a Young Adult Cancer Survivor.

A 26-year-old woman previously treated for acute lymphoblastic leukemia (ALL) 14 years ago faced challenges in managing chronic pain resulting from right femoral head necrosis, a complication of her earlier ALL treatment. Ultimately, the persistent chronic pain was successfully treated via a comprehensive rehabilitation approach. The patient presented with hip contractures, muscle weakness, and reduced endurance without evident arthropathic changes or inflammatory findings in the femoral head. Active physiotherapy was implemented with the primary objective of increasing her social activity. This therapeutic intervention effectively managed the severe pain without the necessity for analgesic drugs, leading to a significant improvement in the patient's social activity. Recognizing the adolescent and young adult age group as a critical phase of physical, psychological, and social development, cancer survivors within this age group require multimodal care. This study highlights the role of stepwise rehabilitation treatments involving stretching, muscle strengthening, and endurance training, particularly in challenging cases of chronic pain. Post-treatment interviews revealed that successful experiences in each movement contributed to increased self-efficacy and promoted not only the control of chronic pain but also fostered improvements in social activities.

Three-dimensional imaging analysis of the developmental process of posterior meniscofemoral ligaments in rat embryos.

INTRODUCTION: The posterior meniscofemoral ligament (pMFL) of knee joint is a ligament that runs posterior to the posterior cruciate ligament (PCL) and it is known that the height of the pMFL attachment site causes meniscus avulsion. Therefore, understanding the three-dimensional (3D) structure of the pMFL attachment site is essential to better understand the pathogenesis of meniscus disorders. However, the developmental process of pMFL has not been well investigated. The purpose of this study was to analyze pMFL development in rat knee joints using 3D reconstructed images produced from episcopic fluorescence image capture (EFIC) images and examine its relationship with other knee joint components. METHODS: Knee joints of Wistar rat embryos between embryonic day (E) 16 and E21 were observed with HE stained tissues. Serial EFIC images of the hindlimbs of E17-E21 were respectively captured, from which 3D images were reconstructed and the features of pMFL structure: length and angle, were measured. Besides, the chronological volume changes and the volume ratio of the knee joint components compared to E17 were calculated to identify the differences in growth by components. RESULTS: pMFL was observed from E17 and was attached to the medial femoral condyle and lateral meniscus at all developmental stages, as in mature rats. The lack of marked variation in the attachment site and angle of the pMFL with the developmental stage indicates that the pMFL and surrounding knee joint components developed while maintaining their positional relationship from the onset of development. CONCLUSION: Current results may support to congenital etiology of meniscus disorder.

Peripheral nerve regeneration following scaffold-free conduit transplant of autologous dermal fibroblasts: a non-randomised safety and feasibility trial.

BACKGROUND: The use of Bio 3D nerve conduits is a promising approach for peripheral nerve reconstruction. This study aimed to assess their safety in three patients with peripheral nerve defects in their hands. METHODS: We describe a single institution, non-blinded, non-randomised control trial conducted at Kyoto University Hospital. Eligibility criteria included severed peripheral nerve injuries or a defect in the region distal to the wrist joint not caused by a congenital anomaly; a defect with a length of ≤20 mm in a nerve with a diameter ≤2 mm; failed results of sensory functional tests; ability to register in the protocol within 6 months from the day of injury; refusal of artificial nerve or autologous nerve transplantation; age 20-60 years; and willingness to participate and provide informed written consent. Six weeks before transplantation, skin was harvested, dermal fibroblasts were isolated and expanded, and Bio 3D nerve conduits were created using a Bio 3D printer. Bio 3D nerve conduits were transplanted into the patients' nerve defects. The safety of Bio 3D nerve conduits in patients with a peripheral nerve injury in the distal part of the wrist joint were assessed over a 48-week period after transplantation. RESULTS: No adverse events related to the use of Bio 3D nerve conduits were observed in any patient, and all three patients completed the trial. CONCLUSIONS: Bio 3D nerve conduits were successfully used for clinical nerve reconstruction without adverse events and are a possible treatment option for peripheral nerve injuries.

Physical injuries often result in damage to nerves, for example, in the hands. Replacement of the nerve with nerves removed from elsewhere in the patient's body is often the suggested treatment when the nerve is unable to repair itself. As an alternative to remove healthy nerve from elsewhere in the body, we used an adapted printer to create an artificial nerve equivalent from skin cells obtained from the patient's skin. We reconstructed the nerves of three individual with nerve defects in their hands, and we found that the function of the nerve improved, and the people did not experience negative consequences. This approach could be used widely to repair damaged nerves.

Analysis of Molecular Changes and Features in Rat Knee Osteoarthritis Cartilage: Progress From Cellular Changes to Structural Damage.

OBJECTIVE: Although knee osteoarthritis (KOA) is a common disease, there is a lack of specific prevention and early treatment methods. Hence, this study aimed to examine the molecular changes occurring at different stages of KOA to elucidate the dynamic nature of the disease. DESIGN: Using a low-force compression model and analyzing RNA sequencing data, we identified molecular changes in the transcriptome of knee joint cartilage, including gene expression and molecular pathways, between the cellular changes and structural damage stages of KOA progression. In addition, we validated hub genes using an external dataset. RESULTS: Gene set enrichment analysis (GSEA) identified the following pathways to be associated with KOA: "B-cell receptor signaling pathway," "cytokine-cytokine receptor interaction," and "hematopoietic cell lineage." Expression analysis revealed 585 differentially expressed genes, with 579 downregulated and 6 upregulated genes. Enrichment and clustering analyses revealed that the main molecular clusters were involved in cell cycle regulation and immune responses. Furthermore, the hub genes Csf1r, Cxcr4, Cxcl12, and Ptprc were related to immune responses. CONCLUSIONS: Our study provides insights into the dynamic nature of early-stage KOA and offers valuable information to support the development of effective intervention strategies to prevent the irreversible damage associated with KOA, thereby addressing a major clinical challenge.

Gap between the prevalence of and consultation rate for lumbopelvic pain in postnatal Japanese women.

BACKGROUND: We aimed to assess the prevalence of lumbopelvic pain (LPP), including low back pain (LBP) and/or pelvic girdle pain (PGP), consultation rate, and desire for treatment of postnatal Japanese women. METHODS: We performed a cross-sectional study of 98 postnatal Japanese women within 1 year of childbirth. We retrospectively evaluated the prevalence of LBP before and during pregnancy and the prevalence of LPP after childbirth using a self-administered questionnaire. We used the distribution of pain to differentiate LBP and/or PGP after childbirth and its intensity was assessed using a visual analogue scale. The effects of LPP on daily life were assessed using the Oswestry disability index (ODI). In addition, we assessed the consultation rate for LPP and the desire to consult a healthcare professional, using self-administered questionnaires. RESULTS: The prevalence of LPP after childbirth was 66%. Women with a history of LBP before and during pregnancy were more likely to have LPP following childbirth (both P < 0.001). The consultation rate among the postnatal women with LPP was 9%, but 56% of the women wished to consult a healthcare professional. The ODI score was significantly higher in postnatal women who wanted to consult a healthcare professional than in those who did not (P < 0.01). CONCLUSIONS: Two thirds of the postnatal Japanese women who participated in this study had LPP, but the consultation rate was low. However, more than half of these women had the desire to consult a healthcare professional.

Incidence and Characteristics of Elbow Injury in Japanese Youth Baseball Players: Comparison Between 2011 and 2021.

Background: Little League elbow, including humeral epicondylitis and osteochondritis dissecans, is a severe throwing injury in school-aged pitchers. Recent rule revisions have been implemented, and thus, prevention awareness may have increased. Purpose: To compare the incidence of elbow injury in 2011 from a previous study with that in 2021 and examine changes in the incidence and characteristics of players with elbow injuries. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A survey based on the 2011 survey was conducted from September 1 to December 31, 2021, among 4060 third- to sixth-grade Little League players belonging to 203 teams in Kyoto, Japan. This survey included a 23-item checklist on physical condition and injury. The participants were classified into 2 groups according to the presence or absence of an elbow injury in the dominant arm during the season. The Wilcoxon rank-sum test was conducted to compare differences in basic information between the 2 groups. We also compared the differences in the 23 checklist items between the 2 groups using the chi-square or Fisher exact probability test. Results: Overall, 98 teams (1335 players; age range, 8-12 years) returned the questionnaires (collection rate, 32.9%). The final analysis population (excluding incomplete questionnaires) was 678 (mean age, 10.6 ± 1.1 years). Elbow injuries accounted for 30.7% of all injury sites in the players. Overall, 61 players (9.0%) reported elbow injuries in 2021 compared with 19.1% of the players in the 2011 survey (P < .01) A significantly higher percentage of players with elbow injuries had elbow pain in extension (item 2 on the survey checklist, P < .001) and flexion (item 4, P < .0024), were regular players (item 5, P = .0288), played baseball under fatigue (item 8, P = .0028), and had lower and upper limb inflexibility (item 17, P = .0379; item 18, P = .0146; and item 22, P = .0085). Conclusion: Study findings indicated that the incidence of elbow injuries has decreased significantly over the past 10 years, although the elbow joint still accounted for almost one-third of all injuries in Japanese youth baseball players.

Analyses of actions which cause anterior cruciate ligament injuries in the national basketball association players: YouTube-based video analyses.

BACKGROUND: Anterior cruciate ligament (ACL) injuries are among the most common injuries in the National Basketball Association (NBA), and it is important to investigate the actual nature of the injury because it can impair a player's performance after returning to the game. Although the moment of injury has been investigated, the details of the movements and circumstances leading to injury in basketball games are unknown. This study aimed to clarify the actions leading to ACL injuries and to investigate their characteristics, based on YouTube video analyses of the NBA players. METHODS: Players with ACL injuries in the NBA were identified through web-based research over 10 seasons (2011/2012-2021/2022, through October 2021), with 29 recorded videos of ACL injuries in the NBA. Actions were categorized based on basketball-specific gestures, and determined whether the player was in contact with an opponent or not and, if so, the location of the contact was analyzed focusing on two time points: at the injury frame (IF) and one step before the injury frame (IF-1). The "injury leg" timing was counted for each of the first and second steps after ball possession. RESULTS: The majority (68.2%) of ACL injury occurred during the 2 steps phase (only two steps can proceed after ball retention in basketball, so we defined them as two steps) in the offense action, and most notably during the first step (80.0%). 73.3% of players who were injured during the 2 steps phase got contact to an area other than the knee (Indirect contact) at the IF-1, with 81.8% of contact being located in the upper body contralateral to the respective knee injury. The probability of players with ACL injuries during the 2 steps at the IF-1 who got Indirect contact was statistically significantly greater than those who got no contact with other players (p = 0.042). CONCLUSIONS: We argue that including pre-injury play and contact falls into the novelty category. Through YouTube-based video analyses, this study revealed that ACL injuries tend to be characterized by specific types of actions, the timing of contact, and the location of contact in NBA players.

Development of a novel model for intraarticular adhesion in rat knee joint.

In this study, a novel rat model of knee joint adhesion was developed, and its formation was analyzed quantitatively over time. Thirty-nine Wistar rats were randomly divided into intact control (n = 3) and experimental (n = 36) groups. The latter was equally divided into three groups according to the experimental intervention: fixed with deep bending of the knee joint (group I), fixed after incision of the capsule (group II), and fixed after exposure of the patellofemoral joint to artificial patellar subluxation (group III). All rats were subdivided according to their joint immobilization period (1, 2, or 4 weeks). Thereafter, the limited range of motion of the knee joint with (limited knee range of motion) and without (limited knee joint intrinsic range of motion) skin and muscles were measured. The lengths of adhesions of the anterior knee joint and posterior capsules were evaluated histologically. The limited intrinsic range of motion of the knee joint was found to be increased in groups II and III compared to that in group I 4 weeks after immobilization. Adhesions were confirmed within 1 week after immobilization in groups II and III. The length of the adhesions in group III was significantly longer than in other groups at 2 weeks and remained longer than in group I at 4 weeks. This model may contribute to the assessment of the adhesion process and development of new therapeutic avenues following trauma or surgical invasion.

Investigating Subtypes of Motor Skills and Activities of Daily Living among Young Children with Motor Delay.

The purpose of this study was to classify preschool children into subtypes based on motor skills and to characterize the activities of daily living for each subtype. The subjects were 45 preschool children whose scores on the Movement Assessment Battery for Children-Second Edition (MABC-2) and the Functional Independence Measure for Children (WeeFIM) were measured. The fine score and gross score were calculated from the MABC-2, and a cluster analysis was performed. The difference between the fine score and the gross score was evaluated for each subtype, and multiple comparisons among subtypes were performed for the fine, gross, and WeeFIM scores. Subtype analysis showed that the fine score was significantly lower than the gross score for subtype I (p < 0.001), and the gross score was significantly lower than the fine score for subtype III (p = 0.018). Subtype II had a significantly lower score than subtype I and subtype III (p < 0.001). Children with subtype II had more difficulty dressing movements and less communication skills than subtype III (p < 0.05). Classification into three subtypes according to motor ability and some of the characteristics of ADLs were identified.

Differences in physical activity and mental function according to the employment status of elderly Japanese.

OBJECTIVES: In recent years, the employment statuses of the elderly have become more diverse, and it is important to investigate the differences in health status according to employment statuses. This study aimed to examine the differences in physical activity and mental function among elderly Japanese according to their employment status and to examine the differences between men and women. METHODS: This cross-sectional study used an online questionnaire. The participants were persons aged ≥60 years. Data on their sociodemographic indicators, employment status, physical activity, and mental function were collected. They were classified into six groups according to their employment status: being employed, completely retired, re-hired at the same workplace, re-hired at a different workplace, early retirement, and working at a job without a mandatory retirement age. Differences in the surveyed items according to employment status were compared using the Kruskal-Wallis test. RESULTS: The total number of participants in the analysis with complete responses was 1552 (1207 men and 345 women; mean age 67.8 ± 5.9 years). The results revealed that among men, those who were re-hired at different workplaces had higher walking physical activity, and retirees and early retirees had longer sedentary time and lower sense of self-usefulness. There was no clear difference among women according to their employment status. CONCLUSIONS: The results suggest that physical activity and mental function among older adults may differ according to their employment status, especially for men. Employment among the elderly may play an important role in maintaining their physical activity and mental function.

Femoral posture during embryonic and early fetal development: An analysis using landmarks on the cartilaginous skeletons of ex vivo human specimens.

The pre-axial border medially moves between the fetal and early postnatal periods, and the foot sole can be placed on the ground. Nonetheless, the precise timeline when this posture is achieved remains poorly understood. The hip joint is the most freely movable joint in the lower limbs and largely determines the lower-limb posture. The present study aimed to establish a timeline of lower-limb development using a precise measurement of femoral posture. Magnetic resonance images of 157 human embryonic samples (Carnegie stages [CS] 19-23) and 18 fetal samples (crown rump length: 37.2-225 mm) from the Kyoto Collection were obtained. Three-dimensional coordinates of eight selected landmarks in the lower limbs and pelvis were used to calculate the femoral posture. Hip flexion was approximately 14° at CS19 and gradually increased to approximately 65° at CS23; the flexion angle ranged from 90° to 120° during the fetal period. Hip joint abduction was approximately 78° at CS19 and gradually decreased to approximately 27° at CS23; the average angle was approximately 13° during the fetal period. Lateral rotation was greater than 90° at CS19 and CS21 and decreased to approximately 65° at CS23; the average angle was approximately 43° during the fetal period. During the embryonic period, three posture parameters (namely, flexion, abduction, and lateral rotation of the hip) were linearly correlated with each other, suggesting that the femoral posture at each stage was three-dimensionally constant and exhibited gradual and smooth change according to growth. During the fetal period, these parameters varied among individuals, with no obvious trend. Our study has merits in that lengths and angles were measured on anatomical landmarks of the skeletal system. Our obtained data may contribute to understanding development from anatomical aspects and provide valuable insights for clinical application.

The Relationship Between Health Literacy, Knowledge, Fear, and COVID-19 Prevention Behavior in Different Age Groups: Cross-sectional Web-Based Study.

BACKGROUND: COVID-19 prevention behaviors have become part of our lives, and they have been reported to be associated with health literacy, knowledge, and fear. However, the COVID-19 pandemic may be characterized by different situations in each age group. Since the severity of the infection and the means of accessing information differ by age group, the relationship between health literacy, knowledge, and fear may differ. Thus, factors that promote preventive behavior may differ by age group. Clarifying the factors related to prevention behaviors by age may help us consider age-appropriate promotion. OBJECTIVE: This study aims to examine the association between COVID-19 prevention behaviors and health literacy, COVID-19 knowledge, and fear of COVID-19 by age group. METHODS: A cross-sectional study was conducted among 512 participants aged 20-69 years, recruited from a web-based sample from November 1 to November 5, 2021. A web-based self-administered questionnaire was used to obtain the participants' characteristics, COVID-19 prevention behaviors, health literacy, COVID-19 knowledge, and fear of COVID-19. The Kruskal-Wallis rank sum test was used to compare the scores of each item for each age group. The relationships among COVID-19 prevention behaviors, health literacy, COVID-19 knowledge, and fear of COVID-19 were analyzed using the Spearman rank correlation analysis. Additionally, multiple regression analysis was conducted with COVID-19 prevention behaviors as dependent variables; health literacy, COVID-19 knowledge, and fear of COVID-19 as independent variables; and sex and age as adjustment variables. RESULTS: For all participants, correlation and multiple regression analyses revealed that prevention behaviors were significantly related to health literacy, COVID-19 knowledge, and fear of COVID-19 (P<.001). Additionally, correlation analysis revealed that fear of COVID-19 was significantly negatively correlated with COVID-19 knowledge (P<.001). There was also a significant positive correlation between health literacy and COVID-19 knowledge (P<.001). Furthermore, analysis by age revealed that the factors associated with prevention behaviors differed by age group. In the age groups 20-29, 30-39, and 40-49 years, multiple factors, including health literacy, influenced COVID-19 prevention behaviors, whereas in the age groups 50-59 and 60-69 years, only fear of COVID-19 had an impact. CONCLUSIONS: The results of this study revealed that the factors associated with prevention behaviors differ by age. Age-specific approaches should be considered to prevent infection.

Ultrasound Assessment of Abdominal Muscle Thickness With and Without Lumbopelvic Pain in Pregnant Women.

OBJECTIVES: Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and LPP in pregnant women has not been studied extensively, despite the significant abdominal changes that occur during pregnancy. This study aimed to examine the relationship between abdominal muscle thickness and LPP in pregnant women. METHODS: In this study, 49 pregnant women in their second trimester participated. The intensity of LPP was assessed using a numerical rating scale. Ultrasound imaging was used to measure the thickness of abdominal muscles, including the rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. Participants were classified into two groups, the LPP group and non-LPP group, and the abdominal muscle thickness was compared between the two groups. The statistical significance level was set at P < .05. RESULTS: There were 24 and 25 participants in the LPP and non-LPP groups, respectively. Internal oblique (IO) thickness was significantly thinner in the LPP group than in the non-LPP group (5.4 ± 0.2 mm versus 6.1 ± 0.2 mm; P = .042). Multivariate logistic regression analysis showed that IO thickness was significantly associated with LPP (odds ratio, 0.516; 95% confidence interval, 0.284-0.935; P = .019). CONCLUSIONS: This study suggested that LPP in second trimester pregnancy might be related to IO thickness. Further longitudinal studies are needed to understand the role of this muscle as an LPP risk factor for pregnant women.

Preliminary study of assessing cognitive impairment in older patients with chronic obstructive pulmonary disease by using a cognitive functional assessment tool via a touchscreen personal computer.

Background: Unique cognitive impairments related to chronic obstructive pulmonary diseases (COPD) have been increasingly reported. Considering the dementia risk and medication management, older patients with COPD should be evaluated for cognitive impairment. This study aimed to examine whether specific cognitive impairments related to COPD could be detected by an assessment tool using a touchscreen personal computer (PC) in older patients with COPD. Methods: This study included 28 older male patients with COPD and 30 healthy older male individuals. A touchscreen PC-based cognitive assessment application called CogEvo was used to assess and compare the cognitive function according to five domains: spatial cognition, orientation, working memory, executive function, and attention. Results: Analysis of variance showed an interaction effect on the indices of cognitive function based on five domains between the two groups, indicating differences in the characteristics of cognitive function in such groups. Betweengroup comparisons as a subtest showed that attention, executive function, and working memory were significantly lower in the COPD group than in the healthy group. Conclusions: CogEvo can detect specific cognitive impairments associated with COPD, suggesting that it can be potentially used as a screening tool for cognitive impairment in older patients with COPD.

Association between forefoot pain and sesamoid rotation angle determined using a weight-bearing plantar ultrasound imaging device.

Forefoot pain is a common symptom for several foot problems. This study aimed to determine whether parameters of forefoot structure (hallux valgus angle (HVA), transverse arch height (TAH) and sesamoid rotation angle (SRA)) are associated with forefoot pain. 547 feet of adult women were divided into two groups: without pain (n = 472) and with pain (n = 75). HVA was measured with a goniometer, TAH and SRA were measured using a weight bearing plantar ultrasound imaging device.Associations between forefoot pain and parameters of forefoot structure were analyzed using the Mann-Whitney U test and univariate and multivariate logistic regression analyses. The intra-rater and inter-rater reliability of the ultrasound images were also tested. SRA was significantly greater in the group with pain compared to the group without pain (p = 0.031) but not HVA (p = 0.057) nor TAH (p = 0.117). The association between forefoot pain and SRA was significant (univariate: p = 0.015 and multivariate p = 0.015), but not between HVA nor TAH. The intra-rater and inter-rater reliability were almost perfect (SRA: ICC1,1 = 0.94, ICC2,1 = 0.91 and TAH: ICC1,1 = 0.88, ICC2,1 = 0.81). We conclude that a higher SRA is related to forefoot pain and should be taken into consideration for assessment of patients with forefoot pain.

Comparison of Psychological Quality of Life Between Long-Term Survivors of Childhood Cancer and Their Families.

Purpose: Although treatment outcomes for childhood cancer have improved in recent years, some patients continue to experience physical symptoms and psychological stress several years after the end of treatment. This study aimed to examine the correlation between the quality-of-life (QOL) scores of childhood cancer survivors (CCSs) aged 18-39 and (1) their families and (2) the time since the end of treatment. Methods: Measuring the QOL of CCSs attending the long-term follow-up (LTFU) and those of their families. The Short-Form Health Survey (SF-36) was used for CCSs and the Caregiver Quality of Life Index-Cancer (CQOLC) for their families. Spearman's rank correlation analyses were used to examine the relationship between the CCSs' and their families' QOL and the time since the end of treatment. Results: Twenty-nine CCSs (mean age, 24.2 years; mean the time since the end of treatment, 13.9 years), each paired with one family member, were included. Time since the end of treatment was positively correlated with the CCSs' QOL on the physical component score (ρ = 0.42, p = 0.03) and negatively correlated with mental health (MH) (ρ = -0.50, p = 0.01), a subscale of the mental component score (MCS). Furthermore, the CCSs' QOL on the MCS was positively correlated with their families' QOL scores (ρ = 0.58, p < 0.01). Conclusion: Psychological stress may persist in CCSs long after treatment, even when physical symptoms improve. Therefore, it is necessary to establish a comprehensive support system for the LTFU of CCSs, including MH care and QOL monitoring for patients and their families.

One session of 20 ​N cyclic compression induces chronic knee osteoarthritis in rats: A long-term study.

Objective: Mechanical stimulation is a risk factor for knee osteoarthritis. Non-surgical compression has been used to study the effects of mechanical stimulation in vivo. However, the long-term effects of low-force compression on knee joint had not been studied. Therefore, we sought to identify the long-term effects of low-force cyclic compression on the rat knee joint. Design: In this study, we applied one session cyclic compression with a peak load of 20 â€‹N for 60 cycles to the rat knee joint in an approximately 140-degree flexion position (Wistar, male, 12 weeks old), followed by 1 year of observation (including data from 1 week, 2 weeks, 4 weeks, 8 weeks, 6 months, and 1 year after compression), and then performed a sub-regional analysis with hematoxylin-eosin, Safranin O and Fast Green, and MMP13 immunohistochemical staining. Results: We observed osteoarthritis-like cartilage damage, synovial inflammation, and high expression of MMP13 within 1 year after compression. However, these changes progressed slowly, with obvious matrix cracks that did not appear until 1 year after compression. In the regional analysis, we found that low-force compression caused a much slower development of injury at the compression contact site, and no significant structural cartilage damage was observed after 1 year of compression. In contrast, the non-contact site during compression at tibial cartilage in the same joint was the first to show significant structural damage. Conclusion: This study demonstrates that one session of 20 â€‹N cyclic compression induces a chronic osteoarthritis-like phenotype in the rat knee in the long term.

Explanation of hand, foot, and mouth disease cases in Japan using Google Trends before and during the COVID-19: infodemiology study.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) pandemic affects common diseases, but its impact on hand, foot, and mouth disease (HFMD) is unclear. Google Trends data is beneficial for approximate real-time statistics and because of ease in access, is expected to be used for infection explanation from an information-seeking behavior perspective. We aimed to explain HFMD cases before and during COVID-19 using Google Trends. METHODS: HFMD cases were obtained from the National Institute of Infectious Diseases, and Google search data from 2009 to 2021 in Japan were downloaded from Google Trends. Pearson correlation coefficients were calculated between HFMD cases and the search topic "HFMD" from 2009 to 2021. Japanese tweets containing "HFMD" were retrieved to select search terms for further analysis. Search terms with counts larger than 1000 and belonging to ranges of infection sources, susceptible sites, susceptible populations, symptoms, treatment, preventive measures, and identified diseases were retained. Cross-correlation analyses were conducted to detect lag changes between HFMD cases and search terms before and during the COVID-19 pandemic. Multiple linear regressions with backward elimination processing were used to identify the most significant terms for HFMD explanation. RESULTS: HFMD cases and Google search volume peaked around July in most years, excluding 2020 and 2021. The search topic "HFMD" presented strong correlations with HFMD cases, except in 2020 when the COVID-19 outbreak occurred. In addition, the differences in lags for 73 (72.3%) search terms were negative, which might indicate increasing public awareness of HFMD infections during the COVID-19 pandemic. The results of multiple linear regression demonstrated that significant search terms contained the same meanings but expanded informative search content during the COVID-19 pandemic. CONCLUSIONS: The significant terms for the explanation of HFMD cases before and during COVID-19 were different. Awareness of HFMD infections in Japan may have improved during the COVID-19 pandemic. Continuous monitoring is important to promote public health and prevent resurgence. The public interest reflected in information-seeking behavior can be helpful for public health surveillance.