Hard to let it go: repetitive negative thinking and hoarding in later life in Japan.

Objectives: Hoarding in older adults can have a detrimental effect on daily life. Repetitive negative thinking (RNT) could result in a greater avoidance of discarding and increased saving behaviors; yet, the unique role of RNT on hoarding in older adults remains understudied. This study aimed to investigate whether the intensity of RNT contributes to hoarding in older adults. Methods: Two hundred and sixty-four older adults in Japan (ages 65-86 years, 132 males and 132 females) participated in an online survey. Hierarchical regression analyses were conducted to examine whether RNT could significantly explain the variance of hoarding after controlling for age, sex, years of education, self-reported cognitive impairment, and depression. Results: As we expected, RNT was significantly associated with greater hoarding behaviors, such as excessive acquisition (ß = .27, p = .005) and difficulty in discarding (ß = .27, p = .003). On the other hand, reflection, repetitive thinking without negative emotional valence, was significantly associated with higher scores on clutter (ß = .36 p < .001). Conclusion: Our findings highlight the importance of addressing RNT in the prevention and treatment of hoarding symptoms among older adults, potentially leading to more effective interventions and improved outcomes in managing hoarding behaviors in this population.

Optimizing simulated interviews and feedback to maximize medical students' self-efficacy in real time.

BACKGROUND: Self-efficacy is crucial in improving medical students' communication skills. This study aims to clarify where medical students' self-efficacy is greatest following an interview with a simulated patient and subsequent feedback. METHODS: A total of 162 medical students (109 men, 53 women) in their fourth or fifth year at a university in Japan participated in this study. The degree of self-efficacy in medical interviewing was measured before and after a medical interview with a simulated patient, and after the subsequent feedback session. RESULTS: ANOVA analysis revealed that self-efficacy for medical interviews was higher after both the interview and the feedback session than before the interview. Among all three time points, self-efficacy was highest after the feedback session. CONCLUSIONS: Feedback following a simulated interview with a simulated patient is important to improve the self-efficacy of medical students when learning medical interviewing skills.

Microstructural properties of the vertical occipital fasciculus explain the variability in human stereoacuity.

Stereopsis is a fundamental visual function that has been studied extensively. However, it is not clear why depth discrimination (stereoacuity) varies more significantly among people than other modalities. Previous studies have reported the involvement of both dorsal and ventral visual areas in stereopsis, implying that not only neural computations in cortical areas but also the anatomical properties of white matter tracts connecting those areas can impact stereopsis. Here, we studied how human stereoacuity relates to white matter properties by combining psychophysics, diffusion MRI (dMRI), and quantitative MRI (qMRI). We performed a psychophysical experiment to measure stereoacuity and, in the same participants, we analyzed the microstructural properties of visual white matter tracts on the basis of two independent measurements, dMRI (fractional anisotropy, FA) and qMRI (macromolecular tissue volume; MTV). Microstructural properties along the right vertical occipital fasciculus (VOF), a major tract connecting dorsal and ventral visual areas, were highly correlated with measures of stereoacuity. This result was consistent for both FA and MTV, suggesting that the behavioral-structural relationship reflects differences in neural tissue density, rather than differences in the morphological configuration of fibers. fMRI confirmed that binocular disparity stimuli activated the dorsal and ventral visual regions near VOF endpoints. No other occipital tracts explained the variance in stereoacuity. In addition, the VOF properties were not associated with differences in performance on a different psychophysical task (contrast detection). These series of experiments suggest that stereoscopic depth discrimination performance is, at least in part, constrained by dorso-ventral communication through the VOF.

Trajectory and factors of radiation risk perception of students aged 10-12 years at the time of the Fukushima Daiichi Nuclear Power Station accident.

Various studies have investigated radiation risk perceptions after the accident at the Fukushima Daiichi Nuclear Power Station. However, student surveys are limited. This study aimed to investigate the perception of radiation risk among students aged 18-20 years who were in the 5th and 6th grades of elementary school at the time of the accident. We surveyed students in the Fukushima Prefecture and outside the prefecture. Out of all the data, 59% of the respondents were living in the Fukushima Prefecture at the time of the accident and 41% outside the prefecture. Trajectory analysis showed that changes in anxiety levels over time since 2011 could be divided into five classes: (a) the anxiety was the highest, and this tendency persisted. (b) High at the beginning, but decreased more quickly than class 1. (c) High at the beginning, but it diminished quickly. (d) Not high, but did not diminish easily in later years. (e) Low from the beginning, and persisted. Multinomial logistic analysis showed that among students living outside the prefecture at the time of the accident, a significantly higher proportion was in groups 4 and 5 than in group 2. A significant proportion of boys were present in groups 3, 4 and 5. A significant proportion of students whose current educational institutions were inside the prefecture were present in group 3. The level of anxiety was associated with the academic course, but not with subjective knowledge of radiation. In contrast, in the qualitative analysis of the free text, 31% considered 'knowledge about radiation' as the reason for the reduction in anxiety level. At the time of the investigation, most young people were not anxious about radiation. However, approximately 20% still had strong anxiety. We established that continuous risk communication is necessary. Furthermore, that stabilization and support related to life in general is important.

A relative frame of reference underlies reversed depth perception in anticorrelated random-dot stereograms.

Binocular disparity is represented by interocular cross-correlation of visual images in the striate and some extrastriate cortices. This correlation-based representation produces reversed depth perception in a binocularly anticorrelated random-dot stereogram (aRDS) when it is accompanied by an adjacent correlated RDS (cRDS). Removal of the cRDS or spatial separation between the aRDS and cRDS abolishes reversed depth perception. However, how an immediate plane supports reversed depth perception is unclear. One possible explanation is that the correlation-based representation generates reversed depth based on the relative disparity between the aRDS and cRDS rather than the absolute disparity of the aRDS. Here, we psychophysically tested this hypothesis. We found that participants perceived reversed depth in an aRDS with zero absolute disparity when it was surrounded by a cRDS with nonzero absolute disparity (i.e., nonzero relative disparity), suggesting a role of relative disparity on the depth reversal. In addition, manipulation of the absolute disparities of the central aRDS and surrounding cRDS caused depth perception to reverse with respect to the depth of the surround. Further, depth reversal persisted after swapping the locations of the two RDSs. A model of relative-disparity encoding explains all these results. We conclude that reversed depth perception in aRDSs occurs in a relative frame of reference and suggest that the visual system contains correlation-based representation that encodes relative disparity.

Localized amyloidosis of the ureter: a case report.

BACKGROUND: Amyloidosis is a collection of disorders characterized by the extracellular deposition of amyloid, a specialized fibrous protein, in diverse tissues, leading to functional impairments. CASE PRESENTATION: A 70-year old Asian-Japanese female was referred to our department for further examination of her left hydronephrosis come from lower ureteral obstruction. Contrast enhanced CT and retrograde pyelo-nephrography revealed left ureteral tumor. Though ureteroscropic biopsy did not show malignant pathological findings, ureteroscopic image suspected malignant disease, thus nephroureterectomy was performed. Pathological findings revealed localized ureteral amyloidosis. Whole body examination including gastro endoscopy and cardio ultrasonography could not reveal amyloidosis except ureter. She was free from recurrence 9 months postoperatively. CONCLUSION: We herein report a rare case of localized ureteral amyloidosis.

Reconstructing visual illusory experiences from human brain activity.

Visual illusions provide valuable insights into the brain's interpretation of the world given sensory inputs. However, the precise manner in which brain activity translates into illusory experiences remains largely unknown. Here, we leverage a brain decoding technique combined with deep neural network (DNN) representations to reconstruct illusory percepts as images from brain activity. The reconstruction model was trained on natural images to establish a link between brain activity and perceptual features and then tested on two types of illusions: illusory lines and neon color spreading. Reconstructions revealed lines and colors consistent with illusory experiences, which varied across the source visual cortical areas. This framework offers a way to materialize subjective experiences, shedding light on the brain's internal representations of the world.

Unwinding on the Weekend from Work-Related Stress: Moderating Effect of Weekday Psychological Stress on the Relationship between Increased Recovery Experience and Reduction of Psychological Stress on the Weekend.

Recovery is described as a process that is in contrast to the process whereby the psychological stress response increases. Recovery experiences refer to specific experiences that promote recovery and represent psychological attributes including relaxation. This preliminary study tested the hypothesis that levels of psychological stress before the weekend have a moderating effect on the relationship between an increased recovery experience during the weekend and a reduction of psychological stress from workdays to the weekend. Of 270 Japanese teachers who were invited to participate, 181 completed questionnaires on the psychological stress response before, on the psychological stress response and the recovery experience during the weekend. Data from 7 part-time teachers and 38 teachers who were not stressed at all before the weekend were excluded; therefore, data for 136 participants were ultimately analyzed. Results of hierarchal regression analysis indicated that increased relaxation was associated with an increased reduction in psychological stress response during the weekends in participants with high levels of psychological stress before the weekends. This moderating effect was not observed for other recovery experiences. Considering the psychological stress response is important for research on recovery experiences during weekends.

Processes of change, pros, cons, and self-efficacy as variables associated with stage transitions for effective stress management over a month: a longitudinal study.

BACKGROUND: The transtheoretical model of intentional health behavior change categorizes people into experiencing five stages in understanding the process of initiating and maintaining effective stress management (i.e., engagement in any form of healthy activity that is practiced for at least 20 min per day). The first purpose of this study was to observe whether any cases would disclose stage misclassification over one month. The second was to examine whether different model's variables are associated with the stage transitions for effective stress management at different stages. METHODS: Data from 946 Chinese students and workers were subjected to analyses. This study is a part of a larger, longitudinal web-based study in which three surveys were conducted in March, April, and September 2014. This study analyzes the data of demographic variables, perceived stress, stages of change, processes of change, pros, cons, and self-efficacy at the point of the first survey and stages of change at the point of the second survey. RESULTS: Of 144 participants who progressed from the pre-Action stages to the post-Action stages, 44 then progressed to Maintenance (practicing effective stress management for six months or longer). These patterns could not technically occur, and thus, these participants were excluded from the following analyses. Data from the remaining 902 participants were subject to a series of logistic regression analyses. Generally, the model's variables failed to predict the stage transitions. Exceptions were found that higher experiential processes (the cognitive activities required to progress through stages) and lower self-efficacy (the confidence that one can engage in effective stress management despite barriers to it) predicted the forward and backward stage transitions from Precontemplation (with no intention to initiate effective stress management in the next six months) and Action/Maintenance (practicing effective stress management). CONCLUSIONS: Evidence of stage misclassification indicated the limitations of the model's stage classification. Experiential processes and self-efficacy as predictors at different stages were in line with the model's assumption that different variables are assumed to be predictors of stage transitions at different stages, partially supporting the utility of the stage classification.

Validation of the Japanese Big Five Scale Short Form in a University Student Sample.

The Japanese Big Five Scale Short Form (JBFS-SF), a 29-item self-report scale, has recently been used to measure the Big Five personality traits. However, the scale lacks psychometric validation. This study examined the validity and reliability of the JBFS-SF with data collected from 1,626 Japanese university students participating in a randomized controlled clinical trial. Structural validity was tested with exploratory and confirmatory factor analysis and measurement invariance tests were conducted across sex. Internal consistency was evaluated with McDonald's omega. Additionally, construct validity was estimated across factors using the PHQ-9, GAD-7, AQ-J-10, and SSQ. EFA results showed that the JBFS-SF can be classified according to the expected five-factor structure, while three items had small loadings. Therefore, we dropped these three items and tested the reliability and validity of the 26-item version. CFA results found that a 26-item JBFS-FS has adequate structural validity (GFI = 0.907, AGFI = 0.886, CFI = 0.907, and RMSEA = 0.057). The omega of each factor was 0.74-0.85. Each JBFS-SF factor was specifically correlated with the PHQ-9, GAD-7, and SSQ. This research has shown that the JBFS-SF can be a clinically useful measure for assessing personality characteristics.

A systematic review of the effect of sleep interventions on presenteeism.

BACKGROUND: Sleep problems interfere with work performance. Decreased work productivity due to health problems is defined as presenteeism. Although empirical data on the improvement of presenteeism by sleep interventions have been published, a systematic review elucidating whether there is a difference in the improvement of presenteeism across various types of sleep interventions has not yet been published. This systematic review of studies aimed to clarify which sleep interventions are more likely to be effective in improving presenteeism. METHODS: The electronic databases PubMed, PsycINFO, and MEDLINE were used to perform a literature search (the start and end search dates were October 20, 2019, and March 11, 2020, respectively). A combination of terms such as "employee*," "sleep," "insomnia," and "presenteeism" was used for the search. Both randomized and non-randomized control trials were included in this systematic review. RESULTS: Six types of sleep interventions were identified, including cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, yoga, mindfulness, weight loss program, and changing the color temperature of fluorescent lights in the workplace. Only CBT-I improved both sleep problems and presenteeism compared with a control group. The results of this review also show that there is heterogeneity in the measurement of presenteeism. CONCLUSIONS: The results of this systematic review suggested that CBT-I could be adapted for workers with sleep problems and presenteeism. We discussed whether CBT-I improved both sleep problems and presenteeism compared with other interventions. In addition, methods for measuring presenteeism in future research are proposed.

Brain hierarchy score: Which deep neural networks are hierarchically brain-like?

Achievement of human-level image recognition by deep neural networks (DNNs) has spurred interest in whether and how DNNs are brain-like. Both DNNs and the visual cortex perform hierarchical processing, and correspondence has been shown between hierarchical visual areas and DNN layers in representing visual features. Here, we propose the brain hierarchy (BH) score as a metric to quantify the degree of hierarchical correspondence based on neural decoding and encoding analyses where DNN unit activations and human brain activity are predicted from each other. We find that BH scores for 29 pre-trained DNNs with various architectures are negatively correlated with image recognition performance, thus indicating that recently developed high-performance DNNs are not necessarily brain-like. Experimental manipulations of DNN models suggest that single-path sequential feedforward architecture with broad spatial integration is critical to brain-like hierarchy. Our method may provide new ways to design DNNs in light of their representational homology to the brain.

Prognosis of patients with T1 bladder cancer after en bloc transurethral resection of bladder tumor stratified by invasion to the level of the muscularis mucosa.

PURPOSE: To evaluate the prognosis of patients with pT1 bladder cancer who underwent en bloc resection of bladder tumors (ERBTs), stratified by invasion to the muscularis mucosa (MM) level. METHODS: Among 64 specimens obtained by ERBT with bipolar energy from patients with pT1 bladder cancer, MM was detected in 61 specimens. Thus, 61 specimens were included in this retrospective study. Patients were stratified by invasion to the MM level (pT1a, invasion above the MM level; pT1b, invasion within the MM level; and pT1c, invasion beyond the MM level). In specimens with discontinuous MM, invasion to the MM level was predicted from the dispersed MM in the specimen. The primary endpoints were progression-free survival (PFS) and cancer-specific survival (CSS). RESULTS: Progression occurred in 2/39 patients with pT1a (5.1%), 1/6 patients with pT1b (16.7%), and 6/16 patients with pT1c cancer (37.5%). Cancer death occurred in 1/39 patients with pT1a (2.6%), 0/7 patients with pT1b, and 3/16 patients with pT1c cancer (18.8%). Patients with pT1a or pT1b cancer had a significantly better prognosis than those with pT1c cancer. On univariate analysis, tumor size ≥ 3 cm and pT1c were significantly associated with shorter PFS. On multivariate analysis, only pT1c was independently associated with shorter PFS. CONCLUSION: This is the first study evaluating the prognosis by T1 substaging based on invasion to the MM level using ERBT specimens. ERBT provided high-quality specimens for diagnosing the MM and showed poor prognosis in pT1c bladder cancer. ERBT could be an appropriate surgical approach for an accurate diagnosis and prognosis of the T1 bladder cancer substage.

Development and validation of the Cognitive Behavioural Therapy Skills Scale among college students.

BACKGROUND: There are many different skill components used in cognitive behavioural therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients. OBJECTIVE: To develop a comprehensive and brief measure of five main CBT skills: self-monitoring, behavioural activation, cognitive restructuring, assertiveness training and problem-solving. METHODS: University students (N=847) who participated in a fully factorial randomised controlled trial of smartphone CBT were assessed with the CBT Skills Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 (GAD-7) and the short form of the Japanese Big Five Scale. Structural validity was estimated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency evaluated with Cronbach's α coefficients. Construct validity was evaluated with the correlations between each factor of the CBT Skills Scale, the PHQ-9, the GAD-7 and the Big Five Scale. FINDINGS: The EFA supported a five-factor solution based on the original instruments assessing each CBT skill component. The CFA showed sufficient goodness-of-fit indices for the five-factor structure. The Cronbach's α of each factor was 0.75-0.81. Each CBT skills factor was specifically correlated to the PHQ-9, GAD-7, and the Big Five Scale. CONCLUSIONS: The CBT Skills Scale has a stable structural validity and internal consistency with a five-factor solution and appropriate content validity concerning the relationship with depression, anxiety and personality. CLINICAL IMPLICATIONS: The CBT Skills Scale will be potential predictor and effect modifier in studying the optimisation of CBT interventions. TRIAL REGISTRATION: CTR-000031307.

Pembrolizumab-Induced Severe Neuropathy in a Patient with Metastatic Urothelial Carcinoma after Achieving Complete Response: Guillain-Barré Syndrome-Like Onset.

An 85-year-old female was admitted to our hospital for left ureteral cancer and para-aortic lymph node metastasis. To control hematuria, a laparoscopic retroperitoneal nephroureterectomy was performed, and papillary urothelial carcinoma (pT3b) was found. To treat para-aortic lymph node metastasis, she received chemotherapy with gemcitabine and nedaplatin. After 2 cycles, a computed tomography scan revealed its disappearance; however, bilateral lung metastases appeared. The patient was administered second-line therapy with pembrolizumab every 3 weeks. After 3 courses, lung metastases disappeared and she achieved a complete response. After the fifth administration of pembrolizumab, she was readmitted with right upper limb pain and weakness in both lower extremities. She was diagnosed with pembrolizumab-induced grade 3 peripheral neuropathy with Guillain-Barré syndrome-like onset. High-dose monocorticotherapy was initiated for treatment. Three weeks later, the pain and weakness of the limbs improved. After discharge, the dose of prednisolone was tapered and there was no relapse of adverse events. Pembrolizumab was discontinued at the onset of neuropathy, but she maintained a complete response.

Bilateral Encrusted Metallic Stent Successfully Removed by Ureteroscopic Lithotripsy Using a Ho:YAG Laser in a Patient with Malignant Myeloma.

Ureteral stent encrustation is sometimes encountered, especially in cases in which a ureteral stent has been forgotten. An 84-year-old female patient with malignant myeloma underwent metallic ureteral stent insertion to treat malignant ureteral obstruction. At the time of scheduled ureteral stent exchange, the stent was heavily encrusted and could not be removed on either side. We performed endoscopic lithotripsy to remove the encrusted ureteral stents. The bilaterally encrusted metallic ureteral stents were successfully removed using Ho:YAG laser lithotripsy after inserting another ureteral stent placement besides the encrusted metallic ureteral stents.

Characterization of deep neural network features by decodability from human brain activity.

Achievements of near human-level performance in object recognition by deep neural networks (DNNs) have triggered a flood of comparative studies between the brain and DNNs. Using a DNN as a proxy for hierarchical visual representations, our recent study found that human brain activity patterns measured by functional magnetic resonance imaging (fMRI) can be decoded (translated) into DNN feature values given the same inputs. However, not all DNN features are equally decoded, indicating a gap between the DNN and human vision. Here, we present a dataset derived from DNN feature decoding analyses, which includes fMRI signals of five human subjects during image viewing, decoded feature values of DNNs (AlexNet and VGG19), and decoding accuracies of individual DNN features with their rankings. The decoding accuracies of individual features were highly correlated between subjects, suggesting the systematic differences between the brain and DNNs. We hope the present dataset will contribute to revealing the gap between the brain and DNNs and provide an opportunity to make use of the decoded features for further applications.

Sparse Ordinal Logistic Regression and Its Application to Brain Decoding.

Brain decoding with multivariate classification and regression has provided a powerful framework for characterizing information encoded in population neural activity. Classification and regression models are respectively used to predict discrete and continuous variables of interest. However, cognitive and behavioral parameters that we wish to decode are often ordinal variables whose values are discrete but ordered, such as subjective ratings. To date, there is no established method of predicting ordinal variables in brain decoding. In this study, we present a new algorithm, sparse ordinal logistic regression (SOLR), that combines ordinal logistic regression with Bayesian sparse weight estimation. We found that, in both simulation and analyses using real functional magnetic resonance imaging (fMRI) data, SOLR outperformed ordinal logistic regression with non-sparse regularization, indicating that sparseness leads to better decoding performance. SOLR also outperformed classification and linear regression models with the same type of sparseness, indicating the advantage of the modeling tailored to ordinal outputs. Our results suggest that SOLR provides a principled and effective method of decoding ordinal variables.

Mediating effects of perceived stress on the relationship of positivity with negative and positive affect.

BACKGROUND: Positivity refers to "a general tendency to view life and experiences with a positive outlook". Enhanced positivity has been linked with decreased negative affect and increased positive affect, but rather little is known about the factors that mediate these relationships. One potential such factor is perceived stress, which refers to how one appraises life situations as stressful. This study examined the mediating effects of perceived stress on the associations of positivity with negative and positive affect. Two hypotheses were tested: 1) positivity is negatively associated with perceived stress, which in turn is positively associated with negative affect, and 2) positivity is negatively associated with perceived stress, which in turn is negatively associated with positive affect. METHODS: An online survey was conducted with 100 Japanese men and 100 Japanese women who were members of a survey company in January 2018. They completed questionnaires on positivity, perceived stress, and negative and positive affect. All survey procedures were managed and conducted by a web-survey company. RESULTS: Mediation analyses indicated that perceived stress was a mediator in the relationship between positivity and negative affect. Perceived stress was also found to be a mediator in the relationship between positivity and positive affect. CONCLUSION: Positivity was found to be associated with negative affect and positive affect via perceived stress.

Coping as a mediator of the relationship between stress mindset and psychological stress response: a pilot study.

BACKGROUND: Coping, the cognitive and behavioral effort required to manage the effects of stressors, is important in determining psychological stress responses (ie, the emotional, behavioral, and cognitive responses to stressors). Coping was classified into categories of emotional expression (eg, negative feelings and thoughts), emotional support seeking (eg, approaching loved ones to request encouragement), cognitive reinterpretation (eg, reframing a problem positively), and problem solving (eg, working to solve the problem). Stress mindset refers to the belief that stress has enhancing (stress-is-enhancing mindset) or debilitating consequences (stress-is-debilitating mindset). This study examined whether coping mediated the relationship between stress mindset and psychological stress responses. Psychological stress responses were conceptualized as depression-anxiety, irritability-anger, and helplessness. The following two hypotheses were tested: 1) a stronger stress-is-enhancing mindset is associated with less frequent use of emotional expression, emotional support seeking, and problem solving, which in turn is associated with lower levels of depression-anxiety, irritability-anger, and helplessness; 2) a stronger stress-is-debilitating mindset is associated with more frequent use of these coping strategies, which in turn is associated with higher levels of these psychological stress responses. MATERIALS AND METHODS: The participants were 30 male and 94 female undergraduate and graduate students (mean age =20.4 years). Stress mindset, coping, and psychological stress responses were measured using self-report questionnaires. Six mediation analyses were performed with stress-is-enhancing mindset or stress-is-debilitating mindset as the independent variable, one of the psychological stress responses as the dependent variable, and the four coping strategies as mediators. RESULTS: Emotional expression partially mediated the relationship between a strong stress-is-debilitating mindset and higher irritability-anger levels. The other three coping strategies did not exhibit mediating effects. None of the coping strategies mediated the relationship between a stress-is-enhancing mindset and psychological stress responses. CONCLUSION: These results provide initial evidence that stress mindset is associated with psychological stress responses, through coping strategies.