Hiroshima Cosmopolitan University

Identifying reproducible neurobiological markers for Major Depressive Disorder (MDD) remains challenging due to methodological heterogeneity across neuroimaging studies. Functional connectome (FC) uniqueness, an individual-level metric derived from brain fingerprinting, quantifies the distinctiveness of intrinsic connectivity patterns and may offer a robust framework for biomarker discovery. We analyzed multi-site resting-state fMRI data from healthy controls (HC) and patients with Major Depressive Disorder (MDD), aged 19-37years. Individual functional connectomes were constructed using 300 regions of interest grouped into 14 canonical networks. FC uniqueness was defined as the ratio of self-similarity (calculated as Pearson correlation between connectomes from the same individual across different time points) to similarity-to-others (calculated as Pearson correlations between an individual's connectome and those of other participants at the next timepoint). An FC uniqueness index greater than one indicates successful individual identification, referred to as fingerprinting accuracy. Replicating prior studies, fingerprinting accuracy was highest at the whole-brain level, followed by the default mode and frontoparietal networks. MDD patients exhibited significantly lower FC uniqueness with pronounced reductions in frontoparietal and sensorimotor networks. Notably, reduced FC uniqueness was associated with higher PHQ-9 and BDI-II scores in this study. Comorbidity and age distribution differences may have introduced confounding effects. Reduced FC uniqueness in frontoparietal and sensorimotor networks corelate with neurobiological organization in MDD and represents a reproducible, clinically interpretable neuroimaging marker with potential utility for diagnosis and stratification.

IntroductionCommunity development is a vital area of practice in occupational therapy, aligned with a recent shift in focus from individual‐level interventions to community and societal issues. Despite its growing significance, knowledge and understanding of community development in occupational therapy remain fragmented. This study aimed to provide a comprehensive map of how community development is researched, discussed, and conceptualised within the field of occupational therapy.MethodsA scoping review was conducted using 10 databases to identify relevant literature published up to September 2025. The search strategy combined the terms ‘occupational therapy’ with either ‘community development’ or ‘community‐centred practice’. Descriptive statistics and content analysis were used to examine the characteristics of the literature and to identify trends in the understanding of community development in the field of occupational therapy.Consumer and Community InvolvementThis study did not include consumer or community involvement.ResultsA total of 38 articles published between 1996 and 2025 were included, with most originating in Canada, Australia, and South Africa. Of these, 18 were empirical studies, and most employed qualitative methodologies. Findings related to community development in occupational therapy were divided into two main themes: ‘What is known about community development?’ and ‘How community development is described in relation to occupational therapy.’ConclusionThe results revealed limited contextual and methodological diversity in community development research on occupational therapy. We also identified key barriers and enablers in community development practice, offering insights to support practitioners and researchers in advancing this emerging area of occupational therapy. Future studies are required to explore community development practices in diverse geographical and cultural contexts, develop theoretical frameworks to guide occupational therapists, and apply the concept of collective occupation. Strengthening educational systems and institutional support is necessary for practitioners and students to promote and improve their engagement with community development in occupational therapy.

This study aimed to investigate how changes in outpatient care during the coronavirus disease (COVID-19) pandemic affected the quality of medical care provided by Japanese physicians. A cross-sectional, anonymous online survey was conducted among members of the Japan Geriatrics Society between October and December 2022. Physicians were asked about changes in outpatient care and their perceived impact on the quality of care. Descriptive statistics, χ2 tests, and multivariate logistic regression analyses were used to examine the relationships between care changes and perceived declines in care quality. Of the 321 respondents, 135 (42.1%) reported that the quality of their medical care was negatively affected during the pandemic. Significant associations were found between the perceived decline in care quality and a decrease in the number of new outpatients at outpatient clinics, extended intervals between return visits, and conduct of outpatient telephone consultations. Extended intervals between return visits and conduct of outpatient telephone consultations were also independently associated with difficulties in understanding patients' conditions and living situations. These relationships remained significant after adjusting for covariates, such as physician experience and facility type. Changes in outpatient care during the COVID-19 pandemic, particularly extended intervals between return visits and conduct of outpatient telephone consultations, were significantly associated with a decline in physician-perceived care quality. These disruptions impair physicians' ability to assess patients comprehensively and underscore the need to maintain continuity of care and holistic evaluation practices, especially for older adults, during public health emergencies.

PurposeThe role of intestinal flora in carcinogenesis and chemotherapy efficacy has been increasingly studied; however, comparisons between oral and intestinal flora remain limited. Given the oral microbiome’s role in systemic inflammation and immune modulation, it may significantly influence cancer progression and response to immunotherapy. This study aimed to identify the microbial changes in urothelial carcinoma (UC) by analyzing oral saliva and stool samples from healthy individuals and UC patients. We also examined the association between microbial composition and immune checkpoint inhibitor (ICI) response.MethodsA total of 20 healthy individuals and 38 patients with UC were analyzed. Among them, 27 patients with UC underwent ICI treatment. Oral saliva and stool samples were analyzed for 16S rRNA sequences to assess bacterial composition. Operational taxonomic units were generated, and phylogenetic analysis was performed using the Illumina BaseSpace.ResultsPatients with UC showed higher Veillonellaceae and Prevotellaceae levels in saliva and stool, with lower levels of these bacteria associated with more prolonged overall survival and progression-free survival, particularly Veillonellaceae in stool. A higher neutrophil-to-lymphocyte ratio correlated with increased levels of these bacteria.ConclusionVeillonellaceae and Prevotellaceae are potential microbial biomarkers of survival outcomes and ICI efficacy in patients with UC. Non-invasive oral microbial sampling may facilitate personalized cancer treatment strategies.

ABSTRACTLocomotive syndrome is a decline in mobility and is believed to occur before the occurrence of frailty and sarcopenia; therefore, early detection of risk factors is important. However, systematic reviews have not been conducted. A systematic review of observational studies was performed to identify risk factors for the development or progression of locomotive syndrome. We searched the electronic databases of MEDLINE, Scopus, Web of Science, Ichushi Web (in Japanese), and Cumulative Index to Nursing and Allied Health Literature. Studies that used the development or progression of locomotive syndrome as an outcome and were written in English or Japanese were included. However, studies with nonadult participants and review articles were excluded. The quality of the eligible studies was evaluated using the Cochrane risk-of-bias instrument. This study included 79 observational studies (8 cohort and 71 cross-sectional studies). A meta-analysis was not performed. All studies were conducted in Japan. The eight cohort studies included 2,343 participants aged 57.0–79.3 years upon study initiation. The risk factors for developing locomotive syndrome were objectively assessed by parameters of motor function and muscle strength, such as short one-leg standing time and weak grip strength. The progression of locomotive syndrome was associated with the preoperative risk stage of locomotive syndrome and postoperative surgical failure syndrome. Locomotive syndrome can be detected through the regular assessment of motor function and muscle strength. To prevent locomotive syndrome in middle-aged and older people, an examination by an expert is necessary.

Life support robots in care settings must be able to read a person's emotions from facial expressions to achieve empathic communication. This study aims to determine the degree of agreement between Multi-task Cascaded Convolutional Neural Networks (MTCNN) results and human subjective emotion analysis as a function to be installed in this type of robot. Forty university students talked with PALRO robot for 10 minutes. Thirteen area of interest videos were used to assess the validity identified by MTCNN was facial expression was happy or combination of happy and other emotions. Twenty university students and 20 medical professionals identified which of the 7 emotions (angry, disgust, fear, happy, sad, surprise, neutral) were present. Fleiss' kappa coefficient was calculated. Kappa coefficients of the emotion analysis for seven emotions ranged from 0.21 to 0.28. Kappa coefficient for "Happy" was the highest (0.52 to 0.57) with moderate agreement. Among female university students, only "Surprise" had a moderate agreement with Fleiss' kappa coefficient of 0.48. MTCNN emotion analysis and human emotion analysis were in moderate agreement for the identification of "Happy" emotions. The comparison of the agreement between the results of emotion analysis from facial expressions using non-contact MTCNN and subjective human facial expression analysis suggested that the use of MTCNN may be effective in understanding subjects' happy feelings. J. Med. Invest. 72 : 93-101, February, 2025.

The prevalence of locomotive syndrome naturally increases with age, but approximately half of nonelderly individuals also meet the criteria for locomotive syndrome, suggesting that even younger people need to pay attention to their own health status. Sleep is important for physical, cognitive, and psychological health. Some individuals with poor sleep quality may be at risk of developing negative health status. Although the effects of sleep hygiene strategies for elderly individuals have been well investigated, optimal nonpharmacological sleep hygiene strategies for improving sleep quality in nonelderly individuals has not been identified. We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials aimed to elucidate the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals and to identify the optimal intervention. Cochrane Central Register of Controlled Trials, Medline, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, and Scopus were comprehensively searched. We identified 27 studies focusing on the effects of various nonpharmacological sleep hygiene strategies in nonelderly individuals, and 24 studies were applied into NMA. The present results showed that resistance training was the most effective intervention for improving sleep quality in nonelderly individuals. In addition, this study revealed the effects of nonpharmacological interventions, such as physical activity, nutritional intervention, as well as exercise interventions. This is the first report that utilized NMA to compare the effects of various nonpharmacological interventions on sleep quality in nonelderly individuals.

Benign lymphoid polyps of the rectum, also termed "Rectal tonsil" or "Pseudolymphoma," are submucosal tumor-like growths with localized hyperplasia of the lymphoid follicles and are often discovered incidentally during colonoscopy. Its diagnosis and differentiation from other submucosal tumors pose challenges owing to their similar endoscopic features. A 72-year-old woman presented with a positive fecal occult blood test, which led to the discovery of a 10-mm lower rectal tumor resembling a neuroendocrine tumor during colonoscopy. Upon closer examination, the lesion had a yellow submucosal appearance with dilated capillaries. Endoscopic submucosal resection with a ligation device (ESMR-L) was performed because the patient preferred immediate removal. Histopathological examination revealed lymphocytic infiltration with germinal center-containing lymphoid follicles, confirming the diagnosis of benign lymphoid polyp. Benign lymphoid polyps are often difficult to differentiate from carcinoid tumors and malignant lymphomas because the endoscopic findings are similar. Although preoperative endoscopic ultrasonography aids localization and characterization, definitive differentiation remains elusive and necessitates complete lesion resection. ESMR-L is a viable approach for diagnostic accuracy and therapeutic intervention, offering advantages in terms of procedural efficiency and patient care, particularly in cases involving submucosal rectal lesions.