Abstract PurposeTo clarify the predictors of dural tear (DT) through a prospective cohort study with a low dropout rate. Methods In this prospective multicenter cohort study in Japan, a registry was established to collect information about patients undergoing spinal surgery between July 1, 2020 and June 30, 2021 at 10 hospitals. Clinical features, laboratory data, and operative factors were collected from the database. Risk factors were analyzed by comparing DT and non-DT groups. ResultsA total of 1,698 patients were enrolled. There were 74 cases with unintended DTs (4.4%; DT group) and 1624 cases without DTs (non-DT group). Multivariate analysis revealed that age, rheumatoid arthritis, non-attending surgeon as the operator, and creatinine kinase were significant risk factors for DTs. Conclusions The incidence of DTs in spinal surgery was 4.4%, and identified risk factors were age, rheumatoid arthritis, non-attending surgeon as the operator, and creatinine kinase.

The lactate dehydrogenase-to-albumin ratio (LAR) has been reported as a potential prognostic biomarker in various cancers; however, only a few pieces of information have been reported on esophageal cancer. Therefore, this study aimed to evaluate the prognostic significance of preoperative LAR in patients with esophageal cancer. This study included 236 patients (193 men and 43 women; mean age of 66 years [range, 41-83 years]) with esophageal cancer who underwent curative surgery between September 2008 and March 2020. A total of 107 patients underwent upfront surgery, and 129 patients received neoadjuvant treatment. Patients were assigned into two groups, high and low LAR, based on preoperative LAR using a cutoff value of 6.2. The clinicopathological and prognostic significance of preoperative LAR was evaluated in univariate and multivariate analyses. Patients with deep tumors and neoadjuvant treatment were significantly associated with high LAR (p <0.05). The high LAR group showed a significantly poorer prognosis than the low LAR group (p <0.01). The multivariate analysis for the overall survival showed that deep tumors, lymph node metastasis, and high LAR were independent poor prognostic factors (p <0.05). High LAR was a useful poor prognostic biomarker in patients with esophageal cancer.

Flat-flexible shoes with unique characteristics, such as low pitch and flexibility, can increase the efficiency of ankle energy and running performance. If flat-flexible shoes have the same effect during walking, they could be used for gait training. This study aimed to investigate the effects of flat-flexible shoes on the kinematics and kinetics of the lower limb. Twenty-one healthy young adults (21.8 ± 4.6 years) participated in this study. The participants wore flat-flexible and standard athletic shoes with reflective markers attached according to the Plug-in-Gait model. Walking motion was recorded using infrared cameras and a treadmill embedded with force plates. The angle(s), moment(s), and power(s) of the ankle, knee, and hip joints were calculated. Paired t-test and Wilcoxon’s signed-rank test were used to compare the parameters between the two footwear types. The use of flat-flexible shoes increased maximum ankle dorsiflexion and knee flexion angles. The maximum ankle plantar flexion angle was significantly reduced. There was no significant difference in the joint moment between the two footwear types. The peaks of ankle power absorption in late stance, ankle power generation, and hip power generation significantly increased with the use of flat-flexible shoes. These results suggest that flat-flexible shoes have potential as a tool to promote ankle energy storage and release during gait.

This study examined the effects of positive social-comparative feedback on learners’ intrinsic motivation on a motor learning task, as well as its association with learners’ competitiveness. The participants, who performed a balance task in a positive social-comparative feedback and a control group, were assessed for performance outcome, perceived competence, and competitiveness. The positive social-comparative feedback group demonstrated more effective balance performance than the control group on the retention test. In addition, the participants in the positive social-comparative feedback group reported significantly higher perceived competence than the participants in the control group after practice. Further, a subscale of learners’ competitiveness—instrumental competitiveness—predicted the performance on a retention test in the positive social-comparative feedback group, but not in the control group. Our results suggest that positive social-comparative feedback is not beneficial to all learners, and may even be less effective for learners with lower competitiveness.

Background: Although various technologies are used to evaluate driving skill, there are some limitations such as the limited range of the monitor and the possible risk of causing cybersickness. The purpose of this study is to investigate differences in the hazard perception and cybersickness experienced between novice and experienced drivers measured in a VR hazard perception test with a head-mounted display (HMD). Methods: The novice (n = 32) and the experienced drivers (n = 36) participated in the hazard perception test through the VR of an HMD. Results: The total number of identified hazards was 1071 in the novice drivers and 1376 in the experienced drivers. Two of the hazards appeared to be only identifiable through the HMD. A chi-square test revealed that experienced drivers were more likely to identify the hazards than the novice drivers (p &lt; 0.05). The novice drivers appeared to identify “hazard prediction of the current behavior of other road users” more than other hazard types, unlike the experienced group. The Simulator Sickness Questionnaire scores indicated no significant difference in the different age or gender groups (p &gt; 0.05). Conclusion: Our results suggest that the VR hazard perception test may be useful for evaluating patients’ driving skills.

ABSTRACT Objective This study aimed to examine the effects of a six-month group-based low-intensity resistance exercise program on depression and the cognitive function of hemodialysis patients. Method We conducted a quasi-cluster randomized, open-label controlled study from October 2017 to December 2018. Forty-two patients undergoing hemodialysis completed the trial over six months; half participated in the resistance exercise group (n = 21, mean = 74.90 years of age, SD = 2.23, 66.67% female) and the other half were in a stretching control group (n = 21, mean = 72.57 years of age, SD = 2.26, 28.57% female). Depressive symptoms and cognitive function were the primary outcome measures. Behavioral and psychological problems associated with cognitive decline (NPI-Q), subjective insomnia, and exercise self-efficacy were secondary outcomes. Outcomes were measured at baseline, three-month (mid-intervention), six-month (end of intervention), and 12-month (six months after intervention) follow-ups. Linear mixed model analyses were used to determine short-term (immediately after intervention) and long-term (six months after intervention) effects. Results In depression, cognitive function, and the NPI-Q, there were no significant effects. In subjective insomnia, a short-term group-by-time interaction in the intervention group compared to the control group was found (ES = .43). However, the effect had disappeared by the 12-month follow-up. In exercise self-efficacy, short- and long-term group-by-time interactions were found. A significant short-term increase in the resistance exercise and a significant decrease in the stretching control was observed (ES = -.83). However, the effect was weakened in the long term (ES = -.38). Conclusion The results showed that low-intensity group resistance exercise would reduce subjective insomnia and improve exercise self-efficacy, but the effect was not maintained by six months after the program. Trial registration: This study was registered on the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029372). Trial registration: UMIN Japan identifier: UMIN000029372.