Sound levels in the operating theatre resulting from hammering during cementless total hip arthroplasty.

Background: Although hearing loss in orthopaedic surgeons from exposure to hammering sounds have been previously reported, there are no reports on the noise environment during total hip arthroplasty (THA) in Japan. The aim of this study was to investigate the sound level generated by cementless THA in Japan, and to discuss the broader sound environment within this space.

Methods: 94 cementless THAs (94 patients with informed consent) performed by four surgeons were included.

Serum B-cell maturation antigen could be a simple and accurate biomarker to identify and prognosticate monoclonal gammopathy of undetermined significance and smoldering multiple myeloma.

Not available.

Genome Analysis of Japanese Yersinia pseudotuberculosis Strains Isolated From Kawasaki Disease Patients and Other Sources and Their Phylogenetic Positions in the Global Y. pseudotuberculosis Population.

Yersinia pseudotuberculosis (Ypt) is a gram-negative bacterium that infects both humans and animals primarily through fecal‒oral transmission. While Ypt causes acute gastroenteritis in humans, an association with Kawasaki disease (KD), a disease that primarily affects infants and young children and causes multisystemic vasculitis, has also been suspected. Although KD represents a significant health concern worldwide, the highest annual incidence rate is reported in Japan.

Enhancing quality of care for older adults: The age-friendly health system (4Ms framework) and the role of general medicine physicians as system-based complexologists.

The aging population presents critical challenges to global healthcare systems, with Japan expected to have 35% of its population aged 65 or older by 2040. Older adults often experience multimorbidity, cognitive impairments, and physical frailties, increasing healthcare utilization and costs. Traditional medical approaches that focus on organ-specific diagnoses are insufficient for addressing these multifaceted needs.

Diagnostic Techniques for Posterior Cutaneous Nerve Entrapment Syndrome.

This case report highlights the diagnostic process for posterior cutaneous nerve entrapment syndrome (POCNES) in an older adult female patient, with an emphasis on using video demonstrations to guide clinicians. POCNES should be diagnosed based on a combination of specific clinical features, including localized back pain accompanied by pinpoint tenderness lateral to the spinous process, cutaneous sensory abnormalities over the area of pain, severe pain response to pressure on the tender point, and normal clinical and imaging findings. This case demonstrates how these criteria were identified via a thorough physical examination captured on video to provide a visual guide for clinicians.

Unique gel-like colony forming bacterium sp. nov., isolated from a membrane bioreactor (MBR) treating sewage.

A novel, gelatinous, colony-forming, rod-shaped bacterial strain, designated IK01 was isolated from biofilms formed on the membrane surface of a sewage-treating membrane bioreactor (MBR). Strain IK01 produced gelatinous and almost transparent colonies at lower medium concentrations. Fourier transform infrared analysis of the gelatinous colony matrix showed that the matrix could be a biofilm substance.

Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study.

Background: Lower gastrointestinal perforation (LGP) is an acute abdominal condition associated with a high mortality rate. Timely and accurate diagnosis is crucial. Nevertheless, a diagnostic delay has been estimated to occur in approximately one-third of the cases, and the factors contributing to this delay are yet to be clearly understood.

The Simplest Method for Fishhook Removal: The String-Yank Technique.

Fishing is a popular recreational activity worldwide, but complications arise when fishhooks become embedded in the skin. Barbed hooks, due to their design, are particularly challenging to remove. While many individuals attempt self-extraction, some present to emergency departments for medical intervention.

Evaluation of an optimal agar medium for detecting hypervirulent Klebsiella pneumoniae using string test.

The string test is a screening method for detecting hypervirulent (hvKp). Agar media are used for string tests; however, the effect of the type of media on the test results remains unclear. We aimed to determine the optimal agar medium and cutoff value for the string test.

A Questionnaire Study of Leadership in General Medicine: General Physicians in Japan are Facing Challenges in Education and Research.

Purpose: General physicians are required to demonstrate diverse leadership skills depending on their environment. It is essential for them to understand the characteristics of the medical institutions to which they belong and put this understanding into practice. Leadership skills are acquired through experience and training, and their acquisition is a goal in various medical training programs.

The relation between resident mentorship and in-training examination scores: A nation-wide, cross-sectional study in Japan.

Background: Mentorship is a dynamic reciprocal relationship, wherein a novice (mentee) grows with the encouragement of an advanced careerist (mentor). It is widely implemented in medical training programs. However, there are few reports on mentorship's educational effects in the Japanese context.

Endogenous Cushing's Syndrome Due to Right Adrenal Adenoma Presenting With Bilateral Leg Oedema and Skin Ulceration.

Cushing's syndrome (CS) is a rare disorder characterized by an excess of glucocorticoids, leading to distinctive clinical manifestations. However, its presentation can be atypical, complicating diagnosis. We describe a 53-year-old woman's case of endogenous, adrenocorticotropic hormone (ACTH)-independent CS, presenting with bilateral leg edema and shin ulceration, without the classic signs of moon face or truncal obesity initially.

Decarbonizing the global steel industry in a resource-constrained future-a systems perspective.

Decarbonizing the global steel industry hinges on three key limited resources: geological carbon storage, zero-emission electricity and end-of-life scrap. Existing system analysis calls for an accelerated expansion of the supply of these resources to meet the assumed ever-increasing steel demand. In this study, we propose a different view on how to decarbonize the global steel industry, based on the principle that resource supply can only expand in line with historical trends and actual construction plans.

Effectiveness of pulse methylprednisolone in patients with non-human immunodeficiency virus pneumocystis pneumonia: a multicentre, retrospective registry-based cohort study.

Background: A recent database study and meta-analysis reported that adjunctive glucocorticoid therapy reduces mortality in patients with non-human immunodeficiency virus-associated (non-HIV) Pneumocystis jirovecii pneumonia (PCP), having hypoxemia. However, the optimal glucocorticoid dose remains unclear. Our study aimed to evaluate the effectiveness of pulse methylprednisolone compared with mild-to-moderate steroid doses in patients with non-HIV PCP.

Aerobic-anaerobic DHS reactor for enhancing denitrification in municipal wastewater treatment.

Providing anaerobic environments can enhance the denitrification capacity of wastewater treatment systems. This study developed an aerobic-anaerobic downflow hanging sponge (DHS) reactor to increase denitrification. A siphon tube was integrated with a conventional DHS to create anaerobic conditions by controlling a water column inside the reactor.

Soluble B-cell maturation antigen levels for disease monitoring in oligosecretory and nonsecretory relapsed multiple myeloma.

Soluble B-cell maturation antigen (sBCMA) is overexpressed on multiple myeloma (MM) cells. We investigated whether sBCMA levels correlated with other myeloma tumor volume indicators and its utility in monitoring oligo-secretory/non-secretory (O-S/Non-S) MM. In 115 patients with newly diagnosed MM, sBCMA was compared with M-protein levels, bone marrow plasma cells (BMPCs), circulating tumor cells (CTCs), and total diffusion volume (tDV; estimated by whole-body diffusion-weighted magnetic resonance imaging) at diagnosis.

Weak hammering sounds are associated with postoperative subsidence in cementless total hip arthroplasty.

Purpose: The aim of this study was to investigate the relationship between the hammering sound level and the presence of postoperative subsidence.

Methods: The last five hammering sounds during the final-size broaching procedure and during the real stem insertion were recorded and analysed in 95 patients who were operated on by one of seven surgeons using two implants (Trident cup, Accolade II, Stryker; G7 cup, Taperloc Complete Microplasty Stem, Zimmer Biomet). The maximum peak was semi-automatically identified and analysed to determine the maximum C-weighted sound pressure level (LCpeak) of each of the five hammering sounds and the equivalent continuous A-weighted sound pressure (LAeq) of the entire five-sound hammering procedure.

How can we help doctors stay in rural areas of Japan? A comparison in medical students' attitudes toward general practice and clinical research of a medical school in Japan and in Sweden.

Objective: In Sweden, primary healthcare centers play an important role in the performance of general practice, education, and clinical research. In Japan, general physicians or general practitioners are expected to be more active in the small-scale hospitals and clinics in rural areas. This study aimed to explore the differences in attitudes toward general practice and clinical research among medical students in Japan and Sweden to present solutions to help doctors stay in rural areas of Japan.

Application of Biofloc-Down flow hanging sponge system to remove nitrogen components in recirculating zero water exchange aquaculture system.

This study presents a novel approach to sustainable aquaculture by integrating biofloc technology (BFT) with a compact down-flow hanging sponge (DHS) reactor. The integrated BFT-DHS system effectively removed nitrogen compounds while maintaining ammonia-nitrogen (NH-N) concentrations below 1 mg-N L without water exchange. Application of this system in a tank bred with juvenile Oreochromis niloticus showed a high NH-N removal rate of up to 97 % and nitrite (NO -N) concentrations were maintained at 0.

Integration of down-flow hanging sponge reactor to - aquaponics system.

Aquaponics is a promising solution for addressing food security concerns. Nonetheless, an effective water-purification system is necessary to achieve high and stable yields of fish and vegetables. This study aimed to evaluate the nitrification and oxygen transfer performance of a laboratory-scale down-flow hanging sponge (DHS) reactor with aquaponics system to treat water in an closed-aquaculture system.

Combination of a membrane bioreactor with a rotating biological contactor holding several diverse metazoans can reduce excess sludge with fouling mitigation.

In a membrane bioreactor (MBR) system, in situ sludge reduction techniques induce membrane fouling. To address this challenge, we incorporated a rotating mesh carrier, which can adsorb organic matter and provide a habitat for metazoans, into the anoxic tank of a conventional anoxic/oxic-MBR (A/O-MBR) system, termed rotating biological contactor-MBR (RBC-MBR), and evaluated treatment performance. Over 151 days, lab-scale RBC-MBR and A/O-MBR were used to treat municipal sewage.