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Seven species of puffers of the genus Takifugu caught in Japanese waters were examined for monogeneans on the gills. Five new species of Heterobothrium (H. gotoin. sp. from T. porphyreus, H. tabetain. sp. from T. vermicularis, H. aljufailiaen. sp. and H. iwatain. sp. from T. snyderi, H. matsubarain. sp. from T. stictonotus) and two known species (H. praeorchis Bychowsky, Mamaev & Nagibina, 1976 from T. pardalis, T. chrysops and T. flavipterus and H. bychowskyi Ogawa, 1991 from T. flavipterus) were found and described. Heterobothrium tetrodonis of Iwata (1991) was synonymized with H. bychowskyi. Currently, a total of 11 species of Heterobothrium, including the seven species in this study, were recorded from nine species of Japanese Takifugu spp. Ten species excluding H. praeorchis were found from a single host species, suggesting that they are highly host-specific and have co-evolved with the host Takifugu spp. Tagia Sproston, 1946 is synonymized with Heterobothrium. Earlier divergence of Heterobothrium of tetraodontid puffers in Diclidophoridae was suggested by the large subunit ribosomal DNA (rDNA) analyses, and interspecific relationships in this genus inferred from the internal transcribed spacer region of rDNA well corresponded to those inferred from their morphology and adhesive mode to the gills. Including the five new species and synonymization of Tagia with Heterobothrium, the genus Heterobothrium now comprises 19 species.

Perkinsus olseni is an industrially significant protozoan parasite of Manila clam, Ruditapes philippinarum. So far, various media, based on Dulbecco's Modified Eagle Medium and Ham's F-12 nutrient mixture with supplementation of fetal bovine serum (FBS), have been developed to proliferate the parasitizing trophozoite stage of P. olseni. The present study showed that P. olseni did not proliferate in FBS-deficient Perkinsus broth medium (PBMΔF), but proliferated well in PBMΔF supplemented with tissue extract of host Manila clams, indicating that FBS and Manila clam tissue contained molecule(s) required for P. olseni proliferation. Preliminary characterization suggested that the host-derived molecule(s) was a heat-stable molecule(s) with a molecular weight of less than 3 kDa, and finally a single molecule required for the proliferation was purified by high-performance liquid chromatography processes. High-resolution electrospray ionization mass spectrometry and nuclear magnetic resonance analyses identified this molecule as glycine betaine (=trimethylglycine), and the requirement of this molecule for P. olsseni proliferation was confirmed by an assay using chemically synthesized, standard glycine betaine. Although glycine betaine was required for the proliferation of all examined Perkinsus species, supplementation of glycine betaine precursors, such as choline and betaine aldehyde, enhanced the proliferation of 4 Perkinsus species (P. marinus, P. chesapeaki, P. mediterraneus and P. honshuensis), but not of 2 others (P. olseni and P. beihaiensis). Thus, it was concluded that the ability to biosynthesise glycine betaine from its precursors varied among Perkinsus species, and that P. olseni and P. beihaiensis lack the ability required to biosynthesize glycine betaine for proliferation.

Background To reduce the physical burden of caregivers, wearable transfer support robots are highly desirable. Although these robots are reportedly effective for specific tasks in experimental environments, there is little information about their effectiveness at nursing care facilities. The aim of this study was to identify care tasks and operations suitable for the use of these robots among caregivers in nursing facilities where these robots have been in use on a daily basis. Methods A 1-min observational time-motion analysis was conducted to examine care tasks and operations in two nursing facilities where wearable transfer support robots, namely Muscle Suit or HAL® Lumbar Type for Care Support, have been used routinely on a daily basis for more than 24 months. Results Analysis of the care tasks and their time ratio while wearing the equipment revealed that both robots were used conspicuously for direct care in over 70% of transits, especially during transfer assistance and toileting care. Furthermore, these robots were used intensively in the morning along with wake-up calls to care recipients, where pre-assigned wearers used them as part of their “routine work.” Conclusions We found that these wearable transfer support robots enabled effective performance of care tasks and operations in nursing facilities where these robots have been used on a daily basis for an extended period of time. These results may lead to the effective implementation and sustained operation of other types of care robots in the future. Trial registration UMIN Clinical Trials Registry no. UMIN000039204 . Trial registration date: January 21, 2020. Interventional study. Parallel, non-randomized, single blinded.

The Kumamoto oyster, Crassostrea sikamea, is a marine bivalve naturally distributed along the coasts of southern China and southern Japan, with a hatchery population that has been under domestication in the United States since its introduction from Japan in the 1940s. To understand its evolutionary history and environmental adaptation, we produced a chromosome‐level genome assembly of C. sikamea and conducted whole‐genome resequencing of 141 individuals from the US hatchery population and six wild populations from China and Japan. The assembled genome of C. sikamea has a size of 616 Mb covering all 10 chromosomes with a contig N50 of 4.21 Mb and a scaffold N50 of 62.25 Mb. Phylogenetic analysis indicated that C. sikamea diverged from the Crassostrea angulata and Crassostrea gigas clade about 9.9 million years ago. Synteny analysis revealed significant chromosomal rearrangements during bivalve evolution leading to oysters, but remarkable conservation of all 10 oyster chromosomes over ~180 million years, a surprising disparity in chromosomal evolution. Phylogenetic analysis produced three distinct clusters for the US, Japanese, and Chinese populations, with the US population closer to the Japanese population, confirming its origin. No differentiation was detected among the five Chinese populations, indicating strong gene flow. Between the US and Japan populations, 402 genes exhibited selection signals, including three myosin heavy chain genes that were also differentiated in domesticated lines of the eastern oyster, suggesting changes in these genes may be important for domestic production. Among the 768 genes showing selection signals between natural populations of Japan and China, genes related to stress response are most enriched, suggesting responding to environmental stress is critical for local adaptation. These findings provide insights into bivalve evolution and environmental adaptation, as well as useful resources for comparative genomics and genetic improvement of cultured Kumamoto oyster stocks.

Home-based rehabilitation involves professional rehabilitation care and guidance offered by physical, occupational, and speech therapists to patients in their homes to help them recuperate in a familiar living environment. The effects on the patient's motor function and activities of daily living (ADLs), and caregiver burden for community-dwelling patients are well-documented; however, little is known about the immediate benefits in patients discharged from the hospital. Therefore, we examined the effects of continuous home-based rehabilitation immediately after discharge to patients who received intensive rehabilitation during hospitalization. We retrospectively reviewed 150 patients [mean (standard deviation, SD) = 81 (9) years] discharged from the convalescent rehabilitation and community-based integrated care wards undergoing tailored home-based rehabilitation for 6 months (provided by physical or occupational therapists: 1-2 sessions of 40-60 min each per week). The outcome measures at baseline and after 3 and 6 months were compared. The participants included in this study had orthopedic (n = 76), cerebrovascular (n = 50), neuromuscular (n = 11), cardiovascular (n = 5), respiratory (n = 3), cancer (n = 3) and other diseases (n = 2). The mean (SD) time from discharge to the start of rehabilitation was 4 (4) days. One-way analysis of variance and post-hoc comparisons showed significant improvements at 3 months from baseline in grip strength (p = 0.002), 5-repetition sit-to-stand test (p < 0.001), Standing test for Imbalance and Disequilibrium test (p = 0.025), Functional Independence Measure (p < 0.001), modified Frenchay Activities Index (p < 0.001). Additionally, a statistically significant improvement was observed in the Japanese Zarit Caregiver Burden Interview score at 6 months from baseline (p < 0.001). Home-based rehabilitation improves motor function, ADLs, and instrumental ADLs even after intensive inpatient rehabilitation and decreases the burden of the caregiver in the long term. Hence, tailored home-based rehabilitation should be continuously implemented after the completion of intensive inpatient rehabilitation.

Background The introduction of nursing care-support devices using robotic technology is expected to reduce the task burden in long-term care facilities. Objective To investigate the use of the rise-assisting robot, Resyone, in extending and improving the life space of nursing home residents with severe care needs. Methods We performed a feasibility study in which Resyone was used to facilitate visits to additional sites in and around the nursing home as part of the care package of three residents. Two weeks before and four weeks after implementation of the new arrangements, the 30 caregivers involved were asked to record transfer times and destinations, while also checking the residents’ facial expressions. Results Before implementation, participants had limited life spaces, but afterwards they regularly visited additional destinations including the garden, home entrance and corridors, which previously they had not visited frequently. The residents' facial expressions became more positive and less negative. This study demonstrates that Resyone can enrich care activities in severely disabled individuals. Conclusion These findings suggest that the sustainable use of Resyone would improve the quality of care at care facilities. Moreover, the extension of otherwise limited life space has the potential to improve care receivers’ quality of life. Trial registration UMIN Clinical Trials Registry No. UMIN000039204 (20/01/2020); retrospectively registered; interventional study; parallel, non-randomized, single blinded. URL of trial registry records: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000044709 .

PurposeWe prospectively evaluated the 90-day postoperative mortality and morbidity of open radical cystectomy by using a standardized reporting methodology. Additionally, we assessed the preoperative characteristics to determine risk factors for major complications.MethodsThis multicenter prospective study included 185 consecutive patients undergoing open radical cystectomy from October 2010 through March 2014. Postoperative complications within 90 days were recorded and graded according to the modified Clavien–Dindo classification.ResultsTotally, 328 postoperative complications were observed in 149 patients (80.5%). Of these events, 73 (22.2%) were high grade (≥ Grade III), and developed in 46 patients (24.9%). Three patients (1.6%) died postoperatively. Urinary tract infection, wound complications, and paralytic ileus were common complications that occurred in 55 (29.7%), 42 (22.7%) and 41 (22.2%) patients, respectively. Ureteroenteric stricture was diagnosed in 13 of the 151 patients (8.6%) undergoing intestinal urinary diversion. Emergency room visits were required for 13 patients (7.0%) and readmission after discharge was needed for 36 (19.5%). A body mass index ≥ 25 kg/m2, smoking history and Charlson Comorbidity Index ≥ 2 were independent risk factors for high-grade complications, and their odds ratios (95% confidence intervals) were 2.357 (1.123–4.948), 2.843 (1.225–6.596) and 3.025 (1.390–6.596), respectively.ConclusionsOpen radical cystectomy is associated with a high incidence of postoperative complications. Most, however, are of low grade. Our results suggest that obesity, a smoking history, and increasing comorbidity are risk factors for major complications.

Neoheterobothrium chilense González, Oliva & Acuña, 2002 is redescribed based on newly collected specimens from the type host, Hippoglossina macrops and type locality (Coquimbo, Northern Chile). Type specimens of Neoheterobothrium hippoglossini Piasecki, Wierzbicka & Kempter, 2000 and Choricotyle exilis Crane, 1972 are also redescribed. These three diclidophorid monogeneans infecting pleuronectiform flatfishes have pre-ovarian seminal receptacle, ootype inside the semicircle of ovary and elongated pharynx, differentiated from the most similar Orbocotyle Euzet & Suriano, 1975 in that members of the latter genus possess post-ovarian seminal receptacle, post-ovarian ootype and cylindrical or pyriform pharynx. Paraheterobothriumn. g. is proposed for P. chilensen. comb. (type), P. hippoglossinin. comb., P. exilisn. comb., P. papillosumn. comb. and P. syaciin. comb. A redescription of Neoheterobothrium affine (Linton, 1898), the type species of the genus, based on voucher specimens confirmed differences from the new genus in the presence of lamellate plate in the anterior jaw of clamps, absence of seminal receptacle and ovoid pharynx. The genus Neoheterobothrium was emended and N. cynoscioni (MacCallum, 1917) and N. mcdonaldi Payne, 1987 were removed from the genus. Neoheterobothrium now comprises N. affine (type), N. insulare Oliva & Luque, 1995, N. hirame Ogawa, 1999, and N. paralichthyi Suriano & Labriola, 1999, all of them parasites of flatfishes of the genus Paralichthys. Molecular analyses with the internal transcribed spacer 1 distinguished the clade for Paraheterobothrium spp. (P. chilensen. comb. and P. papillosumn. comb.) and Neoheterobothrium spp. (N. hirame, N. affine and N. paralichthyi), supporting this taxonomic emendation.

IntroductionWe evaluated the incidence and risk factors for antiresorptive agent-related osteonecrosis of the jaw (ARONJ) in prostate and kidney cancer patients. Materials and methodsWe retrospectively reviewed the clinical data of 547 patients from 13 hospitals. Prostate and kidney cancer patients with bone metastases who were treated with a bone-modifying agent (BMA) between January 2012 and February 2019 were enrolled. Exclusion criteria were BMA use for hypercalcemia, a lack of clinical data, a follow-up period of less than 28 days and a lack of evaluation by dentists before BMA administration. The diagnosis and staging of ARONJ were done by dentists.ResultsTwo-hundred eighteen patients were finally enrolled in the study, including 168 prostate cancer patients and 50 kidney cancer patients. Of them, 49 (29%) prostate cancer patients and 18 (36%) kidney cancer patients needed tooth extraction prior to BMA initiation. The mean follow-up period after BMA initiation was 552.9 ± 424.7 days (mean ± SD). In the cohort, 23% of the patients were diagnosed with ARONJ in the follow-up period. The 1-year cumulative incidences of ARONJ were 9.4% and 15.4% in prostate and kidney cancer patients, respectively. Multivariate analysis indicated that kidney cancer, tooth extraction before BMA and a body mass index (BMI) ≥ 25 kg/m2 were significant predictors for ARONJ.ConclusionARONJ is not a rare adverse event in urological malignancies. Especially, kidney cancer, high BMI patients and who needed tooth extraction before BMA were high risk for developing ARONJ.

During a survey of myxosporean parasites of marine fish in the coastal region of Vietnam, a species of the genus Henneguya (Myxosporea: Bivalvulida) was found in the gill of yellowfin seabream Acanthopagrus latus (Perciformes: Sparidae). White and oval cysts, measuring 145–220 μm in diameter, were detected in the gill lamellae of 4 of 15 fish examined (26.7%). Mature myxospores were elongate, with smooth valves, two similar polar capsules, and having the following dimensions: spore body length 9.9 ± 0.5 (8.9–12.5) μm, body width 6.7 ± 0.3 (6.1–7.6) μm, thickness 5.1 ± 0.2 (4.8–5.4) μm, caudal appendage length 10.0 ± 1 (8.3–11.6) μm, and total myxospore length 19.3 ± 1.4 (16.5–21.5) μm. The polar capsules were ovoid, measuring 3.2 ± 0.2 (2.8–3.9) μm long and 1.9 ± 0.2 (1.5–2.3) μm wide. Each polar capsule has a polar filament with 4–5 coils. Histological analysis revealed plasmodia in the connective tissues of the gill lamellae, but inflammation and deformation of the gills were not observed. In the phylogenetic tree reconstructed from the small subunit ribosomal DNA (SSU rDNA), sequences of the Henneguya specimens found in this study form a distinct branch. Morphological characteristics and molecular data identified a new species, namely Henneguya lata n. sp.