Objective According to a survey conducted by the Japanese Ministry of Health, Labor and Welfare in 2002, 72% of workers feel fatigued, clearly indicating the degree to which the Japanese populace is affected by this problem. However, few scientifically proven anti-fatigue devices have been developed for the benefit of the Japanese society. An automated air massage chair provides soft stimulation with air bags, not spot stimulation with knead balls, over the muscle surface with movements that push the muscles upward. In the present study, using established methods to evaluate fatigue, we investigated the effect of this automated air massage chair on fatigue in healthy volunteers.
Method Ten healthy subjects participated in a randomized two-way crossover trial. As fatigue-inducing desk work, subjects performed 8 sets of a 30-min Uchida-Kraepelin psychodiagnostic test and 30-min advanced trail making test (ATMT) during the test day. Subjects rested 15 min on the air massage chair or control chair 4 times: immediately before and at 4, 6 and 8 hours after the start of the workload. We evaluated the subjective feeling of fatigue by visual analogue scale, work performance by ATMT, and analyzed underlying mechanisms by biochemical parameters in saliva and urine.
Result Stimulation by air massage chair alleviated the subjective sensation of fatigue and suppressed the decline in work performance. Furthermore, increase in salivary amylase activity and decrease in urine homovanillic acid/creatinine ratio was suppressed.
Conclusion Automated air massage chair attenuated fatigue induced by desk work, most likely by correcting the imbalance in the autonomic nervous system. The air massage chair is thus recommended for relieving fatigue induced by work and daily activities.

The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as grade 1 (strong) or grade 2 (weak) according to the concepts of the grading of recommendations assessment, development, and evaluation system. The 31 CQs covered the six topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, and (6) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.

BACKGROUND: The burden of dementia is growing rapidly and has become a medical and social problem in Japan. Prospective cohort studies have been considered an effective methodology to clarify the risk factors and the etiology of dementia. We aimed to perform a large-scale dementia cohort study to elucidate environmental and genetic risk factors for dementia, as well as their interaction. METHODS: The Japan Prospective Studies Collaboration for Aging and Dementia (JPSC-AD) is a multisite, population-based prospective cohort study of dementia, which was designed to enroll approximately 10,000 community-dwelling residents aged 65 years or older from 8 sites in Japan and to follow them up prospectively for at least 5 years. Baseline exposure data, including lifestyles, medical information, diets, physical activities, blood pressure, cognitive function, blood test, brain magnetic resonance imaging (MRI), and DNA samples, were collected with a pre-specified protocol and standardized measurement methods. The primary outcome was the development of dementia and its subtypes. The diagnosis of dementia was adjudicated by an endpoint adjudication committee using standard criteria and clinical information according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd Revised Edition. For brain MRI, three-dimensional acquisition of T1-weighted images was performed. Individual participant data were pooled for data analyses. RESULTS: The baseline survey was conducted from 2016 to 2018. The follow-up surveys are ongoing. A total of 11,410 individuals aged 65 years or older participated in the study. The mean age was 74.4 years, and 41.9% were male. The prevalence of dementia at baseline was 8.5% in overall participants. However, it was 16.4% among three sites where additional home visit and/or nursing home visit surveys were performed. Approximately two-thirds of dementia cases at baseline were Alzheimer's disease. CONCLUSIONS The prospective cohort data from the JPSC-AD will provide valuable insights regarding the risk factors and etiology of dementia as well as for the development of predictive models and diagnostic markers for the future onset of dementia. The findings of this study will improve our understanding of dementia and provide helpful information to establish effective preventive strategies for dementia in Japan.
Aged ; Alzheimer Disease/genetics* ; Dementia/genetics* ; Environment ; Female ; Humans ; Incidence ; Japan/epidemiology* ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Risk Factors