Background  The Kenya Medical Research Institute (KEMRI) is a national institution (state corporation of the Kenyan government) that conducts human health research in Kenya. The institute is important in the East African region. During the COVID-19 pandemic, KEMRI played a major role in conducting half of the PCR testing in Kenya.  In response to the excessive burden on researchers during the COVID-19 pandemic, to improve support to researchers, KEMRI decided to conduct internal training to develop skills in research management and administration (RMA) for mainly administrative staff, to strengthen collaboration between researchers and administrative staff.Planning, implementation, and evaluation of the RMA Training  From July 2023 to January 2024, in cooperation with Kyoto University and Japan International Cooperation Agency (JICA), a series of internal RMA training courses on the basic knowledge required for RMA staff was planned and conducted for the first time at KEMRI. As part of the training, Kyoto University’s practices were learned, and the “KEMRI RMA Process Mapping” workshop was held to make these processes easier to visualize for researchers by having the training participants compile the organization’s rules and regulations of KEMRI that were difficult to understand for researchers.   This paper describes KEMRI’s first internal RMA training in planning, implementation, and evaluation through group discussions.Conclusion  KEMRI conducted its first internal RMA training, which incorporated a combination of lectures and workshops. The training evaluation revealed that participants developed a more comprehensive understanding of the RMA-related work and enhanced their comprehension of the researchers’ work. The training participants began to utilize the learning of RMA-related specialized knowledge and organizational management related to the work for research support. The communication between RMA-related departments and between RMA staff and researchers was enhanced, and behavioral changes towards cross-departmental collaboration were observed. KEMRI is planning to revise its personnel and organizational regulations and strengthen internal training, including the RMA training.

Tokito is not only used to treat chest and abdominal pain caused by cold, but also acts as a qi-tonifying formula. In this report, we describe three cases of painless abdominal distention treated with tokito. Case 1 was a 53-year-old woman who complained of abdominal coldness and abdominal distension. Case 2 was a 48-year-old woman who complained of abdominal distention that had been bothering her for many years. Case 3 was a 57-year-old woman who complained of a stuffy chest and abdominal distention. All three patients experienced abdominal distention as well as coldness and easy fatigability. Therefore, we thought that the patients were suffering from abdominal distention due to depression unaccompanied by pain, and administered tokito to them. After one month of treatment with tokito, the abdominal distention was alleviated, and with continuous treatment, it improved in all cases. In addition to abdominal distention, the patients’ complaints of coldness and fatigability were also alleviated. Therefore, tokito may be effective in treating abdominal distention due to qi depression unaccompanied by pain.

This study aimed to explore, identify, and classify the strengths of elderly individuals living in rural areas from their own perspectives, using an asset-based approach. A qualitative analysis was conducted through group interviews. The study included two groups of four elderly individuals who resided in District D of Area C, City B, Prefecture A, and three groups of five to six elderly individuals from District E in the same city. As a result, 133 key items related to the strengths of elderly individuals were identified. These items were further classified into 39 subcategories, which were grouped into three major categories: individuals (personal strengths), associations (organizations/groups), and institutions (environments/resources that support strengths). Specifically, 18 subcategories were classified into the individuals category, 11 into the associations category, and 10 into the institutions category. These findings revealed that elderly individuals in rural areas actively take on various roles within their communities, utilizing their rural environment both as individuals and as part of a group. The rural setting itself was found to significantly influence their engagement, while intergenerational support and assistance from public institutions also played a crucial role. In the future, we aim to utilize these “strengths of elderly individuals” to develop strategies that empower community residents to lead vibrant, active, and secure lives in their familiar environments.

Objective: To clarify the progression of core flexibility and core muscle strength in fresh lumbar spondylolysis before and after the introduction of rehabilitation treatment. Methods: We enrolled 160 patients diagnosed with fresh lumbar spondylolysis based on magnetic resonance imaging findings from September 2019 to December 2022. Posterior Lumbar Flexibility test and Lumbar Locked Rotation test were performed to assess core flexibility. The Kraus-Weber test and Sahrmann Core Stability test were performed to assess core muscle strength. The initial and final evaluations of all tests were compared.Results: All tests showed significant improvement at the final evaluation compared to the initial evaluation.Conclusion: Patients with lumbar spondylolysis often had decreased core flexibility and core muscle strength at the initial evaluation; these parameters improved at the final evaluation owing to rehabilitation treatment.

Skeletal muscle fatigue is defined as muscle force depression following exercise or repeated contractions that mimic exercise. Oxidative stress, caused by excessive production of reactive oxygen species (ROS), has long been thought to contribute to muscle fatigue after acute exercise. However, recent studies on antioxidant treatments have suggested little impacts of oxidative stress on muscle fatigue. This review examines the chemical properties of various ROS, their source, their effects on the contractile mechanism, and their production during muscle fatigue. Based on these, this review discusses cellular mechanisms behind the limited ROS influence on muscle fatigue, with a focus on the primary ROS produced during exercise such as superoxide, hydrogen peroxide and hydroxyl radical. These ROS have been shown to exert both positive and negative effects on muscle force. Therefore, the limited effectiveness of antioxidants is thought to be due to their capacity to suppress not only the negative effects but also the positive effects of ROS. This antioxidant effect provides an important insight into the relationship between oxidative stress and muscle force. Previous studies suggest that the low levels of ROS can enhance muscle force, whereas higher levels impair it, which is referred to here as the “invert U” relationship. Developing this concept further, I proposed a hypothesis that the relationship between oxidative stress and muscle force can be divided into two phases: in phase 1, the positive and negative effects of ROS balance out, resulting in minimal impact on muscle force, while oxidative stress dramatically decreases force in phase 2 which occurs under more sever condition.

The Japan Primary Care Association (JPCA) and Royal College of General Practitioners (RCGP) exchange program aims to provide young family physicians with an international perspective and networking opportunities. The project was planned and presented at the 2024 JPCA and RCGP annual conferences, and site visits were conducted to enhance mutual understanding. The outcomes are summarized in this report.

We report a case of persistent pain in a 21-year-old male patient, which responded well to yokukansan and keishikaryukotsuboreito, after biopsy surgery performed 5 years ago. Chronic postsurgical pain (CPSP) is a condition in which pain persists even after the surgical wound has healed, significantly affecting the patient’s daily life and mental state. Our patient was diagnosed with fibrous osteodysplasia based on a biopsy of the sacral region, but his postoperative pain persisted and became chronic. The patient’s activities of daily living (ADL) significantly declined, and he was unable to maintain a normal school life. Simultaneous treatment with shigyakusan, keishibukuryogankayokuinin, tramadol hydrochloride, and acetaminophen was started, and the medication was repeatedly changed. His quality of life notably improved with yokukansan and keishikaryukotsuboreito. In recent years, there have been many reports of the use of yokukansan for chronic pain, and the results of our case suggest that the addition of the anxiolytic and analgesic effects of keishikaryukotsuboreito is effective for intractable chronic pain.

According to a WHO report, more than 80% of the world’s population uses traditional medicine in 170 out of the 194 UN member states. With this background, WHO established the WHO Global Traditional Medicine Centre (GTMC) in Gujarat, India in April 2022. Then, in August 2023, the first WHO Traditional Medicine Global Summit was held in Gandhinagar, Gujarat, India. The Gujarat Declaration was issued as a summary of the summit. This was the first WHO-issued declaration specifically focused on traditional medicine. Based on the G20 vision of “One Earth, One Family, One Future,” a grand vision was presented to utilize the wisdom of traditional medicine for the sustainable society, including planetary health, against the global warming. Furthermore, it was emphasized that scientific evidence for traditional medicine, including indigenous medicine, should be promoted. Following this, several projects have been launched.

Background: Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. Methods: The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. Results: The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.095). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. Conclusion To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.