[Pedunculated Giant Condyloma Acuminatum of the Scrotum].

The patient was a 71-year-old male whose chief complaint was a scrotum mass. The mass had gradually increased in size without any associated symptoms. The physical examination revealed a pedunculated, radish brown, and elastic soft tumor (4. 5×3. 5×3. 0 cm) in the right scrotum. Blood chemical analysis of HbA1c and squamous carcinoma antigen were 8. 3% and 38. 4 ng/ml (≦1. 5), respectively. This tumor was successfully treated with surgical resection. Histopathological examination showed condyloma acuminatum without malignant findings. Giant condyloma acuminatum commonly affects the genital and perianal areas. An immunocompromised state generally exists in the background of the patients.

Network analysis to estimate central insomnia symptoms among daytime workers at-risk for insomnia.

Although insomnia complaints are associated with mental health problems and reduced work productivity, the central insomnia symptoms in workers at-risk for insomnia remain unclear. This study aimed to identify the central insomnia symptoms among daytime workers at risk for insomnia. The participants were 881 Japanese daytime workers at-risk for insomnia with a mean age of 49.33 ± 9.92 years. At-risk for insomnia was defined as an Athens Insomnia Scale score of six or higher. The Athens Insomnia Scale was used as a screening for at-risk insomnia because it has higher sensitivity and specificity than other insomnia screening scales. The Insomnia Severity Index is recommended as a mechanism of insomnia and an outcome measure; therefore, a network analysis was conducted with the seven items of the Insomnia Severity Index. The important variables in the connections between insomnia symptoms were estimated from centrality indices, which were interpretable only for strength. The strength value results suggest that difficulty staying asleep and worry about sleep problems were the central insomnia symptoms. The connections were stronger for difficulty staying asleep and problem waking up too early, difficulty staying asleep and difficulty falling asleep, and interference with daytime functions and noticeable to others. Worry about sleep problems was strongly associated with variables other than nocturnal insomnia symptoms. Therefore, difficulty staying asleep and worry about sleep problems are important variables in daytime workers at-risk for insomnia and are key points for improvement or exacerbation of insomnia symptoms.

Population­based prostate­specific antigen screening for prostate cancer may have an indirect effect on early detection through opportunistic testing in Kusatsu City, Shiga, Japan.

Prostate cancer is the most common genitourinary cancer in men. Population-based serum prostate-specific antigen (PSA) testing is used to screen men for the early detection of asymptomatic prostate cancer. The present study compared the features of patients with prostate cancer in Kusatsu City, the only municipality in Shiga Prefecture of Japan to implement organized PSA screening, with those in other municipalities. The target population for organized PSA screening by mail invitation was men ≥50 years. Patients were pathologically diagnosed via prostate biopsy because of elevated serum PSA. This multicenter observational study was subsequently conducted in 14 hospitals. The following information was extracted from patient records: age, reason for PSA testing, initial PSA level, Gleason score, clinical stage, and place of residence. Risk classification was defined as low, intermediate, high, and advanced. Each patient was stratified according to their city/town. A total of 984 patients diagnosed with prostate cancer in Shiga in 2012 and 2017 were analyzed, of which 955 (97%) were opportunistically tested, with the remaining 29 (3%) assessed by organized screening. In Kusatsu, 93 patients were diagnosed, of whom 26 (28%) were detected by organized screening. By contrast, only three of 891 patients (0.3%) were detected by organized screening in other municipalities. Of patients in Kusatsu, cases identified by opportunistic testing had a higher initial PSA value (P=0.010) than those identified by organized screening. However, patients detected through opportunistic testing in Kusatsu City were younger (P=0.034), had a lower PSA value (P=0.001), and improved risk classification (P<0.001) than those in other municipalities. It was concluded that more patients were diagnosed with early-stage cancer by organized PSA screening. Furthermore, population-based PSA screening in Kusatsu City may have indirectly affected early detection, even by opportunistic testing.

Association between insomnia severity and presenteeism among Japanese daytime workers.

Presenteeism is the loss of productivity due to a worker's health problems, despite the worker being present at the workplace. Although the association between presenteeism and insomnia complaints is well known, few studies have examined the association between insomnia severity and presenteeism. This study aimed to explore the association between insomnia severity and presenteeism. This study included 1925 participants (1543 males, 379 females, and three of other genders) in total. The mean age of the participants was 49.94 ± 9.82 years. The inclusion criteria were full-time employment, working 8 hr per day and 5 days per week, and having no night shifts. The insomnia severity was classified based on the Insomnia Severity Index and Athens Insomnia Scale criteria. Logistic regression analysis showed that moderate and severe insomnia severity were associated to a greater magnitude with presenteeism than mild insomnia severity. Severe insomnia severity was associated to a greater magnitude with presenteeism than moderate insomnia severity. In summary, logistic regression analysis showed that increased insomnia severity based on Insomnia Severity Index classification was associated with increased odds of presenteeism, but increased insomnia severity based on Athens Insomnia Scale classification was not fully consistent with increased odds of presenteeism. Because increased insomnia severity is associated with worsening of presenteeism, early detection of and early intervention against insomnia complaints are important for reducing presenteeism. This study was the first to examine the associations between presenteeism and insomnia severity classification of no insomnia, mild, moderate, and severe insomnia severity.

Validation of the Japanese Big Five Scale Short Form in a University Student Sample.

The Japanese Big Five Scale Short Form (JBFS-SF), a 29-item self-report scale, has recently been used to measure the Big Five personality traits. However, the scale lacks psychometric validation. This study examined the validity and reliability of the JBFS-SF with data collected from 1,626 Japanese university students participating in a randomized controlled clinical trial. Structural validity was tested with exploratory and confirmatory factor analysis and measurement invariance tests were conducted across sex. Internal consistency was evaluated with McDonald's omega. Additionally, construct validity was estimated across factors using the PHQ-9, GAD-7, AQ-J-10, and SSQ. EFA results showed that the JBFS-SF can be classified according to the expected five-factor structure, while three items had small loadings. Therefore, we dropped these three items and tested the reliability and validity of the 26-item version. CFA results found that a 26-item JBFS-FS has adequate structural validity (GFI = 0.907, AGFI = 0.886, CFI = 0.907, and RMSEA = 0.057). The omega of each factor was 0.74-0.85. Each JBFS-SF factor was specifically correlated with the PHQ-9, GAD-7, and SSQ. This research has shown that the JBFS-SF can be a clinically useful measure for assessing personality characteristics.

Impact of sleep debt, social jetlag, and insomnia symptoms on presenteeism and psychological distress of workers in Japan: a cross-sectional study.

BACKGROUND: Presenteeism is an indicator of productivity loss and the risk of absence from work due to mental health problems. The purpose of this study was to determine the impact of sleep debt, social jetlag, and insomnia symptoms on presenteeism and psychological distress. METHODS: The participants were 351 Japanese workers (271 males, 79 females, and one of other gender, with a mean age of 49 ± 9.49 years). The eligibility criteria for this study were full-time employment, working eight hours per day, five days per week, and no night shifts. The participants answered questionnaires measuring sleep debt, social jetlag, insomnia symptoms, presenteeism, and psychological distress. RESULTS: Insomnia symptoms had the greatest impact on presenteeism and psychological distress when compared with sleep debt and social jetlag (adjusted odds ratio (OR) = 5.61, 95% confidence interval (CI) = 2.88-10.91; adjusted OR = 7.29, 95%CI = 3.06-17.35). Sleep debt had a greater impact on presenteeism and psychological distress than did social jetlag (adjusted OR = 1.61, 95%CI = 1.14-2.27; adjusted OR = 1.68, 95%CI = 1.11-2.54), which had no impact on these variables (adjusted OR = 1.04, 95%CI = 0.91-1.20; adjusted OR = 0.96, 95%CI = 0.76-1.22). CONCLUSIONS: The findings of this study indicated that insomnia symptoms had a more significant impact on presenteeism and psychological distress than social jetlag and sleep debt. Although sleep debt might have an independent impact on presenteeism and psychological distress, social jetlag did not.

Unwinding on the Weekend from Work-Related Stress: Moderating Effect of Weekday Psychological Stress on the Relationship between Increased Recovery Experience and Reduction of Psychological Stress on the Weekend.

Recovery is described as a process that is in contrast to the process whereby the psychological stress response increases. Recovery experiences refer to specific experiences that promote recovery and represent psychological attributes including relaxation. This preliminary study tested the hypothesis that levels of psychological stress before the weekend have a moderating effect on the relationship between an increased recovery experience during the weekend and a reduction of psychological stress from workdays to the weekend. Of 270 Japanese teachers who were invited to participate, 181 completed questionnaires on the psychological stress response before, on the psychological stress response and the recovery experience during the weekend. Data from 7 part-time teachers and 38 teachers who were not stressed at all before the weekend were excluded; therefore, data for 136 participants were ultimately analyzed. Results of hierarchal regression analysis indicated that increased relaxation was associated with an increased reduction in psychological stress response during the weekends in participants with high levels of psychological stress before the weekends. This moderating effect was not observed for other recovery experiences. Considering the psychological stress response is important for research on recovery experiences during weekends.

A systematic review of the effect of sleep interventions on presenteeism.

BACKGROUND: Sleep problems interfere with work performance. Decreased work productivity due to health problems is defined as presenteeism. Although empirical data on the improvement of presenteeism by sleep interventions have been published, a systematic review elucidating whether there is a difference in the improvement of presenteeism across various types of sleep interventions has not yet been published. This systematic review of studies aimed to clarify which sleep interventions are more likely to be effective in improving presenteeism. METHODS: The electronic databases PubMed, PsycINFO, and MEDLINE were used to perform a literature search (the start and end search dates were October 20, 2019, and March 11, 2020, respectively). A combination of terms such as "employee*," "sleep," "insomnia," and "presenteeism" was used for the search. Both randomized and non-randomized control trials were included in this systematic review. RESULTS: Six types of sleep interventions were identified, including cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, yoga, mindfulness, weight loss program, and changing the color temperature of fluorescent lights in the workplace. Only CBT-I improved both sleep problems and presenteeism compared with a control group. The results of this review also show that there is heterogeneity in the measurement of presenteeism. CONCLUSIONS: The results of this systematic review suggested that CBT-I could be adapted for workers with sleep problems and presenteeism. We discussed whether CBT-I improved both sleep problems and presenteeism compared with other interventions. In addition, methods for measuring presenteeism in future research are proposed.

Clinical, pathological, and therapeutic features of newly diagnosed prostate cancer predominantly detected by opportunistic PSA screening: A survey of Shiga Prefecture, Japan.

BACKGROUND: In all the prefectures of Japan, with the exception of Shiga Prefecture, more than half of local governments have an organized prostate-specific antigen (PSA) screening system in place. However, in the Shiga Prefecture, only a single city performed PSA screening over the time period of this survey. The purpose of the present study was to determine the clinical, pathological, and therapeutic features of newly diagnosed prostate cancer in localities where a formally organized screening system was almost entirely absent. METHODS: A multicenter observational study was conducted in the Shiga Prefecture, which has the lowest rate of population-based PSA-screening in Japan. Patients' age, initial PSA, reasons for PSA testing, Gleason score, clinical stage, and primary treatments were surveyed. We stratified patients according to the reasons for PSA measurement, and compared the differences between groups subject to organized versus opportunistic screening. RESULTS: In the 2 years 2012 and 2017, 984 newly diagnosed prostate cancer patients were analyzed. Of these, 954 (97%) were opportunistically tested (i.e., not as part of an organized screening system), with the remaining 29 (3%) measured as part of an organized screening program. Patients in the former group exhibited a higher initial PSA value than in the organized screening group (median: 11.49 vs. 5.67 ng/ml). They also had worse clinical features, including higher Gleason score and TNM stage. More patients in the organized screening group were treated curatively than in the nonorganized screening group in terms of the primary treatment. The results were similar in a subanalysis of the patients of age 50-69 years. CONCLUSIONS: Organized PSA screening contributes to increasing the number of patients diagnosed with early-stage cancer who can be treated curatively.

Single Short Retention Instillation of Pirarubicin Prevents Intravesical Recurrence of Low-risk Non Muscle Invasive Bladder Cancer.

BACKGROUND: This study evaluated the efficacy of a single instillation of pirarubicin with a short retention time for preventing intravesical recurrence of low-risk non-muscle-invasive bladder cancer. PATIENTS AND METHODS: We analyzed 165 patients with low-risk non-muscle-invasive bladder cancer who underwent transurethral surgery. Single instillation of pirarubicin with 15-min retention time immediate after surgery was performed in 47 (28%) patients. The other patients (118, 72%) were treated without instillation therapy. The primary endpoint was recurrence-free survival. RESULTS: Median overall follow-up was 50 (range=6-134) months. Recurrence-free survival at 1 and 5 years was 91% and 72%, and 79% and 54% in the group treated with pirarubicin, and that treated with surgery alone, respectively (p=0.031). Cox's hazard analysis revealed lack of instillation and larger tumor size (>10 mm) as significant factors for risk of recurrence. No adverse events regarding intravesical chemotherapy were observed. CONCLUSION: Pirarubicin instillation with 15-min retention time can prevent intravesical recurrence of low-risk bladder tumors.

Development and validation of the Cognitive Behavioural Therapy Skills Scale among college students.

BACKGROUND: There are many different skill components used in cognitive behavioural therapy (CBT). However, there is currently no comprehensive way of measuring these skills in patients. OBJECTIVE: To develop a comprehensive and brief measure of five main CBT skills: self-monitoring, behavioural activation, cognitive restructuring, assertiveness training and problem-solving. METHODS: University students (N=847) who participated in a fully factorial randomised controlled trial of smartphone CBT were assessed with the CBT Skills Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalised Anxiety Disorder-7 (GAD-7) and the short form of the Japanese Big Five Scale. Structural validity was estimated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and internal consistency evaluated with Cronbach's α coefficients. Construct validity was evaluated with the correlations between each factor of the CBT Skills Scale, the PHQ-9, the GAD-7 and the Big Five Scale. FINDINGS: The EFA supported a five-factor solution based on the original instruments assessing each CBT skill component. The CFA showed sufficient goodness-of-fit indices for the five-factor structure. The Cronbach's α of each factor was 0.75-0.81. Each CBT skills factor was specifically correlated to the PHQ-9, GAD-7, and the Big Five Scale. CONCLUSIONS: The CBT Skills Scale has a stable structural validity and internal consistency with a five-factor solution and appropriate content validity concerning the relationship with depression, anxiety and personality. CLINICAL IMPLICATIONS: The CBT Skills Scale will be potential predictor and effect modifier in studying the optimisation of CBT interventions. TRIAL REGISTRATION: CTR-000031307.

A mixed Müllerian cystadenoma presenting as a paraurethral tumor.

•We report the first case of a paraurethral mixed Müllerian cystadenoma.•The cystic lesion was lined by a mixture of three different types of epithelium.•All epithelial cells were positive for estrogen receptor and PAX8.

Relationship between cognitive behavioral variables and mental health status among university students: A meta-analysis.

Cognitive behavioral therapy is an effective treatment for improving mental health problems among university students. However, intervention components have different effects on mental health problems. This paper is a meta-analysis of the data concerning the relationship between cognitive behavioral variables and mental health status among university students. A total of five electronic databases were reviewed, and 876 articles met the initial selection criteria. Reviewers applied standardized coding schemes to extract the correlational relationship between cognitive behavioral variables and mental health status. A total of 55 articles were included in the meta-analysis. Correlations were found for three cognitive behavioral variables (attention, thought, and behavior) across nine mental health domains (negative affect, positive affect, happiness, social function, stress response, psychological symptom, quality of life, well-being, and general health). Across each cognitive behavioral process and all mental health domains, the estimated mean correlation was medium (r = .32 - .46), and varied by the domain of mental health.

Cognitive behavioral therapy for psychosomatic problems in dental settings.

Cognitive behavioral therapy (CBT) has been applied for various problems, including psychiatric diseases such as depression and anxiety, and for physical symptoms such as pain. It has also been applied for dental problems. Although the effect of CBTs on temporomandibular disorders and dental anxiety are well documented, its effectiveness on other types of oral symptoms remain unclear. Little information comparing the different types of CBTs in the dental setting is currently available. Because dental professionals are often expected to conduct CBTs in the dental setting, it is important to develop proper training programs for dental professionals. In this review article, we demonstrate and discuss the application of CBTs for psychosomatic problems, including temporomandibular disorders, dental anxiety, burning mouth syndrome, and other oral complaints in dental settings.

Self-efficacy, pros, and cons as variables associated with adjacent stages of change for regular exercise in Japanese college students.

This study examined self-efficacy (confidence to exercise), pros (exercise's advantages), and cons (exercise's disadvantages) as variables associated across the transtheoretical model's six stages of change in 403 Japanese college students. A series of logistic regression analyses were conducted. Results showed that higher pros and lower cons were associated with being in contemplation compared to precontemplation. Lower cons were associated with being in preparation compared to contemplation. Higher self-efficacy was associated with being in action compared to preparation as well as being in maintenance compared to action. Lower cons were associated with being in termination compared to maintenance.

Validation of the Japanese Version of the Body Vigilance Scale.

The Body Vigilance Scale is a self-report measure of attention to bodily sensations. The measure was translated into Japanese and its reliability, validity, and factor structure were verified. Participants comprised 286 university students (age: 19 ± 1 years). All participants were administered the scale, along with several indices of anxiety (i.e., Anxiety Sensitivity Index, Short Health Anxiety Inventory Illness Likelihood Scale, Social Interaction Anxiety Scale, and Hospital Anxiety and Depression Scale). The Japanese version of the Body Vigilance Scale exhibited a unidimensional factor structure and strong internal consistency. Construct validity was demonstrated by significant correlations with the above measures. Results suggest that the Japanese version of the scale is a reliable, valid tool for measuring body vigilance in Japanese university students.

[The psychological effects of taking in "Shikohin": A cross-sectional exploratory study].

This study explores the psychological effects that Japanese people experience when consuming their "Shikohin", such as alcohol, tea, coffee, and tobacco. We'conducted a cross-sectional study among 542 people, from 20-to 69-year-old; who regularly consumed any one of "Shikohin" in Tokyo, Kanagawa, Saitama, and Chiba. The participants responded to an anonymous questionnaire concerning the consumption patterns of their "Shikohin" and the psychological effects that they experienced in taking in their "Shikohin". Results obtained using the K-J methods showed three common psychological effects in each "Shikohin". These effects included an increase in relaxation response, the promotion of social relationships, and an increase in positive mood. Our findings suggest that Japanese people may get some common effects through consumption of different "Shikohin".

Anger tendency may be associated with duration of illness in panic disorder.

BACKGROUND: Several studies have reported an increased tendency towards anger in patients with panic disorder (PD). If this propensity for anger arises from the pathological process of PD, it may be associated with the duration of the illness. The present study therefore examined the relationship between duration of PD and the personality tendency to experience anger in PD patients. METHODS: Participants were 413 patients (132 men and 281 women; age = 38.7 years) with PD. Diagnoses were confirmed using the Mini-International Neuropsychiatric Interview. Illness duration ranged from less than a year to 51 years. After participants completed the Revised NEO Personality Inventory, we examined the association between illness duration and the Angry Hostility and Impulsiveness subscale scores. In the analysis, participants were divided into two groups by duration of illness (long group, n = 186 and short group, n = 200) using the median value (9 years) as a cut-off because of the skewed distribution of the duration. Patients with an illness duration of 9 years (n = 27) were excluded from the comparison. RESULTS: The duration of illness was significantly correlated with the Angry Hostility score (p = 0.002) after controlling for age. Scores were significantly higher in the long group than in the short group (p = 0.04). No significant association was observed between Impulsiveness scores and duration of illness. CONCLUSION: The present study suggests that longer PD duration is related to a stronger tendency to experience anger.

The effect of cognitive appraisal for stressors on the oral health-related QOL of dry mouth patients.

BACKGROUND: Dry mouth is very common symptom, and psychological factors have an influence on this symptom. Although the influence of emotional factor related to patients with oral dryness has been examined in previous studies, the cognitive factors have not been examined thus far. OBJECTIVE: The purpose of this study was to examine the influence of cognitive factors on patients with oral dryness. METHODS: The participants were 106 patients complaining of oral dryness. They were required to complete a questionnaire measuring subjective oral dryness, oral-related QOL, cognition for stressors, and mood state. RESULTS: Correlational analyses revealed that OHIP-14 is significantly related to oral dryness, appraisal for effect, appraisal for threat, and commitment. These correlations were maintained even after controlling for the influence of depression and anxiety. Using oral dryness, appraisal for effect, appraisal for threat, and commitment, cluster analysis was done and three clusters (cluster-1, severe oral dryness; cluster-2, positive cognitive style: cluster-3, negative cognitive style) were extracted. The results of ANOVA showed that the group with severe oral dryness (cluster-1) had a significantly higher score on OHIP-14 than the other two groups. There was no significant difference between the groups with positive (cluster-2) and negative (cluster-3) cognitive style. CONCLUSION: Although the group of patients with positive cognitive style complained of more severe oral dryness than the group with negative cognitive style, no significant difference was observed between these two groups in OHIP-14. These results indicate that cognitive factors would be a useful therapeutic target for the improvement of the oral-related QOL of patients with oral dryness.

A parental report of children's anxiety symptoms in Japan.

Using parental reports, the current study investigated anxiety symptoms among Japanese children as part of the process of developing the Japanese version of the Spence Children's Anxiety Scale for Parents (SCAS-P). The participants were 677 parents and children aged 9-12 years. Confirmatory factor analysis on 568 parents and children supported that the SCAS-P had a 6-factor structure. The scale showed satisfactory internal consistency and good convergent validity. A MANOVA indicated no significant gender or age differences except for the obsessive-compulsive disorder subscale. Among Japanese children, the most prevalent symptoms within the parental report were items related to fear of the dark and of insects/spiders. Finally, we observed very low correlations between parental and child reports of anxiety symptoms; the relationships between child and parental reports were rather poor among Japanese children. We briefly discuss the utility of the SCAS-P as a screening instrument assessing parental reports of anxiety symptoms.