The use of mouthguards in contact sports effectively prevents oral injury and preserves oral structures. We investigated oral injuries and awareness concerning mouthguards among Japanese high school soccer and rugby players. Athletes were asked a series of questions concerning their history of oral injury while participating in sports, and their pattern of mouthguard use was determined. The data were evaluated statistically using chi-square analysis. The incidence of oral injuries was 32.3% for soccer athletes and 56.5% for rugby athletes, with 0.8% and 24.1% of the respective groups having mouthguards. There were significant differences between the soccer and rugby groups (P < 0.001). Although 81.8% of soccer athletes thought mouthguards were unnecessary, only 26.2% of rugby athletes shared this opinion and there was a significant difference between the soccer and rugby groups. Many soccer athletes had insufficient knowledge about mouthguards and were not concerned about preventing oral injury, although it was in fact a common problem in their sport. Athletes as well as coaches must be made aware of the high risk of oral injury when playing soccer, rugby, and other contact sports.

Psychotic-like experiences are associated with suicidal feelings and deliberate self-harm behaviors in adolescents aged 12-15 years.Objective: Psychotic disorders are a significant risk factor for suicide, especially among young people. Psychotic-like experiences (PLEs) in the general population may share an etiological background with psychotic disorders. Therefore, the present study examined the association between PLEs and risk of suicide in a community sample of adolescents. Method: Psychotic-like experiences, suicidal feelings, and self-harm behaviors were studied using a self-report questionnaire administered to 5073 Japanese adolescents. Depression and anxiety were evaluated using the 12-item General Health Questionnaire (GHQ). Results: The presence of PLEs was significantly associated with suicidal feelings (OR = 3.1, 95% CI = 2.2-4.5) and deliberate selfharm behaviors (OR = 3.1, 95% CI = 2.0-4.8) after controlling for the effects of age, gender, GHQ-12 score, victimization, and substance use. Suicidal feelings and behaviors were more prevalent in subjects with a greater number of PLEs. Conclusion: Psychotic-like experiences may increase the risk of suicidal problems among adolescents. Significant outcomes• Psychotic-like experiences are associated with suicidal feelings and deliberate self-harm behaviors among adolescents aged 12-15 years.• Suicidal feelings and deliberate self-harm behaviors are more prevalent in subjects with a greater number of psychotic-like experiences. Limitations• This is a cross-sectional study and subjects were recruited from public schools.• A self-report questionnaire was used to assess the psychotic-like experiences, suicidal feelings, and self-harm behaviors.• There was a lack of data about confounding factors, such as individual personality and family circumstances.

Background: The incidence of suicide has increased markedly in Japan since 1998. As psychological autopsy is not generally accepted in Japan, surveys of suicide attempts, an established risk factor of suicide, are highly regarded. We have carried out this study to gain insight into the psychiatric aspects of those attempting suicide in Japan.

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Chair-seat height affects the burden on the lowerlimbs during sit-to-stand (STS) movement. Previous studies used the same height chair, attaching importance to practicability, but the difference in each subject's lower thigh length may relate to the burden on the lower-limbs. This study aimed to examine the influence of different lower thigh lengths on floor reaction force and lower-limb strength during an STS movement. Thirty young-adult male subjects participated in this study (age: 22.7Ϯ2.6 yr, height: 172.8Ϯ4.8 cm, bodymass: 66.3Ϯ5.2 kg). The subjects were divided into three groups (G1Ͼ42 cm, 42 cmмG2м38 cm, 38 cmϾG3) based on lower thigh length (G1: 44.1Ϯ2.5 cm, G2: 39.8Ϯ1.3 cm, G3: 34.3Ϯ2.1 cm). Namely, G1 was characterized by lower thigh length longer than 105% of 40 cm, G2 by 95-105% of lower thigh length and G3 by lower thigh length less than 95% of 40 cm, respectively. Subjects performed an STS movement twice from chairs at 40 cm-height and height adjusted by the lower thigh length of each subject. Vertical floor reaction force and electromyogram (EMG) on the rectus femoris and tibialis anterior muscles during an STS movement were measured to evaluate the force of knocking over and the burden on the lower-limbs. Fifteen parameters regarding floor reaction force (10) and EMG (5) were selected for analyses. Significant differences were found in floor reaction force at hip-syneresis (F1) and the impulse between hip-syneresis and appearance of the peak floor reaction force (F2). G1 was greater than G2 for the former, and G3 for the latter. Significant differences were found in active muscle mass of the tibialis anterior from the beginning of an STS movement to hip-syneresis (TE1) and peak active muscle level of the tibialis anterior (TE6). G1 was greater than G2 for the former, and G2 and G3 for the latter. It was suggested that when an STS movement is performed using a chair with the same height for each subject, the load imposed on the subject's leg at the time of an STS movement and the STS movement achievement strategy differed since chair seat height changes relatively by the difference in lower thigh length. Moreover, it is thought that the difference in these load conditions and movement strategies occurs when the chair seat height of a subject's lower thigh length is longer than 110%. When conducting the ability to achieve STS movement rating test, chair seat height considering each subject's lower thigh length may be needed.

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AIMTo demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method.METHODSThis retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips (OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTSThe TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer.CONCLUSIONOTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success.

Japan has one of the highest suicide rates in the world. Suicides numbered 32 863 in 1998 and have exceeded 30 000 in every subsequent year. Education of those involved in general and psychosocial patient care can contribute greatly to suicide prevention. The authors administered a brief knowledge and attitude assessment questionnaire concerning suicide to students in their first, third, and fifth years at a Japanese medical school. Participants numbered 160 (94 men with a mean age of 21.8 years, SD = 3.01, and 66 women with a mean age of 21.2 years, SD = 2.64); 59 first year, 52 third year, and 49 in their fifth year. The questionnaire consists of eight multiple-choice questions asking knowledge of suicide and one open-ended question asking attitude. In the knowledge part, only about half of the items were answered correctly (mean score was 4.21, SD = 1.28). A significant difference was observed in prevalence of attitudes as categorical variables between student years (P = 0.001). Sympathetic comments increased along with student years, while critical comments decreased. Given the frequent and interventional opportunities of primary-care medical contacts, poor understanding of suicide from the medical viewpoint was of concern. Moreover, judgmental attitudes were common, especially in earlier school years. Better informed, more understanding physicians and other health professionals could contribute greatly to prevention.