5 Background: The role of bursectomy dissecting the peritoneal lining covering the pancreas and the anterior plane of the transverse mesocolon for preventing peritoneal metastasis had long been controversial. We conducted a phase III trial evaluating the role of bursectomy in patients with subserosal (SS) / serosal (SE) gastric cancer. Patient accrual had been completed on Mar. 2015. Methods: Eligibility criteria included histologically proven adenocarcinoma of the stomach; cT3(SS) or cT4a(SE). Patients were intraoperatively randomized to non-bursectomy arm or bursectomy arm. Primary endpoint was overall survival. A total of 1,200 patients were required to detect a hazard ratio of 0.77 with a one-sided alpha of 5% and 80% power. Results: Between Jun 2010 and Mar 2015, 1,204 patients were accrued from 57 institutions (non-bursectomy 602, bursectomy 602). Patients’ background and operative procedures were well balanced between the arms. After completion of patient enrollment, the second interim analysis was performed on Sep 2016, with 54% (196/363) of the expected events observed. The 3y-survival were 86.0% (95%CI, 82.7 to 88.7) in non-bursectomy arm and 83.3% (95%CI, 79.6 to 86.3) in bursectomy arm. Hazard ratio for bursectomy was 1.075 (98.5%CI: 0.760 to 1.520) with predictive probability in favor of bursectomy at the final analysis of 12.7%. These results led to early study termination based on the recommendation of the Data and Safety Monitoring Committee. Operation time was longer (median 222 min vs 254 min) and blood loss was larger (230 ml vs 330 ml) in bursectomy arm; however, the incidence of patients received blood transfusion was not different between the arms (4.8% vs 4.5%). Although the incidence of pancreatic fistula was a bit higher in bursectomy arm (2.5% vs 4.8%), the incidence of Grade 3 or higher complications was not different between the arms (11.6% vs 13.3%). Five patients in non-bursectomy arm and one patient in bursectomy showed in-hospital death. Conclusions: Although bursectomy can be safely performed without increasing morbidity and mortality, bursectomy was not recommended as a standard treatment for cT3 or cT4 gastric cancer. Clinical trial information: UMIN000003688.

Background Toe grip-related training requires individuals to actively exercise muscles that are not frequently used; therefore, it may improve not only toe grip strength but also cognitive function. The purpose of this study was to examine the effects of toe grip-related training on predictors of physical performance and cognitive function in nursing home residents. Methods A total of 35 nursing home residents (35 left and 35 right feet; mean age, 82.1 ± 7.9 years) were included in this study. The participants were divided into two groups: a training group and a control group. The Mini-Mental State Examination (MMSE) was used to assess the cognitive function of the participants, and the Fall Risk Index (FRI) was used to evaluate the risk of falls. Toe grip-related physical function was also assessed. Baseline endpoints were evaluated and the effects of toe grip-related training were examined following a 12-week training intervention. Results The training group showed significant improvements in MMSE score, FRI score, toe grip strength, and the toe skill (TS) test; however, the control group did not show these changes. The training group showed significant increases in Δ MMSE, Δ toe grip strength, and Δ TS (right foot) than the control group. Stepwise regression analysis revealed that Δ toe grip strength is an independent factor of Δ MMSE. Conclusions Toe grip training improves not only toe grip strength itself, but also cognitive function. Furthermore, change in toe grip strength was an independent factor of change in MMSE in those populations. Trial registration UMIN, UMIN000027437 . Registered on 26 May 2017.

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The present study aimed to examine the effects of brain function check and training tools on cognitive function and behavior modification in 59 community-dwelling people. Cognitive function was evaluated using CogEvo Ri, and the cognitive training was one month of free access to CogEvo personal. In addition, we evaluated a questionnaire survey on mood profiles, quality of life, fatigue, physical activity and behavioral changes. Orientation, recent memory, planning and working memory were significantly improved after cognitive training. Moreover, cognitive training significantly improved mood profile and fatigue.Stepwise regression analysis revealed age, cognitive function at baseline and the total usage of CogEvo personal as an independent predictor of change in average accuracy rate of cognitive function. In conclusion, it was suggested that the use of CogEvo contributed to interest in the need to prevent dementia and the development of new behavior.

We aim to develop earphone type wearable devices for measuring occlusal force. In this article, we investigated the correlation between occlusal force and the movement of the ear canal as a basic study to estimate the occlusion force. The proposed estimation method uses the least squares method and the weighted average. We developed an experimental device for simultaneously measuring occlusal force and the movement of the ear canal. This device primarily consists of an occlusal force sensor and a wearable ear sensor, and converts analog signals from both sensors into digital signals using an analog‐to‐digital (AD) converter, then records the data as signals associated with measurement time. The experiment involved six subjects, who performed chewing of the occlusal force sensor five times, for 2 seconds. The occlusal force sensor was placed at the right second molar, with the wearable ear sensor placed on the right ear. Through the experiment, the occlusion and the ear canal movement were found to have a strong correlation. The average correlation coefficients consistently exceeded 0.89 for all subjects.