東北福祉大学

The hypothalamus is a central regulator of neuroendocrine function and social behavior, yet its internal organization has remained difficult to examine in vivo in human neurodevelopmental research. Based on neuroendocrine models, we hypothesized that anterior hypothalamic subunits enriched in magnocellular neurosecretory nuclei—approximating the paraventricular (PVN) and supraoptic (SON) regions—form a structurally coherent axis linked to dimensional traits associated with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). To test this hypothesis, we applied a convolutional neural network–based automated segmentation framework to high-resolution T1-weighted MRI data from a non-clinical adult sample (n = 23), enabling volumetric quantification of ten hypothalamic subunits. After adjustment for biological sex, age, and total intracranial volume, PVN- and SON-associated volumes showed a significant positive structural covariance (r = 0.51, p = 0.022), consistent with a coherent anterior magnocellular-rich network. Reduced SON-associated volume was significantly associated with higher autistic traits (Autism-Spectrum Quotient: r = − 0.45, p = 0.046) and greater ADHD symptom severity (CAARS: r = − 0.59, p = 0.006). Bootstrapped path analyses (5,000 iterations) further supported this network organization, revealing a robust association between PVN- and SON-associated volumes (β = 0.51, p = 0.013) and a significant indirect association between PVN-associated volume and ADHD symptoms via SON-associated volume (β = − 0.29, p = 0.006), with a marginal indirect association observed for autistic traits. Together, these preliminary findings provide in vivo evidence linking anterior hypothalamic structure to dimensional neurodevelopmental traits and highlight a potential neuroendocrine pathway relevant to psychiatric vulnerability.

Objective: To assess the correlation between lifelong learning for physical therapists and regional differences in the provision of rehabilitation services. Materials and Methods: We conducted an ecological study using open data from the 2019 National Database of Health Insurance Claims and Specific Health Checkups. We investigated claims for disease-specific rehabilitation. The standardized claims ratio (SCR) for each of the 47 prefectures was calculated to evaluate regional differences. We also examined the number of certified physical therapists (CPTs) and specialist physical therapists (SPTs) in each prefecture certified by the Japan Physical Therapy Association across specialty fields. Population-adjusted therapist density was expressed per 100,000. Prefecture-level correlations between the SCR for each disease-specific rehabilitation program and therapist density were evaluated using Spearman's rank correlation. Multiple tests were performed using Storey's q-value method. Results: The SCRs for disease-specific rehabilitation showed regional variation. The SCR for respiratory rehabilitation had the largest range (32.2-192.5). The population-adjusted numbers of CPTs and SPTs ranged from 3.9-14.7 and 0.4-6.9 per 100,000 population, respectively. The SCR for cardiovascular rehabilitation was positively correlated with the CPT field, "orthopedic disorders" (ρ=0.54, q<0.01) and the SPT field, "orthopedic physical therapy" (ρ=0.45, q<0.05). The cerebrovascular rehabilitation SCR was positively correlated with the CPT field, "prevention for frail elderly" (ρ=0.45, q<0.05). Conclusion: Japanese prefectures with greater densities of CPTs or SPTs delivered higher volumes of rehabilitation services. Our findings suggest that the unequal distribution of postgraduate educational opportunities and certified personnel may contribute to these regional differences. Strengthening access to lifelong learning and specialty certifications in underserved regions may help reduce geographic disparities in rehabilitation services.

Background The coronavirus disease 2019 (COVID‐19) pandemic has disrupted healthcare and public health systems, even in Japan’s universal healthcare context, where administrative coordination and voluntary compliance are central to infection control. Difficulties, including delayed health observations and mismatched isolation arrangements, may have shaped individuals’ emotional memories of their illnesses. We aimed to identify the factors associated with distressing memories of COVID‐19 among adults in Japan. Methods In August 2022, a nationwide cross‐sectional web‐based survey was conducted among 956 adults who experienced COVID‐19 between January 2020 and August 2022. The participants provided information on their demographics, illness characteristics, isolation settings, and post‐COVID sequelae. Distressing illness memories were measured using a six‐item original scale based on cognitive appraisal theory (Cronbach’s α = 0.87). Multiple regression analysis examined the associations between distress scores and demographic, clinical, and contextual variables. Results On a total score of 6–24 points, higher distress scores were associated with younger age ( B = −0.06 per year, 95% CI −0.08 to −0.04), female sex ( B = 0.48, 0.22–0.75), coresidence with older adults ( B = 0.58, 0.27–0.90), risk factors for severe illness ( B = 1.07, 0.74–1.41), severe acute symptoms ( B = 0.27, 0.003–0.54), current post‐COVID sequelae ( B = 1.37, 0.88–1.87), and nonpreferred isolation setting ( B = 1.17, 0.65–1.69). Conversely, prompt health observation from public health centers or clinics was associated with lower distress ( B = −0.43, −0.80 to −0.06). Conclusions Distressing memories of COVID‐19 were associated with physical and contextual factors, including timeliness of the initial public health contact, persistent sequelae, and a mismatch between preferred and actual isolation settings. Early and consistent follow‐ups by health authorities, attention to individual isolation preferences, and integrated psychosocial care may help reduce distress and foster recovery during future public health emergencies.

Crisis planning based on stated treatment preferences should not be judged by trials that never verified delivery infrastructure. Lessons from UK joint crisis plans and advance choice documents (ACDs) suggest outcomes depend on facilitation, accessibility, specificity and exception governance. Japan should test ACDs as measurable crisis-care infrastructure, not paperwork.