PURPOSE:To develop and validate Deep24-2C, a machine learning (ML) model that reconstructs comprehensive Humphrey Field Analyzer (HFA) 10-2 visual field (VF) thresholds from HFA 24-2C. DESIGN:A retrospective study. PARTICIPANTS:A total of 3653 HFA 24-2C tests, including 181 actual tests from 136 eyes of 130 patients with glaucoma or suspected glaucoma, and 3472 synthesized tests at the Jikei University School of Medicine were included. Thirty-five actual HFA 24-2C tests from 24 eyes of 21 patients at Tajimi Iwase Eye Clinic were used for pilot external validation. METHODS:The HFA 24-2C testing grid incorporates 10 additional central test points into the conventional 24-2 pattern. Deep24-2C was trained to predict all 68 threshold values of the HFA 10-2 test using subsets of 24-2C points (22-26 within the 10° region) along with age. Three ML architectures-random forest (RF), XGBoost, and multilayer perceptron (MLP)-were developed, and their ensemble combination was evaluated. Model training and internal validation were conducted using the Jikei dataset, while external validation used the Tajimi dataset. Data augmentation was applied using synthesized 24-2C tests, which combined paired HFA 24-2 and 10-2 tests. Model performance was evaluated using mean absolute error (MAE). MAIN OUTCOME MEASURES:Mean absolute error for 10-2 point-wise thresholds and mean deviation. RESULTS:We first trained and validated Deep24-2C using the Jikei dataset. Incorporating synthesized data improved predictive accuracy from MAE 2.52 ± 0.07 dB to 2.42 ± 0.07 dB. Furthermore, models utilizing additional central test points outperformed those based on conventional 24-2 points across all ML architectures (RF, XGBoost, and MLP); the best-performing XGBoost model achieved MAE 2.30 ± 0.01 dB for predicting 10-2 thresholds. Subsequently, we performed external validation on the Tajimi dataset using an ensemble model that combined all models utilizing 10 additional central test points; the ensemble model yielded MAE 1.81 (95% confidence interval [1.69-1.93]) dB. CONCLUSIONS:Deep24-2C enables reconstruction of 10-2 VF thresholds from a 24-2C Swedish Interactive Thresholding Algorithm Faster test. Incorporating additional central points enhances predictive performance compared with conventional 24-2 grids. Deep24-2C may serve as a practical and efficient tool for evaluating central VF defects, reducing testing burden, and supporting individualized glaucoma management. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

OBJECTIVE:To examine associations between occupation and overall and site-specific cancer risk in Japan. METHODS:We conducted a multicenter, hospital-based matched case-control study using the Inpatient Clinico-Occupational Survey of the Rosai Hospital Group (2005-2023), including 146,994 cancer cases and 278,244 matched controls. Conditional logistic regression was used to estimate sex-specific adjusted odds ratios by occupation. RESULTS:Occupational disparities in cancer risk were observed, with more pronounced associations among men than women. Elevated risks were identified in manual and transport-related occupations, whereas lower risks were observed in selected professional occupations. Site-specific patterns varied by cancer type and sex. CONCLUSIONS:Occupation is associated with cancer risk in Japan, showing distinct sex-specific and site-specific patterns. These findings underscore the importance of occupational context in cancer epidemiology and provide a hypothesis-generating framework highlighting behavioral and detection-related factors.

BACKGROUND:Although cancer screening is essential for early detection and an improved prognosis, screening beyond the recommended guidelines may increase the risk of false-positive results. Consequently, educating individuals about the potential harm of non-guideline-based cancer screening is essential; however, effective communication methods remain unclear. OBJECTIVE:This study aimed to evaluate the effectiveness of different types of educational videos in encouraging preferences for guideline-based cancer screening. METHODS:This 3-arm pseudorandomized controlled trial was conducted in June 2025 using a Japanese online survey platform. Eligible respondents were working adults aged 30 to 60 years with no history of major cancer. Respondents were assigned to 1 of the following 3 video conditions: video A, which provided a logical explanation of false-positive risks; video B, which presented the narrative of a woman who received a false-positive result from breast cancer screening; and video C, which depicted a man who underwent unnecessary follow-up testing after tumor marker screening. The primary outcome was the preference for guideline-based cancer screening after watching the videos. The secondary outcomes included 7 self-reported video evaluation items, such as perceived relevance and clarity, assessed using a 5-point Likert scale. Differences in the primary outcome between video groups were analyzed using multivariable logistic regression with adjustment for covariates. Means and 95% CIs were calculated for each secondary outcome according to sex and video group. In addition, before-and-after changes in screening preferences were assessed using McNemar test, with a significance level of .05. RESULTS:In total, 1200 respondents (400 per group) completed the survey. No statistically significant differences in the primary outcome were observed among the video groups. With reference to video A, the adjusted odds ratios for preferring guideline-based screening were 0.89 (95% CI 0.59-1.32) for video B and 0.98 (95% CI 0.65-1.46) for video C. Regarding secondary outcomes, male respondents rated video B less favorably than female respondents in terms of relevance and willingness to undergo guideline-based screening. The before-and-after comparison showed a significant change in preference for guideline-based screening (P=.04). These videos appeared to be more effective for individuals with an annual history of colorectal cancer screening than for those without such a history. CONCLUSIONS:Educational videos have the potential to influence cancer screening preferences; however, no single video format has demonstrated clear superiority. These findings underscore the importance of tailoring educational materials to the target audience characteristics. Further research is required to develop effective strategies for encouraging guideline-based cancer screening. TRIAL REGISTRATION:University Hospital Medical Information Network Clinical Trials Registry UMIN000060549; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000066119.

Public awareness campaigns and testing promotion must be strengthened to eliminate infections with hepatitis B and C viruses (HBV and HCV, respectively) by 2030. Although public health campaigns using various types of advertising are widely conducted, the appropriate channels for viral hepatitis testing remain unclear. To identify web services and digital advertising channels appropriate for promoting HBV and HCV testing, segmented by prior testing history and testing intention. A nationwide cross-sectional online survey of Japanese adults aged 20–69 years was conducted. The respondents answered questions on viral hepatitis testing status, routinely used web services with 180 options, and exposure to digital advertising with 25 choices. Correspondence analysis was used to visualize the associations among the testing segments, web services, and digital advertising. The distinctiveness was quantitatively evaluated. Of the 2000 respondents (1011 men, 989 women), 18.0% (359/2000) reported prior HBV and HCV testing, and 22.1% (441/2000) were unsure whether they had ever been tested. Web services characteristically associated with those who had never been tested but were willing to be tested included Lawson (convenience store) and cosme (cosmetic shopping). The corresponding digital advertising channels included in-store and storefront screens at Welcia (pharmacy chain) and Lawson (convenience store). Segment-specific patterns varied according to age group and sex. In Japan, the convenience store chain Lawson was a distinctively frequent touchpoint, both online and offline, among individuals who wished to undergo viral hepatitis testing. Future studies are needed to determine whether implementing awareness-raising activities through Lawson can lead to an increased uptake of testing and subsequent treatment.

Purpose:Predicting the Humphrey Field Analyzer (HFA) 10-2 visual field (VF) using machine learning (ML) based on IMOvifa 24plus(1-2) VF data. Design:Retrospective cross-sectional study. Participants:Seventy actual IMOvifa 24plus(1-2) tests from 25 patients (The Jikei University School of Medicine) and 3472 synthesized IMOvifa 24plus(1-2) tests from 884 patients who underwent HFA 24-2 and HFA 10-2 VF measurements at 4 affiliated hospitals. Methods:Synthesized 24plus(1-2) data were created by merging 54 points from HFA 24-2 and 24 points from HFA 10-2 tests. An XGBoost model, trained on the synthetic data set, predicted thresholds at the 68 HFA 10-2 test locations. Model performance was assessed on the actual data set using leave-one-out cross-validation. Stratified patient-level bootstrap analyses accounting for multiple tests per patient were used to compare results across 3 glaucoma severity groups (mild, moderate, and advanced) based on HFA 10-2 mean deviation. Four models utilizing different input subsets were evaluated: model 1 (all 78 IMOvifa 24plus[1-2] points), model 2 (54 points of 24-2), model 3 (central 40 points of 24plus[1-2]), and model 4 (central 16 points of 24-2). Test durations were also compared. Main Outcome Measures:Mean absolute error (MAE), root mean squared error (RMSE), and coefficient of determination (R2) between predicted and measured HFA 10-2 sensitivities. Results:Model 1 (all 24plus[1-2] points) achieved the highest overall accuracy (MAE 3.59 dB, RMSE 5.71 dB, R2 0.76), significantly outperforming model 2 (24-2 points; MAE 4.15 dB, RMSE 6.31 dB, R2 0.70) (P < 0.05 for all metrics). Similarly, model 3 significantly outperformed model 4 (P < 0.05). Stratified analysis indicated that adding central test points yielded significant accuracy improvements, consistently across all metrics in the moderate group, whereas results varied by metric in the mild and advanced groups. The IMOvifa 24plus(1-2) test duration (mean 155 seconds) was significantly shorter than the HFA 10-2 Swedish Interactive Thresholding Algorithm Standard test (mean 376 seconds) (P < 0.001). Conclusions:Incorporating the additional central test points from the IMOvifa 24plus(1-2) significantly enhances the accuracy of ML based HFA 10-2 VF prediction. This approach offers an efficient strategy for obtaining detailed central VF information from a single, rapid test, potentially improving glaucoma management. Financial Disclosures:Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

ObjectiveThis study aimed to identify key performance indicators (KPIs) in workplace health promotion (WHP) and their associations with initiative performance, history, and industrial background.MethodsWe conducted a cross-sectional study analyzing descriptions of KPIs from 2679 Japanese companies participating in government-led WHP initiatives. Text-mining techniques were used to categorize the KPIs and examine their association with company rankings, submission history, and industry.ResultsEleven KPIs were identified, including health status, productivity improvement, and recruitment. Productivity improvements and losses were frequently referenced by top-ranked companies, whereas lower-ranked companies and new participants prioritized recruitment and retention, which were commonly discussed in the retail, healthcare, and welfare industries. Mental health was more prevalent in the information, technology, communication, and electrical equipment sectors.ConclusionsThe findings support effective KPI setting in WHP and provide insights to inform dissemination of government-led initiatives.

‘Request for cooperation on measures against viral hepatitis in the workplace’ (the notification) was issued to provide hepatitis screening opportunities in workplaces. However, employees may take hepatitis tests multiple times because the results are not recognised. ‘Negative hepatitis virus test result cards’ (NHVC), designed to certify negative results for hepatitis B virus (HBV) and hepatitis C virus (HCV) tests, were developed to decrease multiple screenings. We aimed to examine the association between word awareness of the notification/NHVC, and hepatitis testing opportunities provided by employers, as well as the knowledge regarding hepatitis and the presence of employees with HBV/HCV infection. An online questionnaire survey was conducted in Japan in March 2024 among executives and human resources personnel. Having or lacking word awareness of the notification/NHVC was defined as responding as ‘know about it/heard of it’ or ‘never heard of it’ to these items. The number of employees with opportunities for hepatitis testing, number of employees with HBV/HCV, and number of correct answers in hepatitis quizzes were assessed. Odds ratios (ORs) and 95

Background:The transtheoretical model (TTM) explains behavior changes through sequential stages influenced by the balance of perceived benefits and barriers. Although previous studies have identified the inhibitors and facilitators of exercise behavior, only a few have elucidated how these factors vary across the stages of behavior change. Objective:This study aimed to identify the inhibitors and facilitators of each stage of behavior change using text mining. Methods:A nationwide cross-sectional study was conducted using an internet-based questionnaire with a panel of approximately 2 million members. From this panel, 93,460 individuals were randomly selected and invited to participate via email and app push notifications. A total of 1500 valid responses were included in the analysis through stratified sampling based on sex, age group, and geographic region. The participants self-assessed their stages of change. Two open-ended questions captured the perceptions of inhibitors and facilitators of exercise behavior. Text responses were analyzed in a 4-step process: morphological analysis to extract frequently used words, correspondence analysis to visualize relationships between frequently used words and the 5 change stages, conceptual categorization with coding rules, and creation of heat maps to illustrate stage-specific categories in inhibitors and facilitators. Results:Out of 1500 respondents, 754 (50.3%) were males and 355 (23.7%) individuals were in the 50-59 age group. Stage percentages were precontemplation 24.3% (365/1500), contemplation 23.5% (352/1500), preparation 21.3% (320/1500), action 5% (75/1500), and maintenance 25.9% (388/1500). The inhibitors and facilitators were described using 9893 words and 8372 words, respectively. Inhibitors clustered into 7 categories; most frequent were time (408/1500, 27.2%), motivation (253/1500, 16.9%), health (189/1500, 12.6%), and working (158/1500, 10.5%). Facilitators formed 8 categories; most frequent were subjectivity (155/1500, 10.3%), relationship (93/1500, 6.2%), opportunity (84/1500, 5.6%), reward (78/1500, 5.2%), and record (78/1500, 5.2%). Stage-specific patterns emerged: inhibitors shifted from motivation and health (precontemplation) to family, time, and working (contemplation and preparation), opportunity (action), and weather and health (maintenance). Facilitators of reward, health, and record rose progressively from precontemplation to maintenance. Conclusions:This study enhances our understanding of the dynamic mechanisms underlying exercise behavior change by identifying how specific inhibitors and facilitators vary across behavioral stages. The findings underscore the need to tailor interventions based on individuals' readiness to change, rather than relying on one-size-fits-all strategies. For both practitioners and policymakers, incorporating behavioral stage frameworks into assessments and interventions, such as those conducted during health checkups or workplace programs, may improve the effectiveness and sustainability of physical activity promotion.

Optical coherence tomography (OCT) is an efficient tool for non-invasively evaluating retinal structures. Retinal thinning changes assessed using OCT are recognized as potential biomarkers for systemic conditions such as Alzheimer's disease, Parkinson's disease, and chronic kidney disease. However, age-related retinal changes remain largely unexplored, complicating the differentiation between physiological and pathological alterations. Here, we introduced a highly granular approach to assess age-related spatial changes in the inner retina using latent retinal archetypes, identifying 36 retinal archetypes of macula and peripapillary sector images from 189,387 OCTs of 22,494 individuals. Subsequently, we evaluated the associations between these archetypes and age; age-related archetypes are characterized by total or superior thinning in the macula sector. Among individuals with myopia, the inferior thinning pattern in the macula ganglion cell-inner plexiform layer was associated with aging. The age-related effects in the peripapillary sector were primarily reflected in the shape of retinal artery trajectories. Overall, latent retinal archetypes would offer new avenues for the effective utilization of retinal biomarkers in age-related diseases.

PURPOSE:To compare the diagnostic accuracy of 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and 10-2 SITA Standard in detecting macular damage in mild-stage glaucoma. DESIGN:Multicenter diagnostic accuracy study based on prospectively collected data. PARTICIPANTS:In total, 108 eyes from 108 patients with mild-stage glaucoma (normal-tension glaucoma, 58; high-tension glaucoma, 50) and 52 eyes from 52 healthy controls at the Jikei University School of Medicine and Tajimi Iwase Eye Clinic. METHODS:Participants underwent 24-2C SITA Faster and 10-2 SITA Standard visual field testing on the same day, in randomized order. OCT with ganglion cell analysis identified macular damage. McNemar test and noninferiority analysis (10% margin) compared detection accuracy. Test durations were compared using pairwise t-tests. MAIN OUTCOME MEASURES:Sensitivity and specificity of 24-2C SITA Faster and 10-2 SITA Standard for detecting macular damage and test duration. RESULTS:For overall macular damage, 24-2C SITA Faster demonstrated sensitivity or specificity of 0.64/0.93 (total deviation [TD]) and 0.67/0.93 (pattern deviation [PD]), while 10-2 SITA Standard demonstrated 0.69/0.94 (TD) and 0.77/0.93 (PD). McNemar test revealed no significant difference, and 24-2C SITA Faster was noninferior within the 10% margin. Subanalysis with a strict 5% margin, revealed that 10-2 SITA Standard was superior to 24-2C SITA Faster when using PD plot for all parameters. The mean test duration was significantly shorter for 24-2C SITA Faster (158.5 seconds) than for 10-2 SITA Standard (330.0 seconds; P < 0.001). CONCLUSIONS:24-2C SITA Faster is a noninferior and more time-efficient alternative to 10-2 SITA Standard for detecting macular damage in mild-stage glaucoma; however, 10-2 SITA Standard may be considered superior for detecting subtle macular defects using PD. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Objectives While there is growing evidence that physical activity reduces the risk of hepatocellular carcinoma (HCC), the impact of occupational physical activity and sedentary behaviour remains unclear. This study aimed to investigate the associations between occupational physical activity and sedentary behaviour and HCC risk.Design Matched case-control study.Setting Nationwide multicentre, hospital-inpatient data set in Japan, from 2005 to 2021.Participants The study included 5625 inpatients diagnosed with HCC and 27 792 matched controls without liver disease or neoplasms. Participants were matched based on sex, age, admission date, and hospital.Primary measures The association between levels of occupational physical activity (low, medium, high) and sedentary time (short, medium, long) with the risk of HCC.Secondary measures Stratification of HCC risk by viral infection status (hepatitis B/C virus), alcohol consumption levels and the presence of metabolic diseases (hypertension, diabetes, dyslipidaemia, obesity).Results High occupational physical activity was not associated with HCC caused by hepatitis B/C virus infection in men. In women, high occupational physical activity was associated with a reduced risk of non-viral HCC, with ORs (95% CIs) of 0.65 (0.45–0.93). Among patients with non-viral HCC, medium occupational physical activity combined with medium alcohol intake further decreased the HCC risk in men with an OR of 0.70 (0.50–0.97), while high occupational physical activity combined with lowest alcohol intake decreased the HCC risk in women with an OR of 0.69 (0.48–0.99). Men and women with medium sedentary time had a lower HCC risk compared with those with long sedentary time, with ORs of 0.88 (0.79–0.98) in men and 0.77 (0.62–0.97) in women, respectively. In patients without viral infection or alcohol use, medium sedentary time reduced the HCC risk associated with fatty liver disease without comorbid metabolic diseases in women.Conclusions High levels of occupational physical activity and/or medium periods of sedentary time are associated with a reduced risk of HCC, particularly non-alcoholic steatohepatitis.

BACKGROUND:This study aimed to identify the occupational class and specific occupations associated with hospitalisations due to alcohol-related liver disease and alcoholic liver cirrhosis, based on the distribution of alcohol consumption. METHODS:This matched case-control study used a nationwide, multicentre, inpatient dataset from the Inpatient Clinico-Occupational Database of the Rosai Hospital Group in Japan. A total of 5,490 cases with alcohol-related liver disease and 10,961 controls were included in this study. Participants were categorised according to occupational class (blue-collar, service, professional, and manager) and industrial sector (blue-collar, service, and white-collar). Professionals in white-collar industries were set as the reference group. We calculated the odds ratios (ORs) and confidence intervals (CIs) of alcohol-related liver disease and alcoholic liver cirrhosis using conditional logistic regression models. RESULTS:Blue-collar workers and service workers in both the service and blue-collar industries had a higher risk of hospitalisations due to alcohol-related liver disease: The ORs (95% CIs) for alcohol-related liver disease were 1.33 (1.15-1.55) for blue-collar workers in the blue-collar industry, 1.21 (1.03-1.42) for service workers in the blue-collar industry, 1.23 (1.01-1.51) for blue-collar workers in the service industry, and 1.47 (1.25-1.72) for service workers in the service industry. Among service workers, food and drink preparatory workers and customer service workers had a higher risk of hospitalisations due to alcohol-related liver disease and alcoholic liver cirrhosis compared to professionals (reference group), with ORs of 2.28 (1.81-2.89) and 2.18 (1.64-2.89), respectively, for alcohol-related liver disease. Among blue-collar workers, skeleton construction workers had a higher risk of hospitalisations due to alcohol-related liver disease, with an OR of 2.31 (1.63-3.3). Workers in occupations with a high risk of hospitalisations due to alcohol-related liver disease had higher percentages of alcohol consumption compared to professionals. CONCLUSIONS:Occupational class and specific jobs were associated with the risk of hospitalisations due to alcohol-related liver disease and alcoholic liver cirrhosis, with alcohol consumption patterns contributing to this increased risk.

This study examined long-term trajectories of liver enzyme levels and their associations with type 2 diabetes risk in Japanese adults. Data were analyzed from 24,380 individuals aged 30-64 years at baseline without type 2 diabetes, comprising 296,171 health check-up records from the Hitachi Cohort Study. Liver enzyme levels, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT), were measured annually. Over a mean follow-up of 12.8 years, 3,840 participants (15.8%) developed type 2 diabetes. Group-based trajectory modeling identified six ALT, three AST, and four GGT trajectory groups. Persistently elevated ALT levels and trajectories with early-adulthood elevation were strongly linked to increased type 2 diabetes risk. The persistently elevated ALT group (Group 6) exhibited an odds ratio (OR) of 7.97 (95% CI: 7.40-8.57), while the early-adulthood elevated group (Group 5) showed an OR of 4.23 (95% CI: 4.00-4.48) compared to the consistently low group (Group 1). Repeated exceedance of ALT and AST thresholds significantly increased type 2 diabetes risk, with higher thresholds and frequencies of exceedance showing stronger associations. Regular liver enzyme monitoring may help identify high-risk individuals, supporting early intervention strategies to mitigate type 2 diabetes incidence.

Purpose: To develop DeepISP, a deep learning model that predicts the comprehensive visual field (VF) information of the Humphrey visual field analyzer (HFA) based on rapid screening perimetry (Imo/TEMPO screening program [ISP]). Design: A retrospective, cross-sectional, and longitudinal cohort database study. Participants: One hundred eighty-seven actual ISPs from 112 patients who underwent both ISP and HFA 24-2 on the same day at the Jikei University School of Medicine Affiliated Hospital and 3470 synthesized ISPs from 883 patients who underwent VF measurements using HFA 24-2 and HFA 10-2 at 4 hospitals affiliated with Jikei University School of Medicine. Methods: We developed 2 variants of multitask neural networks designed to predict both current VF parameters and VF progression parameters. We also evaluated the efficacy of data augmentation to synthesize ISP tests created by combining 20 points from HFA 24-2 and 8 points from HFA 10-2, with thresholding applied to these 28 points. Main Outcome Measures: Mean absolute error for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). Mean F1 score for total deviation (TD) and pattern deviation (PD) probability plot classification. Area under the curve (AUC) for MD progression (MD slope <−1.0 decibel/year) and VFI progression (VFI slope <−1.8%/year). Results: DeepISP could predict current VF status. Mean absolute errors for predicting MD, PSD, and VFI were 1.869 ± 0.114, 1.918 ± 0.082, and 5.146 ± 0.487, respectively. The mean F1 scores for pointwise classification of TD and PD probability plots were 0.761 ± 0.002 and 0.775 ± 0.002, respectively. The AUC for classifying glaucoma hemifield test was 0.920 ± 0.008. DeepISP was also capable of predicting VF progression, with AUCs of 0.828 ± 0.060 and 0.832 ± 0.062 for predicting MD and VFI progression, respectively. Conclusions: We demonstrated ISP's versatility and capability in predicting comprehensive VF information, including current severity and progression risk. Our DeepISP serves as an efficient tool for screening and prioritizing patients with glaucoma for clinical intervention using only a single rapid ISP test. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

PURPOSE:To compare the postoperative visual performance of the Vivinex Impress (Hoya Surgical Optics) with that of a monofocal intraocular lens (IOL) on the same platform. METHODS:This retrospective observational study analyzed consecutive patients who underwent cataract surgery between February and October 2024. Patients with postoperative emmetropia as the target refraction, preoperative corneal astigmatism less than 1.00 diopter (D), no history of refractive surgery, and no other ocular diseases or amblyopia were analyzed. Fifty eyes implanted with the Vivinex Impress (Impress group) were compared with 50 eyes implanted with the Vivinex MultiSert (MultiSert group). One month postoperatively, uncorrected distance visual acuity, uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity, corrected distance visual acuity, and contrast sensitivity were evaluated. Data on patient satisfaction levels, dysphotopsia incidence, and spectacle use rates were obtained. RESULTS:UIVA (logarithm of the minimum angle of resolution) was significantly better in the Impress group (0.12 ± 0.12) compared to the MultiSert group (0.18 ± 0.13) (P = .003), with no significant differences in other visual acuity measures. Multivariate analysis revealed a negative correlation between UIVA and postoperative pupil diameter in the Impress group. Predicted refractive error differed significantly (Impress group: -0.13 ± 0.43 and MultiSert group: 0.10 ± 0.46). No significant differences were observed in the contrast sensitivity, patient satisfaction levels, dysphotopsia incidence, or spectacle use rates between the groups. CONCLUSIONS:The Impress group demonstrated superior intermediate visual acuity and a myopic shift from the target refraction. Preoperative pupil diameter may help identify patients most likely to benefit from the Impress lens. [J Refract Surg. 2025;41(6):e551-e557.].

PURPOSE:To evaluate whether the difference between artificial intelligence (AI)-estimated retinal biological age and chronological age-the retinal age gap (RAG)-is associated with postoperative visual function after cataract surgery. DESIGN:Retrospective, consecutive interventional case series. METHODS:Consecutive cataract surgeries at Machida Municipal Hospital (February 2024-May 2025) targeting postoperative emmetropia were included. Eligible eyes had preoperative corneal astigmatism <1 diopter and no prior ocular surgery or other ocular disease. Overall, 142 eyes (mean age, 77.6 ± 6.2 years) received a monofocal intraocular lens (IOL) or an enhanced monofocal IOL. Retinal age was estimated with the Japan Ocular Imaging Registry (JOIR) AI model, and RAG was computed as retinal age minus chronological age. Quartiles (Q1-Q4) were defined; after age matching between Q1 and Q4, 1-month outcomes-visual acuity, contrast sensitivity (CS), patient satisfaction, spectacle independence, and dysphotopsia-were compared. Multivariable logistic regression assessed factors associated with satisfaction. RESULTS:The JOIR model's mean absolute error was 6.98 years and root-mean-square error was 8.97 years. RAG correlated negatively with chronological age (Spearman's ρ = -0.671, P < .001). With age matching, most visual acuity and contrast sensitivity measures did not differ; however, Q1 showed higher satisfaction, higher spectacle independence, and more patients reporting no glare and no waxy vision (all P < .01). Larger RAG independently predicted lower satisfaction, irrespective of corrected distance visual acuity (P < .05). CONCLUSIONS:Smaller RAG was associated with greater postoperative satisfaction. RAG may serve as a practical biomarker to personalize intraocular lens selection.

PURPOSE:To compare the performance of the 24-2C Swedish Interactive Thresholding Algorithm (SITA) Faster and Standard with the 10-2 SITA Standard in assessing visual function in patients with glaucoma. DESIGN:A multicenter prospective cross-sectional study. PARTICIPANTS:Overall, 71 eyes of 71 patients with primary open-angle or normal-tension glaucoma were included. METHODS:The participants underwent visual field testing using the 24-2C SITA Faster, 24-2C SITA Standard (research prototype), and 10-2 SITA Standard in a randomized order on the same day. The global indices, threshold values, total deviation (TD), pattern deviation (PD), and test durations of the algorithms were compared. Correlations among the 10-2 SITA Standard mean deviation (MD) and number of depressed test point locations in the TD and PD probability plots at P < 5%, P < 2%, and P < 1% significance levels within the central 10° were analyzed. MAIN OUTCOME MEASURES:Differences in global indices, threshold values, TD, PD, and test duration between algorithms. Correlations of the MD and number of TD and PD points of the 10-2 SITA Standard and those of the central 10° region for the 24-2C algorithms. RESULTS:No significant differences were found in the global indices between the 24-2C SITA Faster and Standard. The 24-2C SITA Faster had a significantly shorter test duration (55.2% shorter) than the 24-2C SITA Standard. The 24-2C SITA Standard was 45.2% shorter than the combined 24-2 SITA Standard plus 10-2 SITA Standard. The 24-2C SITA Standard showed significantly higher correlation with the 10-2 SITA Standard than the 24-2C SITA Faster. CONCLUSIONS:There were no significant differences in global indices between the 24-2C SITA Standard and 24-2C SITA Faster. However, the 24-2C SITA Standard showed a stronger correlation with the 10-2 SITA Standard. The 24-2C SITA Standard demonstrates potential for more effectively assessing central visual field function in patients with glaucoma. FINANCIAL DISCLOSURE(S):Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

OBJECTIVE:This study aimed to identify key performance indicators (KPIs) in workplace health promotion (WHP) and their associations with initiative performance, history, and industrial background. METHODS:We conducted a cross-sectional study analyzing descriptions of KPIs from 2679 Japanese companies participating in government-led WHP initiatives. Text-mining techniques were used to categorize the KPIs and examine their association with company rankings, submission history, and industry. RESULTS:Eleven KPIs were identified, including health status, productivity improvement, and recruitment. Productivity improvements and losses were frequently referenced by top-ranked companies, whereas lower-ranked companies and new participants prioritized recruitment and retention, which were commonly discussed in the retail, healthcare, and welfare industries. Mental health was more prevalent in the information, technology, communication, and electrical equipment sectors. CONCLUSIONS:The findings support effective KPI setting in WHP and provide insights to inform dissemination of government-led initiatives.

This cross-sectional study aimed to investigate the promoting and inhibitory factors of diabetic retinopathy (DR) according to diabetes mellitus (DM) stage using standardized evaluation of fundus images by artificial intelligence (AI). A total of 30,167 participants underwent blood and fundus examinations at a health screening facility in Japan (2015–2016). Fundus photographs were screened by the AI software, RetCAD and DR scores (DRSs) were quantified. The presence of DR was determined by setting two cut-off values prioritizing sensitivity or specificity. DM was defined as four stages (no DM: DM0; advanced DM: DM3) based on treatment history and hemoglobin A1c (HbA1c) levels. Associated factors of DR were identified using logistic regression analysis. For cutoff values, multivariate analysis revealed age, sex, systolic blood pressure (SBP), smoking, urinary protein, and HbA1c level as positively associated with the risk of DR among all DM stages. In addition to glycemic control, SBP and Fibrosis-4 index might act as promoting factors for DR at all or an earlier DM stage. T-Bil, cholinesterase, and T-cho level might be protective factors at an advanced DM stage.