Inter-rater reliability of streetscape audits using online observations: Microscale Audit of Pedestrian Streetscapes (MAPS) global in Japan

This study aimed to evaluate the inter-rater reliability of streetscape audits among online observations using the Microscale Audit of Pedestrian Streetscapes-Global version (MAPS-Global) in Japan. MAPS-Global observations were conducted on routes with distances ranging from 400 to 725 m from a residence toward a non-residential destination. Google Street View audits were independently conducted by two trained raters on each route. A tiered scoring system was applied to summarize the items at multiple levels of aggregation. Positive and negative valence scores were created based on the expected association with physical activity. Inter-rater reliability analyses were performed using kappa statistics or intraclass correlation coefficients (ICC). Of the 32 older adults participating in an intervention study in the community-wide physical activity promotion project in Fujisawa City, 19 addresses were used, excluding those with nearby addresses. Results demonstrated “excellent” agreement for most of the summary scores analyzed (kappa or ICC values of 0.75 or higher [80.4 %]), while 6.5 % of items exhibited “good” agreement (ICC = 0.60–0.74). By contrast, only 13.0 % of the scales had ICC values lower than 0.60 (“fair” or “poor” reliability). The results illustrated high reliability for the grand summary scores and composite subscale measures. However, caution should be exercised when interpreting subscale scores for less frequently observed negative attributes and aesthetic/social characteristics. The results presented in this study support the application of online observations using MAPS-Global in urban areas of Japan, which could be implemented to inform decisions related not only to physical activity but also to traffic safety

Diagnostic Significance of Absence of Post-Feeding Contraction of the Gallbladder in Biliary Atresia: Two Case Reports

Ultrasonography is an essential part of the diagnostic process of biliary atresia (BA). The characteristic findings of BA include a hilar hyperechoic zone, the triangular cord sign (TCS), an absence of gallbladder contraction after feeding, and gallbladder atrophy. However, approximately 10% of patients with BA have a normal gallbladder. We herein present two cases of BA with normal morphology of the gallbladder as shown by ultrasonography. In the first case, the patient was positive for the TCS, negative for gallbladder atrophy, and positive for contraction of the gallbladder after feeding; the final diagnosis was hilar obstructive BA complicated by pancreaticobiliary maljunction. In the second case, the patient was positive for the TCS, negative for gallbladder atrophy, and negative for contraction of the gallbladder after feeding; the patient also had common bile duct obstruction and stenosis of the hepatic duct in the hilar region. Based on these two cases, we conclude that gallbladder findings are not diagnostic for BA because in some types, the gallbladder may be normal in morphology and even have the capacity for contraction after feeding

How do case presentation teaching methods affect learning outcomes?-SNAPPS and the One-Minute preceptor

Background: Various techniques have been developed to enable preceptors to teach residents effectively in outpatient settings to promote active learning, including SNAPPS and the One-Minute Preceptor (OMP). This study aimed to ascertain the differences between SNAPPS and the OMP in case presentation content and learner evaluation when used to teach residents about case presentation. Methods: From 2011 to 2013, participants were 71 junior clinical residents employed in two hospitals for clinical training. They were randomly allocated to two groups, one using SNAPPS and the other the OMP. From recorded discussions, the "differential diagnoses", "questions and uncertainties", "treatment plans", and "learning issues" were counted. Also, a self-evaluation form was distributed at the end of the study to evaluate the residents' satisfaction with the case presentation. Results: Members of the SNAPPS group used significantly more meaning units related to questions and uncertainties compared with those of the OMP group (P < 0.001). Self-evaluation sheets revealed that members of the SNAPPS group had significantly higher positive responses than those of the OMP group in terms of the following evaluations: "It was easy to bring up questions and uncertainties" (P = 0.046), "It was easy to present the case efficiently" (P = 0.002), "It was easy to present the case in the sequence given" (P = 0.029), and "I was able to give an in-depth case presentation" (P = 0.005). Conclusions: SNAPPS may induce more meaning units related to questions and uncertainties and give more satisfaction to residents than the OMP

Parentage analyses suggest female promiscuity and a disadvantage for athletic males in the colour-polymorphic lizard Podarcis melisellensis

Although laboratory measurements of whole-animal performance have become a standard tool in evolutionary biology, if and how interindividual variation in performance translates into differential fitness remains poorly understood. Particularly rare are studies that have connected performance to mating and reproductive success in the field. In this study, we use DNA microsatellite parentage analyses to study the fitness gradient in a colour-polymorphic lizard, Podarcis melisellensis. We report on two surprising findings. First, contrary to our expectations, individual sprint speed and bite force capacity correlated negatively, not positively, with male mating and reproductive success. Second, we found an unexpected degree of promiscuity in females. Also, contrary to traditional parental investment theory, the variation in mating success and reproductive success was as high in females as in males. Our results call for a better integration of whole-animal performance and life history traits, and for a reconsideration of the ideas on the likeliness of sexual selection acting on female phenotypes

Social jetlag affects subjective daytime sleepiness in school-aged children and adolescents: A study using the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J)

The aim of this study was to elucidate the level of daytime sleepiness in Japanese school-aged children and adolescents, and to examine associated factors including sleep loss and social jetlag using the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J). After the linguistic validation of the PDSS-J with a multi-step translation methodology, consisting of forward translation, back translation, expert review and cognitive debriefing interviews, we conducted a psychometric validation for 492 students aged 11-16 years (46.7% boys) of public elementary school, junior high school and high school, using the PDSS-J, the Karolinska Sleepiness Scale (KSS), and bedtimes and wake-up times on school days and free days. Internal consistency (Cronbach\u27s alpha) of the PDSS-J was 0.77, and the test-retest reliability demonstrated by the intraclass coefficient was 0.88. Multivariate logistic regression analysis revealed that both short sleep duration and social jetlag were identified as factors associated with daytime sleepiness, after adjustment for age and sex. PDSS-J scores were significantly higher in the group with large social jetlag with or without sufficient sleep duration than in the group with sufficient sleep duration and small social jetlag. The PDSS-J is an important tool for assessing daytime sleepiness, given its ease of administration and robust psychometric properties. The impact of not only sleep loss but also social jetlag on daytime sleepiness among school-aged children and adolescents must be fully taken into account