Background: This study aimed to clarify the association between the co-existence of possible sarcopenia (PS) and dysphagia in patients with acute stroke and the functional outcomes 12 months after stroke. Methods: This multicenter retrospective cohort study was conducted on patients with stroke admitted to two acute care hospitals in Japan between November 2020 and October 2023. PS was defined based on grip strength (males <28 kg, females <18 kg) and calf circumference (males <34 cm, females <33 cm) on admission. Dysphagia was defined as a Functional Oral Intake Scale score of less than 4. The outcome was defined as a composite of either poor functional outcome (modified Rankin Scale [mRS] score of 3–6) or failure to recover to the premorbid mRS at 12 months after stroke onset. Modified Poisson regression analysis was used to examine the association between the co-existence of PS and dysphagia and poor functional outcomes. Results: This study included 604 patients (median age 76 years; 367 men). Compared with the non-PS and non-dysphagia group, the PS and dysphagia group had a higher proportion of poor functional outcomes. Subsequently, modified Poisson regression analysis was performed. The interaction between PS and dysphagia was significantly associated with poor functional outcomes (risk ratio=4.348, 95% confidence interval 2.683–7.046). Conclusion In patients with acute stroke, the co-existence of PS and dysphagia was associated with poor functional outcomes 12 months after stroke. Future multicenter prospective interventional studies are required to clarify the effectiveness of multifaceted intervention programs in high-risk patients.

BACKGROUND: Happiness may help to prevent negative physiological outcomes in response to life events; however, factors contributing to happiness during the COVID-19 pandemic have not been longitudinally investigated. This study explored the predictors of happiness in mothers of young children in Japan using comparable data that were obtained before and during the COVID-19 pandemic. METHODS: We conducted the baseline survey in February 2020, and 4 months later, we also conducted the follow-up survey. Throughout all 47 prefectures in Japan, 4,700 (100 respondents/prefecture) mothers of infants and/or preschoolers (0-6 years) participated in the baseline online survey; 2,489 of these also participated in the follow-up survey. RESULTS: We performed hierarchical multiple regression analysis and our final model indicated that maternal happiness during COVID-19 pandemic was positively related to employment status (homemaker, β = 0.052, p = 0.014), levels of available social support (average, β = 0.052, p = 0.012, high, β = 0.055, p = 0.010) and happiness score before the pandemic (β = 0.467, p < 0.001), and satisfaction toward the measures against the COVID-19 at partners' workplace (average, β = 0.129, p < 0.001; high, β = 0.279, p < 0.001), preventive behavior against COVID-19 (average, β = 0.055, p = 0.002; high, β = 0.045, p = 0.015) and positive attitudes/thinking (β = 0.087, p < 0.001) during the pandemic. In contrast, poor mental health (K6 ≥5, β = -0.042, p = 0.011) before the pandemic and negative changes during the pandemic (≥3, β = -0.085, p < 0.001) were negatively related to maternal happiness during the pandemic. Our final model explained 44.9% of the variance in mothers' happiness during the COVID-19 pandemic. CONCLUSIONS Satisfaction toward the measures against the COVID-19 at partners' workplace, preventive behavior, and positive attitudes/thinking were especially important for maternal happiness during the COVID-19 pandemic. Future study is needed to consider measures against infectious diseases in the workplace that are desirable for the well-being of parents with young children, taking into account the gender perspective.
COVID-19/epidemiology* ; Child ; Child, Preschool ; Female ; Happiness ; Humans ; Japan/epidemiology* ; Mothers/psychology* ; Pandemics

Injuries of the cervical spine occur in contact sports. Generally, muscle strengthening training of the neck is performed to prevent injuries of the cervical spine. Isometric resistance training with chin-in posture exercise is recommended for strengthening the neck. However, muscle strength and electromyography(EMG)date for chin-in posture have not been reported. The purpose of this study was to validate muscle strength and EMG testing during chin-in posture. Subjects were fifteen healthy men without pathological conditions in the neck. Muscle strength date and EMG measurements were taken for maximal voluntary isometric contraction(MVIC)flexion and extension actions during normal and chin-in posture. Subjects performed MVIC using a handheld dynamometer and surface EMG was recorded sternocleidomastoid, scalenus, upper trapezius, and splenius muscles. Results of chin-in posture showed a significant increase in muscle strength and EMG of all muscles. These results indicate the beneficial effect of chin-in posture which can increase muscle strength and prevent injuries of the neck.