Background: This study examined how the frequency of in-person, telephone, text-based communication, and video interactions with non-cohabiting family and friends relates to loneliness among older adults in Japan. Methods: We analyzed data from 6,786 adults aged ≥65 in the 2024 Japan COVID-19 and Society Internet Survey (JACSIS) study. Interaction frequency with non-cohabiting family and friends was categorized into none (reference), monthly, and weekly or more. Loneliness was measured using the 3-item UCLA Loneliness Scale and dichotomized at ≥4, indicating loneliness; a ≥7 cut-off was used in sensitivity analyses. Logistic regression models adjusted for sociodemographic, lifestyle, and health-related factors. Results: For family, significant associations with lower loneliness were observed only at weekly frequencies—in-person (adjusted odds ratio [aOR]=0.764, 95% confidence interval [CI] 0.664–0.879), text (aOR=0.747, 95% CI 0.659–0.846), and telephone (aOR=0.624, 95% CI 0.543–0.718), whereas for friends, significant associations were observed at monthly frequencies—in-person (aOR=0.621, 95% CI 0.549–0.701), text (aOR=0.881, 95% CI 0.778–0.997), and telephone (aOR=0.734, 95% CI 0.659–0.819). Video calls were associated with lower odds of severe loneliness (score ≥7) in sensitivity analyses—weekly calls with family (aOR=0.736, 95% CI 0.547–0.991) and monthly calls with friends (aOR=0.656, 95% CI 0.470–0.917). Conclusion Interactions with friends show associations with lower levels of loneliness at lower frequencies than family contact. While text and phone calls are broadly associated with reduced loneliness, video calls showed an association specifically with a lower prevalence of severe loneliness, underscoring the potential for tailored communication strategies.

Background: Promoting physical activity among older adults is essential for extending healthy life expectancy. Municipality-led walking programs have been introduced in Japan; however, evidence of their effectiveness in promoting readiness for lifestyle improvement among older adults remains limited. We examined the association between participation in a municipality-led walking promotion program and readiness for lifestyle improvement among community-dwelling older adults. Methods: Data of community-dwelling adults aged ≥65 years who participated in a municipality-led walking promotion program implemented in Zushi City, Japan, in 2021, were compared with those of non-participants selected from the National Health Insurance database. Behavioral readiness was evaluated using the five-stage classification of the transtheoretical model. Pre- and post-intervention stages were assessed in both groups. Associations between participation and behavioral stage were examined using ordinal logistic regression with unadjusted, basic-adjusted, and fully adjusted models, controlling for baseline stage and habitual exercise. Results: Participants in the walking event had higher odds of being at a higher readiness stage than non-participants (unadjusted odds ratio [OR]=2.91; basic-adjusted OR=2.99; fully adjusted OR=2.98). Analyses using a dichotomized transtheoretical model variable also indicated consistently higher odds of being in the action or maintenance stages among participants. Conclusion Our findings suggest that short-term, municipality-led walking initiatives contribute to early-stage behavioral readiness for lifestyle improvement in older adults. They provide a valuable foundation for planning community-based health promotion and long-term care prevention strategies. Further studies are needed to evaluate similar programs across different settings and over more extended periods.

Use of benzodiazepine (BZD) receptor agonists for delirious or elderly patients has occasionally been found as a result of inappropriate instructions for insomnia or restlessness, according to research of the dementia and delirium support team (DDST), which manages instructions on admission and during hospital rounds. We believe that one reason for this is the lack of hospital guidelines for managing insomnia and restlessness. When changing electronic medical record vendors, we took the opportunity to establish proper drug usage instructions. The percentage of available instructions for insomnia and restlessness at the time of admission and the prescribed medications were surveyed and compared before and after the vendor change. The prescription rate for insomnia was 88.6% (1,779/2,007) before and 91.9% (1,902/2,069) after the change, showing a significant increase. The prescription rate of benzodiazepine receptor agonist use was 47.7% (848/1,779) before and 41.6% (792/1,902) after the change, showing a significant decrease. The prescription rate for restlessness was 71.2% (1,429/2,007) before and 85.6% (1,771/2,069) after the change, showing a significant increase. The recommended drug usage instructions affected prescriptions for insomnia and restlessness at admission and prescriptions of BZD receptor agonist usage at admission. Our findings seem to suggest that setting drug usage instructions for insomnia and restlessness when changing the electronic medical record vendor will be useful for promoting proper medication use.

Objective: The provision of drug information from medical representatives (MRs) of pharmaceutical departments was changed to non-face-to-face on the principle of preventing further spread of the Coronavirus disease 2019 (COVID-19). However, there have been no reports investigating the impact of operational changes under such circumstances on the drug information response service and drug information provision activities of MRs. In this study, we investigated the influence of such changes.Methods: We investigated the number of requests for drug information from MRs, the number of visits by MRs, and the response rate for information issued by companies. In addition, a questionnaire survey was conducted with MRs who provided information to drug departments to investigate their workload, work efficiency, and sense of anxiety about the provision of information.Results: The MRs’ average number of requests per operating day was 16.0±6.4 (cases/day). The median number of visits to the pharmacy department per operating day was 11 before the operational change, compared to 1 after the change, revealing a significant decrease (p < 0.001). The response rate for information provided by companies was 64.9% (161/248) after the operational change,compared to 64.6% (93/170) after the change, showing no significant difference (p=1.00). As for the influence on information provision activities, less than half of the MRs perceived a negative influence in terms of workload and efficiency; however, more than half of the MRs perceived a negative influence in terms of anxiety about information provision.Conclusion: We clarified the impact of operational changes during the COVID-19 pandemic on our work. We believe that the results of this study can be one of the most useful sources of information for continuing information provision activities based on the principle of non-face-to-face communication.

BACKGROUND: The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco. METHODS: The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures. RESULTS: The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies. CONCLUSIONS Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.
Biomarkers/blood* ; Child ; Child Health ; Child, Preschool ; Cohort Studies ; Environmental Exposure/adverse effects* ; Environmental Health ; Environmental Pollutants/adverse effects* ; Female ; Fetal Blood/chemistry* ; Follow-Up Studies ; Growth/drug effects* ; Humans ; Hypersensitivity/etiology* ; Infant ; Japan/epidemiology* ; Male ; Neurodevelopmental Disorders/etiology* ; Pregnancy ; Prenatal Exposure Delayed Effects/etiology* ; Prevalence ; Smoking/adverse effects*

A 24-year-old man was admitted to another hospital due to fever and chest and back pain. Enhanced chest computed tomography showed an aneurysm between the distal aortic arch and left pulmonary artery. The patient was transferred to our hospital for surgery. Because of suspicion of an infectious ductus arteriosus aneurysm, antibiotic therapy was started. Urgent graft replacement of the descending aorta was performed on the third day due to the enlargement of the aneurysm. All blood cultures including the preoperative examination, and the aneurysmal culture were negative. The histopathological study showed non-specific inflammatory response with plasma cell, T lymphocyte, and B lymphocyte infiltrations. There was no evidence of infection. Eventually we diagnosed this patient as having a ductus arteriosus aneurysm with non-specific inflammation. The antibiotic therapy was terminated on postoperative day 10, and the postoperative course was uneventful.

Purpose: While the amylase concentration of the drainage fluid (dAmy) has been reported to be a predictor of postoperative pancreas-related complications (PPRC), the optimal timing for its measurement has not been fully investigated. Materials and Methods: The clinicopathological data of 387 patients who underwent elective gastrectomy for gastric cancer were reviewed. Laboratory data, including dAmy on postoperative days 1 (dAmy1) and 3 (dAmy3), and serum C-reactive protein (sCRP) concentrations on postoperative days 1 (sCRP1) and 3 (sCRP3) were compared between patients with PPRC and without PPRC. Results: Nineteen of the 387 patients (4.9%) developed PPRC. The optimal cutoff values of dAmy1, dAmy3, sCRP1, and sCRP3 were 1514 IU/L, 761 IU/L, 8.32 mg/dL, and 15.15 mg/dL, respectively. The area under the curve of dAmy1 was greater than that of dAmy3 (0.915 vs.0.826), and that of sCRP3 was greater than that of sCRP1 (0.820 vs. 0.659). In the multivariate analysis, dAmy1 (P<0.001) and sCRP3 (P=0.004) were significant predictors of PPRC, while dAmy3 (P=0.069) and sCRP1 (P=0.831) were not. Thirteen (41.9%) of 31 patients with both dAmy1 ≥1,545 IU/L and sCRP3 ≥15.15 mg/dL had PPRC ≥Clavien-Dindo II. In contrast, among 260 patients with both dAmy1 <1,545 IU/L and sCRP3 <15.15 mg/dL, none developed PPRC. Conclusions dAmy1 was more useful than dAmy3 in predicting PPRC. The combination of dAmy1 and sCRP3 may be a useful criterion for the removal of drains on postoperative day 3.

No abstract available.
Carcinoma, Basal Cell

BACKGROUND/AIMS: Although studies using conventional animal models have shown that specific stressors cause irritable bowel syndrome (IBS), it is unclear whether depression itself causes IBS. Our aim was to establish a rat model to determine if depression itself promotes the onset of IBS and to elucidate the role of gut microbiota in brain-gut axis pathogenesis during coincident depression and IBS. METHODS: Rat models of depression were induced using our shuttle box method of learned helplessness. Visceral hypersensitivity was evaluated by colorectal distension (CRD) to diagnose IBS. Gut microbiota compositions were analyzed using high-throughput sequencing. In the subanalysis of rats without depression-like symptoms, rats with posttraumatic stress disorder (PTSD) were also examined. RESULTS: The threshold value of CRD in depressed rats was significantly lower than that in control rats. Microbial community analysis of cecal microbiota showed that the relative abundance of Clostridiales incertae sedis, the most prevalent microbe, was significantly lower in depressed rats than in control rats. The distribution pattern of the microbiota clearly differed between depressed rats and control rats. Neither visceral hypersensitivity nor the composition of gut microbiota was altered in rats with PTSD-like phenotypes. CONCLUSIONS: Our rat model of depression is useful for clarifying the effect of depression on IBS and suggests that depression itself, rather than specific stressors, promotes the onset of IBS. Further, we provided evidence that various psychiatric diseases, viz., depression and PTSD, are associated with unique gut microbiota profiles, which could differentially affect the onset and progression of coincident IBS.
Animals ; Clostridiales ; Depression ; Dysbiosis ; Gastrointestinal Microbiome ; Helplessness, Learned ; Hypersensitivity ; Irritable Bowel Syndrome ; Methods ; Microbiota ; Models, Animal ; Phenotype ; Rats ; Stress Disorders, Post-Traumatic