Personal status of general health checkups and medical expenditure: A large-scale community-based retrospective cohort study.

BACKGROUND: We sought to clarify the association between the personal utilization of general health checkups (GHCs) and medical expenditures (MEs) in a middle-aged Japanese population. METHODS: A retrospective cohort study was conducted. Subjects were 33,417 residents (15,819 males and 17,598 females) aged 48 years or older in 2010 who were invited to undergo GHCs every year. Official records on GHCs from 2002 to 2007 and MEs from 2008 to 2010 were provided by Soka City, Saitama Prefecture, Japan. The utilization of GHCs was divided into zero times (non-utilizers), 1-3 times (low-frequency utilizers), and 4-6 times (high-frequency utilizers). Tweedie distributions in the generalized linear model were used to analyze the association between MEs and the subgroups of GHC utilization after adjustment for age and sex. RESULTS: Of the 33,417 subjects, 20,578 (61.6%) were non-utilizers, 5,777 (17.3%) were low-frequency utilizers, and 7,062 (21.1%) were high-frequency utilizers, based on the attendance to GHCs from 2002 to 2007. Compared with the non-utilizers, the high-frequency utilizers showed significantly higher outpatient MEs (JPY394,700 vs. JPY373,100). The low- and high-frequency utilizers showed significantly lower inpatient MEs (JPY224,000 and JPY181,500 vs. JPY309,300) and total MEs (JPY610,600 and JPY580,700 vs. JPY689,600) than the non-utilizers based on the pooled data from 2008 to 2010. CONCLUSIONS: This study suggests that the outpatient MEs rise when annual GHCs are increasingly attended (not including the GHC cost), but inpatient and total MEs are lower. To reduce MEs, increasing the rates of attendance at GHCs by the general public may be important.

Association between eating speed and metabolic syndrome in a three-year population-based cohort study.

BACKGROUND: Metabolic syndrome has received increased global attention over the past few years. Eating behaviors, particularly eating speed, have long been of interest as factors that contribute to the development of obesity and diabetes. The aim of this study was to assess the relationship between eating speed and incidence of metabolic syndrome among middle-aged and elderly Japanese people. METHODS: A total of 8941 community residents from Soka City in Saitama Prefecture, aged from 40 to 75 years and without a diagnosis of metabolic syndrome, participated in the baseline survey in 2008 and were followed until 2011. Anthropometric measurements and lifestyle factors were measured at baseline and follow-up. The association between eating speed and incidence of metabolic syndrome was evaluated using Cox proportional hazards models adjusted for potential confounding variables. RESULTS: During the 3-year follow-up, 647 people were diagnosed with metabolic syndrome (25.0 cases/1000 person-years). The incidence rates of metabolic syndrome among non-fast-eating and fast-eating participants were 2.3% and 3.1%, respectively. The multivariate-adjusted hazard ratio for incidence of metabolic syndrome in the fast-eating group compared to the not-fast-eating group was 1.30 (95% confidence interval [CI], 1.05-1.60) after adjustment for the potential confounding factors. Eating speed was significantly correlated with waist circumference and high-density lipoprotein cholesterol (HDL-C) components of metabolic risk factors. Hazard ratios in the fast-eating group compared with the reference group were 1.35 (95% CI, 1.10-1.66) for waist circumference and 1.37 (95% CI, 1.12-1.67) for HDL-C. CONCLUSIONS: Eating speed was associated with the incidence of metabolic syndrome. Eating slowly is therefore suggested to be an important lifestyle factor for preventing metabolic syndrome among the Japanese.

Differential sweetness of commercial sour liquids elicited by miracle fruit in healthy young adults.

Miracle fruit (Synsepalum dulcificum) contains the glycoprotein miraculin which turns a sour taste into a sweet one. Chemical analyses and sensory evaluation experiments were conducted to examine the sweetening effect of miracle fruit with regard to five different commercial sour liquids which were diluted until they were subjectively equally sour. HPLC-based analyses revealed that (1) the predominating acids in two and three of the liquids were citric acid and acetic acid, respectively and (2) all five liquids contained fructose and glucose. Healthy young adults (eight males and 10 females) in the sensory evaluation experiments were asked to chew a miracle fruit and apply their saliva to the oral mucosae. They were asked to score the sweetness elicited by the five liquids relative to a sucrose standard at 0, 15, 25 and 35 min thereafter. The citric acid-based liquids were perceived as being sweeter than the acetic acid-based liquids at all timepoints. Thus, commercial sour liquids that mainly contain citric acid are more effective than acetic acid-based liquids in eliciting a perception of sweetness after the miracle fruit application, while the sugars in the liquids seemed to play a minimal role as determinants of sweetness.

Purinergic P2X7 receptor antagonist ameliorates intestinal inflammation in postoperative ileus.

Postoperative ileus (POI) is a postsurgical gastrointestinal motility dysfunction caused by mechanical stress to the intestine during abdominal surgery. POI leads to nausea and vomiting reduced patient quality of life, as well as high medical costs and extended hospitalization. Intestinal inflammation caused by macrophages and neutrophils is thought to be important in the mechanism of POI. Surgery-associated tissue injury and inflammation induce the release of adenosine triphosphate (ATP) from injured cells. Released ATP binds the purinergic P2X7 receptor (P2X7R) expressed on inflammatory cells, inducing the secretion of inflammatory mediators. P2X7R antagonists are thought to be important mediators of the first step in the inflammation process, and studies in chemically induced colitis models confirmed that P2X7R antagonists exhibit anti-inflammatory effects. Therefore, we hypothesized that P2X7R plays an important role in POI. POI models were generated from C57BL/6J mice. Mice were treated with P2X7R antagonist A438079 (34 mg/kg) 30 min before and 2 hr after intestinal manipulation (IM). Inflammatory cell infiltration and gastrointestinal transit were measured. A438079 ameliorated macrophage and neutrophil infiltration in the POI model. Impaired intestinal transit improved following A438079 treatment. P2X7R was expressed on both infiltrating and resident macrophages in the inflamed ileal muscle layer. The P2X7R antagonist A438079 exhibits anti-inflammatory effects via P2X7R expressed on macrophages and therefore could be a target in the treatment of POI.

Molecular epidemiological features of SARS-CoV-2 in Japan, 2020-1.

There were five epidemic waves of coronavirus disease 2019 in Japan between 2020 and 2021. It remains unclear how the domestic waves arose and abated. To better understand this, we analyzed the pangenomic sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and characterized the molecular epidemiological features of the five epidemic waves in Japan. In this study, we performed deep sequencing to determine the pangenomic SARS-CoV-2 sequences of 1,286 samples collected in two cities far from each other, Tokyo Metropolis and Nagoya. Then, the spatiotemporal genetic changes of the obtained sequences were compared with the sequences available in the Global Initiative on Sharing All Influenza Data (GISAID) database. A total of 873 genotypes carrying different sets of mutations were identified in the five epidemic waves. Phylogenetic analysis demonstrated that sharp displacements of lineages and genotypes occurred between consecutive waves over the 2 years. In addition, a wide variety of genotypes were observed in the early half of each wave, whereas a few genotypes were detected across Japan during an entire wave. Phylogenetically, putative descendant genotypes observed late in each wave displayed regional clustering and evolution in Japan. The genetic diversity of SARS-CoV-2 displayed uneven dynamics during each epidemic wave in Japan. Our findings provide an important molecular epidemiological basis to aid in controlling future SARS-CoV-2 epidemics.

Effects of the appearance care program for breast cancer patients receiving chemotherapy: A mixed method study.

BACKGROUND: Treatment of breast cancer entails surgery, often followed by chemotherapy. Alopecia is a major, intractable side effect with potentially profound impacts on appearance. We developed a nurse-facilitated program targeting appearance-related symptoms. AIMS: This study explored the effects of the appearance care program on quality of life (QOL). The program was delivered across three sessions, each involving personal reflections on appearance concerns, short lectures on skincare and makeover techniques, and small group discussions. METHOD AND RESULTS: Seventy-two women who attended the appearance care program were invited to participate. We employed a mixed-method design combining quantitative and qualitative methods. QOL instruments were used to measure effects of the program at the first and final sessions and at a one-month follow-up. The qualitative data were collected as open-ended notes regarding participants' perception of the program at the final session and at a one-month follow-up. Fifty-seven women completed all three sessions. Of them, 55 participated in this study. Their mean age was 46.4 years; 39 (70.9%) had partners, and 34 (61.8%) had children. Most participants experienced hair loss at one-month post-program; however, cancer-specific QOL improved after attending the program. Patients' experience of fatigue and weakness may explain observations of decreased physical well-being. Emotional well-being continued to increase 1 month following the program, while social and functional well-being was consistent. Participants felt empowered by the information on skincare and cosmetic techniques and valued the intimate support from the group members facing similar circumstances. CONCLUSIONS: This study showed that the appearance care program increased or maintained the well-being of participants. Findings suggest the appearance care program which promoted group sharing experiences empowered participants and may have enhanced their coping strategies.

Effect of high-intensity intermittent swimming on postexercise insulin sensitivity in rat epitrochlearis muscle.

A bout of prolonged aerobic exercise can enhance the sensitivity of muscle glucose uptake to insulin, and this may be mediated by activation of 5'-adenosine monophosphate-activated protein kinase (AMPK). The aim of this study was to examine whether high-intensity short-term exercise resulting in a significantly greater increase in the activation of AMPK is more effective in enhancing muscle insulin sensitivity compared with low-intensity prolonged aerobic exercise. We measured insulin sensitivity after high-intensity intermittent swimming (HIS) or low-intensity continuous swimming (LIS) exercise in rat epitrochlearis muscle. During HIS, the rats underwent eight 20-second bouts of swimming with a weight equal to 18% of body weight. The LIS rats swam with no load for 3 hours. High-intensity intermittent swimming increased (P < .05) 2-deoxyglucose uptake approximately 8-fold, whereas LIS increased it (P < .05) approximately 2-fold immediately after exercise compared with rested muscle. This response was associated with an increase (P < .05) in phosphorylation of AMPK Thr(172) and its downstream target acetyl-coenzyme A carboxylase (ACC) Ser(79) in HIS (13- and 6-fold, respectively) and LIS (2.8- and 2-fold, respectively) immediately after exercise. In contrast, submaximal (30 microU/mL) insulin-stimulated 2-deoxyglucose uptake measured 4 hours after exercise was 73% and 46% higher (P < .05) in LIS and HIS, respectively, compared with rest. The HIS exercise resulted in a greater activation of AMPK compared with LIS, but insulin sensitivity was higher after LIS compared with HIS. The results suggest that HIS is not more effective in enhancing insulin sensitivity than LIS. Thus, AMPK activation immediately after exercise may not be the only factor that determines the magnitude of the exercise-induced increase in insulin sensitivity in rat epitrochlearis muscle.

Microdeletions in the Y chromosome of patients with idiopathic azoospermia.

AIM: To evaluate the occurrence and prevalence of microdeletions in the gamma chromosome of patients with azoospermia. METHODS: DNA from 29 men with idiopathic azoospermia was screened by polymerase chain reaction (PCR) analysis with a set of gamma chromosome specific sequence-tagged sites (STSs) to determine microdeletions in the gamma chromosome. RESULTS: Deletions in the DAZ (deleted in azoospermia) loci sgamma254 and sgamma255 were found in three patients with idiopathic azoospermia, resulting in an estimated frequency of deletions of 10.7% in idiopathic azoospermia men. CONCLUSION: We conclude that PCR analysis is useful for the diagnosis of microdeletions in the Y chromosome, which is important when deciding the suitability of a patient for assisted reproductive technology such as testicular sperm extracion-intracytoplasmic sperm injection (TESE-ICSI).

Synchronization of masseter activity patterns between the right and left sides during chewing in healthy young males.

Masseter activity patterns during chewing, which were quantitatively assessed using T50 values, were compared between the right and left sides of healthy young males. Surface electromyograms were recorded from both masseters, and each participant was asked to chew four different agar samples at his own pace across two separate sessions. The four agar samples, each possessing differing textural properties, consisted of two normal and two distinctive agar varieties. The Pearson's correlation coefficient was calculated for each pair of T50 values to evaluate the degree of synchronization of activity patterns between both masseters. A three-way analysis of variance revealed significant main effects of the 'participant' and 'experimental session' factors, but not of the 'test food'. The number of significant coefficients increased stepwise by increasing the number of chews per sequence. These results suggest the importance of the initial stages of chewing sequences in facilitating the synchronization of bilateral masseter activity patterns.

Sequential analysis of masseter activity patterns during chewing in healthy males.

The present study examined sequential changes in masseter activity patterns observed during chewing of four different agar samples in eight healthy young males. Two parameters, T(50) and D(50), were specifically used for evaluation of the activity patterns of individual bursts. Statistical significances were detected in regression coefficients (21.9% of 32 trials) and Spearman's rank correlation coefficients (28.1%) between the calculated T(50) values and chewing cycles, whereas no significant differences among the four agar samples were found. Three (I-III) types of activity patterns of masseter bursts during chewing sequences were classified by the D(50) values, which were derived from the T(50) values. The three types physiologically corresponded to incrementing (Type I), decrementing (Type III) and mixed discharge patterns (Type II). The classification of activity patterns suggested the usefulness of D(50) values in the sequential analysis of masseter activity patterns.