Long-term shareholder perks and stock price reaction.

This study aimed to examine the impact and source of announcements introducing additional long-term shareholder perks on stock prices of Japanese listed companies. We produced more precise analysis results by categorizing the total sample into favorable change and unfavorable change sample. As a result, we found that long-term shareholder perks have a positive impact on stock prices through the expansion of the shareholder base in the case of a favorable change, whereas there is no negative impact on stock liquidity due to an increased number of long term individual shareholders. On the contrary, in the case of an unfavorable change, we found a weak trend of shrinkage in the shareholder base due to individual shareholders' defection and a consequent decrease in stock liquidity. In the case of a favorable change, the long-term shareholder perks program functions as a means to increase the number of shareholders and encourage them to hold the shares for a longer period of time.

Parental age and child growth and development: child health check-up data.

BACKGROUND: The aim of the present study was to determine whether parental age has any influence on child health. METHODS: Well-baby check-up data at 1 month and at 12 months of age were used. The trends of parental age in association with growth measurements, incidence of physical and developmental abnormalities, occurrence of low birthweight, and maternal history of spontaneous abortion were analyzed. RESULTS: Associations between increasing paternal age and incidence of psychomotor developmental delay at 12 months, increasing paternal and maternal age and increasing birthweight, and increasing parental age and higher incidence of history of spontaneous abortion were found. The incidence of low-birthweight infants was significantly decreased with increasing paternal age. CONCLUSIONS: Not only increasing maternal age but also increasing paternal age have influences on child development and growth in the general population.

Impact of Workplace on the Risk of Severe COVID-19.

Indiscriminate regional lockdowns aim to prevent the coronavirus disease 2019 (COVID-19) infection by restricting the movement of people; however, this comes with psychological, social, and economic costs. Measures are needed that complement lockdowns and reduce adverse effects. Epidemiological studies, to date, have identified high-risk populations, but not workplaces appropriate for closure. This study was conducted to provide evidence-based measures that used exact and reliable follow-up data of the PCR-positive COVID-19 cases to complement lockdowns. The data are not subjected to selection or follow-up biases, since the Japanese government, by law, must register and follow all the PCR-positive cases until either recovery or death. Direct customer exposure may affect the quantity of viral inoculum received, which, in turn, may affect the risk of the severity of disease at infection. Therefore, the professions of the cases were grouped according to their frequency of direct customer exposure (FDCE) based on subjective observations, which resulted in five workplaces; hospital, school, food service, outdoor service, and indoor office being identified. Analyzing the follow-up data, we obtained precise estimates for the risk of severe disease, defined as intensive care unit (ICU) hospitalization or death, for the workplaces adjusted for age, sex, family status, and comorbidity. Major findings are as follows: hospital and school are the lowest risk, food and outdoor services are, despite higher FDCE, safer than indoor office. Unemployed and unclear are the highest risk, despite low FDCE. These results suggest the following workplace-specific measures complementing the lockdown: school should not be closed and indiscriminate closing of food and outdoor service industries should be avoided, since it would be more effective to reinforce their efforts to promote adherence to public health guidelines among students and customers. These actions would also reduce the adverse effects of the lockdown. This study is the first to address the causality between the workplaces and severe disease. We introduce FDCE and adherence to public health guidelines (APHGs) to associate the workplace characteristics with the risk of COVID-19 severity, which provided the basis for the measures complementing lockdowns.

Association factors for atopic dermatitis in nursery school children in Ishigaki islands - Kyushu University Ishigaki Atopic Dermatitis Study (KIDS).

Atopic dermatitis (AD) is a multifactorial disease that usually decreases the quality of life of affected patients. The purpose of this study was to evaluate the associated factors for atopic dermatitis, asthma, rhinitis, and food allergy by physical examination of the skin and a questionnaire in nursery school children in Ishigaki Island, Okinawa, Japan. Enrolled in this study were 460 children from 0 to 6 years of age. Physical examination of skin symptoms and blood tests were performed. Information on past history and family history of atopic dermatitis, asthma, rhinitis, and food allergy were collected by questionnaire. The prevalence of atopic dermatitis was 12.2% (56/460). The cumulative prevalence of asthma, rhinitis, and food allergy was 19.9% (91/458), 3.3% (15/457), and 5.5% (25/456), respectively. In multivariate analysis, maternal history of rhinitis, atopic dermatitis siblings, past history of asthma and food allergy, and elevation of total IgE were significantly related to atopic dermatitis. A high total IgE level was a strong risk factor specific for atopic dermatitis in this population.

Statistical resolutions for large variabilities in hair mineral analysis.

Measuring biomaterials is usually subject to error. Measurement errors are classified into either random errors or biases. Random errors can be well controlled using appropriate statistical methods. But, biases due to unknown, unobserved, or temporary causes, may lead to biased conclusions. This study describes a verification method to examine whether measurement errors are random or not and to determine efficient statistical methods. A number of studies have dealt with associations between hair minerals and exposures such as health, dietary or environmental conditions. Most review papers, however, emphasize the necessity for validation of hair mineral measurements, since large variations can cause highly variable results. To address these issues, we answer the following questions: How can we ascertain the reliability of measurements?How can we assess and control the variability of measurements?How do we efficiently determine associations between hair minerals and exposures?How can we concisely present the reference values? Since hair minerals all have distinctive natures, it would be unproductive to examine each mineral individually to find significant and consistent answers that apply to all minerals. To surmount this difficulty, we used one simple model for all minerals to explore quantitative answers. Hair mineral measurements of six-year-old children were analyzed based on the statistical model. The analysis verified that most of the measurements were reliable, and their inter-individual variations followed two-parameter distributions. These results allow for sophisticated study designs and efficient statistical methods to examine the effects of various kinds of exposures on hair minerals.

The 5-year incidence and risk factors for age-related maculopathy in a general Japanese population: the Hisayama study.

PURPOSE: To estimate the 5-year incidence and risk factors for age-related maculopathy (ARM) in a representative older Japanese population. METHODS: A population-based cohort study was conducted in 1998 on 1482 Hisayama residents aged 50 years or older, and 961 of these subjects attended the 5-year follow-up examinations in 2003. At both time points, the characteristics of ARM were determined by grading color fundus photographs according to the Wisconsin Age-Related Maculopathy Grading System. Using these cohort data, logistic regression analyses were performed to determine the risk factors for ARM. Nine possible risk factors were examined: age, sex, hypertension, diabetes, hyperlipidemia, smoking, alcohol intake, body mass index, and white blood cell count. RESULTS: The 5-year incidence of early ARM was 8.5%, and that of late ARM was 0.8%. Men were found to have a significantly higher incidence of late ARM than did women. The incidence of both early and late ARM increased significantly with age. Multiple logistic regression analysis showed that age and smoking were significantly associated with early and late ARM. CONCLUSIONS: The results suggest that the overall 5-year incidence of early ARM is 8.0% and that of late ARM is 0.8% in the general Japanese population and that higher age and smoking are relevant risk factors for early and late ARM in the Japanese.

The prevalence of pseudoexfoliation syndrome in a Japanese population: the Hisayama study.

PURPOSE: To examine the prevalence and systemic associations of pseudoexfoliation syndrome (PXS) in a Japanese population. METHODS: In 1998, a cross-sectional population-based survey was conducted among residents of Hisayama. Of a total of 3054 residents living in Hisayama, Japan, aged 50 years or older, 1844 consented to participate in the study. Each participant underwent a comprehensive examination that included an ophthalmic examination. The presence of any pseudoexfoliation material on the iris or lens capsule was determined by slit-lamp examination. The participants were classified as having pseudoexfoliation syndrome if any pseudoexfoliation material was present in either eye. Using these cross-sectional data, logistic regression analyses were performed to determine the systemic associations of pseudoexfoliation syndrome. The following eight possible correlates were considered: age, sex, hypertension, diabetes, hyperlipidemia, current smoker, alcohol intake, and body mass index. RESULTS: Among the subjects, 50 (3.4%) had pseudoexfoliation syndrome. The prevalence of pseudoexfoliation syndrome increased significantly with age. Multiple logistic regression analysis showed that age and hypertension were significantly associated with pseudoexfoliation syndrome. CONCLUSION: The prevalence of pseudoexfoliation syndrome in a Japanese population was 3.4%, and increased with age. This study suggests that hypertension strongly correlates with pseudoexfoliation syndrome in our population-based sample of Japanese subjects aged 50 years or older.

Prevalence of atopic dermatitis and serum IgE values in nursery school children in Ishigaki Island, Okinawa, Japan.

There have been many studies of the prevalence of atopic dermatitis (AD), but few population-based epidemiologic studies measure the prevalence in Japan among children aged 5 years and younger. We examined the prevalence of AD, serum total IgE levels and specific IgE antibodies to 10 common allergens among children in Ishigaki Island, Okinawa, Japan in 2001. We also obtained information on the predictability of the U.K. Working Party diagnostic questionnaire criteria for AD in this population. Five hundred and sixty five children aged 5 years and younger were enrolled in this study with informed consent from their parents. The questionnaire of the U.K. Working Party diagnostic criteria for AD was translated into Japanese, and the parents completed the questionnaire sheet. Physical examination and blood sampling were done for all children. Thirty-nine out of the 565 (6.9%) children were diagnosed with AD by physical examination. The total and specific IgE levels were significantly higher in the children with AD than in those without AD. High levels of total IgE were found in 33.3% of the children with AD. A specific IgE to one or more allergens was detected in 64.1% of children with AD. However, a substantial population of children without AD also had high levels of total IgE (12.7%) and a specific IgE to one or more allergens (30.2%), and the increment of total and specific IgE levels was significantly associated with age. The percentage of positive answers to the questionnaire of the U.K. Working Party diagnostic criteria for AD was significantly higher in children with AD (59.0%) than in children without AD (5.3%) (P<0.0001). Its specificity was 94.7%. The false negative rate was 41%. In conclusion, the prevalence of AD was relatively low in children in Ishigaki Island. High levels of total IgE were found in only one third of children with AD under 5 years of age. The Japanese translated form of the questionnaire of the U.K. Working Party diagnostic criteria for AD should be refined to improve its sensitivity.

A rapid speech synthesizing software on a PDA for Japanese with speech impairments.

We developed a Japanese-language, rapid synthesizing software application for use on a personal digital assistant. It has an unrestricted vocabulary and can synthesize words and sentences within 3 s. Eight hundred common sentences and words are preregistered. By touching the first character at the head of a preregistered sentence or word from an on-screen Kana (Japanese alphabet) chart, the user can select the sentence or word to be spoken. Characters on the Kana chart can also be input sequentially. Two Japanese subjects with speech impairments rated the device highly for its portability and quick response. Whereas communication previously had to be done by writing or sign language, it was easy for listeners with or without specialized training in communication with persons with speech impairments to understand the output from this device, making conversation easier which, in turn, improved the quality of life and social activity of these persons with speech impairments.

Dosage and adverse effects of topical tacrolimus and steroids in daily management of atopic dermatitis.

Since 1999, combination therapy with tacrolimus and topical steroids has been widely used for the treatment of adolescent/adult-type atopic dermatitis. In order to determine the clinical doses of topical tacrolimus and steroids for daily treatment of atopic dermatitis and to elucidate their beneficial and adverse effects, we analyzed the clinical data from 215 patients with atopic dermatitis who were more than 16 years old. Less than 70 g of tacrolimus and less than 15 g of steroids were applied to 90% of the patients on the face and neck, and less than 75.8 g of tacrolimus and less than 322 g of steroids were applied to 90% of the patients on the trunk and extremities during the six-month treatment period. Topical tacrolimus is much more frequently used on face and neck lesions (99.1%); in only 39.5% of cases was it used on the trunk and extremities. The majority of patients improved after six months of the combination topical therapy; however, atopic dermatitis was not controlled in 6% of the patients. The combination therapy did not seem to increase the risk of cutaneous infections; however, the incidence of herpes simplex infection on the face and neck was 2.8% at pre-treatment and slightly increased to 4.7% during the therapy. The incidence of all steroid-induced adverse effects was reduced both in frequency and intensity with a decrease in the dose of topical steroids through simultaneous tacrolimus application. Combination therapy with topical tacrolimus and steroids is useful for treating atopic dermatitis, but a small percentage of the patients still cannot be satisfactorily treated. For such patients, adjustments of the dose and rank of topical steroids and tacrolimus and other therapeutic adjuncts are necessary.

Cohort study for prevention of atopic dermatitis using hair mineral contents.

We undertook a cohort study to determine the association between hair mineral content and the onset of atopic dermatitis (AD) in infants. Eight hundred and thirty-four mother-infant pairs, who donated hair samples during one and ten-month health checkups, had their samples analyzed by proton induced X-ray emission (PIXE) for 32 mineral concentrations, and these mineral concentration data together with their AD family history were statistically examined for any relationships between them. Results indicated that of all minerals, only selenium (Se) and strontium (Sr) showed statistically significant associations for infants, while the same two elements were only marginally significant for mothers. Se deficiency in either infant or mother increased the AD risk. A Sr deficiency in infants increased AD risk, while the same deficiency in mothers decreased the risk. To predict the probability of AD development using this data, we performed logistic regression analysis, which provided a sensitivity of 65.9%, a specificity of 70.5%, a positive predictive value (PPV) of 10.3%, a negative predictive value (NPV) of 97.6% and a relative risk (RR) of 4.2, all far better than any corresponding figures explicitly mentioned in previously published papers.

Simulation program for power and sample size determination in logistic analysis of single nucleotide polymorphisms when the response variable is subject to misclassification.

The main objective of this study was to develop a simulation program to determine the sample size for a clinical study to confirm a genetic-disease association observed in a retrospective exploratory study. The effect of misclassification of a binary response variable on the power is also investigated. A general expression for the magnitude of the decrease in statistical power due to misclassification is obtained based on the Pitman asymptotic relative efficiency. The simulation program presents an estimate of the exact power when misclassification exists. Running the program several times under different settings of parameters, it revealed that the effect of even low misclassification rates is serious. Response misclassification should be taken into consideration when determining the sample size. The program can be used on the Internet.

STAT3 polymorphism predicts interferon-alfa response in patients with metastatic renal cell carcinoma.

PURPOSE: To clarify the effect of genetic polymorphisms on the response to interferon alfa (IFN-alpha) for metastatic renal cell carcinoma (MRCC), and to find a reliable molecular marker to select those patients with MRCC who would benefit from IFN-alpha immunotherapy. PATIENTS AND METHODS: We carried out an association study in which 463 single nucleotide polymorphisms (SNPs) in 33 candidate genes were genotyped in 75 Japanese patients who had received IFN-alpha for MRCC. RESULTS: After adjusting for lung metastasis, stepwise logistic regression analysis revealed that the SNPs in signal transducer and activator 3 (STAT3) were most significantly associated with better response to IFN-alpha. Linkage disequilibrium mapping revealed that the SNP in the 5' region of STAT3, rs4796793, was the most significant predictor of IFN-alpha response (odds ratio [OR] = 2.73; 95% CI, 1.38 to 5.78). The highest OR was shown in the CC genotype at rs4796793 compared to the GG + GC genotypes (OR = 8.38, 95% CI, 1.63 to 42.96). Genotype-dependent expressions of STAT3 in B lymphocyte cell lines and the enhanced growth inhibitory effects of IFN- by STAT3 suppression in an RCC cell line supported the results of the present association study. CONCLUSION: The present study suggested that the STAT3 polymorphism is a useful diagnostic marker to predict the response to IFN-alpha therapy in patients with MRCC. An efficient response marker for IFN-alpha needs to be utilized to establish individual optimal treatment strategies, even when newer drug therapies are used as first line treatments for MRCC.

A tool for improving the Web accessibility of visually handicapped persons.

Abstract Much has been written concerning the difficulties faced by visually handicapped persons when they access the internet. To solve some of the problems and to make web pages more accessible, we developed a tool we call the "Easy Bar," which works as a toolbar on the web browser. The functions of the Easy Bar are to change the size of web texts and images, to adjust the color, and to clear cached data that is automatically saved by the web browser. These functions are executed with ease by clicking buttons and operating a pull-down list. Since the icons built into Easy Bar are quite large, it is not necessary for the user to deal with delicate operations. The functions of Easy Bar run on any web page without increasing the processing time. For the visually handicapped, Easy Bar would contribute greatly to improved web accessibility to medical information.

A practical procedure to prevent electromagnetic interference with electronic medical equipment.

Problems involving electromagnetic interference (EMI) with electronic medical equipment are well-documented. However, no systematic investigation of EMI has been done. We have systematically investigated the causes of EMI. The factors involved in EMI were determined as follows: 1) Electric-field intensity induced by invasive radio waves from outside a hospital. 2) Residual magnetic-flux density at welding points in a building. 3) Electric-field intensity induced by conveyance systems with a linear motor. 4) The shielding capacity of hospital walls. 5) The shielding capacity of commercial shields against a wide range frequency radio waves. 6) The immunity of electronic medical equipment. 7) EMI by cellular telephone and personal handy-phone system handsets. From the results of our investigation, we developed a following practical procedure to prevent EMI. 1) Measurement of electric-field intensity induced by invasive radio waves from outside the hospital and industrial systems in the hospital. 2) Measurement of residual magnetic-flux density at electric welding points of hospital buildings with steel frame structures. 3) Control of the electromagnetic environment by utilizing the shielding capacity of walls. 4) Measurement of the immunity of electronic medical equipment. And 5) Installation of electronic gate equipment at the building entrance to screen for handsets.

A simple method for calculating the financial balance of a hospital, based on proportional dividing.

It is necessary to estimate financial status to determine hospital management policy. The costs and revenues (financial balance) of each hospital division are one good index. However, it is difficult to calculate the financial balance for each division, since clinics and central services are intricately involved with each other There are no reports on a pragmatic method for calculating the financial balance. We devised a simple method based on proportional dividing. Consequently, one individual was able to complete the calculation for our hospital, which consists of 1300 beds and 23 clinics, without using the central hospital computer system.

A filter that prevents the spread of mail-attachment-type Trojan horse computer worms.

The malicious code "W32/Sircam" is spread via e-mail and potentially through the file space shared by local area networks. Such Trojan-horse-type computer worms easily penetrate Internet firewalls and propagate via the "backdoor" to other computers. Once a malicious code, such as "W32/Sircam," has been executed on a system, it may reveal or delete confidential data, such as clinical records. In order to protect against the leakage of clinical records, we devised a mail filter that successfully prevents the spread of mail containing this malicious code. It is significant that neither access control nor packet filtering is guaranteed to prevent the spread of this mail-attachment-type Trojan horse computer worm.

Negligible electromagnetic interaction between medical electronic equipment and 2.4 GHz band wireless LAN.

Wireless LANs using radio waves have recently gained popularity for installation in hospitals. Because electromagnetic waves transmitted from mobile telephones have been shown to cause interference with medical electronic equipment, prudence would seem necessary when introducing radio wave communication devices into hospitals. Therefore, we tested the effect of wireless LAN communication on medical electronic equipment and the effect of electronic equipment on wireless LAN communication. We observed nine pieces of electronic equipment in the operating mode while transmitting radio waves from a wireless LAN. Even when the access point was put very close to the medical electronic equipment surface and data was transmitted, no malfunction of the equipment was observed. The medical electronic equipment caused little change in the effectiveness of the communication device, although radio waves emitted from electric knives and a remote patient monitor reduced the reception rate to about 60%. The communication speed of the wireless LAN was temporarily reduced only when a microwave oven was located close to and facing the access point. Because output in Japan is limited to a maximum of 10 mW wireless LAN following the IEEE802.11b standard should be able to be installed safely in Japanese hospitals. However, wireless LAN access points should not be installed near microwave ovens.