Phylogenetic and antigenic analyses of coxsackievirus A6 isolates in Yamagata, Japan between 2001 and 2017.

Although coxsackievirus A6 (CV-A6) is generally recognized as a causative agent of herpangina in children, CV-A6 infections globally emerged as a new and major cause of epidemic hand-foot-and-mouth-diseases (HFMDs) around 2008. To clarify the longitudinal epidemiology of CV-A6, we carried out sequence and phylogenetic analyses for the VP1 and partially for the VP4-3D regions as well as antigenic analysis using 115 CV-A6 isolates and 105 human sera in Yamagata, Japan between 2001 and 2017. Phylogenetic analysis revealed that CV-A6 isolates were clearly divided into two clusters; strains in circulation between 2001 and 2008 and those between 2010 and 2017. Neutralizing antibody titers of two rabbit antisera, which were immunized with Yamagata isolates in 2001 and 2015, respectively, against 28 Yamagata representative strains as well as the prototype Gdula strain were 1:2560-1:5120 and 1:160-1:640, respectively. The neutralizing antibody titers among residents in Yamagata against the above two strains were similar. Our analyses revealed that there were cross-antigenicities among all analyzed CV-A6 strains, although the newly emerged strains were introduced into Yamagata around 2010 and replaced the previous ones. With regard to control measures, these findings suggest that we can prevent CV-A6 infections through the development of a vaccine that effectively induces neutralizing antibodies against CV-A6, irrespective of genetic cluster.

Emotional relationships between child patients and their mothers during dental treatments.

BACKGROUND/PURPOSE: The behavioral control of child patients is an important issue in pediatric dentistry. The emotional states of the mothers of patients may influence the attitudes of their children. The aim of this study was to investigate the emotional states estimated from physiological responses of child patients and the subjective anxieties of their mothers during dental treatments and discuss the emotional relationships between children and their mothers. MATERIALS AND METHODS: To assess physiological responses associated with emotional changes induced by dental treatments in child patients aged 3-6 years, activity in the autonomic nervous were analyzed from variations in inter-beat intervals in electrocardiogram. Anxiety levels of accompanying mothers were examined using the State Trait Anxiety Inventory, which was filled out during the treatment of their child. RESULTS: Regarding the stress of child patients from the aspect of autonomic nervous activities during dental treatments, comparison between the cooperative and uncooperative patient groups showed that the uncooperative group demonstrated significantly higher sympathetic nervous activity and significantly lower parasympathetic nervous activity relative to the cooperative group, and their accompanying mothers showed significantly higher state anxiety scores relative to the mothers of cooperative children. Moreover, positive correlation between state anxiety scores of mothers and sympathetic nervous activities of their children was observed. CONCLUSION: These results indicated that uncooperative child patients undergo more stress and their mothers feel more anxiety from dental treatments, resulting in an emotional relationship between children and their mothers, which requires dental professionals to make special considerations to calm the anxiety of the mother, as well as the stress of the child patient.