Three-year trajectories of social networks, face-to-face interactions, and non-face-to-face interactions among community-dwelling older adults in Japan during the COVID-19 pandemic: Otassha study.

OBJECTIVES: To investigate the trajectories of social networks and interactions among older Japanese individuals during the COVID-19 pandemic. STUDY DESIGN: We used data from a cohort of community-dwelling older individuals from the Otassha study's 2019-2022 survey. Participants comprised 606 older individuals who participated in the 2019 survey and were followed up at least once. MAIN OUTCOME MEASURES: Social networks were assessed using the Lubben Social Network Scale-6 (LSNS-6), whereas social interactions were assessed by the frequency of face-to-face or non-face-to-face contact with non-resident family members and friends. Trajectories of the LSNS-6 and face-to-face and non-face-to-face interactions were identified using group-based semiparametric mixture modeling. The trajectories of change in the LSNS-6 from 2019 were also identified. The factors associated with the changes in trajectory patterns were examined using logistic regression analysis. RESULTS: Three LSNS-6 trajectories were identified, with slightly decreasing patterns over time. Specifically, face-to-face interactions tended to decrease over time, whereas non-face-to-face interactions exhibited almost no change. The reduction in LSNS-6 in the decreased pattern failed to recover to its pre-pandemic level. The group of participants with the decreased pattern had a significantly higher proportion of people participating in group activities [odds ratio (95 % confidence interval): 2.27 (1.12-4.59)] and performing calisthenics twice a week than the group with the maintained pattern [2.08 (1.18-3.68)]. CONCLUSIONS: During the three years of the pandemic, no changes were observed in the social networks of community-dwelling older Japanese individuals.

Enhancing exercise tolerance in interstitial lung disease with high-flow nasal cannula oxygen therapy: A randomized crossover trial.

BACKGROUND AND OBJECTIVE: Interstitial lung disease (ILD) is characterized by dyspnoea on exertion and exercise-induced hypoxaemia. High-flow nasal cannula (HFNC) therapy reduces the respiratory workload through higher gas flow and oxygen supplementation, which may affect exercise tolerance. This study aimed to examine the effects of oxygen and gas flow rates through HFNC therapy on exercise tolerance in ILD patients. METHODS: We conducted three-treatment crossover study. All ILD patients performed the exercises on room air (ROOM AIR setting: flow, 0 L/min; fraction of inspired oxygen [FiO2], 0.21), HFNC (FLOW setting: flow 40 L/min, FiO2 0.21), and HFNC with oxygen supplementation (FLOW + OXYGEN setting: flow 40 L/min, FiO2 0.6). The primary endpoint was the endurance time, measured using constant-load cycle ergometry exercise testing at a peak work rate of 80%. RESULTS: Twenty-five participants (10 men, 71.2 ± 6.7 years) were enrolled. The increase in exercise duration between the ROOM AIR and FLOW was 46.3 s (95% CI, -6.1 to 98.7; p = 0.083), and the FLOW and FLOW + OXYGEN was 91.5 s (39.1-143.9; p < 0.001). The percutaneous oxygen saturation (SpO2) at rest was significantly higher with the FLOW + OXYGEN setting than with the ROOM AIR and FLOW settings, and the difference persisted during exercise. At equivalent time points during exercise, the SpO2 with the FLOW setting was significantly higher than that with the ROOM AIR setting. CONCLUSION: Oxygen supplementation in HFNC therapy improved exercise tolerance and SpO2. We found that gas flow alone did not improve exercise tolerance, but improved SpO2 during exercise.

Development and validation of a rapid sarcopenia screening questionnaire: The Otassha study.

AIM: To develop a rapid and easy screening tool to detect sarcopenia. METHODS: In total, 683 community-dwelling older adults who participated in our cohort study, the "Otassha Study," in 2019, completely responded to a questionnaire, and were diagnosed with sarcopenia were included. Participants responded to a nine-item questionnaire, including candidate items for a new sarcopenia screening tool named rapid sarcopenia screening, based on items of the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. To select appropriate items for the new screeening tool, multiple logistic regression analyses were performed, with sarcopenia as the dependent variable and questionnaire responses as independent variables. The area under the curve using 10 000 bootstraps was used to assess the rapid sarcopenia screening diagnostic ability for detecting sarcopenia. RESULTS: Responses to question nos 2 (how much can you squeeze a wet towel?), 5 (how much muscle strength do you think you have compared with that of people of your age and sex?), 7 (how fast do you usually walk?), and 9 (age-related item) were related to sarcopenia in multiple logistic regression analysis. The area under the curve of the total score of rapid sarcopenia screening was 0.82, 0.80, and 0.81 for men, women, and overall, respectively. At a cut-off value of 14/15, the sensitivity and specificity for sarcopenia detection were 0.73 and 0.73, respectively. CONCLUSIONS: The newly developed sarcopenia screening tool has a better diagnostic ability for sarcopenia than the SARC-F. Rapid sarcopenia screening does not require physical function measurements, making it a useful and accessible tool among older adults to detect sarcopenia. Geriatr Gerontol Int 2023; 23: 945-950.

Relationship between muscle thickness measured by ultrasound and physical functions: A 2-year follow-up study of allogeneic hematopoietic stem cell transplantation recipients.

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for hematological malignancies. Several complications following allo-HSCT, such as graft-versus-host disease, infection, and malnutrition, often cause physical dysfunction, and the assessment of physical function and evaluation of muscle mass are incompletely performed. Use of ultrasound (US) allows muscle mass measurement in patients with poor general conditions. In allo-HSCT recipients, the correlation between physical function and muscle thickness, as measured by US, remains unclear. OBJECTIVE: To clarify whether muscle thickness measured by US correlated with physical function in allo-HSCT recipients. DESIGN: A single-center prospective cohort study. SETTING: Hospital. PATIENTS: Ninety-two patients underwent allo-HSCT at our hospital from April 2017 to March 2019. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Biceps and quadriceps muscle thickness measured by US, grip strength, isometric muscle strength (elbow flexion and knee extension), and 6-minute walking test (6MWT) before allo-HSCT and on days 30, 90, 180, 1 year, and 2 years after allo-HSCT. The implementation rates of these assessments were also investigated. RESULTS: Correlations were observed between biceps thickness and elbow flexion muscle strength/grip strength before allo-HSCT, on days 30, 90, 180, 1 year, and 2 years after allo-HSCT (r = 0.71/0.74, 0.73/0.72, 0.70/0.79, 0.67/0.75, 0.72/0.75, and 0.85/0.79, respectively, all p < .001). At the same time points, quadriceps thickness moderately correlated with knee extensor strength (r = 0.49, 0.50, 0.45, 0.64, 0.61, and 0.58, all p < .001). However, biceps and quadriceps thicknesses did not correlate with the 6MWT. The percentages of patients measured with US and 6MWT were 93.4% and 82.4% (p = .01) on day 30 and 97.5% and 87.8% (p = .02) on day 90, respectively. CONCLUSIONS: US assessment may be a useful alternative method for estimating muscle strength in fragile allo-HSCT recipients, particularly when physical function assessment is difficult to quantify.

Social interaction trajectories and all-cause mortality in older adults: the Otassha study.

Introduction: This longitudinal study aimed to identify aging trajectory patterns of social interaction by sex and determine the association between these patterns and all-cause mortality. Methods: Participants were 4,065 community-dwelling older adults (1849 men) in Japan, aged 65-89 years, who responded twice or more to a mail survey conducted between 2012 and 2020. Social interaction was examined through the frequency of face-to-face and non-face-to-face contact with non-resident family and friends. The aging trajectories of the social interaction scores were identified using group-based trajectory modeling. Results: Two groups were identified among both men and women. Among men with high-frequency interaction, a rapid decrease in the frequency of social interaction was observed after 80 years of age. Conversely, among women, the frequency tended to remain the same, even after 80 years of age. The social interaction score among those aged 65 years in the low-frequency group was approximately 4 points for men and 6 points for women. Among men, no decrease was observed; however, it tended to decline after 85 years of age among women. Among men, the factors associated with the low-frequency group were instrumental activities of daily living score, perceived financial status, and social participation, while among women, they were self-rated health and social participation. The adjusted hazard ratio in the low-frequency group for all-cause mortality was 1.72 (95% confidence interval, 1.27-1.72) for men and 1.45 (95% confidence interval, 0.98-2.14) for women. Discussion: In the low-frequency group, men had a higher risk of all-cause mortality than women. Daily social interaction from mid-age is important to reduce the risk of social isolation and all-cause mortality in later life.

Impact of combinations of subscale declines in higher-level functional capacity on 8-year all-cause mortality among community-dwelling older Japanese adults.

BACKGROUND: The frequency of combined declines in domains of multi-faceted frailty and their impact on adverse health outcomes have not been adequately investigated. We aimed to examine the association between combined subscale declines in higher-level functional capacity and 8-year all-cause mortality among community-dwelling older Japanese individuals and the impact of multi-faceted frailty on mortality. MATERIALS AND METHODS: We administered a questionnaire to 7015 community-dwelling older adults aged 65-85 years. The higher-level functional capacity of the 3381 respondents was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Subscale decline was defined as (1) none, (2) only social role (SR), (3) only intellectual activity (IA), (4) SR and IA, (5) only instrumental activities of daily living (IADL), (6) IADL and SR, (7) IADL and IA, and (8) all. Associations between combined subscale declines and mortality were examined using adjusted Cox proportional hazards models. Follow-up was conducted from October 1, 2012, to death or November 1, 2020. RESULTS: The mortality rate was 16.7/1000 person-years. Moreover, 44% of respondents had declined SR, and half of them had multiple declines. Compared with no decline, SR (adjusted hazard ratio [HR]: 1.49, 95% confidence interval [CI]: 1.14-1.93), SR and IA (HR: 1.59, 95% CI: 1.16-2.17), IADL and SR (HR: 1.97, 95% CI: 1.31-2.99), and all-domain (HR: 2.72, 95% CI: 1.98-3.74) declines were significantly associated with higher mortality risks. CONCLUSIONS: Overlapping SR and IADL declines increased mortality risk, suggesting the importance of measuring social frailty and overlapping physical and social frailty.

[Sub-staff training program for community residents to provide community-based care services at day-care facilities].

Objectives　As the birthrate declines and the population ages, increase in the number of older adults certified as requiring long-term care and shortage of care staff are important issues to be considered. This study developed a sub-staff training program that trains community residents as sub-staff (paid auxiliary staff who possess knowledge and skills in care prevention and confidentiality) to provide care for enhancing independence of older adults with the support of staff in day-care facilities. The study also examined the program's feasibility and key factors, through the introduction of practical examples and surveys, for implementation in care prevention projects of local governments.Methods　The four-month training program included lectures on care prevention and provided job training to ensure participants understood the goals and contents of the care plan and learnt to provide care services with the assistance of facility staff. The training program was conducted at 14 facilities in Tokyo and Chiba from 2015 to 2017. The evaluation focused on the completion rate, change in understanding of care prevention and confidence regarding activities at the facility and in the community, participation in community activities after program completion, the psychological impact on care service recipients, and the perception of workload reduction by the facility staff.Results　A total of 96 out of 104 participants completed the training program (completion rate of 92.3%). The survey results showed that participants' confidence in activities at the facilities and understanding of care prevention increased significantly; 65.3% participated in new community activities after program completion, including activities at the facilities. The results of the survey of care service recipients showed that negative psychological effects did not increase among those who received care services from the participants compared to those who did not receive care from participants. Among the facility staff, 85.7% indicated that their workload had reduced after the community residents' participation in care services.Conclusion　The training program improved participants' confidence in care-related activities and their understanding of care prevention. More than half of them engaged in new community activities afterwards. Participants' provision of care services had a less negative impact on the service recipients and led to a reduction in workload for the facility staff. These results suggest high feasibility of the training program for care prevention projects.

Association between daily life walking speed and frailty measured by a smartphone application: a cross-sectional study.

OBJECTIVES: To assess whether frailty can be assessed using a smartphone and whether daily walking speed (DWS) is associated with frailty. DESIGN: Cross-sectional study. SETTING: Three prefectures (Kanagawa, Saitama and Tokyo) in Japan. PARTICIPANTS: The study enrolled 163 participants (65 in the robust group, 69 in the prefrailty group and 29 in the frailty group) by sending letters to house owners aged≥55 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The participants downloaded the DWS measurement application on their smartphones, which measured the daily walking (DW) parameters (DWS, step length and cadence) and the Kihon checklist for frailty assessment. The differences in the DW parameters between the robust, prefrailty and frailty groups were examined using one-way analysis of variance. We conducted logistic regression analysis for the Crude model (each DW parameter), model 1 (adjusted for the number of steps) and model 2 (model 1+age, sex and the number of chronic diseases). RESULTS: DWS was marginally significantly slower in the frailty group than in the prefrailty and robust group (robust 1.26 m/s vs prefrailty 1.25 m/s vs frailty 1.19 m/s, p=0.060). Step length was significantly smaller in the frailty group than in the robust group (robust 66.1 cm vs prefrailty 65.9 vs frailty 62.3 cm, p<0.01). Logistic regression analysis for the three models revealed that DWS was significantly associated with frailty. CONCLUSIONS: DWS measured using the smartphone application was associated with frailty. This was probably due to the shorter step length and body height seen in frail individuals.

Population-based reference values for tongue pressure in Japanese older adults: A pooled analysis of over 5,000 participants.

PURPOSE: To establish age- and sex-specific population reference values for tongue pressure (TP) in community-dwelling Japanese older adults. METHODS: For this analysis, we pooled four population-based studies on community-dwelling adults aged ≥65 years that measured TP using a JMS tongue pressure measuring device. We calculated the means and deciles of TP per 5-year age group for each sex. We also estimated age trends in TP for men and women. RESULTS: In total, 5,083 individuals (2,150 men and 2,933 women, with a mean [standard deviation] age of 75.2 [6.5] years) were included in the present analysis. In male participants, the mean (standard deviation) TPs for ages 65-69, 70-74, 75-79, 80-84, and ≥85 years were 34.0 (8.4), 32.2 (8.1), 30.8 (8.3), 28.4 (8.9), and 24.4 (8.2) kPa, respectively. In female participants, the corresponding values were 31.5 (7.1), 30.5 (7.5), 29.6 (7.3), 28.4 (8.0), and 26.4 (7.6) kPa, respectively. For both sexes, there were significant declining trends in TP with advanced age. In addition, the interaction between age and sex had a significant effect on TP (regression coefficient [95% confidence interval] = -0.18 [-0.25 to -0.11] when age was modeled as a continuous variable and sex was modeled as a categorical variable [coded as 0=women, 1=men]). CONCLUSIONS: This study determined age- and sex-specific reference values for TP, presented as means and deciles, in community-dwelling Japanese older adults aged ≥65 years. This study also demonstrated sex differences in age-related declines in TP.

Association of social disengagement with health status and all-cause mortality among community-dwelling older adults: evidence from the Otassha study.

This study examined the impact of disengagement on health status and mortality among community-dwelling older adults in Japan. Disengagement from society was operationally defined as dropping out of a longitudinal survey. A follow-up mail survey was conducted, in 2014, among respondents (n = 3696) of the baseline mail survey. Step-by-step follow-up surveys (FLs), including simplified mail, postcard, and home-visit surveys, were sent to participants who did not respond. Disengagement levels were defined according to the response to the FLs as zero (mail survey), low (simplified mail survey), middle (postcard survey), high (home-visit survey), and highest (non-responders to the home-visit survey). After adjusting for health status at baseline, the proportion of respondents self-rated as "not healthy" during FLs was significantly higher in the high-level than in the zero-level group. The proportion of respondents reporting a "once a week or less" frequency of going outdoors during FLs was significantly higher in the low-, middle-, and high-level groups than in the zero-level group. Mortality rates were significantly higher in the high and highest levels than in the zero-level group. Higher disengagement levels increased the risk of lower health status and mortality, suggesting an urgent need to prevent societal disengagement among older adults.

Comparison of Characteristics of Definition Criteria for Respiratory Sarcopenia-The Otassya Study.

We compared the definitions of respiratory sarcopenia obtained from a model based on forced vital capacity (FVC) and whole-body sarcopenia, as recommended by the Japanese Association of Rehabilitation Nutrition (JARN), and a model based on the peak expiratory flow rate (PEFR), as recommended in our previous study. A total of 554 community-dwelling older people without airway obstruction who participated in our study in 2017 were included in the current study. Respiratory function, sarcopenia, and frailty were assessed. Pearson's correlation coefficients of the associations of the FVC and PEFR with physical performance and the receiver operating curves of FVC and PEFR's association with sarcopenia, long-term care insurance (LTCI) certification, and frailty were calculated. The sensitivity and specificity of the two respiratory sarcopenia models were assessed. The FVC and PEFR were associated significantly with physical performance. The areas under the curve for sarcopenia and the LTCI certification in the FVC and PEFR groups were statistically significant in both sexes. While Kera's model had a lower specificity in determining sarcopenia, it had a sensitivity higher than the JARN model. Both models provide suitable definitions of respiratory sarcopenia. Future studies are required to determine other appropriate variables to define respiratory sarcopenia.

[Association between issues in activities and psychosocial health status in the social positions of older residents' community-based activities: a cross-sectional study].

Objectives　When local governments and community nurses provide support for community-based activities led by older residents, it is imperative to reduce the burden of participants in leadership positions. This study aimed to identify the issues associated with the activities by social position, such as leadership, support, and regular participation, to discuss effective support for community-based activities and to examine the association between social position, relating issues, and psychosocial health.Methods　Participants in community-based activities were recruited by the local government in Tokyo, Japan. Overall, 2,367 people from 155 activity groups from 40 municipalities responded. Social positions in the groups were defined as leaders who manage activities; supporters who support leaders; and regular members who do not have any specific role. The participants chose the issues of community-based activities from 10 items. Psychosocial health was measured by the WHO-5 well-being index (WHO-5) and Lubben social network scale-6 (LSNS-6). The relationship between recognition of issues and social positions were examined by the chi-square test. Interaction effects of social positions and issues (with or without) on the WHO-5 and LSNS-6 were investigated using a two-way analysis of covariance.Results　The final sample comprised 2,096 respondents: 174 leaders, 296 supporters, and 1,626 regular members. There was a significant association between recognition of social positions and issues in the groups: respondents who reported no issues in the activities comprised 8.6% of the leaders, 27.7% of the supporters, and 53.6% of the regular members (P<0.001). There was a large difference in recognition between roles for issues related to group management, such as the lack of management members. There was no significant interaction between these issues and social positions in either WHO-5 or LSNS-6 (P=0.729, P=0.171, respectively). The main effect of the social positions was significant in both analyses (P<0.001). The leaders and supporters showed significantly higher WHO-5 and LSNS-6 scores than regular members.Conclusion　The issues that the participants reported differed by social positions in activities. It may be effective to provide support according to the difficulty of sharing issues within the group. Regardless of whether or not the participants report issues, leaders and supporters had improved psychosocial health than regular members. The study concludes that organizational position in community-based activities may offer health benefits for older adults.

Time spent walking and disability-free survival in older Japanese: The Ohsaki Cohort 2006 Study.

The extent to which long disability-free survival (DFS) time can be extended according to the amount of time spent walking has not been investigated. The aim of this study was to examine the association between time spent walking per day and DFS time in older adults. We conducted a cohort study of 14 342 disability-free individuals (aged ≥ 65 years) living in Ohsaki City, Japan. The amount of time spent walking per day (<0.5 h, 0.5-1 h, ≥1 h) by each individual in 2006 was assessed by a self-reported questionnaire. Data on 11-year incident functional disability were retrieved from the public Long-Term Care Insurance database. After estimating the multivariable-adjusted hazard ratios (HRs) of the composite outcome (incident functional disability or death), the multivariable-adjusted 50th percentile differences (50th PDs; difference in the period until the first 50% of the composite outcome occurred) were estimated according to time spent walking. Among 114 764 person-years, the composite outcome occurred in 7761 persons (67.6 per 1000 person-years). The HRs (95% confidence intervals) of the composite outcome were 1.00 (reference) for <0.5 h, 0.84 (0.79, 0.88) for 0.5-1 h, and 0.78 (0.74, 0.83) for ≥1 h (p-trend < 0.001). The 50th PDs (95% confidence intervals) of DFS time were 238 (155, 322) days longer for 0.5-1 h and 360 (265, 454) days longer for ≥1 h, in comparison with <0.5 h. The results suggest that longer time spent walking per day contributes to longer DFS time.

Reliability and validity of ultrasound to measure of muscle mass following allogeneic hematopoietic stem cell transplantation.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients frequently show physical dysfunction due to loss of muscle mass. This study aimed to clarify the reliability and validity of ultrasound in evaluating muscle mass and to analyze the patterns of change in muscle mass before and after allo-HSCT. We conducted a prospective observational study using data from 68 patients who had undergone their first allo-HSCT. We evaluated the thickness of the quadriceps, biceps, and suprahyoid muscle. Three individual evaluators underwent this examination for each muscle before transplantation and on days 30, 90, and 180 after allo-HSCT. Inter-rater reliability was calculated using the interclass correlation (ICC), and the level of correlation between muscle mass measured by ultrasound and psoas muscle mass assessed using computed tomography (CT) was assessed using Pearson correlation. ICC values ranged from 0.897 to 0.977 in the measurement. The correlation scores were 0.730, 0.546 and 0.579 between psoas muscle and the biceps, quadriceps, and suprahyoid muscle. The thickness of the biceps and quadriceps muscle were both significantly decreased after allo-HSCT from baseline. These results showed that the ultrasound technique was a reliable tool for evaluating muscle mass and detecting changes in muscle mass following allo-HSCT.

Interaction between warfarin and molnupiravir in a patient with coronavirus disease 2019 infection.

Molnupiravir is a novel antiviral agent for coronavirus disease 2019 (COVID-19) treatment. Warfarin is an oral anticoagulation agent with difficult management due to drug interactions. Here, we describe a case of international normalized ratio (INR) prolongation in a patient who administrated warfarin with molnupiravir for COVID-19. An increased INR at 3.80, enough to discontinue warfarin, was observed on the fifth day of molnupiravir therapy, although the warfarin dose and INR were stable at 4 mg/day and approximately 2.0 before the molnupiravir initiation, respectively. Factors that affect the INR, such as severe COVID-19, cytokine, diet, liver dysfunction, and the concomitant use of medications other than molnupiravir, were unlikely in this patient. This case suggests that healthcare physicians should be aware of the possibility of drug interaction between molnupiravir and warfarin.

[Factors associated with participation in community activities after receiving long-term care preventive services].

Objectives　Since amending the long-term care insurance system to cover community-based services in 2015, community activities led by older residents have become increasingly important in Japan. It is necessary for local governments to effectively promote participation in community activities during long-term care prevention services. This study aimed to identify the factors associated with participation in community activities and the contents of intervention after long-term care prevention services in which interventions were conducted to promote older residents' participation in community activities.Methods　A secondary analysis of data collected in two classes of long-term care preventive services of a local government in Tokyo was conducted. This service provided not only interventions to improve physical function but also initiatives to promote participation in community activities after the service, such as learning and group-work activities. We analyzed participants' responses to self-administered questionnaires in 2016 and 2017; three months after the service started (T1) and six months after the service ended (T2). A total of 216 people (51 men and 165 women; age range: 65-95 years) responded to the questionnaires. Types of intervention, self-rated health, responses to the Kihon Checklist, and social capital, which was measured through items such as "Interaction with neighbors (SC1)," "Participation in groups other than preventive activity (SC2)," "Strength of trust for neighbors (SC3)," and "Mutual trust with neighbors (SC4)," were assessed at T1. Engaging in community activities was assessed to determine whether they participated in the self-motivating group for preventive activity at T2. Logistic regression analyses were conducted to examine the factors associated with participation in community activities by adjusting for each variable.Results　Totally, 113 respondents participated in community activities (participation rate=52.3%), and 103 did not participate (47.7%). Univariate logistic regression analyses revealed that types of intervention was significantly associated with participation in community activities (OR: 0.31, 95% CI: 0.15-0.63, P=0.001). Multivariate logistic regression models adjusted for all independent variables also indicated that types of intervention was significantly associated with participation in community activities (OR: 0.29, 95% CI: 0.14-0.62, P=0.001).Conclusion　The results showed that approximately 50% of the participants were involved in community activities because participation in such activities was promoted in long-term care preventive services. Types of intervention was a significant factor associated with participation in community activities. These findings highlight the importance of program contents in community activities during preventive services.

Hokkaido birth cohort study on environment and children's health: cohort profile 2021.

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.

Change in outdoor walking behavior during the coronavirus disease pandemic in Japan: A longitudinal study.

BACKGROUND: Due to the high infectivity and seriousness of coronavirus disease, people's daily activities were restricted in countries worldwide; governments implemented lockdown measures and advised individuals to perform self-restraint in terms of leaving the house. However, there have been few scientific reports on the effects of such behavioral restrictions on walking parameters. RESEARCH QUESTION: Did behavioral restrictions during the state of emergency in Japan effect walking parameters in daily life outdoor walking? METHODS: In this retrospective cohort study, four walking parameters, namely, the average number of steps taken, walking speed, step length, and cadence, were measured using a smartphone application among 3901 participants (mean age ± standard deviation: 60.3 ± 28.9 years) from March 2 to June 15 in both 2019 and 2020. Repeated-measures two-way analysis of variance was used to compare the walking parameters between the two years. RESULTS: The number of steps significantly decreased (p < .001) in 2020 (∼3400 steps) compared to that in 2019 (∼4400 steps), indicating that the state of emergency greatly affected the amount of physical activity performed per individual. Conversely, walking speed increased (p < .001 during the period when the state of emergency was issued) in 2020 (∼1.25 m/s) compared to that in 2019 (∼1.23 m/s), attributable to an increased step length. SIGNIFICANCE: Although changes in walking speed and step length were small compared to those in the number of steps, those changes were consistently seen during the state of emergency, suggesting that people tried to walk faster in their outdoor walking. Such change in walking behavior may have protected further deterioration of health due to restricted activity.

Isolation and Characterization of a Novel Jumbo Phage from Leaf Litter Compost and Its Suppressive Effect on Rice Seedling Rot Diseases.

Jumbo phages have DNA genomes larger than 200 kbp in large virions composed of an icosahedral head, tail, and other adsorption structures, and they are known to be abundant biological substances in nature. In this study, phages in leaf litter compost were screened for their potential to suppress rice seedling rot disease caused by the bacterium Burkholderia glumae, and a novel phage was identified in a filtrate-enriched suspension of leaf litter compost. The phage particles consisted of a rigid tailed icosahedral head and contained a DNA genome of 227,105 bp. The phage could lyse five strains of B. glumae and six strains of Burkholderia plantarii. The phage was named jumbo Burkholderia phage FLC6. Proteomic tree analysis revealed that phage FLC6 belongs to the same clade as two jumbo Ralstonia phages, namely RSF1 and RSL2, which are members of the genus Chiangmaivirus (family: Myoviridae; order: Caudovirales). Interestingly, FLC6 could also lyse two strains of Ralstonia pseudosolanacearum, the causal agent of bacterial wilt, suggesting that FLC6 has a broad host range that may make it especially advantageous as a bio-control agent for several bacterial diseases in economically important crops. The novel jumbo phage FLC6 may enable leaf litter compost to suppress several bacterial diseases and may itself be useful for controlling plant diseases in crop cultivation.