Association between maternal dissatisfaction with oneself at birth and shaking and smothering toward the offspring up to 18 months old.

BACKGROUND: A mother who feels dissatisfaction with herself may resort to abusive behavior such as shaking or smothering toward their offspring. Understanding this association can inform effective prevention strategies. OBJECTIVE: This study aimed to investigate the associations between maternal feelings of dissatisfaction with oneself and infant physical abuse. PARTICIPANTS AND SETTING: The study included 434 mothers who had recently given birth in two obstetric wards in a relatively wealthy area in Tokyo, Japan. METHODS: Adopting a longitudinal design, the study used questionnaires post-childbirth to measure mothers' dissatisfaction with themselves. This involved evaluating perceptions of failing to meet personal standards or self-image. Physical abuse (specifically shaking or smothering) in infants was tracked at 3, 6, 12, and 18 months. Data analysis comprised multilevel analysis, group-based trajectory modeling, and multivariable logistic regression to explore the association between maternal dissatisfaction and child physical abuse. RESULTS: Multilevel analysis showed that mothers with middle or high dissatisfaction with themselves were more likely to abuse their infant compared to mothers with low dissatisfaction with themselves (adjusted odds ratios [aOR] 5.71, 95 % confidence interval [CI], 1.06-30.78 and aOR 12.47, 95 % CI: 2.11-73.69, respectively). Trajectory analyses indicated that mothers with middle or high dissatisfaction with themselves were consistently more likely to abuse their infants up to 18 months (aOR 8.08, 95 % CI 1.61-40.53 and aOR 6.42, 95 % CI 1.27-32.43, respectively). CONCLUSIONS: Our findings highlight a robust association between mother's dissatisfaction with themselves and a higher risk of infant physical abuse. These insights call for a comprehensive review of preventive measures for childhood physical abuse.

GPT-4/4V's performance on the Japanese National Medical Licensing Examination.

BACKGROUND: Recent advances in Artificial Intelligence (AI) are changing the medical world, and AI will likely replace many of the actions performed by medical professionals. The overall clinical ability of the AI has been evaluated by its ability to answer a text-based national medical examination. This study uniquely assesses the performance of Open AI's ChatGPT against all Japanese National Medical Licensing Examination (NMLE), including images, illustrations, and pictures. METHODS: We obtained the questions of the past six years of the NMLE (112th to 117th) from the Japanese Ministry of Health, Labour and Welfare website. We converted them to JavaScript Object Notation (JSON) format. We created an application programming interface (API) to output correct answers using GPT-4 for questions without images and GPT4-V(ision) or GPT4 console for questions with images. RESULTS: The percentage of image questions was 723/2400 (30.1%) over the past six years. In all years, GPT-4/4V exceeded the minimum score the examinee should score. In total, over the six years, the percentage of correct answers for basic medical knowledge questions was 665/905 (73.5%); for clinical knowledge questions, 1143/1531 (74.7%); and for image questions 497/723 (68.7%), respectively. CONCLUSIONS: Regarding medical knowledge, GPT-4/4V met the minimum criteria regardless of whether the questions included images, illustrations, and pictures. Our study sheds light on the potential utility of AI in medical education.

Childhood book availability helps to preserve cognitive function in older adults with low education: Results from the NEIGE study.

OBJECTIVES: It is well-known that low educational attainment is associated with cognitive function decline in older age. Childhood book availability may help to preserve cognitive function in older adults with low education. The study objective was to examine the association between childhood book availability and cognitive function among older adults with low educational attainment, and to investigate the mediating effect of the volume of reading-related brain regions (e.g., superior temporal cortex). METHODS: A cross-sectional study of community-dwelling older Japanese adults aged 65-84 years was conducted (n=474). Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Childhood book availability was assessed using a retrospective questionnaire. Brain region volume was measured using magnetic resonance imaging. Multivariate regression modeling and structural equation modeling were used for analysis. RESULTS: Both high educational attainment and childhood book availability were independently associated with high MMSE score. Stratification of educational level showed that childhood book availability was positively associated with MMSE score among participants with low educational attainment (coefficient=1.48, 95% confidence interval (CI): 0.31 to 2.66), but not among those with moderate or high educational attainment (coefficient=-0.01, 95% CI: -1.44 to 1.42 and -1.21, 95% CI: -3.85 to 1.42, respectively). Among participants with low educational attainment, left superior temporal cortex volume mediated the association between childhood book availability and MMSE score. DISCUSSION: The availability of books in childhood helps to preserve cognitive function in older adults with low education via left superior temporal cortex volume. Further research is needed to replicate these findings.

Association of excess visceral fat and severe illness in hospitalized COVID-19 patients in Japan: a retrospective cohort study.

BACKGROUND/OBJECTIVES: Obesity, defined by body mass index (BMI), is a well-known risk factor for the severity of coronavirus disease 2019 (COVID-19). Adipose tissue distribution has also been implicated as an important factor in the body's response to infection, and excess visceral fat (VF), which is prevalent in Japanese, may contribute significantly to the severity. Therefore, this study aimed to evaluate the association of obesity and VF with COVID-19 severe illness in Japan. SUBJECTS/METHODS: This retrospective cohort study involved 550 COVID-19 patients admitted to a tertiary care hospital with BMI and body composition data, including VF. The primary endpoint was severe illness, including death, due to COVID-19 during hospitalization. Logistic regression analysis was applied to examine the quartiles of BMI and VF on severe illness after adjusting for covariates such as age, sex, subcutaneous fat, paraspinal muscle radiodensity, and comorbidities affecting VF (COPD, cancer within 5 years, immunosuppressive agent use). RESULTS: The median age was 56.0 years; 71.8% were males. During hospitalization, 82 (14.9%) experienced COVID-19 severe illness. In the multivariate logistic regression analysis, Q4 of BMI was not significantly associated with severe illness compared to Q1 of BMI (OR 1.03; 95% CI 0.37-2.86; p = 0.95). Conversely, Q3 and Q4 of VF showed a higher risk for severe illness compared to Q1 of VF (OR 2.68; 95% CI 1.01-7.11; p = 0.04, OR 3.66; 95% CI 1.30-10.26; p = 0.01, respectively). Stratified analysis by BMI and adjusted for covariates showed the positive association of VF with severe illness only in the BMI < 25 kg/m2 group. CONCLUSIONS: High BMI was not an independent risk factor for COVID-19 severe illness in hospitalized patients in Japan, whereas excess VF significantly influenced severe illness, especially in patients with a BMI < 25 kg/m2.

Applying negative ions and an electric field to countermeasure droplets/aerosol transmission without hindering communication.

In the COVID-19 pandemic, lockdown and acryl partitions were adopted as countermeasures against droplets/aerosol infections; however, these countermeasures restrict communication. In this study, a blocking device was developed using negative ions and an electric field. The device blocks mists simulating droplets/aerosol by a maximum of 89% but transmits light and sound, which is important for communication. The device demonstrated effective blocking performance for aerosol, including the COVID-19 virus spread from patients in a clinic. Our device can help prevent infections without disrupting communication.

Change of human flourishing during the COVID-19 pandemic in Japan: Results from population-based U-CORONA study.

Longitudinal change in flourishing during the pandemic of COVID-19 would provide new insight to reveal determinants of well-being. We aimed to describe changes in flourishing during the COVID-19 pandemic in Japan and to examine the association of sex, age, education, and income with changes in flourishing. Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study conducted in October 2020 and November 2021 was used (n = 419 in 2020 and n = 478 in 2021, and n = 327 for both waves). Flourishing was assessed using a 12-item multidimensional flourishing scale including six domains. Change of flourishing was categorized into decreased, unchanged, and increased. Multinomial logistic regression was applied to longitudinal data to estimate the relative risk ratio of increase and decrease in flourishing scores. Cross-sectional analysis showed that the mean score of flourishing was approximately seven in both waves, with no sex differences, but older adults had higher scores than young-aged adults. We found that men were twice as likely to lose their flourishing scores as women and lower levels of education were associated with 2-3 times declining flourishing scores than higher levels of education. Age and income were not significantly associated with the change of flourishing. During the COVID-19 pandemic, flourishing declined, and men and lower-educated people were more vulnerable. In prolonged difficult situations, support for men and less educated people may contribute to the prevention of declining well-being in Japan.

Interventions to change parental parenting behaviour to reduce unintentional childhood injury: a randomised controlled trial.

OBJECTIVE: The previous study has shown the impact of paternal involvement in childcare on unintentional childhood injury; yet the causality is unknown. The purpose of this study is to investigate whether the intervention of an educational video on paternal involvement in childcare can prevent unintentional injury among young children. METHODS: A randomised controlled trial of parents of children born at two obstetrics wards in Japan (n=451, intervention group: 223, control group: 228) was conducted. Parents in the intervention group watched an educational video that promote paternal involvement in childcare, while parents in the control group watched an educational video on the prevention of shaken baby syndrome. The participants were followed for up to 18 months after the birth of their child. The primary outcome of this study was unintentional injury at 3, 6, 12 and 18 months. The secondary outcome was paternal involvement in childcare based on maternal observation. Unintentional injury-free rates over time were assessed using the Cox proportional hazard model. RESULTS: Children in the intervention group were less likely to have unintentional injury, such as burn (HR: 0.29 (95% CI: 0.09 to 0.87)) and caught by a door (HR: 0.66 (95% CI: 0.48 to 0.91)) compared with the control group. Fathers in the intervention group showed higher frequency of taking their children for a walk (coefficient: 0.19 (95% CI: 0.05 to 0.32)). CONCLUSIONS: Educational videos promoting paternal involvement in childcare is effective to prevent unintentional childhood injury.

Effectiveness of remdesivir with corticosteroids for COVID-19 patients in intensive care unit: A hospital-based observational study.

The effectiveness of remdesivir on survival in coronavirus disease 2019 (COVID-19), especially in cases treated in the intensive care unit (ICU), is controversial. We investigated the effectiveness of remdesivir with corticosteroids on the survival of COVID-19 patients in a real ICU clinical practice. For laboratory-confirmed COVID-19 patients admitted to the ICU of a tertiary hospital in Tokyo (April 2020-November 2021) and who received corticosteroids, the effectiveness of remdesivir for survival, stratified by interval length (within 9 or 10+ days), was retrospectively analyzed using Cox regression model. A total of 168 patients were included: 35 with no remdesivir use (control), 96 with remdesivir use within 9 days, and 37 with remdesivir use with an interval of 10+ days. In-hospital mortality was 45.7%, 10.4%, and 16.2%, respectively. After adjusting for possible covariates including comorbidities, laboratory data, oxygen demand, or level of pneumonia, remdesivir use within 9 days from symptom onset reduced mortality risk (hazard ratio [HR]: 0.10; 95% confidence interval (CI): 0.025-0.428) compared to the control group. However, remdesivir use with an interval of 10+ days showed no significant association with mortality (HR: 0.42; 95% CI: 0.117-1.524). Among COVID-19 patients who received corticosteroids in ICU, remdesivir use within 9 days from symptom onset was associated with reduced in-hospital mortality risk.

Extreme enhancement of secondary chirality through coordination-driven steric changes of terpyridyl ligand in glutamide-based molecular gels.

Aggregation-induced chirality is potentially useful in sensor technology applications. Herein we show extreme enhancement of secondary chirality through coordination-driven steric changes of terpyridyl ligand in molecular gels. The secondary chirality reflecting on enhancement of chiral signals (i.e., circular dichroism (CD) and circularly polarised luminescence (CPL)) of the molecular gels formed from glutamide-attached terpyridine (G-tpy) is extremely enhanced by the coordination of its terpyridyl groups to metal ions such as Cu2+, Zn2+ and Ru2+, which is due to dramatic changes in the stacked structure of the chromophore groups through the formation of metal ion complex. Metal-free terpyridine exists in a non-planar geometry, which suppress π-π stacking interactions among aggregates. The planarity of the terpyridyl group is improved through metal-ion complexation, which induces the metal-ion-coordinated terpyridyl groups to stack. The thermal stabilities of the CD signals are strongly affected by the metal-ion species. CPL signal is generated in the molecular gel formed from G-tpy-Zn2+ complex accompanied by chelation-enhanced fluorescence. It is expected that large and sensitive coordination-driven secondary chirality signals (CD and CPL) are useful for sensing guest molecules and the surrounding environment.