Relationship between office blood pressure and actual antihypertensive drug use in patients with hypertension following the promulgation of the guidelines for hypertension (JSH2019).

To achieve appropriate blood pressure control in the treatment of hypertension in Japan, this study examined the relationship between office blood pressure and actual antihypertensive drug use in general hospitals following the promulgation of the guidelines for hypertension (JSH2019). This study focused on blood pressure levels and drug use in outpatients on antihypertensive treatment from June to July 2020. The subjects were 2,537 patients classified into four groups based on their medical history, patients with: hypertension only; hypertension and cardiovascular disease; hypertension and dyslipidaemia; and hypertension and diabetes mellitus. The results showed a significant difference in systolic blood pressure (SBP) between patients with hypertension only and those with hypertension and cardiovascular disease (138.3±17.9 mmHg vs 135.6±19.9 mmHg, p<0.05). Regarding actual drug use, it was found that diuretics were prescribed more frequently in patients with hypertension and cardiovascular disease than in those with hypertension alone (15.5% vs 37.9%, p<0.05), even though the number of drugs for hypertension did not differ significantly. In addition, the dose of diuretics was greater only in patients with cardiovascular disease. These results show the actual drug use and blood pressure for each comorbidity. Furthermore, they suggest that the results of antihypertensive treatment may differ by changing the combination and dosage of antihypertensive drugs without changing the number of antihypertensive drugs used. The study also shows the problem of using less diuretics depending on the risk the patient has, and solving the problem may lead to achieving further antihypertensive goals.

Probing Superatomic Orbitals of Sc-Doped and Undoped Silver Cluster Anions via Photoelectron Angular Anisotropy.

Valence s electrons in alkali- or coinage-metal clusters are conceived to delocalize over the metal frameworks. The electrons occupy so-called superatomic orbitals (SAOs, i.e., 1S, 1P, 1D, 2S, 1F, ...), which provide an essential picture for understanding the size-dependent, unique properties of these metal clusters. While such electronic shells are unambiguously identified in their photoelectron spectra and supported by electronic structure calculations, characterization of SAOs in heteroatom-doped metal clusters has remained elusive as the doping significantly affects its energy levels and even alters the ordering of SAOs. Here, we present a photoelectron imaging study to explore SAOs formed in Sc-doped and undoped silver cluster anions, AgNSc- (N = 15, 16) and AgN- (N = 18, 19). Photoelectron angular distributions from their outermost SAOs are clearly visualized, whose characters are analyzed with the aid of density functional theory calculations. The present methodology enables us to explore not only the quantized energy levels but also the spatial distributions of SAOs formed in various metal cluster anions.

Association between parental occupations, educational levels, and household income and children's psychological adjustment in Japan.

OBJECTIVES: Most research on the association between parental or family socio-economic status and psychological adjustment in children has been performed mainly in Western countries, while there is limited evidence of such research in Asian countries. We examined the association of parental occupation and educational levels and household income with children's psychological adjustment in Japan. STUDY DESIGN: This was a cross-sectional study. METHODS: Study subjects were 6329 children aged 3 years. Children's psychological adjustment was assessed using the Strengths and Difficulties Questionnaire. RESULTS: Compared with having an unemployed father, having a father who worked in an administrative and managerial or clerical job was associated with a lower prevalence of peer problems. Compared with having an unemployed mother, having a mother who worked in the professional and engineering, sales, service, or manufacturing process area was associated with a lower prevalence of low prosocial behaviors, whereas having a mother who worked in the clerical, service, or manufacturing process area was associated with an increased prevalence of emotional problems. Having a mother who worked in a clerical area was associated with a higher prevalence of conduct problems. Higher paternal and maternal educational levels were inversely associated with the prevalence of conduct problems and hyperactivity but were positively associated with low prosocial behaviors. A higher household income was inversely associated with the prevalence of emotional problems, conduct problems, and hyperactivity. CONCLUSION: Parental occupation, educational levels, and household income may affect children's psychological adjustment in Japan.

Evaluating the impact of de-escalating antimicrobial therapy in burn patients: a retrospective cohort study.

Antimicrobials should be used appropriately to minimise the risk of resistant strains arising in association with overuse. De-escalation of antimicrobial therapy is one strategy used to ensure appropriate use, but its safety and efficacy in burn patients are unclear. The aim of this study was to evaluate the safety and efficacy of de-escalation therapy for treating infections in burn patients. This retrospective cohort study investigated patients admitted to our intensive care unit with burns and treated for infection between October 1, 2013, and September 30, 2020. Patients were classified into a de-escalation group (Group D) comprising patients treated with empiric antimicrobial therapy followed by de-escalation and a non-de-escalation group (Group ND) comprising patients who did not undergo de-escalation. Characteristics and outcomes were compared between groups. Forty-three patients met the inclusion criteria, including 15 patients in Group D and 28 patients in Group ND. Bacterial species commonly detected in these patients were Corynebacterium spp. (17.3%), Pseudomonas aeruginosa (16.1%), and Staphylococcus aureus (9.6%) . No inter-group difference was seen in 28-day mortality (6.7% vs 21.4%, p =0.391). Multidrug-resistant strains were detected significantly less frequently in Group D (13.0%) than in Group ND (26.1%, p =0.003). De-escalation was associated with use of two or more antimicrobials as empiric antimicrobial therapy. As the use of de-escalation in infection treatment did not impact 28-day mortality, de-escalation might be safe for treating infections in burn patients.

Effects of C-factor on dentin bonding using various adhesive systems.

Aims and Background: This study evaluated the effect of C-factor on the bond strength of a resin composite to floor and wall dentin using various adhesive systems. Materials and Methods: Four dentin substrates (flat wall, flat floor, cavity wall, or cavity floor) were prepared on human molars. Each specimen was restored with one of three adhesives; Clearfil SE Bond, Single Bond, or Clearfil tri-S Bond followed by buildup or filling using Z100 resin composite. The specimen was cut perpendicular to the bonded surface parallel to the floor or wall to obtain beams after light curing at 24,000 mJ/cm2. The microtensile bond strength to wall specimens or the cavity floor was determined. Data were analyzed. Results: All adhesive systems exhibited the highest bond strength to flat wall group (p < 0.05). The bond strength to the cavity group was significantly lower than that to the respective flat group regardless of the bonding system (p < 0.05). There was no significant difference in bond strength with Clearfil SE Bond and Clearfil tri-S Bond between the cavity wall and cavity floor (p > 0.05). Conclusion: The findings suggested that the strength of bonding to the cavity floor and cavity wall was affected by C-factor regardless of the adhesive system. Bonding to flat wall was higher than flat floor regardless of the adhesive system. Self-etching system provided uniform bond to the cavity wall and cavity floor dentin. However, total etching system reduced bond to the cavity floor than to the cavity wall.

Perinatal smoking exposure and risk of asthma in the first three years of life: A prospective prebirth cohort study

BACKGROUND: There is limited evidence on the association between prenatal smoking exposure and the risk of asthma in children. The aim of this prebirth cohort study was to investigate the association between prenatal and postnatal tobacco smoke exposure and the risk of asthma in Japanese children. METHODS: Study subjects were 1304 mother-child pairs. Information on the variables under study was obtained using repeated questionnaires that were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, 24, and 36 months after delivery. Ever asthma was defined as a maternal report of physician-diagnosed asthma at any time since birth. Current asthma was defined as the use of asthma medication at the time of the sixth survey. RESULTS: Logistic regression models revealed that maternal active smoking, either before pregnancy or during pregnancy, was not associated with the risk of ever asthma or current asthma. Further, no association was observed between postnatally living with at least one household smoker and the risk of asthma. Among children whose mothers are never smokers, maternal second-hand smoke (SHS) exposure at work and/or at home during pregnancy increased the risk of ever asthma and current asthma in children; adjusted odds ratio (95% confidence intervals) for ever asthma and current asthma were 2.41 (1.13-5.05) and 4.82 (1.68-13.43), respectively. CONCLUSIONS: Our findings suggest that maternal SHS exposure during pregnancy might be associated with an increased risk of ever asthma and current asthma in young children whose mothers have never smoked

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Perinatal smoking exposure and risk of asthma in the first three years of life: A prospective prebirth cohort study.

BACKGROUND: There is limited evidence on the association between prenatal smoking exposure and the risk of asthma in children. The aim of this prebirth cohort study was to investigate the association between prenatal and postnatal tobacco smoke exposure and the risk of asthma in Japanese children. METHODS: Study subjects were 1304 mother-child pairs. Information on the variables under study was obtained using repeated questionnaires that were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, 24, and 36 months after delivery. Ever asthma was defined as a maternal report of physician-diagnosed asthma at any time since birth. Current asthma was defined as the use of asthma medication at the time of the sixth survey. RESULTS: Logistic regression models revealed that maternal active smoking, either before pregnancy or during pregnancy, was not associated with the risk of ever asthma or current asthma. Further, no association was observed between postnatally living with at least one household smoker and the risk of asthma. Among children whose mothers are never smokers, maternal second-hand smoke (SHS) exposure at work and/or at home during pregnancy increased the risk of ever asthma and current asthma in children; adjusted odds ratio (95% confidence intervals) for ever asthma and current asthma were 2.41 (1.13-5.05) and 4.82 (1.68-13.43), respectively. CONCLUSIONS: Our findings suggest that maternal SHS exposure during pregnancy might be associated with an increased risk of ever asthma and current asthma in young children whose mothers have never smoked.

An artificial impact on the asteroid (162173) Ryugu formed a crater in the gravity-dominated regime.

The Hayabusa2 spacecraft investigated the small asteroid Ryugu, which has a rubble-pile structure. We describe an impact experiment on Ryugu using Hayabusa2's Small Carry-on Impactor. The impact produced an artificial crater with a diameter >10 meters, which has a semicircular shape, an elevated rim, and a central pit. Images of the impact and resulting ejecta were recorded by the Deployable CAMera 3 for >8 minutes, showing the growth of an ejecta curtain (the outer edge of the ejecta) and deposition of ejecta onto the surface. The ejecta curtain was asymmetric and heterogeneous and it never fully detached from the surface. The crater formed in the gravity-dominated regime; in other words, crater growth was limited by gravity not surface strength. We discuss implications for Ryugu's surface age.

A very-high-energy component deep in the γ-ray burst afterglow.

Gamma-ray bursts (GRBs) are brief flashes of γ-rays and are considered to be the most energetic explosive phenomena in the Universe1. The emission from GRBs comprises a short (typically tens of seconds) and bright prompt emission, followed by a much longer afterglow phase. During the afterglow phase, the shocked outflow-produced by the interaction between the ejected matter and the circumburst medium-slows down, and a gradual decrease in brightness is observed2. GRBs typically emit most of their energy via γ-rays with energies in the kiloelectronvolt-to-megaelectronvolt range, but a few photons with energies of tens of gigaelectronvolts have been detected by space-based instruments3. However, the origins of such high-energy (above one gigaelectronvolt) photons and the presence of very-high-energy (more than 100 gigaelectronvolts) emission have remained elusive4. Here we report observations of very-high-energy emission in the bright GRB 180720B deep in the GRB afterglow-ten hours after the end of the prompt emission phase, when the X-ray flux had already decayed by four orders of magnitude. Two possible explanations exist for the observed radiation: inverse Compton emission and synchrotron emission of ultrarelativistic electrons. Our observations show that the energy fluxes in the X-ray and γ-ray range and their photon indices remain comparable to each other throughout the afterglow. This discovery places distinct constraints on the GRB environment for both emission mechanisms, with the inverse Compton explanation alleviating the particle energy requirements for the emission observed at late times. The late timing of this detection has consequences for the future observations of GRBs at the highest energies.

Preterm birth is associated with higher prevalence of wheeze and asthma in a selected population of Japanese children aged three years

Background: The present cross-sectional study investigated the associations between low birthweight (LBW), high birthweight, preterm birth (PTB), postterm birth, small for gestational age (SGA), and large for gestational age (LGA) and the prevalence of wheeze and asthma in Japanese children aged three years (age range, 33-54 months; mean age, 38.7 months). Methods: Study subjects were 6364 children. A questionnaire was used to collect all data. Wheeze and asthma were defined according to the criteria of the International Study of Asthma and Allergies in Childhood. Results: The prevalence values of wheeze and asthma were 19.5% and 7.7%, respectively. Of the 6364 subjects, 8.8% were classified as LBW (< 2500g), 90.4% as normal birthweight, 0.8% as high birthweight (≥ 4000g), 4.8% as PTB (< 37 weeks), 94.8% as term birth, 0.4% as postterm birth (≥ 42 weeks), 7.8% as SGA (< 10th percentile), 82.5% as appropriate for gestational age, and 9.7% as LGA (> 90th percentile). Compared with term birth, PTB was independently positively associated with wheeze and asthma: the adjusted ORs (95% CI) were 1.47 (1.11-1.92) and 1.52 (1.02-2.20), respectively. An independent positive association was shown between PTB and wheeze only in boys; the interaction between PTB and sex was significant. Such an interaction between PTB and sex was not seen for asthma. No evident associations were observed between LBW, high birthweight, postterm birth, SGA, or LGA and wheeze or asthma. Conclusions: This is the first study in Japan to show that PTB, but not LBW or SGA, was significantly positively associated with childhood wheeze and asthma

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Hayabusa2 arrives at the carbonaceous asteroid 162173 Ryugu-A spinning top-shaped rubble pile.

The Hayabusa2 spacecraft arrived at the near-Earth carbonaceous asteroid 162173 Ryugu in 2018. We present Hayabusa2 observations of Ryugu's shape, mass, and geomorphology. Ryugu has an oblate "spinning top" shape, with a prominent circular equatorial ridge. Its bulk density, 1.19 ± 0.02 grams per cubic centimeter, indicates a high-porosity (>50%) interior. Large surface boulders suggest a rubble-pile structure. Surface slope analysis shows Ryugu's shape may have been produced from having once spun at twice the current rate. Coupled with the observed global material homogeneity, this suggests that Ryugu was reshaped by centrifugally induced deformation during a period of rapid rotation. From these remote-sensing investigations, we identified a suitable sample collection site on the equatorial ridge.

Preterm birth is associated with higher prevalence of wheeze and asthma in a selected population of Japanese children aged three years.

BACKGROUND: The present cross-sectional study investigated the associations between low birthweight (LBW), high birthweight, preterm birth (PTB), postterm birth, small for gestational age (SGA), and large for gestational age (LGA) and the prevalence of wheeze and asthma in Japanese children aged three years (age range, 33-54 months; mean age, 38.7 months). METHODS: Study subjects were 6364 children. A questionnaire was used to collect all data. Wheeze and asthma were defined according to the criteria of the International Study of Asthma and Allergies in Childhood. RESULTS: The prevalence values of wheeze and asthma were 19.5% and 7.7%, respectively. Of the 6364 subjects, 8.8% were classified as LBW (<2500g), 90.4% as normal birthweight, 0.8% as high birthweight (≥4000g), 4.8% as PTB (<37 weeks), 94.8% as term birth, 0.4% as postterm birth (≥42 weeks), 7.8% as SGA (<10th percentile), 82.5% as appropriate for gestational age, and 9.7% as LGA (>90th percentile). Compared with term birth, PTB was independently positively associated with wheeze and asthma: the adjusted ORs (95% CI) were 1.47 (1.11-1.92) and 1.52 (1.02-2.20), respectively. An independent positive association was shown between PTB and wheeze only in boys; the interaction between PTB and sex was significant. Such an interaction between PTB and sex was not seen for asthma. No evident associations were observed between LBW, high birthweight, postterm birth, SGA, or LGA and wheeze or asthma. CONCLUSIONS: This is the first study in Japan to show that PTB, but not LBW or SGA, was significantly positively associated with childhood wheeze and asthma.

Search for γ-Ray Line Signals from Dark Matter Annihilations in the Inner Galactic Halo from 10 Years of Observations with H.E.S.S.

Spectral lines are among the most powerful signatures for dark matter (DM) annihilation searches in very-high-energy γ rays. The central region of the Milky Way halo is one of the most promising targets given its large amount of DM and proximity to Earth. We report on a search for a monoenergetic spectral line from self-annihilations of DM particles in the energy range from 300 GeV to 70 TeV using a two-dimensional maximum likelihood method taking advantage of both the spectral and spatial features of the signal versus background. The analysis makes use of Galactic center observations accumulated over ten years (2004-2014) with the H.E.S.S. array of ground-based Cherenkov telescopes. No significant γ-ray excess above the background is found. We derive upper limits on the annihilation cross section ⟨σv⟩ for monoenergetic DM lines at the level of 4×10^{-28} cm^{3} s^{-1} at 1 TeV, assuming an Einasto DM profile for the Milky Way halo. For a DM mass of 1 TeV, they improve over the previous ones by a factor of 6. The present constraints are the strongest obtained so far for DM particles in the mass range 300 GeV-70 TeV. Ground-based γ-ray observations have reached sufficient sensitivity to explore relevant velocity-averaged cross sections for DM annihilation into two γ-ray photons at the level expected from the thermal relic density for TeV DM particles.

High birthweight is associated with increased prevalence of dental caries in Japanese children.

OBJECTIVE: We determined the prevalence of dental caries in 3-year-old Japanese children in a cross-sectional study and analysed its associations with birthweight, gestational age and birthweight for gestational age among the study subjects. METHODS: Study subjects were 6327 children. Their parents or guardians completed our study questionnaire with information on birth conditions and oral examinations taken from their Maternal and Child Health Handbooks, as documented by medical personnel at the hospital, clinic or public health centre. Children with one or more primary teeth that had either decayed or been filled were categorized as having caries. RESULTS: The prevalence of dental caries was 14.7%. We found a significant association between high birthweight (≥4000 g) and a higher prevalence of caries, compared with normal birthweight (2500-3999 g). Low birthweight (<2500 g) was not associated with dental caries prevalence. In addition, no measurable associations between gestational age or birthweight for gestational age and caries prevalence were observed. CONCLUSIONS: Our findings indicate that high birthweight might increase the likelihood of dental caries in children.

Intake of dairy products and calcium and prevalence of depressive symptoms during pregnancy in Japan: a cross-sectional study.

OBJECTIVE: To examine the relationship between the intake of dairy products and calcium and the prevalence of depressive symptoms during pregnancy. DESIGN: Cross-sectional study. SETTING: Kyushu Okinawa Maternal and Child Health Study (KOMCHS). SAMPLE: A cohort of 1745 pregnant Japanese women. METHODS: Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Scores of 16 or higher on the Center for Epidemiologic Studies Depression Scale denoted depressive symptoms. Adjustment was made for age, gestation, region of residence, number of children, family structure, history of depression, family history of depression, smoking, secondhand smoke exposure at home and at work, job type, household income, education, and body mass index. In our analyses regarding dairy products in general, adjustment was also made for fish intake; in our analysis regarding calcium, adjustment was also made for the intake of saturated fatty acids, eicosapentaenoic acid plus docosahexaenoic acid, and vitamin D. MAIN OUTCOME MEASURES: Depressive symptoms during pregnancy. RESULTS: Higher intake levels of yogurt and calcium were independently related to a lower prevalence of depressive symptoms during pregnancy: the adjusted odds ratios between extreme quartiles were 0.69 (95% CI 0.48-0.99, P for trend = 0.03) and 0.59 (95% CI 0.40-0.88, P for trend = 0.006), respectively. No relationships were observed between the intake of all dairy products, milk, or cheese and depressive symptoms during pregnancy. CONCLUSIONS: The current results suggest that a higher intake of yogurt and calcium may be associated with a lower prevalence of depressive symptoms during pregnancy.

IL5RA polymorphisms, smoking and eczema in Japanese women: the Kyushu Okinawa Maternal and Child Health Study.

The present case-control study examined the relationship between IL5RA SNPs and eczema in young adult Japanese women. Cases and control subjects were selected from pregnant women who participated in the baseline survey of the Kyushu Okinawa Maternal and Child Health Study, which is an ongoing prebirth cohort study. Cases comprised 188 women with eczema in the previous 12 months as defined according to the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC), regardless of the presence of a doctor's diagnosis of atopic eczema. Control subjects comprised 1130 women without eczema as defined according to the ISAAC criteria who also had not been diagnosed with atopic eczema by a doctor. Compared with the AA genotype of IL5RA SNP rs17881144, the AT genotype, but not the TT genotype, was significantly associated with a decreased risk of eczema. The ATTAGA haplotype and the GTAGCA haplotype of rs17882210, rs3804797, rs334809, rs9831572, rs6771148 and rs17881144 were significantly associated with an increased risk of eczema. In contrast, the GCTGCA haplotype was significantly related to a decreased risk of eczema. Multiplicative interactions between IL5RA SNPs rs334809 and rs17881144 and smoking with respect to eczema were marginally significant (P = 0.07 and 0.07, respectively). This is the first study to show significant associations between IL5RA SNP rs17881144, the ATTAGA haplotype, the GTAGCA haplotype, and the GCTGCA haplotype and eczema. Smoking may modify the relationships between SNPs rs334809 and rs17881144 and eczema.

Influence of losartan intake on the circadian rhythm of melatonin secretion in humans.

It has been reported that losartan, an angiotensin II receptor blocker, alters the circadian rhythm of melatonin secretion and significantly reduces melatonin production. However, this finding has been confirmed at the animal experiment level only, and there are no reports of studies in humans. Therefore, we performed this study to confirm the reproducibility of the aforementioned findings of animal experiments in humans. Ten male subjects who were in good general health and free from any medical condition were recruited for this study. After a preliminary observation period of 7 days, the subjects received oral losartan treatment, 50 mg daily for 7 days. Blood samplings for measurement of the plasma melatonin concentrations were performed on day 7 of the preliminary observation period and day 7 of the losartan treatment period. The circadian rhythm of melatonin secretion after the 7-day treatment with losartan showed no significant difference from that recorded before the losartan administration. The significant decrease of the home blood pressure was observed on the afternoons. The blood samples showed significant decrease of the serum sodium and uric acid levels, along with a significant increase of the serum potassium level. The pharmacological actions of losartan at the ordinarily used clinical dose level were confirmed in humans, however, no significant inhibitory effect of the drug on melatonin secretion could be confirmed. These results are expected to be useful for guiding the proper use of angiotensin II receptor blockers.

IL3 rs40401 polymorphism and interaction with smoking in risk of asthma in Japanese women: the Kyushu Okinawa Maternal and Child Health study.

Three previous genetic association studies conducted in Korea and China investigated the relationship between IL3 single nucleotide polymorphism (SNP) rs40401 and asthma, but their results were inconsistent. We examined this relationship and the possibility of an interaction between IL3 SNP rs40401 and smoking in young adult Japanese women. Included were 89 women who met the criteria of the European Community Respiratory Health Survey (ECRHS) for asthma. Control subjects were 700 women without asthma according to the ECRHS criteria who had not been diagnosed with asthma and/or allergic rhinitis by a doctor and/or who had not met the criteria of the International Study of Asthma and Allergies in Childhood for rhinoconjunctivitis. A significant positive association was found between SNP rs40401 and the risk of asthma, with the TT genotype as the reference under the additive model: the adjusted odds ratio was 1.39 (95% CI: 1.004-1.93). The positive association was not statistically significant in any other genetic model. Compared with subjects with the TT or TC genotype of SNP rs40401 who had never smoked, those with the CC genotype who had ever smoked had a significantly increased risk of asthma: the adjusted OR was 2.67 (95% CI: 1.23-5.79); the additive interaction, but not the multiplicative interaction, was significant. This study suggests that IL3 SNP rs40401 is significantly associated with the risk of asthma in young adult Japanese women and reveals that the combination of ever smoking and having the CC genotype of IL3 SNP rs40401 is significantly positively associated with asthma.