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The Nursery School Absenteeism Surveillance System (NSASSy), which includes 40% of all nursery schools in Japan, has a degree of effectiveness that is difficult to prove: nursery schools and areas without NSASSy cannot be evaluated for their incidence of infectious diseases as precisely as those with NSASSy. Instead, we examine nursery school countermeasures against infectious diseases by considering the endogeneity bias of NSASSy. After sending questionnaires to 500 Tokyo metropolitan and nearby nursery schools in November 2022, we received their responses through the end of 2022. Questionnaires asked about infection control measures of nursery schools: (1) cooperation with public health centers; (2) cooperation with staff; (3) cooperation with children's parents; (4) precautions among children; (5) countermeasure systems; (6) precaution systems; (7) recording of health conditions of children; (8) usefulness of studying while students; and (9) usefulness of training at nursery schools. Ordered probit with inverse probability weighted adjustment was used as the estimation procedure. The explanatory variable was a dummy variable for using NSASSy. Probability in weight was estimated using the first-step probit for NSASSy. Explanatory variables were a dummy variable for publicly funded nursery schools and a dummy variable for local governments that had adopted NSASSy. We analyzed 193 nursery schools. NSASSy was negative and associated significantly with (3) cooperation with children's parents and (7) recording of health conditions of children. These countermeasures were more likely to have been taken by NSASSy nursery schools. [ABSTRACT FROM AUTHOR]

A guideline published in 2018 by the Ministry of Health, Labour and Welfare stipulated confirmation of the vaccine history of nursery staff members. This study was conducted to elucidate nursery teachers' vaccine and infection histories for measles, mumps, rubella, and varicella through survey responses. After sending questionnaires through the mail to 5000 nursery teachers in November 2022, we received responses through December 2022. We measured the proportion of susceptibility in three ways. Additionally, we compared the proportions of susceptibility by disease by age class. After receiving 1620 responses in all, the data of 1229 respondents under 50 years old were analyzed. Under the broad definition by which "no answer" was also regarded as unvaccinated or uinfected as well as "unknown," the proportions of susceptibility for measles, rubella, and varicella were higher: 22–23%. For mumps, the proportion was 42%. For varicella, they were 31% for respondents in their 30 s, and 14% for respondents in their 40 s. For mumps, the respective values were 58% and 26%. Respondents assessed for this study were less susceptible and unknown in comparison with earlier studies investigating health care workers, school teachers, university students, and pregnant women. The survey revealed that measles and rubella susceptibility was higher among respondents in their 30 s. However, it was higher for varicella and mumps among respondents in their 20 s. [ABSTRACT FROM AUTHOR]

• About 40% of two-dose vaccinated nursery school children became ill with varicella. • Outbreaks at nursery schools might be transmitted from older students, perhaps siblings. • Vaccine effectiveness in the nursery school for more than one dose was not confirmed. • Vaccination using one dose or more can reduce severity significantly. In Japan, routine administration to one-year-old children of two-dose immunization for varicella was introduced in October 2014. Object The object of this study was to report outbreaks of varicella under routine immunization at a nursery school and in its surrounding area using data of surrounding areas from the (Nursery) School Absenteeism Surveillance System. Then, we measured the effectiveness of routine two-dose immunization for varicella to onset. We tentatively assessed its severity in a nursery school. The study period extended from April 2017 through March 2018. The study area comprised Nursery school B and other nursery schools, and elementary and junior high schools in City A. Subjects in Nursery school B were 120 children. We analyzed vaccine effectiveness (VE) as an observational study and assessed severity using Fisher's exact test. We also assessed VE for severity using linear regression. Severity was defined as the length of nursery school absence attributable to varicella infection. During the one month preceding a period of two weeks before the initial case at Nursery school B, there were 16 cases of varicella infection in nursery schools, 45 cases in elementary schools, and one case in junior high schools in City A. For children who had received one vaccine dose or more, VE was 48.1% for all ages and 49.2% among children three years old and older. No significant VE against infection was found. Vaccination using one dose or more can reduce severity significantly. Discussion and conclusion: Because many nursery school children who had received two doses of vaccine were infected, VE was estimated as low in the nursery school and not significant. Although VE for severity with more than one dose was confirmed, a second dose might not reduce severity compared to one dose. [ABSTRACT FROM AUTHOR]

Simple Summary: This was a multicenter, single-arm, phase II study comprising two protocol treatments. Patients were enrolled after craniotomy or biopsy and initiated the concurrent phase; oral daily temozolomide concomitant with radiation therapy during the first 6 weeks of treatment. Bevacizumab was intravenously administered every other week. The protocol-defined secondary therapy (i.e., BBP regimen) was given as bevacizumab monotherapy or in combination with other chemotherapeutic agents upon first progression or recurrence until further progression or unacceptable toxicity developed. The primary endpoint, the 2-year survival rate of the BBP group, was 27.0% and was unmet. Expression profiling using RNA sequencing identified that Cluster 2, enriched with the genes involved in macrophage or microglia activation, was associated with longer OS and PFS independent of the MGMT methylation status. We evaluated the efficacy and safety of bevacizumab beyond progression (BBP) in Japanese patients with newly diagnosed glioblastoma and explored predictors of response to bevacizumab. This phase II study evaluated a protocol-defined primary therapy by radiotherapy with concurrent and adjuvant temozolomide plus bevacizumab, followed by bevacizumab monotherapy, and secondary therapy (BBP: bevacizumab upon progression). Ninety patients received the protocol-defined primary therapy (BBP group, n = 25). Median overall survival (mOS) and median progression-free survival (mPFS) were 25.0 and 14.9 months, respectively. In the BBP group, in which O6-methylguanine-DNA methyltransferase (MGMT)-unmethylated tumors predominated, mOS and mPFS were 5.8 and 1.9 months from BBP initiation and 16.8 and 11.4 months from the initial diagnosis, respectively. The primary endpoint, the 2-year survival rate of the BBP group, was 27.0% and was unmet. No unexpected adverse events occurred. Expression profiling using RNA sequencing identified that Cluster 2, which was enriched with the genes involved in macrophage or microglia activation, was associated with longer OS and PFS independent of the MGMT methylation status. Cluster 2 was identified as a significantly favorable independent predictor for PFS, along with younger age and methylated MGMT. The novel expression classifier may predict the prognosis of glioblastoma patients treated with bevacizumab. [ABSTRACT FROM AUTHOR]

Objective Little is known about the cortisol awakening response (CAR) in children with attention deficit hyperactivity disorder (ADHD). Here, we examined the CAR in children with ADHD and their mothers before, immediately after, and 4 months after an intensive summer treatment program (STP). Methods Participants were 37 children aged 7–12 years who completed the STP in 2009 and 2010, and their mothers. Daily saliva samples for cortisol measurement were collected twice daily at awakening and 30 min afterwards at pre-STP, post-STP, and during a follow-up measurement period. ADHD symptom scores were evaluated by parents, and participants completed the Kid-KINDL R QOL questionnaire. Results CAR was low in children with ADHD before the STP, and increased to the control range 4 months after STP. Maternal CAR also tended to increase after STP. Changes in the CAR in children tended to correlate with an improved ADHD inattention scores ( p = 0.091), physical health ( p = 0.070), and school life subscales scores in the Kid-KINDL R ( p = 0.079). Conclusion We demonstrated that STP improved the behavior and QOL of children with ADHD. Our results indicate that STP could lead to improvements in HPA axis function, as reflected by increased CAR after STP. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to investigate the developmental trajectories of attention, short-term memory, and working memory in school-aged children using a 10 min test battery of cognitive function. Methods Participants comprised 144 typically developing children (TDC) aged 7–12 years and 24 healthy adults, divided according to age into seven groups (12 males and 12 females for each age group). Participants were assessed using CogHealth, which is a computer-based measure composed of five tasks. We measured attention, short-term memory, and working memory (WM) with visual stimulation. Each task was analyzed for age-related differences in reaction time and accuracy rate. Results Attention tasks were faster in stages from the age of 7–10 years. Accuracy rate of short-term memory gradually increased from 12 years of age and suddenly increased and continued to increase at 22 years of age. Accuracy rate of working memory increased until 12 years of age. Correlations were found between the ages and reaction time, and between ages and accuracy rate of the tasks. Conclusion These results indicate that there were rapid improvements in attention, short-term memory, and WM performance between 7 and 10 years of age followed by gradual improvement until 12 years of age. Increase in short-term memory continued until 22 years of age. In our experience CogHealth was an easy and useful measure for the evaluation of cognitive function in school-age children. [ABSTRACT FROM AUTHOR]

Background: To control hyperthyroidism due to Graves' disease, antithyroid drugs should be administered. Several studies have shown that exposure to methimazole (MMI) during the first trimester of pregnancy increases the incidence of specific congenital anomalies that are collectively referred to as MMI embryopathy. Congenital anomalies associated with exposure to propylthiouracil (PTU) have also recently been reported. Methods: This study investigated whether substituting potassium iodide (KI) for MMI in the first trimester would result in a lower incidence of major congenital anomalies than continuing treatment with MMI alone. The cases of 283 women with Graves' disease (GD) were reviewed whose treatment was switched from MMI to KI in the first trimester (iodine group), as well as the cases of 1333 patients treated with MMI alone (MMI group) for comparison. Another major outcome of interest was the incidence of neonatal thyroid dysfunction. The subjects of the analysis of major congenital anomalies and neonatal thyroid dysfunction were live-born infants. Results: The incidence of major anomalies was 4/260 (1.53%) in the iodine group, which was significantly lower than the incidence of 47/1134 (4.14%) in the MMI group. Two neonates in the iodine group had anomalies consistent with MMI embryopathy (0.8%), as opposed to 18 neonates in the MMI group (1.6%). None of the neonates exposed to KI had thyroid dysfunction or goiter. Conclusions: Substituting KI for MMI as a means of controlling hyperthyroidism in GD patients during the first trimester may reduce the incidence of congenital anomalies, at least in iodine-sufficient regions. [ABSTRACT FROM AUTHOR]