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Social relationships are associated with physical function. However, little scholarly attention has been focused on the effect of changing social factors on physical function.This study was designed to examine the effects on physical function of changes in social relationships in adults aged 65 years and older.This study is part of a longitudinal, prospective cohort study that was conducted on community-dwelling older adults in a suburban area of central Japan. Baseline self-report data were collected in 2011, and a follow-up survey was conducted in 2017. Social relationships were assessed using the Index of Social Interaction, and physical function was evaluated using a subscale of the Kihon Checklist. Chi-square tests, Mann-Whitney U tests, and multiple logistic regression analysis were used to analyze data from 442 older adults who were functionally independent at baseline.After controlling for covariates in 2011, negative changes in social relationships (odds ratio [ OR ] = 3.20, 95% CI [1.18, 8.69]) were found to be associated with physical function decline. Moreover, 1-point increases in the different social-relationship values between baseline and follow-up were associated with protective effects against functional decline ( OR = 0.71, 95% CI [0.63, 0.80]). Furthermore, median trends between baseline and follow-up revealed associations between decreasing ( OR = 4.18, 95% CI [1.53, 11.39]) and continuously low ( OR = 2.98, 95% CI [1.42, 6.28]) social relationships and physical function decline.The findings support a strong association between negative changes in social relationships and physical function decline and highlight the importance of promoting social relationships to delay physical function decline in older adults.

This study investigated the household secondary attack rate (HSAR) of patients with coronavirus disease (COVID-19) during the omicron variant-dominant period. The HSAR of COVID-19 cases during the omicron variant-dominant period (4–20 January 2022) was calculated and compared with the delta variant-dominant period (20 August to 7 November 2021) in Itako, Japan. In Itako, all 47 and 119 samples tested during the omicron and delta variant-dominant periods were negative and positive, respectively, for the L452R mutation. We used a generalized estimating equation regression model. The HSAR was 31.8% (95% confidence interval (CI) 27.7–36.2) for 456 household contacts during the omicron variant-dominant period; it was higher than that during the delta variant-dominant period (25.2%) (adjusted risk ratio [aRR] 1.61, CI 1.13–2.28). During the omicron variant-dominant period, HSAR was lower for the household contacts of completely vaccinated index patients (27.3%) than for contacts of other index patients (41.2%) (vaccine effectiveness for infectee 0.43, 95% CI 0.16–0.62) and was significantly higher for female contacts than for male contacts (36.2% vs. 26.1%; aRR 1.29, 95% CI 1.01–1.65). The HSAR was significantly higher during the omicron variant-dominant period than the delta variant-dominant period. The vaccination of index patients might protect household contacts.

Purpose The aim of the present study was to evaluate the genetic and environmental factors influencing the localization of mandibular third molars by analyzing the panoramic radiographs of twins. We examined the mandibular third molars of Japanese monozygotic (MZ) and dizygotic (DZ) twins recruited by the Osaka University Center for Twin Research. Materials and Methods The present study included 49 pairs (98 participants) of MZ twins and 11 pairs (22 participants) of DZ twins. Using panoramic radiography, we evaluated the degree of eruption of mandibular third molars according to the height of the alveolus bone and the third molar space/crown width ratio. Using co-twin control analysis and a generalized linear mixed model, we evaluated the effects of various factors, including gender, age, body height, number of teeth, length of the lower dental arch, existence of a second molar, bruxism, and previous orthodontic therapy. Results Body height, third molar space/crown width ratio, and length of the mandibular dental arch were related to the degree of mandibular third molar eruption and were strongly influenced by genetic factors rather than common or unique environmental factors. Conclusions The degree of third molar eruption was more similar among MZ twins than among DZ twins; therefore, genetic factors can be expected to have more significant influence than will environmental factors. These results can help identify the trend of third molar eruption from a young age, allowing us to advise the early extraction of mandibular third molars for patients with a short stature, narrow retromolar space, or short mandibular dental arch. In addition, if the genes that influence the degree of eruption were identified, we would be better equipped to predict an individual's risk of impaction, and indications for extraction might change.

The aim of the study was to investigate the effect of chemo-radiation on the genetic and immunological status of rectal cancer patients who were treated with preoperative chemoradiotherapy (CRT). The expression of immune response-associated genes was compared between rectal cancer patients treated (n = 9) and not-treated (n = 10) with preoperative CRT using volcano plot analysis. Apoptosis and epithelial-to-mesenchymal transition (EMT) marker genes were analysed by quantitative PCR (qPCR). Other markers associated with the tumor microenvironment (TME), such as tumor-infiltrating lymphocytes (TIL) and immune checkpoint molecules, were investigated using immunohistochemistry (IHC). The clinical responses of preoperative CRT for 9 rectal cancer patients were all rated as stable disease, while the pathological tumor regression score (TRG) revealed 6 cases of grade2 and 3 cases of grade1. According to the genetic signature of colon cancers, treated tumors belonged to consensus molecular subtype (CMS)4, while not-treated tumors had signatures of CMS2 or 3. CRT-treated tumors showed significant upregulation of EMT-associated genes, such as CDH2, TGF-beta and FGF, and cancer stem cell-associated genes. Additionally, qPCR and IHC demonstrated a suppressive immunological status derived from the upregulation of inflammatory cytokines (IL-6, IL-10 and TGF-beta) and immune checkpoint genes (B7-H3 and B7-H5) and from M2-type macrophage accumulation in the tumor. The induction of EMT and immune-suppressive status in the tumor after strong CRT treatment urges the development of a novel combined therapy that restores immune-suppression and inhibits EMT, ultimately leading to distant metastasis control.

This study aimed to elucidate the household secondary attack rate (HSAR) of the Delta variant in comparison to the Alpha variant, and evaluate the risk factors among unvaccinated household contacts of patients with coronavirus disease 2019 (COVID-19). We studied household contacts of index cases of COVID-19 infected with Delta (L452R mutation), Alpha (N501Y mutation), and wild strain from December 2020 through November 2021 in Itako, Japan. The HSARs of the entire household contact, and the contact of index case with Delta variant were calculated and compared across the risk factors. We used a generalized estimating equation regression model for the multivariate analysis. We enrolled 1257 unvaccinated contacts from 580 households. The HSAR was higher in household contacts of index patients with Delta (48.5%) than with Alpha variant (21.7%) (aOR = 3.34, p = 0.000). In Delta variants, the HSAR was higher in household contacts with spousal relationships to index patients (63.4%) than contacts with other relationships (45.5%) (aOR 1.94, p = 0.026), and was lower in household contacts of index patients aged ≤19 (33.1%) than for contacts of index cases aged 20–59 years (52.6%) (aOR = 0.50, p = 0.027). The result of our study can be used to devise informed strategy to prevent transmission within households.

Background Vaccines for coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being promoted worldwide. In this study, we analyzed the relationship between adverse reactions and the profile of vaccinated recipients. Methods Vaccinated subjects who received two doses of BNT162b2 between May 17 and June 11, 2021, at Osaka University Dental Hospital were included in this study. Adverse reactions and profiles were collected by questionnaires, and the relationship between the presence of adverse reactions and the profiles of the vaccinated persons was analyzed by logistic regression analysis. The correlation between the severity of adverse reactions and age was analyzed by Spearman’s rank correlation. Results Logistic regression analysis showed that, for many kinds of adverse reactions, the incidence was significantly higher in females than in males and in younger than in older people. There was a very weak but significant negative correlation between age and the severity of many kinds of adverse reactions. The relationship between sex and the incidence of each adverse reaction was significant for injection site reactions and fatigue in the first vaccination, whereas significant relationships were found for fatigue, chills, fever, arthralgia, myalgia and headache in the second vaccination, all of which were clearly more likely to occur in females. Conclusion Adverse reactions to BNT162b2 were found to be more frequent and more intense in females and younger people in Japan, especially after the second vaccination.

Objectives Social relationships may help in maintaining functional status among older adults. This study examined the types of social relationships that were related to functional status among Japanese community-dwelling older adults. Study design This is a prospective cohort study. Methods We used baseline data from 2008 and conducted follow-up surveys six years later. Participants included individuals older than 65 years who lived in a suburban community in Japan. The Index of Social Interaction measure was used to assess multiple elements of social relationships. Two functional status outcomes were set: (1) functional decline and (2) functional decline and mortality. A multiple logistic regression model was used to examine the association between social relationships and functional decline six years later. Results After controlling for age, sex, family structure and disease status in 2008, poor social curiosity (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.02–1.69) and interaction (OR = 2.57, 95% CI: 1.20–5.51) were found to be associated with functional decline. Furthermore, social curiosity (OR = 1.39, 95% CI: 1.14–1.69) and interaction (OR = 2.84, 95% CI: 1.44–5.59) were also associated with the composite outcome. Conclusions Social curiosity and interacting with others were significantly associated with functional status. Promotion of social interaction may be essential for preventing future need for care.

Postoperative pneumonia is one of the major complications after esophageal cancer surgery. The risk factors associated with postoperative pneumonia are poor general health, smoking, decreased pulmonary function, diabetes mellitus, surgical stress, old age, postoperative aspiration, and oral hygiene. In this study, we examined the effect of perioperative oral care on reducing postoperative pneumonia since the evidence to-date is not clear. A multicenter, retrospective investigation of the relationship between perioperative oral care and incidence of postoperative pneumonia in patients undergoing esophageal cancer surgery was conducted. A total of 775 patients who underwent thoracoscopic esophageal resection at 25 hospitals between 2016 and 2017 were enrolled in the study. Various factors were examined for correlation with development of postoperative pneumonia. Multivariate analysis showed that old age, smoking habit, lower hemoglobin, higher creatinine, postoperative dysphagia, and lack of oral care intervention were independent risk factors for pneumonia. Oral care was more effective in preventing pneumonia in hospitals in which the incidence of postoperative pneumonia was lower than 20%, while it was not effective in hospitals in which the incidence was higher than 20%. Results of the study suggest that it is recommended to carry out perioperative oral care in esophageal cancer surgery.

Recently, clinical studies using anti-immune checkpoint molecule antibodies have been successful in solid tumors, such as melanoma and non-small cell lung cancers. However, pancreatic cancers are still intractable and difficult to treat once recurrence or metastasis occurs; thus, novel combined use of immune checkpoint blockade (ICB) with molecular targeted drugs is considered a therapeutic option. Previously, we developed a novel humanized MHC-double knockout (dKO) NOG mouse model and demonstrated that an anti-PD-1 antibody or a STAT3 inhibitor showed anti-tumor effects through an immunological mechanism. In the current study, using a humanized mouse model, we aimed to develop a combination therapy with an anti-PD-1 antibody and a STAT3 inhibitor (STX-0119) for use in vivo against pancreatic cancer. In an in vitro investigation, STX-0119 showed weak to moderate cytotoxic activity against several pancreatic cancer cell lines, which exhibited activated pSTAT3 and weak PD-L1 expression. However, unexpectedly, an in vivo study indicated that the combination of the anti-PD-1 antibody with STX-0119 remarkably reduced the anti-tumor effect and TIL numbers despite the effective anti-tumor activity against pancreatic cancer was produced individually by STX-0119 and the anti-PD-1 antibody. These results suggested that the combination of an anti-PD-1 antibody with specific signal inhibiting drugs should be carefully evaluated to avoid unexpected side effects, and such studies might contribute to the development of an effective combination regimen of ICB with cancer-targeting drugs such as tyrosine kinase inhibitors (TKIs).

Background Social relationships may be the key to successful aging among older adults. However, little is known about the variability of social relationships among community-dwelling older people. This study aimed to describe the patterns of social relationships and examine the differences in sociodemographic characteristics and mental and physical health status among these patterns. Methods We obtained the data from a questionnaire survey in 2017 for older adults aged 65 and above who lived in a suburban area in Japan. The Index of Social Interaction (ISI) was used to evaluate social relationships. The final sample comprised 964 people who were independently mobile and answered at least one item of the ISI. To clarify the patterns of social relationships, latent class analysis was performed with five subscales of ISI treated as indicator variables. Multinomial logistic regression was conducted to examine the factors associated with the patterns of social relationships. Results The patterns of social relationships were classified into three classes: “Active” (73.6%), “Socially isolated” (14.7%), and “Less motivated” (11.7%). Persons who had depressive symptoms were more likely to be allocated to the “Socially isolated” (Odds Ratio [OR] 1.80, 95% Confidence Interval [CI] 1.13–2.86) or the “Less motivated” groups (OR 1.69, 95% CI 1.00–2.85) compared to the “Active” group. In addition, men (OR 1.72, 95% CI 1.07–2.76) and those living alone (OR 3.07, 95% CI 1.43–6.61) were more likely to be allocated to the “Socially isolated” group. Moreover, those who were dependent, according to the instrumental activities and daily living functions, were more likely to be assigned to the “Socially isolated” (OR 2.19, 95% CI 1.21–3.97) or “Less motivated” (OR 6.29, 95% CI 3.47–11.39) groups. Conclusion This study revealed the patterns of social relationships in older adults and suggested that there may be variations of social relationships among community dwellers. The results also indicated the necessity of assessing individual patterns of social relationships and devising strategies for each pattern in public health practice.

The purpose of the present study was to investigate the efficacy of perioperative oral managements (POMs) on perioperative nutritional conditions in patients undergoing surgery with general anesthesia. Medical records were retrospectively reviewed and the effects of POMs were investigated based on a large number of cases using a multicenter analysis. The profile of serum albumin levels was assessed and compared between patients with and without POMs using the multivariate analysis. Seventeen Eleven thousand and one hundred sixty patients (4,873 males and 6,287 females) were reviewed. Of these, 2710 patients (24.3%) had undergone POMs. The results of a multivariate analysis revealed the significant positive effect of POMs on perioperative serum albumin level (change between at admission and discharge, (Estimate: 0.022, standard error: 0.012, P

Objectives: Eating behaviour in early childhood serves as a foundation for future health outcomes. Diet patterns can have long-term beneficial or adverse effects on social behaviour development. Therefore, the objective of this study was to evaluate food consumption frequency in 1- to 6-year-olds as an eating behaviour-related predictor of behaviour problems six years later. Methods: This longitudinal study involved 124 mother-child dyads from a project named ‘Community Empowerment and Care for Wellbeing and Health Longevity’ initiated in 1991 and conducting surveys every three years. We studied children aged 1–6 years in July 2011, with a follow-up assessment in August 2017. The primary exposure examined was the frequency of food items intake. The primary outcome was behaviour problems as assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: The adjusted results suggested that a higher intake of leafy green and light-coloured vegetables were significantly associated with decreased odds of conduct problems and prosocial behaviour problems in Japanese children. However, no associations were observed among fruits, milk, small fish, eggs, soybeans, seaweed, and any SDQ subscales. Conclusion: This study shows that eating leafy green and light-coloured vegetables may have a protective effect on a child’s conduct and prosocial behaviour problems. Due consideration should be given to children’s eating habits in the early stages of their lives, to ensure better mental health. Keywords: Child; Diet; Impulsive Behaviour; Longitudinal Studies; Mental Health; Nutrients; Sugars; Vegetables.

Summary Background & aim Hypertension as a risk factor for cardiovascular disease has growing prevalence. An increase in body weight is typically followed by an increase in blood pressure. This study aimed to investigate the association of general and central obesity with hypertension in Indonesian women using WHO and Indonesian classification systems. Methods Cross-sectional study of Indonesian women aged 18 years or and more (313,714 participants), using national level Indonesia National Basic Health Research (2013). Results The prevalence of hypertension in Indonesian women in this study was 32.8%. Based on logistic regression analysis, hypertension was significantly associated with residential area, educational attainment, self-reported smoking status, cardiovascular disease, chronic kidney disease, diabetes mellitus, body mass index and waist circumference. Furthermore, the odds of having hypertension for general and central obesity according to WHO classification were adjusted odds ration (aOR) 2.61, 95% CI 2.52–2.70 and aOR 1.50, 95% CI 1.46–1.53. By Indonesian classification were aOR 2.21, 95% CI 2.16–2.26 and aOR 1.48, 95% CI 1.45–1.51. Conclusion By using International WHO and standard Indonesia classification systems, general and central obesity were associated with hypertension in Indonesia women. Thus, not only general obesity but also central obesity should be used to assess obesity in Indonesian women.

Reduction of children's behavioral problems has the potential to ameliorate parental stress, mental health problems, and family dysfunction. The current study was designed as a 3-year longitudinal study with secondary data. A total of 99 caregivers with preschool aged children were required to complete two self-reported questionnaires: the Index of Child Care Environment and Strengths and Difficulties Questionnaire. It demonstrated that a positive home-rearing environment had a positive influence on children's behavioral problem 3 years’ later. Our study suggests that we may reduce behavioral problems in children's later development by providing a positive home rearing environment.

Objectives To examine the relationship between multimorbidity and functional limitation, and how social relationships alter that association. Methods This cross-sectional study used data collected by self-reported questionnaires from adults aged 65 years and older living in a rural area in Japan in 2017. This analysis included complete data from 570 residents. Multimorbidity status was defined as having two chronic diseases exist simultaneously in one individual, and the function status was measured by their long-term care needs. Social relationships were assessed by the Index of Social Interaction and divided into high and low levels. Multiple logistic regression analysis was used to examine the association between social relationships and functional limitation and to assess the role of social relationships in this association. Results The logistic regression model indicated that the risk of functional limitation was higher in multimorbidity participants than free-of-multimorbidity participants (OR = 2.55, 95% CI = 1.56–4.16). Compared with participants with no multimorbidity and a high level of social relationships, low level of social relationships increased the risk of functional limitation among participants both with and without multimorbidity, with the OR = 7.71, 95% CI = 3.03–19.69 and OR = 3.28, 95% CI = 1.30–8.27, respectively. However, no significant result was found in participants with multimorbidity and a high level of social relationships (P = 0.365). Conclusions Multimorbidity was associated with functional limitations. However, this association could be increased by a low level of social relationships and decreased by a high level of social relationships.

Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over. A survey was conducted 8 times from 1994 to 2014 in the suburban area of Tobishima, Japan. The Index of Social Interaction Scale was used and each subscale and the total score were calculated. Subsequently, the 2014 scores were compared with the 1994 scores using the Wilcoxon rank sum test. Logistic regression analysis was conducted to clarify the factors related to social interaction, focusing on the association between the use of community resources (local elderly management center, health care center, health promotion facility, library) in 2011 and social interaction 3 years later. Age, gender, disease, and mobility were also entered into the model as control variables.Results Comparing social interaction in 1994 and 2014, total scores were found to have significantly increased in all age groups. Independence scores significantly increased in the overall group and in females aged 75-84. Curiosity scores also increased in both males and females. These results show that social interaction has increased over 2 decades. In addition, the use of local elderly management and health care centers, and health promotion facilities was associated with total social interaction scores 3 years later.Conclusion The current study clarified changes in social interaction, both comprehensively and for each of its aspects, among community-dwelling elderly adults. Increasing social isolation has been reported in recent years; however, the current study showed that social interaction, including social curiosity and independence, has increased over 20 years. The effect of preventive intervention in local elderly management centers, health care centers, and health promotion facilities may be one of the causes for this increase.

Background Understanding patterns of health service utilization can improve health care and increase use of health services. We examined patterns of health service utilization among residents of Ulaanbaatar, Mongolia. Methods A total of 500 adults were surveyed using paper-based questionnaires. The χ2 test and multiple logistic regression were used to identify associations between factors. Results 44.1% of respondents had visited a physician during the previous 12 months. After controlling for determinants, the significant predictors of utilization of health service were attention to health examinations (OR = 3.6, CI: 1.93–6.76), being married (OR = 2.7, CI: 1.50–4.72), being satisfied with the overall cleanliness of the hospital (OR = 2.4, CI: 1.12–5.19), being a nonsmoker (OR = 2.2, CI: 1.21–3.98), having periodic physical examinations (OR = 2.2, CI: 1.25–3.71), not being a hospital patient during the previous 3 years (OR = 2.1, CI: 1.22–3.73), having proper documentation (OR = 1.9, CI: 1.10–3.43), having medical insurance (OR = 1.9, CI: 1.96–3.28), not wanting to receive information on food and nutrition (OR = 0.6, CI: 0.36–0.96), having more than 5 household members (OR = 0.5, CI: 0.50–0.85), low income (OR = 0.5, CI: 0.30–0.85), lack of concern for food and nutrition (OR = 0.5, CI: 0.28–0.84), self-medication during the past 12 months (OR = 0.4, CI: 0.24–0.69), and desire for treatment abroad (OR = 0.4, CI: 0.20–0.60). Conclusions A number of health-related behaviors and sociodemographic factors were important predictors of health service utilization.

Background: The purpose of this paper is to describe the features of the Interaction Rating Scale (IRS) as an evidence-based practical index of children’s social skills and parenting. Methods: The participants in our study, which was conducted as part of a Japan Science and Technology Agency (JST) project, were 370 dyads of children (aged 18, 30, and 42 month) and 81 dyads of 7-year-old children with their caregivers. The participants completed the five minute interaction session and were observed using the IRS. Results: The results indicated that the IRS can measure children’s social skill development and parenting with high validity. Along with the discriminate validity for pervasive development disorder (PDD), attention-deficit/ hyperactivity disorder (ADHD), abuse and maltreatment, a high correlation with the SDQ (Strength and Difficulties Questionnaire), and high reliability, the IRS is effective in describing features of social skill development. Conclusions: The IRS provides further evidence of the fact that in order to study children’s social skill development, it is important to evaluate various features of the caregiver-child interaction as a predictor of social skills.

Background: This study investigated developmental change and stability in infant responses to the still-face (SF) situation, as well as predictive validity at age 18 months, focusing on autonomy and responsiveness.Methods: A total of 231 children (117 boys and 114 girls) and their Japanese mothers were observed in a face-to-face SF situation at two infant ages (4 and 9 months), as well as a caregiver-child teaching interaction at age 18 months. Each infant’s facial expression, gaze direction, and vocalization were coded according to the SF paradigm, including the Natural Interaction (NI) and SF phases. Each child’s Autonomy and Responsiveness to the Caregiver at age 18 months were both evaluated by means of the Interaction Rating Scale.Results: The results indicated that negative facial expression and vocalization in the SF phases at age 9 months predicted the Autonomy rating at age 18 months, while positive facial expression and gaze toward the caregiver in the NI at age 9 months predicted the Responsiveness to Caregiver rating at age 18 months.Conclusions: The results are discussed in the context of developmental continuity and change in the children’s social cognition and voluntary movements.

Background: The present study examines gender differences in the correlations between intelligence and developmental problems as well as social competence in first graders. Methods: Ninety parent-child dyads participated in this study. The children comprised 7-year-olds recruited from the first grade of an elementary school. All the children were administered the Wechsler Intelligence Scale for Children–Third Edition (WISC-III), Parent-child Interaction Rating Scale (IRS), and the parent report version of Strength and Difficulties Questionnaire (SDQ). Results: The findings clarified that the processing speed of boys significantly correlated with their peer relationship. On the other hand, the emotional symptoms exhibited by girls had a more common association with their intellectual abilities. The correlations between parenting and intellectual abilities differed in boys and girls. Conclusions: Children’s gender should be taken into account when assessing the diversity in their intellectual abilities and developmental problems. Moreover, parenting also influences the development of children in various ways.

Background: It is known that sleep problems impact children’s health, learning, and school performance. The purpose of this paper is to examine the association between sleeping habits and social competence development.Methods: Three hundred and nine caregiver-child dyads participated in this study, which was conducted as part of a Japan Science and Technology Agency (JST) project. The caregivers answered some questionnaires about sleeping habits when the child was 9 months and 18 months old. Caregiver-child interaction was observed when the child was 30 months old, and the features of the interaction were examined using the Interaction Rating Scale (IRS) as a measure of social competence.Results: The caregivers’ attitude toward sleeping in the 9-month period was found to be significantly correlated with the children’s social competence at 30 months. Moreover the caregivers’ attitude toward sleeping in the 9-month period significantly correlated with the children’s sleeping habits at 9 and 18 months.Conclusions: These findings show that the caregivers’ attitude toward sleeping is an important factor influencing the development of children’s social competence.

Background: Many studies have suggested that the daily emotional interactions between a child and his/her caregiver play a significant role in his/her development. The purpose of this study was to determine whether the trajectory patterns of parenting patterns of caregivers raising toddlers affect the social competence of the toddlers. Methods: The study participants were 246 dyads of 18-month-old children (baseline) and their caregivers, which was conducted as part of a Japan Science and Technology Agency (JST) project. We used the Interaction Rating Scale (IRS) to evaluate the children’s social competence. We assessed the child rearing environments by analyzing the caregivers’ responses to the Index of Child Care Environment (ICCE). Results: Multiple logistic regression analysis showed that the children’s total score on the IRS was significantly related to how frequently they sang songs together with their caregivers. Their score was also significantly related to how closely their caregiver worked with his/her partner in raising the child. These relationships did not change according to demographic information. Conclusions: The results confirm previous findings on the relationship between parenting patterns and children’s social competence. In particular, the study shows that varied and continual parenting significantly affects a child’s social competence.

Title. Relationship of working mothers’ parenting style and consistency to early childhood development: a longitudinal investigation. Aim. This paper is a report of a longitudinal study of the relationship of working mothers’ parenting style to their children’s social competence and vocabulary/motor/intellectual development. Background. With an increasing number of women choosing to remain in the workforce after starting a family, there has been a concomitant increase in use of non-parental childcare facilities to help look after the child while the mother is at work. This increase in non-parental care has led to a dramatic change in the traditional child-rearing environment. Methods. Long-term investigations were conducted over a period of 2 years in 41 Japanese government-licensed childcare facilities. Child development was evaluated by childcare professionals and parenting style was assessed by questionnaire. A total of 504 children and their mothers participated in the study. Data collection was carried out in 2004 and 2006. Findings. We found that the changes in parenting style were statistically significantly related to children’s development after 2 years. For instance, changes in the parent-child playing routine contributed to the child’s social competence (odds ratio = 11·088). Variation in working mothers’ disciplinary practices was also associated with children’s vocabulary development after 2 years (odds ratio = 2·246). Conclusion. Working mothers should increase interactions with their children in their free time to reduce the risk of developmental delay. Daily childcare support provided by family members or social organizations for long-term working mothers is helpful in mediating the negative relationship of mothers’ working with children’s development.

Previous studies have shown that social relationships positively contribute to the functioning of older adults. However, the particular aspects of social relationships that are most predictive remain unknown. Consequently, the current study aimed to clarify what elements of social relationships impacted the maintenance of functioning among older adults.The present study used baseline data collected in 2011, and follow-up surveys were carried out 3 years later. Participants included individuals aged 65 years or older who lived in a suburban community in Japan. A total of 434 participants met inclusion criteria for the study and were included in analysis. The Index of Social Interaction measure consists of five subscales (independence, social curiosity, interaction, participation and feeling of safety), and was used to assess the multiple elements of social relationships.After controlling for age, sex, disease status and mobility in 2011, the results showed that the social curiosity subscale was significantly associated with functional status after 3 years (OR 1.29, 95% CI 1.02-1.63). Other Index of Social Interaction subscales were non-significant.The current study suggests that interaction with environment and multifaceted social relationships have the strongest impact on functional ability for older adults in Japan. Geriatr Gerontol Int 2017; 17: 1522-1526.

Cisplatin (CDDP) is a key drug in the systemic treatment of various solid tumors. Brand-name CDDP may differ across generic formulations considering various clinical parameters. Therefore, in this study, we aimed to assess the safety of a generic CDDP formulation. To compare brand-name CDDP with a generic formulation, the incidence of adverse events, especially renal toxicity, was investigated in 500 patients with thoracic malignancies who received chemotherapy with more than 60 mg/m2 of either brand-name or generic CDDP. We compared the maximum serum creatinine (Cr) level after chemotherapy in the 2 groups. The correlation coefficients between the pretreatment Cr and the maximum Cr after CDDP administration did not differ between brand-name CDDP and generic CDDP (0.610 and 0.644, respectively; p=0.528). Furthermore, the correlation coefficients did not differ in subgroup analysis according to sex or adjuvant therapy. The severity of adverse events was similar in the 2 groups. In conclusion, generic CDDP can safely be used as an alternative to brand-name CDDP in the clinical setting.

Push back palatoplasty induces postoperative contraction and collapse of the dental arch. To inhibit collapse, 2 kinds of intersegment fixation plate, segment yoking plates, were applied. In one method, the segments were fixed with a resin plate onto the mucoperiosteal flap by 2 screws to fix palatal bone for 6 months (PB resin group, number of patients = 11). In the other method, the segments were fixed with a titanium plate by 2 screws onto the palatal bone under the mucoperiosteal flap until 4 years of age (PB titanium group, n = 10). Operation by conventional push back palatoplasty (PB Group, n = 25) was used as a control. Consecutive plaster models were measured by 3-dimensional laser scanner from at palatoplasty up to 4 years of age. In the PB resin group, the anticontraction effect worked only at the early postoperative stage. At 4 years of age, the narrowest intercanine width due to segment rotation caused by medial shift of the cleft side canine point and lateral shift of the cleft side tuberosity point was observed. As a result, a V-shaped dental arch developed. In the PB titanium group, the widest intercanine width due to a rigid anticontraction effect was observed at 4 years of age. Three push back methods demonstrated different arch morphologies due to each rigidity of the plate.

The prevalence of child abuse is increasing in Japan. Therefore, we need appropriate and practical approaches for implementing feasible prevention, early detection, and support services for abused children. The purpose of this study was to examine child-rearing anxieties and the home environment as factors affecting caregivers of suspected abused children who attend child-care centers .First, we applied the millennium edition of the Japan Child and Family Research Institute (JCFRI) Child Rearing Support Questionnaire, and the Index of Child Care Environment (ICCE), for 1,801 caregivers whose children were enrolled in child-care centers based in City A. The millennium edition of the JCFRI Child Rearing Support Questionnaire measures difficulties in childcare for caregivers in terms of feelings, anxiety, and tendencies toward depression. The ICCE measures the quality and frequency of involvement of caregivers with their children and the child-care environment. Next, we interviewed the directors and child-care professionals in the centers to collect information on child abuse. The children were divided into two groups: abused and non-abused. The "abused group" consisted of the children whom the directors and professionals of the child-care centers suspected of being "possibly abused" and so had been placed under the protection of the center; furthermore, the center exchanged information with the City A Municipality "City A municipal government" about these children. We conducted Fisher's exact test to examine the relationship between the "abused group" and the "non-abused group," in relation to child-rearing anxiety and the children's home environments. Questionnaire scores from the two groups were assessed. We calculated odds ratios to examine the significant factors related to child abuse. Our dependent variable was child abuse, our main independent variables were items related to child-care difficulties and the child-care environment, and the moderating variables were age and gender. We used multiple logistic regression to assess the actual child abuse predictors.The odds ratios obtained by comparing the "abused group" with the "non-abused group" showed that the caregivers of children in the "abused group" had a 5.5-fold greater odds of saying, "I am riddled with uneasiness and awful feelings," and a 4.6-fold greater odds of saying, "I do not have anyone to look after my child except a child-care center." The moderating variables (age and gender) were not significant.Child-care professionals have a policy for ensuring there is concrete and usable support for caregivers, depending on the relationship between the abused child and the difficulties present in the child's environment. We suggest that awareness of these relationships can be promoted as an aid for early child abuse detection, support, and prevention.

A peripheral ameloblastoma (PA) is a rare variant of ameloblastoma that generally occurs in the extraosseous region; an extragingival PA is extremely rare. There have been 5 cases reported of a PA occurring in the buccal mucosa and 1 in the oral floor. We present the sixth known case of extragingival PA in the buccal mucosa, which occurred in an 88-year-old woman.

Purpose: To reevaluate postoperative radiotherapy for thoracic esophageal carcinoma. Methods and Materials: Reviewed were the outcome of 89 patients who underwent esophagectomy with systematic dissection of regional lymph nodes between 1988 and 1993. Of the 89 patients, 19 underwent no adjuvant treatment, 22 underwent adjuvant chemotherapy alone, and 48 underwent postoperative radiotherapy. Twelve of the 48 also underwent adjuvant chemotherapy. Results: All patients who experienced local-regional recurrence had lymph node metastases at the time of surgery. The acturial local-regional control rate at 2-year of follow-up was 94% for patients with lymph node metastatses at the time of surgery who underwent postoperative radiotherapy alone or plus chemotherapy, and 74% for those who underwent adjuvant chemotherapy alone. The local-regional control rate was significantly better for those who had undergone postoperative radiotherapy (p < 0.01). Conclusions: Postoperative radiotherapy still plays an important role as adjuvant treatment.

Previous research has established links between corporal punishment and children's developmental problems, but few studies have investigated the moderating effect of positive parenting between corporal punishment and children's developmental difficulties in detail. This study investigated the buffering effect of parental engagement on the association between corporal punishment and children's emotional/behavioral problems.The main caregivers completed the Evaluation of Environmental Stimulation Scale (EES), which is an evaluation of daily parenting behaviors, and the Strengths and Difficulties Questionnaire (SDQ), which evaluates children's developmental problems.Corporal punishment was associated with worse emotional and behavioral problems in children, whereas parental engagement in games or sports was associated with fewer emotional symptoms. Similarly, parental engagement in homework or housework significantly moderated the association between corporal punishment and children's behavioral problems.Parental engagement positively moderated the association between parental corporal punishment and children's developmental difficulties. This association varied with child gender.

BACKGROUND Bifocal distraction osteogenesis has been shown to be a reliable method for reconstructing missing bone segments. However, there are no reports regarding inferior alveolar nerve regeneration during bifocal distraction. In the present study, the authors evaluated the function of inferior alveolar nerve regenerated by bifocal distraction after segmental resection in the mandibles of dogs. METHODS Using a bifocal distraction osteogenesis method, the authors produced a 10-mm mandibular defect and distracted the transport disk at a rate of 1 mm/day. The regenerated inferior alveolar nerve was evaluated by electrophysiologic analysis that was performed on all dogs after euthanasia at 3, 6, and 12 months after the first operation. RESULTS At 6 and 12 months, stable evoked potential measurements were obtained from the nerves throughout the study on electrophysiologic analyses. CONCLUSIONS The authors' results indicate that the inferior alveolar nerve regenerated by bifocal distraction osteogenesis functioned electrophysiologically at 6 months after the first operation. Although our research is still at the stage of animal experiments, future application in humans is considered to be possible.

Background: The purpose of this study was to examine the relations between children’s social competence and initial index of theory of mind at 30 months of age.Methods: The participants of the study were 322 toddlers and parents/caregivers who were registered with the Japan Science and Technology Agency (JST) project. They completed a five-minute interaction session, which was coded using the Interaction Rating Scale (IRS) as an evidence-based practical index of children’s social competence. In addition, the children were asked to complete a diverse-desire task as a ToM (theory of mind) index.Results: The results showed that the ToM index was related to the total score and subscales of the IRS, such as Empathy and Emotional regulation.Conclusions: These findings show that the IRS score was related to ToM task performance at 30 months of age.

Maxillary distraction osteogenesis using intraoral distractors is now one of the standard treatments of maxillary retrusion. This report shows 2 cases of breakage of this internal maxillary distractor in patients with cleft lip and palate; one was observed during the distraction period and the other was during the retention period. The first case required a rotational movement of the distraction segment, and this movement caused the laterally dislocation of the posterior part of the distractor, where the distractor suffered some mechanical forces by mouth opening. In the latter case, breakage of distractor was observed on the radiographs taken 3 months after distraction and this complication may have been caused by mechanical force by occlusion and mastication. Both breakages were found at the joint of the anchorage plate and the extension rod, which has some flexibility for adjusting the plate to the bone surface. Therefore, surgeons should pay special attention for this mechanical weak area in this distractor not only during the advancement period, but also during the retention period and should avoid unnecessary frequent bending for adopting the bone surface, which directly weakens the joint.

Vascularized bone grafts have become the preferred method of mandibular reconstruction. However, the technique is considered to increase both the operating time and blood loss, which might be associated with an increased morbidity and mortality. We conducted a retrospective analysis of 100 consecutive patients who underwent immediate bridging plate reconstruction. The median follow-up duration was 70 months. The 5-year overall survival rate was 69.9%. Cox multivariate analysis revealed that red blood cell transfusion was an independent prognostic factor for the overall survival. The plate survival with no complications was 62.2% at 5 years. Anterolateral defects and preoperative radiotherapy emerged as an independent adverse factor for plate survival. The use of bridging plates is an option for lateral mandibular reconstruction with no preoperative irradiation to avoid the risk from blood transfusion.

Osteochondroma is a benign neoplasm that usually develops in long bones and very rarely occurs in craniofacial bones. Nearly all reported mandibular osteochondromas have arisen in the condyle and the coronoid process, and occurrence in other locations is extremely rare. We describe a case of osteochondroma arising from the inferior border of the mandibular symphysis.

The study aim was to evaluate by ALS patients' satisfaction regarding information about invasive ventilators provided by medical doctors.Semi-structural interviews were conduced for 12 cases (11 patients and 9 family members provided information) at three areas in Japan.1) Most patients were unsatisfied with the information by doctors; 2) some cases felt strong distrust of doctors' attitudes; 3) more than half of the cases complained of insufficient information.This study suggests that in the informed consent for ALS patients, doctors' negative attitudes to life prolongation adversely impact on ALS patients. Roles of service providers, patients and family members should be reconsidered for cases of ALS and other incurable diseases.