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Background In 2020, the Japanese Orthopaedic Association established a new stage 3 in clinical decision limits (CDL) to evaluate the stage of locomotive syndrome (LS). This study focused on total CDL stage 3 with the aim of investigating indicators related to improvements in total CDL by evaluating the improvement of LS in patients who underwent total hip arthroplasty (THA). Methods Of the 125 patients who underwent THA at our hospital, the subjects of the analysis were 105 patients determined to be total CDL stage 3 in an evaluation performed before THA. LS was evaluated using the stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25). Indicators related to improvements in total CDL were also investigated. All evaluation items were measured before THA and three months after THA. Results Before THA, all subjects (n = 105) were classified as total CDL stage 3. Three months after THA, improvements in total CDL were seen in 49 subjects (46.7%). The results of stepwise multiple logistic regression analysis showed that the before THA stand-up test and GLFS-25 were significantly related to improvements in total CDL. Conclusions Three months after THA, improvements in LS were seen in approximately half of the subjects. The stand-up test and GLFS-25 can be used as indicators of improvement in total CDL. Design Prospective cohort study design.

Objective To establish a model to predict high cytomegalovirus (CMV) immunoglobulin (Ig)G avidity index (AI) using clinical information, to contribute to the mental health of CMV-IgM positive pregnant women. Methods We studied 371 women with IgM positivity at ≤14 w of gestation. Information on the age, parity, occupation, clinical signs, IgM and G values, and IgG AI was collected. The IgG AI cut-off value for diagnosing congenital infection was calculated based on a receiver operating characteristic curve analysis. Between-group differences were assessed using the Mann–Whitney U-test or χ2 analysis. The factors predicting a high IgG AI were determined using multiple logistic regression. Results The women were divided into high or low IgG AI groups based on an IgG AI cut-off value of 31.75. There were significant differences in the IgG and IgM levels, age, clinical signs, and the number of women with one parity between the two groups. In a multiple logistic regression analysis, IgM and the number of women with one parity were independent predictors. This result helped us establish a mathematical model that correctly classified the IgG AI level for 84.6% of women. Conclusion We established a highly effective model for predicting a high IgG AI immediately after demonstrating IgM positivity.

This study aimed to estimate the prevalence of locomotive syndrome (LS) risk in age groups using the LS risk test proposed by the Japanese Orthopaedic Association. Based on this, this study identified the lifestyle-related signs that lead to LS, by clarifying the association between LS risk and lifestyle factors.A total of 728 individuals aged 20-91 years who were without specific mobility disorders were evaluated. Participants were asked to perform the LS risk test and complete a self-administered original questionnaire survey for this study. The Mann-Whitney U test was used to examine the relationships of sex and age with LS. The prevalence of LS by sex and age was compared using the Chi-squared test or Student's t-test, as appropriate. The Mantel-Haenszel test was used to examine the relationship of each component of the lifestyle factors.Overall, 36.4% of males and 49.1% of females were classified into the LS group; the prevalence of LS was significantly higher in females than males (p .001). The prevalence of LS tended to increase with age in both males and females (p .05). As for health condition, pain in the locomotive organs, knees, back, and hip joints was significantly associated with LS (p .05). Of the lifestyle-related diseases, only hypertension (p .05) was significantly associated with LS, and drug treatment was significantly associated with LS (p .05). As for lifestyle, anxiety about physical fitness, self-assessed poor health, irregular dietary habits, and lack of exercise were also associated with LS (p .05).Interventions to prevent LS are important during its early stages, especially for females, and lifestyle-related signs of LS, such as pain in the locomotive organs, lifestyle-related disease, drug treatment, and a lower subjective evaluation of health must not be overlooked.

Background:In 2020, the Japanese Orthopaedic Association added a new clinical decision limit (CDL), stage 3, to evaluate the stages of locomotive syndrome (LS). However, so far there has been no study of total knee arthroplasty (TKA) to examine the efficacy of LS treatment and there are no motor function indicators to predict LS improvement, focusing on stage 3. The purpose of this study is to investigate the treatment efficacy of TKA on LS focusing on total CDL stage 3 leading to revealing the motor function indicators that can predict LS improvement in patients who had received TKA.Methods:This prospective cohort study was conducted with 59 patients among 70 patients who underwent TKA, with total CDL stage 3 before TKA evaluation. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA.Results:Of the 59 subjects who were evaluated to be in total CDL stage 3 before TKA, 17 patients (28.8%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 77.8%. Even if the CDL of the two-step test before TKA was higher than 2 and if the 3m-Timed Up & Go test (3m-TUG) before TKA was 9.15 or less, the improvement rate was 60%.Conclusions:As of three months after surgery, TKA can improve LS in about 30% of patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

Introduction This study aimed to examine the immunity level against rubella in pregnant women of different birth cohorts. Methods In total, 512 pregnant women who visited a primary clinic between May 2019 and March 2020 were enrolled. Information in terms of the patients’ hemagglutination inhibition (HI) titers, birthdate, obstetrical history, and vaccination history were collected. Participants were divided into three generational groups according to the vaccination policy in Japan. Publicly funded vaccination was administered twice as part of a routine program in group A (n = 11), once as part of a routine program and once in a catch-up program in group B (n = 181), and once in group C (n = 320). Results All groups had some women with negative rubella HI antibody titers (7.6% of all the women, 18.2% of group A, 9.4% of group B, and 6.3% of group C) and those with rubella HI antibody titers of ≤1:16 (45.1% of all women, 90.9% of group A, 56.4% of group B, and 37.2% of group C). Rubella HI antibody titers differed between the groups; group C had higher titers than that in group B. In groups B and C, the proportions of women with rubella HI antibody titers of ≤1:16 were not statistically different between primipara and multipara. Conclusions Our study showed that an increase in immunity to rubella, a vaccine-preventable disease, is nevertheless required among childbearing women to prevent rubella and congenital rubella syndrome.

To reduce the risk of long-term care, it is important to prevent the functional decline of the locomotorium of elderly individuals early in life. This study aimed to clarify locomotive syndrome (LS) in Japanese office workers. The participants included 263 workers that mainly performed deskwork. Participants performed the LS risk test and completed a self-administered questionnaire survey that focused on lifestyle-related diseases, anxiety about physical strength, pain in the locomotorium, and health-related quality of life. Sixty participants (22.8%) were at risk for LS, and 17.5% of these participants were in their 20s. Of the participants at risk for LS (LS group), 30.0% had anxiety about physical strength, which was a significantly high ratio compared to the 14.3% of participants who expressed anxiety about physical strength, but were not at risk for LS (non-LS group) (χ2 = 6.479, p < .05). There were significant differences between risk for LS and pain in the back and hip joints (χ2 = 5.813, p < .05, χ2 = 4.895, p < .05). The LS group had a significantly lower mean physical summary score than the non-LS group (t = 3.286, p < .01). Thus, an intervention to prevent LS is important during the early stages, and signs such as pain in the locomotorium and anxiety about physical strength must not be overlooked.

1. The present study determined descriptive values of the main production measurements of flocks and assessed the relationship between these measurements and related management factors in Japanese commercial broiler farms. 2. The data set included 5060 flock records from 183 farms. The production index was calculated as follows: liveability × average daily gain/feed conversion ratio × 10. Management factors included in the analysis were broiler breeder age, the time interval between successive flocks, the season of placement and stocking density. 3. The mean (±SD) production index was 283.9 ± 28.83. Management factors significantly associated with a decreased production index were low broiler breeder age, flocks placed in summer and high stocking density (P < 0.05). 4. In regard to an interaction for the production index, flocks with high stocking density had a lower production index than those with low stocking density in flocks with a low broiler breeder age (P < 0.05). In summer, flocks with a short time interval between successive flocks had a lower production index than those with an intermediate or long time interval (P < 0.05). 5. The present study identified factors related to flock performance. The knowledge obtained from this analysis will contribute to improve flock performance by optimising management.

Cataract surgery results when a patient decides to undergo lens surgery following a diagnosis of a clinically significant cataract (CSC). Because the presence of a CSC is generally latent and unobserved, a person might not receive cataract surgery even if the person has a CSC. This misclassification needs to be adjusted in the statistical analysis of CSC so as to reduce the bias in the parameter estimation. Following Magder and Hughes (1997) and using the cataract surgery data on atomic-bomb survivors at the Radiation Effects Research Foundation, we used this method for estimating the prevalence of CSC in a linear logistic dose response model taking account of the sensitivity and/or specificity of the decision for lens surgery. The estimated sensitivity was 0.385 (95% CI: 0.268, 0.517) and the estimated specificity was perfect. The odds ratio estimate for the radiation dose response changed from 1.39 (95% CI: 1.24, 1.55) to 1.58 (95% CI: 1.26, 1.98) when allowing for the imperfect sensitivity. A large sample simulation study with a continuous covariate was conducted, assuming either imperfect sensitivity or imperfect specificity, to investigate the performance of the method. Results indicated that the parameter estimates are almost correct. We calculated the asymptotic relative efficiency (ARE) for a simple logistic regression slope estimate and showed that the ARE depends only on the values of slope and intercept parameters.

The purpose of this study was to develop a simple screening technique for estimation of salivary flow and to test the usefulness of the method for determining decreased salivary flow.A novel assay system comprising 3 spots containing 30 microg starch and 49.6 microg potassium iodide per spot on filter paper and a coloring reagent, based on the color reaction of iodine-starch and theory of paper chromatography, was designed. We investigated the relationship between resting whole salivary rates and the number of colored spots on the filter produced by 41 hospitalized subjects.A significant negative correlation was observed between the number of colored spots and the resting salivary flow rate (n = 41; r = -0.803; P.01). For all complaints of decreased salivary flow (n = 9) having cutoff values100 microL/min for the salivary flow rate, 3 colored spots appeared on the paper, whereas for healthy subjects there wasor =1 colored spot.This novel assay system might be effective for estimation of salivary flow not only in healthy but also in bedridden and disabled elderly people.

Positivity of anti-thyroglobulin antibody (TgAb) is one of the markers of chronic thyroiditis (Hashimoto disease). From 2000 to 2003, a thyroid disease prevalence study was conducted at the Radiation Effects Research Foundation, in Hiroshima and Nagasaki. Utilizing the study's results, we show that via EM algorithm log-transformed TgAb level is compatible with a two-component mixture normal distribution, with the smaller normal distribution corresponding to the TgAb negative group but the larger distribution not necessarily corresponding to the TgAb positive group. A subject is determined to be TgAb positive if TgAb level is greater than a given cutoff. We compared the cutoff values from population-based methods and the laboratory method. The population-based methods consist of a simple method, a receiver operating characteristic (ROC) curve method, and a minimum misclassification rate (MMR) method. The simple method is used to determine positivity from only TgAb negative populations. Since the ROC curve and MMR methods are valid only when TgAb positivity and negativity are known but the simple method is valid only when TgAb negativity is known, the simple method was deemed useful for determining the cutoff in our data. In comparison with the simple, population-based method, we show that the cutoff from the laboratory method is appropriate and that the TgAb positive rates from various methods are approximately equal. With the two-component mixture normal distribution in TgAb level, our simple population-based method for determination of cutoff is another more practical example of handling the clinical measurement than the method given in Thompson et al. (Applied Statistics 1998).

There are few epidemiological studies of asymptomatic chlamydial infection among students in non-medical settings with minimal bias and improved accuracy; thus, useful data from screening among students are limited. We aimed to obtain accurate epidemiological information about asymptomatic chlamydial infection among students in non-medical settings. A population-based cross-sectional survey of 10,440 ≥18-year-old asymptomatic students who volunteered for a urine screening test for chlamydia was conducted. The prevalences of asymptomatic infection were 9.5% for women and 6.7% for men. Multivariate analysis revealed the risk factors to be a lifetime history of ≥4 sexual partners for women (odds ratio [OR] 3.17) and inconsistent condom use for men (OR 4.18). For both sexes, younger age at first intercourse was associated with a higher rate of inconsistent condom use. This study produced accurate epidemiological information on asymptomatic chlamydial infection. These results may contribute to the establishment of preventive countermeasures against such infection.

大腸癌143例の核DNA量をflow cytometryを用いて測定し, DNA index (DI) からみたリンパ節転移との関係について検討した.DNA ploidy patternはDNA diploidy: 50例, DNA aneuploidy: 93例でリンパ節転移を認めたものはそれぞれ, 30.0% (15/50), 62.4% (58/93) とDNA aneuploidyに有意に高率であった.リンパ節転移陽性率は, DI;1.3 (75.0%), 1.5 (71.4%), 1.6 (100%), 1.7 (70.0%) にやや頻度が高く, これらのDIを示す大腸癌はリンパ節転移をきたしやすい可能性が示唆された.さらに21例についてリンパ節転移巣の核DNA量を測定し原発巣と比較したところ, 両者のDIは全例で一致した.

Objectives A long-term care insurance (LTCI) system was introduced in 2000 in Japan. The clarification of information on the users and the ways in which services under this system have been utilized is essential for improving the system operation. This study was conducted for the purpose of clarifying what level of health-related quality of life (HRQOL) was achieved by individuals using the services under the LTCI system. Methods The subjects were inhabitants of two cities in the Kyushu district of Japan who were receiving daily home care services under the LTCI system. To analyze the relationships of the beneficiaries’ HRQOL with their characteristics, the dependent variable was the EuroQol-5D (EQ-5D) scores adopted as an index of HRQOL, and the independent variables comprised the demographic features (gender, age, and living condition) of users receiving long-term care service as well as their opinions about fees for services, satisfaction with the services provided, and the degree of support/care required. Results The EQ-5D score was higher for females than for males and higher for the subjects living alone than for those displaying any other family composition. EQ-5D score decreased with an increase in the degree of support/care required. Multivariate analysis revealed that the degree of support/care required, gender and living condition were found to serve as variables that significantly contribute to utility. Conclusions Our analysis of the relationships between the characteristics of the LTCI beneficiaries and their HRQOL has yielded basic data that will be useful for improving the recently introduced LTCI system.