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It is unclear whether women have a higher risk of stroke than men. This study aimed to clarify the effects of a sex difference on the risk of ischaemic stroke in patients with atrial fibrillation (AF).Health check and insurance claims data were used of people who were aged75 years from 2005 to 2017 in Japan. Patients with AF who were not on anticoagulation therapy were identified. After excluding patients with artificial valves (n=28), haematological disease (n=1,124), aged ≤20 years (n=207), and taking anticoagulant therapy (n=11,848), 9,733 remained for inclusion into the study. The primary outcome was hospital admission due to ischaemic stroke.Of the 9,733 participants, 7,079 (72.7%) were men. The mean age of women (54.4 years) was significantly higher than that of men (53.2 years). During a mean 2.5-year follow-up period, 143 ischaemic stroke events occurred. Female sex was not associated with ischaemic stroke (adjusted hazard ratio [95% confidence interval]: 1.13 [0.78-1.66]). When stratified using the CHAIn this large-scale, real-world study of patients with AF, the risk of ischaemic stroke among those aged75 years was comparable between women and men. These findings are consistent with the current guidelines, which do not recommend anticoagulant therapy for women with no other risk factors (CHA

Little is known about the optimal daily magnesium (Mg) intake for individuals with high levels of physical activity. The aim of this study was to clarify the optimal dietary Mg intake for people with high levels of physical activity in a scoping review. In this review, we searched MEDLINE and Japan Medical Abstracts Society for studies published up to May 31, 2020. We conducted two searches, one for studies using gold standard measurement methods such as the balance method and factorial calculation (Search 1), and the other for studies using estimation from daily food intake (Search 2). We also performed a meta-analysis of studies that compared the Mg intake among physically active people with the Mg intake among controls. After the primary and secondary screening, 31 studies were included in the final review. All of the included studies examined professional or recreational athletes. We found no studies that examined the optimal intake of Mg using gold standard measurement methods. The Mg intake among physically active individuals was below the recommended dietary allowance in most studies. In five studies that conducted meta-analyses, physically active individuals had significantly higher intakes of Mg than controls, although these levels were still below the recommended dietary allowance. The present review revealed that evidence regarding the optimal daily magnesium intake is currently scarce, and further studies are needed.

We aimed to investigate the association between serum uric acid (SUA) level and development of hypertension as well as the interaction effect of chronic kidney disease (CKD) on this relationship in the general Japanese population. We included 7895 participants aged ≥30 years from the ISSA-CKD study, a population-based retrospective cohort study that used annual health check-up data of residents from Iki Island, Japan. After the exclusion of 1881 with l < 1-year follow-up, 2812 with hypertension at baseline, and 165 with missing information on SUA, a total of 3037 participants were enrolled in this analysis. Participants were divided into four groups according to the quartiles of SUA level at baseline, and multivariable-adjusted hazard ratios for new-onset hypertension were calculated. Stratified analyses were performed for each subgroup (defined by sex, age, alcohol intake, and CKD) to assess the interaction effects. During a mean follow-up period of 4.4 years, 943 participants developed hypertension. The first quartile group was set as the reference group, and the multivariable-adjusted hazard ratios (95% confidence interval) for new-onset hypertension were 1.11 (0.90-1.36) in the second quartile, 1.25 (1.02-1.54) in the third quartile, and 1.35 (1.07-1.70) in the fourth quartile compared with those in the reference group (p = .007 for trend). The stratified analyses showed that the association between SUA and hypertension was significantly stronger in participants with CKD than in those without CKD (p = .035 for interaction). SUA level is an independent risk factor for new-onset hypertension. This tendency was significantly stronger in participants with CKD.

Introduction: Evidence using real-world data is sparse regarding the effects of oral anticoagulants (OACs) among patients with kidney disease. The aim of this study was to investigate the effects of kidney disease on ischemic stroke (IS) or systemic embolism (SE) among patients taking OAC, using large-scale real-world data in Japan. Methods: This was a retrospective cohort study using claims data and health checkup data from health insurance associations in Japan, from January 2005 to June 2017. We enrolled 21,581 patients diagnosed with atrial fibrillation (AF). Of the total population, 11,848 (54.9%) patients were taking OAC. A Cox proportional hazards model was used to examine the effect of kidney disease on IS/SE with or without OAC. Results: During follow-up, 208 participants who were not taking OAC (mean follow-up 2.6 years) and 200 who were taking OAC (mean follow-up 3.0 years) experienced IS/SE. The % IS/SE incidence rates with and without kidney disease were 2.42/person-year and 0.63/person-year in the total population, 3.66/person-year and 0.76/person-year in the group without OAC use, and 1.52/person-year and 0.55/person-year in patients with OAC use, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) of kidney disease for IS/SE were high, irrespective of OAC, even after adjustment: adjusted HR 2.62 (95% CI: 1.72–3.99) without OAC and adjusted HR 2.03 (95% CI: 1.20–3.44) with OAC; p = 0.193 for interaction between no OAC and OAC. Although bleeding risk was also high for kidney disease irrespective of OAC use (HR 2.93 [95% CI: 2.27–3.77] in the total population, HR 3.08 [95% CI: 2.15–4.43] in the group without OAC, and HR 2.73 [95% CI: 1.90–3.91] in the group with OAC use), net clinical benefit indicated that the benefit of OAC use exceeded the risk of bleeding: HR 4.50 (95% CI: 0.76–8.23) among those with kidney disease and HR 0.35 (95% CI: 0.04–0.66) among those without kidney disease. Conclusion: Although we found that OAC use was effective and recommended for patients with AF, advanced kidney disease is still an independent risk factor for IS/SE, even in patients taking OAC. Physicians should be aware of this risk and strictly control modifiable risk factors, regardless of OAC use.

ObjectiveAmong patients with atrial fibrillation, the risks of ischaemic stroke and systemic embolism (IS/SE) are high even with effective anticoagulation. Using large-scale, real-world data from Japan, this study aims to clarify residual risks of IS/SE attributable to modifiable risk factors among patients with atrial fibrillation who are taking oral anticoagulants.MethodsThe study design we employed was a retrospective cohort. Health check-ups and insurance claims data of Japanese health insurance companies were accumulated from January 2005 to June 2017. We identified 11 848 participants with atrial fibrillation who were on oral anticoagulants during the study period. We set the modifiable risk factors as hypertension, diabetes and dyslipidaemia. A Cox proportional hazards model was used to obtain the effects of the risk factors for IS/SE.ResultsDuring an average of 3 years’ follow-up, 200 cases of IS/SE occurred (incidence rate 0.57 per 100 person-years). In multivariable analyses, older age (65–74 vs ConclusionAmong patients with atrial fibrillation on anticoagulant therapy, approximately one-third of the residual risks were estimated to be attributable to modifiable risk factors such as hypertension, diabetes and dyslipidaemia.

Background This large‐scale observational study on negative events in a real‐world setting investigated Japanese patients with atrial fibrillation who were not on anticoagulants. This study aims to evaluate the incidence of ischemic stroke and bleeding events (intracranial hemorrhage, gastrointestinal bleeding, others) based on CHA 2 DS 2‐ VAS c scores in Japanese patients with atrial fibrillation who were not anticoagulated. Methods and Results We used health checkups and insurance claim data from a Japanese insurance organization. Altogether, 9733 atrial fibrillation patients were not prescribed anticoagulation during their follow‐up periods. Patients’ risk levels were defined by their CHA 2 DS 2‐ VAS c scores (range 0–≥3): Men with scores of 0, 1, or ≥2 and women with scores of 1, 2, or ≥3 were considered at low, intermediate, or high risk, respectively. Cox proportional hazards model was used to assess the association between the CHA 2 DS 2‐ VAS c‐determined risk and the incidence of ischemic stroke and intracranial, gastrointestinal, and other bleeding. The mean 2.5‐year follow‐up revealed 143 ischemic strokes and 332 bleeding events. Annual event rates were 0.58% for ischemic stroke and 1.17% for total bleeding events. Annual incidence of ischemic stroke increased with elevated predicted risks based on CHA 2 DS 2‐ VAS c scores: 0.18% for low‐risk, 0.44% intermediate‐risk, and 1.29% high‐risk groups ( P P Conclusions Risks of ischemic stroke and bleeding events were high, particularly among those with high CHA 2 DS 2‐ VAS c scores.

A high-capacity iron- and nickel-substituted Li 2 MnO 3 cathode [i.e., Li 1.26 Fe 0.11 Ni 0.11 Mn 0.52 O 2 (LFNM)] treated by carbothermal reduction was analyzed, and the results clarified that it has both high capacity and high safety levels. X-ray analysis of a reduced LFNM (R-LFNM) cathode clarified the following. Migration of transition metals in the lattice as a result of the carbothermal reduction stabilizes the layered lattice structure, which prevents lattice shrinkage during charging and enhances charge compensation. As a result, more lithium ions can return to the cathode during discharging; namely, the irreversible capacity of the cathode decreases. Thermal stability of the R-LFNM cathode was evaluated by differential scanning calorimetry (DSC), and the results show that the total heat evolved from the R-LFNM cathode remains at a lower level compared with that of other cobalt- and nickel-containing Li 2 MnO 3 cathodes. An analysis of the lattice structure reveals that low exothermic heat from the charged R-LFNM cathode results from the distinctive property of its crystal lattice changing from layered to thermally stable spinel during charging.

AIM The present study aimed to investigate the effects of the 2014 Japanese fee schedule revision on trends in artificial nutrition routes, including gastrostomy, nasogastric tube and parenteral nutrition, among older people with dementia, using time series analysis. METHODS The study used claim data in Japan submitted to Fukuoka Late Elders' Health Insurance from fiscal year 2010 to fiscal year 2016. We identified older people with dementia provided for the first time with artificial nutrition via gastrostomy, nasogastric tube or central venous line and aggregated their data by month. Interrupted time series analyses were used to examine trends in artificial nutrition routes over time. RESULTS The numbers of older people with dementia receiving nutrition via gastrostomy, nasogastric tube and parenterally declined consistently. The slopes for pre-revision trends in gastrostomy, nasogastric tube and parenteral nutrition procedures were all significantly negative in the interrupted time series analyses. The post-revision trends in gastrostomy and parenteral nutrition continuously had significant negative slopes. In contrast, the significant negative trend in nasogastric tube procedures in the pre-revision period had disappeared during the post-revision period. CONCLUSIONS The study showed that the fee schedule revision had limited impact on gastrostomy and parenteral nutrition. However the trend for nasogastric tube was ambiguous; hence, sustainable surveillance is required for evidence-based health policy. Geriatr Gerontol Int 2018; 18: 1405-1409.

The purpose of this study was to investigate the diagnostic accuracy of cardiacWe investigated 600 patients who underwent cardiacMIBG uptakes of PD patients were significantly decreased compared with those of other diseases except dementia with Lewy bodies and pure autonomic failure (p .05 for all). In the early group, the sensitivity and specificity of the delayed heart to mediastinum (H/M) ratio were 68.7% and 91.7%, respectively, while in the late group, the sensitivity was 86.3% and the specificity was 74.0%. In addition, the early and delayed H/M ratios were decreased with higher HoehnYahr stages in PD patients.Our findings demonstrated that cardiac

Objectives: To reveal the effect of age and other factors on perceived anxiety over radiation exposure among decontamination workers in Fukushima Prefecture, Japan. Methods: A survey questionnaire was sent to 1505 workers, with questions regarding age, presence of a written employment contract, previous residence, radiation passbook ownership, presence of close persons for consultation, knowledge of how to access public assistance, and a four-point scale of radiation-related anxiety (1= "Very much," 2= "Somewhat," 3= "A little bit," and 4= "None" ). The relationships between the degree of anxiety and variables were analyzed using the chi-square test and residual analysis. Results: In all, 512 participants responded to the questionnaire. The mean age of participants was 46.2 years (SD: 13.1, range: 18-77). Of them, 50, 233, 168, and 61 workers chose "Very much," "Somewhat," "A little bit," and "None," respectively, on the anxiety scale. Chi-square test showed that participants aged 61 years and over had higher degrees of anxiety (p

Home cooking has been suggested as a key to healthy dietary intakes. However, little is known about the association between cooking behaviour and nutrient intake among young-to-middle-aged women. We aimed to investigate the association between home cooking frequency and nutrient intake adequacy among married Japanese women. Self-administered questionnaires were used to assess the weekly frequency of cooking dinner at home and habitual nutrient intake during the preceding month. We evaluated nutrient intake adequacy by comparing the self-reported intake with two indices of the dietary reference intakes for Japanese (2015): the estimated average requirement (EAR) of fourteen nutrients, and the ‘tentative dietary goal for preventing lifestyle-related diseases’ (DG) of seven nutrients. A total of 143 participants (25–44 years old) completed the questionnaires, with 32·9 % of participants reporting a weekly home cooking frequency of seven times/week. Women with a higher home cooking frequency (seven times/week) were more likely to have children (P = 0·001) than those with a lower home cooking frequency (0–6 times/week). Of the nutrients evaluated, there was no significant difference between the two groups in meeting EAR and DG. Our findings suggest that daily home cooking may not be necessary to achieve adequate nutrient intake, specifically among married, young-to-middle-aged Japanese women.

OBJECTIVES: The aim of this study was to reveal factors related to heat illness in radiation decontamination workers and determine effective preventive measures. METHODS: A self-administered questionnaire was sent to 1,505 radiation decontamination workers. The questionnaire included age, sex, duration of decontamination work, previous occupation, education provided by employers regarding heat illness, preventive action against heat illness, and subjective symptoms of heat illness during work. We included 528 men, who replied and answered all questions, in the statistical analysis. Subjective symptoms of heat illness were categorized as "no symptoms," "Grade I" and "Grade II" according to severity. A multiple linear regression model was used to determine the factors associated with the severity of heat illness. RESULTS: The mean age of the subjects was 47.6 years old (standard deviation: 13.4). Of the 528 workers, 316 (59.8%) experienced heat illness symptoms (213 at Grade I and 103 at Grade II). The results of the stepwise selection revealed that age, outdoor manual labor, adequate sleep, use of a cool vest, and salt intake were selected as preventive factors, whereas living in a company dormitory or temporary housing, wearing light clothing, and consuming breakfast were selected as risk factors for heat illness. CONCLUSIONS: Both working conditions and living environment are associated with heat illness in radiation decontamination workers. Type of housing and sleep are also strongly related to heat illness during work. Employers should consider not only the working conditions of the employee but also the employee's daily living conditions, in order to prevent heat illness. Language: en

The present study aimed to investigate the effects of the 2014 Japanese fee schedule revision on trends in artificial nutrition routes, including gastrostomy, nasogastric tube and parenteral nutrition, among older people with dementia, using time series analysis.The study used claim data in Japan submitted to Fukuoka Late Elders' Health Insurance from fiscal year 2010 to fiscal year 2016. We identified older people with dementia provided for the first time with artificial nutrition via gastrostomy, nasogastric tube or central venous line and aggregated their data by month. Interrupted time series analyses were used to examine trends in artificial nutrition routes over time.The numbers of older people with dementia receiving nutrition via gastrostomy, nasogastric tube and parenterally declined consistently. The slopes for pre-revision trends in gastrostomy, nasogastric tube and parenteral nutrition procedures were all significantly negative in the interrupted time series analyses. The post-revision trends in gastrostomy and parenteral nutrition continuously had significant negative slopes. In contrast, the significant negative trend in nasogastric tube procedures in the pre-revision period had disappeared during the post-revision period.The study showed that the fee schedule revision had limited impact on gastrostomy and parenteral nutrition. However the trend for nasogastric tube was ambiguous; hence, sustainable surveillance is required for evidence-based health policy. Geriatr Gerontol Int 2018; 18: 1405-1409.

Objectives : Nicotine in cigarettes is metabolized primarily by CYP2A6-catalyzed oxi- dation. The CYP2A6*4 allele, in which CYP2A6 is a homozygous whole-deletion variant, com- pletely lacks enzyme activity. The aim of this study was to examine the effects of CYP2A6*4 ge- netic polymorphism on smoking behavior and nicotine dependence in a general population of Japanese men. Methods : The subjects were 124 healthy Japanese men who gave informed consent to give saliva samples. The survey items included general information, smoking behaviors and nicotine depen- dence. The polymerase chain reaction restriction fragment length polymorphism method was used to analyze the genetic polymorphisms of CYP2A6. The subjects were classified into two groups : Group W (CYP2A6*4 absence : *1A/*1A, *1A/*1B and *1B/*1B) and Group D (CYP2A6*4 presence : *1B/*4A, *4A/*4A, *1A/*4A or *1B/*4D, and *1A/*4D). We analyzed the differences in the survey items between the two groups. Results : There were no significant differences in smoking behaviors between the two groups. However, Group D tended to have less difficulty in refraining from smoking after waking in the morning compared to Group W (p=0.051). Conclusions : CYP2A6*4 genetic polymorphisms may not strongly affect smoking behavior but may possibly have an effect on nicotine dependence.

Parasites of the Babesiadivergens Asia lineage, which are closely related to B. divergens in Europe and Babesia sp. strain MO1 in the United States, were recently reported in sika deer (Cervus nippon) in eastern Japan. To identify the tick vector(s) for this parasite, we conducted a field survey in Hokkaido, Japan, where the infection rate in sika deer is the highest in the country. A specific PCR system which detects and discriminates between lineages within B. divergens and between those lineages and Babesia venatorum showed that Ixodes persulcatus (11/822), but not sympatric Ixodes ovatus (0/595) or Haemaphysalis sp. (0/163) ticks, carried B. divergens Asia lineage. Genomic DNA was archived from salivary glands of partially engorged I. persulcatus females and three isolates of B. divergens Asia lineage were newly described. The 18S rRNA gene sequence of the isolates formed the Asia lineage cluster with those previously described in sika deer isolates. One salivary gland also contained parasites of Babesia microti U.S. lineage, which were subsequently isolated in a hamster in vivoB. venatorum (strain Etb5) was also detected in one I. persulcatus tick. The 18S rRNA sequence of Etb5 was 99.7% identical to that of B. venatorum (AY046575) and was phylogenetically positioned in a taxon composed of B. venatorum isolates from Europe, China, and Russia. The geographical distribution of I. persulcatus is consistent with that of B. divergens in sika deer in Japan. These results suggest that I. persulcatus is a principal vector for B. divergens in Japan and Eurasia, where I. persulcatus is predominantly distributed.IMPORTANCE The Babesiadivergens Asia lineage of parasites closely related to B. divergens in Europe and Babesia sp. MO1 in the United States was recently reported in Cervus nippon in eastern Japan. In this study, specific PCR for the Asia lineage identified 11 positives in 822 host-seeking Ixodes persulcatus ticks, a principal vector for many tick-borne disease agents. Gene sequences of three isolates obtained from DNA in salivary glands of female ticks were identical to each other and to those in C. nippon We also demonstrate the coinfection of B. divergens Asia lineage with Babesia microti U.S. lineage in a tick salivary gland and, furthermore, isolated the latter in a hamster. These results suggest that I. persulcatus is the principal vector for B. divergens as well as for B. microti, and both parasites may be occasionally cotransmitted by I. persulcatus This report will be important for public health, since infection may occur through transfusion.

BACKGROUND Nicotine concentration in hair is a useful marker of tobacco exposure. Detection of nicotine in the hair of non-smokers indicates passive smoking. Accurate measurement of nicotine among active and passive smokers can help in smoking cessation programs or programs designed to prevent secondhand smoke exposure. OBJECTIVE To establish, using high-performance liquid chromatography-ultraviolet detection (HPLC/UV), a hair nicotine cut-off value to distinguish active from passive smokers. METHODS Hair samples were collected from randomly chosen Japanese men (n= 192) between 2009 and 2011. Nicotine and cotinine levels in hair were measured using HPLC/UV with column-switching. T-tests and chi-square tests were performed to compare active and passive smokers, while receiver operating characteristic curves were used to evaluate the effectiveness of the cut-off value. RESULTS There were 69 active smokers and 123 passive smokers. The nicotine and cotinine concentrations in hair were significantly higher in active than in passive smokers (p< 0.01). The area under the curve for nicotine was 0.92. A hair nicotine cut-off value of 5.68 ng/mg, with a sensitivity of 94.2% and specificity of 87.0%, was identified as the optimal cut-off value for separating active from passive smokers. CONCLUSION Nicotine and cotinine concentrations in hair clearly distinguished active from passive smokers.

Here we propose the use of a carbon material called graphene-like-graphite (GLG) as anode material of lithium ion batteries that delivers a high capacity of 608 mAh/g and provides superior rate capability. The morphology and crystal structure of GLG are quite similar to those of graphite, which is currently used as the anode material of lithium ion batteries. Therefore, it is expected to be used in the same manner of conventional graphite materials to fabricate the cells. Based on the data obtained from various spectroscopic techniques, we propose a structural GLG model in which nanopores and pairs of C-O-C units are introduced within the carbon layers stacked with three-dimensional regularity. Three types of highly ionic lithium ions are found in fully charged GLG and stored between its layers. The oxygen atoms introduced within the carbon layers seem to play an important role in accommodating a large amount of lithium ions in GLG. Moreover, the large increase in the interlayer spacing observed for fully charged GLG is ascribed to the migration of oxygen atoms within the carbon layer introduced in the state of C-O-C to the interlayer space maintaining one of the C-O bonds.

Introduction The purpose of this study was to investigate the diagnostic accuracy of cardiac 123I-metaiodobenzylguanidine (MIBG) scintigraphy for the diagnosis of Parkinson's disease (PD), especially in the early stages. Methods We investigated 600 patients who underwent cardiac 123I-MIBG scintigraphy to diagnose their parkinsonism and/or cognitive impairment. Of 600 research subjects, 272 patients were clinically diagnosed with PD. MIBG uptake was compared between patients with PD and other diseases. Furthermore, the sensitivity and specificity of cardiac 123I-MIBG scintigraphy to diagnose PD was estimated by disease duration ( Results MIBG uptakes of PD patients were significantly decreased compared with those of other diseases except dementia with Lewy bodies and pure autonomic failure (p Conclusion Our findings demonstrated that cardiac 123I-MIBG scintigraphy had sufficient diagnostic accuracy to detect the early phase of PD. Indeed, this study of a large number of patients provides further external validation that MIBG has diagnostic ability to distinguish PD from atypical parkinsonism.

Objectives : From our previous results, manganese (Mn) and iron (Fe) in the blood of Parkinson's disease (PD) patients without depression were higher than those of both the PD patients with depression and controls, the hypothesis that "two types of PD exist-PD without depression and affected by Mn and Fe, and PD with depression and unaffected by Mn or Fe" was induced. To investigate the hypothesis, correlations among blood and urine met- als were compared in the subjects. Methods : Subjects comprised PD patients with de- pression, PD patients without depression and controls recruited from an outpatient clinic in China. Morning blood and urine samples were used to measure concentrations of metals. Results : In the controls, Mn, Fe and zinc (Zn) levels in blood strongly correlated with each other. The correlation coefficient between Mn and Zn in blood was significant in the PD pa- tients with depression and the controls, but not in the PD patients without depression. Cor- relations of Fe between blood and urine in the PD patients without depression were signifi- cant, but not in the PD patients with depression and the controls. Conclusions : A common route of simultaneous intake of Mn, Fe and Zn could exist in our subjects, however in PD patients without depression, a large intake of Mn may have been from another route. Some results of the PD patients without depression were different from those of the PD pa- tients with depression and the controls. Thus, two types of PD may exist.

Objectives Some heavy metals are suspected to be pathogenic to both Parkinson's disease (PD) and depression. Common background may exist in them. Methods Subjects com- prised PD patients with depression, PD patients without depression and controls recruited from the outpatient clinic in China. Morning blood and urine samples were used to measure concentrations of metals and vitamins. Results Whole-blood manganese was significantly higher in the PD patients without depression than in both the PD patients with depression and the controls. Serum iron was significantly higher in the PD patients without depression than in the controls. Urine iron was also significantly higher in the PD patients without depression than in the controls. Serum copper was significantly lower in the PD patients with depression than in both the PD patients with- out depression and the controls. Conclusions Excessive intake of iron and accumulation of man- ganese seemed to be involved in the etiology of non-depressive PD.

The aim of this study is to clarify factors related to premature death among Japanese professional baseball players by a case-control analysis. The subjects are two matching groups of 622 Japan Professional Baseball (JPB) league players, those deceased and those surviving. Cases and controls are matched by birth year. All players debuted on the first string between 1934 and 2003, and are listed in The Official Baseball Encyclopedia of Japan. To compare means and frequencies of characteristics between deceased and surviving groups, t-tests and chi-square tests were used. A logistic regression analysis was assessed contributions of each independent variable on death. Significant differences between deceased and surviving players were observed in this study; deceased players had higher body mass indexes and longer careers. Furthermore, logistic regression analysis confirmed that body mass index and career length were statistically significant determinants of death for baseball players. This is the first report to examine factors of death for professional baseball players except employing data attained from Major League Baseball.

After the Great East Japan Earthquake on 11 March 2011, the environmental radiation dose in Fukushima City increased. On 11 April, 1 mo after the earthquake, the environmental radiation dose rate at various surfaces in the same area differed greatly by surface property. Environmental radiation measurements continue in order to determine the estimated time to 50% reduction in environmental radiation dose rates by surface property in order to make suggestions for decontamination in Fukushima. The measurements were carried out from 11 April to 11 November 2011. Forty-eight (48) measurement points were selected, including four kinds of ground surface properties: grass (13), soil (5), artificial turf (7), and asphalt (23). Environmental radiation dose rate was measured at heights of 100 cm above the ground surface. Time to 50% reduction of environmental radiation dose rates was estimated for each ground surface property. Radiation dose rates on 11 November had decreased significantly compared with those on 11 April for all surface properties. Artificial turf showed the longest time to 50% reduction (544.32 d, standard error: 96.86), and soil showed the shortest (213.20 d, standard error: 35.88). The authors found the environmental radiation dose rate on artificial materials to have a longer 50% reduction time than that on natural materials. These results contribute to determining an order of priority for decontamination after nuclear disasters.

Nicotine and cotinine in hair are good biomarkers for assessing long-term exposure to smoking. However, analytical devices such as GC/MS are associated with high cost and are not widely used. HPLC/UV is used widely in laboratories, but is unsuitable for measurement of minor constituents, except when using the column-switching method. Thus, we aimed to establish a simple, inexpensive and sensitive method based on HPLC/UV with column switching for measuring nicotine and cotinine in hair. First, we compared the presence and absence of a column selection unit. We then measured amounts of nicotine and cotinine in hair samples collected from the general population, and compared both the corresponding levels and the detection limits with those in previous studies. Finally, initial and running costs of HPLC/UV were compared with other analytical methods. As one of the results, the areas of nicotine and cotinine measured by HPLC/UV with column-switching method were 12.9 and 16.9 times greater, respectively, than those without the column-switching method. The amount of nicotine and cotinine in hair was significantly correlated to number of cigarettes smoked per day (r = 0.228, p = 0.040). In addition, the HPLC/UV method showed similar sensitivity and detection limit (nicotine, 0.10 ng/mg; cotinine, 0.08 ng/mg) as reported in previous studies. The cost of the HPLC/UV method is lower than that of other analytical methods. We were able to establish a low-cost method with good sensitivity for measuring nicotine and cotinine in hair. The HPLC/UV with a column-switching method will be useful as a first step in screening surveys in order to better understand the effects of smoking exposure.

One and a half years have passed since the Fukushima Daiichi nuclear power plant disaster. The environmental radiation dose rate was not critical, but an existing exposure situation has been identified in a large part of Fukushima Prefecture. Although people continue to live and work in the contaminated area, they are not provided with sufficient information to reduce their exposure to radiation by themselves. In this study, we attempt to evaluate the efficiency of radiation shielding by using everyday items widely available to people.NaI scintillation and Geiger-Müller survey meters were used to measure the radiation dose of (1) contaminated soil and (2) soil covered with commonly available items.In the soil at a depth of 10 cm from the surface, the radiation dose rate decreased from 3.36 to 0.65 μSv/h, and the count rate decreased from 3,120 to 352 cpm. Both the radiation dose rate and count rate reduced when the soil was covered with everyday items, such as a magazine more than 20 mm thick, a polystyrene foam board, and a wooden board of the same thickness.To protect residents from unnecessary radiation exposure in the existing exposure situation, covering contaminated soil with a wooden board or a magazine, either of them 20 mm thick, is useful to reduce the radiation dose.

Background & aims Factors associated with depression in Parkinson’s disease, especially lifestyle and nutrition, have been poorly studied. Our study was conducted to investigate nutritional factors associated with depression in Parkinson’s disease. Methods The subjects were 82 Parkinson’s disease patients and the same number of sex and age-matched controls recruited from the outpatient clinic of Xiangfan No. 1 People’s Hospital in Hubei, China between 2006 and 2008. The Parkinson’s disease patients were divided into two groups, 24 Parkinson’s disease with depression and 58 Parkinson’s disease without depression. DSM-IV criteria was used for the primary diagnosis of depressive disorders. The severity of depression in patients was assessed by the criteria of the Hamilton Depression Rating Scale (HAMD-17), and a score ≥14 was defined as “depression”. Information about eating habits and other factors was obtained by subject recall of state prior to diagnosis of Parkinson’s disease and depression Results Compared with the Parkinson’s disease patients without depression and the controls, the Parkinson’s disease patients with depression had relatively low levels of income and education. Fat and vitamin B1 intake was significantly higher in the Parkinson’s disease patients with depression than in both the Parkinson’s disease patients without depression and the controls. Bean product intake was significantly lower in the Parkinson’s disease patients with depression than in both the Parkinson’s disease patients without depression and the controls. Conclusions Less fat and vitamin B1 but more bean product intake might be associated with a lower risk for depression in Parkinson’s disease patients from a higher income bracket with better educational background.

It is well known that manganese (Mn) exposure is involved in parkinsonism. The aim of our study was to test the hypotheses that Mn affects nicotinamide N-methyltransferase (NNMT) activity, increases the metabolism of nicotinamide (NA) to 1-methylnicotinamide (MNA), and leads to neurocytotoxicity.Following demonstration of the effects of Mn concentrations on the survival rate of Mouse CD1 brain striatum neuronal cells (MS cells), the effect of Mn on NNMT activity was investigated by comparing the difference in the amount of MNA produced after various Mn concentrations were added to mouse brain cytosol fractions as an enzyme solution. Toxicity induced by MNA and its precursor NA on MS cells was measured.The survival rate of MS cells decreased significantly with increasing concentrations of Mn in the culture medium. With respect to the influence of Mn on NNMT activity, NNMT activity increased significantly at Mn concentrations of 1 μmol/mg protein. MNA and NA neurotoxicity were compared by comparing cell survival rate. Cell survival rate dropped significantly when the cells were cultivated with 10 mM of MNA. There was also a tendency for the survival rate to fall following the addition of 10 mM NA; however, the difference with the control was not significant.Our study suggests the possibility that Mn causes increased NNMT activity, thereby increasing MNA levels in the brain and bringing about neuron death. Daily absorption of Mn and NA may thus contribute to idiopathic Parkinson's disease.

On 11 March 2011, the Great East Japan Earthquake occurred. Due to this earthquake and subsequent tsunami, malfunctions occurred at the Fukushima Daiichi nuclear power plant. Radioactive material even reached the investigated educational institution despite being 57.8 km away from the power station. With the goal of ensuring the safety of our students, we decided to carry out a risk assessment of the premises of this educational institution by measuring radiation doses at certain locations, making it possible to calculate estimated radiation accumulation.Systematic sampling was carried out at measurement points spaced at regular intervals for a total of 24 indoor and outdoor areas, with 137 measurements at heights of 1 cm and 100 cm above the ground surface. Radiation survey meters were used to measure environmental radiation doses.Radiation dose rates and count rates were higher outdoors than indoors, and higher 1 cm above the ground surface than at 100 cm. Radiation doses 1 cm above the ground surface were higher on grass and moss than on asphalt and soil. The estimated radiation exposure for a student spending an average of 11 h on site at this educational institution was 9.80 μSv.Environmental radiation doses at our educational institution 57.8 km away from the Fukushima Daiichi nuclear power plant 1 month after the accident were lower than the national regulation dose for schools (3.8 μSv/h) at most points. Differences in radiation doses depending on outdoor surface properties are important to note for risk reduction.

In this paper, we describe high-speed 1.1-μm-range oxide-confined vertical-cavity surface-emitting lasers (VCSELs) for large-scale optical interconnection applications. For achieving high data rates up to 25 Gbit/s under high temperature, we applied InGaAs/GaAsP strain-compensated multiple quantum wells (SC-MQWs) as the active layer. The developed device showed 25 Gbit/s error-free operation at 100°C. We also examined reliability of the VCSELs through accelerated life tests. The result showed an extremely long lifetime of about 10 thousand hours in MTTF under an ambient temperature of 150°C and a current density of about 19 kA/cm2. The level of reliability either equaled or surpassed that of conventional 0.85-μm VCSELs. Moreover, we revealed a typical failure mode of the device, which was caused by ≪110≫ dark line defects (DLDs) generated in the n-DBR layers under the current aperture area.

Babesia microti, the erythroparasitic cause of human babesiosis, has long been taken to be a single species because classification by parasite morphology and host spectrum blurred distinctions between the parasites. Phylogenetic analyses of the 18S ribosomal RNA gene (18S rDNA) and, more recently, the beta-tubulin gene have suggested inter-group heterogeneity. Intra-group relationships, however, remain unknown. This study was conducted to clarify the intra- and inter-group phylogenetic features of the B. microti-group parasites with the eta subunit of the chaperonin-containing t-complex polypeptide l (CCTeta) gene as a candidate genetic marker for defining the B. microti group. We prepared complete sequences of the CCTeta gene from 36 piroplasms and compared the phylogenetic trees. The B. microti-group parasites clustered in a monophyletic assemblage separate from the Babesia sensu stricto and Theileria genera and subdivided predominantly into 4 clades (U.S., Kobe, Hobetsu, Munich) with highly significant evolutionary distances between the clades. B. rodhaini branched at the base of the B. microti-group parasites. In addition, a unique intron presence/absence matrix not observable in 18S rDNA or beta-tubulin set the B. microti group entirely apart from either Babesia sensu stricto or Theileria. These results have strong implications for public health, suggesting that the B. microti-group parasites are a full-fledged genus comprising, for now, four core species, i.e., U.S., Kobe, Hobetsu, and Munich species nova. Furthermore, the CCTeta gene is an instructive and definitive genetic marker for analyzing B. microti and related parasites.

We have developed InGaAs-based VCSELs operating around 1.1µm for high-speed optical interconnections. By applying GaAsP barrier layers, temperature characteristics were considerably improved compared to GaAs barrier layers. As a result, 25Gbps 100°C error-free operation was achieved. These devices also exhibited high reliability. No degradation was observed over 3, 000 hours under operation temperature of 150°C and current density of 19kA/cm2. We also developed VCSELs with tunnel junctions for higher speed operation. High modulation bandwidth of 24GHz and a relaxation oscillation frequency of 27GHz were achieved. 40Gbps error-free operation was also demonstrated.

Despite the evidence suggesting that mouse pyruvate kinase (PK) deficiency provides protection against malaria in rodents, there has been no investigation of a parallel protective effect against babesiosis caused by Babesia rodhaini. Here, we examined whether a PK-deficient co-isogenic mouse strain (CBA-Pk-1(slc)) was protected against B. rodhaini infection. We demonstrated that deficiency in pyruvate kinase correlated with a significant protective effect, with survival rates of 50%, 58% and 56% in groups inoculated with 10, 10(3) and 10(5) parasitized erythrocytes, respectively. In contrast, control CBA (CBA-Pk-1(+)) mice exhibited 100% lethality, regardless of the infectious dose. In addition, CBA-Pk-1(slc) mice showed decreased levels of parasitemia when compared to CBA-Pk-1(+) mice, in groups given 10, 10(3) or 10(5) parasitized erythrocytes. These results indicate that similar to PK deficiency in rodents, PK deficiency in mice affects the in vivo growth of B. rodhaini and protects the mice from lethal babesiosis.

A significant number of patients are diagnosed with "fevers of unknown origin" (FUO) in Shimane Prefecture in Japan where tick-borne diseases are endemic. We conducted molecular surveys for Babesia microti, Ehrlichia species, and Candidatus Neoehrlichia mikurensis in 62 FUO cases and 62 wild rodents from Shimane Prefecture, Japan. PCR using primers specific for the Babesia 18S small-subunit rRNA (rDNA) gene and Anaplasmataceae groESL amplified products from 45% (28/62) and 25.8% (16/62) of captured mice, respectively. Of the 28 18S rDNA PCR positives, 23 and five samples were positive for Hobetsu- and Kobe-type B. microti, respectively. In contrast, of the 16 groESL PCR positives, eight, one and seven samples were positive for Ehrlichia muris, Ehrlichia sp. HF565 and Candidatus N. mikurensis, respectively. Inoculation of selected blood samples into Golden Syrian hamsters indicated the presence of Hobetsu- and Kobe-type B. microti in four and one sample, respectively. Isolation of the latter strain was considered important as previous studies suggested that the distribution of this type was so far confined to Awaji Island in Hyogo Prefecture, where the first case of transfusion-associated human babesiosis originated. DNA samples from 62 FUO human cases tested negative for B. microti 18S rDNA gene, Anaplasmataceae groESL gene, Rickettsia japonica 17K genus-common antigen gene and Orientia tsutsugamushi 56K antigen gene by PCRs. We also conducted seroepidemiological surveys on 62 human sera collected in Shimane Prefecture from the FUO patients who were suspected of carrying tick-borne diseases. However, indirect immunofluorescent antibody tests using B. microti- and E. muris-infected cells detected IgG against E. muris in only a single positive sample. This study demonstrates the presence of several potentially important tick-borne pathogens in Shimane Prefecture and suggests the need for further study on the causative agents of FUOs.

Six Eurasian red squirrels (Sciurus vulgaris orientis), victims of road traffic found during 2002 and 2004 near the Noppro Forest Park in Ebetsu, Hokkaido, Japan, were examined for the presence of Babesia parasites. Three of the six squirrels exhibited positive signals by nested PCRs targeting both the 18S rRNA and beta-tubulin genes. Three squirrels proved to be infected with a B. microti-like parasite as evidenced by sequencing the amplified DNAs and by the morphology of the intraerythrocytic parasites. Genotypically, however, the parasite appeared to be of a new type, as it was clearly distinguishable from any of the known types that have previously been reported in various wild animals. This is the first report showing molecular evidence for the presence of B. microti-like parasites in Sciuridae.

Babesia rodhaini is a rodent hemoparasite closely related to B. microti, the major causative agent of human babesiosis. We tested the infectivity of B. rodhaini for human erythrocytes by using the SCID mouse model in which the circulating erythrocytes were replaced with those of humans. Initially, parasites grew very poorly in the mouse model, but a variant capable of propagating in human erythrocytes emerged after an adaptation period of three weeks. In an attempt to identify parasite proteins involved in the alteration of host cell preference, an expression cDNA library of B. rodhaini was constructed and screened with immune mouse sera. Although we were able to obtain three merozoite surface protein (MSP) genes, sequences of these genes from both the parental strain and human erythrocyte-adapted substrain were identical. Our results suggest that B. rodhaini has potential ability to infect human erythrocytes, but development of this ability may not be brought about by an amino acid change in MSPs.

We previously reported that small wild rodents in Japan harbor two types of novel Babesia microti-like parasites (designated as Hobetsu and Kobe types), but not the type commonly found in the northeastern United States (U.S. type) where human babesiosis is endemic. To determine whether these new types of parasites are distributed in places surrounding Japan, an epizootiologic survey was undertaken in three geographically distant areas in northeastern Eurasia; South Korea, Vladivostok in Russia, and Xinjiang in China. Blood samples were collected from a total of 387 animals comprising 24 species. DNAs extracted from the samples were tested by nested PCR targeting babesial nuclear small-subunit rRNA gene (rDNA), which revealed that small rodents harboring B. microti exist in all three survey areas. Sequence analysis showed that all PCR-positive samples had rDNA sequences virtually identical to that of U.S.-type B. microti. However, when beta-tubulin gene sequences were compared, evident geographic variations were seen. By use of primers specific for each of the beta-tubulin genes of Kobe-, Hobetsu-, and U.S.-type parasites, a type-specific PCR was developed. Parasite with Hobetsu- or Kobe-type sequence was not detected from any of the three survey areas. These findings suggest that U.S.-type B. microti is widely distributed among small wild mammals in temperate zones of not only North America, but also Eurasia, whereas that Hobetsu- and Kobe-type parasites may be uniquely distributed in Japan.

It has been known that Hyssopus officinalis (hyssop) is a herb that grows in the wild and is a source of natural antioxidants. We previously reported that a-glucosidase inhibitors, (2S, 3S)1-O-beta-D-6'-O-cinnamoylglucopyranosyl-3-(3", 5"-dimethoxy-4"-hydroxyphenyl)-1,2,3-propanetriol and (2S, 3S)1-O-beta-D-glucopranosyl-3-(3", 5"-dimethoxy-4"-hydroxyphenyl)-1,2,3-propanetriol, from the dry leaves of hyssop, were isolated. This study examined the alpha-glucosidase inhibitory effects of hyssop extracts on intestinal carbohydrate absorption in rat everted gut sac and carbohydrate-loaded hyperglycemia in mice. In the everted gut sac experiment, 10 mM sucrose- and 5 mM maltose-treated increases in glucose concentration in the serosal compartment were inhibited in the presence of 0.5 and 1.0 mg/ mL hyssop extracts, although a 10 mM glucose-induced increase in serosal glucose was not inhibited by the extracts. Additionally, hyperglycemia in sucrose- and maltose-loaded mice was significantly suppressed at an early stage, within 30 to 60 min by oral pre-administration of 300 and 100 mg/kg hyssop extracts, respectively. These findings suggest that hyssop extracts inhibited the digestion of complex carbohydrates, but not that of absorbable monosaccharide, and might be a useful supplemental food for hyperglycemia.

The erythrocyte-exchanged chimera mouse model has become to be a significant tool for studying animal and human (hu) protozoan haemoparasites, though the usefulness of this model varies depending primarily on the acceptability of xenogeneic red blood cells (RBC). To find a superior recipient in comparison with C.B-17/Jcl mouse with severe combined immuno-deficiency (scid) mutation, we examined in this report the non-obese diabetes (NOD)/shi-scid mouse, a recently available strain of SCID. When 2.5 x 10(8) of fluorescent dye-labeled hu-RBCs were transfused, C.B-17scid mouse eliminated them logarithmically by a simple linear regression, while NOD-scid mouse eradicated hu-RBCs by a unique two-step fashion, i.e., a potent but only briefly functioning RBC eradication followed by a weak steadily functioning step. The means of regression line constance +/- their standard deviations (SD) of 205 C.B-17scid and of 213 NOD-scid mice for their short- and long-lasting steps were -0.73 +/- 0.63, -0.53 +/- 0.25 and -0.16 +/- 0.10, respectively. Hu-RBC half-lives determined from these means of C.B-17scid mice and of NOD-scid mice for the short- and long-living steps were 3.6, 4.9 and 16.3 hr, respectively. Higher hu-RBC acceptability of NOD-scid mouse, especially at their long-lasting step, was also demonstrated under at an activated state of mouse innate immunity. Treatment with 1.0 mg heat-killed Candida cells caused an acceleration of hu-RBC elimination in both mouse strains but the magnitudes for the short- and long-living steps of NOD-scid mice evaluated by "stimulation index" were only 1/2.6 and 1/7.6 of C.B-17scid mice, respectively.

Background Quitting smoking is important to reduce smoking-related diseases. What is the difference between people who continue to smoke and those who can quit smoking. We focused on nicotine metabolism. Smokers crave nicotine when their body’s nicotine concentration drops. Therefore, we hypothesized that quick metabolism of nicotine is a contributing factor of continuation of …

Objective To examine the factors related to fatigue accumulation by irregular shift workers after the late-night shift. Method We studied employees of a company in the transportation industry in Fukushima prefecture. The company transports passengers, and many employees, including the crew, engage in irregular shift work. We performed the investigation by using a self-administered questionnaire which was sent to 89 employees in October, 2011. Of the 89 who were given the survey, 84 replied, and 52 of those employees had worked the late-night shift (straddling midnight) at least once during September. In answer to the question "How long does it take you to recover after working the late-night-shift?" choices were "I don't feel tired ", "I recover the next day", "I recover in two or three days", and "It takes more than three days". We classified the choices into two groups of: 1) "I don't feel tired" and "I recover the next day", and 2) "I recover in two or three days" and "It takes more than three days". Other questions were asked about age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shift, risk of lifestyle-related diseases (hypertension, dyslipidemia, and diabetes), awareness of life stress accumulation, and exercise habits. Results Thirty-two employees answered that they recovered from the late-night shift by the next day, whereas 20 employees answered that it took more than 2 days to recover after the late-night-shift. The group who answered that recovery time after the late-night shift took more than 2 days significantly (p=0.035) felt that their stress management was insufficient. Age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shifts, risk of lifestyle-related diseases, and exercise habits showed no significant association with fatigue accumulation. The group who answered that their stress management was insufficient significantly chose liquor (p=0.045) and cigarettes (p=0.030) for stress reduction. Discussion In this study, a relationship was recognized between degree of awareness of daily stress relief and fatigue recovery period. In addition, various means of stress relief had different effects, suggesting the need for individualized mental health care.