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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.

Modern ground-based gravitational wave (GW) detectors require a complex interferometer configuration with multiple coupled optical cavities. Since achieving the resonances of the arm cavities is the most challenging among the lock acquisition processes, the scheme called arm length stabilization (ALS) had been employed for lock acquisition of the arm cavities. We designed a new type of the ALS, which is compatible with the interferometers having long arms like the next generation GW detectors. The features of the new ALS are that the control configuration is simpler than those of previous ones and that it is not necessary to lay optical fibers for the ALS along the kilometer-long arms of the detector. Along with simulations of its noise performance, an experimental test of the new ALS was performed utilizing a single arm cavity of KAGRA. This paper presents the first results of the test where we demonstrated that lock acquisition of the arm cavity was achieved using the new ALS and residual noise was measured to be $8.2\,\mathrm{Hz}$ in units of frequency, which is smaller than the linewidth of the arm cavity and thus low enough to lock the full interferometer of KAGRA in a repeatable and reliable manner., Comment: 21 pages, 8figures

This paper reports on the design and characteristics of a compact module integrating an optical displacement sensor and an electromagnetic actuator for use with vibration-isolation systems installed in KAGRA, the 3-km baseline gravitational-wave detector in Japan. In technical concept, the module belongs to a family tree of similar modules called OSEMs, used in other interferometric gravitational-wave detector projects. After the initial test run of KAGRA in 2016, the sensor part, which is a type of slot sensor, was modified by increasing the spacing of the slot from 5 mm to 15 mm to avoid the risk of mechanical interference with the sensor flag. We confirm the sensor performance is comparable to that of the previous design despite the modification. We also confirm the sensor noise is consistent with the theoretical noise budget. The noise level is 0.5 nm/rtHz at 1 Hz and 0.1 nm/rtHz at 10 Hz, and the linear range of the sensor is 0.7 mm or more. We measured the response of the actuator to be 1 N/A, and also measured the resistances and inductances of coils of the actuators to confirm consistency with theory. Coupling coefficients among the different degrees of freedom were also measured and shown to be negligible, varying little between designs. A potential concern about thermal noise contribution due to eddy current loss is discussed. As of 2020, 42 of the modules are in operation at the site., Comment: 19 pages, 14 figures

著者人数: KAGRA collaboration 198名 (所属. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS): 和泉, 究), Number of authors: KAGRA collaboration 198 (Affiliation. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS): Izumi, Kiwamu), Accepted: 2018-11-19, 資料番号: SA1180423000

Highly pathogenic avian influenza (HPAI) outbreaks engender a severe economic impact on the poultry industry and public health. Migratory waterfowl are considered the natural hosts of HPAI virus, and HPAI viruses are known to be transmitted over long distances during seasonal bird migration. Bird migration is greatly affected by the weather. Many studies have shown the relationship between either autumn or spring bird migration and climate. However, few studies have shown the relationship between annual bird migration and annual weather. This study aimed to establish a model for the number of migratory waterfowl involved in HPAI virus transmission based on meteorological data. From 136 species of waterfowl that were observed at Futatsudate in Miyazaki, Japan, from 2008 to 2016, we selected potential high-risk species that could introduce the HPAI virus into Miyazaki and defined them as ‘risky birds’. We also performed cluster analysis to select meteorological factors. We then analysed the meteorological data and the total number of risky birds using a generalised linear mixed model. We selected 10 species as risky birds: Mallard (Anas platyrhynchos), Northern pintail (Anas acuta), Eurasian wigeon (Anas penelope), Eurasian teal (Anas crecca), Common pochard (Aythya ferina), Eurasian coot (Fulica atra), Northern shoveler (Anas clypeata), Common shelduck (Tadorna tadorna), Tufted duck (Aythya fuligula) and Herring gull (Larus argentatus). We succeeded in clustering 35 meteorological factors into four clusters and identified three meteorological factors associated with their migration: (1) the average daily maximum temperature; (2) the mean value of global solar radiation and (3) the maximum daily precipitation. We thus demonstrated the relationship between the number of risky birds and meteorological data. The dynamics of migratory waterfowl was relevant to the risk of an HPAI outbreak, and our data could contribute to cost and time savings in strengthening preventive measures against epidemics.

著者人数: KAGRA Collaboration 203名 (所属. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS): 和泉, 究), Number of authors: KAGRA collaboration 203 (Affiliation. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS): Izumi, Kiwamu), Accepted: 2019-06-11, 資料番号: SA1190107000

Commentary, 高度な機器を用いた3次元動作解析は歩行分析のゴールドスタンダードである。 しかし、 臨床では歩行機能の問題を同定し、 治療効果の評価のためには目視による歩行観察が一般的である。 機器を用いた動作解析は高価で時間や労力を要するため、 あくまで研究室ベースであり、 日々の臨床の流れにおいて、 めったに活用できないのが現実だ。 本稿の目的は、 簡易に入手可能なISO 16840-1に基づいた定量的な計測ツール"rysis"を用いて、 歩行評価におけるセラピストの観察の信頼性を検討し、 姿勢・動作分析における定量化シークエンスを示し動画切り出し画像の定量評価の簡便な方法を提案することである。 12名のセラピストの検者間信頼性について、 外部身体マーカーあり(ICC=0.970)と外部身体マーカーなし(ICC=0.902)の2つの条件下で比較した。 さらに、 理学療法士が歩行評価をするときの"rysis"の応用可能性についても言及した。

著者人数: 227名 (所属. 宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS): 東谷, 千比呂), Number of authors: 227 (Affiliation. Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency(JAXA)(ISAS): Tokoku, Chihiro), Accepted: 2017-11-21, 資料番号: SA1170370000

The influence of social capital on happiness is attracting attention around the world. Many studies that investigated the relationship between social capital and happiness suggest that happiness correlates to a positive social environment. The aim of this study was to examine the relationship between social capital and happiness in a community with the lowest National Health Insurance expenditures in Miyazaki Prefecture (Japan). This cross-sectional study targeted 2730 residents in the community aged 40-75 years who were covered by National Health Insurance in 2015. A self-administered questionnaire consisting of questions focusing on demographic characteristics, happiness, and social capital was sent to the residents, and 1106 of them (40.5%) returned the questionnaires by the deadline. The analysis of responses indicated a positive relationship between social capital and happiness with regard to all three factors of social capital (trust, connections and interaction, and social participation). Evaluating the relationship between social capital and health in terms of happiness is important to creating a lively society in which citizens support one another, in addition to promoting physical and mental well-being.

KAGRA is a 3-km cryogenic interferometric gravitational wave telescope located at an underground site in Japan. In order to achieve its target sensitivity, the relative positions of the mirrors of the interferometer must be finely adjusted with attached actuators. We have developed a model to simulate the length control loops of the KAGRA interferometer with realistic suspension responses and various noises for mirror actuation. Using our model, we have designed the actuation parameters to have sufficient force range to acquire lock as well as to control all the length degrees of freedom without introducing excess noise., 21 pages, 7 figures (typo in p.12 on magnetic field gradient fixed for v3)

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.

Bovine viral diarrhoea virus (BVDV) infection in cattle can result in growth retardation, reduced milk production, reproductive disorders and death. Persistently infected animals are the primary source of infection. In Hokkaido, Japan, all cattle entering shared pastures in summer are vaccinated before movement for disease control. Additionally, these cattle may be tested for BVDV and culled if positive. However, the effectiveness of this control strategy aiming to reduce the number of BVDV-infected animals has not been assessed. The aim of this study was to evaluate the effectiveness of various test-and-cull and/or vaccination strategies on BVDV control in dairy farms in two districts of Hokkaido, Nemuro and Hiyama. A stochastic model was developed to compare the different control strategies over a 10-year period. The model was individual-based and simulated disease dynamics both within and between herds. Parameters included in the model were obtained from the literature, the Hokkaido government and the Japanese Ministry of Agriculture, Forestry and Fisheries. Nine different scenarios were compared as follows: no control, test-and-cull strategies based on antigen testing of either calves or only cattle entering common pastures, vaccination of all adult cattle or only cattle entering shared pastures and combinations thereof. The results indicate that current strategies for BVDV control in Hokkaido slightly reduced the number of BVDV-infected animals; however, alternative strategies such as testing all calves and culling any positives or vaccinating all susceptible adult animals dramatically reduced those. To our knowledge, this is the first report regarding the comparison of the effectiveness between the current strategies in Hokkaido and the alternative strategies for BVDV control measures.

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.

This paper presents an asymptotic method of power calculations for likelihood ratio tests in the nested case-control designs with a randomly sampled control per case. It is an extension of the approach described in Self et al. (1992) for proportional hazards models. Our approach here focuses on a simple scenario with 1 : 1 case-control ratio, simple random sampling design, and two independent dichotomous covariates with no interaction effects. The approximation of the noncentrality of the noncentral chi-square distribution for the likelihood ratio statistic is provided. Simulation studies are conducted to examine the accuracy for several parameter values and data configurations. Overall the results suggest that estimates of power using our proposed method are consistent with those of actual power from Monte Carlo simulation. Therefore, the proposed approach can be practically useful in assessing the statistical power for the simple nested case-control design.

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.

KAGRA is a cryogenic interferometric gravitational wave detector currently under construction in the Kamioka mine in Japan. Besides the cryogenic test masses, KAGRA will also rely on room temperature optics which will hang at the bottom of vibration isolation chains. The payload of each chain comprises an optic, a system to align it, and an active feedback system to damp the resonant motion of the suspension itself. This article describes the performance of a payload prototype that was assembled and tested in vacuum at the TAMA300 site at the NAOJ in Mitaka, Tokyo. We describe the mechanical components of the payload prototype and their functionality. A description of the active components of the feedback system and their capabilities is also given. The performance of the active system is illustrated by measuring the quality factors of some of the resonances of the suspension. Finally, the alignment capabilities offered by the payload are reported. (C) 2016 AIP Publishing LLC.

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).

In epidemiological studies there are numerous challenges to finding an appropriate experimental design for studying the relationship between an exposure and a disease. A number of designs for observational studies have been investigated; the cohort study and the standard case-control study are the primary types. The nested case-control study design combines features of both. In the nested case-control study some information is available for all cohort members and additional information is obtained using a case-control design based on incidence density sampling rather than cumulative prevalence sampling. To get higher efficiency, it is important to effectively use the information already available on cohort members when we choose the controls. The counter-matched design is one such method, which chooses the controls based on exposure status or a surrogate measure of the exposure. It has high efficiency to estimate the effect of the exposure or interaction between the exposure and another risk factor. Unfortunately, there are few examples of application of this design to real situations. To encourage use of the counter-matched design, we describe the basic concept and statistical methods underlying the method. Some examples are presented to illustrate how to implement the design. We also propose some extensions to provide a more flexible sampling design.

Pairwise conditional score functions are proposed and explored. They provide us with an interpretation on the Mantel–Haenszel estimator, and are applicable to deriving the Mantel–Haenszel-type estimators under the exponential dispersion model with multiple strata. Explicit forms of the estimating functions are presented, and the asymptotic relative efficiency is examined in the cases of the exponential and the geometric distributions. The derivation and the numerical results suggest that the derived estimators are fairly robust and show high efficiency as the Mantel–Haenszel estimator.

The pathogenesis of intravascular lymphoma (IVL) remains inadequately understood. Furthermore, its prognosis remains extremely poor despite combination chemotherapy. Lymphoma cells and hemophagocytosing cells are commonly observed in the livers of IVL patients and less frequently in the bone marrow. We recently encountered an 83-year-old female and a 78-year-old female with IVL, both of whom presented with fever of unknown origin. Following examination, we decided to perform random liver biopsy for diagnostic purposes. The former patient died because of rapid tumor growth, while the latter achieved remission following treatment with a modified R-VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone, and bleomycin plus rituximab) regimen. Considering the possibility of IVL is important when examining a patient presenting with fever of unknown origin. This report demonstrates that random liver biopsy represents a useful diagnostic strategy, particularly in patients with elevated liver enzyme levels.

We are concerned with a counter-matched nested case-control study. Assuming the proportional hazards model, the Mantel-Haenszel estimators of hazard rates are presented in two situations. The proposed estimators can be calculated without estimating the nuisance parameter. Consistent estimators of the variance of the proposed hazard rate estimators are also developed. We compare these estimators to the maximum partial likelihood estimators in the asymptotic variance. The methods are illustrated using the Colorado Plateau uranium miner cohort data.

A projection method is introduced to generalize the Mantel-Haenszel estimator for estimating the common odds ratios in K 2 × J (J > 2) tables. The method provides estimators in an explicit form and needs no iterative computation. It is shown that the generalized Mantel-Haenszel estimator proposed by Greenland, and Yanagawa and Fujii is obtained by this method as a special case. Furthermore, selecting appropriate weight, it is shown that the method leads to an estimator that is asymptotically equivalent to the generalized Mantel-Haenszel estimator proposed by Liang. A dually consistent estimator of the variance of the estimator is proposed. The characteristics of these estimators have been evaluated by Monte Carlo means.

Generalization of Mantel-Haenszel procedure for 2 × J (J > 2) tables is reviewed. Included are generalized Mantel-Haenszel tests, estimators for a common odds ratio, and generalized Breslow-Day test for the homogeneity of odds ratios across the strata.—Environ Health Perspect 102(Suppl 8): 57–60 (1994)

This paper examines the tests of homogeneity of odds ratios in independent experiments. Breslow and Day [2] and Tarone [10] proposed the tests which incorporate the Mantel-Haenszel estimator, but are essentially based on the efficient scores from the likelihood function. To broaden the distributional assumption and also to include the Mantel-Haenszel estimating equation, we introduce estimating equations and develop a homogeneity test. The extension makes it possible for us to apply this procedure to $ 2 \times 2 $ tables which follow a negative binomial distribution.

In the logistic regression problem and the generalized linear regression problem, the dispersion around the fitted regression is sometimes too large. Over-dispersion and random effect models are proposed to provide fitted regressions which conform more closely to the data. However, in the analysis of contingency tables the random effect cannot be detected or corrected, so it is important to understand the influence of the heterogeneity factor on contingency tables. Therefor, this paper investigates the influence of heterogeneity on binary data and evaluates its effect on contingency tables.

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.

A conditional test for the homogeneity of the odds ratios in L2 × K (K > 2) tables is developed based on a multiple hypergeometric distribution. The test is a generalization of the Breslow-Day test (1980) and is useful in sparse tables. For computational feasibility, the conditional maximum likelihood estimator is replaced by a consistent but inefficient estimator in the test statistic. If this is the case, it is shown that the asymptotic distribution is not chi squared, as has been noticed by Tarone (1985) in the case of 2 × 2 tables. Following Tarone we develop a correction method so that the statistic follows an asymptotic chi-squared distribution. An algorithm is developed for calculating the homogeneity test with a generalized Mantel-Haenszel estimator.

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.

The aim of this study was to survey mental health status among patients of a large outbreak of Legionnaires Disease (LD) occurring at a public bath in Hyuga City, Miyazaki Prefecture, from June through July, 2002. It also aimed to provide a basis for establishing a mental health care support system for persons suffering from ill health.Some 295 patients were reported by medical institutions to public health centers as being infected with LD or having suspected infection after using a hot springs bath, where hygiene was assumed to be maintained by regular water circulation, from 6/20 through 7/23, 2002 in Hyuga City, Miyazaki Prefecture. A total of 153 subjects consented to interviews after being informed of the objectives. They were visited and interviewed with a questionnaire from 10/12 through 12/5, 2002. Questions about mental health were written to identify "feeling stressed", based on diagnostic criteria for Post Traumatic Stress Disorder (PTSD) as noted in the DSM-IV. The Japanese version of the General Health Questionnaire (GHQ28) was used to identify high risk subjects for mental disorder, as well as the following four symptoms: "somatic symptoms", "anxiety and insomnia", "social dysfunction", and "severe depression". Factors associated with these were assessed with regard to knowledge and/or information about LD and its effects on daily life.Regarding mental health, 27 (17.6%) were "feeling stressed". High risk patients for mental disorder numbered 39 (25.5%) according to the GHQ28. Patients with "somatic symptoms" numbered 44 (28.8%), those with "anxiety and insomnia" 21 (13.7%), those with "social dysfunction" 18 (11.8%) and with "severe depression" 5 (3.3%). Among the effects on daily life, "changes of human relationships" was related with "feeling stressed" in those suspected of LD infections (P = 0.022). High risk was related to "economic support" (P = 0.009) in LD, and also to "cause and survey" (P = 0.035) in those cases suspected of LD.At 3 to 4 months after the outbreak, the patients still exhibited mental health problems. Therefore we should provide health and social support that deals with the factors identified on a longer-term or continuous basis.

1-Benzyl-4-tert-butyl-1,4-dihydronicotinamide (t-BuBNAH) reacts efficiently with p-benzoquinone (Q) to yield a [2+3] cycloadduct (1) in the presence of Sc(OTf)(3) (OTf = OSO(2)CF(3)) in deaerated acetonitrile (MeCN) at room temperature, while no reaction occurs in the absence of Sc(3+). The crystal structure of 1 has been determined by the X-ray crystal analysis. When t-BuBNAH is replaced by 1-benzyl-1,4-dihydronicotinamide (BNAH), the Sc(3+)-catalyzed cycloaddition reaction of BNAH with Q also occurs to yield the [2+3] cycloadduct. Sc(3+) forms 1:4 complexes with t-BuBNAH and BNAH in MeCN, whereas there is no interaction between Sc(3+) and Q. The observed second-order rate constant (k(obs)) shows a first-order dependence on [Sc(3+)] at low concentrations and a second-order dependence at higher concentrations. The first-order and the second-order dependence of the rate constant (k(et)) on [Sc(3+)] was also observed for the Sc(3+)-promoted electron transfer from CoTPP (TPP = tetraphenylporphyrin dianion) to Q. Such dependence of k(et) on [Sc(3+)] is ascribed to formation of 1:1 and 1:2 complexes between Q(*)(-) and Sc(3+) at the low and high concentrations of Sc(3+), respectively, which results in acceleration of the rate of electron transfer. The formation constants for the 1:2 complex (K(2)) between the radical anions of a series of p-benzoquinone derivatives (X-Q(*)(-)) and Sc(3+) are determined from the dependence of k(et) on [Sc(3+)]. The K(2) values agree well with those determined from the dependence of k(obs) on [Sc(3+)] for the Sc(3+)-catalyzed addition reaction of t-BuBNAH and BNAH with X-Q. Such an agreement together with the absence of the deuterium kinetic isotope effects indicates that the addition proceeds via the Sc(3+)-promoted electron transfer from t-BuBNAH and BNAH to Q. When Sc(OTf)(3) is replaced by weaker Lewis acids such as Lu(OTf)(3), Y(OTf)(3), and Mg(ClO(4))(2), the hydride transfer reaction from BNAH to Q also occurs besides the cycloaddition reaction and the k(obs) value decreases with decreasing the Lewis acidity of the metal ion. Such a change in the type of reaction from a cycloaddition to a hydride transfer depending on the Lewis acidity of metal ions employed as a catalyst is well accommodated by the common reaction mechanism featuring the metal-ion promoted electron transfer from BNAH to Q.