Effects of Cooking Methods on Caffeoylquinic Acids and Radical Scavenging Activity of Sweet Potato

The effects of cooking methods, including steaming, deep-frying, and baking, on the phenolic content, 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity, and isomerization of caffeoylquinic acids in sweet potato were investigated. A high correlation was observed between antioxidant capacity and total phenolic content. Deep-frying treatment resulted in higher antioxidant capacity with increasing heating time. The major phenolic components of raw sweet potat were 5-caffeoylquinic acid (CQA) and 3,5-dicaffeoylquinic acid (diCQA), which were reduced by heat treatment due to the isomerization of 5-CAQ to 3- and 4-CQA, and 3,5-diCQA to 3,4- and 4,5-diCQA. Moreover, 5-CQA was more stable than 3,5-diCQA even at 100 °C. Our results demonstrated that by controlling the cooking temperature and time, new bioactive compounds such as mono- and diCQA derivatives can be produced from sweet potato. These data indicate a potential approach for the development of new functional foods from sweet potato by controlling cooking temperature and time.

Cost-effectiveness analysis of COVID-19 booster vaccination with BNT162b2 in Japan

BACKGROUND

The aim of this study was to evaluate the public health and economic impact of the COVID-19 booster vaccination with BNT162b2 in Japan during an Omicron-dominant period from early 2022.

RESEARCH DESIGN AND METHODS

A combined cohort Markov decision tree model estimated the cost-effectiveness of annual or biannual booster vaccination strategies compared to no booster vaccination for those aged 65 years and above, and those aged 60-64 years at high risk as the base case. The societal perspective was primarily considered. We also examined other target populations with different age and risk groups. Sensitivity and scenario analyses with alternative inputs were performed.

RESULTS

Annual and biannual vaccination strategies were dominant from the societal perspective in the base case. Incremental Cost Effectiveness Ratios (ICERs) from the payer perspective were JPY 1,752,499/Quality Adjusted Life Year (QALY) for annual vaccination and JPY 2,831,878/QALY for biannual vaccination, both less than the threshold value in Japan (JPY 5 million/QALY). The results were consistent even when examining other target age and risk groups. All sensitivity and scenario analyses indicated that ICERs were below JPY 5 million/QALY.

CONCLUSIONS

Booster vaccination with the COVID-19 vaccine BNT162b2 is a dominant strategy and beneficial to public health in Japan.

Erratum: Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande [Phys. Rev. Lett. 130, 031802 (2023)]

This corrects the article DOI: 10.1103/PhysRevLett.130.031802.

Ameliorative Effects of Anthocyanin Metabolites on Western Diet-Induced NAFLD by Modulating Co-Occurrence Networks of Gut Microbiome

Anthocyanins (Acn) have been reported to have preventive effects on Western diet (WD)-induced non-alcoholic fatty liver disease (NAFLD). However, the amount of Acn that reached the bloodstream were less than 1%, suggesting that anthocyanin metabolites (Acn-M) in the gut may contribute to their in vivo effects. This study is focused on a gut microbiota investigation to elucidate the effect of two major Acn-M, protocatechuic acid (PC) and phloroglucinol carboxaldehyde (PG), on NAFLD prevention. C57BL/6N male mice were divided into five groups and fed with a normal diet (ND), WD, WD + 0.5% PC, WD + 0.5% PG and WD + a mixture of 0.25% PC + 0.25% PG (CG) for 12 weeks. The results revealed that WD-fed mice showed a significant increase in final body weight, epididymis fat weight, liver weight and fat accumulation rate, serum total cholesterol, alanine aminotransferase, monocyte chemoattractant protein 1, and 2-thiobarbituric acid reactive substances. At the same time, these indices were significantly decreased by Acn-M in the order of PG, CG > PC. In particular, PG significantly decreased serum glucose and insulin resistance. Gut microbiome analysis revealed that PG significantly increased the relative abundance of Parabacteroides, Prevotella, Prevotella/Bacteroides ratio, and upregulated glucose degradation pathway. Interestingly, the co-occurrence networks of Lachnospiraceae and Desulfovibrionaceae in the PC and PG groups were similar to the ND group and different to WD group. These data suggest that PC and PG were able to recover the gut microbiome networks and functions from dysbiosis caused by WD. Therefore, PG might act as a master metabolite for anthocyanins and prevent WD-induced NAFLD and gut dysbiosis.

Granular flow experiment using artificial gravity generator at International Space Station

Studying the gravity-dependent characteristics of regolith, fine-grained granular media covering extra-terrestrial bodies is essential for the reliable design and analysis of landers and rovers for space exploration. In this study, we propose an experimental approach to examine a granular flow under stable artificial gravity conditions for a long duration generated by a centrifuge at the International Space Station. We also perform a discrete element simulation of the granular flow in both artificial and natural gravity environments. The simulation results verify that the granular flows in artificial and natural gravity are consistent. Further, regression analysis of the experimental results reveals that the mass flow rate of granular flow quantitatively follows a well-known physics-based law with some deviations under low-gravity conditions, implying that the bulk density of the granular media decreases with gravity. This insight also indicates that the bulk density considered in simulation studies of space probes under low-gravity conditions needs to be tuned for their reliable design and analysis.

Multivariate Profiling of Metabolites and Volatile Organic Compounds in Citrus depressa Hayata Fruits from Kagoshima, Okinawa, and Taiwan

Citrus depressa Hayata is a small-fruit citrus species; it is indigenous to Kagoshima, Okinawa, and Taiwan. The metabolites and volatile organic compounds (VOCs) that affect the flavor of its fruits have not been investigated based on geographical origin. In the present study, we investigated the metabolite and VOC profiles of 18 C. depressa cultivation lines from these regions. Multivariate analysis revealed differences in the metabolites of C. depressa based on its cultivation origins; variations in sugar, sugar alcohol, and amino acid contents were also observed. Fruits from Kagoshima and Okinawa had higher galactinol, trehalose, xylose, glucose, and sucrose intensities than fruits from Taiwan (log2-fold change; 2.65-3.44, 1.68-2.13, 1.37-2.01, 1.33-1.57, and 1.07-1.43, respectively), whereas the Taiwanese lines contained higher leucine, isoleucine, serine, and alanine. In contrast to the Taiwanese Nantou line, other cultivation lines had comparable total VOC contents, and the VOCs of all lines were dominated by limonene, γ-terpinene, and p-cymene. Accordingly, the highest VOC intensities were recorded in the Nantou line, which was followed by Shikunin sweet (Kagoshima) and Taoyuan (Taiwan) (log10 normalize concentration; 5.11, 3.08, and 3.01, respectively). Moreover, multivariate analysis plots elucidated the difference in the VOCs of Ishikunibu (Okinawa), Shikunin sweet, and Taoyuan and between those of most Kagoshima and Okinawa cultivation lines. These results suggest that both the cultivation line and origin influence the metabolites and VOCs of C. depressa, thus possibly affecting its flavor quality; the data provide a valuable insight for utilizing C. depressa of different cultivation lines and origins to produce foods and beverages.

Effects of processing methods on the aroma constituents of hihatsumodoki (Piper retrofractum Vahl)

Hihatsumodoki (Piper retrofractum Vahl) is a traditional spice from Okinawa (Japan) that can be processed in different ways to create the desired flavor. Herein, we examined the effects of processing (sun-drying, oven-drying, roasting, and steaming) on the volatile aroma constituents of hihatsumodoki fruits. Among the 106 chromatographic peaks observed in total, 58 were assigned to known aroma compounds. The relative contents of terpenes, for example, linalool, β-caryophyllene, α-caryophyllene, and germacrene D, ranged from 57.6% to 88.1%. Sun-drying decreased the content of aldehydes such as hexanal and trans-2-hexenal but did not significantly affect the total content of aroma compounds. The amount of aroma compounds released during oven-drying and roasting increased with temperature up to a certain point (90°C) and decreased at an excessively high temperature of 180°C. High-temperature roasting generated Maillard reaction products such as furans and furanones, which could impart sweet caramel odors. Steamed fruits had the lowest content of aroma compounds, which was ascribed to the loss of these compounds to vapor. Meanwhile, drying steamed fruits resulted in an approximately 3.6-fold increase in their aroma compound content, and the content of sesquiterpenes in the steamed-dried fruits was similar to that in fruits exposed to high temperatures. The effects of processing on aroma quality were visualized using multivariate statistical analysis. The aroma characteristics of roasted (180°C), steamed, and steamed-dried fruits were different from those of the control. The combined findings provide useful information for the selection of processing methods to achieve the desired flavor of hihatsumodoki. Practical Application: This study reveals the effects of different processing methods on the aroma profile of hihatsumodoki (Piper retrofractum Vahl), a subtropical spice from Okinawa (Japan). The results facilitate the selection of preferred hihatsumodoki flavors for household and industrial applications in foods and beverages. In addition, they inspire research on the processing-induced flavor changes of other tropical or subtropical spices.

Characteristics of needlestick and sharps injuries of the hands in the operating room among orthopedic surgeons in Japan

Among the reports on needlestick and sharps injuries (NSIs), many are orthopedic-related due to the frequent use of sharp devices such as pins and wires. This study aimed to identify high-risk instruments, the most common injury sites for each instrument, and the circumstances of NSIs of the hand during orthopedic surgeries in Japan. Incidents of exposure to blood or bodily fluids among physicians during orthopedic surgeries reported to the Japan-EPINet between 2000 and 2015 were included in this study. The four most common devices were identified and the associations among years of experience, equipment users, and injured sites were analyzed. We identified 666 cases of NSIs affecting orthopedic surgeons in the operating room. The instrument most frequently responsible for NSIs was suture needles, which were involved in 265 cases (39.7%). The second most common instrument was pins/wires, which was involved in 111 cases (16.6%). NSIs of the hands of orthopedic surgeons were frequently caused by suture needles used in all surgeries, but relatively often caused by orthopedic devices. Orthopedic surgeons must be aware that they are at risk of NSIs and must take appropriate measures and always be cautious when performing surgery, regardless of their years of experience.

Composition of Minerals and Volatile Organic Components of Non-Centrifugal Cane Sugars from Japan and ASEAN Countries

Non-centrifugal cane sugar (NCS) is an unrefined dehydrated form of sugar syrup produced worldwide. To date, there is a lack of differentiation in the key nutrients and flavor qualities of NCS products among countries, which makes it difficult for interested parties to select NCSs suitable for their needs. This study aimed to evaluate the minerals and volatile organic components (VOCs) in NCS products from Japan and ASEAN countries. Mineral components were determined using inductively coupled plasma atomic emission spectroscopy (ICP-AES). VOCs and their aroma profiles were examined using gas chromatography–mass spectrophotometry (GC-MS) and MS-e-nose analyses, respectively. The total minerals content in Japanese NCSs ranged from 228.58 to 1347.53 mg/100 g, comprising K, Ca, Mg, P, and Na (69.1, 16.6, 7.9, 4.5, and 3.2%, respectively); their average total amounts were as high as those of Malaysia and Indonesia origins (962.87, 984.67, and 928.47 mg/100 g, respectively). Forty-four VOCs were identified, of which concentrations of pyrazines, furans, and pyranones varied significantly among the NCSs. Additionally, the MS-e-nose analysis provided a multivariate differentiation profile of the NCS products based on differences in the intensities of the VOC ion masses. Nine statistical clusters were presented, wherein certain NCS products of ASEAN origin had volatile profiles comparable to those of the Japanese products. These outcomes suggest that the origin of production greatly influences the mineral and VOC compositions of NCS, affecting their quality traits.

Rational design and structure-activity relationship studies reveal new esterified C20-diterpenoid alkaloid analogues active against MCF-7 human breast cancer cells

Although various diterpenoid alkaloids have been evaluated recently for antiproliferative activity against human tumor cell lines, little information is available regarding the antiproliferative effects of C20-diterpenoid alkaloids against MCF-7 cells. Six new diterpenoid alkaloid derivatives (13, 14, 22, 23, 25, 26) were prepared by C-11 and 15 esterification of kobusine (6). The natural parent alkaloid 6 and all synthesized derivatives (7 - 27, 12a, 15a, 15b, 18a, 18b) were evaluated for antiproliferative activity against MCF-7 cells. The structure-based design strategy resulted in an initial lead derivative, 11,15-dibenzoylkobusine (7; IC50 8.6 µM). Subsequent synthesized 11,15-diacylkobusine derivatives (9, 16, 20, 21, 23, 25, and 26) showed substantially increased suppressive effects against the MCF-7 cell line (IC50 2.3-4.4 µM). In contrast, parent alkaloid 6, two 11-acylkobusine derivatives (15a, 18a), and two 15-acylkobusine derivatives (15b, 18b) showed no effect. 11,15-Diacylation appears to be critical for producing antiproliferative activity in this alkaloid class and could introduce a new avenue in overcoming breast cancer cell proliferation using natural product derivatives. In a preliminary mechanism of action study, representative derivatives (5, 8, 9, and 17) decreased cyclin D1 mRNA expression.

Noble gases and nitrogen in samples of asteroid Ryugu record its volatile sources and recent surface evolution

The near-Earth carbonaceous asteroid (162173) Ryugu is expected to contain volatile chemical species that could provide information on the origin of Earth's volatiles. Samples of Ryugu were retrieved by the Hayabusa2 spacecraft. We measured noble gas and nitrogen isotopes in Ryugu samples and found that they are dominated by presolar and primordial components, incorporated during Solar System formation. Noble gas concentrations are higher than those in Ivuna-type carbonaceous (CI) chondrite meteorites. Several host phases of isotopically distinct nitrogen have different abundances among the samples. Our measurements support a close relationship between Ryugu and CI chondrites. Noble gases produced by galactic cosmic rays, indicating a ~5 million year exposure, and from implanted solar wind record the recent irradiation history of Ryugu after it migrated to its current orbit.

Formation and evolution of carbonaceous asteroid Ryugu: Direct evidence from returned samples

Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide-bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu's parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of <1 (by mass). Less altered fragments contain olivine, pyroxene, amorphous silicates, calcite, and phosphide. Numerical simulations, based on the mineralogical and physical properties of the samples, indicate that Ryugu's parent body formed ~2 million years after the beginning of Solar System formation.

Samples returned from the asteroid Ryugu are similar to Ivuna-type carbonaceous meteorites

Carbonaceous meteorites are thought to be fragments of C-type (carbonaceous) asteroids. Samples of the C-type asteroid (162173) Ryugu were retrieved by the Hayabusa2 spacecraft. We measured the mineralogy and bulk chemical and isotopic compositions of Ryugu samples. The samples are mainly composed of materials similar to those of carbonaceous chondrite meteorites, particularly the CI (Ivuna-type) group. The samples consist predominantly of minerals formed in aqueous fluid on a parent planetesimal. The primary minerals were altered by fluids at a temperature of 37° ± 10°C, about [Formula: see text] million (statistical) or [Formula: see text] million (systematic) years after the formation of the first solids in the Solar System. After aqueous alteration, the Ryugu samples were likely never heated above ~100°C. The samples have a chemical composition that more closely resembles that of the Sun's photosphere than other natural samples do.

Macromolecular organic matter in samples of the asteroid (162173) Ryugu

Samples of the carbonaceous asteroid (162173) Ryugu were collected and brought to Earth by the Hayabusa2 spacecraft. We investigated the macromolecular organic matter in Ryugu samples and found that it contains aromatic and aliphatic carbon, ketone, and carboxyl functional groups. The spectroscopic features of the organic matter are consistent with those in chemically primitive carbonaceous chondrite meteorites that experienced parent-body aqueous alteration (reactions with liquid water). The morphology of the organic carbon includes nanoglobules and diffuse carbon associated with phyllosilicate and carbonate minerals. Deuterium and/or nitrogen-15 enrichments indicate that the organic matter formed in a cold molecular cloud or the presolar nebula. The diversity of the organic matter indicates variable levels of aqueous alteration on Ryugu's parent body.

Soluble organic molecules in samples of the carbonaceous asteroid (162173) Ryugu

The Hayabusa2 spacecraft collected samples from the surface of the carbonaceous near-Earth asteroid (162173) Ryugu and brought them to Earth. The samples were expected to contain organic molecules, which record processes that occurred in the early Solar System. We analyzed organic molecules extracted from the Ryugu surface samples. We identified a variety of molecules containing the atoms CHNOS, formed by methylation, hydration, hydroxylation, and sulfurization reactions. Amino acids, aliphatic amines, carboxylic acids, polycyclic aromatic hydrocarbons, and nitrogen-heterocyclic compounds were detected, which had properties consistent with an abiotic origin. These compounds likely arose from an aqueous reaction on Ryugu's parent body and are similar to the organics in Ivuna-type meteorites. These molecules can survive on the surfaces of asteroids and be transported throughout the Solar System.

Search for Cosmic-Ray Boosted Sub-GeV Dark Matter Using Recoil Protons at Super-Kamiokande

We report a search for cosmic-ray boosted dark matter with protons using the 0.37  megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1  MeV/c^{2} to 300  MeV/c^{2}.

Antiproliferative Effect of N-Heterocyclo-Coumarin Derivatives against Multidrug-Resistant Cells

Chemotherapy refers principally to the use of small molecules to treat cancer, and natural product derivatives have been main sources of clinically using anticancer drugs. While the coumarin skeleton does not inhibit cell growth, its derivatives are often active, and numerous coumarins have been examined for antiproliferative activity against human cancer cell lines. In this study, 16 novel coumarin derivatives (1, 1a-5a, 1b, 2b, 6b, 7b, 8-13) with attached N-heterocycles, including aminopyrrolidine, aminopiperidine, aminoazepane, and indoline, were prepared and ultimately esterified or amidated with alcohols or amines, respectively. All synthesized N-heterocycles containing coumarin derivatives with alcohols, amines, and carboxylic acids were assessed for antiproliferative activity against several human cancer cell lines, containing triple-negative breast cancer (TNBC) as well as a P-glycoprotein (P-gp) overexpressing multidrug-resistant (MDR) KB subline KB-VIN. Five coumarin derivatives (3a-5a, 12, 13) showed no effect (IC₅₀ >40 µM) against all tested cell lines. In contrast, derivative 1a showed broad-spectrum activity against four cell lines, while 1b and 10 were nearly twice as selective for KB-VIN cells as the parent KB. The coumarin derivatives 1a, 1b, and 10 were optimal for antiproliferative activity in this study and could provide a new avenue for overcoming MDR tumors. Derivatives 1a, 1b, and 10 showed MDR cell-selective antiproliferative activity, indicating that N-heterocycle-coumarins exert previously unexplored bioactivity with selective action on MDR cancer cells.

Associations Between Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Traits and Sociodemographic Characteristics in Japanese Workers

Purpose

Most previous studies that described associations between adult attention-deficit/hyperactivity disorder (ADHD) and sociodemographic characteristics were focused on individuals diagnosed with ADHD, and few studies investigated ADHD traits in the general population. Additionally, some workers, who experienced no problems while at university and successfully graduated from university, developed ADHD traits after finding employment. This study described associations between ADHD traits and sociodemographic characteristics among Japanese workers who were university graduates.

Patients and Methods

Participants were randomly selected workers (n=1240) from across Japan who completed a self-administered online survey. ADHD traits were measured using an adult ADHD Self-report Scale, with scoring rules applied to reflect the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Information was collected on sociodemographic characteristics including sex, age, socioeconomic status, working time, and health-related behaviors. We performed partial correlation analysis to estimate trend associations and used analysis of covariance to compare adjusted averages. This model was adjusted for all variables.

Results

Males had higher levels of ADHD traits than females (p = 0.001), and younger age was associated with higher levels of ADHD traits (p < 0.001). Workers with low incomes had higher levels of ADHD traits than workers with high incomes (p = 0.009). More frequent consumption of midnight meals was associated with higher levels of ADHD traits (p < 0.001), although there were no differences for breakfast, lunch, and dinner. Those who did not get enough rest from sleep had higher levels of ADHD traits (p = 0.007).

Conclusion

Results for high levels of ADHD traits among workers were consistent with previous studies for adults diagnosed with ADHD, even though all participants had successfully graduated from university. Assessment of these ADHD traits may support prevention of health deterioration related to these ADHD traits.

A dehydrated space-weathered skin cloaking the hydrated interior of Ryugu

Without a protective atmosphere, space-exposed surfaces of airless Solar System bodies gradually experience an alteration in composition, structure and optical properties through a collective process called space weathering. The return of samples from near-Earth asteroid (162173) Ryugu by Hayabusa2 provides the first opportunity for laboratory study of space-weathering signatures on the most abundant type of inner solar system body: a C-type asteroid, composed of materials largely unchanged since the formation of the Solar System. Weathered Ryugu grains show areas of surface amorphization and partial melting of phyllosilicates, in which reduction from Fe³⁺ to Fe²⁺ and dehydration developed. Space weathering probably contributed to dehydration by dehydroxylation of Ryugu surface phyllosilicates that had already lost interlayer water molecules and to weakening of the 2.7 µm hydroxyl (-OH) band in reflectance spectra. For C-type asteroids in general, this indicates that a weak 2.7 µm band can signify space-weathering-induced surface dehydration, rather than bulk volatile loss.

Depressive symptoms in workers with high autistic trait scores according to job stress type

Individuals with high levels of autistic traits are at a high risk of experiencing depressive symptoms, and are also vulnerable to job stress. This study aimed to identify which combination of autistic traits and type of job stress are related to depressive symptoms. Participants comprised 992 workers from different regions of Japan. Autistic traits, depressive symptoms, and job stress were measured using the Autism-Spectrum Quotient, K6 scale, and Job Content Questionnaire, respectively. Logistic regression was performed to estimate the odds ratio and 95% confidence interval. Workers with high autistic traits scores reported significantly more depressive symptoms for all job stress types, especially high job demand. Depressive symptoms differed according to autistic traits and job stress. In workers with high autistic trait subscale scores, those with active job stress reported more depressive symptoms than those with high strain job stress, except for the "poor imagination" trait. This is contrary to previous reports that the active stress type is generally less associated with depressive symptoms than the high-strain stress type. To prevent depressive symptoms in workers with high autistic trait scores, it is important to understand which combination of autistic traits and type of job stress contribute to depressive symptoms.

Time to update the Japanese standard population for comparing mortality rates

For the last three decades, Japan has been using the population of 1985 for age standardisation to compare mortality rates over time. With the population of Japan declining and ageing rapidly every year, there is a need to update the standard population to make the comparison representative of the current scenario. This is particularly relevant owing to declining mortality rates among the super-ageing Japanese elderly population and more data availability for older age groups. The choice of one population as standard over another is arbitrary because it does not make much difference to the trends in rates. The proportion of elderly in Japan is increasing rapidly and is expected to be one-third of the total population by 2030, in contrast to the proportion of 10% in the 1980s. Using a standard population with a lower proportion of elderly may weight the rates disproportionately for this age group. It is typically suitable to change the standard population every 25 to 30 years. It is advisable to choose the population of 2015 as the new standard population as suggested by the working group of the Ministry of Health, Labour and Welfare of Japan for revising the standard population. However, it should be noted that the newly calculated age-standardised mortality rates will no longer be comparable to those calculated using the older standard populations. Updating the standard population will produce age-standardised rates for recent years closer to the crude rates and would thus reduce the extent of misinterpreting decreased mortality risks using age-standardised rates that do not closely resemble the crude rates.

First asteroid gas sample delivered by the Hayabusa2 mission: A treasure box from Ryugu

The Hayabusa2 spacecraft returned to Earth from the asteroid 162173 Ryugu on 6 December 2020. One day after the recovery, the gas species retained in the sample container were extracted and measured on-site and stored in gas collection bottles. The container gas consists of helium and neon with an extraterrestrial ³He/⁴He and ²⁰Ne/²²Ne ratios, along with some contaminant terrestrial atmospheric gases. A mixture of solar and Earth's atmospheric gas is the best explanation for the container gas composition. Fragmentation of Ryugu grains within the sample container is discussed on the basis of the estimated amount of indigenous He and the size distribution of the recovered Ryugu grains. This is the first successful return of gas species from a near-Earth asteroid.

Occupation- and industry-specific cancer mortality among Japanese women from 1980 to 2015

BACKGROUND

The number of women in Japan who continue working after childbirth is on the rise. Over the past few years, Japan's cancer mortality rate has increased. About 50% of all cancer deaths among Japanese women aged 25-64 are caused by lung, gastric, pancreatic and colorectal cancers. This study aims to examine the difference in mortality risk for key cancers among women and explore the effect of the economic crisis in the mid-1990s separately for occupational and industrial categories.

METHODS

Data from 1980 to 2015 were gathered from the Japanese Population Census and National Vital Statistics conducted in the same year. A Poisson regression analysis was used to estimate mortality risk and mortality trends for lung, gastric, pancreatic and colorectal cancer among Japanese working women aged 25-64 years.

RESULTS

Across most industrial and occupational groups, the trends in age-standardised cancer mortality rate for women have declined. Workers in management, security and transportation have a higher cancer mortality risk than sales workers. The risk of death from all four cancers is higher for workers in the mining and electricity industries than for wholesale and retail workers.

CONCLUSION

To improve the health and well-being of employed Japanese women, it is crucial to monitor cancer mortality trends. Using these population-level quantitative risk estimates, industry- and occupation-specific prevention programmes can be developed to target women at higher cancer risk and enable the early detection and treatment of cancer.

Associations of soluble fms-like tyrosine kinase-1 with cardiovascular events and stroke in patients with atrial fibrillation and suspected or known coronary artery disease: the EXCEED-J study

Background

Atrial fibrillation (AF) increases the risk of stroke. Soluble fms-like tyrosine kinase-1 (sFlt-1), a vascular endothelial growth factor (VEGF) antagonist, has been suggested as a marker of endothelial dysfunction, which are associated with both AF and coronary artery disease (CAD). Recently, we demonstrated that sFlt-1 is independently associated with major adverse cardiovascular (CV) events (MACE) in patients with suspected or known CAD. However, the prognostic utility of sFlt-1 in patients with AF remains unknown.

Methods

Using data from a multicenter, prospective cohort of 3255 patients with suspected or known CAD, we investigated whether AF modifies the prognostic utility of sFlt-1. Heparin-free serum levels of sFlt-1, N-terminal pro-brain natriuretic peptide, high-sensitivity cardiac troponin-I, high-sensitivity C-reactive protein, cystatin C, neutrophil gelatinase-associated lipocalin, VEGF, and placental growth factor were measured in 324 patients with AF and 2931 patients without AF. The primary outcome was MACE defined as a composite of CV death, nonfatal myocardial infarction, and nonfatal stroke. The secondary outcomes were all-cause death, CV death, stroke, heart failure (HF) hospitalization, and coronary/peripheral artery revascularization. The biomarkers were natural log-transformed for use as continuous variables.

Results

After adjustment for potential clinical confounders including anticoagulant drug use, sFlt-1 was significantly associated with MACE (hazard ratio for 1 standard deviation increase [HR], 1.55; 95% confidence interval [CI], 1.14–2.08), CV death (HR, 1.68; 95% CI, 1.10–2.48), and stroke (HR, 1.89; 95% CI, 1.16–3.10), but not with all-cause death (HR, 1.32; 95% CI, 0.99–1.73), HF hospitalization (HR, 0.97; 95% CI, 0.73–1.25), or revascularization (HR, 0.99; 95% CI, 0.74–1.28) in patients with AF, whereas sFlt-1 was significantly associated with MACE (HR, 1.19; 95% CI, 1.02–1.37), all-cause death (HR, 1.19; 95% CI, 1.05–1.34), CV death (HR, 1.26; 95% CI, 1.03–1.48), and HF hospitalization (HR, 1.26; 95% CI, 1.11–1.42), but not with stroke (HR, 1.06; 95% CI, 0.81–1.33) or revascularization (HR, 1.01; 95% CI, 0.95–1.07) in patients without AF. Among other biomarkers, only VEGF was significantly associated with MACE (HR, 1.55; 95% CI, 1.02–2.44), and no biomarkers were significantly associated with CV death or stroke in patients with AF. sFlt-1 added incremental prognostic information for MACE (P=0.005 for net reclassification improvement [NRI], P=0.026 for integrated discrimination improvement [IDI]) and stroke (P=0.034 for NRI, P=0.018 for IDI), but not for CV death (P=0.021 for NRI, P=0.134 for IDI), to the model with potential clinical confounders in patients with AF.

Conclusions

sFlt-1 independently predicted MACE and stroke in patients with AF and suspected or known CAD. sFlt-1 may serve as a novel prognostic biomarker to stratify the risk of MACE and stroke in patients with AF.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health Labour Sciences Research Grant (2013-2014), AMED (2015-2017, Grant Number JP17ek0210008)

Stress amelioration and anti-inflammatory potential of Shiikuwasha (Citrus depressa Hayata) essential oil, limonene, and γ-terpinene

Shiikuwasha (Citrus depressa Hayata) essential oil (SEO) extracted from Shiikuwasha fruit pulp contains two major volatile components, limonene and γ-terpinene (56.56–57.31 and 24.41–24.98%, respectively). In this study, we showed that the aroma streams of SEO, limonene, and γ-terpinene exhibited significant physiological stress amelioration effects in nine healthy female panelists tested in a 30-min visual display task. While SEO administration significantly reduced work errors by 15 min compared to the odorless control condition, the limonene stream reduced work errors only at the first and fourth 5-min intervals, and the γ-terpinene effect lasted only for the initial 5-min. However, γ-terpinene inhalation reduced stress by significantly increasing post-work electrocardiogram R–R interval variability and lowering electroencephalogram beta wave powers at the midline occipital Oz position. Additionally, SEO, limonene, and γ-terpinene displayed anti-inflammatory activity in vitro by suppressing the pro-inflammatory markers NO and IL-1β in BV-2 microglial cells in a dose-dependent manner.

Difference in Mortality Rates by Occupation in Japanese Male Workers Aged 25 to 64 Years from 1980 to 2015

This study examines the trends in mortality among Japanese working men, across various occupational categories, from 1980 to 2015. A Poisson model of trend, occupational category, and step variable was analysed for eight occupational categories separately, by cause, to explore the trends in mortality. This study found a sharp increase in mortality in the late 1990s, especially among professionals and managers. The overall trends in cancer, ischemic heart disease (IHD), cerebrovascular disease (CVD), and suicide mortality decreased across almost all occupational categories from 1980 to 2015, although there was an increasing trend in cancer of 0.5% among managers. Clerical workers had the greatest relative decrease in mortality rates from cancer (-82.9%), IHD (-81.7%), and CVD (-89.1%). Japan continues to make gains in lowering mortality and extending life expectancy, but its workplace culture must improve to ensure that those working at the heart of the Japanese corporate world can also benefit from Japan's progress in health. Mortality rates in working-aged Japanese men have been declining. However, similar declines are not evident among managers, for whom the mortality rate is remaining stable or slightly increasing. There is a need to address the needs of managers and improve workplace environments for these workers.

Discovery of C20-Diterpenoid Alkaloid Kobusine Derivatives Exhibiting Sub-G1 Inducing Activity

Although many diterpenoid alkaloids have been evaluated recently for antiproliferative activity against human cancer cell lines, little data have been offered relating to the antiproliferative effects of hetisine-type C₂₀-diterpenoid alkaloids, such as kobusine (1), likewise as their derivatives. A total of 43 novel diterpenoid alkaloid derivatives (2-10, 2b, 3a, 3b, 6a-16a, 7b, 9b, 10b, 13, 15-26, 15b, 18a, 23a, 27a) were prepared by C-11 and -15 esterification of 1. Antiproliferative effects of the natural parent compound (1) and all synthesized kobusine derivatives against human cancer cell lines, including a triple-negative breast cancer (TNBC) cell line as well as a P-glycoprotein overexpressing multidrug-resistant subline, were assessed. The structure-based design strategy resulted in the lead derivative 11,15-dibenzoylkobusine (3; average IC₅₀ 7.3 μM). Several newly synthesized kobusine derivatives (particularly, 5-8, 10, 13, 15-26) exhibited substantial suppressive effects against all tested human cancer cell lines. In contrast, kobusine (1), 11,15-O-diacetylkobusine (2), 11-acylkobusine derivatives (3a, 6a, 9a, 11a, 12a, 15a, 27a), and 15-acylkobusine derivatives (2b, 3b, 7b, 9b, 10b, 15b) showed no effect. The most active kobusine derivatives primarily had two specific substitution patterns, C-11,15 and C-11. Notably, 11,15-diacylkobusine derivatives (3, 6-10, 13, 15, 16, 18, 23) were more potent compared with 11- and 15-acylkobusine derivatives (3a, 3b, 6a-10a, 7b, 9b, 10b, 13a, 15a, 15b, 16a, 18a, 23a). Derivatives 13 and 25 induced MDA-MB-231 cells to the sub-G1 phase within 12 h. 11,15-Diacylation of kobusine (1) appears to be crucial for inducing antiproliferative activity in this alkaloid class and could introduce a new avenue to overcome TNBC using natural product derivatives.

Stability of hen egg-white lysozyme during embryonic development

It is of interest to determine whether and how egg-white proteins are maintained in fertile eggs. We previously observed that egg-white ovalbumin attained high stability during embryogenesis. Herein, we observed that the total mass of egg white and that of its gross protein content showed a decrease according to the days of incubation. The total bacteriolytic activity also lowered, in accord with previous observations. We purified lysozyme from egg-white samples on several incubation days. These purified lysozyme proteins were observed to have enzymatic and bacteriolytic activities against Micrococcus lysodeikticus as well as growth-inhibition potency against Staphylococcus aureus. As the embryogenesis proceeded, the purified lysozyme showed changes in Km and Vmax, a small decrease in the denaturation temperature, and symptoms of an increase in surface hydrophobicity. These results indicate that the lysozyme protein maintained its enzymatic and antibacterial activities until the late period of incubation while undergoing slight conformational changes.

Method-specific suicide trends from 1979 to 2016 among Japanese adolescents

BACKGROUND

In 2015 the Japanese government set a target of a 30% reduction in the total suicide rate by 2025, but deaths among adolescents have been rising since. In 2018 the overall suicide rate increased by 33% among Japanese students, as a part of a continued trend of rising suicide among adolescents. This study analysed the trends in method-specific suicide among Japanese adolescents from 1979 to 2016.

METHODS

We conducted a cross-sectional study using data obtained from the vital statistics registration of the Ministry of Health, Labour and Welfare Japan. Poisson regression analysis was performed among 10-20-year-olds separately by sex, with year, age category, suicide method and a 1998 step variable as covariates.

RESULTS

There was a sharp increase in suicide rates among boys (Incidence Rate Ratio (IRR), 1.68; 95% CI, 1.58-1.77) and girls (IRR, 1.69; 95% CI, 1.56-1.84) aged 10-20 years in 1998 when the overall suicide rate in Japan was at its peak. The commonly used method of suicide, hanging, has increased rapidly among high school and university-level aged adolescents since 1998.

LIMITATIONS

The computed mortality rates may have been affected by the shift in mortality coding from ICD-9 to ICD-10 in 1995.

CONCLUSIONS

Suicide among adolescents has been rising since the early 1990s. Several cultural factors such as notoriety of internet suicide and detergent suicide could have influenced the increase in suicide among adolescents. There is an urgent need to address suicide by hanging and gas among high school and university-aged adolescents.

Increased Secondary Attack Rates among the Household Contacts of Patients with the Omicron Variant of the Coronavirus Disease 2019 in Japan

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

Effect of the duration of previous osteoporosis treatment on the effect of romosozumab treatment

The effect of romosozumab is affected by previous osteoporosis treatment. Here we showed that the duration of the previous treatment just before romosozumab affects the therapeutic effect of romosozumab. Using denosumab and oral bisphosphonates for more than 1 year attenuates the effect of romosozumab.

INTRODUCTION

As an anti-sclerostin antibody, romosozumab suppresses bone resorption and stimulates bone formation. We investigated whether the effectiveness of 12 months of romosozumab treatment depended on the duration of previous treatment with teriparatide, denosumab, or oral bisphosphonates.

METHODS

In total, 259 osteoporosis patients received subcutaneous injections of romosozumab (210 mg) every 4 weeks during 2019 and 2020. This study was designed as a pre-post comparison. The end points were the percent changes of bone mineral density (BMD) after 12 months of romosozumab treatment. The patients were divided into seven groups depending on the type and duration of previous treatment before starting romosozumab as follows: non-previous treatment group, change from teriparatide used for 1 year or less/more than 1 year, change from denosumab used for 1 year or less/more than 1 year, and change from oral bisphosphonates used for 1 year or less/more than 1 year.

RESULTS

The effects of previous treatment with teriparatide on the effectiveness of 12-month romosozumab did not clearly depend on the duration of treatment (p > 0.05). In contrast, the effects of previous treatments with denosumab or oral bisphosphonates on the effectiveness of 12-month romosozumab depended on the previous treatment duration, which was reflected by the differences in percent change of the spine BMD (both p < 0.05), however, there were no significant differences in the percent change of the total hip BMD (both p > 0.05).

CONCLUSION

The duration of the previous treatment affected the effectiveness of romosozumab. Using denosumab and oral bisphosphonate for more than 1 year attenuated the effect of romosozumab.

Bioactivity inspired C19-diterpenoid alkaloids for overcoming multidrug-resistant cancer

The pharmacological activities of C₁₉-diterpenoid alkaloids are related to their basic skeletons (e.g., aconitine-type or lycoctonine-type). Also, few studies have been reported on the chemosensitizing effects of diterpenoid alkaloids. Consequently, this study was aimed at determining the chemosensitizing effects of synthetic derivatives of lycoctonine-type C₁₉-diterpenoid alkaloids on a P-glycoprotein (P-gp)-overexpressing multidrug-resistant (MDR) cancer cell line KB-VIN. The acyl-derivatives of delpheline and delcosine showed moderate cytotoxicity against chemosensitive cancer cell lines. Among non-cytotoxic synthetic analogs (1-14), several derivatives effectively and significantly sensitized MDR cells by interfering with the drug transport function of P-gp to three anticancer drugs, vincristine, paclitaxel, and doxorubicin. The chemosensitizing effect of derivatives 2, 4, and 6 on KB-VIN cells against vincristine were more potent than 5 μM verapamil, and derivatives 4 and 13 were more effective than 5 μM verapamil for paclitaxel. Among them, 2 in particular increased the sensitivity of KB-VIN cells to vincristine by 253-fold.

Knowledge about Dementia and its Associated Factors: Study among the Middle-aged Population in Indonesia

BACKGROUND: Dementia is a general term for loss of memory, language, problem solving, and other thinking skills that can interfere with daily life. Dementia is generally experienced by the older people. Nearly 10 million new cases of dementia reported each year, and more than 50% of dementia patients live in low and middle-income countries. With these potentially increasing number of dementia cases, accurate knowledge about dementia is essential for the community as it could be beneficial for the quality of care and reducing its progression. AIM: This study aimed to assess knowledge about dementia in the middle-aged age group and to determine the sociodemographic factors associated with knowledge about dementia in Indonesia. METHODS: A cross-sectional survey targeted the middle-aged population (40–59 years old), using an online questionnaire examining sociodemographic characteristics (age, gender, occupation), living arrangements, and the Dementia Knowledge Assessment Scale. RESULTS: A total of 1147 respondents were examined, revealing that more than 67% of the participants had poor knowledge about dementia. We revealed that female gender, younger age, and higher occupational level were significantly associated with good knowledge about dementia in various subscales. Interestingly, the living arrangements showed no significant association with knowledge about dementia in any subscale. CONCLUSION: The results emphasize the importance of intensive public health awareness to improve public knowledge about dementia in Indonesia, specifically targeting men and older individuals, as well as those with lower occupational levels.

Public health responses to COVID-19 in Japan

Two years have passed since the confirmation of the first case of coronavirus disease (COVID-19) in Japan. The aim of this article was to review the public health responses to COVID-19 in Japan. As of January 31, 2022, COVID-19-positive cases have cumulatively totaled 2,669,638 and deaths cases have cumulatively totaled 18,784. To deter COVID-19 transmission in the community, the government declared a state of emergency to minimize the impact on people's livelihoods and the economy. The prefectural (province) governor of an area under a "State of Emergency" may request special action to prevent the spread of infection among residents. A nationwide campaign, Avoid the "3 Cs" (Closed spaces, Crowded spaces, and Close-contact settings), has been widely acknowledged to have controlled infection in high-risk areas. In Japan, COVID-19 vaccines were supplied by Pfizer, Moderna, and AstraZeneca. Pfizer's vaccine received regulatory approval in Japan in February 2021, and Moderna and AstraZeneca's did so in May 2021. Public health centers (PHCs) under the jurisdiction of local governments are responsible for conducting Polymerase Chain Reaction (PCR) testing, coordinating the treatment of COVID-19-positive patients, and identifying persons in close contact with COVID-19 patients through an epidemiological study of each positive case. These public health responses have been implemented based on the assessment of the impact of each variant and support from a government panel of experts. Further studies may be need to be conducted develop more flexible and efficient public health responses.

Increased Secondary Attack Rate among Unvaccinated Household Contacts of Coronavirus Disease 2019 Patients with Delta Variant in Japan

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

Pebbles and sand on asteroid (162173) Ryugu: In situ observation and particles returned to Earth

The Hayabusa2 spacecraft investigated the C-type (carbonaceous) asteroid (162173) Ryugu. The mission performed two landing operations to collect samples of surface and subsurface material, the latter exposed by an artificial impact. We present images of the second touchdown site, finding that ejecta from the impact crater was present at the sample location. Surface pebbles at both landing sites show morphological variations ranging from rugged to smooth, similar to Ryugu's boulders, and shapes from quasi-spherical to flattened. The samples were returned to Earth on 6 December 2020. We describe the morphology of >5 grams of returned pebbles and sand. Their diverse color, shape, and structure are consistent with the observed materials of Ryugu; we conclude that they are a representative sample of the asteroid.

Does poor spousal health negatively affect own health among elderly retired Japanese couples? A 1-year follow-up study

Background

We aimed to determine whether poor spousal health affected respondents’ own self-rated health after 1 year among older retired Japanese couples.

Methods

Data were extracted from the nationwide population-based survey, the “Longitudinal Survey of Middle-aged and Elderly Persons”, which has been conducted annually since 2005 by the Japanese Ministry of Health, Labour and Welfare. We used 2016 survey data as a baseline and 2017 data for 1-year follow-up. Baseline respondents comprised 21,916 individuals; of these, we focused on 4397 respondents who were retired, married, aged 65–70 years, and had good self-rated health. The survey included questions about respondents' own health and lifestyle, and their spouses' health status. Multivariate logistic regression analysis was used to explore the association between spousal health at baseline and respondents' own self-rated health after 1 year.

Results

We found that poor spousal health is associated with respondents' own self-rated poor health after 1 year. The odds ratio (OR) for worsening health was 1.67 (95% confidence interval (CI): 1.11–2.52) for men and 1.72 (95% CI: 1.25–2.37) for women when their spouse's health was “somewhat bad”. The OR was 2.25 (95% CI: 1.40–3.62) for women when spousal health was “bad/very bad”, compared with “somewhat good”. Conversely, good spousal health was associated with a low risk of declining health for respondents after 1 year. The association for men was apparent when their spouse's health was “good” [OR: 0.69; 95% CI: 0.49–0.98], and the association for women was apparent when their spouse's health was “very good” [OR: 0.46; 95% CI: 0.24–0.90].

Conclusions

Poor spousal health is an independent factor that negatively affects own self-rated health after 1 year among retired couples in Japan aged 65–70 years.

•

Of married post-retirees aged 65–70 years with good baseline health, 14% had worsening health 1 year later.

•

Poor spousal health negatively affects own self-rated health after 1 year controlling for lifestyle and social factors.

•

Health worsened more among female respondents whose spouses had poor health at baseline.

•

Health did not worsen for both male and female respondents whose spouses had good health at baseline.

Eleven new C19-diterpenoid alkaloids from Delphinium elatum cv. Pacific Giant

Diterpenoid alkaloids, the main components of plants of the genera Aconitum, Delphinium, and Garrya, are a group of natural products with notable chemical properties and biological activities. Several C₁₉-diterpenoid alkaloid components from Delphinium elatum cv. Pacific Giant, as well as their derivatives, exhibited cytotoxic activity against lung, prostate, cervical, and vincristine-resistant cervical cancer cell lines. In the current phytochemical investigation on the seeds of D. elatum cv. Pacific Giant, eleven new C₁₉-diterpenoid alkaloids, elapaciline (1), meladine (2), melapacitine (3), iminoeladine (4), 19-oxopaciline (5), 19-oxopacinine (6), N-deethyldelpheline (7), N-deethylpacinine (8), N-deethyl-19-oxoeladine (9), N-deethyl-N-formyleladine (10), and N-deethyl-N-formyldelpheline (11), together with 15 known C₁₉-diterpenoid alkaloids were isolated. Their structures were elucidated by extensive spectroscopic methods including NMR (1D and 2D), IR, and MS (HRMS). Three known diterpenoid alkaloids, 6-dehydrodelcorine (12), delelatine (23), and 6-dehydroeldelidine (24), were isolated for the first time from this plant. Six of the new C₁₉-diterpenoid alkaloids (2, 4-7, and 11) and three of the known diterpenoid alkaloids (18, 23, and 24) were evaluated for cytotoxic activity against five human tumor cell lines.

Early clinical effects, safety, and predictors of the effects of romosozumab treatment in osteoporosis patients: one-year study

Romosozumab is an effective treatment for spine osteoporosis because it reduces the incidence of new fractures and significantly increases the percent change in the spine BMD at 12 months. The percent change in the spine BMD is higher in patients not previously treated with other anti-osteoporosis medications.

INTRODUCTION

Romosozumab appeared as a new osteoporosis medication in Japan in 2019. It is an anti-sclerostin antibody, which increases bone formation and suppresses bone resorption. The aim of our study was to elucidate the clinical effects, safety, and predictors of the effects of one-year romosozumab treatment.

METHODS

This study was an observational study designed as a pre-post study in 262 patients. Romosozumab (210 mg) was administered subcutaneously once every 4 weeks during 12 months. We focused on incidence of new fractures, safety, bone mineral density (BMD) at the spine and total hip, and bone metabolism markers.

RESULTS

There were five cases of new fractures during one-year romosozumab treatment. There were no fatal adverse events. Percent changes from baseline in the spine and total hip BMD after 12 months of romosozumab treatment were 10.67% and 2.04%, respectively. Romosozumab had better effects in cases of severe osteoporosis with low spine BMD, high TRACP-5b, and high iP1NP at the start of romosozumab treatment. The percent change in the spine BMD at 12 months was significantly lower in the group transitioning from bisphosphonates than in the group not previously treated with other anti-osteoporosis medications.

CONCLUSION

Romosozumab is an effective treatment for spine osteoporosis because it significantly increases the percent change in the spine BMD at 12 months. The percent change in the spine BMD is higher in patients not previously treated with other anti-osteoporosis medications.

Proactive Engagement of the Expert Meeting in Managing the Early Phase of the COVID-19 Epidemic, Japan, February-June 2020

To deal with the risk of emerging diseases with many unknowns, close and timely collaboration and communication between science experts and policymakers are crucial to developing and implementing an effective science-based intervention strategy. The Expert Meeting, an ad hoc medical advisory body, was established in February 2020 to advise Japan’s COVID-19 Response Headquarters. The group played an important role in the policymaking process, promoting timely situation awareness and developing science-based proposals on interventions that were promptly reflected in government actions. However, this expert group may have been overly proactive in taking on the government’s role in crisis management. For the next stage of managing the coronavirus disease pandemic and future pandemics, the respective roles of the government and its advisory bodies need to be clearly defined. Leadership and strategic risk communication by the government are key.

489Trends in method-specific suicide among Japanese adolescents in the past four decades

Background

In 2018 the overall suicide rate increased by 33% among students, as a part of a continued trend of rising suicide among adolescents. In 2015, the government of Japan aimed to reduce the overall suicide rate to 13 per 100,000 or less by 2025, but deaths among adolescents have been rising. This study analysed the trends in method-specific suicide among Japanese adolescents from 1979 to 2016 and compared suicide mortality rate in Japan with other OECD countries.

Methods

We obtained vital statistics data from the Japanese Ministry of Health, Labour and Welfare as well as the global health observatory of the WHO. Poisson regression analysis was performed separately by sex with year, age category, suicide method and a 1998 step variable as covariates.

Results

We found that hanging suicide rates among high school level boys are 12.15 times and girls are 6.17 times the rate of elementary school-aged children. The year 1998 saw a peak in suicide rates by hanging, which increased by more than 60% among both boys and girls. Japan is near the median of OECD suicide rates, with crude suicide mortality rates of 7.8 per 100,000 among 15–19-year-olds in 2016.

Conclusions

Suicide among adolescents has been rising during the last decades. Several factors related to the school and family environment, and mental health problems may have affected the adolescent suicide rate in Japan

Key messages

An urgent need is evident to address suicide among high school and university-aged adolescents.

Factors associated with adults' actions to confirm their own rubella immune status in Japan's drive toward rubella elimination: Cross-sectional online survey of non-healthcare workers in their 20s to 40s

Background

Rubella outbreaks occurred among adults in Japan in 2013-2014 and 2018-2019 due to immunity gaps. In response and aiming at rubella elimination by 2020, the government introduced countermeasures comprising supplementary immunization activities for voluntary testing of adult non-healthcare-related workers and vaccination of susceptible individuals. However, as of October 2020, rubella immunity testing and vaccination rates remained low. This study was conducted to identify factors associated with adults voluntarily confirming their rubella immune status, to help develop effective promotion activities for hard-to-reach and left-behind populations.

Methods

In this cross-sectional study, a general population sample of non-healthcare workers aged 20-49 years in Japan completed an online survey in November 2020. Univariate analysis was performed to examine associations of specific actions taken to confirm rubella immune status with social background characteristics, knowledge of rubella, and attitude to testing and vaccination. Log binomial regression analysis was performed to explore the associations following adjustment for social background characteristics.

Results

Among 1,854 respondents (927 men, 927 women), only 23.4% of men and 39.4% of women in their 20s to 40s have taken some action related to rubella prevention. Three major factors were associated with the targeted population having taken voluntary action: (1) knowing about testing for confirmation of immunity status (adjusted odds ratio [AOR] 4.29 men, 2.89 women), the rubella outbreak in 2013 among men in their 20s to 40s (AOR 2.79 men, 1.64 women), and congenital rubella syndrome (AOR 1.89 men, 3.10 women); (2) having acquaintances who were vaccinated against or tested for rubella (AOR 2.98 men, 1.95 women); and (3) having a positive attitude toward influenza vaccination (AOR 2.48 men, 1.83 women). Marriage, desire for pregnancy, and having children were weakly associated with taking action.

Conclusions

Currently, insufficient voluntary action is being taken by high-risk adult populations to close the identified immunity gaps. In this last mile to rubella elimination, our findings and suggested potential interventions via annual health check-ups and occupational health and public health initiatives could prove helpful in developing further countermeasures that actively promote and implement supplementary immunization activities targeting all adult generations.

Packing fraction of clusters formed in free-falling granular streams based on flash x-ray radiography

We study the packing fraction of clusters in free-falling streams of spherical and irregularly shaped particles using flash x-ray radiography. The estimated packing fraction of clusters is low enough to correspond to coordination numbers less than 6. Such coordination numbers in numerical simulations correspond to aggregates that collide and grow without bouncing. Moreover, the streams of irregular particles evolved faster and formed clusters of larger sizes with lower packing fraction. This result on granular streams suggests that particle shape has a significant effect on the agglomeration process of granular materials.

Early clinical effects, safety, and appropriate selection of bone markers in romosozumab treatment for osteoporosis patients: a 6-month study

Our 6-month study showed the usefulness of romosozumab for preventing fractures and its safety. It was effective in patients with low baseline spine BMD, high TRACP-5b, and high iP1NP. Percent change from baseline of TRACP-5b and iP1NP after 1 month correlated with that from baseline of BMD after four to 6-month treatment.

INTRODUCTION

Romosozumab appeared as a new osteoporosis medication in Japan in 2019. It is an anti-sclerostin antibody which increases bone formation and suppresses bone resorption. In this study, we analyzed the actual clinical effects, adverse effects, and the optimal way to evaluate the treatment.

METHODS

Romosozumab was administered as subcutaneous injection of 210 mg once every 4 weeks. We conducted pre-post study in 185 patients treated for 6 months. We focused on the incidence of new vertebral fractures, safety, bone mineral density (BMD) at the spine and total hip, and bone metabolism markers. We evaluated BMD before romosozumab treatment and after 4 to 6 months and performed the serum analysis before romosozumab treatment, after 1, 3, and 6 months.

RESULTS

There was no new fracture during treatment, and there was no fatal adverse event including cardiovascular disease. Since percent changes from baseline of the spine and total hip BMD were 6.34% and 1.53% after 4- to 6-month treatment, the treatment was effective for spine osteoporosis. Tartrate-resistant acid phosphatase 5b (TRACP-5b) and intact type I procollagen N-terminal propeptide (iP1NP) had significant changes during romosozumab treatment (p < 0.05). Percent change from baseline of TRACP-5b and iP1NP after 1 month correlated with percent change from baseline of BMD after 4 to 6 months of treatment.

CONCLUSION

Romosozumab is effective in preventing fractures and useful for increasing the spine BMD. Also, romosozumab is relatively safe to use. It is especially effective in patients with low baseline spine BMD, high TRACP-5b, and high iP1NP.