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Human immunodeficiency virus (HIV) treatment with antiretroviral regimens containing integrase strand transfer inhibitors such as dolutegravir (DTG) and bictegravir (BIC) offers high levels of protection against the development of drug resistance mutations. Despite this, resistance to DTG and BIC can occur through the development of the R263K integrase substitution.

We examine the impact of life and health insurance spending on subjective well-being. Taking advantage of insurance spending and subjective well-being data on more than 700,000 individuals in Japan, we examine whether insurance spending can buffer declines in subjective well-being due to exposure to mass disaster. We find that insurance spending can buffer drops in subjective well-being by approximately 3–6% among those who experienced the mass disaster of the great East Japan earthquake. Subjective health increases the most, followed by life satisfaction and happiness. On the other hand, insurance spending decreases the subjective well-being of those who did not experience the earthquake by approximately 3–7%. We conclude by monetizing the subjective well-being loss and calculating the extent to which insurance spending can compensate for it. The monetary value of subjective well-being buffered through insurance spending is approximately 33,128 USD for happiness, 33,287 USD for life satisfaction, and 19,597 USD for subjective health for a person in one year. Therefore, we confirm that life/health insurance serves as an ideal option for disaster adaptation. Our findings indicate the importance of considering subjective well-being, which is often neglected when assessing disaster losses.

Background Every year, more than 700,000 people die due to suicide, one of the most common reasons for youth death. While many studies have revealed two main factors for suicidal behavior: impulsive suicidal behavior due to mental illness and financial stress, it is not clear what happens if individuals face deterioration of mental health and economic recession. This paper attempts to answer this question and how suicide rates are correlated with these factors. Methods We empirically investigate whether economic recessions and air pollution trigger suicides by examining Japan, a country with one of the highest suicide rates, from 2014 to 2021. We take advantage of the characteristics of the COVID-19 pandemic and the periods before the pandemic, when both economic recessions and reductions in air pollution occurred simultaneously. Using monthly and municipal- level data, we construct a triple difference model that takes air pollution and unemployment as treatments. Results Our findings show that high (upper half of each period) levels of air pollution and unemployment have substantial impacts on the suicide rates of adults (22.9% in the short term) and children (42.7% in the short term, 36.0% in the long term), indicating that the increase in suicide rates among children is almost twice as high as that among adults. Our study finds that unemployment and air pollution alone are not associated with increased suicide rates but their simultaneous occurrence triggers suicides during the pandemic. Conclusions Our study urges suicide prevention, particularly among children, as an essential consideration for public health. Furthermore, our results indicate the need for the government to allocate resources to recover air quality and the economy simultaneously during a recession to reduce suicide mortality of both child and adults.

Objectives The development of HIV drug resistance against the integrase strand transfer inhibitor dolutegravir is rare. We report here the transient detection, by near full-genome ultradeep sequencing, of minority HIV-1 subtype B variants bearing the S153F and R263K integrase substitutions in the proviral DNA from blood cells of one patient who successfully initiated dolutegravir-based ART, over 24 weeks. Our objective was to study the effects of these substitutions. Methods Strand transfer and DNA-binding activities of recombinant integrase proteins were measured in cell-free assays. Cell-based resistance, infectivity and replicative capacities were measured using molecular clones. Structural modelling was performed to understand experimental results. Results R263K emerged first, followed by the addition of S153F at Week 12. By Week 24, both mutations remained present, but at lower prevalence. We confirmed the coexistence of S153F and R263K on single viral genomes. Combining S153F or S153Y with R263K decreased integration and viral replicative capacity and conferred high levels of drug resistance against all integrase inhibitors. Alone, S153Y and S153F did little to infectivity or dolutegravir resistance. We identified altered DNA binding as a mechanism of resistance. The patient remained with undetectable viral loads at all timepoints. Conclusions Drug-resistant minority variants have often been reported under suppressive ART. Our study adds to these observations by unravelling a progression towards higher levels of resistance through a novel pathway despite continuous undetectable viral loads. Poorly replicative HIV drug-resistant minority proviral variants did not compromise viral suppression in one individual treated with dolutegravir.

Objectives: We report a case of incomplete HIV-1 suppression on a dolutegravir, lamivudine, and abacavir single-tablet regimen with the emergence of the H51Y and G118R integrase resistance mutations. Methods: Integrase sequencing was performed retrospectively by Sanger and next-generation sequencing. Rates of emergence and decline of resistance mutations were calculated using next-generation sequencing data. Dolutegravir plasma concentrations were measured by ultra-performance liquid chromatography-tandem mass spectrometry. The effects of H51Y and G118R on infectivity, fitness, and susceptibility to dolutegravir were quantified using cell-based assays. Results: During periods of non-adherence to treatment, mutations were retrospectively documented only by next-generation sequencing. Misdiagnosis by Sanger sequencing was caused by the rapid decline of mutant strains within the retroviral population. This observation was also true for a M184V lamivudine-resistant reverse transcriptase mutation found in association with integrase mutations on single HIV genomes. Resistance rebound upon treatment re-initiation was swift (>8000 copies per day). Next-generation sequencing indicated cumulative adherence to treatment. Compared to WT HIV-1, relative infectivity was 73%, 38%, and 43%; relative fitness was 100%, 35%, and 10% for H51Y, G118R, and H51Y+G118R viruses, respectively. H51Y did not change the susceptibility to dolutegravir, but G188R and H51Y+G118R conferred 7- and 28-fold resistance, respectively. Conclusion: This case illustrates how poorly-fit drug-resistant viruses wax and wane alongside erratic treatment adherence and are easily misdiagnosed by Sanger sequencing. We recommend next-generation sequencing to improve the clinical management of incomplete virological suppression with dolutegravir.

We investigate the automobile preferences of consumers and evaluate financial incentives designed to promote automobiles of higher fuel economy in Japan from sales data. We explore two different groups of consumers, namely, general consumers and selective consumers, according to their fuel economy preferences. Then we estimate the effectiveness of financial incentives and the price sensitivity of such incentives to different groups of consumers. We use ordered logit, linear regression, and simultaneous equations. Estimates suggest that only tax incentives are effective for general consumers, thereby implying a need to improve Japanese policies.

Reaching carbon neutrality would require the retirement of conventional power sources and substitution with renewable energy sources. Given that immediate substitution from conventional to renewable power sources is not feasible in the status quo, we investigate whether adding residential solar photovoltaic (PV) technology in addition to conventional power sources would reduce residential emissions. We use a large survey dataset of more than 300,000 observations and employ a structural equation model (SEM) to validate our findings. Interestingly, emissions increase by 1.75% if residential PV is adopted, and Japanese citizens with residential PV systems end up using 3.02% more electricity. We also find that pro-environmental consumers may also produce more emissions with PVs. As a result, reaching target carbon reductions in the residential sector would necessitate eliminating conventional energy sources. We address the policy implications for pathways to reduce residential emissions.

We investigate whether the information disclosure of Environmental, Social, Governance (ESG) criteria is more crucial than actions for the financial performance of firms by using two different ratings with more than 1,000,000 samples. Our result shows that disclosure is more important for profits while action is more critical in Tobin’s Q and IVA scores.

As a market for sustainability investing is growing rapidly, understanding the impact of environmental, social, and governance (ESG) activities on firms’ financial performance is becoming increasingly important. In this study, we examine the effect of ESG performance on stock returns and volatility during the financial crisis resulting from the coronavirus (COVID-19) pandemic. To quantify the impact, we use company-level daily ESG score data and United Nations Global Compact (GC) score data. In our dataset, ESG scores indicate ESG performance that is deemed important to financial materiality, and the GC score indicates the firm reputation for following UN rules. Our results indicate that during the pandemic, an increase in the ESG score, especially the E score component, is related to higher returns and lower volatility. Conversely, increasing GC scores is correlated with lower stock returns and higher volatility. In addition, we find that firms in lower return groups benefit more than other firms. Focusing on energy sector impacts, we show that although the non-energy sector benefits more than the energy sector from increasing E scores, energy sector firms can still reduce their stock price volatility by increasing these scores. Our study offers significant implications for ESG investment strategies during financial crises.

Which comes first in reducing the Carbon Dioxide (CO2 ) emissions from the transportation sector: consumer preference or technological advancement? Using a series of discrete-choice demand models, we estimate the demand for automobiles in Japan. Our model explicitly allows consumer preferences for fuel economy to evolve over time, and the estimation results confirm the existence of such a change. We then simulate consumer behavior , enabling consumers in 2010 to choose automobiles from 2016, and vice versa. The results imply that both consumer preferences and technological advancement are important—without technological advancement and increases in consumers’ appreciation for fuel-efficient cars, CO 2 emissions cannot be reduced.

We investigate whether the contrasting set of transportation policies in Korea---reductions in fuel taxes and increases in diesel automobile prices---has decreased emissions. Using a random-coefficient discrete choice model and hypothetical policy sets, we estimate the automobile demand of consumers, the market share of cars by fuel type, and total emissions, assuming that consumer preferences for driving costs change over time. Then, we separately analyze the effect of each policy set on automobile sales and emissions, particularly carbon dioxide, nitrogen oxide, and particulate matter. Our analyses reveal that Korean consumers have become more sensitive toward fuel costs over time and that the emission consequences of Korean policies depend on consumer preferences.

While the fuel economy of Japanese automobiles has improved by 40% in the past decade, gasoline consumption in the transportation sector from 2007 to 2016 only decreased by 4%. We seek to explain this discrepancy by investigating Japanese fuel economy standards and the financial incentives given to consumers of fuel-efficient cars. To do so, this study explores whether Japanese policies caused such a rebound effect, by employing the difference-in-difference framework. We find that these policies contribute to energy rebound effect, by enabling higher fuel consumption at lower costs and thus causing higher energy usages. We provide evidence that policies can increase not only fuel usage but also fuel costs. The main driving force behind the rebound effect is the increase in the sales of hybrid vehicles, induced by financial incentives.