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Purpose The present study aimed to evaluate the clinical characteristics of exudative age-related macular degeneration (AMD) in Japanese patients over a 10-year period and to compare the past our report. Methods We retrospectively reviewed 1,600 treatment-naïve patients (1,777 eyes) with exudative AMD. The 10 years were divided into 2-year phases I to V. Results Of the 1,600 patients, 720 (45.0%), 733 (45.8%), 98 (6.1%), and 49 (3.1%) were diagnosed with typical AMD, polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation, and combined subtypes, respectively. The prevalence of PCV decreased from 54.7% in phase I to 46.0% at phase V. Of the 1,777 eyes, the mean baseline logarithm of the minimum angle of resolution best-corrected visual acuities (BCVAs) in phases I, II, III, IV, and V were 0.70, 0.66, 0.55, 0.50, and 0.48, respectively. Phases III, IV, and V had significantly (P = 0.0012, P Conclusions Although the prevalence of PCV decreased from 54.7% in phase I to 46.0% at phase V, PCV has nevertheless been highly prevalent in Japanese patients with AMD compared with Caucasian patients. The annual better baseline VAs and smaller lesion sizes over time might be related to development of treatment and better concerns about AMD.

The Coronavirus Disease 2019 has resulted in a transition from physical education to online learning, leading to a collapse of the established educational order and a wisdom test for the education governance system. As a country seriously affected by the pandemic, the health of the Indian higher education system urgently requires assessment to achieve sustainable development and maximize educational externalities. This research systematically proposes a health assessment model from four perspectives, including educational volume, efficiency, equality, and sustainability, by employing the Technique for Order Preference by Similarity to an Ideal Solution Model, Principal Component Analysis, DEA-Tobit Model, and Augmented Solow Model. Empirical results demonstrate that India has high efficiency and an absolute health score in the higher education system through multiple comparisons between India and the other selected countries while having certain deficiencies in equality and sustainability. Additionally, single-target and multiple-target path are simultaneously proposed to enhance the Indian current education system. The multiple-target approach of the India-China-Japan-Europe-USA process is more feasible to achieve sustainable development, which would improve the overall health score from .351 to .716. This finding also reveals that the changes are relatively complex and would take 91.5 years considering the relationship between economic growth rates and crucial indicators. Four targeted policies are suggested for each catching-up period, including expanding and increasing the social funding sources, striving for government expenditure support to improve infrastructures, imposing gender equality in education, and accelerating the construction of high-quality teachers.

Background The coronavirus disease 2019 (COVID-19) pandemic is continuing unabated in Japan, as of October 2021. We aimed to compare first-year university students’ psychological distress before the pandemic in 2019, during the pandemic in 2020, and one year after the onset of the pandemic, in 2021. Methods The study conducted online surveys over three years from April to May each year. Participants were 400 first-year students in 2019, 766 in 2020, and 738 in 2021. We examined differences in scores on the Counseling Center Assessment of Psychological Symptoms—Japanese version (CCAPS-Japanese) between the three years using a one-way analysis of variance, and differences in the CCAPS-Japanese critical items using chi-squared test and residual analysis. Results The average scores on the Depression and Generalized Anxiety subscale in 2021 were significantly higher than those in 2020, but remained the same as in 2019. The Academic Distress subscale score in 2020 was the worst compared to 2019 and 2021. Meanwhile, the number of students who experienced severe suicidal ideation increased year by year from 2019 to 2021. Conclusion The mean mental health of first-year university students worsened after the onset of the COVID-19 pandemic, and recovered to the pre-pandemic level over the next two years. However, the number of high-risk students with suicidal ideation continued to increase. A system is required for early detection and support for students at high risk of mental health issues.

It is difficult for university hospitals to recruit and retain technically efficient surgeons because their missions include teaching and research as well as clinical services. The authors hypothesized that technically efficient surgeons do not continue to provide active clinical services in a university hospital. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30 in 2013–2018. The dependent variable was defined as a length of each surgeon’s active clinical services measured by month. Data envelopment analysis was employed to calculate each surgeon’s technical efficiency score. Five control variables were selected; experience, medical school, surgical volume, gender, and academic ranks. Multiple regression analysis was performed. Efficiency scores had significantly negative association with length of active clinical services. Experience and surgical volume had significantly positive association with length of active clinical services. The other coefficients of control variables were insignificant. Technically efficient surgeons provide shorter active clinical services in a university hospital.

Aim To enable early identification of university students at high risk for suicide, we examined personality as a predictive factor for major depressive episodes and suicide-related ideation. Methods From 2011 to 2013, we administered the Patient Health Questionnaire-9 (PHQ-9) and the Temperament and Character Inventory (TCI) to 1,997 university students at enrollment (T1). We previously conducted a study using the same data set; this is a re-analysis of the dataset. To prevent contamination of data, participants diagnosed with a depressive episode were excluded at T1. Three years after enrollment (T2), we re-administered the PHQ-9 to the same students. We statistically compared TCI scores at T1 among depressive episode groups and suicide-related ideation groups. Two-way ANOVA and Cochran-Armitage trend tests were used to analyze the relationships between personality traits, depressive episodes, and suicide-related ideation. Results The PHQ-9 summary scores at baseline (T1) were 3.0 (±2.7), with female students scoring 4.6 (±2.9) and male students 2.9 (±2.6, p = 0.025). The major depressive episode group at T2 had lower self-directedness (SD) scores at T1 than the non-depressive episode control group. The suicide-related ideation (SI) group at T2 also had higher harm avoidance (HA), lower SD, and lower cooperativeness (C) scores than the non-SI group at T1. The Cochran-Armitage trend tests revealed significant associations between character configurations composed of SD and C, and both depressive episodes at T2 and SI at T2. Conclusion The temperament feature of high HA at baseline and character configurations of low SD and low C at baseline are the most contributory predictors for the novel development of depressive episodes and SI among Japanese university students.

Background Rapid eye movement sleep behavior disorder (RBD) and olfactory dysfunction are useful for early diagnosis of Parkinson’s disease (PD). RBD and severe olfactory dysfunction are also regarded as risk factors for cognitive impairment in PD. This study aimed to assess the associations between RBD, olfactory function, and clinical symptoms in patients with PD. Methods The participants were 404 patients with non-demented PD. Probable RBD (pRBD) was determined using the Japanese version of the RBD screening questionnaire (RBDSQ-J) and the RBD Single-Question Screen (RBD1Q). Olfactory function was evaluated using the odor identification test for Japanese. Clinical symptoms were evaluated using the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts I–IV. Results In total, 134 (33.2%) patients indicated a history of pRBD as determined by the RBD1Q and 136 (33.7%) by the RBDSQ-J based on a cutoff value of 6 points. Moreover, 101 patients were diagnosed as pRBD by both questionnaires, 35 by the RBDSQ-J only, and 33 by the RBD1Q only. The MDS-UPDRS parts I–III scores were significantly higher and disease duration significantly longer in the pRBD group. pRBD was significantly associated with male gender and the MDS-UPDRS part I score. The olfactory identification function was significantly reduced in the pRBD group. Conclusions About 33% of the patients with PD had pRBD based on the questionnaires, and both motor and non-motor functions were significantly decreased in these patients. These results suggest that more extensive degeneration occurred in patients with non-demented PD with RBD.

Frailty is considered to be a complex concept based mainly on physical vulnerability, but also vulnerabilities in mental/psychological and social aspects. Frailty can be reversible with appropriate intervention; however, factors that are important in recovering from frailty have not been clarified. The aim of the present study was to identify factors that help an individual reverse frailty progression and characteristics of individuals that have recovered from frailty. Community-dwelling people aged ≥75 years who responded to the Kihon Checklist (KCL) were enrolled in the study. The KCL consists of 25 yes/no questions in 7 areas: daily-life related activities, motor functions, nutritional status, oral functions, homebound, cognitive functions, and depressed mood. The number of social activities, degree of trust in the community, degree of interaction with neighbors, and subjective age were also evaluated. Frailty was assessed based on the number of checked items: 0–3 for robust, 4–7 for pre-frailty, and ≥8 for frailty. A total of 5050 participants were included for statistical analysis. At the time of the baseline survey in 2016, 18.7% (n = 942) of respondents had frailty, and the follow-up survey showed that the recovery rate from frailty within 2 years (median 24 months) was 31.8% (n = 300). Multiple logistic regression analysis showed that exercise-based social participation (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2–3.4; PP = 0.02) were related to reversing frailty progression. Principal component analysis indicated that the main factors constituting the first principal component (contribution rate, 18.3%) included items related to social capital, such as interaction with neighbors, trust in the community, and number of social participation activities. Our results demonstrate that exercise-based social participation and high self-rated health have associations with reversing frailty progression. Individuals that recovered from frailty are characterized by high individual-level social capital components (i.e., trust in community, interaction with neighbors, and social participation).

The purpose of this study was to identify typologies of diurnal sedentary behavior patterns and sociodemographic characteristics of desk-based workers. The sedentary time of 229 desk-based workers was measured using accelerometer devices. The within individual diurnal variations in sedentary time was calculated for both workdays and non-workdays. Diurnal variations in sedentary time during each time period (morning, afternoon, and evening) was calculated as the percentage of sedentary time during each time period divided by the percentage of the total sedentary time. A hierarchical cluster analysis (Ward’s method) was used to identify the optimal number of clusters. To refine the initial clusters, a non-hierarchical cluster analysis (k-means method) was performed. Four clusters were identified: stable sedentary cluster (46.7%), off-morning break cluster (26.6%), off-afternoon break cluster (8.3%), and evening sedentary cluster (18.3%). The stable sedentary cluster had the lowest variations in sedentary time throughout the day and the highest amount of total sedentary time. Participants in the off-morning and off-afternoon break clusters had nearly the same sedentary patterns but took short-term breaks during non-workday mornings or afternoons. The evening sedentary cluster had a completely different pattern, with a longer sedentary time during the evening both on workdays and non-workdays. Sociodemographic attributes such as sex, household income, educational attainment, employment status, sleep duration, and residential area, differed significantly between groups. Initiatives to address desk-based workers’ sedentary behavior need to focus not only on the workplace but also on the appropriate timing for reducing excessive sedentary time in non-work contexts depending on the characteristics and diurnal patterns of target subgroups.

Background “Third agers” are people over retirement age in relatively good health; third agers make up an increasing percentage of the global population as the world’s longevity increases. Therefore, the challenge of prolonging a healthy third age and shortening the unhealthy period during the “fourth age” in the global health and social contexts is important in this process. However, no means to measure and support this has been developed as yet. We developed the Social Contact Self-Efficacy Scale for Third Agers (SET) and evaluated its reliability and validity. Methods We used a self-administered mail survey covering 2,600 randomly selected independent older adults living in Yokohama, Japan. The construct validity of the SET was determined using exploratory factor and confirmatory factor analyses. Its criterion-related validity was assessed using the General Self-Efficacy Scale (GSES), the Japan Science and Technology Agency Index of Competence (JST-IC), and subjective health status. Results In total, 1,139 older adults provided responses. Exploratory and confirmatory factor analyses identified eight items within two factors: social space mobility and social support relationship. The final model had a Cronbach’s alpha 0.834, goodness-of-fit index 0.976, adjusted goodness-of-fit index 0.955, comparative fit index 0.982, and root mean square error of approximation 0.050. There was good correlation between scale scores and the GSES (r = 0.552, p < 0.001), JST-IC (r = 0.495, p < 0.001) and subjective health status (r = 0.361, p < 0.001). Conclusions The SET showed sufficient reliability and validity to assess self-efficacy in promoting social contact among third agers. This scale may help third agers in gaining and expanding opportunities for social contact, which can improve their physical health and quality of life and contribute to care prevention and healthy longevity.

Sense of agency (SoA), the feeling of control over one’s own actions and their effects, is fundamental to goal-directed actions at the individual level and may constitute a cornerstone of everyday life, including cooperative behavior (i.e., goal sharing). Previous studies have demonstrated that goal sharing can activate the motor prediction of both agent’s action and partner’s action in joint-action tasks. Moreover, given that from an SoA perspective, predictive processes are an essential basis, there is a possibility that goal sharing may modulate SoA. However, the possibility for goal sharing to modulate SoA remains unclear. This study aimed to investigate whether goal sharing modulates the intentional binding (IB) effect (a method that can quantitatively measure SoA) of self-generated and observed partner’s actions and improves motor accuracy. Participants were required to stop a circular horizontal moving object by pressing a key when the object reaches the center of a target in a social situation. This task measured IB by having participants estimate the time interval between action and effect in several 100 milliseconds, with shorter time interval estimations indicating enhancement of SoA. Participants were randomly divided into 13 Cooperative groups (goal sharing) and 13 Independent groups (non-goal sharing). Cooperative groups were instructed to perform the task together, while Independent groups did so individually. Participants estimated the time interval between them by pressing the key and hearing the corresponding sound (Self-generated action) and the other person pressing the key and hearing the sound (Observed action). Our results indicated that goal sharing improved motor accuracy and enhanced both the IB of Self-generated and Observed actions compared to non-goal sharing. We suggest that SoA can be modulated by goal sharing in specific social contexts.

Truth-Default Theory (TDT) predicts that across countries and cultures, a few people tell most of the lies, while a majority of people lie less frequently than average. This prediction, referred to as “a few prolific liars,” is tested in Japan. The study further investigated the extent to which the Dark Triad personality traits predict the frequency of lying. University students (N = 305) reported how many times they lied in the past 24 hours and answered personality questions. Results indicate that the few prolific liars pattern is evident in Japan thereby advancing TDT. Results also show that Japanese frequent liars tend to have Dark Triad personality traits, but the nature of the findings may be unique to Japan. Results of the generalized linear model suggest that the Dark Triad components of Machiavellianism and psychopathy exacerbate lying behavior by reducing the guilt associated with lying. However, narcissism encourages guilt and therefore inhibits lying behavior with both direct and indirect effects. These narcissism findings appear to contradict prior studies but stem from use of a more appropriate statistical analysis or the Japanese context.

Background To control the COVID-19 outbreak in Japan, sports and entertainment events were canceled and schools were closed throughout Japan from February 26 through March 19. That policy has been designated as voluntary event cancellation and school closure (VECSC). Object This study assesses VECSC effectiveness based on predicted outcomes. Methods A simple susceptible–infected–recovered model was applied to data of patients with symptoms in Japan during January 14 through March 26. The respective reproduction numbers for periods before VECSC (R0), during VECSC (Re), and after VECSC (Ra) were estimated. Results Results suggest R0 before VECSC as 2.534 [2.449, 2.598], Re during VECSC as 1.077 [0.948, 1.228], and Ra after VECSC as 4.455 [3.615, 5.255]. Discussion and conclusion Results demonstrated that VECSC can reduce COVID-19 infectiousness considerably, but after VECSC, the value of the reproduction number rose to exceed 4.0.

COVID-19 is spreading worldwide, causing various social problems. The aim of the present study was to verify the reliability and validity of the Japanese version of the Fear of COVID-19 Scale (FCV-19S) and to ascertain FCV-19S effects on assessment of Japanese people's coping behavior. After back-translation of the scale, 450 Japanese participants were recruited from a crowdsourcing platform. These participants responded to the Japanese FCV-19S, the Japanese versions of the Hospital Anxiety and Depression scale (HADS) and the Japanese versions of the Perceived Vulnerability to Disease (PVD), which assesses coping behaviors such as stockpiling and health monitoring, reasons for coping behaviors, and socio-demographic variables. Results indicated the factor structure of the Japanese FCV-19S as including seven items and one factor that were equivalent to those of the original FCV-19S. The scale showed adequate internal reliability (α = .87; ω = .92) and concurrent validity, as indicated by significantly positive correlations with the Hospital Anxiety and Depression Scale (HADS; anxiety, r = .56; depression, r = .29) and Perceived Vulnerability to Disease (PVD; perceived infectability, r = .32; germ aversion, r = .29). Additionally, the FCV-19S not only directly increased all coping behaviors (β = .21 - .36); it also indirectly increased stockpiling through conformity reason (indirect effect, β = .04; total effect, β = .31). These results suggest that the Japanese FCV-19S psychometric scale has equal reliability and validity to those of the original FCV-19S. These findings will contribute further to the investigation of various difficulties arising from fear about COVID-19 in Japan.

Most single-factor and multifactor asset pricing models constitute special cases of the consumption-based asset pricing theory, in which investors' marginal utility is the key determinant of asset prices. However, in recent years, production-based asset pricing models have been extraordinarily successful in correctly pricing a wide range of anomaly portfolios that are typically mispriced in previous research. In parallel, research on conditioning information has contributed to significantly improve the performance of classic consumption-based asset pricing models. On this basis, in this paper we conduct an in-depth research on the performance of consumption and production-based asset pricing models on the Tokyo Stock Exchange, for the period from 1992 to 2018, in order to test to what extent consumer confidence helps consumption models to correctly capture shifts in the investment opportunity set of investors. To overcome the constraints imposed by the periodicity of macroeconomic data, we use a factor-mimicking portfolio approach that allows us to test the performance of the models into consideration at different frequencies. Our results suggest that the consumer confidence index for Japan helps consumption-based asset pricing models outperform production-based models for different anomaly portfolios. Conversely, in those cases where consumption models perform worse, the production models also perform poorly. These results help to partially reconcile the results provided by the consumption and production models, and constitute a step forward for the purpose of identifying the fundamental risk factors that drive asset prices.

To prevent the spread of COVID-19, many cities, states, and countries have ‘locked down’, restricting economic activities in non-essential sectors. Such lockdowns have substantially shrunk production in most countries. This study examines how the economic effects of lockdowns in different regions interact through supply chains, which are a network of firms for production, by simulating an agent-based model of production using supply-chain data for 1.6 million firms in Japan. We further investigate how the complex network structure affects the interactions between lockdown regions, emphasising the role of upstreamness and loops by decomposing supply-chain flows into potential and circular flow components. We find that a region’s upstreamness, intensity of loops, and supplier substitutability in supply chains with other regions largely determine the economic effect of the lockdown in the region. In particular, when a region lifts its lockdown, its economic recovery substantially varies depending on whether it lifts the lockdown alone or together with another region closely linked through supply chains. These results indicate that the economic effect produced by exogenous shocks in a region can affect other regions and therefore this study proposes the need for inter-region policy coordination to reduce economic loss due to lockdowns.

Background We previously developed the Tobacco Craving Index (TCI) to assess craving of smokers. In the present study, we validated the relationship between the TCI grade over the 5 sessions of Japanese smoking cessation therapy (SCT) and success of quitting smoking among 889 Japanese patients. Methods The Japanese SCT consists of 5 sessions of SCT (first session and sessions 2, 4, 8 and 12 weeks later). In the TCI questionnaire, patients are asked to rate their strength of craving and frequency of craving, each on a four-point Likert scale. Patients are classified into one of four grades based on their responses (0, I, II, III, with III indicating severe craving). The TCI questionnaire was administered to each participant at each session of the SCT. This study included participants of Japanese SCT who answered the TCI at the first session of the SCT at five Japanese smoking cessation clinics. Patients who dropped out of the SCT from the second to the fifth sessions were considered to have failed smoking cessation. To elucidate how much the TCI grade predicts smoking status at the last session, we performed multivariate logistic regression analysis with adjustment for confounding factors. Results Participants who had higher TCI grade(III) in the 2nd through 5th sessions showed significantly lower probability for success of quitting smoking than those who had lower TCI grades(0 or I) (adjusted odds ratio: 2nd session: 0.30, 3rd session: 0.15, 4th session: 0.06, 5th session: 0.02). Conclusions We validated the usefulness of the TCI grade for assessing probability of quitting smoking by using a large number of smoking cessation settings.

Purpose Antimicrobial use (AMU) is estimated at the national level by using sales data (S-AMU) or insurance claims data (C-AMU). However, these data might be biased by generic drugs that are not sold through wholesalers (direct sales) and therefore not recorded in sales databases, or by claims that are not submitted electronically and therefore not stored in claims databases. We evaluated these effects by comparing S-AMU and C-AMU to ascertain the characteristics and limitations of each kind of data. We also evaluated the interchangeability of these data by assessing their relationship. Methods We calculated monthly defined daily doses per 1,000 inhabitants per day (DID) using sales and claims data from 2013 to 2017. To assess the effects of non-electronic claim submissions on C-AMU, we evaluated trends in the S-AMU/C-AMU ratio (SCR). To assess the effects of direct sales of S-AMU, we divided AMU into generic and branded drugs and evaluated each SCR in terms of oral versus parenteral drugs. To assess the relationship between S-AMU and C-AMU, we created a linear regression and evaluated its coefficient. Results Median annual SCRs from 2013 to 2017 were 1.046, 0.993, 0.980, 0.987, and 0.967, respectively. SCRs dropped from 2013 to 2015, and then stabilized. Differences in SCRs between branded and generic drugs were significant for oral drugs (0.820 vs 1.079) but not parenteral drugs (1.200 vs 1.165), suggesting that direct sales of oral generic drugs were omitted in S-AMU. Coefficients of DID between S-AMU and C-AMU were high (generic, 0.90; branded, 0.84) in oral drugs but relatively low (generic, 0.32; branded, 0.52) in parenteral drugs. Conclusions The omission of direct sales information and non-electronically submitted claims have influenced S-AMU and C-AMU information, respectively. However, these data were well-correlated, and it is considered that both kinds of data are useful depending on the situation.

This study examined the association between the use of social networking sites (SNS), perceived social support (PSS), and life satisfaction (LS), focusing on the mediating effect of PSS on the association between SNS use and LS. To this end, we used data (N = 15,574) obtained from a population-based, nationwide internet survey conducted in Japan. First, we confirmed that the number of SNS friends was positively associated with life satisfaction for all age groups: young (15–29 years), middle-aged (30–59 years), and old (60–86 years). However, the association was mixed if there were 100 or more SNS friends. Second, our structural equation modeling analysis underscored the mediating effect of PSS on the association between the number of SNS friends and LS for all age groups. Specifically, PSS mediated 36.5% (standard error [SE]: 8.6%), 39.8% (SE: 6.3%), and 40.3% (SE: 11.4%) of the association for the young, middle-aged, and old groups, respectively, if we defined SNS use as having 10 or more SNS friends. The mediating effect of PSS consistently contributed to the positive association between SNS use and LS regardless of the number of SNS friends, suggesting that SNS use has the potential to enhance subjective well-being via its positive impact on PSS.

Background The world is becoming individualized due to modernization. International migration is one of the factors that lead to family dissociation and a lack of social support. Social support is viewed as a crucial factor that contributes to psychological well-being and satisfaction with life among migrants. However, very little is known about the impacts of social support on psychological distress and satisfaction with life among migrants. Therefore, we conducted this study to assess the association of perceived social support with psychological distress and satisfaction with life among Nepalese migrants, and we evaluated the factors associated with receiving social support. Methods This was a cross-sectional study conducted with a convenience sample of Nepalese migrants (N = 249) living in Tokyo. Self-administered online questionnaires were distributed using social networks and chain referral methods. The measures included the Multidimensional Scale of Perceived Social Support, the General Health Questionnaire, and Satisfaction with Life Scale. Descriptive analysis, Pearson’s correlation analysis, and multiple linear regression analyses were performed using SPSS ver. 25. Results The mean (SD) age of the respondents was 31.8 years old (7.3). The family, friends, and significant others subscales of the multidimensional scale of perceived social support were negatively correlated with psychological distress (p Conclusion Social support from family, friends, and significant others was found to be influential in decreasing psychological distress and increasing satisfaction with life among Nepalese migrants in Tokyo. Strengthing social support system through the expansion of interpersonal network may help minimize the psychological distress

We propose the epsilon-tau procedure to determine up- and down-trends in a time series, working as a tool for its segmentation. The method denomination reflects the use of a tolerance level ε for the series values and a patience level τ in the time axis to delimit the trends. We first illustrate the procedure in discrete random walks, deriving the exact probability distributions of trend lengths and trend amplitudes, and then apply it to segment and analyze the trends of U.S. dollar (USD)/Japanese yen (JPY) market time series from 2015 to 2018. Besides studying the statistics of trend lengths and amplitudes, we investigate the internal structure of the trends by grouping trends with similar shapes and selecting clusters of shapes that rarely occur in the randomized data. Particularly, we identify a set of down-trends presenting similar sharp appreciation of the yen that are associated with exceptional events such as the Brexit Referendum in 2016.

Introduction This study aimed to investigate the differences in the Injustice Experience Questionnaire (IEQ) scores during the early period after the diagnosis of Whiplash-associated disorder (WAD) between Japanese and Canadian samples, and the associations between the IEQ scores and treatment terms in Japanese patients with acute WAD. Methods We used secondary data for the IEQ scores of Canadian patients with acute WAD. In Japan, we collected data from 85 consecutively enrolled patients with acute WAD, and their treatment terms were collected; these referred to the number of days between the date of injury and the closure date of the insurance claim and the number of treatment visits. Before treatment, the Numeric Rating Scale, Neck Disability Index, Hospital Anxiety and Depression Scale, IEQ, and Euro Quality of Life five-dimensional questionnaire were administered. The variables were subjected to multivariate analysis with each treatment term. Results The IEQ scores were higher in Japan than in Canada. Through multiple regression analysis, IEQ scores were independently correlated with treatment terms. The optimal cutoff point of the IEQ scores for a prolonged treatment term was 21 and 22 points, respectively. Conclusions The IEQ scores were associated with treatment terms in patients with acute WAD in Japan.

Purpose The purpose of this study was to evaluate neurodevelopmental outcomes in 18-month old (corrected age) preterm infants who received an intravitreal bevacizumab (IVB) injection for the treatment of type 1 retinopathy of prematurity (ROP). Methods In this ten-year retrospective study, we reviewed the medical records of patients who underwent ROP screening at Kyushu University Hospital. Among the patients who received IVB or laser photocoagulation (LPC) for the treatment of type 1 ROP, we included infants whose neurodevelopmental examination (the Kyoto Scale of Psychological Development [KSPD]) results at 18 months corrected age were available. Then, the effect of IVB on the developmental quotient (DQ) in each KSPD domain (Postural-Movement, Cognitive-Adaptive, or Language-Social domain) or the overall DQ was investigated by performing linear regression analysis. Results Out of the 513 patients reviewed, 53 were included in the study. IVB and LPC were performed for 14 and 39 patients, respectively. Administration of IVB was significantly associated with neurodevelopmental delay in the Language-Social domain (p = 0.01). The observed association remained even after adjusting for gestational age and birth weight (p = 0.03). Conclusions Administration of IVB may introduce a risk of developmental impairment of interpersonal relationships, socializations, and/or verbal abilities of preterm children. We recommended that preterm infants who received IVB undergo a neurodevelopmental reassessment during their school years or in adulthood.

The interactions among macroprices with leads and lags play a significant role in explaining the behavior of an aggregate price index. Thus, to understand inflation and deflation, it is essential to explore the mechanism according to which these macroprices interact with each other. On the basis of a new method, we show that, irrespective of the sources of shocks, a robust flow of changes occurs in domestic prices from upstream to downstream. Moreover, we demonstrate that macroprices change in clusters, and we identify these clusters. Firms are not symmetric. Overall, our analysis suggests that the inertia arising from input/output linkages in production explains the behavior of aggregate prices.

The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) was created to evaluate specific treatment outcomes in terms of physical functioning, social ability, and mental health in patients with back pain-related diseases. In this study, we investigated whether the JOABPEQ could be used to construct a regression model to quantify low back pain and lower limb symptoms in patients with lumbar disc herniation (LDH). We reviewed 114 patients with LDH scheduled to undergo surgery at our hospital. We measured the degrees of 1) lower back pain, 2) lower limb pain, and 3) lower limb numbness using the visual analog scale before the surgery. All answers and physical function data were subjected to partial least squares regression analysis. The degrees of lower back and lower limb pain could be used as a regression model from the JOABPEQ and had a significant causal relationship with them. However, the degree of lower limb numbness could not be used for the same. Based on our results, the questions of the JOABPEQ can be used to multilaterally understand the degree of lower back pain and lower limb pain in patients with LDH. However, the degree of lower limb numbness has no causal relationship, so actual measurement is essential.

This study investigated the developmental paths in the use of audiovisual information for the perception of emotions and phonemes by Japanese speakers. Children aged 5 to 12 years and adults aged 30 to 39 years engaged in an emotion perception task in which speakers expressed their emotions through their faces and voices, and a phoneme perception task using phonemic information in speakers' lip movements and speech sounds. Results indicated that Japanese children's judgement of emotions by using auditory information increased with increasing age, whereas the use of audiovisual information for judging phonemes remained constant with increasing age. Moreover, adults were affected by visual information more than children. We discuss whether these differences in developmental patterns are due to differential integration processes for information indicative of emotions and phonemes, as well as possible cultural / linguistic reasons for these differences.

Background The prevalence of dementia has increased rapidly in Japan, while the proportion of the population accounted for by working-age individuals is facing a sharp decline. Optimizing the balance between work and caregiving for persons with dementia is a major public health issue. Aims Using a nationally representative sample, this study investigated the working status of caregivers (CGs) for elderly people (care recipients) with dementia (CRDs) and assessed the effects of sociodemographic factors on this status. Methods Data were obtained from the 2013 Comprehensive Survey of the Living Conditions for CRDs and CGs (the latter aged 65 years or less). Individual data of CRDs and CGs were linked, and 452 pairs were extracted. The Japanese version of the Kessler 6 (K6) with a cut-off point of 13 was used to assess general psychological distress among CGs. Multivariable logistic regression analysis with the forward selection method was used to identify the predictors of their working status. Results Overall, the mean age of CGs was 57.1 ± 6.8 years, with 57.5% (260/452) performing paid work. Male sex, higher educational attainment, and having their own house were associated with having paid work for CGs, while higher age, spending almost all day performing nursing care, and participation in helping with toilet activities and laundry were associated with not performing paid work. Conclusions Several sociodemographic factors, including nursing care-related factors, are associated with the employment status of CGs. Further research should examine detailed information on CRDs' activities of daily living, behavioral and psychological symptoms, medical service use, and social support to strengthen the system of supportive services for both CRDs and their CGs.

Influenza causes numerous deaths worldwide every year. Predicting the number of influenza patients is an important task for medical institutions. Two types of data regarding influenza-like illnesses (ILIs) are often used for flu prediction: (1) historical data and (2) user generated content (UGC) data on the web such as search queries and tweets. Historical data have an advantage against the normal state but show disadvantages against irregular phenomena. In contrast, UGC data are advantageous for irregular phenomena. So far, no effective model providing the benefits of both types of data has been devised. This study proposes a novel model, designated the two-stage model, which combines both historical and UGC data. The basic idea is, first, basic regular trends are estimated using the historical data-based model, and then, irregular trends are predicted by the UGC data-based model. Our approach is practically useful because we can train models separately. Thus, if a UGC provider changes the service, our model could produce better performance because the first part of the model is still stable. Experiments on the US and Japan datasets demonstrated the basic feasibility of the proposed approach. In the dropout (pseudo-noise) test that assumes a UGC service would change, the proposed method also showed robustness against outliers. The proposed model is suitable for prediction of seasonal flu.

This study aims to clarify the relationships between length of overtime work and various stress responses using large-scale cross-sectional data of Japanese workers. This study’s participants are 59,021 Japanese workers in 117 companies. Data was collected by self-reporting questionnaire. The Brief Job Stress Questionnaire was used to measure stress responses on six scales (i.e. “lack of vigor”, “irritability”, “fatigue”, “anxiety”, “depression”, and “somatic responses”). Length of overtime work hours were classified as 0–20, 21–30, 31–40, 41–50, 51–60, 61–70, 71–80, and >80 hours/month. Multiple linear regression analyses were used to examine the association of stress responses with overtime while adjusting all possible confounders. In result, workers with longer overtime showed significantly higher “irritability”, “fatigue”, “anxiety”, “depression”, and “somatic responses” for both genders (p-for-trend

BackgroundA country's ability to become a prominent knowledge economy is tied closely to its ability to acquire skilled people who can compete internationally while resolving challenges of the future. To equip students with competence that can only by gained by being immersed in a foreign environment, outbound mobility is vital.MethodsTo analyze outbound student mobility in Taiwan using time series methods, this study aims to propose a hybrid approach FSDESVR which combines feature selection (FS) and support vector regression (SVR) with differential evolution (DE). FS and a DE algorithm were used for selecting reliable input features and determining the optimal initial parameters of SVR, respectively, to achieve high forecast accuracy.ResultsThe proposed approach was examined using a dataset of outbound Taiwanese student mobility to ten countries between 1998 and 2018. Without the requirements of any special conditions for the proprieties of the objective function and constraints, the FSDESVR model retained the advantage of FS, SVR, and DE. A comparison of the FSDESVR model and other forecasting models revealed that FSDESVR provided the lowest mean absolute percentage error (MAPE) and root mean square error (RMSE) results for all the analyzed nations. The experimental results indicate that FSDESVR achieved higher forecasting accuracy than the compared models from the literature.ConclusionWith the recognition of outbound values, key findings of Taiwanese outbound student mobility, and accurate application of the FSDESVR model, education administration units are exposed to a more in-depth view of future student mobility, which enables the implement of a more accurate education curriculum.

Today's consumer goods markets are rapidly evolving with significant growth in the number of information media as well as the number of competitive products. In this environment, obtaining a quantitative grasp of heterogeneous interactions of firms and customers, which have attracted interest of management scientists and economists, requires the analysis of extremely high-dimensional data. Existing approaches in quantitative research could not handle such data without any reliable prior knowledge nor strong assumptions. Alternatively, we propose a novel method called complex Hilbert principal component analysis (CHPCA) and construct a synchronization network using Hodge decomposition. CHPCA enables us to extract significant comovements with a time lead/delay in the data, and Hodge decomposition is useful for identifying the time-structure of correlations. We apply this method to the Japanese beer market data and reveal comovement of variables related to the consumer choice process across multiple products. Furthermore, we find remarkable customer heterogeneity by calculating the coordinates of each customer in the space derived from the results of CHPCA. Lastly, we discuss the policy and managerial implications, limitations, and further development of the proposed method., Comment: 27 pages with 9 Figures and 7 Tables, including a 2-page Appendix

Given scientific and technological advancements, expectations of online medical education are increasing. However, there is no way to predict the effectiveness of online clinical clerkship curricula. To develop a prediction model, we conducted cross-sectional national surveys in Japan. Social media surveys were conducted among medical students in Japan during the periods May–June 2020 and February–March 2021. We used the former for the derivation dataset and the latter for the validation dataset. We asked students questions in three areas: 1) opportunities to learn from each educational approach (lectures, medical quizzes, assignments, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, and interactive discussions with physicians) in online clinical clerkships compared to face-to-face, 2) frequency of technical problems on online platforms, and 3) satisfaction and motivation as outcome measurements. We developed a scoring system based on a multivariate prediction model for satisfaction and motivation in a cross-sectional study of 1,671 medical students during the period May–June 2020. We externally validated this scoring with a cross-sectional study of 106 medical students during February–March 2021 and assessed its predictive performance. The final prediction models in the derivation dataset included eight variables (frequency of lectures, medical quizzes, oral presentations, observation of physicians’ practice, clinical skills practice, participation in interprofessional meetings, interactive discussions with physicians, and technical problems). We applied the prediction models created using the derivation dataset to a validation dataset. The prediction performance values, based on the area under the receiver operating characteristic curve, were 0.69 for satisfaction (sensitivity, 0.50; specificity, 0.89) and 0.75 for motivation (sensitivity, 0.71; specificity, 0.85). We developed a prediction model for the effectiveness of the online clinical clerkship curriculum, based on students’ satisfaction and motivation. Our model will accurately predict and improve the online clinical clerkship curriculum effectiveness.

In the game of softball, the batter should possess the necessary skills to hit the ball toward various directions with high initial speed. However, because various factors influence each other, there are limitations to the range that can be controlled by the batter’s skill. This study was aimed at extracting the impact characteristics associated with the launch speed/direction and batted ball spin and clarifying the important skills required to improve the batter’s hitting performance. In our experiments, 20 female softball players, who are members of the Japan women’s national softball team, hit balls launched from a pitching machine. The movements of the ball and bat before, during, or after the impact were recorded using a motion capture system. Stepwise multiple regression analysis was performed to extract factors relating the side spin rate. The undercut angle (elevation angle between the bat’s trajectory and the common normal between the ball and bat: ΔR2 = 0.560) and the horizontal bat angle (azimuth of bat’s long axis at ball impact: ΔR2 = 0.299) were strongly associated with the side spin rate (total R2 = 0.893, p < 0.001). The undercut angle in opposite-field hitting was significantly larger than that in pull-side hitting (p < 0.001). The side spin rate was associated with the undercut angle because the bat’s distal (barrel) side inclined downward (–29.6 ± 8.7°) at impact. The ball exit velocity was higher when it was hit at a smaller undercut angle (R2 = 0.523, p < 0.001). Therefore, it is deemed desirable to focus on maximizing the ball exit velocity rather than ball spin because the ball–bat impact characteristics vary inevitably depending on the launch direction. Meanwhile, the use of the ball delivery machine and the slower pitched ball are the limiting factors in the generalization of the findings.

Purpose The aim of this cohort study was to evaluate the development and progression of presbyopia and the status of dry eye-related symptoms from 2017 to 2020, to assess the impact of the COVID-19 pandemic. Methods Near add power at 30 cm was measured in 339 participants aged between 40 and 55 from 2017 to 2021 at Japanese eye clinics. Regression analysis of near add power and age was analyzed to compare 2017 with later years up to the pandemic. The prevalence of dry eye-related signs and six common symptoms were compared. Results The number and mean age (y) of participants were 183 (48.6±4.1) in 2017, 46 (51.3±7.5) in 2019, and 110 (49.2±3.7) in 2020–21, respectively. The mean progression rate of near add power (D/y) was 0.13 for 2017, 0.09 for 2019 (P = 0.028, vs 2017), and 0.08 for 2020–21 (P Conclusion Estimated presbyopia developed earlier and progressed slower from 2017 to 2021, the COVID-19 pandemic. Stress and rapid digitalization related to strict infection control and quarantine might be contributing factors.

This study aimed to examine the types and causes of dizziness experienced by individuals after a major earthquake. This cross-sectional study enrolled healthy participants who experienced the 2016 Kumamoto earthquakes and their aftershocks. Participants completed a questionnaire survey on their symptoms and experiences after the earthquakes. The primary outcome was the occurrence of dizziness and the secondary outcome was the presence of autonomic dysfunction and anxiety. Among 4,231 eligible participants, 1,543 experienced post-earthquake dizziness. Multivariate logistic regression analysis revealed that age (≥21, P < .001), female sex (P < .001), floor on which the individual was at the time (≥3, P = .007), tinnitus/ear fullness (P < .001), anxiety (P < .001), symptoms related to autonomic dysfunction (P = .04), and prior history of motion sickness (P = .002) were significantly associated with the onset of post-earthquake dizziness. Thus suggesting that earthquake-related effects significantly affect inner ear symptoms, autonomic function, and psychological factors. Earthquake-induced disequilibrium may be further influenced by physical stressors, including sensory disruptions induced by earthquake vibrations, changes in living conditions, and autonomic stress. This study increases our understanding of human equilibrium in response to natural disasters.

Iodine thyroid blocking (ITB) is effective for preventing childhood thyroid cancer when radioactive iodine is released into the environment during a nuclear power plant accident. Japan employs the pre-distribution of stable iodine (PDSI) to residents living near nuclear power plants; however, the number of residents who have actually received stable iodine to date remains limited. The aim of this study was to evaluate the profile of guardians of children living around the Genkai Nuclear Power Plant (GNPP) in Japan. We distributed self-administered questionnaires regarding perception of risks associated with administration of stable iodide to approximated 400 guardians of children aged 0–6 in 10 kindergartens located in four municipalities. We obtained responses from 286 guardians, and after excluding invalid responses, 247 were included in the analysis. Logistic regression analysis revealed that living within 5 km of the GNPP (odds ratio [OR] = 4.48, 95% confidence interval [CI]: 2.43–8.24), awareness of preferential implementation of ITB to children (OR = 3.33, 95%CI: 1.78–6.22), and awareness of the prophylaxis booklet published by the local government (OR = 2.53, 95%CI: 1.37–4.68) were independently associated with PDSI for children. The main reasons for not receiving PDSI were “anxiety about the side effects of stable iodine” (40.2%), “distrust of the effectiveness of SI” (23.5%), “complicated procedures for receiving stable iodine” (15.7%) and “missed the date for receiving stable iodine” (8.8%). In the case of ITB implementation during a nuclear emergency, it is necessary to clarify the risk perceptions of guardians and adapt risk communication accordingly., PLoS ONE, 16(5), art. no. e0250570; 2021

The last few years have seen increasing research on self-report measures of compassion. The Compassionate Engagement and Action Scale (CEAS) is rooted in an evolutionary approach to compassion, which focuses on the competencies of compassion those are engagement with distress or suffering, and taking action to alleviate and prevent it. This study sought to validate the CEAS in a Japanese population using a cross-sectional design. A total of 279 students (82 males, 191 females, 6 unknown) answered self-report questionnaires, including the Japanese version of CEAS. We found single-factor structures for compassion for others scales, compassion from others scales, and compassion for self scales. All scales were found to have acceptable internal consistency, test-retest reliability, content validity, and construct validity. Even though some limitations, these results indicate that the Japanese version of CEAS is an adequately constructed and useful measure to assess compassionate engagement and action toward others, from others, and for the self with Japanese population.

Purpose This study examined the association between perceived organizational justice (i.e., procedural justice and interactional justice) and reporting of illness to one's company (illness reporting) among Japanese employees with chronic diseases. Methods This online cross-sectional survey included 1,134 employees (aged 18-65 years) who required workplace support to combine work with disease treatment. Participants were classified into tertiles of perceived organizational justice (low, moderate, and high). Multiple logistic regression analyses were conducted to examine sex differences in the associations between perceived justice and illness reporting. Results Males reporting perceived high levels of procedural and interactional justice had significantly higher odds of illness reporting than those with perceived low levels of procedural (odds ratio [OR] 2.62, 95% confidence interval [CI]: 1.47-4.66) and interactional justice (OR 4.34, 95% CI: 2.28-8.27). Females with perceived high levels of interactional justice had significantly higher odds of illness reporting than those with perceived low levels of interactional justice (OR 1.74, 95% CI: 1.08-2.80). There was no significant association between procedural justice and illness reporting among females. Conclusion The findings indicate that high perceived organizational justice is positively associated with illness reporting among Japanese employees who require workplace support to combine work and disease treatment.

IntroductionOnly a few, large population-based studies, have reported on whiplash-associated disorder (WAD). However, none of them have investigated the influence of crash severity on WAD outcome. In the present study, we aimed to determine whether crash severity predicts outcomes among patients with no-fault government insurance for acute WAD.MethodsWe utilized data from a compulsory, no-fault government automobile liability insurance agency in Japan. Individuals involved in a car accident between April 2001 and June 2015 with residual disabilities reported at the end of the treatment between October 2014 and September 2015 were included. Crash severity was assessed based on property damage costs, size of the other vehicle (large car, medium car, small car, or two-wheeled vehicles), and collision types (rear-end collision, contact with vehicle moving in the same direction, or in the opposite direction). Outcomes included the time to claim closure and the number of treatment visits.ResultsWe analyzed data for a total of 52,251 individuals (28,571 male and 23,680 female) with a median age of 44 years (range: 2-95 years). The median time to claim closure was 220 days (range: 1-4,938 days), and the median number of treatment visits was 102 (range: 1-2,492). There was no significant association between outcomes and property damage costs or size of the other vehicle. Collision types exhibited no consistent association with outcomes. However, older age and affected body parts, in addition to the neck, were independent risk factors for delayed claim closure and a large number of visits, although, all odds ratios were low (often less than 2.0).ConclusionsThere was no obvious association of outcomes with property damage costs, size of the other vehicle, or collision types in acute WAD patients. Further studies should investigate the influence of psychological factors, compensation systems, and cultural conditions.

Quantitative applied linguistics research often takes place in restricted settings of an intact language classroom, workplace, phonetics laboratory or longitudinal sample. In such settings the samples tend to be small, which raises several methodological problems. The main aim of the current paper is to give a detailed explanation of methodological and practical implications inherent in a robust statistical method called bootstrapped quantile regression (BQR) analysis. Importantly for applied linguistics research, the BQR method could help to deal with methodological difficulties inherent in small sample studies. The current study employed a moderately small sample (N = 27) of students learning the Japanese language in a Malaysian public university. It examined the relationships between the students' language learning motivation (specifically, integrative orientation), the students' images or stereotypes about Japan and their global attitudes toward the target language country and its people. The findings indicated that there was a statistically significant relationship between the students' attitudes toward the target language country and their integrative orientation. In addition, these attitudes were found to be the most constant determinant of the integrative orientation. Besides the applied linguistics research, the BQR method can be used in a variety of the human sciences research where a sample size is small.

Problem: Do conservative econometric models that comply with the Golden Rule of Forecasting provide more accurate forecasts? Methods: To test the effects of forecast accuracy, we applied three evidence-based guidelines to 19 published regression models used for forecasting 154 elections in Australia, Canada, Italy, Japan, Netherlands, Portugal, Spain, Turkey, U.K., and the U.S. The guidelines direct forecasters using causal models to be conservative to account for uncertainty by (I) modifying effect estimates to reflect uncertainty either by damping coefficients towards no effect or equalizing coefficients, (II) combining forecasts from diverse models, and (III) incorporating more knowledge by including more variables with known important effects. Findings: Modifying the econometric models to make them more conservative reduced forecast errors compared to forecasts from the original models: (I) Damping coefficients by 10% reduced error by 2% on average, although further damping generally harmed accuracy; modifying coefficients by equalizing coefficients consistently reduced errors with average error reductions between 2% and 8% depending on the level of equalizing. Averaging the original regression model forecast with an equal-weights model forecast reduced error by 7%. (II) Combining forecasts from two Australian models and from eight U.S. models reduced error by 14% and 36%, respectively. (III) Using more knowledge by including all six unique variables from the Australian models and all 24 unique variables from the U.S. models in equal-weight “knowledge models” reduced error by 10% and 43%, respectively. Originality: This paper provides the first test of applying guidelines for conservative forecasting to established election forecasting models. Usefulness: Election forecasters can substantially improve the accuracy of forecasts from econometric models by following simple guidelines for conservative forecasting. Decision-makers can make better decisions when they are provided with models that are more realistic and forecasts that are more accurate. Refereed/Peer-reviewed

Schizophrenia is a disorder characterized by psychotic relapses. Globally, about 15%–30% of patients with schizophrenia discharged from inpatient psychiatric admissions are readmitted within 90 days due to exacerbation of symptoms that leads to self-harm, harm to others, or self-neglect. The purpose of this study was to investigate the structure and predictors of in-hospital nursing care leading to reduction in early readmission among patients with schizophrenia. A new questionnaire was developed to assess the extent to which respondents delivered in-hospital nursing care leading to reduction in early readmission among patients with schizophrenia. This study adopted a cross-sectional research design. The survey was conducted with the new questionnaires. The participants were registered nurses working in psychiatric wards. Item analyses and exploratory factor analyses were performed using the new questionnaires to investigate the structure of in-hospital nursing care leading to reduction in early readmission. Stepwise regression analyses were conducted to examine the factors predicting in-hospital nursing care leading to reduction in early readmission. Data were collected from 724 registered nurses in Japan. In-hospital nursing care leading to reduction in early readmission was found to consist of five factors: promoting cognitive functioning and self-care, identifying reasons for readmission, establishing cooperative systems within the community, sharing goals about community life, and creating restful spaces. In-hospital nursing care leading to reduction in early readmission was predicted by the following variables: the score on the nursing excellence scale in clinical practice, the score on therapeutic hold, and the participation of community care providers in pre-discharge conferences. Japanese psychiatric nurses provide nursing care based on these five factors leading to reduction in early readmission. Such nursing care would be facilitated by not only nurses’ excellence but also nurses’ environmental factors, especially the therapeutic climate of the ward and the participation of community care providers in pre-discharge conferences.