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Background: Unintentional injuries are the leading cause of death and disability in children worldwide, and many are preventable. Public maternal and child health services provide ideal opportunities for disseminating injury prevention education. However, the COVID-19 pandemic significantly impacted these services, reducing access to injury prevention information. This study aimed to obtain suggestions for delivering injury prevention information to the public during future pandemics. Methods: In March 2022, a nationwide Internet survey of mothers raising children ages 0-2 was conducted, asking whether they could obtain injury prevention information when required and when, what, and how they would like to receive it. Results: Over half of the mothers wanted injury prevention information throughout their pregnancy. They preferred receiving information through traditional face-to-face services provided by local governments, such as antenatal classes or checkups. However, 34.1% of mothers said they did not obtain the information they needed, especially those unemployed, mothers of children aged 0 to 1, and mothers of children with illnesses requiring hospital visits. In public services, failure to be interviewed when submitting pregnancy notification was associated with failure to obtain injury prevention information. Conclusions: It is suggested that the interruption of public services prevented mothers, especially those with fewer opportunities to obtain informal information, from obtaining injury prevention information. Maintaining face-to-face services with infection control measures and considering alternative means of information and support are crucial to prevent parents from being cut off from information sources during future pandemics.

We built a new pulse-echo system using a small tank (1 × 1 × 1 m) for measuring the broadband target strength of weakly scattering animals such as krill and shrimp. The system transmits a linear frequency modulated signal with a frequency sweep of 20–220 kHz. To increase the signal-to-noise ratio (SNR), a very long (50 ms) signal is used, and pulse compression processing is applied to received echoes. To determine the accuracy and effectiveness of the system and method, the obtained measurements were compared with predictions by theoretical acoustic scattering models. According to the verification experiment for a sphere and cylinders, the mean absolute errors were 0.97 in the frequency range above 20-dB SNR (40–210 kHz for the cylinders). Our measurement system was thus very accurate. We then performed the experiment for a commercially important shrimp, sakura shrimp Lucensosergia lucens. The measured spectra of three samples (35–38 mm) were in good agreement with the predicted spectra using an assumed sound-speed contrast. The $$r$$ values were > 0.88 in the frequency range above 20-dB SNR (approximately 110–190 kHz). The effectiveness of our new method for weakly scattering animals was confirmed.

Aim To investigate the association between children and their families' daily life routines and the implementation of safety practices in their homes. Methods A cross-sectional study was conducted using a self-administered questionnaire among parents of 3-year-old children, who visited a public health center in Tokyo for their health checkups. Associations between the implementation of safety practices and family and children's basic daily routines were assessed using a multivariate logistic regression. Results Data from 336 parents were analyzed. Three items were found to be significantly related to the non-implementation of safety practices, such as "television-watching behavior: after 8:00 p.m." (adjusted odds ratio = 1.88, p = .02), "washing hands: not every time after getting home" (adjusted odds ratio = 2.24, p = .02), and "Family Routines Inventory: lower score" (a measurement of the routinization of a family's daily life; adjusted odds ratio = .83, p = .01). Conclusion The cumulative results suggest that the lack of safety practices implementation signify nonadherence to daily routine practices by parents.

Aim To investigate the relationship between maternal mindfulness and maternal anxiety 1 month after childbirth. Methods A cross-sectional design was used, featuring anonymous questionnaires that were completed between July and December 2014 at two Japanese hospitals. The participants (n = 151) completed the Mindful Attention Awareness Scale (Japanese version) and the State–Trait Anxiety Inventory Form X (Japanese version). The data analysis was carried out by using a hierarchical multiple regression. Results The state and trait anxiety scores showed significant relationships with mindfulness, the mother's age, and the perceived difference between the expectations of motherhood before childbirth and the reality of post-partum daily life. Furthermore, the amount of average sleep time in the past week (including naps) showed a negative association with the state anxiety score, whereas the marital relationship showed a positive association with trait anxiety. Finally, at 1 month post-partum, the mothers with greater mindfulness scores showed lower anxiety. Conclusions Improvements in mindfulness could help mothers to reduce their post-partum anxiety.

Measuring and improving home care clinic resource volume and geographic allocation are an important public health issue regarding prolonging home care system usage among disabled elderly people. This study examined clinic volume and accessibility’s association with hospitalization duration among disabled elderly people in 13 municipalities in Japan; additionally, this study compared clinic volume and accessibility’s ability to explain hospitalization duration in this population. Home care clinics’ service volume and geographic accessibility were calculated for 17 municipalities using public data and geographic information systems. We analyzed medical claim data from October 2012; the sample included 22,662 persons who were aged ≥75 years, certified as disabled in daily living, and lived in 13 municipalities regarding which data could be obtained for all examined municipality characteristics. Multilevel logistic models with random intercepts were constructed for municipalities and individual- and municipality-level independent variables in order to examine home care clinic volume and accessibility’s correlation with hospitalization duration. Clinic volume ranged from 0 to 9.53 per 10,000 elderly people; clinic accessibility ranged from 0% to 83%. Clinic volume and accessibility were both significantly negatively correlated with hospitalization duration of ≥10 days (odds ratios, 0.944 and 0.713; confidence intervals, 0.914 - 0.974 and 0.553 - 0.921, respectively). Clinics were not homogeneously geographically distributed; clinic accessibility explained hospitalization duration better than clinic volume. Clinic accessibility may more accurately indicate care clinic allocation appropriateness than clinic volume.

Objective Anti–citrullinated protein antibodies (ACPAs) are highly specific to rheumatoid arthritis (RA), and strong associations between HLA–DRB1 alleles and ACPA levels have been detected in RA patients. We undertook this study to elucidate the associations between particular amino acid positions in HLA–DRB1 and ACPA levels in patients with RA. Methods We analyzed ACPA data on a total of 4,371 Japanese ACPA-positive RA patients in whom HLA–DRB1 allele genotyping had been performed. Generalized linear regression analysis and omnibus testing were carried out to determine associations of HLA–DRB1 alleles, amino acid residues, or amino acid positions with levels of ACPA. Results HLA–DRB1*09:01 and HLA–DR15 were confirmed to be associated with ACPA levels. HLA–DRB1*08:03 and DRB1*14:06 were associated with reduced and increased ACPA levels, respectively. We detected a strong association between ACPA levels and amino acid position 74 (P = 1.9 × 10−51). The association was mainly conferred by alanine residue (P = 4.5 × 10−51). After adjustment for position 74, amino acid positions 60 and 57 were found to be associated with ACPA levels. Amino acid positions 74 and 57 had previously been reported to be associated with susceptibility to ACPA-positive RA in Asians. Combinations of the amino acid residues at position 74 and position 60 or 57 could induce improvement in Akaike's information criterion comparable to that induced by the 5 significant HLA–DRB1 alleles (HLA–DRB1*08:03, DRB1*09:01, DRB1*14:06, DRB1*15:01, and DRB1*15:02). Conclusion Amino acid position 74 in HLA–DRB1 is strongly associated with ACPA levels in ACPA-positive RA, as well as with RA susceptibility. The mechanisms of ACPA production and susceptibility to ACPA-positive RA seem to partly overlap.

To prevent the development of metabolic syndrome among adult members of the community, improving the participation rate in the specific medical checkup (a medical examination focused on factors associated with metabolic syndrome prior to the onset of lifestyle-related disease) is an important public health issue. This study used claim data and health checkup data and aimed to detect those community-dwelling adults who were least likely to participate in the specific medical checkup. Analysis included the medical and health checkup chart data of 61,753 adults aged 60 - 69 years (as of April 2011) who lived in Fukui prefecture, Japan. The chi-squared interaction was used to analyze data. If a person did not participate in the specific medical checkup, individual was categorized as “absent.” Between April 2012 and March 2013, 66.3% of subjects were absent from the specific medical checkup. Those most likely to be absent included those who were also absent at the previous year’s checkup, those who were men, and those who did not have an examination for hypertension; 87.9% of patients who met all of these criteria were absent. Among women who were absent at the previous year’s checkup, the absentee rate differed by about 10.0% between those whose municipalities did (74.8%) or did not (84.2%) have a free checkup program. Our findings may help public health professionals detect those who require intervention and to effectively and efficiently improve participation in the specific medical checkup.

Aim: Over 60% of Japanese people hope to die at home; hence, assisting clients in achieving this outcome is an important responsibility of home care providers. This study investigated the effects of nurses' relational coordination with physicians on clients' place of death in home visiting nursing (HVN) agencies. Method: Secondary analysis of a public survey conducted in 2015 by local governments in Kurume city, Fukuoka prefecture, Western Japan. Manager nurses from 17 HVN agencies provided data about themselves and their relational coordination with community physicians and 85 deceased clients. Results: Among 85 deceased clients, 52 (61.2%) had died at home. Four regression models showed significant positive effects of HVN nurse managers' relational coordination on clients' home death (the odds ratios (95% CI) were 2.488 (1.442–4.293), 2.111 (1.014–4.396), 2.562 (1.409–4.658) and 2.275 (1.079–4.796) in models 1–4, respectively. Conclusion: Measuring relational coordination among HVN nursing managers and physicians indicated readiness for home death among HVN clients in an agency or community.

Unintentional injury in children is a worldwide public health problem, as it increases the health burden and is a leading cause of death among children. It is important to understand the differences between different age groups of children in regard to unintentional injury, in order to effectively implement child safety education. The present study aimed to determine the current trends of unintentional injury in children, and to identify the differences between different age groups of children with regard to unintentional injury. We identified 1,521 children who attended an 18-month health checkup (18-month group), and 1,368 children who attended a 36-month health checkup (36-month group), between January 1, 2014 and December 31, 2014. The rate of hospital visits associated with unintentional injury was 10.6% (161/1,521) in the 18-month group, and 13.1% (180/1,368) in the 36-month group. In both groups, present/past illness was associated with hospital visits, and in the 36-month group, hospital visits were more common in boys than in girls. The number of unintentional injuries that occurred outdoors was higher in the 36-month group than in the 18-month group. Unintentional injuries resulting from accidental ingestion and falls were more common in the 18-month group, while unintentional injuries resulting from turning over were more common in the 36-month group. In conclusion, the number of hospital visits for unintentional injury might be higher, and the number of preventive actions taken by mothers might be lower, among children attending the 36-month health checkup than among those attending the 18-month health checkup.

Cadmium-catalyzed complexation of zinc with 5,10,15,20-tetraphenyl-21H,23H-porphinetetrasulfonic acid (TPPS) was monitored spectrophotometrically. A kinetic parameter for the determination was obtained under kinetic consideration. Absorbance of zinc-TPPS at a fixed reaction time was proportional to the concentration of cadmium at pH 8 and 25°C. Tolerable concentration of interfering ions were 200, 200, 2000, 50, 500 and 1 μg L(-1) for Mg(II), Al(III), Ca(II), Fe(III), Zn(II) and Hg(II), respectively, in the determination of 20 μg L(-1) of cadmium, indicating Ca(II) and Mg(II) interferes with the analysis of natural fresh water. Such interference became tolerable at 5 mg L(-1) by the addition of an excess Ca(II) (50 mg L(-1)) in the reacting solution of sample and cadmium standards. A calibration curve of Cd(II) was linear up to 100 μg L(-1) with a detection limit of 2 μg L(-1). The reliability of the proposed method was confirmed by the recovery test of cadmium spiked into tap, river and reservoir water samples.

Anti-citrullinated protein antibodies (ACPAs) are highly specific to rheumatoid arthritis (RA), and strong associations between HLA-DRB1 alleles and ACPA levels have been detected in RA patients. We undertook this study to elucidate the associations between particular amino acid positions in HLA-DRB1 and ACPA levels in patients with RA.We analyzed ACPA data on a total of 4,371 Japanese ACPA-positive RA patients in whom HLA-DRB1 allele genotyping had been performed. Generalized linear regression analysis and omnibus testing were carried out to determine associations of HLA-DRB1 alleles, amino acid residues, or amino acid positions with levels of ACPA.HLA-DRB1*09:01 and HLA-DR15 were confirmed to be associated with ACPA levels. HLA-DRB1*08:03 and DRB1*14:06 were associated with reduced and increased ACPA levels, respectively. We detected a strong association between ACPA levels and amino acid position 74 (P = 1.9 × 10(-51) ). The association was mainly conferred by alanine residue (P = 4.5 × 10(-51) ). After adjustment for position 74, amino acid positions 60 and 57 were found to be associated with ACPA levels. Amino acid positions 74 and 57 had previously been reported to be associated with susceptibility to ACPA-positive RA in Asians. Combinations of the amino acid residues at position 74 and position 60 or 57 could induce improvement in Akaike's information criterion comparable to that induced by the 5 significant HLA-DRB1 alleles (HLA-DRB1*08:03, DRB1*09:01, DRB1*14:06, DRB1*15:01, and DRB1*15:02).Amino acid position 74 in HLA-DRB1 is strongly associated with ACPA levels in ACPA-positive RA, as well as with RA susceptibility. The mechanisms of ACPA production and susceptibility to ACPA-positive RA seem to partly overlap.

This paper describes a Nitrous Oxide (N2O)/Ethanol thruster using arc discharge assisted combustion. Ethanol and N2O, which are neither toxic nor reactive, can be stored as liquid owing to their relatively low freezing point. Arc discharge is used for the assistance of N2O/Ethanol combustion, as an alternative to Iridium based particulate catalyst, which has been applied to conventional chemical thrusters. The experiment showed that the combustion was successfully started and sustained with assistance of 1-kW class arc discharge. Thrust chamber pressure measurement yielded 88-% characteristic exhaust velocity (C* efficiency), which indicates the degree of combustion completion, at a specific power of 2.8 MJ/kg.

A 65-year-old man was admitted to our hospital with a productive cough, fever, and dyspnea; his chest radiographs revealed diffuse nodular and ground-glass opacities. He had worked on a farm for 11 years. Six months earlier, he had presented with similar symptoms at another hospital, and was admitted with suspected atypical pneumonia. After treatment with antibiotics, his condition improved and he was discharged. Examination on admission to our hospital revealed markedly elevated serum KL-6 levels. Histological findings from specimens obtained by video-assisted thoracic surgical lung biopsy showed caseating and non-caseating epitheloid cell granuloma, lymphocyte infiltration, and alveolitis. Bacteriological tests for mycobacteria and fungi were all negative. Farmer's lung was diagnosed in accordance with the criteria for hypersensitive pneumonia. It is generally accepted that the distinguishing histological finding for Farmer's lung disease is non-caseating epitheloid cell granuloma, but in this case, caseous granuloma was also present.

This paper discusses a 1-N class space propulsion thruster using SHP163 monopropellant and arc discharge assisted combustion. SHP163 is a hydroxyl-ammonium nitrate (HAN)-based monopropellant, which has relatively low toxicity and reactivity to materials such as metal and polymers, and can be stored in a liquid form due to its relatively low freezing point. Arc discharge, supporting a SHP163 exothermic chemical reaction, is used as an alternative to conventional particulate catalysts. Part of the pressurant is used as working fluid for the arcjet. Tests using prototyped thrusters show that combustion started and was successfully sustained with the assistance of a 1-kW class arc discharge. Thrust chamber pressure measurements yielded a characteristic exhaust velocity efficiency of 90 % at a specific power of 2.8 MJ/kg.