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The association between screen time (ST) , including that for smartphones, and overweight/obesity (OW/OB) in children was examined separately for boys and girls, considering the influence of lifestyle factors including diet, physical activity, and sleep time. A cross-sectional study was conducted in 2242 Japanese children (1278 girls) aged 10-14 years. OW/OB was defined by the International Obesity Task Force. Logistic regression analysis showed that only for girls, total ST (≥4h) , smartphone ST (≥3h) and non-smartphone ST (≥2h) were all independently and significantly associated with overweight/obesity compared to In Japanese girls, smartphone ST, non-smartphone ST, and total ST were all significantly associated with OW/OB. To avoid OW/OB, it is suggested to keep smartphone ST, non-smartphone ST, and total ST to Disclosure K. Fujihara: None. S.Y. Morikawa: None. H. Ishiguro: None. M.H. Yamada: None. C. Horikawa: None. Y. Ogawa: None. H. Sone: Research Support; Astellas Pharma Inc., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Novo Nordisk, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Holdings Co., Ltd., Takeda Pharmaceutical Company Limited.

Introduction The combined effects of energy intake (EI) and physical activity (PA) on obesity have been poorly investigated. We have investigated the combined effects of EI and PA quantitatively in Japanese men and women with type 2 diabetes. Methods Data on 1395 patients with type 2 diabetes who attended 25 diabetes clinics located throughout Japan, obtained by questionnaire, were analyzed. A logistic regression model was used to calculate the odds ratio for obesity. Results Multi-adjusted odds ratios for the top versus the bottom tertile of EI and the bottom versus the top tertile of PA were 1.39 (95% confidence interval [CI] 1.02–1.89) and 1.64 (95% CI 1.22–2.22), respectively. The combination of EI (kcal/day) ≥ 1967 and PA (metabolic equivalents [METs] h/week) ≤ 9.9 for men and of EI ≥ 1815 and PA ≤ 8.3 for women were significantly associated with obesity. Conclusions The existence of “allowable maximum EI” and “required minimum PA” that is significantly associated with “not being obese” is implied, suggesting the need for lifestyle education for Japanese patients with type 2 diabetes. Electronic Supplementary Material The online version of this article (10.1007/s13300-019-0610-x) contains supplementary material, which is available to authorized users.

The aim of this study was to investigate the association between habitual dietary intake for patients with diabetes and the content of family support for medical nutritional therapy (MNT). Analyzed were 289 Japanese with type 2 diabetes (men, 58.5%, mean age, 62.0 years, mean HbA1c, 53.4 mmol/mol) who completed the Food Frequency Questionnaire and Diabetes Family Behavior Checklist (DFBC). Relationships of mean values for food group intake to DFBC responses regarding MNT were examined using multivariate analysis of covariance. Positive response to &ldquo, Praise for following diet&rdquo, was associated with lower sweets intake (none: 60.1 g/day, &ge, once monthly: 50.9 g/day, p = 0.038) and higher seasoning intake (none: 21.6 g/day, &ge, once monthly: 24.1 g/day, p = 0.046). Energy intake was higher with positive responses to &ldquo, Eat at the same time that you do&rdquo, (none: 1636 kcal/day, &ge, once monthly: 1818 kcal/day, p = 0.038). &ldquo, Nags about not following diet&rdquo, was associated with higher fish (none: 68.7 g/day, &ge, once monthly: 78.7 g/day, p = 0.042) and salt intake (none: 8.3 g/day, &ge, once monthly: 9.0 g/day, p = 0.014). Eating foods not part of the diabetic diet (none: 218.4 g/day, &ge, once monthly: 246.9 g/day, p = 0.014) resulted in a higher vegetable intake. In females, significant differences in relationships in the overall analysis were reversed. Our results clarified relationships between types of family support of patients with type 2 diabetes and their dietary intake and the importance of sex differences for more effective MNT.

Although cardiorespiratory fitness (CRF) and muscular fitness (MF) are modifiable factors for metabolic risk, the role of weight status in these factors has not been clarified in the pediatric population. We examined associations between metabolic indices and CRF or MF according to weight categories and compared the prevalence of metabolic abnormalities among four groups stratified by combinations of PF and weight categories. Cross-sectionally analyzed were 1744 Japanese adolescents aged 13-14 years. The PF test included measurements of CRF (20-m shuttle run test), upper-limb strength (handgrip test), lower limb strength (standing long jump test), and muscular endurance (sit-ups). Participants were classified as non-overweight (non-OW) or overweight/obese (OW) according to BMI cutoffs by the International Obesity Task Force. Metabolic risk was defined as ≥1 SD of the clustered metabolic risk (estimated by summing standardized sex-specific Z scores of HbA1c, MAP, and non-HDL-C). After adjusting for BMI and other characteristics, linear regression analysis showed that non-HDL-C was inversely associated with CRF in the non-OW group (P In summary, relationships of metabolic risk with components of PF differed according to weight status. In OW adolescents, MF might be more useful for stratifying metabolic risk than CRF. Disclosure S.Y. Morikawa: None. K. Fujihara: None. R. Nedachi: None. I. Ikeda: None. Y. Takeda: None. M. Takeuchi: None. M. Hatta: None. H. Ishiguro: None. T. Yamada: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.

An increase in screen time (ST) is reportedly associated with insulin resistance and obesity in children. However, most studies are of TV viewing but not smartphone use. Also, little is known of the relationship between ST and diet. In this study, we clarified the relationships among ST including smartphone use, lifestyle factors including dietary content, and obesity. Cross-sectionally analyzed were 1393 children between 11-15 years of age. ST (min/day) was classified into 4 groups: In conclusion, the increase in ST including smartphone usage was suggested to be associated with various unfavorable lifestyles including dietary habits that could be connected to obesity. Disclosure I. Ikeda: None. K. Fujihara: None. R. Nedachi: None. S.Y. Morikawa: None. H. Ishiguro: None. M.H. Yamada: None. Y. Matsubayashi: None. T. Yamada: None. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.

Although both average BMI and foods vary greatly between Asian and Western countries, few studies have examined the relationship between dietary patterns and obesity in Asians. We investigated dietary patterns significantly associated with obesity in Japanese with diabetes. Cross-sectionally analyzed were 2070 Japanese with type 2 diabetes (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. Principal component analysis was performed on 20 food groups to elucidate dietary patterns significantly associated with obesity. We also divided participants into quintiles according to factor scores of each dietary pattern. The adjusted odds ratios (ORs) for obesity, defined as BMI ≥25 according to the Asian cutoff, were calculated with other covariates including energy intake. Six dietary patterns were determined from eigenvalues (≥1) and screen plots. For Factor 1, characterized by a well-balanced food group with high intake of light-colored vegetables, green and yellow vegetables, sugar, seaweed, beans, fish and seafood, fruit and potato, the OR for obesity in Quintile5 compared to Quintile1 was 0.34 (95% CI: 0.22-0.53). Conversely, that of Factor 2, characterized by high intake of seasoning and spices, sugar-sweetened beverages, rice and eggs, was 2.56 (1.69-3.89) (Table). In conclusion, a balanced diet with various food groups might help to avoid obesity in Japanese with type 2 diabetes. Disclosure M. Hatta: None. K. Fujihara: None. I. Ikeda: None. M. Takeuchi: None. R. Nedachi: None. S.Y. Morikawa: None. C. Horikawa: None. M. Kato: None. N. Kato: None. H. Maegawa: Speaker’s Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Sanofi K.K., Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Kyowa Hakko Kirin Co., Ltd., Novartis AG, Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co.

Background: In order to provide effective dietary guidance, it is necessary to consider dietary intake, which can change over time. This study analyzed changes in the diet of Japanese patients with type 2 diabetes over a 20-year period. Methods: We compared the results of two dietary surveys that used the food frequency questionnaire format. The first was conducted in 1996 by the Japan Diabetes Complications Study (JDCS) (n = 1509; males 53.3%), and the second in 2014–2018 by the Japan Diabetes Clinical Data Management Study (JDDM) (n = 1145; males 65.6%). Both are nationwide representative registries of outpatients with type 2 diabetes in Japan. Results: Over a 20-year period, both men and women with type 2 diabetes had a significant increase in body mass index (BMI). Nonetheless, there was only a small change in energy intake. Conversely, there was a significant increase in fat intake and thus in the fat-to-energy ratio. With regard to food groups, there was a significant increase in meat intake and a decrease in the intake of fish, soybeans/soy products, vegetables, and fruits, with a particularly significant decrease in vegetables. Conclusions: Even in Japan, an industrialized country with a stable socioeconomic environment, there were many significant changes in the dietary intake of patients with type 2 diabetes over the 20-year period.

To investigate the association between dietary energy density (DED) and obesity in people with type 2 diabetes mellitus. Moreover, we compared the strength of the associations of DED with intake of energy and macronutrients in terms of obesity as well as nutritional factors that have long been used for medical nutritional therapy. Cross-sectionally investigated were 1615 outpatients with type 2 diabetes who attended 26 clinics nationwide with diabetes specialists. Odds ratios (ORs) were calculated for the association between obesity and DED, energy, and macronutrients by quintile categories and a 1 SD increment with adjustment for potential confounders. β coefficients were calculated for the association between body mass index (BMI) and each nutritional factor by 1 SD increments in nutritional values. Multi-adjusted OR for obesity between extreme quintiles of DED was 2.99 (95% confidence interval (95% CI): 2.01–3.12). Conversely, the ORs did not differ significantly according to the quintiles of other nutrient factors. Multi-adjusted β coefficient of BMI per 1 SD according to DED was far higher than those of other nutrient factors (β coefficient 0.65, 95% CI: 0.41–0.88). These findings indicated that DED in persons with type 2 diabetes was positively associated with BMI and the prevalence of obesity. DED was also much more potently associated with obesity and BMI than nutritional indicators such as intake of energy or macronutrients.

Pediatric obesity is associated with clustered cardiometabolic risk and the future incidence of diabetes. However, few studies have determined the effect of pediatric obesity in Asia, where obesity is less common than in Western countries. Thus, we clarified whether metabolic risk factors are associated with weight status including slight overweight and underweight among Japanese adolescents. We performed a cross-sectional analysis of 2241 Japanese adolescents (1180 boys) aged 13-14 years whose height, weight, HbA1c, blood pressure (BP), and serum lipids were measured. Participants were classified as underweight, normal weight, slightly overweight, overweight, or obese according to both the universal and Asian cutoffs of the International Obesity Task Force, which correspond to adult BMI cutoffs. The clustered cardiometabolic risk (Z-CMR) was estimated by summing standardized sex-specific Z scores of HbA1c, mean arterial pressure (MAP), and non-high-density lipoprotein cholesterol (non-HDL-C). Linear regression analysis showed that MAP (sex-specific Z score), non-HDL-C (sex-specific Z score), and Z-CMR were higher in the slightly overweight, overweight, and obese groups than in the normal weight group after adjusting for confounders. Compared with the normal weight group, the slightly overweight, overweight, and obese groups had significantly higher odds ratios (ORs) for high BP [OR = 1.38 (95% CI, 1.03-1.85); OR = 2.63 (1.77-3.91); and OR = 2.39 (1.57-3.64), respectively]. Compared with the normal weight group, underweight boys, but not girls, had a significantly lower OR for high Z-CMR [OR = 0.20 (0.05-0.84)]. Our results indicated that adolescents classified as slightly overweight had higher levels of BP, serum lipids (but not HbA1c), and clustered cardiometabolic risk than those classified as normal weight. This observation demonstrated that significant associations between weight status and cardiometabolic risk factors could be seen during adolescence even in East Asia. Disclosure S.Y. Morikawa: None. K. Fujihara: None. D. Ishii: None. R. Nedachi: None. M. Ishizawa: None. H. Ishiguro: None. Y. Matsubayashi: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Dietary energy density (DED) is receiving increased attention reflecting recent reports of inverse associations with health outcomes. Although high DED meals are reportedly associated with low diet quality in the general population, such evidence in patients with diabetes is sparse, which led us clarify this issue in Japanese patients with T2DM. Analyzed were 1,615 outpatients with T2DM (men 62.2%) who attended 24 clinics specializing in diabetes care nationwide. Dietary habits were obtained using a food frequency questionnaire (FFQg) based on 18 food groups. DED (kcal/g) was calculated by dividing EI (kcal) from foods (excluding beverages) by weights of these foods (g). Mean DED (±SD) was 1.53±0.23 (kcal/g). Typical dietary patterns comprised of some significant food groups were extracted by principal component analysis. Pearson's correlation analysis was used to evaluate the associations between identified food patterns and DED. We could extract and validate three dietary patterns, which we labeled as “Healthy,” “Western,” and “Animal foods and confectionery.” Two patterns were significantly correlated with DED (Healthy: r=-0.48, Animal foods and confectionery: r=-0.69). A multivariate linear regression model was used to determine food groups that were independently related to DED. DED was positively associated with confectioneries (standardized β=0.19, P In conclusion, lower DED, which is related to higher intakes of vegetables and fruits was associated with a healthy diet pattern in T2DM patients. DED is a useful indicator of diet quality and could be utilized in nutritional education for people with T2DM. Disclosure Y. Takeda: None. K. Fujihara: None. M. Hatta: None. S.Y. Morikawa: None. C. Horikawa: None. D. Ishii: None. R. Nedachi: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Diabetes self-management is an essential part of diabetes care. Although several personality traits were reportedly associated with self-management behaviors or glycemic control in Western countries, clinical evidence of such an association is still sparse, especially among Asian patients with diabetes. Thus, we aimed to clarify the associations among personality, self-management behaviors, and glycemic control in Japanese patients with T2DM. Analyzed were 510 Japanese patients with T2DM (62.2 ± 11.2 y; 57% men) with available information on personality (assessed by NEO Five-Factor Inventory), diabetes self-management activities (assessed by the Japanese version of Summary of Diabetes Self-Care Activities), body mass index (BMI), and HbA1c. Coefficient of correlation indicated that those with high scores for neuroticism, as well as low scores for conscientiousness, had lower levels of diet (neuroticism r = -0.14, P Disclosure S.Y. Morikawa: None. K. Fujihara: None. M. Hatta: None. Y. Takeda: None. D. Ishii: None. J. Yachida: None. C. Horikawa: None. M. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Although support from patients’ family members is essential in managing type 2 diabetes, evidence is sparse on family support for medical nutritional therapy (MNT) and habitual dietary intake. This study investigated the association between patients’ perception of family support for MNT and their dietary intake. Analyzed were 154 Japanese patients with type 2 diabetes (men, 45.5%) who completed the Food Frequency Questionnaire and Diabetes Family Behavior Checklist. Multivariate analysis of covariance was used adjusting for age, gender, BMI, duration for diabetes, HbA1c, and use of oral hypoglycemic agents and/or insulin. Participants’ mean age, duration of diabetes and HbA1c were 63.5 y, 12.7 y and 7.0%, respectively. After adjusting for confounders, positive family support, i.e., ‘Praise for following diet,’ was only significantly associated with higher fish intake (none 72.0 g/d, once a month 73.1 g/d, once a week 85.8 g/d, several times a week 97.6 g/d, and at least daily 92.1 g/d; trend p= 0.008). With greater frequency of eating at the same time as the family, salt intake was significantly higher (none 7.8 g/d, once a month 8.3 g/d, once a week 8.7 g/d, several times a week 9.3 g/d, and at least once daily 8.8 g/d; trend p= 0.037). Conversely, negative family support indicated by ‘Nags about following the diet’ was significantly associated with higher fish intake (none 70.3 g/d, once a month 84.4 g/d, once a week 84.3 g/d, several times a week 86.5 g/d, at least once daily 107.9 g/d; trend p= 0.012) and higher intake of vegetables was more frequent in those eating foods not part of the diabetic diet (none 242.1 g/d, once a month 192.1 g/d, once a week 270.4 g/d, several times a week 255.0 g/d, at least once daily 305.5 g/d; trend p= 0.027). These findings implied that patients’ perception of family support for MNT was not always associated with an ideal dietary intake to control diabetes. To facilitate diabetes treatment, sharing patient-family perceptions of MNT could be important. Disclosure C. Horikawa: None. Y. Takeda: None. M. Hatta: None. D. Ishii: None. S.Y. Morikawa: None. K. Fujihara: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited. Funding Japan Association for Diabetes Education and Care

Although obesity is closely associated with development and progression of type 2 diabetes mellitus (T2DM) and its complications, food group intake associated with obesity in diabetic patients has been very poorly investigated to date largely due to lack of large-scale databases with details on dietary intake. Thus, we aimed to determine intake of food groups by utilizing our nationwide database for people with diabetes with adjustment for confounders including energy intake. Analyzed were 1891 Japanese patients with T2DM (mean age, 62 y; men, 62%) who completed the Food Frequency Questionnaire. Obesity was defined by BMI>25. The associations between obesity and food groups were determined by multivariate quartile analysis. Among 15 food groups, both green and yellow and light-colored vegetables had significant negative associations with the presence of obesity among both men and women (Table). In addition, fruit and beans in men and fish in women were also negatively associated with obesity. Conversely, confectionery had positive associations with obesity in both men and women. Other food groups such as rice, meat or eggs did not show significant trends toward the presence of obesity. These results identified favorable dietary patterns for people with T2DM, which could be used for effective nutritional education to prevent obesity. Disclosure M. Hatta: None. K. Fujihara: None. Y. Takeda: None. R. Nedachi: None. D. Ishii: None. S.Y. Morikawa: None. C. Horikawa: None. M. Kato: None. H. Maegawa: Research Support; Self; Antares Pharma, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. Speaker's Bureau; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Company Limited. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Background Efficacy of programs for patients with diabetes mellitus (DM) that have promoted family members to help with patients’ self-care activities has been largely inconsistent. This meta-analysis aims to assess the effect of family-oriented diabetes programs for glycemic control (GC). Methods Electronic literature searches were conducted for clinical trials with a parallel design wherein there were two groups according to whether family members were included (intervention group) or not included (control group) and changes in glycohemoglobin A1C (A1C) were assessed as a study outcome. Each effect size (i.e. difference in A1C change between the intervention and control group) was pooled with a random-effects model. Results There were 31 eligible trials consisting of 1466 and 1415 patients in the intervention and control groups, respectively. Pooled A1C change [95% confidence interval (CI)] was −0.45% (−0.64% to −0.26%). Limiting analyses to 21 trials targeted at patients with type 1 DM or 9 trials targeted at patients with type 2 DM, the pooled A1C changes (95% CI) were −0.35% (−0.55% to −0.14%) and −0.71% (−1.09% to −0.33%), respectively. Conclusion This meta-analysis suggests that focusing on the family as well as the individual patient in self-management diabetes programs to improve the performance of self-care activities of patients with DM is effective in terms of proper GC.

Composite-type breakwaters made of concrete caisson and rubble mound are widely employed in Japan. The powerful tsunami of 2011 severely damaged these breakwaters. Hence, there is an urgent need to reinforce them to prevent such extensive damage in another tsunami. One of the possible reinforcement methods involves piling stones behind the caisson. A stability assessment method has been proposed, but it has not been completely verified. Thus, centrifuge modelling was implemented to examine the stabilities of the rubble mound and piled stones under the condition of a significant tsunami-induced water-level difference. The effect of reinforcement was investigated by altering the sectional shape of the piled stones. Consequently, a bearing capacity failure was observed in the cases with none and insufficient amount of piled stones. The stability observed in the centrifuge was analysed using the proposed stability assessment method with the help of the circular slip analysis. This method was verified to be able to simulate the model tests.

Compaction grouting (CPG) is an in-situ grout injection technique used to improve the liquefaction resistance of loose sandy ground by densification and increasing lateral confining pressure. The present study investigates ground response during grout injection using a transparent granular soil and a natural sand soil. The injection process was simulated using models placed in a geotechnical centrifuge. The experimental results relating injection pressure to injection depth are shown to be in good qualitative agreement with field data. The results of models using transparent granular soil are shown to be in good agreement with the same models using standard opaque silica sand. The experimental methodology to simulate CPG and to observe grout volumes and ground movements during injection holds promise to better understand the mechanisms of compaction grouting and to improve its efficiency in the field.

DED, defined as the ratio of energy intake (EI) to food weight, is receiving increased attention reflecting recent reports of its associations with elevated risks for obesity and T2DM in general populations. However, only a few studies have investigated the associations between DED and metabolic variables in patients with established diabetes, which led us to analyze the association between DED and obesity in Japanese patients with T2DM. Cross-sectionally investigated were 1,576 outpatients with T2DM (men 60.8%) who attended 26 clinics having diabetes specialists. Dietary habits were obtained by the Food Frequency Questionnaire based on food groups (FFQg). DED (kcal/g) was calculated by dividing EI (kcal) from foods (excluding beverages) by these food weights (g) and was categorized into tertiles (low (L), In conclusion, higher DED, which is related to higher fat intake, was strongly associated with a greater chance of having obesity in T2DM patients regardless of EI. Therefore, DED is critical in assessing diet quality and has clinical relevance in obesity management of patients with T2DM. Disclosure Y. Takeda: None. K. Fujihara: None. S.Y. Morikawa: None. C. Horikawa: None. M. Hatta: None. D. Ishii: None. R. Hirasawa: None. Y. Yachi: None. H. Sone: Research Support; Self; Novo Nordisk Inc., Eli Lilly and Company, MSD K.K., Chugai Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Development Center Asia, Pte. Ltd., Daiichi Sankyo Company, Limited, Ono Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Sanofi, Kowa Pharmaceuticals America, Inc., Eisai Inc..

OBJECTIVE To examine the independent and combined associations of cardiorespiratory fitness (CRF) and muscular fitness (MF) with cardiometabolic risk factors in Japanese adolescents. METHODS A cross-sectional study including 993 Japanese adolescents (aged 13-14 years) was undertaken. Height, body mass, blood pressure, lipid profile (non-fasting), and HbA1c were measured. The physical fitness (PF) test included measurements of CRF (20 m multistage shuttle run test), upper limb strength (hand grip strength), lower limb strength (standing long jump), and muscular endurance (sit-ups). The clustered cardiometabolic risk (CCMR) was estimated by summing standardized Z-scores of body mass index (BMI), mean arterial pressure (MAP), non-high-density lipoprotein cholesterol (non-HDL-C), and HbA1c. RESULTS Linear regression analysis showed that all PF factors except for muscular endurance were inversely correlated with CCMR (P

Summary Objective This study investigated the relationship between frequency of skipping breakfast and annual changes in body mass index (BMI) and waist circumference (WC). Methods The participants were 4,430 factory employees. BMI and WC were measured repeatedly at annual medical examinations over a 5‐year period. The association between frequency of skipping breakfast at the baseline examination and annual changes in anthropometric indices was evaluated using the generalized estimating equation method. Results The mean (standard deviation) BMI was 23.3 (3.0) kg m−2 for men and 21.9 (3.6) kg m−2 for women; and the mean WC was 82.6 (8.7) cm for men and 77.8 (9.8) cm for women. During the follow‐up period, mean BMI increased by 0.2 kg m−2 for men and women, and mean WC increased by 1.1 cm for men and 1.0 cm for women. The annual change in the BMI of men who skipped breakfast four to six times per week was 0.061 kg m−2 higher, and that of those who skipped breakfast seven times per week was 0.046 kg m−2 higher, compared with those who did not skip breakfast. Annual changes in the WC of male participants who skipped breakfast seven times per week was 0.248 cm higher than that of those who did not skip breakfast. Skipping breakfast was not associated with changes in BMI or WC in women. Conclusions Skipping breakfast was closely associated with annual changes in BMI and WC among men, and eating breakfast more than four times per week may prevent the excessive body weight gain associated with skipping breakfast.

Objective: Laparoscopic pull-through has become the standard surgical modality for Hirschsprung's disease in the field of pediatric surgery. This article discusses the minimal invasiveness of the prolapsing technique. This technique allows mucosectomies to be performed under direct vision even at the deepest dissected portion because the procedure is conducted via an extra-anal approach. Method: The laparoscopic prolapsing technique (Lap) is compared with the conventional open Soave technique in terms of the change in CRP and WBC, defecation function, both clinical and manometric, after surgery. Results: As a result, the timing of surgery has become earlier and the patients younger. Soiling occurs in 33% of open Soave and 0% of Lap patients. Manometry after Lap. pull-through revealed a positive recto-anal inhibitory reflex in 39% and evoked high amplitude propagated contraction was demonstrated in 85% of patients. Conclusion: These results suggest that the present technique, including minimal dissections of the mesentery and the preservation of pelvic nerves in combination with fine mucosectomy under direct vision, could be beneficial for postoperative anorectal function in patients with Hirschspurung's disease.

The Japan Arteriosclerosis Longitudinal Study-Existing Cohorts Combine (JALS-ECC) is a pooled study based on individual participant data from existing prospective cohort studies in Japan. Its purpose was to consider associations between risk factors and cardiovascular disease (CVD) outcomes, as well as differences between subgroups, defined by age, gender or geographical region, which could not be detected in the smaller samples.Individual records for 66,691 participants in 21 cohort studies were pooled, accounting for a total of 575,628 person-years. From this data, there were 409 deaths attributed to stroke and 169 deaths attributed to coronary heart disease (CHD). Total stroke and CHD events were 1,478 and 178, respectively. Of the 1,424 total stroke events with a reported stroke subtype, 975 were classified as ischemic, 267 as hemorrhagic, and 178 as subarachnoid hemorrhage.The JALS-ECC collected data from existing cohort studies covering a diverse Japanese population, which has provided information about the effects of modifiable factors on the risks of the CVD. Such information should provide a reliable basis for establishing prevention strategies.

We have studied the heteroepitaxial growth of 3C–SiC film on an Si(100) substrate by plasma chemical vapor deposition using monomethylsilane, a single-molecule gas containing both Si and C atoms. We have tried to introduce an interval process, in which we decrease the substrate temperature for a few minutes at a suitable stage of film growth. It was expected that, during the interval process, stabilization such as desorption of nonreacted precursors and lateral diffusion of species produced at the initial stage of film growth would occur. From the results, it appears that the interval process using a substrate temperature of 800 °C effectively suppresses polycrystallization of 3C–SiC growth on the Si(100) surface

A multi-channel microwave interferometer can measure plasma density radial profiles in a single plasma shot. It has six observing channels for measuring the radial electron line integrated density ...

The diffuse scattering from atomic short-range order (SRO) associated with an order–disorder transformation was observed in single decagonal quasicrystals of Al 72 Ni 20 Co 8 . The diffuse scattering was distributed around the superstructure reflections. The correlation length of the diffuse scattering was estimated to be 2.8 nm at room temperature and developed into more than 11.0 nm on the superstructure phase at high temperature. Full width at half maximum of Bragg reflections increased monotonically above the transformation temperature, T c2 . On the other hand, SRO diffuse intensities decreased gradually in the same temperature region. Moreover, hysteresis of SRO diffuse scattering appeared above T c2 . These behaviors at high temperature originate in the thermally activated fluctuations.

Deposition of Ni as contact on 4H–SiC has been investigated. Ni/4H–SiC samples were annealed at temperatures of 600, 800 and 950 °C for 30 min and were non-destructively characterized by soft X-ray emission spectroscopy (SXES) using synchrotron radiation as excitation. Si L2,3 SXE showed the formation of Ni2Si for all annealing temperatures. The C K SXE indicated the formation of graphite and graphitic carbons at annealing temperatures of 950 °C and below 800 °C, respectively.

Low-k materials etching for FLARE™ and a porous silica were carried out in a magnetic neutral loop discharge plasma at low pressure, below 1 Pa. Fluorinated carbon molecules were used as etching gases for porous silica. The etch rate of the porous silica was approximately two times higher than that of thermal SiO2. This result means that consumption of perfluoro compound (PFC) gases is suppressed below at approximately half volumes. And organic low-k materials etching where ammonia gas or a gas mixture of nitrogen and hydrogen were used instead of PFC gas is an environmentally friendly process. After investigating an influence of a N2/H2 mixture ratio in the organic materials etch process, a good experimental condition to get a low microloading profile was found at a N2 ratio of 70%–80%. Under this condition N2+ and N2H+ ions were dominant, and the signal intensity of the N2H+ ion showed a maximum value in the mass spectrum. This may mean N2+ and N2H+ ions play an important role for a low microloading etc...

Sequence-characterized amplified regions (SCARs) were developed, based on nucleotide differences within resistance gene-like fragments isolated from a potato plant carrying the Ryadg gene, which confers extreme resistance to potato Y potyvirus (PVY). It originates from Solanum tuberosum subsp. andigena, and a susceptible potato plant. SCARs were tested using 103 potato breeding lines and cultivars with diverse genetic backgrounds derived from Europe, North America, and Japan. Two markers showed high accuracy for detection of the Ryadg gene. The SCAR marker RYSC3 was generated only in genotypes carrying Ryadg. The SCAR marker RYSC4 was detected in all genotypes carrying Ryadg but also in four PVY-susceptible genotypes. Neither marker was detected in genotypes carrying other Ry genes originating from different species than S. tuberosum subsp. andigena. Therefore, these SCAR markers should be powerful tools in marker-assisted selection for Ryadg in potato breeding programs, and should also be useful for cloning of the Ryadg gene. Key words: SCAR, potato virus Y, extreme resistance gene, Solanum.

The applicability of the NLD plasma etching apparatus to the 0.1 μm wafer process was verified through the experiments. The uniformity of the SiO 2 etch rate was obtained within 1.6% (3% as 3 σ value) on 200 mm wafer, by applying a functional current to the magnetic coil with 0.1 Hz. A super-fine trench pattern with 20 nm width and 800 nm depth was also successfully fabricated with an electron beam resist mask in a C 4 F 8 +CH 2 F 2 plasma at 0.3 Pa.

Rectoceleに対して,経膣的に余剰な膣壁の切除,縫縮と同時に,直腸膣中隔の補強の目的で,恥骨直腸筋および肛門挙筋の縫縮を行うanteriorlevatorplasty(ALP)を施行した症例の,術後の症状と機能の変化にっき検討した.対象は,有症状のrectocele5症例で,平均年齢は61歳で,2例は便失禁を,3例は尿失禁を合併していた.手術は,全例に余剰膣壁の切除,縫縮とALPを行い,便失禁の2例にはsphincter plicationを追加した.術後,全例で症状と便,尿の失禁は改善した.直腸肛門内圧検査では,全体として大きな変化はなかったが,術前に最小便意発現量,最大耐容量,最大静止圧が異常高値を示した例では,術後これらの値が低下し,便失禁例では,肛門管長,最大静止圧の上昇がみられた.術後の排便造影検査では,全例rectoceleは消失した.rectoceleに対するALPは,症状,形態異常の改善とともに,合併失禁例にも有用な術式であることが示唆された.

Two kinds of dipeptidyl aminopeptidase I (DAP I [cathepsin C])-like activities which hydrolyze Gly-Phe-p-nitroanilide (Gly-Phe-pNA) were detected in Pseudomonas sp. strain WO24. They were purified and characterized. The isolated enzymes, named DAP BII and DAP BIII, were revealed to be homogeneous by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and isoelectric focusing. DAP BII was estimated to have a molecular mass of 150,000 Da by gel filtration and a subunit size of 73,000 Da by SDS-PAGE, indicating it to be a homodimer. The molecular mass of DAP BIII was evaluated to be approximately 60,000 Da by gel filtration and 69,000 Da by SDS-PAGE, indicating that it is monomeric. The isoelectric points of DAP BII and DAP BIII were 6.1 and 5.0, and their optimal pHs were 8.0 and 8.5 to 9.0, respectively. The result of peptide mapping for DAP BII and DAP BIII showed that these enzymes consist of different components. Both enzymes were completely inhibited by diisopropylphosphofluoride but not by general thiol inhibitors, indicating that they are serine proteases. DAP BII and DAP BIII hydrolyzed Gly-Phe-pNA but not Gly-Arg-pNA, both of which are model substrates for mammalian DAP I. Despite these shared activities toward DAP I, DAP BII released dipeptides from Ala-Ala-pNA and Lys-Ala-4-methylcoumarinamide (a substrate for DAP II), whereas DAP BIII did not hydrolyze either of these compounds and was presumed to prefer substrates composed of bulky, hydrophobic amino acids at P1 and P1' positions. In addition, DAP BII showed no endopeptidase activity, whereas DAP BIII possessed the activity on N-terminally blocked peptide derivatives besides exopeptidase activity. Assays performed with bioactive peptides such as angiotensin I and neuromedin N as substrates indicate that DAP BII has a considerably broader substrate specificity than DAP BIII and is able to hydrolyze an X-Pro bond, an imido bond that few peptidases and no known DAPs can cleave. These characteristics, namely, substrate specificities, molecular mass, pI, peptide mapping, pH optimum, and effect of inhibitors, suggested that the two DAPs purified in this work are distinct enzymes and do not belong to any of the previously reported DAP classes.

A new interferometer is installed on the west anchor cell of the GAMMA 10 tandem mirror. In GAMMA 10, we have used a heterodyne-type interferometer with a 70-GHz IMPATT oscillator and a 150-MHz oscillator for frequency modulation. The new interferometer consists of a 17.5-GHz phase locked dielectric resonator oscillator and a 37.5-MHz temperature-compensated crystal oscillator, as well as frequency multipliers. The main motivation for the new interferometer using frequency multipliers is to achieve a stable and cost effective interferometer. Direct anchor heating experiments with new anchor ion cyclotron range of frequency antennas in both the west and the east anchor cells are carried out. Density increases in both anchor cells are clearly observed using the new interferometer.

Chemokines play an important role in immune and inflammatory responses by inducing migration and adhesion of leukocytes. We have isolated a novel chemokine cDNA, designated CCF18, from a cDNA library of an IL-3-dependent murine pro-B cell line, Ba/F3. The cDNA encodes a protein structurally related to the C-C chemokine members. Among this family, C10 shows the highest homology to CCF18, and MIP-1 alpha also has a significant homology but to a lesser extent. CCF18 produced from COS cells induced chemotaxis and Ca2+ flux in CD4+ T cell clones. Moreover, prior administration of MIP-1 alpha desensitized the cells to CCF18. The CCF18 gene (Scya10) was mapped to a middle region of murine chromosome 11, where other genes for several C-C chemokine members are localized. These results clearly indicate that CCF18 is a new member of the C-C chemokine family. Since a high level of CCF18 mRNA is constitutively expressed in macrophage and myeloid cell lines, CCF18 may play a role in inflammatory processes.

便失禁を伴う直腸膣壁弛緩症と直腸脱に対して,これまで本邦での報告のない骨盤底修復術を付加した手術を施行した.直腸膣壁弛緩症に対しては,経膣的に余剰膣壁の切除,縫合閉鎖とともに,骨盤底修復術として恥骨直腸筋および肛門挙筋の縫縮を行うanterior levatorplastyと外肛門括約筋縫縮術を施行した.直腸脱と直腸膣中隔の菲薄化を認めた症例には,経会陰的にGant-三輪法と,骨盤底修復術としてanterior levatorplastyと外肛門括約筋縫縮術,postanal repairを行うtotal pelvic floor repairを施行した.肛門括約筋欠損を伴う直腸脱には,腹式直腸後方固定術とS状結腸人工肛門造設術後,経会陰的に括約筋修復術とともに,total pelvic floor repairを施行した.術後,肛門括約筋がほぼ欠損した症例では,便失禁の改善はなかったが,他の2例は改善し,改善した症例では,直腸肛門内圧検査で肛門静止圧の上昇と肛門管長の延長がみられた.