Diarrhea and related personal characteristics among Japanese university students studying abroad in intermediate- and low-risk countries

Despite an increasing number of students studying abroad worldwide, evidence about health risks while they are abroad is limited. Diarrhea is considered the most common travelers' illness, which would also apply to students studying abroad. We examined diarrhea and related personal characteristics among Japanese students studying abroad. Japanese university students who participated in short-term study abroad programs between summer 2016 and spring 2018 were targeted (n = 825, 6-38 travel days). Based on a 2-week-risk of diarrhea (passing three or more loose or liquid stools per day) among travelers by country, the destination was separated into intermediate- and low-risk countries. After this stratification, the associations between personal characteristics and diarrhea during the first two weeks of their stay were evaluated using logistic regression models. Among participants in intermediate-risk countries, teenagers, males and those with overseas travel experience were associated with an elevated risk of diarrhea; the odds ratios (95% confidence intervals) were 2.42 (1.08-5.43) for teenagers (vs. twenties), 1.93 (1.08-3.45) for males (vs. females) and 2.37 (1.29-4.33) for those with overseas experience (vs. none). Even restricting an outcome to diarrhea during the first week did not change the results substantially. The same tendency was not observed for those in the low-risk countries. Teenage students, males and those with overseas travel experience should be cautious about diarrhea while studying abroad, specifically in intermediate-risk countries

Combined effects of body mass index and unhealthy behaviors on disability in older Japanese adults: the Okayama study

Background: Body mass index (BMI) is a significant predictor of functional disability in older adults. However, when evaluated, the association between BMI and incident functional disability, considering behaviors only as covariates or not, may not be appropriate. The primary purpose of the study was to investigate the combined effects of BMI and unhealthy behaviors on the risk of incident functional disability. Methods: This was a retrospective cohort study that took place in Okayama City, Japan. Data on BMI and unhealthy behaviors were obtained using the health check-up questionnaire. The certification of Long-Term Care Insurance was used to measure functional disability. Cox proportional hazard models were used; adjusted hazard ratios (HRs) with 95% confidence interval (CI) were calculated for incidence of functional disability across categories of BMI and number of unhealthy behaviors. Results: The relationship between BMI and incident functional disability was U-shaped (HR = 1.18, 95% CI [1.11-1.25], among the underweight range; and 1.26 [1.19-1.34] among the obesity range), and its risk was significantly higher within the normal-to-overweight range of BMI values with co-occurring unhealthy behaviors (with normal weight range and one, 1.17 [1.01-1.21]; two, 1.29 [1.18-1.41]; and three or four unhealthy behaviors 1.38 [1.24-1.54]; as well as among overweight range and one, 1.16 [1.05-1.27]; two, 1.26 [1.15-1.38]; and three or four unhealthy behaviors, 1.47 [1.31-1.64]). In each BMI category, the risk of incident functional disability increased with increasing number of unhealthy behaviors (p = 27.5, for both sexes (2.20 [1.64-2.92] in men and 1.66 [1.35-2.04] in women). Conclusion: It is necessary to consider the combined effects of BMI and behaviors on incident functional disability. Furthermore, interventions targeting multiple behaviors should be considered as such interventions may offer greater benefits than simple interventions

Association of breast feeding with early childhood dental caries: Japanese population-based study

Objectives: We investigated the association between breastfeeding duration during the first half year of life and the risk of early childhood caries from the age of 30 to 66 months in Japan. Design: Observational study of a longitudinal survey. Setting: A secondary data analysis of the Japanese Longitudinal Survey of Babies in the 21st Century. Participants: 43 383 infants at the age of 6 months. Outcome measures Early childhood caries—defined as a child's visit to a dentist for treatment of dental caries during the past 12 months—was ascertained from the caregiver from the age of 30 months in the survey. We estimated the risk of dental caries each year according to duration of breast feeding using logistic regression analyses. We controlled for a set of biological factors (birth weight, sex, parity and maternal age at delivery) and socioeconomic factors (maternal educational attainment and smoking status, marital status at delivery, family income and region of birth and residence). Results: We found that infants who had been breast fed for at least 6 or 7 months, both exclusively and partially, were at elevated risk of dental caries at the age of 30 months compared with those who had been exclusively formula fed. Adjusted ORs were 1.78 (95% CI, (1.45 to 2.17)) for the exclusively breastfed group and 1.39 (1.14 to 1.70) for the partially breastfed group. However, the associations became attenuated through the follow-up period and were no longer statistically significant beyond the age of 42 months for the partially breastfed group and beyond the age of 54 months for the exclusively breastfed group. Conclusions: We found an association between breast feeding for at least 6 or 7 months and elevated risk of dental caries at age 30 months. However, the association became attenuated as children grew older

Association of dietary fiber intake with subsequent fasting glucose levels and indicators of adiposity in school-age Japanese children

Abstract Objective: To evaluate the relationships of fiber intake with subsequent body mass index SD-score, waist-to-height ratio, and serum fasting glucose levels among school-age Japanese children. Design: A prospective study of school-age Japanese children. Participants were followed from 6–7 to 9–10 years of age (follow-up rate: 92.0%). Fiber intake was assessed using a validated food frequency questionnaire. Serum fasting glucose was measured by a hexokinase enzymatic method. Using a general linear model, the associations between dietary fiber intake at baseline and body mass index SD-score, waist-to-height ratio, and serum levels of fasting glucose at follow-up were evaluated after considering potential confounding factors. Setting: Public elementary schools in a city in Japan Participants: A total of 2,784 students. Results: The estimated means for fasting glucose at 9–10 years of age were 86.45, 85.68, 85.88, and 85.58 mg/dl in the lowest, second, third, and highest quartile of fiber intake at 6–7 years of age, respectively (p= 0.033, trend p= 0.018). Higher fiber intake at 6–7 years of age was associated with lower waist-to-height ratio at 9–10 years of age (trend p= 0.023). The change in fiber intake was inversely associated with concurrent change of body mass index SD-score (trend p= 0.044). Conclusion: These results suggest that dietary fiber intake may be potentially effective to limit excess weight gain and lower glucose levels during childhood

Personal characteristics associated with handwashing behaviour among Japanese university students studying abroad: Prospective observational studies

Background: Hand hygiene is recommended to travellers to prevent common travel-related illnesses such as diarrhoea and respiratory infection. For effective hygiene promotion interventions, we aimed to identify the personal characteristics associated with handwashing behaviour. Methods: Prospective observational studies consisting of pre- and post-travel surveys were conducted among Japanese university students studying abroad between 2016 and 2018 (n = 825; 6–38 travel days). Associations of age, sex, study major, and overseas travel experience with handwashing behaviour (5-point scale) were evaluated using ordinal logistic regression models, with adjustment for destination, travel duration, and psychological factors (risk perception of diarrhoea and concern about hygiene). Results: Among the participants in our analysis (n = 629), 28.0 % washed their hands before every meal while abroad. The male sex and no overseas travel experience were associated with decreased frequency of infrequent handwashing, even after adjusting for all potential confounding factors, whereas the study major was not associated. The adjusted odds ratios (95 % confidence intervals) were 0.74 (0.56–0.99) for men vs. women and 0.69 (0.52–0.93) for no overseas travel experience vs. overseas travel experience but not to the current destination. Conclusions: The lack of overseas travel experience correlated with handwashing frequency in both men and women. In addition to the travel destination, the male sex and no overseas travel experience should be highlighted in pretravel hand hygiene interventions

Prediction of Aspiration by Perceptual Evaluation of Pre-swallow Wet Voice and Wet Expiratory Sounds in Adults Diagnosed with Head and Neck Cancer

This study investigated the relationships between the perceptual evaluation of “wetness” of both pre-swallow voice and expiratory sound and video fluoroscopic swallowing study (VFSS) findings. Pre-swallow phonation of the vowel “a” and expiratory sounds were recorded immediately before VFSS in 51 patients with head and neck cancer. During VFSS, subjects were requested to swallow 3 ml of a jelly-like, radiopaque test food. A total of 61 samples of “a” phonations and expiratory sounds were investigated in this study. These sound samples were randomized and presented to 12 examiners with various years of experience in dysphagia management. The examiners perceptually evaluated the wetness of sound samples using a 5-point “wetness” grade. VFSS findings were evaluated using the 8-point penetration aspiration (PA) scale. The relationships between the wetness of sound samples and VFSS findings were analyzed. Penetration/aspiration without materials ejected out of the airway can be predicted by the wetness of sound samples. In this study, both the pre-swallow wet voice and wet expiratory sounds were suitable for predicting penetration/aspiration after swallowing. High inter-rater and intra-rater reliabilities were verified in the high – and low-experience examiners, with no significant difference evident between these groups. These findings suggest that clinicians could predict penetration/aspiration in head and neck cancer patients by perceptually evaluating the wetness of pre-swallow voice and expiratory sounds regardless of clinical experience

Association of maternal age with child health: A Japanese longitudinal study

Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children’s health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554). We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children’s unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers 40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health

Blockage of retinoic acid signaling via RARγ suppressed the proliferation of pancreatic cancer cells by arresting the cell cycle progression of the G1-S phase

Abstract Background Our study and several studies have reported that in some cancers, including pancreatic ductal adenocarcinoma (PDAC), the expression of squamous lineage markers, such as esophagus-tissue-specific genes, correlated with a poor prognosis. However, the mechanism by which the acquisition of squamous lineage phenotypes leads to a poor prognosis remains unclear. We previously reported that retinoic acid signaling via retinoic acid receptor γ (RARγ signaling) determines the differentiation lineage into the esophageal squamous epithelium. These findings hypothesized that the activation of RARγ signaling contributed to acquiring squamous lineage phenotypes and malignant behavior in PDAC. Methods This study utilized public databases and immunostaining of surgical specimens to examine RARγ expression in PDAC. We evaluated the function of RARγ signaling by inhibitors and siRNA knockdown using a PDAC cell line and patient-derived PDAC organoids. The mechanism of the tumor-suppressive effects by blocking RARγ signaling was examined by a cell cycle analysis, apoptosis assays, RNA sequencing and Western blotting. Results RARγ expression in pancreatic intraepithelial neoplasia (PanIN) and PDAC was higher than that in the normal pancreatic duct. Its expression correlated with a poor patient prognosis in PDAC. In PDAC cell lines, blockade of RARγ signaling suppressed cell proliferation by inducing cell cycle arrest in the G1 phase without causing apoptosis. We demonstrated that blocking RARγ signaling upregulated p21 and p27 and downregulated many cell cycle genes, including cyclin-dependent kinase 2 (CDK2), CDK4 and CDK6. Furthermore, using patient-derived PDAC organoids, we confirmed the tumor-suppressive effect of RARγ inhibition and indicated the synergistic effects of RARγ inhibition with gemcitabine. Conclusions This study clarified the function of RARγ signaling in PDAC progression and demonstrated the tumor-suppressive effect of selective blockade of RARγ signaling against PDAC. These results suggest that RARγ signaling might be a new therapeutic target for PDAC