High hepatitis C virus cure rates with approved interferon-free direct-acting antivirals among diverse mainland Chinese patients including genotypes 3a and 3b.

BACKGROUND AND AIM: Globally, China has the highest chronic hepatitis C (CHC) burden, but its real-world direct-acting antiviral (DAA) data are limited. Our aim is to investigate the real-world outcome of China Food and Drug Administration-approved DAA therapies across mainland China including those with genotype (GT) 3. METHODS: The REAL-C is a multinational real-world interferon-free DAA-treated CHC registry of several mainland China and other Asian centers. We evaluated the sustained virological response rate 12 weeks after end of treatment (SVR12), adverse events, and treatment effect on liver function and fibrosis (fibrosis-4 index). RESULTS: We analyzed 859 DAA-treated CHC patients (6/1/2017-5/30/2019) from 12 mainland China centers (three municipalities and nine provinces): median age 52, 49.9% male, 33.1% cirrhosis, 95% treatment naïve, and 2.5% HBsAg+ . The most common GT was GT1b (523, 62.2%), followed by GT2a (156, 18.5%), GT3b (74, 8.8%), GT3a (41, 4.9%), and GT6 (37, 4.4%). SVR12 rates were 98.0% overall (95% confidence interval 96.9-98.8%), 98.1% for GT1b, 96.8% GT2a, 100% GT3a, 97.3% GT3b, and 100% GT6. Baseline cirrhosis and male sex but not prior treatment history, renal dysfunction, age, and GTs were associated with SVR12. For both cirrhotic and non-cirrhotic patients, there were significant improvement in liver function tests, alpha fetoprotein, and fibrosis-4 index with SVR12. Serious adverse events were rare (1.1%) with only nine patients discontinuing therapy prematurely and anemia being the most common adverse event (13.1%, mostly with ribavirin). CONCLUSIONS: In real-world Chinese patients with diverse GTs, Chinese Food and Drug Administration-approved interferon-free DAAs were well tolerated, provided high cure rates (98.0% overall) including GT3a/3b, and led to improvement of liver function.

Does the Association between Guardians' Sense of Coherence and their Children's Untreated Caries Differ According to Socioeconomic Status?

Untreated caries is the most prevalent disease in the world. A sense of coherence (SOC) is believed to contribute to oral health. We aimed to clarify the association between guardians' SOC and their children's caries based on socioeconomic status (SES) in Japan. This study's subjects were Japanese public junior high schoolers (N = 1730), aged 12-15, and their guardians in Kosai City. We administered a questionnaire survey among guardians in 2016 to assess their SOC and family environment. With their students' consent, public junior high schools shared the results of the dental examinations that were part of their school physicals. Multivariate logistic regression was conducted to clarify the association between guardians' SOC and their children's untreated decayed permanent teeth. We also conducted a stratified analysis according to a relative poverty line. We observed in the multivariate regression a significant inverse association between children's untreated decay and their guardians' SOC (OR 0.93, 95%CI 0.87-1.00). The association of SOC was stronger in the low economic group (OR 0.64, 95%CI 0.43-0.95). Guardians with higher SOC were associated with children having fewer caries. Guardians' SOC is a factor for the prevalence of caries and access to dental care, especially among children with low economic status.

Association between the time perspective and type of involvement in bullying among adolescents: A cross-sectional study in Japan.

AIM: To examine the association between the types of involvement in bullying and the time perspective among Japanese adolescents. METHODS: A questionnaire was conducted among Japanese junior high school students at eight public schools that were located in two cities in Shizuoka Prefecture, Japan. Shirai's Experiential Time Perspective Scale was used, which comprises four subscales: goal-directedness, hopefulness, self-fulfillment, and acceptance of the past. An analysis of covariance was applied, with the time-perspective subscales as the objective variable, type of involvement in bullying as a fixed factor, and grade, family structure, and economic status as the covariates. RESULTS: The analysis sample included 2630 adolescents (valid response rate: 88.6%). The bullying rate of the boys was 10.8% and 4.1% for the girls, for the male victims it was 10.1% and 14.5% for the female victims, and for both the bully and the victim, it was 8.5% and 5.4%, respectively. The students who were not involved in bullying had the highest scores of hopefulness, self-fulfillment, and acceptance of the past. For both sexes, bullying was significantly associated with hopefulness, self-fulfillment, and acceptance of the past. Goal-directedness was not associated with the type of involvement in bullying. CONCLUSIONS: The victims of bullying had low time perspectives of hopefulness, self-fulfillment, and acceptance of the past. Providing support that increases hopefulness, self-fulfillment, and acceptance of the past might help to prevent pessimistic decision-making, such as that seen in cases of suicide.

Teachers' support and depression among Japanese adolescents: a multilevel analysis.

PURPOSE: Depression is a major cause of suicide among adolescents. Therefore, childhood and adolescent depression is an important public health concern. This study explored factors as class and individual levels that may influence depression among adolescents in Japan. METHODS: A questionnaire survey among junior high school students (N = 2968) from two cities in Japan was conducted. Depression was assessed using the Depression Self-Rating Scale for Children; teachers' support was assessed using the Scale of Expectancy for Social Support. The class average score of teachers' support was calculated to indicate what we termed the "homeroom teachers' support." Multilevel analysis was applied to clarify the relation between homeroom teachers' support and depression. RESULTS: Finally, 2466 students completed the questionnaire without missing variables (valid response rate, 83.1%). There was no random effect of the teachers' support at the class level on depression, although there was a significant association between teachers' support and depression for 9th graders (ß = -0.12, p = 0.009). Moreover, there were significant associations between economic status, having a best friend, and experiencing unforgettable stress at the individual level and depression in all grades. CONCLUSIONS: There was no significant random effect of homeroom teachers' support in class level although there might be marginal negative association between teacher's support and depression. It is suggested that homeroom teachers need to promote population approaches to mental health.

Association between economic status and body mass index among adolescents: a community-based cross-sectional study in Japan.

BACKGROUND: Childhood overweight and obesity is a growing health challenge in Japan and might be associated with childhood poverty. We aimed to investigate the association between low economic status and body mass index (BMI) and to reveal the mediators of this association among junior high school students in Japan. METHODS: Junior high school students (N = 2968) from two cities in Shizuoka, Japan, were surveyed. Questionnaires assessed subjective economic status, weight, and height. Economic status was categorized into low and non-low, and BMI z-scores were calculated using the WHO Growth Reference. Multivariate regression analyses were conducted to determine the association between economic status and BMI z-scores, adjusted for covariates and stratified by gender. RESULTS: Among girls, low economic status was significantly positively associated with BMI z-scores in the crude model (coefficient: 0.35; p = 0.001). In a model adjusted for breakfast skipping, the coefficient of economic status decreased by 28.57 % but remained significant (coefficient: 0.25; p = 0.017). In the final model adjusted for other possible covariates, low economic status remained significantly positively associated with BMI z-score (coefficient: 0.22; p = 0.044). The same association was not found for boys. CONCLUSIONS: Low economic status was positively associated with higher BMI among girls in junior high school in Japan, but this was not true for boys. Childhood poverty might be associated with overweight and obesity among adolescent girls in Japan. Health policies at junior high schools to discourage breakfast skipping might be effective for countering the association between childhood poverty and overweight in adolescent girls.

Class Average Score for Teacher Support and Relief of Depression in Adolescents: A Population Study in Japan.

BACKGROUND: Factors contributing to the relief of depression among adolescents have not been sufficiently revealed. The aim of this study was to assess the effect of teacher support on depression in adolescent students. METHODS: We conducted a self-rating questionnaire survey among 2862 junior high school students and 93 homeroom teachers in Japan. We employed binary logistic regression models, with teacher support averaged for each class as an explanatory variable and depression as an objective variable. To examine the interaction terms of class average score for teacher support by economic status, by student sex, and by grade satisfaction were estimated. RESULTS: Higher class average scores for teacher support were independently associated with lower levels of depression among adolescents (odds ratio [OR], 0.739; 95% confidence interval [CI], 0.575-0.948). Furthermore, the interaction of class average scores for teacher support with grade satisfaction was significant (p = .025). The interaction of class average score for teacher support with economic status and with student sex was not significant. CONCLUSIONS: Our findings suggest that higher class average scores for teacher support were significantly associated with lower depression. These results can help homeroom teachers enhance interventions and promote the health of their homeroom students.

The inhibitors of cyclin-dependent kinases and GSK-3ß enhance osteoclastogenesis.

Osteoclasts are multinucleated cells with bone resorption activity that is crucial for bone remodeling. RANK-RANKL (receptor activator of nuclear factor κB ligand) signaling has been shown as a main signal pathway for osteoclast differentiation. However, the molecular mechanism and the factors regulating osteoclastogenesis remain to be fully understood. In this study, we performed a chemical genetic screen, and identified a Cdks/GSK-3ß (cyclin-dependent kinases/glycogen synthase kinase 3ß) inhibitor, kenpaullone, and two Cdks inhibitors, olomoucine and roscovitine, all of which significantly enhance osteoclastogenesis of RAW264.7 cells by upregulating NFATc1 (nuclear factor of activated T cells, cytoplasmic 1) levels. We also determined that the all three compounds increase the number of osteoclast differentiated from murine bone marrow cells. Furthermore, the three inhibitors, especially kenpaullone, promoted maturation of cathepsin K, suggesting that the resorption activity of the resultant osteoclasts is also activated. Our findings indicate that inhibition of GSK-3ß and/or Cdks enhance osteoclastogenesis by modulating the RANK-RANKL signaling pathway.

Physical and psychological effects of 6-week tactile massage on elderly patients with severe dementia.

Tactile massage is a soft massage that improves physical relaxation and psychological well-being. The purpose of this study was to clarify the effects of a 6-week tactile massage on changes in physical and mental function, symptoms of behavioral and psychological symptoms of dementia (BPSD) among elderly patients with dementia. In addition, chromogranin A (CgA) levels as an index of stress examined the effects of tactile massage intervention. A tactile massage group consisting of elderly patients with dementia received tactile massage therapy a total of 30 times each for about 20 minutes between 16:00 and 17:00 hours. In the control group, the mean scores for ''intellectual'' and ''emotional function'' score decreased significantly after 6 weeks (P < .05); however, no change was observed in the tactile massage group. Both the ''aggressiveness'' score (P < .05) and CgA levels decreased significantly after 6 weeks in the tactile massage group. These results suggest that tactile massage reduces aggressiveness and stress level in patients with dementia.