Prevalence of congenital cytomegalovirus infection according to the type of maternal infection in Japan.

INTRODUCTION: Variable rates of cytomegalovirus (CMV) seropositivity in mothers from different individual's background may translate to distinct epidemiological patterns of congenital CMV infection. METHODS: The prospective cohort study was conducted in Japan to evaluate the prevalence of vertical transmission rate according to the type of maternal infection. Post hoc power as a follow-up analysis was evaluated to compare the statistical power with other studies from France, Finland and Brazil. One thousand one hundred sixty-three pregnant women were measured IgG, IgM and IgG avidity index. The urine samples of neonates of these women were evaluated using polymerase chain reaction to diagnose the vertical transmission. RESULTS: The prevalence of congenital CMV infection in the study population was 0.4%. The proportions of patients with primary and nonprimary infections were 60% and 40%, respectively, with a maternal seroprevalence of 82.5%. The rate of vertical transmission among the seronegative pregnant women before pregnancy was statistically higher than that among the seropositive pregnant women before pregnancy (p < 0.05), with a study power of 52.7%. The same difference was observed in France and Finland for maternal seroprevalence of 61% and 72% and statistical power of 56.9% and 66.7%, respectively. CONCLUSION: The maternal seroprevalence of the present study conducted in Japan was much higher than that of studies in France and Finland. Nevertheless, seronegative pregnant women had a higher risk of vertical transmission before pregnancy.

Effect of total hip arthroplasty on improving locomotive syndrome in hip disease patients: A prospective cohort study focused on total clinical decision limits stage 3.

BACKGROUND: In 2020, the Japanese Orthopaedic Association established a new stage 3 in clinical decision limits (CDL) to evaluate the stage of locomotive syndrome (LS). This study focused on total CDL stage 3 with the aim of investigating indicators related to improvements in total CDL by evaluating the improvement of LS in patients who underwent total hip arthroplasty (THA). METHODS: Of the 125 patients who underwent THA at our hospital, the subjects of the analysis were 105 patients determined to be total CDL stage 3 in an evaluation performed before THA. LS was evaluated using the stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale (GLFS-25). Indicators related to improvements in total CDL were also investigated. All evaluation items were measured before THA and three months after THA. RESULTS: Before THA, all subjects (n = 105) were classified as total CDL stage 3. Three months after THA, improvements in total CDL were seen in 49 subjects (46.7%). The results of stepwise multiple logistic regression analysis showed that the before THA stand-up test and GLFS-25 were significantly related to improvements in total CDL. CONCLUSIONS: Three months after THA, improvements in LS were seen in approximately half of the subjects. The stand-up test and GLFS-25 can be used as indicators of improvement in total CDL. DESIGN: Prospective cohort study design.

Serological and molecular survey of tick-borne zoonotic pathogens including severe fever with thrombocytopenia syndrome virus in wild boars in Miyazaki Prefecture, Japan.

BACKGROUND: Miyazaki Prefecture is one of the hotspots of severe fever with thrombocytopenia syndrome (SFTS) cases and related deaths in Japan since 2013 and other pathogens of tick-borne diseases (TBDs). Japanese spotted fever and scrub typhus are also endemic in this region. OBJECTIVES: A total of 105 wild boars, hunted in 2009, were serologically examined as sentinels for TBDs to indirectly demonstrate the potential hazard of ticks transmitting pathogens to humans in the studied area. METHODS: The collected blood and spleens of the wild boars underwent serological and molecular tests for SFTSV, Rickettsia japonica (Rj) [antibody to spotted fever group rickettsiae (SFGR) were tested by using species-common antigen], and Orientia tsutsugamushi (Ot). RESULTS: Seroprevalences of SFTSV, SFGR, and Ot were 41.9%, 29.5%, and 33.3%, respectively. SFTS viral RNA was identified in 7.6% of the sera, whereas DNA of Rj or Ot was not detected in any sample. In total, 43.8% of the boars possessed an infection history with SFTSV (viral gene and/or antibody). Of these, 23.8% had multiple-infection history with SFGR and/or Ot. CONCLUSIONS: The high prevalence of SFTSV in wild boars might reflect the high risk of exposure to the virus in the studied areas. In addition, SFTSV infection was significantly correlated with Ot infection, and so were SFGR infection and Ot infection, indicating that these pathogens have common factors for infection or transmission. These data caution of the higher risk of SFTSV infection in areas with reported cases of other TBDs.

Total Knee Arthroplasty Improved Locomotive Syndrome in Knee Osteoarthritis Patients: A Prospective Cohort Study Focused on Total Clinical Decision Limits Stage 3.

PURPOSE: The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. METHODS: This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. RESULTS: Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. CONCLUSIONS: As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

Differences in levels of rubella hemagglutination inhibition antibody titers according to birth cohort.

INTRODUCTION: This study aimed to examine the immunity level against rubella in pregnant women of different birth cohorts. METHODS: In total, 512 pregnant women who visited a primary clinic between May 2019 and March 2020 were enrolled. Information in terms of the patients' hemagglutination inhibition (HI) titers, birthdate, obstetrical history, and vaccination history were collected. Participants were divided into three generational groups according to the vaccination policy in Japan. Publicly funded vaccination was administered twice as part of a routine program in group A (n = 11), once as part of a routine program and once in a catch-up program in group B (n = 181), and once in group C (n = 320). RESULTS: All groups had some women with negative rubella HI antibody titers (7.6% of all the women, 18.2% of group A, 9.4% of group B, and 6.3% of group C) and those with rubella HI antibody titers of ≤1:16 (45.1% of all women, 90.9% of group A, 56.4% of group B, and 37.2% of group C). Rubella HI antibody titers differed between the groups; group C had higher titers than that in group B. In groups B and C, the proportions of women with rubella HI antibody titers of ≤1:16 were not statistically different between primipara and multipara. CONCLUSIONS: Our study showed that an increase in immunity to rubella, a vaccine-preventable disease, is nevertheless required among childbearing women to prevent rubella and congenital rubella syndrome.

Compact integrated optical sensors and electromagnetic actuators for vibration isolation systems in the gravitational-wave detector KAGRA.

This paper reports on the design and characteristics of a compact module integrating an optical displacement sensor and an electromagnetic actuator for use with vibration-isolation systems installed in KAGRA, the 3-km baseline gravitational-wave detector in Japan. In the technical concept, the module belongs to a family tree of similar modules used in other interferometric gravitational-wave detector projects. After the initial test run of KAGRA in 2016, the sensor part, which is a type of slot sensor, was modified by increasing the spacing of the slot from 5 mm to 15 mm to avoid the risk of mechanical interference with the sensor flag. We confirm that the sensor performance is comparable to that of the previous design despite the modification. We also confirm that the sensor noise is consistent with the theoretical noise budget. The noise level is 0.5 nm/Hz1/2 at 1 Hz and 0.1 nm/Hz1/2 at 10 Hz, and the linear range of the sensor is 0.7 mm or more. We measured the response of the actuator to be 1 N/A and also measured the resistances and inductances of coils of the actuators to confirm consistency with theory. Coupling coefficients among the different degrees of freedom were also measured and shown to be negligible, varying little between designs. A potential concern about thermal noise contribution due to eddy current loss is discussed. As of 2020, 42 of the modules are in operation at the site.

A multiple regression model for predicting a high cytomegalovirus immunoglobulin G avidity level in pregnant women with IgM positivity.

OBJECTIVE: To establish a model to predict high cytomegalovirus (CMV) immunoglobulin (Ig)G avidity index (AI) using clinical information, to contribute to the mental health of CMV-IgM positive pregnant women. METHODS: We studied 371 women with IgM positivity at ≤14 w of gestation. Information on the age, parity, occupation, clinical signs, IgM and G values, and IgG AI was collected. The IgG AI cut-off value for diagnosing congenital infection was calculated based on a receiver operating characteristic curve analysis. Between-group differences were assessed using the Mann-Whitney U-test or χ2 analysis. The factors predicting a high IgG AI were determined using multiple logistic regression. RESULTS: The women were divided into high or low IgG AI groups based on an IgG AI cut-off value of 31.75. There were significant differences in the IgG and IgM levels, age, clinical signs, and the number of women with one parity between the two groups. In a multiple logistic regression analysis, IgM and the number of women with one parity were independent predictors. This result helped us establish a mathematical model that correctly classified the IgG AI level for 84.6% of women. CONCLUSION: We established a highly effective model for predicting a high IgG AI immediately after demonstrating IgM positivity.

Meteorological factors affecting the risk of transmission of HPAI in Miyazaki, Japan.

Highly pathogenic avian influenza (HPAI) outbreaks engender a severe economic impact on the poultry industry and public health. Migratory waterfowl are considered the natural hosts of HPAI virus, and HPAI viruses are known to be transmitted over long distances during seasonal bird migration. Bird migration is greatly affected by the weather. Many studies have shown the relationship between either autumn or spring bird migration and climate. However, few studies have shown the relationship between annual bird migration and annual weather. This study aimed to establish a model for the number of migratory waterfowl involved in HPAI virus transmission based on meteorological data. From 136 species of waterfowl that were observed at Futatsudate in Miyazaki, Japan, from 2008 to 2016, we selected potential high-risk species that could introduce the HPAI virus into Miyazaki and defined them as 'risky birds'. We also performed cluster analysis to select meteorological factors. We then analysed the meteorological data and the total number of risky birds using a generalised linear mixed model. We selected 10 species as risky birds: Mallard (Anas platyrhynchos), Northern pintail (Anas acuta), Eurasian wigeon (Anas penelope), Eurasian teal (Anas crecca), Common pochard (Aythya ferina), Eurasian coot (Fulica atra), Northern shoveler (Anas clypeata), Common shelduck (Tadorna tadorna), Tufted duck (Aythya fuligula) and Herring gull (Larus argentatus). We succeeded in clustering 35 meteorological factors into four clusters and identified three meteorological factors associated with their migration: (1) the average daily maximum temperature; (2) the mean value of global solar radiation and (3) the maximum daily precipitation. We thus demonstrated the relationship between the number of risky birds and meteorological data. The dynamics of migratory waterfowl was relevant to the risk of an HPAI outbreak, and our data could contribute to cost and time savings in strengthening preventive measures against epidemics.

Lifestyle-related signs of locomotive syndrome in the general Japanese population: A cross-sectional study.

BACKGROUND: This study aimed to estimate the prevalence of locomotive syndrome (LS) risk in age groups using the LS risk test proposed by the Japanese Orthopaedic Association. Based on this, this study identified the lifestyle-related signs that lead to LS, by clarifying the association between LS risk and lifestyle factors. METHODS: A total of 728 individuals aged 20-91 years who were without specific mobility disorders were evaluated. Participants were asked to perform the LS risk test and complete a self-administered original questionnaire survey for this study. The Mann-Whitney U test was used to examine the relationships of sex and age with LS. The prevalence of LS by sex and age was compared using the Chi-squared test or Student's t-test, as appropriate. The Mantel-Haenszel test was used to examine the relationship of each component of the lifestyle factors. RESULTS: Overall, 36.4% of males and 49.1% of females were classified into the LS group; the prevalence of LS was significantly higher in females than males (p < .001). The prevalence of LS tended to increase with age in both males and females (p < .05). As for health condition, pain in the locomotive organs, knees, back, and hip joints was significantly associated with LS (p < .05). Of the lifestyle-related diseases, only hypertension (p < .05) was significantly associated with LS, and drug treatment was significantly associated with LS (p < .05). As for lifestyle, anxiety about physical fitness, self-assessed poor health, irregular dietary habits, and lack of exercise were also associated with LS (p < .05). CONCLUSIONS: Interventions to prevent LS are important during its early stages, especially for females, and lifestyle-related signs of LS, such as pain in the locomotive organs, lifestyle-related disease, drug treatment, and a lower subjective evaluation of health must not be overlooked.

Relationship between social capital and happiness in a Japanese community: A cross-sectional study.

The influence of social capital on happiness is attracting attention around the world. Many studies that investigated the relationship between social capital and happiness suggest that happiness correlates to a positive social environment. The aim of this study was to examine the relationship between social capital and happiness in a community with the lowest National Health Insurance expenditures in Miyazaki Prefecture (Japan). This cross-sectional study targeted 2730 residents in the community aged 40-75 years who were covered by National Health Insurance in 2015. A self-administered questionnaire consisting of questions focusing on demographic characteristics, happiness, and social capital was sent to the residents, and 1106 of them (40.5%) returned the questionnaires by the deadline. The analysis of responses indicated a positive relationship between social capital and happiness with regard to all three factors of social capital (trust, connections and interaction, and social participation). Evaluating the relationship between social capital and health in terms of happiness is important to creating a lively society in which citizens support one another, in addition to promoting physical and mental well-being.

Characterization of the room temperature payload prototype for the cryogenic interferometric gravitational wave detector KAGRA.

KAGRA is a cryogenic interferometric gravitational wave detector currently under construction in the Kamioka mine in Japan. Besides the cryogenic test masses, KAGRA will also rely on room temperature optics which will hang at the bottom of vibration isolation chains. The payload of each chain comprises an optic, a system to align it, and an active feedback system to damp the resonant motion of the suspension itself. This article describes the performance of a payload prototype that was assembled and tested in vacuum at the TAMA300 site at the NAOJ in Mitaka, Tokyo. We describe the mechanical components of the payload prototype and their functionality. A description of the active components of the feedback system and their capabilities is also given. The performance of the active system is illustrated by measuring the quality factors of some of the resonances of the suspension. Finally, the alignment capabilities offered by the payload are reported.

[Two cases of intravascular lymphoma diagnosed by random liver biopsy].

The pathogenesis of intravascular lymphoma (IVL) remains inadequately understood. Furthermore, its prognosis remains extremely poor despite combination chemotherapy. Lymphoma cells and hemophagocytosing cells are commonly observed in the livers of IVL patients and less frequently in the bone marrow. We recently encountered an 83-year-old female and a 78-year-old female with IVL, both of whom presented with fever of unknown origin. Following examination, we decided to perform random liver biopsy for diagnostic purposes. The former patient died because of rapid tumor growth, while the latter achieved remission following treatment with a modified R-VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone, and bleomycin plus rituximab) regimen. Considering the possibility of IVL is important when examining a patient presenting with fever of unknown origin. This report demonstrates that random liver biopsy represents a useful diagnostic strategy, particularly in patients with elevated liver enzyme levels.

A pilot study of a simple screening technique for estimation of salivary flow.

OBJECTIVES: The purpose of this study was to develop a simple screening technique for estimation of salivary flow and to test the usefulness of the method for determining decreased salivary flow. STUDY DESIGN: A novel assay system comprising 3 spots containing 30 microg starch and 49.6 microg potassium iodide per spot on filter paper and a coloring reagent, based on the color reaction of iodine-starch and theory of paper chromatography, was designed. We investigated the relationship between resting whole salivary rates and the number of colored spots on the filter produced by 41 hospitalized subjects. RESULTS: A significant negative correlation was observed between the number of colored spots and the resting salivary flow rate (n = 41; r = -0.803; P < .01). For all complaints of decreased salivary flow (n = 9) having cutoff values <100 microL/min for the salivary flow rate, 3 colored spots appeared on the paper, whereas for healthy subjects there was < or =1 colored spot. CONCLUSION: This novel assay system might be effective for estimation of salivary flow not only in healthy but also in bedridden and disabled elderly people.

Health-related quality of life and beneficiaries of long-term care insurance in Japan.

OBJECTIVES: A long-term care insurance (LTCI) system was introduced in 2000 in Japan. The clarification of information on the users and the ways in which services under this system have been utilized is essential for improving the system operation. This study was conducted for the purpose of clarifying what level of health-related quality of life (HRQOL) was achieved by individuals using the services under the LTCI system. METHODS: The subjects were inhabitants of two cities in the Kyushu district of Japan who were receiving daily home care services under the LTCI system. To analyze the relationships of the beneficiaries' HRQOL with their characteristics, the dependent variable was the EuroQol-5D (EQ-5D) scores adopted as an index of HRQOL, and the independent variables comprised the demographic features (gender, age, and living condition) of users receiving long-term care service as well as their opinions about fees for services, satisfaction with the services provided, and the degree of support/care required. RESULTS: The EQ-5D score was higher for females than for males and higher for the subjects living alone than for those displaying any other family composition. EQ-5D score decreased with an increase in the degree of support/care required. Multivariate analysis revealed that the degree of support/care required, gender and living condition were found to serve as variables that significantly contribute to utility. CONCLUSIONS: Our analysis of the relationships between the characteristics of the LTCI beneficiaries and their HRQOL has yielded basic data that will be useful for improving the recently introduced LTCI system.

[Mental health status and effects on daily life of patients of a large outbreak of Legionnaires Disease].

OBJECTIVES: The aim of this study was to survey mental health status among patients of a large outbreak of Legionnaires Disease (LD) occurring at a public bath in Hyuga City, Miyazaki Prefecture, from June through July, 2002. It also aimed to provide a basis for establishing a mental health care support system for persons suffering from ill health. METHODS: Some 295 patients were reported by medical institutions to public health centers as being infected with LD or having suspected infection after using a hot springs bath, where hygiene was assumed to be maintained by regular water circulation, from 6/20 through 7/23, 2002 in Hyuga City, Miyazaki Prefecture. A total of 153 subjects consented to interviews after being informed of the objectives. They were visited and interviewed with a questionnaire from 10/12 through 12/5, 2002. Questions about mental health were written to identify "feeling stressed", based on diagnostic criteria for Post Traumatic Stress Disorder (PTSD) as noted in the DSM-IV. The Japanese version of the General Health Questionnaire (GHQ28) was used to identify high risk subjects for mental disorder, as well as the following four symptoms: "somatic symptoms", "anxiety and insomnia", "social dysfunction", and "severe depression". Factors associated with these were assessed with regard to knowledge and/or information about LD and its effects on daily life. RESULTS: Regarding mental health, 27 (17.6%) were "feeling stressed". High risk patients for mental disorder numbered 39 (25.5%) according to the GHQ28. Patients with "somatic symptoms" numbered 44 (28.8%), those with "anxiety and insomnia" 21 (13.7%), those with "social dysfunction" 18 (11.8%) and with "severe depression" 5 (3.3%). Among the effects on daily life, "changes of human relationships" was related with "feeling stressed" in those suspected of LD infections (P = 0.022). High risk was related to "economic support" (P = 0.009) in LD, and also to "cause and survey" (P = 0.035) in those cases suspected of LD. CONCLUSIONS: At 3 to 4 months after the outbreak, the patients still exhibited mental health problems. Therefore we should provide health and social support that deals with the factors identified on a longer-term or continuous basis.