Static and Dynamic Impacts of Internet Use on Self-Rated Health among Adults in China: A Hybrid Model Analysis Based on National Panel Survey Data.

The widespread use of the Internet has a substantial impact on people's livelihoods, including health-related factors. Whether this impact is beneficial or harmful to people's health remains unclear. Some cross-sectional studies found static differences in the health status between Internet users and nonusers, whereas panel data studies found dynamic changes in an individuals' health over time, making the issue, including its causality, controversial. Therefore, we aimed to clarify the association between the use of the Internet and people's health from both static and dynamic aspects. Data were obtained for 46,460 adults from the China Family Panel Studies in 2014, 2016, and 2018. The analysis applied a logistic regression hybrid model with self-rated health as the dependent variable and Internet use as the main independent variable. In the hybrid model, time-varying independent variables were decomposed into between-individual (static) differences and within-individual (dynamic) changes over time. The results indicated that the between-individual coefficient of Internet use was significantly positive, but the within-individual coefficient was not, i.e., Internet users felt healthier than nonusers from the static aspect but starting to use the Internet did not increase the self-rated health from the dynamic aspect. These findings suggest that attention is needed in order to not confuse the static differences with dynamic change regarding the causality between Internet use and self-rated health.

Inequality and Mother's Age as Determinants of Breastfeeding Continuation in Bangladesh.

The World Health Organization recommends continuing breastfeeding up to 2 years of age or beyond for sound growth and development of children. In Bangladesh, continuation rates for breastfeeding have recently decreased and effective measures are required to counter this downward trend. Although recent years have seen economic development and reductions in poverty, Bangladesh still has the highest rate of child marriage worldwide. Thus, we aimed to clarify the factors influencing breastfeeding continuation, especially from the perspective of inequality and mother's age in Bangladesh, using data from the Bangladesh Demographic and Health Survey 2011. Event history analyses were performed during a 24-month follow-up period on 7,041 mothers with duration of breastfeeding as the outcome variable, with wealth index (an indicator for inequality) and mother's age used as the main explanatory variables. The results showed that poorer mothers were on the whole more likely to continue breastfeeding through 24 months after childbirth, and younger mothers were less likely to continue breastfeeding particularly past the first year. However, both younger and older mothers continued breastfeeding to the same extent within the first year after childbirth. Mother's age had time-varying effects on breastfeeding continuation, meaning that the effects on breastfeeding continuation were affected by the child's age. These findings imply that policymakers should be aware that efforts to reduce child marriage may increase the rate of breastfeeding continuation beyond the first year after childbirth. In contrast, efforts at poverty alleviation, aimed at preventing child marriage, may decrease the rate irrespective of the child's age.

Gene expression analysis of Arc mRNA as a neuronal cell activity marker in the hippocampus and amygdala in two-way active avoidance test in rats.

INTRODUCTION: Immediate early genes are widely used as neuronal cell activity markers in neuroscience. The present study investigated the relationship between their expression and abnormality in context fear conditioning. METHODS: The learning test (two-way active avoidance test) was conducted in male rats administered with nonselective muscarinic antagonist scopolamine or selective dopamine D1-like receptor antagonist SCH 23390 at a dose level of 2.0 or 0.1mg/kg, respectively, for 4days. Expression levels of Arc and Fos mRNA in the hippocampus and amygdala were also evaluated on the second day of dosing by fluorescent in situ hybridization (FISH) and reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR). RESULTS: Scopolamine had no effect on avoidance rate, but decreased freezing in the two-way active avoidance test. SCH 23390 decreased avoidance rate and increased freezing. In FISH and RT-qPCR assays, scopolamine decreased Arc mRNA in the hippocampus and amygdala, whereas SCH 23390 increased Arc mRNA in the hippocampus. By contrast, scopolamine and SCH 23390 did not change Fos mRNA expression compared to Arc mRNA expression. DISCUSSION: The results of the learning test indicated that scopolamine or SCH 23390 respectively inhibited fear or context conditioning in rats. Furthermore, alteration of the expression of Arc mRNA but not of Fos mRNA in the hippocampus and amygdala of the brain was suggested to be a sensitive neuronal cell activity marker to detect behavioral abnormality in the two-way active avoidance test.

Localization of connexin 32 in spontaneous liver lesions of mice.

We examined the localization of connexin 32 (Cx32), a component of gap junctions, in 24-month-old male B6C3F1 mice with spontaneously occurring hepatocellular altered foci or tumors. Immunohistochemically, Cx32-staining intensity in cell-to-cell membranes of altered hepatocytes was decreased in eosinophilic foci and increased in basophilic foci as compared to those in intact hepatocytes. These alterations were enhanced in adenomas and carcinomas with both eosinophilic and basophilic cytoplasm. In cell membranes facing on the sinusoidal portions, the intensities increased in all lesions. Image analyses confirmed that the spot areas of Cx32 were decreased in eosinophilic foci, but increased in basophilic foci, adenomas and carcinomas. These results demonstrate that Cx32 shows different expression in different types of hepatic lesions.

Role of connexin 32 in acetaminophen toxicity in a knockout mice model.

Gap junctional intercellular communication (GJIC), by which glutathione (GSH) and inorganic ions are transmitted to neighboring cells, is recognized as being largely involved in toxic processes of chemicals. We examined acetaminophen (APAP)-induced hepatotoxicity clinicopathologically using male wild-type mice and mice lacking the gene for connexin32, a major gap junction protein in the liver [knockout (Cx32KO) mice]. When APAP was intraperitoneally administered at doses of 100, 200, or 300mg/kg, hepatic centrilobular necrosis with elevated plasma aminotransferase activities was observed in wild-type mice receiving 300mg/kg, and in Cx32KO mice given 100mg/kg or more. At 200mg/kg or more, hepatic GSH and GSSG contents decreased significantly and the effect was more severe in wild-type mice than in Cx32KO mice. On the other hand, markedly decreased GSH staining was observed in the hepatic centrilobular zones of Cx32KO mice compared to that of wild-type mice. These results demonstrate that Cx32KO mice are more susceptible to APAP hepatotoxicity than wild-type mice, and indicate that the distribution of GSH of the centrilobular zones in the hepatic lobules, rather than GSH and GSSG contents in the liver, is important in APAP hepatotoxicity. In conclusion, Cx32 protects against APAP-induced hepatic centrilobular necrosis in mice, which may be through the GSH transmission to neighboring hepatocytes by GJIC.

Effectiveness of health sector reforms in reducing disparities in utilization of skilled birth attendants in Tanzania.

Improving maternal health is a Millennium Development Goal adopted at the 2000 Millennium Summit of the United Nations. As part of the improving maternal health in Tanzania, it has been recommended that skilled birth attendants be present at all births to help reduce the high maternal mortality ratio. However, utilization of these attendants varies across socio-economic groups. The government of Tanzania has repeatedly attempted to carry out health sector reforms (HSRs) to alleviate disparities in health service utilization. In particular, around 1999, HSRs were incorporated into two approaches, including Decentralization by Devolution and Sector Wide Approach. This study aims to clarify the unresolved questions with little published evidence on the effect of HSRs on reducing disparities in utilization of skilled birth attendants across socio-economic groups over time. We used four cross-sectional datasets from the Tanzania Demographic and Health Survey: 1992, 1996, 1999, and 2004/05. Subjects included 14,752 women of reproductive age (15-49 years) and data on the most recent birth in the 5 years before each survey. Logistic regression analysis was performed with the dependent variable of whether respondents utilized skilled birth attendants or not, and with the main independent variables of time and socio-economic group. Results showed that the disparity in utilization of skilled birth attendants was significantly decreased from 1999 to 2004/05. These findings suggest that the two strategies, Decentralization by Devolution and Sector Wide Approach, in the process of HSRs are effective in reducing the disparities in utilization of skilled birth attendants among socio-economic groups.

Background lesions during a 24-month observation period in connexin 32-deficient mice.

Connexin 32 (Cx32) is a major gap junction protein in the liver. Neoplastic and non-neoplastic lesions were examined in Cx32-deficient (Cx32KO) mice maintained for 24-month, and compared with those in wild-type mice as a corresponding control. In neoplastic lesions, hepatocellular carcinoma increased significantly only in male Cx32KO mice, suggesting that Cx32 deficiency may be related to their pathogenesis. For females, the incidence of pituitary adenoma in the pars distalis of Cx32KO mice was lower than that of wild-type mice. No non-neoplastic lesions related to Cx32-deficiency were observed in the Cx32KO mice. In conclusion, these results demonstrate that the incidence of hepatocellular carcinoma increases only in male Cx32KO mice, presumably due to enhanced tumor promotion and progression signals associated with Cx32 deficiency.

The impact of Gonoshasthaya Kendra's Micro Health Insurance plan on antenatal care among poor women in rural Bangladesh.

Low utilization of antenatal care (ANC) by pregnant women, particularly in rural areas, is an obstacle to ensuring safe motherhood in Bangladesh. Currently, Micro Health Insurance (MHI) is being considered in many developing countries as a potential method for assuring greater access to health care, especially for the poor. So far, there is only limited evidence evaluating MHI schemes. This study assesses the impact of MHI administered by Gonoshasthaya Kendra (GK) on ANC utilization by poor women in rural Bangladesh. We conducted a questionnaire survey and collected 321 valid responses from women enrolled in GK's MHI scheme and 271 from women not enrolled in any health insurance plan. We used a two-part model in which dependent variables were whether or not women utilized ANC and the number of times ANC was used. The model consisted of logistic regression analysis and ordinary least squares regression analysis. The main independent variables were dummies for socioeconomic classes according to GK, each of which represented the premiums and co-payments charged by class. The results showed that destitute, ultra-poor, and poor women enrolled in MHI used ANC significantly more than women not enrolled in health insurance. Women enrolled in MHI, except for those who were destitute or ultra-poor, utilized ANC significantly more times than women not enrolled in health insurance. We assume that GK's sliding premium and co-payment scales are key to ANC utilization by women. Expanding the MHI scheme may enhance ANC utilization among poor women in rural Bangladesh.

New casemix classification as an alternative method for budget allocation in thai oral healthcare service: a pilot study.

This study aimed to develop a new casemix classification system as an alternative method for the budget allocation of oral healthcare service (OHCS). Initially, the International Statistical of Diseases and Related Health Problem, 10th revision, Thai Modification (ICD-10-TM) related to OHCS was used for developing the software "Grouper". This model was designed to allow the translation of dental procedures into eight-digit codes. Multiple regression analysis was used to analyze the relationship between the factors used for developing the model and the resource consumption. Furthermore, the coefficient of variance, reduction in variance, and relative weight (RW) were applied to test the validity. The results demonstrated that 1,624 OHCS classifications, according to the diagnoses and the procedures performed, showed high homogeneity within groups and heterogeneity between groups. Moreover, the RW of the OHCS could be used to predict and control the production costs. In conclusion, this new OHCS casemix classification has a potential use in a global decision making.

Relationship between GST Yp induction and hepatocyte proliferation in rats treated with phase II drug metabolizing enzyme inducers.

Butylated hydroxyanisole (BHA) and 1,2-bis(2-pyridyl)ethylene (2PY-e) are phase II drug metabolizing enzyme inducers which cause hepatomegaly without hepatocyte hypertrophy and induce glutathione S-transferase Yp (GST Yp, pi-class GST), which is known as a tumor marker. To evaluate the relationship between GST Yp induction and hepatocyte proliferation, male F344/DuCrj rats were treated with BHA, 2PY-e, or phenobarbital (PB) for three or seven days. All three chemicals caused increases in liver weight after three and seven days. Immunohistochemical examinations revealed that BHA and 2PY-e induced GST Yp in the hepatocytes of the periportal and centrilobular areas at three and seven days, respectively, whereas PB did not. Significant increases in the BrdU labeling indices were found in the livers of rats in each of the three-day treatment groups, but the labeling index of rat livers treated with BHA was decreased to the control level at seven days, although the high labeling indices of 2PY-e and PB persisted at seven days. Double immunostaining confirmed that BrdU-positive nuclei corresponded to GST Yp-positive hepatocytes in both BHA and 2PY-e treated rats. These results suggest that the GST Yp induction caused by BHA or 2PY-e has some kind of relationship with hepatocyte proliferation.

Relationships between behavioral risk factors and dental care costs in a Japanese worksite.

PURPOSE: To identify the magnitude of dental care costs and examine the relationship between behavioral risk factors and dental care costs in a Japanese corporation. DESIGN: A one-time cross-sectional design was used with each employee as a unit of analysis. SETTING: The setting was a large Japanese corporation where Japan's standard health care insurance, including dental care coverage, was provided for all employees. SUBJECTS: A full-time employee population of 6543 was included. Seventy-six percent were men, and the majority were white-collar workers. MEASURES: Data were available on dental care costs and self-reported behavioral dental care risk, including smoking and oral self-care, obtained from the company's annual physical checkups in the 2000 fiscal year Dichotomous variables of expenditures for employees having no dental claims and those having high claims defined as 90th percentile or above were created. RESULTS: The dental care costs made up approximately 24.3% of the health care costs. Thirty-five percent of the employees were smokers. Employees who were at least 40 years old and employees who were women were associated with the likelihood of using dental care services (odds ratio [OR] = 1.622 and 0.783, respectively), and no behavioral risk was associated. The likelihood of incurring high dental care costs was associated with smoking when including all employees in addition to those who used any dental care services (OR = 1.315 and 1.386, respectively). CONCLUSIONS: This study suggests the relationships of smoking as well as age and sex to dental care costs in an employer setting. To provide a strong case for health promotion in Japan, future research should address critical issues such as reliable and valid risk measurement and the use of longitudinal designs and intervention studies.

[Patients' survey on regular check-up system in dental clinics].

This survey classified the issues involved in promoting the regular check-up system in dental clinics. The survey was conducted in two parts: interviews with 39 dental clinics and a questionnaire survey of 5,129 patients (response rate: 56.8%). The results are summarized as follows: 1. Among the dental clinics that participated in this survey, the proportion of regular patients, the number of dental hygienists working at clinics, and the number of patients per day were higher than those of the national average. 2. The demographic patterns of regularly attending patients were "female, aged under 14 years and students or public servants". 3. Satisfaction with the technical competence of hygienists has the strongest correlation with regularity of visiting. The degree of correlation was about twice that of the correlation with technical competence of the dentist. 4. Patients' priorities for improving dental services to enhance satisfaction were treatment charges, appointment system, and attitude of staff and doctors toward welcoming the patients.

A novel model of continuous depletion of glutathione in mice treated with L-buthionine (S,R)-sulfoximine.

L-buthionine (S,R)-sulfoximine (BSO), an inhibitor of glutathione (GSH) synthesis, was administered to mice via drinking water for 14 days in order to establish an animal model with continuously depleted levels of GSH. No toxicity was observed at 20 mM BSO, even though a significant decrease in liver weight was observed at 30 mM BSO. GSH levels in the liver, kidney, brain, lung, heart, spleen, pancreas, small intestine, large intestine, skeletal muscle, plasma and blood cells from mice given 20 mM of BSO were all less than those from the control mice continuously throughout a 24-hr period. The ratios of the GSH levels to that of the control were 46.4% and 16.7% in the liver and kidney, respectively, suggesting a decrease in GSH conjugation activity in vivo by GSH depletion. Liver cytochrome P450 content and UDP-glucuronosyltransferase activity to p-nitrophenol were not influenced by the BSO dosing. To confirm the adequacy of this GSH-depletion model, 0.125 or 0.25% of acetaminophen (APAP) was administered via diet to this model for 14 days. Nine out of the ten mice given both 20 mM BSO and 0.25% APAP died on Day 2, and remarkable necrosis was observed in the hepatocytes and renal tubular epithelium. Moreover, focal necrosis of hepatocytes with proliferation of fibroblasts was observed on Day 15 in some mice coadministered 20 mM BSO and 0.125% APAP. However, no toxicity was observed in mice given APAP alone. Based on these results, a mouse given 20 mM of BSO via drinking water for 14 days was concluded to be an animal model with continuously depleted levels of GSH in various organs without toxicity. This model shows high susceptibility to toxicity induced by chemicals which are metabolized to electrophilic and reactive metabolite(s), such as APAP.