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Obesity during development has been reported to be a determinant factor in the future development of non-communicable diseases (NCDs). Parental obesity is suggested to be a predictor of children’s obesity, and it is important to consider parental factors to prevent NCDs in the progeny. Previously, we showed that paternal height had a stronger association with infant birth weight than paternal body mass index (BMI) in the Japanese population. However, only a few studies have examined the association between paternal physique and postnatal obesity. This study aimed to investigate the association between parental physique and obesity in children at the age of 3. This study used fixed data on 33,291 parent–child pairs from the Japan Environment and Children’s Study, an ongoing national birth cohort study. The association between paternal physique (BMI and height) and children’s obesity at the age of 3 was examined using multivariate logistic regression analysis. The higher the paternal BMI quartiles, the higher the odds ratio for obesity in male and female children at 3 years of age (P < 0.0001). However, paternal height quartiles were not associated with male or female obesity. These results differ from the association between paternal physique and infant birth weight, and it is possible that prenatal epigenetic and environmental factors of paternal origin were responsible for the differences between these two studies. The association between paternal BMI and obesity in children at the age of 3 suggests that paternal factors may be involved in the development of NCDs in future progeny.
Fontan-associated liver disease leads to liver cirrhosis and hepatocellular carcinoma, worsening patient prognosis. Although the Model of End-Stage Liver Disease Excluding International Normalized Ratio score correlates with disease severity, precise prediction methods remain elusive. The hepatic computed tomography (CT) attenuation is used to assess steatohepatitis, which may offer insight into disease progression. This study aimed to determine the usefulness of hepatic CT attenuation values in assessing Fontan-associated liver disease progression. All post-Fontan patients with >20 years’ follow-up data between 1980 and 2021 were reviewed. We set five regions of interest with a 20-mm-diameter circle in the peripheral region of the liver to obtain minimum, maximum, mean, and standard deviation of the CT attenuation values, which were adjusted to those of the aorta. The impact of hepatic CT attenuation values on cirrhosis development was evaluated. Cox regression revealed significant associations between adjusted minimum (hazard ratio: 0.01 [0.00–0.02, p < 0.01), adjusted maximum (hazard ratio: 159 [4.34–5831, p < 0.01]), and standard deviation (hazard ratio: 1.89 [1.29–2.76, p < 0.01]) and Model of End-Stage Liver Disease Excluding International Normalized Ratio score (hazard ratio: 1.2 [1.02–1.43, p = 0.03]) with cirrhosis. In cirrhosis cases, the adjusted minimum value exhibited significant longitudinal alteration prior to cirrhosis (p < 0.01), whereas Model of End-Stage Liver Disease Excluding International Normalized Ratio scores remained stable. The hepatic CT attenuation values were associated with cirrhosis development and the longitudinal changes are more sensitive than the Model of End-Stage Liver Disease Excluding International Normalized Ratio score.
Although small fish are an important source of micronutrients, the relationship between their intake and mortality remains unclear. This study aimed to clarify the association between intake of small fish and all-cause and cause-specific mortality.
Design:
We used the data from a cohort study in Japan. The frequency of the intake of small fish was assessed using a validated FFQ. The hazard ratio (HR) and 95 % confidence interval (CI) for all-cause and cause-specific mortality according to the frequency of the intake of small fish by sex were estimated using a Cox proportional hazard model with adjustments for covariates.
Setting:
The Japan Multi-Institutional Collaborative Cohort Study.
Participants:
A total of 80 802 participants (34 555 males and 46 247 females), aged 35–69 years.
Results:
During a mean follow-up of 9·0 years, we identified 2482 deaths including 1495 cancer-related deaths. The intake of small fish was statistically significantly and inversely associated with the risk of all-cause and cancer mortality in females. The multivariable-adjusted HR (95 % CI) in females for all-cause mortality according to the intake were 0·68 (0·55, 0·85) for intakes 1–3 times/month, 0·72 (0·57, 0·90) for 1–2 times/week and 0·69 (0·54, 0·88) for ≥ 3 times/week, compared with the rare intake. The corresponding HR (95 % CI) in females for cancer mortality were 0·72 (0·54, 0·96), 0·71 (0·53, 0·96) and 0·64 (0·46, 0·89), respectively. No statistically significant association was observed in males.
Conclusions:
Intake of small fish may reduce the risk of all-cause and cancer mortality in Japanese females.
The continuous conversion of smectite to illite in samples from the Shinzan hydrothermal alteration area of Japan has been examined by X-ray powder diffraction (XRD) and transmission (TEM) and analytical transmission electron microscopy (AEM). TEM shows that randomly interstratified illite/ smectite (I/S) containing 100-50% expandable layers exhibits a flakey shape, whereas regularly and partially ordered interstratified I/S having 50-0% expandable layers exhibits a lath-like habit. An early- formed lath of regularly interstratified I/S is typically <35 Å in thickness and 300–500 Å in width; these dimensions gradually increase with decreasing percentage of expandable layers. XRD shows that the lathshaped I/S has a 1M polytype mica structure. AEM shows that the interlayer K content of flakey I/S increases monotonously with decreasing percentage of expandable layers in the range 100-50% expandable layers, whereas the interlayer K content of lath-shaped I/S increases along a different trend from that for the flakey I/S in the range 50-0% expandable layers. These observations suggest that randomly interstratified I/S is fundamentally smectite that is undergoing K-fixation and dissolution and that regularly and partially ordered interstratified I/S are immature illite which is still growing. Consequently, they suggest a mechanism for the hydrothermal smectite-to-illite conversion that is based on the K-fixation in and dissolution of smectite and the precipitation and growth of thin illite particles. Furthermore, these data suggest that the kinetics of smectite dissolution and illite growth are the most important factors controlling the smectite-to-illite conversion.
The structures of 11 smectites and 2 interstratified mica/smectites containing mainly Ca2+ and Na+ as exchangeable cations in variable ratio were studied under a relative humidity of about 40%. Observed X-ray powder diffraction patterns were compared with diagrams calculated from interstratification models containing 15.2-Å Ca-smectite layers (C), 12.4-Å Na-smectite layers (N), and 10.0-Å mica layers (M) in various combinations. The smectites appear to be a random interstratification of component layers C and N, and display a tendency towards segregation. One of the interstratified minerals studied is a regular interstratification of C and M layers; the other is a regular interstratification of C, N, and M layers, in which N and C layers are randomly distributed in equal proportion and show a tendency towards segregation.
Structure, morphology, and chemical composition of illite/smectite (I/S) containing 30–50% smectite layers (% S) from Kinnekulle bentonites, Sweden, of diagenetic origin were examined using X-ray powder diffraction (XRD) and transmission electron microscopy (TEM). Interlayer arrangements of I/S changed from random interstratification to short-range ordered at about 40% S. The transition from random to ordered structure proceeded continuously as reflected by the gradual decrease in probability of two smectite neighbors (Pss) towards zero. TEM observations of water-dispersed samples that had not been cation-exchanged showed that the I/S consisted dominantly of flakes coexisting with laths having a length/width ratio of about 4, regardless of % S. The thickness of the I/S particles ranged from 30 to 100 Å, and no systematic variation in thickness was detected with decreasing % S. The chemical composition of the I/S also changed continuously with decreasing % S. These observations suggest no dissolution of smectite layers and no recrystallization of illite layers during the formation of the I/S in these bentonites; rather, cationic substitutions occurred within a smectite precursor (termed a solid-state transformation mechanism). A comparison of interlayer order, particle texture, and chemistry of the I/S from various types of rocks suggests that the mechanism of smectite-to-illite conversion in the range 100% S-30% S was related to the porosity and permeability of original rocks. The solid-state transformation mechanism appears to have predominated in rocks of low porosity and permeability.
X-ray powder diffraction (XRD) patterns for many interstratified mica/glycolated smectites were calculated by changing combinations of probabilities and transition probabilities of two-component layers. Three basal XRD reflections, 5. l°–7.6°2θ (p1), 8.9°–10.2°2θ (p2), and 16.1°–17.2°2θ (p3) were selected for the quantification curves. A distinct relationship exists between Δ2θ, (p2–p1) and Δ2θ2 (p3–p2) which shows systematic changes with expandability at constant Reichweite values. The calculated values were plotted with Δ2θ1 and Δ2θ2 as the axes of coordinates, and quantification curves were calculated. The components and stacking parameters of mica/smectites were estimated easily using this diagram. Probabilities of existence of component layers and their transition probabilities for Reichweite (R=0) and (R=l) structures, and special cases of R=2 and R=3 structures were obtained.
The changes in amount and location of layer charge during diagenetic alteration have been investigated for smectites and smectite layers of illite/smectite interstratified minerals (I/S) by X-ray powder diffraction analysis with various expansion behavior tests: 1) ethylene glycol (EG) solvation (XRD); 2) K-saturation and EG solvation; 3) Li-saturation, heating at 250 °C and glycerol or EG solvation (Greene-Kelly test); and 4) alkylammonium saturation. In the course of low-temperature diagenesis but before the onset of illitization, mean layer charge of smectites continuously increases from approximately 0.56 to 0.73 per O20(OH)4 with increasing depth, and tetrahedral charge also increases continuously from approximately 0.21 to 0.38 per O20(OH)4 (beidellitization). The continuous increase in tetrahedral charge without change in peak intensity and shape suggests that the solid-state Al for Si substitution mechanism appears to predominate within beidellitization. After illitization, the content of the beidellitic layers continuously decreases, while the mean layer charge of expandable layers and the content of illite layers in I/S increase. This suggests that the conversion of a beidellitic layer to an illitic layer preferably occurs during early illitization. Thus, before illitization, beidellite-like layers are formed from precursor smectite, and during the early stage of illitization, the high charged beidellitic layers are probably consumed to form illite layers.
Hydration behavior of Na-smectite crystals synthesized at a pressure of 5.5 GPa and temperatures of 1400°–1500°C was examined by X-ray powder diffraction at various relative humidities (RH) in the range of 0–100%. The basal spacing of the Na-smectite crystal increased stepwise with increase in RH. The reflections observed were only normal reflections of a single or dual hydration states of smectite. No irrational, intermediate, or asymmetrical reflections were observed. The simple hydration behavior, not known for natural smectite with fine particle sizes and low crystallinity, indicates that the Na-smectite crystals are as perfect as common inorganic crystals with an ordered structure.
Expansion properties often homoionic smectites that differed in amount and location of layer charge were examined by X-ray powder diffraction analysis at various relative humidities, or after glycerol or ethylene glycol solvations. Except for K-samples with glycerol solvation, and Na- and Ca-samples with ethylene glycol, differences in the basal spacings are observed in samples having similar layer charge. These results show that the basal spacings are larger when the layer charge is located in octahedral sites than when it is in tetrahedral sites. This suggests that expansion is due to the combined effects of the charge location and amount.
The effects of layer charge magnitude and location on expansion were represented by an energy change (expansion energy: ΔEr) during the hydration and solvation processes. Plots of basal spacings versus ΔEr show a reasonable relationship; the spacings generally decrease stepwise as the value of ΔEr increases. The basal spacings of K-samples with glycerol solvation, Na-saturated and K-saturated samples at 100% RH are apt to contract stepwise with increasing value of ΔEr. For these samples, the figures showing the relationship between each expanded phase and the charge characteristics are obtained from the isoquants of ΔEr, given the boundary of the expanded phases. A behavior test using these figures may be combined with the Greene-Kelly test to estimate the amount and the location of the layer charge of common smectites.
The purpose of this report is to describe the appropriate use of indices relating to crystallinity, such as the ‘crystallinity index’, the ‘Hinckley index’, the ‘Kübler index’, and the ‘Árkai index’. A ‘crystalline’ solid is defined as a solid consisting of atoms, ions or molecules packed together in a periodic arrangement. A ‘crystallinity index’ is purported to be a measure of crystallinity, although there is uncertainty about what this means (see below). This report discusses briefly the nature of order, disorder and crystallinity in phyllosilicates and discusses why the use of a ‘crystallinity index’ should be avoided. If possible, it is suggested that indices be referred to using the name of the author who originally described the parameter, e.g. ‘Hinckley index’ or ‘Kübler index’, or in honor of a researcher who investigated the importance of the parameter extensively, e.g. ‘Árkai index’.
Clinical practice guidelines for schizophrenia and major depressive disorder have been published. However, these have not had sufficient penetration in clinical settings. We developed the Effectiveness of Guidelines for Dissemination and Education in Psychiatric Treatment (EGUIDE) project as a dissemination and education programme for psychiatrists.
Aims
The aim of this study is to assess the effectiveness of the EGUIDE project on the subjective clinical behaviour of psychiatrists in accordance with clinical practice guidelines before and 1 and 2 years after participation in the programmes.
Method
A total of 607 psychiatrists participated in this study during October 2016 and March 2019. They attended both 1-day educational programmes based on the clinical practice guidelines for schizophrenia and major depressive disorder, and answered web questionnaires about their clinical behaviours before and 1 and 2 years after attending the programmes. We evaluated the changes in clinical behaviours in accordance with the clinical practice guidelines between before and 2 years after the programme.
Results
All of the scores for clinical behaviours in accordance with clinical practice guidelines were significantly improved after 1 and 2 years compared with before attending the programmes. There were no significant changes in any of the scores between 1 and 2 years after attending.
Conclusions
All clinical behaviours in accordance with clinical practice guidelines improved after attending the EGUIDE programme, and were maintained for at least 2 years. The EGUIDE project could contribute to improved guideline-based clinical behaviour among psychiatrists.
To determine whether carbapenem consumption and Pseudomonas aeruginosa resistance rates can be used as benchmarks to compare and improve antimicrobial stewardship programs across multiple pediatric hospitals.
Design:
A prospective study.
Setting and participants:
Healthcare institutions in Japan with >100 pediatric beds.
Methods:
An annual survey of the total days of therapy (DOT) per 1,000 patient days for carbapenem antibiotics (meropenem, imipenem-cilastatin, panipenem-betamipron, doripenem) and susceptibility rates of Pseudomonas aeruginosa to meropenem and imipenem-cilastatin from each institution was conducted over a 7-year period. Data were reported to the administration, as well as to the infection control team, of each institution annually.
Results:
Data were obtained from 32 facilities. The median total carbapenem DOT per 1,000 patient days was 16.6 and varied widely, with a range of 2.7 to 59.0. The median susceptibility to meropenem was 86.6%, ranging from 78.6% to 96.6%. We detected an inverse correlation between total carbapenem DOT versus susceptibility (r = – 0.36; P < .01). Over the 7-year period, the DOT per 1,000 patient days of carbapenem decreased by 27% from a median of 16.0 to 11.7 (P < .01). We also observed an improvement in susceptibility to meropenem from a median of 87% to 89.7% (P = .01) and to imipenem-cilastatin from 79% to 85% (P < .01). The decreases in the use of carbapenem were greater in institutions with antimicrobial stewardship programs led by pediatric infectious disease specialists.
Conclusions:
Antimicrobial use and resistance, targeting carbapenems and P. aeruginosa, respectively, can serve as benchmarks that can be utilized to promote antimicrobial stewardship across pediatric healthcare institutions.
The torrential rain triggering massive flooding and hundreds of landslides was the worst weather disaster in Western Japan. A temporary pharmacy was established in the Kurashiki health center, which provided medicine to victims.
Aim:
To evaluate the supply status of prescription under the health insurance system during a disaster.
Methods:
When the enormous disaster occurred, victims get a prescription in the hospital or community pharmacy under the Disaster Relief Act or Health Insurance Act. Under the Disaster Relief Act, prescriptions that are given at a first aid station are able to be filled at the mobile pharmacies at no cost to the patient from the local government. Prescriptions that are issued by a medical institution, and are in accordance with the Health Insurance Act or National Health Insurance Act, can be dispensed at hospitals or community pharmacies. Patients may be exempt from the co-payment by being covered by their health insurance. Here, we investigated the supply status of prescription to affected people.
Results:
The good points of the supply status were as following: 1) dispensing out of disaster area was a good system to relieve a pharmacist2. ) J-SPEED was also a good reporting system to provide appropriative medicine inventory management, and 3) sending prescription using a mobile phone was very useful for pharmaceutical activities. On the other hand, the points for improvement were as following: 1) more time to learn the medical insurance system during the disaster was needed, and 2) the mobile pharmacy is better to make the rounds of shelters including health care consultation.
Discussion:
In case of a disaster, two different medicine supply systems cause confusion to medical relief teams. It is considered that collaboration relief activities with relief teams that included a pharmacist was very important.
Various herbivorous invertebrates in seagrass beds are considered to be generalists in food use and their diets may temporally fluctuate according to the availability of food sources. We assessed whether food sources of herbivorous gastropods vary in a subtropical seagrass bed in Nagura Bay, Ishigaki Island, where coexisting seaweeds grow densely in spring but minimally in summer. Abundant gastropods and their possible food sources were collected in spring and summer of 2013 and 2015, and their stable carbon and nitrogen isotope ratios were measured. Between the two seasons, each possible food source had similar isotopic values, but all the herbivorous gastropod species in summer were more enriched in 13C than the gastropod samples in spring. The mixing models in SIAR (Stable Isotope Analysis in R) showed that the total contribution rates of seaweeds, i.e. rhodophytes, phaeophytes and chlorophytes, for all herbivorous gastropod species decreased from spring to summer; in contrast, the contribution rate of seagrasses increased. Linear Mixed Models showed that the seasonal variation in δ13C of the herbivorous gastropods was larger than that of the possible food sources, adding further evidence to the seasonal change in food sources of the herbivorous gastropods. This seasonal change in food use appears to correspond to the change in seaweed biomass, suggesting that herbivorous gastropods flexibly change their diets depending on food availability.
Hyperbolic polariton modes are highly appealing for a broad range of applications in nanophotonics, including surfaced enhanced sensing, sub-diffractional imaging, and reconfigurable metasurfaces. Here we show that attenuated total reflectance (ATR) micro-spectroscopy using standard spectroscopic tools can launch hyperbolic polaritons in a Kretschmann–Raether configuration. We measure multiple hyperbolic and dielectric modes within the naturally hyperbolic material hexagonal boron nitride as a function of different isotopic enrichments and flake thickness. This overcomes the technical challenges of measurement approaches based on nanostructuring, or scattering scanning near-field optical microscopy. Ultimately, our ATR approach allows us to compare the optical properties of small-scale materials prepared by different techniques systematically.
To investigate molecular composition of low-metallicity environments, we conducted spectral line survey observations in the 3 mm band toward three dwarf galaxies, the Large Magellanic Cloud, IC 10, and NGC 6822 with the Mopra 22 m, the Nobeyama 45 m and the IRAM 30 m, respectively. The rotational transitions of CCH, HCN, HCO+, HNC, CS, SO, 13CO, and 12CO were detected in all three galaxies. We found that the spectral intensity patterns are similar to one another regardless of star formation activities. Compared with Solar-metallicity environments, the molecular compositions of dwarf galaxies are characterized by (1) deficient nitrogen-bearing molecules and (2) enhanced CCH and suppressed CH3OH. These are interpreted (1) as a direct consequence of the lower elemental abundance of nitrogen, and (2) as a consequence of extended photon dominated regions in cloud peripheries due to the lower abundance of dust grains, respectively.
We have previously shown that the C-terminal region of the intermediate subunit of Entamoeba histolytica galactose- and N-acetyl-D-galactosamine-inhibitable lectin (C-Igl) is a useful antigen for serodiagnosis of amebiasis. An immunochromatographic kit was developed using fluorescent silica nanoparticles coated with C-Igl prepared in Escherichia coli. Samples for examination were added to the freeze-dried particles and then applied to the immunochromatographic device, in which a test line on the membrane was also coated with C-Igl. Fluorescent intensity was measured using a hand-held reader. In an evaluation of the kit using a human monoclonal antibody, the minimum amount of C-Igl specific antibody showing positive results was 100 pg. In the evaluation of serum samples with different antibody titers in indirect immunofluorescent antibody tests in the kit, 20 µL of serum was sufficient to obtain positive results at 30 min. Serum samples from symptomatic patients with amebic colitis and amebic liver abscess and those from asymptomatic E. histolytica-cyst carriers showed positive results in the kit. Based on evaluation using sera from healthy controls and patients with other infectious diseases, the sensitivity and specificity of the kit were 100 and 97.6%, respectively. Therefore, we conclude that the newly developed kit is useful for rapid serodiagnosis of amebiasis.