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This study aims at increasing earthquake preparedness knowledge perception and practice among Nepalese immigrants residing in Japan through an educational intervention. A single arm quasi experimental study was conducted among Nepalese immigrants residing in Japan. An educational intervention was prepared along with a 52 itemed questionnaire. In total, 165 participants responded to our questionnaire. Majority of them were male (67.88%), and the mean age was 32.78 years. Generalized equation model showed that the knowledge score of earthquake preparedness was 4.01 points higher immediately after the intervention [95% CI (2.78–5.24), p-value < 0.001] compared to baseline with a further increase by 7.02 points [95% CI (5.96–8.09), p-value < 0.001] at two weeks follow up. However, the practice score increased only by 2.83 points [95% CI (2.51–3.14), p-value < 0.001] immediately after the intervention with a similar increase at two weeks and 12 weeks follow up period [OR: 2.62, 95% CI (2.29–2.96), p-value < 0.001]. The educational intervention, when conducted in native language, can increase both the knowledge and practice score of earthquake preparedness hence, information related to earthquake preparedness in Nepali languages in the government websites of Japan could potentially increase information seeking behavior of people.

Background Natural disasters have increased during the last several decades all over the world. Due to its geographical and climate conditions, Japan has long been vulnerable to several natural disasters. Coping with disasters is a major challenge overall and even harder for foreigners residing in Japan. Thus, the objective of this study was to examine the perceived knowledge, attitude, practice and perceived barriers of disaster preparedness among Nepalese immigrants in Japan. Methods A cross-sectional study was conducted among Nepalese immigrants residing in Japan with an online survey questionnaire. The questionnaire was validated and then administered. The participants were recruited via Facebook for this survey. Bivariable and multivariable logistic regression analyses were conducted to examine the factors associated with the perceived knowledge, attitude and practice of Nepalese immigrants regarding disaster preparedness. Results A total of 404 respondents were analyzed in this study and among them two-third were male. We found that the mean score of disaster preparedness practice was lowest than the knowledge and attitude (mean ± S D = 15.86 ± 5.52) as evidenced by the majority of the participants not being prepared for disaster situations and a limited proportion had ever taken necessary natural disaster preparedness measures. Japanese language was identified as the major barrier in assessing the knowledge, attitude and practice regarding disaster preparedness and was significantly associated with the knowledge level of disaster preparedness after adjusting for some socio-demographic covariates. (aOR: 1.84, 95% CI: (1.04 – 3.25)). Conclusions This study observed that the perceived knowledge and practices regarding natural disasters are very poor while barriers to access these are substantial among Nepalese immigrants in Japan. As Japanese language was identified as a major barrier, the availability of language translation services in every health care sector also in the government offices of Japan might encourage people to learn more about disaster preparedness.

There is current debate regarding whether body weight variability is associated with cardiovascular events. Recently, high body fat percentage (BF%) has been shown to be a cardiovascular risk factor. We therefore hypothesized that BF% variability would present a stronger cardiovascular risk than body weight variability. A single-center retrospective cohort study of medical check-up examinees aged 20 years or older at baseline (2005) was performed. Examinees were followed in 2007, 2009, and 2013-2014. BF% variability in 2005, 2007 and 2009 was calculated as the root-mean square error (RMSE) using a simple linear regression model. Multiple logistic regression models estimated the association between BF%-RMSE and new diagnoses of cardiovascular risk factors occurring between the 2009 and 2013-2014 visits. In total, 11,281 participants (mean age: 51.3 years old, 48.8% were male) were included in this study. The average BF%-RMSE of our subjects was 0.63, and the average BMI-RMSE was 0.24. The high BF%-RMSE group (76-100th percentile) had a higher incidence of hypertension and a lower incidence of diabetes mellitus than the low BF%-RMSE group (1-25th percentile). This tendency was particularly evident in male participants. BMI-RMSE was not associated with any cardiovascular risks in our study. This study indicates that body fat variability has contrasting effects on cardiovascular risk factors, while body weight variability has no significant effects.

Objective: To demonstrate the utility of somatosensory evoked potentials (SEPs) following median nerve stimulation for chronological assessment of sensory function in patients with subacute stroke during rehabilitation. Design: Retrospective study. Patients: Forty‐seven patients with hemiparesis due to stroke during the subacute phase. Methods: We screened 363 patients who underwent SEP measurements at a rehabilitation hospital. Among them, 47 who underwent SEP measurements within 1 week after admission and at least 2 weeks after the initial assessment were included in this study. Sensorimotor assessments, including the Semmes−Weinstein monofilament test (SWMT), pain sensation, position sensation, two‐point discrimination, and Stroke Impairment Assessment Set (SIAS) motor tests simultaneously with SEP measurements were available for 20 of the 47 patients. The relationship between the SEP peak count and each sensorimotor assessment was examined. Results: SEP amplitudes and latencies showed no significant differences between the initial and second assessments (paired t ‐test, p > 0.05). However, the counts of SEP peaks after NI (N20) increased (Wilcoxon signed‐rank test, p < 0.05), indicating changes in the SEP waveform. Furthermore, strong correlations were observed between SEP peak counts, stage, and all functional assessments (counts and SWMT, RS = −0.77, p < 0.001; counts and pain sensation, RS = −0.71, p < 0.001; counts and position sensation, RS = 0.75, p < 0.001; counts and two‐point discrimination, RS = −0.74, p < 0.001; stage and SWMT, RS = −0.74, p < 0.001; stage and pain sensation, RS = −0.69, p < 0.001; stage and position sensation, RS = 0.74, p < 0.001; and stage and two‐point discrimination, RS = −0.75, p < 0.001; all Spearman’s rank correlation coefficients). Conclusion: Despite the limitations of the retrospective study design, our study highlights the utility of SEPs for evaluating sensory function in patients with subacute stroke, setting the foundation for further investigations on the use of SEPs to assess functional changes in patients with subacute stroke undergoing rehabilitation.

Water at interfaces plays crucial roles in various natural phenomena and in the material sciences. Therefore, understanding the structure and hydrogen-bonding network at such interfaces is essential. Recent advances in porous crystalline materials, combined with single-crystal X-ray diffraction techniques, have enabled the visualization of molecular structures on pore surfaces at atomic resolution. Herein, we report the formation of a supramolecular porous crystal composed of a resorcin[4]arene and a rigid cationic coordination complex, stabilized by hydrogen bonds and noncovalent interactions. This specific arrangement creates a porous framework with anisotropic, information-rich surfaces, accommodating water molecules to form multi-layered water channels. The analysis reveals clustering motifs and hydrogen-bonding patterns in the water molecules at interfaces, supported by molecular dynamics simulations and spectroscopy studies. These findings advance our understanding of the structure–property relationship of water at interfaces in low-entropy crystalline materials, offering insights into their behavior on complex surfaces. Water at interfaces plays crucial roles in various natural phenomena and in material sciences. Here, the authors report the formation of a supramolecular crystal forming a porous framework with anisotropic, information-rich surfaces, accommodating water molecules to form multi-layered water channels.

The aim of this study was to evaluate the association between the frequency of daily tooth brushing and the development of any type of malignancy. We conducted a retrospective longitudinal study, including all adult participants who underwent health check-ups. Primary outcome was the development of any type of malignancy, compared to the frequency of daily tooth brushing, adjusting for potential confounders. A total of 71,449 participants were included and 5,025 participants developed a certain type of malignancy. Not brushing everyday (Odds Ratio (OR)=1.52, 95% Confidence Interval (CI)=1.03-2.25) and brushing once a day (OR=1.25, 95%CI=1.16-1.35) had significantly higher ORs for the outcome than brushing after every meal, although those who brushed once to twice a day had significantly lower OR (OR=0.78, 95%CI=0.72-0.83). As the frequency of daily tooth brushing increased, except for brushing after every meal, the development of all types of malignancies decreased.

The objectives of this study were two-fold: 1) to investigate differences in activity duration and amplitude of the submental muscles during swallowing measured with surface electromyography (sEMG) in older patients with sarcopenic dysphagia compared to those without dysphagia and 2) to examine the diagnostic accuracy of submental sEMG signals for sarcopenic dysphagia. Patients (n = 60) aged ≥65 years participated in this cross-sectional study. The submental muscle activity duration parameters were the duration from the onset of swallowing to the maximum amplitude (duration A), duration from the maximum amplitude to the end of the swallowing activity (duration B), and total duration. The amplitude parameters were mean and maximum amplitude. Maximum lingual pressures were also measured for comparison with sEMG parameters. Duration A was not significantly different between the groups (p = 0.15), but duration B (p < 0.001) and total duration (p < 0.001) were significantly different between the non-dysphagic and sarcopenic dysphagic groups. The mean (p = 0.014) and maximum (p < 0.001) amplitudes were significantly different between the groups. The area under the receiver operating characteristic curve (AUC) was 0.94 (95% confidence interval (CI) 0.87-0.98) for duration B, 0.95 (95% CI 0.89-0.99) for total duration, 0.76 (95% CI 0.63-0.87) for maximum amplitude, and 0.61 (95% CI 0.47-0.75) for mean amplitude. The AUC of the total duration was significantly greater than that of lingual pressure (p = 0.02). Patients with sarcopenic dysphagia had longer submental muscle activity duration and higher amplitude during swallowing as assessed using sEMG. The findings of this study can be useful in elucidating the underlying pathophysiology of sarcopenic dysphagia and in diagnosing sarcopenic dysphagia.

Few data are available on the intensity of pain that women experience during the first five days after vaginal childbirth. Moreover, it is unknown if the use of neuraxial labor analgesia has any impact on the level of postpartum pain. We performed a retrospective cohort study based on chart review of all women who delivered vaginally at an urban teaching hospital between April 2017 and April 2019. The primary outcome was the area under the curve of pain score on numeric rating scale (NRS) documented in electronic medical records for five days postpartum (NRS-AUC5days). Secondary outcomes included peak NRS score, doses of oral and intravenous analgesics consumed during the first five days postpartum, and relevant obstetric outcomes. Logistic regression was used to examine the associations between the use of neuraxial labor analgesia and pain-related outcomes adjusting for potential confounders. During the study period, 778 women (38.6%) underwent vaginal delivery with neuraxial analgesia and 1240 women (61.4%) delivered without neuraxial analgesia. Median (Interquartile range) of NRS-AUC5days was 0.17 (0.12-0.24) among women who received neuraxial analgesia and 0.13 (0.08-0.19) among women who did not (p<0.001). Women who received neuraxial analgesia were more likely to require the first- and second-line analgesics postpartum than women who did not: diclofenac (87.9% vs. 73.0%, p< 0.001, respectively); acetaminophen (40.7% vs. 21.0%, p< 0.001, respectively). The use of neuraxial labor analgesia was independently associated with increased odds of having NRS-AUC5days in the highest 20 percentile (adjusted odds ratio [aOR] 2.03; 95% confidence interval [CI] 1.55-2.65), having peak NRS ≥ 4 (aOR 1.54; 95% CI 1.25-1.91) and developing hemorrhoids during the postpartum hospitalization (aOR 2.13; 95% CI 1.41-3.21) after adjusting for relevant confounders. Although women who used neuraxial labor analgesia had slightly higher pain scores and increased analgesic requirement during postpartum hospitalization, pain after vaginal childbirth was overall mild. The small elevation in the pain burden in neuraxial group does not seem to be clinically relevant and should not influence women's choice to receive labor analgesia.

Background The evaluation of breast density is important, because dense breast has been shown to be associated with increased risk of breast cancer and a greater risk of a false-negative diagnostic performance due to masking a tumor. Although the relationship between parity and dense breast is under investigation, conclusive evidence is lacking. We aimed to investigate whether parity affects breast density. Methods The study design is a cross-sectional study. The subjects are healthy Japanese women who underwent opportunistic mammographic screening at the center for preventive medicine at a single institution from January 2016 to December 2018. Clinical characteristics and lifestyle factors were obtained from questionnaires. Breast density was categorized into 4 groups, namely, almost entirely fatty dense, scattered fibroglandular dense, heterogeneously dense, and extremely dense, according to the Breast Imaging Reporting and Data System. Heterogeneously and extremely dense were considered collectively as dense breast. Multivariate logistic regression analysis was conducted to investigate the relationship between parity and dense breast among premenopausal and postmenopausal women separately. Results 7612 premenopausal and 9252 postmenopausal women were investigated. Dense breast was shown in 62.6% of nulliparity, 57.3% of single parity, 47.3% of two parity, 37.6% of more than two parity among premenopausal women, and in 41.6% of nulliparity, 31.1% of single parity, 19.3% of two parity, 10.1% of more than two parity among postmenopausal women. For premenopausal women, two parity, single parity and nulliparity showed a higher risk for dense breast with statistically significance (Odds Ratio (OR) adjusted for potential confounding factors: 1.458 (95% Confidence interval (CI); 1.123–1.894), 2.349 (95%CI; 1.801–3.064), 3.222 (95%CI; 2.500–4.151), respectively), compared with more than two parity. For postmenopausal women, two parity, single parity and nulliparity had a higher risk (OR: 1.849 (95%CI; 1.479–2.312), 3.023 (95%CI; 2.385–3.830), 4.954 (95%CI; 3.975–6.174), respectively) with statistically significance, compared with more than two parity. Conclusions Parity showed an inverse trend of having dense breast among both premenopausal and postmenopausal women. In particular, nulliparous women need to recognize their higher risk of dense breast. In the future, the declining fertility rate may affect the prevalence of dense breast in the world.

ObjectivesTo examine the relationship between health literacy and multimorbidity.DesignNationwide cross-sectional study.SettingCommunity settings across Japan.ParticipantsCommunity-dwelling participants aged 20 years or older were selected based on a quota sampling method that adjusted for age, sex and residential area. In total, 3678 participants from the Health Diary Study, with a mean age of 52.3 years (SD, 18.2 years; 1943 (52.8%) female participants), were included.Primary outcome measureMultimorbidity, the primary outcome measure, was defined as the presence of two or more chronic diseases.ResultsOf the 3678 participants, 824 (22.4%) had multimorbidity. The mean functional health literacy (FHL) and communicative and critical health literacy (CCHL) scores were 3.2 (SD, 0.7) and 3.6 (SD, 0.9), respectively. In the univariable analysis, both scores were associated with multimorbidity (p<0.001). However, in the multivariable modified Poisson regression analysis, only the FHL score was significantly associated with multimorbidity (per 1-point increase, 0.91; 95% CI 0.84 to 0.99).ConclusionsAfter adjusting for confounding variables, FHL, not CCHL, was significantly related to the presence of multimorbidity. Further longitudinal studies are required to examine the causal relationship between health literacy and multimorbidity.