Dokkyo University (獨協大学, Dokkyō Daigaku) is a private university in Sōka, Saitama, Japan, which is a liberal, co-educational institution noted for its language education programs and international exchanges. The university was founded in 1964, its roots can be traced back as early as 1881. Undergraduate admissions are selective, with an admission rate ranging from 30–40%.
Adverse childhood experiences (ACEs) have been established as major risk factors for developing mental disorders across the lifespan. In contrast, positive childhood experiences (PCEs) have been shown to be associated with better mental health outcomes across different levels of ACE exposure. However, few studies have examined whether different types of PCEs—particularly family-based and community-based experiences—show distinct associations with adult mental health outcomes. This study aimed to examine whether family PCEs (FPCEs) and community PCEs (CPCEs) are independently associated with mental disorders in adulthood and whether these associations differ according to the level of ACE exposure. We conducted a cross-sectional analysis of 28,221 adults aged 18 years and older from the 2023 wave of the Japan COVID-19 and Society Internet Survey (JACSIS). Mental disorders were assessed using a self-reported checklist of physician-diagnosed conditions. Logistic regression models were used to evaluate associations between ACEs, FPCEs, CPCEs, and mental disorders, adjusting for sociodemographic covariates. Among individuals with no ACEs, experiencing 3 or 4 CPCEs was associated with lower odds of mental disorders (AOR = 0.59, 95
Purpose Fertility counseling before cancer treatment is crucial for reproductive-aged female patients with cancer. This study aimed to examine differences in fertility-related information provision across cancer type and hospital characteristics among reproductive-aged female patients with cancer. Methods Using data from a nationwide cancer patient experience survey, we analyzed female patients with cancer diagnosed at Stages 0 to III who were younger than 43 years at diagnosis. The primary outcome was the receipt of fertility-related information from physicians before cancer treatment. Factors associated with receiving fertility-related information were evaluated using multivariable logistic regression models, and adjusted predicted percentages were estimated. Results Of the 12,676 participants in the survey, 686 (5.4%) met the inclusion criteria. Overall, 64.2% received fertility-related information. Fertility-related information receipt was higher among patients with gynecologic cancers (83.7%) and breast cancer (72.4%), and lower among those with head and neck cancers (32.4%) and gastrointestinal cancers (24.6%). In the multivariable analysis, information receipt was associated with cancer type, not having co-living children, having a co-living partner, higher adolescent and young adult (AYA) patient volume, and designated cancer care hospitals. Among participants who needed information, information receipt was associated with cancer type, not having co-living children, stage I disease, and higher AYA patient volume. Conclusion Fertility-related information provision among female patients with cancer younger than 43 years varied by cancer type, patient demographic characteristics, and hospital characteristics. A care delivery system should ensure that fertility-related information is provided irrespective of these factors.
Text difficulty has traditionally been evaluated using objective indices such as readability measures. However, difficulty is also inherently subjective. In this study, we examined how second-language English readers’ subjective judgments of text difficulty were associated with established readability indices. We also explored their relationship with difficulty estimates derived from large language models (LLMs) as a further objective indicator. Additionally, we investigated how these subjective and objective difficulty measures related to eye-movement behavior during reading. The results indicated that subjective ratings were strongly correlated with objective difficulty measures. Bayesian multilevel models further indicated that the LLM-derived estimate and text-level mean subjective difficulty were associated with selected passage-level eye-movement measures, such as total reading time and skipping count. However, model comparisons showed that these text-level predictors provided only limited incremental improvement once participant- and text-level differences were modeled. The clearest incremental information came from reader-specific deviations in subjective difficulty. These findings suggest that objective and subjective difficulty measures are related but not interchangeable. Objective measures are useful for characterizing text-level difficulty, whereas reader-specific subjective ratings provide additional insight into how individual readers experience and process the same text.
In this study, we assessed patient experiences with cancer care in Japan as part of the national evaluation of the National Cancer Control Plan. We aimed to identify strengths and gaps in cancer care delivery across patient groups, including those with rare cancers and individuals aged < 40 years, to inform future policy development. We conducted a nationwide cross-sectional survey between December 2023 and March 2024 using a self-administered mail questionnaire. Eligible participants were selected from the national database of Hospital-Based Cancer Registries using a two-stage stratified random sampling method. Among the 32,716 individuals invited, 11,247 eligible responses were analyzed. Sampling weights were applied to ensure national representativeness. Outcomes included overall ratings of care, information provision, access to care, symptom burden, psychosocial support, and socioeconomic issues. Patients rated the care they received highly (mean score = 8.2/10); however, notable gaps were identified. Only 55.0
Abstract Rationale Responses to biologic therapies in severe asthma vary widely, and improvements in lung function are likely influenced by multiple factors, including airway structure and inflammatory profiles. However, patterns of lung function improvement with biologics and their predictors remain insufficiently defined. To classify early (8-week) response patterns based on changes in spirometric indices after dupilumab initiation and to characterize the clinical features of each pattern. Methods In a prospective, multicenter observational study across 13 sites in Japan, 84 patients with severe asthma received dupilumab. Changes at 8 weeks in six spirometric indices (FVC, %FVC, FEV₁, %FEV₁, FEV₁/FVC, %FEF25-75%) were used for hierarchical clustering. Baseline clinical characteristics, biomarkers, and symptom scores were compared across clusters. Results Four distinct clusters were identified: Cluster 1 (lung-volume-predominant improvement), Cluster 2 (non-responder), Cluster 3 (small-airway-predominant improvement), and Cluster 4 (global improvement). The non-responder Cluster 2 exhibited the youngest mean age and age at onset with the longest disease duration, consistent with an early-onset phenotype; total IgE was highest, whereas FeNO and blood eosinophils were lowest, indicating an IgE-centric Th2 profile. Cluster 1 showed marked improvements in FVC and %FVC; Cluster 3 demonstrated clear gains in small-airway function, typified by increases in %FEF25-75%; Cluster 4 had the most severe large- and small-airway dysfunction at baseline yet showed broad improvements across lung volumes, airflow, and small-airway measures. Responder clusters (1, 3, and 4) shared higher baseline FeNO and blood eosinophil counts—features of IL-5/IL-13-type Th2 inflammation—along with poorer lung function and greater symptom burden/exacerbation history. Conclusion Phenotyping based on 8-week changes in lung function after dupilumab suggests limited improvement in early-onset, IgE-centric Th2 asthma, whereas IL-5/IL-13-type Th2 inflammation is associated with multidimensional gains, including lung volume and small-airway function. Early functional response patterns may help optimize individualized dupilumab therapy. This abstract is funded by: None
