Low-carbohydrate diet (LCD) scores show inconsistent associations with diabetes across regions. As Japanese diets have shifted toward higher meat and lower fish intake in recent decades, the metabolic implications of higher LCD scores in contemporary Japanese populations may differ from earlier findings. We aimed to examine the association between LCD scores and glucose metabolism markers in adults in Hokkaido, Japan, in 2015. We conducted a study involving 348 adults aged 35–79 years. Dietary intake was assessed using a validated food frequency questionnaire. Participants with diagnosed diabetes, those receiving diabetes treatment, and those with HbA1c ≥ 6.5

Objective　Academic conferences provide opportunities for research presentation, networking, and career advancement. However, travelling for conferences can pose challenges for those with childcare responsibilities. To explore childcare support at conferences, the 83rd Annual Meeting of the Japanese Society of Public Health conducted a survey among in-person attendees.Methods　An online survey was conducted among in-person attendees of the meeting in November 2024. The participants were recruited via email invitations sent to pre-registered attendees and members of the Japanese Society of Public Health. The respondents provided demographic information and shared their opinions on attending conferences with their children. Those with elementary school-aged children or younger were asked about the age of their youngest child, childcare arrangements during the conference, and perceived usefulness of various childcare support measures. Data were analyzed based on the presence or absence of children in this age group and sex. Free-text responses were analyzed using content analysis and quantitative text analysis with the KH Coder software.Results　Of 856 respondents, 615 (71.8%) rated attending conferences with children as "favorable" or "very favorable." The proportion of women with elementary school-aged children or younger (15.3%) was significantly lower than that of men (31.0%) (P < 0.01). Furthermore, there were significantly fewer women with children aged 0-2 years (15.9%) than men (31.3%) (P = 0.03). Participants with elementary school-aged children or younger valued a "welcoming atmosphere for attendees bringing children to the conference venue" (men; 83.8%, women; 82.9%), "kids' space within the conference venue" (men; 80.8%, women; 84.1%), and "free childcare room at the conference venue" (men; 80.8%, women; 79.3%). Free-text responses highlighted a desire for expanded childcare capacity, parent-priority seating, weekend conference scheduling, on-demand streaming, and welcoming atmosphere for attending conferences with children.Conclusion　The meeting initiative to support conference attendance of participants with children received positive feedback. However, the attendance remained low among women with very young children. Future efforts should continue on-demand streaming and expand childcare capacity while introducing new initiatives, such as parent-priority seating and children's spaces. These measures foster "a welcoming atmosphere for attendees bringing children to the conference venue," thereby making conferences more accessible to participants with childcare responsibilities.

ABSTRACT Aim With the rapid proliferation of heated tobacco products (HTPs) in Japan, understanding pain‐related smoking expectancies across tobacco use patterns has become increasingly important. In this study, we aimed to profile these expectancies among adults with pain using the Pain and Smoking Inventory (PSI) and to evaluate its psychometric properties in a Japanese context. Methods We conducted a cross‐sectional internet‐based survey in 2024 among 300 Japanese adults with pain who smoked daily. Participants were categorized as combustible‐only, HTP‐only, switchers (from cigarettes to HTPs), or dual users. Psychometric evaluation included assessment of factor structure, internal consistency, and convergent validity. We used a structural equation model to examine associations between the latent PSI score and pain‐related outcomes. We then conducted analyses of covariance to compare PSI scores across tobacco use groups (adjusted for age and gender). Results Psychometric validation indicated high internal consistency (α = 0.93), mixed but essentially unidimensional fit, and expected correlations with nicotine dependence, pain, and psychological measures. The structural equation model demonstrated significant positive associations between the latent PSI factor and pain intensity (β = 0.29, p < 0.001) as well as pain‐related disability (β = 0.39, p < 0.001). Exploratory group comparisons revealed higher PSI scores among dual users than switchers, reflecting stronger perceived pain–smoking relationships. HTP‐only users also showed descriptively elevated profiles similar to combustible and dual users. Conclusions Pain‐related smoking expectancies differed across tobacco product use patterns, with dual users showing higher‐risk expectancy profiles. The PSI may serve as a useful tool for screening and tailored intervention in pain and tobacco use contexts.

Tumour cells commonly exhibit aerobic glycolysis and produce lactate despite oxygen availability. Lactate dehydrogenase (LDH) catalyses pyruvate-lactate interconversion and regulates intracellular lactate levels. Endothelial cells also depend on glycolysis for ATP production, which prompted us to investigate LDH in canine hemangiosarcoma (HSA), a malignant endothelial tumour. We inhibited LDH with (R)-GNE-140 or sodium oxamate in two canine HSA cell lines (HU-HSA-2 and HU-HSA-3) and generated HU-HSA-3 clones with knockout of LDHA or LDHB to evaluate the effects of LDH perturbation. (R)-GNE-140 and sodium oxamate suppressed proliferation and reduced global histone lactylation levels in both cell lines. mRNA-sequencing (mRNA-seq) of (R)-GNE-140-treated HU-HSA-2 cells identified cholesterol/lipid metabolism-related gene sets among the top negatively enriched pathways. Representative cholesterol/lipid metabolism genes such as SREBF2, SQLE and LDLR responded differently depending on cell lines and inhibitors. (R)-GNE-140 decreased these genes in HU-HSA-2 but not HU-HSA-3, whereas sodium oxamate decreased them in HU-HSA-3 with limited effects in HU-HSA-2. In HU-HSA-3, LDHA and LDHB knockout clones decreased SREBP2 expression and reduced the number of lipid droplets. Fluvastatin, a cholesterol metabolism inhibitor, inhibited HSA cell growth in vitro but did not significantly suppress tumour growth in two HSA patient-derived xenograft (PDX) models. In contrast, combined fluvastatin and dipyridamole treatment inhibited proliferation in vitro and tumour growth in PDX models. Collectively, these results suggest a context-dependent association between LDH and cholesterol/lipid metabolism in canine HSA cell lines and provide a rationale for further evaluation of combined cholesterol pathway inhibition.

INTRODUCTION:Nurse practitioners are being increasingly integrated into critical care teams. In Western countries, nurse practitioner (NP)-led care yields clinical outcomes comparable to physician-led care. However, no study in Asia has compared intensive care unit (ICU) mortality rates between patients managed by NPs and those managed by physicians. OBJECTIVES:The aim of this study was to compare mortality rates between patients managed by an NP and those managed by physicians, both under the supervision of attending intensivists and to evaluate the potential impact of this care model on patient outcomes. METHODS:This retrospective cohort study included patients aged 18 years or older who were admitted to the ICU between April 1, 2023, and March 31, 2024. Those managed by a single NP were classified into the NP group, and those managed by intensivists or residents were classified into the physician group. Due to potentially nonrandom allocation of patients, a weighted analysis based on propensity scores was applied. ICU mortality, ventilator days, and ICU length of stay were compared between the groups using weighted analyses. RESULTS:Among the 975 eligible patients, 109 and 866 were assigned to the NP and physician groups, respectively. Weighted analyses estimated the ICU mortality rate was 6.1% in the NP group and 7.2% in the physician group (risk difference: -0.01; 95% confidence interval [CI]: -0.06 to 0.03; risk ratio: 0.84; 95% CI: 0.39 to 1.83), the mean number of ventilator days was 1.6 in both groups (mean difference: 0.001; 95% CI: -1.09 to 1.09), and the mean ICU length of stay was 4.8 days in the NP group and 3.9 days in the physician group (mean difference: 0.91; 95% CI: -0.40 to 2.29). CONCLUSIONS:Our findings suggest that outcomes in the NP group were similar to those in the physician group. This specific model of NP-led care, delivered under supervision of attending intensivists, may be a feasible option to manage critically ill patients. However, this study was conducted in a single centre involving a single NP, and the wide CIs warrant cautious interpretation regarding the precision of the estimates.

Human milk oligosaccharides (HMOs) are bioactive components of human breast milk (HBM), but their concentrations vary with maternal secretor phenotype and lactation stage, making individual HMO quantification analytically demanding. Here, we present a reference-guided benchtop 60 MHz NMR workflow integrating chemometrics and machine learning to quantify major fucosylated HMOs in HBM. A total of 111 HBM samples from 37 donors across lactation stages were analyzed. Using 800 MHz NMR-derived concentrations as references, predictive models were developed from benchtop NMR spectra for 2'-fucosyllactose (2'-FL), 3-fucosyllactose (3-FL), and lacto-N-fucopentaose I (LNFP-I). Unlike conventional peak-fitting-based NMR quantification, this workflow recovered HMO-specific quantitative information from highly overlapped 60 MHz carbohydrate signals that were not directly resolvable in authentic HBM. Elastic Net yielded practical models, particularly for lower-abundance 3-FL and LNFP-I. These results support benchtop NMR combined with machine learning as an accessible platform for HMO screening.

Dietary acid load (DAL), which reflects diet's overall acid-base balance, has been proposed to influence glucose metabolism; however, epidemiological findings on its relationship with diabetes risk remain inconsistent. While Western studies suggest that higher DAL is associated with higher diabetes risk, particularly among women, findings from East Asian populations have been inconsistent, particularly regarding sex-specific associations. The present prospective study examined the association between DAL and 5-year diabetes incidence among Japanese adults, focusing on sex-specific differences. Data were obtained from 19 040 participants (7037 men and 12 003 women) in the Japan Collaborative Cohort Study. DAL was estimated based on the potential renal acid load (PRAL) and net endogenous acid production (NEAP) derived from a validated food-frequency questionnaire. Odds ratios and 95 % confidence intervals for incident diabetes were estimated separately for men and women across PRAL and NEAP quartiles using multivariable logistic regression with multiple imputations for missing covariates. During follow-up, 490 new diabetes cases were identified (245 in each sex). Among women, higher DAL was significantly associated with a higher risk of diabetes; OR (95 % CI) from multivariable-adjusted model, including socio-demographic, lifestyle, health status and macronutrient covariates, comparing the highest with the lowest quartiles were 1·61 (1·09, 2·37) for PRAL and 1·72 (1·18, 2·52) for NEAP. No clear associations were observed among men. The findings provide a foundation for further studies in East Asian populations using more precise dietary assessment methods to clarify the association between DAL and incident diabetes and to inform dietary guidelines and preventive strategies.

High pathogenicity avian influenza (HPAI) is a highly infectious and lethal disease of birds that causes systemic symptoms and has been spreading globally, including in Japan. The Okinawa rail (Hypotaenidia okinawae), a flightless bird endemic to Japan, is classified as an endangered species on the Red List. In 2004, the Ministry of the Environment of Japan began implementing a conservation breeding program for Okinawa rails, focusing on maintaining the species' genetic diversity, captive breeding, and reintroduction to the wild. Given the potential for significant losses due to HPAI in Okinawa rails, the establishment of a treatment protocol as a preparedness measure is essential. The aim of this study was to determine an appropriate treatment method for HPAI in Okinawa rails using baloxavir marboxil (BXM), a drug shown to be effective in an avian laboratory model of HPAI virus infection. Single oral administration of BXM at 2.5 or 12.5 mg/kg did not produce plasma concentrations sufficient to achieve the expected therapeutic efficacy. Therefore, oral administration was deemed inadequate for generating the desired pharmacological effects. Consequently, subcutaneous administration of BXM to Okinawa rails at a dose of 2.5 or 7.5 mg/kg was explored as an alternative protocol, which resulted in higher systemic exposure compared with oral administration. Furthermore, plasma concentrations were maintained at therapeutically relevant levels up to 24 hours after subcutaneous administration at 7.5 mg/kg, with mild and reversible injection site irritation the main adverse effect. Based on these results, subcutaneous administration of BXM is proposed as a viable treatment protocol for HPAI in the conservation of endangered Okinawa rails.

The risk factors for long-term persistent post-coronavirus disease (COVID-19) condition (PCC) years after infection remain unclear. In this study, we investigated the prevalence of PCC and the associated risk factors after severe acute respiratory syndrome coronavirus 2 infection in the general population. This prospective cohort study included individuals aged 18-79 years diagnosed with COVID-19 between March 2021 and April 2022 and matched non-infected individuals living in Yao City, Japan. Baseline and follow-up surveys were conducted in 2022 and 2024, respectively. PCC was defined as symptoms persisting for ≥2 months at 3 months post-infection. Among 7404 eligible individuals, 3628 (2314 infected, mean age: 44.2 years, 62.7% females; 1314 non-infected, mean age: 45.0 years, 63.2% females) participated in the follow-up survey. PCC prevalence at 3, 6, 12, and 18 months was 14.3%, 12.0%, 6.3%, and 5.4%, respectively. Older age, being overweight, comorbidities, severe disease in the acute phase, and low household income were associated with persistent PCC at ≥ 18 months. Compared with no vaccination, ≥ 2 doses of the COVID-19 vaccine prior to infection were associated with a lower PCC risk. These findings highlight PCC as an important public health concern in the post-COVID-19 era. Trial Registration: UMIN000049807.

Supplementary Table 1: Study population and exclusion criteria by cohorts as established by the ACC reproductive factor working group

Glanders is a contagious zoonotic disease caused by Burkholderia mallei that primarily affects horses, donkeys, and mules. It remains endemic in parts of Asia, Africa, the Middle East, and South America, where increasing case reports highlight the need for accessible diagnostic tools. Conventional diagnostic methods are limited by high costs and specialized laboratory requirements, whereas lateral flow assays (LFAs) offer practical, user-friendly, and rapid alternatives. In this study, we developed three LFAs targeting antibodies against the B. mallei antigens Hcp1, GroEL, and whole-cell lysate (WCL), previously identified as promising markers in indirect enzyme-linked immunosorbent assays. Recombinant streptococcal protein G served as the colloidal gold conjugate. Diagnostic performance was evaluated using glanders-positive (n = 31) and glanders-negative (n = 51) equine sera collected in Mongolia. Hcp1-LFA demonstrated 100% sensitivity and 100% specificity, while WCL-LFA achieved 100% sensitivity and 98.0% specificity. GroEL-LFA showed 100% sensitivity but lower specificity (90.2%). Hcp1- and WCL-LFA also exhibited high sensitivity in asymptomatic horses. No cross-reactivity was observed with sera from horses with other infections (n = 60) collected in Japan. All LFAs remained functional for at least 16 weeks at 37°C. These results indicate that Hcp1- and WCL-based LFAs provide accurate, rapid, and equipment-free detection of glanders. Their simplicity, stability, and affordability make them highly suitable for field diagnosis, especially in low-resource endemic settings. Nonetheless, further validation using larger and more diverse sample sets is required to confirm their broader applicability. IMPORTANCE:Glanders is a contagious disease affecting horses, donkeys, and mules that can have serious economic and animal health consequences. Current diagnostic tests are expensive, time-consuming, and require specialized equipment. The assays developed in this study are simple, rapid, and cost-effective, allowing veterinarians to quickly identify infected animals in the field. Early detection helps prevent the spread of the disease, safeguarding livestock, supporting animal health, and reducing economic losses in affected regions.

Psychological resilience is a key protective factor for mental health. Reducing inequalities in access to childhood experiential activities may foster resilience across socioeconomic backgrounds. However, Japan limits policies ensuring equitable access to such activities before entering elementary school. This cross-sectional study examined the association between exposure to experiential activities before entering elementary school and psychological resilience in Japanese individuals aged 15–39 years (n = 8000). Experiential activities were classified into nature-related, social, and cultural domains and by number and combination (none, any single, any two, and all three types). Psychological resilience was assessed using the 14-item Resilience Scale (Japanese version). Multivariable linear regression models were adjusted for demographic and socioeconomic covariates with Benjamini–Hochberg (BH) correction. Exposure to one or two activity domains was significantly associated with higher psychological resilience, except for the nature-related plus social activities combination. Exposure to all three domains showed the strongest association (β = 8.06, 95% confidence interval [6.73, 9.38], BH-adjusted p < 0.001). Therefore, early childhood experiential activities may promote psychological resilience, with persistent long-term effects. Implementing social policies to reduce the disparity in access may be a key strategy for promoting psychological resilience among Japanese individuals aged 15–39 years.

Supplementary Table 3: Pooled relative risks for recategorized age at menarche and age at menopause & incident thyroid cancer risk, Overall and papillary type

Supplementary Table 2: Distribution of total cases according to histology according to participating cohorts

Supplementary Figure 3: Forest plots of the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) generated by combining cohort-specific HRs for the association between reproductive factors and the overall risk of thyroid cancer in the Asia Cohort Consortium. A - Forest plot for the pooled HRs and CIs for breastfeeding status and thyroid cancer risk, overall B - Forest plot for the pooled HRs and CIs for postmenopausal status and thyroid cancer risk, overall C - Forest plot for the pooled HRs and CIs for age at menopause and thyroid cancer risk, overall

OBJECTIVE:We examined whether the association between adherence to the Japanese dietary pattern and all-cause and cardiovascular disease (CVD) mortality is consistent across diverse residential topographical settings in Japan. METHODS:This prospective cohort study included 48 479 adults aged 40-79 years from the Japan Collaborative Cohort Study, with baseline dietary assessment in 1988-1990. Adherence was quantified by the Japanese Diet Index 8 (JDI-8), with components dichotomized at sex-specific medians. Residential municipalities were classified as coastal, urban inland, flat/intermediate inland, or mountainous inland. Shared frailty Cox proportional hazards models with a municipality-level random intercept (33 municipalities) estimated hazard ratios (HRs) and 95% confidence intervals (CIs). We tested effect modification by residential area using interaction tests and stratified analyses. RESULTS:During a median follow-up of 19.2 years, 9304 all-cause deaths and 2685 CVD deaths occurred. Comparing the highest with the lowest JDI-8 quartile, HRs were 0.929 (95% CI, 0.872-0.990; p for trend = 0.034) for all-cause mortality and 0.862 (95% CI, 0.766-0.970; p for trend = 0.023) for CVD mortality. Interactions by residential area were not statistically significant (p for interaction = 0.246 for all-cause and 0.185 for CVD mortality). Component-level distributions varied by area, with urban inland residents having lower proportions of miso soup, rice, and fish intake. CONCLUSIONS:Higher adherence to the Japanese dietary pattern was associated with lower all-cause and CVD mortality, with directionally consistent associations across diverse residential settings. The absence of significant heterogeneity supports generalizability within Japan, although stratified estimates are exploratory.

BACKGROUND:Tobacco smoking and alcohol drinking are major risk factors for head and neck cancer (HNC), but their interaction effects have not been investigated in the Japanese population. METHODS:We conducted a pooled analysis using data from 11 prospective cohorts in Japan, covering a total of 434 431 participants with 5 969 082 person-years of follow-up. Cox proportional hazards model analyses were performed separately in each cohort. Interactions and population-attributable fractions (PAFs) were estimated through meta-analyses. RESULTS:During follow-up, 1835 incidents of HNC were newly identified. Both smoking and drinking habits significantly increased HNC risk. Subsite analysis showed that smoking increased risk in several subsites, while drinking was associated with hypopharyngeal cancer only. The multiplicative interaction was 1.55 [95% confidence interval (CI): 1.12-2.14] and the additive interaction (relative excess risk due to interaction) was 0.87 (95% CI: 0.42-1.36). Among men, PAFs were 0.414 for smoking and 0.336 for drinking, while the combined PAF was 0.469. Subsite-specific analysis showed larger PAFs of smoking in the nasopharynx and larynx, and larger PAFs of drinking in the oral cavity and hypopharynx. CONCLUSION:Tobacco smoking and alcohol drinking interact to increase the risk of HNC in the Japanese population. The attributable fraction of each factor differs by subsite. These findings may aid the development of future preventive strategies for HNC.

Supplementary Methods 1: Details on the development of the Asia Cohort Consortium reproductive factor working group protocol

Glanders is a zoonotic disease caused by Burkholderia mallei (Bm). Bm is phylogenetically similar to B. pseudomallei (Bp), the causative agent of melioidosis, making it difficult to differentiate between them. Recently, the PCR method recommended by the World Organisation for Animal Health (WOAH) failed to detect a Kuwait strain of Bm, and the WOAH has cautioned that ongoing Bm evolution may lead to the emergence of variants that escape standard assays. Therefore, this study aimed to develop a novel real-time PCR method to discriminate between Bm and Bp. Local and web-based BLAST searches identified a 494-bp sequence conserved across Bm but absent from other bacterial genomes, including Bp, except for one B. thailandensis strain. The optimized probe-based real-time PCR targeting this sequence detected the genomes of five Bm isolates but did not amplify DNA from closely related Burkholderia species. In clinical specimens from Mongolia, this assay amplified Bm DNA at an equivalent detection rate to the WOAH-recommended real-time PCR method. These findings provide a novel, highly sensitive diagnostic method for differentiating glanders from melioidosis and suggest its potential use as an alternative method in clinical applications. Further verification using a large number of samples collected from various regions will be necessary in the future.