Kobe International University

Birthweight is a key indicator of health capital, influencing long-term outcomes such as education, income, and adult health. Previous studies have examined both its determinants and consequences, showing that low birthweight is associated with poor health, limited schooling, and lower socioeconomic status later in life. However, the pathways of birthweight's intergenerational transmission remain insufficiently understood, particularly the mediating role of maternal education. Moreover, most existing evidence comes from Western countries, and little is known about these mechanisms in Japan, where delayed childbirth and infertility treatments are increasingly common. We conducted an original survey of Japanese mothers, collecting data on their own birthweight, their children's birthweight, and socioeconomic attributes. Using Structural Equation Modeling (SEM), we estimated direct and indirect effects through a path diagram linking maternal birthweight, education, age at childbirth, and pregnancy-related factors such as preterm birth and multiple pregnancies. Paternal factors were also examined. Maternal birthweight positively influenced both maternal education and child birthweight. However, maternal education had no direct effect on child birthweight and showed indirect negative effects through older maternal age and multiple pregnancies. Paternal education and age at childbirth showed weaker effects compared to maternal factors. Our findings show birthweight is transmitted across generations, but maternal education does not necessarily strengthen this intergenerational transmission. Our analysis indicates that its indirect pathway-through delayed childbirth among highly educated women-increases risks to infant health. Addressing these risks will require comprehensive investments in maternal health, maternity and workplace support, fertility assistance, and education policies.

This study examines how climate variability affects child labor in the Occupied Palestinian Territories, where ongoing conflict and scarce resources amplify household vulnerabilities. Drawing on Palestinian Labor Force Survey data from 2000 to 2018 linked with district-level data on climate indicators, we employ a linear probability model to measure the effects of climate shocks on child labor. Our analysis reveals that rainfall increases child labor, particularly among boys in agricultural roles, while extreme heat discourages it. We also find that girls often respond to rainfall shocks through early marriage. These patterns vary across northern, central, and southern districts, highlighting the importance of place-based adaptation. Our findings show that structural constraints mediate how households cope with environmental stress. The results suggest that effective policy must integrate climate-resilient agricultural investments with targeted social-protection measures, educational support, and gender-responsive programming to mitigate the risks of child labor and early marriage under increasing climate pressure.

Chronic low back pain (CLBP) significantly impairs quality of life and increases mortality among older adults, making its effective management essential for healthy aging. This quasi-randomized trial compared Pain Neuroscience Education emphasizing physical activity (PNE-PA) with traditional biomechanical treatments (BM) in older women with CLBP over 12 weeks. Community-dwelling women aged 65–90 years with CLBP were assigned to either group based on recruitment timing, using a double-blinded design. PNE-PA aimed to reduce pain-related fear by educating patients about pain neuroscience and encouraging physical activity. Outcomes included physical function, pain intensity, self-reported disability and psychological factors. Analyses used intention-to-treat and bootstrap resampling methods. Between-group differences were assessed using mean differences, 95% confidence intervals (CI), and Cohen’s d. The PNE-PA group (n = 24) showed significantly greater improvements than the BM group (n = 18) in Chair Stand Test (95% CI: 1.53 to 7.76, d = 0.88), step count (95% CI: 475.97 to 2550.42, d = 0.87), pain catastrophizing (95% CI: -10.64 to -1.95, d = -0.87), and fear-avoidance beliefs (95% CI: -7.40 to -0.14, d = -0.65). These findings suggest that Pain Neuroscience Education emphasizing physical activity was associated with better physical and psychological outcomes among older women with chronic low back pain.

• Developed a dynamic programming-based transport mode selection model integrating trucks, private cars, and trains for optimized urban parcel delivery. • Incorporated time constraints, congestion limits, and environmental cost factors , encouraging sustainable transport choices. • Conducted empirical validation using GIS and logistics datasets from Osaka, Japan, ensuring real-world applicability. • Identified that the proposed CCTS model can reduce CO 2 emissions by up to 80% , lower delivery costs, and improve last-mile efficiency. • Demonstrated the feasibility of leveraging public transport and parcel lockers to enhance urban freight resilience and sustainability. This study proposes a novel approach to sustainable urban logistics through a crowdsourced co-modality transportation system (CCTS) integrated with public transport networks. The research introduces a dual-layer multi-modal CCTS framework that optimally combines conventional delivery services with crowd shipping, leveraging existing passenger transport infrastructure to reduce environmental impacts. A dynamic programming model is developed to optimize mode selection, incorporating multiple transport modes in the context of physical internet, congestion constraints, train capacity, and carbon footprint considerations. By employing heuristic search methods for parcel locker placement, the study enhances last-mile delivery efficiency. Using Osaka as a case study, simulation results demonstrate that engaging commuters as delivery agents and integrating smart parcel lockers can significantly reduce urban freight emissions – achieving up to 80% carbon savings in specific scenarios. These findings highlight the potential of public transport-based crowd shipping to enhance delivery efficiency while contributing to cleaner and more sustainable cities.

IntroductionAlthough the effects of self-control on motor learning have been well studied, the effects of self-controlled feedback timing have not been thoroughly investigated. Therefore, this study aimed to examine the effects of self-controlled feedback timing on motor learning through two experiments.MethodsIn Experiment 1, participants were randomly assigned to one of three groups: concurrent feedback, terminal feedback, or self-controlled feedback. The procedure included a pre-test, practice session, and a retention test conducted 1 week after the practice, with visual feedback provided only during the practice session. Participants also completed three subscales of the Intrinsic Motivation Inventory before/after the practice session and the NASA-Task Load Index (NASA-TLX) after the practice session. In Experiment 2, participants were randomly assigned to either a self-controlled feedback group or a yoked feedback group, following the same procedure as in Experiment 1.ResultsIn Experiment 1, the concurrent feedback group demonstrated the smallest performance errors during practice, while the terminal feedback group showed the largest performance errors. However, both the self-controlled and terminal feedback groups exhibited significantly smaller errors than the concurrent feedback group in the retention test. In Experiment 2, the self-controlled group made significantly fewer errors than the yoked group in the retention test. The self-controlled group showed significantly higher intrinsic motivation and significantly lower scores in the performance subscale of NASA-TLX than the yoked group.ConclusionIn the present study, concurrent visual feedback interfered with motor learning by inducing a dependency on visual feedback. Our findings suggest that self-controlled feedback timing may overcome the potential negative effects of concurrent visual feedback through the positive influence of self-control, which may arise through the involvement of both intrinsic motivation and information processing.

Background: For both men and women, family planning, including decisions regarding marriage and childbearing, is a significant life event that contributes to overall “happy life.” Patients with chronic diseases such as inflammatory bowel disease face not only concerns about common pregnancy-related complications but also disease-specific challenges, including the potential effects of medications on the fetus and the risk of disease exacerbation during pregnancy. In response to these concerns, patients may occasionally make misguided decisions, such as the self-discontinuation of necessary treatment, increasing the risk of adverse health outcomes for both maternal health and fetal development. Summary: Preconception care aims to address these concerns by providing guidance to mitigate factors that may negatively impact maternal and fetal health. This includes optimizing behavioral, personal, and environmental determinants of health. In this review article, we discuss the role of preconception care in supporting an optimized pregnancy, safe delivery, and healthy postpartum period for the patients wishing to have babies. Key Messages: Proper preconception counseling can improve the pregnancy outcomes. Healthcare professionals play a crucial role in preconception care by providing patients with accurate medical knowledge and guidance, enabling them to make informed decisions and ensuring a safe and well-prepared pregnancy and childbirth.

Abstract Background Cervical esophagogastric anastomosis is conventionally performed using the McKeown esophagectomy. However, an optimal anastomotic technique has not yet been established. This study aimed to compare the clinical outcomes of triangular anastomosis (TA) and totally mechanical Collard anastomosis (TMCA) for cervical esophagogastric anastomosis during minimally invasive esophagectomy with gastric conduit reconstruction through the retrosternal route. Methods In this matched- cohort study, 117 patients who underwent minimally invasive esophagectomy between 2019 and 2024 were divided into TA and TMCA groups. The TA technique was performed between September 2019 and December 2021, and the TMCA technique was performed between January 2022 and January 2024. We then compared the surgical outcomes and postoperative complications (pneumonia, recurrent laryngeal nerve palsy, anastomotic leakage, and stricture) between the two groups. Results Propensity score matching revealed that 40 patients were included in both the TA and TMCA groups. The rates of pneumonia, recurrent laryngeal nerve palsy, and anastomotic leakage were not significantly different between the two groups. However, the rate of anastomotic stricture was lower in the TMCA than in the TA group (2.5% vs. 27.5%, respectively, P = 0.003). Conclusion Compared with the TA technique, the TMCA technique reduced the rate of anastomotic stricture when performing cervical esophagogastric anastomosis during minimally invasive esophagectomy with gastric conduit reconstruction through the retrosternal route.

The choice of an Early Childhood Education (ECE) institution for children is influenced by various aspects, including school costs, parental socio-economic rank, parental impression of the institution, and the school’s quality. Insufficient research exists regarding the influence of parental perspective and socio-economic status on school selection within Bangladesh’s setting. This study investigates the fundamental aspects that influence parental decision-making about school selection. This study employs a qualitative method using a case study approach. In-depth and key informant interviews were conducted with the parents to acquire data. The participants were chosen using a random purposive method to fulfil the research objectives. The participants included parents who had already registered their children in ECE schools and those contemplating enrolling them. The findings demonstrate that parental viewpoint has a substantial influence on the selection of an ECE school. In contrast, parental socio-economic condition does not exert a noteworthy effect on school choice. Additionally, this study investigates the cost disparity across various ECE schools and other pertinent elements influencing parents’ decision-making regarding school choice.