Okinawa University

Objectives The aim of this study was to analyze the association between employment status, family structure, and nutrient adequacy in working-age Japanese adults (aged 20-64 years).Methods Data from the 2019 National Health and Nutrition Survey and the Comprehensive Survey of Living Conditions, conducted by the Ministry of Health, Labour and Welfare, were used to examine the associations between nutrient adequacy and employment status (full-time, part-time, unemployed, or not applicable) and family structure (single, couple only, two-parents and child [parent, child], single parent and child [parent, child], three-generations [parent, child], and other family structures). Logistic regression analysis was performed with nutrient deficiency as the dependent variable and employment status and family structure as independent variables, controlling for age, municipality size, and prefecture of residence.Results The association between employment status and nutrient adequacy, as assessed by the chi-squared test, showed statistically significant differences in the percentage of nutrient inadequacy across employment status categories among women for three nutrients, but not among men. The chi-squared test between family structure and nutrient adequacy showed statistically significant differences for 10 nutrients for men and 14 nutrients for women. Among men, parents in three-generation families had higher inadequacy rates; among women, those living alone showed higher inadequacy rates. Logistic regression revealed that, compared with those in full-time employment, men in part-time employment had statistically higher inadequacy in total fiber, folic acid, potassium, and magnesium. For women, employment status was associated with inadequacy of n-6 fatty acids, total fiber, vitamin A, vitamin C, salt equivalents, and magnesium. Furthermore, nutrient inadequacy differed significantly by family structure for 14 nutrients in men and 16 nutrients in women. For men, single individuals, and parents in three-generation families showed statistically higher inadequacy rates for some nutrients, while for women, of the 16 nutrients showing statistically significant differences, children in "two-parent and child families" and women in "couple-only families" showed lower rates of nutrient inadequacy for 9 and 8 nutrients, respectively.Conclusion Nutritional disparities among working-age adults are associated with employment patterns and family structure. In addition, nutrient excesses and deficiencies were identified in groups previously overlooked, such as parents in two-parent and child households and three-generation households, highlighting the need for policies that address these diverse factors.

BackgroundAdvancing antimicrobial stewardship programs (ASP) has led to various metrics for assessing antimicrobial consumption. Since introducing the antimicrobial spectrum index (ASI) in 2017, similar metrics, such as days of antibiotic spectrum coverage (DASC), have emerged to better evaluate antimicrobial use, particularly considering de-escalation process. This study assessed antimicrobial consumption with a de-escalation process using DASC in 12 hospitals across three regions in Japan.Table 1.Characteristics of participating hospitalsFigure 1.Trend of monthly DASC/DOT and DOT per 1,000 patient-days stratified by hospital types.MethodsIntravenous antimicrobial consumption data from 12 Japanese hospitals (April 2016–March 2024) were collected. The participating hospitals were located in three regions: West (Okinawa, n=6), East (Tokyo, n=5), and Midwest (Aichi, n=1). Monthly antimicrobial consumption was expressed as days of therapy (DOT) and then converted to DASC per 1,000 patient-days (PD). Hospital-wide de-escalation was evaluated using DASC/DOT. The correlation between DASC/DOT (a new metric) and DOT per 1,000 PD (a conventional metric) was assessed using Spearman’s rank-order correlation test. Hospital characteristics, including ASP availability, and infectious disease consultation, were also collected.Figure 2.Trends of DOT per 1,000 PD, DASC per 1,000 PD and DASC/DOT stratified by hospital regionsResultsA total of 96 months of data were analyzed. Monthly median DOT, DASC, and DASC/DOT were 303.4, 2107.0, and 7.2, respectively. There was little correlation between DASC/DOT and DOT per 1,000 PD (rho=0.11; P< 0.73). University hospitals (median 7.7) and a cancer center (median 8.0) had higher DASC/DOT than the remaining 9 community hospitals (median 6.9), likely owing to the availability of transplant services and a larger number of ICU beds (Figure 1 and Table 1). A substantial decrease in DASC/DOT at one university hospital since August 2022 was observed, likely due to implementing a hospital-wide restriction of carbapenem use. Median DASC/DOTs in East and West were 6.9 and 7.2, respectively, suggesting that the de-escalation process has progressed more at hospitals in Tokyo than at hospitals in Okinawa (Figure 2).ConclusionDASC/DOT, showing little correlation with traditional DOT per 1,000 PD, is a useful metric to assess antimicrobial use and de-escalation process. A regional-level and hospital type-level comparisons can help identify facilities needing further ASP promotion.DisclosuresAll Authors: No reported disclosures

X chromosome inactivation (XCI) is an essential mechanism for gene dosage compensation between male and female cells in mammals. The Okinawa spiny rat (Tokudaia muenninki) is a native rodent in Japan with XX/XY sex chromosomes, like most mammals; however, the X chromosome has acquired a neo-X region (Xp) by fusion with an autosome. We previously reported that dosage compensation has not yet evolved in the neo-X region; however, X-inactive-specific transcript (Xist) RNA (long non-coding RNA required for the initiation of XCI) is partially localized in the region. Here, we show that the neo-X region represents an early chromosomal state in the acquisition of XCI by analyses of heterochromatin and Barr body formation. We found no evidence for heterochromatin formation in the neo-X region by RBA (R-banding by acridine orange) assays and immunostaining of H3K27me3. Double-immunostaining of H3K27me3 and HP1, a component of the Barr body, revealed that the entire ancestral-X chromosome region (Xq) showed a bipartite folded structure. By contrast, HP1 was not localized to the neo-X region. However, BAC FISH revealed that the signals of genes on the neo-X region of the inactive X chromosome were concentrated in a narrow region. These findings indicated that although the neo-X region of the inactive X chromosome does not form a complete Barr body structure (e.g., it lacks HP1), it forms a slightly condensed structure. These findings combined with the previously reported partial binding of Xist RNA suggest that the neo-X region exhibits incomplete inactivation. This may represent an early chromosomal state in the acquisition of the XCI mechanism.