Tokiwa University

BackgroundClinical Practice Guidelines (CPGs) support evidence-based, shared decision-making by providing recommendations based on the best available evidence, including systematic reviews, clinical trials, and expert consensus. Despite their potential to improve the quality of healthcare and reduce unnecessary interventions, CPGs remain inadequately disseminated and implemented. Key barriers include limited awareness and poor perception among patients and the general public. To inform strategies to improve CPG dissemination, this study aimed to investigate the association between socioeconomic factors and the awareness, reading, and perceptions of CPGs among the Japanese general population.MethodsA nationwide cross-sectional anonymous mail survey (INFORM Study 2023) was conducted among 10,000 randomly selected Japanese adults aged ≥20 years using stratified two-stage random sampling. This study was conducted as part of the INFORM Study 2023, with items related to CPGs included as an approved module. Logistic regression models were used to identify respondent characteristics associated with the awareness and reading experience of CPGs, and to assess the association between reading CPGs and eight perceptions held about them.ResultsThe response rate was 35.3% (n = 3,452). After excluding cases with missing data on CPG awareness, the remaining responses were included in the analysis (n = 3,343). Among these, 82.5% were unaware of CPGs, 9.9% were aware of CPGs but had never read one, and 7.6% were aware of CPGs and had read one. Awareness was significantly higher among individuals with higher education (adjusted odds ratio [aOR]: 2.060 for vocational school; 1.813 for university graduates), higher household income (aOR: 1.882 for ≥8 million yen), excellent health (aOR: 1.373), and frequent healthcare visits (aOR: 1.741 for ≥10 visits/year). Household size of ≥2 members (aOR: 0.591) was associated with lower awareness. Reading CPGs was associated with a self-history of cancer (aOR: 1.858). Of eight perceptions, respondents who had read CPGs correctly disagreed with the notion that CPGs harm patient-provider relationships. Among other respondents, misconceptions about CPGs persisted, particularly regarding their limitations and recommendations.ConclusionsAmong the general population in Japan, awareness of CPGs is associated with demographic and socioeconomic characteristics. Tailored dissemination strategies—particularly for individuals with lower income or education levels and other groups identified in this study—are essential to improving awareness and supporting informed healthcare decision-making. These findings also highlight the need to integrate CPG literacy into national health education initiatives to enhance public access to evidence-based care.

ABSTRACT This study examines the relationship between workplace bullying and mental health outcomes among gay and bisexual (GB) male workers in Japan, based on the minority stress framework. Prior research has shown that lesbian, gay, bisexual, transgender, queer, and other populations with diverse sexual orientations are more vulnerable to mental health problems and suicide, yet few studies have focused specifically on workplace bullying as a distal stressor. Using an anonymous web-based survey conducted in 2020, data were collected from 1,202 employed GB men aged 20–69. Logistic regression analyses, including Firth’s penalized likelihood method for rare events, assessed associations between bullying and psychological distress, suicidal ideation, and suicide attempts, adjusting for sociodemographic, employment, and workplace factors. Results showed that 8.8% of respondents reported bullying due to sexual orientation. Bullying was significantly associated with higher odds of psychological distress, suicidal ideation, and suicide attempts. These associations remained significant after controlling for confounders. The findings indicate workplace bullying is not only linked to psychological distress but also extends to suicide-related behaviors. This highlights the urgent need for organizational interventions, legal protections, and inclusive workplace cultures in Japan. Future research should adopt longitudinal designs and address intersectionality to strengthen empirical evidence and policy relevance.

Abstract We investigated the effect of additives on the crystal shape of β‐silicon nitride (β‐Si 3 N 4 ) synthesized via the carbothermal reduction‐nitridation process. When SrF 2 was used as an additive, tabular β‐Si 3 N 4 crystals with an aspect ratio of 0.3–0.5 were obtained. The oxygen content within the crystal lattice of the β‐Si 3 N 4 particles varied with the synthesis conditions, reaching 0.94 wt% in samples synthesized at 1600°C for 10 h. The morphology of the β‐Si 3 N 4 crystals was found to be significantly influenced by the surface tension of the silicate glass formed during synthesis, its wettability on silicon nitride, and the vapor pressure of the alkaline earth oxide ( AE O). Specifically, the use of additives with high vapor pressure and low cation field strength suppressed grain growth after Si 3 N 4 nucleation. The volatilization of the AE O then depleted the liquid phase, leading to the formation of β‐Si 3 N 4 crystals with a low aspect ratio. The newly synthesized tabular‐shaped particles hold potential as heat‐dissipating fillers capable of improving heat dissipation in the thickness direction.

Naïve pluripotency represents the ground state of mammalian development. A comprehensive understanding of the molecular mechanisms governing its establishment is crucial for elucidating the unique properties of embryonic cells and the regulatory mechanisms controlling cell fate determination. However, the key molecule to robustly achieve naïve pluripotency with minimal manipulation remains unclear. We found that the acetylation status of lysine 49 (K49) of Catenin beta-1 (Ctnnb1) plays a critical role in naïve pluripotency of murine stem cells. Deacetylated Ctnnb1 at K49 binds to transcription factor Nanog, impeding its repressor function and thereby promoting differentiation. Remarkably, treatment with IQ1, an inhibitor of interaction between acetyltransferase Ep300 and Ctnnb1, enhances acetylation at K49 of Ctnnb1, enabling the establishment and long-term maintenance of embryonic stem cells independently of the leukemia inhibitory factor, and also driving complete conversion of epiblast stem cells to the naïve state. This study reveals the critical role of Ctnnb1 in naïve pluripotency and introduces an effective strategy for its induction and maintenance.

Duchenne/Becker muscular dystrophies (DMD/BMD) are inherited muscle diseases, collectively referred to as dystrophinopathy, which are characterized by progressive degeneration or loss. Although serum creatine kinase (CK) is a classical biomarker of DMD and BMD, it alone cannot clearly differentiate between severe DMD and milder BMD. Among potential biomarkers, the levels of the fragmented products of titin, a structural muscle protein, may directly reflect the degree of muscle loss in DMD and BMD. Therefore, this study measured the serum titin/creatinine (Cr) ratio and evaluated its discriminatory ability in patients with DMD and BMD. The patients with dystrophinopathy and healthy controls were included in this study. Patients were classified by the reading frame rule (out-of-frame, DMD; in-frame, BMD). Exceptional cases in which in-frame variants presented with severe symptoms or out-of-frame variants presented with mild symptoms were considered clinically DMD or clinically BMD, respectively. Serum titin levels were measured using enzyme-linked immunosorbent assay. Serum Cr levels measured on the same day were used to calculate serum titin/Cr ratios. The DMD, BMD, and control groups included 89 patients (85 DMD and four clinically DMD; aged 3-32 years), 21 patients (16 BMD and five clinically BMD; aged 6-33 years), and five participants (aged 7-12 years), respectively. Although serum CK levels did not differ significantly between DMD and BMD, the serum titin/Cr ratio in DMD was approximately 10 times higher than that in BMD group (p < 0.0001). Receiver operating characteristic curve analysis revealed that the ability of serum titin/Cr to distinguish DMD from BMD was superior to that of serum CK. Serum titin/Cr ratios in patients with DMD were higher than those with BMD across all age groups (3-10, 11-15, 16-20, and 21-33), but serum CK levels in patients with DMD were significantly higher than those with BMD only in the 11-15 and 21-33-year age groups. Unlike serum CK, the serum titin/Cr ratio in patients with DMD was consistently higher than that in patients with BMD, regardless of age. Serum titin/Cr was shown to be a biomarker to discriminate clinical severity in patients with dystrophinopathy.

The number of studies suggesting that social networking services (SNSs) use poses a risk to children's body image continue to expand, but most studies have focused on adolescents. The study aimed to examine the associations between SNS use and body image among elementary school children in Japan. This study examined the relationship between SNSs use and body size perception and preference, body size misperception, and ideal body image among 1261 preadolescents (611 boys and 650 girls), aged 8-12 years (mean age = 9.64; SD =1.15; 52% girls), separately by sex. Using hierarchical multivariate linear regression analyses and logistic regression analyses, we examined body image factors and SNS use as the dependent and independent variables, respectively. Findings indicate that children who use SNSs do not significantly differ from nonusers regarding body dissatisfaction. However, SNS use is positively associated with body size misperception in girls. Additionally, for boys and girls, SNS use seems to increase the likelihood of admiring the body image of media figures rather than friends or classmates. Understanding how SNS use influences body image remains important for promoting healthy development in children.

This cross-sectional study examined the link between screen time and lifestyle habits in upper elementary school children. It included 400 elementary schoolchildren studying in the fifth and sixth grades in elementary (187 boys, 213 girls, age: 10-12 y) in Japan. Gender, obesity index, physical fitness score, screen time, and lifestyle habits related to breakfast, midnight snacks, exercise, and sleep were the study items. Using logistic regression analysis, we examined lifestyle habits factors and screen time as the dependent and independent variables, respectively. We found that >3 h of screen time was significantly associated with increased odds of eating breakfast sometimes or never (odds ratio [95% confidence interval] 2.37 [1.05, 5.38]) and eating midnight snacks (2.72 [1.41, 5.23]). Additionally, the same factor significantly associated with <6 h of sleep (10.45 [2.78, 39.30]) and bedtime later than 10 pm (2.81 [1.43, 5.53]) and 11 pm (3.97 [1.95, 8.07]). These results hold true even after accounting for demographics, obesity index, and physical fitness score. Conversely, 2-3 h of screen time was significantly associated with sleep onset conditions (2.05 [1.17, 3.58]), whereas >3 h of screen time was not. Our results showed that increased screen time was associated with skipping breakfast, midnight snacks, sleep onset conditions, and less bedtime.

Estrogens can modulate energy balance by regulating food intake and energy expenditure. Hayashi etal. revealed that hypothalamic neuroestrogens, especially E2 from aromatase Cyp19a1, regulate appetite and body weight. In ovariectomized mice, elevated hypothalamic Cyp19a1 and Mc4r expression coincided with reduced food intake and weight loss. Pharmacological or genetic disruption of aromatase in mice lowered Mc4r expression and increased food intake, whereas neuronal Cyp19a1 overexpression enhanced Mc4r expression and suppressed appetite, independent of leptin. Therefore, neuroestrogens critically maintain metabolic equilibrium, positioning aromatase-derived E2 as a promising anti-obesity target.