Yuko Araki

Scale properties of the Japanese version of the Strengths and Difficulties Questionnaire (SDQ): A study of infant and school children in community samples

The Strengths and Difficulties Questionnaire (SDQ) is a short screening instrument which addresses the positive and negative behavioral attributes of infants, children and adolescents. The SDQ is widely used to evaluate child developmental disabilities, psychological and psychiatric conditions or disorders in Japan. However, we did not have normative data for the Japanese version until now. To establish the community-based data and properties for the Japanese version, we collected and evaluated parent ratings of a total of 2899 Japanese children aged 4-12 years, including 1463 boys and 1436 girls. Statistical evaluation of psychometric properties included a factor analysis verifying the proposed scale structure, an assessment of scale homogeneities, and the determination of age, gender and relationship of each difficulties scale, or prosocial scale. The total difficulties score in boys (8.70 +/- 5.03) was higher than in girls (7.86 +/- 4.88). Based on the distributions of SDQ scores observed in the Japanese community sample, recommended bandings identifying normal, borderline, and abnormal (clinical ranges) were defined for each scale, and some gender difference was found in some difficulties and prosocial SDQ scores. After evaluating parent ratings obtained in a community-based sample, the Japanese SDQ was shown to possess favorable psychometric properties. Thus, the Japanese translation of this popular and versatile instrument seems to be approximately as reliable and useful as the original English questionnaire.

Gene and cytokine profile analysis of macrolide-resistant Mycoplasma pneumoniae infection in Fukuoka, Japan

BackgroundRecent epidemiologic data suggest that the prevalence of macrolide resistant Mycoplasma pneumoniae (MR-M. pneumoniae) is increasing rapidly worldwide. This study assessed the present status of M. pneumoniae infection in Japan and clinical end-points to distinguish children with MR-M. pneumoniae.MethodsDuring an outbreak of M. pneumoniae infections in Fukuoka, Japan in 2010–11, a total of 105 children with clinically suspected M. pneumoniae infection were enrolled. M. pneumoniae was analyzed for macrolide resistance in domain V of the 23S rRNA gene. Sixty -five patients with PCR positive for M. pneumoniae were analyzed with regard to clinical symptoms, efficacy of several antimicrobial agents and several laboratory data.ResultsCausative pathogens were detected in 81.0% (85 of 105) and M. pneumoniae was identified 61.9% (65 of 105). The resistance rate of M. pneumoniae was 89.2% (58 of 65) in this general pediatric outpatient setting. Patients infected with MR-M. pneumoniae showed longer times to resolution of fever and required frequent changes of the initially prescribed macrolide to another antimicrobial agent. We observed three different genotypes of M. pneumoniae including the rarely reported A2063T mutation (A2063G: 31 strains, A2063T: 27 strains, no mutation: 7 strains). Drug susceptibility testing showed different antimicrobial susceptibility profiles for each genotype. Serum IFN-gamma, IL-6 and IP-10 levels were higher in patients with MR-genotypes than in those infected with no-mutation strains (p < 0.001).ConclusionsMacrolide resistance is more common than previously thought and a small epidemic of rarely reported A2063T mutation was observed in Fukuoka, Japan. Furthermore our results reveal the possibility that levels of certain inflammatory cytokines may be a candidate to predict MR-M.pneumoniae infection.

Functional Logistic Discrimination Via Regularized Basis Expansions

We introduce a functional logistic discrimination based on basis expansions with the help of regularization, which classifies functional data into several distinct groups. A crucial issue in model building process is the choice of regularization parameters. Choosing these parameters can be viewed as a model selection and evaluation problem. We derive a Bayesian model selection criterion for evaluating models estimated by the method of regularization in the context of functional logistic discrimination. Monte Carlo experiments are conducted to examine the efficiency of the proposed functional discrimination procedure. We also apply our procedure to the analysis of yeast cell cycle microarray data. The results show that our modeling procedure provides useful tools for classifying functions or curves.

Therapeutic hypothermia can be induced and maintained using either commercial water bottles or a phase changing material mattress in a newborn piglet model

Background: Therapeutic hypothermia, a safe and effective treatment for neonatal encephalopathy in an intensive care setting, is not available in low-resource settings. Aims/Methods: To assess two low-tech, low-cost cooling devices for use in low-resource settings: (i) commercially available water bottles filled with tepid water (25°C); (ii) a mattress made of phase changing material (PCM) with a melting point of 32°C (PCM works as a heat buffer at this temperature). Eleven anaesthetised newborn piglets were studied following transient hypoxia–ischaemia. The cooling device was applied 2–26 h after hypoxia–ischaemia with a target rectal temperature (Trectal) of 33–34°C. Trectal undershoot was adjusted using cotton blankets; the cooling device was renewed when Trectal rose above 35°C. Trectal data during cooling were dichotomised (within or without target) to assess: (a) the total period within the target Trectal range; (b) the stability and fluctuation of Trectal during cooling. Results: Therapeutic hypothermia was achieved with both water bottles (n = 5) and the PCM mattress (n = 6). The mean (SD) time to reach target Trectal was 1.8 (0.5) h with water bottles and 1.9 (0.3) h with PCM. PCM cooling led to a longer period within the target Trectal range (p<0.01) and more stable cooling (p<0.05). Water bottle cooling required device renewal (in four out of five piglets). Conclusion: Simple, low-tech cooling devices can induce and maintain therapeutic hypothermia effectively in a porcine model of neonatal encephalopathy, although frequent fine tuning by adjusting the number of blankets insulating the piglet was required to maintain a stable temperature. PCM may induce more stable cooling compared with water bottles.

Multivariate Regression Modeling for Functional Data

We propose functional multivariate regression modeling, using Gaussian basis functions along with the technique of regularization. In order to evaluate the model estimated by the regularization method, we derive model selection criteria from information-theoretic and Bayesian viewpoints. Monte Carlo simulations are conducted to investigate the efficiency of the proposed model. We also apply our modeling strategy to the analysis of spectrometric data.

Prefrontal brain function in children with anorexia nervosa: A near-infrared spectroscopy study

To investigate the prefrontal hemodynamic response during a cognitive task in childhood anorexia nervosa (AN), we measured regional cerebral blood volume changes in terms of changes in hemoglobin concentrations [Hb], using near-infrared spectroscopy (NIRS). Sixteen females with AN (mean age 14.2 years old) and 12 age-matched healthy female control subjects (mean age 14.3 years old) participated in this study. Waveform patterns for [Hb] during the word fluency task differed between the two groups, although their task performances showed no significant difference. In the control group, the [total-Hb] and [oxy-Hb] immediately increased and the [deoxy-Hb] immediately decreased after the beginning of the task and gradually reached the baseline level after the end of the task. The patients with AN were consistently characterized by an unchanged or less fluctuating response pattern of [total-Hb], [oxy-Hb] and [deoxy-Hb] during the task and rest periods. In the AN group, subjects with higher Eating Attitudes Test (EAT-26) scores showed higher [oxy-Hb] during the task. On the other hand, in the control group, subjects with higher EAT-26 scores showed lower [oxy-Hb] during the task. The grand waveforms of each [Hb] during a motor activation task, which was applied as a control task, did not differ significantly between two groups. The different prefrontal hemodynamic responses might indicate that AN subjects might apply fewer brain circuits or fewer neurons per circuit during cognitive tasks and might use different brain circuits in relation to their preoccupation with eating behaviors.

Leisure-Time Physical Inactivity Associated with Vascular Depression or Apathy in Community-Dwelling Elderly Subjects: The Sefuri Study

BACKGROUND Although physical inactivity is a major public health problem, the causative factors for physical inactivity per se are poorly understood. To address this issue, we investigated the relationship between deep white matter lesions (DWMLs) on magnetic resonance imaging, apathy, and physical activities using structural equation modeling (SEM). METHODS We examined 317 community-dwelling elderly subjects (137 men and 180 women with a mean age of 64.5 years) without dementia or clinically apparent depression. Physical activity was assessed with a questionnaire consisting of 3 components (leisure-time, work, and sport activities). RESULTS The mean score from the apathy scale (a visual analogue version of Starksteins apathy scale) of the Grades 2-3 DWML group was 420 (95% confidence interval [CI] 379-461), which was lower (more apathetic) than the Grade 0 DWML group score of 478 (95% CI 463-492) after adjustment for education as a covariate. SEM showed that the direct paths from DWMLs or education to apathy were significant, and the direct path from apathy to leisure-time activity was highly significant (β = .25, P < .001). The degree of apathetic behavior was negatively associated with sport activity in female subjects and positively associated with TV watching in male subjects. CONCLUSIONS The results of the study show that DWMLs are one of the major factors that cause apathetic behavior and that apathy has significant negative effects on leisure-time physical activity in community-dwelling elderly subjects. Even a minor level of apathy without major depression would have a significant impact on activities of daily living and quality of life.

Characteristic prefrontal blood volume patterns when imaging body type, high-calorie food, and mother–child attachment in childhood anorexia nervosa: A near infrared spectroscopy study

The aim of this study was to investigate the prefrontal activation in childhood anorexia nervosa (AN) patients when imaging symptom-provocative factors such as body type, high-calorie food, and attachment between mother and child. The prefrontal activations during each task, in terms of blood volume changes, were measured by near infrared spectroscopy. Twelve females with childhood AN (mean age, 14.4 years old) and 13 age-matched healthy female controls (mean age, 14.3 years old) participated in this study. Both groups showed increased prefrontal blood volume when viewing images of each symptom-provocative factor. Unexpectedly, there was no significant difference in the prefrontal blood volume increases between the control group and the childhood AN group when viewing images of slender and obese body types and high-calorie food. On the other hand, images of mother-child attachment resulted in significantly greater increases in prefrontal blood volume in the childhood AN group than in the control group. These results indicated that prefrontal activation in AN might be associated with imaging attachment between mother and child, but not associated with imaging body type or high-calorie food.

A pilot study on the changes in immunity after ACTH therapy in patients with West syndrome

Adrenocorticotropic hormone (ACTH) has been the first-line drug for the treatment of West syndrome, although the therapy has various adverse effects. ACTH depresses resistance to a variety of bacterial, viral, protozoal, and fungal agents. The timing of the various vaccinations is delayed after ACTH therapy in Japan, because the immune system is believed to be affected for approximately 6 months. However, the duration of the effect of ACTH on the immune system is not known. Therefore, we examined changes in the immunity levels before and after ACTH therapy. We measured white blood cell counts, lymphocyte counts, T/B cell counts, CD4(+) and CD8(+) T cell counts, CD 4/8 ratio, lymphocyte blastoid transformation by PHA or Con-A, and the levels of IgA, IgM, and IgG before, immediately after, and 1, 3, 6, and 12 months after ACTH therapy. The lymphocyte counts and CD4(+) T cell counts were significantly decreased immediately after and at 1 and 3 months after the therapy, and did not return to the previous levels even at 6 months and 12 months after ACTH treatment; however, these levels returned to within normal limits (within the 95% confidence interval). Immunoglobulin levels did not change after the ACTH therapy. Helper T cells were more depressed than cytotoxic T cells after ACTH therapy.

Regularized logistic discrimination with basis expansions for the early detection of Alzheimer's disease based on three-dimensional MRI data

In recent years, evidence has emerged indicating that magnetic resonance imaging (MRI) brain scans provide valuable diagnostic information about Alzheimer’s disease. It has been shown that MRI brain scans are capable of both diagnosing Alzheimer’s disease itself at an early stage and identifying people at risk of developing Alzheimer’s. In this article, we have investigated statistical methods for classifying Alzheimer’s disease patients based on three-dimensional MRI data via L2-type regularized logistic discrimination with basis expansions. Preceding studies adopted an open approach when applying three-dimensional data analysis. Our proposed classification model with dimension reduction techniques offers discriminant functions with excellent prediction performance in terms of sensitivity and specificity.