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To identify behavioural and household factors associated with poor oral hygiene among Japanese kindergarten children in a population with high health awareness, using the Debris Index-Simplified (DI-S) as a clinical proxy for early oral hygiene deterioration.
Cross-sectional study.
Seven kindergartens in Sapporo city, Japan.
Of the 1229 kindergarten children invited, 871 provided parental consent (consent rate: 70.9%). Among them, 675 children aged 1–6 years who completed both the questionnaire and oral examination (completion rate: 54.9%). Most post-consent losses were due to logistical and staffing constraints. Children were stratified into ≤3 year and ≥4 year academic classes.
The primary outcome was oral hygiene status based on the DI-S scores (categorised as good (DI-S=0) or poor (DI-S>0). The secondary outcome was the presence of dental caries, defined as decayed, missing and filled primary teeth: dmft≥1. Multivariable logistic regression was used to estimate associations between poor oral hygiene and behavioural and household factors.
Among the 675 children, 168 children (24.9%) exhibited poor oral hygiene (DI-S>0) and 89 children (13.2%) had dental caries (dmft≥1). In multivariable analysis adjusted for demographic, dental and dietary variables, poor oral hygiene was significantly associated with being from a multiple-child household (OR 1.67, 95% CI 1.16 to 2.42) and irregular juice consumption (OR 1.60, 95% CI 1.07 to 2.38). Age-stratified analysis revealed that these associations persisted among those in the ≥4 year class, with additional significance for infrequent tooth brushing (
In a high health awareness Japanese preschool population, poor oral hygiene was independently associated with household composition and juice consumption, rather than traditional dental behaviours. These findings suggest the need to broaden preventive strategies beyond routine dental guidance to include family structure and dietary patterns, particularly in low-prevalence settings. Differential associations between DI-S and caries experience emphasise the utility of early clinical indices in oral health promotion.
by Keiji Koyama, Chisa Watanabe, Yusuke Oyama
The aim of this study was to determine whether and which lower limb muscles contribute to maintaining dynamic balance during the stepping test. Twelve healthy young men performed in-place stepping at tempos of 44 (slow) and 132 (fast) bpm. Vertical ground reaction forces and lower limb muscle activity were recorded using a force plate and a telemetric electromyography (EMG) system, respectively. EMG signals were recorded from the rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), gastrocnemius medialis (GM), and soleus (SOL) on the right leg. The single-leg support time and the time difference between metronome sound and foot contact at the slow tempo were greater than those at the fast tempo. The impact force at the fast tempo was greater than that at the slow tempo. In the single-leg support phase, the mean EMG signals of the RF, VL, and SOL at the slow tempo were 63%, 17%, and 23% lower, respectively, than those at the fast tempo, whereas the integrated EMG signals of the VL, BF, GM, and SOL at the slow tempo were 171%, 315%, 214%, and 157% greater, respectively. There were no significant relationships among the rate of change in the single-leg support time, the time difference from the slow to the fast tempo, or the rate of change in the EMG activity of each muscle. In the stepping test, movement characteristics associated with tempo were reflected in lower limb muscle activity, while dynamic balance indicators appeared to be influenced by factors other than muscle activation.This research paper presents a study protocol for an exploratory clinical trial evaluating the safety and potential efficacy of autologous peripheral blood mononuclear cell (PBMNC)-loaded injectable cell scaffold (ICS-001) for angiogenic therapy in chronic limb-threatening ischaemia (CLTI). CLTI, the advanced stage of peripheral artery disease, presents significant therapeutic challenges.
Angiogenic therapy using ICS-001 with PBMNCs—a novel approach designed to enhance local cell retention and promote neovascularisation—will be explored. The study will address the pathophysiology of CLTI, the limitations of current treatments and the rationale for cell-based therapies, alongside the clinical trial design for evaluating the safety and efficacy of ICS-001. We hypothesise that ICS-001 will improve ulcer healing and reduce ischaemic rest pain in patients with CLTI. This paper outlines the methodology, including patient selection, CD34+ cell mobilisation, scaffold preparation, injection protocols, clinical assessments, data collection and safety monitoring. The anticipated results, discussion and conclusion will offer insight into the clinical significance and potential impact of ICS-001 as a pioneering angiogenic therapy for CLTI.
The institutional review boards of all participating hospitals approved this study protocol (latest version V.6.0, 5 June 2025). Final data will be made publicly available. A report detailing the study results will be submitted for publication in an appropriate peer-reviewed journal.
Data are available on reasonable request. Technical appendix, statistical code is available by contacting the corresponding author. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) licence, which permits others to distribute, remix, adapt, build on this work non-commercially, and licence their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
jRCT2052230115, Japan Registry of Clinical Trials.
Post-COVID-19 conditions (PCC) may include pulmonary sequelae, fatigue and other symptoms, but its mechanisms are not fully elucidated.
This study investigated the correlation between fatigue and the presence of pulmonary abnormalities in PCC patients with respiratory involvement 6–12 months after hospitalisation.
Cross-sectional study.
A tertiary hospital in Brazil.
315 patients, aged ≥18 years, were considered eligible based on SARS-CoV-2 infection confirmed by reverse transcription-PCR.
Pulmonary function tests (PFT), cardiopulmonary exercise tests (CPET), chest CT and hand grip were performed. The following scales were applied: Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, Euroqol 5 Dimensions quality of life (EQ-5D) and Hospital Anxiety and Depression Scale (HADS). Participants were divided between the fatigue group (FACIT-F≤30) and the non-fatigue group (FACIT-F>30). For the statistical analysis, the primary outcome was the difference in the diffusing capacity of the lungs for carbon monoxide (DLCO) between groups. Considered secondary outcomes were differences in PFT, CPET, chest CT, hand grip, EQ-5D and HADS.
The fatigue group had 81 patients (25.7%) against 234 (74.3%). PFT and CPET showed no significant difference in DLCO and oxygen consumption peak values between groups. The fatigue group had a lower workload (mean 55.3±21.3 watts vs 66.5±23.2 watts, p=0.003), higher breathing reserve (median 41.9% (33.8–52.5) vs 37.7% (28.9–47.1), p=0.028) and lower prevalence of ground glass opacity (60.8% vs 77.7%, p=0.003) and reticulation (36.7% vs 54.9%, p=0.005) in chest CT. The fatigue group had higher anxiety (57% vs 24%, p
Fatigue in patients with PCC 6–12 months after hospitalisation is relatively common and had weak correlation with pulmonary disorders. Our results suggested fatigue could be strongly related with peripheral disorders such as reduced musculoskeletal strength or psychosocial limitations.
FreshRSS 