Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library of Science (PLoS)  

Aim

This study aimed to determine whether excessive maternal weight gain during pregnancy was associated with a higher risk of prolonged labor.

Methods

We analyzed the data regarding maternal weight gain during pregnancy for the participants of Japan Environment and Children’s Study (JECS), which is an ongoing nationwide prospective birth cohort study in Japan. After excluding participants with multiple pregnancies, with deliveries before 37 or beyond 42 weeks of gestation, or who had undergone cesarean section, 71,154 (nulliparous, n = 28,442) Japanese women were included. Prolonged labor was defined by a cutoff ranking at the 95^th percentile and consequently defined as labor duration exceeding 12.7 h in multiparous women and exceeding 23.2 h in nulliparous women. These classifications were made according to labor curves established by the Japanese Society of Obstetrics and Gynecology Perinatal Committee developed in June 2021. Considering that no studies have conducted an investigation based on this new guideline, we analyzed the association between excessive maternal weight gain during pregnancy and prolonged labor by parity.

Results

The overall incidence of prolonged labor was 10.2% (2,907/28,442) in nulliparous women and 6.1% (2,597/42,712) in multiparous women. Multivariable analysis indicated that excessive maternal weight gain was significantly associated with prolonged labor in nulliparous (adjusted odds ratio, 1.21; 95% confidence interval, 1.10–1.32) and multiparous women (adjusted odds ratio, 1.15; 95% confidence interval, 1.05–1.27). Kaplan–Meier survival analysis showed that as labor progressed, the percentage of women who had not yet delivered was higher among those with excessive maternal weight gain than among those with normal maternal weight gain in both the nulliparous (median labor duration 12.9 h vs 12.2 h, p<0.001) and multiparous (median labor duration 6.2 h vs 5.8 h, p<0.001) groups.

Conclusion

Excessive maternal weight gain was significantly associated with prolonged labor in Japanese women.

DOI： 10.1371/journal.pone.0306247

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Language：Japanese   Publishing type：Research paper (other science council materials etc.)   Publisher：(一社)日本糖尿病学会  

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Language：English   Publishing type：Research paper (scientific journal)  

File： J Psychiatr Res 2024 Ohashi Y MMSP of of postpartum depression.pdf

DOI： 10.1016/j.jpsychires.2024.01.033

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Language：English   Publishing type：Research paper (scientific journal)  

File： J Dermatol 2024 Kojima R Association between filaggrin gene mutations and the clinical features of molluscum contagiosum.pdf

DOI： 10.1111/1346-8138.17157

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： https://doi.org/10.1016/j.xjon.2023.11.020

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

File： Diabetol Int 2024 Matsuura N Mortality in type 1 diabetes in Japan.pdf

DOI： 10.1007/s13340-023-00688-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

File： 1-s2.0-S2666273623004175-main.pdf

DOI： 10.1016/j.xjon.2023.11.020

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1111/irv.13221

DOI： 10.1111/irv.13221

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: High-resolution manometry (HRM) and esophagography are used for achalasia diagnosis; however, achalasia phenotypes combining esophageal motility and morphology are unknown. Moreover, predicting treatment outcomes of per-oral endoscopic myotomy (POEM) in treatment-naïve patients remains an unmet need. METHODS: In this multicenter cohort study, we included 1,824 treatment-naïve patients diagnosed with achalasia. In total, 1,778 patients underwent POEM. Clustering by machine learning (ML) was conducted to identify achalasia phenotypes using patients' demographic data, including age, sex, disease duration, body mass index, and HRM/esophagography findings. ML models were developed to predict persistent symptoms (Eckardt score ≥3) and reflux esophagitis (RE) (Los Angeles grades A to D) after POEM. RESULTS: ML identified three achalasia phenotypes: phenotype 1, type I achalasia with a dilated esophagus (n=676; 37.0%); phenotype 2, type II achalasia with a dilated esophagus (n=203; 11.1%); phenotype 3, late-onset type I-III achalasia with a non-dilated esophagus (n=619, 33.9%). Types I and II achalasia in phenotypes 1 and 2 exhibited different clinical characteristics from those in phenotype 3, implying different pathophysiologies within the same HRM diagnosis. A predictive model for persistent symptoms exhibited an area under the curve (AUC) of 0.70. Pre-POEM Eckardt score ≥6 was the greatest contributing factor for persistent symptoms. The AUC for post-POEM RE was 0.61. CONCLUSION: Achalasia phenotypes combining esophageal motility and morphology indicated multiple disease pathophysiologies. ML helped develop an optimal risk stratification model for persistent symptoms with novel insights into treatment resistance factors.

DOI： 10.1111/den.14714

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

The relationship between high body mass index (BMI) >25 kg/m2 and risk for stillbirth in the Japanese population remains unclear. This study aimed to estimate the impact of maternal obesity on the risk of stillbirth in a Japanese population. This prospective cohort study used data from the Japan Environment and Children's Study, which recruited pregnant individuals between 2011 and 2014. A total of 93,772 fetuses were considered eligible for inclusion in this study. Stillbirth (fetal death before or during labor at ≥22 completed weeks of gestation) rates were compared among four pre-pregnancy BMI groups: underweight (<18.5 kg/m2), reference (18.5 to <25.0 kg/m2), overweight (25.0 to <30.0 kg/m2), and obese (≥30.0 kg/m2). The association between pre-pregnancy BMI and the risk of stillbirth was estimated using multiple logistic regression analyses. The overall stillbirth incidence was 0.33% (305/93,722). Compared with the reference group, the risk of stillbirth was significantly higher in the overweight group (adjusted odds ratio [aOR]: 1.55; 95% confidence interval [CI]: 1.08-2.23) and the obese group (aOR: 2.60; 95% CI: 1.59-4.24). The overall incidence of early stillbirth (i.e., <28 weeks) was 0.17% (155/93,722). Similarly, after adjusting for potential confounding factors, the risk of early stillbirth was significantly higher in the obese group (aOR: 4.33; 95% CI: 2.44-7.70). Increased maternal BMI was associated with an increased risk of stillbirth in the Japanese population. Therefore, counselling women planning for pregnancy on the importance of an appropriate pre-pregnancy BMI to minimize the risk of stillbirth is important.

DOI： 10.1016/j.pmedr.2023.102391

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：IWA Publishing  

Abstract

In regions suffering from water scarcity, residents commonly employ several coping strategies such as the use of multiple water sources, water storage and water sharing and borrowing. This study applies a hierarchical linear regression model to investigate the physical (i.e. water source and supply time) and non-physical (i.e. number of families, wealth status, education for household head, house ownership, water treatment and community involvement) factors associated with individual water consumption throughout the Kathmandu Valley, Nepal. During the baseline period (dry season before the 2015 Gorkha earthquake), the average water consumption was 91 litre/capita/day (LPCD) but there was a regional disparity in water consumption, ranging from 16 to 158 LPCD. The statistical analysis indicated that households using many water sources consumed more water regardless of the supply area even in an emergency. In addition, households with many family members used less water per person. During emergencies, households participating in the local community were found to consume more water than households not participating in the community, especially when the water being used was managed by the community.

DOI： 10.2166/washdev.2023.059

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

We measured the association between history of influenza vaccination by age 2 years and influenza virus (IFV) infection at ages 3 and 4 years by relative risk reduction. We also examined the association between history of IFV infection by age 2 years and recurrent IFV infection at age 3 years. This study included 73,666 children from a large Japanese birth cohort. Among children vaccinated never, once or twice when aged under 2 years, 16.0%, 10.8% and 11.3%, respectively, had been infected with IFV by age 3 years, and 19.2%, 14.5% and 16.0%, respectively, by age 4 years. Compared with no history of influenza vaccination, vaccination at ages 1 and/or 2 years reduced the risk of IFV infection at age 3 by 30%-32% and at age 4 by 17%-24%. The relative risk of recurrent IFV infection at ages 3 and 4 years increased in proportion to the number of prior infections by age 2. One-season-prior influenza vaccination history reduced the IFV infection risk at age 3 years by 25%-42%. Influenza vaccination most effectively protected children at age 3 who lacked older sibling(s) and did not attend nursery school. One-season-prior IFV infection increased the relative risk of recurrent infection at age 3 years (1.72-3.33). In conclusion, influenza vaccination-induced protection may partly extend to the next season. Owing to the relative risk reduction by influenza vaccination and the increased relative risk of IFV infection from prior-season infection, annual influenza vaccination is recommended.

DOI： 10.1016/j.ypmed.2023.107599

PubMed

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Background

Animal studies have shown that maternal low-fiber diets during pregnancy may impair brain development and function in offspring, but this has not been validated by epidemiological studies. The aim of this study was to investigate the link between maternal dietary fiber intake during pregnancy and neurodevelopmental delay in offspring using a large birth cohort.

Methods

A total of 76,207 mother-infant pairs were analyzed using data from the Japan Environment and Children's Study, a nationwide prospective cohort study. Maternal dietary fiber intake was estimated using the food frequency questionnaire in mid-pregnancy. Maternal dietary fiber intake was adjusted for energy and classified into quintiles. Developmental delay was assessed in five domains using the Japanese version of the Ages and Stages Questionnaire, Third Edition at the age of 3 years. The logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI) for the link between dietary fiber intake during pregnancy and developmental delay at the age of 3 years.

Results

The lowest intake group of total dietary fiber had a higher risk of delayed communication [adjusted OR (aOR), 1.51; 95% CI, 1.32–1.74], fine motor (aOR, 1.45; 95% CI, 1.32–1.61), problem-solving (aOR, 1.46; 95% CI, 1.32–1.61), and personal-social skills (aOR, 1.30; 95% CI, 1.12–1.50) than did the highest intake group. An analysis that excluded the effects of insufficient folic acid intake during pregnancy also showed a similar trend.

Conclusion

This study showed that maternal dietary fiber deficiency during pregnancy might influence an increased risk of neurodevelopmental delay in offspring.

DOI： 10.3389/fnut.2023.1203669

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Although it remains debatable, exogenous oxytocin, commonly used for labour induction and augmentation, reportedly increases risks of neurodevelopment delay, attention-deficit/hyperactivity disorder, and autism spectrum disorder among children prenatally exposed to exogenous oxytocin. However, only few studies have objectively examined exogenous oxytocin's impact on early childhood development through scoring evaluations. This study investigated the association between exogenous oxytocin exposure and neurodevelopment in 3-year-old children using the Ages and Stages Questionnaires, Third Edition. In this nationwide prospective cohort study, we extracted data from 104,062 foetal records regarding exogenous oxytocin use during labour from the Japan Environment and Children's Study. Participants completed questionnaires throughout the pregnancy and postpartum periods. Outcomes comprised the developmental status less than each cut-off value for the five domains of the Ages and Stages Questionnaire, Third Edition. We conducted multivariable logistic regression analyses on the data of 55,400 children after controlling for confounders. Among the 55,400 included women, 19.0% (n = 10,506) used exogenous oxytocin during labour and 81.0% (n = 44,894) did not. Children exposed to exogenous oxytocin showed no significantly increased risk of developmental delay in any domain (communication: odds ratio [OR] 1.04, 95% confidence interval [CI] 0.92-1.16; gross motor: OR 0.97, 95% CI 0.87-1.08; fine motor: OR 1.00, 95% CI 0.92-1.09; problem-solving: OR 1.02, 95% CI 0.94-1.11; personal-social: OR 0.91, 95% CI 0.80-1.03).Conclusion: Exogenous oxytocin for labour induction did not adversely affect early childhood development. Further studies accounting for the degree of exogenous oxytocin exposure are required to confirm these results.

DOI： 10.1007/s00431-023-05079-w

Web of Science

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND AIM: Absent contractility (AC) and ineffective esophageal motility (IEM) are esophageal hypomotility disorders diagnosed using high-resolution manometry (HRM). Patient characteristics and disease course of these conditions and differential diagnosis between AC and achalasia are yet to be elucidated. METHODS: A multicenter study involving 10 high-volume hospitals was conducted. Starlet HRM findings were compared between AC and achalasia. Patient characteristics including underlying disorders and disease courses were analyzed in AC and IEM. RESULTS: Fifty-three patients with AC and 92 with IEM were diagnosed, while achalasia was diagnosed in 1784 patients using the Chicago classification v3.0 (CCv3.0). The cut-off integrated relaxation pressure (IRP) value at 15.7 mmHg showed maximum sensitivity (0.80) and specificity (0.87) for differential diagnosis of AC from type I achalasia. While most ACs were based on systemic disorders such as scleroderma (34%) and neuromuscular diseases (8%), 23% were sporadic cases. The symptom severity of AC was not higher than that of IEM. Regarding the diagnosis of IEM, the more stringent CCv4.0 excluded 14.1% of IEM patients than the CCv3.0, although patient characteristics did not change. In patients with the hypomotile esophagus, concomitance of reflux esophagitis was associated with low distal contractile integral and IRP values. AC and IEM transferred between each other, paralleling with the underlying disease course, although no transition to achalasia was observed. CONCLUSION: A successful determination of the optimal cut-off IRP value was achieved using the starlet HRM system to differentiate AC and achalasia. Follow-up HRM is also useful for differentiating AC from achalasia. Symptom severity may depend on underlying diseases instead of hypomotility severity.

DOI： 10.1111/jgh.16268

PubMed

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.3418/jjam.JJAM-2022-0043

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER  

File： 1-s2.0-S0165032723002458-main.pdf

DOI： 10.1016/j.jad.2023.02.088

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Other Link： https://www.sciencedirect.com/science/article/pii/S0165032723002458

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1080/14767058.2023.2209251

DOI： 10.1080/14767058.2023.2209251

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.gie.2022.10.039 Get rights and content

DOI： 10.1016/j.gie.2022.10.039 Get rights and content

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Hypertensive disorders of pregnancy (HDP) increase the risk of preterm births and cesarean delivery. This study aimed to investigate whether maternal blood leukocyte, monocyte, or neutrophil counts in the first trimester are related to the development of HDP. Data were collected from the Japan Environment and Children’s Study, a large birth cohort study (n = 38,194) that recruited pregnant women in 15 Regional Centers across Japan (from January 2011 to March 2014). The odds ratios (ORs) for mild/severe HDP according to the cut-off value of leukocyte/neutrophil/monocyte counts by the receiver operating characteristic curve showed high ORs. Furthermore, pregnant women with the highest quartiles of leukocyte and monocyte counts had higher adjusted ORs (aORs) for mild (leukocyte: aOR = 1.27, 95% confidence interval [CI]: 1.02–1.58; monocyte: aOR = 1.30, 95% CI 1.04–1.63) and severe HDP (leukocyte: aOR = 1.51, 95% CI 1.08–2.13; monocyte: aOR = 1.44, 95% CI 1.03–2.01) compared with those with the lowest quartiles of those counts. In addition, pregnant women with the highest neutrophil counts had higher aOR for mild HDP (aOR = 1.26, 95% CI 1.02–1.56) compared with those with the lowest count. In conclusion, high leukocyte and monocyte counts in the first trimester are associated with the development of HDP. Thus, they may be used to predict subsequent HDP.

DOI： 10.22541/au.167915051.14233222/v1

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Other Link： https://www.nature.com/articles/s41598-024-55623-3

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PORTFOLIO  

The association between maternal pre-pregnancy smoking status and asthma risk is unclear. This study aimed to investigate the association between pre- and post-pregnancy maternal smoking status and bronchial asthma at 3 years of age in a large birth cohort. Data of 75,411 mother-child pairs from the Japan Environment and Children's Study (JECS) were analysed using multivariate logistic regression analysis. Overall, 7.2% of the children had bronchial asthma. The maternal smoking status before childbirth was as follows: Never = 60.0%, Quit before recognising current pregnancy = 24.1%, Quit after finding out about current pregnancy = 12.3%, and Still smoking = 3.6%. Children of mothers who sustained smoking during pregnancy had an increased risk of bronchial asthma at 3 years of age even after adjusting for pre- and postnatal covariates (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.15-1.56). Children of mothers who quit before (aOR 1.09, 95% CI 1.02-1.18) or after (aOR 1.11, 95% CI 1.01-1.23) recognising the current pregnancy had an increased risk of bronchial asthma at 3 years of age. Maternal smoking throughout pregnancy and smoking exposure pre-pregnancy or in early pregnancy increases the risk of bronchial asthma in children.

DOI： 10.1038/s41598-023-30304-9

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Other Link： https://www.nature.com/articles/s41598-023-30304-9

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMC  

DOI： https://doi.org/10.1186/s12887-023-03878-6

Other Link： https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-03878-6

Language：Japanese   Publisher：(一社)日本疫学会  

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Language：Japanese   Publisher：(一社)日本疫学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE SOC ALLERGOLOGY  

BACKGROUND: The relationship between the season of birth, allergen sensitization, and allergic rhinitis have been inconsistent, and there are no studies that simultaneously consider vitamin D and allergen exposure. This study aimed to determine the associations between the season of birth, house dust mite (HDM) and Japanese cedar pollen (JCP) sensitization, and allergic rhinitis and pollinosis, while taking vitamin D levels and allergen exposure into account. METHODS: This study included 4323 participants in the Sub-Cohort Study of the Japan Environment and Children's Study. A logistic regression model was used to analyze the association between the season of birth and sensitization to JCP or HDM (judged by specific immunoglobulin E) at age 2 and allergic rhinitis or pollinosis at age 3, adjusted for HDM or JCP exposure and vitamin D levels with potential confounders. RESULTS: Participants born in spring or summer were more likely to have pollinosis than were those born in winter (adjusted odds ratio [aOR]: 2.08, 95% confidence interval [CI]: 1.13-3.82 for spring; aOR: 1.89, 95% CI: 1.03-3.47 for summer). Participants born in summer were more likely to have HDM sensitization than were those born in winter (Der p 1, aOR: 1.53, 95% CI: 1.10-2.15; Der f 1, aOR: 1.44, 95% CI: 1.03-2.01). Exposure to JCP and HDM were associated with pollinosis and HDM sensitization, respectively. CONCLUSIONS: Spring and summer births were associated with the development of pollinosis, and summer birth was associated with HDM sensitization, even when vitamin D and allergen exposure were considered. Further studies on mechanisms other than vitamin D and allergen exposure are required.

File： Kojima2023 pollinosis.pdf

DOI： 10.1016/j.alit.2023.01.003

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Other Link： https://www.sciencedirect.com/science/article/pii/S1323893023000035

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

File： Health Science Reports - 2022 - Yui - Appropriate procedures to increase the adherence of children to blood collection A.pdf

DOI： 10.1002/hsr2.1036

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1002/hsr2.1036

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGERNATURE  

DOI： https://doi.org/10.1038/s41390-022-02435-8

Other Link： https://www.nature.com/articles/s41390-022-02435-8

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

DOI： 10.2188/jea.je20230210

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：WORLD PLANNING, Inc.  

Other Link： https://mol.medicalonline.jp/library/journal/download?GoodsID=aj2rsizd/2022/003311/013&name=1199-1210j&UserID=133.23.3.163

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

The association between endotoxin and allergic rhinitis (AR) is not conclusive. The aim of this study was to determine the association between endotoxin and house dust mite (HDM) allergens in dust, and HDM sensitization and AR among Japanese infants. This study included 4188 participants in the Sub-Cohort Study of the Japan Environment and Children’s Study. Dust was collected from children’s mattresses at age 18 months and endotoxin and HDM allergen levels were measured. A logistic regression model was used to analyze the association between endotoxin or HDM allergen and the sensitization to HDM (specific-IgE) at age 2 and AR at age 3. The median (interquartile range) endotoxin level was 375.1(186.9–826.5) EU/m2 and the Der 1 (Der p 1 + Der f 1) level was 51.2 (14.8–168.6) ng/m2. There were significant positive associations between endotoxin and HDM sensitization (Der f 1, adjusted odds ratio [aOR] quartile [Q] 4 vs. Q1, 1.44, 95% CI, 1.04–2.00; Der p 1, aOR Q4 vs. Q1, 1.56, 95% CI, 1.12–2.16). There were also significant positive associations between Der 1 exposure and HDM sensitization (Der f 1, aOR Q3 vs. Q1, 1.75, 95% CI, 1.26–2.44; aOR Q4 vs. Q1, 2.98, 95% CI, 2.15–4.13; Der p 1, aOR Q3 vs. Q1, 1.91, 95% CI, 1.37–2.66; aOR Q4 vs. Q1, 2.91, 95% CI, 2.09–4.05). There were, however, no associations between endotoxin or Der 1 and AR. In the population residing mostly in non-farming settings, both endotoxin and HDM allergens in dust were associated with an increased risk of HDM allergen sensitization, but not with AR.

File： ijerph-19-14796-v2.pdf

DOI： 10.3390/ijerph192214796

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Other Link： https://www.mdpi.com/1660-4601/19/22/14796

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2022.04.1347

Other Link： https://www.giejournal.org/article/S0016-5107(22)01666-2/fulltext

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

BACKGROUND & AIMS: Peroral endoscopic myotomy (POEM) is conducted for patients with esophageal motility disorders based on high-resolution manometry (HRM) findings. However, the impact of POEM on HRM findings and the associations between post-POEM HRM and outcomes have not been clarified. METHODS: In a multicenter, observational cohort study, patients with achalasia treated by POEM received follow-up HRM. Associations between patient characteristics, POEM procedures, and post-POEM HRM findings, including integrated relaxation pressure (IRP) and distal contractile integral (DCI), were investigated. Furthermore, the outcomes of the POEM procedure were compared with the post-POEM HRM findings. RESULTS: Of 2,171 patients, 151 (7.0%) showed residual high post-POEM IRP (≥26 mmHg, Starlet). In a multivariate analysis, high pre-POEM IRPs (odds ratio [OR]=24.3) and gastric myotomy >2 cm (OR=0.22) were found to be positive and negative predictive factors of high post-POEM IRPs, respectively. Peristalsis recovery (DCI ≥500 mmHg-cm-sec, at least one swallow, Starlet) was visible in 121 (19.6%) of 618 patients, and they were type II-III achalasia. High pre-POEM IRP (OR=2.65) and DCI ≥500 (OR=2.98) predicted peristalsis recovery, while esophageal dilation (OR=0.42) predicted a risk of no recovery. Extended myotomy did not reveal a significant impact on peristalsis recovery. High or low post-POEM IRP and DCI did not increase the incidence of clinical failure, reflux esophagitis, or symptomatic gastroesophageal reflux disease. CONCLUSIONS: Extended gastric myotomy decreased IRP values, while peristalsis recovery depended on the characteristics of achalasia. A residual high post-POEM IRP does not necessarily mean clinical failure. Routine HRM follow-up is not recommended after POEM.

File： 1-s2.0-S0016510722021319-main.pdf

DOI： 10.1016/j.gie.2022.10.039

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Other Link： https://www.sciencedirect.com/science/article/pii/S0016510722021319

Language：English   Publishing type：Research paper (scientific journal)   Publisher：KOREAN SOC NEUROGASTROENTEROLOGY & MOTILITY  

Background/Aims: ManoScan and Sandhill high-resolution manometry (HRM) systems are used worldwide; however, the diagnosis of achalasia on the Starlet HRM system is not fully characterized. Furthermore, the impact of calcium channel blockers and nitrites in treating achalasia has not been investigated using HRM. Management of recurrent cases is a priority issue, although few studies have examined patient characteristics. Methods: We conducted a multicenter, large-scale database analysis. First, the diagnosis of treatment-naive achalasia in each HRM system was investigated. Next, patient characteristics were compared between type I-III achalasia, and the impact of patient characteristics, including calcium channel blocker and nitrite use for integrated relaxation pressure (IRP) values, were analyzed. Finally, patient characteristics with recurrent achalasia were elucidated. Results: The frequency of type I achalasia with Starlet was significantly higher than that with ManoScan and Sandhill HRM systems. In achalasia, multivariate analysis identified male sex, advanced age, long disease duration, obesity, type I achalasia, and sigmoid type as risk factors related to normal IRP values (< 26 mmHg). Calcium channel blockers and nitrites use had no significant impact on the IRP values, although achalasia symptoms were indicated to be alleviated. In recurrent cases, the IRP value was significantly lower, and advanced age, long disease duration, and sigmoid type were more common than in treatment-naive patients. Conclusions: We should cautiously interpret the type of achalasia and IRP values in the Starlet HRM system. Symptoms of recurrent cases are related to disease progression rather than IRP values, which should be considered in decision making.

DOI： 10.5056/jnm21254

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Other Link： https://www.jnmjournal.org/journal/view.html?uid=1797&vmd=Full&

Language：English   Publishing type：Research paper (scientific journal)   Publisher：GEORG THIEME VERLAG KG  

DOI： 10.1055/a-1753-9801

Other Link： https://www.thieme-connect.com/products/ejournals/html/10.1055/a-1753-9801

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

DOI： https://doi.org/10.1111/ped.15372

Other Link： https://onlinelibrary.wiley.com/doi/epdf/10.1111/ped.15372

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Georg Thieme Verlag KG  

BACKGROUND : Gastroesophageal reflux disease (GERD) and reflux esophagitis remain problems after peroral endoscopic myotomy (POEM). This study aimed to elucidate the risk factors and long-term course of reflux esophagitis and symptomatic GERD after POEM. METHODS : This multicenter cohort study involved 14 high volume centers. Overall, 2905 patients with achalasia-related esophageal motility disorders treated with POEM were analyzed for reflux esophagitis, severe reflux esophagitis (Los Angeles classification C or D), and symptomatic GERD. RESULTS : Reflux esophagitis was diagnosed in 1886 patients (64.9 %). Age ≥ 65 years (risk ratio [RR] 0.85), male sex (RR 1.11), posterior myotomy (RR 1.12), esophageal myotomy > 10 cm (RR 1.12), and gastric myotomy > 2 cm (RR 1.17) were independently associated with reflux esophagitis. Severe reflux esophagitis was diagnosed in 219 patients (7.5 %). Age ≥ 65 years (RR 1.72), previous treatments (RR 2.21), Eckardt score ≥ 7 (RR 0.68), sigmoid-type achalasia (RR 1.40), and esophageal myotomy > 10 cm (RR 1.59) were factors associated with severe reflux esophagitis. Proton pump inhibitors (PPIs) were more effective for reflux esophagitis at 5-year follow-up (P = 0.03) than after 1 year (P = 0.08). Symptomatic GERD was present in 458 patients (15.9 %). Symptom duration ≥ 10 years (RR 1.28), achalasia diagnosis (RR 0.68), integrated relaxation pressure ≥ 26 (RR 0.60), and posterior myotomy (RR 0.80) were associated with symptomatic GERD. The incidence of symptomatic GERD was lower at 5-year follow-up compared with that after 1 year (P = 0.04), particularly in PPI users (P < 0.001). CONCLUSIONS : The incidence of severe reflux esophagitis was low after POEM, but excessive myotomy for older patients with previous treatments should be avoided. Early phase symptomatic GERD is non-acid reflux dependent and the natural course is favorable, basically supporting conservative treatment.

File： Endoscropy 2022 Shiwaku H Risk factors and longterm course of gastroesophageal reflux.pdf

DOI： 10.1055/a-1778-9730

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：GEORG THIEME VERLAG KGGEORG THIEME VERLAG KGGEORG THIEME VERLAG KG  

Background and study aims Peroral endoscopic myotomy (POEM) is effective for the management of achalasia and its variants. However, this treatment can be ineffective in some patients. We aimed to develop and validate a risk scoring system for predicting the clinical failure of POEM preoperatively. Patients and methods Consecutive patients who underwent POEM in 14 high-volume centres between 2010 and 2020 were enrolled in this study. Clinical failure was defined as an Eckardt score of ≥4 or retreatment. A risk scoring system for predicting short-term clinical failure of POEM was developed using multivariable logistic regression and internally validated using bootstrapping and decision curve analysis. Results Of the 2740 study patients, 112 patients (4.1%) had clinical failure 6 months after POEM. Risk scores were assigned for three preoperative factors as follows: preoperative Eckardt score (1 point), manometric diagnosis (-4 points for type II achalasia), and a history of prior treatments (1 point for pneumatic dilation or 12 points for surgical/endoscopic myotomy). The discriminative capacity (concordance statistics, 0.68; 95% confidence interval [CI], 0.62-0.72) and calibration (slope 1.15; 95% CI, 0.87-1.40) were shown. Decision curve analysis demonstrated its clinical usefulness. Patients were categorized into low- (0-8 points: estimated risk of clinical failure <5%) and high-risk (9-22 points: ≥5%) groups. The proportions of clinical failure for the categories were stratified according to the mid-term outcomes (log-rank test; p<0.0001). Conclusions This risk scoring system can predict clinical failure of POEM preoperatively and provide useful information for making treatment decisions.

File： a-1876-7554.pdf

DOI： 10.1055/a-1876-7554

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Gestational diabetes mellitus (GDM) is one of the most common pregnancy-related complications; it is associated with adverse pregnancy outcomes and metabolic disorders in offspring, consistent with the concept of the developmental origins of health and disease. This cohort study of women without diabetes (n = 761), who were part of the Yamanashi Adjunct Study of the Japan Environment and Children's Study, aimed to explore the associations between maternal GDM and their offspring's level of high-sensitivity C-reactive protein (hsCRP), a biomarker of inflammatory and cardiovascular diseases. We analyzed the associations between GDM and the offspring's hsCRP levels using a multiple logistic regression model. A mother with GDM significantly increased the risk for high hsCRP level by 4.07-fold (≥2.0 mg/L) in the child. As such, maternal GDM was significantly associated with increased serum hsCRP levels in 8-year-old children.

File： J of Diabetes Invest - 2022 - Sekine - Association between maternal gestational diabetes mellitus and high‐sensitivity.pdf

DOI： 10.1111/jdi.13796

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.13796

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

DOI： http://dx.doi.org/10.1136/oemed-2021-108034

Other Link： https://oem.bmj.com/content/79/8/521

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS INC  

Summary

Geriatric patients with existing studies on the safety and efficacy of peroral endoscopic myotomy (POEM) for achalasia involve small sample sizes and single institutions. However, multi-center, large-scale data analyses are lacking. The study aimed to clarify the characteristics of geriatric patients with esophageal motility disorders (EMDs) and determine the procedure-related outcomes and clinical course following POEM. This cohort study included 2,735 patients with EMDs who were treated at seven Japanese facilities between 2010 and 2019. The patients’ characteristics and post-POEM clinical courses were compared between the geriatric (age ≥ 75 years; n = 321) and non-geriatric (age &amp;lt; 75 years; n = 2,414) groups. Compared with the non-geriatric group, the geriatric group had higher American Society of Anesthesiologists physical status scores; more recurrent cases; lower incidence of chest pain; and higher incidence of type III achalasia, distal esophageal spasm, and Jackhammer esophagus. Furthermore, the incidence of sigmoid esophagus was higher, although esophageal dilation was not severe in this group. POEM was safe and effective for geriatric patients with treatment-naïve and recurrent EMDs. Furthermore, compared with the non-geriatric group, the geriatric group had lower post-POEM Eckardt scores, fewer complaints of refractory chest pain, and a lower incidence rate of post-POEM reflux esophagitis. Geriatric patients are characterized by worse clinical conditions, more spastic disorders, and greater disease progression of EMDs, which are also the indications for minimally invasive POEM. POEM is more beneficial in geriatric patients as it has lowering symptom scores and incidence rates of reflux esophagitis.

DOI： 10.1093/dote/doab086

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

We aimed to determine the risk of perinatal complications during delivery in mothers with non-normal glucose tolerance in a large Japanese birth cohort. We analysed data of 24,295 neonate-mother pairs in the Japan Environment and Children's Study cohort between 2011 and 2014. We included 67 mothers with type 1 diabetes, 102 with type 2 diabetes (determined by questionnaire), 2,045 with gestational diabetes (determined by diagnosis), and 2,949 with plasma glucose levels ≥140 mg/dL (shown by a screening test for gestational diabetes). Gestational age, birth weight, placental weight, and proportions of preterm birth, and labour and neonatal complications at delivery in mothers with diabetes were compared with those in mothers with normal glucose tolerance. Mean gestational age was shorter in mothers with any type of diabetes than in mothers without diabetes. Birth weight tended to be heavier in mothers with type 1 diabetes, and placental weight was significantly heavier in mothers with type 1 and gestational diabetes and elevated plasma glucose levels (all p<0.05). The relative risks of any labour complication and any neonatal complication were 1.49 and 2.28 in type 2 diabetes, 1.59 and 1.95 in gestational diabetes, and 1.22 and 1.30 in a positive screening test result (all p<0.05). The relative risks of preterm birth, gestational hypertension, and neonatal jaundice were significantly higher in mothers with types 1 (2.77; 4.07; 2.04) and 2 diabetes (2.65; 5.84; 1.99) and a positive screening test result (1.29; 1.63; 1.12) than in those without diabetes (all p<0.05). In conclusion, placental weight is heavier in mothers with non-normal glucose tolerance. Preterm birth, gestational hypertension, and jaundice are more frequent in mothers with types 1 and 2 diabetes. A positive result in a screening test for gestational diabetes suggests not only a non-normal glucose tolerance, but also a medium (middle-level) risk of perinatal complications.

File： PLoS One 2022 Yokomichi H Maternal diabetes and perinatal complications.pdf

DOI： 10.1371/journal.pone.0269610

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0269610

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

OBJECTIVES: Indications for peroral endoscopic myotomy (POEM) and endoscopic submucosal dissection (ESD) in patients with achalasia concomitant with esophageal carcinoma (EC) are unclear. This study aimed to clarify the role of POEM in cases of achalasia concomitant with EC and to elucidate the indications for ESD and efficient surveillance for EC. METHODS: We conducted a multicenter cohort study at 14 hospitals in Japan, including 3707 cases of achalasia-related esophageal motility disorders (EMDs). Factors contributing to EC risk, the characteristics of EC, and clinical outcomes of POEM/ESD were analyzed. RESULTS: In patients undergoing POEM, screening and surveillance endoscopy throughout a 1-year period resulted in diagnosis of 72.1% new EC cases. Of 62 patients with 123 ECs, 40.3% had multiple or metachronous lesions within 37.5 months. EC was predominantly observed in the middle thoracic esophagus (58.5%) and posteriorly (73.2%). POEM had comparable safety and efficacy in cases of concomitant EC even after ESD. Endoscopic en bloc resection was performed in 95.8% and 89.3% of ECs diagnosed before and after POEM, respectively (P = 0.351); however, ESD on the POEM-line was impaired by fibrosis. Multivariate analysis revealed risk factors for EC, including regular alcohol consumption, a history of smoking, advanced age, and extended disease duration. Alcohol intake and smoking had a synergistic effect on EC development. CONCLUSIONS: Screening and surveillance of POEM help in detecting EC. ESD is feasible in achalasia, although on the POEM-line is challenging. Surveillance endoscopy for EC is recommended for cases with specific risks and a history of ECs.

File： Digestive Endoscopy 2021 Sato H Esophageal carcinoma in achalasia patients managed with endoscopic submucosal.pdf

DOI： 10.1111/den.14197

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/den.14197

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

OBJECTIVES: Patients with esophageal motility disorders (EMDs) including achalasia after gastric surgery have not been thoroughly characterized. Furthermore, the efficacy of peroral endoscopic myotomy (POEM) in this population should be clarified. METHODS: In this retrospective multicenter study of 3,707 patients with EMDs, 31 patients (0.8%) had a history of gastric surgery. Patient characteristics and POEM efficacy were compared between patients with and without previous gastric surgery. RESULTS: In patients with EMD after gastric surgery, age at EMD diagnosis was higher (72.0 years), male sex was predominant (90.3%), and the American Society of Anesthesiologists physical status score was higher (≥II, 48.4%). High-resolution manometry (HRM) findings did not reveal significant differences. In patients who underwent gastric surgery, atrophic gastritis was common (80.6%), and gastric cancer was the primary surgical indication (32.3%). Distal gastrectomy was performed in 28 patients (90.3%). POEM was effective (3.3% adverse events; 100% treatment success). The incidence rates of reflux esophagitis (RE) and symptomatic gastroesophageal reflux disease (GERD) were 60.0% and 16.7%, respectively, without significant inter-group differences, and severe RE was not observed in the long-term follow-up. Extended gastric myotomy was a risk factor for RE. CONCLUSIONS: Patients with gastric surgery often present severe disease manifestations; the surgical indication is mainly gastric cancer. HRM findings can be similarly used for diagnosis in patients with and without gastric surgery. POEM maintains safety and efficacy with acceptable RE and symptomatic GERD rates. To prevent RE, extended myotomy should be avoided.

DOI： 10.1111/den.14369

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/den.14369

Language：English  

DOI： 10.1038/s41366-022-01097-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Karger Publishers  

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; It is inconclusive whether prenatal negative life events are a risk for the development of allergic diseases in children or whether social capital modifies the association. The objective of this study was to examine whether women’s experiences of such events during pregnancy were associated with the development of allergic diseases in their offspring at 3 years old and whether social capital moderated this association. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We used data from 81,337 mother-child pairs who participated in the Japan Environment and Children’s Study. This is a prospective birth cohort recruited between January 2011 and March 2014. We examined the associations between prenatal maternal negative life events (e.g., bereavement, financial, and marital problems) during pregnancy and allergic diseases (asthma, eczema, and food allergies) in children after adjustment for covariates using multivariate logistic regression. We also examined interactions between these life events and social capital, measured as two items, social cohesion and social support. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Prenatal negative life events were significantly associated with doctor-diagnosed asthma at 3 years old with a dose-response relationship (one life event vs. none: adjusted odds ratio 1.13, 95% confidence interval [CI]: 1.07–1.20; two life events vs. none: adjusted odds ratio 1.24, 95% CI: 1.13–1.36; three or more life events vs. none: adjusted odds ratio 1.26, 95% CI: 1.10–1.46; &lt;i&gt;p&lt;/i&gt; for trend &amp;#x3c;0.01). Similar results were observed for eczema and food allergies. There were no interactions between life events and social capital. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Prenatal negative life events may be a risk factor for allergies in children. There was no modification of the effect of these events by social capital.

DOI： 10.1159/000524854

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Other Link： https://www.karger.com/Article/Abstract/524854

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2022.04.1347

Other Link： https://www.sciencedirect.com/science/article/pii/S0016510722016662

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

DOI： 10.1371/journal.pone

Other Link： https://journals.plos.org/plosone/article/authors?id=10.1371/journal.pone.0268204

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

File： Digestive Endoscopy - 2021 - Ominami - Impact of the COVID‐19 pandemic on high‐resolution manometry and peroral endoscopic.pdf

DOI： 10.1111/den.14133

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/den.14133

Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Korean Society of Neurogastroenterology and Motility  

BACKGROUND/AIMS: Patients with achalasia-related esophageal motility disorders (AEMDs) frequently present with dilated and sigmoid esophagus, and develop esophageal diverticulum (ED), although the prevalence and patients characteristics require further elucidation. METHODS: We conducted a multicenter cohort study of 3707 patients with AEMDs from 14 facilities in Japan. Esophagography on 3682 patients were analyzed. RESULTS: Straight (n = 2798), sigmoid (n = 684), and advanced sigmoid esophagus (n = 200) were diagnosed. Multivariate analysis revealed that long disease duration, advanced age, obesity, and type I achalasia correlate positively, whereas severe symptoms and integrated relaxation pressure correlate negatively with development of sigmoid esophagus. In contrast, Grade II dilation (3.5-6.0 cm) was the most common (52.9%), while grade III dilation (≥ 6 cm) was rare (5.0%). We found early onset, male, obesity, and type I achalasia correlated positively, while advanced age correlated negatively with esophageal dilation. Dilated and sigmoid esophagus were found mostly in types I and II achalasia, but typically not found in spastic disorders. The prevalence of ED was low (n = 63, 1.7%), and non-dilated esophagus and advanced age correlated with ED development. Patients with right-sided ED (n = 35) had a long disease duration (P = 0.005) with low integrated relaxation pressure values (P = 0.008) compared with patients with left-sided ED (n = 22). Patients with multiple EDs (n = 6) had lower symptom severity than patients with a single ED (P = 0.022). CONCLUSIONS: The etiologies of dilated esophagus, sigmoid esophagus, and ED are considered multifactorial and different. Early diagnosis and optimal treatment of AEMDs are necessary to prevent these conditions.

DOI： 10.5056/jnm21188

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Aims/Introduction Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with adverse pregnancy outcomes. This study aimed to explore the associations between glycated hemoglobin (HbA1c) levels at the early stage of pregnancy and the GDM risk among non-diabetic women in a nationwide study in Japan. In addition, the relationship between GDM and adverse pregnancy outcomes was also analyzed. Materials and Methods This cohort study (n = 89,799) used data from the Japan Environment and Children's Study. We stratified the participants into four groups according to HbA1c levels at an early stage of pregnancy. We investigated the association of HbA1c at an early stage of pregnancy with the risk of GDM, and of GDM with the risk of some representative adverse pregnancy outcomes, using the multiple logistic regression model with adjustment for potential confounders. Results The adjusted odds ratio for GDM per 0.1 percentage point increase in HbA1c (%) was 1.20. The adjusted odds ratio for developing GDM was significantly increased in women from the HbA1c 5.0-5.4% category. GDM significantly increased the adjusted odds ratio for adverse pregnancy outcomes, such as hypertensive disorders of pregnancy, polyhydramnios and premature birth. Conclusions High-normal HbA1c levels at the early stage of pregnancy are significantly associated with GDM risk in women in Japan. GDM was significantly associated with adverse pregnancy outcomes.

DOI： 10.1111/jdi.13701

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/jdi.13701

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER MEDICAL ASSOC  

IMPORTANCE: It is unclear to what extent the duration of screen time in infancy is associated with the subsequent diagnosis of autism spectrum disorder. OBJECTIVE: To examine the association between screen time in infancy and the development of autism spectrum disorder at 3 years of age. DESIGN, SETTING, AND PARTICIPANTS: This cohort study analyzed data from mother-child dyads in a large birth cohort in Japan. This study included children born to women recruited between January 2011 and March 2014, and data were analyzed in December 2020. The study was conducted by the Japan Environment and Children's Study Group in collaboration with 15 regional centers across Japan. EXPOSURES: Screen time at 1 year of age. MAIN OUTCOMES AND MEASURES: The outcome variable, children diagnosed with autism spectrum disorder at 3 years of age, was assessed using a questionnaire administered to mothers of the participating children. RESULTS: A total of 84 030 mother-child dyads were analyzed. The prevalence of children with autism spectrum disorder at 3 years of age was 392 per 100 000 (0.4%), and boys were 3 times more likely to have been diagnosed with autism spectrum disorder than were girls. Logistic regression analysis showed that among boys, when "no screen" was the reference, the adjusted odds ratios were as follows: less than 1 hour, odds ratio, 1.38 (95 % CI, 0.71-2.69; P = .35), 1 hour to less than 2 hours, odds ratio, 2.16 (95 % CI, 1.13-4.14; P = .02), 2 hours to less than 4 hours, odds ratio, 3.48 (95% CI, 1.83-6.65; P < .001), and more than 4 hours, odds ratio, 3.02 (95% CI, 1.44-6.34; P = .04). Among girls, however, there was no association between autism spectrum disorder and screen time. CONCLUSIONS AND RELEVANCE: Among boys, longer screen time at 1 year of age was significantly associated with autism spectrum disorder at 3 years of age. With the rapid increase in device usage, it is necessary to review the health effects of screen time on infants and to control excessive screen time.

File： JAMA Pediatr 2022 Kushima M Screen time and autism.pdf

DOI： 10.1001/jamapediatrics.2021.5778

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Other Link： https://jamanetwork.com/journals/jamapediatrics/fullarticle/2788488

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

File： PIIS2212440321006830.pdf

DOI： 10.1016/j.oooo.2021.10.004

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Other Link： https://www.oooojournal.net/article/S2212-4403(21)00683-0/fulltext

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMC  

Abstract

Background

Barley contains abundant soluble beta-glucan fibers, which have established health benefits. In addition, the health benefits conferred by the gut bacteria have attracted considerable interest. However, few studies have focused on the barley consumption and gut bacteria of the Japanese population. In this study, we aimed to identify the relationship between the barley consumption and gut bacteria composition of the Japanese population.

Methods

In total, 236 participants were recruited in Japan, and 94 participants with no complications of diabetes, hypertension, or dyslipidemia were selected for the study. We analyzed fecal samples from the participants, their medical check-up results, and responses to questionnaires about dietary habits. The participants were grouped according to their median barley consumption. Then, we assessed the relative abundance of 50 genera. Characteristic bacteria were evaluated for their relationship with barley consumption by multiple regression analysis, adjusted for disease and dietary habits, in all participants. We also analyzed the networks and clustering of the 20 selected genera.

Results

According to the comparison between barley groups, Bifidobacterium, Butyricicoccus, Collinsella, Ruminococcus 2, and Dialister were characteristic candidate bacterias of the group that consumed large amounts of barley (P &lt; 0.05). The relationship between barley consumption and Bifidobacterium remained after adjusting for disease and dietary habits, and that of Butyricicoccus remained after adjusting for disease. Furthermore, network and cluster analyses revealed that barley consumption was directly correlated with Bifidobacterium and Butyricicoccus.

Conclusions

Barley consumption generates changes in the intestinal bacteria of the Japanese population. We found that Bifidobacterium and Butyricicoccus abundance was positively associated with barley consumption.

File： s40795-022-00500-3.pdf

DOI： 10.1186/s40795-022-00500-3

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Other Link： https://bmcnutr.biomedcentral.com/articles/10.1186/s40795-022-00500-3

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

DOI： 10.1111/jgh.15708

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/jgh.15708

Language：English   Publishing type：Research paper (scientific journal)   Publisher：OXFORD UNIV PRESS  

Abstract

In Nepal, the number of diarrhoea hospitalizations in all ages is seriously high. According to the World Health Organization, diarrheal diseases can be substantially prevented through safe drinking water sources. In the Kathmandu Valley, because of the shortage of piped water, local residents use alternative water sources, such as groundwater, jars and tanker water. However, these alternative water sources can be contaminated. This study aimed to clarify the relationship between diarrhoea risk and the combinations of drinking water sources. A survey using multiple questionnaires on diarrhoea occurrence, water sources and water treatment was conducted three time between 2015 and 2016. The odds ratios (ORs) of developing diarrhoea were significantly high for drinking jar (OR 6.1) and tanker water (OR 8.4) compared with not drinking. The combined drinking of jar and tanker water obtained the 1 log higher OR compared with drinking only piped water. Conversely, drinking groundwater had a low OR, implying that the residents refrained from drinking polluted groundwater. In conclusion, diarrhoea occurrence was related not only to the level of water contamination, but also to a behavioural factor, i.e. people's careful management of the choice of multiple water sources.

File： Int Health Koyayashi Y Drinking water source and diarrhoea.pdf

DOI： 10.1093/inthealth/ihab032

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Other Link： https://academic.oup.com/inthealth/article/14/2/195/6296858

Language：Japanese   Publisher：(一社)日本肥満学会  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

The hygiene hypothesis assumes a low incidence of allergic diseases in families engaging in farming work. However, a few studies have indicated rural life as a potential risk factor for atopic dermatitis (AD). Using a large Japanese birth cohort dataset, we calculated the accumulated incidence of AD in children aged 6 months and 1, 2, and 3 years by family business and the hazard ratio. We adjusted for confounding factors. The father's job was considered the family business. We analysed data on 41,469 father-child pairs at 6 months of age, 40,067 pairs at 1 year, 38,286 pairs at 2 years, and 36,570 pairs at 3 years. We found the highest accumulated incidence of AD among children with fathers engaged in primary industry, with 2.5% at the age of 6 months, 6.6% at 1 year, 12.0% at 2 years, and 15.4% at 3 years. Among primary industry occupations, forestry was associated with the highest incidence of AD across these ages. The hazard ratio of AD was also highest for children whose family business was primary industry. In conclusion, the highest incidence and hazard ratio of AD were observed among children whose fathers worked in primary industry.

File： IJREPH 2022 Yokomichi H et al. Farming household and incidence of atopic dermatitis.pdf

DOI： 10.3390/ijerph19031761

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Other Link： https://www.mdpi.com/1660-4601/19/3/1761

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

BACKGROUND: We aimed to examine whether the timing of adiposity rebound (AR) could be a predictive index of body size in Japanese adolescents. METHODS: The longitudinal individual data of 1438 Japanese children, including 714 boys and 724 girls born between 2001 and 2007, were obtained from child health check-ups conducted at ages 1.5, 2, 3, and 5 years, and then yearly after the age of 6 years. We examined whether the timing of AR could be used to estimate the body size at 14 years of age. RESULTS: The AR had a normal distribution with a mean occurrence at age 6-7 years. The odds ratio of having obesity at age 14 were 8.32 for boys and 4.81 for girls, whereas boys and girls with later AR at the same age had a relative risk of thinness of 6.27 and 8.14, respectively. The probability that children with an early AR (i.e., <6 years old) would be obese was nearly 40%. Similar to obesity, the probability of thinness at 14 years remained approximately 8% for both sexes. CONCLUSIONS: The findings suggest that early AR could raise the risk of obesity, and AR could later raise the risk of thinness. However, both probabilities of AR timing as predictors of adolescent weight status may only be about 10%-20%. This study cannot clearly determine whether the results were influenced by other factors after controlling for the timing of AR. Future studies that also consider lifestyle and genetic factors are warranted.

File： Obes Res Clin Pract 2021 Haga C Adiposity rebound as predictor of adolescent obesity.pdf

DOI： 10.1016/j.orcp.2021.12.003

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Other Link： https://www.sciencedirect.com/science/article/pii/S1871403X2100154X

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Endocrine Society  

In this study, we aimed to determine the association of neonatal/post-neonatal hypothyroidism with mother's iodine exposure, especially povidone iodine disinfection, and hysterosalpingography. Participants were mother-child pairs in a Japanese birth cohort (n = 100,286). Risk factors of hypothyroidism were supplement intake, seaweed intake, other daily iodine intake, povidone iodine disinfection at delivery, and maternal history of hysterosalpingography, thyroid disease (Graves' disease and Hashimoto's thyroiditis), and medication (thiamazole and levothyroxine). Congenital hypothyroidism (CH) at age 1 year was assessed using a questionnaire. Transient hypothyroidism was defined as elevated thyroid stimulating hormone level at birth and absence of CH at age 1 year. The incidence of CH at age 1 year per 100 children was 1.1 for those born at 22-30 weeks' gestation, 0.17 following povidone iodine disinfection, and 0.07, 0.95, 0.81, 1.17, and 1.15 with a maternal history of hysterosalpingography, Graves' disease, Hashimoto's thyroiditis, thiamazole use, and levothyroxine use, respectively. Odds ratios (95% confidence intervals) of CH at age 1 year for povidone iodine disinfection, hysterosalpingography history, maternal Graves' disease, and maternal Hashimoto's thyroiditis were 1.13 (0.71-1.79), 0.47 (0.07-3.36), 7.06 (3.70-13.5), and 5.93 (2.90-12.1), respectively. For transient hypothyroidism for povidone iodine disinfection and hysterosalpingography history, these values were 1.99 (1.51-2.62) and 0.63 (0.20-1.96), respectively. Maternal thyroid disease greatly increased neonatal/post-neonatal hypothyroidism risk. Povidone iodine disinfection may increase transient hypothyroidism risk but not the risk at 1 year of age. Hysterosalpingography does not increase hypothyroidism risk from birth to age 1 year.

File： Endcr J 2022 Yokomichi H et al. Mother's iodine exposure and neonate's hypothyroidism.pdf

DOI： 10.1507/endocrj.EJ21-0168

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Other Link： https://www.jstage.jst.go.jp/article/endocrj/69/1/69_EJ21-0168/_article/-char/en

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Karger Publishers  

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Socioeconomic status has been found to be associated with allergic diseases in children, but results are inconsistent. This study aimed to assess the association between household income and the development of allergic disease in children at 3 years old. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We used data from 72,180 participants from the Japan Environment and Children’s Study, which is a prospective birth cohort study with participants recruited from January 2011 to March 2014. We examined the associations between household income and allergic diseases (asthma, eczema, and food allergies) in children, adjusting for covariates using multivariate logistic regression. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The percentages of doctor-diagnosed allergies at 3 years old were 7.5% for asthma, 7.2% for eczema, and 6.2% for food allergies. Children from households with an annual income of &amp;#x3c;2 million yen (approx. 18,000 USD) had a significantly higher risk of doctor-diagnosed asthma and eczema than those from households with an income of 4–6 million yen. The adjusted odds ratios (aORs) were 1.17 (95% confidence interval [CI] 1.03–1.34) and 1.21 (95% CI 1.06–1.39). Children from households with an income of &amp;#x3e;6 million yen tended to have an increased risk of food allergies (aOR 1.07, 95% CI 0.98–1.15). &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Low household income was a risk for doctor-diagnosed asthma and eczema, suggesting that public health professionals should recognize low-income groups as vulnerable populations for these conditions.

DOI： 10.1159/000519153

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Other Link： https://www.karger.com/Article/Abstract/519153

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

DOI： https://doi.org/10.1007/s10388-021-00875-5

Other Link： https://link.springer.com/article/10.1007/s10388-021-00875-5

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

File： Esophagus 2022 Sato C Characteristics of patients with esophageal motility disorders.pdf

DOI： 10.1007/s10388-021-00875-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

The eligibility of COVID-19 vaccines has been expanded to children aged 12 and above in several countries including Japan, and there is a plan to further lower the age. This study aimed to assess factors related to parental COVID-19 vaccine hesitancy. A nationwide internet-based cross-sectional study was conducted between May 25 and June 3, 2021 in Japan. The target population was parents of children aged 3–14 years who resided in Japan, and agreed to answer the online questionnaire. Parental COVID-19 vaccine hesitancy (their intention to vaccinate their child) and related factors were analyzed using logistic regression models. Interaction effects of gender of parents and their level of social relationship satisfaction related to parental vaccine hesitancy was tested using log likelihood ratio test (LRT). Social media as the most trusted information source increased parental vaccine hesitancy compared to those who trusted official information (Adjusted Odds Ratio: aOR 2.80, 95% CI 1.53–5.12). Being a mother and low perceived risk of infection also increased parental vaccine hesitancy compared to father (aOR 2.43, 95% CI 1.57–3.74) and those with higher perceived risk of infection (aOR 1.55, 95% CI 1.04–2.32) respectively. People with lower satisfaction to social relationships tended to be more hesitant to vaccinate their child among mothers in contrast to fathers who showed constant intention to vaccinate their child regardless of the level of satisfaction to social relationship (LRT p = 0.021). Our findings suggest that dissemination of targeted information about COVID-19 vaccine by considering means of communication, gender and people who are isolated during measures of social distancing may help to increase parental vaccine acceptance.

File： PLoS One 2021 Horiuchi S COVID-19 vaccine hesitancy in Japan.pdf

DOI： 10.1371/journal.pone.0261121

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

Maternal smoking during pregnancy is a risk factor for childhood obesity; however, the combined effect of secondhand smoking during pregnancy on children in the early years is unclear. We examined the effects of maternal active and secondhand smoking during pregnancy on childhood obesity in a large population-based cohort. A nested case-control study originating from the Japan Environment and Children's Study was performed. The maternal smoking status was collected via self-administered questionnaires during mid/late pregnancy. Obesity in children was determined based on BMI measured at 3 years of age. In total, 4875 cases and 19,491 controls were included in the analyses. Conditional logistic regression models with a significance level of 5% (two-tailed test) were used to test the association. The proportion of mothers who continued smoking and who were exposed to secondhand smoking daily during pregnancy were 3.9% and 13.0% in cases and 2.9% and 10.8% in controls, respectively. Continuous maternal smoking was associated with increased odds of obesity compared to those who never smoked or quit smoking before the pregnancy (adjusted odds ratio, 1.39; 95% confidence interval, 1.01-1.92). The odds increased further when combined with secondhand smoking. The promotion of non-smoking among family members, in public and workplace could benefit pregnant women and offspring.

File： ijerph-18-12506-v2.pdf

DOI： 10.3390/ijerph182312506

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Scarce knowledge is available on the relationship between maternal chemical exposure during pregnancy and foetal deaths. We studied the association of spontaneous abortions and stillbirths with occupational or daily maternal exposure to chemicals commonly used by pregnant women. Data from the Japan Environment and Children's Study (JECS), a nationwide prospective birth cohort study, were used. The participants of the study were asked about the frequency of their use of gasoline, pesticides, hair dye, and chlorine bleach during the first and the second to third trimesters of pregnancy. We investigated the relationship between the frequency of the use of chemicals and foetal death. Of the 104,065 foetuses, 923 (0.91%) were spontaneous abortions and 379 (0.37%) were stillbirths. Any type of exposure during the first trimester was not significantly associated with spontaneous abortions. Nevertheless, a more than weekly occupational use of hair dye from the first to the second/third trimester was significantly associated with stillbirth. The results of this study suggest that the frequent use of hair dye during pregnancy can have severe adverse effects on the foetus. These findings can help pregnant women, especially hairdressers, refrain from the continuous use of hair dyes.

File： ijerph 2021 Ooka T Chemicals during pregnancy and foetal death.pdf

DOI： 10.3390/ijerph182211748

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

BACKGROUND AND AIMS: Early-term birth between 37 and 38 weeks of gestation increases the risk of mortality and morbidity. This study investigated the status and impact of early-term birth among neonates born by cesarean section in Japan. METHODS: All singleton live births that had data of gestational age at birth available in the Japan Environment and Children's Study (JECS), a nationwide birth cohort study launched in 2011, were eligible for this study. Neonates born by cesarean delivery at term without indications for early delivery were included to examine the association between early-term birth and respiratory distress at birth. The gestational age at birth was categorized as 37 weeks 0 day to 38 weeks 6 days (early-term), 39 weeks 0 day to 40 weeks 6 day (full-term), and 41 weeks 0 day to 41 weeks 6 days (late-term). Respiratory distress at birth included respiratory distress syndrome, transient tachypnea, and difficulty in breathing after birth. Univariable and multivariable analyses were performed using logistic regression models with a two-tailed significance level of 5%. All statistical analyses were performed using SAS, version 9.4, for Windows (SAS Institute, Cary, NC). RESULTS: In total, 32 078 of 100 011 (32.1%) neonates had early-term birth. At 37 gestational weeks, 49.7% of the deliveries were via cesarean section, and half of the cesarean deliveries were due to a previous cesarean section. Among the 10 051 neonates born by elective cesarean delivery at term, neonates with early-term births were more likely to have respiratory distress at birth (adjusted odds ratio: 4.19; 95% confidence interval, 1.70, 10.34) than those born at full term. CONCLUSIONS: Early-term birth is associated with a high risk of respiratory distress in births involving cesarean delivery without indication for early delivery. There is a need for guidelines for early delivery considering adverse effects of early-term births.

File： Health Sci. Rep 2021 Horiuchi S Caesarian delivery and respikratory distress of neonatespdf.pdf

DOI： 10.1002/hsr2.421

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER  

File： J Hydrol Reg Study 2021 Ito Y Water consumption-associated factors.pdf

DOI： 10.1016/j.ejrh.2021.100928

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Other Link： https://www.sciencedirect.com/science/article/pii/S2214581821001579

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/ped.14635

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

BACKGROUND: Kawasaki disease is suspected to be triggered by previous infection. The prevention measures for coronavirus disease 2019 (COVID-19) have reportedly reduced transmission of certain infectious diseases. Under these circumstances, the prevention measures for COVID-19 may reduce the incidence of Kawasaki disease. METHODS: We conducted a retrospective study using registration datasets of patients with Kawasaki disease who were diagnosed in all 11 inpatient pediatric facilities in Yamanashi Prefecture. The eligible cases were 595 cases that were diagnosed before the COVID-19 pandemic (from January 2015 through February 2020) and 38 cases that were diagnosed during the COVID-19 pandemic (from March through November 2020). Incidence of several infectious disease were evaluated using data from the Infectious Disease Weekly Report conducted by the National Institute of Infectious Diseases. RESULTS: Epidemics of various infectious diseases generally remained at low levels during the first 9 months (March through November 2020) of the COVID-19 pandemic. Moreover, the incidence of COVID-19 was 50-80 times lower than the incidence in European countries and the United States. The total number of 38 cases with Kawasaki disease for the 9 months during the COVID-19 pandemic was 46.3% (-3.5 standard deviations [SDs] of the average [82.0; SD, 12.7 cases] for the corresponding 9 months of the previous 5 years. None of the 38 cases was determined to be triggered by COVID-19 based on their medical histories and negative results of severe acute respiratory syndrome coronavirus 2 testing at admission. CONCLUSION: These observations provide a new epidemiological evidence for the notion that Kawasaki disease is triggered by major infectious diseases in children.

File： J Epidemiol Katsumata Precipitated Kawasaki disease by COVID-19.pdf

DOI： 10.2188/jea.JE20210132

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Other Link： https://www.jstage.jst.go.jp/article/jea/31/11/31_JE20210132/_article/-char/en

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Oxford University Press  

DOI： 10.1093/ije/dyab168.51510.1093/ije/dyab168.515

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Other Link： https://academic.oup.com/ije/article/50/Supplement_1/dyab168.515/6361855?login=true

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGERNATURE  

DOI： 10.1038/s41366-021-00947-7

Other Link： https://www.nature.com/articles/s41366-021-00947-7https://www.nature.com/articles/s41366-021-00947-7

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

File： Text_2021KD4_48.pdf

DOI： 10.1097/BRS.0000000000004021

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Other Link： https://journals.lww.com/spinejournal/abstract/9000/factors_affecting_pedicle_screw_insertional_torque.93764.aspx

Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

File： Addict Behav 2021 Kojima R Internet use and depression.pdf

DOI： 10.1016/j.addbeh.2021.106989

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

We aimed to determine mortality risk in underweight patients with diabetic nephropathy for microalbuminuria or macroalbuminuria. We analyzed mortality and death‐cause data from BioBank Japan, with baseline years 2003–2007. We analyzed mortality rates from all causes and ischemic heart disease, according to body mass index (<18.5, 18.5–21.9, 22–24.9, and ≥25 kg/m2). Mean (standard deviation) of patients’ age, body mass index, and glycated hemoglobin at enrollment was 61.6 (11.7) years, 25.0 (4.4) kg/m2, and 7.7% (1.5)%, respectively. Hazard ratios of all‐cause and ischemic heart disease mortality were highest (1.79 (p=0.0001) and 2.95 (p=0.027), respectively) in patients with body mass index <18.5 kg/m2, as compared with body mass index 22–24.9 kg/m2. All‐cause mortality risk for body mass index <18.5 kg/m2 was similar to that for current smokers (hazard ratio 1.70, p<0.0001). Underweight could be a predictor of mortality risk in patients with diabetic nephropathy for microalbuminuria or macroalbuminuria.

File： JDI 2021 Yokomichi H et al. Underweight mortality risk in diabetic nephropathy.pdf

DOI： 10.1111/jdi.13483

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer International Publishing  

Purpose
Intranasal insulin administration may improve cognitive function in patients with dementia and may prevent cognitive problems after surgery. Although the metabolic effects of intranasal insulin in non-surgical patients have been studied, its influence on glucose concentration during surgery is unknown.

Methods
We conducted a randomized, double-blind, placebo-contolled trial in patients scheduled for elective cardiac surgery. Patients with type 2 diabetes mellitus (T2DM) and non-T2DM patients were randomly allocated to one of three groups (normal saline, 40 international units [IU] of intranasal insulin, and 80 IU intranasal insulin). Insulin was given after the induction of general anesthesia. Glucose and plasma insulin concentrations were measured in ten-minute intervals during the first hour and every 30 min thereafter. The primary outcome was the change in glucose concentration 30 min after intranasal insulin administration.

Results
A total of 115 patients were studied, 43 of whom had T2DM. In non-T2DM patients, 40 IU intranasal insulin did not affect glucose concentration, while 80 IU intranasal insulin led to a statistically significant but not clinically important decrease in blood glucose levels (mean difference, 0.4 mMol·L−1; 95% confidence interval, 0.1 to 0.7). In T2DM patients, neither 40 IU nor 80 IU of insulin affected glucose concentration. No hypoglycemia (< 4.0 mMol·L−1) was observed after intranasal insulin administration in any patients. In non-T2DM patients, changes in plasma insulin were similar in the three groups. In T2DM patients, there was an increase in plasma insulin concentrations ten minutes after administration of 80 IU of intranasal insulin compared with saline.

Conclusions
In patients with and without T2DM undergoing elective cardiac surgery, intranasal insulin administration at doses as high as 80 IU did not cause clinically important hypoglycemia.

DOI： 10.1007/s12630-021-01969-5

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ Publishing Group  

OBJECTIVE: To compare the incidence of atopic dermatitis in children aged from 6 months to 3 years across birth seasons and climate conditions. DESIGN: Cohort study. SETTING: Fifteen regional centres across Japan. PARTICIPANTS: A total of 100 304 children born from 2011 to 2014. EXPOSURE: Birth month, and mean sunshine duration (short/long) and humidity (high/low) in the first 6 months of life. PRIMARY OUTCOME MEASURE: Incidence of atopic dermatitis. RESULTS: The highest incidence of atopic dermatitis was in children born in the months of October to December. The lowest incidence of atopic dermatitis was in the months of April to June and in periods with a long duration of sunshine and high humidity. Low humidity was significantly associated with a higher incidence of atopic dermatitis. However, this significant difference disappeared when the birth season and parental history of allergic disease were considered in multivariate analysis. CONCLUSIONS: In Japan, being born in the late autumn to early winter months is associated with a risk of developing atopic dermatitis until the age of 3 years. Sunshine duration and humidity from birth to 6 months of age are not associated with the incidence of atopic dermatitis.

File： BMJ Open 2021 Yokomichi H et al. Birth month and atopic dermatitis.pdf

DOI： 10.1136/bmjopen-2020-047226

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Other Link： https://bmjopen.bmj.com/content/11/7/e047226.full

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ Publishing Group  

INTRODUCTION: Early intervention in type 2 diabetes can prevent exacerbation of insulin resistance. More effective interventions can be implemented by early and precise prediction of the change in glycated haemoglobin A1c (HbA1c). Artificial intelligence (AI), which has been introduced into various medical fields, may be useful in predicting changes in HbA1c. However, the inability to explain the predictive factors has been a problem in the use of deep learning, the leading AI technology. Therefore, we applied a highly interpretable AI method, random forest (RF), to large-scale health check-up data and examined whether there was an advantage over a conventional prediction model. RESEARCH DESIGN AND METHODS: This study included a cumulative total of 42 908 subjects not receiving treatment for diabetes with an HbA1c <6.5%. The objective variable was the change in HbA1c in the next year. Each prediction model was created with 51 health-check items and part of their change values from the previous year. We used two analytical methods to compare the predictive powers: RF as a new model and multivariate logistic regression (MLR) as a conventional model. We also created models excluding the change values to determine whether it positively affected the predictions. In addition, variable importance was calculated in the RF analysis, and standard regression coefficients were calculated in the MLR analysis to identify the predictors. RESULTS: The RF model showed a higher predictive power for the change in HbA1c than MLR in all models. The RF model including change values showed the highest predictive power. In the RF prediction model, HbA1c, fasting blood glucose, body weight, alkaline phosphatase and platelet count were factors with high predictive power. CONCLUSIONS: Correct use of the RF method may enable highly accurate risk prediction for the change in HbA1c and may allow the identification of new diabetes risk predictors.

File： BMJ Nutr Prev 2021 Ooka T Random forest predicts type 2diabetes.pdf

DOI： 10.1136/bmjnph-2020-000200

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Other Link： https://nutrition.bmj.com/content/4/1/140

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

BACKGROUND AND AIM: Achalasia is a rare disease, with an incidence of one in 100 000. Genetic factors and autoimmune involvement have been reported in its etiology, and their involvement is strongly suspected, especially in patients with familial achalasia and those with comorbid hereditary or autoimmune diseases. However, these special types of achalasia are rare, and their frequency and clinical characteristics remain unclear. METHODS: This retrospective, multicenter cohort study included Japanese patients with a diagnosis of achalasia, treated between 2010 and 2019 across six tertiary centers in Japan. The frequency and clinical characteristics of special types of achalasia, namely, familial achalasia, achalasia with a comorbid hereditary disease, and achalasia with a comorbid autoimmune disease, were retrospectively investigated using a large-scale multicenter database. RESULTS: During the study period, 1115 patients were treated for achalasia at six tertiary centers. Familial achalasia, achalasia with a comorbid hereditary disease, and achalasia with a comorbid autoimmune disease occurred in 7 (0.63%), 11 (0.99%), and 27 (2.4%) patients, respectively. Familial achalasia had a slightly younger age of onset (37.6 ± 12.1 years old) and a higher incidence in male patients (six patients; 85.7%). Down's syndrome was the most common hereditary comorbidity, and thyroid disease was the most common autoimmune comorbidity. CONCLUSIONS: We clarified the frequency and clinical characteristics of special types of achalasia. Although special types of achalasia are rare, these comorbidities should be considered when treating patients with achalasia.

File： J Gastroenterol Hepatol 2021 Tanaka S Special type of achalasiapdf.pdf

DOI： 10.1111/jgh.15557

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE  

BACKGROUND: Hair dye use frequently induces allergic contact dermatitis, and on rare occasions induces immunoglobulin E-mediated immediate urticaria, anaphylaxis, and asthma. The effects of hair dye use during pregnancy on offspring have been studied for carcinogenicity, but not for development of allergies. This study aimed to assess the association between hair dye use during pregnancy and allergic disease in children at 3 years old. METHODS: Data of 77,303 participants from the Japan Environment and Children's Study, which is a prospective birth cohort recruited from January 2011 to March 2014, were used. We examined the associations between using hair dye during pregnancy and allergic diseases (food allergy, asthma, atopic dermatitis and allergic rhinitis) in children after adjustment for covariates by multivariable logistic regression. RESULTS: Among mothers who were exposed to hair dye during pregnancy, 50.0% were exposed in hair salons, 21.3% had home use, and 9.5% had occupational exposure. The percentages of doctor-diagnosed allergies at 3 years old were 6.3% for food allergies, 7.7% for asthma, 7.3% for atopic dermatitis, and 4.6% for allergic rhinitis. In univariable analyses, hair dye use at home and occupational exposure was significantly associated with asthma respectively (odds ratio [OR] 1.15, 95% CI 1.07-1.24 for at home; OR 1.18, 95% CI 1.08-1.28 for occupational exposure). Hair dye use at home were significantly associated with doctor-diagnosed allergic rhinitis at 3 years old (OR 1.12, 95% CI 1.02-1.22). After adjustment for covariates, these associations for asthma decreased and were no longer significant (aOR 1.06, 95% CI 0.98-1.14 for at home; aOR 1.09, 95% CI 1.00-1.20 for occupational exposure, p = 0.057), also for allergic rhinitis (aOR 1.07, 95% CI 0.97-1.19). Doctor-diagnosed allergic rhinitis at 3 years old was significantly associated with hair dye use at home in the most frequent use group (aOR for quite often versus never 1.78, 95% CI 1.22-2.60). CONCLUSION: Both home and occupation use of hair dye during pregnancy showed a trend of increased odds of allergic rhinitis and asthma in offspring at 3 years. However, the only association that reached significance was in frequency of use analyses between the highest frequency of home hair dye users and allergic rhinitis.

File： Environ Res 2021 Kojima R Hair dye and allergies at 3 years old JECS.pdf

DOI： 10.1016/j.envres.2021.111530

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Other Link： https://www.sciencedirect.com/science/article/pii/S0013935121008240

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

DOI： 10.1111/ped.14635

Other Link： https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ped.14635

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

File： Pediatr Int 2020 Tanaka T Height SDS change in Japan.pdf

DOI： 10.1111/ped.14577

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

File： Medicine 2021 Yoshizawa K Point-rating system for oral health.pdf

DOI： 10.1097/MD.0000000000026111

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

This study aimed to estimate the distribution of usual intakes in protein, sodium, potassium, and calcium by age group and assessed whether proportions of deficiencies/excesses of each nutrient would occur more in older age via a comparison with the dietary reference intakes for the Japanese population (DRIs_J). A cross-sectional analysis was conducted using a database of the 2-day nutrient intake of 361 Japanese people aged 65-90 years. The AGEVAR MODE was used to estimate usual intake. Percentile curves using estimated distribution by sex and age and usual nutrient intake were compared to those of the DRIs_J. The usual intake of protein (male and female) and potassium and calcium (female) were lower with older age. Within-individual variance of protein in female (p = 0.037) and calcium in male (p = 0.008) subjects were considerably lower with older age. The proportion of deficiencies in protein (male and female), potassium (female), and calcium (female) were higher with older age. However, the proportion of people with excess salt (converted from sodium; male and female) did not differ by age. The variances found herein could be important for enhancing the understanding of differences in dietary intake by age.

File： Nutrients Ishikawa M 2021 Difference and variance in nutireint intake by age in Japapnese oler adults.pdf

DOI： 10.3390/nu13051431

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Japan KK  

BACKGROUND: Achalasia has been reported to be associated with esophageal cancers (ECs). However, owing to the rarity of achalasia, details of achalasia-related ECs are not well investigated. METHOD: The incidence of ECs in Japanese patients with achalasia and achalasia-related esophageal motility disorders (EMDs) was estimated, and risk factors for achalasia-related ECs were determined. Characteristics of ECs and treatment courses were also analyzed. RESULTS: Between 2010 and 2019, 2714 Japanese patients with achalasia and achalasia-related EMDs were recorded in 7 high-volume centers; 24 patients (21 men, 3 women) developed ECs. The incidence of ECs was estimated at 0.078 and 0.28 per 100 person-years from the onset and the diagnosis of disease, respectively. Kaplan-Meier estimate suggested that, in addition to a long history of achalasia, advanced age, male sex, and regular alcohol consumption were statistically significant risk factors for EC development. A prevalence of 40 ECs (12.5% multiple lesions, and 22.7% metachronal lesions) was also noted, predominantly distributed over the thoracic esophagus. All were histologically diagnosed as squamous cell carcinoma. Superficial ECs were successfully treated with endoscopic treatment in all cases, except one. Achalasia-related Barret esophagus was extremely rare, and Barret adenocarcinoma was not detected in our cohort. CONCLUSION: The high relative risk of ECs was clarified in Japanese achalasia patients, although the absolute risk remained low. Therefore, surveillance endoscopy may be recommended in limited patients with several aforementioned risk factors determined. Superficial cancer can be treated with endoscopic treatment. Multiple and metachronal ECs should be screened.

File： J Gastroenterol 2021 Sato H Achalasia and esophageal cancer in Japan.pdf

DOI： 10.1007/s00535-021-01763-6

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：John Wiley & Sons, Ltd.  

Introduction: Several studies have examined the incidence of childhood T1DM in Japan from the 1970s onwards, but none have been long-term studies using registration data. We estimate the incidence of childhood type 1 diabetes mellitus (T1DM) from 1986 to 2018 in Yamanashi Prefecture, Japan. Methods: We began a population-based, long-term study of childhood T1DM in 1986 involving every hospital paediatrics department in Yamanashi Prefecture. In the Prefecture, every child newly diagnosed with T1DM is referred to a hospital, and therefore, almost 100% of new patients aged <15 years are registered. We calculated the incidence of T1DM among children aged <15 years from 1986 to 2018. All cases met the Japan Diabetes Society diagnostic criteria and were tested for T1DM-related autoantibodies whenever possible. Results: Ninety-nine patients (44 boys and 55 girls) were newly diagnosed with T1DM. The annual incidence among 5- to 9-year-olds increased by 5.35% over the study period (95% confidence interval 2.34%-8.35%, p = .0005), and there was a trend towards increasing 3-year incidence (15.52% increase, p = .0516). There were also trends towards increasing annual and 3-year incidence among 0- to 14-year-olds. However, there were no changes over time in annual or 3-year incidence in the 0-4 year or 10-14 year age groups. Conclusions: The incidence of T1DM in Yamanashi Prefecture increased among children aged 0-14 years over the study period, with the most significant increase occurring among 5- to 9-year-olds. These data suggest that the number of children aged <15 years with T1DM is gradually increasing in one of the local prefectures in Japan, Yamanashi Prefecture and that the age of onset is decreasing.

File： Endocrinol Diabetes Metab 2020 Saito T T1DM incidence in Yamanashi.pdf

DOI： 10.1002/edm2.214

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Other Link： https://onlinelibrary.wiley.com/doi/10.1002/edm2.214

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Frontiers Media SA  

Background: Scientific innovation is often achieved through the intersection of ideas from different fields. However, barriers prevent non-epidemiologists from cultivating interests in epidemiology or undertaking epidemiologic work. In this study, we evaluated changes in the diversity of research topics in an epidemiologic journal over time. We aimed to understand how epidemiologists and non-epidemiologists communicate about epidemiologic data and how this impacts innovation in the field. Methods: We categorized the topics of articles published in the Journal of Epidemiology during the early and late 2010s based on their titles. We calculated the Shannon-Weaver diversity index (H') to measure changes in the diversity of topics addressed by published articles. Results: Comparing 2011-2013 with 2017-2019, there was no significant change in the diversity of article topics (H' = 4.25 and 4.21, respectively) published in the Journal of Epidemiology. Conclusion: To encourage healthcare providers and public administrators to conduct or comment on epidemiologic studies, epidemiologists should present their findings in easily understood language with appropriate and relevant statistical indicators and useful illustrations. Bringing experience from other specialties into epidemiology may yield new findings from epidemiologic data because of the exposure of non-epidemiologists to different values, workplaces, and occupations. Collaboration among professionals from varied backgrounds and with varied occupational experiences may help to promote scientific innovation by broadening perspectives. In addition, a range of professional experiences may enable individuals to solve difficult research questions more easily by themselves.

File： Frontiers Public Health 2021 Yokomichi H et al. Innovation in epidemiology.pdf

DOI： 10.3389/fpubh.2021.641882

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Other Link： https://www.frontiersin.org/articles/10.3389/fpubh.2021.641882/full

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

School-based programmes need to be effective, easy for all, easy to perform within a short duration, and inexpensive. However, no studies have reported whether voluntarily and very short-time active play programmes contribute to improved health outcomes. This study aims to describe the GRoup activity, Active Play and Exercise (GRAPE) cluster randomised controlled trial that examined whether active play interventions of very short durations contribute to increasing physical activity (PA) and bone mass among school-aged children. The trial was conducted in 2018 from January to June, and the activity comprised ≥2 children jumping together for approximately 10 s per session, at least five times a day (approximately 1 min/day). School clusters, pair-matched as per school size (total number of children) and region, were randomly allocated to either intervention or wait-list control groups. The primary outcomes comprised objectively measured changes in PA levels (moderate-to-vigorous PA) evaluated using wrist-worn activity trackers from baseline to the one-year follow-up (six-month post-intervention follow-up) and changes in bone mass evaluated using calcaneus quantitative ultrasound parameters. This study could describe the problems and challenges in school-based PA intervention studies and present findings that could make a potentially important contribution to health education and PA promotion.

File： Int J Environ Pes Public Health 2021 Yamakita M Protocol of GRAPE Study.pdf

DOI： 10.3390/ijerph18073351

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Other Link： https://www.mdpi.com/1660-4601/18/7/3351/htm

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Sci Ltd  

We calculated the Poisson-regression-adjusted relative risk (RR) of new influenza infection by vaccination, prior infection, and vaccination after prior infection in a large Japanese birth cohort, using data from ≤89,253 children aged 6 months to 3 years. The effectiveness of risk reduction (1 - RR) by vaccination at ages 1.5-3 years was 21%-31%. The RR of new infection after prior infection vs. no prior infection was 2.58-19.3 at age 1-3 years. An analysis of the 1 - RR data stratified by having at least one senior sibling and/or attending nursery school revealed that vaccination reduced the RR by 22%-40%. The 1 - RR of new infection was 21% in 3-year-old children who were vaccinated after prior infection. All these findings are statistically significant. The results consistently indicate that, regardless of having at least one senior sibling, attending nursery school, and/or being previously infected with influenza, infants and toddlers will benefit from influenza vaccination.

File： Vaccine 2021 Yokomichi H et al. Influenza vaccine effectiveness after prior infection.pdf

DOI： 10.1016/j.vaccine.2021.02.044

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Other Link： https://www.sciencedirect.com/science/article/pii/S0264410X21002243

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本小児保健協会  

Other Link： https://www.jschild.or.jp/research/archive/

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer  

Aim
To investigate the association between falls and accelerometer measured physical activity among older people living in cold, snowy regions in Japan.

Findings
A higher moderate-to-vigorous intensity physical activity levels and walking steps were associated with falls on a frozen road.

Message
The risk of falls, especially on frozen roads, increased among active older people living in cold, snowy regions, and environmental factors should be considered when determining prevention strategies.

File： Eur Geriatr Med 2020 Kojima R et al. Physical activity and fal on snow.pdf

DOI： 10.1007/s41999-020-00398-9

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Other Link： https://link.springer.com/article/10.1007/s41999-020-00398-9

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Atherosclerosis Society  

© 2021 Japan Atherosclerosis Society. Aim: Endothelial lipase (EL) plays an important role in lipoprotein metabolism. Our recent study showed that increased hepatic expression of EL attenuates diet-induced hypercholesterolemia, thus subsequently reducing atherosclerosis in transgenic (Tg) rabbits. However, it is yet to be determined whether increased EL activity itself per se is anti-atherogenic or whether the anti-atherogenic effect of EL is exclusively dependent on its lipid-lowering effect. Methods: To determine the mechanisms underlying EL-mediated anti-atherogenic effect, we fed Tg and non-Tg rabbits diets containing different amounts of cholesterol to make their plasma cholesterol levels similarly high. Sixteen weeks later, we examined their lipoprotein profiles and compared their susceptibility to atheroscle-rosis. Results: With Tg and non-Tg rabbits having hypercholesterolemia, the plasma lipids and lipoprotein profiles were observed to be similar, while pathological examinations revealed that lesion areas of both aortic and coronary atherosclerosis of Tg rabbits were not significantly different from non-Tg rabbits. Moreover, Tg rabbits exhibited faster clearance of DiI-labeled β-VLDLs than non-Tg rabbits. Conclusion: The results of our study suggest that the enhancement of β-VLDL catabolism is the major mechanism for atheroprotective effects of EL in Tg rabbits.

File： J Atheoscler Thromb 2020 Yan H, Niimi M Endothelial lipase function through beta-VLDL catabolism .pdf

DOI： 10.5551/jat.55244

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Other Link： https://www.jstage.jst.go.jp/article/jat/28/2/28_55244/_article/-char/en

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：John Wiley & Sons, Ltd.  

Patients with diabetic nephropathy have the highest mortality rates of all causes, cancer, and macrovascular and infectious diseases. The primary cause of death of patients with diabetes with and without all vascular complications was cancer. The cancer mortality rate was similar, regardless of whether vascular complications were present.

File： Endocrionol Diab Metab 2020 BBJ T2DM vascular complication and mortality.pdf

DOI： 10.1002/edm2.181

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Other Link： https://onlinelibrary.wiley.com/doi/10.1002/edm2.181

Language：English  

[This corrects the article DOI: 10.1371/journal.pone.0243702.].

DOI： 10.1371/journal.pone.0250191

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library Science  

DOI： https://doi.org/10.1371/journal.pone.0243702

Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243702

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library Science  

BACKGROUND: Recently, anthropometric indices in children with type 1 diabetes mellitus (T1DM) have begun to change. OBJECTIVE: To examine secular trends in patients' anthropometric indices. SUBJECTS: Japanese children with T1DM from the 1995, 2000, 2008 and 2013 cohorts of The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes. METHODS: We analysed serum haemoglobin A1c (HbA1c) levels, the incidence of severe hypoglycaemic events, the types and doses of insulin, height standard deviation scores (SDS), body mass index (BMI) percentiles compared with healthy Japanese children and obesity prevalence over time. We also stratified the patients according to glycaemic control levels of <58 mmol/mol (optimal), 58-75 mmol/mol (suboptimal) and ≥75 mmol/mol (high-risk). RESULTS: Data for 513-978 patients from each of the cohorts were analysed. The incidence of severe hypoglycaemic events decreased over time (from 21 to 4.8/100 patient-years), while the proportion of insulin analogue doses increased (14.6% to 98.6%). In addition, patient height SDS (-0.22 to +0.17), BMI percentile (52.1 to 58.7) and obesity prevalence (2.1% to 5.1%) increased. Height SDS increased in all of the glycaemic control subgroups, while BMI percentile and obesity prevalence increased in the suboptimal and high-risk groups. CONCLUSIONS: Since 1995, the average height of children with T1DM has increased in parallel with increasing insulin doses. Clinicians should be aware of increased BMI in these patients and the associated risk of developing cardiovascular disease in the future.

File： PLoS One 2020 Mochizuki M Increase in height and obesity in Japanese T1DM.pdf

DOI： 10.1371/journal.pone.0242259

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242259

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Spandidos Publications  

Despite the importance of oral care in the prevention of aspiration pneumonia, the association between oral hygiene and the prevalence of pneumonia‑causing bacteria has not yet been determined. The present study is a cross‑sectional study aimed at determining the association between the original point‑rating system used during oral examinations (the prompt non‑invasive oral assessment) and the prevalence of pneumonia‑causing bacteria in a population of hospitalized patients with malnutrition. The nutrition support team cared for 61 patients; 6 were excluded as they were not eligible. Bedside analyses were conducted using the point‑rating system. The findings were analyzed to determine the association between the prompt non‑invasive oral assessment and the detection of pneumonia‑causing bacteria. Patients who tested positive for pneumonia‑causing bacteria (n=13) received significantly higher total and hygiene item scores than those who tested negative (n=42) [median (25th, 75th percentile), total score, 6 (4, 7) vs. 3 (1, 5), P=0.02; hygiene score, 2 (1, 3) vs. 1 (0, 2), P=0.02]. In the receiver operating characteristic analysis, a total oral assessment cut‑off score of 4 was identified as optimal for detecting pneumonia‑causing bacteria. Additionally, a multivariable analysis revealed a high odds ratio for the presence of pneumonia‑causing bacteria in patients with poor oral hygiene (odds ratio, 2.09; 95% CI, 1.04 to 4.22). Thus, the present study demonstrates that the prompt non‑invasive oral assessment is a simple and effective tool for detecting pneumonia‑causing bacteria in hospitalized patients.

File： Int J Funct Nutr 2020 Yoshizawa K Point rating for oral health and bacterial pneumonia.pdf

DOI： 10.3892/ijfn.2020.8

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Other Link： https://www.spandidos-publications.com/10.3892/ijfn.2020.8

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Lippincott Williams & Wilkins  

Objective: With the advance of medical care, the duration of dependency on nursing care in later life has increased worldwide. There is a question of whether farm work could extend or shorten the dependency duration. We investigated the association between farm work experience and the duration of dependency on nursing support or care in late life.

Methods: We randomly selected 600 adults aged ≥ 65 years, who were independent and not hospitalized, as part of the Yamanashi Healthy–Active Life Expectancy cohort and
followed them for 13 years. We defined the duration of dependency as the time from
reception of long-term care insurance benefits to death, and we adjusted for multiple
covariates.

Results: We analyzed data from 225 adults (139 men and 86 women) who died during the
follow-up period. Ninety-four had received long-term care benefits. Mean age was 79.6
years (standard deviation [SD]: 6.3) in individuals with farm work experience and 80.1
years (SD: 7.2) in individuals without farm work experience. The estimated duration of
dependency on long-term care was 1.3 years (standard error [SE]: 0.4) in individuals
with farm work experience vs. 2.1 years (SE: 0.5) in individuals without farm work
experience (p = .01). The estimated duration of dependency in individuals with farm
work experience and without farm work experience was 0.4 years (SE: 0.5) vs. 1.3
years (SE: 0.6) in men respectively (p = .03) and 1.6 years (SE: 0.9) vs. 2.4 years (SE:
0.9) in women, respectively (p = .16). The sensitivity analysis yielded an estimated
duration of 1.2 years (SE: 0.5) in those with farm work experience and 2.3 years (SE:
0.5) in those without farm work experience (p = .004).

Conclusion: Individuals with farm work experience required less long-term care prior to death, suggesting that agricultural and physical activities promote health. Policymakers
focusing on preventing the need for nursing care in older populations could consider
promoting farming or gardening.

File： Medicine 2020 Haruyama K et al. Farm work reduces late life duration.pdf

DOI： 10.1097/MD.0000000000022248

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Other Link： https://journals.lww.com/md-journal/Fulltext/2020/09180/Farm_working_experience_could_reduce_late_life.69.aspx

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMC  

DOI： 10.21203/rs.2.18119/v310.21203/rs.2.18119/v3

Other Link： https://link.springer.com/article/10.1186/s12891-020-03564-z

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Medical Association/The Japanese Associaiton of Medical Sciences  

File： JMA J 2020 Concordance and discordance of BRAF in metastatic vs. primary lesion of melanoma.pdf

DOI： 10.31662/jmaj.2020-0016

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMC  

Background
Unplanned pregnancy is a public health issue with adverse consequences for maternal and neonatal health. In Japan, the prevalence of unplanned pregnancy was 46.2% in 2002. However, few studies have investigated this topic, and there is little recent data from Japan. We described and examined the prevalence and determinants of unplanned pregnancy among rural women in Japan from 2011 to 2016.

Methods
We used cross-sectional data from a community-based cohort study (Project Koshu). Data were collected from 2011 to 2016 via a self-report questionnaire included in the Maternal and Child Health Handbook of Japan. Pregnancy intention was measured as a binary variable (planned or unplanned). Univariate and multivariate logistic regression analyses were performed to examine factors associated with unplanned pregnancy, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). We conducted sensitivity analyses with different definitions of pregnancy intention to assess the robustness of the results. The significance level was set at 5%.

Results
Of the 932 participants (mean ± standard deviation age at baseline: 31.3 ± 5.2 years), 382 (41%) pregnancies were reported as unplanned. The multivariate analyses showed that maternal age (+ 1 year: OR = 0.94, 95% CI: 0.92–0.97, p <  0.001), ‘other’ family structure (OR = 2.76, 95% CI: 1.12–6.76, p = 0.03), three or more pregnancies (OR = 2.26, 95% CI: 1.66–3.08, p <  0.001), current smoking (OR = 2.60, 95% CI: 1.26–5.35, p = 0.01), balanced diet (OR = 0.62, 95% CI: 0.47–0.83, p <  0.001) and current depression (OR = 1.63, 95% CI: 1.24–2.16, p <  0.001) were strongly associated with unplanned pregnancy. These associations were consistent across definitions of pregnancy intention, supporting the robustness of our results.

Conclusions
The prevalence of unplanned pregnancy in the study population was high (41%). Risk factors for unplanned pregnancy were age, number of pregnancies, smoking, having a balanced diet and current depression. These results suggest greater efforts are needed to enhance sex education for young people, improve access to family planning services and provide comprehensive health care for high-risk women to help reduce unplanned pregnancies.

File： BMC Pregnancy Childbirth 2020 Huynh ST Prevalence of unplanned pregnancy from Project Koshu.pdf

DOI： 10.1186/s12884-020-03088-3

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Other Link： https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03088-3

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

File： Spine 2020 Oba H et al. Teriparatide vs bisphosphnate for multilevel lumbar interbody fusion.pdf

DOI： 10.1097/BRS.0000000000003426

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Other Link： https://journals.lww.com/spinejournal/Abstract/publishahead/Weekly_Teriparatide_versus_Bisphosphonate_for_Bone.94335.aspx

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/BSD.0000000000000945

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Other Link： https://www.ingentaconnect.com/content/wk/clss/2020/00000033/00000004/art00016

Authorship：Last author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：MOSBY-ELSEVIER  

BACKGROUND AND AIMS: Peroral endoscopic myotomy (POEM) is an available treatment modalities for achalasia. The reported efficacy of POEM in the only prospective multicenter study was 82%; however, a retrospective multicenter study in Japan reported a higher efficacy rate of 95%. The aim of this study was to prospectively verify treatment outcomes after POEM at multiple facilities in Japan. METHODS: This was a prospective single-arm trial of POEM for achalasia at 8 facilities in Japan between April 2016 and March 2018 to evaluate its safety and efficacy. Patients were re-evaluated at 3 months and up to 1 year after POEM. RESULTS: Among the 233 patients with achalasia who underwent POEM, procedure-related adverse events occurred in 24 patients (10.3%), none of whom required surgical intervention. In the 207 patients satisfying the inclusion criteria, the efficacy rate of POEM, defined by an Eckardt score ≤3 at 1 year, was 97.4% (95% CI, 95.3%-99.7%). The Eckardt score decreased significantly from 6.6 ± 2.0 preoperatively to 1.1 ± 1.1, 1 year after POEM. Postoperative reflux esophagitis, severe reflux esophagitis, and symptomatic GERD were reported in 54.2%, 5.6%, and 14.7%, respectively, and proton pump inhibitors were administered in 21.1%. CONCLUSIONS: Our prospective multicenter study in Japan showed greater efficacy of POEM for achalasia compared with the results of a previous prospective multicenter study. POEM is safe and highly effective for at least 1 year. (Clinical trial registration number: UMIN 000021550.).

File： Gastrointestinal Endoscopy 2020 Shiwaku H et al. Prognosis of achalasia in Japan.pdf

DOI： 10.1016/j.gie.2019.11.020

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Other Link： https://www.giejournal.org/article/S0016-5107(19)32470-8/fulltext

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer JAPAN KK  

This case-control study investigated immune thrombocytopenic purpura (ITP) risk following live, inactivated, and simultaneous vaccination, with a focus on infants aged < 2 years. We matched case patients with ITP to one or two control patients with other diseases by institution, hospital visit timing, sex, and age. We calculated McNemar's pairwise odds ratios (ORs [95% confidence interval]) with 114 case-control pairs. The case group had 27 (44%) males and 22 (35%) infants, and the control group included 49 (43%) males and 42 (37%) infants. For all age groups, the McNemar's OR for ITP occurrence was 1.80 (0.54-6.84, p = 0.64) for all vaccines. Among infants, these were 1.50 (0.17-18.0, p = 0.50) for all vaccines, 2.00 (0.29-22.1, p = 0.67) for live vaccines, and 1.00 (0.01-78.5, p = 0.50) for inactivated vaccines. Sex-adjusted common ORs for simultaneous vaccination were 1.52 (0.45-5.21, p = 0.71) for all vaccines, 1.83 (0.44-7.59, p = 0.40) for inactivated vaccines only, and 1.36 (0.29-6.30, p = 0.69) for mixed live and inactivated vaccines. In infants, these were 1.95 (0.44-8.72, p = 0.38), 1.41 (0.29-6.94, p = 0.67) and 2.85 (0.43-18.9, p = 0.28), respectively. These limited data suggest no significant ITP risk following vaccinations or simultaneous vaccination in any age group, including infants.

File： Int J Hematol 2020 ITP risk by inactivated and simultaneous vaccinations.pdf

DOI： 10.1007/s12185-020-02866-1

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Other Link： https://link.springer.com/article/10.1007/s12185-020-02866-1

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AME Publ Co  

Background: Small bowel motility remains inadequately understood because of the complex and various functions as well as its anatomical position. The aimed of the study was to investigate the small bowel transit time (SBTT) of capsule endoscopy (CE) and to analyze the clinical factors affecting SBTT. Methods: SBTT was analyzed in patients who underwent small bowel CE. Factors contributing to SBTT and CE retention were investigated. Results: Among 397 patients enrolled in this study, 336 (84.6%) completed CE. The mean SBTT (± standard deviation) was 282.1±132.2 min. According to the univariate and multivariate analyses, aging and small bowel stenosis extended SBTT. In 38 patients who underwent multiple CE studies, considerable variation in SBTT were observed [mean of standard deviations (SDs) =97.97 min, SD of the SDs =81.99 min]. CE retention was observed in 61 patients (13.3%), and it was statistically associated to small bowel lesion. Conclusions: Aging and small bowel stenosis were associated with longer SBTT. Furthermore, SBTT analyzed by CE should be interpreted carefully considering the intra-individual differences in SBTT.

File： Ann Transl Med 2020 Tominaga K et al. Capsule endoscopy transit time variation.pdf

DOI： 10.21037/atm.2020.02.40

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Other Link： http://atm.amegroups.com/article/view/37251/html

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (bulletin of university, research institution)   Publisher：Yamanashi Medical Association  

Other Link： https://yamanashi.repo.nii.ac.jp/index.php?action=pages_view_main&active_action=repository_view_main_item_snippet&index_id=206&pn=1&count=20&order=7&lang=japanese&page_id=30&block_id=67

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：American Public Health Association  

Other Link： https://apha.confex.com/apha/2019/meetingapp.cgi/Paper/447242

Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：Japanese   Publisher：(公社)日本小児科学会  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

Aims/Introduction: To compare the dementia risk associated with pre-existing diabetes, hypertension, dyslipidemia, obesity (body mass index [BMI] ≥25 kg/m ) and underweight (BMI <18.5 kg/m ) among older adults. We also explored the dementia risk associated with combinations of metabolic diseases and BMI. Materials and Methods: We used data from the Japan Gerontological Evaluation Study. Participants completed a health checkup in 2010 and were followed for 5.8 years on average. Dementia was measured by municipal long-term care insurance registration. Diabetes, hypertension, dyslipidemia, obesity and underweight were diagnosed by medication use or health examination results. We calculated the incidence of dementia and adjusted hazard ratios (HRs). Results: Among 3,696 participating older adults, 338 developed dementia. Adjusted HRs (95% confidence intervals) in men and women (reference: those without corresponding disease of normal weight) were as follows: 2.22 (1.26–3.90) and 2.00 (1.07–3.74) for diabetes; 0.56 (0.29–1.10) and 1.05 (0.64–1.71) for hypertension; 1.30 (0.87–1.94) and 0.73 (0.49–1.08) for dyslipidemia; 0.73 (0.42–1.28) and 0.82 (0.49–1.37) for BMI of 25–29.9 kg/m ; and 1.04 (0.51–2.10) and 1.72 (1.05–2.81) for underweight. Dementia risk was significantly higher in underweight men with dyslipidemia (HR 4.15, 95% CI 1.79–9.63) compared with normal-weight men without dyslipidemia, and in underweight women with hypertension (HR 3.79, 1.55–9.28) compared with normal-weight women without hypertension. Dementia incidence was highest among underweight older adults with hypertension followed by dyslipidemia. Conclusions: Among Japanese older adults, underweight and prevalent diabetes are risk factors for developing dementia. Lower BMI is also associated with a higher incidence of dementia. 2 2 2

File： J Diabetes Investig 2020 Yokomichi H et al. Dementia risk of underweight in older people JAGES Cohort.pdf

DOI： 10.1111/jdi.13103

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/jdi.13103

Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

Smoking during pregnancy causes various maternal and fetal health problems. Although there are considerable differences in maternal smoking proportions between localities, only a few studies have investigated the effects of regional characteristics on maternal smoking behavior. This study aimed to clarify the association between maternal smoking during pregnancy and individual and regional characteristics. We used data from a large nationwide birth cohort study in Japan that consisted of information on 20,267 women with children aged 3-4 months. The multilevel regression model was used to examine the association between smoking behavior during pregnancy and individual and regional characteristics. On multilevel analysis, late birth order, young age of the mother at birth, low birth weight, low economic status, husband's smoking during pregnancy, maternal alcohol consumption during pregnancy, absence of a pregnancy counselor, and lack of participation in local events for childrearing were significantly associated with maternal smoking behavior during pregnancy at the individual level. Meanwhile, a high unemployment rate and a high number of nurseries were significantly associated with maternal smoking behavior during pregnancy at the regional level. In conclusion, we showed the relation between maternal smoking during pregnancy and the individual- and regional-level characteristics.

File： Int J Environ Res Public Health 2020 Ooka T et al. Individual and regional characteristics and maternal smoking.pdf

DOI： 10.3390/ijerph17010173

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Other Link： https://www.mdpi.com/1660-4601/17/1/173

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Health, Labour and Welfare Statistics Association  

Other Link： https://www.hws-kyokai.or.jp/paper/120-2016-02-15-03-07-32/2352-201910-3.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wolters Kluwer  

DOI： 10.1097/BRS.0000000000003086

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Other Link： https://journals.lww.com/spinejournal/Abstract/publishahead/Predictors_of_Poor_Global_Alignment_and_Proportion.94618.aspx

Language：Japanese   Publisher：日本公衆衛生学会  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer  

Other Link： https://link.springer.com/content/pdf/10.1007%2Fs00125-019-4946-6.pdf

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer  

Other Link： https://link.springer.com/content/pdf/10.1007%2Fs00125-019-4946-6.pdf

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (scientific journal)   Publisher：北隆館  

Other Link： http://hokuryukan-ns.co.jp/cms/book_category/x11/

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Japan KK  

BACKGROUND: Achalasia is a well-known esophageal motility disorder, but epidemiological studies in Japan are lacking. We investigated the incidence and period prevalence of achalasia in Japan, including the rate of coexistence of esophageal carcinoma, and evaluated treatment trends. METHODS: To estimate the nationwide number of patients with achalasia, a large-scale insurance claims database from 2005 to 2017 were used for our analyses. Patients with achalasia and coexistence of esophageal carcinoma were identified based on the diagnosis code registered. Interventional treatment was also evaluated. RESULTS: Of the total 5,493,650 populations, 385 were diagnosed with primary achalasia. The incidence was calculated as 0.81-1.37 per 100,000 person-years (male-to-female ratio was almost 1; mean age at diagnosis was 43.3 ± 14.4 years). The period prevalence was 7.0 per 100,000 persons. There were statistically significant trends of increase in the incidence and period prevalence over age groups (all p values < 0.0001). Four men with achalasia developed esophageal carcinoma, and the incidence of esophageal carcinoma with achalasia was estimated as 0.25 per 100 person-years. With regard to intervention, esophageal dilation was performed as a first treatment in 64.7% of patients, with repeat intervention required in 56.9% of these. The proportion of patients treated using peroral endoscopic myotomy (POEM) increased annually to 41.1% in 2017. CONCLUSIONS: In Japan, the incidence and period prevalence of achalasia is comparable to that in other countries. The absolute risk of esophageal carcinoma is rather low. Esophageal dilation has been the mainstay of achalasia treatment, and the role of POEM has increased annually.

File： J Gastroenterol 2019 Sato H achalasia prevalence in Japan.pdf

DOI： 10.1007/s00535-018-01544-8

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Other Link： https://link.springer.com/article/10.1007/s00535-018-01544-8

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (scientific journal)   Publisher：北隆館  

Other Link： http://hokuryukan-ns.co.jp/cms/books/bio-clinica-2019%E5%B9%B4-2%E6%9C%88%E5%8F%B7/

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer  

Soluble forms of platelet membrane proteins are released upon platelet activation. We previously reported that soluble C-type lectin-like receptor 2 (sCLEC-2) is released as a shed fragment (Shed CLEC-2) or as a whole molecule associated with platelet microparticles (MP-CLEC-2). In contrast, soluble glycoprotein VI (sGPVI) is released as a shed fragment (Shed GPVI), but not as a microparticle-associated form (MP-GPVI). However, mechanism of sCLEC-2 generation or plasma sCLEC-2 has not been fully elucidated. Experiments using metalloproteinase inhibitors/stimulators revealed that ADAM10/17 induce GPVI shedding, but not CLEC-2 shedding, and that shed CLEC-2 was partially generated by MMP-2. Although MP-GPVI was not generated, it was generated in the presence of the ADAM10 inhibitor. Moreover, antibodies against the cytoplasmic or extracellular domain of GPVI revealed the presence of the GPVI cytoplasmic domain, but not the extracellular domain, in the microparticles. These findings suggest that most of the GPVI on microparticles are induced to shed by ADAM10; MP-GPVI is thus undetected. Plasma sCLEC-2 level was 1/32 of plasma sGPVI level in normal subjects, but both soluble proteins significantly increased in plasma of patients with acute coronary syndrome. Thus, sCLEC-2 and sGPVI are released by different mechanisms and released in vivo upon platelet activation.

File： Int J Hematol 2019 Inoue O et al. Soluble CKEC-2 in acute coronary syndrom.pdf

DOI： 10.1007/s12185-019-02680-4

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Other Link： https://link.springer.com/article/10.1007/s12185-019-02680-4

Language：Japanese   Publishing type：Research paper (scientific journal)  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

OBJECTIVE: To calculate the incidence of hospitalisation due to acute respiratory failure, pneumonia, acute respiratory distress syndrome (ARDS), febrile seizures and encephalitis/encephalopathy among influenza-positive patients in Japan, where point-of-care tests are routinely used to diagnose influenza. DESIGN: A cross-sectional study using routinely collected data. SETTING: Japanese clinics and hospitals between 2012 and 2016. PARTICIPANTS: Japanese patients aged 0-74 years diagnosed with influenza by a rapid test in employment-related health insurance records. PRIMARY OUTCOME MEASURES: Incidence of hospitalisation per 100 000 influenza-positive episodes. RESULTS: We included over 16 million influenza-positive episodes, 1.0% of whom were hospitalised. Of these, 3361 were acute respiratory failure, 27 253 pneumonia, 18 ARDS, 2603 febrile seizure and 159 encephalitis/encephalopathy. The percentage of hospitalisations by age was 2.96% of patients aged 0-1 years, 0.77% aged 2-5, 0.51% aged 6-12, 0.78% aged 13-18, 1.36% aged 19-44, 1.19% aged 45-64, and 2.21% aged 65-74. The incidence of hospitalisations from these five complications combined was highest in influenza-positive patients aged 0-1 years (943 per 100 000) compared with 307 in those aged 2-5 years and 271 in those aged 65-74 years. For pneumonia, the incidence was highest for influenza-positive patients aged 0-5 years and 65 years or more. There were statistically significant decreasing trends over the years in the incidence of all-cause hospitalisations, pneumonia and febrile seizures. CONCLUSIONS: Japanese administrative data revealed that 1.0% of influenza-positive patients aged under 75 years were hospitalised. Male patients had a higher incidence of pulmonary complications and febrile seizures. Children aged 0-5 years and adults aged 65-74 years were at high risk of being admitted to hospital for pneumonia.

File： BMJ Open 2019 Yokomichi H et al. Incidence of hospitalisation with influenza in Japan.pdf

DOI： 10.1136/bmjopen-2018-024687

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Other Link： https://bmjopen.bmj.com/content/9/1/e024687.full

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：(MISC) Introduction and explanation (scientific journal)   Publisher：北隆館  

Other Link： http://hokuryukan-ns.co.jp/cms/books/bio-clinica-2019%E5%B9%B4-2%E6%9C%88%E5%8F%B7/

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ Journals  

Objectives: Healthy-weight children tend to gain weight during winter but lose weight during summer. However, overweight elementary school children have shown accelerated summertime weight gain. Whether this seasonal growth variation occurs during preschool period is of substantial interest. Methods: Data were derived from a nationwide retrospective cohort of nursery school children. Eight consecutive sets of longitudinal measurements on height and weight were obtained from 15 259 preschool children. Thereafter, growth in height, weight and body mass index (BMI) over a period of 6 months was calculated. Summertime growth was defined as that from April to October, whereas wintertime growth was defined as that from October to April of the following year. Longitudinal growth seasonality was analysed by classifying children according to their BMI status at the age of elementary school entry. Results: Accelerated summertime weight and BMI gain were observed among children with obesity. This distinctive growth seasonality was detected from around age 2. Children having this growth seasonality at approximately 2 years of age tended to be obese at the age of elementary school entry (OR: 3.7
95% CI: 2.9 to 4.6
p&lt
0.0001). In height gain, obese children were growing apparently faster than those in the other groups at all ages. Conclusion: Early excessive growth with distinct seasonality was observed in preschool obese children. These findings suggest that individuals involved in child healthcare should pay closer attention to early excessive growth with distinct seasonality in preschool obesity.

DOI： 10.1136/archdischild-2018-314862

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Other Link： https://adc.bmj.com/content/104/1/53

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Baishideng Publishing Group  

File： World J Clin Case 2019 Takano S et al. perforation risk factors of ERCP after intestinal reconstruction.pdf

DOI： 10.12998/wjcc.v7.i1.3091

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Other Link： https://www.wjgnet.com/2307-8960/full/v7/i1/10.htm

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

File： Psychiatr Clin Neurosci 2019 Kojima R et al Intenet addiction and related factors.pdf

DOI： 10.1111/pcn.12791

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/pcn.12791

Language：Japanese  

J-GLOBAL

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper (other science council materials etc.)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Health, Labour and Welfare Statistics Association  

Other Link： https://www.hws-kyokai.or.jp/publishing/type/magazine/103-magazine-list/2213-koseinoshihyou1810.html

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Language：Japanese   Publisher：日本公衆衛生学会  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier  

BACKGROUND: The body mass index (BMI) of preschool children from 4 years of age through primary school has increased since the Great East Japan Earthquake, but that of children aged under 3 years has not been studied. This study evaluated how the anthropometrics of younger children changed following the earthquake. METHODS: Height and weight data of children living in northeast Japan were collected from 3-, 6-, 18-, and 42-month child health examinations. We compared the changes in BMI, weight, and height among infants affected by the earthquake between their 3- and 6-month health examinations, toddlers affected at 21-30 months of age (affected groups), and children who experienced the earthquake after their 42-month child health examination (unaffected group). A multilevel model was used to calculate the BMI at corresponding ages and to adjust for the actual age at the 3-month health examination, health examination interval, and gestational age. RESULTS: We recruited 8,479 boys and 8,218 girls living in Fukushima, Miyagi, and Iwate Prefectures. In the infants affected between their 3- and 6-month health examinations in Fukushima, the change in BMI at 42 months of age was greater than among the unaffected children. In the toddlers affected at 21-30 months of age in Fukushima, the change in BMI was greater, but changes in weight and height were less. CONCLUSIONS: Affected infants and toddlers in Fukushima suggested some growth disturbances and early adiposity rebound, which can cause obesity. The future growth of children affected by disasters should be followed carefully.

File： J Epidemiol 2018 Yokomichi H et al. Great east Japan earthquake and infant growth.pdf

DOI： 10.2188/jea.JE20170006

DOI： 10.2188/jea.JE2017000610.2188/jea.JE20170006

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Other Link： https://www.jstage.jst.go.jp/article/jea/28/5/28_JE20170006/_article/-char/en

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier  

BACKGROUND: Socioeconomic status (SES) imbalances in developed and developing countries may result in individuals being overweight and obese. However, few studies have investigated this issue in Japan. We herein examined the relationship between SES and being underweight, overweight or obese according to sex and age groups (20-64 or ≥65 years) in Japan. METHODS: In 2010, we established a cohort of participants in the National Health and Nutrition Survey of Japan. We divided 2,491 participants (1,081 men and 1,410 women) according to the WHO definitions of underweight, overweight or obesity and performed multinomial logistic analyses using BMI <18.5 kg/m2 (underweight), BMI 25.0-29.9 kg/m2 (overweight), and BMI ≥30.0 kg/m2 (obese) versus BMI 18.5-24.9 kg/m2 (normal) as the outcome, with SES groups as the main explanatory variables. RESULTS: In adult men, a lower education level relative to a higher education level was inversely associated with obesity after adjustments for other SESs (odds ratio [OR] 0.41; 95% confidence interval [CI], 0.18-0.96). However, in adult women, lower education level was positively associated with being overweight and obese (OR 1.67; 95% CI, 1.07-2.49 for overweight and OR 2.66; 95% CI, 1.01-7.01 for obese). In adult women, a lower household income was positively associated with being overweight and obese (obese: OR 4.84; 95% CI, 1.36-17.18 for those with a household income <2 million JPY relative to those with ≥6 million JPY). CONCLUSIONS: In adult women, a lower education level and lower household income were positively associated with being overweight or obese. In contrast, in adult men, a lower education level was inversely associated with obesity. Gender and age differences in SESs affect the prevalence of being overweight or obese.

File： J Epidemiol 2018 Nakamura T et al. SES and underweight and obesity in Japanese population NIPPON DATA.pdf

DOI： 10.2188/jea.JE20170249

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Other Link： https://www.jstage.jst.go.jp/article/jea/28/Supplement_III/28_JE20170249/_article/-char/en

Language：Japanese   Publishing type：(MISC) Summary of the papers read (national conference and other science council)   Publisher：(公社)日本小児科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Publishing Group  

Objectives:Longitudinal growth data of children were analyzed to clarify the relationship between the timing of body mass index (BMI) rebound and obesity risk in later ages.Subjects/Methods:Of 54 558 children born between April 2004 and March 2005 and longitudinally measured in April and October every year in the preschool period, 15 255 children were analyzed wherein no longitudinal measurement is missing after 1 year of age. BMI rebound age was determined as the age with smallest BMI value across longitudinal individual data after 1 year of age. Rebound age was compared between overweight and non-overweight groups. The subjects were divided into groups based on the timing of rebound. The sex- A nd age-adjusted mean of the BMI, height and weight s.d. scores for age group, along with 6 months weight and height gain, were compared among groups using analysis of covariance.Results:Among those who were overweight at 66-71 months of age, BMI rebound age obtained at approximately 3 years of age was compared with the non-overweight group, whose BMI rebound age was utmost 66 months or later (P&lt
0.001). The comparison among BMI age group showed that earlier BMI rebound results in larger BMI (P&lt
0.001) and larger weight and height gain after the rebound (P&lt
0.001). Among the group with BMI rebound earlier than 30 months of age, low BMI was observed (P&lt
0.001). Slight elevation of height and weight gain was observed before the BMI rebound among groups with rebound age earlier than 60 months of age (P&lt
0.001).Conclusion:Earlier BMI rebound timing with pre-rebound low BMI leads to greater childhood obesity risk
hence, early detection and prevention is necessary for such cases.

DOI： 10.1038/ijo.2017.242

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Other Link： https://www.nature.com/articles/ijo2017242

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier  

[Aims] This study aims to suggest an informative interval for HbA1c in DM patients with stable glycemic control, based on test characteristics of the HbA1C assay using the signal-to-noise ratio method. [Methods] This was a retrospective, open cohort study. Data were collected between January 2005 to December 2014 at a tertiary-level community hospital in Japan. All adult patients aged under 75 years, with stable glycemic control on a first pharmaceutical regimen for Type II diabetes, and at least two HbA1c measurements after they achieved glycemic stability, were included in the analysis. We defined stable glycemic control as HbA1c <7.0% (52 mmol/mol) and requiring no change in the medication regimen after three consecutive measurements. We adapted a signal-to-noise method for distinguishing true change from measurement error by constructing a linear random effects model to calculate signal and noise for HbA1c. The screening interval for HbA1c was defined as informative when the signal-to-noise ratio exceeded 1. [Results] Among 1066 adults with diabetes, 639 patients (18.5%) were identified as achieving stable glycemic control (511 male (67.3%)), with a mean HbA1c (SD) of 6.4 (0.4)% (46 mmol/mol). Patients with stable glycemic control increase their HbA1c 0.27% (3 mmol/mol) every year while HbA1c has 0.32% (3.5 mmol/mol) noise, as testing characteristics. Signal exceeds noise after 1.2 years (95%CI: 0.9-1.6). [Conclusion] Once patients achieve stable glycemic control at their HbA1c goal, an informative interval for HbA1c monitoring is once every year. Current guidelines, which suggest testing every six months, may contribute to substantial over-testing.

File： Diabetes Res Clin Pract 2018 Ohde S et al. Optimal HbA1c monitoring interval in type 2 diabetes.pdf

DOI： 10.1016/j.diabres.2017.11.013

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Other Link： https://www.sciencedirect.com/science/article/pii/S0168822717305995

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer Nature  

The data indicate that immediately aftermath of the earthquake, the growth of the affected suckling infants were slightly disturbed. The affected suckling infants in Fukushima also represent increased BMI at the age of 42 months and may have potential to show early adiposity rebound. The results highlight the need of medical follow-up to the infants in Fukushima.

Other Link： https://ijpeonline.biomedcentral.com/articles/10.1186/s13633-017-0054-x

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer Nature  

Seasonal growth variation in weight and BMI was detected in relatively overweight preschool children during infancy. These findings suggested that we should be careful of summer time weight gain even in infancy for preventing the future obesity.

Other Link： https://ijpeonline.biomedcentral.com/articles/10.1186/s13633-017-0054-x

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier  

Purpose: We identified metabolites using a metabolomics approach and investigated the association between these metabolites and lower urinary tract symptoms. Materials and Methods: We used a 24-hour bladder diary and I-PSS (International Prostate Symptom Score) to assess micturition behavior and lower urinary tract symptoms in 58 male patients without apparent neurological disease. Lower urinary tract symptoms were defined as a total I-PSS score of 8 or greater. Patients with a score of 7 or less were placed in the control group. A comprehensive study of plasma metabolites was also performed by capillary electrophoresis time-of-flight mass spectrometry. Metabolites were compared between the lower urinary tract symptoms and control groups using the Mann-Whitney U test. Biomarkers of male lower urinary tract symptoms from the metabolites were analyzed using multivariable logistic regression analysis to determine the OR. Results: Of the 58 men 32 were in the lower urinary tract symptoms group and the remaining 26 were in the control group. The 24-hour bladder diary showed that nocturnal urine volume, 24-hour micturition frequency, nocturnal micturition frequency and the nocturia index were significantly higher in the lower urinary tract symptoms group. Metabolomics analysis identified 60 metabolites from patient plasma. Multivariate analysis revealed that increased glutamate and decreased arginine, asparagine and inosine monophosphate were significantly associated with lower urinary tract symptoms in males. Decreases in citrulline and glutamine could also be associated with male lower urinary tract symptoms. Conclusions: Male lower urinary tract symptoms may develop due to abnormal metabolic processes in some pathways. Potential new treatments for lower urinary tract symptoms can be developed by identifying changes in the amino acid profiles.

File： J Urology 2018 Mitsui et al.pdf

DOI： 10.1016/j.juro.2017.11.070

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Other Link： https://www.jurology.com/article/S0022-5347(17)77960-8/abstract

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier  

Background: Data for earthquake-related alterations in physique among young children in developed countries is lacking. The Great East Japan Earthquake caused severe damage in Iwate, Miyagi, and Fukushima Prefectures in northeastern Japan.
Methods: We retrospectively obtained anthropometric measurements in nursery school from 40,046 (cohort 1, historical control) and 53,492 (cohort 2) children aged 3.5-4.5 years without overweight in October 2008, and in October 2010, respectively. At the time of the earthquake in March, 2011, children in cohort 1 had already graduated from nursery school; however, children in cohort 2 were still enrolled in nursery school at this time. We compared the onset of overweight at 1 year after the baseline between children enrolled in their school located in one of the three target prefectures versus those in other prefectures using a logistic regression model, with adjustment for sex, age, history of disease, and obesity index at baseline. Overweight was defined as an obesity index of &gt; +15%, which was calculated as (weight minus sex-and height-specific standard weight)/sex-and height-specific standard weight.
Results: The odds ratio (OR) for the onset of overweight in the three target prefectures was significant in cohort 2 (OR 1.25; 95% confidence interval [CI], 1.01-1.55) but not in cohort 1. When the two cohort were pooled (n = 93,538), the OR of the interaction term for school location x cohort was significant (OR 1.56; 95% CI, 1.09-2.23).
Conclusions: Incident overweight in young children was significantly more common in the three prefectures affected by the Great East Japan Earthquake than in other prefectures after the disaster. (C) 2017 The Authors. Publishing services by Elsevier B. V. on behalf of The Japan Epidemiological Association.

File： J Epidemiol 2017 Kikuya M et al. Young child body alteration after the Greas East Japan Earthquake.pdf

DOI： 10.1016/j.je.2016.09.012

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Other Link： https://www.jstage.jst.go.jp/article/jea/27/10/27_JE81/_article/-char/en

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Springer  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Objective: Although insulin analogs have dramatically changed diabetes treatment, scarce evidence is available on those effects. We aimed to explore whether glycemic control had improved, the use of insulin analogs had been increased, and hypoglycemic events had decreased over time in Japanese pediatric patients with type 1 diabetes (T1D).
Methods: Glycated hemoglobin A1c (HbA1c) values, proportion of insulin regimens, incidence of severe hypoglycemic events, and pubertal increase in HbA1c were compared in three cohorts of childhood-onset Japanese T1D patients (567 subjects in the 1995 cohort, 754 subjects in the 2000 cohort, and 806 subjects in the 2008 cohort).
Results: Mean HbA1c values tended to decrease [78.5 mmol/mol (9.33%) in the 1995 cohort, 68.2 mmol/mol (8.39%) in the 2000 cohort, and 61.2 mmol/mol (7.75%) in the 2008 cohort; P &lt; .0001]. The proportion of patients who received basal-bolus treatment tended to increase with statistical significance, as did the proportion on insulin analogs. The incidence of severe hypoglycemic events (events/100 patients/y) had decreased (19.1 in the 2000 cohort and 8.7 in the 2008 cohort; P = .02). The pubertal increase in HbA1c tended to decrease [males, 12.0 mmol/mol (1.10%) in 1995, 9.4 mmol/mol (0.85%) in 2008, and 9.4 mmol/mol (0.86%) in 2008; P = .55; females, 14.0 mmol/mol (1.28%) in 1995, 10.3 mmol/mol (0.94%) in 2000, and 4.2 mmol/mol (0.38%) in 2008; P = .0003].
Conclusions: Glycemic control and incidence of severe hypoglycemic events were chronologically improved, especially in female adolescents.

File： Pediatr Diabetes 2016 Mochizuki M et al. Secular ttend of glycaemic control improvement in type 1 diabetes.pdf

DOI： 10.1111/pedi.12409

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/pedi.12409

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nagoya Univ Sch Med  

It has been suggested that low health literacy (HL) is associated with poor medication adherence. This study aimed to examine the effect of a text message-based HL intervention to promote medication adherence, compared with text messages that only sent medication reminders, in patients with type 2 diabetes. This was a single-center, open-label, randomized (1: 1) controlled pilot study. The study period was 6 months. Intervention group was sent HL related text messages, compared to the reminder messages that were sent to the control group. The primary outcome was the difference in the change rate of scores on the Morisky Eight-Item Medication Adherence Scale (MMAS-8). Forty-one participants were randomized into the intervention (n = 21) and control (n = 20) groups and completed the 6-month follow-up. Although almost participants read and understood the information provided in the messages, no significant difference was observed between groups for the primary outcome (p = 0.78). Our results suggested that medication adherence at 6 months after discharge in patients with type 2 diabetes did not significantly change by text messages, which aimed to improve their HL levels.

File： Nagoya J Med 2017 Sugita H et al. Text message and health literacy in type 2 diabetes. RCT.pdf

DOI： 10.18999/nagjms.79.3.313

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Other Link： https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/793.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Publishing Group  

Thyroid papillary carcinoma is the most common endocrine neoplasm and generally carries a favorable prognosis. However, a small subset of papillary carcinomas transforms into anaplastic carcinoma, an undifferentiated cancer with a dismal prognosis. Recent studies using next-generation sequencing revealed the genomic landscape of papillary carcinoma and anaplastic carcinoma. However, risk factors for anaplastic transformation in papillary carcinoma remain obscure. In the present study, we investigated molecular alterations of papillary carcinoma and anaplastic carcinoma components in 27 tumors in which anaplastic carcinoma coexisted with antecedent papillary carcinoma. We conducted direct sequencing for BRAF, TERT promoter and PIK3CA, and immunohistochemistry for p53, TTF-1 and subunits of the SWI/SNF complex (ARID1A, ARID1B, ATRX, SMARCA2, SMARCA4, SMARCB1, and PBRM1). BRAFV600E and TERT promoter mutated at the rate of 90% and 95%, respectively, and these mutational statuses were almost identical between the papillary carcinoma and anaplastic carcinoma components. PIK3CA mutation was positive in 33% of our samples with a heterogeneous mutation pattern of the papillary carcinoma and anaplastic carcinoma components. Aberrant expression of p53 and loss of TTF-1 were present in 63 and 59%, respectively, and these two alterations were confined to the anaplastic carcinoma components. There was a loss of the SWI/SNF complex in a subset of the tumors with a heterogeneous pattern of the papillary carcinoma and anaplastic carcinoma components: SMARCA4 in 4% and PBRM1 in 4%. In a multivariate comparison between the antecedent papillary carcinoma components and control papillary carcinomas without anaplastic transformation, TERT promoter mutation was independently associated with anaplastic transformation. Collectively, papillary carcinoma-derived anaplastic carcinomas are characterized by BRAF and TERT promoter mutations, and these mutations occur prior to anaplastic transformation. Alterations of PIK3CA and the SWI/SNF complex are relatively rare and temporally heterogeneous. Of note, a papillary carcinoma harboring TERT promoter mutation is at higher risk for anaplastic transformation.

File： Modern Pathol 2017 Oishi N et al. Molecular alterations in coexisting thyroid papillary and anaplastic carcinomas.pdf

DOI： 10.1038/modpathol.2017.75

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Other Link： https://www.nature.com/articles/modpathol201775

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

BackgroundThe Great East Japan Earthquake followed by tsunamis and the Fukushima Daiichi Nuclear Power Plant (NPP) accident caused catastrophic damage. The effects of the disaster on the growth of affected children are of great concern but remain unknown.
MethodsThe subject group was derived from two Japanese nationwide retrospective cohorts (historical control and exposure groups, respectively). The exposure group experienced the disaster at 47-59months of age. We analyzed longitudinal changes in standard deviation score (SDS) for height and body mass index (BMI) using normal Japanese children's standards. Moreover, we analyzed the details of the affected children in Fukushima using Fukushima-specific growth charts established with the historical control data to clarify any indirect effect of the disaster on growth.
ResultsAffected children in Fukushima had significantly higher BMI SDS than the historical control group (difference, 0.13; 95% CI: 0.044-0.21, P=0.0029) and the regional controls (difference, 0.14; 95% CI: 0.074-0.20, P&lt;0.0001) 1.5years after the disaster. Similar sustained increases in BMI SDS were also found with Fukushima-specific growth charts, but the phenomenon was detected only in boys. Notably, the BMI SDS of affected children who lived near the NPP had been increasing after the disaster, whereas those in distant areas had not changed. In contrast, height SDS had not changed throughout the analysis.
ConclusionsProlonged elevated BMI SDS was detected only in affected children in Fukushima. This phenomenon may be explained by an indirect effect of the NPP accident.

File： Pediatr Int Isojima G et al. Prolonged elevated BMI in children after the Great East Japan Earthquake.pdf

DOI： 10.1111/ped.13340

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/ped.13340

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: To investigate how weight cycling (gaining and losing weight) affects the risk of diabetes. DESIGN: Cohort studies. SETTING: Primary healthcare in urban and rural Japan. PARTICIPANTS: 20 708 urban and 9670 rural residents. PRIMARY OUTCOME MEASURES: ORs for diabetes in those with weight loss, weight loss-gain, stable weight, weight gain-loss and weight gain over 10 years. Weight gain and loss were defined as a change of more than ±4% from baseline weight. RESULTS: In the urban region, the ORs relative to the stable group for the loss-gain and gain-loss groups were 0.63 (95% CI 0.45 to 0.89) and 0.51 (95% CI 0.32 to 0.82) for men and 0.72 (95% CI 0.39 to 1.34) and 1.05 (95% CI 0.57 to 1.95) for women. In the rural region, they were 1.58 (95% CI 0.78 to 3.17) and 0.44 (95% CI 0.15 to 1.29) in men and 0.41 (95% CI 0.12 to 1.44) and 0.77 (95% CI 0.28 to 2.14) in women. The ORs for an increase in weight between 5 and 10 kg from the age of 20 years were 1.54 (95% CI 1.03 to 2.30) in men and 0.96 (95% CI 0.55 to 1.65) in women. CONCLUSIONS: In Japan, weight cycling was associated with a significant reduction in the risk of diabetes for men from urban regions. The associations were unclear for women from urban regions and both men and women from rural regions. These results differ from those in Western studies, probably because of differences in diet, insulin secretion and sensitivity and weight-consciousness.

File： BMJ Open 2017 Yokomichi H et al. Weight cycling and type 2 diabetes onset in urban and rural Japan.pdf

DOI： 10.1136/bmjopen-2016-014684

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Other Link： https://bmjopen.bmj.com/content/7/5/e014684

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=di6mibyo&ye=2017&vo=&issue=suppl

Language：Japanese   Publisher：(一社)日本糖尿病学会  

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OBJECTIVE: To investigate the relationship between personal experience of the Great East Japan Earthquake and various disease types among nursery school children. DESIGN: We conducted a nationwide survey of nursery school children born between 2 April 2006 and 1 April 2007. Nursery school teachers completed questionnaires if they agreed to join the study. Questionnaire items for children consisted of their birth year and month, sex, any history of moving into or out of the current nursery school, presence of diseases diagnosed by a physician at the age of 66-78 months and type of disaster experience. The survey was conducted from September 2012 to December 2012. SETTING: Japan, nationwide. PARTICIPANTS: A total of 60 270 nursery school children were included in the analysis, 840 of whom experienced the disaster on 11 March 2011. MAIN OUTCOME MEASURES: The health status of children 1.5 years after the disaster based on nursery school records. RESULTS: Experiencing the disaster significantly affected the prevalence of overall and individual diseases. Furthermore, there was a difference in disease prevalence between boys and girls. In boys, experiencing the tsunami (OR 2.53, 95% CI 1.22 to 5.24) and living in an evacuation centre (OR 2.92, 95% CI 1.46 to 5.83) were remarkably associated with a higher prevalence of atopic dermatitis, but these trends were not observed among girls. Instead, the home being destroyed (OR 3.50, 95% CI 2.02 to 6.07) and moving house (OR 4.19, 95% CI 2.01 to 8.71) were positively associated with a higher prevalence of asthma among girls. CONCLUSIONS: Our study indicates that experiencing the disaster may have affected the health status of nursery school children at least up to 1.5 years after the disaster. Continuous monitoring of the health status of children is necessary to develop strategic plans for child health.

File： BMJ Glob Health 2017 Ishikuro M et al. Disease prevalence among nursery school children after the Great East Japan Earthquake.pdf

DOI： 10.1136/bmjgh-2016-000127

PubMed

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Other Link： https://gh.bmj.com/content/2/2/e000127

Language：Japanese   Publishing type：(MISC) Introduction and explanation (international conference proceedings)   Publisher：東北大学大学  

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background: The number of patients with diabetes is increasing worldwide. Macrovascular disease, chronic kidney disease, chronic respiratory disease, cancer and smoking frequently accompany type 2 diabetes. Few data are available related to mortality of Asians with diabetes associated with these serious comorbidities. The present study aimed to quantify the excess mortality risks of type 2 diabetic patients with comorbidities.
Methods: We analysed the available records of 30,834 Japanese patients with type 2 diabetes from the BioBank Japan Project between 2003 and 2007. Men and women were followed up for median 8.03 and 8.30 years, respectively. We applied Cox proportional hazard model and Kaplan-Meier estimates for survival curves to evaluate mortality in diabetic patients with or without macrovascular disease, chronic respiratory disease, chronic kidney disease, cancer and smoking.
Results: Adjusted hazard ratios (HRs) for mortality were 1.39 (95% CI, 1.09-1.78) for male sex, 2.01 (95% CI, 1.78-2.26) per 10-year increment of age. Adjusted HRs of primary interest were 1.77 (95% CI, 1.42-2.22), macrovascular disease; 1.58 (95% CI, 1.08-2.31), chronic respiratory disease; 2.03 (95% CI, 1.67-2.47), chronic kidney disease; 1.16 (95% CI, 0.86-1.56), cancer; and 1.74 (95% CI, 1.30-2.31), current smoking.
Conclusions: Diabetic patients with a past or current history of chronic kidney, macrovascular or respiratory diseases or smoking habit have exhibited the highest risk of mortality. Data were limited to those of survivors of comorbidities but we propose the need to improve comorbidities and terminate cigarette smoking for better prognosis in patients with diabetes. (C) 2017 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association.

File： J Epidemiol 2017 Yokomichi H et al. Survival of complications and commorbidities with type 2 diabetes from BioBank Japan.pdf

DOI： 10.1016/j.je.2016.12.012

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Other Link： https://www.sciencedirect.com/science/article/pii/S0917504016301113

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background: Controlling serum cholesterol is critical to prevent cardiovascular disease in patients with dyslipidaemia. Guidelines emphasise the need to select treatment for dyslipidaemia based on specific patient profiles; however, there is little information about the serum cholesterol levels of patients in each profile in Japan. Therefore, we aimed to describe the serum cholesterol levels and prevalence of uncontrolled cases in Japanese patients with dyslipidaemia.
Methods: We included data for patients with dyslipidaemia between 2003 and 2007 from the BioBank Japan Project (66 hospitals). Then, we reported their serum cholesterol levels by age, body mass index, glycaemic control (glycated haemoglobin A1c), blood pressure, smoking, drinking, comorbidity and medication profiles.
Results: We included 22,189 male and 21,545 female patients. The mean serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and non-HDL-C levels in males were 117.4 mg/dL, 51.0 mg/dL, 187.6 mg/dL and 153.6 mg/dL, respectively; the corresponding levels in females were 129.5 mg/dL, 60.5 mg/dL, 144.9 mg/dL and 157.9 mg/dL, respectively. In both males and females, the LDL-C levels were the highest in the following profiles: age 19-44 years, body mass index 18.5-22 kg/m(2), glycated haemoglobin A1c &lt;6.0%, never smoker, chronic respiratory disease as a comorbidity and no medication use.
Conclusions: These data provide details of serum cholesterol levels by risk-factor profile in patients with dyslipidaemia and could add evidence of treatment decisions. (C) 2017 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association.

File： J Epidemiol 2017 Yokomichi H et al. Cholesterol levels in Japanese dyslipidaemic patients in BioBank Japan.pdf

DOI： 10.1016/j.je.2016.12.014

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Other Link： https://www.sciencedirect.com/science/article/pii/S0917504016301083

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background
Statins are the first-line agents used to treat patients with high serum low-density lipoprotein cholesterol levels, thus reducing the risk of death from arterial sclerotic cardiovascular disease; however, little is known about the effects of non-statin pharmacological interventions on mortality as well as about the potential protective effects of statin use against cancer death. This work aimed to compare all-cause and cancer mortality among patients with hyperlipidaemia who did and did not receive statin treatment.

Methods
Between 2003 and 2007 fiscal years, we recruited Japanese patients diagnosed with hyperlipidaemia from 66 hospitals. Patients in our cohort were followed up for a maximum of 12 years to observe the causes of death. Kaplan–Meier estimates from the baseline were used to compare the mortality of patients based on the administered medicine. All-cause mortality were compared among patients with/without administration of statins and other agents; any-organ and colorectal cancer mortality were compared between patients with/without administration of statins.

Results
Our cohort included 41,930 patients with mean ages of 64–66 years and mean body mass indices of 24–25 kg/m2. Patients who received statin monotherapy and were treated with lifestyle modification exhibited nearly identical survival curves, whereas statin use represented a non-significant but potentially protective effect against colorectal cancer-related mortality. The lowest mortality in this cohort was associated with resin monotherapy.

Conclusions
Mortality rate has been similar for patients treated with statin monotherapy and lifestyle modification. Statin monotherapy could potentially reduce any-organ- and colorectal cancer-related mortality.

File： J Epidemiol 2017 Yokomichi H et al. Statin use and all-cause and cancer mortality from BioBank Japan.pdf

DOI： 10.1016/j.je.2016.12.011

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Other Link： https://www.sciencedirect.com/science/article/pii/S0917504016301095

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Background: Evidence of characteristics of Japanese patients with diabetes from a large-scale population is necessary. Few studies have compared glycaemic controls, complications and comorbidities between type 1 and 2 diabetic patients. This paper focuses on illustrating a clinical picture of Japanese diabetic patients and comparing glycaemic control and prognoses between type 1 and 2 diabetes using multiinstitutional data.
Methods: The BioBank Japan Project enrolled adult type 1 and 2 diabetic patients between fiscal years 2003 and 2007. We have presented characteristics, controls of serum glucose, cholesterol and blood pressure, prevalence of complications and comorbidities and survival curves. We have also shown glycaemic controls according to various individual profiles of diabetic patients.
Results: A total of 558 type 1 diabetic patients and 30,834 type 2 diabetic patients participated in this study. The mean glycated haemoglobin A1c was higher in type 1 diabetes than in type 2 diabetes. In the type 1 diabetic patients, the glycated haemoglobin A1c had no consistent trend according to age and body mass index. The Kaplan-Meier estimates represented a longer survival time from baseline with type 1 diabetes than with type 2 diabetes. Compared with type 1 diabetic patients, type 2 diabetic patients had double the prevalence of macrovascular complications.
Conclusions: This work has revealed detailed plasma glucose levels of type 1 and 2 diabetic patients according to age, body mass index, blood pressure, serum cholesterol levels and smoking and drinking habits. Our data have also shown that the prognosis is worse for type 2 diabetes than for type 1 diabetes in Japan. (C) 2017 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association.

File： J Epidemiol 2017 Yokomichi H et al. Serum glucose and cholesterol and blood pressure level in Japanese type 1 and 2 diabetes.pdf

DOI： 10.1016/j.je.2016.12.013

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Other Link： https://www.sciencedirect.com/science/article/pii/S0917504016301101

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Publishing Group  

Background: The evacuation and disruption in housing caused by the 2011 Great East Japan Earthquake and following nuclear radiation may have influenced child health in many respects. However, studies regarding longitudinal childhood growth are limited. Therefore, in this study we aimed to explore the influence of the earthquake on longitudinal changes in body mass index in preschool children.

Methods: Participants were children from nursery schools who cooperated with the study in the Iwate, Miyagi and Fukushima prefectures. The exposed group consisted of children who experienced the earthquake during their preschool-age period (4–5 years old). The historical control group included children who were born 2 years earlier than the exposed children in the same prefectures. Trajectories regarding body mass index and prevalence of overweight/obesity were compared between the two groups using multilevel analysis. Differences in the changes in BMI between before and after the earthquake, and proportion of overweight/obesity was compared between the two groups. We also conducted subgroup analysis by defining children with specific personal disaster experiences within the exposed group.

Results: A total of 9722 children were included in the study. Children in the exposed group had higher body mass indices and a higher proportion of overweight after the earthquake than the control group. These differences were more obvious when confined to exposed children with specific personal disaster experiences.

Conclusions: Children’s growth and development-related health issues such as increased BMI after natural disasters should evoke great attention.

File： Int J Obes Zheng W 2017 BMI change at the Great East Japan Earthquakte.pdf

DOI： 10.1038/ijo.2017.6

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Other Link： https://www.nature.com/articles/ijo20176

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Autonomic dysfunction in diabetes is serious but often underestimated. The purpose of this study was to evaluate hemodynamics within the important initial phase just after standing, which cannot be evaluated by conventional instruments for orthostatic hypotension. Earlobe blood flow (EBF), which indirectly reflects the blood pressure response on standing, was evaluated using a mini laser Doppler flowmeter during standing from the sitting position in 58 healthy controls and 56 diabetic patients categorized as without (11), mild (27), and advanced diabetic polyneuropathy (18). The response area of the EBF waveform within 30 seconds after standing was calculated. An increased response area indicates poor recovery of EBF. Response area increased significantly with the degree of neuropathy (P &lt;.001 for linear trend). Orthostatic hypotension was detected in two patients in the mild neuropathy group. The present approach may be sensitive and practical for detecting autonomic dysfunction not detected with the conventional orthostatic test. (C) Copyright 2016 American Society of Hypertension. All rights reserved.

DOI： 10.1016/j.jash.2016.11.003

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Other Link： https://www.ashjournal.com/article/S1933-1711(16)30566-6/abstract

Language：Japanese  

J-GLOBAL

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: Guidelines for frequency of Type 2 diabetes mellitus (DM) screening remain unclear, with proposed screening intervals typically based on expert opinion. This study aims to demonstrate that HbA1c screening intervals may differ substantially when considering individual risk for diabetes.
Methods: This was a multi-institutional retrospective open cohort study. Data were collected between April 1999 to March 2014 from one urban and one rural cohort in Japan. After categorization by age, we stratified individuals based on cardiovascular disease risk (Framingham 10-year cardiovascular risk score) and body mass index (BMI). We adapted a signal-to-noise method for distinguishing true HbA1c change from measurement error by constructing a linear random effect model to calculate signal and noise of HbA1c. Screening interval for HbA1c was defined as informative when the signal-to-noise ratio exceeded 1.
Results: Among 96,456 healthy adults, 46,284 (48.0%) were male; age (range) and mean HbA1c (SD) were 48 (30-74) years old and 5.4 (0.4)%, respectively. As risk increased among those 30-44 years old, HbA1c screening intervals for detecting Type 2 DM consistently decreased: from 10.5 (BMI &lt; 18.5) to 2.4 (BMI &gt; 30) years, and from 8.0 (Framingham Risk Score &lt; 10%) to 2.0 (Framingham Risk Score &gt;= 20%) years. This trend was consistent in other age and risk groups as well; among obese 30-44 year olds, we found substantially shorter intervals compared to other groups.
Conclusion: HbA1c screening intervals for identification of DM vary substantially by risk factors. Risk stratification should be applied when deciding an optimal HbA1c screening interval in the general population to minimize overdiagnosis and overtreatment.

File： BMC 2016 Ohde S et al. Optimal diabetes screening on risk stratification.pdf

DOI： 10.1186/s12902-016-0139-1

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Other Link： https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-016-0139-1

Language：Japanese   Publishing type：Research paper (international conference proceedings)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=dh6auxol&ye=2016&vo=22&issue=2

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

BackgroundHypertension is heritable, and genetic factors likely exert an effect from childhood. Puberty is an early life milestone that may relate to adult hypertension. Therefore, this study examined whether there is an association between a family history of hypertension and pubertal growth.
MethodsThe participants were children from a prospective cohort study called Project Koshu, who were born between 1991 and 1998 in Japan. Data on family history of hypertension, maternal characteristics, birth and early life factors were collected from the questionnaire administered to the mothers at the time of pregnancy registration or medical check-up. Child age at peak height velocity (early or non-early) was calculated from the anthropometric data collected during annual school check-up.
ResultsData on 919 children (479 boys and 440 girls) were included in the analysis; 478 participants had a family history of hypertension. After adjustment for potential confounders (birth month, maternal body mass index, maternal work status, maternal education, and paternal education), early age at peak height velocity was found to be associated with a family history of hypertension (OR, 1.52; 95% confidence interval (CI): 1.04-2.24; P = 0.03) and specifically, with having at least one maternal hypertensive relative (OR, 1.81; 95%CI: 1.23-2.68; P = 0.003).
ConclusionsTogether with previous reports on the relationship between puberty and adult hypertension, the present results suggest that the timing of pubertal growth is involved in the process of hypertension development in people with a family history of hypertension. Further confirmative studies are needed.

File： Pediatr Int 2016 Zheng W Pubertal timing and family history of hypertension from Koshu Project.pdf

DOI： 10.1111/ped.12821

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Other Link： https://onlinelibrary.wiley.com/doi/full/10.1111/ped.12821

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://www.jstage.jst.go.jp/article/jhsaiih/19/1/19_24/_article/-char/en

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1136/bmjopen-2015-010978

Other Link： https://bmjopen.bmj.com/content/6/4/e010978

Language：Japanese   Publishing type：(MISC) Summary of the papers read (national conference and other science council)   Publisher：(一社)日本糖尿病学会  

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

Objective The contributions of highly correlated cardiovascular risk factors to intraocular pressure (IOP) are not clear due to underlying confounding problems. The present study aimed to determine which metabolic syndrome parameters contribute to elevating IOP and to what extent.
Design Retrospective cohort study.
Setting A private healthcare centre in Japan.
Participants Individuals who visited a private healthcare centre and underwent comprehensive medical check-ups between April 1999 and March 2009 were included (20007 in the cross-sectional study and 15747 in the longitudinal study).
Primary and secondary outcome measures Changes in IOP were evaluated in terms of ageing and changes in metabolic syndrome parameters. Pearson's correlation coefficients and mixed-effects models were used to examine the relationship of changes in IOP with ageing and changes in metabolic syndrome parameters in cross-sectional and longitudinal studies, respectively.
Results In the cross-sectional study, IOP was negatively correlated with age and positively correlated with waist circumference, high-density lipoprotein cholesterol (HDL-C) levels, triglyceride levels, systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting plasma glucose (FPG) levels. In the longitudinal multivariate analysis, the associated IOP changes were -0.12 (p&lt;0.0001) mmHg with male sex; -0.59 (p&lt;0.0001) mmHg with 10years of ageing; +0.42 (p&lt;0.0001) mmHg with 1mmol/L increase in HDL-C levels; +0.092 (p&lt;0.0001) mmHg with 1mmol/L increase in triglyceride levels; +0.090 (p&lt;0.0001) mmHg with 10mmHg increase in SBP; +0.085 (p&lt;0.0001) mmHg with 10mmHg increase in DBP; and+0.091 (p&lt;0.0001) mmHg with 1mmol/L increase in FPG levels.
Conclusions Elevation of IOP was related to longitudinal worsening of serum triglyceride levels, blood pressure and FPG and improvement in serum HDL-C levels.

File： BMJ Open 2016 Yokomichi H et al. Intraocular pressure and metabolic syndrome. a cross-sectional study from Japan.pdf

DOI： 10.1136/bmjopen-2015-010360

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Other Link： https://bmjopen.bmj.com/content/6/3/e010360

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Nature Publishing Group  

DOI： 10.1038/ajg.2015.269

Other Link： https://journals.lww.com/ajg/Fulltext/2015/10001/The_Association_Between_Meteorological_Factors_and.85.aspx

Language：Japanese   Publishing type：Research paper (international conference proceedings)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=dh6auxol&ye=2015&vo=21&nu=2

Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Oxford University Press  

File： Int J Epiemiol 2015 Yamagata Z et al. Macrosomia as dentary caries risk at 3 years old.pdf

DOI： 10.1093/ije/dyv097.287

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Other Link： https://academic.oup.com/ije/article/44/suppl_1/i77/2573890

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

BACKGROUND: After the first case of per-oral endoscopic myotomy (POEM) at our institution in 2008, the procedure was quickly accepted as an alternative to surgical myotomy and is now established as an excellent treatment option for achalasia. This study aimed to examine the safety and outcomes of POEM at our institution.
STUDY DESIGN: Per-oral endoscopic myotomy was performed on 500 consecutive achalasia patients at our institution between September 2008 and November 2013. A review of prospectively collected data was conducted, including procedure time, myotomy location and length, adverse events, and patient data with short- (2 months) and long-term (1 and 3 years) follow-up.
RESULTS: Per-oral endoscopic myotomy was successfully completed in all patients, with adverse events observed in 3.2%. Two months post-POEM, significant reductions in symptom scores (Eckardt score 6.0 +/- 3.0 vs 1.0 +/- 2.0, p &lt; 0.0001) and lower esophageal sphincter (LES) pressures (25.4 +/- 17.1 vs 13.4 +/- 5.9 mmHg, p &lt; 0.0001) were achieved, and this persisted at 3 years post-POEM. Gastroesophageal reflux was seen in 16.8% of patients at 2 months and 21.3% at 3-year follow-up.
CONCLUSIONS: Per-oral endoscopic myotomy was successfully completed in all cases, even when extended indications (extremes of age, previous interventions, or sigmoid esophagus) were used. Adverse events were rare (3.2%), and there were no mortalities. Significant improvements in Eckardt scores and LES pressures were seen at 2 months, 1 year, and 3 years post-POEM. Based on our large series, POEM is a safe and effective treatment for achalasia; there are relatively few contraindications, and the procedure may be used as either first-or second-line therapy. (C) 2015 by the American College of Surgeons

File： J Am Coll Surg 2015 Inoue H et al. Outcomes of per-oral endoscopic myotomy.pdf

DOI： 10.1016/j.jamcollsurg.2015.03.057

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Other Link： https://www.sciencedirect.com/science/article/pii/S1072751515002793?via%3Dihub

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Other Link： http://www.pieronline.jp/content/article/0386-3603/43070/961

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: Although obesity is a well-studied risk factor for diabetes, there remains an interest in whether "increasing body mass index (BMI)," "high BMI per se," or both are the actual risk factors for diabetes. The present study aimed to retrospectively compare BMI trajectories of individuals with and without diabetes in a case-control design and to assess whether increasing BMI alone would be a risk factor.
Methods: Using comprehensive health check-up data measured over ten years, we conducted a case-control study and graphically drew the trajectories of BMIs among diabetic patients and healthy subjects, based on coefficients in fitted linear mixed-effects models. Patient group was matched with healthy control group at the onset of diabetes with an optimal matching method in a 1:10 ratio. Simple fixed-effects models assessed the differences in increasing BMIs over 10 years between patient and control groups.
Results: At the time of matching, the mean ages in male patients and controls were 59.3 years [standard deviation (SD) = 9.2] and 57.7 years (SD = 11.2), whereas the mean BMIs were 25.0 kg/m(2) (SD = 3.1) and 25.2 kg/m(2) (SD = 2.9), respectively. In female patients and controls, the mean ages were 61.4 years (SD = 7.9) and 60.1 years (SD = 9.6), whereas the mean BMIs were 24.8 kg/m(2) (SD = 3.5) and 24.9 kg/m(2) (SD = 3.4), respectively. The simple fixed-effects models detected no statistical significance for the differences of increasing BMIs between patient and control groups in males (P = 0.19) and females (P = 0.67). Sudden increases in BMI were observed in both male and female patients when compared with BMIs 1 year prior to diabetes onset.
Conclusions: The present study suggested that the pace of increasing BMIs is similar between Japanese diabetic patients and healthy individuals. The increasing BMI was not detected to independently affect the onset of type 2 diabetes.

File： BMC Publ Heal 2015 Mano & Yokomichi et al. BMI trajectory and type 2 diabetes onset. a case-control study.pdf

DOI： 10.1186/s12889-015-2073-y

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Other Link： https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-2073-y

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Public Library Science  

Background
Although many studies have discussed health risks in neonates with a low birth weight, few studies have focused on the risks in neonates with a high birth weight. The objective of this study was to determine whether differences in the incidence of dental caries in early childhood are associated with birth weight status.
Methods
A total of 117,175 children born in Okinawa Prefecture, Japan from 1997 to 2007 were included in this study. Medical professionals collected information about birth records, growth and development, parental child-rearing practices and dental health at 3 months, 18 months and 3 years of age. The risk of dental caries among neonates with macrosomia (birth weight &gt;= 4000 g) was compared with that among neonates with normal weight (2500-3999 g). Sensitivity analyses included 'large for gestational age' (LGA, birth weight above the 90th percentile for gestational age), which was relative to 'appropriate for gestational age' (birth weight between 10th and 90th percentiles). Relative risks and relative risk increases were estimated by multivariate Poisson regression.
Results
At 3 years of age, the relative risk increases for dental caries after adjusting for confounding factors were 19% [95% confidence interval (CI), 11%-28%, P &lt; 0.001] for macrosomic neonates and 12% (95% CI, 9%-16%, P &lt; 0.001) for LGA neonates.
Conclusion
Macrosomia and LGA were associated with an increased risk of dental caries in early childhood. Particular attention should be paid to abnormally large neonates.

File： Plos One 2015 Yokomichi H et al. Macrosomia as dentary carry risk factor at 3 years old from Japan.pdf

DOI： 10.1371/journal.pone.0133872

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0133872

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Other Link： http://www.pieronline.jp/content/article/0386-3603/43070/955

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=co3labor&vo=63&nu=suppl

Language：Japanese   Publisher：(一社)日本血栓止血学会  

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： doi.org/10.1371/journal.pone.0118538

Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118538

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

Background: Smoking during pregnancy is related to fetal constraint and accelerated postnatal growth. However, the pathways between these factors have not been clarified. Pathway analyses that link these factors can help us better understand the mechanisms involved in this association. Therefore, this study aimed to examine pathways between maternal smoking during pregnancy and growth in infancy.
Methods: Participants were singletons born between 1993 and 2006 in rural Japan. The outcome was the change in weight z-score between birth and 3 years of age. Pathways from maternal smoking and other maternal factors (such as maternal body mass index and work status) to growth in infancy via birth factors (such as birth weight and gestational age) and breastfeeding were examined using structural equation modeling.
Results: Complete data were available for 1524 children (775 boys and 749 girls). The model fit appeared adequate. Lower birth weight and non-exclusive breastfeeding mediated the association between maternal smoking during pregnancy and rapid growth in infancy. Maternal smoking was also directly linked to rapid growth in infancy (standardized direct effects 0.06, P = 0.002). Taking all pathways into account, the standardized total effect of maternal smoking on growth in infancy was 0.11.
Conclusions: Maternal smoking during pregnancy may both indirectly, through birth weight and breastfeeding status, and directly influence growth during infancy; however, there may be other pathways that have not yet been identified.

File： J Epidemiol 2015 Zheng W et al. Maternal smoking and infant growth.pdf

DOI： 10.2188/jea.JE20140040

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Other Link： https://www.jstage.jst.go.jp/article/jea/25/1/25_JE20140040/_article

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.2215/CJN.03530708

Other Link： https://link.springer.com/article/10.1007/s10157-013-0923-4

Language：Japanese   Publisher：日本保健科学学会  

DOI： 10.24531/jhsaiih.17.Suppl_28_1

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose:
To investigate the changes in intraocular pressure (IOP) and associated factors over 10 years in subjects who participated in health examinations in 1999 and 2008.
Subjects and Methods:
Subjects with no clear history of ocular disease and who participated in health examinations at Yamanashi Koseiren Health Care Center, Japan, in 1999 and 2008 were enrolled in this study. IOP was evaluated using a noncontact tonometer. The right eye was analyzed in all subjects. The change in IOP between the 2 examinations and the factors that were significantly associated with the change in IOP were investigated.
Results:
A total of 3785 subjects were enrolled (mean age, 50.9 +/- 8.6 y), comprising 2022 males (mean age, 50.3 +/- 8.9 y) and 1763 females (mean age, 51.5 +/- 8.2 y). The mean IOPs of males and females in 1999 were 13.4 +/- 3.1 and 12.8 +/- 2.8 mm Hg, respectively (P &lt; 0.0001). IOP measured in 2008 was significantly lower than that in 1998 in males and females (mean change, -0.8 and -0.6 mm Hg, respectively; P &lt; 0.0001). Univariate regression analysis showed that changes in systolic blood pressure, diastolic blood pressure, total cholesterol, body mass index, and gamma-glutamyl transpeptidase were positively correlated with change in IOP. Multivariate regression analysis showed that the change in IOP was positively associated with the changes in systolic blood pressure, diastolic blood pressure, and body mass index.
Conclusions:
IOP decreased significantly with age. Several systemic factors were significantly correlation with the change in IOP.

DOI： 10.1097/IJG.0b013e3182741c51

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Other Link： https://journals.lww.com/glaucomajournal/Abstract/2014/03000/Changes_in_Intraocular_Pressure_and_Associated.11.aspx

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Background
A trend towards earlier pubertal growth has been identified along with an increase in childhood obesity rates. The study aimed to identify the differences in growth patterns during adolescence between overweight/obese and non-overweight children in Japan.
Methods
The participants were children from a prospective cohort study called Project Koshu, who were born between 1991 and 1998, in Japan. They were classified as overweight/obese or non-overweight according to their body mass index (BMI) in the first grade of elementary school (6-7 years of age) and were followed until graduation from junior high school (14-15 years of age). Anthropometric data were collected at an annual medical check-up in their school. Height gain trajectories were constructed by BMI categories using multilevel analyses. This analysis was stratified by gender.
Results
Overall, 111/850 (13.1%) girls and 109/911(12%) boys were defined as overweight/obese at baseline. Approximately 80% of the children were followed until the third grades of junior high school. Overweight/obese girls gained more height in the first half period, reached their peak height gain about a year earlier than non-overweight girls, and experienced an earlier decline in height gain. Similarly, overweight/obese boys gained more height than non-overweight boys initially. Additionally, non-overweight boys maintained a higher rate of height gain from the age at peak height gain, although the age at peak height gain did not differ between the two groups.
Conclusions
The overweight/obese children grew faster than the non-overweight children in the early pubertal stages, and the non-overweight children caught up and exceeded in height gain at a later stage.

File： Paediatr Perinat Epidemiol 2014 Zheng W et al. Adolescent growth in Japan from Koshu Project.pdf

DOI： 10.1111/ppe.12116

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Other Link： https://onlinelibrary.wiley.com/doi/10.1111/ppe.12116

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

Background: Evidence regarding the mortality rate after administration of the pandemic influenza A (H1N1) 2009 vaccine on patients with underlying diseases is currently scarce. We conducted a case-control study in Japan to compare the mortality rates of patients with idiopathic interstitial pneumonia after the vaccines were administered and were not administered.
Methods: Between October 2009 and March 2010, we collected clinical records in Japan and conducted a 1:1 matched case-control study. Patients with idiopathic interstitial pneumonia who died during this period were considered case patients, and those who survived were considered control patients. We determined and compared the proportion of each group that received the pandemic influenza A (H1N1) 2009 vaccine and estimated the odds ratio. Finally, we conducted simulations that compensated for the shortcomings of the study associated with adjusted severity of idiopathic interstitial pneumonia.
Results: The case and control groups each comprised of 75 patients with idiopathic interstitial pneumonia. The proportion of patients who received the pandemic influenza A (H1N1) 2009 vaccine was 30.7% and 38.7% for the case and control groups, respectively. During that winter, the crude conditional odds ratio of mortality was 0.63 (95% confidence interval, 0.25-1.47) and the adjusted conditional odds ratio was 1.18 (95% confidence interval, 0.33-4.49); neither was significant. The simulation study showed more accurate conditional odds ratios of 0.63-0.71.
Conclusions: In our study, we detected no evidence that the influenza A (H1N1) 2009 vaccine increased the mortality rate of patients with idiopathic interstitial pneumonia. The results, however, are limited by the small sample size and low statistical power. A larger-scale study is required.

File： Plos One 2014 Yokomichi H et al. Pandemic influenza vaccine and mortality in idiopathic interstitial pneumonia. case-control study.pdf

DOI： 10.1371/journal.pone.0088927

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0088927

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

Background: Maternal smoking during pregnancy is a major cause of intrauterine growth restriction and childhood obesity, but only a few studies have examined the association of smoking cessation before and during pregnancy with fetal and childhood growth. We examined this association in a prospective cohort study in Japan.
Methods: Our study included children born between 1991 and 2006 and their mothers. Using a questionnaire, maternal smoking status was recorded at pregnancy. The anthropometric data of the children were collected during a medical check-up at age 3 years. Multiple linear and logistic regression models were used for data analysis stratified by sex.
Results: In total, 2663 mothers reported their smoking status during early pregnancy, and data were collected from 2230 (83.7%) children at age 3 years. Maternal smoking during pregnancy was associated with a significant reduction in birth weight (approximately 120-150 g). Body mass index at age 3 years was significantly higher among boys born to smoking mothers than among boys born to nonsmoking mothers. Maternal smoking during pregnancy was associated with overweight at age 3 years among boys (adjusted odds ratio, 2.4; 95% CI, 1.03-5.4). However, among women who stopped smoking in early pregnancy, there was no increase in the risks of a small for gestational age birth or childhood overweight at age 3 years.
Conclusions: Children born to mothers who stopped smoking before or during early pregnancy had appropriate fetal and childhood growth.

File： J Epidemiol 2014 Suzuki K et al. Maternal smoking cessation and child grwoth.pdf

DOI： 10.2188/jea.JE20130083

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Other Link： https://www.jstage.jst.go.jp/article/jea/24/1/24_JE20130083/_article

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN EPIDEMIOLOGICAL ASSOC  

Background: Determining standard pubertal growth patterns using longitudinal anthropometric measures is important in growth assessment. We used an appropriate repeated-measurements method to identify height growth patterns in Japanese school-aged girls and boys.
Methods: The participants were children born during the period from 1991 through 1999 who had entered the first grade of elementary school in the Enzan district in Koshu City, Japan. This study was part of the Project Koshu cohort study. Height was measured annually in April from the first grade of elementary school (age, 6-7 years) to the third grade of junior middle school (age, 14-15 years). Height gain and growth rate trajectories in boys and girls were constructed using multilevel analysis.
Results: In total, 1984 children (1036 boys and 948 girls) were included in this study. Height in boys and girls was similar at age 6.5 to 9.5 years. Girls subsequently grew faster and were taller than boys at age 10.5 to 11.5 years. Starting at age 12.5 years, male height caught up and exceeded female height. Height gain trajectories showed that annual height gain among girls increased slowly and peaked during age 9.5 to 11.5 years, while male height gains declined slightly at first and peaked at age 11.5 to 12.5 years. Sex differences in height gains were significant during the period from age 7.5 to 14.5 years (P &lt; 0.0001). Growth rate and height gain trajectories were similar between sexes.
Conclusions: Sex differences in growth trajectory were significant, and female height gain peaked approximately 2 years earlier than male height gain.

File： J Epidemiol 2013 Zheng W et al. Sex difference in height gain and growth rate in Japanese schoolers from Koshu Project.pdf

DOI： 10.2188/jea.JE20120164

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Other Link： https://www.jstage.jst.go.jp/article/jea/advpub/0/advpub_JE20120164/_article/-char/en

Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Association for Research in Vision and Ophthalmology  

Other Link： https://iovs.arvojournals.org/article.aspx?articleid=2148290

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：Oxford University Press  

File： 2013 Society for Epidemiologic Studies Proceedings 139.pdf

DOI： 10.1093/aje/kwt103

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Other Link： https://academic.oup.com/aje/article/177/suppl_11/S1/300016

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Other Link： https://www.omicsonline.org/an-improved-statistical-method-to-estimate-usual-intake-distribution-of-nutrients-by-age-group-2155-9600.1000196.php?aid=11927

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=di6mibyo&ye=2013&vo=&issue=suppl

Language：Japanese   Publishing type：Research paper (other science council materials etc.)  

J-GLOBAL

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Language：Japanese   Publishing type：Research paper (research society, symposium materials, etc.)   Publisher：Bunkodo  

Other Link： https://www.jstage.jst.go.jp/browse/ningendock/27/2/_contents/-char/en

Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

Background: The aims of this study were to 1) determine the distinct patterns of body mass index (BMI) trajectories in Japanese children, and 2) elucidate the maternal factors during pregnancy, which contribute to the determination of those patterns.
Methodology/Principal Findings: All of the children (1,644 individuals) born in Koshu City, Japan, between 1991 and 1998 were followed in a longitudinal study exploring the subjects' BMI. The BMI was calculated 11 times for each child between birth and 12 years of age. Exploratory latent class growth analyses were conducted to identify trajectory patterns of the BMI z-scores. The distribution of BMI trajectories were best characterized by a five-group model for boys and a six-group model for girls. The groups were named "stable thin," "stable average," "stable high average," "progressive overweight," and "progressive obesity" in both sexes; girls were allocated to an additional group called "progressive average." Multinomial logistic regression found that maternal weight, smoking, and skipping breakfast during pregnancy were associated with children included in the progressive obesity pattern rather than the stable average pattern. These associations were stronger for boys than for girls.
Conclusions/Significance: Multiple developmental patterns in Japanese boys and girls were identified, some of which have not been identified in Western countries. Maternal BMI and some unfavorable behaviors during early pregnancy may impact a child's pattern of body mass development. Further studies to explain the gender and regional differences that were identified are warranted, as these may be important for early life prevention of weight-associated health problems. Citation: Haga C, Kondo N, Suzuki K, Sato M, Ando D, et al. (2012) Developmental Trajectories of Body Mass Index Among Japanese Children and Impact of Maternal Factors during Pregnancy. PLoS ONE 7(12): e51896. doi: 10.1371/journal.pone.0051896

File： Plos One 2012 Haga C et al. BMI trajectories of Japanese children and associated maternal factors from Koshu Project.pdf

DOI： 10.1371/journal.pone.0051896

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Other Link： https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051896

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

Background: The safety of influenza A (H1N1) 2009 among chronic obstructive pulmonary disease (COPD) patients has not been investigated yet. Our objective was to investigate the safety of the A (H1N1) 2009 vaccine, especially for mortality after vaccination. Methods: From October 2009 to March 2010, we collected records from all Japanese hospitals registered in the Japanese Respiratory Society. We conducted a 1:1 matched case-control study. Patients with COPD who died in the study period were determined as case group patients (n=36). Patients with COPD who survived the study period were determined as control group patients (n=36). In the control group selection process, we selected age, sex, period of home oxygen therapy (measure for COPD severity), hospital, and calendar time as matching factors. We then compared the proportion of patients who received the influenza A (H1N1) 2009 vaccine in each group and evaluated the conditional odds ratio. Results: Both the case and control groups had 36 COPD patients, 32 of whom were men. The mean age was 76.6 years (SD=8.6) in the case group and 76.9 years (SD=8.3) in the control group. The mean period of home oxygen therapy in both groups was 1.8. The proportion of patients receiving A (H1N1) 2009 vaccinations was 47.2% in the case group and 63.9% in the control group. The crude conditional odds ratio of mortality in the winter was 0.33 (95% confidence interval: 0.06-1.34) and adjusted conditional odds ratio was 0.37 (95% confidence interval: 0.09-1.52) with no significance. Conclusions: Our study detected no statistically increased risk of mortality after influenza A (H1N1) 2009 vaccination among COPD patients. The results are, however, limited by the small sample size and low statistical power. A similar larger-scale study is needed in the future to confirm our findings. © 2012 Yokomichi H, et al.

File： J Vaccines Vaccination 2012 Yokomichi H et al. Pandemic influenza vaccinationa and mortality in COPD from Japan. a case-control study.pdf

DOI： 10.4172/2157-7560.1000148

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Other Link： https://www.omicsonline.org/safety-of-the-influenza-a-h1n12009-vaccine-in-chronic-obstructive-pulmonary-disease-a-matched-case-control-study-2157-7560.1000148.php?aid=8597

Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: Birth Defects are a series of diseases that seriously affect children's health. Birth defects are generally caused by several interrelated factors. The aims of the article is to estimate the prevalence rate and types of birth defects in Inner Mongolia, China, to compare socio-demographic characteristics among the children with birth defects and to analyze the association between risk factors and birth defects.
Methods: Data used in this study were obtained through baseline survey of Inner Mongolia Birth Defects Program, a population-based survey conducted from 2005 to 2008. The survey used cluster sampling method in all 12 administrative districts of Inner Mongolia. Sampling size is calculated according to local population size at a certain percentage. All live births, stillbirths and abortions born from October 2005 to September 2008, whose families lived in Inner Mongolia at least one year, were included. The cases of birth defects were diagnosed by the clinical doctors according to their experiences with further laboratory tests if needed. The inclusion criteria of the cases that had already dead were decided according to death records available at local cites. We calculated prevalence rate and 95% confidence intervals of different groups. Outcome variable was the occurrence of birth defects and associations between risk factors and birth defects were analyzed by using Poisson regression analysis.
Results: 976 children with birth defects were diagnosed. The prevalence rate of birth defects was 156.1 per 10000 births (95%CI: 146.3-165.8). The prevalence rate of neural tube defect (20.1 per 10000 births) including anencephaly (6.9 per 10000), spina bifida (10.6 per 10000), and encephalocele (2.7 per 10000) was the highest, followed by congenital heart disease (17.1 per 10000). The relative risk (RR) for maternal age less than 25 was 2.22 (95%CI: 2.05, 2.41). The RR of the ethnic Mongols was lower than Han Chinese (RR: 0.84; 95%CI: 0.80-0.89). The RR of the third and second pregnancy was significantly higher than the first pregnancy while a slight difference between the second and the first pregnancy was also found. Alcohol drinking of mothers, familial inheritance and living area were also found to be related to the occurrence of the birth defects.
Conclusions: Relatively higher birth defect rates were found in Inner Mongolia. This study found that maternal age less than 25, alcohol drinking, familiar inheritance, lower education level of mothers, times of pregnancies and living in rural areas may increase the risk of birth defects. Ethnic Mongols were less likely to have birth defects than Han Chinese.

File： BMC Pediatrics Birth defect prevalence and associated factors in Inner Mongolia, China.pdf

DOI： 10.1186/1471-2431-12-125

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Other Link： https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-12-125

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://www.jstage.jst.go.jp/article/iken/22/1/22_1_91/_article/-char/en

Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://mol.medicalonline.jp/archive/search?jo=aa7rinek&ye=2012&vo=120&issue=1

Language：Japanese   Publisher：日本公衆衛生学会  

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Language：English   Publishing type：Research paper (international conference proceedings)  

Other Link： https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1467-789X.2011.00889.x

Language：Japanese   Publisher：日本公衆衛生学会  

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

Other Link： https://www.niph.go.jp/journal/data/57-3/e57-3.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI IRELAND LTD  

Physicians' attitudes towards the disclosure of a cancer diagnosis to 114 consecutive patients (age range, 65-93 years; median 78 years) admitted to the Tokyo Metropolitan Tama Geriatric Hospital from April 1994 to May 1995 were analyzed utilizing a questionnaire administered to the attending physicians. Eighty-seven patients (76%) had been informed of their diagnosis before the initiation of cancer treatment, while 27 patients (24%) were not told. 'To carry out the treatment under patient's understanding' and 'consideration for patient's quality of life' were the major reasons for diagnosis disclosure, while 'lack of patient's ability to understand the information' and 'family's wish that the patient not be informed of the truth' were the major reasons for non-disclosure. Dementia, deteriorated performance status, and non-curability were major factors related to non-disclosure. Even with decisional ability, 15% of patients were not told their cancer diagnosis because wishes of their families were preferred. The current results suggest that telling cancer diagnosis to the elderly patients will not yield negative attitude of the patients and that there is no rationale for physicians to hesitate to disclose cancer diagnosis merely because of patient's high age. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

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