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1.
Article in Portuguese | LILACS | ID: biblio-1368253

ABSTRACT

RESUMO: Introdução: apesar de ser o país de maior média de idade no mundo, o Japão tem se destacado no combate à pandemia da COVID-19 (do inglês Coronavirus Disease 2019) ao apresentar reduzidas taxas de contaminação pelo vírus e de mortalidade. Objetivo: discutir acerca das estratégias em saúde adotadas pelo Japão diante da pandemia da doença da COVID-19, bem como avaliar os dados sobre contaminação e mortalidade japoneses em comparação com os outros quatro países com maior média de idade do mundo (Itália, Alemanha, Portugal e Espanha) e o Brasil. Metodologia: para avaliação das estratégias em saúde japonesas foi realizada busca nas bases de dados: PubMed, Cochrane e Scielo, utilizando-se combinação dos termos "Japão", "covid", "coronavirus" e "sistemas de saúde", nos idiomas Inglês, Espanhol e Português. Os dados de infecção da COVID-19 foram extraídos do site Our World in Data, correspondendo ao período de 25 de janeiro de 2020 a 30 de julho de 2020. Resultados: dentre as medidas adotadas pelo país no enfrentamento à pandemia, destacam-se o diagnóstico e resposta precoces à infecção, o rastreamento de contatos, o diagnóstico precoce e disponibilidade de cuidados intensivos para pacientes graves e estímulo a medidas comportamentais de distanciamento. Dentre os países analisados, o Japão apresenta as menores taxas de contaminação e mortalidade em termos absolutos pela COVID-19. Conclusões: medidas de distanciamento social, diagnóstico e tratamento precoces parecem ter contribuído para o sucesso no combate à COVID-19 no Japão. No período estudado, em milhão de habitantes, o Japão teve 6,13 casos de Covid, enquanto o Brasil apresentou 218,26 casos. Já no número de mortes confirmadas pela doença, o primeiro teve uma taxa de 0,23 enquanto o segundo de 5,16 casos por milhão de habitantes. É possível, a partir do conhecimento dessas medidas, buscar mecanismos semelhantes ao traçar políticas de saúde no enfrentamento de pandemias em outros países. (AU)


ABSTRAC: Introduction: despite being the country with the highest average age globally, Japan has stood out in the fight against the COVID-19 (Coronavirus Disease 2019) pandemic by presenting low contamination rates by the virus and mortality. Objective: we aim to discuss the health strategies adopted by Japan in the face of the COVID-19 disease pandemic, as well as to evaluate data on Japanese contamination and mortality compared to the other four countries with the highest average age in the world (Italy, Germany, Portugal and Spain) and Brazil. Methodology: the search was carried out to evaluate Japanese health strategies by using the following databases: PubMed, Cochrane, and Scielo using a combination of the terms "Japan", "covid", "coronavirus" and "health systems" in English, Spanish and Portuguese. The COVID-19 infection data was extracted from the Our World in Data website, from January 25, 2020, to July 30, 2020. Results: Among the measures adopted by the country to face the pandemic, the early diagnosis and response to infection, contact tracing, early diagnosis and availability of intensive care for critically ill patients, and encouraging behavioral distancing measures stand out. Among the countries analyzed, Japan has the lowest rates of contamination and mortality in absolute terms by COVID-19. Conclusions: social distancing measures, early diagnosis, and treatment seem to have contributed to the success in combating COVID-19 in Japan. In the studied period, in a million inhabitants, Japan had 6.13 cases of covid while Brazil had 218.26 cases. As for the number of deaths confirmed by the disease, the first had a rate of 0.23 while the second had 5.16 cases per million inhabitants. Based on the knowledge of these measures, it is possible to seek similar mechanisms when designing health policies to face pandemics in other countries.(AU)


Subject(s)
Quality of Health Care , Health Systems/trends , Health Strategies , Early Diagnosis , Physical Distancing , COVID-19 Testing , COVID-19/prevention & control , Health Policy , Japan , Asians
2.
Article in English | WPRIM | ID: wpr-928973

ABSTRACT

OBJECTIVES@#Femoral neck fracture is the most serious osteoporotic fractures that is responsible for high medical costs and high mortality. Femoral neck geometric parameters (FNGPs) are important parameters that reflect the geometrical characteristics of femoral neck, and are closely related to the strength of femoral neck and the risk of fragility fracture.There are differences in the incidence of femoral neck fractures among races. However, whether there is difference in FNGPs among races is unknown.Therefore, this study aims to compare the differences in FNGPs between Chinese and Japanese females.@*METHODS@#This study was a cross-sectional study, in which 3 859 healthy females aged 10-86 (45.7±17.1) years old were recruited from Changsha City of Hunan Province and surrounding areas. The weight and height were measured and recorded, and the body mass index (BMI) was calculated. A dual energy X-ray absorptiometry (DXA) bone densitometer was used to measure femoral neck projective bone area (BA) and bone mineral density (BMD). FNGPs were calculated using the BMD and BA, which included the outer diameter (OD), cross-sectional area (CSA), cortical thickness (CT), endocortical diameter (ED), buckling ratio (BR), section modulus (SM), cross-sectional moment of inertia (CSMI), and compression strength index (CSI). The data of FNGPs in Japanese females was collected from literature. These subjects were grouped by 10-year age. The mean and standard deviation of height, weight, BMI, femoral neck BMD, and FNGPs of each group were calculated. The model with the best goodness-of-fit was selected from various mathematical regression models to analyze the distribution trend and the best fitting curve of FNGPs with age. The differences in FNGPs between Chinese and Japanese females were analyzed by using age-corresponding mean fitting curve for paired t-test, and the relative change rates of FNGPs were compared.@*RESULTS@#The mean values of FNGPs were significantly different among different years old healthy females (all P<0.01). The mean values of OD, CSA, CT, SM, and CSMI in femoral neck were high at 30 to 39 years old, and then they were gradually decreased with age. The CSI reached its peak at 20-29 years old, and it was decreased gradually after 30 years old. ED and BR were at a low level before 40 years old, they were gradually increased after 40 years old, and reached the maximum average value at 80-86 years old. The variations in FNGPs with age were fitted with the best goodness-of-fit by applying the cubic regression model and the determination coefficients of regression equations (R2: 0.062-0.404) were significant (all P<0.01). The distribution trend of FNGPs with age varied with the indices, among which CSA, CT, SM, CSMI and CSI were increased with age before 35 years old, and then they were decreased with age; BR was at a low level in the early stage, and then it was increased with age after about 40 years. There were significant differences in the fitting curves of FNGPs related to age between Chinese and Japanese females (all P<0.01). The fitting curves of OD, ED, BR and SM in Chinese females were significantly higher than those in Japanese females (all P<0.01), while those of CSA and CT in Chinese females were significantly lower than those in Japanese females (all P<0.01). Before the age of 50, the curves of CSMI and CSI of Chinese females were significantly higher than those of Japanese females (all P<0.01), while after the age of 60 the situation was reversed (all P<0.01). Except for SM and CSI, there were significant differences in the rate of OD, CSA, CT, ED, BR and CSMI with age (all P<0.01). By the age of 80 years old, the rates of change in OD, ED, and BR with the age in Chinese females were increased by 0.91%,3.94%, and 47.5%, respectively, while those in Japanese females were increased by 8.57%, 15.8% and 85.3%, respectively;the rates of change of CSA, CT, and CSMI with the age in Chinese females were declined 28.0%, 29.6%, and 25.2%, respectively, while those in Japanese females were declined 29.9%, 36.2%, and 10.9%, respectively. There were significant difference in the rates of change in FNGPs with the age between Chinese and Japanese females (all P<0.01).@*CONCLUSIONS@#The study reveals the variation of FNGPs with age in Chinese, and confirms that there are racial differences in FNGPs between Chinese and Japanese females, which may be one of the important reasons for the difference in the incidence of femoral neck fracture between Chinese and Japanese females.


Subject(s)
Absorptiometry, Photon , Adult , Aged, 80 and over , Bone Density , China/epidemiology , Cross-Sectional Studies , Female , Femoral Neck Fractures/epidemiology , Femur Neck , Humans , Japan , Middle Aged , Young Adult
3.
Chinese Journal of Oncology ; (12): 703-711, 2022.
Article in Chinese | WPRIM | ID: wpr-940929

ABSTRACT

Surgery is so far the most effective treatment for early-stage non-small cell lung cancer (NSCLC). Since the 1990s, the pathology spectrum of early-stage lung cancer has gradually changed because of the increased detection of ground-glass opacity (GGO). The findings from preoperative thin-section computed tomography are strong predictors for the invasiveness and lymph node involvement of GGO, and limited surgery is believed to be implemented safely for radiological less invasive lesions, which calls into question the dominance of lobectomy. After the JCOG0201 trial establishing the radiologic criteria of pathological noninvasiveness for lung adenocarcinoma, the Japan Clinical Oncology Group (JCOG) and the West Japan Oncology Group (WJOG) have successively carried out a series of prospective imaging-guided trials to investigate the optimal surgical procedure for early-stage lung cancer. JCOG0804, was a single-arm, non-randomized, confirmatory trial to evaluate the efficacy and safety of sublobar resection (wedge resection and segmentectomy) for GGO dominant peripheral lung cancer. The primary end point was 5-year relapse-free survival. JCOG0802/WJOG4607L, was a multicentre, open-label, phase 3, randomized, controlled, non-inferiority trial to investigate if segmentectomy was non-inferior to lobectomy in patients with small-sized peripheral NSCLC. The primary endpoint was 5-year overall survival. JCOG1211 was also a non-randomized confirmatory trial to confirm the efficacy of a segmentectomy for clinical T1N0 lung cancer with dominant GGO. The primary endpoint was 5-year relapse-free survival. The findings of JCOG0804 and JCOG0802, and the primary analysis results of JCOG1211 have been officially published. This article systematically reviewed and interpreted the results of the JCOG lung cancer surgery trial series.


Subject(s)
Carcinoma, Non-Small-Cell Lung/surgery , Clinical Trials as Topic , Clinical Trials, Phase III as Topic , Humans , Japan , Lung Neoplasms/surgery , Multicenter Studies as Topic , Prospective Studies , Randomized Controlled Trials as Topic
4.
Article in English | WPRIM | ID: wpr-939789

ABSTRACT

OBJECTIVE@#To evaluate the efficacy of Wen-Luo-Tong Granules (WLT) local administration in the treatment of patients with peripheral neuropathy (PN) induced by chemotherapy or target therapy.@*METHODS@#This study is a randomized, double-blinded, and placebo-controlled trial. Seventy-eight patients with PN induced by chemotherapy or target therapy were enrolled from China-Japan Friendship Hospital between July 2019 and January 2020. They were randomly assigned to WLT (39 cases) and control groups (39 cases) using a block randomization method. The WLT group received WLT (hand and foot bath) plus oral Mecobalamin for 1 week, while the control group received placebo plus oral Mecobalamin. The primary endpoint was PN grade evaluated by the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE). The secondary endpoints included quantitative touch-detection threshold, neuropathy symptoms, Quality of Life Questionnaire-Chemotherapy Induced Peripheral Neuropathy (QLQ-CIPN20), and Quality of Life Questionnaire-Core30 (QLQ-C30).@*RESULTS@#After treatment, the PN grade in the WLT group was significantly lower than that in the control group (1.00 ± 0.29 vs. 1.75 ± 0.68, P<0.01). The total effective rate in the WLT group was significantly higher than that in the control group (82.05% vs. 51.28%, P<0.01). Compared with the control group, the touch-detection thresholds at fingertips, neuropathy symptom score, QLQ-CIPN 20 (sensory scale, motor scale, autonomic scale, and sum score), and QLQ-C30 (physical functioning, role functioning, emotional functioning, and global health) in the WLT group significantly improved after treatment (P<0.01 or P<0.05).@*CONCLUSION@#WLT local administration was significantly effective in the treatment of patients with PN induced by chemotherapy or target therapy. (Trial registration No. ChiCTR1900023862).


Subject(s)
Antineoplastic Agents/adverse effects , China , Humans , Japan , Peripheral Nervous System Diseases/drug therapy , Quality of Life/psychology , Surveys and Questionnaires
5.
Article in English | WPRIM | ID: wpr-928843

ABSTRACT

BACKGROUND@#Pyrethroid (PYR) insecticides are widely used for controlling various pests. There are two types that differ in terms of usage: agricultural-purpose PYR (agriculture-PYR) and hygiene purpose PYR (hygiene-PYRs). Few studies exist on the exposure to these chemicals in small children. In this study, we conducted biomonitoring of urinary pyrethroid metabolites in 1.5-year-old children throughout the year.@*METHODS@#Study subjects were 1075 children participating in an Aichi regional sub-cohort of the Japan Environment and Children's Study as of 18-month health check-up. The concentrations of four specific hygiene-PYR metabolites including 2,3,5,6-tetrafluoro-1,4-benzenedimethanol (HOCH2-FB-Al), and five common metabolites of hygiene- and agriculture-PYRs including 3-phenoxybenzoic acid (3PBA) and cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (DCCA), were measured in urine samples extracted from soiled diapers using a triple quadrupole gas chromatograph-mass spectrometer.@*RESULTS@#The highest detection frequencies were for 3PBA, followed by DCCA, 1R-trans-chrysanthemum dicarboxylic acid, and HOCH2-FB-Al. Among the six metabolites, urinary concentrations were seasonally varied. However, this variation was not observed in the most studied PYR metabolite, 3PBA. Spearman's correlation analysis demonstrated a significant positive correlation between FB-Al and DCCA (r = 0.56) and HOCH2-FB-Al and 4-methoxymethyl-2,3,5,6-tetrafluorobenzyl alcohol (r = 0.60).@*CONCLUSIONS@#This biomonitoring survey found widespread and seasonally specific exposure to multiple hygiene- and agriculture-PYRs in 1.5-year-old Japanese children.


Subject(s)
Agriculture , Child, Preschool , Environmental Exposure/analysis , Humans , Infant , Insecticides , Japan , Mass Spectrometry , Pyrethrins/urine
6.
Article in English | WPRIM | ID: wpr-928841

ABSTRACT

BACKGROUND@#Although the age-adjusted incidence and mortality of cancer and cardiovascular disease (CVD) have been decreasing steadily in Japan, both diseases remain major contributors to morbidity and mortality along with the aging society. Herein, we aim to provide a prescription of 10 health tips for long and healthy life named the "Lifelong Health Support 10 (LHS10)."@*METHOD@#The LHS10 was developed by the preventive medicine specialists at the National Cerebral and Cardiovascular Center in Suita, where it has been used for health guidance to prevent CVD, cancer, and cognitive decline in addition to their major risk factors such as hypertension, diabetes, and obesity. It consisted of the lifestyle modification recommendations of the 2014 Japanese Society of Hypertension guidelines and the 2017 Japan Atherosclerosis Society Guidelines for preventing atherosclerotic CVD. Further, it came in line with other international lifestyle modification guidelines. In this narrative review, we summarized the results of several Japanese epidemiological studies investigating the association between the LHS10 items and the risk of cancer, CVD, and other chronic diseases including dementia, diabetes, and chronic kidney disease.@*RESULTS@#The LHS10 included avoiding smoking and secondhand smoke exposure, engaging in physical activity, refraining from excessive alcohol drinking, reducing fried foods and sugary soft drinks, cutting salt in food, consuming more vegetables, fruits, fish, soy foods, and fibers, and maintaining proper body weight. All items of the LHS10 were shown to reduce the risk of cancer, CVD, and other chronic diseases.@*CONCLUSIONS@#The LHS10 can be a helpful tool for health guidance.


Subject(s)
Cardiovascular Diseases/prevention & control , Humans , Hypertension/prevention & control , Japan/epidemiology , Life Style , Neoplasms , Prescriptions , Risk Factors
7.
Article in English | WPRIM | ID: wpr-928836

ABSTRACT

BACKGROUND@#Community health activities by public health nurses (PHNs) are known to improve lifestyle habits of local residents, and may encourage the practice of infectious disease prevention behaviors during the COVID-19 pandemic. We investigated the association between prefecture-level COVID-19 incidence rate and the number of PHNs per population in Japan, by the COVID-19 variant type.@*METHODS@#Our data were based on government surveys where prefectural-level data are accessible to the public. The outcome variable was the COVID-19 incidence rate (i.e., the cumulative number of COVID-19 cases per 100,000 population for each variant type in 47 prefectures). The explanatory variable was the number of PHNs per 100,000 population by prefecture. Covariates included socioeconomic factors, regional characteristics, healthcare resources, and health behaviors. The generalized estimating equations of the multivariable Poisson regression models were used to estimate adjusted incidence rate ratio (IRR) and 95% confidence interval (CI) for the COVID-19 cases. We performed stratified analyses by variant type (i.e., wild type, alpha variant, and delta variant).@*RESULTS@#A total of 1,705,224 confirmed COVID-19 cases (1351.6 per 100,000 population) in Japan were reported as of September 30, 2021. The number of PHNs per 100,000 population in Japan was 41.9. Multivariable Poisson regression models showed that a lower number of PHNs per population was associated with higher IRR of COVID-19. Among all COVID-19 cases, compared to the highest quintile group of the number of PHNs per population, the adjusted IRR of the lowest quintile group was consistently significant in the models adjusting for socioeconomic factors (IRR: 3.76, 95% CI: 2.55-5.54), regional characteristics (1.73, 1.28-2.34), healthcare resources (3.88, 2.45-6.16), and health behaviors (2.17, 1.39-3.37). These significant associations were unaffected by the variant type of COVID-19.@*CONCLUSION@#We found that the COVID-19 incidence rate was higher in prefectures with fewer PHNs per population, regardless of the COVID-19 variant type. By increasing the number of PHNs, it may be possible to contain the spread of COVID-19 in Japan and provide an effective human resource to combat emerging infectious diseases in the future.


Subject(s)
COVID-19/epidemiology , Humans , Incidence , Japan/epidemiology , Nurses, Public Health , Pandemics , SARS-CoV-2
8.
Article in English | WPRIM | ID: wpr-928832

ABSTRACT

BACKGROUND@#Happiness may help to prevent negative physiological outcomes in response to life events; however, factors contributing to happiness during the COVID-19 pandemic have not been longitudinally investigated. This study explored the predictors of happiness in mothers of young children in Japan using comparable data that were obtained before and during the COVID-19 pandemic.@*METHODS@#We conducted the baseline survey in February 2020, and 4 months later, we also conducted the follow-up survey. Throughout all 47 prefectures in Japan, 4,700 (100 respondents/prefecture) mothers of infants and/or preschoolers (0-6 years) participated in the baseline online survey; 2,489 of these also participated in the follow-up survey.@*RESULTS@#We performed hierarchical multiple regression analysis and our final model indicated that maternal happiness during COVID-19 pandemic was positively related to employment status (homemaker, β = 0.052, p = 0.014), levels of available social support (average, β = 0.052, p = 0.012, high, β = 0.055, p = 0.010) and happiness score before the pandemic (β = 0.467, p < 0.001), and satisfaction toward the measures against the COVID-19 at partners' workplace (average, β = 0.129, p < 0.001; high, β = 0.279, p < 0.001), preventive behavior against COVID-19 (average, β = 0.055, p = 0.002; high, β = 0.045, p = 0.015) and positive attitudes/thinking (β = 0.087, p < 0.001) during the pandemic. In contrast, poor mental health (K6 ≥5, β = -0.042, p = 0.011) before the pandemic and negative changes during the pandemic (≥3, β = -0.085, p < 0.001) were negatively related to maternal happiness during the pandemic. Our final model explained 44.9% of the variance in mothers' happiness during the COVID-19 pandemic.@*CONCLUSIONS@#Satisfaction toward the measures against the COVID-19 at partners' workplace, preventive behavior, and positive attitudes/thinking were especially important for maternal happiness during the COVID-19 pandemic. Future study is needed to consider measures against infectious diseases in the workplace that are desirable for the well-being of parents with young children, taking into account the gender perspective.


Subject(s)
COVID-19/epidemiology , Child , Child, Preschool , Female , Happiness , Humans , Japan/epidemiology , Mothers/psychology , Pandemics
9.
Article in English | WPRIM | ID: wpr-928828

ABSTRACT

BACKGROUND@#Global aging continues to progress. The shortage of human resources involved in long-term care (LTC) is a serious problem worldwide. It is necessary to promote the stable employment of foreign care workers. The purpose of this study was to identify which factors, including well-being, work engagement, and original items, contribute to foreign care workers' intent to continue working.@*METHODS@#We conducted an anonymous self-administered questionnaire survey of 259 foreign LTC workers at LTC facilities in Japan. The questionnaire survey items included the Japanese version of the Subjective Well-being Scale (J-SWBS), the Japanese version of the Utrecht Work Engagement Scale (J-UWES), and original items related to educational needs and issues. We used multiple regression analysis to predict variability from correlations among variables. And after that, we conducted a path analysis using structural equation modeling (SEM), and added that the explanatory variables (IV) were well-being, work engagement, and the original item component, and that the outcome variable (DV) was intention to continue working. We set a hypothetical model based on structural equations, corrected by path analysis, and examined its suitability.@*RESULTS@#The number of returned questionnaires for 259 foreign care workers was 147 (response rate 56.7%), and the number of analyzable questionnaires was 129 (valid response rate 49.8%). For intention to continue working, the results of structural equation modeling showed direct effects for satisfaction with low back pain measure guidance (β = .255), satisfaction with the national examination guidance method (β = .217), well-being (β = .046), and work engagement (β = .026). In work-engagement, there was a direct effect of happiness (β = .715), willingness to learn good care (β = 4.849), and confidence in my ability (β = 2.902,), whilst in well-being, satisfaction with low back pain measure guidance (β = 1.582) and confidence in my ability (β = 1.999) were found to have direct effects.@*CONCLUSIONS@#To increase the intent of foreign care workers to continue working, appropriate guidance should be given related to the development of lumbago. In addition, to provide a place and scene where they can learn good care, having a relationship in practice where foreign care workers can feel that their abilities are being utilized, and developing and maintaining educational support that motivates them to learn good care may be effective.


Subject(s)
Cross-Sectional Studies , Health Personnel , Humans , Intention , Japan , Work Engagement
10.
Article in English | WPRIM | ID: wpr-928826

ABSTRACT

BACKGROUND@#It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19.@*METHODS@#This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N = 33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants.@*RESULTS@#The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine.@*CONCLUSIONS@#It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals.@*TRIAL REGISTRATION@#Not applicable.


Subject(s)
Adult , Aged , COVID-19/prevention & control , COVID-19 Vaccines , Cohort Studies , Cross-Sectional Studies , Humans , Influenza Vaccines , Japan , Middle Aged , Pandemics , Prospective Studies , Young Adult
11.
Asian Journal of Andrology ; (6): 40-44, 2022.
Article in English | WPRIM | ID: wpr-928507

ABSTRACT

Semen analysis has long been used to evaluate male fertility. Recently, several sperm function tests have been developed. Of those, the sperm DNA fragmentation index (DFI), which describes the status of the sperm DNA, is thought to be a suitable parameter for evaluating male fertility. However, there have been no large-scale studies on the sperm DFI of Japanese men. Therefore, we investigated the feasibility of using an in-house flow cytometry-based sperm DFI analysis based on the sperm DNA fragmentation test of sperm chromatin structure assay (SCSA) to assess male fertility in Japan. This study enrolled 743 infertile and 20 fertile Japanese men. To evaluate reproducibility, inter- and intraobserver precision was analyzed. A receiver operating characteristic curve analysis was used to set a cutoff value for the sperm DFI to identify men who could father children by timed intercourse or intrauterine insemination. The variability of the sperm DFI among fertile volunteers was determined. The relationship between semen parameters and the sperm DFI was assessed by Spearman's rho test. A precision analysis revealed good reproducibility of the sperm DFI. The cutoff value of sperm DNA fragmentation in infertile men was 24.0%. Semen volume had no relationship with the sperm DFI. Sperm concentration, sperm motility, total motile sperm count, and percentage of normal-shaped sperm were significantly and negatively correlated with the sperm DFI. The median sperm DFI was smaller in fertile volunteers (7.7%) than that in infertile men (19.4%). Sperm DNA fragmentation analysis can be used to assess sperm functions that cannot be evaluated by ordinary semen analysis.


Subject(s)
Child , Chromatin , DNA Fragmentation , Flow Cytometry , Humans , Infertility, Male/genetics , Japan , Male , Reproducibility of Results , Sperm Motility , Spermatozoa
12.
Article in English | WPRIM | ID: wpr-927642

ABSTRACT

OBJECTIVE@#Traditional epidemiological studies have shown that C-reactive protein (CRP) is associated with the risk of cardiovascular diseases (CVDs). However, whether this association is causal remains unclear. Therefore, Mendelian randomization (MR) was used to explore the causal relationship of CRP with cardiovascular outcomes including ischemic stroke, atrial fibrillation, arrhythmia and congestive heart failure.@*METHODS@#We performed two-sample MR by using summary-level data obtained from Japanese Encyclopedia of Genetic association by Riken (JENGER), and we selected four single-nucleotide polymorphisms associated with CRP level as instrumental variables. MR estimates were calculated with the inverse-variance weighted (IVW), penalized weighted median and weighted median. MR-Egger regression was used to explore pleiotropy.@*RESULTS@#No significant causal association of genetically determined CRP level with ischemic stroke, atrial fibrillation or arrhythmia was found with all four MR methods (all Ps > 0.05). The IVW method indicated suggestive evidence of a causal association between CRP and congestive heart failure ( OR: 1.337, 95% CI: 1.005-1.780, P = 0.046), whereas the other three methods did not. No clear pleiotropy or heterogeneity were observed.@*CONCLUSIONS@#Suggestive evidence was found only in analysis of congestive heart failure; therefore, further studies are necessary. Furthermore, no causal association was found between CRP and the other three cardiovascular outcomes.


Subject(s)
C-Reactive Protein/metabolism , Cardiovascular Diseases/metabolism , Genetic Predisposition to Disease , Genotype , Humans , Japan , Mendelian Randomization Analysis , Polymorphism, Single Nucleotide , Risk Factors
13.
Rev. Assoc. Med. Bras. (1992) ; 67(8): 1087-1092, Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1346964

ABSTRACT

SUMMARY OBJECTIVE: The main aim of this study was to evaluate the structural validity of the Brazilian version of the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). METHODS: Individuals with chronic low back pain were included. The data collection of the study occurred by means of online platform. Confirmatory factor analysis was performed. The theoretical version proposed for the JOABPEQ with five domains was tested. The following indices were considered to verify the fit of the model: comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA), and chi-square/degrees of freedom (DF). RESULTS: The final sample consisted of 175 volunteers, mostly women (68%), adults (mean age of 28.98 years), lean (mean body mass index of 25 kg/m2), with incomplete higher education, single, with mean of pain chronicity of 61.50 months and mean of pain intensity of 6.78 points on the Numeric Pain Scale. Regarding the structure of the JOABPEQ, the original version with five domains was adequate: chi-square/DF=1.52, CFI=0.954, TLI=0.948, and RMSEA=0.055. The factorial load ranges from 0.41 to 0.90. CONCLUSIONS: This study confirms the structure of JOABPEQ with 5 domains (low back pain, lumbar function, walking ability, social life function, and mental health) and 25 items in individuals with chronic low back pain.


Subject(s)
Humans , Female , Adult , Low Back Pain/diagnosis , Psychometrics , Brazil , Surveys and Questionnaires , Reproducibility of Results , Japan
14.
Article in English | WPRIM | ID: wpr-888617

ABSTRACT

BACKGROUND@#Aging is a process that increases oxidative stress. Increased oxidative stress leads to the development of atherosclerosis and mitochondrial dysfunction. Mitochondria contribute to energy production that might have a beneficial influence on maintaining muscle strength. Therefore, the height-related single nucleotide polymorphism (SNP) rs17081935, which is also reported to be associated with mitochondrial metabolism, might be associated with reduced muscle strength and this association might be affected by atherosclerosis status. To clarify those associations, a cross-sectional study of 1374 elderly Japanese individuals aged 60-89 years was conducted.@*METHODS@#Logistic regression was used to clarify the association between rs17081935 and reduced handgrip strength. Since atherosclerosis might affect handgrip strength, participants were stratified by atherosclerosis status. Reduced handgrip strength was defined as being in the lowest quintile of handgrip strength (< 25.6 kg for men and < 16.1 kg for women).@*RESULTS@#No significant associations were found between a minor allele of rs17081935 and reduced handgrip strength among elderly participants without atherosclerosis. A significant inverse association was observed among elderly participants with atherosclerosis. After adjusting for known cardiovascular risk factors and height, the adjusted odd ratio (OR) and 95% confidence interval (CI) for reduced handgrip strength and a minor allele of rs17081935 were 1.13 (0.86, 1.43) for elderly participants without atherosclerosis and 0.55 (0.36, 0.86) for those with atherosclerosis, respectively.@*CONCLUSION@#A minor allele of the height-related SNP rs17081935 was significantly inversely associated with reduced handgrip strength among older individuals with atherosclerosis, but not among those without atherosclerosis.


Subject(s)
Aged , Aged, 80 and over , Atherosclerosis/epidemiology , Body Height , Cross-Sectional Studies , Female , Hand Strength , Humans , Japan/epidemiology , Male , Middle Aged , Polymorphism, Single Nucleotide , Prevalence
15.
Article in English | WPRIM | ID: wpr-888616

ABSTRACT

BACKGROUND@#Remnant-like particle cholesterol (RLP-C) is highly atherogenic, which is associated with atherosclerosis. However, RLP-C has not been routinely measured in the clinical practice. We estimated RLP-C levels using conventional lipid profiles and examined the association between estimated RLP-C and related factors including nutrient intake.@*METHODS@#This study was performed in Uku town, Nagasaki prefecture, Japan in 2019. A total of 225 subjects were enrolled and directly measured RLP-C levels. Estimated RLP-C levels were defined as the following formula [total cholesterol - (LDL-cholesterol) - (HDL-cholesterol)]. Multivariate analyses were used to assess the relationship between estimated RLP-C and atherogenic factors. We calculated cut-off values on dichotomized RLP-C (< 7.5 mg/dL vs. ≥ 7.5 mg/dL) by receiver operating characteristic (ROC) curve.@*RESULTS@#The mean values of directly measured RLP-C levels and estimated RLP-C were 4.0 mg/dL and 16.4 mg/dL, respectively. In the multiple stepwise linear regression analysis, directly measured and estimated RLP-C levels were independently and commonly associated with apolipoprotein E, triglycerides, and vegetable fat intake (inversely). Using ROC curves, we found the cut-off value of estimated RLP-C was 22.0 mg/dL.@*CONCLUSION@#We demonstrated that the estimated RLP-C levels using conventional lipid profiles may substitute for directly measured RLP-C and these levels were independently and inversely associated with vegetable fat intake in the community-dwelling Japanese population.


Subject(s)
Aged , Aged, 80 and over , Cholesterol/blood , Dietary Fats/blood , Female , Humans , Japan , Lipids/blood , Lipoproteins/blood , Male , Middle Aged , Triglycerides/blood , Vegetables
16.
Article in English | WPRIM | ID: wpr-888611

ABSTRACT

BACKGROUND@#Rubella outbreaks occurred among adults in Japan in 2013-2014 and 2018-2019 due to immunity gaps. In response and aiming at rubella elimination by 2020, the government introduced countermeasures comprising supplementary immunization activities for voluntary testing of adult non-healthcare-related workers and vaccination of susceptible individuals. However, as of October 2020, rubella immunity testing and vaccination rates remained low. This study was conducted to identify factors associated with adults voluntarily confirming their rubella immune status, to help develop effective promotion activities for hard-to-reach and left-behind populations.@*METHODS@#In this cross-sectional study, a general population sample of non-healthcare workers aged 20-49 years in Japan completed an online survey in November 2020. Univariate analysis was performed to examine associations of specific actions taken to confirm rubella immune status with social background characteristics, knowledge of rubella, and attitude to testing and vaccination. Log binomial regression analysis was performed to explore the associations following adjustment for social background characteristics.@*RESULTS@#Among 1,854 respondents (927 men, 927 women), only 23.4% of men and 39.4% of women in their 20s to 40s have taken some action related to rubella prevention. Three major factors were associated with the targeted population having taken voluntary action: (1) knowing about testing for confirmation of immunity status (adjusted odds ratio [AOR] 4.29 men, 2.89 women), the rubella outbreak in 2013 among men in their 20s to 40s (AOR 2.79 men, 1.64 women), and congenital rubella syndrome (AOR 1.89 men, 3.10 women); (2) having acquaintances who were vaccinated against or tested for rubella (AOR 2.98 men, 1.95 women); and (3) having a positive attitude toward influenza vaccination (AOR 2.48 men, 1.83 women). Marriage, desire for pregnancy, and having children were weakly associated with taking action.@*CONCLUSIONS@#Currently, insufficient voluntary action is being taken by high-risk adult populations to close the identified immunity gaps. In this last mile to rubella elimination, our findings and suggested potential interventions via annual health check-ups and occupational health and public health initiatives could prove helpful in developing further countermeasures that actively promote and implement supplementary immunization activities targeting all adult generations.


Subject(s)
Adult , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Japan , Male , Middle Aged , Rubella/prevention & control , Vaccination/statistics & numerical data , Young Adult
17.
Article in English | WPRIM | ID: wpr-888609

ABSTRACT

BACKGROUND@#Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes.@*METHODS@#We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance.@*RESULTS@#The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas.@*CONCLUSIONS@#Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.


Subject(s)
Cities/statistics & numerical data , Geography , Hospitals, Teaching/statistics & numerical data , Japan , Physicians/statistics & numerical data , Population Density , Salaries and Fringe Benefits/statistics & numerical data , Students, Medical/psychology , Workload/statistics & numerical data
18.
Article in English | WPRIM | ID: wpr-888605

ABSTRACT

BACKGROUND@#Although the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan.@*METHODS@#We analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups.@*RESULTS@#The prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59-2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04-1.94) and 1.12 (0.81-1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively.@*CONCLUSIONS@#Postpartum women with lower education and lower income had higher risks of hazardous drinking in Japan.


Subject(s)
Adult , Alcohol Drinking/psychology , Cohort Studies , Educational Status , Female , Humans , Income/statistics & numerical data , Japan/epidemiology , Postpartum Period , Pregnancy , Risk Factors , Young Adult
19.
Article in English | WPRIM | ID: wpr-888604

ABSTRACT

BACKGROUND@#Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate.@*METHODS@#Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics.@*RESULTS@#The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27-1.30), 1.53 (95% CI: 1.50-1.55), and 1.46 (95% CI: 1.44-1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08-1.10), 1.10 (95% CI: 1.08-1.11), and 1.35 (95% CI: 1.32-1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54-1.42), 1.39% (95% CI: 0.82-1.97), and 0.13% (95% CI: - 1.24 to 1.48), respectively.@*CONCLUSION@#Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.


Subject(s)
Cardiovascular Diseases/mortality , Cause of Death , Climate Change/mortality , Cold Temperature/adverse effects , Hot Temperature/adverse effects , Humans , Japan/epidemiology , Mortality/trends , Regression Analysis , Respiratory Tract Diseases/mortality , Seasons , Time
20.
Article in English | WPRIM | ID: wpr-880377

ABSTRACT

BACKGROUND@#The Hokkaido Study on Environment and Children's Health is an ongoing study consisting of two birth cohorts of different population sizes: the Sapporo cohort and the Hokkaido cohort. Our primary objectives are to (1) examine the effects that low-level environmental chemical exposures have on birth outcomes, including birth defects and growth retardation; (2) follow the development of allergies, infectious diseases, and neurobehavioral developmental disorders, as well as perform a longitudinal observation of child development; (3) identify high-risk groups based on genetic susceptibility to environmental chemicals; and (4) identify the additive effects of various chemicals, including tobacco.@*METHODS@#The purpose of this report is to provide an update on the progress of the Hokkaido Study, summarize recent results, and suggest future directions. In particular, this report provides the latest details from questionnaire surveys, face-to-face examinations, and a collection of biological specimens from children and measurements of their chemical exposures.@*RESULTS@#The latest findings indicate different risk factors of parental characteristics on birth outcomes and the mediating effect between socioeconomic status and children that are small for the gestational age. Maternal serum folate was not associated with birth defects. Prenatal chemical exposure and smoking were associated with birth size and growth, as well as cord blood biomarkers, such as adiponectin, leptin, thyroid, and reproductive hormones. We also found significant associations between the chemical levels and neuro development, asthma, and allergies.@*CONCLUSIONS@#Chemical exposure to children can occur both before and after birth. Longer follow-up for children is crucial in birth cohort studies to reinforce the Developmental Origins of Health and Disease hypothesis. In contrast, considering shifts in the exposure levels due to regulation is also essential, which may also change the association to health outcomes. This study found that individual susceptibility to adverse health effects depends on the genotype. Epigenome modification of DNA methylation was also discovered, indicating the necessity of examining molecular biology perspectives. International collaborations can add a new dimension to the current knowledge and provide novel discoveries in the future.


Subject(s)
Biomarkers/blood , Child , Child Health , Child, Preschool , Cohort Studies , Environmental Exposure/adverse effects , Environmental Health , Environmental Pollutants/adverse effects , Female , Fetal Blood/chemistry , Follow-Up Studies , Growth/drug effects , Humans , Hypersensitivity/etiology , Infant , Japan/epidemiology , Male , Neurodevelopmental Disorders/etiology , Pregnancy , Prenatal Exposure Delayed Effects/etiology , Prevalence , Smoking/adverse effects
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