Three types of university students with subthreshold depression characterized by distinctive cognitive behavioral skills.

Subthreshold depression impairs young people's quality of life and places them at greater risk of developing major depression. Cognitive behavioral therapy (CBT) is an evidence-based approach for addressing such depressive states. This study identified subtypes of university students with subthreshold depression and revealed discrete profiles of five CBT skills: self-monitoring, cognitive restructuring, behavioral activation, assertive communication, and problem solving. Using data from the Healthy Campus Trial (registration number: UMINCTR-000031307), a hierarchical clustering analysis categorized 1,080 students into three clusters: Reflective Low-skilled, Non-reflective High-skilled, and Non-reflective Low-skilled students. Non-reflective Low-skilled students were significantly more depressed than other students (p < .001). The severity of depression seemed to be related to the combination of self-monitoring skills and other CBT skills. Considering the high prevalence of poor self-monitoring skills in persons with autism, the most severe depression was observed in the significant association between Non-reflective Low-skilled students and autistic traits (p = .008). These findings suggest that subthreshold depression can be categorized into three subtypes based on CBT skill profiles. The assessment of autistic traits is also suggested when we provide CBT interventions for Non-reflective Low-skilled students.

Reliability and validity of the Japanese version of the Valued Living Questionnaire Adapted to Caregiving.

OBJECTIVES: This study developed the Japanese version of the Valued Living Questionnaire Adapted to dementia Caregiving (J-VLQAC) and assessed its reliability and validity. METHODS: A 2-wave longitudinal survey with an interval of two weeks was conducted with Japanese dementia family caregivers (n = 521 at T1; n = 424 at T2). RESULTS: Confirmatory factor analysis demonstrated a poor fit to our data for the original 2-factor model. Exploratory factor analysis resulted in a new 3-factor model (i.e., Own Values, Family Values, and Health Values). Both models showed similar good internal consistency (Cronbach's alpha) and test-retest reliability. Significant correlations between the J-VLQAC and the Valuing Questionnaire (VQ) and measures assessing related constructs (e.g., cognitive fusion) supported good criterion validity and acceptable level of construct validity for both models. Compared to the original 2-factor model, the new 3-factor model showed higher incremental validity, which was assessed through the hierarchical regression analysis examining whether the J-VLQAC predicts depression, anxiety, and life satisfaction over and above the VQ. CONCLUSIONS: The J-VLQAC has good reliability and acceptable validity. CLINICAL IMPLICATIONS: The information gathered from the J-VLQAC can be used to tailor psychological support and help caregivers engage in activities that reflect their personal values.

Interlaboratory comparison about feasibility of insoluble particulate matter test for injections with reduced test volume in light obscuration method.

Insoluble particulate matter test for injections in pharmacopoeia is mandatory for parenteral drug products. In this test using light obscuration, four measurements of at least 5-mL are required. Since therapeutic protein injections of low dosage volumes are getting more popular, reduction of test volumes is desired. In this collaborative study, the impact of lower measurement volume on the accuracy and precision of particle count was evaluated using 2, 5, 10, and 25-µm polystyrene count standards for the validity of test with reduced sample volumes. Good accuracy (3000 particles/mL ±â€¯10%) was obtained at all measurement volumes, and the inter-run variability (RSD) was the same levels between 5 and 1 mL. Although the inter-run variability increased at 0.2 mL, it was below 5%. These results indicated that light obscuration method can be used with 5 mL-0.2 mL, and that it is feasible for monitoring particles ≥2 µm.

Structural equation modeling of the relationship between posttraumatic growth and psychosocial factors in women with breast cancer.

OBJECTIVE: Posttraumatic growth (PTG) is a positive psychological change occurring after struggling with a highly challenging experience. The purposes of this study were to investigate how women's demographic and clinical characteristics as well as psychosocial factors are associated with PTG and to reveal the influence of PTG on depressive symptoms. METHODS: Participants were 157 women with breast cancer (BC) who attended a breast oncology clinic at a university hospital in Japan. The questionnaire included demographic and clinical characteristics, social support, coping strategies, depressive symptoms, and PTG. Structural equation modeling was conducted. RESULTS: Coping was directly related to PTG, and social support and having a religion were partially related to PTG. There was a moderate association between social support and coping. PTG mediated the effect of coping on depressive symptoms. PTG as well as a high level of perceived social support and using positive coping decreased depressive symptoms, whereas using self-restraining coping increased depressive symptoms. CONCLUSION: This study indicated the role of coping strategies and social support in enhancing PTG in Japanese women with BC. Furthermore, perceived social support, a positive approach coping style, and PTG may reduce depressive symptoms. Our results suggest that health care professionals should consider whether patients receive enough support from others, and whether the patients are using the appropriate coping style to adapt to stressors associated with the diagnosis and treatment of BC.

Association between eating speed and metabolic syndrome in a three-year population-based cohort study.

BACKGROUND: Metabolic syndrome has received increased global attention over the past few years. Eating behaviors, particularly eating speed, have long been of interest as factors that contribute to the development of obesity and diabetes. The aim of this study was to assess the relationship between eating speed and incidence of metabolic syndrome among middle-aged and elderly Japanese people. METHODS: A total of 8941 community residents from Soka City in Saitama Prefecture, aged from 40 to 75 years and without a diagnosis of metabolic syndrome, participated in the baseline survey in 2008 and were followed until 2011. Anthropometric measurements and lifestyle factors were measured at baseline and follow-up. The association between eating speed and incidence of metabolic syndrome was evaluated using Cox proportional hazards models adjusted for potential confounding variables. RESULTS: During the 3-year follow-up, 647 people were diagnosed with metabolic syndrome (25.0 cases/1000 person-years). The incidence rates of metabolic syndrome among non-fast-eating and fast-eating participants were 2.3% and 3.1%, respectively. The multivariate-adjusted hazard ratio for incidence of metabolic syndrome in the fast-eating group compared to the not-fast-eating group was 1.30 (95% confidence interval [CI], 1.05-1.60) after adjustment for the potential confounding factors. Eating speed was significantly correlated with waist circumference and high-density lipoprotein cholesterol (HDL-C) components of metabolic risk factors. Hazard ratios in the fast-eating group compared with the reference group were 1.35 (95% CI, 1.10-1.66) for waist circumference and 1.37 (95% CI, 1.12-1.67) for HDL-C. CONCLUSIONS: Eating speed was associated with the incidence of metabolic syndrome. Eating slowly is therefore suggested to be an important lifestyle factor for preventing metabolic syndrome among the Japanese.

Total synthesis and structure revision of didemnaketal B.

Didemnaketal B, a structurally complex spiroacetal that exhibits potent HIV-1 protease inhibitory activity, was originally discovered by Faulkner and his colleagues from the ascidian Didemnum sp. collected at Palau. Its absolute configuration was proposed on the basis of degradation/derivatization experiments of the authentic sample. However, our total synthesis of the proposed structure of didemnaketal B questioned the stereochemical assignment made by Faulkner et al. Here we describe in detail our first total synthesis of the proposed structure 2 of didemnaketal B, which features 1) a convergent synthesis of the C7-C21 spiroacetal domain by means of a strategy exploiting Suzuki-Miyaura coupling, 2) an Evans syn-aldol reaction and a vinylogous Mukaiyama aldol reaction for the assembly of the C1-C7 acyclic domain, and 3) a Nozaki-Hiyama-Kishi reaction for the construction of the C21-C28 side chain domain. The NMR spectroscopic discrepancies observed between synthetic 2 and the authentic sample as well as careful inspection of the Faulkner's stereochemical assignment led us to postulate that the absolute configuration of the C10-C20 domain of 2 has been erroneously assigned. Accordingly, the total synthesis of the revised structure 65 was achieved to show that the NMR spectroscopic properties of synthetic 65 were in good agreement with those of the authentic sample. Furthermore, application of the phenylglycine methyl ester (PGME) method to the C7-C21 spiroacetal domain enabled us to establish the absolute configuration of didemnaketal B.

The dose-response relationship between body mass index and the risk of incident stage ≥3 chronic kidney disease in a general japanese population: the Ibaraki prefectural health study (IPHS).

PURPOSE: To examine the relationship between body mass index (BMI) and the risk of stage ≥3 chronic kidney disease (CKD) in a general Japanese population. METHODS: A total of 105 611 participants aged 40-79 years who completed health checkups in Ibaraki Prefecture, Japan, and were free of CKD in 1993 were followed-up through 2006. Stage ≥3 CKD was defined by an estimated glomerular filtration rate <60 mL/min/1.73 m(2) reported during at least 2 successive annual surveys or as treatment for kidney disease. Hazard ratios (HRs) for the development of stage ≥3 CKD relative to the BMI categories were calculated using the Cox proportional hazards regression model, which was adjusted for possible confounders and mediators. RESULTS: During a mean follow-up of 5 years, 19 384 participants (18.4%) developed stage ≥3 CKD. Compared to a BMI of 21.0-22.9 kg/m(2), elevated multivariable-adjusted HRs were observed among men with a BMI ≥23.0 kg/m(2) and women with a BMI ≥27.0 kg/m(2). Significant dose-response relationships between BMI and the incidence of stage ≥3 CKD were observed in both sexes (P for trend <0.001). CONCLUSIONS: Obesity was associated with the risk of developing stage ≥3 CKD among men and women.

Cardiorespiratory fitness, body mass index, and cancer mortality: a cohort study of Japanese men.

BACKGROUND: The aim of this study is to investigate the independent and joint effects of cardiorespiratory fitness (CRF) and body mass index (BMI) on cancer mortality in a low body mass index population. METHODS: We evaluated CRF and BMI in relation to cancer mortality in 8760 Japanese men. The median BMI was 22.6 kg/m2 (IQR: 21.0-24.3). The mean follow-up period was more than 20 years. Hazard ratios and 95% CI were obtained using a Cox proportional hazards model while adjusting for several confounding factors. RESULTS: Using the 2nd tertile of BMI (21.6-23.6 kg/m2) as reference, hazard ratios and 95% CI for the lowest tertile of BMI (18.5-21.5) were 1.26 (0.87-1.81), and 0.92 (0.64-1.34) for the highest tertile (23.7-37.4). Using the lowest tertile of CRF as reference, hazard ratios and 95% CIs for 2nd and highest tertiles of CRF were 0.78 (0.55-1.10) and 0.59 (0.40-0.88). We further calculated hazard ratios according to groups of men cross-tabulated by tertiles of CRF and BMI. Among men in the second tertile of BMI, those belonging to the lowest CRF tertile had a 53% lower risk of cancer mortality compared to those in the lowest CRF tertile (hazard ratio: 0.47, 95% CI: 0.23-0.97). Among those in the highest BMI tertile, the corresponding hazard ratio was 0.54 (0.25-1.17). CONCLUSION: These results suggest that high CRF is associated with lower cancer mortality in a Japanese population of men with low average BMI.

Concise synthesis and biological assessment of (+)-neopeltolide and a 16-member stereoisomer library of 8,9-dehydroneopeltolide: identification of pharmacophoric elements.

We describe herein a concise synthesis of (+)-neopeltolide, a marine macrolide natural product that elicits a highly potent antiproliferative activity against several human cancer cell lines. Our synthesis exploited the powerful bond-forming ability and high functional group compatibility of olefin metathesis and esterification reactions to minimize manipulations of oxygen functionalities and to maximize synthetic convergency. Our findings include a chemoselective olefin cross-metathesis reaction directed by H-bonding, and a ring-closing metathesis conducted under non-high dilution conditions. Moreover, we developed a 16-member stereoisomer library of 8,9-dehydroneopeltolide to systematically explore the stereostructure-activity relationships. Assessment of the antiproliferative activity of the stereoisomers against A549 human lung adenocarcinoma, MCF-7 human breast adenocarcinoma, HT-1080 human fibrosarcoma, and P388 murine leukemia cell lines has revealed marked differences in potency between the stereoisomers. This study provides comprehensive insights into the structure-activity relationship of this important antiproliferative agent, leading to the identification of the pharmacophoric structural elements and the development of truncated analogues with nanomolar potency.

Evaluation of a community intervention program in Japan using Framingham risk score and estimated 10-year coronary heart disease risk as outcome variables: a non-randomized controlled trial.

BACKGROUND: Community-based programs are being widely adopted in the struggle to prevent cardiovascular diseases. No study has been conducted in Japan to evaluate the effects of a community-based health promotion program by using the Framingham risk score and 10-year CHD risk as outcome variables. The aim of the present study was to assess the effects of a program involving 6-month intervention and 18-month follow-up using such outcomes. METHODS: Participants (n = 1,983, 39.5% women, mean age 63.4 years) were selected for the study in 2008. Of these 1,983, 347 (42.4% women) subjects received the 6-month intervention. The intervention included individual counseling and group sessions, among others. After 18 months, 1,278 participants (intervention group: 238, control group: 1,040) were followed up. Changes in the Framingham risk score and 10-year coronary heart disease (CHD) risk were evaluated. ANCOVA and multiple logistic models adjusted for baseline value, age, sex and intervention times were used. RESULTS: The results showed that the differences in the Framingham risk score and mean 10-year CHD risk were significant in the intervention group compared with the control group after 6-month follow-up (-0.46 and -1.12, respectively) and were also significant after 18-month follow-up (-0.39 and -0.85, respectively). The proportion of those with intermediate 10-year CHD risk (> = 10%) was significantly lower at 6 months (OR 0.30, 95% CI 0.12-0.74) and at 18 months (OR 0.41, 95% CI 0.19-0.92). CONCLUSIONS: The six-month intervention program effectively decreased estimated 10-year CHD risk and the effects were still present at 18-month follow-up. TRIAL REGISTRATION: UMIN-CTR: UMIN000008163.

Non-work-related personal events contribute to depressive symptoms in Japanese discretionary workers.

In Japan, the number of workers with depressive symptoms has increased recently, and long working hours are considered one of the main contributing factors. Currently, the number of workers engaging in discretionary work is small but is expected to increase, as a diverse method of employment is believed to contribute to workers' well-being. However, the factors related to discretionary workers' depressive symptoms are unclear. This study aimed to identify the factors associated with depressive symptoms in discretionary workers. The subjects were 240 male discretionary workers in a Japanese insurance company. A cross-sectional study was performed using a questionnaire that includes demographic characteristics, living and working conditions, work-related and non-work-related stressful events, and the Center for Epidemiologic Studies Depression Scale (CES-D). Depressive symptoms were assessed as more than 16 points on the CES-D. Multiple logistic regression models were employed to estimate odd ratios (OR) with 95% confidence intervals (95% CI) of depressive symptoms in relation to possible factors. Thirty-six subjects (15.5%) showed depressive symptoms. The depressive symptoms were significantly related to age (p = 0.04), presence of child(ren) (p = 0.02), and length of employment (p = 0.01), but unrelated to working hours. Subjects who reported "financial matters" (OR = 4.50, 95% CI = 1.89-10.72) and "own event" such as divorce or illness (OR = 2.93, 95% CI = 1.13-7.61) were more likely to show depressive symptoms. In conclusion, mental health measures for discretionary workers should focus on addressing financial difficulties and consultations and assistance in personal health and family issues.

Low serum LDL cholesterol levels are associated with elevated mortality from liver cancer in Japan: the Ibaraki Prefectural health study.

Liver cancer a global public health concern and well known for poor prognosis. The association between low total cholesterol level and liver cancer has been reported. However, the association between low low-density lipoprotein (LDL) cholesterol levels and liver cancer is still unclear. The aim of this study was to examine the relationship between LDL cholesterol level and liver cancer mortality. A total of 16,217 persons (5,551 men and 10,666 women) aged 40-79 years in 1993 were followed until 2008. LDL cholesterol levels were divided into four categories (<80 mg/dl, 80-99 mg/dl, 100-119 mg/dl, and ≥120 mg/dl). Hazard ratio of LDL cholesterol level for liver cancer mortality was calculated using a multivariable Cox proportional hazards model. Covariates were age, sex, alanine transaminase, body mass index, alcohol intake and smoking status, all of which were correlated with LDL cholesterol levels. There were 51 deaths (32 men and 19 women) from liver cancer. Multivariable hazard ratios of liver cancer deaths for LDL cholesterol levels of <80 mg/dl was 4.33 (95% confident interval [CI]: 1.94, 9.68), for LDL cholesterol levels of 80-99 mg/dl was 1.03 (95% CI: 0.42, 2.53), and for LDL cholesterol levels of ≥120 mg/dl was 0.43 (95% CI: 0.20, 0.92) compared with LDL cholesterol levels of 100-199 mg/dl (p for trend<0.01). Therefore, low LDL cholesterol levels are associated with elevated risk of liver cancer mortality. Low LDL cholesterol may be a predictive marker for death due to liver cancer.

Workers' load and job-related stress after a reform and work system change in a hospital kitchen in Japan.

OBJECTIVES: Many kitchen work environments are considered to be severe; however, when kitchens are reformed or work systems are changed, the question of how this influences kitchen workers and environments arises. The purpose of this study is to examine whether there was a change in workload and job-related stress for workers after a workplace environment and work system change in a hospital kitchen. METHODS: The study design is a pre-post comparison of a case, performed in 2006 and 2008. The air temperature and humidity in the workplace were measured. Regarding workload, work hours, fluid loss, heart rate, and amount of activity [metabolic equivalents of task (METs)] of 7 and 8 male subjects pre- and post-reform, respectively, were measured. Job-related stress was assessed using a self-reporting anonymous questionnaire for 53 and 45 workers pre- and post-system change, respectively. RESULTS: After the reform and work system change, the kitchen space had increased and air-conditioners had been installed. The workplace environment changes included the introduction of temperature-controlled wagons whose operators were limited to male workers. The kitchen air temperature decreased, so fluid loss in the subjects decreased significantly. However, heart rate and METs in the subjects increased significantly. As for job-related stress, although workplace environment scores improved, male workers' total job stress score increased. CONCLUSIONS: These results suggest that not only the workplace environment but also the work system influenced the workload and job stress on workers.

Prognostic factors and effect modifiers for personalisation of internet-based cognitive behavioural therapy among university students with subthreshold depression: A secondary analysis of a factorial trial.

BACKGROUND: Internet-cognitive behavioural therapy (iCBT) for depression can include multiple components. This study explored depressive symptom improvement prognostic factors (PFs) and effect modifiers (EMs) for five common iCBT components including behavioural activation, cognitive restructuring, problem solving, self-monitoring, and assertion training. METHODS: We used data from a factorial trial of iCBT for subthreshold depression among Japanese university students (N = 1093). The primary outcome was the change in PHQ-9 scores at 8 weeks from baseline. Interactions between each component and various baseline characteristics were estimated using a mixed-effects model for repeated measures. We calculated multiplicity-adjusted p-values at 5 % false discovery rate using the Benjamini-Hochberg procedure. RESULTS: After multiplicity adjustment, the baseline PHQ-9 total score emerged as a PF and exercise habits as an EM for self-monitoring (adjusted p-values <0.05). The higher the PHQ-9 total score at baseline (range: 5-14), the greater the decrease after 8 weeks. For each 5-point increase at baseline, the change from baseline to 8 weeks was bigger by 2.8 points. The more frequent the exercise habits (range: 0-2 points), the less effective the self-monitoring component. The difference in PHQ-9 change scores between presence or absence of self-monitoring was smaller by 0.94 points when the participant exercised one level more frequently. Additionally, the study suggested seven out of 36 PFs and 14 out of 160 EMs examined were candidates for future research. LIMITATIONS: Generalizability is limited to university students with subthreshold depression. CONCLUSIONS: These results provide some helpful information for the future development of individualized iCBT algorithms for depression.

Mild retinopathy is a risk factor for cardiovascular mortality in Japanese with and without hypertension: the Ibaraki Prefectural Health Study.

BACKGROUND: It is unclear whether mild hypertensive retinopathy is a risk factor for mortality. This study examined whether mild hypertensive retinopathy could be a risk factor for cardiovascular mortality in subjects with and without hypertension. METHODS AND RESULTS: In this cohort study, 87 890 individuals (29 917 men and 57 973 women) 40 to 79 years of age in 1993 were followed up until 2008. Retinal photography was classified as normal, grade 1, or grade 2 based on the Keith-Wagener-Barker system. Risk ratios for all-cause and cause-specific mortality for each classification were calculated with Cox proportional hazards regression models. Covariates included age, systolic blood pressure, antihypertensive medication use, and other cardiovascular risk factors. Multivariable hazard ratios for total cardiovascular disease mortality were 1.24 (95% confidence interval [CI], 1.12-1.38) and 1.23 (95% CI, 1.03-1.47) for grades 1 and 2 among men and 1.12 (95% CI, 1.01-1.24) and 1.44 (95% CI, 1.24-1.68) for grades 1 and 2 among women, respectively. Hazard ratios for total stroke mortality were 1.31 (95% CI, 1.13-1.53) and 1.38 (95% CI, 1.08-1.77) for grades 1 and 2 among men and 1.30 (95% CI, 1.12-1.50) and 1.70 (95% CI, 1.36-2.11) for grades 1 and 2 among women, respectively. For both hypertensive and normotensive subjects of each sex, multivariable hazard ratios for all-cause mortality, total cardiovascular mortality, and total stroke mortality were significantly higher for grade 1 or 2 compared with normal. CONCLUSIONS: Mild hypertensive retinopathy is a risk factor for cardiovascular mortality independently of cardiovascular risk factors among men and women with and without hypertension.

Discrepancies between public perceptions and epidemiological facts regarding cancer prognosis and incidence in Japan: an Internet survey.

BACKGROUND: This study investigates discrepancies between Japanese public perceptions and epidemiological facts regarding cancer prognosis and lifetime incidence, as well as factors that correlate with public perceptions. METHODS: We conducted a cross-sectional Internet survey with 2369 Japanese survey registrants without a history of cancer. Survey registrants were selected so that distributions of gender, age and place of residence (prefecture) reflected 2010 national census data as much as possible. The questionnaire included questions about their perceptions of 5-year survival rates for cancer in general and 19 site-specific cancers, as well as their perceptions of cumulative lifetime cancer incidence rate among Japanese men and women. RESULTS: The distribution of respondent answers regarding the 5-year survival rate for cancer in general and 19 site-specific cancers varied widely from epidemiological data. Multiple regression analyses revealed that in some cancers, respondents who were of older age, who were female and who had a family/friend with a cancer history were significantly more likely to provide higher estimates regarding the 5-year survival rates. Respondents who correctly estimated cumulative lifetime cancer incidence rates among Japanese men and women were 8.5 and 33.1%, respectively. Respondents who were young, who had a higher educational background and who had a family/friend with a cancer history were significantly more likely to provide higher estimates of cumulative lifetime cancer incidence rates. CONCLUSIONS: Our study revealed wide discrepancies between Japanese public perceptions and epidemiological facts for cancer prognosis and incidence. Accordingly, more efforts should be made to bridge the gap between incorrect perceptions and epidemiological facts.

Low body mass index as a risk factor of moderate to severe oral mucositis in oral cancer patients with radiotherapy.

PURPOSE: The association between body mass index (BMI) and oral mucositis in oral cancer patients receiving radiotherapy is unclear. This study examined whether low BMI could be a risk factor for oral mucositis in oral cancer patients receiving radiotherapy. METHODS: Between April 2007 and March 2011, a total of 33 inpatients with oral cancer receiving radiotherapy were recruited. They were followed from the beginning of radiotherapy to discharge from hospital. All patients had no mucositis when radiotherapy started. The odds ratio (OR) and 95 % confidence interval (CI) of BMI for incident grade 2 and grade 3 mucositis were calculated by use of univariable logistic regression models. RESULTS: All patients developed oral mucositis (grade 1 in 39.4 %, grade 2 in 30.3 %, grade 3 in 30.3 %), with the maximum grade occurring at an average of 32.4 days. Compared with normal BMI (≥22.0), the OR of low BMI (<22.0) for moderate to severe mucositis was 9.07 (95 % CI, 1.72-47.68). CONCLUSIONS: Low BMI may be a risk factor of moderate to severe oral mucositis.

Hypophosphatemia in small for gestational age extremely low birth weight infants receiving parenteral nutrition in the first week after birth.

OBJECTIVES: To investigate the risk of hypophosphatemia and hypercalcemia in small for gestational age (SGA) extremely low birth weight infants (ELBWI) receiving parenteral nutrition. METHODS: A retrospective review of 58 ELBWI was conducted. Serum calcium (Ca) and phosphate (PO4) concentrations on days 1 and 8 after birth were examined for associations with body measurements and nutritional factors in the 1st week of life. RESULTS: Lower birth weight standard deviation (SD) scores were correlated with hypophosphatemia and hypercalcemia in SGA ELBWI on day 8. Higher parenteral amino acid (AA) administration was correlated with hypophosphatemia on day 8. SGA ELBWI exhibited lower serum PO4 concentrations compared to appropriate for gestational age (AGA) ELBWI on day 8. CONCLUSIONS: This is the 1st study to report that parenteral nutrition, in the first 7 days after birth for the treatment of SGA ELBWI, was correlated with hypophosphatemia and hypercalcemia. It is important to determine an ideal nutrition protocol for treatment of SGA ELBWI.

Presence of an interaction between smoking and being overweight increases risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.

OBJECTIVE: We aimed to evaluate the hypothesis that the presence of an interaction between smoking and being overweight increases the risks of lifestyle-related diseases (hypertension, diabetes mellitus, dyslipidemia, and cardiovascular disease) in outpatients with mood disorders. METHODS: In this cross-sectional survey, using data from 213 outpatients with mood disorders (95 men, 118 women), we calculated the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for each of hypertension, diabetes, dyslipedemia, and cardiovascular disease, using a binary logistic regression model; we then calculated the adjusted OR values for smokers and non-smokers with body mass indexes (BMIs) of <25 or ≥25 kg/m². Next, we examined the data for the presence of an interaction between smoking and being overweight, using three measures of additive interaction: relative excess risk due to the interaction (RERI), attributable proportion due to the interaction (AP), and the synergy index (S). RESULTS: Smokers with BMI <25 kg/m² had a significantly lower risk of hypertension (OR 0.27, 95% CI 0.09-0.81) than non-smokers with BMI <25 kg/m² (reference group). Compared with the reference group, overweight non-smokers had a significantly higher risk (2.82, 1.34-6.19) of hypertension, and overweight smokers had a higher risk (4.43, 1.28-15.26) of hypertension and very high risks of diabetes (8.24, 2.47-27.42) and cardiovascular disease (13.12, 1.95-88.41). The highest RERI was derived from the relation with cardiovascular disease. The highest AP and S were derived from the relation with type 2 diabetes. There was no interaction of smoking and being overweight with dyslipidemia. CONCLUSION: The presence of an interaction between smoking and being overweight exacerbates the risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.

[Changes in measurements related to metabolic syndrome among individuals with national health insurance after specific health guidance].

OBJECTIVES: In 2008, "Specific health checkup and guidance," a policy that focused on improving the status of metabolic syndrome (MetS), was launched in Japan. The aim of the present study was to evaluate the effects of a 6-month intervention based on this policy on the participants' metabolic syndrome, obesity risk factors, and lifestyles. METHODS: A quasi-experimental design was used between 2008 and 2009. In total, 500 subjects and 1,483 residents of Soka city, Saitama Prefecture were judged to require an active and motivational support (ACS and MOS, respectively) based on a specific health guidance standard in Japan. Of these residents, 72 and 275 individuals attended a program that included individual counseling and a 6-month intervention, respectively. Those who did not attend any intervention and received only information concerning MetS were classified as the control group. Changes in the risk factors related to obesity and MetS were analyzed using the analysis of covariance and multiple logistic models. RESULTS: Of the 347 participants, 62 (86.1%) and 41 (56.900) receiving ACS and 266 (96.700) and 210 (76.400) receiving MOS finished the 6-month intervention program and subsequent follow-up, respectively. After the 6-month intervention, improvement in obesity-related risk factors with ACS was significantly greater than that with MOS. Compared to the control group, those receiving ACS demonstrated significant improvements in the waist circumference (-3.1 cm, P < 0.001), body mass index (BMI; -0.8 kg/m2, P < 0.001), weight (-2.3 kg, P < 0.001), and HbA1c levels (-0.18%, P = 0.016). Those receiving MOS showed significant improvements in the waist circumference (-1.3 cm, P = 0/001), BMI (-0.5 kg/m2, P < 0.001), weight (-1.2 kg, P < 0.001), systolic and diastolic blood pressure (-2.4 mmHg, P = 0.018; -1.8 mmHg, P = 0.005), and HbA1c levels (-0.06%, P = 0.025) after adjusting for sex, age, and baseline values. The proportion of participants receiving ACS and MOS who met the definition of Mets or pre-Mets at the baseline, but did not achieve this threshold after 1 year, was significantly higher than those participants in the control group. The odds ratio with 9500 confidence intervals was 1.41 (1.05-1.90) for combined ACS and MOS, and 1.39 (1.00-1.94) for MOS, respectively. Conclusion Thus, our program helped in improving factors associated with MetS.