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High scores on Harm Avoidance (HA) on Cloniger’s Temperament and Character Inventory (TCI) have been identified as a risk factor for depression. Group cognitive-behavioral therapy (GCBT) has been found effective in preventing depression and improving depressive symptoms among university students. However, no randomized controlled trials of GCBT have been conducted with university students with high HA. Although we initiated a randomized controlled trial in this study, some participants submitted incomplete questionnaires at baseline interfering with assured randomization; therefore, we report this study as a non-randomized controlled trial. We evaluated whether a GCBT intervention would be effective at reducing HA and, thereby, preventing depression in university students with high HA. We performed final analysis of data on 59 participants in the intervention group and 60 in a control group. We used scores on the Beck Depression Inventory-II (BDI-II) as the primary outcome measure and analysis of covariance to assess group differences on mean BDI-II change scores before the intervention and at six months and one year after the intervention. The intervention group had lower BDI-II scores than the control group at six months after the intervention. GCBT may have facilitated cognitive modification in individuals with high HA, or GCBT may have fostered mutual modeling by group participants. Thus, GCBT may contribute to reducing depressive symptoms in university students with high HA, and associated risk for developing depression.

Hyperhidrosis significantly reduces patients' quality of life, with many reporting feeling highly anxious. However, the relationship between hyperhidrosis and anxiety induced by sweating has not been examined in detail. The current study examined the relationship between: (1) the presence of hyperhidrosis symptoms, (2) hyperhidrosis severity, and (3) the sites of the most sweating and anxiety induced by sweating. A cross-sectional web-based survey was conducted among university students, and 1080 consenting participants (600 males and 480 females; mean age, 18.8 years) were included in the analysis. The survey items were: (1) diagnostic criteria for hyperhidrosis, (2) Hyperhidrosis Disease Severity Scale, (3) presence of anxiety induced by sweating, and (4) site of the most sweating. The results of multiple logistic regression analysis adjusted for sex and age showed that the odds ratio (OR) for anxiety induced by sweating was significantly higher in participants who screened positive for hyperhidrosis than in those who screened negative (OR, 9.72 [95% CI, 5.80-16.27]). The OR of anxiety induced by sweating was 7.11 (95% CI, 3.99-12.65) for mild/moderate hyperhidrosis and 23.46 (95% CI, 7.15-76.93) for severe hyperhidrosis, compared with those who screened negative for hyperhidrosis. Compared with those who screened negative for hyperhidrosis, the OR for anxiety induced by sweating in those with the palmar, plantar, axillary, and head/face as the site of the most sweating was 7.74 (95% CI, 3.91-15.33), 14.86 (95% CI, 1.83-120.58), 16.92 (95% CI, 5.95-48.14), and 5.38 (95% CI, 1.39-20.74), respectively. Our findings suggest that participants who screened positive for hyperhidrosis, mild/moderate or severe, are at a higher risk of anxiety induced by sweating than participants who screened negative for hyperhidrosis.

ObjectiveThis study aimed to evaluate whether a self-management program using the eHealth system could reduce symptom severity in patients with irritable bowel syndrome (IBS). Impact of the intervention on quality of life and gut microbiota were also examined.DesignThis study was designed as an open label, simple randomized controlled trial comparing an intervention group that attended an eHealth self-management program and a treatment as usual group. Participants were Japanese women between the ages of 18 and 36. Forty symptomatic IBS individuals who met the inclusion criteria were recruited and randomly assigned to the two groups. The eHealth group received 8 weeks of unlimited access to the self-management program containing a wide variety of e-learning content. Participants’ severity of IBS symptoms, the main outcome, was assessed using the irritable bowel syndrome-severity index (IBS-SI) at baseline and 8 weeks. The secondary outcomes of participants’ quality of life and gut bacteria were also assessed at baseline and week 8.ResultsThere was a significant difference in the net change in IBS severity index (IBS-SI) score between the eHealth and treatment as usual group (−50.1; 95% CI, −87.6 to -12.6; p = 0.010). The eHealth group had significantly lower IBS-SI scores following 8 weeks of intervention compared with the baseline scores (t = − 3.2, p < 0.01). The implementation of the eHealth program was accompanied by improvement of quality of life and decrease of phylum-level Cyanobacteria occupancy, respectively.ConclusionThe implementation of eHealth for IBS was shown to reduce IBS symptoms.Key MessagesWhat is already known on this topic –eHealth programs based on diet and probiotic use have shown good results in reducing IBS symptomsWhat this study adds– a self-management program with an e-learning component based on a successful self-help guidebook for IBSHow this study might affect research, practice or policy– The proposed eHealth model reduces symptoms and improves the quality of life of IBS patients, providing an efficient and cost-effective intervention option to be adopted in policy and practice, and creates scope for future research in food intake, exercise, and sleep management through eHealth for IBS.

Background Tension-type headaches and migraines are prevalent conditions; however, no reliable biological markers have been identified for screening. A validated screening tool for epidemiological studies would aid in carrying out large-scale epidemiological studies. Therefore, there is a need to develop a screening tool in the Japanese language based on the International Classification of Headache Criteria, which can be used in epidemiological studies. In this study, we aimed to develop a Japanese-language tool that can be used to screen patients for migraine, tension-type headaches, and mixed migraine/tension-type headaches. Consequently, our objective was to develop a questionnaire based on the 3rd edition of the International Classification of Headache Disorders (ICHD-3) using screening items for each type of headache and to examine its validity. Methods The questionnaire consisted of 29 questions based on the ICHD-3 diagnostic criteria. It comprised 10 screening items for migraine, eight for tension-type headache, and five for mixed migraine/tension-type headache. The screening results of the questionnaire were compared with the diagnoses of three neurologists, which were used as the gold standard reference. Results The study population comprised 69 patients (mean age ± standard deviation, 55.0 ± 18.7 years) aged 19–89 years who were visiting the Tominaga Hospital of the Kotobukai Social Medical Corporation. According to the neurologists’ diagnoses, twenty-two patients had migraine, 30 had tension-type headaches, and 17 had mixed migraine/tension-type headaches. The sensitivity and specificity were as follows: migraine, 72.7% and 86.7%; tension-type headache, 50.0% and 86.4%; and mixed migraine/tension-type headache, 70.6% and 67.3%, respectively. Conclusions The screening tool developed in this study has sufficient validity except for tension-type headache. The questionnaire developed in this study is a rapid and sensitive tool for determining migraine, tension-type headache, and mixed migraine/tension-type headache in persons with headache symptoms.

Young adults with irritable bowel syndrome (IBS) occasionally exhibit specific abdominal symptoms, including abdominal pain associated with brain activity patterns. Decoded neural feedback (DecNef) is a biofeedback exercise that allows symptomatic people to exercise self-control over their brain activity patterns relative to those without symptoms. Thus, DecNef can be used to self-control abdominal pain in patients with IBS. To establish a DecNef practice for IBS, it is necessary to develop a classifier that can distinguish the electroencephalography (EEG) patterns (EEG signatures) of IBS between symptomatic and healthy people. Additionally, the accuracy of the "classifier" must be evaluated.This study analyzed EEG data obtained from symptomatic and asymptomatic young adults with IBS to develop a support vector machine-based IBS classifier and verify its usefulness. EEG data were recorded for 28 university students with IBS and 24 without IBS. EEG data were frequency-analyzed by fast Fourier transform analysis, and IBS classifiers were created by supervised learning using a support vector machine.The diagnostic accuracy of IBS symptoms was verified for the whole brain and the frontal, parietal, and occipital regions. We estimated90% accuracy of the IBS classifier in the whole brain and frontal region.The results of this study suggest that EEG data can be used to determine the presence or absence of IBS symptoms. With the IBS classifier, EEG may help provide feedback regarding the presence or absence of symptoms to patients, which is the basis for developing self-management strategies for IBS.

Background: The Cognitive Attentional Syndrome Scale 1 Revised (CAS-1R) is a 10-item self-report measure designed to assess dysfunctional metacognition, which is a transdiagnostic predictor of psychological disorders. Dysfunctional metacognition can be broadly classified into “cognitive attentional syndrome” and “metacognitive beliefs.” In the present study, the CAS-1R was translated into Japanese, and the reliability and validity of the Japanese version of the CAS-1R (CAS-1R-J) were examined in a Japanese community sample. Methods: We recruited 552 Japanese residents via the Internet and received responses from 552 individuals for Time 1 (275 men and 277 women, M age = 39.81, SD = 11.06) and 112 individuals for Time 2. Of these, the data of 87 individuals (46 men and 41 women, M age = 40.31, SD = 10.62) were used to examine test-retest reliability.Results: The results of confirmatory factor analysis indicated that the factor structure (three-factor model) of the CAS-1R-J was appropriate for the data. Each of the subscales of the CAS-1R-J showed good internal consistency. In addition, there was a theoretical relationship between the CAS-1R-J and Metacognition Questionnaire-30, Penn State Worry Questionnaire, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9 Scale. Furthermore, the results of the hierarchical logistic regression analysis showed that the CAS-1R-J has discriminant and incremental validity for clinical symptoms. Conclusions: These results indicate that the CAS-1R-J is a valid instrument for assessing state cognitive attentional syndrome and metacognitive beliefs in Japanese individuals.

This study assessed whether a combined intervention of omega-3 polyunsaturated fatty acids (PUFAs) and psychoeducation better improved mild to moderate depression in workers compared to psychoeducation alone.This study was a double-blinded, parallel group, randomized controlled trial that compared the intervention group, receiving omega-3 fatty acids, with a control group, receiving a placebo supplement. Participants receiving omega-3 fatty acids took 15 × 300 mg capsules per day for 12 weeks. The total daily dose of omega-3 PUFAs was 500 mg docosahexaenoic acid and 1000 mg eicosapentaenoic acid (EPA). The Beck Depression Inventory®-II (BDI-II) was used to assess the severity of depression after treatment.After 12 weeks of treatment, BDI-II scores were significantly lower in the placebo and omega-3 group, when compared to their respective baseline scores (Placebo: t = - 4.6, p 0.01; Omega-3: t = - 7.3, p 0.01). However, after 12 weeks of treatment, we found no significant difference between both groups with respect to changes in the BDI-II scores (0.7; 95% CI, - 0.7 to 2.1; p = 0.30).This study did not measure blood omega-3 fatty acid concentration and presented a high-dropout rate. Moreover, our results may not be generalizable to other regions.The results show that a combination of omega-3 fatty acids and psychoeducation and psychoeducation alone can contribute to an improvement in symptoms in people with mild to moderate depression. However, there is no difference between the interventions in ameliorating symptoms of depression.

Post-stroke depression increases the likelihood of adverse physical symptoms. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Stroke is more likely in older adults, who can have reduced cognitive function. Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). We hypothesized that RT to select neutral facial expression is affected by depressive symptoms and cognitive function in patients with stroke. This study analyzed 61 patients with stroke. Beck Depression Inventory-Second Edition (BDI-II) and Profile of Mood States (short version) scores were determined. Task stimuli comprised eight pairs of facial expressions containing affective (angry) and neutral faces. AB was measured as the RT to select the neutral face in two simultaneously presented images using attention bias modification (ABM) software. Patients were grouped according to depressive symptoms using BDI-II scores. Between-subject factors of depressive symptoms and cognitive function were determined by ANCOVA. No significant interaction was found between depressive symptoms and cognitive function on RT. There was a main effect of cognitive function, but not depressive symptoms. In patients with hemiparesis and depressive symptoms, RT was significantly shorter in patients without MCI compared with patients with MCI. People with stroke and elevated depression symptoms with hemiparesis but without MCI quickly selected neutral facial expressions from neutral and aversive expressions, and thus do not need ABM to escape aversive stimuli. ABM in response to aversive stimuli may be useful in evaluating negative emotions in individuals with post-stroke depression without MCI.

Irritable bowel syndrome (IBS) is a common bowel disorder that manifests as unexplained abdominal pain or discomfort and bowel habit changes in the form of diarrhea, constipation, or alternating patterns of the two. Some evidences demonstrate that increased physical activity improves IBS symptoms. Hence, daily exercise is recommended in these patients. In this study, we aimed to investigate the relationship between physical activity and gastrointestinal symptoms in 101 university students (female = 78) with IBS. Participants were examined by Gastrointestinal Symptoms Rating Scale (GSRS), and gait steps were measured for 1 week using a pedometer. The association between the GSRS score and pedometer counts was determined by ordinal logistic modeling analysis. The ordinal logistic regression model for GSRS and locomotor activity showed a significant stepwise fit (z = -3.05, p = 0.002). The logistic curve separated GSRS score of 5 points (moderately severe discomfort) from 2 points (minor discomfort) by locomotor activity. The probability for daily locomotor activity to discriminate between 5 and 4 points of GSRS (i.e., likely to have reverse symptoms) decreased in accordance with increment of steps per day: 78% probability for 4000 steps, 70% probability for 6000 steps, 59% probability for 8000 steps, and 48% probability for 10000 steps. This study demonstrated that the severity of GSRS is associated with the amount of walking in younger people with IBS. These results may be used as a measure to determine the daily step count to reduce the severity of gastrointestinal symptoms in individuals with IBS.

In industrialized countries, the turnover rate of preschool workers is extremely high and now represents a social problem. Consequently, it has become important to promote stable early care and educational environments for this population. Several factors related to working environments are known to affect turnover intention; however, the specific factors related to turnover intention among preschool workers have not yet been identified. Considering this, the objective of the present study was to determine factors associated with preschool workers’ willingness to continue working.The participants of this study were 1137 preschool workers based in Nagasaki Prefecture, Japan. Multivariate logistic regression analysis was used to analyze the participants’ data,with willingness to continue working for 5 years or more set as the dependent variable.Analysis of the results for all subjects clearly showed that male sex, older age, good mental health, high number of social supports, and good work engagement have a positive effect on willingness to continue working. Further, stratifying the participants in terms of age revealed that for preschool workers under 39 years, male sex,good mental health, high number of social supports, and good work engagement act positively in regard to willingness to continue working. Meanwhile, for those over 40 years, it was found that permanent employment and good work engagement act positively in this regard. Thus, work engagement was the only common factor between preschool workers under 39 and over 40.The findings of this cross-sectional study demonstrate that the factors associated with willingness to continue working among preschool workers differ between younger and older professionals. These findings underline the importance of considering age categories when attempting to maximize such professionals’ willingness to continue working., Medicine, 97(49), e13530; 2018

High harm avoidance (HA) scores on the temperament and character inventory appear to be a risk factor for depressive disorders and suicide. Since 2012, we have conducted group cognitive behavioral therapy (G-CBT) interventions for students at Nagasaki University with high HA and without depressive disorders, with the aim of preventing depression. Here, we report on the effects of the G-CBT at 1-year follow-up for the 2012 to 2015 period. Forty-two participants with high HA were included in the final analysis. Outcomes were measured with the Beck Depression Inventory II, Manifest Anxiety Scale, 28-item General Health Questionnaire, and Brief Core Schema Scales at baseline, and at 6-month, and 1-year follow-ups. Repeated-measures analyses of variance revealed a significant decrease in mean depressive symptom scores at the 6-month follow-up point; this decrease was maintained at 1 year. Improvements in cognitive schemas were also seen at 6 months and 1 year. We observed improvements in cognitive schemas associated with depression as a result of the G-CBT intervention, with effects maintained at 1 year post-intervention. This intervention may be effective in positively modifying the cognitions of students with HA and preventing future depression.

Background Attention bias modification normalizes electroencephalographic abnormalities in alpha and beta power percentages related to attention in patients with irritable bowel syndrome (IBS). Yet, it is unknown whether ABM contributes to the normalization of event-related potentials (ERP) in these patients. We hypothesized that ERP related to attention deficit would be normalized after ABM implementation in individuals with IBS. Methods Thirteen patients with IBS and 10 control subjects completed a 2-month intervention that included five ABM sessions. Each session included 128 trials, resulting in a total of 640 trials during the study period. Event-related potentials were measured at the first and fifth sessions. As per the international 10-20 system for electroencephalographic electrode placement, right parietal P4 was evaluated to measure the attention component of facial expression processing. Key results A group comparison of P100 latency at P4 revealed that latencies were significantly different between groups in session 1 (IBS vs control, 108 ± 8 vs 97 ± 14; t = -2.51, P = .0203). This difference was absent in session 5 (94 ± 11 vs 93 ± 11, respectively; t = -0.397, P = .6954, r = .09), indicating an effect of ABM in the IBS group. Conclusions and inferences Attention bias modification may have clinical utility for normalizing brain function and specifically attentional abnormalities in patients with IBS.

We investigated the relationship between number of weekly working hours and the prevalence of diabetes in the urban Chinese population. Data regarding anthropometric measurements, fasting blood glucose level and number of hours worked per week were collected from 2228 workers in Shanghai, China (Mage = 44 years; 64% men). Participants were divided into three groups according to the number of hours worked per week (

Background Activated mineralocorticoid receptors influence the association between daily salt intake and blood pressure. A relatively low mineralocorticoid receptor function is reported to be a risk for mental distress such as depression. Since mental distress is also a known risk for hypertension and cardiovascular disease, understanding of the association between estimated daily salt intake and mental distress contributing to hypertension is important for risk estimation for cardiovascular disease. However, no single study has reported this association. Methods We conducted a cross-sectional study of 1014 Japanese men undergoing general health check-ups. Mental distress was diagnosed as a Kessler 6 scale score ≥5. We also classified mental distress by levels of hypertension. Estimated daily salt intake was calculated from a causal urine specimen. Results Independent from classical cardiovascular risk factors and thyroid disease, we found a significant inverse association between estimated daily salt intake and mental distress. When we analyzed for mental distress and hypertension, we also found a significant association. With the reference group being the lowest tertiles of estimated daily salt intake, the multivariable odds ratios (ORs) of mental distress and mental distress with hypertension for the highest tertiles were 0.50 (0.29–0.88) and 0.46 (0.22–0.96). Conclusions Lower estimated daily salt intake is a significant risk of mental distress for rural community-dwelling Japanese men. Since depression is reported to be associated with cardiovascular disease, risk estimation for the lower intake of salt on mental distress, especially for mental distress with hypertension, may become an important tool to prevent cardiovascular disease.

The present study tested our hypothesis that university students with irritable bowel syndrome (IBS) may experience less satisfactory academic lives than those of students without IBS. We also verified the hypothesis that university students with IBS might have higher employment anxiety than students without IBS might.We conducted a cross-sectional study of 1, 686 university students. Presence or absence of IBS was assessed via the Rome III Questionnaire. Two original items were used to evaluate academic life. The prevalence rates of IBS with diarrhea, IBS with constipation, mixed IBS, and unsubtyped IBS in the study population were 5%, 2%, 10%, and 3%, respectively. Regarding academic life, the proportions of participants who experienced maladjustment and employment anxiety were 29% and 50%, respectively. After adjusting for age, sex, and faculty, the odds ratios for maladjustment and employment anxiety were significantly higher in students who screened positively, relative to those who screened negatively, for IBS (OR, 1.62; 95% CI, 1.24-2.21; OR, 2.16; 95% CI, 1.68-2.81, respectively). In conclusion, maladjustment and anxiety over future employment were higher in university students with IBS relative to those without., PLOS ONE, 10(6), e0129345; 2015

Atherosclerotic cardiovascular disease is a leading cause of death in most developed countries. Cardiovascular risk factors such as hypertension, diabetes, and dyslipidemia initiate structural and functional abnormalities in the arterial wall, leading to the development of atherosclerosis. Atherosclerosis is characterized by the stiffening and/or thickening of the arterial wall. Aortic pulse wave velocity as evaluated by carotid and femoral arterial waves is the most established measure for arterial stiffness. Recently, a new arterial stiffness measure using brachial and tibial arterial waves has been developed. The measurement of the brachial-ankle wave velocity is fully automatic, needs no skill and is reproducible. Age and blood pressure are robust independent predictors for the brachial-ankle pulse wave velocity. Recent studies have shown that higher brachial ankle pulse wave velocity is associated with more advanced atherosclerotic changes of the arterial wall not only in the clinical patients but also in subclinical individuals. Thus, brachial-ankle pulse wave velocity may be a useful measure of vascular damage, which predisposes individuals to cardiovascular events. A multicenter trial examining the prognostic significance of the brachial-ankle pulse wave velocity is presently in progress.

Background While gastrointestinal function is known to be closely related to psychological status, the influence of Helicobacter pylori-associated atrophic gastritis is currently unknown. We aimed to determine whether atrophic gastritis status or H. pylori infection is associated with psychological distress or depressed mood. Materials and Methods We performed a cross-sectional, observational study involving 975 Japanese individuals (503 females; mean age, 44 ± 8 years) who underwent a health checkup. Psychological distress was defined as a Kessler-6 Scale score ≥13 and depressive mood as a Center for Epidemiological Studies Depression Scale score ≥ 16. The odds ratios with 95% confidence intervals assessing the risk of psychological distress or depressive mood associated with H. pylori infection (H. pylori-specific immunoglobulin G levels >10 U/mL) and atrophic gastritis status (pepsinogen I levels

Background Gastrointestinal symptoms of irritable bowel syndrome (IBS) show a reciprocal relationship with anxiety. In this intervention-based study, we investigated the utility of attention bias modification (ABM) therapy in patients with IBS. We hypothesized that IBS-related electroencephalographic abnormalities would be normalized after ABM therapy. Methods Seventeen patients with IBS and 13 healthy subjects completed five ABM intervention sessions over a 2-month period. Each session included 128 ABM trials, resulting in a total of 640 trials across the intervention period. For each trial, subjects viewed a pair of facial expression images and were instructed to indicate the position of the neutral face as quickly and accurately as possible by pressing one of two buttons on a button box. Electroencephalography data (alpha and beta power percentages) were collected during the 1st and 5th sessions. Key Results Generalized estimating equations of relative alpha power revealed a significant effect of period was identified at O2 (P=.036). Paired t tests revealed that ABM significantly increased relative alpha power at O2 in patients with IBS. Generalized estimating equation of relative beta power revealed a significant effect of the group × period interaction was identified at Pz (P=.035). Paired t tests revealed that ABM significantly decreased relative beta power at Pz in patients with IBS. Conclusions & Inferences Attention bias modification may normalize brain function related to attention and anxiety in patients with IBS.

The purpose of this study was to investigate the factor structure of the Body Image Concern Inventory (BICI) using a Japanese population as a web-based survey. Two thousand and sixty individuals (1030 women, 1030 men) ranging from 20 to 69 years of age ( M = 40, SD = 16) took part in the present research. A confirmatory factor analysis showed that the second-order factor model of the BICI, which had three first-order factors and one second-order factor of dysmorphic appearance concern was an adequate fit to the data. Additionally, the Cronbach's alpha values of the overall and three subscales of the BICI were adequate. Furthermore, measurement invariance tests revealed that the second-order factor model of the BICI had acceptable measurement invariance at the scale and factor-loading levels between genders. These findings suggested that the BICI was reliable, and able to compare its mean scores between women and men in Japan.

Objective: The visceral sensitivity index (VSI) is a useful self-report measure of the gastrointestinal symptom-specific anxiety (GSA) of patients with irritable bowel syndrome (IBS). Previous research has shown that worsening GSA in IBS patients is related to the severity of GI symptoms, suggesting that GSA is an important endpoint for intervention. However, there is currently no Japanese version of the VSI. We therefore translated the VSI into Japanese (VSI-J) and verified its reliability and validity.Material and methods: Participants were 349 university students aged 18 and 19 years and recruited from an academic class. We analyzed data from the VSI-J, Anxiety Sensitivity Index (ASI), Hospital Anxiety and Depression scale (HAD), and Irritable Bowel Syndrome Severity Index (IBS-SI). The internal consistency, stability, and factor structure of the VSI-J and its associations with anxiety, depression and severity measures were investigated.Results: The factor structure of the VSI-J is unidimensional and similar to that of the original VSI (Cronbach's α = 0.93). Construct validity was demonstrated by significant correlations with ASI (r = 0.43, p < 0.0001), HAD-ANX (r = 0.19, p = 0.0003), and IBS-SI scores (r = 0.45, p < 0.0001). Furthermore, the VSI-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p < 0.0001) and incremental (p < 0.0001) validity.Conclusion: These findings suggest that the VSI-J is a reliable and valid measure of visceral sensitivity., BioPsychoSocial Medicine, 8(1), 10; 2014

We investigated the relationship between number of weekly working hours and the prevalence of diabetes in the urban Chinese population. Data regarding anthropometric measurements, fasting blood glucose level and number of hours worked per week were collected from 2228 workers in Shanghai, China (Mage = 44 years; 64% men). Participants were divided into three groups according to the number of hours worked per week (45, 45-54 and ≥55), and multiple logistic regression analysis was conducted with diabetes as the dependent variable. Subjects with a HbA1c of 6.5% or above or those prescribed anti-diabetic medications were defined as having diabetes. The multivariate adjusted odds ratio for having diabetes was found to be significantly higher for those who worked ≥55 h per week compared with those who worked45 h per week, but only for men. This finding indicates that working long hours could be a risk factor for diabetes in Chinese male workers.

Patients with irritable bowel syndrome (IBS)may have a higher tone of corticotropin-releasing hor-mone(CRH)inthebrain.Wetestedourhypothesisthatperipheral administration of CRH antagonist, a-helicalCRH 9)41 (ahCRH), improves decreased alpha powerspectra and increased beta power spectra of electroen-cephalogram (EEG) in IBS patients. A barostat bag wasinserted to the descending colon of 10 normal controlsand 10 IBS patients. The EEG power spectra andtopography were measured during baseline period andcolonic distention period with the administration ofsaline followed by the administration of 10 lgkg )1 ofahCRH. IBS patients showed a significantly loweralpha power percentage and a higher beta power per-centage than normal controls during baseline. Colonicdistention induced a decrease in the alpha power per-centageandanincreaseinthebetapowerpercentageinboth groups without difference between groups. Afterthe administration of ahCRH, changes in the EEGpower spectra in response to colonic distention wereblunted and the differences in the EEG power spectrabetweenIBSpatientsandcontrolsvanished.Peripheraladministration of ahCRH almost normalized EEGactivities in IBS patients. Our data strongly suggestthat CRH plays an important role in IBS.Keywords corticotropin-releasing hormone, irritablebowel syndrome, electroencephalogram, CRH antago-nist, brain gut interactions, visceral perception.

Hyperhomocysteinemia has been reported to be associated with both vascular structure alteration and increased cardiovascular risk. This study examined whether hyperhomocysteinemia causes increased systemic arterial stiffness, thereby enhancing blood pressure response to stress in hypertensive patients. In 50 treated hypertensive patients, we studied brachial-ankle pulse wave velocity (PWV), a new measure for arterial stiffness, blood pressure response to stress, and blood pressure recovery after stress. Autonomic nervous activities were examined by spectral analysis of blood pressure and RR interval variabilities. Total plasma homocysteine and neurohumoral parameters were determined from fasting blood. Brachial-ankle PWV correlated with age (r=0.64, p

Brachial-ankle pulse wave velocity is a new measure of arterial stiffness. We examined whether higher brachial-ankle pulse wave velocity is associated with more advanced carotid atherosclerosis and left ventricular hypertrophy in patients with end-stage renal disease, and whether this effect would be mediated by the influence of wave reflection on central arterial pressure. In 68 patients with end stage renal disease, we examined blood pressures, brachial-ankle pulse wave velocity and the augmentation index of the left common carotid artery, a measure of the impact of wave reflection on the systolic peak in central arteries. The degree of carotid atherosclerosis was quantified by a plaque score and maximum intimal-medial thickness. Echocardiography was used to determine the left ventricular mass index. In simple regression analysis, brachial-ankle pulse wave velocity was correlated with both plaque score and maximum intimal-medial thickness (r = 0.420, p0.001 and r = 0.452, p0.0005, respectively) but not with left ventricular mass index. Multiple regression analysis was performed with the plaque score or maximum intimal-medial thickness as the dependent variable and brachial-ankle pulse wave velocity and known clinical risk factors as the independent variables. The brachial-ankle pulse wave velocity was an independent risk factor for both plaque score (beta = 0.006, p = 0.004) and maximum intimal-medial thickness (beta = 0.008, p = 0.04). Independent risk factors for left ventricular mass index were left ventricular diastolic dimension (beta = 3.509, p = 0.000007) and augmentation index (beta = 0.580, p = 0.04). The brachial-ankle pulse wave velocity was unrelated to augmentation index in patients with end stage renal disease. In conclusion, higher brachial-ankle pulse wave velocity was found to be a risk factor for carotid atherosclerosis in patients with end-stage renal disease; this effect was independent of the influence of wave reflection on central arterial pressure. The brachial-ankle pulse wave velocity was unrelated to left ventricular structure.

Background and aims: Corticotropin releasing hormone (CRH) is a major mediator of the stress response in the brain-gut axis. Irritable bowel syndrome (IBS) is presumed to be a disorder of the brain-gut link associated with an exaggerated response to stress. We hypothesised that peripheral administration of α-helical CRH (αhCRH), a non-selective CRH receptor antagonist, would improve gastrointestinal motility, visceral perception, and negative mood in response to gut stimulation in IBS patients. Methods: Ten normal healthy subjects and 10 IBS patients, diagnosed according to the Rome II criteria, were studied. The tone of the descending colon and intraluminal pressure of the sigmoid colon were measured at baseline, during rectal electrical stimulation (ES), and at recovery after administration of saline. Visceral perception after colonic distension or rectal ES was evaluated as threshold values on an ordinate scale. The same measurements were repeated after administration of αhCRH (10 μg/kg). Results: ES induced significantly higher motility indices of the colon in IBS patients compared with controls. This response was significantly suppressed in IBS patients but not in controls after administration of αhCRH. Administration of αhCRH induced a significant increase in the barostat bag volume of controls but not in that of IBS patients. αhCRH significantly reduced the ordinate scale of abdominal pain and anxiety evoked by ES in IBS patients. Plasma adrenocorticotropic hormone and serum cortisol levels were generally not suppressed by αhCRH. Conclusion: Peripheral administration of αhCRH improves gastrointestinal motility, visceral perception, and negative mood in response to gut stimulation, without affecting the hypothalamo-pituitary-adrenal axis in IBS patients.