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This population-based study aimed to evaluate the association between bowel habits from midlife and dementia. This was a cohort study using certification records for national long-term care insurance in Japan. Participants aged 50 to 79 years who reported bowel habits from eight districts within the Japan Public Health Center-based Prospective Study (JPHC Study) were followed from 2006 to 2016 for incident dementia. Hazard ratio (HR) and 95% confidence interval (CI) were estimated for men and women separately using Cox proportional hazards models accounting for various lifestyle factors and medical histories. Among 19,396 men and 22,859 women, 1889 men and 2685 women were diagnosed with dementia. In men, the multivariable-adjusted HRs compared with bowel movement frequency (BMF) of once/day were 1.00 (95% CI: 0.87–1.14) for twice/day or more, 1.38 (1.16–1.65) for 5–6 times/week, 1.46 (1.18–1.80) for 3–4 times/week, and 1.79 (1.34–2.39) for <3 times/week (P for trend <0.001). In women, the corresponding HRs were 1.14 (0.998–1.31), 1.03 (0.91–1.17), 1.16 (1.01–1.33), and 1.29 (1.08–1.55) (P for trend = 0.043). Harder stool was associated with higher risk (P for trend: 0.0030 for men and 0.024 for women), with adjusted HRs compared to normal stool of 1.30 (1.08–1.57) for hard stool and 2.18 (1.23–3.85) for very hard stool in men, and 1.15 (1.002–1.32) and 1.84 (1.29–2.63) in women. Lower BMF and harder stool were each associated with higher risk of dementia. [ABSTRACT FROM AUTHOR]

Background: Evidence of the association between chronic low-grade inflammation, as reflected by C-reactive protein (CRP) measurements, and cancer risk is equivocal. Specifically, few studies have examined this in uncommon cancers and Asian populations.Methods: We utilised a case-cohort design consisting of multi-types of cancer (N = 3608), and a random subcohort (N = 4432) in a Japanese large population-based study, with a median follow-up time of 15.6 years, and measured baseline plasma CRP using high sensitivity assay. The hazard ratios (HRs) were estimated using weighted Cox proportional hazards methods.Results: The multivariable-adjusted HR (95% confidence interval) for the top quartile of CRP was 1.28 (1.11‒1.48) (Ptrend < 0.001) for overall cancer compared to the bottom quartile of CRP. Among site-specific cancers, higher CRP levels were associated with an increased risk of colorectal, lung, breast, biliary tract, and kidney cancer, and leukaemia. These positive associations remained among participants after >3 years' follow-up. Furthermore, subgroup analyses for overall cancer robustly showed a positive association with CRP levels, regardless of sex and obesity.Conclusion: Our consistent findings suggested that chronic low-grade inflammation measured by CRP is associated with the risk of cancer. [ABSTRACT FROM AUTHOR]

Background: While dementia is a common problem in Japan and the US, primary care physicians' practices and perspectives about diagnosing dementia in these different healthcare systems are unknown.Methods: Qualitative research was conducted in an ethnographic tradition using semi-structured interviews and thematic analysis in primary care settings across Japan and in the Midwest State of Michigan, US. Participants were a total of 48 primary care physicians, 24 each from Japan and the US participated. Both groups contained a mixture of geographic areas (rural/urban), gender, age, and years of experience as primary care physicians.Results: Participants in Japan and the US voiced similar practices for making the diagnosis of dementia and held similar views about the desired benefits of diagnosing dementia. Differences were found in attitudes about the appropriate timing of formally diagnosing dementia. Japanese physicians tended to make a formal diagnosis when problems that would benefit from long-term care services emerged for family members. US physicians were more proactive in diagnosing dementia in the early stages by screening for dementia in health check-ups and promoting advance directives when the patients were still capable of decision-making. Views about appropriate timing of diagnostic testing for dementia in the two systems reflect what medical or nursing care services physicians can use to support dementia patients and caregivers.Conclusions: Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. Testing to establish an early diagnosis of dementia by primary care physicians only partly relates to testing and treatment options available. Benefits of making the diagnosis included the need to activate the long-term care services in Japan and for early intervention and authoring advance directives in the US. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To assess the predictive ability of a genetic risk score for the incidence of Type 2 diabetes in a general Japanese population. Methods: This prospective case–control study, nested within a Japan Public Health Centre‐based prospective study, included 466 participants with incident Type 2 diabetes over a 5‐year period (cases) and 1361 control participants, as well as 1463 participants with existing diabetes and 1463 control participants. Eleven susceptibility single nucleotide polymorphisms, identified through genome‐wide association studies and replicated in Japanese populations, were analysed. Results: Most single nucleotide polymorphism loci showed directionally consistent associations with diabetes. From the combined samples, one single nucleotide polymorphism (rs2206734 at CDKAL1) reached a genome‐wide significance level (odds ratio 1.28, 95% CI 1.18–1.40; P = 1.8 × 10–8). Three single nucleotide polymorphisms (rs2206734 in CDKAL1, rs2383208 in CDKN2A/B, and rs2237892 in KCNQ1) were nominally significantly associated with incident diabetes. Compared with the lowest quintile of the total number of risk alleles, the highest quintile had a higher odds of incident diabetes (odds ratio 2.34, 95% CI 1.59–3.46) after adjusting for conventional risk factors such as age, sex and BMI. The addition to the conventional risk factor‐based model of a genetic risk score using the 11 single nucleotide polymorphisms significantly improved predictive performance; the c‐statistic increased by 0.021, net reclassification improved by 6.2%, and integrated discrimination improved by 0.003. Conclusions: Our prospective findings suggest that the addition of a genetic risk score may provide modest but significant incremental predictive performance beyond that of the conventional risk factor‐based model without biochemical markers. [ABSTRACT FROM AUTHOR]

Mastication is essential to the eating process and forms an important part of feeding behaviour. Many factors related to the food bolus, such as bolus texture and size, are known to influence mastication. The aim of this study was to determine the effects of body posture on (i) chewing duration prior to the first swallow and (ii) patterns of mastication-related EMG activity. We asked 10 healthy adults to chew 8 g of steamed rice with barium sulphate while we recorded masseter, suprahyoid and infrahyoid muscle activity and simultaneously collected videofluorographic images. Participants chewed in either an upright or reclining position. Chewing duration, which was defined as the time from the start of mastication to the first swallow, was not different between the positions. However, the variability of chewing duration was larger in the upright versus reclining position, and the chewing duration in the reclining position was distributed around 15 s. Masseter activity gradually decreased in a time-dependent manner and was significantly larger at the early versus late stage of mastication. Suprahyoid activity was significantly larger at the early versus middle stage of mastication in the upright position only. Finally, masseter activity per second was negatively correlated with changes in chewing duration, that is, the larger the increase in chewing duration in the reclining position, the more the decrease in masseter activity per second. These results suggest that position-dependent changes in chewing behaviours, as described by chewing duration and EMG activity, may vary among participants. [ABSTRACT FROM AUTHOR]

Background/objectives: Epidemiologic evidence on the relationship between antioxidant vitamin intake and stroke is limited. We aimed to investigate the association between dietary intake of antioxidant vitamins and the incidence of total stroke and ischemic stroke.Subjects/methods: The subjects were 82 044 Japanese men and women aged 45-74 years under the Japan Public Health Center-based Prospective Cohort Study. Between 1995 and 1997, dietary assessment was done using a food frequency questionnaire. During 983 857 person-years of follow-up until the end of 2009 we documented 3541 incident total strokes and 2138 ischemic strokes.Results: Dietary intakes of α-carotene, β-carotene, α-tocopherol and vitamin C were not inversely associated with the incidence of total stroke and ischemic stroke adjustment for cardiovascular risk factors and selected lifestyle variables. When stratified by current smoking status, the inverse association between dietary vitamin C intake and incidence of total stroke observed among non-smokers but not smokers, with respective multivariable hazard ratios for the highest versus lowest quintiles of vitamin C of 0.81 (95% confidence interval (CI), 0.68-0.96; P-trend=0.03) among non-smokers; and 1.03 (0.84-1.25; P-trend=0.55) among smokers. As for ischemic stroke, the corresponding multivariable hazard ratios were 0.76 (0.60-0.96; P-trend=0.02) among non-smokers; and 1.00 (0.78-1.28; P-trend=0.61) among smokers.Conclusions: Dietary vitamin C intake was inversely associated with the incidence of total stroke and ischemic stroke among non-smokers. [ABSTRACT FROM AUTHOR]

Objective This study aimed to validate the Japanese version of the LupusPRO questionnaire for use with systemic lupus erythematosus patients. Methods Participants were 205 lupus patients recruited from three rheumatology centers in Japan. Demographic data were collected and quality of life was assessed using the LupusPRO and the Short Form Health Survey-12. Disease activity was evaluated by physicians using the Systemic Lupus Erythematosus Activity Index. Some participants completed questionnaires 10–14 days after the first survey. Internal consistency reliability, test-retest reliability, content validity and convergent validity were examined, and confirmatory factor analysis was performed. Results Participants’ mean age was 47.8 ± 13.6 years. Older participants scored lower on physical quality of life and higher on coping than younger participants. The LupusPRO showed satisfactory test-retest reliability (n = 111). Test-retest reliability was lower for the mental and social aspects of quality of life, indicating fluctuations in quality of life during the two-week interval. Internal consistency reliability was good and convergent validity with the corresponding domains of the Short Form Health Survey-12 was satisfactory. Confirmatory factor analysis showed a good model fit. Conclusion The Japanese LupusPRO is a reliable and valid measure to evaluate treatment interventions for systemic lupus erythematosus. [ABSTRACT FROM AUTHOR]

Background/objectives: Although vitamin D has been experimentally reported to inhibit tumorigenesis, cell growth and prostate cancer invasion, epidemiologic data regarding prostate cancer risk are inconsistent, and some studies have suggested positive but nonsignificant associations. Further, the impact of vitamin D on prostate cancer between Western and Japanese populations may differ due to different plasma vitamin D levels.Subjects/methods: We performed a nested case-control study within the Japan Public Health Center-based Prospective (JPHC) Study in 14,203 men (40-69 years) who answered a self-administered questionnaire at baseline (1990-1994) and gave blood samples, and were followed until 2005. We identified 201 prostate cancers which are newly diagnosed during follow-up (mean 12.8 years). We selected two matched controls for each case from the cohort. We used a conditional logistic regression model to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for prostate cancer with respect to levels of 25-hydroxy vitamin D (25(OH)D) in plasma.Results: We did not observe statistically significant association between 25(OH)D level and total prostate cancer (multivariate OR=1.13 (95%CI=0.66-1.94, Ptrend=0.94) for the highest versus lowest tertile) However, 25(OH) levels were slightly positively associated with advanced cancer. The results remained substantially unchanged after stratification by intake of fish or calcium intake.Conclusions: 25(OH)D level showed no association with overall prostate cancer among Japanese men in this large cohort. [ABSTRACT FROM AUTHOR]

Purpose: Binimetinib is a potent, selective MEK1/2 inhibitor with demonstrated efficacy against BRAF- and RAS-mutant tumors. Retinal adverse events associated with MEK inhibitors have been reported in some cases. The aim of this study was to assess single-agent binimetinib, with detailed ophthalmologic monitoring, in Japanese patients with advanced solid tumors. Methods: This was an open-label phase I dose-escalation and dose-expansion study (NCT01469130). Adult patients with histologically confirmed, evaluable, advanced solid tumors were enrolled and treated with binimetinib 30 or 45 mg twice daily (BID). The primary objective was to determine the maximum tolerated dose (MTD) and/or recommended phase II dose (RP2D) of single-agent binimetinib in Japanese patients. Results: Twenty-one patients were enrolled; 3 and 8 patients had documented BRAF and KRAS mutations, respectively. Two of 6 patients (33 %) receiving binimetinib 45 mg BID in dose-escalation experienced recurrent grade 2 retinal adverse events (AEs) which were reversible, and this dose was declared the MTD and RP2D. All patients experienced ≥1 AE suspected to be treatment related; the most common (>50 %) were blood creatine phosphokinase increase (76 %), retinal detachment and aspartate aminotransferase increase (62 % each), and diarrhea (52 %). There were no complete or partial responses; 14 patients (67 %) had stable disease, which lasted >180 days in 5 patients. Expression of phospho-ERK decreased in the skin following binimetinib treatment at both dose levels, indicating target inhibition. Conclusions: Binimetinib demonstrated efficacy and acceptable safety in Japanese patients with solid tumors, supporting the 45 mg BID dose of binimetinib as the RP2D. [ABSTRACT FROM AUTHOR]

In current practice of clinical genetics, molecular diagnosis has become more widely used than ever before. DNA diagnosis is important for appropriate medical care of the patient, and proper genetic counseling to the family. However, genetic testing of orphan disease cannot always be performed easily. In multiple congenital anomalies ( MCA) syndromes by monogenic cause, the broad mutational spectrum and large size of responsible genes often make molecular diagnosis expensive and cumbersome. We solve this problem with on-demand genetic testing by CHIPS ( CEL nuclease mediated heteroduplex incision with polyacrylamide gel electrophoresis and silver staining) technology, which is the ultimately conventional and economical mutation screening system. In this article, we show eight patients with MCA syndromes who were recently treated at our hospital, and demonstrate that CHIPS successfully offers efficient and inexpensive genetic testing and facilitates clinical genetic service in our local region. [ABSTRACT FROM AUTHOR]

Summary: This study assessed the effects of physical activity on a 10-year incidence of self-reported vertebral fractures in adult women of a large Japanese cohort. Medium levels of strenuous activity and long-duration sedentary activity were associated with a lower incidence of vertebral fractures; association patterns appear to be different from hip fractures. Introduction: Physical activity helps prevent hip fracture, but little is known about the longitudinal association between physical activity and vertebral fractures. The purpose of this study was to evaluate the effects of physical activity on the 10-year incidence of symptomatic vertebral fractures using data from the Japan Public Health Center-based Prospective Study. Methods: Baseline studies were conducted in 1993-1994, and the follow-up study was conducted 10 years later. We analyzed 23,757 women aged 40-69 years. At baseline, physical activity was assessed as a predictor by using a questionnaire. Subjects were asked to report vertebral fractures that occurred during the 10-year follow-up period. Relative risks (RRs) adjusted for confounders were estimated by multiple logistic regression analysis. Results: The 10-year cumulative incidence of vertebral fractures was 0.67 %. Those who engaged in strenuous physical activity of <1 h/day had a significantly lower incidence of vertebral fractures than those who did not engage in such activity (RR = 0.52, 95 % CI 0.28-0.97), while those engaged in such activity ≥1 h/day did not (RR = 0.82, 95 % CI 0.58-1.14). Long-duration sedentary activity was associated with a low incidence of vertebral fractures ( P for trend = 0.0002), but the frequencies of sports activities and metabolic equivalents were not ( P for trend = 0.0729 and 0.4341, respectively). Conclusions: Strenuous activity and sedentary activity are associated with the incidence of vertebral fractures, although the association may not be linear. The pattern of association between physical activity and vertebral fractures appears to be different from that of hip fractures. [ABSTRACT FROM AUTHOR]

Seafood/fish intake has been regarded as a protective factor for coronary heart disease (CHD), while smoking is a strong risk factor. To examine whether associations between smoking and risk of CHD are modified by seafood/fish intake, we studied 72,012 Japanese men and women aged 45–74 years who completed 2 food frequency questionnaires, 5 years apart, during the period 1995–2009. After 878,163 person-years of follow-up, 584 incident cases of CHD (101 fatal and 483 nonfatal), including 516 myocardial infarctions, were documented. There was a clear dose-response association between smoking and CHD risk among subjects with a low seafood/fish intake (<86 g/day) but not among those with a high seafood/fish intake (≥86 g/day). Compared with never smokers, the multivariable hazard ratios in light (1–19 cigarettes/day), moderate (20–29 cigarettes/day), and heavy (≥30 cigarettes/day) smokers were 2.39 (95% confidence interval (CI): 1.60, 3.56), 2.74 (95% CI: 1.90, 3.95), and 3.24 (95% CI: 2.12, 4.95), respectively, among low seafood/fish eaters and 1.13 (95% CI: 0.64, 1.99), 1.29 (95% CI: 0.95, 2.04), and 2.00 (95% CI: 1.18, 3.51), respectively, among high seafood/fish eaters. Compared with heavy smokers with a low seafood/fish intake, light smokers with a high seafood/fish intake had substantially reduced risk of CHD (hazard ratio = 0.57, 95% CI: 0.32, 0.98). High seafood/fish intake attenuated the positive association between smoking and risk of CHD. [ABSTRACT FROM PUBLISHER]

Background:Colorectal cancer (CRC) incidence rate increased rapidly in Japan between the 1950s and 1990s. We examined the association between rice intake and CRC risk in comparison with bread, noodles and cereal among Japanese adults enrolled in the Japan Public Health Center-based prospective Study.Methods:A total of 73 501 Japanese men and women were followed-up from 1995 to 1999 until the end of 2008 for an average of 11 years. During 801 937 person-years of follow-up, we identified 1276 incident cases of CRC. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of CRC for rice, noodle, bread and cereal intake were calculated by Cox proportional hazards model.Results:Overall, no significant association was observed for the highest quartile of rice intake compared with the lowest and the risk of CRC and its subsites in men (HR, 0.77; 95% CI, 0.56-1.07) and women (HR, 1.10; 95% CI, 0.71-1.68). However, a non-significant inverse trend was observed between rice intake and rectal cancer in men. No clear patterns of association were observed in bread, noodle and cereal intake.Conclusion:Our findings suggest that the consumption of rice does not have a substantial impact on the risk of CRC in the Japanese population. [ABSTRACT FROM AUTHOR]

Background/objective:Dietary patterns in Western populations have been linked to type 2 diabetes, but the association of distinctive dietary patterns of Japanese population remains unclear. We prospectively investigated the association between dietary patterns and risk of developing type 2 diabetes among Japanese adults.Subjects/methods:Participants were 27 816 men and 36 889 women aged 45-74 years who participated in the second survey of the Japan Public Health Center-based prospective study and had no history of diabetes. Dietary patterns were derived by using principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Odds ratios of self-reported physician-diagnosed type 2 diabetes over 5 year were estimated using logistic regression analysis.Results:A total of 1194 new cases (692 men and 502 women) of type 2 diabetes were self-reported. We identified three dietary patterns: prudent, westernized and traditional Japanese patterns. Any dietary pattern was not significantly associated with type 2 diabetes risk after adjustment for covariates in both men and women. The multivariate-adjusted odds ratios (95% confidence interval) for type 2 diabetes for the highest versus lowest quartile of each dietary pattern score in men and women, respectively, were 0.93 (0.74-1.16) and 0.90 (0.69-1.16) for the prudent pattern, 1.15 (0.90-1.46) and 0.81 (0.61-1.08) for the westernized pattern, and 0.97 (0.74-1.27) and 0.87 (0.66-1.15) for the traditional pattern.Conclusions:Although a small protective effect of the prudent dietary pattern cannot be excluded, dietary patterns may not be appreciably associated with type 2 diabetes risk in Japanese. [ABSTRACT FROM AUTHOR]

Abstract: A total of 37 seawater samples were collected at 10 sites along the coastline of the Northern Sanriku and Tsugaru Strait, 250–450 km north of the Fukushima Dai-ichi Nuclear Power Plant in April–December 2009 and May–June 2011, and analyzed for 134Cs and 137Cs activities using low-background γ-spectrometry. The 134Cs and 137Cs activities measured in these samples in May 2011 were found to be 2–3 mBq/L and 2.5–4 mBq/L, respectively. By June, these values had decreased by 25–45%/month and 5–30%/month, respectively. These results can be plausibly explained by surface infusion of these isotopes into the sea by atmospheric transport from Fukushima and their subsequent reduction by water migration to off-shore and deeper regions. [Copyright &y& Elsevier]

Abstract: A total of 82 surface seawater samples was collected in the Japan Sea and the southwestern Okhotsk Sea before and after the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident. Analysis of 134Cs and 137Cs concentrations using low-background γ-spectrometry revealed that the 137Cs concentration of the samples collected in June 2011 was 1.5–2.8mBq/L, which is approximately 1–2 times higher than the pre-accident 137Cs level, while the 134Cs concentration was less than detectable to 1mBq/L. In addition to 134Cs being clearly detected (∼1mBq/L), 137Cs concentration in water samples from the northeastern Japan Sea (2–2.8mBq/L) was also higher than that from the coast in the southwestern Japan Sea (∼1.5mBq/L). These higher concentrations in the northeastern Japan Sea could be ascribed to the atmospheric transport of nuclides from the FDNPP as aerosols and subsequent transport and dilution after delivery to the sea surface. [Copyright &y& Elsevier]

Background: To contribute to evidence-based policy decision making for national cancer control, we conducted a systematic assessment to estimate the current burden of cancer attributable to known preventable risk factors in Japan in 2005. Methods: We first estimated the population attributable fractions (PAFs) of each cancer attributable to known risk factors from relative risks derived primarily from Japanese pooled analyses and large-scale cohort studies and the prevalence of exposure in the period around 1990. Using nationwide vital statistics records and incidence estimates, we then estimated the attributable cancer incidence and mortality in 2005. Results: In 2005, ∼55% of cancer among men was attributable to preventable risk factors in Japan. The corresponding figure was lower among women, but preventable risk factors still accounted for nearly 30% of cancer. In men, tobacco smoking had the highest PAF (30% for incidence and 35% for mortality, respectively) followed by infectious agents (23% and 23%). In women, in contrast, infectious agents had the highest PAF (18% and 19% for incidence and mortality, respectively) followed by tobacco smoking (6% and 8%). Conclusions: In Japan, tobacco smoking and infections are major causes of cancer. Further control of these factors will contribute to substantial reductions in cancer incidence and mortality in Japan. [ABSTRACT FROM PUBLISHER]

Summary The present study examined the association of denture quality and health-related quality of life (HRQoL) in patients with removable dentures. In a study of 171 consecutive patients with removable partial dentures or complete dentures (mean age: 68·0 ± 9·3 years) at a university-based prosthodontic clinic, dentists rated two aspects of denture quality (stability and aesthetics) using a 100-mm visual analog scale (VAS). HRQoL was evaluated using the mental and physical component summary (MCS and PCS) scores of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36). Oral health-related quality of life (OHRQoL) was evaluated using the Oral Health Impact Profile-Japanese version (OHIP-J). The associations among denture quality, OHRQoL, and HRQoL were examined by linear regression models. Bivariable linear regression analyses revealed that denture stability was significantly associated with the SF-36 MCS [regression coefficient = 0·52 for a 10-unit increase in denture stability on a 0-100 VAS, 95% confidence interval (CI): 0·03-1·00, P = 0·04], but not with the PCS (0·11, 95% CI: −0·49 to 0·70). Denture aesthetics was not related to the PCS or the MCS (0·22, 95% CI: −0·44 to 0·88 or 0·07, 95%CI: −0·47 to 0·62). When OHIP-J was added to the regression model, this variable was substantially and significantly associated with the MCS and PCS summary scores; in addition, the regression coefficient for denture quality decreased in magnitude and was statistically nonsignificant in all analyses. The quality of removable dentures had a minimal effect on HRQoL in patients with removable dentures, and this association was mediated by OHRQoL. [ABSTRACT FROM AUTHOR]

IL-17 has an important role in the host defense against extracellular pathogens and the pathophysiology of autoimmune diseases. This study retrospectively examined the impact of a single-nucleotide polymorphism (rs2275913, G197A) in the IL-17 gene of a total 510 recipients with hematologic malignancies and their unrelated donors on the clinical outcomes in HLA-matched myeloablative (discovery study) and nonmyeloablative (validation study) BMT through the Japan Marrow Donor Program (JMDP). In the discovery study, the presence of a 197A genotype in the recipient resulted in a higher incidence of grades II-IV acute GVHD (hazard ratio (HR), 1.87; 95% confidence interval (CI), 1.23-2.85; P=0.004). The donor IL-17A genotype did not significantly influence the transplant outcomes. The validation study showed a trend toward an association of the recipient 197A genotype with an increased risk of grades III-IV acute GVHD (HR, 5.84; 95% CI, 0.75-45.72; P=0.09), as well as a significantly increased risk for chronic GVHD (HR, 3.86; 95% CI, 1.29-11.59; P=0.02). These results suggest an association of the 197A genotype in the recipient side with the development of acute GVHD. [ABSTRACT FROM AUTHOR]

Summary Introduction: T-helper cell type 1 (Th1) polarization of the immune response has been documented in patients with chronic immune thrombocytopenia (ITP). Interleukin (IL)-10 is the most important factor regulating Th1 and T-helper type 2 cytokine synthesis. This study evaluated the impact of IL-10 polymorphisms on both susceptibility to, and severity of, chronic ITP. Methods: We analyzed -1082(G/A), -812(C/T), and -592(C/A) IL-10 polymorphisms in 90 patients with adult chronic ITP and 202 race- and sex-matched healthy controls. Results: No significant differences in the genotype or haplotype frequencies were observed between the patient with chronic ITP and the control group. However, more patients with the -592AA genotype showed a severe thrombocytopenic state (platelet count <10 × 109/l) than those with the -592CC/CA genotypes (44.1% vs. 19.6%, P = 0.01). Furthermore, more patients with the ATA/ATA haplotype showed a severe thrombocytopenic state than those without the ATA/ATA haplotype (44.1% vs. 19.6%, P = 0.01). Conclusion: According to our data, patients with low producer type of IL-10 polymorphisms have more severe thrombocytopenia, suggesting that IL-10 gene polymorphisms may reflect the severity of ITP. [ABSTRACT FROM AUTHOR]

The addition of wood waste material to soil may improve infiltration and reduce soil erosion, but there is a need for research to determine the most effective mixing ratios in a range of soil types. We incorporated wood waste material in volumetric mixing ratios of 0.00, 0.05, 0.10, 0.15, 0.20, and 0.30 cm³ cm-3 (ft³ ft-3) into an allophanic Andisol taken from Tohaku in Tottori Prefecture, Japan, and measured the effects on the soil aggregate stability, soil hydraulic properties, and soil erosion under different simulated rainfall intensities. The amended soils were subjected to three separate rainfall intensities: 15, 30, and 60 mm h-1 (0.59, 1.18, and 2.36 in hr-1) for 2,.l, and 0.5 hours, respectively, in order to obtain the same amount of cumulative rain depth. The infiltration capacity increased significantly with increasing rainfall intensity and increased mixing ratio, up to 0.20 cm³ cm-3, and then leveled off The incorporation of wood debris effectively improved the soil saturated hydraulic conductivity and infiltration capacity. The improvement of soil aggregate stability and decrease in dispersivity with amendment mixing ratio limited the development of seal at the soil surface. The interrill soil losses, which decreased significantly with rainfall intensity, decreased nonlinearly as a function of the wood debris mixing ratio. The soil loss ranged from 0.09 to 0.48 Mg ha-1 h-1 (0.04 to 0.21 tn ac-1 hr-1) 0.21 to 1.10 Mg ha-1 h-1 (0.09 to 0.50 tn ac-1 hr-1), and 0.68 to 3.27 Mg ha-1 h-1 (0.30 to 1.46 tn ac-1 hr-1) for soils subjected to 15, 30, and 60 mm h-1 (0.59, 1.18, and 2.36 in hr-1) rainfall intensities, respectively. In the case of soil loss splashed by the three rainfall intensities, the corresponding splashed soil ranged from 0.40 to 0.64 Mg ha-1 h-1 (0.18 to 0.28 to ac-1 hr-1), 0.83 to 1.3 Mg ha-1 L-1 (0.37 to 0.58 tn ac-1 hr-1), and 1.47 to 2.67 Mg ha-1 ha-1 (0.65 to 1.19 tn ac-1 hr-1), respectively, in which no significant effect of wood debris was found. In this study, the effect of wood debris on interrill soil loss was not significant. [ABSTRACT FROM AUTHOR]

Objective:The Japan Public Health Center-based prospective Study examined the association of body mass index (BMI) and weight change with incident stroke in Japanese individuals, for whom BMI levels are generally low.Methods:We used initial data from 1990 to 1994 and 5-year follow-up surveys from 1995 to 1999. We calculated weight change over a 5-year period for 32 847 men and 38 875 women, aged 45-74 years, with no history of cardiovascular disease or cancer. Subjects were followed from the 1995-1999 survey to the end of 2005, and hazard ratios of self-reported BMI levels and weight change for incident stroke were estimated using Cox's proportional hazard models adjusted for potential confounders.Results:During the follow-up period (median 7.9 years) there were 2019 incident strokes, including subtypes. Multivariable-adjusted hazard ratios for all stroke events by BMI levels of 27.0-29.9 and 30 kg m-2 versus 23.0-24.9 kg m-2 were 1.09 (95% confidence interval 0.88, 1.36) and 1.25 (0.86, 1.84) in men (P for trend=0.22), and 1.29 (1.01, 1.65) and 2.16 (1.60, 2.93) in women (P for trend <0.001), respectively. A weight change of 10% in the previous 5 years was associated with total strokes and ischemic strokes in women.Conclusion:Higher BMI levels and a weight gain of 10% over 5 years were associated with an increased risk of stroke in women, whereas this association was weak in men. [ABSTRACT FROM AUTHOR]

This study examined the association between magnesium intake and type II diabetes risk among Japanese adults. Participants were 25 872 men and 33 919 women aged 45-75 years who had no history of diabetes. Magnesium intake was ascertained using a 147-item food frequency questionnaire. Odds ratio of self-reported physician-diagnosed type II diabetes over 5 years was estimated using logistic regression analysis. A total of 1114 new cases of type II diabetes were self-reported. Magnesium intake was not significantly associated with type II diabetes in either men or women. The multivariable-adjusted odds ratios (95% confidence intervals) of type II diabetes for the highest versus lowest quintile of magnesium intake were 0.86 (0.63-1.16) and 0.92 (0.66-1.28) for men and women, respectively. Although a small effect cannot be excluded in men, magnesium intake may not be appreciably associated with risk of type II diabetes for Japanese adults. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of weight perception and lifestyle on body mass index (BMI) over a 2-year period. Study design: Longitudinal study to compare the change in BMI (kg/m²) according to weight perception and lifestyle at baseline. Methods: Study subjects were 6029 men and 18,567 women aged 20-69 years who worked at a large financial firm in Japan. Subjects' weight and height were measured in 2004 and 2006. The data in 2004 were used as baseline data. Weight perception and lifestyle factors, including eating, physical exercise, hours of sleep, smoking and alcohol consumption, were determined by a self-administered questionnaire in 2004. Results: The age-adjusted mean change in BMI over the 2-year period was -0.0593 among men and 0.0890 among women. In men, subjects who perceived themselves to be over-weight had a reduced BMI 2 years later compared with subjects who perceived themselves to be 'just right' or underweight. Multiple regression analysis of lifestyle factors, adjusted for age and BMI at baseline, indicated that less time spent commuting, not having a hobby, not having a fixed lunch time, consumption of sweets, smoking and colleagues' smoking were associated with increased BMI among men. Fewer hours of sleep, no fixed lunch time and frequent soft drink consumption were associated with increased BMI among women. Conclusions: A perception of being overweight was associated with a decrease in BMI for Japanese male workers. Positive lifestyle factors associated with a decrease in BMI in both men and women include having a fixed lunch time and being older. These factors should therefore be highlighted in future health promotion activities in workplaces. [ABSTRACT FROM AUTHOR]

Objective:Limited data are available with regard to longitudinal changes in body weight by food taste preference. Here, we examined the associations between taste preferences and weight change in adults for a large-scale cohort study in Japan.Design:Longitudinal analysis of data from a population-based cohort study, the Japan Public Health Center-based Prospective Study (JPHC Study).Subjects:A total of 29 103 middle-aged men and women, who participated in a JPHC Study and returned questionnaires on lifestyle and diet, including taste preferences, at both baseline and the 10th year of follow-up.Measurements:We assessed the relations of preferences for rich and heavy taste and a sweet taste to weight changes between the age of 20 years and baseline and those during the 10-year follow-up period.Results:Preferences for rich and heavy taste and for sweet taste were significantly positively associated with weight increases between the age of 20 years and baseline (P for trend <0.001); the fully adjusted odds ratios (95% confidence interval) comparing the ‘like’ versus ‘dislike’ groups with a preference for rich and heavy taste were 1.45 (1.31–1.24) for men and 1.28 (1.16–1.41) for women, whereas that for a sweet taste preference was 1.22 (1.09–1.36) for women. As regards weight change during the 10 years of follow-up, subjects who liked the sweet taste and those who neither liked nor disliked this taste experienced a significantly greater increase than those who disliked it in both men and women. There was no such difference for rich and heavy taste.Conclusion:These results suggest that food taste preferences may be an important predictor of weight changes in adults. Taste preferences need to be considered when counseling patients to achieve weight control. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the associations between long-term weight change after age 20 and overall mortality and cause-specific mortality in the general Asian population. Methods: From 1990 to 2005, the Japan Public Health Center (JPHC)-based prospective study conducted a follow-up of 42 242 men and 46 177 women aged 40-69 years with no history of cardiovascular disease (CVD) or cancer. Sex-specific multivariable-adjusted hazard ratios for cause-specific mortality were computed in accordance with weight change categories from age 20, as assessed by a self-administered questionnaire, and clustered by the JPHC communities and age groups, using Cox's proportional hazard model. Results: During the 12.9-year follow-up, there were 6494 deaths, including 2888 from cancer, 1011 from CVD and 2595 from other causes. In all, weight loss ⩾5 kg since age 20 increased hazard ratios for all-cause mortality in men (1.44, 95% CI 1.32 to 1.56) and women (1.33, 95% CI 1.17 to 1.52) compared with maintenance of a stable weight, and elevated risk was also found within each age group. The risk of weight loss was higher for individuals in the younger age group. Weight loss predicted cancer and CVD mortality only for men ⩾50 years of age. The increased risk was observed regardless of whether the individual was ill, a smoker or overweight at baseline or at age 20. There was an inverse association between weight gain and mortality risk. Conclusion: Weight loss strongly predicted all-cause, cancer and CVD mortality, primarily for men. An unfavourable effect of weight gain was small at the population level. [ABSTRACT FROM AUTHOR]

Objective:Limited data are available regarding longitudinal changes in body weight. Here, we describe changes in the prevalences of overweight and obesity and calculated the incidence of these indices during a 10-year follow-up period for a large-scale cohort study in Japan.Design:Longitudinal analysis of data from a population-based cohort study, the Japan Public Health Center (JPHC) Study.Participants:A total of 65 095 Japanese men and women, who were between the ages of 40 and 69 years at baseline and participated in the 5th- and 10th-year follow-up surveys of the JPHC, were enroled in the study.Measurements:Mean body mass index (BMI), calculated using self-reported height and weight, and the prevalences of overweight (BMI 25 kg/m2) and obesity (BMI 30 kg/m2) at each survey period. Incidences of overweight and obesity during the 10-year period.Results:On an average, individuals living in Okinawa had much higher BMIs than those living on the Main islands for all sex and age groups. During the follow-up period, the prevalences of overweight and obesity steadily increased in the cohorts aged less than 50 years at baseline in both sexes. Men in younger cohorts had a higher mean BMI than those in the same age group of older cohorts, whereas the opposite trend was observed in women. The incidence of overweight individuals was greater in Okinawa than on the Main islands and among younger generations than among older ones.Conclusion:A longitudinal analysis at the individual level showed that the prevalences of overweight and obesity increased among middle-aged Japanese participants during the follow-up period. Among men, an increasing prevalence of obesity was observed among the younger generations. These findings should be taken into consideration when planning preventive strategies for obesity and its related diseases.International Journal of Obesity (2008) 32, 1861–1867; doi:10.1038/ijo.2008.188; published online 28 October 2008 [ABSTRACT FROM AUTHOR]

We investigated the association between plasma 25(OH)D and the subsequent colorectal cancer incidence risk by a nested case-control study in The Japan Public Health Center-based Prospective Study, covering 375 newly diagnosed cases of colorectal cancer from 38 373 study subjects during a 11.5-year follow-up after blood collection. Two controls were matched per case on sex, age, study area, date of blood draw, and fasting time. In a conditional logistic regression model with matched pairs adjusted for smoking, alcohol consumption, body mass index, physical exercise, vitamin supplement use, and family history of colorectal cancer, plasma 25(OH)D was not significantly associated with colorectal cancer in men or in women. However, the lowest category of plasma 25(OH)D was associated with an elevated risk of rectal cancer in both men (odds ratio (OR), 4.6; 95% confidence interval (CI), 1.0-20) and women (OR, 2.7, 95% CI, 0.94-7.6), compared with the combined category of the other quartiles. Our results suggest that a low level of plasma 25(OH)D may increase the risk of rectal cancer. [ABSTRACT FROM AUTHOR]

To enrich cosmogenic 7Be and 22Na, artificial 137Cs and natural radium isotopes, three chemical methods were applied to large volumes (100–300 l) of ground water from Daisen Volcano, Japan. The co-precipitation method using BaSO4, Fe(OH)3 and AMP, yielded 7Be, 137Cs and radium isotope levels of nearly 100%. An ordinary ion-exchange column method, selectively recovered 22Na (77%) through two continuous column operations. 40K was satisfactorily removed in both, the co-precipitation and column methods. In addition, the simple batch method was suitable for rapid treatment even on the slope of a volcano without sacrificing yields. Low-background γ-spectrometry combined with these chemical treatments enabled the determination of extremely low-levels of 7Be, 22Na, 137Cs and radium isotopes (0.01–4 mBq/l) in ground water samples. The measurement of these nuclides of Daisen ground water provide new information on the flow system of volcanic water, including residence time, the mixing of precipitation, and the aquifer’s environment. [ABSTRACT FROM AUTHOR]

Extremely low activity levels of cosmic ray induced nuclides have been measured in freshly precipitated rainwater by quick chemical separation coupled with ultra low background gamma-spectrometry. The nuclides detected were 38S ( T 1/2 = 2.83 h)-38Cl (37.2 m), 39Cl (55.6 m), 24Na (14.96 h), 28Mg (20.9 h), 7Be (53.3 d) and 22Na (2.602 y). The number of atoms in rain water were evaluated to be ranging from 400-1900 l-1 for 39Cl ( n = 6, mean: 1200), 30-1500 l-1 for 24Na ( n = 16, mean: 520), 80-600 l-1 for 28Mg ( n = 13, mean: 260), 1 . 106-4 . 107 l-1 for 7Be ( n = 16, mean: 7 . 106) and 2 . 103-1 . 105 l-1 for 22Na ( n = 9, mean: 2 . 104). Measurements of activity levels and activity ratios of short-lived cosmic-ray induced short-lived nuclides will open new method to understand atmospheric processes occurred at the altitude of rain cloud. [ABSTRACT FROM AUTHOR]

Abstract: In this study, low-background γ-spectrometry was used to determine the 228Ra/226Ra ratio of 131 coastal water samples from various environments around Honshu Island, Japan (mainly around Noto Peninsula) at 1–3 month intervals from April 2003 until September 2005. Spatial variation in 228Ra/226Ra ratios was also assessed by analyzing 34 coastal water samples from five areas within the Sea of Japan during May and June 2004. The 228Ra/226Ra ratio of coastal water from all sites around Noto Peninsula shows seasonal variation, with minimum values during summer (228Ra/226Ra=0.7) and maximum values during autumn–winter (228Ra/226Ra=1.7–2). This seasonal variation is similar to that recorded for coastal water between Tsushima Strait and Noto Peninsula. The measured lateral variation in 228Ra/226Ra ratios within coastal water between Tsushima Strait and Noto Peninsula is only minor (0.5–0.7; May–June 2004). Coastal waters from two other sites (Pacific shore and Tsugaru Strait, north Honshu) show no clear seasonal variation in 228Ra/226Ra ratio. These measured variations in 228Ra/226Ra ratio, especially the temporal variations, have important implications for seasonal changes in patterns of coastal water circulation within the Sea of Japan. [Copyright &y& Elsevier]

Despite its decreasing trend in Japan, gastric cancer remains an important public health problem. Although the age standardised rates of gastric cancer have been declining for decades, the absolute numbers are increasing because of the rapid aging of the population. A large proportion of Japanese gastric cancers are detected at an early stage, with a better overall survival rate. As with Western developed countries, a change in the social environment such as reduced salt use and increased fresh vegetable and fruit intake as well as improvement of food storage may play an important part in the decline. Differences in Helicobacter pylori infection rates between generations presumably have contributed to the generation related variation in the declining trends. It is expected that most gastric cancers in Japan may be preventable by lifestyle modification such as salt reduction and increased fruit and vegetable intake, together with avoidance of smoking and countermeasures against H pylori infection so that the level now evident in Western developed countries can be reached. [ABSTRACT FROM AUTHOR]

Abstract: To examine water circulation patterns of coastal water, 72 seaweed (Sargasso) samples and 27 coastal water samples were collected from coastal areas of the Noto Peninsula, Japan, during the period from December 1998 to June 2002. The 228Ra and 226Ra activities of those samples were measured by low-background γ-ray spectrometry. There was a wide range of activities of 228Ra (0.5–2Bq/kg-fresh) and 226Ra (0.5–1.2Bq/kg-fresh) in the Sargasso samples. The 228Ra/226Ra activity ratio of Sargasso samples exhibited seasonal variation with minimum values in June (228Ra/226Ra=∼1) and maximum values in December (1.5–2.5), which was mainly governed by changes in 228Ra activity. It is also notable that the seasonal variation of the 228Ra/226Ra ratio of Sargasso is in approximate agreement with that of the ambient coastal water. Sargasso samples appear to have retained the 228Ra/226Ra ratio of the ambient coastal waters, and the temporal variations in that ratio provide insight into seasonal changes in water circulation in the Noto Peninsula coastal area. [Copyright &y& Elsevier]

We conducted a cohort study of alcohol consumption and total cancer incidence and mortality in 73,281 subjects (35,007 men and 38,274 women) aged 40-59 years old at baseline over a 10-year follow-up period. During 1990-2001, a total of 3403 cases of newly diagnosed cancer and 1208 cancer deaths were identified. In men, the lowest risk of developing cancer was observed among occasional drinkers, and a linear positive association with increased ethanol intake was noted (hazard ratio 1.18 for 1-149 g per week, 1.17 for 150-299 g per week, 1.43 for 300-449 g per week, 1.61 for > or = 450 g per week, P for trend < 0.001). The positive relation was similar for cancer incidence and mortality, but was more striking among current smokers and alcohol-related cancers. Relatively few women were regular drinkers. Our results suggest that increased ethanol intake linearly elevates the risk of cancer, and that nearly 13% of cancers among males in this study were due to heavy drinking (> or = 300 g per week of ethanol), to which smoking substantially contributed. The simultaneous reduction of smoking is therefore important for reducing the effect of alcohol on cancer risk. [ABSTRACT FROM AUTHOR]

1. The effects of channelisation on macroinvertebrates were examined in relation to a spate and flow refugia. Habitat components that can function as flow refugia were identified in a small, low-gradient stream in northern Hokkaido, Japan. 2. Macroinvertebrates and their habitat characteristics (depth, current velocity and substratum) were sampled and measured in natural and channelised sections on three occasions: before, during and immediately after a spate. For macroinvertebrate sampling and habitat measurements, five (riffle, glide, pool, backwater and inundated habitats) and three (channelised-mid, channelised-edge and inundated habitats) habitat types were classified in the natural and channelised section, respectively. 3. The rate of velocity increase with discharge was compared among habitat types to determine which habitat types were less affected by increased discharge. The rate was the highest in riffles followed by glides and channelised-mids. Backwaters maintained low current velocity even at high flow. In addition, current velocity in both natural and channelised inundated habitats was low relative to other habitat types during the spate. 4. Through the spate, total density of macroinvertebrates in channelised-mids and taxon richness in both channelised-mids and edges decreased. In the natural section, however, such a significant decrease was not found except for taxon richness in pools. This indicated that the spate had a greater impact on assemblages in the channelised section. Riffle assemblages exhibited a rapid recovery immediately after the spate, suggesting the existence of flow refugia in the natural section. Among the habitat types we examined, backwaters and inundated habitats appeared to have acted as flow refugia, because these habitats accumulated macroinvertebrates during the spate. 5. The lower persistence of the macroinvertebrate assemblage in the channelised section was attributable to the lower availability of flow refugia such as... [ABSTRACT FROM AUTHOR]

Background, aims: The present study was undertaken to assess the periodontal status of a rural Japanese population and to study the correlation between the periodontal status and the serum antibody titers for Porphyromonas gingivalis (Pg) fimbriae. Method: A total of 236 individuals were examined for their periodontal con-ditions by the use of the community periodontal index for treatment needs (CPITN), and serum antibody titers for Pg fimbriae in their peripheral blood samples were evaluated using the enzyme-linked immunosorbent assay. Results: There was a substantially larger proportion of edentulous subjects in the age group older than 60 years. The remaining teeth were 24.1, 23.2, 11.1 and 10.1 per person in the 40-49, 50-59, 60-69 and >70 age groups, respectively. The % of sextants with a CPITN code of missing sextant (MS) increased towards elderly and reached ±60% in the age group of >70 years, as the % of the CPITN 2, 1 or 0 sextant decreased. The % of CPITN 4 and 3 sextants did not differ between different age groups and were about 6-8% and 15-20%, respectively. The % of CPITN 1 or 0 sextants was higher in female subjects than in male subjects in the 60-69 and >70 age groups, while the % of CPITN 4 or 3 sextants was higher in male subjects than in female subjects in all age groups. There was no significant difference between various age groups in the mean serum antibody titers for Pg fimbriae. The mean anti-Pg fimbriae antibody titers was significantly higher for the subjects with a maximum CPITN code 4 (max.-CPITN 4 subject) than for the subjects with lower maximum CPITN codes. The antibody titers varied extensively among the max.-CPITN 4 or 3 subjects, but not among the max.-CPITN 2/1/0 or MS subjects. Conclusions: The present study demonstrated that tooth loss is a remarkable event in elderly subjects and that oral prophylaxis and mechanical debridement should be mandatory in the population examined... [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to examine the hypothesis that tea and coffee consumption have a protective effect against development of digestive tract cancers.Methods: A comparative case-referent study was conducted using Hospital-based Epidemiologic Research Program at Aichi Cancer Center (HERPACC) data from 1990 to 1995 in Nagoya, Japan. This study comprised 1,706 histologically diagnosed cases of digestive tract cancers (185 esophagus, 893 stomach, 362 colon, 266 rectum) and a total of 21,128 non-cancer outpatients aged 40 years and over. Logistic regression was used to analyze the data, adjusting for gender; age; year and season at hospital-visit; habitual smoking and alcohol drinking; regular physical exercise; fruit, rice, and beef intake; and beverage intake.Results: The odds ratio (OR) of stomach cancer decreased to 0.69 (95 percent confidence interval [CI] = 0.48-1.00) with high intake of green tea (seven cups or more per day). A decreased risk was also observed for rectal cancer with three cups or more daily intake of coffee (OR = 0.46, CI = 0.26-0.81).Conclusions: The results suggest the potential for protective effect against site-specific digestive tract cancer by consumption of green tea and coffee, although most associations are limited only to the upper category of intake and have no clear explanation for site-specificity. [ABSTRACT FROM AUTHOR]

Diabet. Med. 29, e75-e81 (2012) Abstract Aims We investigated the value of persistent fasting hyperglycaemia as assessed by repeated elevated fasting plasma glucose in predicting the progression to diabetes. Methods A retrospective cohort study was conducted from 1998 to 2006 inclusive among 7929 persons (37 742 person-years), with a mean age of 53.0 years at baseline. The cumulative incidence of diabetes was measured. A baseline and follow-up fasting plasma glucose were categorized as normal fasting glucose (< 5.56 mmol/l), or impaired fasting glucose (5.56-6.94 mmol/l). Results The cumulative incidence and incidence density of diabetes were 3.5% (275 cases) and 7.3 per 1000 person-years over a mean follow-up period of 4.8 years. The cumulative incidence of diabetes among subjects with impaired fasting glucose at both previous examinations (persistent impaired fasting glucose) was 30.4% (222/1518) compared with 0.6% (15/5063) of those with normal fasting glucose at both baseline and initial follow-up. The hazard ratios to develop diabetes, adjusted for possible confounders, was 37.10 (95% CI, 21.6-63.7) for persistent impaired fasting glucose versus persistent normal fasting glucose. Persistent impaired fasting glucose predicted diabetes at 80.7% (222/275) sensitivity and 83.1% (6358/7654) specificity, whereas first baseline impaired fasting glucose only predicted diabetes at 86.9% (239/275) sensitivity and 74.9% (5730/7654) specificity. The model using both previous fasting plasma glucose levels had a greater AUROC (area under receiver operating characteristic) than that using first baseline fasting plasma glucose only (0.92 vs. 0.88; P < 0.001). Conclusions Repeated measurements of fasting plasma glucose better predicts incidence of diabetes than a single test. In particular, persistent fasting hyperglycaemia adds more substantial precision to the prediction of future diabetes than transient impaired fasting glucose. This combination is cost efficient and may be practical for early detection of high-risk individuals. [ABSTRACT FROM AUTHOR]

Because the shortage of donor organs is especially serious in Japan, since 2002 a unique partnership between transplant consultant physicians and local physicians has been developed to maximize the organ utilization rate. Since 2011, more than 25 lung consultant physicians have been registered to specifically assess donor lungs and provide advice on intensive respiratory care to donors. In this study, we retrospectively reviewed the efficacy of this system for lung transplantation opportunities and outcomes. One hundred eighty-seven brain-dead lung donor candidates were chronologically divided into 3 phases: I (May 1998–November 2006) and II (December 2006–January 2011), before and after medical consultants requested that local physicians administer aggressive bronchial suctioning using bronchoscopy, respectively; and phase III (February 2011–January 2013), after the emergence of lung consultants. The lung utilization rate, Pa o 2 /F io 2 ratio at the first and second brain death examinations and at the tertiary assessment before recovery, and graft survival were analyzed. The lung utilization rate was significantly higher in phases II and III than in phase I. In phases I and II, the Pa o 2 /F io 2 ratio at the tertiary assessment was significantly lower than that at the first or the second brain death examination, whereas it did not worsen with time in phase III. Graft survival was significantly better in phases II and III than in phase I. Graft death due to primary graft dysfunction was significantly more frequent in phase I than in phases II and III. In conclusion, this system is effective in improving lung transplantation opportunities and outcomes. [ABSTRACT FROM AUTHOR]

“We assessed the associations between BMI and breast cancer incidence by a pooled analysis from eight representative large-scale cohort studies in Japan. The increased risk of postmenopausal and premenopausal breast cancer was found among women with higher BMIs. Body mass in Asian women might have opposite effects on premenopausal breast cancer compared with Western women”.Background A positive association between body mass index (BMI) and breast cancer risk among postmenopausal women has been reported, and a weak inverse association has been suggested among premenopausal women from studies in the Western population. The effects of BMI on breast cancer have remained unclear among the Asian population, especially in premenopausal women. Methods We assessed the associations between BMI and breast cancer incidence by a pooled analysis from eight representative large-scale cohort studies in Japan. Cancer incidence was mainly confirmed through regional population-based cancer registries and/or through active patient notification from major local hospitals. Breast cancer was defined as code C50 according to ICD10. Pooled estimates of the hazard ratios (HRs) and 95% confidence interval (CIs) for breast cancer were calculated using random-effects models. Results Analytic subjects were 183 940 women, 1783 of whom had breast cancer during 2 194 211 person-years of follow-up. A positive association between BMI and the risk of postmenopausal breast cancer was observed (trend P < 0.001). The HRs for premenopausal breast cancer were 1.05 (95% CI 0.56–1.99), 1.07 (95% CI 0.76–1.52), 0.91 (95% CI 0.64–1.30), 1.15 (95% CI 0.76–1.73), 1.45 (95% CI 0.71–2.94), and 2.25 (95% CI 1.10–4.60), respectively, in BMIs of <19, 19 to <21, 21 to <23, 25 to <27, 27 to <30, and ≥30 kg/m2. These results were not substantially altered after excluding the patients who were diagnosed with breast cancer in the first 2 years of follow-up. Conclusions The increased risk of postmenopausal breast cancer among women with higher BMIs was confirmed in Japanese. A borderline-significant positive association between BMI and premenopausal breast cancer was observed, suggesting that body mass in Asian women might have opposite effects on breast cancer compared with Western women. [ABSTRACT FROM AUTHOR]

Background: Obesity has been recognized as important risk factors for colorectal cancer. However, limited evidence is available on colorectal cancer and body mass index (BMI) in Asian population. Methods: We conducted a pooled analysis of eight population-based prospective cohorts studies in Japan with more than 300 000 subjects to evaluate an impact of obesity in terms of BMI on colorectal cancer risk with unified categories. We estimated summary hazard ratio (HR) by pooling of study-specific HR for BMI categories with random effect model. Results: We found a significant positive association between BMI and colorectal cancer risk in male and female. Adjusted HRs for 1 kg/m2 increase were 1.03 [95% confidence interval (CI) 1.02–1.04] for males and 1.02 (95% CI 1.00–1.03) for females. The association was stronger in colon, especially in proximal colon, relative to rectum. Males showed a stronger association than females. Population attributable fraction for colorectal cancer by BMI ≥25 kg/m2 was 3.62% (95% CI 1.91–5.30) for males and 2.62% (95% CI 0.74–4.47) for females. Conclusions: We found significant association between BMI and colorectal cancer risk by pooling of data from cohort studies with considerable number of subjects among Japanese population. This information is important in cancer control planning, especially in Asian population. [ABSTRACT FROM PUBLISHER]

Reports on the development of a wide-field pattern inspection system that cuts the time needed to check an entire exposure shot for defects by NanoGeometry Research Inc. and Topcorn Corp. in Japan. Ability of the high-resolution scanning electron microscopy (SEM) system in comparing the pattern on the wafer to the design layout and flags and analyzes the defects; Function of the newly developed e-beam SEM inspection technology to enlarge the field of view; Specification of the types of circuit patterns to be measured by the operator.

Managing soil erosion by water from marginal acidic soil employing traditional methods is difficult, if not impossible. The ability of Sedum sediforme (Rupestria group) to germinate, grow, and establish good ground cover under harsh environmental conditions induced us to assess its effectiveness as surface cover on an acid soil taken front mountain cuts (non-agricultural field) in Yamaguchi prefecture, Japan. This soil is widely used for road embankments in this prefecture. Two rainfall intensities, 30 and 60 mm h-1, were tested for 2 h and 1 h, respectively, on sedum grown in soil plots measuring 50 x 30 x 5 cm at three levels of vegetation cover: bare soil, 25% cover, and 75% cover. Under both simulated rainfall intensities, the sediment concentration, total soil loss, and total splashed soil decreased significantly with increasing vegetation cover. The dissipation of the raindrop impact energy by sedum cover was among the main factors contributing to the improvement of aggregate size distribution of the sediment and the total splashed soil and consequently a decrease in the seal formation on the soil surface. Compared with the bare soil, cumulative soil loss decreased by 77% and 73% under 30 and 60 mm h-1 rainfall intensities, respectively. The total splashed soil under sedum cover decreased by 30% as compared to that from the bare soil. The mean weight diameter of the surface soil aggregate increased significantly with increasing sedum cover. This is attributed to its ability to effectively protect the soil surface, thereby reducing soil aggregate breakdown and detachment, and consequently soil erosion. [ABSTRACT FROM AUTHOR]

This study aimed to complement the results of the REACH-2 study by prospectively evaluating the safety and efficacy of ramucirumab in advanced hepatocellular carcinoma (HCC) in a real-world setting. This was an open-label, nonrandomized, multicenter, prospective study conducted at 13 institutions in Japan (jRCTs031190236). The study included Child-Pugh Class A patients with advanced HCC who had received pretreatment with atezolizumab plus bevacizumab (Atez/Bev) or lenvatinib. Ramucirumab was introduced as a second-line treatment after Atez/Bev or lenvatinib and as a third-line treatment after Atez/Bev and lenvatinib. Between May 2020 and July 2022, we enrolled 19 patients, including 17 who received ramucirumab. Additionally, seven patients received lenvatinib, another seven patients received Atez/Bev, and three patients received Atez/Bev followed by lenvatinib as prior treatment. The primary endpoint was a 6-month progression-free survival (PFS) rate, which was 14.3%. The median PFS and overall survival were 3.7 and 12.0 months, respectively. The most common grade ≥ 3 adverse events (AEs) were hypertension (23.5%), proteinuria (17.6%), and neutropenia (11.8%). The discontinuation rate due to AEs was 29.4%. Six patients progressed from Child-Pugh A to B after treatment with ramucirumab. Thirteen patients were eligible for post-ramucirumab treatment, including systemic therapy. Despite the limited number of patients, the efficacy of ramucirumab was comparable to that observed in the REACH-2 study when used after lenvatinib and Atez/Bev. However, the incidence of AEs was higher than that in the REACH-2 study., (© 2024. The Author(s).)

Purpose: Fish and shellfish consumption is suggested to be a cancer-protective factor. However, studies investigating this association for gastric cancer, especially considering Helicobacter pylori (H. pylori) and atrophic gastritis (AG), are limited. We investigated gastric cancer risk associated with fish, shellfish, and n-3 polyunsaturated fatty acids (n-3 PUFAs) consumption among Japanese adults., Methods: 90,504 subjects enrolled in the Japan Public Health Center-based Prospective Study (JPHC Study) were followed until December 2013. Dietary intake data were collected using a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for gastric cancer risk associated with fish and shellfish consumption and marine n-3 PUFAs (sum of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA)) using Cox proportional hazards models. Among those with avaliable data, we conducted a subgroup analysis taking H. pylori infection and AG status  into consideration., Results: There were 2,701 gastric cancer cases during an average of 15 years of follow-up. We observed an increased gastric cancer risk for salted fish consumption for men [HR for fifth quintile versus first quintile 1.43 (95% CI 1.18-1.75)] and for women [HR 1.33 (95% CI 1.00-1.77)]. We observed a weak risk reduction trend for women as the intake of marine n-3 PUFAs increased (p-trend:0.07). When we included H. pylori infection and atrophic gastritis status in the analysis, the associations diminished., Conclusion: Our results suggest that salted fish increases gastric cancer risk for men and women, while marine n-3 PUFAs marginally decreases this risk among women in Japan., (© 2024. The Author(s).)

Background: The novel coronavirus disease 2019 (COVID-19) pandemic has significantly impacted end-of-life decisions for cancer patients in Japan, with disparities existing between preferred and actual care settings. Our study investigates the potential shifts in cancer death locations during the pandemic and if there were excess cancer deaths., Methods: Utilizing national mortality data from the Ministry of Health, Labour and Welfare from January 2012 to February 2023, we identified cancer deaths using International Classification of Disease, 10 th revision codes. We assessed death locations, including medical institutions, nursing facilities, and homes. The Farrington algorithm was employed to estimate expected death counts, and the differences between observed and expected counts were denoted as excess deaths., Results: From January 2018 to February 2023, there was consistently increase in the weekly observed cancer deaths. The presence of a definitive excess during the pandemic period remains uncertain. The percentage of deaths in medical institutions declined from 83.3% to 70.1%, while home deaths increased from 12.1% to 22.9%. Between April 2020 and February 2023, deaths in medical institutions frequently fell below the 95% prediction lower limit. Home deaths consistently exceeded the 95% prediction upper limit, with significant excess deaths reported annually., Conclusion: Our study found a shift in cancer death locations from medical institutions to homes in Japan during the COVID-19 pandemic. Our study did not confirm an overall increase in cancer deaths during this period. As with global trends, the profound shift from hospitals to homes in Japan calls for a comprehensive exploration to grasp the pandemic's multifaceted impact on end-of-life cancer care decisions.

Background: An association between birth weight and cardiovascular disease (CVD) in adulthood has been observed in many countries; however, only a few studies have been conducted in Asian populations., Methods: We used data from the baseline survey (2011-2016) of the Japan Public Health Center-based Prospective Study for the Next Generation Cohort, which included 114,105 participants aged 40-74 years. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were calculated from the prevalence of present and past histories of CVD and other lifestyle-related diseases, including hypertension, diabetes, hyperlipidemia, and gout, by birth weight, using Poisson regression., Results: The prevalence of CVD increased with lower birth weight, with the highest prevalence among those with birth weight under 1,500 grams (males 4.6%; females 1.7%) and the lowest one among those with birth weight at or over 4,000 g (males 3.7%: females 0.8%). Among 88,653 participants (41,156 males and 47,497 females) with complete data on possible confounders, birth weight under 1,500 g was associated with a higher prevalence of CVD (aPR 1.76; 95% CI, 1.37-2.26), hypertension (aPR 1.29; 95% CI, 1.17-1.42), and diabetes (aPR 1.53; 95% CI, 1.26-1.86) when a birth weight of 3,000-3,999 grams was used as the reference. Weaker associations were observed for birth weight of 1,500-2,499 grams and 2,500-2,999 grams, while no significant associations were observed for birth weight at or over 4,000 grams. The association between birth weight and the prevalence of hyperlipidemia was less profound, and no significant association was observed between birth weight and gout., Conclusion: Lower birth weight was associated with a higher prevalence of CVD, hypertension, and diabetes in the Japanese population.