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Journal of Epidemiology

Volume 32, Issue 5(May 2022)

Exploring the Causal Roles of Circulating Remnant Lipid Profile on Cardiovascular and Cerebrovascular Diseases: Mendelian Randomization Study
  • This study explored the metabolic risk of the conventional lipids and remnant lipids.
  • The remnant lipid profiles have heterogeneity for the risk of CHD and IS by the particle size of triglyceride-rich lipoproteins.
  • The different TGLs presented positive and negative effects for different CVD that suggest not all remnant lipids was harmful that required intervention.
  • This research provides causal evidence for potential intervention targets of remnant lipids.
Did Expanded Dental Insurance Improve Chewing Ability in the Older Korean Population? Results of an Interrupted Time-series Analysis
  • We aimed to explore the causal inference of expanded dental insurance on older adults’ chewing ability using multi-group interrupted time-series analysis (ITSA) model.
  • We used data from the Korea National Health and Nutrition Examination Survey conducted from 2007 to 2016–2018.
  • The ITS analysis showed that chewing difficulty decreased annually by 0.93% and 0.38% after the policy extension in older than 65 and younger than 65, respectively.
  • Chewing difficulty decreased over time in the both eligible and ineligible groups after the expansion of dental insurance in South Korea. These trends appear to be attributable to forces external to changes in dental insurance benefits.
  • These trends appear to be attributable to forces external to changes in dental insurance benefits.
Combined Associations of Liver Enzymes and Obesity With Diabetes Mellitus Prevalence: The Tohoku Medical Megabank Community-based Cohort Study
  • Alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) are enzymes associated with diabetes mellitus (DM) prevalence.
  • We examined whether ALT and GGT enzymes combined is associated with the prevalence of DM regardless of obesity in a general Japanese population.
  • High ALT and GGT levels are associated with DM prevalence in obese and non-obese participants.
  • This finding suggests that correcting ALT and GGT levels and controlling obesity are important for the prevention of DM.
Study Design and Participants’ Profile in the Sub-Cohort Study in the Japan Environment and Children’s Study (JECS)
  • The Japan Environment and Children’s Study (JECS) is a nationwide birth cohort study investigating environmental effects on children’s health and development. A Sub-Cohort Study has measured extended exposure and outcomes by randomly selecting a subgroup from the JECS Main Study.
  • Participants are followed up at 1.5 and 3 years old for home visits, and 2, 4, 6 and 8 years old for developmental/medical examination. The details of protocols after age 10 are under discussion.
  • Of 10,302 selected children, 5,017 participated. The profiles of the participating mothers, fathers and children did not substantially differ between the Main Study and Sub-Cohort Study.
  • The JECS Sub-Cohort Study offers a platform for investigating associations between environmental exposure and outcomes.
Short Communication
Association Between Long-term Weight Change Since Midlife and Risk of Incident Disabling Dementia Among Elderly Japanese: The Ohsaki Cohort 2006 Study
  • Previous studies indicated weight loss was associated with dementia among Caucasians, but it remained unclear among Asians.
  • Our study is the first to report the association between weight loss and incident dementia among elderly Japanese.
  • Our study suggests that a ≤-3.5kg weight loss was associated with a higher risk of incident dementia.

Volume 32, Issue 4(April 2022)

Special Article
AI Implementation Science for Social Issues: Pitfalls and Tips
  • Outcomes of social implementation should be carefully set while staying close to the field and achieving consensus on which issues should be solved.
  • It is important to design social implementation that can repeat the loop of practice and evaluation using data.
  • The cycle of retaining new system functions that worked well and improving those that did not is repeated quickly from research to social implementation.
  • When implementing a product in a society, researchers must always create an exit strategy to expand the product’s implementation and maximize social impact.
  • A sustainable service team as research and development (SSTRD) model should be developed for social implementation.
Epidemiological Study of Hospital Admissions for Food-Induced Anaphylaxis Using the Japanese Diagnosis Procedure Combination Database
  • Food-induced anaphylaxis is a serious disease with a risk of death.
  • We identified 9,079 patients from the Japanese Diagnosis Procedure Combination Database who were admitted for treatment for FIA from April 1, 2014 through March 31, 2017.
  • The most common causative food of FIA among patients aged 0–3, 4–6, 7–19 and ≥ 20 years old was hen’s egg, cow’s milk, peanuts and wheat, respectively.
  • Taking measures to prevent peanut allergies in school is important.
Association Between Birth Weight and Risk of Pregnancy-Induced Hypertension and Gestational Diabetes in Japanese Women: JPHC-NEXT Study
  • No large epidemiological study on women of Asian ancestry have studied whether birth weight is associated with risk of complications during pregnancy.
  • Utilizing a large cross-sectional database, we observed higher risk of pregnancy induced hypertension among Japanese women born with lower birthweight.
  • The risk of GDM was significantly higher among women born with birthweight of 1500-2500 grams compared to those born with 2500-3500 grams, albeit non-significant association among women in other birthweight categories.
The Association Between Informal Caregiving and Poor Self-rated Health Among Ever-married Women in Japan: A Nationally Representative Survey
  • Informal caregiving (childcare, nursing care, dual care) could negatively affect caregivers’ health due to multiple burden.
  • However, no previous research studied the health effects of combining these different types of informal caregiving.
  • We assessed self-rated health (SRH) of informal caregivers using the nationally representative 2013 Comprehensive Survey of Living Conditions data.
  • Nursing and dual caregivers were more likely to have poor SRH than non-caregivers; dual caregivers showed the highest odds ratio among all groups (no care, childcare, nursing care, and dual care).
  • The association between types of informal caregiving and SRH was not different by socio-economic conditions.
Changes in Smoking Habits and Behaviors Following the Introduction and Spread of Heated Tobacco Products in Japan and Its Effect on FEV1 Decline: A Longitudinal Cohort Study
  • In our cohort study in Japan, dual users of both cigarettes and HTPs, tended to smoke/use more tobacco products when they started to use HTPs.
  • FEV1 appears to have declined more strongly in these dual users than in the combustible cigarette-only smokers and HTP-only users.
  • Individuals who switched to HTP-only use a mean of 1.7 years before had a similar reduction in FEV1 as those who had exclusively smoked cigarettes.
  • This study could provide evidence that dual users should be addressed as a high-risk group when tobacco policies for HTPs are considered.
Economic Hardships and Self-reported Deterioration of Physical and Mental Health Under the COVID-19 Pandemic: A Cross-sectional Study, 2020, Japan
  • During Apr-Sep 2020, COVID-19-related income loss, money shortage, and financial anxiety predicted deterioration of physical/mental health in Japan.
  • Regardless of whether pre-existing or newly induced, money shortage and financial anxiety were associated with adverse health outcomes.
  • Financial exploitation was associated with deterioration of physical/mental health only among non-working individuals.

Volume 32, Issue 3(March 2022)

Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants
  • Less than 60% of countries in the WHO European Region had nationwide legislation on e-cigarette use.
  • More European Union than non-European Union countries legislated e-cigarette use.
  • Countries had different number of places covered by e-cigarette use legislation, and education facilities were the most protected place by the legislation.
  • There was a moderate level of challenges for adopting e-cigarette use legislation.
  • Countries may need different assistance in dealing with the issues encountered while enacting and enforcing the e-cigarette use regulations.
Short Communication
Use and Awareness of Heated Tobacco Products in Europe
  • In our large pan-European cross-sectional study, heated tobacco products (HTPs) use was still limited in 2017-2018 among the general population.
  • However, dual use of HTPs with other tobacco products, their high use among younger generations and the interest of non-smokers are worrying.
  • These results indicate the need for close monitoring in terms of prevalence and user characteristics.
Short Communication
The Association Between Sleeping Pill Use and Metabolic Syndrome in an Apparently Healthy Population in Japan: JMS-II Cohort Study
  • Compared to non-users, sleeping pill users with a short sleep duration had a 3-fold higher risk of metabolic syndrome.
  • The frequency of sleeping pill use was positively associated with the prevalence of metabolic syndrome.
  • It also increased the risk of metabolic syndrome components such as obesity, hypertension, dyslipidemia, and glucose intolerance.
  • Attention must be paid to the metabolic status and atherosclerosis risk among sleeping pill users with a short sleep duration.

Volume 32, Issue 2(February 2022)

Review Article
Online Peer Support and Well-being of Mothers and Children: Systematic Scoping Review
  • Systematic scoping review was conducted to examine the effectiveness of online peer support groups on maternal and child well-being.
  • Our review on 21 studies revealed that mothers received informational and emotional support and felt a sense of connection and community.
  • Although some positive effects on mothers’ mental well-being were found, the effects of online-based peer support groups were inconclusive.
Maternal Baseline Characteristics and Perinatal Outcomes: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
  • The maternal baseline profile and perinatal data of participating mothers and infants of The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study were demonstrated.
  • The baseline maternal sociodemographic characteristics, results of prenatal screening tests, and obstetric outcomes were analyzed according to the maternal age group.
  • A total of 23,406 pregnancies involving 23,730 fetuses resulted in 23,143 live births.
  • The distribution of maternal baseline characteristics and the range of perinatal outcomes according to maternal age group were clearly demonstrated.
  • This cohort study can provide strategic information for creating breakthroughs in the developmental origins of health and diseases by collaborative data visiting or sharing.
Comparison of Disease Patterns and Outcomes Between Non-Japanese and Japanese Patients at a Single Tertiary Emergency Care Center in Japan
  • Our baseline data consisted of 19,420 patients requiring tertiary care or ICU or HCU admission to the ED at the Tokyo Medical and Dental University.
  • Among non-Japanese patients, there were more anaphylaxis, burn, and infectious disease diagnoses and less cardiovascular diagnoses compared to Japanese patients.
  • When compared with the Japanese patient sample, there were significantly more anaphylaxis diagnoses for the Caucasian and Hispanic group as well as the East Asian group, whereas the South/Southeast Asian and Middle Eastern group had significantly more burn and overdose diagnoses.
  • All non-Japanese anaphylaxis cases were food-induced, of which 71% were triggered by the Japanese traditional “soba” noodles, fish, or shellfish.
  • There were no notable patient care outcome differences between Japanese and non-Japanese in a tertiary emergency care setting.
Transmission Network of Measles During the Yamagata Outbreak in Japan, 2017
  • A 60-case measles outbreak occurred in Yamagata, Japan in 2017.
  • Analysis of temporal data allowed us to assess the reproduction number over generations.
  • Using a transmission network, variance in the number of secondary transmissions was shown to have declined over time.
  • High viral shedding from the throat was identified as a potential predictor of transmissibility.
Serologic Survey of IgG Against SARS-CoV-2 Among Hospital Visitors Without a History of SARS-CoV-2 Infection in Tokyo, 2020–2021
  • Serum of 23,234 visitors to Tokyo hospitals from September 2020 through March 2021 was tested for IgG antibodies against SARS-CoV-2.
  • The overall anti–SARS-CoV-2 IgG seroprevalence among all participants was 1.83% (95% CI, 1.66–2.01%).
  • After adjusting for population age and sex, the estimated seroprevalence in Tokyo in March 2021 was 3.40%.
  • The estimated number of people with a history of SARS-CoV-2 infection was 3.9-fold higher than the number of confirmed cases.

Volume 32, Issue 1 (January 2022)

Parental Working Hours and Children’s Sedentary Time: A Cross-sectional Analysis of the J-SHINE
  • Parental working conditions were associated with sedentary behavior of children.
  • Children with mothers who worked longer or fathers who did not work had prolonged sedentary time.
  • When limited to children whose fathers worked, there was no statistically significant association between children’s sedentary time and paternal working hours.
  • Supplementing the shortages in resources for childcare may be necessary among families with diverse parental working conditions.
Occupational and Non-occupational Injuries Can Result in Prolonged Augmentation of Psychiatric Disorders
  • Considerable effort has been devoted to reducing occupational injury globally. However, little is known about psychiatric consequences occurring after such injury, particularly measures for preventing such conditions.
  • We used a nationally representative cohort to determine the psychiatric consequences among workers with occupational injury, nonoccupational injury, and no injury. Compared with workers with no injury, workers with occupational injury had a higher risk of developing psychiatric disorders, similar to workers with nonoccupational injury.
  • In contrast to general belief, time did not attenuate these psychiatric conditions, even up to 10 years after injury.
Incidence of Mumps Deafness in Japan, 2005–2017: Analysis of Japanese Insurance Claims Database
  • Japanese health insurance claims data were used to estimate the incidence of mumps deafness reported during 2005–2017.
  • The overall incidence of mumps deafness per 10,000 mumps cases was 15.0.
  • The incidence was 8.4 times higher in 16–64-year-olds than in 0–15-year-olds and 7.2 times higher in 6–15-year-olds than in 0–5-year-olds.
  • Peak age at onset was 6–15 years, followed by 26–35 years, indicating that these two age groups are at highest risk for developing mumps deafness.
Impact of the Clinical Trials Act on Noncommercial Clinical Research in Japan: An Interrupted Time-series Analysis
  • This study is the first to verify Japan’s Clinical Trials Act’s (CTA) impact on number of clinical studies using interrupted time-series analysis.
  • Trends and levels of the monthly numbers of new clinical studies decreased significantly during one year following the CTA implementation.
  • In the analysis using the multigroup ITSA, the trend decreased especially for the studies with smaller sample sizes, interventional designs, and nonprofit funding sponsors.
  • Establishing a new system to promote clinical studies in Japan, while ensuring research transparency and safety, is vital.
A Nationwide Epidemiological Survey of Adolescent Patients With Diverse Symptoms Similar to Those Following Human Papillomavirus Vaccination: Background Prevalence and Incidence for Considering Vaccine Safety in Japan
  • We aimed to estimate prevalence and incidence of severe diverse symptoms among Japanese adolescents without a history of human papillomavirus (HPV) vaccination.
  • A descriptive nationwide epidemiological survey was conducted in Japan in 2016, covering a 6-month target period from July to December, 2015.
  • The 6-month period prevalence and annual incidence among girls aged 12–18 years without HPV vaccination was 20.2 and 7.3 per 100,000, respectively.
  • Adolescent Japanese girls without HPV vaccination also visited hospitals with diverse symptoms similar to those of girls following HPV vaccination.
  • Our findings predict the medical demands for coincident diverse symptoms, which are temporally associated with but not caused by HPV vaccination of Japanese adolescents.
Study Profile
Study Design and Baseline Profiles of Participants in the Tianjin Birth Cohort (TJBC) in China Study Profile
  • The Tianjin Birth Cohort Study (TJBC) is a large-scale prospective cohort in northern China, aiming to explore the link between early-life exposures and health consequences.
  • Pregnant women and their spouses are recruited at early pregnancy, and followed at mid-pregnancy, late pregnancy, delivery, 42 days after delivery, 6 months after delivery, and each year until 6 year-old.
  • A diverse range of biological samples are periodically collected including blood, urine, faeces, placental tissues, products of conception and breastmilk.