Highlights
Volume 35, Issue 1-5 (2025)
Issue 5 (May 2025)
Issue 4 (April 2025)
Issue 3 (March 2025)
Issue 2 (February 2025)
Issue 1 (January 2025)
Volume 35, Issue 5 (May 2025)
Review Article
Patterns of Use of Heated Tobacco Products: A Comprehensive Systematic Review
Patterns of Use of Heated Tobacco Products: A Comprehensive Systematic Review
- The prevalence of heated tobacco product (HTP) use highly increased over the last decade in specific countries among teenagers and adults.
- Knowing the patterns of HTP use could put an end to the tobacco industry-led debate about the effectiveness of this product as a harm reduction tool.
- More than two out of three HTP users were dual users.
- HTP users were more likely to start conventional cigarette smoking, while current cigarette smokers using HTPs were less likely to quit.
- The results of our review strongly suggest the need for stricter legislation on HTPs.
- Few studies have estimated the recent prevalence of multiple tobacco product (MTP) use since heated tobacco products (HTPs) became widely available in Japan.
- We used an internet survey of 30,141 participants (mean age 47.8 years, 48.8% male) for the analysis.
- Using the weighted scores obtained from the internet survey and government statistics, the prevalence of MTP use in Japan in 2022 was 6.8%.
- Compared to non-smokers, being an MTP user was associated with being younger, male, and having low education, and poor self-rated health.
- Smokers who used both cigarettes and HTPs at home had a higher prevalence of MTP use than those who were prohibited from smoking at home.
The incidence of maternal liver dysfunction in early pregnancy is increasing and its impact on spontaneous pregnancy loss (SPL) is unknown.
This is the first study to find that abnormal liver function in early pregnancy is associated with a 49% increased risk of SPL.
Primary health care institutions may need to be aware of the serious implications caused by abnormal liver function and offer appropriate preconception counselling.
This study evaluated the support project for administering the 23-valent Pneumococcal Polysaccharide Vaccine (PPSV23) to the elderly in a super-aged town in Japan, conducted from 2010 to 2015.
A 5-year follow-up showed an incidence of 20.3 pneumonia cases per 1,000 person-years among vaccinated residents aged 65 or older.
The interrupted time series analysis demonstrated a 25% reduction in pneumonia mortality following the introduction of the pneumococcal vaccination support project. This shift was observed as a change in mortality from a pre-project annual increase of 0.23 to a post-project annual decrease of 0.04 per 1,000 population.
Short Communication
News Coverage of Older Drivers’ Fatal Car Crashes: Is It Over-represented?
- In Japan, older drivers are often considered unsafe despite having lower crash rates than young drivers.
- Public perceptions of older drivers may be influenced by media coverage of their crashes.
- Older drivers’ at-fault fatal crashes were not disproportionally represented in news coverage of overall fatal crashes.
- Older drivers’ at-fault crashes involving child fatalities were more often reported, whereas their single fatal crashes were less often reported.
Volume 35, Issue 4 (April 2025)
Special Article
- This tutorial paper summarizes when and how to split the follow-up time in the analysis of epidemiological or clinical studies with follow-ups.
- Typical situations to split the follow-up time include estimating the outcome incidence rate (ratio) according to specific follow-up time periods.
- The proportional hazards assumption in Cox models can also be assessed by splitting the follow-up time.
- This tutorial also covers the situations to deal with time-varying exposures and confounders, as well as self-controlled case series analysis.
- By splitting the follow-up time, the “wide-format” type data is transformed into the “long-format” type data.
- This study investigated body mass index (BMI), height, and incidence of head and neck cancer (HNC) among a Japanese population.
- Both lower and higher BMI was significantly associated with HNC, and this U-shaped association was also observed among never smokers.
- No statistically significant associations were observed between height and HNC risk.
Associations of Parental Education With Children’s Infectious Diseases and Their Mediating Factors: The Japan Environment and Children’s Study (JECS)
- For varicella, mumps, and influenza, the higher fathers’ education level, the lower the infection incidence in children up to 3 years of age.
- Higher vaccination rates and income, and lower rates of daycare attendance and household smoking mediated this association.
- Mothers’ education level was less associated with lower infection rates in children compared to fathers’ education level due to higher rates of daycare attendance.
- Both income-mediated and non-income-mediated effects were found in the relationship between parental education and child voluntary vaccination.
- The infection rates for diseases covered by routine immunizations were low and not associated with parental education.
- The cessation of caregiving relieved caregivers’ psychological distress.
- More benefits exist for female caregivers than for male caregivers.
- The unfavorable impact of co-residence with a care-receiving parent diminished quickly.
- The impact of long-hour daily care, extended duration, and lack of social activity persisted.
- In 7 years, we followed up on more than 30,000 Shanghai residents in China.
- We observed the astonishingly high prevalence of 36.8% of metabolic dysfunction-associated steatotic liver disease (MASLD) at baseline.
- A high incidence rate of 8.4/100 person-years and active recovery of 11.4/100 person-years were observed.
- Weight loss and serum lipid reduction were helpful in both preventing and reversing MASLD.
Short Communication
Comparison of Demographic and Clinical Characteristics of Taiwan Biobank Participants With Nonparticipants
- Taiwan Biobank cohort exhibits disparities in sociodemographic and health-related attributes compared to the general population.
- Taiwan Biobank participants exhibited higher mortality rates yet lower cancer incidence.
- Despite limitations in representativeness, the Taiwan Biobank's size and exposure measures offer valuable insights into associations between exposures and health conditions.
Volume 35, Issue 3 (March 2025)
- Cohort studies in the Tohoku Medical Megabank Project used a self-administered food frequency questionnaire (TMM-FFQ) for adults.
- The percentages of participants who chose the “constitutionally unable to eat/drink it” TMM-FFQ option were non-negligible for some food groups.
- Comparison of food group intakes derived from the TMM-FFQ and those from food records showed that the TMM-FFQ has reasonable validity.
- The TMM-FFQ with the “constitutionally unable to eat/drink it” option showed reasonable reproducibility for food group intakes.
- The TMM-FFQ with the “constitutionally unable to eat/drink it” option seems suitable for use in the TMM cohort studies.
- All-cause mortality risk was not increased after a partner’s cancer diagnosis among men and women.
- Suicide risk significantly increased after a partner’s cancer diagnosis among men, and it persisted for more than 5 years.
- All-cause, cardiovascular disease (CVD), respiratory disease (RD) and externally-caused mortality risks increased after a partner’s death among men, but not among women.
- CVD and RD mortality risks after a partner’s death among men differed by smoking status. They increased among smokers, but not among never-smokers.
- Low bB reast cancer (BC) examination rates (9/1,000) and cervical cancer (CC) tests rates (20/1,000) are very low in India.
- Rural women experience greater socioeconomic inequality in BC and CC testing than urban peers.
- Highest uptake is observed in the Southern India, with lower rates in Eastern and Northern regions.
- Education-driven inequalities in BC and CC testing are evident across all regions.
- Determinants include: Higher education, socioeconomic status, overweight, community education, and South/urban residence.
Short Communication
Validation of Self-reported Medical Condition in the Taiwan Biobank
- The concordance between self-reports in the Taiwan Biobank and the claims records generally showed moderate agreement for most clinical diagnoses.
- The concordance was higher among those with higher education attainment and lower among married individuals.
- Integrating complementary databases from the claims database can enhance accuracy through customized algorithms.
Statistical Data
Non-cancer-related Deaths in Cancer Survivors: A Nationwide Population-based Study in Japan
- Non-cancer-related disease death increased over time, from 10.2% at 6 months to 31.6% at 4 years post-diagnosis.
- Heart disease, cerebrovascular disease, and pneumonia were the leading causes of non-cancer-related mortality.
- The suicide mortality risk lost significance in males and females 2- and 2.5-years post-diagnosis, respectively.
- Non-cancer deaths among cancer patients increased over time, emphasizing the need for managing comorbidities.
Statistical Data
Changes in Mortality During the COVID-19 Pandemic in Japan: Descriptive Analysis of National Health Statistics up to 2022
- In Japan, the annual all-cause age-standardized mortality rate increased 6.0% for men and 6.5% for women, respectively, and increased in all prefectures between 2021 and 2022.
- Primary contributors to the increase in annual all-cause age-standardized mortality rates included coronavirus disease 2019 (COVID-19) COVID-19, senility, heart disease, malignant neoplasms (for women).
- The leading contributors to the increase in 2022 were COVID-19 (+29.1 per 100,000 people for men and +13.4 per 100,000 people for women) and senility (+14.1 per 100,000 people for men and +12.5 per 100,000 people for women).
- Continuous monitoring of the long-term effects of COVID-19 on public health and the healthcare system is necessary.
Volume 35, Issue 2 (February 2025)
Review Article
- This systematic review aimed to determine seasonal variations in dietary intake in Japanese adults.
- The reported seasonal variations were inconsistent across studies for most nutrients and food groups.
- Meta-analyses showed significant seasonal differences in mean intakes of vegetables, fruits, and potatoes in five out of six comparisons.
- Most of the differences in mean intakes between seasons were attributed to the heterogeneity of the included studies, not just seasonal variations.
- At-risk drinking prevalence in Italy: 26.4% pre-lockdown, 23.4% during, stabilized at 30.0% post-lockdown.
- Findings indicate unfavorable post-pandemic alcohol trends, emphasizing specific groups at increased risk.
- Economic status linked to at-risk consumption, with a significant downward trend.
- Higher rates of at-risk drinking were observed among younger individuals, women with higher economic status and married individuals.
- Higher vulnerability was observed among those with anxiety/depressive symptoms, psychotropic drug users, and tobacco consumers.
- To date, a simple assessment tool to evaluate early low nutrition risk in the general older population has not been available.
- In this study, we developed such an indicator consisting of 13 items with four factors through a rigorous scale development process.
- This indicator showed good internal reliability and criterion-related validity, indicating a potential to evaluate early low nutrition risk.
- We determined the influence of cumulative maternal physical activity during the pre-pregnancy to child-rearing period on children’s physical activity in early childhood in a Japanese population.
- We also compared the influence of maternal physical activity of each stage on children’s physical activity in early childhood.
- The level of cumulative maternal physical activity was positively associated with the level of children’s physical activity at 5.5 years of age.
- Maternal physical activity during pregnancy and at 5.5 years postpartum was positively associated with children’s physical activity at 5.5 years of age.
- Japan exhibits significantly lower mortality from chronic obstructive pulmonary disease (COPD) than the United States, despite much higher smoking rates among Japanese men.
- We conducted a systemic review and meta-analysis of COPD prevalence in Japan and compared the prevalence in the United States .
- COPD prevalence is consistently over 10% lower in Japan than in the United States across different age groups and sexes.
- Investigating the factors behind Japan's lower COPD burden could inform more effective prevention strategies globally.
- We performed an ecological study to clarify regional disparities in measles vaccination coverage and their associated factors in Japan.
- Data on measles vaccination coverage and potential associated factors for each municipality were obtained from official statistics of Japan.
- Among the municipalities, 54.3% had less than 95.0% measles vaccination coverage.
- Negative binomial regression showed that measles vaccination coverage was positively associated with population density.
- It also showed that measles vaccination coverage was negatively associated with single-father households, mother’s age, and area deprivation index.
Volume 35, Issue 1 (January 2025)
Special Article
- Identifying a sufficient set of confounders is crucial for estimating the causal effect of exposure on outcome.
- We summarize approaches to identifying a sufficient set of confounders from both epidemiological and statistical perspectives.
- We also describe some pitfalls and considerations in confounder selection.
- E-value and robustness value are introduced as approaches to assess the sensitivity to unmeasured confounders.
- Integrating these principles and approaches will enhance our understanding of confounder selection in future epidemiological studies.
- A comprehensive side-by-side comparison of different instrumental variable (IV) methods in binary outcome and continuous exposures with many IVs was performed.
- The findings indicated that the bias associated with these methods could not be fully addressed.
- The use of multiple IV methods (e.g., one method for primary analysis and another for sensitivity analysis) may be helpful.
- We employ disease-mediating mortality separating disease-specific mortality into disease (the mediator) and mortality (the outcome) to characterize the natural course of hepatitis C virus (HCV).
- We identified three liver diseases (eg, liver cirrhosis, liver cancer) and nine non-liver diseases (eg, septicemia, renal diseases, endocrine diseases, hypertension) that mediate HCV-induced mortality and provide the proportion of mediation to reflect their relative contributions.
- For developing countries with limited access to direct-acting antiviral agents, our study may guide health policies in screening for particular diseases (except liver diseases) to reduce the preventable deaths of the HCV-infected population.
- The association between income and colorectal cancer (CRC) risk varies across countries.
- The role of income dynamics in CRC risk is unknown in individuals with type 2 diabetes mellitus (T2DM) who are at increased risk of colorectal cancer.
- Individuals with T2DM who had persistent low-income status over 5 years or experienced income declines had an elevated CRC risk.
- In contrast, constant high income over 5 years was associated with reduced risk of colorectal cancer.
- This study investigated the association between the patterns of various metabolites and cognitive decline in Japanese community-dwelling older adults.
- Amino acids were protectively associated with cognitive decline, whereas ketone metabolites were associated with higher odds of cognitive decline.
- Metabolome monitoring can be useful for predicting and preventing future cognitive decline.
- We compared self-reported participation in cancer screenings and health checkups with municipality records.
- Self-reported participation in colorectal, stomach, breast, and cervical cancer screenings was moderately valid.
- Self-reported participation in lung cancer screening was underreported and participation in health checkup was overreported.
- Self-reported screening participation should be carefully interpreted to assess the performance of preventive measures.
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