Faculty Profiles - TAKAO Soshi

Papers - TAKAO Soshi

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Non-woven Masks and SARS-CoV-2 Infection in a Cluster Setting in Japan

Yukari Takahashi, Soshi Takao, Tomoka Kadowaki, Naomi Matsumoto, Takashi Yorifuji

Japanese Journal of Infectious Diseases 78 ( 2 ) 110 - 113 2025.3

Association Between Dinner-to-Bed Time and Gastroesophageal Reflux-Related Diseases in Children. International journal

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Cureus 17 ( 1 ) e77709 2025.1

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: Gastroesophageal reflux disease (GERD) is characterized by esophageal mucosal injury due to the reflux of gastroduodenal contents. Typical symptoms include heartburn and acid regurgitation. In addition, gastroesophageal reflux (GER) can influence conditions such as otitis media, rhinitis, and asthma. This study aimed to examine the association between dinner-to-bed time and GER-related diseases, such as otitis media, allergic rhinitis, and asthma. METHODS: This was a longitudinal cohort study using secondary data. Data were collected from a large-scale birth cohort study conducted in Japan including babies born in 2001 and 2010. Dinner-to-bed time was categorized as "longer dinner-to-bed time" (>120 minutes), "shorter dinner-to-bed time" (≤120 minutes or less), and "irregular dinner-to-bed time." Modified Poisson regression with robust variance was used to estimate risk ratios (RRs). RESULTS: A total of 60,392 children were included in this study. Children with shorter dinner-to-bed time had a higher risk of asthma (adjusted RR (aRR) = 1.10; 95% confidence interval (CI), 1.03-1.18) than those with longer dinner-to-bed time. However, no significant association was observed between shorter dinner-to-bed time and otitis media or allergic rhinitis. Furthermore, supplementary analyses revealed that the risk of asthma was significantly higher in children born in 2001 (aRR = 1.13; 95% CI, 1.04-1.22). CONCLUSION: This study showed that dinner-to-bed time within 120 minutes after dinner increases the risk of developing asthma. This underscores the importance of considering lifestyle modifications, as certain pediatric asthma cases may be influenced by behaviors that promote GER.

DOI： 10.7759/cureus.77709

Area Deprivation and Health Outcomes in Preschool Children in Japan: A Nationwide Cohort Study

Naomi Matsumoto, Etsuji Suzuki, Soshi Takao, Tomoki Nakaya, Ichiro Kawachi, Takashi Yorifuji

Journal of Epidemiology 2025

Impact of high blood pressure on the risk of mortality among Japanese people aged 65 years and older.

Shinsuke Akagi, Soshi Takao, Rumi Matsuo, Naomi Matsumoto, Takashi Yorifuji

Geriatrics & gerontology international 2024.12

Language：English Publishing type：Research paper (scientific journal)

AIM: The purpose of this study is to investigate the impact of abnormal blood pressure on the risk of all-cause and cardiovascular mortality in a large cohort of older Japanese people aged ≥65 years. METHODS: This cohort study enrolled 54 760 participants from Okayama City aged ≥65 years who underwent basic health checkups from April 2006 to March 2008. Based on blood pressure, the participants were divided into six categories, from C1 (lowest) to C6 (highest). To assess the association of blood pressure with all-cause and cardiovascular mortality, we used survival analysis to estimate hazard ratios (HRs) for all-cause mortality and subdistribution HRs (SHRs) for cardiovascular mortality on C3. We then repeated the analyses based on age groups (65-74 years, 75-84 years, and ≥85 years). RESULTS: The fully adjusted HRs for all-cause mortality, which included all individual potential confounders, were 1.11 (95% confidence interval [CI]: 1.04-1.19) for C5 and 1.23 (95% CI: 1.09-1.38) for C6, respectively. The fully adjusted SHRs for cardiovascular mortality were 1.11 (95% CI: 1.01-1.21) for C4, 1.19 (95% CI: 1.05-1.34) for C5, and 1.36 (95% CI: 1.09-1.70) for C6. In the age-stratification, an increased risk of hypotension was observed with older age. The HR for C1 was 1.28 (95% CI: 1.16-1.41) for ≥85 years. CONCLUSIONS: Hypertension increased the risk of all-cause and cardiovascular mortality among those aged 65-74 and 75-84 years, but not among those aged ≥85 years. Geriatr Gerontol Int 2024; ••: ••-••.

DOI： 10.1111/ggi.15046

Outdoor playing during preschool was associated with a reduced risk of school‐age obesity in Japan

Takahiro Tsuge, Naomi Matsumoto, Soshi Takao, Takashi Yorifuji

Acta Paediatrica 2024.10

Publishing type：Research paper (scientific journal) Publisher：Wiley

Abstract

Aim

This study investigated the association between outdoor play habits during preschool and school‐age obesity.

Methods

We conducted a longitudinal cohort study of all children born in Japan during 2 weeks in January and July 2001. We defined outdoor play habits at age 2.5 years (third survey) as exposure, while parent‐reported height and weight at age 7 years (seventh survey) were defined as overweight and obesity status using the WHO reference. Logistic regression models were used to estimate odds ratios (ORs) for associations between preschool outdoor play habits and school‐age obesity, adjusting for parental and child factors.

Results

Of 53 575 children born, 42 812 had data on outdoor play habits at age 2.5 years, with 91% (38 970) having such habits. At age 7 years, 31 743/42 812 (74%) children had height and weight data, with 3249/31 743 (10%) classified as overweight or obesity (BMI SD score ≥1.0). Outdoor play habits were negatively associated with obesity (adjusted OR 0.85, 95% confidence interval (CI): 0.74–0.97).

Conclusion

Outdoor play habits in early preschool years are associated with a reduced risk of school‐age obesity. Parents and caregivers may consider encouraging their children to outdoor play habits at an early age to help prevent obesity later in life.

DOI： 10.1111/apa.17441

Small-for-Gestational-Age Status and the Risk of Kawasaki Disease: A Nationwide Birth Cohort in Japan.

Satoe Takanaga, Naomi Matsumoto, Tomoka Kadowaki, Soshi Takao, Takashi Yorifuji

Acta medica Okayama 78 ( 5 ) 363 - 370 2024.10

Language：English Publishing type：Research paper (scientific journal)

Kawasaki disease (KD) is a pediatric disease of unknown etiology that commonly affects infants in East Asia. Infants born small for gestational age (SGA) have weaker immune systems and are more susceptible to infection. Using data from a nationwide Japanese birth cohort study conducted in 2010 (n=34,579), we investigated whether SGA increases the risk of KD. SGA was defined as birth weight below the 10th percentile for gestational age. The outcome was hospitalization for KD between 6 and 30 months of age. The association between SGA and hospitalization for KD, adjusted for child and maternal factors, was examined using logistic regression. Of the 231 children hospitalized for KD, 9.5% were SGA. Further statistical analysis showed that SGA did not increase the odds ratio (OR) of hospitalization for KD (adjusted OR 1.12, 95% confidence interval 0.71-1.75). This result was not changed with stratification by early daycare attendance and preterm status. Reasons for the lack of association may include the multifactorial pathogenesis of KD; in addition, the types of infections to which SGA infants are predisposed may differ from those triggering KD. Overall, our large nationwide study found no association between SGA and KD.

DOI： 10.18926/AMO/67656

Kinetics of SARS-CoV-2 antibody titers after booster vaccinations during an Omicron surge in Japan

Naomi Matsumoto, Ayako Sasaki, Tomoka Kadowaki, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Vaccine 42 ( 21 ) 126156 - 126156 2024.8

Emergency Dispatches for Suicide Attempts during the COVID-19 Pandemic in Okayama, Japan: An Interrupted Time-series Analysis.

Yuka Yamamura, Naomi Matsumoto, Soshi Takao, Takashi Yorifuji

JMA journal 7 ( 3 ) 418 - 422 2024.7

Pediatric otitis media in Japan: A nationwide longitudinal study of the pre- and post-pneumococcal conjugate vaccine eras born in 2001 and 2010. International journal

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Vaccine 2024.5

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Otitis media (OM) is a prevalent respiratory disease in children and poses significant public health challenges due to its impact on child health and economic burdens. However, there have no nationwide epidemiological studies conducted in Japan. This study investigates the epidemiological trends of OM in Japan, taking into account the impact of the 7-valent pneumococcal conjugate vaccine (PCV7) introduction. METHOD: This study was retrospective cohort study using secondary data on the nationwide longitudinal birth cohort. This survey followed two cohorts born in 2001 (pre-PCV era) and 2010 (post-PCV era) until the age of 9. Every year, parents were surveyed about their children's health status, including occurrences of OM. The annual period prevalence and cumulative incidence of OM were assessed in this study, and the two cohorts were compared using a modified Poisson regression model adjusted environmental factors with the 2001 cohort as reference. RESULT: The study included 47,015 children from the 2001 cohort and 38,554 from the 2010 cohort. Peak annual period prevalence of OM varied by era. Cumulative incidence was 13.8 % for the 2001 cohort and 18.5 % for the 2010 cohort by 1.5 years of age and 28.9 % and 33.3 %, respectively, by 3.5 years of age. In particular, from the fourth survey onward, covering ages 2.5-3.5 years, a shift was observed from an increased risk to a decreased risk of OM. CONCLUSION: This nationwide longitudinal study emphasizes variations in OM epidemiology across Japan over time, with changes potentially influenced by the introduction of PCV7. In this study, due to the absence of individual PCV7 vaccination data, the effect of PCV7 was estimated based on the vaccination rate at the population level. The results suggest a notable decrease in the incidence of OM in later years, aligning with the increased uptake of PCV7.

DOI： 10.1016/j.vaccine.2024.05.020

Effect of COVID-19 Infection on Presenteeism: Cohort Study Using Large Health Insurance-Based Data in Japan. International journal

Chikara Miyaji, Tomoko Kobayashi, Hiroshi Habu, Akikazu Hagiyama, Yoshiharu Horie, Soshi Takao

Journal of occupational and environmental medicine 2024.4

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Presenteeism occurs when employees attend work despite experiencing problems and ill-health that require sick leave. This study examined whether presenteeism worsened following COVID-19 infection. METHODS: We used the DeSC, a large health insurance claims database. Participants were 9,241 individuals who responded to questionnaires at baseline (June 2020) and 6 months later, had been continuously insured for at least 6 months prior to baseline, and reported being employed. Propensity score matching was performed. Adjusted multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of worsening presenteeism from baseline according to COVID-19 infection compared with non-infection. RESULTS: Conditional logistic regression analysis showed that the adjusted OR for presenteeism in the COVID-19 infected group was 1.555 (95% CI, 1.086-2.225). CONCLUSION: The findings suggest that COVID-19 infection affected worsening of presenteeism.

DOI： 10.1097/JOM.0000000000003128

Antibody titers and the risk of infection during the SARS-CoV-2 Omicron phase in Bizen City, Japan. International journal

Tomoka Kadowaki, Ayako Sasaki, Naomi Matsumoto, Toshiharu Mitsuhashi, Hideharu Hagiya, Soshi Takao, Takashi Yorifuji

The Journal of infectious diseases 2024.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Understanding the association between the immune response and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has implications for forthcoming prevention strategies. We evaluated the association between antibody titers and the risk of infection for the general population during the Omicron-dominant phase. METHODS: This was a prospective cohort study of residents or people affiliated with institutions in Bizen City, which included 1,899 participants. We measured the titers of antibodies against SARS-CoV-2 repeatedly every 2 months from June 2022 to March 2023. Infection status was obtained from self-reported questionnaires and the official registry. We estimated risk ratios (RRs) for infection within 2 months of the date of each antibody measurement with 95% confidence intervals (CIs) based on antibody titer categories and spline functions. RESULTS: Compared with the <2,500 arbitrary unit (AU)/mL category, the 2,500-5,000, 5,000-10,000, and ≥10,000 AU/mL categories had adjusted RRs (95% CI) of 0.81 (0.61-1.08), 0.51 (0.36-0.72), and 0.41 (0.31-0.54), respectively. The spline function showed a non-linear relationship between antibody titer and risk. CONCLUSIONS: Higher antibody titers were associated with a lower risk. We demonstrate the usefulness of measuring an antibody titers to determine the appropriate timing for future vaccination.

DOI： 10.1093/infdis/jiae207

Longitudinal antibody dynamics after COVID-19 vaccine boosters based on prior infection status and booster doses

Naomi Matsumoto, Ayako Sasaki, Tomoka Kadowaki, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Scientific Reports 14 ( 1 ) 2024.2

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Global concern over COVID-19 vaccine distribution disparities highlights the need for strategic booster shots. We explored longitudinal antibody responses post-booster during the Omicron wave in a Japanese cohort, emphasizing prior infection and booster doses. This prospective cohort study included 1763 participants aged 18 years and older with at least three vaccine doses (7376 datapoints). Antibody levels were measured every 2 months. We modeled temporal declines in antibody levels after COVID-19 vaccine boosters according to prior infection status and booster doses using a Bayesian linear mixed-effects interval-censored model, considering age, sex, underlying conditions, and lifestyle. Prior infection enhanced post-booster immunity (posterior median 0.346, 95% credible interval [CrI] 0.335–0.355), maintaining antibody levels (posterior median 0.021; 95% CrI 0.019–0.023) over 1 year, in contrast to uninfected individuals whose levels had waned by 8 months post-vaccination. Each additional booster was correlated with higher baseline antibody levels and slower declines, comparing after the third dose. Female sex, older age, immunosuppressive status, and smoking history were associated with lower baseline post-vaccination antibodies, but not associated with decline rates except for older age in the main model. Prior infection status and tailored, efficient, personalized booster strategies are crucial, considering sex, age, health conditions, and lifestyle.

DOI： 10.1038/s41598-024-55245-9

Other Link： https://www.nature.com/articles/s41598-024-55245-9

Impact of COVID-19 Infection on Health-Related Quality of Life in the Japanese Population: A Large Health-Insurance-Based Database Study Reviewed International journal

Tomoko Kobayashi, Chikara Miyaji, Hiroshi Habu, Yoshiharu Horie, Soshi Takao

International Journal of Environmental Research and Public Health 2024.2

Longitudinal changes in antibody titers in a nursing home in which COVID-19 clusters occurred

Tomoka Kadowaki, Ayako Sasaki, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

American Journal of Infection Control 2024.2

Significance of Continuous Low-Dose Lenvatinib for the Treating of the Patients with Unresectable Thyroid Carcinoma.

Daizo Murakami, Kohei Nishimoto, Soshi Takao, Satoru Miyamaru, Tomoka Kadowaki, Haruki Saito, Hiroki Takeda, Momoko Ise, Koichi Suyama, Yorihisa Orita

Acta medica Okayama 78 ( 1 ) 63 - 70 2024.2

Language：English Publishing type：Research paper (scientific journal)

The tyrosine kinase inhibitor lenvatinib has been confirmed as an effective treatment option for patients with unresectable thyroid carcinoma. We conducted a retrospective analysis of the significance of the effect of continued lenvatinib treatment for the longest duration possible at a reasonable daily dose and with a minimum discontinuation period in 42 patients with unresectable thyroid carcinoma treated with lenvatinib between 2015 and 2020. A Cox proportional hazard model-based analysis revealed that the overall survival of the patients treated with a <8 mg/day mean dose of lenvatinib was significantly better than that of the patients treated with 8-24 mg/day (hazard ratio [HR] 0.38 for 1.14-4.54 mg/day, and HR 0.01 for 4.56-7.97 mg/day) adjusted for various factors (e.g., sex, age, drug interruption period). The cumulative dose of lenvatinib administered tended to be higher in the patients treated with low doses (< 8 mg/day) than in the patients treated with relatively high doses (8-24 mg/day). Considering its adverse events, the continuation of lenvatinib treatment with an adequate daily dose and drug interruption may help prolong the survival of patients with unresectable thyroid carcinoma.

DOI： 10.18926/AMO/66672

Antibody levels and the risk of SARS-CoV-2 infection during the Omicron surge

Ayako Sasaki, Tomoka Kadowaki, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

GHM Open 2024

Association Between Clinical Remission of Infantile-Onset Allergic Rhinitis During the School-Age Period and the Type of Housing: A Longitudinal Population-Based Japanese Study. International journal

Kensuke Uraguchi, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 2023.12

Language：English Publishing type：Research paper (scientific journal)

This study investigated the association between housing type and clinical remission of infantile-onset allergic rhinitis (AR) in 53,575 children born in 2001 in Japan. Infantile-onset AR was defined as the presence of AR symptoms reported between ages 1.5 and 4.5 years, and remission was assessed between ages 10 and 12. The type of housing was categorized into detached houses and multi-unit residential buildings with 1-2, 3-5, or ≥6 floors. Among the 4,352 infantile-onset AR, 42.9% experienced remission. Notably, living in multi-unit residential buildings, particularly those with 1-2 and ≥6 floors, was positively associated with AR remission.

DOI： 10.1016/j.pedhc.2023.11.011

Review of a Series of Surveys on Adverse Reactions to the COVID-19 mRNA-1273 Vaccine at Okayama University.

Naomi Matsumoto, Chigusa Higuchi, Chikara Miyaji, Toshiharu Mitsuhashi, Hideharu Hagiya, Soshi Takao, Takashi Yorifuji

Acta medica Okayama 77 ( 6 ) 567 - 575 2023.12

Language：English Publishing type：Research paper (scientific journal)

This paper presents the results of a series of surveys conducted from July 2021 to March 2023 to investigate the post-vaccination adverse reactions to the mRNA-1273 (Moderna) vaccine among faculty, staff, and students at Okayama University. These studies complement the official surveys conducted by the Ministry of Health, Labour and Welfare (MHLW) and provide a more representative picture of adverse reactions in the general population including large numbers of healthy young people. Pain, swelling, redness at the injection site, fever, headache, and malaise were the main adverse reactions reported. The proportion of adverse reactions was generally higher after the second vaccination and decreased with each additional vaccination. No statistically significant differences in the adverse reactions were found for males and females and those with/without a history of allergy, but a lower proportion of fever was observed in older participants and those with underlying medical conditions. We also evaluated the association between adverse reactions and antibody titers after the third vaccination and found no significant differences in antibody levels one month after vaccination. This series of studies highlights the importance of conducting surveys in diverse populations to provide a more representative picture of post-vaccination adverse reactions during a pandemic.

DOI： 10.18926/AMO/66148

Fine particulate matter and diabetes prevalence in Okayama, Japan Reviewed International journal

Tani Y, Kashima S, Mitsuhashi T, Suzuki E, Takao S, Yorifuji T

Acta Medica Okayama 77 ( 6 ) 607 - 612 2023.12

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Many studies have shown an association between long-term exposure to particulate matter having an aerodynamic diameter of 2.5 μm or less (PM2.5) and diabetes mellitus (DM), but few studies have focused on Asian subjects. We thus examined the association between long-term exposure to PM2.5 and DM prevalence in Okayama City, Japan. We included 76,591 participants who had received basic health checkups in 2006 and 2007. We assigned the census-level modeled PM2.5 data from 2006 and 2007 to each participant and defined DM using treatment status and the blood testing. PM2.5 was associated with DM prevalence, and the prevalence ratio (95% confidence interval) was 1.10 (1.00-1.20) following each interquartile range increase (2.1 μg/m3) in PM2.5. This finding is consistent with previous results and suggests that long-term exposure to PM2.5 is associated with an increased prevalence of DM in Okayama City, Japan, where the PM2.5 level is lower than in other cities in Asian countries.

DOI： 10.18926/AMO/66152

Effectiveness of the Original COVID-19 Vaccine against COVID-19 Exacerbations during the Omicron Wave: A Population-based Study in Okayama, Japan.

Naomi Matsumoto, Toshiharu Mitsuhashi, Rumi Matsuo, Tomoka Kadowaki, Soshi Takao, Takashi Yorifuji

JMA journal 6 ( 4 ) 463 - 469 2023.10

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: In Japan, approximately 97 million individuals have received their primary two doses of coronavirus disease 2019 (COVID-19) vaccine at the end of 2022. In this study, we aim to examine the effectiveness of the primary vaccines and compare its efficacy to booster vaccine shots in terms of preventing COVID-19 exacerbations during the Omicron-predominant period in Japan. METHODS: For this analysis, we have collected all the confirmed COVID-19-positive cases from different medical institutions in Okayama City and have also utilized the information from the public Vaccination Record System. Taking the number of vaccinations into consideration, we then conducted a population-based study to assess the effectiveness of the two primary vaccine doses in preventing COVID-19 exacerbations during the Omicron waves. Our primary and secondary outcomes were COVID-19 exacerbations with respiratory failure (i.e., oxygen saturation on room air ≤ 93%, requiring supplemental oxygen), intensive care unit admission and/or mechanical ventilator requirement, or death, in accordance with the Japanese COVID-19 guidelines, and pneumonia during the course of COVID-19 infection, respectively. RESULTS: In total, 95,329 COVID-19-positive individuals, aged 5 years and above, were included in this analysis (study period from January 1 to September 10, 2022). As per our findings, the effectiveness of the primary two doses against COVID-19 exacerbations compared with those who had never been vaccinated was 55.5% (95% confidential interval [CI]: 32.6-71.7), whereas it was higher after the third dose (76.9%; 95% CI: 66.7-84.0) and the fourth dose (75.7%; 95% CI: 58.8-85.7). Effectiveness was sustained for ≥ 5 months after the third vaccination, and preventive effectiveness was observed in individuals aged ≥ 65 years. CONCLUSIONS: As per the results of this study, we can conclude that the efficacy of the primary two doses of SARS-CoV-2 vaccine can be further strengthened in terms of preventing COVID-19 exacerbations by administering third and fourth booster vaccine shots. The additional bivalent vaccine is anticipated to further increase its efficacy against the Omicron strain, suggesting that individuals who have not received their booster shots yet should consider getting them to prevent COVID-19 exacerbations.

DOI： 10.31662/jmaj.2023-0019

Effectiveness of the original COVID-19 vaccine in preventing COVID-19 exacerbations during the Omicron wave: A population-based study in Okayama, Japan. Reviewed

Matsumoto N, Mitsuhashi T, Matsuo R, Kadowaki T, Takao S, Yorifuji T

JMA J. 6 ( 4 ) 463 - 46 2023.10

Childcare and Child Development in Japan. Reviewed

Murata A, Matsumoto N, Miyaji C, Takao S, Yorifuji T

Acta Med Okayama. 77 ( 5 ) 479 - 490 2023.10

Participation in the Setouchi Triennale and the Health of Residents in Naoshima: A Cross-Sectional Study Reviewed

Habu H, Takao S, Miyaji C, Matsumoto N, Aoo K, Nishita Y, Tsuri M, Yorifuji T

77 ( 5 ) 491 - 497 2023.10

ASO Visual Abstract: EGFR Mutation is a Prognostic Factor in Lung Cancer Patients with Pleural Dissemination Detected During or After Surgery. International journal

Toshiya Fujiwara, Kazuhiko Shien, Motoki Matsuura, Junichi Soh, Hiromasa Yamamoto, Soshi Takao, Yuho Maki, Tsuyoshi Ueno, Ryujiro Sugimoto, Ken Suzawa, Mikio Okazaki, Hiroyuki Tao, Makio Hayama, Masafumi Kataoka, Yoshifumi Sano, Hidetoshi Inokawa, Motohiro Yamashita, Osamu Kawamata, Kazuhiko Kataoka, Shinichi Toyooka

Annals of surgical oncology 30 ( 11 ) 6705 - 6706 2023.10

Does Participation in the Setouchi Triennale Foster Social Capital? : A Cross-Sectional Study.

Chikara Miyaji, Soshi Takao, Hiroshi Habu, Naomi Matsumoto, Ken Aoo, Yosuke Nishita, Masao Tsuri, Takashi Yorifuji

Acta medica Okayama 77 ( 5 ) 443 - 449 2023.10

Language：English Publishing type：Research paper (scientific journal)

This study examined whether participation in an art project was associated with higher social capital (SC). We conducted a questionnaire survey from November 2021 to March 2022 among residents aged 20 years or older of Naoshima, an island in Kagawa Prefecture, Japan. Before the survey, the Setouchi Triennale had been held on Naoshima four times, starting in 2010. We calculated propensity scores for Triennale participation and performed propensity score matching. We then compared cognitive and structural SC by Triennale participation and found significant differences, respectively. We adopted a conditional ordered logistic regression analysis with propensity score matching for cognitive or structural SC, and found adjusted odd ratios of 2.913 (95%CI, 1.846-4.596) for cognitive SC and 4.535 (95%CI, 2.839-7.244) for structural SC. Our findings suggest that Triennale participation enhanced the cognitive aspect of SC while also building structural SC.

DOI： 10.18926/AMO/65966

EGFR Mutation is a Prognostic Factor in Lung Cancer Patients with Pleural Dissemination Detected During or After Surgery. International journal

Toshiya Fujiwara, Kazuhiko Shien, Motoki Matsuura, Junichi Soh, Hiromasa Yamamoto, Soshi Takao, Yuho Maki, Tsuyoshi Ueno, Ryujiro Sugimoto, Ken Suzawa, Mikio Okazaki, Hiroyuki Tao, Makio Hayama, Masafumi Kataoka, Yoshifumi Sano, Hidetoshi Inokawa, Motohiro Yamashita, Osamu Kawamata, Kazuhiko Kataoka, Shinichi Toyooka

Annals of surgical oncology 30 ( 11 ) 6697 - 6702 2023.10

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Primary lung tumors are sometimes resected when either pleural dissemination (PD) or malignant pleural effusion (MPE) exists. This study clarified the prognostic factors for non-small cell lung cancer (NSCLC) with either PD and MPE, or both, detected during or after surgery. PATIENTS AND METHODS: We examined patients with NSCLC from a multicenter database who had either PD, MPE, or both, detected during or after surgery between 2005 and 2015. Hazard ratios and 95% confidence intervals were estimated using the Cox proportional hazards model adjusted for potential confounding factors. RESULTS: Among 9463 registered patients, PD, MPE, or both, were found in 114 patients with NSCLC during or after surgery. Primary tumor resection and exploratory thoracotomy were performed in 65 and 49 patients, respectively. In univariate analysis, adenocarcinoma, clinically undetected lymph node metastasis (c-N0 or unknown), EGFR mutation, and combination of chemotherapy or tyrosine kinase inhibitors after surgery were better prognostic factors for overall survival (OS), whereas in the multivariate analysis, adenocarcinoma, clinically undetected lymph node metastasis, and EGFR mutation were favorable independent prognostic factors in OS. Additionally, limited to patients with EGFR mutation, patients with primary lung tumor resection showed a significantly better 5-year OS than those with exploratory thoracotomy (86.4 vs. 44.8%; p < 0.001). CONCLUSION: Our findings show that surgical resection of primary tumors could improve the prognosis of patients with PD, MPE, or both, detected during or after surgery when the tumors harbor an EGFR mutation.

DOI： 10.1245/s10434-023-13791-y

Antibody Titers After a Third and Fourth SARS-CoV-2 Vaccine Dose in Bizen City, Japan

Tomoka Kadowaki, Ayako Sasaki, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Journal of Epidemiology 33 ( 9 ) 484 - 486 2023.9

Endolymphatic Hydrops on Magnetic Resonance Imaging May Be an Independent Finding on Aging in Neurotologic Patients. International journal

Yukihide Maeda, Katsuhide Kojima, Soshi Takao, Ryotaro Omichi, Shin Kariya, Mizuo Ando

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 44 ( 7 ) 737 - 741 2023.8

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To clarify whether age impacts the development of endolymphatic hydrops (ELH) in neurotologic patients. Documentation of ELH in living patients on magnetic resonance imaging (MRI) allows analysis of patient age and formation of ELH, which is impossible by means of postmortem temporal bone pathology. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fifty patients (100 ears) with top 3 diagnoses of definite Menière's disease, delayed ELH, or probable Menière's disease. INTERVENTIONS: Endolymph MRI after intravenous gadolinium injection and pure-tone audiometry. MAIN OUTCOME MEASURES: Cochlear and vestibular ELH confirmed by MRI. RESULTS: The prevalences of ears showing both cochlear and vestibular ELH were similar among age groups <30 years (30%), 30-59 years (25.9%), and ≥60 years (34.4%; p > 0.05; χ2 test). Using logistic regression modeling, mean hearing level at the six frequencies was positively associated with a higher risk of cochlear ELH (odds ratio, 1.3; 95% confidence interval, 1.1-1.5 per 10-dB increment). In the same regression model, age did not impact the outcome of cochlear ELH (odds ratio, 1.0; 95%confidence interval, 0.7-1.4 per 10-year increment). Age did not differ among ears with no ELH (mean ± standard deviation age, 48.6 ± 14.4 yr), ears with only cochlear ELH (59.3 ± 10.7 yr), ears with only vestibular ELH (50.4 ± 16.9 yr), or ears with both cochlear and vestibular ELH (51.5 ± 18.4 yr; p > 0.05, analysis of variance). CONCLUSION: Chronological age was not associated with the formation of ELH. Aging per se may not be associated with the development of ELH in neurotologic patients.

DOI： 10.1097/MAO.0000000000003945

Obesity, overweight, and severe prognosis in COVID-19 patients in Japan

Tomoka Kadowaki, Naomi Matsumoto, Rumi Matsuo, Toshiharu Mitsuhashi, Ayako Sasaki, Soshi Takao, Takashi Yorifuji

Journal of Infection and Chemotherapy 2023.8

Association between Radon Hot Spring Bathing and Health Conditions: A Cross-Sectional Study in Misasa, Japan.

Takahiro Kataoka, Hiroshi Habu, Ayumi Tanaka, Shota Naoe, Kaito Murakami, Yuki Fujimoto, Ryohei Yukimine, Soshi Takao, Fumihiro Mitsunobu, Takashi Yorifuji, Kiyonori Yamaoka

Acta medica Okayama 77 ( 4 ) 387 - 394 2023.8

Language：English Publishing type：Research paper (scientific journal)

No epidemiological studies have examined the health effects of daily bathing in radon hot springs. In this cross-sectional study, we investigated the associations between radon hot spring bathing and health conditions. The target population was 5,250 adults ≥ 20 years old in the town of Misasa, Japan. We collected information about the participants' bathing habits and alleviation of a variety of disease symptoms, and their self-rated health (SRH). Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated. In both the adjusted and unadjusted models of hypertension, significant associations between the > 1×/week hot spring bathing and the alleviation of hypertension symptoms were observed compared to the group whose hot spring bathing was <1×/week: adjusted model, OR 5.40 (95%CI: 1.98-14.74); unadjusted model, 3.67 (1.50-8.99) and for gastroenteritis: adjusted model, 9.18 (1.15-72.96); unadjusted model, 7.62 (1.59-36.49). Compared to the no-bathing group, higher SRH was significantly associated with both bathing < 1×/week: unadjusted model, 2.27 (1.53-3.37) and > 1×/week: adjusted model, 1.91 (1.15-3.19). These findings suggest that bathing in radon hot springs is associated with higher SRH and the alleviation of hypertension and gastroenteritis.

DOI： 10.18926/AMO/65749

Association between Radon Hot Spring Bathing and Health Conditions: A Cross-Sectional Study in Misasa, Japan

Kataoka Takahiro, Habu Hiroshi, Tanaka Ayumi, Naoe Shota, Murakami Kaito, Fujimoto Yuki, Yukimine Ryohei, Takao Soshi, Mitsunobu Fumihiro, Yorifuji Takashi, Yamaoka Kiyonori

77 ( 4 ) 387 - 394 2023.8

Comparison between olanzapine and aripiprazole treatment for 104 weeks after hospital discharge in schizophrenia spectrum disorders: a multicenter retrospective cohort study in a real-world setting

Tomonari Hosokawa, Chikara Miyaji, Yusaku Yoshimura, Kenji Washida, Yuji Yada, Shinji Sakamoto, Yuko Okahisa, Soshi Takao, Akira Nomura, Yoshiki Kishi, Toshiki Harada, Manabu Takaki, Toshihiko Takeda, Norihito Yamada

Psychopharmacology 2023.7

Association between handwashing and gargling education for children and prevention of respiratory tract infections: a longitudinal Japanese children population-based study

Kensuke Uraguchi, Toshiharu Mitsuhashi, Naomi Matsumoto, Soshi Takao, Seiichiro Makihara, Mizuo Ando, Takashi Yorifuji

European Journal of Pediatrics 2023.7

Outcomes of solitary postoperative recurrence of esophageal squamous cell carcinoma diagnosed with FDG-PET/CT and treated with definitive radiation therapy.

Hiroki Ihara, Kotaro Yoshio, Shunsuke Tanabe, Soichi Sugiyama, Masashi Hashimoto, Naoaki Maeda, Shinsuke Akagi, Soshi Takao, Kazuhiro Noma, Takao Hiraki

Esophagus : official journal of the Japan Esophageal Society 20 ( 3 ) 548 - 556 2023.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Surgical resection of esophageal cancer is frequently performed to achieve a complete cure. However, the postoperative recurrence rate is 36.8-42.5%, leading to poor prognosis. Radiation therapy has been used to treat recurrences; solitary recurrence has been proposed as a prognostic factor for radiation therapy, though its significance is unclear. 18F-fluorodeoxyglucose positron emission tomography is a highly accurate diagnostic modality for esophageal cancer. This retrospective study aimed to analyze the outcomes of solitary postoperative recurrences of esophageal squamous cell carcinoma diagnosed with 18F-fluorodeoxyglucose positron emission tomography and treated with definitive radiation therapy. METHODS: We examined 27 patients who underwent definitive radiation therapy for single or multiple postoperative recurrences of esophageal squamous cell carcinoma between May 2015 and April 2021. 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed within 3 months before the commencement of radiation therapy. Kaplan-Meier, univariate, and multivariate analyses were performed to examine the overall survival and identify potential prognostic factors. RESULTS: The 1-, 2-, and 3-year overall survival rates were 85.2%, 62.6%, and 47.3%, respectively, and solitary recurrence was the only significant factor associated with overall survival (P = 0.003). The 1-, 2-, and 3-year overall survival rates in patients with solitary recurrence were 91.7%, 80.2%, and 80.2%, respectively, and in patients with multiple recurrences they were 80.0%, 50.3%, and 25.1%, respectively. Multivariate analysis also showed solitary recurrence as a significant factor for overall survival. CONCLUSIONS: When diagnosed with 18F-fluorodeoxyglucose positron emission tomography/computed tomography, solitary recurrence appears to have a more favorable prognosis than multiple recurrences.

DOI： 10.1007/s10388-023-01000-4

Complementary and Alternative Medicine Use, Cancer Screening, and Medical Checkups in Japan from 2001 to 2013: A Repeated Cross-Sectional Study. International journal

Nobuyoshi Matsuki, Etsuji Suzuki, Toshiharu Mitsuhashi, S V Subramanian, Soshi Takao, Takashi Yorifuji

Journal of integrative and complementary medicine 2023.6

Language：English Publishing type：Research paper (scientific journal)

Introduction: The association between complementary and alternative medicine (CAM) use and other health-related behaviors is an important issue. A previous study reported that complementary medicine use is related to greater use of cancer screening, whereas alternative medicine use is related to lower use of cancer screening. Given the sparse evidence from Japan, we aimed to examine the association of CAM use with cancer screening and medical checkups. We used a repeated cross-sectional survey of a nationally representative sample of Japanese people and conducted age-period-cohort analysis. Methods: The study population was 68,217 of 83,827 individuals observed from 2001 to 2013 who received cancer screening. CAM users were defined as individuals who received acupuncture, moxibustion, anma/massage/shiatsu, or judo therapy for their most worrisome symptom. The outcomes of interest were receiving stomach, lung, colorectal, uterine, and breast cancer screenings and medical checkups. Using crossclassified multilevel logistic regression models, we estimated odds ratios (ORs) and 95% credible intervals (CIs) for cancer screening and medical checkups. Results: For CAM users of complementary medicine, the adjusted ORs for stomach, lung, and colorectal cancer screening were 1.40 (95% CI: 1.35-1.44), 1.37 (95% CI: 1.34-1.40), and 1.52 (95% CI: 1.49-1.54), respectively. We found similar results for uterine and breast cancer screening, and medical checkups. Conclusions: Irrespective of whether they use CAM, CAM users in Japan tend to receive a variety of cancer screenings and medical checkups.

DOI： 10.1089/jicm.2023.0077

Breastfeeding at 6 months of age had a positive impact on overweight and obesity in Japanese adolescents at 15 years of age International journal

Tomoka Kadowaki, Naomi Matsumoto, Etsuji Suzuki, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Acta Paediatrica 112 ( 1 ) 106 - 114 2023.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

AIM: A number of studies have indicated the potential benefits that breastfeeding has on reducing childhood obesity, but few studies have evaluated the effect on adolescent obesity. We examined the association between breastfeeding and overweight or obesity at 15 years of age using data from a large nationwide longitudinal study launched by the Japanese Government in 2001. METHODS: We analysed data for 26 164 participants with known infant feeding practices at 6 months of age, namely the duration of breastfeeding or formula feeding. Overweight or obesity at 15 years of age were calculated based on the subject's self-reported height and weight. Multinomial logistic regression analysis adjusted the data for child factors, namely sex, siblings, birth weight and physical activity clubs and the maternal factors of age, educational attainment and smoking status. RESULTS: Formula feeding was associated with an increased risk of overweight or obesity at 15 years of age. The adjusted odds ratios (95% confidence intervals) were 0.99 (0.89-1.09) for partial breastfeeding and 1.23 (1.02-1.48) for formula feeding, when exclusive breastfeeding was the reference category. CONCLUSION: Breastfeeding during infancy had potential benefits for overweight or obesity among 15-year-old adolescents. Our results provide further evidence of the importance of breastfeeding.

DOI： 10.1111/apa.16551

Differential association of frailty with the incidence of mild and severe disability in older people: A 3-year cohort study. International journal

Akikazu Hagiyama, Soshi Takao, Rumi Matsuo, Takashi Yorifuji

Annals of geriatric medicine and research 2022.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Frailty is associated with the incidence of disability in older people, but few studies investigated differences in the association of frailty with mild and severe disability by Japanese long-term care insurance certification. This study investigated the association of frailty with the incidence of mild and severe disability separately. METHODS: This was a retrospective cohort study for 3 years. The participants were community-dwelling people aged ≥ 65 in Okayama City. We assessed frailty status using the Kihon Checklist and defined outcomes as mild and severe disability in long-term care insurance certifications. Multinomial logistic regression analysis was used to investigate the association of frailty with the incidence of mild and severe disability. RESULTS: A total of 36043 participants were analyzed. For mild disability, the odds ratios (ORs) comparing frail to robust and prefrail to robust were 3.85 (95% confidence interval [CI] 3.36-4.42) and 1.82 (95% CI 1.58-2.10). Similarly, the corresponding ORs for severe disability were 4.35 (95% CI 3.55-5.34) and 1.78 (95% CI 1.43-2.21). In the age-stratified analysis, in mild disability, the pre-old group (aged 65-74) with frail showed a higher association than the old group (aged ≥ 75) with frail. In severe disability, the old group with frail showed a higher association than the pre-old group with frail. CONCLUSION: The results showed that both prefrail and frail were associated with the incidence of mild and severe disability, and there were different patterns of association between the pre-old/old age groups.

DOI： 10.4235/agmr.22.0097

Frailty and all-cause and cause-specific mortality in Japan. International journal

Rumi Matsuo, Naomi Matsumoto, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Archives of gerontology and geriatrics 107 104906 - 104906 2022.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: In aging societies, there is an increasing focus on the concept of frailty. However, there is no consistent means to assess this concept. We assessed frailty using the Kihon Checklist (KCL), which is widely used in Japan, and examined the association between frailty and all-cause and cause-specific mortality in Japan, the most aged society in the world. METHODS: This was a retrospective cohort study, and we analyzed 43,312 participants aged ≥ 65 years who were enrolled in basic health checkups in Okayama City, Japan. We defined the frailty status of the participants using the KCL. To assess the association of frailty status with all-cause and cause-specific mortality, we used cause-specific Cox proportional hazard models to estimate hazard ratios (HRs), adjusting for individual potential confounders. Mean follow-up time was 9.3 years. RESULTS: The fully adjusted HR for all-cause mortality was 1.34 (95% confidence interval [CI]: 1.27-1.41) for the prefrail group and 2.22 (95% CI: 2.11-2.33) for the frail group. A similar pattern was observed for cardiovascular disease, respiratory disease, and cancer mortality. Younger people (65-74 years) and women tended to have higher effect estimates than older people (≥ 75 years) and men. CONCLUSION: Prefrailty and frailty can increase the risk of both all-cause and cause-specific mortality. Our study suggests that to support frail patients, it could be effective to focus on the prevention and management of cardiovascular and respiratory disease, and that the KCL may be useful as a method of screening for frailty.

DOI： 10.1016/j.archger.2022.104906

Association Between Fever and Antibody Titer Trends After a Third Dose of the mRNA-1273 Vaccine

Naomi Matsumoto, Tomoka Kadowaki, Rumi Matsuo, Ayako Sasaki, Chikara Miyaji, Chigusa Higuchi, Masanori Nakayama, Yasue Sakurada, Hideharu Hagiya, Soshi Takao, Fumio Otsuka, Takashi Yorifuji

Journal of Epidemiology 32 ( 12 ) 567 - 569 2022.12

Do Complementary and Alternative Medicine Users Also Use Conventional Medicine? A Repeated Cross-Sectional Study in Japan from 1995 to 2013 International journal

Nobuyoshi Matsuki, Etsuji Suzuki, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Journal of Integrative and Complementary Medicine 2022.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Mary Ann Liebert Inc

Introduction: It is recommended that users of complementary and alternative medicine (CAM) also seek conventional medical care to prevent the loss of access to appropriate medical care. However, the status of such use is unknown. The aim of this study was to examine the time trends in the proportion of CAM users who also receive conventional medical care for the same symptoms. Methods: This is a repeated cross-sectional study. Of data for 753,978 respondents to the Comprehensive Survey of Living Conditions, which was conducted seven times between 1995 and 2013, data from 17,707 individuals who used acupuncture, moxibustion, anma-massage-shiatsu, or judo therapy were analyzed. Cross-classified multilevel logistic regression models with individuals as level 1 and survey year and cohort as level 2 were used to calculate odds ratios (ORs) and 95% credible intervals (CIs) for combined use of CAM and conventional medical care. Age was entered as an individual-level variable. The period effect after 2003 was entered as a survey year-level variable because the number of eligible persons providing CAM treatments has increased since 2003. Results: Among the 17,707 CAM users, 11,567 (65.3%) were women. When age was entered as an explanatory variable, the results showed that both older men and women tended to receive conventional medical care (women, OR: 1.04, 95% CI: 1.03-1.04; men, OR: 1.03, 95% CI: 1.02-1.04). Additional examination of the possible period effect after 2003 showed a positive (although nonsignificant) association (women, OR: 1.36, 95% CI: 0.89-1.99; men, OR: 1.37, 95% CI: 0.94-1.91). Conclusions: As patient age increased, patients combined CAM use with conventional medicine. The findings also suggested that the combined use of CAM and conventional medicine has increased since 2003.

DOI： 10.1089/jicm.2022.0631

Other Link： https://www.liebertpub.com/doi/pdf/10.1089/jicm.2022.0631

Timing of REGEN-COV administration and progression to severe COVID-19 International journal

Tomoka Kadowaki, Sato Imajou, Naomi Matsumoto, Soshi Takao, Takashi Yorifuji

Journal of Infection and Chemotherapy 28 ( 11 ) 1459 - 1463 2022.11

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

INTRODUCTION: Several clinical trials have demonstrated that REGEN-COV (casirivimab and imdevimab) decreases the risk of hospitalization and death among COVID-19 patients. However, these trials did not evaluate the optimal timing of its administration, and evidence is limited regarding the relationship between the timing of administration and progression to severe COVID-19 among patients who receive REGEN-COV in a real-world setting. We examined the association between the timing of REGEN-COV administration and progression to severe COVID-19 among patients who received REGEN-COV in Japan. METHODS: We included a total of 342 COVID-19 patients (37 hospitals) who received REGEN-COV between July 19 and September 30, 2021. We calculated the difference between the date of symptom onset and the date of administration as an indicator of the timing of REGEN-COV administration and determined progression to severe COVID-19 after REGEN-COV administration. We conducted a logistic regression analysis, adjusting for potential confounders. RESULTS: The proportion of cases progressing to severe COVID-19 increased daily from symptom onset and sharply increased from day 5 of onset. The early administration (days 0-4) decreased the risk of progression to severity compared with late administration (after day 5), with an adjusted odds ratio of 0.29 (95% confidence interval: 0.11-0.56). CONCLUSIONS: The early administration of REGEN-COV was associated with a decreased risk of progression to severe COVID-19 when the delta variant was dominant. The present epidemiological findings indicate that this monoclonal antibody therapy should be implemented very early in the clinical course probably even for emerging variants such as omicron BA.2.

DOI： 10.1016/j.jiac.2022.07.002

The validity of atypical psychosis diagnostic criteria to detect anti-NMDA receptor encephalitis with psychiatric symptoms International journal

Kenji Hinotsu, Chikara Miyaji, Yuji Yada, Hiroki Kawai, Shinji Sakamoto, Yuko Okahisa, Ko Tsutsui, Takashi Kanbayashi, Keiko Tanaka, Soshi Takao, Yoshiki Kishi, Manabu Takaki, Norihito Yamada

Schizophrenia Research 248 292 - 299 2022.10

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

Anti-NMDAR encephalitis has a psychotic presentation that is difficult to distinguish from primary psychosis. An atypical psychosis that is similar to schizophrenia, mood disorder, and epilepsy is unique, and the original diagnostic criteria exist only in Japan. The clinical symptoms and courses of anti-NMDAR encephalitis and atypical psychosis are very similar. We investigated whether the diagnostic criteria of atypical psychosis are useful to increase the detection rate of anti-NMDAR encephalitis with psychiatric symptoms. The presence of anti-NR1/NR2B IgG antibodies in the cerebrospinal fluid of 218 newly admitted inpatients initially diagnosed with schizophrenia (n = 151), mood disorder (n = 47), or epilepsy with psychiatric symptoms (n = 20) was assessed by cell-based assay. Of 218 patients, 123 (36.3 years ± SD 17.2, 69.9 % females) fulfilled the diagnostic criteria of category B for atypical psychosis. All 12 patients (9.8 %, 12/123) with anti-NR1/NR2B IgG antibodies fulfilled category B of atypical psychosis statistically better than the patients without anti-NR1/NR2B IgG antibodies (P = 0.0009). Of the 12 patients with anti-NMDAR antibodies, two did not fulfill either criteria of catatonia (DSM-5) or Graus' diagnostic criteria of anti-NMDAR encephalitis during the time course, and 11 patients showed good prognosis with early immunotherapies. In ROC analysis, abnormal electroencephalogram findings showed the highest sensitivity (0.833) for detection of anti-NR1/NR2B IgG antibodies, and 31.3 % of patients with category B atypical psychosis and abnormal electroencephalogram findings had anti-NMDAR antibodies. Lumbar puncture and detection of anti-NMDAR antibodies should be considered for patients who fulfill atypical psychosis diagnosis criteria with an abnormal electroencephalogram.

DOI： 10.1016/j.schres.2022.08.024

フレイルと障害程度別の要介護認定との関連について 3年間のコホート研究

萩山明和, 高尾総司, 頼藤貴志, 濱田全紀, 堅山佳美, 千田益生

The Japanese Journal of Rehabilitation Medicine 59 ( 秋季特別号 ) S480 - S480 2022.10

A Simple and Descriptive Assessment of Morphology Based on the Horizontal Plane of the Pediatric Head and Creation of a Normative Database in Japanese Children 6 Years Old and under: Horizontal Vector Analysis.

Sho Komagoe, Takaya Senoo, Soshi Takao, Yoshinori Shiraishi, Hiroshi Matsumoto, Yoshihiro Kimata

Acta medica Okayama 76 ( 5 ) 565 - 575 2022.10

Language：English Publishing type：Research paper (scientific journal)

We herein introduce horizontal vector analysis, a simple method for assessing cranial morphology based on measurement of the head's horizontal plane, and use this method to establish normal cranial morphology in Japanese children Computed tomography scans taken in 2010-2019 in healthy Japanese children aged ≤ 6 years. The two measurement planes were parallel to the orbitomeatal plane: namely, a plane passing through the dorsum sellae (DS) and the plane superior to that with the maximal area (Max plane). A protractor was used to circumferentially measure the lengths from the central point to the outer surface of the skull. A total of 487 images were extracted. The distances between the DS and Max planes were consistently almost 30 mm for each age group, so we fixed the Max plane as the plane 30 mm superior to the DS plane. Finally, we established datasets of normal values for each age group and sex. Using these norms, perioperative evaluation of various cranial deformities could be performed more easily and circumstantially.

DOI： 10.18926/AMO/64038

Examining the association between vaccine reactogenicity and antibody titer dynamics after the third dose of BNT162b2 vaccine using a mixed-effects model International journal

Naomi Matsumoto, Hideharu Hagiya, Masanori Nakayama, Masanori Furukawa, Toshiharu Mitsuhashi, Soshi Takao, Fumio Otsuka, Takashi Yorifuji

Journal of Infection and Chemotherapy 29 ( 1 ) 39 - 42 2022.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

BACKGROUND: To mitigate the COVID-19 pandemic, many countries have recommended the use of booster vaccinations. The relationship between the degree of adverse vaccine reactions and elevated antibody titers is of interest; however, no studies have investigated the temporal changes in antibody titers based on repeated measurements after a third dose of the BNT162b2 vaccine. METHODS: This prospective longitudinal cohort study was conducted with 62 healthcare workers who received a third dose of the BNT162b2 at Okayama University Hospital, Japan. Venous blood draw and fingertip whole blood test sample collection were conducted at the early (3-13 days) and 1-month time points; only FWT sample collection was conducted at the 2-month time point. Information on adverse reactions within 1 week after vaccination was also obtained. The association between fever of 37.5 °C or higher and antibody titers after the third dose of BNT162b2 was examined using a mixed-effects model and Poisson regression with robust variance. RESULTS: A trend toward higher antibody titers in the early period after vaccination was observed in the febrile individuals, but the differences were not significant at 1 and 2 months post-vaccination (the partial regression coefficient for fever was 8094.3 [-1910.2, 18,098.8] at 1 month after vaccination, and 1764.1 [-4133.9, 7662.1] at 2 months after vaccination in the adjusted models). CONCLUSION: The findings suggest that the presence of fever after the third vaccine does not predict a sustained elevation in serum antibody titers.

DOI： 10.1016/j.jiac.2022.09.012

Effects of Tanden Breathing on Constipation: A Randomized Controlled Trial.

Hiroshi Habu, Toshiharu Mitsuhashi, Akiko Tokinobu, Takashi Yorifuji, Soshi Takao

Acta medica Okayama 76 ( 4 ) 391 - 398 2022.8

Language：English Publishing type：Research paper (scientific journal)

Tanden breathing, an ancient health technique, involves expiratory abdominal pressure breathing is practiced in Japan. In this study we examined the ability of Tanden breathing to relieve constipation. The study was designed as a stratified-block randomized controlled trial enrolling 20 participants. Nineteen were female and one was male, none were elderly. During the 6-week intervention period, the participants performed video-guided Tanden breathing about 10 min once day. We evaluated constipation using the Constipation Assessment Scale (CAS). There were significant differences in the mean CAS score between time points (baseline, 3 weeks after baseline, 6 weeks after baseline), groups (intervention and control), and their interaction (time×group) using repeated-measures analysis of variance. The control group showed no change in the mean CAS score; the mean CAS scores of the intervention group changed from 7.2 at baseline to 3.9 at 3 weeks and 3.1 at 6 weeks after baseline. A regression analysis of the difference in the mean CAS between baseline and 6 weeks later showed that the CAS of the intervention group was 4.3 points lower than that of the control group (95% confidence interval, 2.5-6.1). The results suggested that Tanden breathing is effective in relieving constipation among young women.

DOI： 10.18926/AMO/63893

Social Capital and Post-traumatic Stress Disorder among Heavy Rainfall and Flood Victims in Japan.

Chikara Miyaji, Soshi Takao, Masayuki Noguchi, Tsubasa Okazaki, Shunsuke Sato, Takashi Yorifuji

Acta medica Okayama 76 ( 4 ) 439 - 446 2022.8

Language：English Publishing type：Research paper (scientific journal)

This study examined the relationship between cognitive/structural social capital and post-traumatic stress disorder (PTSD) among victims of heavy rain and flood. Participants were individuals aged≥18 years affected by the July 2018 heavy rainfall in the cities of Kurashiki and Soja, Japan, and living in temporary housing. We distributed five copies of a questionnaire to 1,991 households and received responses from 1,927 individuals (907 men, 1,008 women, 12 respondents of unspecified sex) in 1,029 households (51.7%). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between high (vs. low) social capital and PTSD or other outcomes. After covariate adjustment, the odds of having PTSD were lower in participants with high cognitive social capital than those with low cognitive social capital (OR=0.346, 95%CI: 0.263-0.456). Elderly women with higher structural social capital tended to have lower PTSD odds than those with lower structural social capital (OR=0.671, 95%CI: 0.431-1.046). The opposite pattern was observed for elderly men (OR=1.315, 95%CI: 0.792-2.183). Cognitive social capital is a protective factor that may reduce PTSD or promote a favorable PTSD prognosis after heavy rainfall and flood events. The associations between structural social capital and PTSD differ by age and sex.

DOI： 10.18926/AMO/63903

アルコール依存症に対するナルメフェンの無作為化比較試験における臨床的モデレーターについて探索的分析

橋本望, 土生裕, 高尾総司, 酒本真次, 岡久祐子, 松尾恵太郎, 高木学, 来住由樹, 山田了士

日本アルコール・薬物医学会雑誌 57 ( 4 ) 239 - 239 2022.8

Candidemia in patients with head and neck cancer: mortality and a novel risk factor. International journal

Kensuke Uraguchi, Takuma Makino, Shin Kariya, Youhei Noda, Hidenori Marunaka, Akira Doi, Kenichi Kozakura, Soshi Takao, Mizuo Ando

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 30 ( 7 ) 5921 - 5930 2022.7

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

PURPOSE: Candidemia is a bloodstream infection (BSI) by Candida spp. and is associated with high mortality. However, there have been few reports about BSI in head and neck cancer (HNC). We aimed to evaluate the impact of candidemia in patients with HNC and compared it with bacteremia. STUDY DESIGN: A multicenter retrospective study. METHODS: We retrospectively analyzed 83 BSI episodes in HNC (2011 to 2020) and divided them into the candidemia and bacteremia groups. We then compared the survival rate and risk factors for candidemia between the groups. RESULTS: The overall cumulative incidence (risk) of candidemia in BSI was 12 out of 83 episodes (14.5%). The 1-year mortality for the bacteremia and candidemia groups was 33.3% and 58.3%, respectively (log-rank p = 0.041). Broad-spectrum antibiotics (odds ratio [OR]: 29.5; 95% confidence interval [CI], 2.49-350), mucositis (OR 11.0; 95% CI, 1.52-80.1), and malignant wounds (OR 79.5; 95% CI 1.33-4737) were significant risk factors for candidemia in HNC. CONCLUSIONS: Candidemia causes high mortality in patients with HNC. To our knowledge, malignant wounds have not been previously reported as a risk factor for candidemia. For early diagnosis and treatment of candidemia, risk factors should be considered, and antifungal therapy started earlier.

DOI： 10.1007/s00520-022-07010-9

Relationship between spontaneous nystagmus and video Head Impulse Test findings among patients with chronic neurotologic conditions. International journal

Yukihide Maeda, Soshi Takao, Iku Abe-Fujisawa, Shin Kariya, Mizuo Ando

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 99 244 - 247 2022.5

Language：English Publishing type：Research paper (scientific journal)

The vestibulo-ocular reflex (VOR) in neurotologic patients can be evaluated most quickly by spontaneous nystagmus examinations, and the video Head Impulse Test (vHIT) quantitatively evaluates the VOR of the semicircular canals. We aimed to clarify the concordance and discrepancies between spontaneous nystagmus and vHIT findings, to provide guidance on screening vestibular functions by initial spontaneous nystagmus examination then vHIT. We evaluated 169 outpatients by spontaneous nystagmus examination in the dark using a charge-coupled device camera, then by horizontal vHIT the same day. Vestibular loss on vHIT was defined if both reduced VOR gain (<0.8) and corrective saccade were observed. Adjusted logistic regression modelling revealed that differences in right and left VOR gain positively impacted the presence of nystagmus, which suggests lateralised vestibular dysfunction (P<0.05; odds ratio 1.39 [95% confidence interval, 1.1-1.8] per 0.1 increment). When vHIT is regarded as the standard clinical test, the positive predictive value of nystagmus for vestibular loss on vHIT was 44.4%, and the negative predictive value was 93.5%. The adjusted odds ratio of adults ≥65 years old compared to younger patients associated with a discrepancy of nystagmus and vHIT was significant (2.4 [1.1-5.3]). In conclusion, if spontaneous nystagmus is initially observed in patients, further assessment by vHIT could confirm vestibular dysfunction in 40-50% of cases. If no nystagmus is observed, vHIT might also result in a negative finding in >90% of cases. Older adults appear more likely to show discrepancies between nystagmus and vHIT.

DOI： 10.1016/j.jocn.2022.03.018

Adverse reactions and attitudes toward vaccines among young populations one month after receiving a second dose of mRNA-1273 in Japan

Naomi Matsumoto, Chigusa Higuchi, Toshiharu Mitsuhashi, Hideharu Hagiya, Soshi Takao, Takashi Yorifuji

Global Health & Medicine 4 ( 2 ) 141 - 143 2022.4

Language：English Publishing type：Research paper (scientific journal) Publisher：National Center for Global Health and Medicine (JST)

To investigate adverse reactions and attitudes toward the vaccine during the first month after mRNA- 1273 vaccination in a larger sample including younger men and women in Japan, we distributed a 1-month post-vaccination questionnaire using a Google form to 8,566 people who received a second dose of mRNA-1273 at Okayama University. The response rate was about 40.2% (3,447 responses), the sex ratio was about the same, and 73.3 % (2,528 respondents) were students in their twenties or younger. Poisson regression with robust variance was performed to calculate the prevalence ratio of each symptom by different attributes. The most common adverse reactions after the second vaccine dose were local pain (80.4%), fever (85.1%), malaise (82.0%), headache (64.0%), and chills (57.4%). Approximately 99% of respondents reported that their adverse reactions resolved within 1 week. Over 80% of respondents were satisfied with their vaccination (87.2%), expressed interest in receiving the third vaccination (83.3%), and would recommend vaccination to their loved ones (80.2%). However, among them, 22.0% (757 respondents) would recommend and 28.4% (980 respondents) also stated that they would consider the type of vaccine in these decisions.

DOI： 10.35772/ghm.2021.01125

Clinical moderators of response to nalmefene in a randomized-controlled trial for alcohol dependence: An exploratory analysis. International journal

Nozomu Hashimoto, Hiroshi Habu, Soshi Takao, Shinji Sakamoto, Yuko Okahisa, Keitaro Matsuo, Manabu Takaki, Yoshiki Kishi, Norihito Yamada

Drug and alcohol dependence 233 109365 - 109365 2022.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Nalmefene is the only medication marketed to reduce the consumption of alcohol in patients with alcohol dependence, but it remains unclear which patients could most benefit from it. This study aimed to identify clinical moderators that affect treatment response to nalmefene in patients with alcohol dependence. METHODS: In a multicenter, randomized, controlled, double-blind, phase 3 study of nalmefene on Japanese patients with alcohol dependence, the relationship between the reduction of heavy drinking days (HDD) and total alcohol consumption (TAC) at 12 and 24 weeks of treatment and baseline variables of the participants were analyzed in a linear regression and multiple adjusted analysis. RESULTS: Age < 65, no family history of problem drinking, age at onset of problem drinking ≥ 25, and not currently smoking were possible positive moderators. Nalmefene showed a significant HDD reduction in patients with age < 65 or no family history of problem drinking, and a significant TAC reduction in patients with age at onset of problem drinking ≥ 25 or who were not currently smoking. After multiple adjusted analyses, age < 65 (p = .028), no family history of problem drinking (p = .047), and age at onset of problem drinking ≥ 25 (p = .030) were statistically significant. Not currently smoking (p = .071) was marginally significant. In combination, these moderators indicated synergistic effects. CONCLUSIONS: Alcohol-dependent patients with favorable prognostic factors such as non-smoking status, no family history of problem drinking, and a late-onset of problem drinking selectively benefit from nalmefene. Further research is needed to validate these exploratory results.

DOI： 10.1016/j.drugalcdep.2022.109365

Effect of mRNA Vaccines in Preventing COVID-19 Severe Pneumonia Among COVID-19 Patients in Japan

Rumi Matsuo, Naomi Matsumoto, Tomoka Kadowaki, Toshiharu Mitsuhashi, Soshi Takao, Takashi Yorifuji

Journal of Epidemiology 32 ( 3 ) 151 - 152 2022.3

Association between depression in chronic phase and future clinical outcome of patients with schizophrenia. International journal

Yuto Yamada, Yusuke Yamauchi, Shinji Sakamoto, Masaki Fujiwara, Yuko Okahisa, Soshi Takao, Manabu Takaki, Norihito Yamada

Psychopharmacology 239 ( 3 ) 965 - 975 2022.3

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

RATIONALE: Depression in schizophrenia is an important symptom. We investigated whether depression and suicidal symptoms in the chronic phase are related to remote future clinical outcomes in patients with schizophrenia and whether psychotropics improved clinical outcomes. OBJECTIVES: The subjects included 462 outpatients of working age (15 to 64 years old) with schizophrenia treated at Okayama University Hospital from January 2010 to December 2011. We investigated the relationship between the Clinical Global Impression-Severity score at the last visit (average 19.2 years) and the existence of previous depression, suicidal ideas, and suicide attempts. We adjusted by several possible confounders including medical history using multiple regression analysis or logistic regression analysis. RESULTS: Of 462 patients, 168 (36.4%) presented with depression 2 years after schizophrenia onset. A history of suicidal ideas and attempts was related to worse clinical outcome. In males, a history of depression was related to worse clinical outcome, but not in females. Lithium carbonate was related to better clinical outcome in all schizophrenia patients with depression, especially in males. Treatment with antidepressants was related to better clinical outcome only in males. CONCLUSIONS: A history of depression or suicidal symptoms in the chronic phase predicted the future worse clinical outcome in patients with schizophrenia. The administration of lithium carbonate or antidepressants might be recommended, especially to male schizophrenia patients with depression.

DOI： 10.1007/s00213-022-06099-4

Reusable Medical Isolation Gowns with a Liquid Barrier: Washing Gowns in the Coronavirus Disease 2019 Pandemic Era?

Hiromichi Naito, Kohei Tsukahara, Soshi Takao, Takashi Yorifuji, Atsunori Nakao

JMA journal 5 ( 1 ) 107 - 108 2022.1

Language：English Publishing type：Research paper (scientific journal)

Healthcare providers are at risk of exposure to SARS-CoV-2 via droplets, respiratory secretions, and contact with contaminated surfaces. Personal protective equipment (PPE) is necessary for primary reliable prevention to treat patients with coronavirus disease 2019 (COVID-19). However, PPE shortages have had a significant impact on every medical facility, and outpatient clinics are especially vulnerable to shortages of medical supplies. During the first stage of the pandemic, efforts were made to reduce the use of medical supplies. Guidance and strategies were proposed to ration the use of PPE, including reusing it. However, reuse (wash) of isolation gowns has not been practically promoted despite these suggestions. Further, reusable products may have advantages for economic and ecologic reasons. We developed an adult universally sized, long-sleeved, 100% polyester, reusable/washable gown with liquid barrier protection. The isolation gown can be worn repeatedly through washing and subsequent disinfection, and it can withstand washing in 80°C hot water for 10 min and/or immersion in 0.05%-0.1% sodium hypochlorite for 30 min and then dried. This new gown's liquid barrier performance is at Association for the Advancement of Medical Instrumentation level 1, even after 20 repeated uses with low cost. The choice of barrier level for gowns should be made based on the risk of contamination. However, the healthcare setting for COVID-19 patients varies greatly with not fully elucidated transmissibility. The newly made reusable isolation gown can be one option for treating COVID-19 patients especially in low-risk settings with economical advantage. Further, preparedness for reuse may have critical implications in extreme shortage. Reconsideration should be focused on reusable gowns with liquid barrier performance and their appropriate use.

DOI： 10.31662/jmaj.2021-0075

Association of nighttime sleep with behaviors in Japanese early childhood International journal

Yusuke Yamauchi, Soshi Takao, Naomi Matsumoto, Takashi Yorifuji

Pediatrics International 64 ( 1 ) e15354 2022.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Wiley

BACKGROUND: Preschool children in Asian countries, including Japan, sleep for a shorter duration at night than those in Europe and the USA. We examined the effects of the nighttime sleep duration on behavioral development in early childhood in Japan. METHODS: We used data from a large Japanese nationwide, population-based, longitudinal survey that began in 2001. We restricted the study participants to children born after 37 gestational weeks, with a birth weight ≥ 2500 g and singleton births (n = 41 890). The nighttime sleep duration was examined at 2.5 years old. Responses to survey questions regarding age-appropriate behavior at 5.5 years old were used as indicators of behavioral development. We conducted logistic regression analyses with adjustment for confounding factors, with ≥11 h of nighttime sleep as the reference group. RESULTS: The odds ratios for children who had ≤9 h of nighttime sleep, which was associated with being unable to listen with fidgeting and being unable to remain patient, were 1.26 (95% confidence interval, 1.14-1.39) and 1.27 (1.16-1.38), respectively. Children who had an irregular nighttime sleep duration were associated with age-appropriate behavioral inabilities. These results were similar in children who usually and sometimes took naps to those before stratification by the frequency of napping. CONCLUSION: A short nighttime sleep duration especially affects hyperactivity and impulsivity. An irregular nighttime sleep duration increases the inability to perform overall age-appropriate behaviors more than a short sleep duration. Ensuring a regular and sufficient nighttime sleep duration in early childhood is important for healthy behavioral development.

DOI： 10.1111/ped.15354

Static posturographic balance in neurotologic patients may be associated with middle-high-frequency hearing levels during ageing process. International journal

Yukihide Maeda, Soshi Takao, Iku Abe-Fujisawa, Shin Kariya, Mizuo Ando

Acta oto-laryngologica 142 ( 3-4 ) 280 - 284 2022

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Understanding how sensorineural hearing loss (SNHL) impacts postural balance in patients is important, as postural balance predicts the risk of falls. AIMS/OBJECTIVES: We aimed to clarify the relationship between characteristics in the configuration of audiograms and static postural balance as measured by posturography. MATERIALS AND METHODS: We evaluated 385 outpatients (mean [± standard deviation] age, 58.4 ± 18.4 years) with SNHL by audiometry and posturography. Data were analysed by multiple regression models with the outcome of postural sway area with eyes closed (PSA) and predictive variables of audiometric data, adjusted for sex, age and the presence of nystagmus. RESULTS: The increased hearing threshold in the better hearing ear was associated with poorer or higher PSA (beta coefficient [β] = 0.39, 95% confidence interval [CI] = 0.03-0.75, per 10-dB increment). No difference in PSA was detected between patients with asymmetric or symmetric SNHL. None of the frequent diagnoses (presbyacusis, Meniere's disease, and idiopathic sudden SNHL) were associated with poorer PSA. Hearing thresholds at middle (β = 0.39, 95%CI = 0.10-0.67) and high frequencies (β = 0.31, 95%CI = 0.07-0.55) were associated with poorer PSA, whereas those at low frequencies was not. CONCLUSIONS AND SIGNIFICANCE: Postural balance in neurotologic patients may be associated with middle-high-frequency hearing levels during ageing.

DOI： 10.1080/00016489.2022.2047222

Impairment of early neuronal maturation in anti-NMDA-receptor encephalitis

Sojiro Okamoto, Manabu Takaki, Kenji Hinotsu, Hiroki Kawai, Shinji Sakamoto, Yuko Okahisa, Soshi Takao, Ko Tsutsui, Takashi Kanbayashi, Keiko Tanaka, Norihito Yamada

PSYCHOPHARMACOLOGY 239 ( 2 ) 525 - 531 2021.12

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

Rationale Adequate immunotherapies for anti-NMDAR encephalitis during pregnancy produce a relatively good clinical outcome for pregnant mothers and their infants, but there are no reports about the future growth of their babies. The damage of anti-NMDAR antibodies to early neuronal development is still unknown. Objectives Serum or cerebrospinal fluid from one patient with anti-NMDAR encephalitis (the index patient) and one patient with schizophrenia (the control patient) was administered to primary cultures of dissociated rat cortical neurons, and dendritic outgrowth, centrosome elimination, and branching of dendrites were investigated. For rescue experiments, serum of the index patient was replaced with normal culture media after 3 days' administration of the index patient. Results Serum and cerebrospinal fluid of the index patient statistically significantly impaired dendritic outgrowth of cultured rat cortical primary neurons. Serum of the index patient also statistically significantly delayed centrosome elimination. Impaired dendritic outgrowth and delayed centrosome elimination were not perfectly rescued by changing to normal culture media. Serum of the index patient also statistically significantly reduced the branching of dendrites. Conclusions This is the first demonstration of the damage by anti-NMDAR antibodies on early dendritic development in vitro. As a strategy to protect embryonic neurons, our findings may support the efficacy of early immunotherapy for anti-NMDAR encephalitis in pregnancy.

DOI： 10.1007/s00213-021-06036-x

Emergency Dispatches for Suicide Attempts During the COVID-19 Outbreak in Okayama, Japan: A Descriptive Epidemiological Study.

Hiroshi Habu, Soshi Takao, Ryohei Fujimoto, Hiromichi Naito, Atsunori Nakao, Takashi Yorifuji

Journal of epidemiology 31 ( 9 ) 511 - 517 2021.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Hardships associated with the ongoing coronavirus disease 2019 (COVID-19) pandemic can affect mental health, potentially leading to increased risk of suicide. We examined the relationship between the COVID-19 outbreak and suicide attempts in Okayama, Japan using information from emergency dispatches. METHODS: This was a descriptive epidemiological study. We collected information on emergency dispatches in Okayama City and Kibichuo from March to August in 2018, 2019, and 2020 (n = 47,770 cases). We compared emergency dispatches and their demographic characteristics, especially focusing on suicide attempts, during these 3 years. RESULTS: The number of emergency dispatches in 2020 decreased compared with the previous 2 years, while the number and proportion of emergency dispatches related to suicide attempts increased. This increase was more pronounced among women and those aged 25-49 years. Among women aged 25-49 years, there was a cumulative total of 43 suicide attempts in 2018 and 2019 and 73 suicide attempts in 2020. CONCLUSIONS: The number and proportion of emergency dispatches related to suicide attempts increased in 2020 compared with the previous 2 years, especially among women and those aged 25-49 years. This increase may be partly explained by hardships, such as economic losses or reduced social ties, during the COVID-19 outbreak.

DOI： 10.2188/jea.JE20210066

Subjective Evaluation of Balance by the Dizziness Handicap Inventory Does Not Predict Fall Risk in Older Adults Visiting Otolaryngology Clinics. International journal

Iku Abe-Fujisawa, Yukihide Maeda, Soshi Takao, Shin Kariya, Kazunori Nishizaki

The Annals of otology, rhinology, and laryngology 130 ( 9 ) 990 - 995 2021.9

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: Subjective symptoms of dizziness in older adults are affected not only by objective data such as postural balance, but also by complex psychological factors. Published data analyzing how simultaneous evaluations of both objective and subjective assessments of balance can predict fall risk remain lacking. This study examined how fall risk can be predicted based on both objective data for balance and hearing and subjective symptoms of dizziness among older adults visiting otolaryngology clinics. METHODS: Medical charts of 76 patients ≥65 years old with dizziness/vertigo who visited the otolaryngology clinic were reviewed. Objective data were evaluated by postural balance (posturographic data with eyes open and closed, and one-leg standing test), spontaneous nystagmus, and mean hearing levels. Subjective handicap associated with dizziness/vertigo was assessed using the Dizziness Handicap Inventory (DHI). Subjective mental status of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Information on history (cardiovascular diseases) and fall accidents within the preceding year was collected using an in-house interview sheet. RESULTS: Objective data on postural balance did not correlate with subjective symptoms on DHI or HADS (P > .05, Pearson's correlation coefficient). Adjusted logistic regression modeling with the outcome of incident falls revealed that poor postural balance significantly predicted fall risk (P < .05; 4.9 [1.4-16.8] per 10-cm2 increment). Nystagmus tended to be associated with fall risk. In contrast, DHI score did not predict fall risk (P = .43; 1.0 [0.9-1.03]). Receiver operating characteristic analysis proposed a cut-off for postural sway with eyes closed >6.1 cm2 as optimal to predict falls in patients with nystagmus (AUC, 0.74; 95% confidence interval, 0.48-0.997). CONCLUSION: Poor postural balance is associated with increased fall risk after adjusting for subjective symptoms in older adults at otolaryngology clinics. Conversely, the self-perceived dizziness handicap of DHI score is an insufficient tool to evaluate their fall risk.

DOI： 10.1177/0003489420987972

Percutaneous Cryoablation of Lower Limb Soft-Tissue Venous Malformations: Preliminary Results of Long-Term Efficacy. International journal

Hiroyasu Fujiwara, Takao Hiraki, Yusuke Matsui, Mayu Uka, Koji Tomita, Toshihiro Iguchi, Jun Sakurai, Takao Soshi, Hideo Gobara, Susumu Kanazawa

Cardiovascular and interventional radiology 44 ( 9 ) 1485 - 1490 2021.9

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To retrospectively evaluate long-term efficacy of percutaneous cryoablation for lower limb soft-tissue venous malformations. MATERIALS AND METHODS: Nine patients (mean age, 36.6 years) with lower limb soft-tissue venous malformations were included. Cryoablation was performed percutaneously using an argon-based system. Adverse events (AE) using the Common Terminology Criteria for AEs version 4.0 were evaluated. The visual analog scale (VAS) scores and lesion volumes measured on magnetic resonance imaging were also evaluated at 12 months and 5-6 years. RESULTS: Technical success (i.e., complete coverage of the lesion by an iceball) was achieved in eight of the nine patients. All patients developed a total of 14 grade 1 or 2 adverse events. The mean (± standard deviation) VAS score was 6.0 (± 1.7) before therapy, whereas it was 0.14 (± 0.27) at 12 months and 0.97 (± 1.3) at 5-6 years (58-78 months). Complete pain relief was obtained in 6 and 5 patients at 12 months and 5-6 years, respectively. The median lesion volume was 2.49 mL before therapy, whereas it was 0.26 mL at 12 months and 0.35 mL at 5-6 years. CONCLUSION: Percutaneous cryoablation of lower limb soft-tissue venous malformations achieved considerable pain relief and lesion shrinkage for 5-6 years in this small preliminary study. LEVEL OF EVIDENCE: Level 4, Case Series.

DOI： 10.1007/s00270-021-02876-4

The relationship between plasma clozapine concentration and clinical outcome: a cross-sectional study International journal

Yuji Yada, Kohei Kitagawa, Shinji Sakamoto, Atsushi Ozawa, Akihiro Nakada, Hiroko Kashiwagi, Yuko Okahisa, Soshi Takao, Manabu Takaki, Yoshiki Kishi, Norihito Yamada

ACTA PSYCHIATRICA SCANDINAVICA 143 ( 3 ) 227 - 237 2021.3

Language：English Publisher：WILEY

Objective There is no report that statistically evaluates the therapeutic reference (350-600 ng/ml) and adverse drug reaction (ADR) range (>1000 ng/ml) of clozapine (CLZ) recommended by the Arbeitsgemeinschaft fur Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) consensus guidelines in an isolated and large sampling study.Methods We administered CLZ to 131 Japanese patients with treatment-resistant schizophrenia in a multicenter cross-sectional study. Plasma CLZ concentrations were assayed by high-performance liquid chromatography using trough sampling. The Brief Psychiatric Rating Scale (BPRS) and severe dose-dependent ADR (sedation, myoclonus, and seizures) were analyzed statistically after adjusting for possible confounders.Results The daily CLZ dosage showed a moderately positive relationship with the plasma concentration (r = 0.49, p 0.001). Every 100 ng/ml increase in plasma CLZ concentration improved the total BPRS score 1.95% (95% CI: 0.89-3.01, p 0.001) and the odds ratio (OR) 1.38 (95% CI: 1.14-1.66, p = 0.001) for BPRS response. Compared with concentrations below 350 ng/ml CLZ, 350-600 ng/ml (11.12%; 95% CI: 2.52-19.72, p = 0.012) and 600-1000 ng/ml (11.05%; 95% CI: 2.40-19.71, p = 0.013) showed significant improvement in the total BPRS score. Dosages above 1000 ng/ml showed greater improvement (25.36%; 95% CI: 13.08-37.64, p 0.001) of the total BPRS score but more severe ADRs than dosages below 1000 ng/ml (OR: 31.72; 95% CI: 1.04-968.81, p = 0.048).Conclusion The AGNP therapeutic reference range (350-600 ng/ml) is useful, and a dose above 1000 ng/ml is potentially more effective but carries the risk of severe ADRs in the central nervous system.

DOI： 10.1111/acps.13264

The relationship between plasma clozapine concentration and clinical outcome: a cross-sectional study. International journal

Yuji Yada, Kohei Kitagawa, Shinji Sakamoto, Atsushi Ozawa, Akihiro Nakada, Hiroko Kashiwagi, Yuko Okahisa, Soshi Takao, Manabu Takaki, Yoshiki Kishi, Norihito Yamada

Acta psychiatrica Scandinavica 143 ( 3 ) 227 - 237 2021.3

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

OBJECTIVE: There is no report that statistically evaluates the therapeutic reference (350-600 ng/ml) and adverse drug reaction (ADR) range (>1000 ng/ml) of clozapine (CLZ) recommended by the Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie (AGNP) consensus guidelines in an isolated and large sampling study. METHODS: We administered CLZ to 131 Japanese patients with treatment-resistant schizophrenia in a multicenter cross-sectional study. Plasma CLZ concentrations were assayed by high-performance liquid chromatography using trough sampling. The Brief Psychiatric Rating Scale (BPRS) and severe dose-dependent ADR (sedation, myoclonus, and seizures) were analyzed statistically after adjusting for possible confounders. RESULTS: The daily CLZ dosage showed a moderately positive relationship with the plasma concentration (r = 0.49, p < 0.001). Every 100 ng/ml increase in plasma CLZ concentration improved the total BPRS score 1.95% (95% CI: 0.89-3.01, p < 0.001) and the odds ratio (OR) 1.38 (95% CI: 1.14-1.66, p = 0.001) for BPRS response. Compared with concentrations below 350 ng/ml CLZ, 350-600 ng/ml (11.12%; 95% CI: 2.52-19.72, p = 0.012) and 600-1000 ng/ml (11.05%; 95% CI: 2.40-19.71, p = 0.013) showed significant improvement in the total BPRS score. Dosages above 1000 ng/ml showed greater improvement (25.36%; 95% CI: 13.08-37.64, p < 0.001) of the total BPRS score but more severe ADRs than dosages below 1000 ng/ml (OR: 31.72; 95% CI: 1.04-968.81, p = 0.048). CONCLUSION: The AGNP therapeutic reference range (350-600 ng/ml) is useful, and a dose above 1000 ng/ml is potentially more effective but carries the risk of severe ADRs in the central nervous system.

DOI： 10.1111/acps.13264

PD-L1 expression in tongue squamous cell carcinoma.

Naoki Akisada, Kohei Nishimoto, Soshi Takao, Yuka Gion, Hidenori Marunaka, Tomoyasu Tachibana, Takuma Makino, Kentaro Miki, Yusuke Akagi, Munechika Tsumura, Tomohiro Toji, Tadashi Yoshino, Kazunori Nishizaki, Yorihisa Orita, Yasuharu Sato

Medical molecular morphology 54 ( 1 ) 52 - 59 2021.3

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Immune checkpoint proteins programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are important therapeutic targets for head and neck cancer. This large-scale case study aimed to analyze tongue squamous cell carcinomas (SCCs) and evaluate the correlation between PD-L1 expression and clinical prognosis. So far, this study is the largest case study on PD-L1 expression in tongue SCCs. METHODS: This is a case-control study that analyzed 121 tongue SCCs. Paraffin-embedded sections and clinical data were obtained retrospectively and immunohistochemistry with PD-L1 was performed. RESULTS: 11.6% contained ≥ 50% of PD-L1-positive cells, 57.1% of these cases had a poor prognosis with nodal metastasis. Among cases of T1/2 primary lesions with nodal metastasis, cases of high PD-L1 expression had a significantly shorter disease-free survival than cases of no PD-L1 expression (p = 0.018). The hazard ratio for high PD-L1 expression was 3.21 (95 per cent CI, 1.26-8.72) compared with no PD-L1 expression after adjusting for other factors. CONCLUSIONS: These data indicate that PD-L1 upregulation in tongue SCCs is associated with a more advanced stage and shorter disease-free survival. PD-1/PD-L1 inhibitors might hence constitute potential adjuvant therapy for tongue SCCs with PD-L1 upregulation.

DOI： 10.1007/s00795-020-00261-7

Correction to: PD-L1 expression in tongue squamous cell carcinoma.

Naoki Akisada, Kohei Nishimoto, Soshi Takao, Yuka Gion, Hidenori Marunaka, Tomoyasu Tachibana, Takuma Makino, Kentaro Miki, Yusuke Akagi, Munechika Tsumura, Tomohiro Toji, Tadashi Yoshino, Kazunori Nishizaki, Yorihisa Orita, Yasuharu Sato

Medical molecular morphology 54 ( 1 ) 68 - 68 2021.3

Language：English Publishing type：Research paper (scientific journal)

In the original publication of the article an affiliation should be added to the first author “Naoki Akisada” as given below:5Departments of Otolaryngology Head and Neck Surgery,Okayama University Graduate School of Medicine,Dentistry and Pharmaceutical Sciences, Okayama 700‑8558,Japan

DOI： 10.1007/s00795-020-00270-6

Excess All-Cause Mortality During the COVID-19 Outbreak in Japan.

Takashi Yorifuji, Naomi Matsumoto, Soshi Takao

Journal of epidemiology 31 ( 1 ) 90 - 92 2021.1

Serum IgG4 as a biomarker reflecting pathophysiology and post-operative recurrence in chronic rhinosinusitis. Reviewed International journal

Aiko Oka, Takahiro Ninomiya, Tazuko Fujiwara, Soshi Takao, Yasuharu Sato, Yuka Gion, Akira Minoura, Shin-Ichi Haruna, Naohiro Yoshida, Yasunori Sakuma, Kenji Izuhara, Junya Ono, Masami Taniguchi, Takenori Haruna, Takaya Higaki, Shin Kariya, Takahisa Koyama, Tetsuji Takabayashi, Yoshimasa Imoto, Masafumi Sakashita, Masanori Kidoguchi, Kazunori Nishizaki, Shigeharu Fujieda, Mitsuhiro Okano

Allergology international : official journal of the Japanese Society of Allergology 69 ( 3 ) 417 - 423 2020.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Type 2 chronic rhinosinusitis (CRS), especially eosinophilic CRS (ECRS), is an intractable upper airway inflammatory disease. Establishment of serum biomarkers reflecting the pathophysiology of CRS is desirable in a clinical setting. As IgG4 production is regulated by type 2 cytokines, we sought to determine whether serum IgG4 levels can be used as a biomarker for CRS. METHODS: Association between the serum IgG4 levels and clinicopathological factors was analyzed in 336 CRS patients. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value of serum IgG4 levels that can be used to predict the post-operative recurrence. RESULTS: Serum IgG4 levels were significantly higher in patients with moderate to severe ECRS versus those with non to mild ECRS. The levels were also significantly higher in asthmatic patients and patients exhibiting recurrence after surgery compared to controls. ROC analysis determined that the best cut-off value for the serum IgG4 level to predict the post-operative recurrence was 95 mg/dL. The corresponding sensitivity and specificity were 39.7% and 80.5%, respectively. When we combined the two cut-off values for the serum IgG4 and periostin, patients with high serum levels of either IgG4 or periostin exhibited a high post-operative recurrence (OR: 3.95) as compared to patients having low serum levels of both IgG4 and periostin. CONCLUSIONS: The present results demonstrate that the serum IgG4 level is associated with disease severity and post-operative course in CRS. In particular, the combination of serum IgG4 and periostin could be a novel biomarker that predicts post-operative recurrence.

DOI： 10.1016/j.alit.2019.12.004

MACC1 expression is an indicator of recurrence in early-stage glottic cancer International journal

Takuma Makino, Yorihisa Orita, Yuka Gion, Tomoyasu Tachibana, Soshi Takao, Hidenori Marunaka, Kentaro Miki, Naoki Akisada, Yusuke Akagi, Tadashi Yoshino, Kazunori Nishizaki, Yasuharu Sato

Japanese Journal of Clinical Oncology 50 ( 4 ) 392 - 398 2020.4

Language：English Publishing type：Research paper (scientific journal)

Background Metastasis-associated in colon cancer 1 (MACC1) has been reported to be an independent indicator of poor prognoses in some kinds of cancer due to disease metastasis or recurrence. We investigated the correlation between MACC1 expression and the prognosis of glottic cancer. Methods Paraffin-embedded, early-stage (I or II) glottic cancer specimens (n = 52) were immunohistochemically analyzed to explore MACC1 expression. The clinical records associated with each case were also examined. Recurrence-free survival (RFS) was estimated using the Kaplan- Meier method, and between-group RFS differences were assessed using the log-rank test. The multivariate analyses were evaluated using the Cox's proportional-hazard model. Results Patients were treated with only radiotherapy (RT) (n = 37, including 18 with T1 disease and 19 with T2 disease), or with chemoradiotherapy (CRT) (n = 15, including 1 with T1 disease and 14 with T2 disease). Eleven patients demonstrated local recurrence and two patients experienced cervical lymph node recurrence. Tumor specimens were MACC1-positive in 9 of the 13 (69.2%) patients with local or neck recurrence, and 7 of the 11 (63.6%) patients with local recurrence. The RFS rate of patients who were treated with only RT was significantly lower than that of patients who were treated with CRT (P = 0.0243). The RFS rate was significantly lower in cases with MACC1 expression than in those without MACC1 expression (P = 0.0003). Multivariate analysis revealed that MACC1 expression was an independent risk factor of local recurrence (P = 0.0016). Conclusion MACC1 is an independent indicator of recurrence related to RFS in early-stage glottic cancer.

DOI： 10.1093/jjco/hyz206

Switching strategies for antipsychotic monotherapy in schizophrenia: a multi-center cohort study of aripiprazole. International journal

Yoshiaki Obayashi, Satoshi Mitsui, Shinji Sakamoto, Nozomu Minao, Bunta Yoshimura, Toshiki Kono, Yuji Yada, Yuko Okahisa, Soshi Takao, Yoshiki Kishi, Toshihiko Takeda, Manabu Takaki, Norihito Yamada

Psychopharmacology 237 ( 1 ) 167 - 175 2020.1

Language：English Publishing type：Research paper (scientific journal)

RATIONALE: Changing antipsychotics of patients with chronic schizophrenia involves several risks. Switching to aripiprazole is especially difficult. We investigated switching methods and related factors for successful switching patients with chronic schizophrenia to aripiprazole. OBJECTIVES: This study was a multi-center historical cohort study and approved by the research ethics committee of Okayama University Hospital and Okayama Psychiatric Medical Center. We compared survival proportions of 178 chronic schizophrenia patients who continued aripiprazole monotherapy for 6 months after non-direct switching (add-on switching (n = 45), cross switching (n = 62)) or direct switching (n = 71). We adjusted possible confounders using a Cox proportional hazards model. RESULTS: Of patients with chronic schizophrenia, 56.7% (101/178) were switched to aripiprazole monotherapy, and 55.0% (98/178) showed improvement in symptoms as demonstrated by the Clinical Global Impression Severity score. Kaplan-Meier survival curves showed that non-direct switching had a higher survival proportion than direct switching (log-rank test, p = 0.012). Even after adjusting for several variables using a Cox proportional hazards model, add-on switching had a significantly lower hazard at 6 months than direct switching (hazard ratio 0.42, 95% confidence interval 0.21-0.82, P = 0.01). In cases of switching to aripiprazole for psychiatric symptoms, non-direct switching had a lower hazard than direct switching (hazard ratio 0.41, 95% confidence interval 0.21-0.81, P = 0.01) but was not significant for adverse reaction. When aripiprazole was switched from olanzapine, add-on switch showed the lowest hazard ratio for continuation (hazard ratio 0.29, 95% confidence interval 0.07-1.11, P = 0.07). CONCLUSIONS: Flexibility in strategies when switching to aripiprazole may induce a better outcome for patients with chronic schizophrenia.

DOI： 10.1007/s00213-019-05352-7

Switching strategies for antipsychotic monotherapy in schizophrenia: a multi-center cohort study of aripiprazole

Yoshiaki Obayashi, Satoshi Mitsui, Shinji Sakamoto, Nozomu Minao, Bunta Yoshimura, Toshiki Kono, Yuji Yada, Yuko Okahisa, Soshi Takao, Yoshiki Kishi, Toshihiko Takeda, Manabu Takaki, Norihito Yamada

PSYCHOPHARMACOLOGY 237 ( 1 ) 167 - 175 2020.1

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

Rationale Changing antipsychotics of patients with chronic schizophrenia involves several risks. Switching to aripiprazole is especially difficult. We investigated switching methods and related factors for successful switching patients with chronic schizophrenia to aripiprazole. Objectives This study was a multi-center historical cohort study and approved by the research ethics committee of Okayama University Hospital and Okayama Psychiatric Medical Center. We compared survival proportions of 178 chronic schizophrenia patients who continued aripiprazole monotherapy for 6 months after non-direct switching (add-on switching (n = 45), cross switching (n = 62)) or direct switching (n = 71). We adjusted possible confounders using a Cox proportional hazards model. Results Of patients with chronic schizophrenia, 56.7% (101/178) were switched to aripiprazole monotherapy, and 55.0% (98/178) showed improvement in symptoms as demonstrated by the Clinical Global Impression Severity score. Kaplan-Meier survival curves showed that non-direct switching had a higher survival proportion than direct switching (log-rank test, p = 0.012). Even after adjusting for several variables using a Cox proportional hazards model, add-on switching had a significantly lower hazard at 6 months than direct switching (hazard ratio 0.42, 95% confidence interval 0.21-0.82, P = 0.01). In cases of switching to aripiprazole for psychiatric symptoms, non-direct switching had a lower hazard than direct switching (hazard ratio 0.41, 95% confidence interval 0.21-0.81, P = 0.01) but was not significant for adverse reaction. When aripiprazole was switched from olanzapine, add-on switch showed the lowest hazard ratio for continuation (hazard ratio 0.29, 95% confidence interval 0.07-1.11, P = 0.07). Conclusions Flexibility in strategies when switching to aripiprazole may induce a better outcome for patients with chronic schizophrenia.

DOI： 10.1007/s00213-019-05352-7

Impact of reading and writing skills on academic achievement among school-aged hearing-impaired children. International journal

Akiko Sugaya, Kunihiro Fukushima, Soshi Takao, Norio Kasai, Yukihide Maeda, Akie Fujiyoshi, Yuko Kataoka, Shin Kariya, Kazunori Nishizaki

International journal of pediatric otorhinolaryngology 126 109619 - 109619 2019.11

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVES: Reading and writing skills are important for hearing-impaired children since these skills help them to develop their language skills, but the prevalence of reading/writing difficulties and its effects on language development aspects among them are unclear. In this study, we identified language development features and demographic factors of Japanese hearing-impaired children diagnosed as having reading/writing difficulties. METHODS: We analyzed data from a total of 546 sever-to-profound pre-school and elementary school hearing-impaired children for this study. Children with reading/writing difficulties (Group A) were defined as children obtaining low scores (-1.5 SD compared to others in the same grade) in the Screening Test of Reading and Writing for Japanese Primary School Children (STRAW), and we compared other language development features (communication ability, vocabulary, syntax and academic achievement) and demographic factors to those of hearing-impaired children with normal reading and writing skills (Group B). We assessed language development domains as outcomes using the Assessment of Language Development for Japanese Children (ALADJIN) package, and analyzed the results stratified by age groups (5-6, 7-8, 9-10, and 11-12 years) using multiple regression analyses. RESULTS: The prevalence of reading/writing difficulties was 20.1% among the participants. Almost all point estimates in each language development domain showed better odds ratios (OR) except Criterion Referenced Test -II (CRT-II) mathematics in 11- to 12-year-olds in fully-adjusted models. Among 9- to 10-year-olds, the ORs (95% confidence interval) for fair academic achievement measured by CRT-II were 2.60 (1.09-6.20) for Japanese and 3.02 (1.29-7.11) for mathematics in Group B, even after adjusting for possible confounding factors. CONCLUSIONS: Reading and writing are important for language development of hearing-impaired children, especially for academic achievement during the middle phase of elementary school. Screening for reading/writing difficulties is important for appropriate intervention and to prevent language and academic delays among hearing-impaired children.

DOI： 10.1016/j.ijporl.2019.109619

Anti-NMDA-receptor antibody in initial diagnosis of mood disorder. Reviewed International journal

Hiroki Kawai, Manabu Takaki, Shinji Sakamoto, Takashi Shibata, Ayaka Tsuchida, Bunta Yoshimura, Yuji Yada, Namiko Matsumoto, Kota Sato, Koji Abe, Yuko Okahisa, Yoshiki Kishi, Soshi Takao, Ko Tsutsui, Takashi Kanbayashi, Keiko Tanaka, Norihito Yamada

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology 29 ( 9 ) 1041 - 1050 2019.9

Language：English Publishing type：Research paper (scientific journal)

Anti-NMDAR encephalitis is increasingly recognized as one etiology of psychiatric symptoms, but there is not enough evidence on patients with mood disorder. We assayed anti-NR1/NR2B IgG antibodies in serum and/or cerebrospinal fluid of 62 patients initially diagnosed with mood disorder by a cell-based assay. We also investigated the specific patient characteristics and psychotic symptoms. At first admission, the patients showed only psychiatric symptoms without typical neurological signs or abnormal examination findings. Four of the 62 patients had anti-NR1/NR2B IgG antibodies. The anti-NR1/NR2B IgG antibody-positive patients showed more super- or abnormal sensitivity (P = 0.00088), catatonia (P = 0.049), and more conceptual disorganization (P < 0.0001), hostility (P = 0.0010), suspiciousness (P < 0.0001), and less emotional withdrawal (P < 0.0001) and motor retardation (P < 0.0001) on the Brief Psychiatric Rating Scale than the antibody-negative patients. During the clinical course, anti-NR1/NR2B IgG antibody-positive patients showed more catatonia (P = 0.0042) and met Graus's criteria for diagnosis of anti-NMDAR encephalitis, but negative patients did not. Immunotherapy was effective for anti-NR1/NR2B IgG antibody-positive patients, and there was the weak relationship (R² = 0.318) between the anti-NR1/NR2B IgG antibody titer in the cerebrospinal fluid and the Brief Psychiatric Rating Scale score.

DOI： 10.1016/j.euroneuro.2019.07.137

Relationship between workplace social capital and suicidal ideation in the past year among employees in Japan: a cross-sectional study. International journal

Daisuke Hori, Soshi Takao, Ichiro Kawachi, Yuh Ohtaki, Christina-Sylvia Andrea, Tsukasa Takahashi, Nagisa Shiraki, Tomohiko Ikeda, Yu Ikeda, Shotaro Doki, Yuichi Oi, Shinichiro Sasahara, Ichiyo Matsuzaki

BMC public health 19 ( 1 ) 919 - 919 2019.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: A growing body of evidence has demonstrated the associations between social capital and health. In residential or geographical areas, social capital has attracted attention for its protective effects against suicide. However, to this date, the relationship between social capital and suicidal ideation is not fully elaborated in the occupational setting. Therefore, the aim of the present study was to examine the association between workplace social capital and suicidal ideation in the past year among employees in Japan. METHODS: A cross-sectional, web-based survey was conducted in February/March 2017 via an anonymous self-administered questionnaire distributed to workers in Tsukuba Science City, Japan. Binomial logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for suicidal ideation in the past year, controlling for age group, marital status, educational attainment, and annual household income. The results were shown stratified by sex and occupation. RESULTS: In total, 7255 of 19,481 workers responded, out of which we could analyze 6325 responses (4030 men, 2295 women). The prevalence of suicidal ideation in the past year was 5.9% for men and 7.8% for women. Low workplace social capital was statistically significantly associated with suicidal ideation both for men (OR = 2.57, 95% CI = 1.72-3.83) and for women (OR = 1.75, 95% CI = 1.15-2.66), compared with high workplace social capital after controlling for socioeconomic factors. CONCLUSION: Higher workplace social capital was associated with a reduced risk of suicidal ideation in the past year. Promoting workplace social capital could contribute to preventing suicide among employees in Japan.

DOI： 10.1186/s12889-019-7244-9

Reciprocity of social support is associated with psychological distress and suicidal ideation in older Japanese people: A population-based study. International journal

Yuki Mizuno, Hiroyuki Hikichi, Masayuki Noguchi, Ichiro Kawachi, Soshi Takao

Social science & medicine (1982) 230 131 - 137 2019.6

Significance of IgG4-positive cells in severe eosinophilic chronic rhinosinusitis. Reviewed International journal

Koyama T, Kariya S, Sato Y, Gion Y, Higaki T, Haruna T, Fujiwara T, Minoura A, Takao S, Orita Y, Kanai K, Taniguchi M, Nishizaki K, Okano M

Allergology international : official journal of the Japanese Society of Allergology 68 ( 2 ) 216 - 224 2018.10

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: IgG4 production is regulated by type 2 (IL-4 and IL-13) and regulatory (IL-10) cytokines involved in the pathophysiology of chronic rhinosinusitis (CRS). We sought to determine the pathophysiological characteristics of IgG4-positive cells in sinonasal tissues in CRS, especially eosinophilic CRS (ECRS). METHODS: IgG4-positive cells in uncinate tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. Associations between the number of IgG4-positive cells and clinicopathological factors were analyzed. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value of IgG4-positive cells in tissue that can predict the post-operative course. RESULTS: IgG4 was mainly expressed in infiltrating plasma and plasmacytoid cells, and the number of IgG4-positive cells was significantly higher in NP, especially those from severe ECRS patients, than in UT. In CRS patients, the number of IgG4-positive cells significantly and positively correlated with blood and tissue eosinophilia, radiological severity, and serum level of total IgE. The number of infiltrating IgG4-positive cells was significantly higher in patients with a poor post-operative course (sustained sinus shadow 6 months after surgery) than in those with a good one. The number of IgG4-positive cells in NP could discriminate patients with a good or a poor post-operative course (area under the curve: 0.769). Also, 73.3% sensitivity and 82.5% specificity were achieved when the cut-off value was set at 17 cells/high-power field. CONCLUSIONS: Our results suggest that the local expression of IgG4 on cells may be used as a biomarker that reflects the pathophysiology of CRS, including the post-operative course.

DOI： 10.1016/j.alit.2018.09.002

Risk factors of thrombosis in a single method of microsurgical head and neck reconstruction: A multi-institutional study of 773 reconstructions with a free jejunal graft after total pharyngolaryngoesophagectomy for hypopharyngeal cancer Reviewed

Narushi Sugiyama, Soshi Takao, Etsuji Suzuki, Yoshihiro Kimata

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 38 ( 11 ) 1688 - 1694 2016.11

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Background. The risk factors for thrombus formation in anastomotic vessels in free-flap head and neck reconstruction have been previously reported. However, the evidence is inconsistent.
Methods. In total, 773 patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled at 12 institutions in Japan from 1995 to 2006. Both the resection area and the applied reconstruction method were constrained to overcome the limitations of previous studies. After the exclusion of recurrent cases, odds ratios (ORs) and 95% confidence intervals (CIs) for thrombosis were calculated in a multivariate logistic regression analysis.
Results. Postoperative anastomotic thrombosis developed in 23 patients (3.0%). In the multivariate analysis, the OR for thrombosis per 100-mL increase in blood loss was 1.24 (95% CI = 1.02-1.51), even after controlling for other risk factors.
Conclusion. Our results show that the blood loss volume is an independent risk factor for thrombosis in free tissue grafts. (C) 2016 Wiley Periodicals, Inc.

DOI： 10.1002/hed.24504

Correction: Community-Level Social Capital and Psychological Distress among the Elderly in Japan: A Population-Based Study International coauthorship International journal

Tomoko Kobayashi, Etsuji Suzuki, Masayuki Noguchi, Ichiro Kawachi, Soshi Takao

PLOS ONE 10 ( 12 ) e0144683 - e0144683 2015.12

Home visits by commissioned welfare volunteers and psychological distress: a population-based study of 11,312 community-dwelling older people in Japan Reviewed

Masayuki Noguchi, Toshihide Iwase, Etsuji Suzuki, Soshi Takao

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY 30 ( 12 ) 1156 - 1163 2015.12

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

ObjectiveNovel countermeasures to increase healthcare expenditures should be explored in rapidly aging societies, including Japan. Social support is a resource for the older people that effectively reduces psychological distress, with or without specialized health service provision. This cross-sectional study was conducted to determine whether home visits by commissioned welfare volunteers (organizations of community residents assigned by national or local governments) are associated with a lower risk of psychological distress among the older people.
MethodsQuestionnaires were sent in August 2010 to all residents aged 65years in three municipalities (n=21,232) in Okayama Prefecture in Japan; 13,929 were returned (response rate=65.6%). The final sample size for the analysis was 11,312 participants. Home visits, psychological distress (Kessler Psychological Distress Scale: K6>5), and severe psychological distress (K6>13) were measured by the questionnaire. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for psychological distress, adjusting for age, gender, education, marital status, and qualification for long-term care insurance.
ResultsThe prevalence was 41.4% for psychological distress and 6.5% for severe psychological distress among all participants. Home visits were significantly associated with a lower risk of psychological distress after adjusting for the covariates (OR: 0.71, 95% CI: 0.65-0.77). These associations were comparable for men and women. The association was clearer for severe psychological distress (OR: 0.51, 95% CI: 0.43-0.61).
ConclusionsHome visits by commissioned welfare volunteers are significantly associated with a lower risk of psychological distress among older people. Copyright (c) 2015 John Wiley & Sons, Ltd.

DOI： 10.1002/gps.4268

Community-Level Social Capital and Psychological Distress among the Elderly in Japan: A Population-Based Study Reviewed

Tomoko Kobayashi, Etsuji Suzuki, Masayuki Noguchi, Ichiro Kawachi, Soshi Takao

PLOS ONE 10 ( 11 ) e0142629 2015.11

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Despite accumulating evidence, previous studies have not clearly separated the contribution of community-level social capital on mental health from that of individual-level social support. We examined the association between community-level social capital and psychological distress in a sample of older Japanese individuals, taking into account the effects of individual-level social capital and social support. We collected data via a cross-sectional survey among all residents aged >= 65 in three rural municipalities in Okayama Prefecture. We measured two components of social capital in the questionnaire: perceptions of trust and reciprocity in the community. Community-level social capital was obtained by aggregating individual responses and calculating the proportion of subjects reporting mistrust and lack of reciprocity. Psychological distress was assessed by the Kessler Psychological Distress scale. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for psychological distress using two-level Poisson regression models (9,761 individuals nested within 35 communities). The prevalence of psychological distress was 39.8%. Low community-level social capital was associated with psychological distress, even after controlling for individual-level social support, age, sex, educational attainment, frequency of alcohol consumption, smoking status, body mass index, marital status, socioeconomic status, and number of cohabiters. The adjusted RRs per 10% increase of the proportion of mistrust and lack of reciprocity in the communities were 1.23 (95% CI: 1.01-1.51) and 1.12 (95% CI: 1.02-1.24), respectively. Lower levels of community-level social capital are associated with psychological distress among the Japanese elderly population, even after adjusting for individual- level perceptions of social capital and social support.

DOI： 10.1371/journal.pone.0142629

Prospective Evaluation of Zoledronic Acid in the Treatment of Bone Metastases from Differentiated Thyroid Carcinoma. Reviewed International journal

Yorihisa Orita, Iwao Sugitani, Soshi Takao, Kazuhisa Toda, Jun Manabe, Satoshi Miyata

Annals of surgical oncology 22 ( 12 ) 4008 - 13 2015.11

Language：English

PURPOSE: The objectives of this study were to prospectively delineate the efficacy and safety of zoledronic acid for treating bone metastases (BM) from differentiated thyroid carcinoma (DTC), and to evaluate the relationships between levels of bone metabolic markers and occurrence of skeletal-related events (SREs). METHODS: This was a prospective, single-arm, single-center study. Nineteen patients with BM from DTC were assigned to receive zoledronic acid therapy every 4-5 weeks. Imaging studies for sites of BM were conducted every 6 months, and levels of bone metabolic markers, including serum bone-specific alkaline phosphatase (BAP) and urinary N-telopeptide of type I collagen (NTx), were assessed every 3 months. To evaluate the efficacy of zoledronic acid use, data of SREs were compared with those of 16 historical controls. RESULTS: SREs developed in eight patients (42 %), but metastatic spinal cord compression (MSCC) appeared in only one patient. Pain scores were ameliorated in five patients, but aggravated in six patients. Ten patients had stable disease, six showed progressive disease, and none showed partial or complete response during the observation period. Decreases in levels of bone metabolic markers were observed in ten patients for BAP and 15 for NTx. However, no significant correlations were identified between changes in bone metabolic marker levels and development of SREs. CONCLUSIONS: Zoledronic acid may offer a mainstay of multidisciplinary treatment for patients with BM for the purpose of reducing SREs. Levels of serum BAP and urinary NTx do not appear reliable as indicators of amelioration of BM symptoms.

DOI： 10.1245/s10434-015-4497-0

How long should we continue S-1 as adjuvant chemotherapy for squamous cell carcinoma of the head and neck?

Misato Hirai, Yorihisa Orita, Soshi Takao, Tomoyasu Tachibana, Hidenori Marunaka, Seiichiro Makihara, Kentaro Miki, Yasuyuki Noyama, Sayaka Fuji, Akiko Torigoe, Yasuharu Sato, Kazunori Nishizaki

ACTA OTO-LARYNGOLOGICA 135 ( 10 ) 1079 - 1085 2015

Language：English Publishing type：Research paper (scientific journal) Publisher：TAYLOR & FRANCIS LTD

Conclusion: It appears that patients with SCCHN should be recommended to take S-1 for more than 1 year and, if possible, more than 2 years, as adjuvant chemotherapy for SCCHN. Objectives: There is no established consensus on the duration of administration of S-1 as adjuvant chemotherapy for squamous cell carcinoma of the head and neck (SCCHN). Since it might be difficult to undergo prospective randomized study to identify the optimal duration of the administration period of S-1 without a standard, the authors have undergone a retrospective clinical study to decide the tentative standard of therapeutic duration of S-1 as adjuvant chemotherapy for SCCHN. Methods: The clinical records of 89 patients with SCCHN who underwent adjuvant chemotherapy with S-1 were investigated. Results: The median duration of S-1 administration as adjuvant chemotherapy for SCCHN was 7 months (range = 0.1-58 months). Disease-free survivals (DFSs) were generally longer when S-1 administration periods were longer. After adjusting for prognostic factors, S-1 administration periods of 24 months or longer showed significantly lower hazard ratios (HRs) than 0-12 months.

DOI： 10.3109/00016489.2015.1049664

Does HMGB1 predict occult neck lymph node metastasis in early tongue carcinoma? A case-control study of 26 patients

H. Hanakawa, Y. Orita, Y. Sato, M. Takeuchi, S. Takao, K. Ohno, T. Kohno, N. Iwaki, H. Marunaka, R. Tamamura, M. Nishibori, H. Nagatsuka, K. Nishizaki, T. Yoshino

Journal of Laryngology and Otology 128 ( 10 ) 926 - 931 2014.10

Publishing type：Research paper (scientific journal)

Objective: This study examined whether the occurrence of late neck metastasis in early tongue squamous cell carcinoma can be predicted by evaluating HMGB1 (high mobility group box 1) expression in the primary lesion. Methods: A case-control study was conducted. The cases comprised 10 patients with late neck metastasis. The controls consisted of 16 patients without recurrence. All were examined immunohistochemically for HMGB1 protein expression. The odds ratio for late neck metastasis in relation to HMGB1 was estimated. Results: Results for HMGB1 were dichotomised into positive staining scores (score, 5-7) and negative scores (0-4). Six cases (60 per cent) and four controls (25 per cent) were HMGB1-positive. Although no significant result was seen, compared with HMGB1-negative patients the odds ratio for late neck metastasis in HMGB1-positive patients was 3.8 (95 per cent confidence interval, 0.6-26.5) after adjusting for other factors. Conclusion: In the present study, immunohistochemical study of HMGB1 in early tongue squamous cell carcinoma did not appear to be very useful for predicting occult neck metastasis. Further study is necessary to clarify the relationship between HMGB1 expression and late neck metastasis in early tongue squamous cell carcinoma.

DOI： 10.1017/S0022215114001819

Novel and simple prognostic index for nasal natural killer/T- cell lymphoma

Hiroyuki Hanakawa, Yorihisa Orita, Yasuharu Sato, Soshi Takao, Hidenori Marunaka, Tokiwa Morishita, Yasuhiko Yamashita, Yasutaka Hori, Shuhei Domae, Ikuo Inokuchi, Seiko Akagi, Eisei Kondo, Noriko Iwaki, Kana Motomiya, Hirokazu Okumura, Tadashi Yoshino, Kazunori Nishizaki

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 36 ( 4 ) 551 - 556 2014.4

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

BackgroundFew studies have investigated the prognostic factors for nasal natural killer (NK)/T-cell lymphoma.
MethodsThis was a retrospective multicenter clinical study. The clinical records of 36 patients with nasal NK/T-cell lymphoma who had been first treated between 1996 and 2011 were collected from 12 hospitals.
ResultsHigh serum levels of C-reactive protein (1.0 mg/dL), lactate dehydrogenase (350 IU/L), and soluble interleukin-2 receptor (sIL-2R; 600 U/mL) were associated with worse prognosis. A prognostic score was devised by totaling the number of these 3 predictors: 0 or 1 = score 0; and 2 or 3 = score 1. As for tumor invasion, local invasion beyond the nasal cavity was associated with poor prognosis, and a prognostic score was devised as: tumor restricted to nasal cavity, yes = score 0; no = score 1. A novel prognostic index (NPI) was established based on these scores from 0 to 2. Disease-specific survival rates at 5 years were: 90.0% for NPI = 0; 29.3% for NPI = 1; and 0.0% for NPI = 2.
ConclusionOur NPI is valid for anticipating prognosis of nasal NK/T-cell lymphoma. (c) 2013 Wiley Periodicals, Inc. Head Neck36: 551-556, 2014

DOI： 10.1002/hed.23322

Social support and suicidal ideation in Japan: are home visits by commissioned welfare volunteers associated with a lower risk of suicidal ideation among elderly people in the community?

Masayuki Noguchi, Toshihide Iwase, Etsuji Suzuki, Yoko Kishimoto, Soshi Takao

SOCIAL PSYCHIATRY AND PSYCHIATRIC EPIDEMIOLOGY 49 ( 4 ) 619 - 627 2014.4

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER HEIDELBERG

Aims Social support has consistently been reported to be effective in reducing suicidal ideation. This cross-sectional study was performed to determine whether home visits by commissioned welfare volunteers (i.e., organizations of community residents appointed by national or prefectural governments) are associated with a lower risk of suicidal ideation among the elderly.
Methods In August 2010, questionnaires were sent to all residents aged >= 65 years in three municipalities (n = 21,232) in Okayama prefecture, Japan, and 13,929 returned the questionnaire (response rate: 65.6 %). We finally analyzed 11,218 subjects. Both home visits by commissioned welfare volunteers and suicidal ideation within the last 30 days were assessed in the questionnaire. Odds ratios (ORs) and 95 % confidence intervals (CIs) for suicidal ideation were calculated adjusting for age, sex, educational attainment, and marital status. We then additionally adjusted for instrumental and emotional support, separately.
Results The prevalence of suicidal ideation was 10.0 % and higher in women than in men (11.4 % vs. 8.0 %). Home visits were significantly associated with a lower risk of suicidal ideation after adjusting for instrumental and emotional support, respectively (OR: 0.60, 95 % CI: 0.53-0.69; OR: 0.67, 95 % CI: 0.59-0.78). In sex-stratified analysis, the association was clearer for women than for men: the corresponding ORs among women were 0.55 (95 % CI: 0.46-0.65) and 0.61 (95 % CI: 0.52-0.73), whereas they were 0.71 (95 % CI: 0.56-0.90) and 0.78 (95 % CI: 0.61-0.99) among men.
Conclusion Our findings suggest that home visits by commissioned welfare volunteers are significantly associated with lower suicidal ideation among the elderly, particularly in women.

DOI： 10.1007/s00127-013-0752-5

The Bright Side and Dark Side of Workplace Social Capital: Opposing Effects of Gender on Overweight among Japanese Employees

Tomoko Kobayashi, Etsuji Suzuki, Tuula Oksanen, Ichiro Kawachi, Soshi Takao

PLOS ONE 9 ( 1 ) e88084 2014.1

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Background: A growing number of studies have sought to examine the health associations of workplace social capital; however, evidence of associations with overweight is sparse. We examined the association between individual perceptions of workplace social capital and overweight among Japanese male and female employees.
Methodology/Principal Findings: We conducted a cross-sectional survey among full-time employees at a company in Osaka prefecture in February 2012. We used an 8-item measure to assess overall and sub-dimensions of workplace social capital, divided into tertiles. Of 1050 employees, 849 responded, and 750 (624 men and 126 women) could be linked to annual health check-up data in the analysis. Binomial logistic regression models were used to calculate odds ratios and 95% confidence intervals for overweight (body mass index: >= 25 kg/m(2), calculated from measured weight and height) separately for men and women. The prevalence of overweight was 24.5% among men and 14.3% among women. Among men, low levels of bonding and linking social capital in the workplace were associated with a nearly 2-fold risk of overweight compared to high corresponding dimensions of social capital when adjusted for age, sleep hours, physiological distress, and lifestyle. In contrast, among women we found lower overall and linking social capital to be associated with lower odds for overweight even after covariate adjustment. Subsequently, we used multinomial logistic regression analyses to assess the relationships between a 1 standard deviation (SD) decrease in mean social capital and odds of underweight/overweight relative to normal weight. Among men, a 1-SD decrease in overall, bonding, and linking social capital was significantly associated with higher odds of overweight, but not with underweight. Among women, no significant associations were found for either overweight or underweight.
Conclusions/Significance: We found opposite gender relationships between perceived low linking workplace social capital and overweight among Japanese employees.

DOI： 10.1371/journal.pone.0088084

Group involvement and self-rated health among the Japanese elderly: an examination of bonding and bridging social capital

Yoko Kishimoto, Etsuji Suzuki, Toshihide Iwase, Hiroyuki Doi, Soshi Takao

BMC PUBLIC HEALTH 13 1189 2013.12

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

Background: To date, only a small amount of research on bonding/bridging social capital has separately examined their effects on health though they have been thought to have differential effects on health outcomes. By using a large population-based sample of elderly Japanese people, we sought to investigate the association between bonding and bridging social capital and self-rated health for men and women separately.
Methods: In August 2010, questionnaires were sent to all residents aged >= 65 years in three municipalities in Okayama prefecture (n = 21232), and 13929 questionnaires were returned (response rate: 65.6%). Social capital was measured from survey responses to questions on participation in six different types of groups: a) the elderly club or sports/hobby/culture circle; b) alumni association; c) political campaign club; d) citizen's group or environmental preservation activity; e) community association; and f) religious organization. Participant perception of group homogeneity (gender, age, and previous occupation) was used to divide social capital into bonding or bridging. Odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health were calculated.
Results: A total of 11146 subjects (4441 men and 6705 women) were available for the analysis. Among men, bonding and bridging social capital were inversely associated with poor self-rated health (high bonding social capital; OR: 0.55, 95% CI: 0.31-0.99; high bridging social capital; OR: 0.62, 95% CI: 0.48-0.81) after adjusting for age, educational attainment, smoking status, frequency of alcohol consumption, overweight, living arrangements, and type-D personality. The beneficial effect among women was more likely limited to bonding social capital (high bonding social capital; OR: 0.34, 95% CI: 0.12-1.00), and the association between bridging social capital and self-rated health was less clear (high bridging social capital; OR: 0.69, 95% CI: 0.44-1.07).
Conclusions: Bonding/bridging social capital could have differential associations with self-rated health among the Japanese elderly depending on the individual's sex. Considering the lack of consensus on how to measure bonding and bridging social capital, however, we need to carefully assess the generalizability of our findings. Further research is warranted to identify health-relevant dimensions of social capital in different cultural or economic settings.

DOI： 10.1186/1471-2458-13-1189

Workplace Determinants of Social Capital: Cross-Sectional and Longitudinal Evidence from a Finnish Cohort Study

Tuula Oksanen, Ichiro Kawachi, Anne Kouvonen, Soshi Takao, Etsuji Suzuki, Marianna Virtanen, Jaana Pentti, Mika Kivimaki, Jussi Vahtera

PLOS ONE 8 ( 6 ) 2013.6

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Objective: To examine which contextual features of the workplace are associated with social capital.Methods: This is a cohort study of 43,167 employees in 3090 Finnish public sector workplaces who responded to a survey of individual workplace social capital in 2000-02 (response rate 68%). We used ecometrics approach to estimate social capital of work units. Features of the workplace were work unit's demographic and employment patterns and size, obtained from employers' administrative records. We used multilevel-multinomial logistic regression models to examine cross-sectionally whether these features were associated with social capital between individuals and work units. Fixed effects models were used for longitudinal analyses in a subsample of 12,108 individuals to examine the effects of changes in workplace characteristics on changes in social capital between 2000 and 2004.Results: After adjustment for individual characteristics, an increase in work unit size reduced the odds of high levels of individual workplace social capital (odds ratio 0.94, 95% confidence interval 0.91-0.98 per 30-person-year increase). A 20% increase in the proportion of manual and male employees reduced the odds of high levels of social capital by 8% and 23%, respectively. A 30% increase in temporary employees and a 20% increase in employee turnover were associated with 11% (95% confidence interval 1.04-1.17) and 24% (95% confidence interval 1.18-1.30) higher odds of having high levels of social capital respectively). Results from fixed effects models within individuals, adjusted for time-varying covariates, and from social capital of the work units yielded consistent results.Conclusions: These findings suggest that workplace social capital is contextually patterned. Workplace demographic and employment patterns as well as the size of the work unit are important in understanding variations in workplace social capital between individuals and workplaces.

DOI： 10.1371/journal.pone.0065846

Individual-level social capital and self-rated health in Japan: An application of the Resource Generator

Tomoko Kobayashi, Ichiro Kawachi, Toshihide Iwase, Etsuji Suzuki, Soshi Takao

SOCIAL SCIENCE & MEDICINE 85 32 - 37 2013.5

Language：English Publishing type：Research paper (scientific journal) Publisher：PERGAMON-ELSEVIER SCIENCE LTD

Despite accumulating evidence of associations between social capital and health in public health research, a criticism of the field has been that researchers have exclusively focused on concepts of social cohesion to the exclusion of individual-level approaches. In the present study, we evaluated the association between social capital measured by the Resource Generator (an individual-level assessment of access to social capital) and self-rated health among Japanese population in a cross-sectional study. A postal survey of 4000 randomly selected residents in Okayama City (western Japan) was conducted in February 2009. We divided the overall scores from the Resource Generator Japan scale into quartiles. Odds ratios (ORs) and 95% confidence intervals (CIs) for self-rated health were calculated separately by sex. Individuals with the highest quartile of scores had significantly lower odds of poor health compared to the lowest group after covariate adjustment among both men and women (men; OR: 0.45, 95% CI: 0.24-0.86, women; OR: 0.44, 95% CI: 0.25-0.79, respectively) and there were also significant dose-response relationships. In the sub-domains of Resource Generator Japan scale, a differential pattern was observed by sex. Women showed a clear dose response relationship with health across all four sub-scales (domestic resources, expert advice, personal skills, and problem solving resources). In contrast, only the domain of expert advice exhibited a strong association with men's health. Among both men and women individual-level social capital measured by the Resource Generator was related to reduced odds of poor health even after taking into account individual confounders. Although we cannot exclude reverse causation due to the cross-sectional design, our study adds to the accumulating evidence of the potential utility of the Resource Generator for evaluating the relationship between individual-level access to social capital and health. (C) 2013 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.socscimed.2013.02.027

Residential proximity to major roads and adverse birth outcomes: a hospital-based study Reviewed

Takashi Yorifuji, Hiroo Naruse, Saori Kashima, Soshi Takao, Takeshi Murakoshi, Hiroyuki Doi, Ichiro Kawachi

ENVIRONMENTAL HEALTH 12 ( 34 ) 2013.4

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

Background: Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight (LBW). Although evidence has accumulated on characteristics associated with increased risk of air pollution-related health effects, most studies have been conducted in the adult population and evidence on reproductive outcomes is limited. We examined whether socio-economic position (SEP) and parental characteristics (parental behavior and co-morbidity) modified the relationship between air pollution and adverse birth outcomes. Methods: Data were extracted from a perinatal hospital database based in Shizuoka, Japan. We restricted the analysis to mothers who delivered live-born single births from January 1997 to December 2010 (n = 16,615). Each birth was assigned proximity to major roads. Multivariate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated for the outcomes of preterm birth and term LBW. We stratified subjects by individual/area-level SEP and parental characteristics. We then measured interactions on the additive scale between the respective factors and exposure. Results: Lower SEP at both individual and area levels was asso

DOI： 10.1186/1476-069X-12-34

Shift Work and Diabetes Mellitus among Male Workers in Japan: Does the Intensity of Shift Work Matter? Reviewed

Katsuhiko Ika, Etsuji Suzuki, Toshiharu Mitsuhashi, Soshi Takao, Hiroyuki Doi

ACTA MEDICA OKAYAMA 67 ( 1 ) 25 - 33 2013.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

The purpose of this study was to examine the association between shift work and diabetes mellitus by separating shift workers according to the intensity of their shift work (seasonal shift work and continuous shift work). Between May and October 2009, we collected data from annual health checkups and questionnaires at a manufacturing company in Shizuoka, Japan. Questionnaires were returned by 1,601 workers (response rate: 96.2%, men/women = 1,314/287). Diabetes mellitus was defined as hemoglobin Alc >= 6.5% and fasting blood sugar >= 126 mg/dl. After exclusions, which included all the women and clerical workers because they did not work in shifts, we analyzed 475 skilled male workers. After adjusting for age, smoking status, frequency of alcohol consumption, and cohabitation status, odds ratios for diabetes mellitus were 0.98 (95% confidence interval [CI]: 0.28-4.81) and 2.10 (95% CI: 0.77-5.71) among seasonal shift workers and continuous shift workers, respectively, compared with non-shift workers. In an age-stratified analysis (< 45 years vs. >= 45 years), the association between continuous shift work and diabetes mellitus was more pronounced among older participants. Compared with non-shift workers, the risk of diabetes mellitus was increased among continuous shift workers, whereas its effect is limited among seasonal shift workers.

DOI： 10.18926/AMO/49254

Critical Appraisal of the 1977 Diagnostic Criteria for Minamata Disease

Takashi Yorifuji, Toshihide Tsuda, Sachiko Inoue, Soshi Takao, Masazumi Harada, Ichiro Kawachi

ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 68 ( 1 ) 22 - 29 2013.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD

Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata disease). Although the diagnostic criteria for the disease remain current, few studies have been carried out to assess the diagnostic accuracy of the criteria. From a 1971 population-based investigation, data from 2 villages were selected: Minamata (high-exposure area; n = 779) and Ariake (low-exposure area; n = 755). The authors examined the prevalence of neurologic signs characteristic of methylmercury poisoning and the validity of the criteria. A substantial number of residents in the exposed area exhibited neurologic signs even after excluding officially certified patients. Using paresthesia of the extremities as the gold standard of diagnosis, the criteria had a sensitivity of 66%. The current diagnostic criteria as well as the official certification system substantially underestimate the incidence of Minamata disease.

DOI： 10.1080/19338244.2011.627894

Contribution of smoking to the gender gap in life expectancy in Japan Reviewed

Yorifuji, T, Takao, S, Inoue, S, Tanihara, S, Kawachi, I

Public Health 127 ( 5 ) 482 - 484 2013

Clarifying the Use of Aggregated Exposures in Multilevel Models: Self-Included vs. Self-Excluded Measures

Etsuji Suzuki, Eiji Yamamoto, Soshi Takao, Ichiro Kawachi, S. V. Subramanian

PLOS ONE 7 ( 12 ) 2012.12

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Background: Multilevel analyses are ideally suited to assess the effects of ecological (higher level) and individual (lower level) exposure variables simultaneously. In applying such analyses to measures of ecologies in epidemiological studies, individual variables are usually aggregated into the higher level unit. Typically, the aggregated measure includes responses of every individual belonging to that group (i.e. it constitutes a self-included measure). More recently, researchers have developed an aggregate measure which excludes the response of the individual to whom the aggregate measure is linked (i.e. a self-excluded measure). In this study, we clarify the substantive and technical properties of these two measures when they are used as exposures in multilevel models.Methods: Although the differences between the two aggregated measures are mathematically subtle, distinguishing between them is important in terms of the specific scientific questions to be addressed. We then show how these measures can be used in two distinct types of multilevel models-self-included model and self-excluded model-and interpret the parameters in each model by imposing hypothetical interventions. The concept is tested on empirical data of workplace social capital and employees' systolic blood pressure.Results: Researchers assume group-level interventions when using a self-included model, and individual-level interventions when using a self-excluded model. Analytical re-parameterizations of these two models highlight their differences in parameter interpretation. Cluster-mean centered self-included models enable researchers to decompose the collective effect into its within-and between-group components. The benefit of cluster-mean centering procedure is further discussed in terms of hypothetical interventions.Conclusions: When investigating the potential roles of aggregated variables, researchers should carefully explore which type of model-self-included or self-excluded-is suitable for a given situation, particularly when group sizes are relatively small.

DOI： 10.1371/journal.pone.0051717

Workplace social capital and risk of chronic and severe hypertension: a cohort study

Tuula Oksanen, Ichiro Kawachi, Markus Jokela, Anne Kouvonen, Etsuji Suzuki, Soshi Takao, Marianna Virtanen, Jaana Pentti, Jussi Vahtera, Mika Kivimaki

JOURNAL OF HYPERTENSION 30 ( 6 ) 1129 - 1136 2012.6

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Objective: The association between workplace factors and the development of hypertension remains uncertain. We examined the risk of hypertension as a function of workplace social capital, that is, social cohesion, trust and reciprocity in the workplace.
Methods: A total of 11 777 male and 49 145 female employees free of chronic hypertension at baseline in 2000-2004 were followed up for incident hypertension until the end of 2005 (the Finnish Public Sector Study). We used survey responses from the participants and their coworkers in the same work unit to assess workplace social capital at baseline. Follow-up for incident hypertension was based on record linkage to national health registers (mean follow-up 3.5 years, 1424 incident hypertension cases).
Results: Male employees in work units characterized by low workplace social capital were 40-60% more likely to develop chronic hypertension compared to men in work units with high social capital [age-adjusted hazard ratio 1.57, 95% confidence interval (CI) 1.15-2.14 for self-assessed social capital and 1.41, 95% CI 1.01-1.97 for coworkers' assessment]. According to path analysis adjusted for covariates, the association between low self-reported social capital and hypertension was partially mediated by obesity (P for pathway = 0.02) and alcohol consumption (P = 0.03). For coworker-assessed social capital, the corresponding mediation pathways did not reach statistical significance (P = 0.055 and 0.22, respectively). No association between workplace social capital and hypertension was found for women.
Conclusion: These data suggest that low self-reported workplace social capital is associated with increased near-term risk of hypertension in men in part due to unhealthy lifestyle.

DOI： 10.1097/HJH.0b013e32835377ed

Clarifying the use of aggregated exposures in multilevel models: self-included vs. self-excluded measures Reviewed International coauthorship International journal

Etsuji Suzuki, Eiji Yamamoto, Soshi Takao, Ichiro Kawachi, S. V. Subramanian

American Journal of Epidemiology 175 ( Suppl 11 ) S17 - S17 2012.6

Long working hours and metabolic syndrome among Japanese men: a cross-sectional study

Tomoko Kobayashi, Etsuji Suzuki, Soshi Takao, Hiroyuki Doi

BMC PUBLIC HEALTH 12 395 2012.5

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

Background: The link between long working hours and health has been extensively studied for decades. Despite global concern regarding metabolic syndrome, however, no studies to date have solely evaluated the relationship between long working hours and that syndrome. We therefore examined the association between long working hours and metabolic syndrome in a cross-sectional study.
Methods: Between May and October 2009, we collected data from annual health checkups and questionnaires from employees at a manufacturing company in Shizuoka, Japan. Questionnaires were returned by 1,601 workers (response rate: 96.2%; 1,314 men, 287 women). After exclusions, including women because of a lack of overtime work, the analysis was performed for 933 men. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for metabolic syndrome. Further, we conducted a stratified analysis by age-group (<40 years vs. >= 40 years).
Results: Metabolic syndrome was identified in 110 workers (11.8%). We observed a positive association between working hours and metabolic syndrome after adjusting for age, occupation, shift work, smoking status, frequency of alcohol consumption, and cohabiting status. Compared with subjects who worked 7-8 h/day, multivariate ORs for metabolic syndrome were 1.66 (95% CI, 0.91-3.01), 1.48 (95% CI, 0.75-2.90), and 2.32 (95% CI, 1.04-5.16) for those working 8-9 h/day, 9-10 h/day, and >10 h/day, respectively. Similar patterns were obtained when we excluded shift workers from the analysis. In age-stratified analysis, the corresponding ORs among workers aged >= 40 years were 2.02 (95% CI, 1.04-3.90), 1.21 (95% CI, 0.53-2.77), and 3.14 (95% CI, 1.24-7.95). In contrast, no clear association was found among workers aged <40 years.
Conclusions: The present study suggests that 10 h/day may be a trigger level of working hours for increased risk of metabolic syndrome among Japanese male workers.

DOI： 10.1186/1471-2458-12-395

Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects? (vol 54, pg 79, 2012)

Takashi Yorifuji, Miyuki Noguchi, Toshihide Tsuda, Etsuji Suzuki, Soshi Takao, Saori Kashima, Yukio Yanagisawa

JOURNAL OF OCCUPATIONAL HEALTH 54 ( 3 ) 254 - 254 2012.5

Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects? Reviewed

Takashi Yorifuji, Miyuki Noguchi, Toshihide Tsuda, Etsuji Suzuki, Soshi Takao, Saori Kashima, Yukio Yanagisawa

JOURNAL OF OCCUPATIONAL HEALTH 54 ( 2 ) 79 - 87 2012.3

Language：English Publishing type：Research paper (scientific journal) Publisher：JAPAN SOC OCCUPATIONAL HEALTH

Does Open-air Exposure to Volatile Organic Compounds near a Plastic Recycling Factory Cause Health Effects?: Takashi YORIFUJI, et al. Department of Human Ecology, Okayama University Graduate School of Environmental Sciences-Objectives: After a plastic reprocessing factory began to operate in August 2004, the residents around the factory in Neyagawa, Osaka, Japan, began to complain of symptoms. Therefore, we conducted an exposure assessment and a population-based epidemiological study in 2006. Methods: To assess exposure, volatile organic compounds (VOCs) and total VOCs were measured at two locations in the vicinity of the factory. In the population-based study, a total of 3,950 residents were targeted. A self-administered questionnaire was used to collect information about subjects' mucocutaneous or respiratory symptoms. Using logistic regression models, we compared the prevalence of symptoms in July 2006 by employing the farthest area from the factory as a reference, and prevalence odds ratios (PORs) and their 95% confidence intervals (Cis) were estimated. Results: The concentration of total VOCs was higher in the vicinity of the factory. The prevalence of mucocutaneous and respiratory symptoms was the highest among the residents in the closest area to the factory. Some symptoms were significantly increased among the residents within 500 m of the factory compared with residents of an area 2800 m from the factory: e.g., sore throat (POR=3.2, 95% CI: 1.3-8.0), eye itch (POR=3.0, 95% CI: 1.5-6.0), eye discharge (POR=6.0, 95% CI: 2.3-15.9), eczema (POR=3.0, 95% CI: 1.1-7.9) and sputum (POR=2.4, 95% CI: 1.1-5.1). Conclusions: Despite of the limitations of this study, these results imply a possible association of open-air VOCs with mucocutaneous and respiratory symptoms. Because this kind of plasticre cycling factory only recently came into operation, more attention should be paid to the operation of plastic recycling factories in the environment. (J Occup Health 2012; 54: 79-87)

DOI： 10.1539/joh.11-0202-OA

Maternal Working Hours and Early Childhood Overweight in Japan: A Population-based Study Reviewed

Toshiharu Mitsuhashi, Etsuji Suzuki, Soshi Takao, Hiroyuki Doi

JOURNAL OF OCCUPATIONAL HEALTH 54 ( 1 ) 25 - 33 2012.1

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

Maternal Working Hours and Early Childhood Overweight in Japan: A Population-based Study: Toshiharu MITSUHASHI, et al. Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Objectives: There has been a growing concern that maternal employment could have adverse or beneficial effects on children's health. Although recent studies demonstrated that maternal employment was associated with a higher risk of childhood overweight, the evidence remains sparse in Asian countries. We sought to examine the relationship between maternal working hours and early childhood overweight in a rural town in Okayama Prefecture. Methods: In February 2008, questionnaires were sent to parents of all preschool children aged >= 3 yr in the town to assess maternal working status (working hours and form of employment), children's body mass index, and potential confounders. Childhood overweight was defined following the age and sex-specific criteria of the International Obesity Task Force. Odds ratios (ORs) and 95% confidence intervals (CIs) for childhood overweight were estimated in a logistic regression. We used generalized estimating equations with an exchangeable correlation matrix, considering the correlation between siblings. Results: We analyzed 364 preschool children. Adjusting for each child's characteristics (age, sex), mother's characteristics (age, obesity, educational attainment, smoking status, and social participation), and family's characteristics (number of siblings), children whose mothers work <8 h/day had a substantially lower risk for being overweight (OR: 0.28, 95% CI: 0.09, 0.93) compared with children of non-working mothers, whereas the relationship was less pronounced among children whose mothers work >= 8 h/day (OR: 0.71, 95% CI: 0.19, 2.68). We observed similar patterns in a stratified analysis by the form of maternal employment. Conclusion: Short maternal working hours are associated with a lower odds of early childhood overweight. (J Occup Health 2012; 54: 25-33)

DOI： 10.1539/joh.11-0100-OA

Does Caregiver's social bonding enhance the health of their children?: The association between social capital and child behaviors

Takeo Fujiwara, Soshi Takao, Toshihide Iwase, Jun Hamada, Ichiro Kawachi

Acta Medica Okayama 66 ( 4 ) 343 - 350 2012

Language：English Publishing type：Research paper (scientific journal)

Little is known about the association between social capital and child behaviors. This study aims to investigate that association A complete population-based, cross-sectional survey was conducted for all the caregivers with preschool children in a rural town in Okayama prefecture in Japan. Two dimensions of individual-level social capital and unhealthy child behaviors were reported by parent-administered questionnaire. We analyzed 354 preschool children (57.6% of all children for whom questionnaires were completed). Children whose main caregiver had high cognitive social capital were 89% less likely to miss breakfast (odds ratio [OR] =0.11
95% confidence interval [CI]: 0.01-1.03). Children whose caregiver had high structural social capital were 71 % less likely to wake up late (OR = 0.29
95% CI: 0.120.71) and 78% less likely to skip tooth brushing more than once per day (OR = 0.22
95% CI: 0.05-0.93). Both cognitive and structural social capital were negatively associated with unhealthy child behaviors. A further intervention study is needed to confirm the impact of social capital on child behavior.©2012 by Okayama University Medical School.

The role of medicine in the decline of post-War infant mortality in Japan Reviewed

Takashi Yorifuji, Shinichi Tanihara, Sachiko Inoue, Soshi Takao, Ichiro Kawachi

PAEDIATRIC AND PERINATAL EPIDEMIOLOGY 25 ( 6 ) 601 - 608 2011.11

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Yorifuji T, Tanihara S, Inoue S, Takao S, Kawachi I. The role of medicine in the decline of post-War infant mortality in Japan. Paediatric and Perinatal Epidemiology 2011; 25: 601-608.
The infant mortality rate (IMR) in Japan declined dramatically in the immediate post-War period (1947-60) in Japan. We compared the time trends in Growth Domestic Product (GDP) in Japan against declines in IMR. We then conducted a prefecture-level ecological analysis of the rate of decline in IMR and post-neonatal mortality from 1947 to 1960, focusing on variations in medical resources and public health strategies. IMR in Japan started to decline after World War II, even before the era of rapid economic growth and the introduction of a universal health insurance system in the 1960s. The mortality rates per 1000 infants in 2009 were 2.38 for IMR, 1.17 for neonatal mortality and 1.21 for post-neonatal mortality. The rate of decline in IMR and preventable IMR (PIMR) during the post-War period was strongly correlated with prefectural variations in medical resources (per capita physicians, nurses, and proportion of in-hospital births). The correlation coefficients comparing the number of physicians in 1955 with the declines in IMR and PIMR from 1947 to 1960 were 0.46 [95% confidence interval (CI) 0.19, 0.66] and 0.39 [95% CI 0.11, 0.61], respectively. By contrast, indicators of public health strategies were not associated with IMR decline. The IMR in Japan has been decreasing and seems to be entering a new era characterised by lower neonatal compared with post-neonatal mortality. Furthermore, the post-War history of Japan illustrates that improvement in infant mortality is attributable to the influence of medical care, even in the absence of rapid economic development.

DOI： 10.1111/j.1365-3016.2011.01216.x

Workplace Social Capital and Adherence to Antihypertensive Medication: A Cohort Study

Tuula Oksanen, Ichiro Kawachi, Anne Kouvonen, Etsuji Suzuki, Soshi Takao, Noora Sjosten, Marianna Virtanen, Jaana Pentti, Jussi Vahtera, Mika Kivimaki

PLOS ONE 6 ( 9 ) e24732 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：PUBLIC LIBRARY SCIENCE

Background: While hypertension is a common and treatable health problem, adherence to antihypertensive medication remains a challenge. This study examines the hypothesis that workplace social capital may influence adherence to antihypertensive medication among hypertensive employees.
Methodology/Principal Findings: We linked survey responses to nationwide pharmacy records for a cohort of 3515 hypertensive employees (mean age 53.9 years, 76% women) who required continuous antihypertensive drug therapy (the Finnish Public Sector study). A standard scale was used to measure workplace social capital from co-workers' assessments and self-reports in 2000-2004. Non-adherence to antihypertensive medication was determined based on the number of days-not-treated at the year following the survey using comprehensive prescription records. Negative binomial regression models were conducted adjusting for socio-demographic characteristics, duration of hypertension, behaviour-related risk factors, and co-morbid conditions. The overall rate of days-not-treated was 20.7 per person-year (78% had no days-not-treated). Higher age, obesity, and presence of somatic co-morbidities were all associated with better adherence, but this was not the case for co-worker-assessed or self-reported workplace social capital. The rate of days-not-treated was 19.7 per person-year in the bottom fourth of co-worker-assessed workplace social capital, compared to 20.4 in the top fourth. The corresponding rate ratio from the fully-adjusted model was 0.95 (95% confidence interval (CI) 0.58-1.56). In a subgroup of 907 new users of antihypertensive medication this rate ratio was 0.98 (95% CI 0.42-2.29).
Conclusions/Significance: We found no consistent evidence to support the hypothesized effect of workplace social capital on adherence to drug therapy among employees with chronic hypertension.

DOI： 10.1371/journal.pone.0024732

Regional disparities in compliance with tobacco control policy in Japan: an ecological analysis Reviewed

Takashi Yorifuji, Shinichi Tanihara, Soshi Takao, Ichiro Kawachi

TOBACCO CONTROL 20 ( 5 ) 374 - 379 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：B M J PUBLISHING GROUP

Background The slow progress of tobacco control policy in Japan reflects the tension among the interests of the Finance Ministry (which remains the majority shareholder of Japan Tobacco, Inc), the Health Ministry, tobacco growers and consumers.
Methods We sought to examine regional disparities in compliance with national tobacco control legislation (the 2003 Health Promotion Law). Specifically, we sought to examine whether prefecture-level compliance with legislation was correlated with decreases in smoking prevalence, and decreases in lung cancer mortality rates. We also examined whether prefectural involvement in growing tobacco was associated with lower compliance with the law.
Results From 2001 to 2007, higher prefectural compliance with tobacco control laws was associated with decreased prevalence of smoking. Decreased tobacco consumption was in turn associated with declining lung cancer mortality. Prefectures involved in growing tobacco exhibited lower levels of compliance with national tobacco control laws. The same prefectures also exhibited the worst improvement in smoking prevalence.
Conclusions This study in Japan suggests that tobacco control policies are being unevenly implemented across prefectures, and that measures to counteract the influence of local tobacco culture are required to reduce the disparities in regional tobacco control outcomes in that country.

DOI： 10.1136/tc.2010.041442

Workplace Social Capital and All-Cause Mortality: A Prospective Cohort Study of 28043 Public-Sector Employees in Finland

Tuula Oksanen, Ichiro Kawachi, S. V. Subramanian, Mika Kivimaki, Jaana Pentti, Paula Salo, Marianna Virtanen, Jussi Vahtera, Soshi Takao, Etsuji Suzuki, Anne Kouvonen

AMERICAN JOURNAL OF PUBLIC HEALTH 101 ( 9 ) 1742 - 1748 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：AMER PUBLIC HEALTH ASSOC INC

Objectives. We examined the association between workplace social capital and all-cause mortality in a large occupational cohort from Finland.
Methods. We linked responses of 28043 participants to surveys in 2000 to 2002 and in 2004 to national mortality registers through 2009. We used repeated measurements of self- and coworker-assessed social capital. We carried out Cox proportional hazard and fixed-effects logistic regressions.
Results. During the 5-year follow-up, 196 employees died. A 1-unit increase in the mean of repeat measurements of self-assessed workplace social capital (range 1-5) was associated with a 19% decrease in the risk of all-cause mortality (age- and gender-adjusted hazard ratio [HR]=0.81; 95% confidence interval [CI) =0.66, 0.99). The corresponding point estimate for the mean of coworker-assessed social capital was similar, although the association was less precisely estimated (age- and gender-adjusted HR=0.77; 95% CI=0.50, 1.20). In fixed-effects analysis, a 1-unit increase in self-assessed social capital across the 2 time points was associated with a lower mortality risk (odds ratio=0.81; 95% CI=0.55, 1.19).
Conclusions. Workplace social capital appears to be associated with lowered mortality in the working-aged population. (Am J Public Health. 2011;101: 1742-1748. doi:10.2105/AJPH.2011.300166)

DOI： 10.2105/AJPH.2011.300166

Diesel vehicle emission and death rates in Tokyo, Japan: A natural experiment

Takashi Yorifuji, Ichiro Kawachi, Mariko Kaneda, Soshi Takao, Saori Kashima, Hiroyuki Doi

SCIENCE OF THE TOTAL ENVIRONMENT 409 ( 19 ) 3620 - 3627 2011.9

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE BV

Evidence linking air pollution with adverse cardiopulmonary outcomes is accumulating. However, few studies have been conducted to evaluate whether vehicle emission control improves public health. We thus evaluated the effect of a diesel emission control law on mortality rates in 23 wards of Tokyo metropolitan area, Japan. We obtained daily counts of mortality and concentrations of nitrogen dioxide (NO2) and particulate matter less than 2.5 mu m in diameter (PM2.5) from April 2003 to December 2008. Time-series and interrupted time-series analysis were employed to analyze the data in two periods: prior to the introduction of tighter restrictions (April 2003 to March 2006) and after the enforcement (April 2006 to December 2008). Concentrations of air pollutants gradually decreased during the study period: from 36.3 ppb (NO2) and 22.8 mu g/m(3) (PM2.5) to 32.1 ppb and 20.3 mu g/m(3), respectively. Air pollutants were positively associated with circulatory and pulmonary disease mortality, especially cerebrovascular disease. Each same-day PM2.5 increase of 10 mu g/m(3) was associated with a 1.3% increase in cerebrovascular mortality rate (95% confidence interval: 0.2-2.4). Rate ratios were attenuated after the enforcement in most of the outcomes, probably due to reduced toxicity of the pollutants. In the crude interrupted time-series analysis, reductions of standardized mortality rates after the enforcement were the greatest in high traffic areas. Even after adjustment of longer-time trend, mortality rate from cerebrovascular disease was reduced by 8.50% (p<.001) with dose-response relationship. However, the declines in other cause-specific mortality became equivocal. This natural experiment in Tokyo suggests that emission controls improved air quality. Although suggestive, further data are needed to conclusively demonstrate an impact on mortality rates. (C) 2011 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.scitotenv.2011.06.002

Long-term exposure to methylmercury and psychiatric symptoms in residents of Minamata, Japan Reviewed

Takashi Yorifuji, Toshihide Tsuda, Sachiko Inoue, Soshi Takao, Masazumi Harada

ENVIRONMENT INTERNATIONAL 37 ( 5 ) 907 - 913 2011.7

Language：English Publishing type：Research paper (scientific journal) Publisher：PERGAMON-ELSEVIER SCIENCE LTD

Introduction: It is well-known that prenatal or postnatal exposure to methylmercury can produce neurological signs in adults and children, exemplified by a case of large-scale poisoning in Minamata, Japan, in the 1950s. However, evidence regarding whether pre- or postnatal exposure to methylmercury causes psychiatric symptoms (e.g., impairment of intelligence and mood and behavioral dysfunction) is still limited-excluding cases of fetal Minamata disease patients.
Methods: We evaluated the effects of pre- or postnatal exposure to methylmercury on psychiatric symptoms using data derived from a 1971 population-based survey in Minamata and neighboring communities. We adopted residential areas as an exposure indicator and psychiatric symptoms as the outcome. Then, we estimated the adjusted prevalence odds ratio (POR) and confidence interval (Cl) of psychiatric symptoms in relation to residential area.
Results: There were 904 participants in Minamata (high exposure area), 1700 in Goshonoura (middle exposure area), and 913 in Ariake (low exposure area). Compared to the Ariake area, participants in the Minamata area manifested psychiatric symptoms more frequently: PORs for impairment of intelligence and mood and behavioral dysfunction were 5.2 (95% Cl: 3.7-7.3) and 4.4 (95% Cl: 2.9-6.7), respectively. Furthermore, participants with psychiatric symptoms in the Minamata area more frequently had neurological signs. Peaks in prevalence of psychiatric symptoms occurred around age 20 and in older age adults in the area. These findings did not change when we excluded those who had been officially certified as Minamata disease patients by that time.
Conclusions: The present study suggests a relationship between pre- or postnatal exposure to methylmercury and psychiatric symptoms among the general population in Minamata even after excluding officially certified patients. (C) 2011 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.envint.2011.03.008

Residential proximity to heavy traffic and birth weight in Shizuoka, Japan Reviewed

Saori Kashima, Hiroo Naruse, Takashi Yorifuji, Shigeru Ohki, Takeshi Murakoshi, Soshi Takao, Toshihide Tsuda, Hiroyuki Doi

ENVIRONMENTAL RESEARCH 111 ( 3 ) 377 - 387 2011.4

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

An association between exposure to traffic-related air pollution and reduced birth weight has been suggested. However, previous studies have failed to adjust for maternal size, which is an indicator of individual genetic growth potential. Therefore, we evaluated the association of air pollution with birth weight, term low birth weight (term-LBW), and small for gestational age (SGA), with adjustment for maternal size. Individual data were extracted from a database that is maintained by a maternal and perinatal care center in Shizuoka, japan. We identified liveborn singleton births (n=14,204). Using geocoded residential information, each birth was assigned a number of traffic-based exposure indicators: distance to a major road; distance-weighted traffic density; and estimated concentration of nitrogen dioxide by land use regression. The multivariate adjusted odds ratios and their 95% confidence intervals (CIs) for the associations between exposure indicators and outcomes were then estimated using logistic regression models. Overall, exposure indicators of air pollution showed no clear pattern of association. Although there are many limitations, we did not find clear associations between birth-weight-related outcomes and the three markers of traffic-related air pollution. (C) 2011 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.envres.2011.02.005

Residential Proximity to Major Roads and Preterm Births

Takashi Yorifuji, Hiroo Naruse, Saori Kashima, Shigeru Ohki, Takeshi Murakoshi, Soshi Takao, Toshihide Tsuda, Hiroyuki Doi

EPIDEMIOLOGY 22 ( 1 ) 74 - 80 2011.1

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background: Preterm births cause a large public-health burden, and air pollution is considered to be a potential risk factor. We evaluated the association between proximity to major roads (as an index for air pollution) and preterm births, classified by gestational age and specific clinical manifestations.Methods: Data on parental information and birth outcomes were extracted from the database maintained by the perinatal hospital in Shizuoka, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,226). Using the geocoded residential information, each birth was classified on its proximity to major roads. We estimated the multivariate-adjusted odds ratios and their 95% confidence intervals (CIs) for the association of proximity to major roads with preterm births, using logistic regression.Results: We found positive associations between proximity to major roads and preterm births at all gestational ages. Living within 200 m increased the risk of births before 37 weeks by 1.5 times (95% CI = 1.2-1.8), birth before 32 weeks by 1.6 times (1.1-2.4), and births before 28 weeks by 1.8 times (1.0-3.2). Proximity specifically increased the risk of preterm births with preterm premature rupture of the membranes and with pregnancy hypertension.Conclusions: This study demonstrates that exposure to traffic-related air pollution increases even the risk of preterm births of less than 30 weeks' gestational age and proposes a possible mechanism.

DOI： 10.1097/EDE.0b013e3181fe759f

Environmental Factors and Seasonal Influenza Onset in Okayama City, Japan: Case-Crossover Study

Yuuki Tsuchihashi, Takashi Yorifuji, Soshi Takao, Etsuji Suzuki, Shigeru Mori, Hiroyuki Doi, Toshihide Tsuda

ACTA MEDICA OKAYAMA 65 ( 2 ) 97 - 103 2011

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Seasonal influenza infection is a major challenge in public health. The term "seasonal influenza" refers to the typical increase in the number of influenza patients in the winter season in temperature zones. However, it is not clear how environmental factors within a single flu season affect influenza infection in a human population. Therefore, we evaluated the effects of temperature and humidity in the 2006-7 flu season on the onset of seasonal influenza using a case-crossover study. We targeted patients who attended one pediatric clinic in Okayama city, Japan and who were diagnosed as being infected with the seasonal influenza virus. Using 2 references (time-stratified and symmetric bidirectional design), we estimated the effects of average temperature and relative humidity from the onset day (lag0) to 10 days before (lag10). The total number of subjects was 419, and their onset days ranged from 26 December 2006 to 30 April 2007. While the onset was significantly associated with lower temperature, relative humidity was not related. In particular, temperatures before the 3-day incubation period had higher-magnitude odds ratios. For example, the odds ratio and 95% confidence interval for average temperature at time lag 8 was 1.12 (1.08-1.17) per 1.0 degrees C decrease. Low environmental temperature significantly increased the risk of seasonal influenza onset within the 2006-7 winter season.

DOI： 10.18926/AMO/45268

Multi-level, cross-sectional study of workplace social capital and smoking among Japanese employees

Etsuji Suzuki, Takeo Fujiwara, Soshi Takao, S. V. Subramanian, Eiji Yamamoto, Ichiro Kawachi

BMC PUBLIC HEALTH 10 2010.8

Language：English Publishing type：Research paper (scientific journal) Publisher：BMC

Background: Social capital is hypothesized to be relevant to health promotion, and the association between community social capital and cigarette smoking has been examined. Individual-level social capital has been found to be associated with smoking cessation, but evidence remains sparse on the contextual effect of social capital and smoking. Further, evidence remains sparse on the association between smoking and social capital in the workplace, where people are spending an increasing portion of their daily lives. We examined the association between workplace social capital and smoking status among Japanese private sector employees.Methods: We employed a two-stage stratified random sampling procedure. Of the total of 1,800 subjects in 60 companies, 1,171 (men/women; 834/337) employees (65.1%) were identified from 46 companies in Okayama in 2007. Workplace social capital was assessed in two dimensions; trust and reciprocity. Company-level social capital was based on inquiring about employee perceptions of trust and reciprocity among co-workers, and then aggregating their responses in order to calculate the proportion of workers reporting mistrust and lack of reciprocity. Multilevel logistic regression analysis was conducted using Markov Chain Monte Carlo methods to explore whether individual-and company-level social capital was associated with smoking. Odds ratios (ORs) and 95% credible intervals (CIs) for current smoking were obtained.Results: Overall, 33.3% of the subjects smoked currently. There was no relationship between individual-level mistrust of others and smoking status. By contrast, one-standard deviation change in company-level mistrust was associated with higher odds of smoking (OR: 1.25, 95% CI: 1.06-1.46) even after controlling for individual-level mistrust, sex, age, occupation, educational attainment, alcohol use, physical activity, body mass index, and chronic diseases. No clear associations were found between lack of reciprocity and smoking both at the individual-and company-level.Conclusions: Company-level mistrust is associated with higher likelihood of smoking among Japanese employees, while individual perceptions of mistrust were not associated. The link between lack of reciprocity and smoking was not supported either at the individual-or company-level. Further studies are warranted to examine the possible link between company-level trust and smoking cessation in the Japanese workplace.

DOI： 10.1186/1471-2458-10-489

Does low workplace social capital have detrimental effect on workers' health?

Etsuji Suzuki, Soshi Takao, S. V. Subramanian, Hirokazu Komatsu, Hiroyuki Doi, Ichiro Kawachi

SOCIAL SCIENCE & MEDICINE 70 ( 9 ) 1367 - 1372 2010.5

Language：English Publishing type：Research paper (scientific journal) Publisher：PERGAMON-ELSEVIER SCIENCE LTD

While the majority of studies of social capital and health have focused on conceptualizing social capital at the geographic level, evidence remains sparse on workplace social capital. We examined the association between workplace social capital and health status among Japanese private sector employees in a cross-sectional study. By employing a two-stage stratified random sampling procedure, 1147 employees were identified from 46 companies in Okayama in 2007. Workplace social capital was measured based on two components; trust and reciprocity. Company-level social capital was based on aggregating employee responses and calculating the proportion of workers reporting mistrust and lack of reciprocity. Multilevel logistic regression analysis was conducted using Markov Chain Monte Carlo methods to explore whether individual- and company-level mistrust and lack of reciprocity were associated with poor self-rated health. Odds ratios (ORs) and 95% credible intervals (as) for poor health were obtained for each variable. Workers reporting individual-level mistrust and lack of reciprocity had approximately double the odds of poor health even after controlling for sex, age, occupation, educational attainment, smoking, alcohol use, physical activity, body mass index, and chronic diseases. While we found some suggestion of a contextual association between company-level mistrust and poor health, no association was found between company-level lack of reciprocity and health. Despite the thorough examination of cross-level interaction terms between company-level social capital and individual characteristics, no clear patterns were observed. Individual perceptions of mistrust and lack of reciprocity at work have adverse effects on self-rated health among Japanese workers. Although the present study possibly suggests the contextual effect of workplace mistrust on workers' health, the contextual effect of workplace lack of reciprocity was not supported. (C) 2010 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.socscimed.2010.01.014

Long-term exposure to methylmercury and its effects on hypertension in Minamata Reviewed

Yorifuji T, Tsuda T, Kashima S, Takao S, Harada M

Environmental Research 110 ( 1 ) 40 - 46 2010.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Recent studies suggest potential adverse effects of methylmercury exposure on cardiovascular disease, although the evidence of association with hypertension is still inconsistent. Therefore, we evaluated the effects of methylmercury exposure on hypertension in Minamata. We used data derived from the 1971 population-based survey in Minamata and neighboring communities. We also utilized data on hair mercury content of the participants (derived from a 1960 investigation). We adopted two exposure indices (residential area and hair mercury content) and two hypertension outcomes (past history of hypertension and hypertension defined by measurements in the examination). Then, we estimated the adjusted prevalence odds ratio (POR) and its confidence interval (CI) of both hypertension outcomes in relation to residential area and hair mercury content. In the Minamata area (high exposure area), 87% (833) of the eligible population (aged >= 10 years) participated in the 1971 investigations. In the Goshonoura area (middle exposure area) and the Ariake area (low exposure area), 93% (1450) and 77% (755), respectively, of the eligible population participated. Compared with subjects in the Ariake area, the subjects in the Minamata area manifested hypertension more frequently, and PORs observed for two hypertension outcomes were 1.6 (95% CI: 1.2-2.1) and 1.4 (95% CI: 1.1-1.9), respectively. Furthermore, dose-response trends with hair mercury content were observed for both hypertension outcomes. The present finding supports the causal relationship between methylmercury exposure and hypertension. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.envres.2009.10.011

Green Tea Consumption and Mortality among Japanese Elderly People: The Prospective Shizuoka Elderly Cohort Reviewed

Etsuji Suzuki, Takashi Yorifuji, Soshi Takao, Hirokazu Komatsu, Masumi Sugiyama, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

ANNALS OF EPIDEMIOLOGY 19 ( 10 ) 732 - 739 2009.10

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

PURPOSE: To investigate the association between green tea consumption and mortality from all causes, cancer, and cardiovascular disease (CVD) among elderly people.METHODS: In a population-based, prospective cohort study, a total of 14,001 elderly residents (aged 65-84 years), randomly chosen from all 74 municipalities in Shizuoka, Japan, completed questionnaires that included items about frequency of green tea consumption. They were followed for up to 6 years, from December 1999 to March 2006. Consequently, 12,251 subjects were analyzed to estimate the hazard ratios (HRs) for all-cause mortality, cancer, and CVD.RESULTS: Among 64,002 person-years, 1,224 deaths were identified (follow-up rate, 71.6%). The multivariate HRs and 95% confidence intervals (CIs) for CVD mortality compared those who consumed seven or more cups per day with those who consumed less than one cup per day, were 0.24 (0.14-0-40), 0.30 (0.15-0.61), and 0.18 (0.08-0.40) for total participants, men, and women, respectively. Although green tea consumption was not inversely associated with cancer mortality, green tea consumption and colorectal cancer mortality were inversely associated with a moderate dose-response relationship.CONCLUSIONS: Green tea consumption is associated with reduced mortality from all causes and CVD. This study also suggests that green tea Could have protective effects against colorectal cancer. Ann Epidemiol 2009; 19:732-739. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.annepidem.2009.06.003

Sleep duration, sleep quality and cardiovascular disease mortality among the elderly: A population-based cohort study Reviewed

Etsuji Suzuki, Takashi Yorifuji, Kazumune Ueshima, Soshi Takao, Masumi Sugiyama, Toshiki Ohta, Kazuko Ishikawa-Takata, Hiroyuki Doi

PREVENTIVE MEDICINE 49 ( 2-3 ) 135 - 141 2009.8

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Objective. To investigate the associations between sleep duration and mortality in the elderly by controlling for sleep quality.Method. Data were collected from participants in a cohort study in Shizuoka, Japan. A total of 14,001 elderly residents (aged 65-85 years), randomly chosen from all 74 municipalities in the prefecture. completed questionnaires that evaluated sleep duration, sleep complaints, and the use of hypnotics. Participants were followed from 1999 to 2006. We analyzed 11,395 subjects to estimate the hazard ratios (HR) for mortality from all causes and cardiovascular disease (CVD).Results. With 60,252 person-years, 1004 deaths were identified. While short sleep duration and mortality were not associated, longer sleep duration was associated with higher risk of mortality in both sexes. Compared with those who slept 7 h, the multivariate HR and 95% confidence interval of CVD mortality for those who slept >= 10 h was 1.95 (1.18-3.21) and, for those who slept <= 5 h, it was 1.10 (0.62-1.93). Although no clear association was found between sleep quality and mortality, long sleep duration was associated with higher risk of CVD mortality among those with poor sleep quality.Conclusion. Long sleep duration is associated with higher risk of CVD mortality among the elderly with poor sleep quality. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ypmed.2009.06.016

Total Mercury Content in Hair and Neurologic Signs Historic Data From Minamata

Takashi Yorifuji, Toshihide Tsuda, Soshi Takao, Etsuji Suzuki, Masazumi Harada

EPIDEMIOLOGY 20 ( 2 ) 188 - 193 2009.3

Language：English Publishing type：Research paper (scientific journal) Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background: Large-scale methylmercury poisonings have occurred in Japan (Minamata and Niigata) and in Iraq. The current WHO threshold for adult exposure (hair level: 50 mu g/g) was based on evidence from Niigata, which included only acute and severe cases. That study leaves open the possibility of more subtle effects at lower exposure levels.Methods: The Shiranui sea had been contaminated in the 1950s by the discharge of methylmercury from a factory near Minamata.In 1960, the hair mercury content of 1694 residents living on the coastline of the Shiranui sea was measured by researchers from the Kumamoto Prefecture Institute for Health Research. Independently, in 1971, a population-based study to examine neurologic signs was conducted in the Minamata and Goshonoura areas, on the coastline of the Shiranui Sea, and the Ariake area (reference), by researchers at Kumamoto University. We identified 120 residents from exposed areas who were included in both datasets, plus 730 residents of Ariake (an unexposed area) who were also examined for neurologic signs.Results: Hair mercury levels were associated with perioral sensory loss in a dose-response relationship. The adjusted prevalence odds ratios and 95% confidence intervals for perioral sensory loss, compared with the lowest exposure category (0-10 mu g/g), were 4.5 (0.5-44), 9.1 (1.0-83), and 10 (0.9-110), for the dose categories >10 to 20, >20 to 50, and >50 mu g/g, respectively. The prevalence of all neurologic signs was higher in the exposure area than in Ariake.Conclusions: An increased prevalence of neurologic signs, especially perioral sensory loss, was found among residents with hair mercury content below 50 mu g/g.

DOI： 10.1097/EDE.0b013e318190e73f

Impact of Breastfeeding on Body Weight of Preschool Children in a Rural Area of Japan: Population-based Cross-sectional Study Reviewed

Hirokazu Komatsu, Takashi Yorifuji, Toshibide Iwase, Ayako Sasaki, Soshi Takao, Hiroyuki Doi

ACTA MEDICA OKAYAMA 63 ( 1 ) 49 - 55 2009.2

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

To investigate the effect of exclusive breastfeeding on the likelihood of Japanese preschool children being overweight, population-based cross-sectional survey data from M town in Japan were used. Using the population registry of this town, all 616 preschool children were identified, and a self-administered questionnaire was sent to their parents. The exposure variable of interest was exclusive breastfeeding from. birth to 6 months, and the outcome variable of interest was the children being overweight at preschool age. Statistical analyses used included logistic regression and sensitivity analyses. In the final analyses, we included 448 preschool children. Although all point estimates indicated a protective effect, logistic regression analyses showed no significant reduction in being overweight due to exclusive breastfeeding in the unadjusted model (odds ratio (OR)= 0.70, 95% confidence intervals: 0.30-1.64), the model adjusted for birth weight (OR = 0.70, 95% CI: 030-1.63), the model adjusted for child lifestyle (OR = 0.71, 95% CI: 0.30-1.67), or the model adjusted for parental factors (OR=0.46, 95% CI: 0.15-1.37). In sensitivity analyses, point estimates were not significant, but a protective effect was observed. In conclusion, our results suggest that breastfeeding might have a protective effect on Japanese preschool children against being overweight, although statistical significance was not observed due to the limitation of the statistical power of the findings.

Long-Term Exposure to Particulate Matter and All-Cause and Cause-Specific Morality in Japan: Shizuoka Study Reviewed

Takashi Yorifuji, Saori Kashima, Etsuji Suzuki, Soshi Takao, Toshihide Tsuda, Hiroyuki Doi

The journal of obstetrics and gynaecology research 19 ( 6 ) S195 2008.11

[Utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health among enterprises in Japan]. Reviewed

Toshiharu Mitsuhashi, Soshi Takao, Akizumi Tsutsumi, Norito Kawakami

Sangyo eiseigaku zasshi = Journal of occupational health 48 ( 5 ) 183 - 91 2006.9

Language：Japanese Publishing type：Research paper (scientific journal)

In order to know utilization, needs, and related factors for e-learning and its application to education and training in occupational safety and health (OSH) among enterprises in Japan, a questionnaire survey was conducted of enterprises randomly selected from those with 1,000 or more employees and those with 999 or less (500 for each). Data from 134 (56 and 78, respectively) enterprises were analyzed (response rate, 13%). Among total enterprises, 19% had introduced and 16% planned to introduce e-learning. However, only 7% of larger enterprises and less than 3% of smaller enterprises used e-learning for education and training in OSH. On the other hand, 80-90% of enterprises responded positively to considering the use of e-learning for education and training on various OSH topics for various users. Highly rated merits of e-learning were "can use whenever", "can use anywhere"; and its highly rated obstacles were "cost", "individual PC not available", "insufficient information on efficacy". However, the merit "can monitor training" was significantly associated with the use/plan of e-learning. "Good contents not available" was more frequent among enterprises which used/planned e-learning. The study indicated a greater need for e-learning based OSH education and training, despite a currently low rate of its use. Improvement of e-learning platforms and contents, reduction of cost, and improvement of e-learning infrastructure at work may be needed to facilitate the use of e-learning in OSH.

職場における管理監督者メンタルヘルス研修前後の知識・態度・行動の変化 Reviewed

西内恭子, 高尾総司, 峰山幸子, 堤明純, 川上憲人

産業衛生学雑誌 46 ( 臨増 ) 323 - 323 2004.3

心理社会的職業性ストレスと仕事のパフォーマンス自記式質問紙による検討 Reviewed

堤明純, 川上憲人, 高尾総司, 峰山幸子, 西内恭子

産業衛生学雑誌 46 ( 臨増 ) 426 - 426 2004.3

管理監督者の傾聴的態度スキルと一般従業員のメンタルヘルスの関連についての検討 Reviewed

峰山幸子, 高尾総司, 西内恭子, 堤明純, 川上憲人

産業衛生学雑誌 46 ( 臨増 ) 323 - 323 2004.3

職場における管理監督者向けメンタルヘルス基礎研修のRCTによる効果評価 Reviewed

津田佳穂, 高尾総司, 峰山幸子, 西内恭子, 堤明純, 川上憲人

産業衛生学雑誌 46 ( 臨増 ) 322 - 322 2004.3

F305 原因確率とAction・Lnaction・Causal lnference

津田敏秀, 大津忠弘, 高尾総司, 茂見潤, 馬場園明, 三野善央

産業衛生学雑誌 44 516 - 516 2002

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