Practices, Recommendations, Knowledge, and Sources of Information for Primary Care Physicians regarding Vaccinations: A Nationwide Survey in Japan, 2019 / 日本プライマリ・ケア連合学会誌

Introduction: Vaccine policies have changed in recent years in Japan. In the present study, we assessed practices, recommendations, knowledge, and sources of information among primary care physicians (PCPs) regarding vaccinations in Japan. Methods: We conducted a nationwide cross-sectional study targeting PCPs in Japan. We used a web-based self-administered questionnaire targeting physicians that were members of the Japan Primary Care Association in 2019. We analyzed respondent administrations, recommendations, knowledge, and sources of information regarding vaccinations. Results: We received responses from 1,084 PCPs (20.1%) and invited 981 participants for the analysis. The rates at which physicians gave routine and voluntary vaccines in their own practices were 23.3-95.5% and 13.2-94.4%, respectively. The active recommendation rates for routine and voluntary vaccines were 41.6-92.0% and 13.6-75.5%, respectively. Furthermore, among routine vaccines, human papillomavirus vaccine was the least administered and recommended. PCPs working at clinics had the most accurate knowledge about vaccinations, and PCPs utilized academic organizations most readily as an information resource. Conclusion: We clarified practices, recommendations, knowledge, and sources of information regarding vaccinations among PCPs in Japan.

Association between Serum Gamma-Glutamyltransferase and Prevalence of Metabolic Syndrome Using Data from the Korean Genome and Epidemiology Study

BACKGROUND: The aim of this study was to determine whether there is a positive correlation between gamma-glutamyltransferase (GGT) levels and the prevalence of metabolic syndrome and whether GGT can be used as an easily checkable metabolic index using data from the large-scale Korean Genome and Epidemiology Study (KoGES).METHODS: We obtained data of 211,725 participants of the KoGES. The collected data included age, sex, height, weight, waist circumference, and various biochemical characteristics, including serum GGT levels. The data of study participants who ingested more than 40 g/day of alcohol and who were diagnosed with metabolic syndrome at baseline was excluded. We analyzed the prevalence of metabolic syndrome according to GGT quartiles in both genders.RESULTS: The GGT level was significantly higher in subjects with metabolic syndrome compared to normal subjects (37.92±48.20 mg/dL vs. 25.62±33.56 mg/dL). The prevalence of metabolic syndrome showed a stepwise increase with GGT quartiles in both male and female subjects. Compared to the lowest GGT quartile, the odds ratio was 1.534 (95% confidence interval [CI], 1.432 to 1.643), 1.939 (95% CI, 1.811 to 2.076), and 2.754 (95% CI, 2.572 to 2.948) in men and 1.155 (95% CI, 1.094 to 1.218), 1.528 (95% CI, 1.451 to 1.609), and 2.022 (95% CI, 1.921 to 2.218) in women with increasing GGT quartile. The cutoff value of GGT predicting risk of metabolic syndrome was 27 IU/L in men and 17 IU/L in women.CONCLUSION: We suggested that GGT could be an easily checkable marker for the prediction of metabolic syndrome.

Several issues in research on suicide behavior / 中华疾病控制杂志

This paper summarized and discussed current problems in research on suicide behavior, including conceptualization of suicide behavior and reporting of suicide rate, risk and protective factors of suicide behavior, as well as prediction and prevention of suicide behavior. The author also provided some suggestions for further research.

Framingham risk score and risk of incident chronic kidney disease: A community-based prospective cohort study

BACKGROUND: Cardiovascular disease and chronic kidney disease share several common risk factors. The Framingham risk score is hypothesized to predict chronic kidney disease development. We determined if the Framingham risk scoring system can correctly predict incident chronic kidney disease in the general population. METHODS: This study included 9,080 subjects who participated in the Korean Genome and Epidemiology Study between 2001 and 2014 and had normal renal function. The subjects were classified into low- ( 20%) risk groups based on baseline Framingham risk scores. The primary endpoint was de novo chronic kidney disease development (estimated glomerular filtration rate [eGFR], < 60 mL/min/1.73 m²). RESULTS: During a mean follow-up duration of 8.9 ± 4.3 years, 312 (5.3%), 217 (10.8%), and 205 (16.9%) subjects developed chronic kidney disease in the low, intermediate, and high risk groups, respectively (P < 0.001). Multivariable analysis after adjustment for confounding factors showed the hazard ratios for the high- and intermediate risk groups were 2.674 (95% confidence interval [CI], 2.197–3.255) and 1.734 (95% CI, 1.447–2.078), respectively. This association was consistently observed irrespective of proteinuria, age, sex, obesity, or hypertension. The predictive power of this scoring system was lower than that of renal parameters, such as eGFR and proteinuria, but increased when both were included in the prediction model. CONCLUSION: The Framingham risk score predicted incident chronic kidney disease and enhanced risk stratification in conjunction with traditional renal parameters in the general population with normal renal function.

Analysis on antimicrobial resistance of methicillin-resistant and multidrug-resistant staphylococcus aureus from primary school students in Guangzhou City / 中华疾病控制杂志

Objective To explore the carry rate and antimicrobial resistance of Staphylococcus aureus (S.aureus) among primary school students.Methods Nasal swab samples were collected from healthy primary school students in Guangzhou.Antibiotic susceptibility testing was applied to test S.aureus strains.Results The overall carriage rate of S.aureus,methicillin-resistant S.aureus (MRSA) and multi-drug-resistant S.aureus (MDRSA) among 1 012 primary school students were 40.1％,1.2％ and 4.0％,respectively.Most S.aureus isolates were resistant to penicillin,erythromycin and clindamycin.The dominant multidrug resistance patterns of MDRSA isolates were resistant to erythromycin-clindamycin-tetracycline and erythromycin-clindamycin-cefoxitin.Multifactor dimensionality reduction analysis showed that the rate of resistance to cefoxitin,tetracycline and chloromycetin among MDRSA was 104.39 times as much as that of nonMDRSA.Conclusions The carriage rate of S.aureus in healthy primary school students from Guangzhou was high and these isolates showed multidrug resistance.These data provide basis for guiding the rational use of antibiotics.

Association between Genetic Variations Affecting Mean Telomere Length and the Prevalence of Hypertension and Coronary Heart Disease in Koreans

In this study, we investigated whether the single nucleotide polymorphisms (SNPs) associated with telomere length (TL) were associated with the incidence of hypertension (HTN)/coronary heart disease (CHD) and cardiovascular risk factors in the Korean population. Data from 5,705 (ages 39–70) participants in the Korean Genome Epidemiology Study (rural Ansung and urban Ansan cohorts) were studied. Twelve SNPs known to be associated with telomere biology were tested for an association with HTN/CHD. As results, no significant associations were found between the selected TL-related SNPs and prevalence of HTN and CHD. Among non-alcohol users, subjects with minor alleles in rs1269304 and rs10936601 (TERC and LRRC34, respectively) exhibited a higher rate of CHD occurrence (odds ratio [OR], 1.862; 95% confidence intervals [CIs], 1.137, 3.049; OR, 1.855; 95% CIs, 1.111, 2.985; respectively). However, alcohol users with minor alleles in rs398652 (PELI2) were significantly associated with higher HTN prevalence (OR, 1.179; 95% CIs, 1.040, 1.336). Of the 3 SNPs related to disease outcomes, rs1296304 was significantly associated with increased levels of diastolic blood pressure (β estimate, 0.470; 95% CIs, 0.013, 0.926). The minor allele in rs398652 was significantly associated with higher levels of body mass index (OR, 0.128; 95% CIs, 0.010, 0.246) and γ-glutamyl transpeptidase (OR, 0.013; 95% CIs, 0.001, 0.024). In conclusion, there were no significant associations between the selected TL-related SNPs and the occurrence of HTN/CHD in Koreans. However, the results suggest the presence of a possible interaction between related SNPs and alcohol behavior associated with HTN/CHD occurrence.

Developing Dish-based Food Frequency Questionnaire for the Epidemiology Study of Hypertension Among Korean / 대한지역사회영양학회지

The purpose of the present study was aimed to identify dish items applicable in developing dish?based food frequency questionnaire (DFFQ) for a hypertension study of Koreans. The 24-hour recall data of 4,401 subjects aged 20~65 years from the 2001 Korean National Health and Nutrition Examination Survey were used for the analysis. Logistic regression model was used to identify the nutrient related with hypertension. Energy, fiber, sodium, calcium, carotene, vitamin B1 and vitamin C were associated with hypertension. Selection the top 30 dish items for these seven nutrients was performed based on their degree of contribution in supplying nutrients in terms of the cumulative percent contribution (cPC), as well as on their degree of explanation for between?person variation, in terms of the cumulative regression coefficient (cMRC). Rice supplied 43% of total energy consumption. Korean cabbage and radish kimchi were two major sources of sodium and it also covered the 27% of between person variation of sodium intake. Soybean paste soup and single item of orange?colored fruits supplied 43% of total vitamin C intake for Koreans and it covered the almost 79% of between person variation among the Korean population. Korean cabbage kimchi was the major source of fiber, calcium, sodium, carotene, and vitamin C for Koreans. In summary, the top 30 selected dish items supplying the 78% to 89% of the 7 nutrients. Those items also covered the 79% to 94% of between person variation of the 7 nutrients consumption. Therefore, the selected 30 dish items in each categories of nutrient could be applicable in developing dish based food frequency questionnaire for hypertension study.

Dietary Patterns and Prevalence Odds Ratio in Middle-aged Adults of Rural and Mid-size City in Korean Genome Epidemiology Study

Recently, dietary pattern analysis was emerged as an approach to examine the relationships between diet and risk of chronic diseases. This study was to identify groups with population who report similar dietary pattern in Korean ge-nome epidemiology study (KoGES )and association with several chronic diseases. The cohort participants living in Ansung and Ansan (Gyeonggi province )were totally 10,038. Among those, 6,873 subjects with no missing values in food frequency questionnaire were included in this analysis. After combining 103 food items into 17 food groups, 4 dietary factors were obtained by factor analysis based on their weights. Factor 1 showed high factor loadings in vege-tables, mushrooms, meats, fish, beverages, and oriental-cereals. Factor 2 had high factor loadings in vegetables, fruits, fish, and factor 3 had high factor loadings in cereal-oriental, cerial-western and snacks. Factor 4 showed positive high factor loadings in rice and Kimchi and negative factor loadings in mushrooms and milk and dairy products. Using factor scores of four factors, subjects were classified into 3 clusters by K-means clustering. We named those 'Rice and Kimchi eating' group, 'Contented eating' group, and 'Healthy and light eating' group depending on their eating cha-racteristics. 'Rice and Kimchi eating' group showed high prevalence in men, farmers and 60s. 'Contented eating' group and 'Healthy and light eating' group had high prevalence in women, people living in urban area (Ansan Citizen ), with high-school education and above, and a monthly income of one million won and more. 'Contented eating' group appeared lower distribution proportion in the sixties and 'Healthy and light eating' group does higher in the fifties. 'Contented eating' versus 'Rice and Kimchi eating', odds ratio for hypertension, diabetes, metabolic syndrome and obesity significantly decreased after adjusting age and sex (OR =0.64, 0.73, and 0.85 respectively, 95% CI ). Although our results were from a cross-sectional study, these imply that the dietary patterns were related to diseases.

Progress of Epidemiology Study on Cooking Oil Fume Toxicity / 环境与健康杂志

In China, cooking oil fume is a kind of indoor air pollutant that is ubiquitous. With the development of catering trade, the pollution of cooking oil fume is becoming more and more severe. The results of animal experiments showed that cooking oil fume could damage the genetic substance and cause cancer. The results from the epidemiological studies indicated that cooking oil fume could induce lipid peroxidation and change the pulmonary and immunologic functions, cause chromosome damage and increase the risk of lung cancer.