BCG Vaccination and Mortality of COVID-19 across 173 Countries: An Ecological Study.

Ecological studies have suggested fewer COVID-19 morbidities and mortalities in Bacillus Calmette-Guérin (BCG)-vaccinated countries than BCG-non-vaccinated countries. However, these studies obtained data during the early phase of the pandemic and did not adjust for potential confounders, including PCR-test numbers per population (PCR-tests). Currently-more than four months after declaration of the pandemic-the BCG-hypothesis needs reexamining. An ecological study was conducted by obtaining data of 61 factors in 173 countries, including BCG vaccine coverage (%), using morbidity and mortality as outcomes, obtained from open resources. 'Urban population (%)' and 'insufficient physical activity (%)' in each country was positively associated with morbidity, but not mortality, after adjustment for PCR-tests. On the other hand, recent BCG vaccine coverage (%) was negatively associated with mortality, but not morbidity, even with adjustment for percentage of the population ≥ 60 years of age, morbidity, PCR-tests and other factors. The results of this study generated a hypothesis that a national BCG vaccination program seems to be associated with reduced mortality of COVID-19, although this needs to be further examined and proved by randomized clinical trials.

[An analysis of the relation between stress coping profile and job stress using structural equation modeling (SEM)].

OBJECTIVES: This study aimed to clarify what type of coping profile can reduce the stress reaction caused by job stress. METHODS: Using the Brief Job Stress Questionnaire and the Brief Scales for Coping Profile Questionnaire, 1,319 male workers in Japanese manufacturing companies were surveyed. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Structural Equation Modeling (SEM) were used for the statistical analysis. RESULTS: Six factors for coping profile and job stress were extracted by EFA. Three factors of job stress were thought to correspond to job overload, good human relations and stress reaction, and three factors of coping profile were thought to correspond to problem-focused coping, emotion-focused active coping and escape-avoidance coping. These factors showed good agreement (GFI=0.947, AGFI=0.915, RMSEA=0.070) in CFA. A path diagram showing that coping profile influenced human relations and job overload, and that these conscious stress factors caused the stress reaction was constructed. The validity of this path model was shown (GFI=0.937, AGFI=0.904, RMSEA=0.074) using SEM. In the path analysis, the emotion-focused active coping profile created good human relations and reduced job overload, and either or both of these stress factors worked in the direction in which the stress reaction was reduced. The emotion-focused active coping profile acted finally to reduced the stress reaction (standardized total effect: -0.205). On the other hand, the escape-avoidance coping profile influences human relations harmfully and increased job overload. The escape-avoidance coping profile remarkably deteriorated the stress reaction (standardized total effect: +0.160). The problem-focused coping profile created good human relations though it increased job overload. Through both stress factors the problem-focused coping profile only increased slightly the stress reaction (standardized total effect: +0.019). However, a correlation existed among the three coping profiles. The problem-focused coping profile positively correlated with the emotion-focused active coping profile, that decreases the stress reaction, but negatively correlated with the escape-avoidance coping profile, that increases the stress reaction. Because it was thought that a worker who tends to use a problem-focused coping profile also often adopted other coping profiles that simultaneously reduced the stress reaction, the many workers who tend to use a problem-focused coping profile finally have reduced stress reactions. CONCLUSIONS: The emotion-focused active coping profile reduced the stress reaction caused by job stress, but the escape-avoidance coping profile intensified the stress reaction. The problem-focused coping profile, that has often been reported to reduce the stress reaction, finally increased the stress reaction slightly because job overload increased as a cost.

Of the three classifications of healthy lifestyle habits, which one is the most closely associated with the prevention of metabolic syndrome in Japanese?

OBJECTIVE: Metabolic syndrome is associated with a high risk of cardiovascular morbidity and mortality. The predominant cause of metabolic syndrome is an unhealthy lifestyle. Healthy habits are represented by Breslow's 7 healthy practices, Morimoto's 8 items and Ikeda's 6 healthy habits. This study was done to determine which set of healthy habits was most likely to result in a reduced risk of developing the metabolic syndrome. METHODS: From April 1, 2000 through March 31, 2007, 6,765 males and 2,789 females underwent a medical check-up at Jikei University Hospital in Japan. They completed a simple, self-administered lifestyle questionnaire based on the 3 classifications of healthy habits. The responses were divided into 3 groups (poor, moderate and favorable) according to each of the healthy habit criteria. The incidence of metabolic syndrome was defined in participants who were newly diagnosed during the follow-up using Japanese-specific diagnostic criteria. The Kaplan-Meier cumulative 7-year incidence was calculated. Kaplan-Meier curves were compared using the long-rank test adjusted for age. RESULTS: In females, Breslow's, Morimoto's and Ikeda's healthy habits showed significant differences in the incidence between poor and moderate groups, and between poor and favorable groups. In males, a significant difference was observed among the poor, moderate and favorable groups for Ikeda's healthy habits. However, no significant difference was observed for Breslow's healthy practices. Morimoto's items only showed a significant difference between the poor and moderate groups. CONCLUSION: Among the 3 models tested, Ikeda's healthy habits were the most useful for decreasing the risk of metabolic syndrome in Japanese.

Relationship between the three kinds of healthy habits and the metabolic syndrome.

OBJECTIVES: In 2005, the diagnostic criteria for Japan-specific metabolic syndrome were published. The representative health habits are Breslow's seven healthy practices, Morimoto's eight items and Ikeda's six healthy habits. We investigated the prevalence of metabolic syndrome related with life-style strongly among these three sets of healthy habit. METHODS: Cross-sectional study was conducted for the prevalence of metabolic syndrome by practicing these healthy habits. 20,776 Japanese individuals visited the Health Science Center at Jikei University Hospital in Japan for medical check-ups. Subjects were divided into 8 groups based on gender and age (females in their 30s, 40s, 50s and 60s, and males in their 30s, 40s, 50s and 60s). Participants completed a simple, self-administered lifestyle questionnaire based on the three sets of healthy habits. Subjects were divided into three groups (poor, moderate and favorable) according to each of the healthy habit criteria. RESULTS: Significant differences were observed among 10 groups for Breslow's seven healthy practices, 4 groups for Morimoto's eight items, and 13 groups for Ikeda's six healthy habits. Ikeda's six healthy habits showed the most significant differences among the three sets of habits. CONCLUSIONS: Among the three methods tested, to practice more Ikeda's healthy habits were the most useful for metabolic syndrome.