食生活の多様性とうつ病および自殺の有病率との関連 ―26年間の国際比較研究―

Purpose: This study aimed to determine the associations of dietary diversity with depression and suicide rates by an ecological analysis using 26-years worldwide statistics.Methods: Average food supply and energy supply by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database (FAOSTAT). Dietary diversity scores were calculated from food group classifications. Age-standardized depression prevalence and suicide rates per 100,000 people by country were obtained from the Global Burden of Disease (GBD) 2017 database. The association between food diversity scores and depression prevalence and suicide rates was analyzed by a mixed effects model controlling for covariates in 137 countries with populations of 1 million or greater.Results: A significant negative association was found in the analysis of the relationship between dietary diversity and the prevalence of major depression in the model controlled for all covariates [β (se) = –225.6 (61.9), p < 0.001]. In addition, a significant negative association between dietary diversity and the suicide rate was also found in the model controlled for all covariates [β (se) = –3.08 (1.50), p < 0.05].Conclusion: Dietary diversity was significantly negatively associated with the rates of major depression and suicide. Diets rich in foods may reduce the prevalence of depression and suicide rate.【目的】本研究は、26年間の世界的な統計を用いた生態学的分析により、食生活の多様性とうつ病や自殺率との関連を明らかにすることを目的とした。【方法】生産と家庭間の喪失を除く国別平均食料供給量とエネルギー供給量を国連食糧農業機関統計局データベース（FAOSTAT）から入手した。食物群分類から食事多様性スコアを算出した。年齢標準化された国別の人口10万人当たりのうつ病有病率と自殺率は、Global Burden of Disease（GBD）2017データベースから取得した。人口100万人以上の137カ国を対象に、食品多様性スコアとうつ病有病率および自殺率との関連を、共変量を制御した混合効果モデルで解析した。【結果】食生活の多様性とうつ病の有病率との関係を分析したところ、すべての共変量を調整したモデルにおいて、有意な負の関連が認められた［β（se）＝－225.6（61.9）、p < 0.001］。さらに、食生活の多様性と自殺率との間の有意な負の関連も、すべての共変量を調整したモデルで認められた［β（se）= －3.08（1.50）、p < 0.05］。【結論】食生活の多様性は、うつ病および自殺の発生率と有意に負の関連があった。食物を豊富に含む食事は、うつ病や自殺を減少させる可能性がある

Public transportation and the disabled person

機能訓練事業として実施している「生活リハビリ教室」の教室生208名を対象に，公共交通機関を利用して外出するために障害になっている要因を明らかにする目的で，郵送法による自記式アンケート調査を行った。回答は125名（60.1％）からあった。外出経験がある者は67名（53.6％）で外出経験がない者が58名であった。外出時に付添いが必要と思っている者は，外出経験のない者に多かった。公共交通機関を利用しての外出を阻害している要因には，乗り物の昇降口に段差があることや早く発車して危険である，また周囲の人に介助を依頼しにくいことなどが挙げられている。身体機能障害者が外出できない理由は個人によって異なってはいるが，地域社会に身体機能障害者を受け入れる環境を整えていく必要がある。A survey was distributed by mail to disabled people who received functional training in 1997. Of 208 questionnaires sent, 125 (60.1%) were returned. Sixty-seven (53.6%) of the respondents had experience traveled outside. People who participate in functional trainning for disability hope to have an attendant to accompany them when traveling. One primary factor that hinders traveling outside and using public transportation is that they cannot ask for help because of shyness. Another factor is the construction of entrances (e.g.,bumps) for vehicles which cannot be traversed easily. Reasons differed among those who had traveled outside and those who had not. It is necessary to prepare an environment (e.g., public transportationto) for ease of use for disabled persons in regional communities

Body Mass Index and Risk of Colorectal Cancer Incidence and Mortality in Asia

Importance: The global burden of obesity is increasing, as are colorectal cancer (CRC) incidence and mortality. Objectives: To assess the association between body mass index (BMI) and risks of incident CRC and CRC-related death in the Asian population. Design, Setting, and Participants: This cohort study includes data pooled from 17 prospective cohort studies included in The Asia Cohort Consortium. Cohort enrollment was conducted from January 1, 1984, to December 31, 2002. Median follow-up time was 15.2 years (IQR, 12.1-19.2 years). Data were analyzed from January 15, 2023, through January 15, 2024. Exposure: Body mass index, calculated as weight in kilograms divided by height in meters squared. Main Outcomes and Measures: The primary outcomes were CRC incidence and CRC-related mortality. The risk of events is reported as adjusted hazard ratios (AHRs) and 95% CIs for incident CRC and death from CRC using the Cox proportional hazards regression model. Results: To assess the risk of incident CRC, 619 981 participants (mean [SD] age, 53.8 [10.1] years; 52.0% female; 11 900 diagnosed incident CRC cases) were included in the study, and to assess CRC-related mortality, 650 195 participants (mean [SD] age, 53.5 [10.2] years; 51.9% female; 4550 identified CRC deaths) were included in the study. A positive association between BMI and risk of CRC was observed among participants with a BMI greater than 25.0 to 27.5 (AHR, 1.09 [95% CI, 1.03-1.16]), greater than 27.5 to 30.0 (AHR, 1.19 [95% CI, 1.11-1.29]), and greater than 30.0 (AHR, 1.32 [95% CI, 1.19-1.46]) compared with those with a BMI greater than 23.0 to 25.0 (P 27.5-30.0: AHR, 1.18 [95% CI, 1.04-1.34]; BMI >30.0: AHR, 1.38 [95% CI, 1.18-1.62]; P  Conclusions and Relevance: In this cohort study that included a pooled analysis of 17 cohort studies comprising participants across Asia, a positive association between BMI and CRC incidence and related mortality was found. The risk was greater among men and participants with colon cancer. These findings may have implications to better understand the burden of obesity on CRC incidence and related deaths in the Asian population.</p

Quantitative digital image analysis of tumor-infiltrating lymphocytes in HER2-positive breast cancer

As visual quantification of the density of tumor-infiltrating lymphocytes (TILs) lacks in precision, digital image analysis (DIA) approach has been applied in order to improve. In several studies, TIL density has been examined on hematoxylin and eosin (HE)-stained sections using DIA. The aim of the present study was to quantify TIL density on HE sections of core needle biopsies using DIA and investigate its association with clinicopathological parameters and pathological response to neoadjuvant chemotherapy in human epidermal growth factor receptor 2 (HER2)-positive breast cancer. The study cohort comprised of patients with HER2-positive breast cancer, all treated with neoadjuvant anti-HER2 therapy. DIA software applying machine learning-based classification of epithelial and stromal elements was used to count TILs. TIL density was determined as the number of TILs per square millimeter of stromal tissue. Median TIL density was 1287/mm^2 (range, 123–8101/mm^2). A high TIL density was associated with higher histological grade (P = 0.02), estrogen receptor negativity (P = 0.036), and pathological complete response (pCR) (P 2420/mm^2) was significantly associated with pCR (P < 0.0001). Our results indicate that DIA can assess TIL density quantitatively, machine learning-based classification algorithm allowing determination of TIL density as the number of TILs per unit area, and TIL density established by this method appears to be an independent predictor of pCR in HER2-positive breast cancer.博士(医学)琉球大

Efp promotes in vitro and in vivo growth of endometrial cancer cells along with the activation of nuclear factor-κB signaling.

Endometrial cancer is common among postmenopausal women and its incidence is increasing in developed countries. Considering that >80% of endometrial cancers are assumed to be estrogen-related, higher estrogen exposure will be relevant to tumorigenesis. Therefore, the roles of estrogen target genes will be important to understand the pathophysiological mechanisms. We previously revealed that estrogen-responsive RING finger protein Efp contributes to breast cancer progression through the protein degradation of cell cycle checkpoint 14-3-3σ. We and others also proposed that Efp has tumor-promoting activities in estrogen receptor (ER)-negative cancer cells. In addition, Efp plays a role in type I interferon production by activating antiviral signaling, which provokes nuclear factor-κB (NF-κB) signaling. In the present study, we investigate whether Efp plays a critical role in endometrial cancer biology. We show that siRNA-mediated Efp knockdown represses the proliferation and migration of endometrial cancer ER-positive Ishikawa and ER-negative HEC-1A cells. Efp knockdown increases 14-3-3σ protein levels and decreases the rates proliferative stage cells. Efp siRNA significantly inhibits the in vivo tumor growth of endometrial cancer cells in both subcutaneous and orthotopic xenograft models. Intriguingly, Efp knockdown represses NF-κB-dependent transactivation and transcription of target genes, such as IL6ST and IL18, in endometrial cancer cells. Overall, Efp would exert a tumor-promoting role through modulating NF-κB pathway and 14-3-3σ protein degradation in endometrial cancer regardless of its estrogen receptor status. Our results indicate that Efp could be a potential diagnostic and therapeutic target for endometrial cancer

Traditional japanese diet score and the sustainable development goals by a global comparative ecological study

Abstract Background Reducing the environmental impact of the food supply is important for achieving Sustainable Development Goals (SDGs) worldwide. Previously, we developed the Traditional Japanese Diet Score (TJDS) and reported in a global ecological study that the Japanese diet is associated with reducing obesity and extending healthy life expectancy etc. We then examined the relationship between the TJDS and environmental indicators. Methods The average food (g/day/capita) and energy supplies (kcal/day/capita) by country were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. The TJDS was calculated from eight food groups (beneficial food components in the Japanese diet: rice, fish, soybeans, vegetables, and eggs; food components that are relatively unused in the traditional Japanese diet: wheat, milk, and red meat) by country using tertiles, and calculated the total score from − 8 to 8, with higher scores meaning greater adherence to the TJDS. We used Land Use (m2), Greenhouse gas (GHG) emissions 2007/2013 (kg CO2eq), Acidifying emissions (g SO2eq), Eutrophying emissions (g PO4 3− eq), Freshwater (L), and water use (L) per food weight by Poore et al. as the environmental indicators and multiplied these indicators by each country’s average food supply. We evaluated the cross-sectional and longitudinal associations between the TJDS and environmental indicators from 2010 to 2020. This study included 151 countries with populations ≥ 1 million. Results Land use (β ± standard error; -0.623 ± 0.161, p < 0.001), GHG 2007 (-0.149 ± 0.057, p < 0.05), GHG 2013 (-0.183 ± 0.066, p < 0.01), Acidifying (-1.111 ± 0.369, p < 0.01), and Water use (-405.903 ± 101.416, p < 0.001) were negatively associated with TJDS, and Freshwater (45.116 ± 7.866, p < 0.001) was positively associated with TJDS after controlling for energy supply and latitude in 2010. In the longitudinal analysis, Land Use (β ± standard error; -0.116 ± 0.027, p < 0.001), GHG 2007 (-0.040 ± 0.010, p < 0.001), GHG 2013 (-0.048 ± 0.011, p < 0.001), Acidifying (-0.280 ± 0.064, p < 0.001), Eutrophying (-0.132 ± 0.062, p < 0.05), and Water use (-118.246 ± 22.826, p < 0.001) were negatively associated with TJDS after controlling for confounders. Conclusions This ecological study suggests that the traditional Japanese dietary pattern might improve SDGs except Fresh water