Prevalence of Exogenous Hormone Use in Japanese Women

Background: There have been few community-based epidemiological studies in which the prevalence of exogenous hormone use, including the use of oral contraceptives (OCs) and hormone replacement therapy (HRT), has been accurately assessed in Japan. Methods: We have been conducting repeated surveys of participants in the Japan Nurses’ Health Study (JNHS), as a nationwide prospective cohort study, since 2001. We determined the prevalence of exogenous hormone use at baseline and during a 10-year follow-up period. A total of 15,019 female nurses participated in the JNHS follow-up cohort. We determined the prevalence of OC use in 14,839 women <60 years of age at baseline and the prevalence of HRT use in 7,915 women, excluding premenopausal women, at the last time they answered a questionnaire. The duration of HRT use was estimated using the Kaplan-Meier method. Results: Six percent of the participants used OCs. The proportion of HRT users who stopped HRT before the baseline survey, the proportion of women using HRT during the follow-up period, and the proportion of all of the participants who had used HRT were 3.2%, 10.6%, and 13.8%, respectively. The median duration of HRT use was 2 years. Conclusions: The lifetime prevalences of exogenous hormone use during this prospective study conducted in Japanese nurses were 6.0% for OCs and 13.8% for HRT. The information obtained in this study will be useful for clarification of the association between exogenous estrogen exposure and estrogen-related diseases as future research

Urinary FSH in postmenopausal women

The change in follicle-stimulating hormone (FSH) during the menopausal transition and associations of FSH with various diseases have been assessed by using blood samples. We examined cross-sectionally the variation of FSH levels, associations of estrone and estradiol with FSH, and associations of BMI with these hormones by using urinary samples from peri- and postmenopausal women in Japan. Of 4472 participants in the Urinary Isoflavone Concentration Survey of the Japan Nurses’ Health Study, we analyzed urinary levels of estrone, estradiol and FSH in 547 women aged from 45 to 54 years. Urinary FSH levels varied widely in postmenopausal women and the pattern of change in urinary FSH levels seems to be similar to that in blood FSH levels in previous studies. There were no significant differences in age, body mass index (BMI), estradiol, estrone and estradiol/estrone ratio among three groups according to the tertile of FSH. In postmenopausal women, there were significant associations of BMI with levels of estrone and estradiol, but there was no significant association of BMI with FSH. Studies using urinary samples will allow us to establish a study project as a large-scale population-based study to determine associations between FSH and various diseases after menopause

Association between FSH, E1, and E2 levels in urine and serum in premenopausal and postmenopausal women

Objective: We aimed to establish correlations for the levels of follicle-stimulating hormone (FSH), estrone (E1) and estradiol (E2) between urine and serum in premenopausal and postmenopausal women using immunoassays. Methods: In this study of 92 women (61 postmenopausal, 31 premenopausal), both urine and blood specimens were collected on the same day and stored at 4 °C for analysis by chemiluminescent immunoassay, radioimmunoassay and/or electrochemiluminescent immunoassay. Results: There were correlations in the levels of FSH, E1 and E2 between urine and serum in both postmenopausal (r = 0.96 for FSH, r = 0.91 for E1, r = 0.80 for E2) and premenopausal (r = 0.98 for FSH, r = 0.92 for E1, r = 0.90 for E2) women. It is indicated that the correlations were stronger in the premenopausal group compared with the postmenopausal group, especially for FSH. Conclusion: The levels of FSH, E1 and E2 in urine correlated with those in the serum in premenopausal and postmenopausal women. Urine samples could be used instead of serum samples to measure hormone levels, which would reduce the difficulty of conducting large survey studies

Avoiding the Worst Decisions: A Simulation and Experiment

Many practical decisions are more realistic concerning preventing bad decisions than seeking better ones. However, there has been no behavioral decision theory research on avoiding the worst decisions. This study is the first behavioral decision research on decision strategies from the perspective of avoiding the worst decisions. We conducted a computer simulation with the Mersenne Twister method and a psychological experiment using the monitoring information acquisition method for two-stage decision strategies of all combinations for different decision strategies: lexicographic, lexicographic semi-order, elimination by aspect, conjunctive, disjunctive, weighted additive, equally weighted additive, additive difference, and a majority of confirming dimensions. The rate of choosing the least expected utility value among the alternatives was computed as the rate of choosing the worst alternative in each condition. The results suggest that attention-based decision rules such as disjunctive strategy lead to a worse decision, and that striving to make the best choice can conversely often lead to the worst outcome. From the simulation and the experiment, we concluded that simple decision strategies such as considering what is most important can lead to avoiding the worst decisions. The findings of this study provide practical implications for decision support in emergency situations.</jats:p

Classifying Decision Strategies in Multi-Attribute Decision-Making: A Multi-Dimensional Scaling and Hierarchical Cluster Analysis of Simulation Data

Previous studies on decision strategies in multi-attribute decision-making (MADM) have primarily relied on computational simulations to assess strategy performance under varying conditions, with particular emphasis on comparisons to the weighted additive rule (WAD) and on evaluations of the cognitive effort required. In contrast, considerably less attention has been devoted to examining the consistency of decision outcomes across different strategies or to developing a systematic classification of strategies based on outcome similarity. To address this gap, the present study investigates the characteristics of decision strategies by analyzing the concordance rates of choices made under identical conditions, along with measures of decision accuracy and information-processing effort. We conducted a hierarchical cluster analysis and applied multi-dimensional scaling (MDS) to a choice concordance matrix derived from simulations using the Mersenne Twister method. In addition, linear multiple regression analyses were performed using the MDS coordinates as predictors of both decision accuracy and cognitive effort. The cluster analysis revealed a primary bifurcation between two major groups: one centered around the Disjunctive (DIS) rule, and another encompassing compensatory strategies such as WAD. Notably, although the Lexicographic (LEX) rule is traditionally considered non-compensatory, it exhibited high similarity in choice patterns to compensatory strategies when assessed via concordance rates. In contrast, DIS-based strategies produced markedly distinct choice patterns