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Summary: Introduction: The COVID‐19 pandemic posed tremendous challenges for children. However, the long‐term effects of the pandemic on various aspects of physical health at a national level remain unclear. Methods: In this retrospective cohort study, we analysed data from nationwide health checkup records amongst children aged 7–15 years. The dataset comprised 3 544 146 records from 393 794 individuals who graduated from junior high school during fiscal years 2007 to 2022. Difference‐in‐differences (DID) analyses with multiple time periods were used to examine the impact of COVID‐19 on physical health outcomes. Results: Compared with the pre‐pandemic period, the COVID‐19 pandemic was associated with excess increases in obesity for boys and girls, persisting over the 3 years (+0.42%; [95% CI, 0.23–0.61]). Also, it was associated with excess increases in underweight (+0.28% [0.25–0.32]) and poor visual acuity amongst boys in the 3rd year (+1.80% [1.30–2.30]). There were excess reductions in dental caries (−1.48% [−2.01 to −0.95]), glucosuria (−0.55 [−0.88 to −0.23]) and hematuria (−0.43% [−0.73 to −0.13]) during the 3rd year of the pandemic. Conclusions: These findings underscore the multifaceted impact of the pandemic on various health indicators for school‐aged children. This information could be valuable for public health policy and paediatric healthcare planning in the post‐pandemic era. [ABSTRACT FROM AUTHOR]

In observational studies, instrumental variable (IV) methods are commonly applied when there are unmeasured covariates. In Mendelian randomization, constructing an allele score using many single nucleotide polymorphisms is often implemented; however, estimating biased causal effects by including some invalid IVs poses some risks. Invalid IVs are those IV candidates that are associated with unobserved variables. To solve this problem, we developed a novel strategy using negative control outcomes (NCOs) as auxiliary variables. Using NCOs, we are able to select only valid IVs and exclude invalid IVs without knowing which of the instruments are invalid. We also developed a new two‐step estimation procedure and proved the semiparametric efficiency of our estimator. The performance of our proposed method was superior to some previous methods through simulations. Subsequently, we applied the proposed method to the UK Biobank dataset. Our results demonstrate that the use of an auxiliary variable, such as an NCO, enables the selection of valid IVs with assumptions different from those used in previous methods. [ABSTRACT FROM AUTHOR]

Polymerization‐induced self‐assembly (PISA) is conducted in a non‐polar medium (n‐dodecane) via reversible complexation‐mediated polymerization (RCMP). Stearyl methacrylate (SMA) is used to synthesize a macroinitiator, and subsequent block polymerization of benzyl methacrylate (BzMA) from the macroinitiator in n‐dodecane afforded a PSMA–PBzMA block copolymer, where PSMA is poly(stearyl methacrylate) and PBzMA is poly(benzyl methacrylate). Because PSMA is soluble but PBzMA is insoluble in n‐dodecane, the block copolymer formed a self‐assembly during the block polymerization (PISA). Spherical micelles, worms, and vesicles are obtained, depending on the degrees of polymerization of PSMA and PBzMA. "One‐pot" PISA is also attained; namely, BzMA is directly added to the reaction mixture of the macroinitiator synthesis, and PISA is conducted in the same pot without purification of the macroinitiator. The spherical micelle and vesicle structures are also fixed using a crosslinkable monomer during PISA. RCMP‐PISA is highly attractive as it is odorless and metal‐free. The "one‐pot" synthesis does not require the purification of the macroinitiator. RCMP‐PISA can provide a practical approach to synthesize self‐assemblies in non‐polar media. [ABSTRACT FROM AUTHOR]

The Japan Diabetes Society and the Japan Cancer Association launched a joint committee and published their "First Joint Committee Report on Diabetes and Cancer" in 2013, compiling recommendations for physicians and health‐care providers as well as for the general population. In 2016, the "Second Joint Committee Report on Diabetes and Cancer" summarized the current evidence on glycemic control and cancer risk in patients with diabetes. The current "Third Joint Committee Report on Diabetes and Cancer", for which the joint committee also enlisted the assistance of the Japanese Society of Clinical Oncology and the Japanese Society of Medical Oncology, reports on the results from the questionnaire survey, "Diabetes Management in Patients Receiving Cancer Therapy," which targeted oncologists responsible for cancer management and diabetologists in charge of glycemic control in cancer patients. The results of the current survey indicated that there is a general consensus among oncologists and diabetologists with regard to the need for guidelines on glycemic control goals, the relevance of glycemic control, and glycemic control during cancer therapy in cancer patients. [ABSTRACT FROM AUTHOR]

One‐pot synthesis of methacrylic and acrylic polymers from benzylic alcohols (R−OH) used as initiating moieties was developed. R−OH was converted to alkyl iodide (R−I), and the generated R−I was used as an initiator without purification or isolation in the subsequent reversible complexation mediated polymerization (RCMP), leading to one‐pot RCMP from R−OH. As a useful application, this technique was exploited for one‐pot polymer‐grafting from lignin that is the second most abundant renewable carbon‐source on earth and bears benzylic alcohols. The direct initiation from lignin eliminates tedious initiator attachment and purification, offering a facile access to polymer‐grafted lignin. The obtained polymer‐grafted lignin was utilized to form an efficient UV‐absorbing film with high transparency in visible region. One‐pot RCMP may serve as a practical method to obtain value‐added functional lignin‐polymer composites. [ABSTRACT FROM AUTHOR]

Sulfur‐33(33S) stable‐isotope labeled taurine, 2‐aminoethanesulfonic acid, has been synthesized, and a series of solution and solid‐state 33S nuclear magnetic resonance (NMR) experiments at 14.1 and 18.8 T, respectively, have been carried out at room temperature. The single peak of a solution 33S NMR spectrum in 0.1‐mM [33S]‐taurine in D2O can be observed with the signal‐to‐noise (S/N) ratio of 9 in 40,000 scans, which paves the way toward in vivo analysis of pharmacokinetics and metabolism of 33S‐labeled taurine. Undistorted magic‐angle‐spinning (MAS) and static 33S NMR spectra of polycrystalline [33S]‐taurine are observed with sufficient S/N ratios for analysis, and the magnitudes of 33S EFG and CS tensors can be obtained. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To investigate whether the COVID‐19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. Materials and Methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician–patient interaction and the impossibility of consultation and examination were cited as sources of concern. Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID‐19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Non‐attendance from regular medical care is a major problem in diabetes patients. This study aimed to examine the impact of a multifaceted lifestyle intervention by face‐to‐face approach (FFA) on non‐attendance from regular medical care in comparison with that by telephone from the technical support center (TSC). Materials and Methods: This was secondary analysis from a 1‐year, prospective, cluster randomized, intervention study. Patients with type 2 diabetes, who were regularly visiting primary care physicians cluster‐randomized into the control or intervention (TSC or FFA according to resource availability of the district medical associations) groups, were consecutively recruited. The primary end‐point was non‐attendance from regular medical care. The interaction between the type of intervention (TSC vs FFA) and behavioral change stage (pre‐ vs post‐action stage) in diet and exercise for the dropout rate was assessed. Results: Among the 1,915 participants (mean age 56 ± 6 years; 36% women) enrolled, 828, 564 and 264 patients belonged to the control, TSC and FFA groups, respectively. We found evidence suggestive of an interaction between the intervention type and behavioral change stage in diet (P = 0.042) and exercise (P = 0.038) after adjusting for covariates. The hazard ratios (95% confidence interval) of FFA to TSC were 0.21 (0.05–0.93) and 7.69 (0.50–117.78) in the pre‐action and post‐action stages for diet, respectively, whereas they were 0.20 (0.05–0.92) and 4.75 (0.29–73.70) in the pre‐action and post‐action stages for exercise. Conclusions: Among diabetes patients, the impact of multifaceted intervention on non‐attendance from medical care might differ by the behavioral change stage. [ABSTRACT FROM AUTHOR]

The influence of sugar consumption on the risk of colorectal cancer (CRC) remains controversial. Prospective cohort studies focusing on total and specific types of sugar intake among the Asian population who have different patterns of sugar intake sources than American and European populations are scarce. We intended to examine the association of sugar intake with CRC risk among middle‐aged adults in a Japanese large‐scale population‐based cohort study. The participants (42,405 men and 48,600 women) who were 45–74 years old and answered the questionnaire in 1995–1999 in the Japan Public Health Center‐based Prospective Study were followed up until December 2013. Total sugars, total fructose, and specific types of sugar intake were estimated using a validated 147‐item food frequency questionnaire and divided into quintiles (Q1–Q5). We used Cox proportional hazard regression models adjusted for potential confounders to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During the follow‐up, 2118 CRC cases (1226 men and 892 women) were identified. We did not observe any clear association between all types of sugar intake and an increased risk of CRC. Analyses by tumor sites yielded a positive association of total sugar consumption with rectal cancer in women (1.75 [1.07–2.87] for Q1 vs. Q5; plinear trend = 0.03), but no statistically significant trend was detected among men. Sugar intake was not associated with CRC risk in middle‐aged Japanese adults. However, for rectal cancer, the probability of an increased risk among women with a higher total sugar intake cannot be excluded. [ABSTRACT FROM AUTHOR]

Biomimetic actuators are critical components of bionics research and have found applications in the fields of biomedical devices, soft robotics, and smart biosensors. This paper reports the first study of nanoassembly topology‐dependent actuation and shape memory programming in biomimetic 4D printing. Multi‐responsive flower‐like block copolymer nanoassemblies (vesicles) are utilized as photocurable printing materials for digital light processing (DLP) 4D printing. The flower‐like nanoassemblies enhance thermal stability, attributed to their surface loop structures on the shell surfaces. Actuators prepared from these nanoassemblies display topology‐dependent bending in response to pH and temperature‐programmable shape memory properties. Biomimetic octopus‐like soft actuators are programmed with multiple actuation patterns, large bending angles (≈500°), excellent weight‐to‐lift ratios (≈60), and moderate response time (≈5 min). Thus, nanoassembly topology‐dependent and shape‐programmable intelligent materials are successfully developed for biomimetic 4D printing. [ABSTRACT FROM AUTHOR]

Weighing the additional benefit of antidiabetic medications for cardiovascular disease Large-scale clinical trials of SGLT2 inhibitors (i.e., EMPA-REG, CANVAS, and DECLARE TIMI 58) have been conducted in people with type 2 diabetes having cardiovascular disease or high-risk patients with type 2 diabetes with major adverse cardiovascular events (MACE) (a composite of cardiovascular death, non-fatal myocardial infarction (MI), and non-fatal ischemic stroke) as the primary endpoint and demonstrated a significant reduction in MACE with these agents[[51], [53]] with this finding also confirmed by independent meta-analyses of these trials[[54]]. INITIAL ANTIDIABETIC MEDICATION PRESCRIBING PATTERNS FOR PEOPLE WITH DIABETES IN JAPAN It is not difficult to imagine how significantly such differences in treatment strategy for type 2 diabetes mellitus might impact on the choice of medications or their prescribing patterns. Keywords: Algorithm; Pharmacotherapy; Type 2 diabetes EN Algorithm Pharmacotherapy Type 2 diabetes 151 164 14 01/04/23 20230101 NES 230101 PREFACE In 2020, the Japan Diabetes Society (JDS) adopted a sweeping decision to release consensus statements on relevant issues in diabetes management that require updating from time to time and launched a "JDS Committee on Consensus Statement Development". In contrast, the treatment strategy for type 2 diabetes mellitus in Japan is characterized as allowing for the choice of medications from all classes to address the diabetes pathology in each affected individual, while taking into account the extent of their metabolic derangement, but also on their age, extent of their obesity, status of their insulin secretion/insulin resistance, severity of their chronic complications, status of their liver/renal function[20]. [Extracted from the article]

This work reports the first use of organic chloride salts as catalysts for reversible complexation mediated living radical polymerization. Owing to the strong halogen‐bond forming ability of Cl−, the studied four tetraalkylammonium chloride catalysts (R4N+Cl−) successfully control the polymerizations of methyl methacrylate, yielding polymers with low dispersities up to high monomer conversion (>90%). Benzyldodecyldimethylammonium chloride is further exploited to other methacrylates and yields low‐dispersity block copolymers. The advantages of the chloride salt catalysts are wide monomer scope, good livingness, accessibility to block copolymers, and good solubility in organic media. Because of the good solubility, the use of the chloride salt catalysts can prevent agglomeration of catalysts on reactor walls in organic media, which is an industrially attractive feature. Among halide anions, chloride anion is the most abundant and least expensive halide anion, and therefore, the use of the chloride salt catalysts may lower the cost of the polymerization. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Among colorectal cancer (CRC) patients, pre‐existing diabetes is suggested to influence poor prognosis, but the impact on adjuvant chemotherapy implementation is largely unknown. We aimed to compare the implementation rate of adjuvant chemotherapy between CRC patients with and without pre‐existing diabetes in a retrospective cohort study. Materials and Methods: Colorectal cancer diagnosis information was obtained from the hospital‐based cancer registry of patients with stage III CRC who underwent curative surgery in 2013 in Japan (n = 6,344). Health claims data were used to identify diabetes and chemotherapy. We examined the association between diabetes and the implementation rate of adjuvant chemotherapy using a generalized linear model adjusted for age, sex, updated Charlson Comorbidity Index, hospital type and prefecture. Furthermore, we applied a mediation analysis to examine the extent to which postoperative complications mediated the association. Results: Of the 6,344 patients, 1,266 (20.0%) had diabetes. The mean ages were 68.2 and 71.3 years for patients without and with diabetes, respectively. Compared with those without diabetes, patients with diabetes were less likely to receive adjuvant chemotherapy (crude rate 58.9 and 49.8%; adjusted percentage point difference 4.6; 95% confidence interval 1.7–7.5). The difference was evident for patients aged <80 years, and larger for platinum‐containing regimens than others. Mediation analysis showed that postoperative complications explained 9.1% of the inverse association between diabetes and adjuvant chemotherapy implementation. Conclusions: We observed that patients with stage III CRC and diabetes are less likely to receive adjuvant chemotherapy than those without diabetes, and postoperative complications might partially account for the association. [ABSTRACT FROM AUTHOR]

Purpose: This study determined the validity of claims‐based definitions for identifying the incidence of total and site‐specific cancers in a population‐based cohort study. Methods: Claims data were obtained for 21 946 participants aged 40–74 years enrolled in the Japan Public Health Center‐based Prospective Study for the Next Generation. We defined total and site‐specific cancer incidence using combinations of codes from claims data, including diagnosis and procedure codes for cancer therapy. Data from the cancer registry were used as the gold standard to evaluate validity. Results: Among 21 946 participants, 454 total, 89 stomach, 67 colorectal, 51 lung, 39 breast and 99 prostate invasive cancer cases were newly diagnosed in the cancer registry. For invasive cancer, the sensitivity and specificity of the definition that combined codes for diagnosis and procedures for cancer therapy were 87.0% and 99.4% for total, 88.8% and 99.9% for stomach, 80.6% and 99.9% for colorectal, 86.3% and 99.9% for lung, 100% and 99.9% for breast and 91.9% and 99.9% for prostate cancer, respectively. Furthermore, for invasive and/or in situ cancer, the sensitivity and specificity of the definition were 84.5% and 99.5% for total, 66.7% and 99.9% for colorectal and 100% and 99.9% for breast cancer. Conclusions: Our findings suggest that claims‐based definitions using diagnosis and procedure codes generally have high validity for total, stomach, lung, breast and prostate cancer incidence, but may underestimate colorectal cancer incidence. [ABSTRACT FROM AUTHOR]

Aim: Urbanization and ageing are worldwide issues for healthcare providers. In particular, older adults aged 90 years and older have increased cognitive impairment and lower daily functioning than younger adults. However, the healthcare use of the oldest old remains unclear. This study aimed to describe the healthcare use of the oldest old compared with younger older adults in a city using the ecology of medical care model. Methods: We conducted a cross‐sectional study. This study targeted all residents aged 75 years and older registered in a city in Japan for one year. We described healthcare use per 1000 inhabitants over a 1‐month period and included: outpatient visits, emergency department visits, hospitalizations, home visits, home care services, and facility services. We also compared healthcare use among older adults aged 75–89 years and 90 years and older. Results: We described the healthcare use of 454 366 (male/female: 186 177/268 189) older adults. The numbers of persons per 1000 residents who used healthcare resources at least once in 1 month (75–89 years/90 years and older) were: outpatient clinic visits, 622/570; hospital outpatient visits, 300/263; advanced treatment hospital outpatient visits, 16/6; emergency department visits, 10/27; hospitalizations, 45/96; advanced treatment hospital hospitalizations, 2/1; planned home visits, 36/228; urgent home visits, 6/38; home care services, 173/533; and facility services, 32/178. Conclusions: The results revealed that older adults over 90 years had more hospitalizations, emergency department visits and home visits, and used facility/home care services more compared with older adults aged 75–89 years. The results provide a useful benchmark for healthcare use estimation. Geriatr Gerontol Int 2022; 22: 483–489. [ABSTRACT FROM AUTHOR]

An air‐tolerant reversible complexation mediated polymerization (RCMP) technique, which can be carried out without prior deoxygenation, is developed. The system contains a monomer, an alkyl iodide initiating dormant species, air (oxygen), an aldehyde, N‐hydroxyphthalimide (NHPI), and a base. Oxygen is consumed via the NHPI‐catalyzed conversion of the aldehyde (RCHO) to a carboxylic acid (RCOOH). The generated RCOOH is further converted to a carboxylate anion (RCOO−) by the base. The RCOO− generated in situ works as an RCMP catalyst; the polymerization proceeds with the monomer, alkyl iodide dormant species, and RCOO− catalyst. Thus, the system is not only air‐tolerant but also does not require additional RCMP catalysts, which is a notable feature of this system. (NHPI is used as an oxidation catalyst for converting RCHO to RCOOH.) This technique is amenable to methyl methacrylate, butyl methacrylate, benzyl methacrylate, 2‐hydroxyethyl methacrylate, and styrene, yielding polymers with relatively low‐dispersity (Mw/Mn = 1.20−1.49), where Mw and Mn are the weight‐ and number‐average molecular weights, respectively. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To investigate the national trend in the prescription of first‐line non‐insulin antidiabetic agents and total medical costs (TMCs) after prescribing the drug in Japanese patients with type 2 diabetes. Materials and Methods: Using the National Database of Health Insurance Claims and Specific Health Check‐ups of Japan covering almost the entire Japanese population, we calculated the proportion of each antidiabetic drug from 2014 to 2017, and determined the factors associated with drug selection. The TMCs in the first year after starting the drugs were calculated, and factors associated with the costs were also determined. Results: Among 1,136,723 new users of antidiabetic agents, dipeptidyl peptidase‐4 inhibitors were the most prescribed (65.1%), followed by biguanides (15.9%) and sodium–glucose cotransporter 2 inhibitors (7.6%). Sodium–glucose cotransporter 2 inhibitor and biguanide use increased during 2014–2017 (2.2%–11.4% and 13.7%–17.2%, respectively), whereas the others decreased. Biguanides were not prescribed at all in 38.2% of non‐Japan Diabetes Society‐certified facilities. The TMCs were the lowest among those who started with biguanides. Fiscal year, age, sex, facility, number of beds and comorbidities were associated with drug choice and TMCs. There were wide regional variations in the drug choice, but not in the TMCs. Conclusions: Unlike in the USA and Europe, dipeptidyl peptidase‐4 inhibitor is the most prescribed first‐line medication for type 2 diabetes patients in Japan, while there is a wide variation in the drug choice by facility‐type and prefecture. [ABSTRACT FROM AUTHOR]

Terpolymers are used to generate bio‐decomposable self‐assemblies. PEG‐PVL‐PGMA terpolymers are synthesized via a combination of organocatalyzed living radical polymerization (RCMP) with polymerization‐induced self‐assembly (PISA), generating vesicle, multicompartment micelle (MCM), and core‐compartmentalized worm (CCW), where PEG, PVL, and PGMA are poly(ethylene glycol) monomethyl ether, poly(δ‐valerolactone), and poly(glycidyl methacrylate) and PGMA is grown during the PISA. MCM and CCW are uniquely obtainable using terpolymers. The PVL segment is biodegradable, and the obtained assemblies are bio‐decomposable. Heavy metal‐free and sulfur‐free synthesis and bio‐decomposability of the assemblies are attractive features. [ABSTRACT FROM AUTHOR]

Evidence supporting the association of glycemic index (GI) and glycemic load (GL) with the risk of endometrial cancer is controversial and reports from Asia were limited. Therefore, we aimed to investigate the association in Japanese women. We evaluated 52 460 women in the Japan Public Health Center‐based Prospective Study aged 45‐74 years who responded to the 5‐year follow‐up survey. GI and GL were calculated from a validated food frequency questionnaire, and the participants were divided into three groups by GI and GL. The hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with the Cox proportional hazard model adjusted for potential confounding factors. As a result, within 15.5 years of follow‐up, 166 new cases of endometrial cancer were identified. Compared with the lowest GI and GL tertile groups, the HR of the risk of endometrial cancer in the highest GI tertile group was 0.80 (95% CI, 0.53‐1.20; Ptrend =.33), and that of the highest GL tertile group was 0.79 (95% CI, 0.52‐1.19; Ptrend =.82). The results were unchanged after stratification by body mass index, coffee consumption, and history of diabetes. In conclusion, we did not find any significant association between GI and GL with the risk of endometrial cancer. Further research is required to clarify the association. [ABSTRACT FROM AUTHOR]

Evidence of the association between dietary fiber intake and gastric cancer (GC) risk from prospective studies is limited. We examined the association between dietary fiber intake and GC risk in a large prospective study. A total of 91 946 eligible Japanese aged 45 to 74 years (42 773 men and 49 173 women) participated in a population‐based cohort study (Japan Public Health Center‐based prospective study). From a validated food frequency questionnaire with 138 food items, total and food source‐specific dietary fiber intake was calculated as exposure. The hazard ratio (HR) and the 95% confidence interval (CI) of GC incidence according to quintile of dietary fiber intake were examined after adjusting for confounding factors. In total, 2228 GC cases (1559 men and 669 women) were observed during the 15.0 years follow‐up. Total dietary fiber intake was not associated with GC risk; however, a marginally increased risk trend because of high HR in the highest quintile of total fiber intake was found in women (HR [95% CI] in Q5 vs Q1: 0.95 [0.79‐1.14], P for trend.30 in men, HR [95% CI] 1.25 [0.98‐1.61], P for trend.05 in women). Stratification by tumor location did not change the results. A marginal but not significant inverse trend was observed regarding cereal fiber intake and GC risk in men. Total dietary fiber intake was not associated with GC risk. Further studies are warranted to confirm this association. What's new? Since dietary fiber is abundantly contained in whole grains, fruits, and vegetables, it is expected to have beneficial effects on health. But so far, only the association with decreased colorectal cancer risk has been fully established. In a 15‐year prospective study with more than 2000 gastric cancer cases from 91 946 Japanese subjects, total dietary fiber intake was not associated with gastric cancer risk. However, a marginally increased association between total fiber intake and gastric cancer incidence in women, and a non‐significant inverse trend with cereal fiber intake in men, was observed. Stratification by tumor location did not change the results. [ABSTRACT FROM AUTHOR]

Traditional observational studies have reported a positive association between higher body mass index (BMI) and the risk of colorectal cancer (CRC). However, evidence from other approaches to pursue the causal relationship between BMI and CRC is sparse. A two‐sample Mendelian randomization (MR) study was undertaken using 68 single nucleotide polymorphisms (SNPs) from the Japanese genome‐wide association study (GWAS) and 654 SNPs from the GWAS catalogue for BMI as sets of instrumental variables. For the analysis of SNP‐BMI associations, we undertook a meta‐analysis with 36 303 participants in the Japanese Consortium of Genetic Epidemiology studies (J‐CGE), comprising normal populations. For the analysis of SNP‐CRC associations, we utilized 7636 CRC cases and 37 141 controls from five studies in Japan, and undertook a meta‐analysis. Mendelian randomization analysis of inverse‐variance weighted method indicated that a one‐unit (kg/m2) increase in genetically predicted BMI was associated with an odds ratio of 1.13 (95% confidence interval, 1.06‐1.20; P value <.001) for CRC using the set of 68 SNPs, and an odds ratio of 1.07 (1.03‐1.11, 0.001) for CRC using the set of 654 SNPs. Sensitivity analyses robustly showed increased odds ratios for CRC for every one‐unit increase in genetically predicted BMI. Our MR analyses strongly support the evidence that higher BMI influences the risk of CRC. Although Asians are generally leaner than Europeans and North Americans, avoiding higher BMI seems to be important for the prevention of CRC in Asian populations. [ABSTRACT FROM AUTHOR]

Background: Although preclinical studies suggest that fermented soy foods may have a protective effect against breast cancer, no prospective cohort studies have examined this association. Objective: Our study examined the association between fermented and nonfermented soy food intake and breast cancer risk using a population‐based prospective cohort study in Japan. Methods: We included a total of 47,614 women aged 45–74 years in an analysis of the Japan Public Health Center‐based Prospective Study (JPHC Study). A validated food frequency questionnaire (FFQ) was used for the assessment of dietary intake. Breast cancer incidence was analyzed by multivariate Cox proportional hazards regression models. Results: During an average of 15.5 years of follow‐up, 825 breast cancer cases were newly identified. We found no association of intake of soy foods with breast cancer risk, regardless of fermentation, with multivariate hazard ratios (HRs) and 95% confidence intervals (CIs) for the highest quartiles of fermented and nonfermented soy food intake of 0.94 (0.67, 1.32) and 1.15 (0.85, 1.57) compared with the lowest quartile (p for trend = 0.305 and 0.393). Unlike nonfermented soy, higher intake of fermented soy foods was associated with a significant decrease in the risk of nonlocalized breast cancer. The HR and 95% CI in the highest compared to lowest intake category of fermented soy foods was 0.53 (0.28, 0.99) versus nonfermented soy foods 0.85 (0.51, 1.42) (p for trend = 0.026 and 0.797). Conclusions: Our analyses showed that fermented soy foods had no association with overall breast cancer but may be associated with decreased risk of nonlocalized breast cancer. [ABSTRACT FROM AUTHOR]

Although intake of highly sugary foods is considered to be a potential risk factor for colorectal cancer through hyperinsulinemia, the association of sugar intake and colorectal adenoma, a precursor lesion to most colorectal cancer, is poorly understood, particularly in Asian populations. We undertook a cross‐sectional study in a Japanese population to investigate the association between dietary sugar intake and the prevalence of colorectal adenoma. Study subjects were selected from participants who underwent magnifying colonoscopy with dye spraying as part of a cancer screening program and who responded to a self‐administered questionnaire before the colonoscopy. A total of 738 cases with colorectal adenoma and 697 controls were enrolled. Dietary intakes of glucose, fructose, galactose, sucrose, maltose, lactose, and total sugars (sum of these six mono‐ or disaccharides) were calculated from a food frequency questionnaire, and divided into quartiles based on the distribution among controls. Odds ratios and 95% confidence intervals of colorectal adenoma were estimated using unconditional logistic regression models, with adjustment for potential confounding factors. Total sugar intake was not significantly associated with the prevalence of colorectal adenoma (odds ratio for the highest intake group compared to reference group = 1.18; 95% confidence interval, 0.81‐1.73; P for trend =.34). Furthermore, no statistically significant positive associations were observed for any of the six mono‐ or disaccharides. Findings were similar on additional analyses by site, size, and number of adenomas. Our findings do not support an association between high sugar intake and increased odds ratios of colorectal adenoma. [ABSTRACT FROM AUTHOR]

The well‐known gene‐environment interaction between alcohol consumption and aldehyde dehydrogenase 2 (ALDH2) genotype in upper aerodigestive tract cancer risk may improve our ability to identify high‐risk subjects. Here, we developed and validated risk prediction models for this cancer in Japanese men and evaluated whether adding the gene‐environment interaction to the model improved the predictive performance. We developed two case‐cohort datasets in the Japan Public Health Center‐based Prospective Study: one from subjects in the baseline survey for model development (108 cases and 4049 subcohort subjects) and the second from subjects in the 5‐year follow‐up survey for model validation (31 cases and 1527 subcohort subjects). We developed an environmental model including age, smoking status, and alcohol consumption, and a gene‐environment interaction model including age, smoking status, and the combination of alcohol consumption and the ALDH2 genotype. We found a statistically significant gene‐environment interaction for alcohol consumption and the ALDH2 genotype. The c‐index for the gene‐environment interaction model (0.71) was slightly higher than that for the environmental model (0.67). The values of integrated discrimination improvement and net reclassification improvement for the gene‐environment interaction model were also slightly higher than those for the environmental model. Goodness‐of‐fit tests suggested that the models were well calibrated. Results from external model validation by the 5‐year follow‐up survey were consistent with those from the model development by the baseline survey. The addition of a gene‐environment interaction to a lifestyle‐based model might improve the performance to estimate the probability of developing upper aerodigestive tract cancer for Japanese men. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The aim of the current study was to prospectively evaluate the association between passive smoking from a spouse and the risk of diabetes among never‐smoking Japanese women. Passive smoking at a workplace (or public facilities) was assessed as a secondary measure. Materials and Methods: In the Japan Public Health Center‐based Prospective Study (baseline 1990 or 1993), we followed 25,391 never‐smoking women aged 40–69 years and without diabetes. Passive smoking was defined as having a husband who was a self‐reported smoker, and the exposure at a workplace (or public facilities) was self‐reported by women. The development of diabetes was identified in questionnaires administered at the 5‐year and 10‐year surveys. A pooled logistic regression model was used to assess the association between passive smoking and the development of diabetes with adjustment for age and possible confounders. Results: Compared with women whose husbands had never smoked, women whose husband smoked ≥40 cigarettes/day had significantly higher odds of developing diabetes in an age‐adjusted model, but the association was attenuated in a multivariable model (odds ratio 1.34, 95% confidence interval 0.96–1.87). There was a dose–response trend between the number of cigarettes smoked by a husband and the odds of developing diabetes (P = 0.02). Women reporting daily passive smoking at a workplace (or public facilities) had higher odds of developing diabetes than women reporting no such exposure (odds ratio 1.23, 95% confidence interval 0.995–1.53). Conclusions: Our results indicated a higher risk of diabetes among never‐smoking Japanese women with higher exposure to passive smoking from a spouse. [ABSTRACT FROM AUTHOR]

Cancer patients with diabetes experience a poorer prognosis, yet the population burden of this multimorbidity remains unknown. This study aimed to estimate the latest incidence and prevalence of cancer with diabetes mellitus in Japan. We used projection of cancer incidence and latest survival data from population‐based cancer registries. The incidence of cancer associated with diabetes was estimated separately for patients with pre‐existing diabetes and those without diabetes, and used to estimate the 5‐year cancer prevalence for those with and without diabetes. The prevalence of pre‐existing diabetes in cancer patients at any cancer site was estimated to be 20.7% (647,160 men and women). Among cancer sites, diabetes prevalence was high in patients with liver and pancreatic cancers in both sexes. In conclusion, our study shows a large burden of diabetes in cancer patients in Japan, which warrants further attention by health practitioners and policy‐makers. [ABSTRACT FROM AUTHOR]

Family history (FH) of cancer is an important factor of increased risk of several cancers. Although the association between FH of cancer and concordant cancer risk has been reported in many previous epidemiological studies, no comprehensive prospective study with adjustment for lifestyle habits has evaluated the association of FH of cancer and concordant cancer risk. We investigated the association between FH of cancer and concordant cancer risk in a Japanese population‐based prospective study, initiated in 1990 for cohort I and in 1993 for cohort II. We analyzed data on 103,707 eligible subjects without a history of cancer who responded to a self‐administered questionnaire including FH of cancer at baseline. Study subjects were followed through 2012 and analyzed using multivariable‐adjusted Cox proportional hazards regression models. During 1,802,581 person‐years of follow‐up, a total of 16,336 newly diagnosed cancers were identified. Any site (Hazard ratios = 1.11 (95% confidence interval = 1.07–1.15]), esophagus (2.11 [1.00–4.45]), stomach (1.36 [1.19–1.55]), liver (1.69 [1.10–2.61]), pancreas (2.63 [1.45–4.79]), lung (1.51 [1.14–2.00]), uterus (1.93 [1.06–3.51]) and bladder cancers (6.06 [2.49–14.74]) with FH of the concordant cancer were associated with an increased risk compared to those without FH. Our findings suggest that having FH of cancer is associated with an increased risk of several concordant cancer incidences in an Asian population. Enquiring about FH of several types of cancer may be important in identifying groups at high‐risk of those cancers. What's new? Although many epidemiological studies have reported an association between family history of cancer and concordant cancer risk, the association has not been evaluated in a comprehensive prospective study with adjustment for lifestyle habits. We found that a family history of cancer is associated with increased risk in the incidence of several concordant cancers in an Asian population. [ABSTRACT FROM AUTHOR]

Keywords: Diabetes; Diagnosis; Guideline; Treatment EN Diabetes Diagnosis Guideline Treatment 1020 1076 57 07/27/20 20200701 NES 200701 PREFACE Objectives of the current guideline for the management of diabetes The current guideline represents the 6th edition of the "Japanese Clinical Practice Guideline for Diabetes" which has been revised every three years since its first appearance in 2004 to promote evidence-based, rational, efficient and consistent clinical practice in diabetes. b Intensive insulin therapy has been shown to be effective in preventing the onset of macroangiopathy in type 2 diabetes 9,31,32. 7 DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT FOR THE SELF-MANAGEMENT OF DIABETES B [CQ7-1] Are organized support and education for the self-management of diabetes useful for the management of diabetes? MNT for elderly patients with diabetes B [VIII-CQ-1] Is MNT as effective for elderly patients with diabetes as for non-elderly patients? Glycemic control and cancer risk in patients with diabetes The "Report of the Committee on Diabetes and Cancer II" addressed this issue and examined the impact of glycemic control on the subsequent risk of cancer in patients with diabetes[443], demonstrating that there is no high-quality evidence available, at present, to clarify the association between glycemic control and cancer risk in patients with diabetes. Management and prognosis of patients with cancer and diabetes It is reported that patients with cancer and diabetes are associated with poorer short-term and long-term life prognosis than patients with cancer without diabetes[[446]]. [Extracted from the article]

Sonogelation by supramolecular gelators is highlighted as a paradigm shift for their potential applications in material and biomedical sciences. Yet, these materials require organic solvents and low‐frequency ultrasound, limiting their utility. Here, a comb‐like polymethacrylate copolymer is synthesized with 2,6‐bis(1‐methylbenzimidazolyl)‐4‐oxypyridine tridentate ligand randomly distributed on poly(ethylene glycol) side chains. Upon addition of zinc perchlorate salt, this copolymer rapidly forms a hydrogel after exposure to either mechanical (i.e., ultrasound) or thermal stimuli. Spectroscopic analysis, to elucidate the mechanism, indicates metal ion coordination to ligand as well as the carbonyl and ethylene glycol units; interestingly, 1H‐NMR suggests that the coordination between tridentate ligand moiety and Zn2+ is unexpectedly weaker in water than in acetonitrile. Investigations by dynamic light scattering indicates that the copolymer forms nanodispersions in excess salt, which coalesces to form a hydrogel by either heating or high intensity focused ultrasound (HIFU). Rheological quantification of these gels suggests stronger crosslinking by HIFU compared to heating. [ABSTRACT FROM AUTHOR]

Liquid vinyl monomers were converted into solid crystals via halogen bonding. They underwent solid‐phase radical polymerizations through heating at 40 °C or ultraviolet photo‐irradiation (365 nm). The X‐ray crystallography analysis showed the high degree of monomer alignment in the crystals. The polymerizations of the solid monomer crystals yielded polymers with high molecular weights and relatively low dispersities because of the high degree of the monomer alignment in the crystal. As a unique application of this system, the crystalized monomers were assembled to pre‐determined structures, followed by solid‐phase polymerization, to obtain a two‐layer polymer sheet and a three‐dimensional house‐shaped polymer material. The two‐layer sheet contained a unique asymmetric pore structure and exhibited a solvent‐responsive shape memory property and may find applications to asymmetric membranes and polymer actuators. [ABSTRACT FROM AUTHOR]

Organocatalyzed living radical polymerizations of itaconates are studied, yielding low‐dispersity linear and star polymers (Đ = Mw/Mn = 1.28−1.46) up to Mn = 20 000 and monomer conversion = 62%, where Mn and Mw are the number‐ and weight‐average molar masses, respectively. The block polymerization with functional methacrylates, an acrylate, and styrene yields various rod−coil block copolymers. Linear A−B diblock, linear B−A−B triblock, and 3‐arm star A−B diblock copolymers generate spherical micelles (nanoparticles) and vesicles (nanocapsules), depending on the polymer structures. Itaconates can be derived from bioresources, and thus the obtained polymers may serve as green polymers. Because of the biocompatibility of polyitaconates, the assemblies may serve as biocompatible nanocarriers. [ABSTRACT FROM AUTHOR]

ABC‐type miktoarm star copolymers are synthesized using a single living radical polymerization (organocatalyzed living radical polymerization) via a "combinatorial" approach. The arm A is poly(butyl acrylate), the arm B is poly(methyl methacrylate), and the arm C encompasses hydrophobic and hydrophilic polyacrylates. A poly(butyl acrylate) with a vinyl chain end (macromonomer) is synthesized. A poly(methyl methacrylate) is subsequently connected to the reactive vinyl group to generate diblock copolymer. From the junction of the diblock copolymer, polymer C grew to yield star copolymers. An amphiphilic star copolymer is also synthesized, and its self‐assembly structure is studied in an aqueous solution. [ABSTRACT FROM AUTHOR]

Although occupational sitting time has been associated with adverse health outcomes and mortality, the association with cancer incidence remains unknown. This study investigated the association between occupational sitting time and risk of total and site‐specific cancer in a Japanese population. We evaluated 33 307 participants aged 50‐79 years who responded to a questionnaire in 2000‐2003 in the Japan Public Health Center‐based Prospective Study and were followed until 2013. Participants were grouped by sitting time at work. Hazard ratio (HR) and 95% confidence interval (CI) of cancer incidence were calculated with adjustment for potential confounders including moderate‐to‐vigorous physical activity. During 10.2 years of follow‐up, 3807 newly diagnosed cases of cancer were identified. Occupational sitting time was marginally associated with total cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 1.12 (95% CI, 0.99‐1.26; P for trend =.071) in men, but not women. Among findings for cancers at specific sites, long occupational sitting time was associated with increased risk of pancreas cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 2.25 (95% CI, 1.17‐4.34; P for trend =.021) in men, and lung cancer, with multivariable HRs for the ≥7 h/d vs 1 to <3 h/d category of 2.80 (95% CI, 1.33‐5.90; P for trend =.013) in women. Extended sitting time at work was associated with an increased risk of pancreas cancer in men and lung cancer in women. [ABSTRACT FROM AUTHOR]

Earlier cohort studies using conventional regression models have consistently shown an increased cancer risk among individuals with type 2 diabetes. However, reverse causality and residual confounding due to common risk factors could exist, and it remains unclear whether diabetes per se contributes to cancer development. Mendelian randomization analyses might clarify the true association between diabetes and cancer risk. We conducted a case–cohort study with 10,536 subcohort subjects and 3,541 newly diagnosed cancer cases derived from 32,949 eligible participants aged 40–69 years within the Japan Public Health Center‐based Prospective Study. With 29 known type 2 diabetes susceptibility variants, we used an inverse variance‐weighted method to estimate hazard ratios for the associations of diabetes with risks of total and site‐specific cancers. The hazard ratios of cancer per doubling of the probability of diabetes were 1.03 (95% confidence interval [CI], 0.92–1.15) overall, 1.08 (95% CI: 0.73–1.59) for the pancreas, 0.80 (95% CI: 0.57–1.14) for the liver and 0.90 (95% CI: 0.74–1.10) for the colorectum. Additional analyses, using publicly available large‐scale genome‐wide association study data on colorectal cancer in Japan, resulted in a narrower CI (hazard ratio: 1.00; 95% CI: 0.93–1.07). In this prospective Mendelian randomization study with a large number of incident cancer cases, we found no strong evidence to support associations between diabetes and overall and site‐specific cancer risks. Our findings suggest that there is little evidence to support the genetic role of type 2 diabetes in cancer development in the Japanese population. What's new? While type 2 diabetes is implicated in cancer development, the two conditions share multiple risk factors, raising questions about the actual contribution of diabetes to cancer risk. Here, a Mendelian randomization (MR) analysis was used to clarify the relationship between diabetes and cancer in a Japanese cohort. Based on data for 32,949 individuals, including 3,541 incident cancer cases, MR analysis revealed no strong genetic evidence supporting a link between diabetes and cancer risk, including site‐specific and overall risk. This finding was confirmed by investigation of data from a genome‐wide association study of colorectal cancer from the BioBank Japan Project. [ABSTRACT FROM AUTHOR]

A temperature‐directed micellar morphological transformation was developed using CABC multi‐block copolymers with a hydrophobic block A, a hydrophilic block B, and a thermally responsive block C with a lower critical solution temperature (LCST). The micellar structure was switched from a star (below LCST) to a flower (above LCST). The transition temperature was tunable in a wide range (11–90 °C) by varying the C monomer composition. The large difference in the loading capacity between the star and flower enabled efficient encapsulation and controlled release of external molecules. Unlike conventional systems, the present star‐to‐flower transformation keeps micellar structures and hence does not liberate polymers but only external molecules selectively. Another application is a hidden functional segment. A functional segment is hidden (shielded) below the LCST and exposed to interact with external molecules or surfaces above the LCST. [ABSTRACT FROM AUTHOR]

An effective method to synthesize azido‐end polymethacrylates from tetrabutylammonium azide (BNN3) in a nonpolar solvent (toluene) was developed. Several low‐mass alkyl halides were reacted with BNN3 in toluene as model reactions and the rate constants of these reactions were determined, to confirm fast BNN3 azidation for tertiary and secondary halides. The end‐group transformation of halide‐end polymethacrylates was effective and nearly quantitative. Notably, the combination of organocatalyzed living (or reversible deactivation) radical polymerization and BNN3 azidation enabled the metal‐free synthesis of azido‐end polymethacrylates, including single‐azido‐end and multi‐azido‐end functional homopolymers and block copolymers. The rapid and quantitative reaction without the requirement for a large excess of BNN3, metal‐free and polar‐solvent‐free nature, and broad polymer scope are attractive features of this azidation. [ABSTRACT FROM AUTHOR]

Previous epidemiological studies evaluated endogenous sex hormone levels and colorectal cancer (CRC) risk have yielded inconsistent results. Also, it is unknown if consumption of dietary isoflavones may influence the endogenous sex hormones and CRC relationships. We conducted a nested case–control study within the JPHC Study Cohort II wherein 11,644 women provided blood samples at the 5‐year follow‐up survey. We selected two matched controls for each case from the cohort (185 CRC cases and 361 controls). Multivariable conditional logistic regression was used to estimate odds ratios (ORs), 95% confidence intervals (CIs) for the association between circulating sex hormone levels and CRC risk. Comparing extreme tertiles, circulating testosterone levels were positively associated with CRC risk (OR = 2.10, 95% CI = 1.11–3.99, p for trend = 0.03). Levels of estradiol, SHBG, and progesterone were not associated with CRC risk. In a subgroup analysis by dietary isoflavone intake, SHBG levels were positively associated with CRC risk among those with low total isoflavone intake (p for trend = 0.03), with a statistically nonsignificant inverse association among those with high total isoflavone intake (p for trend = 0.22; p for interaction = 0.002). Endogenous levels of testosterone were positively associated with CRC among postmenopausal women. The association of endogenous SHBG with CRC development may be altered by the level of dietary isoflavone intake. What's new? It is well established that women are at lower risk of colorectal cancer (CRC) than men. Whether this difference can be explained in part by differences in sex hormone exposures, however, remains uncertain. Here, potential associations between endogenous sex hormone levels and CRC risk were investigated in more than 11,600 Asian postmenopausal women in the Japan Public Health Center‐based Prospective Study. From blood analyses, circulating testosterone levels were found to be positively associated with CRC risk. In addition, for some women, low dietary intake of soy isoflavones was associated with increased CRC risk and elevated endogenous sex hormone‐binding globulin levels. [ABSTRACT FROM AUTHOR]

Background & Aims: The association of serum liver enzyme levels with all‐cause mortality in individuals without hepatitis B virus or hepatitis C virus infection is inconsistent. We aimed to investigate all‐cause and non‐liver disease mortality according to levels of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma‐glutamyltransferase (GGT) stratified by hepatitis virus infection status in a Japanese cohort. Methods: Participants were 7243 men and 13 513 women aged 40‐69 years at the baseline survey in 1993‐1994. Multivariate‐adjusted hazard ratios of death from the baseline health check‐up to December 2012 were calculated with a Cox proportional hazards model controlling for potential confounding factors. Results: During follow‐up, 2235 deaths in men and 1901 deaths in women were identified. All serum liver enzymes were associated with all‐cause mortality in each sex and hepatitis virus infection status. In participants without infection, those with more than twice the upper level of normal (ULN), which was defined as 30 IU/L for AST and ALT and 50 IU/L for GGT, had a higher risk of non‐liver disease mortality compared to those below the ULN (HR 1.69; 95% confidence interval 1.13‐2.53, 1.49; 1.02‐2.18, 1.39; 1.11‐1.73, 1.72; 1.08‐2.74 and 1.72; 1.10‐2.69 for AST, ALT, and GGT in men and AST and GGT in women, respectively), except for ALT in women. Conclusions: In participants without hepatitis virus infection, serum liver enzyme levels were positively associated with all‐cause mortality. Similar associations were also found for non‐liver disease mortality. See Editorial on Page 1389 [ABSTRACT FROM AUTHOR]

Aims/Introduction: The aim of the present study was to examine the associations of pregestational body mass index (BMI) and gestational weight change with birthweight for gestational age in Japanese mothers with gestational diabetes mellitus (GDM). Materials and Methods: We retrospectively examined the clinical and laboratory characteristics of 101 mothers with GDM (pregestational BMI 24.7 ± 5.8 kg/m2; maternal age at delivery 34.7 ± 5.1 years; gestational age 38.5 ± 1.4 weeks) at a single center from January 2011 to December 2016. Results: Gestational weight changes were 6.22 ± 5.39 kg, and infant birthweights were 2,987.3 ± 393.6 g. Multivariable analysis showed that, in all mothers, pregestational BMI and gestational weight change were positively associated with infant birthweight (P < 0.001 and P = 0.007, respectively). Pregestational BMI, but not gestational weight change, was positively associated with infant birthweight (P = 0.007) in 31 mothers with GDM who had pregestational BMI ≥25 kg/m2; in 68 mothers with GDM who had pregestational BMI 18.5–24.9 kg/m2, only gestational weight gain was positively associated with infant birthweight (P = 0.039). Two mothers had pregestational BMI <18.5 kg/m2. No statistically significant interactions of pregestational BMI with gestational weight change were found (P = 0.158). Conclusions: In mothers with GDM, pregestational BMI ≥25 kg/m2 and excessive gestational weight gain were significantly associated with increased infant birthweight. A prospective multicenter clinical study enrolling a larger number of mothers with GDM will be required to verify the effects of adequately controlling pregestational and gestational weights on infant birthweight for gestational age. [ABSTRACT FROM AUTHOR]

Aims/Introduction: To examine the association between adult‐onset diabetes and life‐course bodyweight changes. Materials and Methods: In a cross‐sectional study, 17,398 Japanese female nurses aged ≥30 years completed a self‐administered questionnaire in 2001–2007. Bodyweight indices were calculated for three life stages: birthweight (adjusted for gestational age), body mass index (BMI) at age 18 years and current BMI. Odds ratios for being diagnosed with adult‐onset diabetes were calculated according to the combined bodyweight categories of two life stages: at birth and age 18 years; and at age 18 years and the survey (current). Path analysis was carried out to decompose the effect of each bodyweight index into direct and mediating effects. Results: After adjustment for age at survey and parental diabetes history, "low" birthweight (<25th percentile), when combined with either "low" or "high" BMI (≥75th percentile) at age 18 years, had significant odds ratios (2.32, 95% confidence interval [CI] 1.22–4.44; 3.69, 95% CI 2.12–6.42, respectively) compared with the group of "middle" category (25th–74th percentile) at both life stages. The combination of "low" BMI at age 18 years and "high" current BMIs showed the highest odds ratio (7.97, 95% CI 3.97–16.00). Among women without parental diabetes history, "low" BMI at age 18 years showed a significantly high odds ratio (2.25, 95% CI 1.01–4.99), even when combined with the "middle" category of current BMI. Path analysis showed that both birthweight and BMI at age 18 years had a negative direct effect on adult‐onset diabetes. Conclusions: Underweight at adolescence, as well as overweight, is a potential risk factor for adult‐onset diabetes among Japanese women. [ABSTRACT FROM AUTHOR]

Molecular weight distribution of polymers, termed dispersity (Đ), is a fundamental parameter for determining polymer material properties. This paper reports a novel approach for controlling Đ by exploiting a temperature‐selective radical generation in organocatalyzed living radical polymerization. The polymers with tailored Đ were synthesized in a batch system without the assistance of an external pump. A unique aspect of this approach is that Đ was tuneable from 1.11 to 1.50 in any segment in diblock, triblock, and multiblock copolymers and in any form of star and brush polymer without segmental or topological restriction. This approach is amenable to various monomers and free from metals and thus attractive for applications. The approach also generated polymer brushes on surfaces with tailored Đ. An interesting finding was that the polymer brushes exhibited unique interaction with external molecules, depending on the Đ value. Brush up: A novel approach for modulating polymer dispersity was developed. It is based on temperature‐selective organocatalyzed living radical polymerization and enabled dispersity modulation in any segment in linear and branched block copolymers as well as polymer brushes. A dispersity‐dependent size‐exclusion effect to external molecules was observed for the polymer brushes. [ABSTRACT FROM AUTHOR]

Oxidative stress and chronic inflammation are potential pathogenic factors of pancreatic cancer. Although fruits and vegetables are abundant in antioxidants and anti‐inflammatory constituents, the reported associations between fruit and vegetable intake and pancreatic cancer risk have been inconsistent. Here, we investigated the association between fruit and vegetable intake and pancreatic cancer risk as part of the Japan Public Health Center‐based Prospective Study. The analysis included 90,185 participants who responded to a medical and lifestyle questionnaire during 1995–1998. Associations between fruit and vegetable intake and pancreatic cancer risk were evaluated with Cox proportional hazards models. Additional analyses were stratified by smoking status and body mass index. During follow‐up (median duration, 16.9 years), 577 participants were diagnosed with pancreatic cancer. In multivariate‐adjusted models, pancreatic cancer risk was inversely associated with total fruit intake (highest vs. lowest intake quartile; hazard ratio [HR]: 0.74, 95% confidence interval [CI]: 0.57–0.95, p‐trend: 0.116) and positively associated with total vegetable intake (HR: 1.30, 95% CI: 1.01–1.66, p‐trend: 0.151). For total fruit intake, the inverse association with pancreatic cancer risk was more apparent in never smokers (HR: 0.67, 95% CI: 0.47–0.97, p‐trend: 0.034). For total vegetable intake, the positive association was statistically significant in ever smokers (HR: 1.49, 95% CI: 1.01–2.19, p‐trend: 0.043) and statistically nonsignificant in never smokers. In summary, total fruit intake and total vegetable intake had inverse and positive associations, respectively, with pancreatic cancer risk. Vegetable intake may correlate with increased risk partly because of the influence of smoking on vegetable intake. What's new? Oxidative stress and chronic inflammation are potential pathogenic factors of pancreatic cancer. Possible causes of oxidative stress and chronic inflammation including chronic pancreatitis, diabetes mellitus, obesity, and smoking are all risk factors. Although fruits and vegetables are abundant in antioxidants and anti‐inflammatory constituents, the reported associations between fruit and vegetable intake and pancreatic cancer risk have been inconsistent, however. In this prospective Japanese study, pancreatic cancer risk was inversely associated with total fruit intake and positively associated with total vegetable intake. The association between vegetable intake and pancreatic cancer risk was observed in ever smokers, but not in never smokers. [ABSTRACT FROM AUTHOR]

Although a possible role of reproductive factors in lymphomagenesis has been hypothesized, results of epidemiological studies have been inconsistent. Here, we investigated the association between reproductive factors and the risk of lymphoid neoplasm and its subgroups. We used data from a large‐scale, population‐based prospective study in a Japanese cohort with 42 691 eligible women aged 40‐69 years from 1990 to 1994. During a mean follow up of 18.7 years, we identified 176 cases of lymphoid neoplasm and 90 of non‐Hodgkin lymphoma (NHL). A multivariable‐adjusted Cox proportional hazards regression model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the risk of lymphoid neoplasms and its subgroups according to self‐reported reproductive factors. Parous women had an increased risk of lymphoid neoplasm compared with nulliparous women (HR = 2.51, 95% CI, 1.03‐6.13). An increased risk of lymphoid neoplasms was found in women with later onset of menarche (≤13 years old; reference: 14‐15; HR = 1.75, 95% CI = 1.10‐2.79: ≥16; HR = 1.93, 95% CI = 1.17‐3.19: P‐trend: 0.01) and a shorter menstrual cycle (28‐29 days; reference: ≤27; HR = 1.60, 95% CI = 1.05‐2.43, P‐trend = 0.81). No association was observed between lymphoid neoplasms and other reproductive factors, including age at first birth, breastfeeding, type of menopause, or exogenous hormone use. Our study suggests that ever parity, late age at menarche and a short menstrual cycle length may be associated with the development of lymphoid neoplasms. The inconsistency seen in epidemiological research to date warrants further investigation. A possible mechanism of the higher incidence rate of lymphoid neoplasms in men than women is immune‐mediated associations of sex hormones on lymphomagenesis. Here, we aimed to investigate the association between female reproductive factors and risk of lymphoid neoplasm and its common subtypes using data from a large‐scale prospective study in Japan. Results showed that parity and early onset of menarche may confer an increased risk of overall lymphoid neoplasms. [ABSTRACT FROM AUTHOR]

To elucidate the individual impacts of insulin and blood glucose on cancer risk, we investigated the association of plasma C‐peptide, a surrogated marker of insulin and glycated albumin (GA), a more stable marker of blood glucose, with all‐site and site‐specific cancer risk by mutually accounting for their confounding effects. The study was prospectively conducted with nearly 4,000 cancer cases arising in our population‐based cohort of 33,736 subjects who answered the baseline questionnaire and supplied blood samples. After exclusion of subjects with apparent DM, analysis was done in 3,036 cancer cases and 3,667 subcohort subjects. Among men and women combined, highest levels of C‐peptide were statistically significantly associated with an increased risk of all‐site [Hazard ratio (HR): 1.21; 95% confidence interval: 1.02–1.42], colon [1.73; 1.20–2.47], liver [3.23; 1.76–5.91], kidney, renal pelvis and ureter cancers [2.47; 1.07–5.69], compared to the respective lowest levels, after adjustment for GA levels. Among these C‐peptide‐related cancers, colon and liver cancers also showed an increased risk associated with elevated GA levels independently of C‐peptide levels. The corresponding HRs for colon and liver cancers compared to the highest and lowest GA levels were 1.43 [1.02–2.00] and 2.02 [1.15–3.55], respectively. Effect modification by gender was only evident for the association between C‐peptide and colon cancer (p for interaction = 0.04). Higher insulin levels, independently of higher blood glucose levels, may be relevant to DM‐related carcinogenesis for several cancer sites. Examination of circulating insulin levels is a plausible option in evaluating cancer risk even in individuals who have not developed DM. What's new? While diabetes mellitus (DM) is associated with an increased cancer risk, carcinogenesis may not be explained by the influence of higher blood glucose levels only. This prospective case‐cohort study shows that higher levels of surrogate insulin marker C‐peptide are significantly associated with an increased risk of all‐site, colon, liver, kidney, renal pelvis, and ureter cancers after adjustment for blood glucose levels. (Colon and liver cancers also showed an increased risk associated with elevated blood glucose levels independently of C‐peptide levels.) Higher insulin levels, independently of higher blood glucose levels, may thus be relevant to DM‐related carcinogenesis for several cancer sites. [ABSTRACT FROM AUTHOR]

Aims/Introduction: Menstrual and reproductive factors, including age at menarche, parity and breast‐feeding, have been linked to type 2 diabetes risk. We prospectively investigated the association between these factors and type 2 diabetes risk in a large Japanese cohort. Materials and Methods: Participants were 37,511 women aged 45–75 years who participated in the baseline (1990–1993), second (1995–1998) and third surveys (2000–2003) of the Japan Public Health Center‐based Prospective Study, and who had no history of diabetes at the second survey. Menstrual and reproductive history was ascertained using questionnaires at the baseline and second surveys. Odds ratios of self‐reported, physician‐diagnosed type 2 diabetes over the 5‐year period from the second survey were estimated using logistic regression. Results: At the third survey, 513 new cases of type 2 diabetes were self‐reported. The odds ratios of type 2 diabetes tended to increase with the number of parity, after adjustment for covariates other than body mass index (P for trend = 0.029). The multivariable‐adjusted odds ratios of type 2 diabetes for women with three or more births was 1.56 (95% confidence interval 0.96–2.53) compared with those who were nulliparous. The association between parity and type 2 diabetes risk was attenuated after additional adjustment for body mass index (P for trend = 0.12). No factors other than parity were significantly associated with type 2 diabetes risk. Conclusions: Higher parity might be associated with an increased risk of type 2 diabetes among Japanese women, partly through increasing bodyweight. Higher parity was associated with an increased risk of type 2 diabetes, and this association was attenuated after additional adjustment for BMI. This finding suggest that increased risk of type 2 diabetes associated with higher parity may be partly explained by increasing body weight. Other menstrual and reproductive factors was not associated with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Abstract: Photocontrolled surface‐initiated reversible complexation mediated polymerization (photo‐SI‐RCMP) was successfully applied to fabricate concentrated polymer brushes with complex patterning structures. Positive‐type patterned polymer brushes were obtained by photo‐SI‐RCMP under visible light (550(±50) nm) using photomasks. A particularly interesting finding was that negative‐type patterned polymer brushes were also obtainable in a facile manner. A nonspecial UV light (250–385 nm) enabled the preparation of pre‐patterned initiator surfaces in a remarkably short time (1 min), leading to negative‐type patterned polymer brushes. Based on this unique selectivity between visible and UV light, the combination of two patterning techniques enabled the preparation of complex patterned brushes, including diblock copolymers, binary polymers, and functional binary polymers, without multistep immobilization of one or more initiators on the surfaces. [ABSTRACT FROM AUTHOR]

We sought to estimate the exact causes of death, mortality rate and life expectancy of diabetes patients by analyzing death records in a diabetes specialist clinic in Japan. Of the 6,140 participants included in our analysis, the average age was 58.1 years and 77% were men. A total of 261 deaths were recorded during the total follow‐up period of 24,079 total person‐years. The leading causes of death were cancer, heart diseases and cerebrovascular diseases. Using a life table prepared from the mortality rates estimated with the exponential distribution model, a life expectancy at 40 years was 39.2 years (95% confidence interval 37.9–40.2 years) for men and 43.6 years (95% confidence interval 41.8–45.3 years) for women. Although the present results must be interpreted with caution, compared with populations with diabetes surveyed during similar periods by the Japan Diabetes Society, our diabetes patients had similar ranking of the causes of death. [ABSTRACT FROM AUTHOR]

Abstract: Background: Sex hormones are implicated in the development of diabetes. However, whether genetic variations in sex hormone pathways (SHPs) contribute to the risk of type 2 diabetes mellitus (T2DM) remains to be determined. This study investigated associations between genetic variations in all candidate genes in SHPs and T2DM risk among a cohort of women participating in the Women’s Health Initiative (WHI). Methods: Single nucleotide polymorphisms (SNPs) located within 30 kb upstream and downstream of SHP genes were comprehensively examined in 8180 African American, 3498 Hispanic American, and 3147 European American women in the WHI. In addition, whether significant SNPs would be replicated in independent populations was examined. Results: After adjusting for age, region, and ancestry estimates and correcting for multiple testing, seven SNPs were significantly associated with the risk of T2DM among Hispanic American women were identified in the progesterone receptor (PGR) gene, with rs948516 showing the greatest significance (odds ratio 0.67; 95% confidence interval 0.57–0.78; P = 8.8 × 10−7; false discovery rate, Q = 7.8 × 10−4). These findings were not replicated in other ethnic groups in the WHI or in sex‐combined analyses in replication studies. Conclusion: Significant signals were identified implicating the PGR gene in T2DM development in Hispanic American women in the WHI, which are consistent with genome‐wide association studies findings linking PGR to glucose homeostasis. Nevertheless, the PGR SNPs–T2DM association was not statistically significant in other ethnic populations. Further studies, especially sex‐specific analyses, are needed to confirm the findings and clarify the role of SHPs in T2DM. [ABSTRACT FROM AUTHOR]