JMA journal最新文献

Introduction: To examine the interaction between lifestyle habits and the COVID-19 vaccinations for preventing SARS-CoV-2 infection, we analyzed 11,016 adult participants registered in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

Methods: Lifestyle variables, including regular exercise, smoking and drinking habits, sleep status, body mass index, and daily breakfast consumption, were assessed from 2014 to 2019 using baseline questionnaires. Information on SARS-CoV-2 infection and the COVID-19 vaccination were also collected from March 2020 to May 2023. The study period was divided into two in the postvaccination phase: the first period (the beginning of the vaccination program) and the second period (the fourth shot onward).

Results: In the Cox proportional-hazards model analysis, the five-time vaccinations group showed a significantly lower risk of SARS-CoV-2 infection adjusted age, sex, underlying health condition, and lifestyle variables (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.76-0.86). Logistic regression analysis revealed that a higher number of vaccinations was significantly associated with a low risk of SARS-CoV-2 infection regardless of lifestyle habits (three times in the first period: odds ratio [OR] 0.19, 95% CI 0.15-0.24; five times in the second period: OR 0.07, 95% CI 0.05-0.11 vs. none). Regarding lifestyle habits, the risk reduction in those who had sleep satisfaction (OR 0.12, 95% CI 0.08-0.18) was slightly larger than in those who had sleep dissatisfaction (OR 0.23, 95% CI 0.17-0.32) in the group with the highest number of vaccinations in the first period; however, this interaction was hardly confirmed in the second period when the number of infected cases significantly increased.

Conclusions: Our findings indicated that a higher number of COVID-19 vaccinations was associated with reduced risk of SARS-CoV-2 infection; otherwise, we may need to understand the advantages and limitations of a healthy lifestyle for preventing infection depending on the situation with vaccinations and infection spreading.

In recent years, Japan has faced a significant demographic crisis, which was further exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. By 2022, the country experienced a 1.5% decrease in population, which is in contrast to other G7 nations, and had the highest rate of excess mortality among Organization for Economic Co-operation and Development (OECD) countries. This crisis is mainly attributed to aging population, with Japan's aging rate reaching 29.9%, the highest among its peer countries. The Japanese government, led by Prime Minister Fumio Kishida, has proposed policies aimed at addressing these challenges, focusing on increasing fertility rates. Despite these efforts, an evidence-based policymaking (EBPM) analysis reveals that the anticipated impact on fertility rates is marginal, with financial interventions estimated to yield only a slight population increase by 2060. Furthermore, the analysis highlighted the need for a more comprehensive approach, indicating that addressing societal issues such as gender norms and workplace culture might be crucial for a sustainable solution to Japan's demographic challenges. This emphasizes the need for Japan to consider broader societal changes alongside fiscal policies to effectively combat its demographic decline.

Introduction: Elucidating the epidemiological picture in the early phase of a pandemic is crucial to strengthening preparedness and public health responses to future emerging infectious diseases. Using data from the "Osaka Prefectural Novel Coronavirus Response Status Management System," we evaluated factors associated with mortality among patients with novel coronavirus disease 2019 (COVID-19) in Osaka Prefecture, Japan.

Methods: The study periods were from January 29 to June 13, 2020 (first surge), from June 14 to October 9, 2020 (second surge), and from October 10 to December 24, 2020 (up to the middle of the third surge). The odds ratios (ORs) and 95% confidence intervals (95% CIs) for mortality were calculated using logistic regression models.

Results: Of the 14,864 patients with COVID-19 (8,207 men, 6,657 women) registered, 297 (2%) died. The ORs for mortality were significantly higher in men (OR = 2.00, 95% CI = 1.54-2.60) than in women, in 70- to 79-year-olds (OR = 25.4, 95% CI = 16.8-38.2) and ≥80-year-olds (OR = 78.1, 95% CI = 53.3-114) than in 0- to 69-year-olds (P for trend < 0.001), and in those with underlying diseases (OR = 1.74, 95% CI = 1.34-2.27) than in those without. The ORs for the second surge (OR = 0.42, 95% CI = 0.31-0.57) and third surge (OR = 0.41, 95% CI = 0.29-0.58) decreased compared with the first surge. Detailed evaluation of underlying diseases by time period showed that "Diseases of the blood and blood-forming organs and certain disorders involving immune mechanisms," "Endocrine, nutritional, and metabolic diseases," "Diseases of the genitourinary system," and "Diseases of the respiratory system" were associated with increased risk of mortality.

Conclusions: Among those affected early in the COVID-19 epidemic, male sex, older age, first-surge infection, and underlying medical conditions were significantly associated with mortality. Our findings are expected to provide a useful reference for future countermeasures in the early stages of pandemics involving unknown emerging infectious diseases.

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are neurodegenerative diseases with a progressive and fatal course. They are often comorbid and share the same molecular spectrum. Their key pathological features are the formation of the aggregation of TDP-43, an RNA-binding protein, in the cytoplasm and its depletion from the nucleus in the central nervous system. In the nucleus, TDP-43 regulates several aspects of RNA metabolism, ranging from RNA transcription and alternative splicing to RNA transport. Suppressing the aberrant splicing events during RNA processing is one of the significant functions of TDP-43. This function is impaired when TDP-43 becomes depleted from the nucleus. Several critical cryptic splicing targets of TDP-43 have recently emerged, such as STMN2, UNC13A, and others. UNC13A is an important ALS/FTD risk gene, and the genetic variations, single nucleotide polymorphisms, cause disease via the increased susceptibility for cryptic exon inclusion under the TDP-43 dysfunction. Moreover, TDP-43 has an autoregulatory mechanism that regulates the splicing of its mRNA (TARDBP mRNA) in the healthy state. This study provides recent findings on the splicing regulatory function of TDP-43 and discusses the prospects of using these aberrant splicing events as efficient biomarkers.