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  1. Li Y, Babazono A, Jamal A, Liu N, Liang L, Yamao R, et al.
    J Glob Health, 2024 Feb 09;14:04007.
    PMID: 38334270 DOI: 10.7189/jogh.14.04007
    BACKGROUND: Japan has implemented a national lifestyle guidance intervention programme for potential metabolic syndrome among adults aged 40-74 years; however, there is limited evidence regarding the causal impact of this intervention. The study aims to determine the causal effect of this intervention on health outcomes and health care utilisation.

    METHODS: We performed a regression discontinuity design study. A total of 46 975 adults with ≥1 cardiovascular risk factor in 2015 were included in the study. A two-stage evaluation process (stage 1: waist circumference ≥85 cm for men or ≥90 cm for women and ≥1 cardiovascular risk factor; stage 2: body mass index (BMI)≥25 kg/m2 and ≥2 cardiovascular risk factors) was applied. Changes in obesity, cardiovascular outcomes, and health care utilisation were evaluated in a one-year follow-up in the fiscal year 2016.

    RESULTS: Participants who received lifestyle guidance intervention based on the waist circumference had a statistically significant reduction in obesity outcomes (Δ weight: -0.30 kg, 95% CI = -0.46 to -0.11; Δ waist circumference: -0.26 cm, 95% CI = -0.53 to -0.02; Δ BMI = -0.09 kg/m2, 95% CI = -0.17 to -0.04) but not in other cardiovascular risk factors and health care utilisation. Analyses based on BMI and results according to demographic subgroups did not reveal significant findings.

    CONCLUSIONS: The provision of this intervention had a limited effect on health improvement and a decrease in health care costs, health care visits, and length of stay. A more intensive intervention delivery could potentially improve the efficacy of this intervention programme.

  2. Li Y, Babazono A, Jamal A, Liu N, Fujita T, Zhao R, et al.
    Soc Sci Med, 2022 Dec;314:115468.
    PMID: 36327638 DOI: 10.1016/j.socscimed.2022.115468
    Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.
  3. Mohamad S, Liew HJ, Zainuddin RA, Rahmah S, Waiho K, Ghaffar MA, et al.
    J Fish Biol, 2021 Jul;99(1):206-218.
    PMID: 33629400 DOI: 10.1111/jfb.14712
    Climate warming and low pH environment are known to negatively impact all levels of aquatic organism from cellular to organism and population levels. For ammonotelic freshwater species, any abiotic factor fluctuation will cause disturbance to the fish, specifically at the gills which act as a multifunctional organ to support all biological processes. Therefore, this study was designed to investigate the effect of temperature (28 vs. 32°C) and pH (7.0 vs. 5.0) stress on the gill plasticity of Hoven's carp after 20 days of continuous exposure. The results demonstrated that high temperature and low pH caused severe changes on the primary and secondary lamellae as well as the cells within lamellae. An increasing trend of the proportion available for gas exchange was noticed at high temperature in both pH exposures, which resulted from a reduction of the primary lamellae width with elongated and thinner secondary lamellae compared to fishes at ambient temperature. Following exposure to high temperature and acidic pH, Hoven's carp experienced gill modifications including aneurysm, oedema, hypertrophy, curling of secondary lamellae, epithelial lifting, hyperplasia and lamellae fusion. These modifications are indicators of the coping mechanism of Hoven's carp to the changing environment in order to survive.
  4. Mohamad S, Rahmah S, Zainuddin RA, A Thallib Y, Razali RS, Jalilah M, et al.
    Heliyon, 2024 Feb 29;10(4):e25559.
    PMID: 38404778 DOI: 10.1016/j.heliyon.2024.e25559
    Current water warming and freshwater acidification undoubtedly affect the life of aquatic animals especially ammonotelic teleost by altering their physiological responses. The effect of temperature (28 °C vs 32 °C) and pH (7 vs. 5) on the metabolic compromising strategies of Hoven's carp (Leptobarbus hoevenii) was investigated in this study. Fishes were conditioned to (i) 28 °C + pH 7 (N28°C); (ii) 32 °C + pH 7 (N32°C); (iii) 28 °C + pH 5 (L28°C) and (iv) 32 °C + pH 5 (L32°C) for 20 days followed by osmorespiration assay. Results showed that feeding performance of Hoven's carp was significantly depressed when exposed to low pH conditions (L28°C and L32°C). However, by exposed Hoven's carp to L32°C induced high metabolic oxygen intake and ammonia excretion to about 2x-folds higher compared to the control group. As for energy mobilization, Hoven's carp mobilized liver and muscle protein under L28°C condition. Whereas under high temperature in both pH, Hoven's carp had the tendency to reserve energy in both of liver and muscle. The findings of this study revealed that Hoven's carp is sensitive to lower water pH and high temperature, thereby they remodeled their physiological needs to cope with the environmental changes condition.
  5. Tsubota K, Yokoi N, Watanabe H, Dogru M, Kojima T, Yamada M, et al.
    Eye Contact Lens, 2020 Jan;46 Suppl 1:S2-S13.
    PMID: 31425351 DOI: 10.1097/ICL.0000000000000643
    The 2017 consensus report of the Asia Dry Eye Society (ADES) on the definition and diagnosis of dry eyes described dry eye disease as "Dry eye is a multifactorial disease characterized by unstable tear film causing a variety of symptoms and/or visual impairment, potentially accompanied by ocular surface damage." The report emphasized the instability of tear film and the importance of visual dysfunction in association with dry eyes, highlighting the importance of the evaluation of tear film stability. This report also discussed the concept of tear film-oriented therapy, which stemmed from the definition, and which is centered on provision of insufficient components in each tear film layer and ocular surface epithelium. The current ADES report proposes a simple classification of dry eyes based on the concept of tear film-oriented diagnosis and suggests that there are three types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation. It is suggested that these three types respectively coincide with the problems of each layer: aqueous, membrane-associated mucins, and lipid/secretory mucin. Although each component cannot be quantitatively evaluated with the current technology, a practical diagnosis based on the patterns of fluorescein breakup is recommended. The Asia Dry Eye Society classification report suggests that for a practical use of the definition, diagnostic criteria and classification system should be integrated and be simple to use. The classification system proposed by ADES is a straightforward tool and simple to use, only through use of fluorescein, which is available even to non-dry eye specialists, and which is believed to contribute to an effective diagnosis and treatment of dry eyes.
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