The association between the socioeconomic deprivation level and ischemic heart disease mortality in Japan: an analysis using municipality-specific data

Tasuku Okui(Tasuku Okui ),Tetsuya Matoba(Tetsuya Matoba ),Naoki Nakashima(Naoki Nakashima ) 한국역학회 2022 Epidemiology and Health Vol.44 No.-

OBJECTIVES: Geographical variation in the standardized mortality ratio (SMR) for ischemic heart disease (IHD) among municipalities has not been assessed in Japan. Additionally, associations between area-level socioeconomic deprivation indices and IHD mortality have not been identified in Japan. The present study investigated this association. METHODS: Information on IHD mortality was extracted from Vital Statistics data from 2018 to 2020 for each municipality in Japan. The socioeconomic deprivation level was derived from multiple socioeconomic characteristics. We classified municipalities into quintiles based on the deprivation level and investigated the association between the deprivation level and the SMR of IHD. Additionally, a Bayesian spatial regression model was used to investigate this association, adjusting for other municipal characteristics. RESULTS: Geographical variation in the SMR of IHD was revealed, and municipalities with high SMRs were spatially clustered. There was a weak negative correlation between the socioeconomic deprivation level and the SMRs (correlation coefficient, -0.057 for men and -0.091 for women). In contrast, the regression analysis showed a statistically significant positive association between deprived areas and the IHD mortality rate, and the relative risks for the most deprived municipalities compared with the least deprived municipalities were 1.184 (95% credible interval [CrI], 1.110 to 1.277) and 1.138 (95% CrI, 1.048 to 1.249) for men and women, respectively. CONCLUSIONS: A weak negative correlation between the socioeconomic deprivation level and the SMR was observed in the descriptive analysis, while the regression analysis showed that living in deprived areas was statistically positively associated with the IHD mortality rate.

Age-Period-Cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan

Okui Tasuku 대한예방의학회 2020 Journal of Preventive Medicine and Public Health Vol.53 No.6

Objectives: This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan. Methods: We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort. Results: Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women. Conclusions: Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.

Socioeconomic Predictors of Diabetes Mortality in Japan: An Ecological Study Using Municipality-specific Data

Okui, Tasuku The Korean Society for Preventive Medicine 2021 Journal of Preventive Medicine and Public Health Vol.54 No.5

Objectives: The aim of this study was to examine the geographic distribution of diabetes mortality in Japan and identify socioeconomic factors affecting differences in municipality-specific diabetes mortality. Methods: Diabetes mortality data by year and municipality from 2013 to 2017 were extracted from Japanese Vital Statistics, and the socioeconomic characteristics of municipalities were obtained from government statistics. We calculated the standardized mortality ratio (SMR) of diabetes for each municipality using the empirical Bayes method and represented geographic differences in SMRs in a map of Japan. Multiple linear regression was conducted to identify the socioeconomic factors affecting differences in SMR. Statistically significant socioeconomic factors were further assessed by calculating the relative risk of mortality of quintiles of municipalities classified according to the degree of each socioeconomic factor using Poisson regression analysis. Results: The geographic distribution of diabetes mortality differed by gender. Of the municipality-specific socioeconomic factors, high rates of single-person households and unemployment and a high number of hospital beds were associated with a high SMR for men. High rates of fatherless households and blue-collar workers were associated with a high SMR for women, while high taxable income per-capita income and total population were associated with low SMR for women. Quintile analysis revealed a complex relationship between taxable income and mortality for women. The mortality risk of quintiles with the highest and lowest taxable per-capita income was significantly lower than that of the middle-income quintile. Conclusions: Socioeconomic factors of municipalities in Japan were found to affect geographic differences in diabetes mortality.

Grouping and clustering methods in econometrics

Ryo Okui 서울대학교 경제연구소 2020 經濟論集 Vol.59 No.2

This paper reviews recent developments in the application of clustering methods in econometrics. In particular, we discuss how the k-means algorithm can be extended and applied to econometric problems. Models with group structures are useful to describe heterogeneity across units. Such models can be estimated by extensions of the k-means algorithm. We also discuss inference methods for group memberships and methods to incorporate possible structural breaks.

Resection for Pancreatic Cancer Lung Metastases

Masayuki Okui,Takashi Yamamichi,Ayaka Asakawa,Masahiko Harada,Hirotoshi Horio 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.5

Background: Pancreatic cancer is a highly aggressive solid tumor. Patients with metastases from pancreatic cancer have poor survival rates. Here, we report the outcomes of 6 patients for whom resection of lung metastases was performed after a pancreatectomy to treat pancreatic cancer. Methods: We retrospectively reviewed the perioperative clinical data of patients with lung metastases resulting from primary pancreatic cancer who were treated with lung resection between 2008 and 2015. We report 6 cases where lung resection was performed to treat lung metastases after a pancreatectomy. Results: The number of lung metastases was 1 in 5 cases and 2 in 1 case. The surgical procedures performed to treat the lung metastases included 4 wedge resections and 2 lobectomies. The cell type of the primary tumor and metastases was tubular adenocarcinoma in 5 cases and intraductal papillary-mucinous carcinoma in 1 case. All 6 patients survived with a mean follow-up period of 65.6 months, although the disease recurred in 2 patients. Conclusion: Resection of lung metastases resulting from primary pancreatic cancer may lengthen survival, provided the patient can tolerate surgery.

Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020

Tasuku Okui The Korean Society for Preventive Medicine 2023 예방의학회지 Vol.56 No.4

Objectives: We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan. Methods: We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant's sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. "Other countries" indicates countries except for Japan, Korea, China, the Philippines, and Brazil. Results: The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively). Conclusions: The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.

Trend of asthma prevalence among children based on regional urbanization level in Japan; 2006–2019

Tasuku Okui 환경독성보건학회 2021 환경독성보건학회지 Vol.36 No.4

Although it has been known that the prevalence of asthma tends to be higher among children in the metropolitan areas of Japan, trends of the prevalence with respect to the regional urbanization level has not been investigated in recent years. We investigated trends in the prevalence of asthma among children and air pollutant concentrations by regional urbanization levels using data from the School Health Statistics Survey in Japan from 2006 to 2019. We calculated the age-standardized prevalence of asthma for each year, gender, regional urbanization level, and annual percent change (APC). In addition, the slope index of inequality (SII) and relative index of inequality (RII) were calculated for evaluating disparity in age-standardized asthma prevalence depending on regional urbanization levels. Moreover, we calculated the mean of the annual average values by regional urbanization levels for sulfur dioxide (SO₂), nitrogen dioxide (NO₂), suspended particulate matter (SPM), carbon monoxide (CO), and photochemical oxidant (Ox) from 2006 to 2018. We found that the age-standardized prevalence significantly decreased in the periods in the metropolis for males and females, and the degree of the decrease was largest in the metropolis. Conversely, the age-standardized prevalence increased in towns and villages, and the APC was greater than zero. In addition, both the SII and RII showed significant decreasing trends in the study period, and the regional disparity shrank over the years. Moreover, concentrations of the air pollutants were highest in the metropolis throughout the years except for Ox, whereas the difference in the concentrations of NO₂, SPM, and CO decreased between the metropolis and the other areas over the years. In conclusion, disparity in asthma prevalence depending on regional urbanization level decreased from 2006 to 2019, and there is a possibility that regional difference in trend of the air pollutants is related to the result.

Sensory Evaluation of Friction and Viscosity Rendering with a Wearable 4 Degrees of Freedom Force Feedback Device Composed of Pneumatic Artificial Muscles and Magnetorheological Fluid Clutches

Manabu Okui,Toshinari Tanaka,Yuki Onozuka,Taro Nakamura 유공압건설기계학회 2021 드라이브·컨트롤 Vol.18 No.4

With the progress in virtual reality technology, various virtual objects can be displayed using head-mounted displays (HMD). However, force feedback sensations such as pushing against a virtual object are not possible with an HMD only. Focusing on force feedback, desktop-type devices are generally used, but the user cannot move in a virtual space because such devices are fixed on a desk. With a wearable force feedback device, users can move around while experiencing force feedback. Therefore, the authors have developed a wearable force feedback device using a magnetorheological fluid clutch and pneumatic rubber artificial muscle, aiming at presenting the elasticity, friction, and viscosity of an object. To date, we have developed a wearable four-degree-of-freedom (4-DOF) force feedback device and have quantitatively evaluated that it can present commanded elastic, frictional, and viscous forces to the end effector. However, sensory evaluation with a human has not been performed. In this paper, therefore, we conduct a sensory evaluation of the proposed method. In the experiment, frictional and viscous forces are rendered in a virtual space using a 4-DOF force feedback device. Subjects are asked to answer questions on a 1- to 7-point scale, from 1 (not at all) to 4 (neither) to 7 (strongly). The Wilcoxon signed rank test was used for all data, and answer 4 (neither) was used as compared standard data. The experimental results confirmed that the user could feel the presence or absence of viscous and frictional forces. However, the magnitude of those forces was not sensed correctly.

Proposal of a Fixation Method for Wearable Assistive Systems Using Jamming Transition and the Expansion of an Elastic Bag

Manabu Okui,Kazuya Sekido,Shingo Iikawa,Yasuyuki Yamda,Taro Nakamura 제어로봇시스템학회 2017 제어로봇시스템학회 국제학술대회 논문집 Vol.2017 No.10

Pure Red Cell Aplasia Associated with Good Syndrome

Masayuki Okui,Takashi Yamamichi,Ayaka Asakawa,Masahiko Harada,Hirotoshi Horio 대한흉부외과학회 2017 Journal of Chest Surgery (J Chest Surg) Vol.50 No.2

Pure red cell aplasia (PRCA) and hypogammaglobulinemia are paraneoplastic syndromes that are rarer than myasthenia gravis in patients with thymoma. Good syndrome coexisting with PRCA is an extremely rare pathology. We report the case of a 50-year-old man with thymoma and PRCA associated with Good syndrome who achieved complete PRCA remission after thymectomy and postoperative immunosuppressive therapy, and provide a review of the pertinent literature.