• Title/Summary/Keyword: Journal of Korean Medicine

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Factors Associated With Suicidal Attempt among Suicidal Ideators of Korean Adults (한국 성인 자살관념자의 자살시도 연관 요인)

  • Yuncheol, Choi;Hyunseuk, Kim;Sang-Shin, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.127-136
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    • 2022
  • Objectives : The study aimed to identify factors associated with suicidal attempt in Korean adults experiencing thoughts of suicide. Methods : This study analyzed outcomes of suicidal behavior in the Korea National Health and Nutrition Examination Survey (KNHANES) 2015, 2017, and 2019. This survey was administered by the Korea Centers for Disease Control and Prevention (KCDC). The suicidal idea group was divided into individuals who had attempted suicide (n=92) and those who had not (n=831). Complex samples crosstabs analysis was conducted to compare the two groups' sociodemographic, psychiatric, and clinical characteristics. In addition, factors related to attempted suicide were investigated using complex samples logistic regression analysis. Results : The attempted suicide group had significantly higher rates of depression, recent psychiatric counseling, and suicidal plan (p<0.001) than the non-attempting group. In addition, the groups differed significantly in the frequency of binge drinking and smoking (p<0.05). Adjusted multivariate analysis revealed that the presence of a suicidal plan (Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), daily binge drinking (OR=3.14, 95% CI=1.26-7.84), psychiatric counseling within the past year (OR=3.03, 95% CI=1.75-5.23), low income level (OR=2.89, 95% CI=1.17-7.10), and history of depression (OR=2.39, 95% CI=1.29-4.42) were significantly associated with suicidal attempt. Conclusions : Factors associated with suicidal attempt among suicidal ideators in the general Korean population were identified across all sociodemographic, psychiatric, and clinical variables. Assessment of and intervention in suicidal plan, binge drinking, income level, and depression might prevent progression to suicidal attempt among those contemplating suicide.

Studies on the Hematology and Blood Chemistry of Korean Cattle Part II. Studies on the Blood Chemistry of Korean Cattle (한국성우(韓國成牛)의 혈액학치(血液學値) 및 혈액화학치(血液化學値)에 관한 연구(硏究) 제2보(第二報) 한국성우(韓國成牛)의 혈액화학치(血液化學値)에 관한 연구(硏究))

  • Cheong, Chang Kook
    • Korean Journal of Veterinary Research
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    • v.5 no.1
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    • pp.97-123
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    • 1965
  • Observations were made on the blood picture of total 196 heads of healthy Korean cattles, including 98 males and females in the purpose of determination of blood chemical values and their sex differences and seasonal variations during one year period from December, 1963 to November, 1964. The blood sampling were scheduled by random in four different seasons and the sample size of both sex included in each season were designated to be same size. The ranges, averages or mean values of the blood glucose, total serum protein, serum globulin, serum albumin, total non-protein nitrogen, blood urea nitrogn, total serum cholesterol, serum inorganic phosphorus and serum calcium were determined in this studies and their respective standard deviation, standard error of means, sex differences and seasonal variations were as follows. 1. The blood glucose values for the male ranged from 32.8 to 70.0 mg/100cc. with a mean of $49.781{\pm}0.823mg/100cc$; for the female the range was 32.0 to 64.0mg/100cc. with a mean of $47.235{\pm}0.782mg/100cc$. Sex difference showed significant at 5% level and seasonal variation was highly significant at 1% level. 2. The total serum protein values for the male ranged from 5.61 to 8.83 gm/100cc with a. mean of $7.366{\pm}0.062gm/100cc$; for the female ranged from 5.53 to 8. 43 gm/100cc. with a mean of $6.832{\pm}0.063gm/100cc$. Sex difference and seasonal variation was not significant. 3. The serum globulin values for the male ranged from 2.97 to 4.78 gm/100cc. with a mean of $3.961{\pm}0.039gm/100cc$.; for the female ranged from 2.87 to 4.41 gm/100cc. with a mean of $3.699{\pm}0.037gm/100cc$. Sex difference showed highly significant at 1% level and seasonal variation was not significant. 4. The serum albumin values for the male ranged from 2.58 to 4.21 gm/100cc. with a mean of $3.405{\pm}0.029gm/100cc$.; for the female ranged from 2.39 to 4.10 gm/100cc. with a mean of $3.204{\pm}0.031gm/100cc$. Sex difference showed highly significant at 1% level and seasonal variation was not significant. 5. The total non-protein nitrogan values for the male ranged from 19.1 to 44.8 gm/100cc. with a mean of $31.166{\pm}0.582mg/100cc$.; for the female the range was 15.2 to 50.5 mg/100cc. with a mean of $28.89.6{\pm}0.673mg/100cc$. Sex difference showed significant at 5% level and seasonal variation was highly significant at 1 % level. 6. The blood urea nitrogen values for the male ranged from 6.4 to 28.3 mg/100cc. with a mean of $13.371{\pm}0.466mg/100cc$.; for the female the range, was 6.0 to 26.9 mg/100cc. with a mean of $13.631{\pm}0.321mg/100cc$. Sex difference was not significant and seasonal variation showed highly significant at 1 % level. 7. The total serum cholesterol values for the male ranged from 60.0 to 238.6 mg/100cc. with a mean of $140.897{\pm}2.826mg/100cc$.; for the female ranged from 50.0 to 243.0 mg/100cc. with a mean of $124.840{\pm}3.553mg/100cc$. Sex difference and seasonal variation showed highly significant at 1% level. 8. The serum inorganic phosphorus values for the male ranged from 3.5 to 7.8 mg/100cc. with a mean of $5.426{\pm}0.096mg/100cc$.; for the female ranged from 3.1 to 8.8 mg/100cc. with a mean of $5.570{\pm}0.128mg/100cc$. Sex difference and seasonal variation showed no significant. 9. The serum calcium values for the male ranged from 7.8 to 12.8 mg/100cc. with a mean of $10.761{\pm}0.102mg/100cc$.; for the female ranged from 8.0 to 13.0 mg/100cc. with a mean of 10. $756{\pm}0.097mg/100cc$. Sex difference was not significant and seasonal variation showed highly significant at 1% level. 10. The age of test group ranged from 2 years to 6 years in both sex and the averageage were, $4.45{\pm}0.114$ years in male and $4.50{\pm}0116$ years in female. Sex difference and seasonal variation of age were not found to be significant.

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Meaning of Plantain(Musa basjoo) Planting and Design Use through Classic Poetry and Prose (고전 시문을 통해 본 파초(Musa basjoo)의 식재 의미와 설계용도(Design Use))

  • Hong, Hyoung-Soon
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.29 no.2
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    • pp.52-62
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    • 2011
  • By studying the classic poetry and prose with a theme of Plantain, I would like to study why Plantain has been planted in our traditional garden for a long time. Also, through this study, I want to find when Plantain was introduced to in our country. We use description study method for studying the classic poetry and prose with a theme of Plantain. As a result, we found a few things like below. First, the introduction of Plantain to our country traces back to unified Silla in the poetry of Choe Chi Won. Also, Plantain was planted and loved generally as a general garden plant in the middle of Goryeo through poetry and paintings. Second, the meaning of Plantain is like this. 1) It means development and enjoyment of arts of summer because the leaves of Plantain were used for drinking alcohol and writing and poetry instead of papers. 2) In Buddhism, Plantain was thought to awaken 'gong(空)', 'mua(無我)', and 'brevity' of lesson of Buddha by the special shape and the image of falling rain to the leaves. Also, it was used widely in Buddhist temples because of the story of 'Hye ga dan bi(慧可斷臂)'. 3) In Confucianism, it is the emblem of lesson 'a wise man tries to be strong and tries not to stop following to God'(自强不息). 4) The large leaf of Plantain is called 'bongmi(鳳尾)' thanks to the image of likeness with tails of Bongwhang(鳳凰). Third, design use of Plantain is like this. 1) The large leaf of Plantain was used for giving an image of freshness and brightness in the garden in summer. 2) Our ancestor thought 'the sound of falling rain to Plantain'(芭蕉雨聲) as a picturesque sound in summer. Also, Plantain was highly utilized because our ancestor thought Plantain is the best plant for implementing 'soundscape'. Thus, the most characteristic use of several design uses is 'acoustic use'. 3) Plantain was also planted in a indoor pot for viewing. 4) Plantain was used for making food and medicine in the palace and private house as a practical use. The limit of this study is that I mainly use the text translated into Korean of database of overall Korean classics. We hope the new things related to this study would be added up to this study by translating original texts into Korean more.

The Relationship between Posttraumatic Stress Disorder and the Quality of Life among the Vietnam War Veterans (베트남전 참전 퇴역 군인에서 외상후스트레스장애와 삶의 질과의 관계)

  • Oum, Se-Joon;Choi, Jin-Hee;Kim, Tae-Yong;Chung, Hae-Gyung;Chung, Moon-Yong;So, Hyung-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.83-91
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    • 2011
  • Objectives: Posttraumatic stress disorder(PTSD) has devastating effects on multiple aspects of the quality of life(QoL). Therefore, the purpose of this study is to compare the QoL between PTSD group and non-PTSD group, and identify the variables affecting the QoL of the Vietnam War veterans. Methods: We recruited 39 veterans with PTSD and 43 veterans without PTSD, all of whom had deployed to the Vietnam War. We used the Korean version of Mini International Neuropsychiatric Interview-Plus, the Korean version of Clinician-Administered PTSD Scale, Combat Exposure Scale and the Korean version of World Health Organization Quality of Life Assessment Instrument abbreviated version. We used independent samples t-test to identify the differences between PTSD and non-PTSD group in each domains of the quality of life. We also used stepwise multiple linear regression analysis to figure out the variables affecting the QoL of the Vietnam War veterans. Results: In the PTSD group, all domains of the QoL and the QoL total score(p<0.01) were significantly lower than those in the non-PTSD group. In the Vietnam War veterans, PTSD, major depressive disorder and education levels were the variables affecting the QoL. Among these, PTSD uniquely explained the QoL of the overall and general health(${\beta}$=-1.411, $R^2$=0.180), the physical health domain(${\beta}$=-2.806, $R^2$=0.089) and the total score (${\beta}$=-11.479, $R^2$=0.104). Conclusions: These results suggest that among the Vietnam War veterans, the QoL of the PTSD group is significantly lower than that of the non-PTSD group. Among the combat exposed veterans, PTSD may be one of the main reasons that affect the multiple domains of the QoL.

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Antidiabetic Effect of Korean Red Ginseng by Puffing Process in Streptozotocin-Induced Diabetic Rats (Streptozotocin 유발 당뇨쥐에서 팽화가공 처리한 홍삼의 항당뇨 효과)

  • Kim, Shin-Hee;Kang, Ju-Seop;Lee, Sang-Jun;Chung, Young-Jin
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.6
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    • pp.701-707
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    • 2008
  • Antidiabetic effect of Korean red ginseng (RG) processed by puffing in streptozotocin (STZ)-induced diabetic (DM) rats was investigated. Five week-old SD rats were divided into four groups; normal control (NC) group, DM group, red ginseng (RG) group and puffed red ginseng (PG) group. The RG and PG groups were orally provided with RG or PG dissolved in water (500 mg/kg) respectively for seven weeks after single injection of STZ (50 mg/kg, i.v.) followed by identification of DM. NC group received saline vehicle instead of STZ. At the end of feeding of RG or PG, the changes of fasting blood glucose, serum insulin and amylase level and serum lipid profiles were evaluated. Also, oral glucose tolerance test (OGTT), comet assay and histopathological examination were performed. At 7th week, the fasting blood glucose levels of the RG and PG groups were reduced compared to the DM group by 11.54% and 20.22%, respectively. The result of OGTT did not show significant differences among DM and two red ginseng groups. While serum insulin and TG levels were predominantly improved in PG group (p<0.05), serum amylase level was increased in RG group. Alkaline comet assay for checking the oxidative damage of DNA showed that TL (tail length, ${\mu}m$) and TM (tail moment) in the blood lymphocyte of PG group significantly decreased in contrast with DM group. Histopathological results of pancreas showed that destruction of exocrine as well as endocrine might be cured by the administration of RG and PG. These results suggest that PG could exert more protection against STZ-induced toxicity than RG group.

A Survey on Preliminary Dental Hygienists' Senses of Employment (예비치과위생사의 취업에 관한 의식 조사)

  • Han, Su-Jin;Lee, Sun-Mi;Lim, Mi-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.583-594
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    • 2007
  • The purpose of this study was to conduct a survey on the senses that preliminary dental hygienists have on employment, who applied for the National Dental Hygienist Examination, so that it could provide a basic reference required for fostering good human resources specializing in oral health with a sense of mission and responsibility as professional. To meet these goals, a self-administered questionnaire survey was conducted for participants in a refresher education meeting for preliminary dental hygienists across three major regions(Seoul, Daejeon and Busan), which was held by the Korean Dental Hygienists Association(KDHA) on Jan. 15, 2006. Total 289 sheets of questionnaire were collected, and 262 sheets except invalid or incomplete ones were used for examination and analysis. As a result, this study came to the following conclusions: First, it was found that 40.4% respondents wanted to be employed in dental clinic or hospital. Most respondents(90.1%) answered that faithfulness is most valued as prerequisite qualification for employment in hospital, and highest percentage of respondents(39.3%) wanted to earn 16 to 17 million Korean won annually. For internship opportunities, 61.9% respondents replied that they could willingly accept the internship, provided that basic pay and switchover to regular employee are all assured. Second, as the results of survey on employment circumstances around respondents, it was found that most respondents(58.3%) were employed in dental clinic or hospital, and highest percentage of respondents(35.0%) earned 15 to 16 million Korean won. Third, it was found that interpersonal relationships among employees had most significant effects(4.81) on selection of employment, which was followed by in-house welfare benefits 1(monthly/annual vacation, resting room, etc; 4.56). For possible influential factors on the selection of employment depending on whether employed or not, it was found that there were Significant differences in pay, welfare benefit 2(seminar, orientation, refresher training opportunities, etc), post-wedding continued employment and merit system between employees and non-employees(pE0.05). Fourth, the survey on respondents' occupational senses of dental hygienist showed that major tasks of dental hygienists were represented by oral disease prevention(92.6%), case management(71.5%), oral health education(66.3%), hospital/clinic management and dental management support(10.4%) and public oral health activities(6.7%) respectively. For job satisfaction, it was found that almost half respondents(48.9%) showed satisfaction at their job and 32.6% felt satisfied at and proud of their job. That is, majority of respondents(81.5%) felt satisfied at their job as dental hygienist. For follow-up requirements to qualify for dental hygienists, it was found that 73.3% felt it necessary to give more investments to self-development, 62.2% respondents considered protection of membership's rights as one of future assignments that KDHA should be more committed to. For future social awareness about dental hygienists as occupation, 69.2% respondents expected that they would be better developed and treated as professional. And desired training courses as a part of qualification for professional dental hygienists were represented by case management(services, manners, etc; 33.3%), implant(28.9%), esthetics(correction, prosthesis, whitening; 18.9%) and so on. For an item on working years, it was noted that 75.9% respondents would keep working as dental hygienists as long as they could.

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Estimated flavonoid intakes according to socioeconomic status of Korean adults based on the Korea National Health and Nutrition Examination Survey 2007~2012 (우리나라 성인의 사회경제적 수준에 따른 플라보노이드 섭취현황 : 2007~2012년 국민건강영양조사 자료를 이용하여)

  • Kim, Seong-Ah;Hei, Yang;Jun, Shinyoung;Wie, Gyung-Ah;Shin, Sangah;Hong, Eunju;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.50 no.4
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    • pp.391-401
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    • 2017
  • Purpose: The purpose of this study was to estimate the dietary flavonoid intakes of Korean adults according to socioeconomic status. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 31,112 subjects aged over 19 years were included in this study. We estimated individuals' daily intakes of total flavonoids and seven flavonoid subclasses, including flavonols, flavones, flavanones, flavan-3-ols, anthocyanins, proanthocyanidin, and isoflavones,by linking food consumption data with the flavonoids database for commonly consumed Korean foods. We compared intakes of flavonoids according to the levels of household income and education. Results: Average dietary flavonoid intakes of the study subjects were 321.8 mg/d in men and 308.3 mg/d in women. Daily flavonoid intakes were positively associated with household income level (p < 0.0001) and education level (p < 0.0001). The subjects in the highest household income and highest education level group (OR 0.37, 95% CI 0.30~0.45, p < 0.0001 in men, OR 0.50, 95% CI 0.41~0.60, p < 0.0001 in women) had a lower likelihood of having low total flavonoid intake (less than 25 percentile) compared to the lowest household income and lowest education level group. The food group that contributed to total flavonoid intake with the biggest difference between the lowest and highest groups for both household income level and education level was beverages. Conclusion: This study shows that socioeconomic status was positively associated with flavonoid intake in a representative Korean population. Further research is needed to analyze the association of flavonoid intake with health outcomes according to socioeconomic status such as household income and education level.

A Formulated Korean Red Ginseng Extract Inhibited Nitric Oxide Production through Akt- and Mitogen Activated Protein Kinase-dependent Heme Oxygenase-1 Upregulation in Lipoteichoic Acid-stimulated Microglial Cells (홍삼추출액은 lipoteichoic acid로 자극된 소교세포에서 Akt 및 MAPK 의존적으로 heme oxygenase-1 발현을 유도함으로써 NO 생성을 억제함)

  • Shin, Ji Eun;Lee, Kyungmin;Kim, Ji-Hee;Madhi, Iskander;Kim, YoungHee
    • Journal of Life Science
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    • v.29 no.4
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    • pp.402-409
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    • 2019
  • Korean red ginseng made from steaming and drying fresh ginseng has long been used as a traditional herbal medicine due to its effects on the immune, endocrine, and central nerve systems and its anti-inflammatory activity. In this study, we investigated the molecular mechanism responsible for the anti-inflammatory effects of a formulated Korean red ginseng extract (RGE) in response to lipoteichoic acid (LTA), a cell wall component of gram-positive bacteria. RGE inhibited LTA-induced nitric oxide (NO) secretion and inducible nitric oxide synthase (iNOS) expression in BV-2 microglial cells, without affecting cell viability. RGE also inhibited nuclear translocation of nuclear factor kappa B ($NF-{\kappa}B$) p65 and degradation of $I{\kappa}B-{\alpha}$. In addition, RGE increased the expression of heme oxygenase-1 (HO-1) in a dose-dependent manner, and the inhibitory effect of RGE on iNOS expression was abrogated by small interfering RNA-mediated knockdown of HO-1. Moreover, RGE induced nuclear translocation of nuclear factor E2-related factor 2 (Nrf2), a transcription factor that regulates HO-1 expression. Furthermore, the phosphoinositide-3-kinase (PI-3K) inhibitor and mitogen-activated protein kinase (MAPK) inhibitors suppressed RGE-mediated expression of HO-1, and RGE enhanced the phosphorylation of Akt, extracellular signal-regulated kinases (ERKs), p38, and c-JUN N-terminal kinases (JNKs). These results suggested that RGE suppressed the production of NO, a proinflammatory mediator, by inducing HO-1 expression via PI-3K/Akt- and MAPK-dependent signaling in LTA-stimulated microglia. The findings indicate that RGE could be used for the treatment of neuroinflammation induced by grampositive bacteria and that it may have therapeutic potential for various neuroinflammation-associated disorders.

Analysis of Urinary Mass Screening for Elementary, Middle and High School Children Over a 3-year Period(1995-1997) in Seoul (서울지역내 초.중.고 학생들에 실시된 3년 동안의($1995{\sim}1997$) 집단뇨검사 결과 분석)

  • Kang Ho-Seok;Lee Chong-Guk
    • Childhood Kidney Diseases
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    • v.3 no.2
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    • pp.161-169
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    • 1999
  • Purpose : The urinary mass screening program for the detection of proteinuria in school aged population has been performed in Seoul since 1981. Systematic evaluation in corporation with the Seoul School Health Center for students with proteinuria identified in the mass screening has been performed from 1987. The results of urinary mass screening up to 1994 was reported. I report here the results of urinary mass screening from 1995 to 1997 and compare them with previous results and attempt to reveal the significance of urinary mass screening. Objects and Methods : In the 3-year period between 1995 and 1997, annually about 460,000 students comprising 3 different age groups; 5th grade of elementary school, 2nd grade of middle school and 2nd grade of high school were chosen, corresponding to the approximate ages of 11, 14, and 17 years, respectively. These subjects accounted for 26% of total school aged children in Seoul. The screening program was carried out in 3 steps. The 1st test was performed with dipstick at school and the 2nd at the Seoul School Health Center. Those students who showed proteinuria in the 1st and 2nd tests were referred to the hospital. Laboratory examinations including renal biopsies were performed to those students with pathologic proteinuria to clarify the incipient renal diseases. Results : 1) The prevalence of asymptomatic proteinuria was 0.28% in the 1st test. It peaked at the group of 14 years old as 0.34%, compared with 0.26% at the group of 11 years old and 0.24% at the group of 17 years old. It reached to 0.26% in male and 0.30% in female. 2) 25 percent of those having proteinuria at the first test were positive at the second test. 3) The proportion of patients with proteinuria by 3rd test were as follows; 25% of transient proteinuria, 55% of orthostatic proteinuria, 6% of constant proteinuria, 12% of proteinuria with hematuria, and 2% of transient proteinuria with isolated hematuria. Pathologic proteinuria were totaled as 20%. The prevalence of renal diseases among the age group of 7-18 years old was estimated to be 1.4 per 10,000. 4) Renal biopsy performed on 38 children with proteinuria at the third test revealed IgA nephropathy in 17(44%), focal segmental glomerusclerosis in 5(13%), minimal change disease in 4(11%), membranoproliferative glomeronephritis in 3(8%), $Henoch-Sch\"{o}nlein$ purpura nephritis in 3(8%), and others in 6(16%). Therefore, the prevalence of IgA nephropathy among the age group of 7-18 years old was estimated to be 0.64 per 10,000. 5) The prevalence of chronic renal failure was estimated to be 5.7 per 1 million of 7 to 18 years age group. Conclusions : 1) The prevalence of proteinuria in the first screening test was 0.28% and finally only 5% of them showed the pathologic proteinuria at the third test. 2) The prevalence of IgA nephropathy and chronic renal failure were 0.63 per 10,000 and 5.7 per 1 million, respectively among school-aged children in Seoul.

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Relevance of Serum Vitamin D and Indices Related To Cardiovascular Disease Among Korean Adults (한국 성인의 혈청 비타민 D 수준과 심혈관 질환 관련 지표와의 관련성)

  • Kim, Han-Soo;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.365-374
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    • 2018
  • This study investigated the relationship between Vitamin D levels and indices related to cardiovascular disease in Korean adults aged ${\geq}19years$. The data for analysis were obtained from the sixth Korea National Health Nutrition Examination Survey in 2013 and 2014. The results showed that the incidence of Vitamin D deficiency was 73.1% among Korean adults and that indices related to cardiovascular disease showed an increasing trend (55.6% of Korean adults). The relationship between Vitamin D levels and indices related to cardiovascular disease with controlled physical activity status was also studied. The odds ratios (ORs) for age were 1.72 for the 4-62 years age group (95% CI, 1.53-1.93) and 2.05 for the ${\geq}65years$ age group (95% CI, 1.71-2.45). For blood pressure, the OR for pre-hypertension was 1.30 (95% CI, 1.15-1.47) and that for hypertension was 1.31 (95% CI, 1.11-1.54). For body mass index (BMI), the OR was 1.36 (95% CI, 1.11-1.66) and that for waist circumference (WC) was 1.36 (95% CI, 1.11-1.66). For fasting blood sugar (FBS), the OR for impaired fasting glucose (IFG) was 1.37 (95% CI, 1.21-1.55) and that for diabetes mellitus (DM) was 1.31 (95% CI, 1.05-1.65). The OR for total cholesterol (TC) was 1.30 (95% CI, 1.11-1.52) and that for triglycerides (TG) was 1.20 (95% CI, 1.04-1.37) in Korean adults. There was a significant relationship between Vitamin D and indices related to cardiovascular disease in Korean adults with respect to age, blood pressure, FBS, BMI, TC and TG. Confirmation of a causal relationship between Vitamin D and indices related to cardiovascular disease may require further research consisting of more systematic cohort studies.