Japan Organization of Occupational Health and Safety

Osteoporosis causes fractures which further increase the disease burden of rheumatoid arthritis (RA), however, osteoporosis treatment rates remain low. While several studies have reported that biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) can prevent or improve osteoporosis in RA, our large-scale, real-world study showed that 1 year-b/tsDMARDs use did not arrest osteoporosis progression. This study aimed to examine longer-term changes in bone mineral density (BMD). BMD was observed for up to 5 years in patients receiving b/tsDMARDs for active RA. The primary endpoint was change in BMD (T-score), and the secondary endpoint was change in T-score-related factors. In total, 797 patients (anti-osteoporosis (-), n = 645; anti-osteoporosis (+), n = 152) were included, with a median 3.1-year follow-up (2,489 patient-years). Clinical disease activity index (CDAI) improved in both groups (26.0/24.4 → 6.6/6.8). T-scores decreased significantly in the femoral neck and radius in the anti-osteoporosis (-) group but not in the anti-osteoporosis (+) group [anti-osteoporosis (-): mean change -0.11/-0.33, both p < 0.001; anti-osteoporosis (+):-0.01/-0.10, p = 0.830/0.071]. Overall, 460 patients (58%) experienced a decrease in T-score. A high baseline T-score correlated with a subsequent decrease, while longer osteoporosis treatment duration correlated with an increase. Unexpectedly, the duration of b/tsDMARD use and mean CDAI during observation were not associated with BMD maintenance. Even when RA activity was controlled with b/tsDMARDs, BMD still decreased. This study emphasizes the importance of considering osteoporosis as an independent aspect of RA, beyond inflammation control.

Historically, the toxicological evaluation of poorly soluble low toxicity particles (PSLTs), such as titanium dioxide nanoparticles (TiO2 NPs), distinct from conventional pigment-grade TiO2, has focused on carcinogenicity and lung overload, leaving their pathological function in the development of pneumoconiosis undefined. In this study, we initiated a "Pneumoconiosis Renaissance", redefining the human "Gold Standard" of pneumoconiosis pathology as a primarily interstitial "Dust Macule (DM) to Mixed Dust Fibrosis (MDF) axis". In contrast, rats developed a species-specific "Airspace-Dominant Phenotype" (Pulmonary Dust Foci) driven by airspace stagnation. Integrating recent continuous inhalation exposure and recovery after inhalation exposure studies, we demonstrate that this overwhelming alveolar pathology in rats acts as a "Biological Mask", physically superimposing upon and obscuring human-relevant interstitial sequestration. Crucially, however, extended recovery periods can unmask these interstitial events, revealing the true underlying pathology. We propose that future risk assessments and Adverse Outcome Pathways (AOPs) must incorporate spatial resolution. By rigorously segregating sensitive rat-specific airspace events from human-relevant interstitial remodeling, we can accurately bridge the interspecies gap. This review argues that rather than discarding the rat model, we must learn to decode it-using spatial distinctions to filter the airspace mask and evaluate the true interstitial risk of inhaled biodurable particles.

To clarify the pollution characteristics of polycyclic aromatic hydrocarbons (PAHs) and nitro-PAHs (NPAHs) in the East Asian monsoon region under different atmospheric environments and to assess their potential influences on receptor areas, this study selected two background monitoring stations with different environments in Shimane Prefecture, Japan: a marine station (MB) and a forest station (SF). PM2.5 samples were simultaneously collected using a high-volume sampler during the summer and winter of 2022–2023, and ten PAHs and three NPAHs were quantified using HPLC. The concentrations of PAHs and NPAHs at MB and SF exhibited significant seasonal variations in 2022 (winter &gt; summer). However, in 2023, a clear seasonal difference was observed only at MB. Isomer ratio analysis of PAHs at both stations indicated that traffic emissions and biomass or coal combustion were major contributors. Seasonal variations in the [2-NFR]/[1-NP] ratio indicated that, while high ratios at MB and SF during summer were mainly associated with local photochemical formation, low ratios in winter reflected long-range transportation of combustion-derived PAHs and NPAHs from the Asian continent. Incremental lifetime cancer risk values (10−7 to 10−11) indicated that even at background stations, the atmospheric environment poses certain health risks. This first comparative investigation of PAHs and NPAHs at two distinct background stations in Shimane again highlights the importance of international cooperation among East Asian countries for effective air pollution control.

The immune landscape of tumor-draining lymph nodes (TDLNs) plays a critical role in shaping antitumor responses and influencing prognosis in oral squamous cell carcinoma (OSCC). Among patients with lymph node (LN) metastasis, clinical outcomes vary widely, yet reliable biomarkers for prognostic stratification remain limited. This study aimed to identify immune features in tumors and LNs that differentiate between favorable and poor outcomes in OSCC patients with nodal metastasis. We analyzed T cell receptor (TCR) CDR3 repertoires and the expression of immune-related genes in primary tumors and paired sentinel LNs from OSCC patients who underwent tumor resection and lymphadenectomy. Patients were divided into three groups: Group A (no nodal metastasis), Group B1 (metastasis without recurrence), and Group B2 (metastasis with recurrence). TCR diversity was assessed using the Shannon index. The expression of immune-related genes (e.g., CD3E, CD4, CD8B, FOXP3, CTLA4, IL2, IL4) was measured by quantitative PCR and normalized to GAPDH. TCR diversity was lower in tumors than in non-metastatic LNs, reflecting clonal expansion. Metastatic LNs exhibited tumor-like diversity, suggesting infiltration by tumor-reactive clones. Tumor gene expression did not differ across groups, but LNs from metastatic cases showed the reduced expression of several immune genes. Notably, CD3E, CD8B, CTLA4, IL2, and IL4 distinguished B1 from B2. The immune profiling of LNs offers superior prognostic value over tumor analysis in OSCC patients with LN metastasis. LN-based evaluation may aid in postoperative risk stratification and personalized postoperative management and could inform decisions regarding adjuvant therapy and follow-up strategies.

Abstract Background Emergency physicians (EPs) experience impostor syndrome and burnout. This study assessed the incidences of burnout and impostor syndrome and their causative factors in Japanese EPs. Methods This cross-sectional study administered questionnaires to 34 Japanese emergency departments (EDs). The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scores, Clance Impostor Phenomenon Scale (CIPS) scores, and their correlations with ED- and EP-level factors underwent a multivariable analysis. Results Of the 307 EPs (70.4%) participants 64 (20.8%), 69 (22.4%), and 197 (64.1%) had MBI-HSS scores that indicated a severe degree of emotional exhaustion (EE), depersonalization, and personal accomplishment (PA), respectively; 34 (11.0%) EPs had severe scores for all three components. Regarding participant CIPS scores, 92 (29.9%) had a higher value than the cutoff. The multivariable analysis of MBI-HSS scores determined severe EE scores were associated with sleep periods (odds ratio [OR], 0.699; 95% confidence interval [CI], 0.496–0.983; P = 0.040) and overnight work (OR, 2.375; 95% CI, 1.006–5.603; P = 0.048). Higher CIPS scores correlated with younger age (OR, 0.941; 95% CI, 0.894–0.991; P = 0.022), personal interviews (OR, 2.636; 95% CI, 1.308–5.312; P = 0.007), and overnight work (OR, 2.679; 95% CI, 1.048–6.851; P = 0.040). Conclusions A high level of burnout was experienced by 11.0% of the participants. Although Japanese EPs more severe scores for PA than EPs in other countries, their CIPS scores were similar. To maintain the well-being of Japanese EPs, ED supervisors should consider supporting younger specialists, interviewing effectively, providing adequate sleep periods, and improving overnight work settings.

Background/Introduction:The WHO EMTCC coordinated responses to Cyclone Idai in Mozambique (2019), the refugee crisis in Moldova (2022), the earthquake in Türkiye (2023), and the humanitarian crisis in Cairo (2024). Each event presented unique Information Management (IM) challenges.Objectives:Analyze and compare WHO EMTCC Information Management practices across these crises, identifying specific challenges and implemented solutions.Method/Description: 2019 MozambiqueDisaster: Cyclone IdaiImpact: Infrastructure destruction, numerous casualtiesInformation Management: Diverse data collection, weak real-time updates, lack of unified management, poor communication infrastructure2022 MoldovaDisaster: Refugee crisis from Ukraine invasionImpact: Overburdened medical systemInformation Management: Fragmented EMT management, information overlaps, language barriers, stable communication infrastructure2023 TürkiyeDisaster: Major earthquakeImpact: Building collapses, numerous injuriesInformation Management: Improved use of tools like MDS, rapid data collection, multi-national team coordination challenges, real-time sharing needs, lack of domestic EMT data2024 CairoDisaster: Palestine Humanitarian CrisisImpact: Numerous casualties, infrastructure damageInformation Management: Secretive management, high-security needs, limited internal sharing, independent coordinator decisionsResults/Outcomes:Mozambique highlighted the need for digitalization and unified data systems. Moldova emphasized unified platforms and pre-registration processes. Türkiye showed progress in data tools but needed better real-time systems and domestic coordination. Cairo underlined secure and efficient information sharing in high-security contexts.Conclusion:WHO EMTCC’s IM practices varied across disasters. Common challenges included unified data management, real-time sharing, and multi-national team coordination. Future efforts should standardize protocols, improve communication infrastructure, and enhance WHO EMT Initiative training. The Japan Disaster Relief team’s contributions provided valuable insights for future improvements.

Using the Miracle Question method, this study comparatively evaluated how older adults and university students were affected by interacting with an active listening counseling robot for three weeks. The research focused on two aspects: (1) evaluating changes in perceptions of the robot and (2) how conversational content influenced these impressions. The results showed that older adults initially rated the robot higher for Anthropomorphism, with increased ratings for Perceived Intelligence and Anthropomorphism by Week 3. Both groups rated Perceived Safety the highest, linked to the prevalence of positive remarks during the counseling session conversations. These findings highlight the potential of positive dialogue strategies for counseling robots to engender trust and emotional safety across these age groups.

当科で2021年１月から2024年３月まで末梢性顔面神経麻痺の予後診断としてENoG（Electroneurography）を施行した症例で経過が追えた22例に対してENoG値と治癒までの期間の関係について検討した．また，初診時の耳痛，アブミ骨筋反射（stapedial reflex：SR）の有無，高血圧症，糖尿病合併の有無がENoG値，治癒までの期間に与える影響について検討した．耳痛，SRの有無，高血圧症，糖尿病合併の有無とENoG値（％）の平均，治癒までの期間（日数）の平均との関係に統計学的に有意差は認めなかった．またENoG値と治癒までの期間との間には統計学上有意な相関が認められた（r=－0.47197, n=22, p=0.0255）．今回の検討では，ENoGで20％以上であれば発症から２ヵ月を目安に回復することが分かった．