JMA journal最新文献

{"title":"Prescription for Change: A Web-Based Cross-Sectional Survey on How Physicians' Relationships with Pharma Reps Are Associated with Views on Stricter Industry Guidelines.","authors":"Michioki Endo, Hiroaki Saito, Yoshitake Takebayashi, Michio Murakami, Tetsuya Tanimoto, Akihiko Ozaki","doi":"10.31662/jmaj.2025-0103","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0103","url":null,"abstract":"<p><strong>Introduction: </strong>Japan, the world's third-largest pharmaceutical market, introduced new guidelines in 2019 to address ethical concerns in pharmaceutical company-physician relationships. This study aimed to analyze Japanese physicians' attitudes toward these strengthened regulations.</p><p><strong>Methods: </strong>An online survey of 1,203 Japanese physicians was conducted in November 2019. Respondents were categorized based on their frequency of interaction with pharmaceutical companies: frequent (82, 6.8%), moderate (930, 77.3%), or rare (191, 15.9%). The survey assessed awareness of the new guidelines, perceived changes in promotional activities, and attitudes toward stricter regulations. Multivariable modified Poisson regression was used to identify factors associated with opposition to the regulations.</p><p><strong>Results: </strong>A total of 640 (53.3%) respondents opposed stricter regulations, while 325 (27.1%) were in favor. Physicians with frequent (adjusted Incidence Rate Ratio [aIRR] 1.61, 95% confidence interval [CI] 1.24-2.10) or moderate (aIRR 1.53, 95% CI 1.24-1.89) interactions were more likely to oppose regulations compared with those with rare interactions. Hospital directors/managers, those affiliated with private institutions, and recent graduates also showed higher opposition. The main reason for favoring regulations was to promote healthy industry relationships (38, 9.3%), while the primary concern among those opposed was related to information gathering or potential patient disadvantages (88, 21.6%).</p><p><strong>Conclusions: </strong>The study reveals diverse views on industry-physician relations in Japan. Frequent interactions and leadership roles correlate with opposition to stricter regulations. The results suggest a need for balanced policies that consider varied perspectives.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"457-466"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: 2025;8(3): 708-17 (DOI: 10.31662/jmaj.2024-0331).","authors":"Shinichiro Yoshida, Akira Babazono, Ning Liu, Reiko Yamao, Reiko Ishihara","doi":"10.31662/jmaj.e0003","DOIUrl":"https://doi.org/10.31662/jmaj.e0003","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.31662/jmaj.2024-0331.].</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"582"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melioidosis Presenting as Parapharyngeal Abscess.","authors":"Srujana Mohanty, Rana Pratap Dutta, Pradeep Pradhan","doi":"10.31662/jmaj.2025-0546","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0546","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"580-581"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan.","authors":"Shunichi Otaka, Takuyo Chiba, Takamichi Nakajima, Takashi Shiga","doi":"10.31662/jmaj.2025-0290","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0290","url":null,"abstract":"<p><strong>Introduction: </strong>Time elapsed since trauma onset is a critical determinant of prognosis in trauma patients. However, factors behind prolonged prehospital on-site time remain unclear. This study aimed to identify associated factors in trauma cases.</p><p><strong>Methods: </strong>Using a nationwide Japanese database, adults who experienced trauma and were treated between January 2004 and May 2019 were identified. Multivariable logistic regression with multiple imputations for missing data was performed to compare characteristics of patients with shorter and longer prehospital on-site times.</p><p><strong>Results: </strong>Data from 150,215 patients were included. Multivariable logistic regression with multiple imputations for missing data revealed that longer prehospital on-site time was associated with younger age, male sex (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.11-1.16), weekends and holidays (OR, 1.06; 95% CI, 1.03-1.08), alcohol consumption (OR, 1.31; 95% CI, 1.26-1.36), fall (OR, 1.07; 95% CI, 1.05-1.10), other blunt trauma (OR, 1.12; 95% CI, 1.07-1.18), suicide (OR, 1.20; 95% CI, 1.13-1.27), violence (OR, 1.33; 95% CI, 1.20-1.46), hypotension (OR, 1.15; 95% CI, 1.09-1.22), higher Revised Trauma Score (OR, 1.21; 95% CI, 1.20-1.23), Abbreviated Injury Scale (AIS) category 6 (spine) ≥ 3 (OR, 1.21; 95% CI, 1.17-1.25), AIS category 7 (upper extremities) ≥ 3 (OR, 1.15; 95% CI, 1.10-1.21), immobilization (OR, 1.25; 95% CI, 1.22-1.28), intravenous line placement (OR, 1.27; 95% CI, 1.17-1.37), intubation (OR, 1.44; 95% CI, 1.26-1.64), mental disease (OR, 1.07; 95% CI, 1.02-1.13), chronic kidney disease undergoing hemodialysis (OR, 1.12; 95% CI, 1.03-1.22), and malignancy (OR, 1.11; 95% CI, 1.04-1.18).</p><p><strong>Conclusions: </strong>Several factors associated with prolonged prehospital on-site time were identified. Interventions targeting these factors may help shorten prehospital on-site time.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"535-546"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Age-Related Changes in the Extracellular Water-to-Total Body Water Ratio among Community-Dwelling Individuals.","authors":"Akemi Hioka, Naoki Akazawa, Naomi Okawa, Shinji Nagahiro","doi":"10.31662/jmaj.2025-0368","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0368","url":null,"abstract":"<p><strong>Introduction: </strong>The European Working Group on Sarcopenia in Older People 2 revised its diagnostic criteria for sarcopenia, highlighting the importance of evaluating not only skeletal muscle mass but also muscle quality. Recently, the extracellular water-to-total body water ratio (ECW/TBW) has gained attention as an indicator of muscle quality. The aim of this study was to investigate the sex differences in the effect of aging on ECW/TBW in community-dwelling individuals.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among community-dwelling males and females (aged ≥20 years). A total of 824 participants (345 males, 479 females) were included. ECW/TBW was measured using bioelectrical impedance analysis. Associations between age and ECW/TBW were analyzed separately for males and females using Spearman's correlation coefficient. Participants were categorized into three age groups: 20-39 years, 40-64 years, and ≥65 years. Among males (n = 345), the age groups 20-39, 40-64, and ≥ 65 years comprised 124, 128, and 93 participants, respectively. Among females (n = 479), the corresponding numbers were 94, 164, and 221 participants, respectively. The Kruskal-Wallis test was used to compare ECW/TBW among the three groups for both males and females. Bonferroni's post hoc test was used to determine the significance when the main effect was confirmed in the Kruskal-Wallis test. In addition, a two-way analysis of variance was performed on ECW/TBW with age group and sex as factors.</p><p><strong>Results: </strong>Correlation analyses revealed a significant positive association between age and ECW/TBW in both males (ρ = 0.733, p < 0.001) and females (ρ = 0.684, p < 0.001). For both males and females, a main effect of age on ECW/TBW was observed among the three groups. In addition, for both males and females, the ECW/TBW in the ≥65-year group was significantly higher than in the 20-39 and 40-64-year groups. ECW/TBW showed a significant interaction between age group and sex (p < 0.001).</p><p><strong>Conclusions: </strong>The results of this study indicated that age is positively related to ECW/TBW in community-dwelling males and females. Additionally, the influence of aging on ECW/TBW was more pronounced in males than in females. Based on our findings, assessing ECW/TBW is important for capturing age-related changes.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"495-501"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Poor Appetite and Nutrient Intake in Community-Dwelling Older Adults: The Otassha Study.","authors":"Yurie Mikami, Keiko Motokawa, Maki Shirobe, Masanori Iwasaki, Tatsunosuke Gomi, Misato Hayakawa, Lena Käläntär, Yasuyuki Sakata, Yutaka Watanabe, Hisashi Kawai, Shuichi Obuchi, Yoshinori Fujiwara, Kazushige Ihara, Hirohiko Hirano","doi":"10.31662/jmaj.2025-0467","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0467","url":null,"abstract":"<p><strong>Introduction: </strong>Poor appetite is a prevalent and serious problem among older adults. However, real-world data regarding appetite and nutrient intake among community-dwelling older adults are scarce. The aim of this study was to clarify the association between appetite and nutrient intake status among community-dwelling older adults.</p><p><strong>Methods: </strong>This cross-sectional study involved participants (N = 583) from the cohort of the \"Otassha study,\" conducted among community-dwelling older adults. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire. Nutrient intake was calculated using the Brief-Type Self-Administered Diet History Questionnaire. In addition, compliance status was assessed using the recommended dietary allowance (RDA) of various nutrients based on the \"Dietary Reference Intakes for Japanese (2020).\" The association between compliance status and appetite was analyzed using logistic regression, with the RDA of multiple nutrients as the dependent variable and poor appetite as the independent variable.</p><p><strong>Results: </strong>In the study population, 32.1% of participants had poor appetite. Multivariable logistic regression revealed that poor appetite was significantly associated with insufficient vitamin C intake relative to the RDA (odds ratio 1.67; 95% confidence interval 1.08-2.57).</p><p><strong>Conclusions: </strong>This study demonstrated an association between poor appetite and vitamin C intake among community-dwelling older adults.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"511-516"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Workplace Social Capital between the Pre- and Post-Restriction Eras of Physician Working Hours: A Nationwide Repeated Cross-Sectional Study.","authors":"Hirohisa Fujikawa, Takuya Aoki, Masato Eto","doi":"10.31662/jmaj.2025-0444","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0444","url":null,"abstract":"<p><strong>Introduction: </strong>Workplace social capital (WSC), defined as the features of social organization that promote coordination and cooperation for mutual benefit, is a relevant construct that contributes positively to employee and organizational wellness, and has recently attracted wide attention. However, factors associated with WSC in the field of medical education have not been investigated, including regarding the effect of physician working hour restrictions. Thus, the aim of the study was to investigate differences in the WSC of resident physicians before and after the April 2024 introduction of restrictions on physician working hours in Japan.</p><p><strong>Methods: </strong>We conducted a nationwide repeated cross-sectional survey in 25 hospitals across Japan. Pre- and post-restriction data were obtained in July and August 2022 and in December 2024, respectively. We evaluated WSC using the Japanese medical resident version of the WSC Scale, which comprises horizontal trust (i.e., trust in co-workers) and vertical trust (i.e., trust in supervisors) subscales. We used the total score and its domain scores, all of which range from 1 to 5, with higher scores indicating greater WSC, as outcome variables. We created a dummy variable (1 = post-restriction data [December 2024], 0 = pre-restriction data [July-August 2022]) and used it as the explanatory variable. We used a linear mixed-effects model to adjust clustering within hospitals and individual covariates.</p><p><strong>Results: </strong>We analyzed data for 428 respondents (pre-restriction, 246; post-restriction, 182 participants; man, 272). After adjusting possible confounders and clustering within hospitals, physician working hour restrictions were significantly associated with greater vertical trust (adjusted mean difference, 0.17; 95% confidence interval, 0.02 to 0.32). No clear trend was observed in the association among restrictions, total WSC score (adjusted mean difference, 0.13; 95% confidence interval, -0.01 to 0.26), and horizontal trust score (adjusted mean difference, 0.10; 95% confidence interval, -0.05 to 0.24).</p><p><strong>Conclusions: </strong>This nationwide multicenter study revealed significant vertical trust score differences between pre- and post-physician working hour restrictions. The implementation of physician working hour restrictions has improved vertical trust. These findings contribute to the literature on potential benefits of working hour restrictions on the organization of physician life and enhancement of patient care quality.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"502-510"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and Environmental Factors of Carbon Monoxide Poisoning and Polycythemia due to Waterpipe Smoking: An Artificial Intelligence-Assisted Systematic Review of Case Reports.","authors":"Isao Muraki","doi":"10.31662/jmaj.2025-0208","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0208","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore behavioral and environmental factors associated with carbon monoxide (CO) poisoning from waterpipe smoking.</p><p><strong>Methods: </strong>We searched the MEDLINE, Web of Science, PubMed, CINAHL, Ichushi-Web, and CiNii databases for case reports or case series on acute CO poisoning and polycythemia related to waterpipe smoking, up to February 2025. Article selection and data extraction were performed with the assistance of generative artificial intelligence (AI) using predefined criteria. All processes performed by AI were verified by the author through careful article review.</p><p><strong>Results: </strong>A total of 68 cases of acute CO poisoning and 13 cases of polycythemia were identified from 37 case reports and series. Most cases involved individuals aged 20‒29 years. The most common symptoms of acute CO poisoning following waterpipe smoking were syncope, headache, dizziness, and nausea/vomiting, in that order. Symptoms typically occurred shortly after exposure, followed by during exposure, and delayed after exposure. Acute CO poisoning was observed after as little as one hour of waterpipe smoking, in outdoor settings, and from secondhand waterpipe smoking exposure.</p><p><strong>Conclusions: </strong>Both active and passive waterpipe smoking can cause acute CO poisoning, depending on the intensity, duration, and environment of exposure. Symptoms may arise not only during or immediately after smoking but also with a delayed onset. The implementation of environmental regulations for closed establishments is necessary to prevent mass CO poisoning and protect workers from it. Further research is needed to better understand the behavioral and environmental factors contributing to CO poisoning from waterpipe smoking.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"447-456"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Analysis of Cognitive Functions in Stable Nonhypoxemic Chronic Obstructive Pulmonary Disease Patients at a Tertiary Care Center, Jaipur.","authors":"Pratima Agrawal, Sudhanshu Kacker, Neha Saboo","doi":"10.31662/jmaj.2024-0398","DOIUrl":"https://doi.org/10.31662/jmaj.2024-0398","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic obstructive pulmonary disease (COPD) is a complex, multi-component disorder characterized by a long-lasting, irreversible airflow limitation due to inflammation, which leads to narrowing of the airway lumen. A variety of influencing factors may cause cognitive impairment (CI) in patients with COPD, including age, disease duration, severity, hypercapnia, smoking, and vascular dysfunction. This study assessed cognitive functions in non-hypoxic stable COPD patients.</p><p><strong>Methods: </strong>An observational study was conducted in the Department of Physiology and Medicine, Rajasthan University of Health Sciences College of Medical Sciences (RUHS CMS). A total of 120 subjects were recruited. The cases (group A) were selected according to the Global Initiative for Obstructive Lung Disease (GOLD) classification. GOLD stage 1 and 2 patients confirmed by spirometry. Controls (group B) were selected as age-matched healthy volunteers(HVs) from the society. The Mini-Mental State Examination (MMSE) and event-related potential (P300) were used to assess cognitive functions in both groups. Data was analyzed using appropriate tests, and p < 0.05 was considered significant.</p><p><strong>Results: </strong>The mean MMSE score was found to decrease in Group A compared to Group B. The mean MMSE score in group A was 24.65 with an standard deviation of ± 2.05; in group B, it was detected as 27.56 ± 2.15 (p < 0.00001). The mean latency of the P300 wave was prolonged in some cases, and a decrease in the Amplitude of the P300 wave was observed in some cases compared to the control group. Mean latency in case group 298.48 ± 21.98 milliseconds compared to control group 265.89 ± 15.80 milliseconds, with a significant p-value <0.0001. The mean amplitude in group A was detected as 4.25 ± 1.502 μV, compared to a mean of 6.06 ± 1.94 μV in group B.</p><p><strong>Conclusion: </strong>Patients with COPD have a higher risk of CI compared to the age-matched healthy volunteer group.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"517-524"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintaining the Human Voice in Scientific Writing in the Era of Artificial Intelligence.","authors":"Shigeki Matsubara","doi":"10.31662/jmaj.2025-0517","DOIUrl":"https://doi.org/10.31662/jmaj.2025-0517","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"9 2","pages":"578-579"},"PeriodicalIF":1.8,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}