JMA journal最新文献

{"title":"Utilizing %Carbohydrate-deficient Transferrin as a Biomarker to Complement Interviews in Stratifying Alcohol Consumption in Patients with Alcohol Dependence: Aiming for Application to Fatty Liver Disease.","authors":"Motoh Iwasa, Akiko Eguchi, Tatsuya Suzuki, Ryuta Shigefuku, Saeko Nagao, Masayuki Morikawa, Kazushi Sugimoto, Hayato Nakagawa","doi":"10.31662/jmaj.2025-0109","DOIUrl":"10.31662/jmaj.2025-0109","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol dependence is linked to various issues, including not only alcohol-associated/related liver disease (ALD) but also social isolation, making the assessment of alcohol consumption crucial for patient management. Meanwhile, a multisociety consensus group has introduced a new classification for steatotic liver disease (SLD), including ALD, based on alcohol consumption. The evaluation of alcohol intake uses tools such as the Alcohol Use Disorders Identification Test and Lifetime Drinking History; however, these tools may lack accuracy in clinical settings. Carbohydrate-deficient transferrin (%CDT) is a quantitative and objective biomarker for alcohol consumption. Therefore, we aimed to determine %CDT values that stratify alcohol consumption.</p><p><strong>Methods: </strong>This cross-sectional analysis included 285 serum samples from patients receiving inpatient or outpatient treatment at two specialized alcohol dependency medical centers. Participants were alcohol-dependent patients who underwent detailed interviews regarding alcohol consumption, biochemical blood tests, and %CDT testing.</p><p><strong>Results: </strong>Among the 285 samples, 32.6%, 19.6%, and 47.7% corresponded to alcohol consumption levels of ≤30 g/day for men/≤20 g/day for women, 30-60 g/day for men/20-50 g/day for women, and ≥60 g/day for men/≥50 g/day for women, respectively. %CDT values increased with increasing alcohol consumption (p < 0.05-0.0001). The cutoff values reflecting alcohol consumption of 30 g/day for men/20 g/day for women and 60g/day for men/50g/day for women were 1.67% and 2.48%, respectively. Gamma-glutamyl transferase (GGT) and GGT-CDT were able to distinguish between alcohol consumption above and below 60 g/day for men and 50 g/day for women (p < 0.0001). However, they had difficulty distinguishing between alcohol consumption above and below 30 g/day for men and 20 g/day for women.</p><p><strong>Conclusions: </strong>%CDT, in conjunction with detailed interviews, can be used to detect alcohol consumption, particularly to distinguish whether it exceeds 30 g/day in men and 20 g/day in women. Applying this to the clinical management of patients with alcohol dependence accompanied by ALD or SLD may contribute to improving the quality of care.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"885-892"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818505","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":"Promotion of Preventive Sleep Research from the Perspective of Health and Public Safety in Japan - Secondary Publication.","authors":"Takeshi Tanigawa","doi":"10.31662/jmaj.2024-0200","DOIUrl":"10.31662/jmaj.2024-0200","url":null,"abstract":"<p><p>Ensuring good sleep quality and adequate sleep duration is crucial for health. Sleep apnea syndrome (SAS) impairs sleep quality and increases the risk of diabetes, cardiovascular diseases, and accidents. The author has significantly advanced the understanding of SAS in Japan through over 20 years of epidemiological studies. Findings have revealed that individuals with a 3% oxygen desaturation index (ODI) ≥15 events/h have a 1.69-fold higher risk of developing diabetes. Those with mild to severe sleep-disordered breathing (SDB) with a 3% ODI ≥5 events/h face high risks of heart disease and lacunar infarction, at 26.1% and 30.1%, respectively. Among shift workers aged ≥40, SDB was significantly associated with elevated blood pressure. Additionally, the risk of traffic accidents in SDB patients is approximately 2.5 times higher than in those without SDB. The author advocated for routine SAS screening, especially for professional drivers, to enhance public safety. In collaboration with the Ministry of Land, Infrastructure, Transport and Tourism, comprehensive guidelines for SAS screening were developed, emphasizing the necessity of objective methods due to the disconnect between subjective sleepiness and objective alertness. These methods include pulse oximetry and the 3-minute psychomotor vigilance test (PVT). Highlighting the health risks for night-shift workers with SDB, the author promoted regular screening and early intervention. Additionally, pediatric SAS was linked to attention-deficit hyperactivity disorder-like symptoms, stressing the need for early treatment. Post-disaster health initiatives showed increased insomnia among Fukushima recovery workers, with continuous positive airway pressure therapy proving beneficial. The author also developed health security measures using PVT for doctors working long hours, linking reduced wakefulness to depression and burnout. These contributions have significantly improved public health and safety in Japan, influencing health policies and promoting widespread SAS screening and sleep debt evaluation. Continued support from doctors of the Japan Medical Association is essential to maintain these advancements.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"673-678"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818486","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":"Work Style Reform for Pediatric Residents.","authors":"Hiro Nakao, Osamu Nomura, Naoya Tonegawa, Mitsuru Kubota, Akira Ishiguro","doi":"10.31662/jmaj.2024-0419","DOIUrl":"10.31662/jmaj.2024-0419","url":null,"abstract":"<p><strong>Introduction: </strong>Work style reform has affected pediatric residents' balance between adequate training and wellness. This study aimed to investigate the impact of work style reform among pediatric trainees at the National Center for Child Health and Development (NCCHD), where several work style amendments were implemented from 2019 to 2024.</p><p><strong>Methods: </strong>We conducted a questionnaire-based cross-sectional survey of pediatric trainees in 2024 and compared the data with a previous survey from 2019 to evaluate the impact of work style reform. The questionnaire included demographic and work condition data, the Center for Epidemiologic Studies Depression Scale, and the Maslach Burnout Inventory (MBI).</p><p><strong>Results: </strong>Participants included 37 trainees (94.9%) in 2019 and 34 trainees (81.0%) in 2024. Median work hours per week (69.0-64.0, p = 0.04) and the frequency of night or holiday shift work (5-4 times/month, p = 0.002) decreased significantly in 2024. Compliance with daytime rest after night work also increased significantly (64.9%-91.2%, p = 0.01). All subscales of the MBI showed improvements, which remained significant after adjusting for demographics and work conditions (p < 0.001 for all).</p><p><strong>Conclusions: </strong>Work style reform has improved work conditions and wellness in pediatric training at NCCHD. Further reports from other medical specialties are awaited to assess the broader impact of work style reform on physicians.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"736-742"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818506","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":"National Trends in the Incidence of Hospitalization for Stroke in Japan.","authors":"Takao Ono, Yuki Miyamoto, Tasuku Matsuyama, Chikamasa Ichita, Kasumi Satoh, Taketo Watase, Tadahiro Goto","doi":"10.31662/jmaj.2024-0311","DOIUrl":"10.31662/jmaj.2024-0311","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"970-973"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818478","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":"Roof-dependent Macro-reentrant Left Atrial Flutter Masked by Probable Epicardial Conduction via the Septopulmonary Bundle.","authors":"Masataka Nakatsuka, Masao Takemoto, Togo Sakai, Takuya Tsuchihashi","doi":"10.31662/jmaj.2025-0112","DOIUrl":"10.31662/jmaj.2025-0112","url":null,"abstract":"<p><p>We encountered a 77-year-old woman who had a roof-dependent macro-reentrant left atrial (LA) flutter (LAFL), masked by probable epicardial conduction via the septopulmonary bundle (SPB). The SPB, an epicardial connection in the LA, may contribute to the maintenance and complexity of LAFL. Thus, when evaluating LAFL, physicians should consider the potential involvement of the SPB. Detailed observation using a three-dimensional mapping and comprehensive electrophysiological pacing maneuvers is crucial for identifying the re-entry circuit of LAFL.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 3","pages":"1005-1010"},"PeriodicalIF":1.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12328907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818497","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":"Dissemination of Information to Foreigners in Preparation for Natural Disasters.","authors":"Hatsune Kido, Soichiro Saeki","doi":"10.31662/jmaj.2024-0327","DOIUrl":"10.31662/jmaj.2024-0327","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"658-659"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144765","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":"Incidence of Bloodstream Infections in Pediatric Patients with Cancer during Febrile Neutropenia: A Retrospective Study.","authors":"Yukihiro Matsukawa, Jun Matsubayashi, Kenichi Sakamoto, Kohei Takashima, Yuhachi Ikeda, Makoto Osawa, Takashi Taga, Yoshihiro Maruo","doi":"10.31662/jmaj.2024-0369","DOIUrl":"10.31662/jmaj.2024-0369","url":null,"abstract":"<p><strong>Introduction: </strong>Bloodstream infections (BSIs) are a major concern in pediatric patients with cancer, especially during episodes of febrile neutropenia (FN). In this study, we aimed to evaluate the incidence of BSI across various pediatric malignancies and identify cancer subtypes associated with a heightened risk of BSI.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study analyzed the electronic medical records of pediatric patients with cancer treated between April 2012 and March 2023. Eligible patients included those diagnosed with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), lymphoma, brain tumors, and solid tumors. For each chemotherapy course, we assessed BSI incidence and FN episodes.</p><p><strong>Results: </strong>This study included 152 pediatric patients who underwent 829 chemotherapy courses. The cohort comprised 21 patients with AML, 52 with ALL, 10 with lymphoma, 26 with brain tumors, and 43 with solid tumors. Compared to other cancer types, the AML group exhibited the highest proportion of BSI across all chemotherapy courses (17% vs. 4%-7%). During FN episodes, the AML cohort had a significantly higher BSI incidence (22%) than other groups (7%-13%). Notably, chemotherapy courses involving high-dose cytarabine (HD-CA) had a substantially higher BSI incidence (30%) among the patients with AML than courses without HD-CA (2%).</p><p><strong>Conclusions: </strong>Patients with AML have the highest risk of BSIs in pediatric malignancies, particularly during FN episodes. In addition, our findings highlight an association between BSIs and HD-CA use in patients with AML.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"560-567"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144801","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":"Innovative Artificial Intelligence System in the Children's Hospital in Japan.","authors":"Akihiro Umezawa, Kazuaki Nakamura, Mureo Kasahara, Takashi Igarashi","doi":"10.31662/jmaj.2024-0312","DOIUrl":"10.31662/jmaj.2024-0312","url":null,"abstract":"<p><p>The evolution of innovative artificial intelligence (AI) systems in pediatric hospitals in Japan promises benefits for patients and healthcare providers. We actively contribute to advancements in groundbreaking medical treatments by leveraging deep learning technology and using vast medical datasets. Our team of data scientists closely collaborates with departments within the hospital. Our research themes based on deep learning are wide-ranging, including acceleration of pathological diagnosis using image data, distinguishing of bacterial species, early detection of eye diseases, and prediction of genetic disorders from physical features. Furthermore, we implement Information and Communication Technology to diagnose pediatric cancer. Moreover, we predict immune responses based on genomic data and diagnose autism by quantifying behavior and communication. Our expertise extends beyond research to provide comprehensive AI development services, including data collection, annotation, high-speed computing, utilization of machine learning frameworks, design of web services, and containerization. In addition, as active members of medical AI platform collaboration partnerships, we provide unique data and analytical technologies to facilitate the development of AI development platforms. Furthermore, we address the challenges of securing medical data in the cloud to ensure compliance with stringent confidentiality standards. We will discuss AI's advancements in pediatric hospitals and their challenges.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"354-360"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144805","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":"Prime Editing Corrects Multiple Mutations in the RSRSP Region of the <i>RBM20</i> Gene Using a Single Prime Editing Guide RNA.","authors":"Takahiko Nishiyama","doi":"10.31662/jmaj.2025-0004","DOIUrl":"10.31662/jmaj.2025-0004","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"587-590"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144861","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":"Response to the Letter by Matsubara.","authors":"Masaki Mori","doi":"10.31662/jmaj.2024-0420","DOIUrl":"10.31662/jmaj.2024-0420","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"664"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144875","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}