The efficacy and safety of a quadrivalent live attenuated influenza nasal vaccine in Japanese children: a phase 3, randomized, placebo-controlled study.

BACKGROUND: Vaccination is the primary method of preventing influenza infection and complications in young children. We evaluated the efficacy and safety of a single dose of MEDI3250 (intranasal, quadrivalent, live attenuated influenza vaccine) in healthy Japanese children during the 2016/17 influenza season. METHODS: In this multicenter, randomized, double-blind, phase 3 study (jRCT2080223345), participants aged 2-18 years received MEDI3250 or placebo (2:1), stratified by age (2-6 years, 7-18 years). The primary and secondary endpoints were the incidence of confirmed symptomatic onset of influenza caused by a circulating wild-type strain or by a vaccine-matched strain, respectively. Safety outcomes included the incidence of adverse events (AEs) and vaccine-related AEs. RESULTS: Overall, 910 participants received MEDI3250 (n = 608) or placebo (n = 302). For the primary endpoint (regardless of the influenza subtype), the incidence of influenza onset was 25.5% (MEDI3250) and 35.9% (placebo); relative risk reduction, 28.8% (95% confidence interval, 12.5% to 42.0%). For the secondary endpoint (vaccine-matched strain), the incidence was 10.9% (MEDI3250) and 17.2% (placebo); relative risk reduction, 36.6% (95% confidence interval, 6.5% to 56.8%). Solicited AEs occurred in 67.6% (MEDI3250) and 63.6% (placebo). Most events were mild; nasal discharge was most common (59.2% [MEDI3250] and 52.6% [placebo]). Unsolicited AEs occurred in 36.0% (MEDI3250) and 33.1% (placebo). The most common unsolicited vaccine-related AE was diarrhea (2.3%, both groups). CONCLUSIONS: MEDI3250 had a greater preventive effect against influenza onset in Japanese children than placebo; no new safety signals were observed relative to previous clinical and post-marketing studies of MEDI3250.

A prospective cohort study in depression and anxiety among Vietnamese migrants in Japan during the early to mid-COVID-19 pandemic.

INTRODUCTION: The enduring COVID-19 pandemic has had persistent, intermittent socioeconomic impacts on migrants. This raises the concern that many Vietnamese migrants in Japan may have developed mental health issues due to the socioeconomic impact. The study aimed to examine changes in the socio-economic and mental health status of Vietnamese migrants in Japan and factors affecting mental health status during the early to mid-COVID-19 period. METHODS: We conducted a prospective cohort study among Vietnamese migrants in Japan from September to October 2021 (baseline) and from May to June 2022 (follow-up) using an online questionnaire. Multiple linear regression analyses were conducted to examine the association between changes in socioeconomic status and alterations in symptoms of depression and anxiety within this demographic. RESULTS: The mean age of the 159 participants was 26.1 ± 4.9 years, with a mean length of residency in Japan of 4.0 ± 4.1 years. The mean PHQ-9 score exhibited a significant decrease from 7.89 (SD = 6.34) to 6.62 (SD = 5.87) (p = 0.01). Variables associated with changes in depression and anxiety included subjective socioeconomic status (unstandardized partial regression coefficient (UPRC): 1.901, 95% confidence interval (CI) 0.30 to 3.50, p = 0.02) and (UPRC: 2.060, 95% CI 0.80 to 3.32, p = 0.002), as well as changes in having someone with whom to discuss one's health (UPRC: 2.689, 95% CI 0.89 to 4.49, p = 0.004) and (UPRC: 1.955, 95% CI 0.54 to 3.38, p = 0.007). CONCLUSIONS: In this prospective cohort study of depression and anxiety, depressive symptoms among Vietnamese migrants decreased from 2021 to 2022. Key findings underscore the importance of socioeconomic status improvement and having someone to discuss to about their health as protective factors against mental health challenges. Employment and social support have emerged as crucial determinants of mental health among Vietnamese migrants in Japan, emphasizing the necessity for comprehensive support strategies addressing both economic vulnerabilities and social connectedness.

Temporal evolution of suicide by levels of rurality and deprivation among Japanese adults aged 20 years or over between 2009 and 2022.

PURPOSE: Previous studies have reported that levels of rurality and deprivation are factors associated with suicide risk. Reports on the association between rurality, deprivation and suicide incidence during the COVID-19 pandemic are scarce. The study aims to investigate how suicide rates evolved in areas with different levels of rurality and deprivation among Japanese adults aged 20 years or older between 2009 and 2022. METHODS: This study used population density in 2020 as an indicator of rurality and per capita prefectural income in 2019 as a proxy for deprivation in Japan's 47 prefectures. Joinpoint regression analysis was performed to analyze secular trends in suicide rates by rurality and deprivation. RESULTS: Suicide rates for both men and women at different levels of rurality and deprivation remained roughly parallel during the research period. Suicide rates for men and women at all levels of rurality and deprivation were on a downward trend until around 2019, just before the onset of the pandemic. Following this, suicide rates in women showed a clear upward trend, while the trend in suicide rates for men also changed around 2019, with a slightly increasing or flat trend thereafter. Changes in suicide rates were greater among women and those aged 20-59 years. CONCLUSIONS: In Japan, time trends in suicide rates for both men and women have changed before and after the pandemic, but levels of rurality and deprivation across the 47 prefectures do not appear to have contributed much to these changes.

Urological cancer statistics on incidence from 1975 to 2019 and mortality from 1958 to 2022 in Japan.

BACKGROUND: In Japan, comprehensive cancer statistics are collected through cancer registries. However, data on urological cancers are rarely summarized or published in research papers. METHODS: This retrospective study was performed using publicly available statistical data on urological cancers (prostate cancer [PCa], bladder cancer [BCa], and cancers of kidney and urinary tract [except urinary bladder]) in Japan, including a summary of the Ministry's mortality statistics, cancer incidence statistics from the Regional Cancer Registries through 2015, and the National Cancer Registry statistics from 2016. We examined the incidence and mortality rates of urological cancers stratified by age groups. RESULTS: The number of new cases of PCa, BCa, and cancers of kidney and urinary tract (except urinary bladder) in 2019 was 94,748, 23,383, and 30,458, respectively, and the number of deaths in 2022 was 13,439, 9,598, and 9,795, respectively. The incidence and mortality rates of urological cancers have consistently increased. Since 2000, there has been a noteworthy increase in the mortality rate of urological cancers among individuals aged > 85 years. The incidence and mortality rates of BCa and cancers of kidney and urinary tract (except urinary bladder) were significantly higher in males than in females. CONCLUSIONS: Urological cancers in very elderly patients (> 85 years) will become increasingly important in the future.

Is Boundary Annotation Necessary? Evaluating Boundary-Free Approaches to Improve Clinical Named Entity Annotation Efficiency: Case Study.

BACKGROUND: Named entity recognition (NER) is a fundamental task in natural language processing. However, it is typically preceded by named entity annotation, which poses several challenges, especially in the clinical domain. For instance, determining entity boundaries is one of the most common sources of disagreements between annotators due to questions such as whether modifiers or peripheral words should be annotated. If unresolved, these can induce inconsistency in the produced corpora, yet, on the other hand, strict guidelines or adjudication sessions can further prolong an already slow and convoluted process. OBJECTIVE: The aim of this study is to address these challenges by evaluating 2 novel annotation methodologies, lenient span and point annotation, aiming to mitigate the difficulty of precisely determining entity boundaries. METHODS: We evaluate their effects through an annotation case study on a Japanese medical case report data set. We compare annotation time, annotator agreement, and the quality of the produced labeling and assess the impact on the performance of an NER system trained on the annotated corpus. RESULTS: We saw significant improvements in the labeling process efficiency, with up to a 25% reduction in overall annotation time and even a 10% improvement in annotator agreement compared to the traditional boundary-strict approach. However, even the best-achieved NER model presented some drop in performance compared to the traditional annotation methodology. CONCLUSIONS: Our findings demonstrate a balance between annotation speed and model performance. Although disregarding boundary information affects model performance to some extent, this is counterbalanced by significant reductions in the annotator's workload and notable improvements in the speed of the annotation process. These benefits may prove valuable in various applications, offering an attractive compromise for developers and researchers.

Prevalence of Generalized Anxiety Disorder in Japan: A General Population Survey.

Purpose: Generalized anxiety disorder (GAD) is among the most prevalent and highly disabling mental health conditions that negatively impacts patient's quality of life (QOL) and disrupts activities of daily living. However, the recognition of GAD is difficult due to substantial overlap with other mental disorders. The purpose of this study was to estimate the prevalence of GAD, assess QOL of probable GAD patients in Japan, and gain insights on the status of visiting medical institutions as well as their recognition/awareness of the disorder. Patients and Methods: We conducted a web-based cross-sectional survey of 20,009 participants using a questionnaire with approximately 30 single/multiple choice or open-ended questions in Japanese. Results: Overall prevalence of GAD based on Generalized Anxiety Disorder 7-item (GAD-7) cutoff score of ≥10 and questionnaires developed with reference to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria was 7.6% (n=1530) and 6.0% (n=1197), respectively. The degree of coincidence between GAD diagnosis by DSM-5 criteria and GAD-7 scores was moderate (Cohen's Kappa=0.47, p<0.01). Younger people reported a substantially higher prevalence of GAD compared to older. QOL scores assessed using EuroQol 5 dimensions 5-level and EuroQol Visual Analog Scale were substantially lower in probable GAD patients than those with GAD-7<10. Anxiety/depression and pain/discomfort were the most prevalent issues and depression was the most reported comorbidity for the probable GAD patients. Probable GAD patients "currently visiting medical institutions" for anxiety or other mental issues were 27.6% (422/1530); a majority had seen specialists. Most of the probable GAD patients had never heard of the disease. Conclusion: We found higher prevalence of GAD and lower QOL of probable GAD patients in Japan. There is a need for creating awareness about GAD among the general population and developing clinical guidelines on GAD in Japan so that physicians can educate their patients.

Unveiling, Analyzing the Mechanisms of, and Proposing Solutions for Bribery in Japan's Medical Device Sector.

Both public and academic scrutiny of the financial relationships between the medical device industry and the healthcare society occur less frequently than those involving the pharmaceutical industry, and Japan is no exception to these shortcomings. This paper examines the ethical and legal challenges inherent in Japan's medical device industry through the lens of bribery scandals, placing these issues within the broader context of global healthcare corruption. It aims to derive lessons and suggest universal strategies for ethical and legal enhancements. The discussion includes two notable cases: one involving inappropriate transactions between a cancer center and a biliary stent manufacturer, and another concerning a corrupt donation scheme between a medical device company and a university's anesthesiology department, which was found guilty. In our analysis, we also acknowledge the industry's efforts toward compliance and reform to maintain a balanced perspective. The analysis not only highlights the unique culture and structure of the Japanese medical device industry, such as the exploitation of flexible pricing and opaque financial practices but also contrasts these issues with the tightly regulated pharmaceutical industry. This approach reveals both sector-specific challenges and common corruption drivers, enhancing our understanding of why such scandals occur and persist. We propose ethical and compliance-focused business measures such as centralizing donation decisions, limiting the financial independence of marketing divisions, and increasing transparency, alongside adopting mandatory disclosure practices based on successful models from the United States and Europe. By emphasizing integrity and presenting diverse perspectives, this study aims to elevate ethical and legal standards in the medical device industry and improve patient health outcomes worldwide.

Quality of work life (QWL) of community pharmacists and its association with subjective evaluations of pharmaceutical services.

Background: In Japan, pharmacists' role has drastically changed in recent years. However, previous studies have not performed internal marketing analysis for Japanese community pharmacists so that they improve the quality of work life (QWL) and be satisfied with it. Further, few studies are conducted on Japanese community pharmacists' QWL and its effect on the quality of pharmaceutical services. Objectives: This study aimed to reveal associations between community pharmacists' QWL and their subjective evaluations of pharmaceutical service. Methods: A questionnaire survey was conducted among 2027 pharmacists, with the cooperation of 20 corporations that run pharmacies. The collected data were subjected to multiple regression analysis, using SPSS 29. Results: Standard multiple regression shows that 27.4% of variance in pharmacists' subjective evaluations of their service was explained by QWL and other control variables, such as age, gender, and employee status (p < .001, R2 = 0.274). This analysis showed that factors behind pharmacists' QWL, "meaning of existence in the workplace" and "pride in work," explained pharmacists' subjective evaluations of pharmaceutical service (ß = 0.307, p < .001, ß = 0.277; p < .001, respectively). Conclusion: This study shows that improving QWL, especially "mental and physical effects on work" and "pride in work," might contribute to improving community pharmacists' services.

Mating Disruption of a Flighted Spongy Moth, Lymantria Dispar Japonica (Motchulsky) in Japan.

Mating disruption of a flighted spongy moth, Lymantria dispar japonica (Motchulsky)(Lepidoptera: Lymantridae), with a synthetic version of its sex pheromone, (+)-disparlure ([7R,8S] -cis-7,8-epoxy-2- methyloctadecane), was tested in the forests in Japan. Pheromone trap catches and the percentage mating of tethered females were measured in the pheromone-treated and untreated control forests. The attraction of male moths to pheromone traps placed at a height of 1.5 m was significantly disrupted when the pheromone dispensers were placed at 1.5 m height, but many moths were captured in control plots. Mating of tethered females placed at 1.5 m was inhibited entirely, while 44% of females were mated in an untreated control forest. We report the first trial of mating disruption against a flighted spongy moth, and these results suggest that mating disruption with the synthetic sex pheromone appears promising for reducing damage caused by L. dispar japonica.

Is the increase in the number of total hip arthroplasties in Japan due to an aging society?

BACKGROUND: The number of total hip arthroplasty (THA) is increasing globally, including Japan. The Japanese Orthopaedic Association has been conducting a registry of joint replacement surgery, but there may be a gap between the reported numbers of THA in the registry and the actual number. This study aimed to investigate the exact number of THA and assess the trends in Japan using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). METHODS: We downloaded data from 2014 to 2019 from the NDB Open Data. Data on primary THA were extracted, and we calculated the annual number and number for each 10-year age group and sex. We also compared the number and trends between elderly and non-elderly groups. RESULTS: During the study period, number of THAs increased by approximately 20,000, showing a continuous upward trend. The highest number of THAs were performed on patients in their 60s, except for the years 2014 and 2019. Comparison of the numbers in 2014 and 2019 by age group showed an increase in the number in patients in their 90s (by 2.05 times). There were significantly a greater number of elderly patients (P < 0.001). The number of THAs performed was higher in women than in men (P < 0.001). CONCLUSION: The number of THAs in Japan increased substantially from 2014 to 2019, despite a decrease in population. Significantly higher number of THAs were performed on elderly patients in Japan, which might be due to an aging society. The NDB data is highly valuable for epidemiological research in Japan, as it might enable the early detection of issues occurring during THA, facilitating their prompt integration into daily clinical practice.

Gender and age variations in the association between multigenerational cohabitation and self-rated health among middle-aged and older adults in Japan.

Despite encouraging multi-generational cohabitation, the population of Japanese people living alone has increased. However, little is known about the association between health and multigenerational cohabitation. This study examined the relationship between self-rated health and living arrangements among Japanese adults using data from the Japan Multi-Institutional Collaborative Cohort Study (2013-2017). The analysis employed multivariate logistic regression to examine the associations. Our results showed no association between living arrangements and self-rated health when stratified by gender. Living alone was found to be associated with poor self-rated health among women aged 65 and above. A similar association may exist among men in the same age group. Among women aged < 65 years, two-generation cohabitation was associated with a good self-rated health, similar to those living alone. Among men aged < 65 years, neither living alone nor two-generation cohabitation was significantly associated with good self-rated health. We found no association between three- or plus-generation cohabitation and self-rated health. Therefore, our findings indicate associations between multigenerational cohabitation and self-rated health, but they vary by gender and age. Invested stakeholders in the public health field should consider the potential impact of living arrangements on health based on gender and age.

A significant outbreak of respiratory human adenovirus infections among children aged 3-6 years in Hokkaido, Japan, in 2023.

Human adenovirus (HAdV) infections present diverse clinical manifestations upon infecting individuals, with respiratory infections predominating in children. We surveyed pediatric hospitalizations due to respiratory HAdV infections across 18 hospitals in Hokkaido Prefecture, Japan, from July 2019 to March 2024, recording 473 admissions. While hospitalizations remained below five cases per week from July 2019 to September 2023, a notable surge occurred in late October 2023, with weekly admissions peaking at 15-20 cases from November to December. There were dramatic shifts in the age distribution of hospitalized patients: during 2019-2021, 1-year-old infants and children aged 3-6 years represented 51.4%-54.8% and 4.1%-13.3%, respectively; however, in 2023-2024, while 1-year-old infants represented 19.0%-20.1%, the proportion of children aged 3-6 years increased to 46.2%-50.0%. Understanding the emergence of significant outbreaks of respiratory HAdV infections and the substantial changes in the age distribution of hospitalized cases necessitates further investigation into the circulating types of HAdV in Hokkaido Prefecture and changes in children's neutralizing antibody titers against HAdV.

Association between Internet Use and Locomotive Syndrome, Frailty, and Sarcopenia among Community-Dwelling Older Japanese Adults.

In the lives of those who are the target of community health nursing, it is important to collaborate with individuals and communities to improve their quality of life. Herein, we aimed to determine the association between Internet use among older individuals and locomotive syndrome (LS), frailty, and sarcopenia. In this cross-sectional study conducted between July 2022 and March 2023, we recruited 105 community-dwelling older Japanese adults who participated in a care prevention project called "Kayoi-no-ba". All participants were divided into Internet and non-Internet user groups according to the classification of a previous study. We assessed LS (standing test, two-step test, and five-question Geriatric Locomotive Function Scale), frailty (through the Questionnaire for Medical Checkup of Old-Old), and sarcopenia (grip strength, normal walking speed, and skeletal muscle mass index) and made group comparisons between Internet users and non-users. Binomial logistic regression analyses were performed with Internet use as the independent variable and sarcopenia or LS as the dependent variables. The Internet and non-Internet user groups had 69 and 36 participants, respectively. The Internet user group comprised 65.7% of all participants, which was similar to that reported in a previous study of the same age group. Between-group comparisons showed significant differences in sarcopenia and LS items, whereas adjusted binomial logistic analysis showed a significant association between sarcopenia and Internet use. In summary, among LS, frailty, and sarcopenia, sarcopenia showed the highest association with Internet use. Older adults without sarcopenia having good physical functions, such as grip strength, walking speed, and skeletal muscle index, more likely used the Internet; while older adults with sarcopenia were less likely to use the Internet. This implied that Internet use may be associated with physical function.

Characterization of Microplastics and Adsorbed/Dissolved Polycyclic Aromatic Hydrocarbons in the Biggest River System in Saitama and Tokyo, Japan.

This study presents a comprehensive characterization of microplastics (MPs) and adsorbed/dissolved polycyclic aromatic hydrocarbons (PAHs) in the Arakawa River, the largest river system in Saitama and Tokyo, Japan. The MPs were sampled at various points along the river, revealing an average number density of 2.21 ± 1.48 pieces/m3, with a predominant size range of 0.5-1 mm. Polymer analysis indicated that polyethylene (PE) comprised the highest proportion of MPs (55.9%), followed by polypropylene (PP) (22.4%) and polystyrene (PS) (21.7%). Seasonal fluctuations in MPs concentration were observed, with the highest values in winter and the lowest in summer. An analysis of adsorbed PAHs revealed a median partition coefficient (Kd) value of 3.58 × 104 L/kg for MPs, indicating their affinity for PAHs. Further PAHs analysis revealed that the PAHs with the highest mean values were bicyclic naphthalene, pyrene, and fluoranthene. A comparison with coastal MPs showed differences in PAH composition, with higher proportions of high-ring PAHs observed in coastal samples. The study also investigated the distribution of PAHs in the dissolved and suspended states in the river, finding that similar PAHs were distributed in both states, with the PAHs present in MPs being about 1/10,000 of those in the dissolved and suspended states. The study underscores the importance of the continued monitoring and management of MPs and associated pollutants in river ecosystems.

Freshwater spreading far offshore the Japanese coast.

River discharge to the ocean influences the transport of salts and nutrients and is a source of variability in water mass distribution and the elemental cycle. Recently, using an underwater glider, we detected thick, low-salinity water offshore for the first time, probably derived from coastal waters, in the central-eastern Sea of Japan, whose primary productivity is comparable to that of the western North Pacific. Thereafter, we aimed to investigate the offshore advection and diffusion of coastal water and its variability and assess their impact. We examined the effects of river water discharge on the flow field and biological production. Numerical experiments demonstrated that low-salinity water observed by the glider in spring was discharged from the Japanese coast to offshore regions. The water is discharged offshore because of its interaction with mesoscale eddies. A relationship between the modeled low-salinity water transport to the offshore region and the observed chlorophyll-a in the offshore region was also observed, indicating the influence of river water on offshore biological production. This study contributes to understanding coastal-offshore water exchange, ocean circulation, elemental cycles, and biological production, which are frontiers in the Sea of Japan and throughout the world.

The latest policies, practices, and hotspots in research in conjunction with the aging of Japan's population.

Population aging is a global concern, and Japan currently has the world's highest proportion of an aging population. In 2020, the population age 65 and over accounted for 10% of the global population, while this proportion was 29% in Japan, and it is expected to reach 38.4% in 2065. The average life expectancy in Japan in 2022 was 81.05 for males and 87.09 for females. At the same time, Japan's healthy life expectancy continues to increase, and it is increasing at a faster rate than the average life expectancy, with males expected to live 72.68 years and females expected to live 75.38 years in 2019. This is causing the social role of elderly people in Japan to constantly change. The Japanese Government continues to adjust its policy orientation, to improve the health level and social participation of the elderly, improve the accessibility of long-term nursing services and the treatment of nursing professionals, and improve the pension system. By 2025, one-fifth of people in Japan are expected to suffer from dementia. Japan has implemented a series of policies to create a dementia-inclusive and less risky society. The proportion of the population ages 65 and over living alone in Japan increased from 4.3% among males and from 11.2% among females in 1980 to 15.0% among males and 22.1% among females in 2020, representing a sustained increase. Changes in the composition of the population have prompted sustained attention to the personalization and diversification of elderly care. At the same time, Japanese researchers continue to utilize scientific and information technology to innovate elderly care products, improve the efficiency of elderly care, and provide intelligent elderly care.

Calculating a Prefecture-Level Well-Being Index in Japan: Applying the framework of the OECD's Better Life Index.

Objectives　Well-being serves as a crucial indicator of national governance and societal advancement. Consequently, the Better Life Index (BLI) developed by the Organisation for Economic Co-operation and Development (OECD) has emerged as a pivotal multidimensional measure of well-being, surpassing traditional indicators such as Gross Domestic Product (GDP). However, current well-being indicators predominantly focus on national measurements and do not effectively evaluate well-being in smaller regions such as states or prefectures. This study aimed to calculate a Regional Well-Being Index (RWI) tailored to localized areas in Japan.Methods　Japanese official statistics, publicly available as open data, were analyzed, focusing on 11 domains similar to those in the BLI: "Income," "Jobs," "Housing," "Health," "Work-Life Balance," "Education," "Community," "Civic Engagement," "Environment," "Safety," and "Life Satisfaction." The RWI scores were calculated for each prefecture in 2010, 2013, 2016, and 2019 using standard normalization techniques. To represent the overall well-being of each prefecture in each year, scores were aggregated across all domains; this aggregate is referred to as the Integrated RWI. The reliability and validity of RWI were assessed by examining time-series changes and Pearson's correlation coefficients.Results　Median Integrated RWI scores for Japanese prefectures remained relatively stable across the study period, with slight variations observed: median = 0.67 (Interquartile range [IQR]: -2.48-2.71) in 2010, median = 0.00 (IQR: -2.85-2.76) in 2013, median = 0.13 (IQR: -3.05-2.49) in 2016, and median = 0.19 (IQR: -2.75-3.06) in 2019. Geographical analysis showed lower scores in regions such as Western Kyushu and Shikoku, and higher scores in Chubu and Eastern Kinki. The RWI and the BLI demonstrated construct validity, with Pearson's correlation coefficients ranging from 0.58 to 0.99 across various domains.Conclusion　The RWI, based on the OECD's BLI, proved to be a reliable and valid tool for assessing comprehensive well-being at the regional level in Japan. It offers foundational data for identifying challenges to regional well-being and shaping targeted policies, thereby contributing to evidence-based policymaking. Moreover, this methodology has potential applicability in evaluating comprehensive well-being beyond GDP at the regional level in other countries using official statistics.

Suicide mortality rates in Japan before and beyond the COVID-19 pandemic era.

Statistical analyses from Japan reported increasing suicides in 2020, first in the world, proving the severity of the public health crisis during the COVID-19 pandemic; however, so far, international suicides have not been shown to be objectively increasing at population level. Followed studies reported the existence of a substantial heterogeneity of suicides among subgroups and time-lag impacts. Against public health crisis in Japan, policymakers, psychiatrists and public health personnel should prioritize improving suicide prevention programs following evidence-based policymaking. Understanding how/what factors relate to the COVID-19 pandemic and what other factors have shaped the increasing suicide numbers since 2020 through objectively well-controlled/fine-grained analyses of high-quality longitudinal/cross-sectional data at the individual, regional, and national levels is important for identifying the reasons for the recent trend. For this purpose, this study examined suicide statistics, statistical analysis methods, and their interpretations. Recent analyses suggest an increased suicide risk among females <50 years and males <30 years in 2020-2022. Notably, time-series analyses revealed that adolescent suicides began increasing before the pandemic, while working-age female suicides sharply increased synchronously with the pandemic outbreak. Causality analyses suggest that social issues facing Japan and recent global psychosocial and socioeconomic transformations are risk factors for suicide in high-risk groups. Finally, this report demonstrates the importance of providing appropriate support based on an objective understanding of individuals who are at risk for suicide, without being bound by traditional established knowledges.

Bridging the Gap in United Nations Environment Programme's Report: The Potential of Nudges to Reduce Plastic Pollution and Health Risks.

Plastic pollution is increasingly becoming a threatening problem worldwide, with highlighted health risks associated with plastic waste incineration. Among the immediate measures to address this problem, proper recycling of polyethylene terephthalate (PET) bottles is a pertinent strategy. Considering the urgent need for administrative-led reforms, we assessed the separation rates of PET bottle caps and labels by 125 administrative staff in a government office of a prefectural in Japan during a four-day period; only 59.3% (48/81) of the pet bottles had both caps and labels removed and properly separated to each trash can. One potential solution for the low separation rate is the use of nudges, which are effective methods for promoting behaviors such as healthy actions. Since both health and environmentally conscious behaviors involve choices across different time points, leveraging insights from nudges developed in the field of health behavior to environmental behaviors is considered crucial, even from a health promotion perspective.

Suicide among national university graduate students in Japan from 2002 to 2021.

Aim: Graduate students are exposed to various types of stress. Thus, they are prone to mental health problems, and the most devastating result is suicide. The aim of this paper is to reveal the status of suicide among graduate students in Japan for 20 years. Methods: We analyzed cumulative data on suicide among national university graduate students from annual surveys on causes of non-graduation in Japan for the 2002-2003 through 2021-2022 academic years. We asked all national universities with graduate schools to complete the surveys, and the participation rate was 91.1%. Results: The total number of students in the surveys was 2,383,858, and the number of deaths by suicide was 347 (292 males, 55 females). Chi-squared test results showed significantly higher suicide mortality rates for the following groups: male (p < 0.001), temporary leave (p < 0.001), repeating the same year (p = 0.006), master's level (p = 0.005), and majoring in engineering (p < 0.001). Psychiatric diagnoses were detected among 44 students (12.7%). The largest distribution (27 cases) of International Classification of Diseases, Tenth Revision (ICD-10) codes among those whose diagnoses were evident was F3, mood disorders. Estimated motives for suicide were reported for only 36 students (10.4%), of which the most prevalent was job search failure. The most prevalent suicide method was hanging (151 cases, 43.5%). Conclusion: Our findings indicate that student support facilities should recognize higher-risk groups for suicide among graduate students. Our study adds suggestions for suicide prevention on campus during future pandemics.