OBJECTIVESAmong the complementary and alternative medical services available in Japan, only judo therapists are covered under the national health-insurance program without a referral from a physician. Many orthopedists claim that judo therapists deprive them of potential patients. If such competition exists, fewer patients would be expected to visit orthopedists in areas where many patients visit judo therapists. Therefore, we examined the correlation between the number of patients visiting judo therapists and those visiting physicians for musculoskeletal diseases.

METHODSIn a cross-sectional study covering each prefecture in Japan (n = 47), we obtained figures for the numbers of judo therapist facilities and elderly patients (over 70 years old) who visited them and the numbers of orthopedists and patients who visited physicians for musculoskeletal diseases. Correlations between the numbers of practitioners per 100,000 population and the numbers of their patients per 100,000 population were examined by prefecture.

RESULTSThere were positive correlations between the numbers of judo therapist facilities and elderly patients who visited them (r = 0.72, P < 0.01, n = 47), and between the numbers of orthopedists and elderly patients who visited physicians for musculoskeletal diseases (r = 0.32, P = 0.03). However, there was no significant correlation between the numbers of elderly patients who visited judo therapist facilities and those who visited physicians (r = 0.06, P = 0.68) for musculoskeletal diseases.

CONCLUSIONSThis study did not find a negative correlation between the numbers of patients visiting judo therapists and patients visiting physicians for musculoskeletal diseases. Thus, these results do not support the orthopedists' claim that the two services compete for patients.

Background: Although radiotherapy is commonly used to treat head and neck cancer, it may lead to radiation-asso‑ ciated dysphagia (RAD). There are various causes of RAD, however, the mechanism has not yet been fully identified.Currently, the only effective treatment for RAD is rehabilitation. Additionally, there are few available animal models of RAD, necessitating the development of new models to establish and evaluate RAD treatments. We hypothesize that radiation-induced neck muscle fibrosis could be one of the causes of RAD due to impairment of laryngeal eleva‑ tion. Therefore, in this study, we focused on the changes in inflammation and fibrosis of the strap muscles (Sternohy‑ oid, Sternothyroid, and Thyrohyoid muscles) after a single-dose irradiation. This research aims to provide a reference animal model for future studies on RAD. Results: Compared to control mice, those treated with 72-Gy, but not 24-Gy, irradiation had significantly increased tumor necrosis factor-α (TNF-α) (p < 0.01) and α-smooth muscle actin (αSMA) (p < 0.05) expression at 10 days and sig‑ nificantly increased expression levels of motif chemokine ligand-2 (CCL2), α-SMA, tumor growth factor-β1 (TGF-β1), type1 collagen, and interleukin-1β (IL-1β) (p < 0.05) in the muscles at 1 month by real-time PCR analysis. The results of immunohistochemistry showed that the deposition of type 1 collagen gradually increased in extracellular space after radiation exposure, and the positive area was significantly increased at 3 months compared to non-irradiated control. Conclusions A single dose of 72-Gy irradiation induced significant inflammation and fibrosis in the strap muscles of mice at 1 month, with immunohistochemical changes becoming evident at 3 months. This cervical irradiationinduced fibrosis model holds potential for establishing an animal model for RAD in future studies.

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.
Aging ; Birth Rate ; trends ; Child ; Child Health ; Environmental Exposure ; adverse effects ; prevention & control ; Female ; Health Planning Guidelines ; Humans ; Japan ; epidemiology ; Male ; Occupational Health ; Reproductive Health ; education ; Research Design ; standards ; Societies, Scientific ; organization & administration ; Stress, Psychological ; prevention & control ; Women's Health