The Tokyo 2020 Olympic and Paralympic Games (the Games) were held from 23 July to 5 September 2021 in Tokyo, Japan, after a 1-year delay due to the coronavirus disease (COVID-19) pandemic. The Tokyo Metropolitan Government was responsible for monitoring and responding to infectious disease outbreaks other than COVID-19 during the Games. A multi-source surveillance system was used from 1 July to 12 September 2021 for the early detection and rapid response to infectious diseases. This included routine notifiable disease surveillance, sentinel surveillance, syndromic surveillance, cluster surveillance, ambulance transfer surveillance and the Tokyo Infectious Alert system. Daily reports were disseminated summarizing the data collected from the multi-source surveillance system. No case of infectious disease under the Tokyo Metropolitan Government system required a response during the Games. The multi-source surveillance was useful for providing intelligence during the Games and, if required, could contribute to the early detection and rapid response to outbreaks during other mass gatherings. The system could be improved to overcome the challenges implied by the findings of this multi-source surveillance.

Objective: In Japan, the healthcare authority encourages physicians to prescribe generic drugs in order to reduce the copayments by the patients for pharmaceutical expenses and to improve the financial status of the national medical insurance system.  In accordance with this governmental policy, we have been actively involved in switching original to generic formulations.  Thus, Utemerine® 50 mg injection was replaced with Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.  There have been some reports on adverse events caused by the generic formulations of Ritodrine hydrochloride.  Factors contributing to these adverse effects may include different additives and/or vehicles and the exemption of demonstrating some conditions for approval, including clinical trials.  Therefore, in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation and to decide on its continued use, we carried out a retrospective cohort study.
Methods: We carried out a retrospective cohort study in order to assess the efficacy and safety of a generic formulation of Ritodrine hydrochloride injection formulation compared with the original formulation.
Results: There were no significant differences in the length of hospital stay, rate of emergency transport to other institutions, gestational week of delivery, rate of stillbirth, rate of abortion, or incidence of adverse events between the two formulations.
Conclusion: Our results may contribute to the safe and secure use of the generic formulations of Ritodrine hydrochloride in the current situation of the increasing use of generic drugs in health care.  Although there are some limitations in our study, the results suggest that there are no particular problems with the continued use of Ritodrine hydrochloride 50 mg intravenous injection produced by Nichiiko.

  In this study, we aimed to clarify the socio-cultural factors affecting the mental and physical health of pregnant and puerperal Brazilian women living in Japan. The study participants were 18 pregnant and puerperal Brazilian women living in two prefectures with large Brazilian populations. A Japanese investigator and a Portuguese interpreter comprised the team, and conducted semi-structured interviews at the participants’ homes. The study period was between 2013 and 2014. The interviews were carried out using the Cultural Determinants of Help Seeking theory. Analytical ethnography was used for data coding and theme extraction.

  The results revealed that “worry” and “shoulder and back pain” were the most common mental and physical symptoms, followed by “headache,” “irritability and anger,” “insomnia and sleeplessness,” and “anxiety.” The reasons given for these included: “pregnancy and child rearing;” “anxiety about work and income;” “complications of being a foreigner;” and “the absence of someone to depend upon.” Moreover, the following five core categories of socio-cultural factors influencing these causes were extracted: “equal and deeply connected family;” “strength to continue working;” “choosing the right conditions to settle down in;” “low satisfaction with the healthcare system;” and “the blessings of God.”

  Pregnant and puerperal Brazilian women living in Japan have various mental and physical distress symptoms, and our findings revealed that differences between Brazilian and Japanese patterns of family life and religion were the major influencers on these. These findings must be understood to provide intervention in order to lead pregnant and puerperal Brazilian women to appropriate health behaviors.

OBJECTIVE: To investigate the clinical feasibility of dual energy subtraction (DES) imaging to improve the delineation of the vocal cord and diagnostic accuracy of vocal cord paralysis as compared with the anterior-posterior view of flat panel detector (FPD) neck radiography. MATERIALS AND METHODS: For 122 consecutive patients who underwent both a flexible laryngoscopy and conventional/DES FPD radiography, three blinded readers retrospectively graded the radiographs during phonation and inspiration on a scale of 1 (poor) to 5 (excellent) for the delineation of the vocal cord, and in consensus, reviewed the diagnostic accuracy of vocal cord paralysis employing the laryngoscopy as the reference. We compared vocal cord delineation scores and accuracy of vocal cord paralysis diagnosis by both conventional and DES techniques using kappa statistics and assessing the area under the receiver operating characteristic curve (AUC). RESULTS: Vocal cord delineation scores by DES (mean, 4.2 +/- 0.4) were significantly higher than those by conventional imaging (mean, 3.3 +/- 0.5) (p < 0.0001). Sensitivity for diagnosing vocal cord paralysis by the conventional technique was 25%, whereas the specificity was 94%. Sensitivity by DES was 75%, whereas the specificity was 96%. The diagnostic accuracy by DES was significantly superior (kappa = 0.60, AUC = 0.909) to that by conventional technique (kappa = 0.18, AUC = 0.852) (p = 0.038). CONCLUSION: Dual energy subtraction is a superior method compared to the conventional FPD radiography for delineating the vocal cord and accurately diagnosing vocal cord paralysis.
Absorptiometry, Photon/*instrumentation/*methods ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Sensitivity and Specificity ; Subtraction Technique ; Vocal Cord Paralysis/*radiography ; Vocal Cords/radiography ; *X-Ray Intensifying Screens ; Young Adult

Coix lacryma-jobi L. var.ma-yuen Stapf (Coix seed) is a grass crop that has long been used in traditional medicine as a nourishing food. However, high-intake safety of the extract of the husks, pellicles and astringent skin of Coix seed has rarely been evaluated. We performed a safety test of hot water extract of all parts of Coix seed (CRD extract) in rats. CRD extract showed no significant toxicity on body weight, blood analyses, urinalysis and histopathological examination in acute toxicity tests.

Coix lacryma-jobi L. var.ma-yuen Stapf (coix seed) is a grass crop that has long been used in traditional medicine as a nourishing food. However, high-intake safety of the extract of the husks, pellicles and astringent skin of coix seed has rarely been evaluated. We performed a 28-day repeated dose oral toxicity test of hot water extract of all parts of Coix seed in rats. The extract showed no significant toxicity on body weight, blood analyses, urinalysis and histopathological examination in acute toxicity tests.

The supply center of the Atsumi Hospital handles medicines, medical supplies, slips, stationery, daily necessities, resterilized things, laundries, linen and washing beds among many others. The center is striving to raise the efficiency of the flow of materials within the hospital and undertakes logistics management single-handed. In January 2003, one copier and one lithographic unit out of the total four duplicating and printing machines in the hospital were removed to the suppy center. Since then, the center has been responsible for handling these machines for individual users. How effective this office meanagement system was in saving time, cutting down on costs and increasing the degree of satisfaction felt by employees was examined as part of TQM activities.Between June 2003, when the advance booking system was adopted for the use of the two machines, and January 2004, it was found that the monthly reservation ratio averaged out 38.3%. A questionnaire survey also found that many menbers of the staff were satisfied as they could make good use of time. As regards cost reduction, the monthly rental for the copying machine was curtailed to ¥57,000. This was made possible as members of the supply center made proper use of the copier and lithography.
Copying Processes ; Economic supply ; Agent ; Central ; Hospitals

Today, the circumstances surrounding the medical economy are severer than ever. Therefore, it is vitally important for a hospital to rationalize management and implement a labor-saving system drastically.In October 2000, Atsumi Hospital moved to a newly built complex. At that time, those sections and departments which do not have any direct relation to medical treatment and care were restructured and established a supply center in order to use human resources effectivily.Before the establishment of the supply center, we had reviewd simple, routine tasks such as ward nursing assistant services, office work and management itself. While introducing our hospital supply center in this paper, we compare efficiencies before and after the move to the new building and dwell on advantages of centralization of ward nursing services.The rearrangement of the personnel, materials and information has made it possible to increase the efficiency of simple work and reduce the number of nursing assistants by 20%. Henceforth, it would be necessary to educate the staff, work on proper personnel changes, carefully make a plan for outsourcing, and choose trustworthy dealers.
Human Resources ; Work ; Economic supply ; Effective ; Central