Psychiatric disorders such as bipolar disorder and schizophrenia are highly heritable. While the genetic contribution to psychiatric disorders is quite sure, specific genetic factors contributing to particular conditions have long been a mystery. Empowered by the initial report of the Human Genome Project, the analysis of the comprehensive set of the human genome, called “genomics,” became possible. Subsequent development of large-scale genomic technologies enabled us to elucidate various disease-related genetic information, accelerating our understanding of various diseases. Genomic research on psychiatric disorders is not an exception. In this Review, I introduce significant advancements in psychiatric genomics with a special focus on our investigation of bipolar disorder. International consortiums and advocacy groups accelerate psychiatric genomics, increasing the sample size and statistical power for robust findings. The genetic architecture of schizophrenia has been elucidated in both common and rare variant studies. The genetic architecture of autism spectrum disorder (ASD) has been elucidated mainly by rare variant analysis. As to bipolar disorder, common variant analysis precedes rare variant analysis, but we are struggling to elucidate relevant rare variants. While the genomic approach has explained specific genetic factors for particular disorders, overlapping risk genes or pleiotropy has been observed more than expected. The boundary in the current nosology of psychiatric disorders is more or less challenged. To understand the genotype-phenotype relation more deeply, an attempt to understand phenotypes based on genotypes, called the “genotype first” approach, has started. I discuss this new approach for better understanding and treatment of psychiatric disorders.

The fundamental conception of delirium is altered arousal. In addition, sleep-wake cycle disturbances including insomnia, excessive daytime napping, and disintegration of the expected circadian patterns have been described as a characteristic component of delirium for decades, and demonstrated to be a core symptom domain of delirium. Although non-pharmacological interventions are successful to some extent, they have limitations due to various biological etiologies for delirium. Among pharmacological interventions, antipsychotics seem to be effective, but they are not suitable for preventive use because of relatively frequent side-effects such as extrapyramidal symptoms. Recently, new type of drugs for insomnia have been focused with respect to delirium prevention. Recent meta-analyses show effectiveness of melatonin receptor agonists and orexin receptor antagonists for delirium prevention, and real-world data support them.

Bipolar disorder is a mental disorder that involves a manic or hypomanic state and a depressive state, and was once called manic-depressive disorder and was considered one of the two major mental disorders along with schizophrenia. Major depressive disorder, on the other hand, is a disorder in which only depressive states occur, and the two are sometimes referred to together as “mood disorders. This review will introduce the pathophysiology, diagnosis, epidemiology, and treatment of bipolar disorder, focusing on the current situation in Japan.

On January 16, 2020, the first case of coronavirus disease 2019 (COVID-19) in Japan was reported. In the spring of the same year, the shortage of personal protective equipment (PPE) such as surgical masks became a significant issue. In addition, the medical staff had to encounter discrimination during this period. Thus, the mental health of these staff has been greatly affected by the social situation, the media coverage of the COVID-19 epidemic, and the shortage of PPE in hospitals.

Various factors make it difficult for the medical staff to seek professional help for mental well-being. Therefore, self-care plays an important role in the prevention of depression and anxiety disorders among healthcare workers. When the healthcare workers face problems in their work environment, they should coordinate with the hospital to promptly improve the system.

COVID-19 resulted in new societal norms and changed our lifestyles significantly. Insomnia is a particular issue among healthcare workers. Lifestyle analysis is thus necessary if insomnia needs to be addressed.

Because the opportunities for communication are reduced during the COVID-19 pandemic, conscious communication is essential. During this difficult time, the staff may not receive sufficient guidance from their superiors at work, for example for guidance received by resident doctors from their seniors. This will also provide opportunities to communicate vital information about matters such as infection control. Therefore, quality communication and accurate information should be directed toward all healthcare workers.

Osteoporosis is an important issue related to life expectancy and healthy life expectancy in Japan, where the super-aging population is growing. Currently, in Japan, some kind of assistance is needed for an average of 10 years at the end of life. In many cases the reason assistance is needed is loss of mobility due to a fracture caused by a fall. When people suffer one fracture due to osteoporosis, they are also more likely to have another fracture, which is called a secondary fracture. Breaking the negative chain of fractures is very important in osteoporosis. In addition, if patients suffer a loss of mobility due to a compression fracture of the spine, this activity cannot be regained even if the fracture is healed. To prevent this from happening, it is also important to heal fractures rapidly, so that patients can quickly return to normal life, thus extending healthy life expectancy.

Objectives To assess the delayed presentation of Retinal Detachment (RD), its association from travel distance to the referral hospital (TDH), the period from symptom onset to consultation (SO-C), Proliferative vitreoretinopathy (PVR) severity, and 6 months follow-up attendance (6mo-FA).

Method A retrospective review based on medical records. Age, sex, initial best-corrected visual acuity (BCVA), TDH, SO-C, PVR type, and 6mo-FA were recorded. Multivariable ordered logistic regression was used to analyze the association between TDH and SO-C, and SO-C and PVR severity. Multivariable logistic regression was used to analyze 6mo-FA according to TDH. Multiple linear regression was used to assess the association between initial BCVA and TDH. Age and sex were included in all multivariable adjustments.

Results A total of 387 patients had RD with 59.2% predominantly males and the mean age±SD was 46.3±13.9 years. The initial BCVA of less than 3/60 was 81.1%. The averages of SO-C and TDH were 183.5±456 days and 160.9±364 km, respectively. The TDH of more than 120 km distance was significantly associated with longer SO-C (adjusted OR 1.78; CI 95% 1.09-2.92). PVR was noted in 17.6% of patients. The SO-C of 31-60 days was significantly associated with PVR severity (adjusted OR 4.28; CI 95% 1.47-12.51). The TDH of more than 120 km distance was significantly associated with 6mo-FA (adjusted OR 0.46; CI 95% 0.27-0.93).

Conclusions Long TDH was significantly associated with a longer period from symptom onset to consultation and 6mo-FA. Hence, accessible eye care is essential to refer RD cases in a timely fashion.

Background The evolution of radiological technology is one of the most remarkable events of modern medical technology. Radiological examination has resulted in non-invasive, individual diagnostic imaging, which has contributed significantly to successful medical treatment of patients.

Key Concepts This review summarizes past and current Japanese educational systems for radiological technologists with a historical perspective focusing on three periods. The first period begins with Roentgen’s discovery of X-rays (1895), the second period begins with the establishment of the Radiological X-ray Technologist Act (1951), and the third period begins with the launch of the first university course for radiological technologists (1987). It is conceivable that those periods are in accordance with the technological paradigm shifts, including the development of contrast radiography and the application of CT and MRI to clinical practice. To maintain awareness of the most recent available technologies and maximize safety, educational programs teaching the latest knowledge were offered during each period.

Conclusions The advanced technologies require highly skilled radiological technologists and highly established educational systems. At present, over 70% of Japanese educational programs for radiological technologists are university courses leading to a bachelor’s degree. The increasing globalization of radiological technology requires future radiological education systems to have a global perspective.

Many thoracic surgeons revealed that consolidation tumor ratio or solid component size on thin-section computed tomography has been considered more prognostic than maximum tumor size in non-small cell lung cancer (NCSLC). According to the results, the 8^th TNM classification drastically changed the staging system, i.e., clinical T category was determined based on the invasive or solid component size excluding a ground-glass opacity (GGO). However, several debates are arising over the application of radiological solid size for the clinical T staging. Meanwhile, recent several institutional reports have noticed a significantly simple fact that the presence of a GGO denotes an influence on the favorable prognosis of NSCLC. More important, radiologic pure-solid lung cancers without a GGO exhibit more malignant behaviors with regard to both the clinical and pathological aspects, and show several histologic types that have a poorer prognosis than radiologic part-solid lung cancer. In contrast, favorable prognostic impact of the presence of a GGO component was demonstrated, which was irrespective of the solid component size in cases in which the tumor showed a GGO component. Recently, this concept has been gradually noticed on a nationwide level.

Obvious distinctions regarding the several baseline characteristics between the tumor with/without GGO component is a fundamental biological feature of early-stage lung cancer, which would result in a big difference in prognosis, modes of recurrence, overall behavior, and appropriate operative strategies. As a future perspective, the presence or absence of a GGO should be considered as an important parameter in the next clinical T classification.