Greater workplace social capital (WSC) can be related to workers’ health and productivity. We sought to clarify the association between horizontal WSC and presenteeism and sickness absence (SA) and to examine the effects of psychological distress on these associations among Japanese workers. A cross-sectional study was conducted in 2017 at seven large Japanese companies. Logistic regression analysis was performed with presenteeism and SA as the dependent variables, horizontal WSC as an independent variable, and sociodemographic characteristics and psychological distress as covariates. After adjustment for sociodemographic characteristics, the results showed that greater horizontal WSC was associated with lower presenteeism and SA. The odds ratios for the relationship between horizontal WSC and presenteeism and that between horizontal WSC and SA dropped moderately after adjustment for psychological distress but remained significant. Further exploration of the factors underlying the relationship between WSC and productivity is needed to confirm if WSC enhances workers’ health and productivity and to inform the development of effective occupational health initiatives.

This study aimed to assess the efficacy of a text messaging intervention that offered pregnancy and childbirth support. Participants included 39 primigravid women who were less than 12 weeks pregnant. Text messages were sent twice weekly to the intervention group from week 13 of pregnancy until childbirth. Outcome measures were anxiety levels, lifestyle in the month before birth, pre-birth weight, pregnancy complications, delivery complications, birth weight, thoughts regarding the text messages, and the frequency of viewing of the text messages. For the item “I engage in body stretching,” the average value in the intervention group was significantly higher than that in the control group. For the item “I have regular bowel movements,” the average value in the intervention group was significantly lower. Most participants reported that the intervention was at least somewhat useful. This study indicates that text messaging intervention is practical and can be used to support numerous pregnant women simultaneously at a relatively low cost. Since this is a study pilot trial, large-scale studies are necessary to improve the method and allow for the generalization of the results.

Management of early nutrition plays an important role in the treatment of acute pancreatitis patients, but the sample sizes of randomized control trials that have compared enteral and parental nutrition were small. From the data of Diagnostic Procedure Combination, we identified patients who had been diagnosed with acute pancreatitis and discharged from the hospital between 2014 and 2015. We compared the length of hospital stay and hospital mortality among patients with acute pancreatitis that was managed with and without enteral nutrition within 7 days from hospitalization. The results showed a significant decrease in the in-hospital mortality rate of 56% (odds ratio 0.444, 95% confidence interval [CI] 0.358 − 0.551, P < 0.001) and length of hospital stay by 8.6 days (95% CI -9.05 − -8.13, P < 0.001) when enteral nutrition was administered within 7 days. According to multivariate analysis, early enteral nutrition was independently associated with in-hospital mortality rate and length of hospitalization. Enteral nutrition is an important management method for the treatment of acute pancreatitis patients.

The aim of the present study was to investigate the association between work engagement and long-term sickness absence due to mental disorders such as mood disorders and anxiety, and whether the relationship differs between men and women, during a 4-year follow-up period. Data were obtained from 21,293 workers at four pharmaceutical companies belonging to the Collabo-Health Study Group in 2014. The baseline data were collected by self-administered questionnaires. We obtained information about long-term sickness absence from the personnel records of the surveyed companies from the baseline survey in 2014 until March 2018. Hazard ratios (HRs) and 95% confidence intervals (CIs) using the low work engagement group as a reference were calculated by Cox proportional hazards analysis as the outcome, defined as the period leading to mental health-related sick leave. A total of 12,025 participants had complete data for analysis, and 123 exhibited long-term sickness absence during a 4-year follow-up period. The high work engagement group for men had a significantly lower HR (0.52, 95% CI: 0.31–0.88, P = 0.015) compared with the low work engagement group. Conversely, among women, the moderate work engagement group had a significantly higher HR (2.44, 95% CI: 1.03–5.84, P = 0.043) compared with the low work engagement group. Work engagement in men may predict the occurrence of long-term sickness absence due to mental disorders in the subsequent four years, but this relationship was different in women. Further research is needed to clarify this issue.

We investigated the adsorbed amount of organic solvent vapors and adsorption rate of a new porous carbon material made from rice husk (rice husk activated carbon) in comparison with those of coconut shell activated carbon by the breakthrough curve. The adsorbed amount on the rice husk activated carbon and that on the coconut shell activated carbon were 81.3 ± 3.3 mg/g and 71.7 ± 5.0 mg/g for acetone, 8.0 ± 1.7 mg/g and 6.3 ± 0.2 mg/g for methanol, 196.8 ± 8.8 mg/g and 262.8 ± 10.4 mg/g for ethyl acetate, 234.8 ± 11.9 mg/g, and 364.6 ± 43.8 mg/g for toluene, respectively. These results suggest that the amount of organic solvent vapors adsorbed per unit weight of rice husk activated carbon is slightly larger for high polar compounds and is smaller for low polar compounds than that of coconut shell activated carbon. We compared the adsorption rate of the two materials by using the slope of the breakthrough curves. Even though there are some limitations to the characteristics of the new porous carbon material, it may be possible to use rice husk activated carbon as an alternative to coconut shell activated carbon in occupational and environmental measures.

This paper provides a picture of the observations made over three hundred years ago by Bernardino Ramazzini (1633−1714) in light of current topical issues ranging from health problems related to work and lifestyle habits to the current burdensome COVID-19 pandemic. The main aspects of his work consist of descriptions of disorders linked to environmental risks, suggestions for measures for risk protection, and recommendations for healthy living. This paper focuses on Ramazzini’s most relevant achievements by (1) analyzing the episodes that stimulated the composition of his main work and highlighting some observations on which current epidemiological and toxicological studies are based; (2) reviewing his work showing not only the systematic descriptions of work-related illnesses caused by occupational factors but also his sound etiological and physiopathological contributions to the field of occupational lung diseases, breast cancer, and environmental disorders; and (3) remarking on his main observations in the fields of risk prevention and health promotion, also in the light of some highly topical issues related to unhealthy lifestyle habits and the COVID-19 pandemic.

A 60-year-old woman with a 37-year history of rheumatoid arthritis (RA) had a sudden onset of headache. Head MRI showed acute multiple infarctions in the vertebrobasilar region, and MR angiography showed stenosis of the right vertebral artery (VA). 3D-CT angiography of the craniovertebral junction showed atlantoaxial subluxation and stenosis of the right VA just distal to the transverse foramen of C2, which was due to osteophytes and degenerative changes secondary to RA. Digital subtraction angiography clearly demonstrated occlusion of the right VA during rightward head rotation. Based on those findings, rotatory instability at C1-2 was considered as the primary cause of the vertebrobasilar infarctions, and Bow Hunter’s syndrome was diagnosed. The patient underwent C1-5 posterior fixation, and brain infarction has not recurred.

A sufficient dose of radiation is difficult to administer in re-irradiation for local recurrence of cancer after radiotherapy because of the dose limitation to organs at risk. Re-irradiation cases also include radioresistant tumors that are difficult to control locally, and their prognosis is poor in general. The effect of re-irradiation using intensity-modulated radiotherapy (IMRT) has recently been reported to significantly reduce the dose to organs at risk, and the efficacy of hyperthermia has been reported for radioresistant tumors. We report a case of local recurrence after concurrent chemoradiotherapy treated with salvage re-irradiation using IMRT and chemotherapy combined with hyperthermia in a patient with nasopharyngeal carcinoma, and include a discussion of the literature.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct procedure designed to sustain the circulation until definitive hemostasis is obtained. The device is indicated in trauma patients with abdominal trauma and/or pelvic fractures, but there is limited evidence for its use in gastrointestinal bleeding. A 76-year-old woman was admitted to the emergency department of our hospital because of shock, manifesting as hematemesis. We performed emergency endoscopy and detected active bleeding from a gastric ulcer. Achieving hemostasis was difficult, and she experienced shock again during the procedure, leading to cardiopulmonary arrest. REBOA was performed after the return of spontaneous circulation because she continued to be in a state of shock. Her blood pressure rose, and endoscopic hemostasis was continued with balloon inflation, but it didn’t stop the bleeding completely, so we shifted to emergency laparotomy and performed suture hemostasis. The patient developed no postoperative complications and was transferred to another hospital. REBOA can be effective at improving the hemodynamic status in patients with uncontrollable gastrointestinal bleeding.

近年，医師の地域偏在対策として様々な取り組みがなされているが，その中で地域の教育水準が医師の地理的分布に与える影響に着目したものはない．本研究では，地域の教育水準と医師の地域偏在との関連を検証するために，政府等の公開データを用いて分析を行った．分析方法として多重線形回帰を用い，二次医療圏毎の人口10万人あたり医師数を被説明変数，偏差値60以上高等学校（以下 高校と省略）数，人口10万人あたり診療所数，人口10万人あたり病床数，高齢化率，外来受療率，人口密度，医学部の有無を説明変数とした．その結果，各二次医療圏において偏差値60以上の高校が1校でもあれば人口10万人あたりの医師数を有意に増加させ，さらに2校以上になると医師数はより増加することがわかった（P<0.05）．加えて，私立高校を除き国公立高校のみを用いて分析した場合も，また二次医療圏における偏差値60以上の高校数ではなく，偏差値65以上の高校数を用いた場合も同様の結果が得られており，地域における入試偏差値の高い高校の存在が医師の分布に及ぼす影響は十分に確かであると考えられる．このことから，医師の地域偏在対策として，地域の教育環境を充実させることも検討すべきである．