To date, there are few real world data comparing the long-term efficacy of high dose liraglutide in Japanese patients with type 2 diabetes mellitus (T2DM). This study investigated the clinical efficacy and safety of high dose liraglutide in Japanese patients with T2DM in a real-world clinical setting. This retrospective study included 71 patients with T2DM (43 in a high dose liraglutide group and 28 in a control group) who had been using liraglutide at 0.9 mg/day for at least 3 months, and then the dosage was increased to 1.2 mg/day or higher at the physician's discretion to reinforce treatment, and this continued for 12 months. The primary endpoint was the change in HbA1c at 12 months in the high dose liraglutide group. HbA1c significantly decreased from 8.4% to 7.8% in high dose liraglutide group after 12 months and remained unchanged from 7.9% to 7.7% in the control group. Body weight significantly decreased from 75.9 kg to 74.2 kg in the high dose liraglutide group after 12 months. No patient in the high dose liraglutide group had to reduce or discontinue the dose due to side effects. Our study suggests that, in Japanese patients with type 2 diabetes with poorly controlled T2DM in clinical practice, if liraglutide 0.9 mg/day is not effective, high dose liraglutide can be expected to improve HbA1c and decrease body weight with few side effects.

With the full-scale transition to autonomous chemical substance management in April 2023, there has been a system shift that emphasizes autonomous decision-making regarding safety measures for most chemicals. Though stringent individual restrictions remain for substances with special regulations, understanding the physical and health hazards of all chemicals is crucial for preventing occupational accidents. While education and training are paramount, accidents involving legally regulated chemicals suggest incomplete worker education. This study investigated factors that influence the perception of the physical and health hazards of chemical substances governed by laws and regulations. A web-based survey using a multiple-choice questionnaire was distributed to 2,000 employees in Japanese manufacturing companies that handle chemicals. Aligned with prior research, the questionnaire encompassed aspects like basic attributes, experience, workplace education/training, knowledge and attitude toward chemicals, work experience, employment status, and regulatory perceptions. Analyses using Fisher’s exact probability test and logistic regression revealed that a significant proportion of employees, even those who do not directly handle chemical substances, perceived legally regulated substances to be more hazardous or toxic than non-regulated ones. Notably, awareness of specific regulations and familiarity with their existence were key factors shaping these perceptions. The survey found that knowledge regarding relevant laws and regulations is a major determinant of the awareness of the hazards and toxicity of legally regulated chemicals. This highlights the importance of disseminating clear information on such regulations to enhance overall understanding and safety.

This study evaluated Japan’s clinical approach to male menopausal disorders, assessing the number of patients, treatments, coexisting conditions, and new consultation morbidity using data from health insurance claims. We obtained 12 years of data (2010–2021) from insured person ledgers and health insurance claims of 14 health insurance associations. There were 595,796 enrollees in 2020, and 4,416,194 observation person-years in total. We extracted and compiled data on patients who had been diagnosed and treated for male menopausal disorders, including the treatment types and coexisting conditions. We calculated the annual male enrollees aged 20 to 70 in 2020, and determined the number of patients, treated cases, and new patient morbidity among male menopausal disorder patients. The highest prevalence was observed in the 55–59 age group: 133 patients (0.19%) in 2020 and 320 new patients (0.07%) from 474,500 person-years of observation in total. Sleep medications and anxiolytics (27%), antidepressants (23%), testosterone enanthate injections (14%), and herbal medicine (Hochuekkito, 12%) were the major prescribed medications. Sleep disorders (29%), neurotic disorders, and stress-related, somatoform (24%), and mood disorders (23%) were the common coexisting conditions. The low proportion of treatment-seeking patients and morbidities compared to the expected prevalence indicates a need for increased awareness and treatment of male menopausal disorders. Similar to prior surveys, patients with male menopausal disorders may have overlapping psychiatric conditions, necessitating careful diagnosis and treatment decisions.

We report a case in which we were able to control gingival bleeding. A patient with Acquired von Willebrand syndrome (aVWS) who had frequent bleeding from the gingiva in the malaligned area of the lower anterior teeth underwent tooth extraction and orthodontic treatment to improve the crowding in the anterior teeth. The patient was a woman in her 20s who had come to our hospital with the chief complaint of gingival bleeding from the upper and lower anterior teeth. Her current medical history included autoimmune hemolytic anemia, with epistaxis and menorrhagia. The patient underwent periodontal treatment, but the frequent gingival swelling and bleeding did not improve, and it was determined that marginal gingivitis due to dental malalignment was likely involved. Because there is a limit to the improvement of periodontal tissue by brushing in a crowded state, and because the patient also had aVWS, we believed that it was necessary to improve the crowding in order to improve the periodontal tissue. The patient underwent orthodontic treatment with tooth extraction because it was possible to extract the tooth under controlled conditions. The crowding on the front teeth was improved after orthodontic treatment, and brushing made it easier to remove plaque, which led to an improvement in the inflammation. The bleeding from the gums stopped, and the patient is progressing well, and is currently continuing to take medication. Her progress continues to be good after 9 years of orthodontic treatment. There are very few reports of this kind, and this is an extremely rare case of an aVWS patient whose dentition improved and gingival bleeding disappeared after orthodontic treatment using tooth extraction. We believe that it is necessary to consider not only systemic factors but also local factors in cases of oral bleeding.

63-year-old female had been aware of a light brown spot on her right heel for about 20 years prior to her first visit to our hospital. She had been seeing a dermatologist at a local doctor’s office for follow-up since 2009. She was referred to our Plastic Surgery Department in 2021 for a close examination of the spot on her heel, which was enlarging. Malignancy could not be ruled out, so she was referred from plastic surgery to our department. A 6 mm-sized dark brown macule was seen on the right heel margin on initial examination. Dermoscopy showed a uniform dark red macule with well-defined borders, unrelated to the papillae and sulcus, with scattered erythematous brown spots in the periphery. Although the clinical findings were suggestive of hemorrhage, we performed an excisional biopsy to rule out malignancy. The pathological findings were pigmented nevus with hemorrhage.

Since there is a lack of professional personnel who can implement Autonomous Chemical Management AC in small-scale companies, a simple implementation support tool is required instead of learning the complicated contents of the revised law of 2022. The purpose of this study was to compare and evaluate the requirements of the revised law with a pre-existing checklist of 49 items in 6 technical areas, and to reduce the number of checklist items by about half to make it easier to use in the field. The six technical areas that are covered in the existing AC were outlined as (1) workplace organization, (2) chemical identification and SDS preparation and labeling, (3) safe handling, (4) exposure monitoring and health screening and education and training, (5) waste management, and (6) emergency response. The participants were persons with no professional experience in handling chemicals (university students) and workers who handle chemicals. The number of items was reduced by having the participants score the priority of the items. The existing AC did not include items such as records of risk assessment and chemical control, handling of carcinogens, or protective equipment managers, while the revised law did not include safety items. In reducing the number of items, a division of upper and lower ranks was recognized between the 23rd and 24th items, so three items were added to allow room for future consideration, and the items from the top to the 26th (there were three items with the same rank of 24th for workers who handle chemicals) were designated as priority items. The majority of the priority items was included in Technical Areas 2 and 3. A new Autonomous Chemicals Management AC consisting of the top 26 priority items was compiled, and it is expected that the new Autonomous Chemicals Management AC, further improved by incorporating opinions of experts reviewing the items in the Delphi method and during the validation process, will be useful for implementing autonomous chemical management in small-scale companies in the future.

The purposes of this study were to collect information on the understanding of the contents (4 question items) and the implementation (22 obligatory items) of the revised law and regulations on autonomous chemicals management among chemical handlers working in small-scale companies (less than 100 employees), and to collect examples of actual preparations for “autonomous chemicals management” being implemented in small-scale companies immediately prior to the implementation of the revised law. A questionnaire survey was conducted on the Internet, targeting approximately 500 respondents. Descriptive statistical analysis, logistic regression analysis, and qualitative text mining analysis were conducted. The results indicated that as the size of the company decreased, the percentage of respondents who understood and implemented the revised laws decreased. The results showed that about 17% of the respondents had started autonomous chemical management. The common needs for implementation were training on the hazards of chemicals (64%), in-house human resources (54%), support from chemical management specialists and working environment measurement experts (31%), and external public support (30%). Among the 22 obligatory items required by the revised law and regulations, the percentage of implementation of guidance on the wearing of protective equipment was about 60%, while the percentages for the other items were 24–45%. The following were identified as examples of preparations in place: wearing dust-proof masks and safety glasses, thorough labeling of hazards, wearing protective gloves when handling chemicals, periodic training sessions with lecturers, work improvement, and measures to prevent injuries and other problems. Although a small number of the cases of preparedness were simple in content, some of the responses were workshops, work improvement, and preventive measures, which provided perspectives for the collection of more detailed and specific measures.

This study aimed to clarify how several factors influence the willingness of the general population to evacuate during chemical disasters. We compared local government officials and manufacturing industry workers, who may be responsible for or assist with evacuation efforts. The main variable of interest was the “willingness to evacuate during a chemical disaster”. Among the general population, higher age and less knowledge of the hazardous properties increased the intention to evacuate during a chemical disaster. Experience with a chemical disaster among local government employees, and knowledge of fire department actions among manufacturing industry workers, decreased the willingness to evacuate. This may result from the prioritization of disaster measures and evacuation support for the general population over individual evacuation. In the general population, “knowledge of the hazardous properties of chemical substances” resulted in an inhibition of evacuation behavior, suggesting that future research is required to clarify the conditions under which people should evacuate, depending on the concentration of hazardous chemicals, in order to lower exposure to hazardous chemicals.