The 2011 Great East Japan Earthquake (GEJE) has renewed the paradigm of disaster medicine. The Tohoku Journal of Experimental Medicine (TJEM) widened its scope to include the disaster science from the health perspectives. TJEM has been accumulating 76 articles related with “disaster” or “pandemic” out of which 69 were published after 2011. Tohoku University established the International Research Institute of Disaster Science (IRIDeS) that took initiative to impact the Sendai Framework for Disaster Risk Reduction 2015-2030 (Sendai Framework) to include health aspect. Sendai Framework provided the platform for collaboration of different sectors, including the terminology that defines the concept of disaster, risk, hazard & exposure, vulnerability and coping capacity. Disaster medicine covers the diverse causes and damages of disasters by various hazards in this globalized and rapidly changing world. TJEM articles range the physical and mental health damage after the GEJE and other disasters with approved ethical consideration of investigations from the view point of affected area, mechanisms of hazard to affect human health including the radiation, virus or hazardous materials, proposal of refinement of health system to cope with disasters such as mental health support, risk communication, disaster medical coordination and hospital business continuity plan and future perspectives with reconstruction including Tohoku Medical Megabank Project. TJEM scope on disaster medicine had been widened during the 10 years after GEJE and IRIDeS can be the bridging hub not only between the health sector and other sectors, but also between disaster medicine and other medical disciplines.

Despite ongoing concerns regarding its clinical application, mass spectrometry (MS)-based steroid assay represents a promising tool in endocrine research. Recent studies indicate that monitoring the blood levels of individual sterols provides improved diagnostic insight into hyperlipidemia compared with immunoassays routinely used in clinical practice. Hypercortisolism and hyperaldosteronism can also be easily evaluated along with successful subtyping of adrenal diseases using MS-based methods, while metabolic signatures of sex steroids provide experimental evidence of abnormal puberty and male infertility. Many MS-based biological and clinical studies are based on liquid chromatography-mass spectrometry (LC-MS) coupled to electrospray ionization and tandem MS scan modes. However, gas chromatography-mass spectrometry (GC-MS) provides better chromatographic separation. Improved chromatographic resolution enables large-scale steroid profiling to allow a bird-eye view and increase the chances of identifying potent biomarkers in endocrine research. In addition to the technical advantages of MS-based assays over immunoassays, minimizing the sample amounts with acceptable analytical sensitivity and standardization of surrogate materials provides cutting-edge tools for precision and personalized medicine.

In postural tachycardia syndrome (POTS), a subtype of orthostatic intolerance, the changes in hemodynamics due to postural changes are poorly understood. We speculated that inappropriate venous return, which may occur in the upright position in patients with school-aged POTS, could be detected by echocardiography. Our prospective study was conducted with 100 POTS patients (45 boys and 55 girls), aged 13.1 ± 1.5 years and 52 age- and sex-matched healthy subjects (control). Echocardiography was performed in the supine and sitting positions. Cardiac parameters [stroke volume index, cardiac index, heart rate, and the maximum inferior vena cava diameter (max IVC)] were evaluated in addition to pulse pressure. Unlike the control subjects, POTS patients demonstrated decreased stroke volume index (P = 0.02) and max IVC (P < 0.01) irrespective of posture. The rates of max IVC change did not differ between control and POTS groups. The enrolled POTS patients were divided into two subgroups [dilatation (n = 57) and contraction (n = 43)] based on whether the change rate of max IVC was less than zero or not. The contraction group showed a significantly higher heart rate than the dilatation group with respect to posture (P = 0.03), indicating the poor response of peripheral vessels in the lower limbs only in the contraction group. In conclusion, echocardiographic assessment detected decreased stroke volume and venous return in POTS. The changes in max IVC in response to postural changes may indicate an underlying pathophysiology in POTS.

Communication between parents and their children’s coaches is important for children’s sports activities, but the relationship between parents and coaches is not well understood. It is possible that parents feel a lack of communication with coaches, which could be due to parents’ experience with sports activities or the social environment of the team. This study aimed to elucidate the characteristics of parents who feel a lack of communication with their children’s coaches of youth sports. A cross-sectional study was conducted on parents of young athletes (n = 6,641) and multivariate logistic regression analyses were performed to assess factors related to parents’ feeling of a lack of communication with their children’s coaches. Among the respondents, 29.4% of parents felt a lack of communication with their children’s coaches. The factors related to the parents’ feeling were a shorter duration of their children playing the present sport, an absence of experience playing the same sport as their children or playing in a team with high competition level, dissatisfaction with their children’s attitude towards sports activities, and an awareness of verbal and/or physical abuse by the coaches and bullying by the teammates in their children’s team. Parents’ previous sports experience and awareness of interpersonal violence in their children’s team were associated with their feeling of a lack of communication with coaches. Educating parents on the sport and their roles in youth sport is necessary to make appropriate mutual communication between parents and coaches, which could lead to better circumstances for young athletes.

Subarachnoid hemorrhage is typically present in cerebral aneurysm rupture, whereas acute subdural hematoma without subarachnoid hemorrhage is rare. We herein report a case of cerebral aneurysm rupture during pregnancy resulting in acute subdural hematoma without subarachnoid hemorrhage. A 37-year-old gravida 4 para 3 pregnant woman was admitted for threatened preterm labor at 29^4/7 weeks of gestation. At 29^6/7 weeks of gestation (day −14), she developed mild left eye pain, which disappeared within one day. At 31^6/7 weeks of gestation (day 0), she developed the sudden onset of severe headache and nausea. A neurological examination revealed no abnormal findings, and analgesics ameliorated her headache. At 32^1/7 weeks of gestation (day 2), after consultations with neurosurgeons, magnetic resonance imaging showed acute subdural hematoma without subarachnoid hemorrhage. Further examinations revealed a cerebral aneurysm. Emergent clipping surgery was performed with the fetus in utero in consideration of the immaturity of the fetus and stable maternal/fetal general conditions. At 35^6/7 weeks of gestation (day 28), her headache of unknown cause recurred. Considering the maturity of the fetus, the patient underwent cesarean section with good maternal and neonatal outcomes. The absence of subarachnoid hemorrhage does not eliminate cerebral aneurysm rupture.

Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19−related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.