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Enzootic bovine leucosis (EBL) is a neoplastic disease of cattle caused by Bovine leukaemia virus (BLV). EBL causes great economic losses, so a fast and reliable diagnostic method is critical for understanding the status of BLV. This will allow us to control BLV infections efficiently and mitigate economic losses. In this study, we established a direct diagnostic test for BLV using dried blood‐spotted filter papers without sample pre‐treatment. The study was based on 159 clinical blood specimens collected in EDTA from one farm in Kyushu, Japan. The blood‐spotted filter papers were used as the template for direct filter PCR. When an ELISA was used as the diagnostic gold standard, the sensitivity and specificity of the direct filter PCR were 90.1% and 97.5%, respectively. The kappa value for the direct filter PCR and real‐time PCR methods was 0.97. The dried blood samples spotted onto filter papers were stable for at least 10 days at room temperature, even when the samples were from cattle with a low BLV proviral load. Direct filter PCR is a rapid, easy, reliable and cost‐effective diagnostic test that directly detects the BLV proviral genome in clinical blood specimens without DNA extraction. Moreover, it simplifies the collection, transportation and storage procedures for clinical blood specimens. [ABSTRACT FROM AUTHOR]

Travertines are hot spring carbonate deposits that exhibit characteristic fabrics, including a paper-thin raft and a coated bubble formed by the calcification of water and bubble surfaces, respectively. A previous study interpreted that compared with the water surface, the bubble surface displays more active CO 2 degassing and resultant active CaCO 3 precipitation. However, considering the CO 2 partial pressure and the volumes of atmosphere and bubbles, it is possible that more active CO 2 degassing occurs on the water surface. In addition, the surfaces of water and bubbles at the travertine-depositing sites are negatively charged, but it is still unclear whether the CaCO 3 nucleation on these surfaces occurs via amorphous precursors, like the CaCO 3 nucleation on negatively charged organic matter. This study provides a solution to these uncertainties by examining the aragonitic travertines formed in the Nagayu area of Japan. Through field observations, two types of paper-thin rafts were recognized: one with a smooth surface and formed in approximately 1 h, and the other with a rough surface and formed in approximately 3 h. In addition, the bubbles generated on the microbial mat during the daytime were covered with white minerals within an hour, and with ivory-colored minerals over 8 h after sunset, forming firm coated bubbles. Microelectrode measurements revealed that the active CO 2 degassing on the water surface significantly increased the CaCO 3 saturation state to cause active CaCO 3 precipitation. In contrast, less active CO 2 degassing on the bubble surface did not increase the saturation state, and moderate CaCO 3 precipitation occurred due to the moderately high saturation state of the hot spring water. Various microscopic observations revealed that the smooth-surfaced paper-thin raft comprises a micritic layer of approximately 10–20 μm, which represents tightly arranged submicron-sized granular aragonite. At the lower surface of this layer, hemispherical aragonite partially grew toward the hot spring water. In addition, the rough-surfaced paper-thin raft and coated bubble comprise bundled and acicular aragonites arranged along the surfaces of water and bubble, from which hemispherical aragonite grew toward the hot spring water. Neither the paper-thin raft nor the coated bubble contains primary amorphous CaCO 3. These results suggest that the smooth-surfaced paper-thin raft is formed by active CaCO 3 nucleation on the water surface and subsequent crystal growth, and that the water surface is unfavorable for preserving the amorphous precursors potentially involved in the nucleation. The rough-surfaced paper-thin raft and the coated bubble could have been formed by the attachment of externally formed acicular aragonite to the water/bubble surface and subsequent crystal growth. The revealed formation processes of the paper-thin raft and coated bubble provide valuable information for interpreting their formation mechanism in other travertine deposits, including those in the geological past. [ABSTRACT FROM AUTHOR]

This study is applying critical discourse analysis (CDA) to mission statements of civil society organizations (CSOs) in the Kansai area of Japan to examine how those texts may be reflecting their views on migration and impacting their practices related to international students. The analysis shows similarities across CSO types in choosing organizational names, using vague and bureaucratic vocabulary for formulating their mission statements, as well as confusing and contradictory style of some statements and event announcements that may be misleading or discouraging for potential members. At the same time, diversity of vocabulary referring to their target audience demonstrates shifting perspectives of CSOs on international students and more generally, on foreigners living in Japan.

The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital tooth bleaching with a mixture of sodium perborate and 30% hydrogen peroxide rolled in Japanese paper for a traumatically injured tooth, and in-office vital-tooth bleaching for the upper front six teeth and first premolars, were performed. Five-year follow-up showed satisfactory stability in the bleaching effects and did not show any problems in the traumatically injured tooth. The use of Japanese paper for non-vital tooth bleaching may minimize damage to discolored non-vital teeth.

Aim: To explore the health beliefs of clinical and academic nurses from Japan, Australia and China regarding wearing paper masks to protect themselves and others, and to identify differences in participants' health beliefs regarding masks., Background: The correct use of face masks and consensus among health professionals across the globe is essential for containing pandemics, and nurses need to act according to policy to protect themselves, educate the public and preserve resources for frontline health workers. Paper masks are worn by health professionals and the general public to avoid the transmission of respiratory infections, such as COVID-19, but there appear to be differences in health beliefs of nurses within and between countries regarding these., Methods: This qualitative descriptive study used content analysis with a framework approach., Findings: There were major differences in nurse participants' beliefs between and within countries, including how nurses use paper masks and their understanding of their efficacy. In addition, there were cultural differences in the way that nurses use masks in their daily lives and nursing practice contexts., Conclusion: Nurses from different working environments, countries and areas of practice hold a variety of health beliefs about mask wearing at the personal and professional level., Implications for Nursing Policy and Health Policy: The COVID-19 pandemic has sparked much discussion about the critical importance of masks for the safety of health professionals, and there has been considerable discussion and disagreement about health policies regarding mask use by the general public. Improper use of masks may have a role in creating mask shortages or transmitting infections. An evidence-based global policy on mask use for respiratory illnesses for health professionals, including nurses, and the general public needs to be adopted and supported by a wide-reaching education campaign., (© 2020 International Council of Nurses.)

We conducted an event study on the concealment of the blending ratio of waste paper with virgin pulp in Japan. By investigating 10 companies in the paper industry between May 30, 2007 and January 18, 2008, we clearly show that stock prices of the relevant companies were affected by the news on the concealment of the blending ratio of waste paper. In addition, the impact of the second event was found to be greater than that of the first event. Therefore, the concealment of major companies negatively affects the stock prices of non-major companies, which did not conceal information during this period. Thus, bad news is negatively assessed by the market, and this influence has spread in the paper industry in general. [Copyright &y& Elsevier]

Abstract: A novel carbon paper has been prepared by pyrolysis from traditional Japanese paper called washi in Japan, which is mainly composed of cellulose microfibers. The washi was iodine-treated before pyrolysis. The effect of iodine-treatment on pyrolysis of the washi was investigated using thermogravimetric analysis. The structural and electrical properties of the carbon papers were also investigated using Raman scattering, X-ray diffraction, electron microscopy, and resistivity measurements. The iodine-treatment prevents cellulose from thermally decomposing and is effective in increasing the carbon yield and retaining its fibrillar structure. Porous carbon papers consisting of many micro and nanofibrils were prepared by the pyrolysis of the iodine-treated washi at 800°C. Those prepared at 800°C and then heat-treated at higher temperatures than 1800°C show electrical conductivities of 3Scm−1 and 24–27Scm−1. The degree of crystallinity and the electrical conductivity of the papers are improved by the heat treatment at higher temperatures. [Copyright &y& Elsevier]

Background: As the volume of scientific publications increases, the rate of retraction of published papers is also likely to increase. In the present study, we report the characteristics of retracted papers from clinical neurosurgery and allied clinical and basic science specialties. Methods: Retracted papers were identified using two separate search strategies on PubMed. Attributes of the retracted papers were collected from PubMed and the Retraction Watch database. The reasons for retraction were analyzed. The factors that correlated with time to retraction were identified. Detailed citation analysis for the retracted papers was performed. The retraction rates for neurosurgery journals were computed. Results: A total of 191 retractions were identified; 55% pertained to clinical neurosurgery. The most common reasons for retraction were plagiarism, duplication, and compromised peer review. The countries associated with the highest number of retractions were China, USA, and Japan. The full text of the retraction notice was not available for 11% of the papers. A median of 50% of all citations received by the papers occurred after retraction. The factors that correlated with a longer time to retraction included basic science category, the number of collaborating departments, and the H-index of the journal. The overall rate of retractions in neurosurgery journals was 0.037%. Conclusions: The retraction notice needs to be freely available on all search engines. Plagiarism checks and reference checks prior to publication of papers (to ensure no retracted papers have been cited) must be mandatory. Mandatory data deposition would help overcome issues with data and results. [ABSTRACT FROM AUTHOR]

This paper describes a patient identification system with a disposable paper card. In general, total costs of cards themselves, equipments and personnel are remarkable, not negligible for the hospital management. Therefore, a disposable identification cards made of a paper were issued to out-patients in our hospital. Many order forms were integrated into only one sheet. Patient identification data were printed on this sheet by a computer system when a patient came to the reception desk, and quickly transmitted to physicians. We could save the hospital costs and printing works by physicians, and also shorten the waiting time of patients at reception desks.

The Clinical Practice Guidelines for Bladder Cancer edited by the Japanese Urological Association were first published in 2009 and a revised edition was released in 2015. Four years has passed since the 2015 edition, and the clinical practice environment surrounding bladder cancer has drastically changed during that time. The main changes include: (i) insurance coverage of a new diagnostic method for non-muscle-invasive bladder cancer; (ii) insurance coverage of an immune checkpoint inhibitor in advanced and metastatic bladder cancer; and (iii) advances in robot-assisted radical cystectomy as a minimally invasive treatment for muscle-invasive bladder cancer. A paradigm shift in bladder cancer diagnosis and treatment is occurring day by day. Therefore, in this 2019 edition, while dealing with the above changes, we carefully selected clinical questions with clear evidence and included other clinically important points in the general statement. We also added a new chapter on rare cancers of the urinary tract. As a new method for the evaluation of study evidence level, we introduce "The Grading of Recommendations Assessment, Development and Evaluation" system modified to Japanese by the Medical Information Network Distribution Service., (© 2020 The Japanese Urological Association.)

The article discusses the papers by Professors Kosoto and End&#x014D on the development of a number of important schools in Japanese "Kanp&#x014D" which is traditional Japanese medicine from ancient China. It describes relationship between different schools of medicine in Japan and between eastern and western medical arts on their development point to a common Japanese thinking. The importance of obtaining necessary foundation for understanding the papers is also included.

To examine trends in educational practice research, this article conducted a survey and analysis of factors affecting the review of research papers in the field of the educational technology in Japan. Two factors, namely, practical orientation and theoretical orientation, were extracted from 63 survey responses, and scores from members of a Japanese academic society were compared with the scores of its editorial board. Results show that the two factor scores were not correlated to each other, and they are independent measures for any evaluation or review of research articles. Also, there was no significant difference between society members and editorial board members, i.e., their preferences when reviewing research papers were identical. For the second part of this study, a group composed of anonymous members of an editorial board conducted a paper review of 12 published “practical papers” and 11 published “general papers.” Results indicated that there was no significant difference between the two categories. The final rating scores of these 23 papers were analyzed using a decision-tree rating model. Results also indicated that for publication, papers need to contribute to theoretical research, in addition to contributing to basic educational practice research in educational technology. [ABSTRACT FROM AUTHOR]

This publication seeks to consider statistics education in Japan while referencing a student paper. The paper to be considered is as follows: "Gakusei no Koudou ga Gakusei Seikatsu Manzokudo ni Ataeru Eikyou" (The Influence of Student Behavior on the Degree of Satisfaction Perceived in Student Life).

Objectives: Digitised patient-reported outcome may be beneficial for physicians and patients. The Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) can only be completed with paper and pencil (pJHEQ). We newly developed a web version of the JHEQ (wJHEQ). This study aimed to determine whether the scores obtained with the wJHEQ are equivalent to those from the pJHEQ, how much the wJHEQ would decrease missing answers, and which JHEQ the participants preferred to use. Methods: To measure equivalence between the pJHEQ and wJHEQ, we evaluated the mean score difference for each subscale (pain, movement, mental) and Visual Analogue Scale (VAS; satisfaction, right hip pain, left hip pain) and then assessed the intraclass correlation coefficients (ICC) between the two scores. ICC values ≥0.75 were defined as excellent agreement. We used Bland-Altman analysis to assess level of agreement between the values of the two questionnaires. We compared the number of incomplete forms and amount of missing data between the two questionnaires. We investigated ease of use by asking the participants which format was easier to use. Results: This study comprised 113 patients (mean age 58.1 years, 81% female) with hip disease. Mean score differences for each subscale between the wJHEQ and pJHEQ were not significantly different. The values of ICC for each subscale and each VAS were all >0.75. All 113 participants completed the wJHEQ questionnaire, whereas nine patients did not complete the pJHEQ form. There was a significant statistical difference between the completion rate of the wJHEQ and that of the pJHEQ ( p  = .0017). Fifty-seven participants (55%) preferred the wJHEQ, whereas 33 participants (32%) preferred the pJHEQ. Conclusion: The wJHEQ was found to be equivalent to the original pJHEQ. The wJHEQ significantly decreased the numbers of missing answers and incomplete forms. The participants felt ease of use was nearly equivalent. The wJHEQ might help facilitate more complete assessments in clinical trials and research.

Abstract: Using the Kobe earthquake of 1995 and the Mid-Java earthquake of 2006 as case studies, this paper discusses the process of providing cultural recovery assistance; it also analyses the term ‘civil society’, a term that reflects efforts to make assistance activities sustainable. The Kobe earthquake should be seen as a point of departure for citizen activism by volunteers; because of it, cultural recovery support was vigorously provided. Since people influenced by those support efforts later became involved in providing Mid-Java earthquake recovery assistance, both earthquake recovery support initiatives can be seen as part of an ongoing chain of events. In analysing the Kobe earthquake, it becomes clear that while there are many semantic meanings for and usages of the term ‘civil society’, it was incorporated into policy guidelines for recovery during a period of low economic growth, and a new civil society was envisioned in this period of social transformation. Organisations participating in assistance efforts following the Mid-Java earthquake sought to make ‘civil society’ a reality; this continued after the earthquake recovery was complete, and it comprised an attempt to build the connections within a civil society by looking to overcome many persistent social problems. The power of communication that ‘culture’ holds plays a large role in this. [ABSTRACT FROM AUTHOR]

Numerous socio-legal factors make the process of surrogate decision-making for people living in dementia very complicated in Japan. In this discussion paper, we argue that the lack of early consultation between patients, surrogate decision-makers and healthcare providers and the overreliance of patients and their families on doctors to assume the decision-making role lead to healthcare practices that may not align with the patient's wishes. Further, we argue that lack of laws on surrogate decision-making, changing family structure and the liabilities associated with the care of people living with dementia contribute to the complexity of the decision-making process in Japan. Finally, given the rapidly changing social and healthcare norms in Japan, we call for greater involvement of nurses and care workers in the decision-making process to ensure patient-centric treatment and care are adopted., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Despite research suggesting that teachers highly influence their students' knowledge and use of language learning resources such as dictionaries (Loucky, 2005; Yamane, 2006), it appears that dictionary selection and use is considered something to be dealt with outside the classroom. As a result, many students receive too little advice to be able to make informed choices about which dictionary to use for which task. In particular, while teachers may recommend a few paper dictionaries, it appears that little thought is given to electronic and online alternatives. This article uses the case of (English) alphabet-background students of Japanese as an example, and discusses the pros and cons of computer versus non-computer dictionary tools, based on a survey of available resources, and making reference to empirical case studies of students and their dictionary use. The article concludes with recommendations for teachers and students. [ABSTRACT FROM AUTHOR]

In Polistes paper wasps, haploid early males can mate with early emerging females and leave viable offspring. In contrast, diploid early males are eventually sterile because they contribute triploid offspring via diploid sperm. Clarifying the ploidy of early males is important for determining whether early male production is a reproductive strategy for the species. We examined the mating behavior and the ploidy of early males in the Japanese paper wasp, Polistes rothneyi iwatai van der Vecht. Thirteen early males from four colonies were all diploid. Two of the nine early males (22.2%) attempted to mate with females, but only one individual (11.1%) was successful (the female's spermatheca contained spermatozoa). These results suggest that although most early males of P. rothneyi iwatai do not produce offspring, their mating may be linked to the occasional production of triploid females. [ABSTRACT FROM AUTHOR]

Aims/Introduction: The prevalence of diabetes mellitus is increasing rapidly in Japan, and diabetic neuropathy is a major factor decreasing diabetic patients' quality of life, as well as a risk factor for sudden death. The present study aimed to determine the prevalence of diabetic neuropathy and raise awareness about it among patients and their physicians. Materials and Methods: Diabetic outpatients ( N = 5077) at 249 medical institutions within Kanagawa Prefecture, Japan, were surveyed by questionnaire and underwent foot examinations. The questionnaire included 10 questions about sensory abnormalities of both feet, muscle cramps and autonomic symptoms. Foot examinations included testing for vibratory perception of the medial malleolus, Achilles tendon reflexes and touch sensation of the bottom of the great toe using tissue paper. Results: Of the 5077 patients surveyed, 70.4% reported symptoms. Overall, 75.4% of the patients underwent vibratory perception testing, of whom 44.9% had abnormal thresholds (≤10 s). On the tissue paper touch test, performed in 94.6% of patients, 11.9% had no touch sensation. Of the 2803 type 2 diabetic patients with known background factors who underwent foot examinations, 49.4% had diabetic neuropathy. There was a high prevalence of diabetic neuropathy (36.1%) in patients with <5-year history. Of the patients with no touch sensation on the tissue paper test, 81.3% had diabetic neuropathy. Conclusions: The present study identified the prevalence of diabetic neuropathy in Kanagawa Prefecture. The tissue paper test is a simple and excellent method of evaluating decreased superficial sensation that can help evaluate the severity of diabetic neuropathy. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00174.x, 2011) [ABSTRACT FROM AUTHOR]

Energy recovery from small and medium scale waste thermal treatment facilities in the municipalities of Japan is challenging, owing to low power generation efficiency and high economic demands. Gas Engine (GE) generation is considered an efficient resource utilization method in these facilities. In this study, new and consistent feedstock, Refuse Paper and Plastic Fuel (RPF), and wood pellets were tested in an air-blown Fluidized Bed Gasifier (FBG) for syngas utilization in a GE. With temperatures ranging from 700 to 940 °C and varying Equivalence Ratios (ER) of 0.3-0.5, some of the most important product gas characteristics were analyzed, including the Lower Heating Value (LHV) and tar concentration levels. Gas composition results revealed that the concentration tendencies varied for the product gases CO, H 2 , and hydrocarbons, depending on the feedstock type, whereas the same tendencies were observed for CH 4 and tar concentrations. Through the ER range, the LHV of product gas for RPF and wood pellets was 3.4-5.9 MJ/Nm 3 . Tar concentrations decreased to 2.5-14.0 g/Nm 3 -dry as the ER was raised. The optimal ER for LHV performance in GE generation was approximately 0.4 for RPF and wood pellets, and remaining tar concentrations were about 5.0 g/Nm 3 -dry at the gasifier exit., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Origami, the art of paper folding in Japan, is a transformative process. Tessellations are defined by Merriam- Webster as the "covering of an infinite geometric plane without gaps or overlaps by congruent plane figures of one type or a few types." A strategic array of repeating and/or combining a set of specific folds, known as motifs or molecules, will yield Origami Tessellation patterns. No paper is added or eliminated during the construction process. The purpose of this exercise is to challenge students with the highly engaging task of applying a defined set of rules to a plain square of paper. In order to do so, strategies need to be explored for the best combination the individual folds on an underlying grid system into a system of corresponding molecules. The synchronized folds of such an array will create the desired geometric tessellation patterns. In essence, the process of folding complex origami tessellations bears strong similarities to the complex methods designers are taught to pursue in order to solve multifaceted problems in the field of product design, product interactions, and design for emergent behaviors. While past generations of designers approached challenges predominantly from a singular, product-centric fashion, the increasing complexity of everyday artifacts has changed the paradigm and now calls for a much broader sensitivity of designing. The act of folding is itself strongly guided by both the designer's mind and skillset. The execution of complex tessellation folds teaches designers to concentrate on the given task from beginning to end, as it is essential to stay focused along the way and work with uttermost precision. Synonymous to problem-solving during a design process, the act of folding tessellations leads to the discovery of opportunities which necessitate the development of strategies for merging individual elements/ideas into a bigger, coherent picture. The rules become the grammar; the individual folds become the words, and the interaction between the two forms a dialogue. Folding origami tessellations is (purposeful) poetry. Within a short amount of time, students are able to create visually stunning results and develop an awareness of the parameters involved. [ABSTRACT FROM AUTHOR]

This study aims to show an analysis of IJBSCHS publications from the perspective of publication number, author distribution, and research topics from 2017 to 2021. It shows that publication number in each issue is stable with 4 to 5 papers, that the papers with authors outside of Japan account for about 26% and papers with international collaboration account for 15%, and that research topics are focused on recognition, data analysis, image processing, welfare instrument, and biometrics. In 2018 and 2019, we tried applying inclusion in Scopus database. Unfortunately, the result is not positive. After an overview of what is happening in the journal in the past 5 years and comparing it with another international journal of IJICIC, this study finds the major challenge in the future for IJBSCHS is to get registered in some leading indexes like Scopus to increase its visibility. [ABSTRACT FROM AUTHOR]

The paper presents a bibliometric analysis of research on Private Equity (PE) and identifies the key contributors, major countries and institutions, and scope for further research. It uses scientific mapping strategy to meet its goals and employs R studio to extract pertinent data. Scopus and Web of Science—two popular databases—were used to extract the data. The study examines 1698 publications from business, management, finance and econometrics journals. The data are analyzed using descriptive statistics. The status of research on PE is represented through graphical and tabular analysis. Since PE first gained popularity in developed nations like US, UK and Japan, these countries boast a majority of studies on the subject. The PE concept is still relatively new in emerging countries, and there is still opportunity for more research. Future research should focus on issues like investment, venture and market. [ABSTRACT FROM AUTHOR]

The increasing presence of e-books (electronic books) has become a major focus in countries around the world. In the United States, e-books represented 28% of the total book sales for 2012. In Japan, the conversion from paper books to e-books is expected to accelerate by the prevalent use of smartphones and tablet PCs. It is therefore important to quantitatively evaluate the environmental load of paper books and e-books for a sustainable society. In this study, paper books are compared to e-books read on different electronic devices (e-ink tablets, tablets, cell phones, smartphones, laptop computers, desktop computers and portable music players) through a case study on a 224-page book. The study is based on key primary data such as use time and reading speed for each device and aims to minimize assumptions made in other studies. GHG emissions for paper books are 1.24 kg-CO 2 e/book, and are reduced to 1.11 kg-CO 2 e/book when the effect of paper recycling is taken into consideration. The results for e-books under average use-time conditions range from 0.25 to 0.91 kg-CO 2 e/book with the e-ink tablet having the lowest emissions. When the average use time of each e-book device is applied, the paper book has a higher impact than all the e-books. However, sensitivity analysis shows that the impact of paper books can be lower than that of e-books for larger screen devices such as tablets, laptops and desktops when the reuse of books is considered or the e-book reading device is hardly used during its life cycle. [ABSTRACT FROM AUTHOR]

Many commentators have opined as to the relative success or failure of Prime Minister Koizumi Junichiro's efforts to enact reform during his first term. This article analyzes the empirical evidence using a simple framework for assessment. The principal questions it asks are: What, if anything, has he accomplished thus far, and how will history remember his legacy? Following a summary of the circumstances that led to Koizumi's ascendancy and the political and economic conditions under which he governs, the article analyzes the results achieved in the prime minister's top three priority areas: banks, government spending, and regulatory reform. Despite the incremental progress achieved by Koizumi in the face of intense political opposition--most particularly from his own party--the article concludes that his current pace of reform is not likely to result in significant reform by the end of his second term as his party's president. [ABSTRACT FROM AUTHOR]

Japan's new defence white paper offers an overview of the security environment surrounding Japan and the numerous issues concerning Tokyo's defence and security policy. It highlights North Korea's increasing missile-related technologies, China's growing military power and assertive activities, and the impact of the COVID-19 (coronavirus disease 2019) infection on security issues. Japan will likely remain a cautious security policy player while emerging as a robust military power with growing deterrence and defence capabilities. [ABSTRACT FROM AUTHOR]

In nonclinical safety studies for new drug development, healthy animals have been commonly used. However, in some cases, the use of animal models of human disease is considered to be more favorable in evaluating risks in patients. To elucidate the current status of the use of animal models for nonclinical safety assessment, an internal questionnaire from the Japan Pharmaceutical Manufacturers Association and surveys (questionnaire period: August 27 to September 30, 2015) of both common technical documents and review reports of approved drugs (approval period: May 1999 to May 2017) disclosed by the Pharmaceutical and Medical Devices Agency were conducted. Although there were some concerns and limitations raised, the survey results revealed that animal models have been used in nonclinical safety assessment on a case-by-case basis and that nonclinical safety studies using animal models were included in the data packages of several approved drugs in Japan. The survey results also revealed that nonclinical safety studies using animal models have become more frequent in the past few years. In almost all cases, useful information, such as signs of toxicity under disease conditions and mechanisms of toxic change, was obtained from the results of nonclinical studies using animal models. Note: This is an opinion article submitted to the Toxicologic Pathology Forum. It represents the views of the author(s). It does not constitute an official position of the Society of Toxicologic Pathology, British Society of Toxicological Pathology, or European Society of Toxicologic Pathology, and the views expressed might not reflect the best practices recommended by these Societies. This article should not be construed to represent the policies, positions, or opinions of their respective organizations, employers, or regulatory agencies.

Objective To determine whether or not displaying the cost of tests can help reduce charges on test ordering in Japan. Methods This study was conducted under the setting of a simulated first visit of an outpatient for general internal medicine in a secondary medical institution in Japan. We randomly assigned 27 residents and clinical fellows to Team A or B. The first half, without charges displayed on the ordering system, was designated the "non-display group," and the participants of Team A selected tests for each paper-based simulated case (Q1-Q14), while the participants of Team B selected tests for Q15-Q28. The second half, which had charges displayed, was designated the "display group," and the participants of Team A selected tests for Q15-Q28, while the participants of Team B selected tests for Q1-Q14. The main outcome measure was the difference in the cost of tests per paper-based simulated case between the non-display and display groups. Results The median (interquartile range) cost of tests per paper-based simulated case was 12,255 yen (5,040-23,695 yen) in the non-display group versus 9,425 yen (2,320-21,700 yen) in the display group, showing a decrease of 2,830 yen with charges being displayed (p=0.002). Conclusion Displaying the charges when ordering tests in paper-based simulated cases resulted in cost reduction. The adoption of this intervention may reduce health insurance costs under the health insurance system in Japan, which has features such as universal health coverage and universal access to care.

Outbreaks of infectious diseases can occur after natural disasters as vital services are disrupted and populations move into evacuation centres. National notifiable disease surveillance may be inadequate in these situations because of resource-consuming disease confirmation or system interruptions. Although syndromic surveillance has been used as an alternative in post-disaster situations, no systematic evaluations of it have been published. We evaluated the ad hoc paper-based syndromic surveillance system implemented in evacuation centres in Ibaraki prefecture after the 2011 Great East Japan Earthquake and Tsunami. We assessed the simplicity, acceptability, data quality, timeliness and portability of this system and reviewed its usefulness. We concluded that the system was simple, acceptable, portable and useful. The documentation and monitoring of disease events and trends were useful for developing interventions in evacuation centres and have since been used to improve post-disaster infectious disease and surveillance knowledge in Japan. We believe timeliness was a challenge due to the chain of data transmission and communication passing through an intermediary. Future implementations of this system could consider a more direct chain of data transmission and communication from collectors to analysers. Too few key informant interviewees and the inability to obtain original paper-based data from evacuation centres limited our findings; we conducted this evaluation four years after the response occurred. Future evaluations should be completed closer to when operations cease. The usefulness of the system suggests adopting it in future disasters. A simple, plain-language manual should be developed to improve future employment.