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Methotrexate (MTX), the anchor drug in the current treatment strategy for rheumatoid arthritis (RA), was first approved for the treatment of RA in Japan in 1999 at a recommended dose of 6–8 mg/week. The approved maximum dose of MTX has been 16 mg/week since February 2011 when MTX was approved as a first-line drug in the treatment of RA. Recent evidence of MTX-polyglutamate concentration in the red blood cells of Japanese patients with RA justifies the current daily use of MTX in Japan. Additionally, after a nationwide clinical trial, a subcutaneous MTX injection formula (7.5–15 mg/week) was approved for RA treatment in September 2022. Therefore, in March 2023, a subcommittee of the Japan College of Rheumatology updated the guidance (formerly 'guidelines') for the use of MTX in Japanese patients with RA. This article, an abridged English translation summarizing the 2023 update of the Japan College of Rheumatology guidance for the use of MTX and management of patients with RA, will be helpful to both Japanese and global rheumatology communities. [ABSTRACT FROM AUTHOR]

Real-world learning is important because it encourages learners to obtain knowledge through various experiences. To design effective real-world learning, it is necessary to analyze the diverse learning activities that occur in real-world learning and to develop effective strategies for learning support. By inventing the technologies of multimodal sensing and knowledge externalization, we propose a method to capture the time-series occurrence of real-world learning and to analyze the spatial characteristics of a learning field that draws out diverse intellectual interactions. Our method generates multi-perspective indexes of the structure of a real-world learning field from the viewpoint of the occurrence probability of important learning behavior and knowledge acquisition. Our data analysis by this method extracted the regions where abundant discovery knowledge was not found and learners did not succeed in acquiring knowledge. Our method is useful for redesigning on-site and off-site activities in real-world learning, and for formatively improving the learning environment of real-world learning.

Objectives: This study investigated whether the phase angle (PhA) on bioelectrical impedance analysis is related to frailty in rheumatoid arthritis (RA) patients. Methods: Data from a prospective cohort study of RA patients were analysed. The PhA was assessed by the bioelectrical impedance analysis method, and frailty was assessed by the Kihon Check List (KCL) annually. The cut-off value of the PhA for frailty was calculated by receiveroperating characteristic analysis. The relationships between the PhA and frailty were evaluated by logistic regression analysis. The relationships between the change in PhA and frailty status and the KCL score were evaluated by analysis of covariance and multiple regression analysis. Results: A total of 170 patients (81.2% female, 66.2 ±13.1 years) were included in the analysis. A PhA of less than the cut-off for frailty was significantly associated with frailty (odds ratio: 4.75, 95% confidence interval: 1.86, 12.17). The change in the PhA was significantly associated with the change in the KCL score (β=-0.15). In robust patients, there was a significant difference in the rate of change of the PhA between the group that became pre-frail in the next year and the group that remained robust. Conclusions: The PhA may be associated with frailty in RA patients. [ABSTRACT FROM AUTHOR]