The Japan Geriatrics Society consensus statement "recommendations for older persons to receive the best medical and long-term care during the COVID-19 outbreak-considering the timing of advance care planning implementation".

Since the end of 2019, a life-threatening infectious disease (coronavirus disease 2019: COVID-19) has spread globally, and numerous victims have been reported. In particular, older persons tend to suffer more severely when infected with a novel coronavirus (SARS-CoV-2) and have higher case mortality rates; additionally, outbreaks frequently occur in hospitals and long-term care facilities where most of the residents are older persons. Unfortunately, it has been stated that the COVID-19 pandemic has caused a medical collapse in some countries, resulting in the depletion of medical resources, such as ventilators, and triage based on chronological age. Furthermore, as some COVID-19 cases show a rapid deterioration of clinical symptoms and accordingly, the medical and long-term care staff cannot always confirm the patient's values and wishes in time, we are very concerned as to whether older patients are receiving the medical and long-term care services that they wish for. It was once again recognized that it is vital to implement advance care planning as early as possible before suffering from COVID-19. To this end, in August 2020, the Japan Geriatrics Society announced ethical recommendations for medical and long-term care for older persons and emphasized the importance of conducting advance care planning at earlier stages. Geriatr Gerontol Int 2020; 20: 1112-1119.

Analysis of dose distribution for heavily exposed workers in the first criticality accident in Japan.

The first criticality accident in Japan occurred in a uranium processing plant in Tokai-mura on September 30, 1999. The accident, which occurred while a large amount of enriched uranyl nitrate solution was being loaded into a tank, led to a chain reaction that continued for 20 h. Two workers who were pouring the uranium solution into the tank at the time were heterogeneously exposed to neutrons and gamma rays produced by nuclear fission. Analysis of dose distributions was essential for the understanding of the clinical course observed in the skin and organs of these workers. We developed a numerical simulation system, which consists of mathematical human models and Monte Carlo radiation transport programs, for analyzing dose distributions in various postures and applied the system to the dose analysis for the two workers. This analysis revealed the extreme heterogeneity of the doses from neutrons and gamma rays in the skin and body, which depended on the positions and postures of the workers. The detailed dose analysis presented here using color maps is indispensable for an understanding of the biological effects of high-dose exposure to a mixed field of neutrons and gamma rays as well as for the development of emergency treatments for victims of radiation exposure.