The difficulty of nuclear emergency prevention measures during natural disasters: Ongoing challenges in Japan.

It is crucial to anticipate nuclear emergency scenarios and implement effective measures. Japan's climate and topography make it vulnerable to natural disasters; thus, it is necessary to address compounding and cascading disaster scenarios involving the simultaneous occurrence of natural and nuclear disasters. On January 1, 2024, an earthquake hit the Noto region of Ishikawa Prefecture, resulting in damage to the area around the Shika Nuclear Power Plant, located 90 km from the epicenter. This earthquake revealed that, in the event of a complex disaster, residents living within 30 kilometers of the Shika Nuclear Power Plant may be completely unprepared for a nuclear disaster. In the event of a complex disaster, it is crucial to implement appropriate countermeasures while balancing responses to both nuclear and natural disasters and optimizing radiation disaster prevention measures.

Modeling and predicting individual variation in COVID-19 vaccine-elicited antibody response in the general population.

As we learned during the COVID-19 pandemic, vaccines are one of the most important tools in infectious disease control. To date, an unprecedentedly large volume of high-quality data on COVID-19 vaccinations have been accumulated. For preparedness in future pandemics beyond COVID-19, these valuable datasets should be analyzed to best shape an effective vaccination strategy. We are collecting longitudinal data from a community-based cohort in Fukushima, Japan, that consists of 2,407 individuals who underwent serum sampling two or three times after a two-dose vaccination with either BNT162b2 or mRNA-1273. Using the individually reconstructed time courses of the vaccine-elicited antibody response based on mathematical modeling, we first identified basic demographic and health information that contributed to the main features of the antibody dynamics, i.e., the peak, the duration, and the area under the curve. We showed that these three features of antibody dynamics were partially explained by underlying medical conditions, adverse reactions to vaccinations, and medications, consistent with the findings of previous studies. We then applied to these factors a recently proposed computational method to optimally fit an "antibody score", which resulted in an integer-based score that can be used as a basis for identifying individuals with higher or lower antibody titers from basic demographic and health information. The score can be easily calculated by individuals themselves or by medical practitioners. Although the sensitivity of this score is currently not very high, in the future, as more data become available, it has the potential to identify vulnerable populations and encourage them to get booster vaccinations. Our mathematical model can be extended to any kind of vaccination and therefore can form a basis for policy decisions regarding the distribution of booster vaccines to strengthen immunity in future pandemics.

Diminished neutralizing activity against the XBB1.5 strain in 55.9% of individuals post 6 months COVID-19 mRNA booster vaccination: insights from a pseudovirus assay on 1,353 participants in the Fukushima vaccination community survey, Japan.

This study investigates the neutralizing activity against the XBB1.5 variant and the ancestral strain in a population post-bivalent vaccination using a pseudo virus assay validated with authentic virus assay. While bivalent booster vaccination and past infections enhanced neutralization against the XBB 1.5 strain, individuals with comorbidities showed reduced responses. The study suggests the need for continuous vaccine updates to address emerging SARS-CoV-2 variants and highlights the importance of monitoring real-world immune responses.

Categorization of disaster-related deaths in Minamisoma city after the Fukushima nuclear disaster using clustering analysis.

The medical situation during disasters often differs from that at usual times. Disasters can lead to significant mortality that can be difficult to monitor. The types of disaster-related deaths are largely unknown. In this study, we conducted a survey to categorize the disaster-related deaths caused by a radiation disaster. A total of 520 people living in Minamisoma City, Fukushima Prefecture, at the time of the Fukushima Daiichi Nuclear Power Plant accident, who were certified to have died due to disaster-related causes were surveyed. We divided the participants into those who were at home at the time of the earthquake and those who were in hospitals or facilities when the disaster struck and conducted a hierarchical cluster analysis of the two groups. Disaster-related deaths could be divided into seven groups for those who were at home at the time of the disaster and five groups for those who were in hospitals or facilities at the time of the disaster. Each group showed different characteristics, such as "the group with disabilities," "the group receiving care," and "the group with depression," and it became evident that not only uniform post-disaster support, but support tailored to the characteristics of each group is necessary.

Idobata-Nagaya: a community housing solution for socially isolated older adults following the great East Japan earthquake.

Introduction: Following the Great East Japan Earthquake, the living environment of socially isolated older adults has become a pressing concern. In response, Nagaya, a collective housing program, was established in Soma City, Fukushima, Japan to address social isolation among older adults and support their long-term health. This study aimed to identify characteristics of individuals in Nagaya and examine the sustainability of this initiative. Methods: We conducted a retrospective analysis of residents who were relocated to Nagaya, emphasizing their characteristics, the continuity of their stay in Nagaya, and their care certification levels, using data up to December 31, 2022. We employed Kaplan-Meier curves to analyze the duration for which residents continued to reside in Nagaya and the time leading up to the requiring care-level certification. Results: Of 65 people who moved to Nagaya after the disaster, 30 people (46.2%) continued to live there, 21 (32.3%) died during their stay, and 14 (21.5%) moved out. The overall duration of occupancy averaged 6.39 years (SD 3.83 years). The proportion of requiring care-level certification occurrences per person-year was 0.0577 for those without care certification and 0.3358 for those with requiring support level at the time of moving in. Conclusion: In summary, Nagaya-style communal housing may offer suitable living environments for older adults with diverse needs during disasters and serve as a valuable tool for developing public policies in aging societies.

Surgical technique of spine-shortening vertebral osteotomy for adult tethered cord syndrome: a case report and review of the literature.

BACKGROUND: Miyakoshi et al. reported three cases of tethered cord syndrome treated by spine-shortening vertebral osteotomy, which provided relief of the patients' symptoms with no complications. Although the details of these cases were described in a previous report, the surgical technique was not thoroughly explained. In the present report, we describe the details of our procedure with reference to a fourth case. CASE PRESENTATION: A 47-year-old Asian woman was admitted to our hospital with a 1-year history of worsening leg numbness and urinary dysfunction. Magnetic resonance imaging revealed a low-lying conus medullaris extending to the level of S2 and surrounded by fat tissue at that level. We diagnosed her condition as adult tethered cord syndrome, and spine-shortening vertebral osteotomy was planned. The target level for the osteotomy was L2. Bilateral pedicle screw implants were placed at L1 and L3 using an anterior-posterior image intensifier. In this procedure, it is essential to use monoaxial screws inserted exactly parallel to the rostral endplates of each vertebral body; this ensures appropriate alignment between the L1 caudal endplate and the L2 osteotomy surface. The upper one-third of the lamina of L2 was resected, and the bilateral two-thirds of the pedicle of L2 was removed with a surgical air drill. After exposure of the lateral side of the L1-2 disc, discectomy was performed with a knife and curette. Following complete discectomy of L1-2, the upper vertebral body of L2 was removed with a surgical air drill. After complete removal of the vertebral body, a straight rod was connected to two screws and applied pressure between the screws. Two polyethylene tapes were applied to the L2 lamina and bilateral rods. CONCLUSION: Spine-shortening osteotomy that preserves the caudal one-third of the pedicle and lamina with one-above and one-below instrumentation successfully reduced the spinal cord tension without causing neural damage.

Multisite Lifestyle for Older People after the Fukushima Nuclear Disaster.

After the Fukushima nuclear power plant disaster in 2011, the Japanese government implemented a return policy, lifting most evacuation orders in former evacuation areas. Consequently, the return of residents is currently underway. However, it has become common for a large number of residents to carry out multisite living, a lifestyle involving returning to their hometown while maintaining their house at the evacuation site, or living at more than two sites. This report focuses on one aspect of the secondary effects of the nuclear incident, which forced affected residents to adopt a multisite lifestyle. Disasters always have a strong impact, via displacement, on those who are socially vulnerable, such as older people in an ageing society. They need intense support to resume their daily life as it was before the incident. For this report, we interviewed an elderly lady in her 90s, who is executing "multisite living" at evacuation sites, in order to obtain reassurance from neighbours and the local community. Our findings may provide valuable suggestions on how older people can restart their lives with the local community in an ageing society after disasters, which could apply to any kind of disaster preparedness.

Why Do They Not Come Home? Three Cases of Fukushima Nuclear Accident Evacuees.

Many people wish to return to where they used to live after evacuation due to disaster. After the Fukushima nuclear accident in 2011, many residents were forced to evacuate due to concerns about radiation. Subsequently, the evacuation order was lifted, and the government promoted a return policy. However, it has been reported that a considerable number of residents living in evacuation sites or other areas wish to return but are unable to do so. Here, we report three cases of Japanese men and one woman who evacuated after the 2011 nuclear accident in Fukushima. These cases reveal the rapid aging of residents and their health issues. These issues suggest that enhancing medical supply systems and access to medical care can aid in post-disaster reconstruction and residents' returning.

Long-term care issues in a municipality affected by the great East Japan earthquake: A case of Katsurao Village, Fukushima prefecture.

Information regarding the proposed measures addressing long-term care problems during disasters at a municipal level is scarce. Thus, this study reviewed the long-term care insurance measures taken in the Katsurao Village after the Fukushima nuclear accident and summarized the measures that municipalities can take against such issues in the future.

Successful Treatment of Atypical Femoral Fracture with Bowed Femur Using Contralateral Intramedullary Nail Combined with Early Daily Teriparatide.

We report a case of atypical femoral fracture achieving early fracture union with combination therapy comprising contralateral nail and immediate teriparatide injection. Fracture union of atypical fractures is often delayed due to bowing deformity and bone metabolic disorders. Combination treatment that takes both problems into consideration represents a useful treatment option for atypical femoral fracture.

COVID-19 risk assessment at the opening ceremony of the Tokyo 2020 Olympic Games.

The 2020 Olympic/Paralympic Games have been postponed to 2021, due to the COVID-19 pandemic. We developed a model that integrated source-environment-receptor pathways to evaluate how preventive efforts can reduce the infection risk among spectators at the opening ceremony of Tokyo Olympic Games. We simulated viral loads of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emitted from infectors through talking/coughing/sneezing and modeled temporal environmental behaviors, including virus inactivation and transfer. We performed Monte Carlo simulations to estimate the expected number of newly infected individuals with and without preventive measures, yielding the crude probability of a spectator being an infector among the 60,000 people expected to attend the opening ceremony. Two indicators, i.e., the expected number of newly infected individuals and the newly infected individuals per infector entry, were proposed to demonstrate the extent of achievable infection risk reduction levels by implementing possible preventive measures. A no-prevention scenario produced 1.5-1.7 newly infected individuals per infector entry, whereas a combination of cooperative preventive measures by organizers and the spectators achieved a 99% risk reduction, corresponding to 0.009-0.012 newly infected individuals per infector entry. The expected number of newly infected individuals was calculated as 0.005 for the combination of cooperative preventive scenarios with the crude probability of a spectator being an infector of 1 × 10-5. Based on our estimates, a combination of cooperative preventions between organizers and spectators is required to prevent a viral spread at the Tokyo Olympic/Paralympic Games. Further, under the assumption that society accepts < 10 newly infected persons traced to events held during the entire Olympic/Paralympic Games, we propose a crude probability of infectors of < 5 × 10-5 as a benchmark for the suppression of the infection. This is the first study to develop a model that can assess the infection risk among spectators due to exposure pathways at a mass gathering event.

Enhancement of synaptic responses in ascending interneurones following acquisition of social dominance in crayfish.

When crayfish have attained dominant status after agonistic bouts, their avoidance reaction to mechanical stimulation of the tailfan changes from a dart to a turn response. Ascending interneurones originating in the terminal ganglion receive sensory inputs from the tailfan and they affect spike activity of both uropod and abdominal postural motor neurones, which coordinates the uropod and abdominal postural movements. Despite the varying output effects of ascending interneurones, the synaptic responses of all interneurones to sensory stimulation were enhanced when they acquired a dominant state. The number of spikes increased as did a sustained membrane depolarizations. Regardless of social status, the output effects on the uropod motor neurones of all interneurones except VE-1 remained unchanged. VE-1 mainly inhibited the uropod opener motor neurones in naive animals, but tended to excite them in dominant animals. Synaptic enhancement of the sensory response of ascending interneurones was also observed in naive animals treated with bath-applied serotonin. However, subordinate animals or naive animals treated with octopamine had no noticeable effect on the synaptic response of their ascending interneurones to sensory stimulation. Thus, enhancement of the synaptic response is a specific neural event that occurs when crayfish attain social dominance and it is mediated by serotonin.

Aversive operant conditioning alters the phototactic orientation of the marbled crayfish.

Aversive learning was applied to affect the phototactic behaviour of the marbled crayfish. Animals initially showed negative phototaxis to white light and positive taxis to blue light. Using an aversive learning paradigm, we investigated the plasticity of innate behaviour following operant conditioning. The initial rate of choosing a blue-lit exit was analysed by a dual choice experiment between blue-lit and white-lit exits in pre-test conditions. During training, electrical shocks were applied to the animals when they oriented to the blue-lit exit. Memory tests were given to analyse the orientation rate to the blue-lit exit in trials 1 and 24 h after training and these rates were compared with the pre-test. In general, animals avoided the blue-lit exit in the memory tests. When training was carried out three times, the long-term memory was retained for at least 48 h, although a single bout of training was also enough to form a long-term memory. Cooling animals at 4°C or injection of cycloheximide immediately after training altered the formation of long-term memory, but had no effect on short-term memory formation. Administration of the adenylate cyclase inhibitor SQ22536, the PKA inhibitor H89 or the CREB inhibitor KG-501 immediately after training also blocked the formation of long-term memory, but had no effect on short-term memory formation. Thus, our pharmacological behavioural analyses showed that new protein synthesis was necessary to form long-term memories and that the cAMP/PKA/CREB pathway is the main signal cascade for long-term memory formation in the marbled crayfish.

Proximal junctional fracture and kyphosis after long spinopelvic corrective fixation for adult spinal deformity.

BACKGROUND: Proximal junctional fractures (PJFx) are the main cause for proximal junctional kyphosis (PJK), a complication of adult spinal deformity surgery. This study investigated risk factors for PJFx when performing long spinopelvic corrective fixation with lateral interbody fusion from T9 to ilium. METHODS: This was a retrospective study of 43 patients with a minimum follow-up of 2 years. Radiographic measurements including thoracic kyphosis (TK), sagittal vertical axis (SVA), T1 pelvic angle (TPA), proximal junctional angle (PJA), lumbar lordosis (LL), lower LL, and pelvic tilt were measured preoperatively, one-month postoperatively, and at final follow up. TK and LL were also measured in a fulcrum backward-bending position preoperatively. RESULTS: At final follow-up, PJK was found in 30/43 patients (69.8%); 20.9% of the cases had PJFx (9 patients). TPA (preoperative, and one-month postoperative) was significantly higher in the PJFx group than in the other groups. The differences in TPA, TK, and PJA between preoperative and one-month postoperative measurements in the PJFx group were significantly higher than those in the other groups. At final follow up, SVA was significantly higher in the PJFx group than in the "PJK without PJFx" group. TPA and TK were significantly higher in the PJFx group than in the other groups. PJA was significantly different between all groups. CONCLUSION: Preoperative large TPA was the only risk factor for PJFx. Preoperative flexibility of the thoracolumbar spine and overcorrection of sagittal deformity were not related to PJFx or PJK.

Diagnosis and Surgical Treatment of Thoracic Dorsal Arachnoid Web: A Report of Two Cases.

INTRODUCTION: An arachnoid web (AW) is a relatively rare disease and shows clinical symptoms and radiological findings similar to those of an arachnoid cyst (AC) or spinal cord herniation (SCH). Since the operative procedures for an AW are generally different from those intrathecal disorders, correct preoperative differential diagnosis is important. The purposes of this study were to report the usefulness of magnetic resonance imaging (MRI) and computed tomography (CT) myelography for diagnosing AW and to show the histological findings and clinical results. Case Description. Two patients, a 79-year-old man and a 43-year-old woman, are presented. The primary diagnoses were AC with ossification of the ligamentum flavum and epidural hematoma, respectively, in previous hospitals. They were finally diagnosed by the characteristic MRI and CT myelogram finding called the "scalpel sign." Histological findings showed epithelial cells and fibrous tissue derived from arachnoid tissues and microcalcifications. After surgery, the scalpel sign has vanished, and aggravation of their symptoms was prevented. CONCLUSION: An AW is refractory, but early detection by MRI and CT myelography and early treatment improve outcomes after surgery.

Sacropelvic Fixation With S2 Alar Iliac Screws May Prevent Sacroiliac Joint Pain After Multisegment Spinal Fusion.

STUDY DESIGN: A retrospective study. OBJECTIVE: To examine the postoperative incidence of sacroiliac joint pain (SIJP) at the lower fusion level following multisegment fusion. SUMMARY OF BACKGROUND DATA: Recently, multisegment fusion is being increasingly performed. While proximal junctional kyphosis (PJK) commonly develops following multisegment fusion, SIJP also commonly occurs following this surgery. In surgery for adult spinal deformity, fixation is often extended to the pelvis to include the sacroiliac joint. Therefore, the question of whether SIJP occurs in such cases is interesting. Here, we examined postoperative incidence of SIJP at the lower fusion level, including the incidence of PJK, and postoperative lumbopelvic alignment. METHODS: Participants included 77 patients who underwent corrective fusion (≥3 segments). Patients were divided into three groups based on the lower fixation end: L5 (L5), S (sacrum), and P (pelvis). In the P group, an S2 alar iliac screw was used. Postoperative incidence of SIJP and PJK in each group was examined along with lumbopelvic parameters. RESULTS: SIJP incidence was 16.7%, 26.1%, and 4.2% in the L5, S, and P groups, respectively, indicating the highest value in the S group and a significantly lower value in the P group. PJK incidence was 23.3%, 30.4%, and 29.2% in the L5, P, and S groups, respectively, with no significant differences. Regarding postoperative lumbopelvic parameters, there was no significant difference between the groups; however, lumbar lordosis tended to be better in the P group. CONCLUSION: SIJP incidence was extremely high with fixation to the sacrum, and in the group with fixation to the pelvis, there was hardly any SIJP. Sacropelvic fixation using S2 alar iliac screws could prevent SIJP onset following multisegment fusion. LEVEL OF EVIDENCE: 3.