Hiroaki Saito

Public media communication, particularly through newspapers, plays a critical role in shaping public awareness, governmental response, and remediation efforts following large-scale crises, including nuclear power plant accidents. Because children are biologically more vulnerable to the effects of ionizing radiation, understanding how media narratives include children following nuclear events is especially important. This study employed a novel multilingual computational approach to analyze newspaper coverage following the Chernobyl (1986) and Fukushima (2011) accidents in Russian and Japanese. Using structural topic modeling (STM), we examined dominant themes related to children, nuclear events, and thyroid-related health concerns across both contexts. The analysis identified four topics in the Russian-language newspaper and six topics in the Japanese newspaper. Themes in the Russian-language newspaper focused more on the geographical environment, affected populations, and disease, while the Japanese newspaper emphasized health management, surveys, peace education, the Fukushima nuclear disaster, radiation, and Chernobyl, showcasing specific cultural emphasis in media reporting. Coverage of the later accident drew explicitly on the earlier one, whereas no comparable precedent was available at the time of Chernobyl, indicating an asymmetry in the information environment available to support protective action. Although the small and uneven corpus limits generalizability, the study demonstrates the exploratory value of multilingual STM for comparing nuclear-disaster reporting across languages and historical contexts.

Background: Financial ties between healthcare professionals and the medical‐device industry raise conflict‐of‐interest and transparency concerns; despite Japan's 2012 self‐regulatory guidelines, device‐related payments receive less scrutiny than pharmaceutical payments globally, including in Japan. Objective: To provide the first detailed analysis of honoraria from medical device companies to Japanese physicians in 2019, offering a baseline before the COVID‐19 pandemic. Methods: We retrospectively examined 2019 payment data from the Yen for Docs database, compiled from disclosures by 118 companies affiliated with the Japan Medical Devices Network and other major firms. The analysis focused on honoraria—lecture, consulting, and writing fees—because these are the only categories disclosed with individual healthcare professionals names. Payments were standardized, cleaned, and aggregated at company and recipient levels. Descriptive analyses identified overall volume, company distribution, and top‐earning specialties. Results: In 2019, 66 companies disclosed 60,161 honorarium payments totaling USD 46.0 million. Most funds (66.7%) were lecture fees, followed by consulting (28.8%) and writing (4.5%). Payments were highly concentrated: the top 10 companies accounted for 63.3% of the total, led by Medtronic, Terumo, and Johnson & Johnson. Among 24,434 recipients, 66.1% received less than USD 1,000, while only seven physicians received more than USD 100,000. Cardiologists (48.0%) and cardiovascular surgeons (24.0%) dominated the top 50 earners. Conclusion: Honoraria from Japan's device industry were modest in scale compared with pharmaceutical companies but highly concentrated among a few firms and cardiovascular specialists. These findings highlight the need for more comprehensive and legally enforceable transparency frameworks to safeguard clinical integrity and public trust.

Background: Japan has a high incidence of gastric cancer and is currently the only nation in which guidelines recommend Helicobacter pylori screening for adolescents. However, the implementation and implications of these initiatives have not been comprehensively characterized. The aim of this study was to provide a comprehensive overview of H. pylori screening programs for adolescents in Japan. Materials and Methods: A narrative review was conducted to summarize the studies on H. pylori screening among adolescents in Japan. Literature searches were performed in PubMed, Ichushi‐Web, CiNii Research, and J‐STAGE for articles published up to February 12, 2026. Studies that described H. pylori screening programs targeting adolescents in Japan were included. Data were extracted on study background and objectives, target age, screening methods, participation rates, infection prevalence, eradication regimens, eradication success rates, and adverse events. Results: Seventeen studies met the inclusion criteria. Screening programs were typically local‐government‐led and school‐based and primarily targeted junior high school students. A two‐step diagnostic strategy employing noninvasive tests was commonly used. The median prevalence of H. pylori infection was 3.1%. Eradication regimens varied across programs; metronidazole‐ or vonoprazan‐containing regimens generally showed higher eradication success rates than proton pump inhibitor‐based clarithromycin‐containing regimens, although cross‐study comparisons should be interpreted cautiously because of heterogeneity. Adverse events were generally mild and predominantly gastrointestinal, and no serious complications were reported. Conclusions: Local‐government‐led and school‐based H. pylori screening among adolescents in Japan represents a feasible approach to the prevention of gastric cancer within a well‐established school health system. The applicability of this strategy to other countries depends on several contextual factors, including the incidence of gastric cancer, health care infrastructure, and the presence of organized school health systems. In settings that lack these conditions, alternative community‐based strategies may be required.

Objective: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Although many countries have developed CRC screening guidelines, how CRC screening guidelines are developed across countries remains unclear. This study examined guideline-development funding, stakeholders, and their conflicts of interest (COI), and compared CRC screening recommendations across Group of Seven (G7) countries. Methods: We reviewed the most recent CRC screening guidelines issued by official research organizations or governmental bodies in G7 countries. We extracted information on responsible organizations, panel composition, recommendations, target ages, screening tests and intervals, supporting evidence, funding, and COI. Results: While CRC screening recommendations showed some similarities across G7 countries, some differences were observed in starting age, screening modality, and implementation structure. Differences were also identified in funding, COI reporting and management, and stakeholder composition, including limited involvement of patient and public representatives. Conclusions: Colorectal cancer screening guidelines among G7 countries varied despite shared international evidence. These differences likely reflect country-specific factors, including population characteristics, screening participation, health system capacity, and cultural context. Given that guideline development involves diverse stakeholders, ensuring transparency in the guideline-development process is essential.

Background: Financial relationships between the medical device industry and healthcare providers have raised concerns about conflicts of interest (COIs). However, these relationships remain poorly characterized in Japan, despite the country’s large medical device market, which was valued at ¥4.41 trillion ($33.3 billion) as of 2021. This study examined the scale, composition, and temporal patterns of payments from the medical device industry and evaluated current transparency practices. Methods: We analyzed publicly disclosed payment data from 117 medical device companies predominantly affiliated with the Japan Federation of Medical Devices Associations (JFMDA) from 2019 to 2022. Payment categories included research and development, academic research support, lecture and consulting fees, information-provision–related expenses, and other payments to healthcare professionals (HCPs) and healthcare organizations (HCOs). We assessed payment magnitude, category composition, company-level concentration, year-to-year changes, and disclosure transparency using an adapted proforma previously applied to European pharmaceutical payment data. Results: Total payments amounted to $942.3 million over four years. Academic research support expenses constituted the largest share (33.0%, $310.7 million), followed by information provision–related expenses (25.2%, $237.5 million) and research and development expenses (21.7%, $204.8 million). Payments were highly concentrated, with the top 10 companies accounting for approximately 58% of total amounts. Using 2019 as the pre-pandemic baseline, total payments declined by 30.2% in 2020 and remained below pre-pandemic levels in 2021 (−24.0%), before partially recovering in 2022 (−11.6%). Category-specific trends diverged during the pandemic, with consulting, lecturing, and manuscript-related fees exceeding pre-pandemic levels by 2022, while information provision–related expenses remained substantially reduced. Transparency was limited: 78.6% of companies disclosed payment data with limited standardization, searchability, or data download functionality. Conclusion: This multi-year analysis revealed substantial financial relationships between the medical device industry and healthcare stakeholders in Japan, alongside persistent shortcomings in transparency of disclosures. Introducing legally mandated disclosure would improve oversight and align Japan’s system with international best practices.

Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer that enables the en bloc resection of large lesions. However, it is associated with a significant risk of delayed bleeding, particularly in patients receiving antithrombotic therapy. Delayed bleeding after ESD causes anemia and serious systemic complications, including cardiovascular events. Here, we report a rare case of Takotsubo syndrome triggered by delayed bleeding after gastric ESD that culminated in cardiac arrest. A man in his 70s who underwent gastric ESD experienced delayed bleeding six days after the treatment, requiring emergency endoscopic hemostasis. The following day, the patient developed sudden ventricular fibrillation without prior chest symptoms. After resuscitation with electrical defibrillation, left ventriculography revealed apical ballooning consistent with Takotsubo syndrome. With intensive care, cardiac function recovered, and the patient was discharged ambulatory. Takotsubo syndrome is typically induced by stress, and often triggers psychological and physical stimuli. Although most patients present with chest pain or discomfort, our patient showed no preceding symptoms and developed sudden arrhythmia and cardiac arrest. This case highlights the need for aggressive bleeding prevention and enhanced post-ESD cardiac surveillance to mitigate rare but potentially fatal complications.

Background While AI-assisted polyp detection has advanced significantly, comprehensive AI-based colonoscopy quality assessment tools remain limited. This study aimed to externally validate an AI-based colonoscopy quality assessment tool (AI-CQ) in Japanese clinical practice. Methods This retrospective study analyzed 40 screening colonoscopy procedures at a tertiary endoscopy hospital in Japan. All videos were recorded using Olympus equipment from anal insertion to complete withdrawal. AI-CQ measurements were compared with manual assessments by a certified endoscopist. Metrics evaluated included insertion time (IT), withdrawal time (WT), withdrawal time minus polypectomy time, and high-quality withdrawal time (HQ-WT). Results AI-CQ successfully identified cecal intubation in 97.5% of cases. Correlations between manual and AI measurements were moderate for IT (ρ = 0.48, p = 0.0025) and strong for WT (ρ = 0.70, p < 0.001). HQ-WT differed significantly by endoscopist experience (388 vs. 273 s, p = 0.025) and polyp detection status (497 vs. 298 s, p < 0.001). These associations remained significant even after adjusting for manual polyp observation time. Conclusion AI-CQ demonstrated feasibility for measuring colonoscopy quality metrics in Japanese practice, though with reduced correlation compared to US validation. Given the pilot nature of this study, these findings should be interpreted as exploratory. Novel metrics like HQ-WT showed promising associations with procedural quality indicators, warranting further validation in larger cohorts.