Are There Shortages and Regional Disparities in Lecanemab Treatment Facilities? A Cross-Sectional Study.

Introduction: Alzheimer disease (AD) is the most common type of dementia, affecting 70% of patients with dementia. In Japan, over 5 million people aged 65 years and older had dementia in 2018, and this figure is expected to rise to 25% to 30% of this age group by 2045. In Japan, lecanemab, which was approved in 2023, is expected to be a new treatment for AD.

Cost-effectiveness analysis for multi adverse events of proton beam therapy for pediatric medulloblastoma in Japan.

Medulloblastomas are one of the most common malignant cancers of the central nervous system in children. Proton beam therapy (PBT) is expected to provide equivalent tumor control to photon therapy while reducing the various adverse events caused by irradiation. Few studies have considered the cost-effectiveness of PBT for pediatric medulloblastoma, considering the multiple adverse effects and reflecting on the latest treatment advancements.

Spatial accessibility of home visiting nursing: An exploratory ecological study.

Background And Aims: Japan is one of the oldest societies worldwide and manages a system of care for older adults in the community. In the 2000s, a community-based integrated care system was introduced to enable older adults to live in their neighborhoods. Home visiting nursing (HVN) is a crucial component of this system; however, the current and future shortage of home visiting nurses is a concern.

The Capacitated Maximal Covering Location Problem Improves Access to Stroke Treatment: A Cross-Sectional Simulation Study.

Disparities in accessing advanced stroke treatment have been recognized as a policy challenge in multiple countries, including Japan, necessitating priority solutions. Nevertheless, more practical healthcare policies must be implemented due to the limited availability of healthcare staff and financial resources in most nations. This study aimed to evaluate the supply and demand balance of mechanical thrombectomy (MT) and identify areas with high priority for enhancing stroke centers.

Events related to medication errors and related factors involving nurses’ behavior to reduce medication errors in Japan: a Bayesian network modeling-based factor analysis and scenario analysis.

Purpose: This study aimed to identify the relationships between medication errors and the factors affecting nurses’ knowledge and behavior in Japan using Bayesian network modeling. It also aimed to identify important factors through scenario analysis with consideration of nursing students’ and nurses’ education regarding patient safety and medications.

Methods: We used mixed methods.

Association between oral frailty and Prevotella percentage in the oral microbiota of community-dwelling older adults who participated in the CHEER Iwamizawa project, Japan.

Background: Prevotella bacteria are associated with inherent diseases of the oral cavity, such as periodontal disease, and systemic diseases. Oral frailty (OF) has been associated with nursing necessity and death. However, the relationship between OF and oral microbiota has not been fully clarified.

Correction: Verification in the Early Stages of the COVID-19 Pandemic: Sentiment Analysis of Japanese Twitter Users.

[This corrects the article DOI: 10.2196/37881.].

Telehealth Consultation for Malaysian Citizens' Willingness to Pay Assessed by the Double-Bounded Dichotomous Choice Method.

Background: Re-envisioning healthcare in technology tools includes robust utilisation of telehealth, improvement in access, quality, care efficiencies and cost-effectiveness of healthcare services. In reality, the technology's potential to transform healthcare may be limited by the ability to pay for it. This study aims to estimate Malaysian citizens' willingness to pay (WTP) for telehealth consultations and determine the factors contributing to it.

Optimal Transport System for Acute Ischemic Stroke Patients: A Cost-Effectiveness Analysis.

This study conducted cost utility analysis comparing 4 systems of transporting acute ischemic stroke patients in Hokkaido, Japan. Hypothetical patients were generated on a geographic information system, and their outcomes were estimated according to their transport time to hospitals administering tissue plasminogen activator and/or endovascular thrombectomy. The transport systems where a neurointerventionist traveled for earlier endovascular thrombectomy were most cost-effective in some rural areas, while direct transportation to comprehensive stroke centers was more cost-effective in other areas.

Deep learning-based video-analysis of instrument motion in microvascular anastomosis training.

Purpose: Attaining sufficient microsurgical skills is paramount for neurosurgical trainees. Kinematic analysis of surgical instruments using video offers the potential for an objective assessment of microsurgical proficiency, thereby enhancing surgical training and patient safety. The purposes of this study were to develop a deep-learning-based automated instrument tip-detection algorithm, and to validate its performance in microvascular anastomosis training.

Verification in the Early Stages of the COVID-19 Pandemic: Sentiment Analysis of Japanese Twitter Users.

Background: The COVID-19 pandemic prompted global behavioral restrictions, impacting public mental health. Sentiment analysis, a tool for assessing individual and public emotions from text data, gained importance amid the pandemic. This study focuses on Japan's early public health interventions during COVID-19, utilizing sentiment analysis in infodemiology to gauge public sentiment on social media regarding these interventions.

[Attempt to Evaluate the Influence of Morphology, Blood Flow, and Hardness in Mammary Gland Malignant Disease].

It is important to make an appropriate diagnosis category by evaluating the morphology, blood flow, and hardness of mammary gland disease in breast ultrasound, such as screening and detailed examination. Therefore, understanding the characteristics and effects of B-mode (BM), color Doppler (CD), and elastography (EG) in ultrasonography is considered to lead to improvement in examination accuracy. In this study, we clarified the impact of each function on qualitative diagnosis, with the aim of assisting technologists with high-accuracy breast ultrasound.

Grad-CAM-Based Explainable Artificial Intelligence Related to Medical Text Processing.

The opacity of deep learning makes its application challenging in the medical field. Therefore, there is a need to enable explainable artificial intelligence (XAI) in the medical field to ensure that models and their results can be explained in a manner that humans can understand. This study uses a high-accuracy computer vision algorithm model to transfer learning to medical text tasks and uses the explanatory visualization method known as gradient-weighted class activation mapping (Grad-CAM) to generate heat maps to ensure that the basis for decision-making can be provided intuitively or via the model.

Tissue Acceleration as a Novel Metric for Surgical Performance During Carotid Endarterectomy.

Background And Objectives: Gentle tissue handling to avoid excessive motion of affected fragile vessels during surgical dissection is essential for both surgeon proficiency and patient safety during carotid endarterectomy (CEA). However, a void remains in the quantification of these aspects during surgery. The video-based measurement of tissue acceleration is presented as a novel metric for the objective assessment of surgical performance.

Regional disparity in the provision of rehabilitation services using the open data from the Japanese national claims database: an ecological study.

Objectives: There are few reports on regional differences in the supply/utilisation balance and provision of rehabilitation services. This study analysed those regional differences in Japan to help policymakers provide more uniform and efficient rehabilitation services and optimally allocate related resources.

Design: An ecological study.

Regional assessment of medical care provision system by principal component analysis.

Introduction: The Japanese government has promoted policies ensuring standardized medical care across the secondary medical care areas (SMCAs); however, these efforts have not been evaluated, making the current conditions unclear. Multidimensional indicators could identify these differences; thus, this study examined the regional characteristics of the medical care provision system for 21 SMCAs in Hokkaido, Japan, and the changes from 1998 to 2018.

Materials And Methods: This study evaluated the characteristics of SMCAs by principal component analysis using multidimensional data related to the medical care provision system.

Cost-effectiveness of seven-days-per-week rehabilitation schedule for acute stroke patients.

Background: Rehabilitation is an essential medical service for patients who have suffered acute stroke. Although the effectiveness of 7-days-per-week rehabilitation schedule has been studied in comparison with 5- or 6-days-per-week rehabilitation schedule, its cost-effectiveness has not been analyzed. In this research, to help formulate more cost-effective medical treatments for acute stroke patients, we analyzed the cost-effectiveness of 7-days-per-week rehabilitation for acute stroke from public health payer's perspective, and public healthcare and long-term care payer's perspective in Japan.

Assessment of the Efficiency of Non-Invasive Diagnostic Imaging Modalities for Detecting Myocardial Ischemia in Patients Suspected of Having Stable Angina.

This study aimed to assess and compare the efficiency of non-invasive imaging modalities in detecting myocardial ischemia in patients with suspected stable angina as easy-to-understand indices. Our study included 1000 patients with chest pain and possible stable myocardial ischemia. The modalities to be assessed were cardiac magnetic resonance imaging (CMRI), single-photon emission computed tomography, positron emission computed tomography (PET), stress echocardiography, and fractional flow reserve derived from coronary computed tomography angiography (FFRCT).

COVID-19-related stress, exercise, and oral health-related quality of life among community-dwelling older adults who participated in the CHEER Iwamizawa project, Japan.

This study examined the association between coronavirus disease 2019 (COVID-19)-related stress, exercise habits, and oral health-related quality of life (OHRQoL) in a sample of 215 community-dwelling older adults in Japan (57 men, 158 women; M = 74.2 years, SD = 6.0).