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.

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.

Evaluation of target area under the concentration-time curve of vancomycin in an initial dosing design: a retrospective cohort study.

Objectives: Area under the concentration-time curve (AUC)-guided dosing of vancomycin was introduced in a clinical setting; however, the target range of non-steady-state AUCs, such as Day 1 AUC and Day 2 AUC, remains controversial. Therefore, we sought to determine pharmacokinetic parameter thresholds and identify independent risk factors associated with acute kidney injury (AKI) to establish a safe initial dosing design for vancomycin administration.

Methods: A single-centre, retrospective, cohort study of hospitalized patients treated with vancomycin was conducted to determine the threshold of both non-steady-state AUCs (Day 1 and 2 AUCs) and trough levels at the first blood sampling point (therapeutic drug monitoring, TDM).

Serum zinc concentration as a potential predictor of presarcopenia in patients with chronic liver disease: a preliminary study.

Background: Presarcopenia is a common complication of chronic liver disease. However, the relationship between serum zinc concentration and presarcopenia in patients with chronic liver disease remains unclear. Herein, we examined whether serum zinc concentration could predict presarcopenia in patients with chronic liver disease.

Optimal allocation of physicians improves accessibility and workload disparities in stroke care.

Background: Inequalities in access to stroke care and the workload of physicians have been a challenge in recent times. This may be resolved by allocating physicians suitable for the expected demand. Therefore, this study analyzes whether reallocation using an optimization model reduces disparities in spatial access to healthcare and excessive workload.

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.

High preoperative serum strontium levels increase the risk of acute kidney injury after cardiopulmonary bypass.

Background: Acute kidney injury (AKI) is a common complication of cardiac surgeries. The incidence of AKI after cardiac surgeries using cardiopulmonary bypass (CPB-AKI) is high, emphasizing the need to determine strategies to prevent CPB-AKI. This study investigates the correlation between CPB-AKI and trace metal levels in clinical and animal studies.

Analysis of predictors after partial splenic embolization for thrombocytopenia with liver cirrhosis.

Blood transfusion, splenectomy, and partial splenic embolization (PSE) are generally performed for thrombocytopenia in patients with cirrhosis. Recently, thrombopoietin (TPO) agonists have become available, and investigations of patients who would benefit from them are necessary. Therefore, it is important to understand the fluctuations in cytokine levels associated with PSE.

ERRATUM: Differences in spatial patterns of long-term care depending on severity in Hokkaido, Japan.

Due to a mistake, the authors' affiliations were incorrectly reported in this article, published in Geospatial Health in 2022 (DOI: 10.4081/gh.2022.

Potential crowdedness of mechanical thrombectomy and cerebral infarction mortality in Japan: Application of inverted two-step floating catchment area method.

Objectives: This study aimed to evaluate a stroke medical delivery system based on population coverage and the potential crowdedness index (PCI) of mechanical thrombectomy and investigate the relationship between PCI and cerebral infarction mortality in Japan.

Materials And Methods: This cross-sectional study defined 662 facilities and 1605 neurointerventionalists as supply, population aged 55 years or older as demand, and set the reachable area for demand as 120 min in driving time. Multiple regression analysis adjusted for spatial autocorrelation was used to examine the relationship between PCI and cerebral infarction mortality.

Differences in spatial patterns of long-term care depending on severity in Hokkaido, Japan.

The increasing demand for long-term care (LTC) among the ageing population is a serious problem worldwide, which has greatly increased also in Japan since the introduction of the LTC insurance system there. Since there is a difference between insurers with respect to the proportion of people needing LTC, this study aimed at clarifying the spatial patterns of LTC. Insurer (n=156) LTC data for the period 2012-2019 were obtained from Ministry of Health, Labour, and Welfare and those needing LTC were classified into three classes: total, mild and severe with ageand sex-adjusted proportions needing LTC.

Histologic Analysis of Transjugular Liver Biopsy Specimens for Early Prediction of Prognosis in Acute Liver Failure.

Background And Aims: The prognosis of acute liver failure (ALF) treated with conservative therapy is extremely poor. Histologic diagnosis at the time ALF occurs provides important clues for determining the prognosis, including indications for liver transplant. Transjugular liver biopsy (TJLB), which helps clarify the pathology of ALF, may be an effective clinical parameter that contributes to prognosis prediction, including indications for liver transplant.

Evaluation of and Intervention for Sarcopenia in Hepatology Departments: A Survey of Nurses in Japan.

Sarcopenia is associated with poor prognosis and decreased quality of life in patients with chronic liver disease (CLD). The present study aimed to clarify the dissemination of interventions such as evaluations, prevention efforts, and treatments for sarcopenia among patients in hepatology outpatient departments and wards in Japan, as well as examine the factors related to such dissemination. A cross-sectional study was performed involving nurses from hospitals accredited by the Japan Society of Hepatology.

Optimal Skeletal Muscle Mass Index Cut-Off Values for Presarcopenia Evaluated by Computed Tomography against Dual-Energy X-ray Absorptiometry in Patients with Chronic Liver Disease.

Although dual-energy X-ray absorptiometry (DXA) and body impedance analysis are commonly used to measure skeletal muscle mass (SMM), a computed tomography (CT) scan is preferred in clinical practice. We aimed to propose the cut-off values of skeletal muscle mass index (SMI) calculated using CT scans, using DXA as the reference method. We retrospectively assessed 589 patients with chronic liver disease.

Effect of levocarnitine administration in patients with chronic liver disease.

L-carnitine administration was reported to improve sarcopenia in patients with cirrhosis. However, the amount of evidence from previous studies is not sufficient. The present study aimed to clarify the effect of levocarnitine (L-carnitine) administration on body composition in patients with chronic liver disease (CLD).

Skeletal Muscle Index at Intensive Care Unit Admission Is a Predictor of Intensive Care Unit-Acquired Weakness in Patients With Sepsis.

Background: Intensive care unit-acquired weakness (ICU-AW) can be diagnosed using the Medical Research Council (MRC) score. However, such scoring may not be possible in ICU patients who may be sedated or delirious or have encephalopathy. Currently, a quantitative assessment of the cross-sectional area of the muscle is available to assess changes in skeletal muscle mass using computed tomography (CT) images.

Efficacy of Physical Activity in Prevention of Muscle Weakness in Patients With Chronic Liver Disease.

Background: Sarcopenia is a prognostic factor for patients with liver cirrhosis and hepatocellular carcinoma, and it affects the onset of hepatic encephalopathy. Therefore, the prevention of sarcopenia contributes to the improvement of the prognosis of patients with chronic liver disease (CLD). We focused on changes of hand grip strength (HGS), one of the indicators of sarcopenia.

Relationship between pre-sarcopenia and quality of life in patients with chronic liver disease: a cross-sectional study.

Aim: This study aimed to clarify the relationship between pre-sarcopenia (PS) and quality of life (QOL) in patients with chronic liver disease (CLD).

Patients And Methods: This cross-sectional study evaluated 335 patients with CLD. PS was diagnosed on the basis of the assessment criteria by the Japan Society of Hepatology.