Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: Although there is increasing evidence to suggest the cost-effectiveness of aspirin use to prevent colorectal cancer (CRC) in the general population, no study has assessed cost-effectiveness in patients with familial adenomatous polyposis (FAP), who are at high risk of developing CRC. We examined the cost-effectiveness of preventive use of low-dose aspirin in FAP patients who had undergone polypectomy in comparison with current treatment practice. DESIGN: We developed a microsimulation model that simulates a hypothetical cohort of the Japanese population with FAP for 40 years. Three scenarios were created based on three intervention strategies for comparison with no intervention, namely intensive downstaging polypectomy (IDP) of colorectal polyps at least 5.0 mm in diameter, IDP combined with low-dose aspirin, and total proctocolectomy with ileal pouch-anal anastomosis (IPAA). Cost-effective strategies were identified using a willingness-to-pay threshold of USD 50,000 per QALY gained. RESULTS: Compared with no intervention, all strategies resulted in extended QALYs (21.01-21.43 QALYs per individual) and showed considerably reduced colorectal cancer mortality (23.35-53.62 CRC deaths per 1000 individuals). Based on the willingness-to-pay threshold, IDP with low-dose aspirin was more cost-effective than the other strategies, with an incremental cost-effectiveness ratio of $57 compared with no preventive intervention. These findings were confirmed in both one-way sensitivity analyses and probabilistic sensitivity analyses. CONCLUSION: This study suggests that the strategy of low-dose aspirin with IDP may be cost-effective compared with IDP-only or IPAA under the national fee schedule of Japan.

DOI： 10.1002/cam4.6488

PubMed

researchmap

researchmap

researchmap

Language：Japanese   Publisher：(一財)厚生労働統計協会  

researchmap

Publishing type：Part of collection (book)   Publisher：Springer Nature Singapore  

DOI： 10.1007/978-981-99-2969-6_15

researchmap

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley  

BACKGROUND AND AIM: Sessile serrated lesions (SSLs) act as precursors to colorectal cancer, sometimes harbor carcinomas, and are sometimes incompletely resected. We aimed to evaluate local recurrence after endoscopic resection of SSL ≥10 mm. METHODS: This prospective, single-arm, observational study was performed at eight Japanese tertiary institutions. Colorectal lesions ≥10 mm were resected endoscopically, and the pathological diagnosis was either an SSL or hyperplastic polyp (HP). Follow-up colonoscopy was performed 1 year later, and the local recurrence was evaluated by biopsy. RESULTS: From October 2018 to September 2021, 104 cases with 123 lesions were registered. Among the pathologically diagnosed 105 SSLs and 18 HPs, 95 and 7 lesions were diagnosed as SSLs and HPs, respectively, by central pathological review. Among the 104 endoscopically diagnosed SSLs, 86 were diagnosed as SSLs, whereas among the 11 endoscopically diagnosed HPs, two were diagnosed as HPs by central pathological review (the rest were SSLs). Among the 95 patients with 113 lesions who underwent follow-up colonoscopy, resection scars were identified in 95 (84%) lesions. Three (3.1%; 95% confidence interval 0.6-8.7%) local recurrences were diagnosed pathologically among 98 pathologically diagnosed SSLs. Two (6%) local recurrences were diagnosed in patients with SSLs ≥20 mm. CONCLUSIONS: The local recurrence rate after endoscopic resection of SSLs ≥10 mm was 3.1%. Careful follow-up is recommended after endoscopic resection of large SSLs. Endoscopically diagnosed HPs ≥10 mm were sometimes pathologically diagnosed as SSL and should be considered for resection.

DOI： 10.1111/jgh.16032

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

During the COVID-19 pandemic in Japan, various measures have been implemented to prevent the spread of infection, including restrictions on human mobility. A dynamic fluctuation in the number of suicides has been observed during this period. The question is whether the increase/decrease in suicides during the pandemic is related to changes in human mobility. To answer the same, we estimated incidence rate ratios (IRR) of suicide for changes in human mobility using the relative number of suicides by month from March 2020 to September 2021, based on the same months in 2019 as reference. The IRR of suicide during the pandemic were significantly lower in the months when mobility decreased-in both the previous and current month-than in the months when mobility was stable; the IRR of suicide were statistically higher in the months with increased mobility compared with the stable months. The burden from a decrease in one's mobility, which might lead to an increase in suicide, may not occur immediately, as seen in the delayed effects of unemployment. It may be important to investigate people's mental health and stress levels after pandemic restrictions were relaxed. The findings may help practitioners and families consider the timing of intervention.

DOI： 10.1016/j.psychres.2022.114898

PubMed

researchmap

Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(一財)厚生労働統計協会  

目的 がん死亡の経時変化のモニタリングはがん対策の計画の策定・評価の各場面において,重要な役割を担う。一方で,経時変化のモニタリングには複雑な数理モデリングやデータ解析が必要となるため,各自治体でがん対策の策定・評価を行う実務者が実行するのは容易ではない。本研究では,公的統計を用いて,各自治体の担当者が利用可能なツールの作成とその概要について紹介することを目的とした。方法 都道府県別の人口動態統計および国勢調査から取得した,1995〜2018年のがん死亡データおよび人口データと国立社会保障・人口問題研究所提供の予測人口データから作成した2019〜2030年の各都道府県予測人口を用いた。これらのデータを基に,Nordpred解析を実行するツールをR言語により作成しWeb上に提供した。結果 本研究で作成したツールでは様々な設定に基づいて,2030年までの各都道府県のがん死亡率の推移と予測値を算出することが可能である。作成したツールを用いることで専門性の高い解析作業なしに,柔軟ながん死亡率の分析が可能となり,迅速ながん対策の策定・評価への活用が期待される。作成したツールはNordpredによるがん死亡率経時変動予測(https://fukui-ke-0507.shinyapps.io/JCanMorTrend/)より利用可能である。結論 医療・保健政策現場におけるEvidence Based Policy Making,Evidence Based Medicineを促進するには,データの利活用を避けることができないが,データ解析技術等の習得には多大な労力を要する。本研究で作成したWeb applicationツールの利用を通じて,様々な保健医療政策において,データに基づく意思決定の支援を促進していくことが求められる。(著者抄録)

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BackgroundThis longitudinal study aimed to investigate how psychological distress levels changed from early to middle phases of the new coronavirus (COVID-19) pandemic depending on the living arrangements of individuals.MethodAn internet-based, longitudinal survey of 2,400 Japanese people was conducted every 5-6 weeks between February 2020 and January 2021. The presence of severe psychological distress (SPD) was measured using the Kessler's psychological distress scale. Living arrangements were classified into two groups, i.e. living alone or living with others. Mixed-effects logistic regression analysis was performed to assess whether changes in SPD status were different depending on living arrangements.ResultsOf 2400 respondents, 446 (18.5%) lived alone. Although the proportion of SPD in both individuals living alone and those living with others increased to the same extent in the early phase of the pandemic, however, after early phase of pandemic, the distress levels decreased in the group living with others, compared with the group living alone, which remained high. The odds ratio (OR) of developing SPD in interaction term with survey phases tended to be higher among those who lived alone than those who lived with others in Phase 6 (OR: 1.89, CI: 0.99-3.64) and Phase 7 (OR:1.88, CI: 0.97-3.63)ConclusionsDuring the COVID-19 pandemic, those living alone are persistently at a higher risk of SPD compared to those living with others. Effective countermeasures targeting those living alone such as enhancing online communication or providing psychological therapies are essential.

DOI： 10.2188/jea.JE20210397

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Screening is one of the effective interventions for the reduction of colorectal cancer mortality. Though the Japanese government recommends faecal occult blood test and colonoscopy as a follow-up examination following a diagnosis, both participation rates have not been so high and the national mortality rate has not shown a clear decreasing trend. METHODS: Microsimulation models simulate the life histories of a large population of individuals under various scenarios. In this study, we applied a microsimulation model to estimate the reduction of colorectal cancer mortality based on screening scenarios. RESULTS: The effect of reducing the age-standardized mortality rate for colorectal cancer was estimated at 9.4% for men and 6.0% for women under the scenario which calls for 50% participation in faecal occult blood test and 90% participation of follow-up examination. This scenario corresponds to the goal setting for screening in the third-term of the Basic Plan to Promote Cancer Control Programs in Japan. CONCLUSIONS: Our microsimulation model was found to be useful in estimating the mortality reduction effect of cancer control policy. Such modelling techniques can be utilized to develop effective and optimal cancer control programs.

DOI： 10.1093/jjco/hyab195

PubMed

researchmap

Language：Japanese  

INTRODUCTION: Recently, registry-based cancer research linking biobanks with clinical information has become practical. In fact, hospital-based cancer registries(HBCR)are considered appropriate for basic medical information provision to link with biospecimen data since they can capture accurate information about cancer incidence and prognosis. The aim of this systematic review was to examine HBCR and biospecimen data uses in clinical and epidemiological studies. METHODS: We searched PubMed and Google Scholar for articles regarding HBCR and biospecimen data uses published before November 2019. Selected articles were summarized by study design into HBCR usage, biospecimen data usage, exposure, outcome, informed consent, and participant numbers. RESULT: Of the 2,767 identified articles, 148 studies were included in this review. In cohort studies, most HBCR usage was noted for patient selection, and most biospecimen data usage was factors affecting prognosis. Meanwhile, in case-control studies, most HBCR usage was noted for cancer incidence identification, and most biospecimen data usage was factors affecting cancer incidence. CONCLUSION: HBCR and biospecimen data usage in clinical and epidemiological studies were found to be different based on study design. Linkage of HBCR and biospecimen data will enable researchers to conduct clinical and epidemiological studies that correspond to varying research question types.

PubMed

J-GLOBAL

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Background: Area differences in life expectancy (LE) and healthy life expectancy (HLE) in large geographical units have been monitored around the world. Area characteristics may be based on culture, history, socioeconomic status and discrimination in smaller geographical units, so it is important to consider these when looking at health inequality. We aimed to evaluate LE, HLE, and non-healthy life expectancy (NHLE) in 1707 municipalities using Areal Deprivation Index (ADI) in Japan for the first time. Methods: We calculated the observed LE, HLE, and NHLE using death, population, and Long-term care insurance data for 2010-2014 and applied the variance weighted least squares model to estimate LE, HLE, and NHLE by 100 percentiles using the standardized ADI. Findings: The estimated LE, HLE, and NHLE became lower as the deprivation index worsened: the differences between the most and least deprived areas for HLE were 2·49 years for LE and 2·32 years for HLE in males; 1·22 years for LE and 0·93 years for HLE in females. The observed LE and HLE in the most deprived areas were much lower than other areas. Interpretation: Using ADI has enabled us to see the disparity within municipalities precisely. LE and HLE outlier for the 100th percentile might be linked to historical areal deprivation and marginalization. Precise monitoring of socioeconomic status-based health inequalities could help manage these inequalities by identifying the groups most in need of intervention.

DOI： 10.1016/j.lanwpc.2021.100204

Scopus

researchmap

Publishing type：Research paper (scientific journal)   Publisher：Informa UK Limited  

DOI： 10.1080/03610926.2021.1931888

researchmap

Language：Japanese   Publisher：The Biometric Society of Japan  

<p>In this paper, we implement a micro-simulation (MS) model for colorectal cancer and report the process of the MS model applying to Japanese data. As an advantage of MS, it is possible to evaluate the effects of interventional cancer control program based on various scenario setting. Although there are many advanced MS projects in policy making in other countries, they are still on the way of developing in Japan. Then, we have tried to construct a colorectal cancer MS model in Japan. The purpose of this paper is to describe the process of colorectal cancer MS in Japan as a useful manual for future reference, and to introduce an on-going research project and future possibility of research extensions.</p>

DOI： 10.5691/jjb.41.93

J-GLOBAL

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution. This single-center, prospective observational study of 249 consecutive patients aged ≥ 20 years proceeded in the ED of a university hospital in Japan during 6 months. Pairs of blood samples were collected for aerobic and anaerobic culture from all patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference. We found 50 (20.1%) patients with potentially contaminated blood cultures. Fifty-six (22.5%) patients were true bacteremia and 143 (57.4%) patients were true negatives. Multivariate analysis associated more frequent contamination when puncture sites were disinfected with povidone-iodine than with alcohol/chlorhexidine (adjusted risk difference, 12.9%; 95% confidence interval [CI] 8.8-16.9; P < 0.001). Sites of blood collection were also associated with contamination. Femoral and central venous with other sites were associated with contamination more frequently than venous sites (adjusted risk difference), 13.1% (95% CI 8.2-17.9; P < 0.001]) vs. 17.3% (95% CI 3.6-31.0; P = 0.013). Rates of contaminated blood cultures were significantly higher when blood was collected from femoral sites and when povidone-iodine was the topical antiseptic.

DOI： 10.1038/s41598-021-85614-7

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Suicide amidst the coronavirus disease (COVID-19) pandemic is an important issue. In Japan, the number of suicides in April 2020 decreased by nearly 20% from that in 2019. To assess the impact of an infectious disease pandemic, excess mortality is often discussed. Our main purpose was evaluating excess mortality from suicide in Japan during the early pandemic period. METHODS: We used data on suicides collected by the National Police Agency of Japan until June 2020. We estimated excess mortality during the early pandemic period (March-June 2020) using a time-series model of the number of suicides before the pandemic. A quasi-Poisson model was employed for the estimation. We evaluated excess mortalities by the categories of age and sex, and by prefecture. RESULTS: No significant excess mortality was observed throughout the early pandemic; instead, a downward trend in the number of suicides for both sexes was noted. For males, negative values of excess mortalities below the lower bound of the 95% prediction interval were observed in April and May. All numbers of females during the period were included in the interval, and the excess mortalities in June were positive and higher than those in April and May. In Tokyo, the number of suicides was below the lower bound throughout the period. CONCLUSION: Our results suggest that various changes, such as communication, and social conditions amid the early COVID-19 pandemic induced a decrease in suicides in Japan. However, continuous monitoring is needed to evaluate the long-term effects of the pandemic on suicides.

DOI： 10.2188/jea.JE20200443

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: Microscopic polyangiitis (MPA) is often complicated by interstitial lung disease (ILD); however, biomarkers that can be used to diagnose and predict the progression of MPA-ILD have not been identified. In this study we evaluated various serum biomarkers in MPA-ILD to assess their diagnostic and predictive performance. METHODS: We enrolled 49 patients with anti-neutrophil cytoplasmic antibody (ANCA)+ MPA and 10 healthy controls, with 32 of the MPA patients also presented ILD. The presence of ILD was assessed by high-resolution computed tomography and evaluated by ground-glass opacity and fibrosis score. We compared 16 biomarker profiles among MPA-ILD patients, those without ILD, and healthy controls and extracted biomarkers with higher levels in MPA-ILD groups to determine correlations with disease activity and other biomarkers. Three lung biopsies were examined by hematoxylin-eosin staining and immunostaining. RESULTS: Initial serum C-C motif chemokine ligand 2 (CCL2) levels were significantly higher in the MPA-ILD group than those of the MPA group, and were significantly higher in MPA-ILD patients 1 year after immunosuppressive therapy than those before treatment. Initial serum CCL2 levels positively correlated with an increased fibrosis score during the year after treatment and with initial serum platelet-derived growth factor levels. Immunohistochemical staining showed intense CCL2 signals in CD68+/CD163+ macrophages and metaplastic epithelial cells in MPA-ILD lungs. CONCLUSION: CCL2 is associated with MPA-ILD pathogenesis and suggested its potential efficacy as a useful marker for diagnosing and predicting MPA-ILD progression. Therefore, targeting CCL2 in alveolar CD68+/CD163+ macrophages might represent a therapeutic intervention in ANCA+ MPA-ILD.

DOI： 10.1093/rheumatology/keab064

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

The prognosis of microscopic polyangiitis (MPA) with interstitial lung disease (ILD) is significantly worse than that of MPA without ILD. However, the clinical characteristics in MPA-ILD, especially poor prognostic factors, are not elucidated. We evaluated demographic, clinical, laboratory, and radiological findings, treatments, and outcomes of 80 patients with MPA, and investigated prognostic factors of respiratory-related death in patients with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA) positive MPA-ILD. Ground-glass opacity and fibrosis were evaluated as scores on high-resolution computed tomography (HRCT). The presence of ILD was consistent with a high risk of respiratory-related death (hazard ratio, 4.8; P = 0.04). Multivariable logistic regression analyses using propensity scoring showed right or left lower lobe fibrosis score to be significantly associated with respiratory-related death (P = 0.0005 and 0.0045, respectively). A right or left lower lobe fibrosis score ≥ 2, indicating the presence of honeycombing at 1 cm above the diaphragm, was determined to be the best cut-off value indicating a poor prognosis. The 5-year survival rate was significantly lower in patients with right or left lower lobe fibrosis score ≥ 2 (survival rates: 37% and 19%, respectively) than those with a score < 2 (71% and 68%, respectively) (P = 0.002 and 0.0007, respectively). These findings suggest that the presence of honeycomb lesions in bilateral lower lobes on chest HRCT was associated with respiratory-related death in patients with MPO-ANCA positive MPA-ILD.

DOI： 10.1038/s41598-021-81311-7

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Japan Epidemiological Association  

BACKGROUND: This longitudinal study aimed to examine the changes in psychological distress of the general public from the early to community-transmission phases of the COVID-19 pandemic and to investigate the factors related to these changes. METHODS: An internet-based survey of 2,400 Japanese people was conducted in two phases: early phase (baseline survey: February 25-27, 2020) and community-transmission phase (follow-up survey: April 1-6, 2020). The presence of severe psychological distress (SPD) was measured using the Kessler's Six-scale Psychological Distress Scale. The difference of SPD percentages between the two phases was examined. Mixed-effects ordinal logistic regression analysis was performed to assess the factors associated with the change of SPD status between the two phases. RESULTS: Surveys for both phases had 2,078 valid respondents (49.3% men; average age, 50.3 years). In the two surveys, individuals with SPD were 9.3% and 11.3%, respectively, demonstrating a significant increase between the two phases (P = 0.005). Significantly higher likelihood to develop SPD were observed among those in lower (ie, 18,600-37,200 United States dollars [USD], odds ratio [OR] 1.95; 95% confidence interval [CI], 1.10-3.46) and the lowest income category (ie, <18,600 USD, OR 2.12; 95% CI, 1.16-3.86). Furthermore, those with respiratory diseases were more likely to develop SPD (OR 2.56; 95% CI, 1.51-4.34). CONCLUSIONS: From the early to community-transmission phases of COVID-19, psychological distress increased among the Japanese. Recommendations include implementing mental health measures together with protective measures against COVID-19 infection, prioritizing low-income people and those with underlying diseases.

DOI： 10.2188/jea.JE20200271

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SAGE Publications  

DOI： 10.1177/0003134820950689

PubMed

researchmap

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/0003134820950689

Language：English   Publishing type：Research paper (scientific journal)  

In Japan, a study using population-based cancer registry data from six prefectures revealed a difference in bladder cancer survival between men and women. However, the period of the study was limited to 1993-2006. The recent introduction of immune checkpoint inhibitors, which have proved to be effective for the treatment for bladder cancer, has led to a rising demand for analysis of long-term trends in net survival in order to accurately assess the effect of the new treatment. The aim of the present study was to examine long-term trends in sex difference in bladder cancer net survival using large-scale population-based cancer registry data from Osaka, Japan (17,500 cases from 1975 to 2009). We also evaluated sex difference in bladder cancer survival after adjustment for stage, histologic type, and other prognostic factors. We showed the long-term trend of five-year net survival for each stage and found that women had poorer five-year net survival than men for the whole study period. The risk of death from bladder cancer was higher among men than women even after adjusting for period at diagnosis, histologic type, stage, age group, and treatment (Excess hazard ratios: 1.17; 95% Confidence interval: 1.10-1.25).

DOI： 10.1002/cam4.3382

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND AIM: Endoscopic resection for early gastric cancer (EGC) is widely performed. However, there is still a paucity of strong evidence regarding long-term outcomes after endoscopic submucosal dissection (ESD) for the expanded indication criteria of the Japanese guidelines (ver. 2010). METHODS: ESD was performed in patients with EGC that met the expanded indication criteria: (1) cT1a, differentiated-type EGC of 2 to 5 cm, ulcer-negative or (2) cT1a, differentiated-type EGC of ≤3 cm, ulcer-positive. Patients whose pathological examination fulfilled the curative resection criteria were then enrolled in this cohort study: negative vertical margin, negative lymphovascular invasion, and (1) pT1a, differentiated-type, and ulcer-negative; (2) pT1a, differentiated-type, ≤3 cm, and ulcer-positive; or (3) pT1b1 (<500 μm submucosal invasion), differentiated-type, and ≤3 cm. Patients with only a positive horizontal margin as a noncurative factor were included for follow-up. RESULTS: From September 2003 to February 2012, a total of 356 patients underwent ESD, and 214 were enrolled in the survival analysis. 120 patients (56%) had >2 cm in diameter and ulcer-negative lesions, and 94 (44%) had ≤3 cm and ulcer-positive lesions. The vital status at 5 years after ESD was confirmed in all (100%) patients. No local or metastatic recurrence was detected; however, 26 metachronous gastric cancers developed, and 1 patient died of metachronous gastric cancer. The 5-year disease-specific and overall survival rates were 99.5% (95% CI, 97.2%-100%) and 93.9% (95% CI, 89.8%-96.4%), respectively. CONCLUSION: ESD for EGC that fulfills the expanded criteria is feasible and shows favorable long-term outcomes.

DOI： 10.1111/jgh.15182

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Epidemiologic information on rare cancers is scarce outside of the Western countries. The project "surveillance of rare cancers in Asia" (RARECAREnet Asia) provides, for the first time, the burden of rare cancers in some Asian countries based on the latest list. OBJECTIVES: 1) to assess whether the European list of rare cancers fits the Asian setting and 2) to compare the incidences of rare cancers between Europe and Asian countries. MATERIAL AND METHODS: Population-based cancer registry data on patients diagnosed from 2011 to 2015 in Japan, Korea, and Taiwan and patients diagnosed from 2000 to 2007 in 94 European registries were analysed. The incidences for all cancers were calculated; they were then grouped into several tiers and families according to the rare cancer list, and whether cancers rare was examined. RESULTS: Rare cancer counts according to the list in the observed population were 196 in Japan, 203 in Korea, 198 in Taiwan, and 198 in the EU. The proportions of rare in overall incidence were 16.3% in Japan, 23.7% in Korea, 24.2% in Taiwan, and 22.2% in the EU. The numbers of newly diagnosed rare cancer cases in 2015 were 140,188 in Japan, 52,071 in Korea, and 24,147 in Taiwan. CONCLUSION: Most rare cancers in Europe were also rare in the Asian countries considered. The observed differences were due to well-known risk factors. The European definition and list of rare cancers appear to reflect well cancer incidence in East Asia.

DOI： 10.1016/j.canep.2020.101702

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Background: Previous clinical studies have reported that Shakuyaku-kanzo-to (SKT) has a therapeutic effect on muscle cramps, but few studies have clarified how SKT acts to treat muscle cramps. The aim of this study was to perform an updated systematic review of clinical trials for SKT in patients with muscle cramps. Methods: The literature was systematically reviewed to assess the effects of SKT in patients with muscle cramps. PubMed, Web of Science, Cochrane Library, Google Scholar, and Ichushi-Web were searched using the terms "Shakuyaku-kanzo-to" ("shakuyakukanzoto", etc), "clinical trials" and "muscle cramps". Two quality assessments were conducted independently by three authors. Data were extracted using a standardized extraction tool, and a qualitative synthesis of evidence was performed. Results: Three randomized controlled articles were identified and enrolled in this study. A systematic review, but not a meta-analysis, was performed because of the high heterogeneity and limited number of studies. In patients with liver cirrhosis, the odds ratio (OR) for improvement with SKT compared to placebo was 1.27 (95% confidence interval [CI], 0.445-2.086) and compared to Goshajinkigan was 0.81 (95%CI, -1.734-0.114). The OR for improvement with SKT compared with eperisone hydrochloride in patients with lumbar spinal stenosis was 2.86 (95%CI, 0.980-4.744). Conclusions: Current evidence appears insufficient to allow a meta-analysis of the effects of SKT, but SKT might show efficacy in treating muscle cramps in patients with cirrhosis or lumbar spinal stenosis.

DOI： 10.1002/jgf2.302

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BackgroundAlthough the incidence and mortality have decreased, gastric cancer (GC) is still a public health issue globally. An international study reported higher survival in Korea and Japan than other countries, including the US. We examined the determinant factors of the high survival in Japan, compared with the US.MethodsWe analysed data on 78,648 cases from the nationwide GC registration project, the Japanese Gastric Cancer Association (JGCA), from 2004-2007 and compared them with 16,722 cases from the Surveillance, Epidemiology, and End Results Program (SEER), a US population-based cancer registry data from 2004-2010. We estimated five-year relative survival and applied a multivariate excess hazard model to compare the two countries, considering the effect of number of lymph nodes (LNs) examined.ResultsFive-year relative survival in Japan was 81.0%, compared with 45.0% in the US. After controlling for confounding factors, we still observed significantly higher survival in Japan. Among N2 patients, a higher number of LNs examined showed better survival in both countries. Among N3 patients, the relationship between number of LNs examined and differences in survival between the two countries disappeared.ConclusionAlthough the wide differences in GC survival between Japan and US can be largely explained by differences in the stage at diagnosis, the number of LNs examined may also help to explain the gaps between two countries, which is related to stage migration.

DOI： 10.2188/jea.JE20190351

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVES: To elucidate the serum cytokine profile and address the pathomechanism of interstitial lung disease (ILD) complicated with PM/DM. METHODS: Forty patients with PM/DM-ILD were enrolled, and principal components analysis and cluster analysis were performed to classify patients into subgroups. Additionally, we compared cytokine profiles between the survivors and dead patients and between anti-melanoma differentiation-associated gene 5 antibody- and anti-aminoacyl tRNA synthetase antibody-positive ILD patients. We also examined the association of various cytokines with disease activity indicators and prognosis of ILD. RESULTS: The principal components analysis data allowed classification of the cytokine profile into three groups: group 1, neutrophilic and M1-macrophage-driven cytokines; group 2, type 1 Th cell-driven and M2-macrophage-induced cytokines; and group 3, M2-macrophage-driven cytokines. Cluster analysis showed the presence of PM/DM-ILD patient groups with high or low levels of total cytokines. Ninety percent of patients who died of ILD were included in clusters with high cytokine levels. Serum cytokine levels of all groups were significantly higher in the anti-melanoma differentiation-associated gene 5 antibody-positive patients than in the anti-aminoacyl tRNA synthetase antibody-positive patients. Groups 1 and 2 significantly correlated with known factors for poor prognosis, such as serum ferritin levels and alveolar-arterial oxygen difference. Serum cytokine levels of patients in group 1 were significantly higher initially and at 2 and 4 weeks in those who died. CONCLUSION: These findings suggested that the activation of monocytes, macrophages and type 1 Th cells, and neutrophils play roles in the pathomechanism of PM/DM-ILD, and group 1 cytokines could be useful biomarkers for predicting prognosis of PM/DM-ILD.

DOI： 10.1093/rheumatology/kez301

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND AND AIM: The true incidence of incomplete muscularis mucosa resection with cold snare polypectomy (CSP) is unknown. We examined the incidence of incomplete muscularis mucosa resection both with and without cold snare defect protrusion (CSDP). METHODS: We prospectively enrolled patients undergoing polypectomy for 4 to 9mm nonpedunculated polyps. We evaluated the presence of CSDP immediately following CSP and biopsied the CSDP or the center of the mucosal defect without CSDP. The presence of the muscularis mucosa and any residual polyp in the biopsies was evaluated histologically. The primary outcome was the incidence of incomplete mucosal layer resection defined as the presence of muscularis mucosa or residual polyp in the biopsies. RESULTS: From August 2017 to October 2018, 188 patients were screened, and 357 polyps were included. CSDP was detected in 122/355 (34%) evaluated mucosal defects. Excluding five lesions requiring hemostasis immediately following CSP, 352 mucosal defects were biopsied. After excluding 102 biopsies containing normal mucosa, we evaluated 250 biopsies. The overall incidence of incomplete mucosal layer resection was 63% (159/250), 76% (68/90) with CSDP and 57% (91/159) without CSDP (P < 0.01). Both univariate and multivariate analyses showed that size (≥ 6 mm), resection time (≥ 5 s), and serrated lesions were risk factors for CSDP. CONCLUSIONS: Cold snare defect protrusion (CSDP), which was present with 36%, was a good indicator for incomplete mucosal layer resection. Even in nonCSDP polypectomies, 57% of the mucosal layer was not removed completely. Thus, CSP should be used for intra-epithelial lesions only, and careful pretreatment evaluation is recommended.

DOI： 10.1111/jgh.14824

PubMed

researchmap

Publishing type：Part of collection (book)   Publisher：Springer Singapore  

DOI： 10.1007/978-981-15-5925-9_24

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The incidence and long-term survival analysis for vulvar cancer, due to its rarity, has not been fully described in Asian population. The objective of the study is to determine the trends in incidence and long-term survival for vulvar cancer in a Japanese population, using a population-based cancer registry data in Osaka, Japan. METHODS: The age-standardized incidence rate of 389 cases of vulvar squamous cell carcinoma (SCC) diagnosed between 1976 and 2010 was calculated, using the 1985 model population of Japan. The annual percentage change (APC) of the age-standardized incidence was estimated by the joinpoint regression models. The 5- and 10-year relative survival of 290 cases with vulvar SCC diagnosed between 1976 and 2008 were analyzed, using a cohort or period approach. Using the 10-year relative survival, the conditional 5-year survival for patients who lived for some years after diagnosis was also calculated. RESULTS: We have found that the age-standardized incidence rate for vulvar cancer trended downward during the period of 1979-1992 (APC - 6.3%; 95% confidence interval (CI) [- 11.3% to - 1.0%]), whereas it trended upward from 1993 to 2010 (APC 1.9%; 95% CI [- 0.7% to 4.6%]). There was no statistically significant difference for the 5- and 10-year relative survival between the two periods of 1976-2000 and 2001-2008. A statistically significant increase in the conditional 5-year survival at 2 years after diagnosis was observed (48.4%; 95% CI [41.1-55.3] versus 75.6%; 95% CI [64.0-83.9]). CONCLUSION: Despite an increasing trend in vulvar cancer incidence among Japanese population, the relative survival rate for vulvar cancer did not change over the 35 years of this study. We found that the conditional 5-year survival for vulvar cancer, as patients survived additional years, approached within reach of 100%. These data can provide valuable information for both patients and clinicians.

DOI： 10.1007/s10147-019-01453-7

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: Our aim was to determine the accuracy of ultrasound (US) examination-based testicular torsion diagnosis in adult patients with acute scrotal pain. METHODS: A comprehensive electronic search was performed using internet retrieval systems up to 5 August 2018 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The quality of eligible studies was assessed using Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2). The diagnostic value of ultrasound in patients with testicular torsion was evaluated using pooled estimates of sensitivity, specificity, likelihood ratio, and diagnostic odds ratio, as well as the summary receiver operating characteristics curve. RESULTS: Twenty-six studies with 2116 patients were included in the study. Overall diagnostic sensitivity was 0.86 [95% confidence interval (CI) 0.79-0.91] and specificity was 0.95 (95% CI: 0.92-0.97). Subgroup analysis of prospective studies showed pooled sensitivity of ultrasound for testicular torsion was 0.94 (95% CI 0.83-0.98), and pooled specificity was 0.98 (95% CI 0.94-1.00). Recent studies after 2010 showed diagnostic sensitivity of 0.95 (95% CI 0.84-0.99) and specificity of 0.98 (95% CI 0.93-0.99). CONCLUSIONS: This meta-analysis demonstrated that ultrasound represents an effective imaging modality for diagnosing testicular torsion in adult patients with acute scrotal pain.

DOI： 10.1007/s10396-019-00937-3

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Cervical cancer screening rate is extremely low and the governmental recommendation of HPV vaccine has been suspended for 5 years in Japan. Here, we utilized data from the Osaka Cancer Registry, collected between 1976 and 2012, to evaluate cervical cancer trends in Japan. Age-adjusted incidence, relative survival, and conditional survival rates were calculated using multiple imputation methods and period analyses in 25,826 cervical cancer cases. Association of survival rates and clinical factors, including patients' age, clinical stage, and treatment procedures, were also analyzed. A trend for significantly decreasing age-adjusted incidence of cervical cancer (per 100,000) began in 1976 but reversed after 2000, increasing significantly to date (annual percent change = 3.8, 95% confidence interval, 2.7-4.8; age-adjusted rate: 28.0 in 1976, 9.1 in 2000, 14.1 in 2012). The 10-year relative survival rate improved significantly after 2002, especially in cases of "localized" and "adjacent organs" disease; this was likely due to the introduction of concurrent chemotherapy and radiation. The conditional 5-year relative survival rate improved significantly yearly until the fourth survival year. In the surgery-based group, we observed no age-dependent differences in outcomes. Unexpectedly, however, prognosis for younger age groups was poorer in the radiation-based treatment group. These results indicate that although relative survival rates have recently increased, treatment for more advanced cases with distant metastasis requires further improvement. In addition, this study is the first to suggest that age might be an important predictor of radiotherapy resistance in cervical cancer.Significance: A large-cohort analysis of cervical cancer cases reveals that age-adjusted incidence in Japan has increased since 2000 and that age may negatively correlate with resistance to radiotherapy.

DOI： 10.1158/0008-5472.CAN-18-3109

PubMed

researchmap

DOI： 10.1093/jjco/hyz033

PubMed

researchmap

Language：English  

Objectives: To evaluate the effectiveness of lung cancer screening using low-dose computed tomography for the general population, we conducted a retrospective cohort study of screening for participants among Hitachi residents. Materials and Methods: Citizens aged 50-74 who underwent low-dose computed tomography screening at least once during 1998-2006 were defined as the computed tomography group, and those who underwent X-ray screening at least once during the same period, but did not receive low-dose computed tomography screening throughout the follow-up period, were defined as the XP group. We investigated the lung cancer incidence rate, mortality rate and all-cause mortality rate for both groups from the first lung cancer screening to the end of 2012. Results: In the computed tomography group (17 935 residents; 9790 males and 8145 females), 273 cases of lung cancer (1.5%), 72 cases of lung cancer death (0.4%), and 885 cases of all-cause death (4.9%) were observed. On the other hand, 164 cases (1.1%) of lung cancer, 80 cases (0.5%) of lung cancer death and 1188 cases (7.6%) of all-cause death were observed in the XP group (15 548 residents; 6526 males and 9022 females). The hazard ratios of the computed tomography group to the XP group adjusted for gender, age and smoking history were 1.23 for lung cancer incidence rate, 0.49 for lung cancer mortality rate and 0.57 for all-cause mortality rate. Non-smokers and light smokers (<30 pack-years) had a significantly lower lung cancer mortality (0.41 and 0.21, respectively). Conclusion: low-dose computed tomography screening for a population including non-smokers and light smokers may be effective.

DOI： 10.1093/jjco/hyy185

PubMed

researchmap

Authorship：Lead author,　Corresponding author  

DOI： 10.1093/jjco/hyy204

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Background: Together with such high-quality approaches as randomized controlled trials and large-scale cohort
studies, simulation models are often employed to evaluate the effect of cancer screening methods and decide on
their appropriateness. This study aimed to evaluate all effects of gastric cancer screening that have been assessed
using simulation models, including cost-effectiveness, mortality reduction, and early-stage detection. Methods: We
performed a systematic review using PubMed and Web of Science. We evaluated the effect of screening related to
cost, such as incremental cost-effectiveness and incremental cost-effectiveness ratios; we also separately assessed
effects other than cost, such as quality-adjusted life-years, number of deaths prevented, life-years saved, relative risk
of mortality from gastric cancer, life expectancy, and incidence reduction. The methods targeted for evaluation were
Helicobacter pylori testing or endoscopy. Results: We identified 19 studies dealing with simulation models in gastric
cancer screenings: 14 examined H. pylori screening and 7 focused on endoscopy. Among those studies, two assessed
both H. pylori and endoscopy screening. Most of the studies adopted a Markov model, and all the studies evaluated
cost-effectiveness. Of the 14 H. pylori screening studies, 13 demonstrated cost-effectiveness and 11 also showed good
results other than cost-effectiveness, such as extension of life-years and increase in early-stage detection. In three of the
five endoscopy studies, the target population was patients; all five studies obtained good results for cost-effectiveness
and four observed good results other than for cost-effectiveness. Conclusions: In this study, we showed that the H.
pylori screening test was cost-effective in terms of simulation model investigations. However, the H. pylori screening
test should not ordinarily be recommended since there is insufficient evidence that it reduces gastric cancer mortality.
In Japan, simulation modeling should be employed to plan for cancer control, and the appropriate use of simulation
models should be examined for future use.

DOI： 10.31557/APJCP.2018.19.12.3321

PubMed

researchmap

DOI： 10.14740/jocmr3559w

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Tokyo  

Background: Vonoprazan, potassium-competitive acid blocker, is expected to reduce incidence of delayed bleeding after gastric endoscopic submucosal dissection (ESD)
however, preliminary data to design a large-scale comparative study are lacking. This study aimed to assess the efficacy of vonoprazan in preventing delayed bleeding after gastric ESD. Methods: In this single-center randomized phase II trial, a modified screened selection design was used with a threshold non-bleeding rate of 89% and an expected rate of 97%. In this design, Simon’s optimal two-stage design was first applied for each parallel group, and efficacy was evaluated in comparison with the threshold rate using binomial testing. Patients were randomly assigned in a 1:1 ratio to receive either vonoprazan 20 mg (VPZ group) or lansoprazole 30 mg (PPI group) for 8 weeks from the day before gastric ESD. The primary endpoint was the incidence of delayed bleeding, defined as endoscopically confirmed bleeding accompanied by hematemesis, melena, or a decrease in hemoglobin of ≥ 2 g/dl. Results: Delayed bleeding occurred in three of 69 patients (4.3%, 95% CI 0.9–12.2%, p = 0.047) in the VPZ group, and four of 70 (5.7%, 95% CI 1.6–14.0%, p = 0.104) in the PPI group. As only vonoprazan showed significant reduction in delayed bleeding compared with the threshold rate, it was determined to be efficacious treatment. Conclusions: Vonoprazan efficaciously reduced the delayed bleeding rate in patients with an ESD-induced gastric ulcer. A large-scale, randomized, phase III study is warranted to definitively test the effectiveness of vonoprazan compared with proton pump inhibitors.

DOI： 10.1007/s00535-018-1487-6

Scopus

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

Background: Patients with liver cirrhosis often exhibit zinc deficiency. Although zinc is involved in many bioactivities, many aspects of clinical implications of zinc deficiency in liver cirrhosis remain unclear. We aimed to reveal the prevalence and implications of zinc deficiency in liver cirrhosis by assessing associations with parameters such as clinical symptoms and laboratory data. Methods: In 235 cirrhosis patients enrolled at multiple medical institutions in 2009, we assessed how blood zinc levels were associated with their clinical symptoms, patients characteristics, and liver function test results. Results: Blood zinc levels were most strongly correlated with blood albumin levels among the study parameters (r = 0.587, P < 0.0001). When blood albumin levels were ≤ 3.5 g/dL, blood zinc levels were < 70 μg/dL in 88% of patients. Additionally, significant correlations were observed with age (r = -0.253, P = 0.0014), aspartate aminotransferase levels (r = -0.254, P = 0.0020), total bilirubin levels (r = -0.222, P = 0.0053), prothrombin time (r = -0.255, P = 0.0029), branched-chain amino acid to tyrosine ratio (r = 0.357, P < 0.0001), Child-Pugh score (r = 0.469, P < 0.0001), ammonia levels (r = -0.246, P = 0.0028), and total cholesterol levels (r = 0.314, P < 0.0001). Blood zinc levels were significantly lower in patients with edema/ascites (P < 0.0001), those with hepatic encephalopathy (P = 0.0215), those receiving oral diuretics (P = 0.0045), and those receiving oral branched-chain amino acids (P < 0.0001) than in those without these conditions. Conclusions: Zinc deficiency is prevalent in cirrhosis patients, whereas nitrogen metabolic disorders, particularly hypoalbuminemia, can be an indicator of zinc deficiency. Thus, cirrhosis patients exhibiting a nitrogen metabolic disorder should be examined for the presence of zinc deficiency.

DOI： 10.14740/jocmr3374w

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)  

The aim of the present study was to compare short-term outcomes of laparoscopic and open liver resection (LLR and OLR, respectively), and we first analyzed a preoperatively enrolled and prospectively collected database. We carried out a secondary analysis using a preoperative enrolled database that included the details of 786 patients who had been enrolled in a previously carried out randomized controlled trial to assess short-term outcomes, including morbidities. Statistical analyses included logistic regression, propensity score matching (PSM) with replacement, and inverse probability of treatment weighting (IPTW) analyses. Among 780 liver resections, OLR was carried out in 543 patients and LLR was carried out in 237 patients. LLR was selected in patients with a worse liver function and was related to a smaller resected liver weight and/or partial resection. Logistic regression, PSM, and IPTW analyses revealed that LLR was associated with less blood loss and a lower incidence of morbidities, but a longer operating time. LLR was found to be a preferred factor in biliary leakage by IPTW only. LLR was a preferred factor for blood loss, morbidities and hospital stay, but was associated with a longer operating time. UMIN-CTR, UMIN000003324.

DOI： 10.1002/ags3.12046

Web of Science

PubMed

researchmap

DOI： 10.1093/ntr/nty020

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Vaginal cancer is such a rare tumor that epidemiological and clinical information for it is based mainly on studies of small numbers of cases. The aim of the present study was to perform a descriptive epidemiological analysis of vaginal cancer using a significantly larger population-based dataset from the Japanese Osaka Cancer Registry.
The age-standardized incidence of vaginal cancer per 1,000,000 persons, from 1976 to 2010, was calculated and examined for trends. Relative-survival analysis was applied to estimate a more up-to-date 10-year period calculation, using data from recently followed-up patients. The conditional 5-year survival of patients who survived for 0 to 5 years after diagnosis was calculated.
A total of 481 cases of vaginal cancer were registered in Osaka during the 35-year period from 1976 to 2010. The age-adjusted incidence rate has significantly and consistently decreased over this time [annual percent change (APC)=-1.29, 95% confidence interval (95% CI): -0.3 similar to -2.2]; however, due to significant population aging, the raw incidence of vaginal cancer appeared to have been increasing. The 10-year relative survival of patients with surgery-based treatments was comparable to that of radiation-based treatments, implying that surgery and radiotherapy provide similar therapeutic benefits (P=.98). The 10-year relative survival was not significantly different during the period of 1976 to 2000 compared with the period of 2001 to 2008, although there has been, in the latter period, a tendency for improvement of long-term survival, especially for survival longer than 5 years. The longer the time after diagnosis, the higher the conditional 5-year relative-survival at 0 to 4 years after diagnosis.
The age-adjusted incidence of vaginal cancer has decreased since 1976. Regrettably, the 10-year survival rate did not similarly improve, and it remained stable during the period from 2001 to 2008, compared with the period from 1976 to 2000, indicating that significant work remains to be done to develop more effective vaginal cancer treatments.

DOI： 10.1097/MD.0000000000007751

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Few studies have examined the association between smoking behavior (especially quitters) at the time of diagnosis and mortality among cancer patients. Our objective was to examine the benefits of quitting on all-cause mortality among cancer patients. 30,658 eligible cancer patients diagnosed between 1985 and 2009, identified by a hospital-based cancer registry in Japan, were followed up for up to 10 years. We evaluated smoking behavior at cancer diagnosis (especially recent quitters vs. current smokers) in association with all-cause mortality using Cox-proportional hazards models and covariates-adjusted survival curves. Risk of death was estimated to be reduced by 11% in recent quitters compared with current smokers. According to adjusted survival curves, median survival time was 8.25 years for recent quitters versus 7.18 years for current smokers, indicating an absolute difference of 1.07 year for a median survivor. Similarly, never and former smokers had 18% and 16% lower risk of death with 1.90 years and 1.77 years gained, respectively, compared with current smokers. In addition to former and never smokers, recent quitters showed consistently higher survival rates than current smokers during the 10-year calendar period after diagnosis among cancer patients. Because recent quitters may be similar to patients who stop smoking shortly after cancer diagnosis in terms of smoking duration, the latter may be able to decrease their risk of death, suggesting that smoking cessation could be part of cancer care.

DOI： 10.1002/ijc.30601

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCI LTD  

Purpose: This study aims to evaluate survival and the objective response to neoadjuvant combination therapy with gemcitabine and radiation therapy in patients with biliary tract cancer.
Methods: The chemoradiation therapy regimen consisted of 3 cycles of full-dose gemcitabine (1000 mg/m(2) at days 1, 8, and 15, every 4 weeks) with 50-60 Gy radiation. We compared 27 patients who received neoadjuvant chemoradiation therapy and 79 patients who were treated without neoadjuvant therapy. Henri-hepatectomy or pancreatoduodenectomy was planned for all of the patients in the study population. CT-based staging was used to adjust for the pre-treatment characteristics of the patients.
Results: After confirming the reproducibility of CT-based staging, we analyzed the survival of the patients. The multivariate analysis showed that the absence of arterial invasion on CT, the absence of lymph node swelling, and neoadjuvant therapy were independent prognostic factors. The three-year recurrence-free survival (RFS) rates in patients treated with and without neoadjuvant therapy were 78% and 58%, respectively (P = 0.0263). The adjusted overall survival (OS) (determined by the inverse probability of treatment weighting method using the inverse propensity score) was improved by neoadjuvant therapy (P = 0.00187); the hazard ratio was 0.3505.
Conclusions: Neoadjuvant chemoradiation therapy might have the potential to improve RFS and OS. Registration: UNIIN-CTR UMN000015450 (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

DOI： 10.1016/j.ejso.2016.12.008

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

OBJECTIVE: Vonoprazan is a potassium-competitive acid blocker, a new type of acid-suppressing drug, and has recently become available for peptic ulcers, gastroesophageal reflux disease, and Helicobacter pylori (H. pylori) eradication. Its efficacy for H. pylori eradication has been reported. However, the evidence for its efficacy and feasibility remains limited. We aimed to compare the feasibility, effectiveness and safety of vonoprazan-based triple therapy with conventional proton pump inhibitor (PPI)-based triple therapy in multicenter clinical practice.
METHODS: We performed a multicenter retrospective study on patients receiving first-line H. pylori eradication therapy between March 2013 and November 2015 with either vonoprazan-based triple therapy or conventional PPI-based triple therapy.
RESULTS: A total of 2715 patients aged 63.0 +/- 12.1 years (1412 [52.0%] males) were analyzed. Eradication rates were 87.2% (368/422) for vonoprazanbased therapy and 72.4%(1661/2293) for conventional PPI-based therapy (P&lt; 0.01). Among the former group, there were 10 cases of diarrhea, six of nausea/vomiting, and five of rash, but the rates of these adverse events were similar to those in the conventional PPI group.
CONCLUSION: Vonoprazan-based triple therapy is feasible, and has a higher rate for H. pylori eradication than conventional PPI as a first-line regimen.

DOI： 10.1111/1751-2980.12398

Web of Science

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

AimThe therapeutic efficacy of branched-chain amino acid (BCAA) when added to sorafenib has not been fully assessed in patients with advanced hepatocellular carcinoma (HCC). This multicenter study investigated whether BCAA supplementation improves prognosis in patients with advanced HCC who underwent sorafenib treatment.
MethodsThis retrospective analysis included 256 patients with advanced HCC treated with sorafenib, including 55 who did and 201 who did not receive BCAA supplementation. Clinical characteristics and outcomes in relation to Child-Pugh classification were compared in the two groups. Statistical analyses of univariate, multivariate and propensity score-based procedures were used for this study.
ResultsAssessment of 216 Child-Pugh A patients showed that median overall survival was significantly longer in patients with BCAA supplementation than in those without it (440 vs 299days, P=0.023). Multivariate analysis showed that BCAA supplementation (P=0.023), low -fetoprotein (&lt;100ng/mL) (P&lt;0.001), less progressive Barcelona Clinic Liver Cancer stage (A and B) (P=0.007) and male sex (P=0.018) were significant independent contributors to better overall survival. The significantly longer overall survival by BCAA supplementation was verified in the analysis using the propensity score in combination with the inverse probability of treatment weighted adjustment (P=0.026). Assessment of the 40 Child-Pugh B patients showed no significant differences in overall survival between patients with and without BCAA supplementation.
ConclusionBCAA supplementation may be a valuable adjunctive therapy for improving prognosis in sorafenib-treated Child-Pugh A patients with advanced HCC.

DOI： 10.1111/hepr.12640

Web of Science

PubMed

researchmap

Language：English   Publisher：FORMATH Research Group  

One reason why trees grow differently over the year may be due to their relative spatial condition. In this paper, we introduce a statistical model called the varying coefficient model to estimate effects on the tree growth from the age and relative space perspectives. This model is a superior way to understand the tree growth, which is because 1) the space effects can be added in the growth curve model and visually checked by drawing contours and cubic diagrams, and 2) both the space and the age effects are estimated with their confidence interval values, and also the hypothesis test can be performed, which improve the confidence of the estimation result. The model is applied to the data of Cryptomeria japonica, the longitude and the latitude are used as the space information, and the significant spatial effect of the DBH on the stem volume was evident from the estimation result.

DOI： 10.15684/formath.15.001

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：HIROSHIMA UNIV, GRAD SCH SCI  

The purpose of this paper is to clarify the conditions for consistency of the log-likelihood-based information criteria in canonical correlation analysis of q- and p-dimensional random vectors when the dimension p is large but does not exceed the sample size. Although the vector of observations is assumed to be normally distributed, we do not know whether the underlying distribution is actually normal. Therefore, conditions for consistency are evaluated in a high-dimensional asymptotic framework when the underlying distribution is not normal.

DOI： 10.32917/hmj/1439219708

Web of Science

researchmap

Language：English   Publisher：FORMATH Research Group  

A growth curve model used for analyzing growth is characterized by a mathematical function with respect to time, called a growth function. As the results of analysis from a growth curve model strongly depend on the growth function used for the analysis, the selection of growth functions is important. A choice of growth function based on the minimization of a model selection criterion is one of the major selection methods. In this paper, we compare the performances of growth-function selection methods using these criteria (e.g., Mallows Cp criterion) through Monte Carlo simulations. As a result, we recommend the use of a method employing the Bayesian information criterion for the selection of growth functions.

DOI： 10.15684/formath.14.004

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：HIROSHIMA UNIV, GRAD SCH SCI  

In the structural equation modeling, unknown parameters of a covariance matrix are derived by minimizing the discrepancy between a sample covariance matrix and a covariance matrix having a specified structure. When a sample covariance matrix is a near singular matrix, Yuan and Chan (2008) proposed the estimation method to use an adjusted sample covariance matrix instead of the sample covariance matrix in the discrepancy function. The adjusted sample covariance matrix is defined by adding a scalar matrix with a shrinkage parameter to the existing sample covariance matrix. They used a constant value as the shrinkage parameter, which was chosen based solely on the sample size and the number of dimensions of the observation, and not on the data itself. However, selecting the shrinkage parameter from the data may lead to a greater improvement in prediction compared to the use of a constant shrinkage parameter. Hence, we propose an information criterion for selecting the shrinkage parameter, and attempt to select the shrinkage parameter by an information criterion minimization method. The proposed information criterion is based on the discrepancy function measured by the normal theory maximum likelihood. Using the Monte Carlo method, we demonstrate that the proposed criterion works well in the sense that the prediction accuracy of an estimated covariance matrix is improved.

DOI： 10.32917/hmj/1419619749

Web of Science

researchmap

Language：English   Publisher：Research Association of Statistical Sciences  

CiNii Books

researchmap

Authorship：Lead author,　Corresponding author   Publishing type：Research paper (international conference proceedings)  

researchmap

Authorship：Lead author  

researchmap

Authorship：Lead author  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本疫学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本疫学会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese  

CiNii Books

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2021189993

Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：English   Publisher：(一社)日本癌学会  

J-GLOBAL

researchmap

Authorship：Lead author   Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

Language：Japanese   Publisher：(NPO)日本がん登録協議会  

researchmap

Language：Japanese   Publisher：(NPO)日本がん検診・診断学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：English   Publisher：(一社)日本癌治療学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本内視鏡外科学会  

J-GLOBAL

researchmap

Language：English   Publisher：(一社)日本癌治療学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：English   Publisher：日本癌学会  

researchmap

Language：English   Publishing type：Research paper, summary (international conference)   Publisher：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

Language：Japanese   Publisher：(一社)日本消化器内視鏡学会  

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本禁煙学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本計算機統計学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本癌治療学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本癌治療学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(一社)日本癌治療学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：(公社)日本婦人科腫瘍学会  

J-GLOBAL

researchmap

Language：Japanese   Publisher：日本公衆衛生学会  

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

Event date： 2022.7

Presentation type：Oral presentation (general)  

researchmap

Event date： 2021.9 - 2021.10

Language：English   Presentation type：Symposium, workshop panel (public)  

researchmap

Event date： 2021.6

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2021.6

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Presentation type：Oral presentation (invited, special)  

researchmap

Presentation type：Oral presentation (invited, special)  

researchmap

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

researchmap

Work type：Web Service  

researchmap

Work type：Web Service  

researchmap

Work type：Web Service  

researchmap

Work type：Web Service  

researchmap

Work type：Web Service  

researchmap

Work type：Web Service  

researchmap

Type：Seminar, workshop

researchmap

researchmap

researchmap

Type：Seminar, workshop

researchmap