Comparison of Application Strategies of Patent Applicants of Classic Traditional Chinese Medicine Prescriptions Between China and Japan / 中国实验方剂学杂志

A total of 290 prescriptions in Treatise on Typhoid and Miscellaneous Diseases （《伤寒杂病论》） and Synopsis of the Golden Chamber （《金匮要略》） and 191 prescriptions in Prescriptionology were selected as representatives of classical prescriptions of traditional Chinese medicine （TCM）， which were translated into Chinese and Japanese. The prescription names were used as keywords for search， and the patent application data up to June 2022 were retrieved. The retrieved results underwent data cleaning and manual noise reduction. Taking the important applicants as the starting point， the key technologies were divided and indexed according to the technical improvement characteristics of classic TCM prescriptions， and the intelligence information of patent applications for classic TCM prescriptions in the two countries was deeply excavated. The differences in the patent applications and layout strategies of classic TCM prescriptions between China and Japan were further compared. This paper drew up an accurate and targeted search strategy for more accurate and comprehensive retrieval， collation， and statistics of patent data of classic TCM prescriptions of representative patent applicants in China and Japan. At the same time， this paper deeply explored the information on Chinese patent applications in Japan and compared the differences in patent application strategies and patent protection of classic TCM prescriptions and Chinese prescriptions in Japan taking the layout of classic TCM prescriptions of representative patent applicants in China and Japan as the entry point. On one hand， it can accurately grasp the current patent application status of classic TCM prescriptions in the two countries， and on the other hand， it can also provide some references for the secondary development and research， patent application， and layout of classic prescriptions of enterprises， universities， and research institutions in China.

Report of Online Conference on Measures against Coronavirus in Japan Organized by President of Subcommittee on Novel Coronavirus Disease Control and Medical Students / 国際保健医療

  An online lifestyle has become typical with the COVID-19 pandemic. Although the number of infected patients in Japan has decreased significantly from its peak, concern remains about the seasonality of the infection and the possibility of variant strains. In this context, 10 medical students and Dr. Shigeru Omi, Chairman of the Subcommittee on Countermeasures against Novel Coronavirus Infections, held an online panel discussion on November 6, 2021.  First, the frailty of Japan’s testing system compared to other countries was highlighted. Although weekly testing for all citizens would be ideal, implementing efficient countermeasures with limited resources was emphasized.  Second, concern exists about other diseases because people are refraining from receiving necessary medical examinations for fear of being infected with COVID-19. Strengthening mass approaches using the media and personal approaches by health care professionals is essential.  Third, much false information exists on social networking sites and is being spread. The importance of suitable individual risk communication was suggested.  Finally, medical students mentioned the loss of experience due to restrictions on school attendance and club activities. Although medical students are treated differently in each country, increasing opportunities to discuss the purpose of medical education and whether online alternatives are possible were highlighted.  This was the first opportunity for a direct discussion between medical students, who have been greatly affected by COVID-19, and Dr. Omi, a policymaker. We hope that more such discussions will be possible, and that people’s opinions will be considered toward a better environment.

A proposal on Kuroko leadership: An element of Japan’s global health competency extracted from the experiences of international health cooperation / 国際保健医療

  In the increasingly globalized world, developing global health competency (GHC) education by determining the required core elements for undergraduates is on the rise. A growing number of people from different backgrounds have migrated to Japan. To accommodate their various healthcare needs, potential GHC elements that facilitate Japanese GHC education should be identified. This paper aims to extract some of the key GHC elements required for students in medical and healthcare fields based on the abundant experience of Japan’s international health cooperation and to make recommendations for GHC education in Japan and worldwide.  To date, Japan’s international health cooperation has cultivated a variety of competencies to realize its mission of reducing global health disparities. Japanese GHC elements are the bases of core concepts in healthcare and share commonalities with GHC elements in global communities: Cultural competency, “Go to the People”, respect for diversity, transdisciplinary collaboration, capacity building, independence, people/patient-centered healthcare, and empowerment.   Comprehensive preparation of these elements is found among kabuki kurokos (black robes), people dressed in all black who assist kabuki actors onstage during performances. The black worn by the kurokos means “nothingness”; they should be invisible on stage, so as not to interfere with the performance. Kurokos understand the culture (values, behaviors, etc.) of the lead actors, manage and coordinate stage proceedings to meet the actors’ needs, and help them achieve the best performance by collaborating with other backstage workers.   Kurokos’s empowering leadership competency is akin to the Western concept of servant-leadership, which emphasizes being a servant first and devoting oneself to enabling greater health and independence/autonomy among vulnerable people. Japanese educators can exemplify kuroko values by providing their students with GHC education. Japanese GHC elements can be integrated into worldwide GHC education. Spiritual care is also essential for inclusion in GHC education to develop students’ holistic care competency.

Report on the Republic of Korea-Japan Symposium on Frailty and Sarcopenia / 全日本鍼灸学会雑誌

The 2022 International Conference for Global Cooperation in Traditional Medicine was held in a hybrid meeting at the Novotel Ambassador Seoul Dongdaemun Hotel in Seoul on the 1st and 2nd of November 2022. This international conference was hosted by the Ministry of Health and Welfare of South Korea, organized by the National Institute for Korean Medicine Development, and supported by The Society of Korean Medicine. At this conference, a bilateral exchange of acupuncture and moxibustion therapies between Japan and Korea was held at the Republic of Korea-Japan Symposium I. The aims of the symposium were to combine conventional and traditional medical knowledge of frailty and sarcopenia and to share possible ideas to develop proper treatment for frailty and sarcopenia.

Social capital, family formation, and childcare for mothers in ethnic Korean communities in Japan / 国際保健医療

Introduction  The demographic composition of the ethnic Korean population in Japan (often referred to as zainichi) shows a declining birthrate. However, zainichi who live in zainichi Korean communities have more children than zainichi living in predominantly Japanese communities. Social capital (SC) can increase societal efficiency by promoting cooperative behavior within communities. This study clarified the family formation and SC that supports childcare for zainichi mothers living in zainichi Korean communities.Methods  We conducted semi-structured interviews with 10 zainichi mothers living in zainichi Korean communities in Japan. We qualitatively and descriptively analyzed the family formation and SC that support childcare in this population. The Ethical Committee of Osaka Prefecture University approved this study and the participants gave their written informed consent.Results  We extracted three categories and 12 subcategories for “thoughts on current family formation” and four categories and 11 subcategories for “SC supporting childcare.” Zainichi mothers living in Korean communities “think consciously about marriage” and “think positively about having multiple children and family formation,” but they have “concerns about childbearing and child-rearing.” “People who support childcare practically and mentally” and “childcare services” were also identified as important factors. Although zainichi mothers felt dissatisfied with “support that they wanted to use but found difficult to use,” they considered childcare support as human and physical SC. As an additional resource, they felt that “the zainichi community fosters security and bonding,” and thus promotes SC for child-rearing.Discussion  Networks with common norms, values, and understanding facilitated cooperation among zainichi mothers. “The zainichi community, which fosters security and bonding,” may support family formation through engendering a positive perception of child-rearing.

Association between meat, fish, and fatty acid intake and incidence of acute myeloid leukemia and myelodysplastic syndrome: the Japan Public Health Center-based Prospective Study

BACKGROUND@#The association between meat, fish, or fatty acid intake and acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) has been investigated in a few studies, and the results were inconsistent. In addition, most studies are mainly based on the United States and European countries, in which the dietary patterns differ from that in Asia. Therefore, the risk of AML/MDS from meat, fish, or fatty acid intake in Asia requires further exploration. The aim of this study was to investigate the association between AML/MDS incidence and meat, fish, or fatty acid intake using the Japan Public Health Center-based prospective study.@*METHODS@#The present study included 93,366 participants who were eligible for analysis and followed up from the 5-year survey date until December 2012. We estimated the impact of their intake on AML/MDS incidence using a Cox proportional hazards model.@*RESULTS@#The study participants were followed up for 1,345,002 person-years. During the follow-up period, we identified 67 AML and 49 MDS cases. An increased intake of processed red meat was significantly associated with the incidence of AML/MDS, with a hazard ratio of 1.63 (95% confidence interval, 1.03-2.57) for the highest versus lowest tertile and a Ptrend of 0.04. Meanwhile, the intake of other foods and fatty acids was not associated with AML/MDS.@*CONCLUSION@#In this Japanese population, processed red meat was associated with an increased incidence of AML/MDS.

The influence of information sources on intention changes to receive COVID-19 vaccination: A prospective cohort study in Japan

BACKGROUND@#Before the COVID-19 vaccine became available, many Japanese people were undecided about whether or not to receive them. Their decisions were keys to achieving herd immunity. The impact of the type of information source on the COVID-19 vaccine uptake decision-making process remains unclear. We aimed to investigate the association between information source usage on COVID-19 and subsequent vaccine uptake status among those who have yet to decide whether to receive vaccines from non-prioritized people for vaccination.@*METHODS@#Prospective cohort online self-administered surveys were conducted in February 2021 (T1), before the start of the mass vaccination program, and September-October 2021 (T2), when the vaccines were available to all citizens. The survey's target population was registered monitors of an Internet research company. Participants who answered "I want to get vaccinated after waiting to see how it goes." at T1 were eligible for analysis. The outcome variable was the COVID-19 vaccine uptake status in T2, and the predictors were 20 types of information sources, categorized based on people (family members, etc.), institutions (governments, etc.), or media (TV news, etc.). Adjusted odds ratio and 95% confidence intervals were estimated using logistic regression adjusted for possible confounders.@*RESULTS@#The 5,139 respondents, mean age and standard deviation was 42.8 ± 12.5, 55.7% female, were eligible for analysis. 85.7% completed vaccination (including reserved/intended people) in T2. In the multivariate logistic analysis, odds ratios (95% confidence interval) for vaccine uptake were 1.49 (1.18-1.89) for workplaces/schools, 1.81 (1.33-2.47) for LINE, 0.69 (0.55-0.86) for Internet news and 0.62 (0.48-0.82) for video sharing sites.@*CONCLUSIONS@#The type of information source usage played an important role in the decision to vaccinate against COVID-19. Although caution is needed in interpreting the results, obtaining information from workplaces/schools and LINE was influential in promoting immunization.

Economic, cognitive, and social paths of education to health-related behaviors: evidence from a population-based study in Japan

BACKGROUND@#There is substantial evidence on the association between lower education and unhealthy behaviors. However, the mechanism underlying this association remains unclear. This study aimed to examine whether income, health literacy, and social support mediate the association between education and health-related behaviors.@*METHODS@#A questionnaire survey was conducted in metropolitan areas in Japan from 2010 to 2011 among residents aged 25-50 years. Data from 3663 participants were used in this study. Health literacy was measured using the Communicative and Critical Health Literacy scale. Health-related behaviors were current smoking, poor dietary habits, hazardous drinking, and lack of exercise. Poisson regression analyses with robust variance estimators were conducted to examine the associations between education and these health-related behaviors. Multiple mediation analyses were conducted to estimate the magnitudes of the mediating effects of income, health literacy, and social support on these associations.@*RESULTS@#Less educated participants had higher risks of all unhealthy behaviors. Income mediated the associations of education with smoking (6.4%) and exercise (20.0%). Health literacy mediated the associations of education with dietary habits (15.4%) and exercise (16.1%). Social support mediated the associations of education with dietary habits (6.4%) and exercise (7.6%). The education-drinking association was mediated by income in the opposite direction (-10.0%). The proportions of the total effects mediated by income, health literacy, and social support were 9.8% for smoking, 24.0% for dietary habits, -3.0% for drinking, and 43.7% for exercise.@*CONCLUSIONS@#These findings may provide clues for designing effective interventions to reduce educational inequalities in health-related behaviors.

Association between vaccination status and COVID-19-related health outcomes among community-dwelling COVID-19 patients in Nara, Japan

BACKGROUND@#Many previous studies have reported COVID-19 vaccine effectiveness, but there are few studies in Japan. This community-based, retrospective observational study investigated the association between vaccination status and COVID-19-related health outcomes in COVID-19 patients by SARS-CoV-2 variant type.@*METHODS@#The study participants were 24,314 COVID-19 patients aged 12 or older whose diagnoses were reported to the Nara Prefecture Chuwa Public Health Center from April 2021 to March 2022, during periods when the alpha, delta, and omicron variants of COVID-19 were predominant. The outcome variables were severe health consequences (SHC) (i.e., ICU admission and COVID-19-related death), hospitalization, and extension of recovery period. The explanatory variable was vaccination status at least 14 days prior to infection. Covariates included gender, age, population size, the number of risk factors for aggravation, and the number of symptoms at diagnosis. The generalized estimating equations of the multivariable Poisson regression models were used to estimate the adjusted incidence proportion (AIP) and 95% confidence interval (CI) for each health outcome. We performed stratified analyses by SARS-CoV-2 variant type, but the association between vaccination status and COVID-19-related health outcomes was stratified only for the delta and omicron variants due to the small number of vaccinated patients during the alpha variant.@*RESULTS@#Of the 24,314 participants, 255 (1.0%) had SHC; of the 24,059 participants without SHC, 2,102 (8.7%) were hospitalized; and of the 19,603 participants without SHC, hospitalization, and missing data on recovery period, 2,960 (15.1%) had extension of recovery period. Multivariable Poisson regression models showed that regardless of SARS-CoV-2 variant type or health outcome, those who received two or more vaccine doses had significantly lower risk of health outcomes than those who did not receive the vaccine, and there was a dose-response relationship in which the AIP for health outcomes decreased with an increased number of vaccinations.@*CONCLUSION@#A higher number of vaccinations were associated with lower risk of COVID-19-related health outcomes, not only in the delta variant but also in the omicron variant. Our findings suggest that increasing the number of COVID-19 vaccine doses can prevent severe disease and lead to early recovery of patients not requiring hospitalization.

The spread of heated tobacco product (HTP) use across various subgroups during 2015-16 and 2017-18 in Japan

BACKGROUND@#Heated tobacco product (HTP) use has increased substantially between 2016 and 2017 in Japan. This study aims to clarify how HTP use (IQOS, Ploom, and glo) spread across the different combustible cigarette smoking statuses during 2015-16 and 2017-18 in Japan.@*METHODS@#We compared the two periods of (i) 2015 to 2016 (N = 5,366) and (ii) 2017 to 2018 (N = 3,422) from a longitudinal study randomly sampling members from the Japan "Society and New Tobacco" Internet Survey (JASTIS). Multivariable logistic regression models for current HTP use in the previous 30 days by combustible cigarette smoking status in the previous year were used adjusting for socio-demographic factors.@*RESULTS@#HTP use increased by 10 times in the 2017-18 cohort compared with the 2015-16 cohort according to the adjusted odds ratio (95% confidence interval) for current HTP use as 10.2 (7.03-14.8). According to smoking status, significantly higher adjusted ORs (95% CIs) of current HTP use for the after period were observed: 2.60 (1.37-4.94) for never smokers, 7.82 (3.64-16.8) for former smokers, 21.1 (5.73-77.9) for current smokers with intention to quit, and 17.0 (9.58-30.3) for current smokers without intention to quit.@*CONCLUSION@#During 2015 to 2018 in Japan, HTP use dramatically increased in all subgroups except for never smokers.

Enlightenment of Japan expanded access clinical trial system to China’s compassionate drug use system / 中国药房

The system of compassionate drug use in China is in the preliminary exploration stage， and the formal management methods and specific implementation rules have not been promulgated， which needs to be further optimized and perfected. Japan realizes the advanced use of unapproved drugs by expanded access clinical trial system， and makes clear provisions on information acquisition， target patient， informed consent， subject of application， implementation plan， handling of refusal to administer medication， drug expenses， implementation deadline， compensation for accidental damages， post-approval data review after expanded access clinical trials. When the enterprise refuses to give drugs because of the “legitimacy reasons of the system”， the attending physician can also apply to the Ministry of Health， Labor and Welfare， and the Ministry of Health， Labor and Welfare will conduct the licensing evaluation to maximize the drug for patients. This “refusal to administer” reprocessing is a unique regulation in Japan， which ensures the accessibility of drugs to the greatest extent possible. Based on the analysis of the expanded access clinical trial system in Japan， it is found that our country could further build the information platform for compassionate drug use， play the leading role of physicians， protect the interests of enterprises， pay attention to the ethical review， and make drug cost payment problems further clear in order to improve and optimize the system of compassionate drug use.

Disease burden of benign prostatic hyperplasia in China, Japan and South Korea from 1990 to 2019: a comparative study / 现代泌尿外科杂志

【Objective】 To analyze the disease burden of benign prostatic hyperplasia (BPH) in China, Japan and South Korea from 1990 to 2019, so as to provide scientific basis for rational allocation of health resources. 【Methods】 Data were obtained from the Global Burden of Disease Study 2019. The incidence, prevalence and years lived with disability(YLD)were used to analyze the burden, and the average annual percent change and annual percent change were calculated. 【Results】 The incidence, prevalence and YLD rate in China were much higher than those in Japan and South Korea. The crude incidence in China, Japan and South Korea increased by 2.56%, 1.49% and 3.59% per year from 1990 to 2019, the crude prevalence rate increased by 2.70%, 2.34% and 4.03%, and the crude YLD rate increased by 2.68%, 2.33% and 4.04%. After age standardization, the disease burden in China decreased with time, but the trend was not significant, and the standardized rate in Japan and Korea increased significantly with time. The disease burden of BPH increased with age, and those aged 60 to 84 years had the highest burden. In addition, the disease burden increased with the increase of socio-demographic index (SDI) in all three countries. 【Conclusion】 The disease burden of BPH was very heavy in China, Japan and South Korea, especially in China. Males aged 60 to 84 years were the high-risk group. Targeted intervention should be adopted for these population.

A brief introduction of Evidence-based clinical practice guidelines for cholelithiasis 2021 by the Japanese Society of Gastroenterology / 临床肝胆病杂志

‍The Japanese Society of Gastroenterology （JSGE） first published evidence-based clinical practice guidelines for cholelithiasis in 2010， followed by a revision in 2016. In April 2023， JSGE published the 2021 edition of evidence-based clinical practice guidelines for cholelithiasis based on the clinical issues associated with cholelithiasis in the databases such as Medline， Cochrane， and Igaku Chuo Zasshi and the latest evidence in literature published in the past five years. The revised edition reviews related clinical questions in the previous edition from the aspects of the epidemiology， pathogenesis， diagnosis， treatment， prognosis， and complications of cholelithiasis and reclassifies them into three categories， with 52 questions in total， among which there are 29 background questions dealing with basic background knowledge， 19 clinical questions， and 4 future research questions requiring further accumulation of evidence， thereby providing guidance for decision making in the clinical management of patients with cholelithiasis.

The edification of Japanese nutrition health educators degree system on the promotion of nutrition and health education in schools in China / 中国学校卫生

Abstract@#Through in-depth investigation into Japanese nutrition health educators post content, configuration, training mode, advanced education practice and the difficulties, the paper explores the effective ways of integrating nutrition health education into the school health education teacher and curriculum system as well as health promotion, so as to guide teachers and students to establish a correct concept of health, enhance health literacy and develop a healthy lifestyle. Additionally, the paper aims at providing suggestions for the construction of nutrition and health school as well as the future development of nutrition health education in China.

Analysis and enlightenment on the current situation of pharmacist team construction in Japanese hospitals / 中华医院管理杂志

With the acceleration of China′s economic and social development and aging process, the construction of the pharmacist team was increasingly valued.By combing and analyzing the status of pharmacist allocation in Japanese medical institutions, the path of pharmacist career development, and the content of pharmaceutical services and the training mode, the author proposed that China should learn from relevant mature experience to further strengthen the allocation of pharmacists in medical institutions, improve the Professional certification system of clinical pharmacists, establish a standardized pharmacist training mode, so as to provide a reference for building a standardized, professional and sustainable team of pharmacists in medical institutions.

Sistema de salud en Japón y su énfasis en la protección de la salud oral: una comparación con Chile / Oral health system in Japan: a comparation with Chile

Japón está compuesto por 126 millones de habitantes y corresponde a la tercera potencia económica mundial. El sistema de salud se basa en un único seguro obligatorio universal, con cobertura médica y odontológica. En las últimas décadas, el envejecimiento poblacional ha sido un punto importante a considerar en la planificación de políticas públicas sanitarias. La eficiencia de este sistema ha sido punto de comparación con distintos países, no así con Chile. Por ello, el objetivo de esta revisión narrativa es comparar el sistema de salud oral chileno y japonés. Se realizó una revisión narrativa utilizando los repositorios de revistas científicas Science Direct, y PubMed, así como publicaciones disponibles en páginas gubernamentales de Japón y Chile.El seguro japonés prioriza la promoción de salud y prevención de enfermedades, enfatizando en la población más vulnerable. Al contrario, en Chile el sistema de salud tiene énfasis en la curación y rehabilitación. Japón ha adoptado un seguro debido a la transición demográfica y epidemiológica, para garantizar la sustentabilidad del sistema en el tiempo, modelo que podría ser aplicado en Chile; considerando el envejecimiento poblacional y la carga de enfermedades crónicas no transmisibles. Ambos países tienen ventajas y limitaciones en los atributos de sus sistemas de salud. Chile tiene una Red integrada de servicios de salud y ha implementado políticas como GES. Japón tiene un sistema universal, más eficiente y equitativo. Las fortalezas del sistema japonés podrían implementarse en Chile, a través de nuevas políticas públicas que fortalezcan la salud del país, incluyendo la odontología.

Japan has a population of 126 million, and it is the third national economy in the world. The health system is on a single universal mandatory insurance, with medical and dental coverage. In the last decades, Japan has faced the ageing of its population, and this has been a relevant matter in the planning of public health policies. The efficiency of the health system has been a point of comparison in different countries, but not in Chile. Thus, the objective of this narrative review is to compare the Chilean oral-health system with the Japanese.A non-systematic review was made using Science Direct, PubMed repositories of journals and official Japanese and Chilean government pages. The Japanese healthcare insurance prioritizes health promotion and disease prevention, emphasizing the most vulnerable population. Conversely, Chile has a health system that focalizes on healing and rehabilitation. Japan has adopted insurance because of the demographic transition to guarantee the system's sustainability. Considering the increased ageing population and the non-communicable disease load, this insurance model could be applied in Chile.Both Chile and Japan have advantages and limitations regarding the attributes of their health systems. Japan has a universal, more efficient, and equitable system. Chile should study the strengths of the Japanese system for its implementation of new public policies that strengthen the country's health, including dentistry.

O Sistema de Saúde japonês e seus mecanismos de enfrentamento à COVID-19 / The Japanese Health System and its coping mechanisms against COVID-19

Introdução: apesar de ser o país de maior média de idade no mundo, o Japão tem se destacado no combate à pandemia da COVID-19 (do inglês Coronavirus Disease 2019) ao apresentar reduzidas taxas de contaminação pelo vírus e de mortalidade. Objetivo: discutir acerca das estratégias em saúde adotadas pelo Japão diante da pandemia da doença da COVID-19, bem como avaliar os dados sobre contaminação e mortalidade japoneses em comparação com os outros quatro países com maior média de idade do mundo (Itália, Alemanha, Portugal e Espanha) e o Brasil. Metodologia: para avaliação das estratégias em saúde japonesas foi realizada busca nas bases de dados: PubMed, Cochrane e Scielo, utilizando-se combinação dos termos "Japão", "covid", "coronavirus" e "sistemas de saúde", nos idiomas Inglês, Espanhol e Português. Os dados de infecção da COVID-19 foram extraídos do site Our World in Data, correspondendo ao período de 25 de janeiro de 2020 a 30 de julho de 2020. Resultados: dentre as medidas adotadas pelo país no enfrentamento à pandemia, destacam-se o diagnóstico e resposta precoces à infecção, o rastreamento de contatos, o diagnóstico precoce e disponibilidade de cuidados intensivos para pacientes graves e estímulo a medidas comportamentais de distanciamento. Dentre os países analisados, o Japão apresenta as menores taxas de contaminação e mortalidade em termos absolutos pela COVID-19. Conclusões: medidas de distanciamento social, diagnóstico e tratamento precoces parecem ter contribuído para o sucesso no combate à COVID-19 no Japão. No período estudado, em milhão de habitantes, o Japão teve 6,13 casos de Covid, enquanto o Brasil apresentou 218,26 casos. Já no número de mortes confirmadas pela doença, o primeiro teve uma taxa de 0,23 enquanto o segundo de 5,16 casos por milhão de habitantes. É possível, a partir do conhecimento dessas medidas, buscar mecanismos semelhantes ao traçar políticas de saúde no enfrentamento de pandemias em outros países (AU)

Introduction: despite being the country with the highest average age globally, Japan has stood out in the fight against the COVID-19 (Coronavirus Disease 2019) pandemic by presenting low contamination rates by the virus and mortality. Objective: we aim to discuss the health strategies adopted by Japan in the face of the COVID-19 disease pandemic, as well as to evaluate data on Japanese contamination and mortality compared to the other four countries with the highest average age in the world (Italy, Germany, Portugal and Spain) and Brazil. Methodology: the search was carried out to evaluate Japanese health strategies by using the following databases: PubMed, Cochrane, and Scielo using a combination of the terms "Japan", "covid", "coronavirus" and "health systems" in English, Spanish and Portuguese. The COVID-19 infection data was extracted from the Our World in Data website, from January 25, 2020, to July 30, 2020. Results: Among the measures adopted by the country to face the pandemic, the early diagnosis and response to infection, contact tracing, early diagnosis and availability of intensive care for critically ill patients, and encouraging behavioral distancing measures stand out. Among the countries analyzed, Japan has the lowest rates of contamination and mortality in absolute terms by COVID-19. Conclusions: social distancing measures, early diagnosis, and treatment seem to have contributed to the success in combating COVID-19 in Japan. In the studied period, in a million inhabitants, Japan had 6.13 cases of covid while Brazil had 218.26 cases. As for the number of deaths confirmed by the disease, the first had a rate of 0.23 while the second had 5.16 cases per million inhabitants. Based on the knowledge of these measures, it is possible to seek similar mechanisms when designing health policies to face pandemics in other countries (AU)

Diagnostic Accuracy of the Japan Narrow-Band Imaging Expert Team (Jnet) Classification System for the Differential Diagnosis of Colorectal Polyps

Background: Real time visual differentiation of colorectal polyps into benign and malignant helps to decide the appropriate treatment strategy and avoid the unnecessary risk associated with endoscopic therapies and need for repeat procedures. The Japan NBI Expert Team (JNET) classification developed in 2014 classifies colorectal polyps into types 1(Hyperplastic polyps including sessile serrated polyps), 2A (low grade dysplasia), 2B (high grade dysplasia/ superficial submucosal invasive carcinomas) and 3 (deep submucosal invasive carcinomas). We conducted this study to evaluate the diagnostic accuracy of the JNET classification for colorectal polyps. Methods: All patients undergoing colonoscopy in a tertiary care Centre in south India from February to July 2020, who had colorectal polyps were included in the study. A prospective image evaluation to identify the JNET class was done by 2 independent observers blinded to the histological diagnosis and the result was compared with the final histopathological diagnosis. Inflammatory polyps were excluded. The collected data was statistically analyzed to assess the diagnostic accuracy. Result: 139 polyps from 102 patients were included in the study. Most common locations were ascending colon (31%) or rectosigmoid (30.3%). 21 polyps were hyperplastic polyps, 78 polyps were LGD, 23 were HGD/SM-S and 17 were SM-D polyps. On NBI imaging, 23, 76, 30, and 10 polyps were classified as JNET types 1, 2a, 2b and 3 respectively. The diagnostic accuracy of JNET classification was 98.5%, 88.4%, 83% and 93.5% respectively. Conclusion: The JNET classification has a high diagnostic accuracy for predicting the histology of colorectal polyps and hence recommended.

O Sistema de Saúde japonês e seus mecanismos de enfrentamento à COVID-19 / The Japanese Health System and its coping mechanisms against COVID-19

RESUMO: Introdução: apesar de ser o país de maior média de idade no mundo, o Japão tem se destacado no combate à pandemia da COVID-19 (do inglês Coronavirus Disease 2019) ao apresentar reduzidas taxas de contaminação pelo vírus e de mortalidade. Objetivo: discutir acerca das estratégias em saúde adotadas pelo Japão diante da pandemia da doença da COVID-19, bem como avaliar os dados sobre contaminação e mortalidade japoneses em comparação com os outros quatro países com maior média de idade do mundo (Itália, Alemanha, Portugal e Espanha) e o Brasil. Metodologia: para avaliação das estratégias em saúde japonesas foi realizada busca nas bases de dados: PubMed, Cochrane e Scielo, utilizando-se combinação dos termos "Japão", "covid", "coronavirus" e "sistemas de saúde", nos idiomas Inglês, Espanhol e Português. Os dados de infecção da COVID-19 foram extraídos do site Our World in Data, correspondendo ao período de 25 de janeiro de 2020 a 30 de julho de 2020. Resultados: dentre as medidas adotadas pelo país no enfrentamento à pandemia, destacam-se o diagnóstico e resposta precoces à infecção, o rastreamento de contatos, o diagnóstico precoce e disponibilidade de cuidados intensivos para pacientes graves e estímulo a medidas comportamentais de distanciamento. Dentre os países analisados, o Japão apresenta as menores taxas de contaminação e mortalidade em termos absolutos pela COVID-19. Conclusões: medidas de distanciamento social, diagnóstico e tratamento precoces parecem ter contribuído para o sucesso no combate à COVID-19 no Japão. No período estudado, em milhão de habitantes, o Japão teve 6,13 casos de Covid, enquanto o Brasil apresentou 218,26 casos. Já no número de mortes confirmadas pela doença, o primeiro teve uma taxa de 0,23 enquanto o segundo de 5,16 casos por milhão de habitantes. É possível, a partir do conhecimento dessas medidas, buscar mecanismos semelhantes ao traçar políticas de saúde no enfrentamento de pandemias em outros países. (AU)

ABSTRAC: Introduction: despite being the country with the highest average age globally, Japan has stood out in the fight against the COVID-19 (Coronavirus Disease 2019) pandemic by presenting low contamination rates by the virus and mortality. Objective: we aim to discuss the health strategies adopted by Japan in the face of the COVID-19 disease pandemic, as well as to evaluate data on Japanese contamination and mortality compared to the other four countries with the highest average age in the world (Italy, Germany, Portugal and Spain) and Brazil. Methodology: the search was carried out to evaluate Japanese health strategies by using the following databases: PubMed, Cochrane, and Scielo using a combination of the terms "Japan", "covid", "coronavirus" and "health systems" in English, Spanish and Portuguese. The COVID-19 infection data was extracted from the Our World in Data website, from January 25, 2020, to July 30, 2020. Results: Among the measures adopted by the country to face the pandemic, the early diagnosis and response to infection, contact tracing, early diagnosis and availability of intensive care for critically ill patients, and encouraging behavioral distancing measures stand out. Among the countries analyzed, Japan has the lowest rates of contamination and mortality in absolute terms by COVID-19. Conclusions: social distancing measures, early diagnosis, and treatment seem to have contributed to the success in combating COVID-19 in Japan. In the studied period, in a million inhabitants, Japan had 6.13 cases of covid while Brazil had 218.26 cases. As for the number of deaths confirmed by the disease, the first had a rate of 0.23 while the second had 5.16 cases per million inhabitants. Based on the knowledge of these measures, it is possible to seek similar mechanisms when designing health policies to face pandemics in other countries.(AU)

Report of the 71st Annual Meeting of the Japan Society for Oriental Medicine Special Program1 — “Pre-and Post-Graduation Education of Kampo Medicine for the Next Generation”: Clinical Practice on Kampo Medicine / 日本東洋医学雑誌

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program focusing on Kampo medicine education, “Pre-graduation post-graduation Kampo medicine education for the next generation.” The following is a summary report on the practical training in Kampo medicine at each educational facility where the project was conducted. We recorded videos with explanations of topics in advance : “Four examinations,” “Decoction and crude drugs,” and “Acupuncture and moxibustion.” The report on the hands-on training in Kampo medicine was viewed 501 times by medical students, educators, and the society members across the country. This initiative was the first nationwide educational activity of the society.