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Article: Association between multimorbidity and utilization of medical and long-term care among older adults in a rural mountainous area in Japan.

Kuwabara, Yuki / Hamada, Toshihiro / Nakai, Tsubasa / Fujii, Maya / Kinjo, Aya / Osaki, Yoneatsu

2024 Volume 19, Issue 2, Page(s) 105–113

Abstract: Objective: With the accelerated population aging, multimorbidity has become an important healthcare issue. However, few studies have examined multimorbidity and its impact on the use of medical and long-term care services in Japan. Therefore, this study ...

Abstract	Objective: With the accelerated population aging, multimorbidity has become an important healthcare issue. However, few studies have examined multimorbidity and its impact on the use of medical and long-term care services in Japan. Therefore, this study aimed to examine the association between multimorbidity and the use of medical and long-term care services among older adults living in the depopulated mountainous areas of Japan. Patients and methods: A cross-sectional study was conducted using insurance claims data from late-stage medical insurance and long-term care insurance (April 2017 to March 2018) for older adults ≥75 years residing in a mountainous area in the Tottori prefecture. In addition to the descriptive analysis, multiple generalized linear regressions with family gamma and log-link functions were used to examine the association between the number of morbidities and total annual medical and long-term care expenditures. Results: A total of 970 participants ≥75 years were included in the analysis. Participants who had two or more morbidities constituted 86.5% of the total sample. Furthermore, participants with mental disorders were found to have more comorbidities. The number of comorbidities is associated with higher medical and long-term care expenditures. Conclusion: Multimorbidity was dominant among late-stage older adults living in depopulated mountainous areas of Japan, and the number of morbidities was associated with higher economic costs of medical and long-term care services. Mitigating the impact of multimorbidity among older adults in depopulated regions of Japan is an urgent challenge. Future research should investigate the degree and effectiveness of social protections for vulnerable older adults living in remote areas.
Language	English
Publishing date	2024-04-12
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2768933-5
ISSN	1880-4888 ; 1880-487X
ISSN (online)	1880-4888
ISSN	1880-487X
DOI	10.2185/jrm.2023-049
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Article ; Online: Lifestyle factors associated with presenteeism among city government office workers: a cross-sectional study.

Otsubo, Tsubasa / Kinjo, Aya / Kuwabara, Yuki / Hongja, Ki / Osaki, Yoneatsu

Journal of occupational health

2023 Volume 66, Issue 1

Abstract: Objectives: Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption.: Methods: Anonymous data of 777 workers in a ... ...

Abstract	Objectives: Presenteeism is a critical issue in occupational health. This study aimed to examine the association between presenteeism and subjective sleep quality, smoking status, and alcohol consumption. Methods: Anonymous data of 777 workers in a Japanese city were retrospectively obtained from City Government Office A. They included variables like absolute presenteeism scores (measured using the Japanese version of the World Health Organization Health and Work Performance Questionnaire short form), gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption. A binary logistic regression analysis was performed with gender, age, family status, subjective sleep quality, smoking status, and alcohol consumption as the independent variables, and absolute presenteeism scores equal to or below 40 as the dependent variable. A gender-stratified binary logistic regression analysis was also performed. Results: The logistic regression analysis results revealed that absolute presenteeism was positively associated with poor subjective sleep quality among all respondents (odds ratio [OR], 1.70; 95% CI, 1.18-2.44) and men (OR, 1.85; 95% CI, 1.12-3.05) and with current drinkers among women (OR, 3.49; 95% CI, 1.36-8.92); it was negatively associated with age among those who were ≥50 years old (OR, 0.50; 95% CI, 0.27-0.93) and with current drinkers among men (OR, 0.43; 95% CI, 0.20-0.92). Conclusions: The factors associated with presenteeism differed between men and women office workers, suggesting that gender differences need to be considered when working toward improving workers' productivity.
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Cross-Sectional Studies ; Local Government ; Presenteeism ; Retrospective Studies ; Life Style
Language	English
Publishing date	2023-12-14
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1340985-2
ISSN	1348-9585 ; 1341-9145
ISSN (online)	1348-9585
ISSN	1341-9145
DOI	10.1093/JOCCUH/uiad012
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Article: Did Depression, Schizophrenia, and Alcohol Use Increase During the COVID-19 Pandemic Even in Low-Risk Regions? An Analysis of the 2017-2020 National Health Insurance Data in Tottori Prefecture.

Kinjo, Aya / Kuwabara, Yuki / Fujii, Maya / Imamoto, Aya / Osaki, Yoneatsu

Yonago acta medica

2023 Volume 66, Issue 1, Page(s) 87–94

Abstract: Background: This study aimed to determine whether the COVID-19 pandemic increased the number of medical consultations for depression, schizophrenia, and alcohol dependence in low-risk regions.: Methods: National Health Insurance enrolments from March ...

Abstract	Background: This study aimed to determine whether the COVID-19 pandemic increased the number of medical consultations for depression, schizophrenia, and alcohol dependence in low-risk regions. Methods: National Health Insurance enrolments from March 2017 to March 2021 in Tottori Prefecture, Japan, where there were minimal COVID-19 cases in 2020, were included in this study. The all-cause mortality and proportion of National Health Insurance members with depression, schizophrenia, and alcohol dependence in the financial years (FY) 2017, 2018, 2019, and 2020 were calculated. The proportion in FY 2020 was compared with the average proportion from FY2017 to FY2019 and the proportion in FY2019. Results: The all-cause mortality for men aged 80-99 years and women aged 70-89 years decreased in FY2020. The proportion of men aged 20-29 years with depression increased to 4.1% in FY2020 compared with 3.0% in FY2019, while the proportion of women aged 20-29 years with depression was 4.4% in FY2017, 4.8% in FY2018, 4.8% in FY2019, and 5.5% in FY2020, confirming an increasing trend from before the COVID-19 pandemic. The proportion of men aged 30-39 years and 60-69 years with schizophrenia increased and that of women aged 40-49 years, 60-69 years, and 90-99 years with schizophrenia also increased, even before the pandemic. The proportion of people with alcohol use disorder has not changed significantly since FY2017. Conclusion: The pandemic has led to an increased proportion of men aged 20-29 years with depression, even in low-risk regions.
Language	English
Publishing date	2023-02-06
Publishing country	Japan
Document type	Journal Article
ZDB-ID	840719-8
ISSN	1346-8049 ; 0513-5710
ISSN (online)	1346-8049
ISSN	0513-5710
DOI	10.33160/yam.2023.02.011
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Article ; Online: Abstaining from annual health check-ups is a predictor of advanced cancer diagnosis: a retrospective cohort study.

Kuwabara, Yuki / Fujii, Maya / Kinjo, Aya / Osaki, Yoneatsu

Environmental health and preventive medicine

2022 Volume 27, Page(s) 1

Abstract: Background: Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In ...

Abstract	Background: Cancer prevention is a crucial challenge in preventive medicine. Several studies have suggested that voluntary health check-ups and recommendations from health professionals are associated with increased participation in cancer screening. In Japan, it is recommended that individuals aged 40-74 years should undergo annual health check-ups; however, the compliance to this recommendation is approximately <50%. According to the national survey, individuals who do not undergo annual health check-ups are at a higher risk for cancer. However, to the best of our knowledge, no previous study has investigated the association between the use of health check-ups and the incidence rate of cancer. We hypothesised that not undergoing periodic health check-ups and/or less use of outpatient medical services are predictors for advanced cancer. Methods: To explore the relationship between health check-up or outpatient service utilisation and cancer incidence, this retrospective cohort study used data at two time points-baseline in 2014 and endpoint in 2017-from the National Health Insurance (NHI) claims and cancer registry. A multivariable logistic regression analysis was performed to investigate whether cancer diagnosis was associated with health check-up or outpatient service utilisation. Results: A total of 72,171 participants were included in the analysis. The results of the multivariable logistic regression showed that individuals who skipped health check-ups had a higher risk of cancer diagnosis (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.04-1.40). Moreover, not undergoing health check-ups increased the risk of advanced-stage cancer (OR, 1.78; 95% CI, 1.29-2.44). Furthermore, increased rate of outpatient service utilisation was negatively associated with advanced cancer diagnosis. Conclusions: This is the first study reporting that not undergoing health check-ups is a predictor of cancer diagnosis and advanced cancer stage. Primary prevention strategies for NHI members who do not undergo health check-ups must be reassessed. Moreover, future research should examine secondary prevention strategies, such as health education and recommendations from health professionals to facilitate adequate utilisation of preventive health services.
MeSH term(s)	Adult ; Aged ; Humans ; Logistic Models ; Middle Aged ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Odds Ratio ; Preventive Health Services ; Retrospective Studies
Language	English
Publishing date	2022-04-05
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2018758-0
ISSN	1347-4715 ; 1342-078X
ISSN (online)	1347-4715
ISSN	1342-078X
DOI	10.1265/ehpm.21-00292
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Article: Spatial and Economic Proximity of Cigarette Sales to School Children in Mongolia.

Purevdorj, Bolormaa / Suh, Eric / Petersen, Anne Berit / Kuwabara, Yuki / Kinjo, Aya / Osaki, Yoneatsu / Narmandakh, Altanzul / Dambardarjaa, Davaalkham / Singh, Pramil

Research square

2024

Abstract: Background: The Western Pacific Region has the highest rate of cigarette smoking in the world. In this region, Mongolia has ratified the WHO FCTC treaty and, as part of treaty implementation, has monitored school tobacco use in children using the 2014 ... ...

Abstract	Background: The Western Pacific Region has the highest rate of cigarette smoking in the world. In this region, Mongolia has ratified the WHO FCTC treaty and, as part of treaty implementation, has monitored school tobacco use in children using the 2014 Global Youth Tobacco Survey (GYTS) and 2019 GYTS. Our objective was to examine the spatial and economic factors associated with cigarette use in schoolchildren of Mongolia. Methods: The 2014 and 2019 GYTS are the most recent and comprehensive national surveys of tobacco use in schoolchildren in Mongolia and are cross-sectional, stratified, multi-stage cluster surveys of 13-15 year-old schoolchildren (7,298 in 2014, 4,146 in 2019) selected from urban and rural schools. For each survey, we conducted logistic regression modelling to examine whether spatial (proximity of cigarette sales to schools), economic (pocket money available to school children), and other environmental/contextual factors were predictors of cigarette use (all, single sticks) in schoolchildren. Results: We found that 1)the prevalence of vendors selling cigarettes near schools increased from 65% in the 2014 GYTS to 94% in the 2019 GYTS, 2) sales of cigarettes near schools were associated with increased current smoking of all cigarettes and this effect increased from a marginal 31% increase in odds in 2014 (OR [95% confidence interval(CI)]=1.31 [0.99, 1.73]) to a 416% increase in odds in 2019 (OR [95% CI]=5.16[3.31, 8.05]), 3) sales of cigarettes near schools were associated with a substantial increase in odds of smoking single cigarettes in 2014 (OR [95% CI]=1.87 [1.14,3.06]) and in 2019 (OR[95% CI]=2.70 [1.42, 5.12]). We also found that smoking of all cigarettes was higher when student pocket money exceeded the price of the cigarette pack (approximately 1.8 USD) and also when parents and/or peers were smokers. Conclusions: Despite the 2012 National Tobacco Laws banning sales of cigarettes and single cigarettes to schoolchildren near schools, the most recent national surveys (2014-2019) have shown that these sales are increasing. We provide new findings indicating that despite the higher pricing of cigarette packs (relative to the region), illicit sales of single cigarettes are targeting schoolchildren near their schools.
Language	English
Publishing date	2024-03-19
Publishing country	United States
Document type	Preprint
DOI	10.21203/rs.3.rs-4088408/v1
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Article: Modulating Perioperative Ventricular Excitability.

Howard-Quijano, Kimberly / Kuwabara, Yuki

Anesthesiology clinics

2019 Volume 37, Issue 4, Page(s) 609–619

Abstract: Ventricular arrhythmias are associated with significant morbidity and mortality. In the perioperative period, more than 10% of patients undergoing a general anesthetic have an abnormal heart rhythm. Arrhythmia development is a dynamic interplay between ... ...

Abstract	Ventricular arrhythmias are associated with significant morbidity and mortality. In the perioperative period, more than 10% of patients undergoing a general anesthetic have an abnormal heart rhythm. Arrhythmia development is a dynamic interplay between an arrhythmogenic substrate, myocardial electrophysiologic properties, modifying factors, and triggering factors. Imbalances in the autonomic nervous system can lead to increased myocardial excitability, which is a major contributor to the pathophysiology of ventricular tachyarrhythmias. Myocardial excitability and ventricular arrhythmogenesis is modulated perioperatively through hemodynamic management, electrolyte balance, anesthetic agents, or regional anesthetic and surgical techniques.
MeSH term(s)	Anesthesia/adverse effects ; Anesthesia/methods ; Anesthesia, General ; Arrhythmias, Cardiac/complications ; Arrhythmias, Cardiac/physiopathology ; Cardiac Surgical Procedures/methods ; Humans ; Intraoperative Complications/physiopathology ; Intraoperative Complications/therapy ; Perioperative Care ; Tachycardia, Ventricular/complications ; Tachycardia, Ventricular/physiopathology
Language	English
Publishing date	2019-10-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2228899-5
ISSN	2210-3538 ; 1932-2275 ; 0889-8537
ISSN (online)	2210-3538
ISSN	1932-2275 ; 0889-8537
DOI	10.1016/j.anclin.2019.08.002
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Article ; Online: Propofol anesthesia decreases the incidence of new-onset postoperative atrial fibrillation compared to desflurane in patients undergoing video-assisted thoracoscopic surgery: A retrospective single-center study.

Tajima, Karin / Yamakawa, Kentaro / Kuwabara, Yuki / Miyazaki, Chika / Sunaga, Hiroshi / Uezono, Shoichi

PloS one

2023 Volume 18, Issue 5, Page(s) e0285120

Abstract: Background: Postoperative atrial fibrillation (POAF) increases postoperative morbidity, mortality, and length of hospital stay. Propofol is reported to modulate atrial electrophysiology and the cardiac autonomic nervous system. Therefore, we ... ...

Abstract	Background: Postoperative atrial fibrillation (POAF) increases postoperative morbidity, mortality, and length of hospital stay. Propofol is reported to modulate atrial electrophysiology and the cardiac autonomic nervous system. Therefore, we retrospectively examined whether propofol suppresses POAF in patients undergoing video-assisted thoracoscopic surgery (VATS) compared to desflurane. Methods: We retrospectively recruited adult patients who underwent VATS during the period from January 2011 to May 2018 in an academic university hospital. Between continuous propofol and desflurane administration during anesthetic maintenance, we investigated the incidence of new-onset POAF (within 48 hours after surgery) before and after propensity score matching. Results: Of the 482 patients, 344 received propofol, and 138 received desflurane during anesthetic maintenance. The incidence of POAF in the propofol group was less than that in the desflurane group (4 [1.2%] vs. 8 patients [5.8%], odds ratio [OR]; 0.161, 95% confidence interval (CI), 0.040-0.653, p = 0.011) in the present study population. After adjustment for propensity score matching (n = 254, n = 127 each group), the incidence of POAF was still less in propofol group than desflurane group (1 [0.8%] vs. 8 patients [6.3%], OR; 0.068, 95% CI: 0.007-0.626, p = 0.018). Conclusions: These retrospective data suggest propofol anesthesia significantly inhibits POAF compared to desflurane anesthesia in patients undergoing VATS. Further prospective studies are needed to elucidate the mechanism of propofol on the inhibition of POAF.
MeSH term(s)	Adult ; Humans ; Propofol/adverse effects ; Desflurane ; Retrospective Studies ; Thoracic Surgery, Video-Assisted/adverse effects ; Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology ; Atrial Fibrillation/prevention & control ; Incidence ; Anesthetics ; Anesthesia
Chemical Substances	Propofol (YI7VU623SF) ; Desflurane (CRS35BZ94Q) ; Anesthetics
Language	English
Publishing date	2023-05-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0285120
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Article: Real-time in vivo thoracic spinal glutamate sensing reveals spinal hyperactivity during myocardial ischemia.

Salavatian, Siamak / Robbins, Elaine Marie / Kuwabara, Yuki / Castagnola, Elisa / Cui, Xinyan Tracy / Mahajan, Aman

bioRxiv : the preprint server for biology

2023

Language	English
Publishing date	2023-03-24
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.03.11.531911
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Article ; Online: Real-time in vivo thoracic spinal glutamate sensing during myocardial ischemia.

Salavatian, Siamak / Robbins, Elaine Marie / Kuwabara, Yuki / Castagnola, Elisa / Cui, Xinyan Tracy / Mahajan, Aman

American journal of physiology. Heart and circulatory physiology

2023 Volume 325, Issue 6, Page(s) H1304–H1317

Abstract: In the spinal cord, glutamate serves as the primary excitatory neurotransmitter. Monitoring spinal glutamate concentrations offers valuable insights into spinal neural processing. Consequently, spinal glutamate concentration has the potential to emerge ... ...

Abstract	In the spinal cord, glutamate serves as the primary excitatory neurotransmitter. Monitoring spinal glutamate concentrations offers valuable insights into spinal neural processing. Consequently, spinal glutamate concentration has the potential to emerge as a useful biomarker for conditions characterized by increased spinal neural network activity, especially when uptake systems become dysfunctional. In this study, we developed a multichannel custom-made flexible glutamate-sensing probe for the large-animal model that is capable of measuring extracellular glutamate concentrations in real time and in vivo. We assessed the probe's sensitivity and specificity through in vitro and ex vivo experiments. Remarkably, this developed probe demonstrates nearly instantaneous glutamate detection and allows continuous monitoring of glutamate concentrations. Furthermore, we evaluated the mechanical and sensing performance of the probe in vivo, within the pig spinal cord. Moreover, we applied the glutamate-sensing method using the flexible probe in the context of myocardial ischemia-reperfusion (I/R) injury. During I/R injury, cardiac sensory neurons in the dorsal root ganglion transmit excitatory signals to the spinal cord, resulting in sympathetic activation that potentially leads to fatal arrhythmias. We have successfully shown that our developed glutamate-sensing method can detect this spinal network excitation during myocardial ischemia. This study illustrates a novel technique for measuring spinal glutamate at different spinal cord levels as a surrogate for the spinal neural network activity during cardiac interventions that engage the cardio-spinal neural pathway.
MeSH term(s)	Swine ; Animals ; Glutamic Acid/metabolism ; Myocardial Ischemia ; Spinal Cord ; Heart ; Coronary Artery Disease ; Arrhythmias, Cardiac ; Myocardial Reperfusion Injury/metabolism
Chemical Substances	Glutamic Acid (3KX376GY7L)
Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	603838-4
ISSN	1522-1539 ; 0363-6135
ISSN (online)	1522-1539
ISSN	0363-6135
DOI	10.1152/ajpheart.00299.2023
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Article: Thoracic dorsal root ganglion stimulation reduces acute myocardial ischemia induced ventricular arrhythmias.

Kuwabara, Yuki / Howard-Quijano, Kimberly / Salavatian, Siamak / Yamaguchi, Tomoki / Saba, Samir / Mahajan, Aman

Frontiers in neuroscience

2023 Volume 17, Page(s) 1091230

Abstract: Background: Dorsal root ganglion stimulation (DRGS) may serve as a novel neuromodulation strategy to reduce cardiac sympathoexcitation and ventricular excitability.: Objective: In this pre-clinical study, we investigated the effectiveness of DRGS on ... ...

Abstract	Background: Dorsal root ganglion stimulation (DRGS) may serve as a novel neuromodulation strategy to reduce cardiac sympathoexcitation and ventricular excitability. Objective: In this pre-clinical study, we investigated the effectiveness of DRGS on reducing ventricular arrhythmias and modulating cardiac sympathetic hyperactivity caused by myocardial ischemia. Methods: Twenty-three Yorkshire pigs were randomized to two groups, which was control LAD ischemia-reperfusion (CONTROL) or LAD ischemia-reperfusion + DRGS (DRGS) group. In the DRGS group ( Results: DRGS decreased the magnitude of activation recovery interval (ARI) shortening in the ischemic region (CONTROL: -201 ± 9.8 ms, DRGS: -170 ± 9.4 ms, Conclusion: DRGS reduced the burden of myocardial ischemia-induced cardiac sympathoexcitation and has a potential to be a novel treatment option to reduce arrhythmogenesis.
Language	English
Publishing date	2023-01-30
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2411902-7
ISSN	1662-453X ; 1662-4548
ISSN (online)	1662-453X
ISSN	1662-4548
DOI	10.3389/fnins.2023.1091230
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