Details of the Researcher

PHOTO

Shuhei Nomura
Section
International Research Institute of Disaster Science
Job title
Professor
Degree

  • PhD in Epidemiology and Biostatistics (Imperial College London)

  • MSc in Health Science (The University of Tokyo)

  • BSc in Pharmacy (The University of Tokyo)

Profile

Shuhei Nomura is Professor at the Global Health Policy Lab, International Research Institute of Disaster Science, Tohoku University, with a concurrent appointment as Professor at the Global Health Policy Lab, Graduate School of Medicine, Tohoku University. He also serves as Professor in the Department of Health Policy and Management, School of Medicine, Keio University, and Professor of the endowed course on Food, Nutrition and Health at the Graduate School of Medicine, International University of Health and Welfare. His areas of expertise include burden of disease, global health, nutritional science, pandemic preparedness and response (PPR), and Health Emergency and Disaster Risk Management (Health EDRM). Through evidence-based decision-making support, he has played a central role in shaping health and medical policy in Japan and internationally. 

▼ Work Centered on Burden of Disease Research (GBD)

Since 2022, Nomura has served on the Scientific Council of the Global Burden of Disease Study (GBD), an international collaboration involving more than 17,000 researchers across over 160 countries, and serves as the focal point for Japan. In Japan, he provides scientific evidence from a burden-of-disease perspective to inform national health policy, including the setting of policy targets and the evaluation of progress toward them. In 2024, he led the signing of a memorandum of understanding between Keio University and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, which leads the GBD, and established Japan’s first GBD research hub, where he serves as its founding Director. 

▼ Engagement in International Policy

Nomura has been actively involved in the development of Japan’s global health policy. As an expert adviser, he has contributed to the formulation and revision of key national policy frameworks, including Japan’s global health strategy, and has provided scientific evidence for policymaking through analyses of health official development assistance (ODA) strategies and outcomes. He has also contributed to international policy discussions, including those related to the G7 Summit, and served as a member of the G7 Global Health Task Force for the 2023 Hiroshima Summit. He also developed VODA, an analytical tool for visualizing trends in ODA. Since 2023, he has been a Fellow of the Global Health and Human Security Program, a public–private platform. He has also served since 2019 as a consultant for SEEK Development, a Berlin-based organization that provides policy advice to international institutions, including the Gates Foundation. In addition, from December 2025, he serves as a Commissioner of The Lancet Commission on Health Systems Performance Assessment, established by the international medical journal The Lancet, contributing to global discussions on how to measure and compare health system performance across countries and translate those insights into policy improvement. In 2026, he also chaired the multidisciplinary working group for two policy reviews published in The Lancet Regional Health – Western Pacific as part of the Lancet group’s first Japan Series since the 2011 Japan Series in The Lancet, addressing Japan’s health system reform and global health strategy.

▼ Activities by Area of Expertise

  • Food and Nutrition
    Nomura serves on the Independent Expert Panel of the Global Nutrition Report (GNR), among other roles, where he has highlighted insufficient progress toward non-communicable disease (NCD) targets and advanced policy recommendations. At the Tokyo Nutrition for Growth Summit 2021, hosted by the Government of Japan, he contributed to the launch of the world’s first Nutrition Accountability Framework. This framework has informed discussions by the International Advisory Group for the subsequent Nutrition for Growth Summit in Paris in 2024, and has contributed to the development of international agendas, including the promotion of healthy diets as reflected in G7 Leaders’ Communiqués.
  • Pandemic Response
    During the COVID-19 pandemic, Nomura led the monitoring of excess mortality and provided evidence to the Advisory Board of Japan’s Ministry of Health, Labour and Welfare. He also developed and operates the Excess Mortality Dashboard, a data visualization platform that supports evidence-based public communication. He concurrently serves as a Senior Fellow at the Center for Asia-Pacific Resilience and Innovation (CAPRI) and as a member of the Advisory Board on Long COVID at Economist Impact, an international policy and economic research organization.
  • Health Emergency and Disaster Risk Management (Health EDRM)
    Building on his work in Minamisoma City immediately after the 2011 Fukushima nuclear accident, Nomura has conducted research on health risks during disasters. His research on evacuation risks among older adults, together with his work as a cooperating investigator for the National Diet of Japan Fukushima Nuclear Accident Independent Investigation Commission, has informed revisions to Japan’s nuclear emergency preparedness guidelines. As a member of the World Health Organization’s Thematic Platform for Health Emergency and Disaster Risk Management Research Network (TPRN), he also contributed to the development of WHO’s first guidance document on research methods in disaster settings. He has also worked on guidance for quantifying the burden of disease associated with disasters, using the Great East Japan Earthquake as a case study, including supervising the Japanese edition.

▼ Career 

Nomura graduated from the Faculty of Pharmaceutical Sciences, The University of Tokyo, in 2011, and completed a master’s degree in Health Science at the same university in 2013. After internships at the United Nations Development Programme (UNDP) Country Office in Tajikistan and at the headquarters of the World Health Organization (WHO), he earned a PhD in Epidemiology and Biostatistics from the School of Public Health, Imperial College London, in 2019. He subsequently served as Assistant Professor at The University of Tokyo in 2016, Associate Professor at Keio University in 2019, and Professor at Keio University in 2024, before assuming his current position.

Research History 22

  • 2026/04 - Present
    Keio University　Department of Health Policy and Management, School of Medicine　Professor

  • 2026/04 - Present
    Tohoku University　Global Health Policy Lab. Graduate School of Medicine　Professor

  • 2025/10 - Present
    Tohoku University　Global Health Policy Lab. International Research Institute of Disaster Science (IRIDeS)　Distinguished Professor

  • 2025/07 - Present
    International University of Health and Welfare　Department o Food, Nutrition and Health, Graduate School of Public Health　Professor

  • 2024/01 - Present
    Osaka University　Center for Infectious Disease Education and Research (CiDER)　Collaborative Researcher

  • 2023/05 - Present
    Center for Asia-Pacific Resilience and Innovation (CAPRI)　Senior Fellow

  • 2022/11 - Present
    University of Washington　Institute for Health Metrics and Evaluation　Global Burden of Disease (GBD) Scientific Council

  • 2021/06 - Present
    Japan Institute for Health Security　Infectious Disease Surveillance Center　Visiting Researcher

  • 2021/04 - Present
    Global Nutrition Report　Independent Expert Group

  • 2019/01 - Present
    SEEK Development　Consultant

  • 2018/11 - Present
    Minamisoma Municipal General Hospital　Research Center for Community Health　Researcher

  • 2018/04 - Present
    National Cancer Center　Division of Prevention, Institute for Cancer Control　Visiting Researcher

  • 2024/08 - 2026/04
    Keio University　Global Research Institute　Professor

  • 2019/10 - 2024/07
    Keio University　School of Medicine, Department of Health Policy and Management　Associate Professor

  • 2016/12 - 2024/07
    The University of Tokyo　Graduate School of Medicine　Assistant Professor

  • 2021/10 - 2024/03
    The Tokyo Foundation for Policy Research　Senior Fellow

  • 2018/03 - 2024/03
    Bill & Melinda Gates Foundation's Japan Office　Consultant

  • 2021/01 - 2023/12
    World Health Organization (WHO)　Centre for Health Development　Research Advisor

  • 2017/07 - 2020/03
    National Center for Global Health and Medicine　Institute for Global Health Policy Research (iGHP)　Researcher

  • 2014/07 - 2014/09
    World Health Organization (WHO)　Policy, Practice and Evaluation Unit, Emergency Risk Management and Humanitarian Response Department　Intern

  • 2013/04 - 2013/09
    The University of Tokyo　Fellow

  • 2012/08 - 2012/10
    United Nations Development Programme (UNDP) Tajikistan Office　Disaster Risk Management Programme　Intern

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Education 4

  • Imperial College London　School of Public Health　Department of Epidemiology and Biostatistics

    2013/09 - 2019/02

  • The University of Tokyo　Graduate School of Medicine　Department of Global Health Policy

    2011/04 - 2013/03

  • The University of Tokyo　Faculty of Pharmaceutical Sciences

    2007/04 - 2011/03

  • Seiko Gakuin Junior & Senior High School

    2001/04 - 2007/03

Committee Memberships 14

  • 厚生労働省　社会保障審議会・人口部会

    2026/06 - Present

  • The Lancet Commission on Health Systems Performance Assessment

    2025/12 - Present

  • 内閣府経済社会総合研究所（ESRI）　健康の価値の計測・記録方法に関する研究会

    2025/05 - Present

  • 内閣感染症危機管理統括庁　感染症危機に向けた合理的な感染対策の実施等に関する意見交換会

    2025/04 - Present

  • Japan Center For International Exchange　Executive Committee on Global Health and Human Security

    2023/12 - Present

  • Japan Center for International Exchange　2023 G7 Global Health Task Force

    2022/08 - Present

  • World Health Organization (WHO)　WHO Thematic Platform for Health EDRM Research Network (TPRN)

    2021/11 - Present

  • International Advisory Group for the Nutrition for Growth (N4G) Summit in Paris

    2024/10 - 2025/03

  • NIKKEI FT Communicable Diseases Conference　The Working Group for Co-Creation Platform of Human Resources to Build a Society Resilient to Infectious Disease Crises

    2024/04 - 2024/10

  • Economist Impact　Advisory Council on Long COVID

    2024/06 - 2024/09

  • Office of Global Health Cooperation, International Affairs Division, Minister's Secretariat, Ministry of Health, Labour and Welfare　Investigative Commission for Policies Japan Should Implement to Achieve Universal Health Coverage Worldwide

    2023/12 - 2024/03

  • Japan Center for International Exchange　Global Health Governance Study Group

    2021/04 - 2022/03

  • Japan Center for International Exchange　Special Commission on Japan's Strategy on Development Assistance for Health

    2019/10 - 2021/03

  • Ministry of Health, Labour and Welfare　Advisory Panel for Global Health

    2015/08 - 2017/04

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Research Interests 8

  • Non-Communicable Diseases (NCDs) Prevention and Control

  • Pandemic Prevention, Preparedness and Response (PPR)

  • Nutrition Science and Policy

  • Health Emergency and Disaster Risk Management (Health EDRM)

  • Universal Health Coverage (UHC)

  • Global Health Diplomacy

  • Global Health Policy

  • Global Burden of Disease (GBD)

Awards 9

  1. World's Top 2% Scientists, 2025, Career

    2025/09　Stanford University / Elsevier

  2. World's Top 2% Scientists, 2025, Single year

    2025/09　Stanford University / Elsevier

  3. World's Top 2% Scientists, 2024, Career

    2024/09　Stanford University / Elsevier

  4. World's Top 2% Scientists, 2024, Single year

    2024/09　Stanford University / Elsevier

  5. World's Top 2% Scientists, 2023, Career

    2023/10　Stanford University / Elsevier

  6. World's Top 2% Scientists, 2023, Single year

    2023/10　Stanford University / Elsevier

  7. World's Top 2% Scientists, 2022, Single year

    2022/11　Stanford University / Elsevier

  8. World's Top 2% Scientists, 2021, Single year

    2021/10　Stanford University / Elsevier

  9. Symbols of Tomorrow

    2014/09　Symbols of Tomorrow

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Papers 306

  1. Global, regional, and national prevalence of second-hand smoke and attributable disease burden in 204 countries and territories, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Second-hand smoke Collaborators

    The Lancet Public Health　2026/09/07

    Publisher: Elsevier BV

    DOI： 10.1016/s2468-2667(26)00168-4 　

    ISSN： 2468-2667

  2. Global, regional, and national burden of HIV/AIDS, 1990–2023, with the estimated burden attributable to intimate partner violence and forecasted impacts of funding cuts through 2030: results from the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 HIV Collaborators

    The Lancet HIV　2026/08/18

    Publisher: Elsevier BV

    DOI： 10.1016/s2352-3018(26)00147-5 　

    ISSN： 2352-3018

  3. Measuring the composition and availability of human resources for health by sex in 204 countries and territories, 1990–2023, and workforce gaps for universal health coverage: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Human Resources for Health Collaborators

    The Lancet Public Health　11　(9)　e604-e629　2026/08/18

    Publisher: Elsevier BV

    DOI： 10.1016/s2468-2667(26)00145-3 　

    ISSN： 2468-2667

  4. A Mixed-Method Study of Unhealthy Feeding Practices Among Mothers of Children Aged 6–23 Months from an Internally Displaced Person Camp, Kayin State, Myanmar Peer-reviewed

    Htet Zaw Shein, Napaphan Viriyautsahakul, Shuhei Nomura, Wandee Sirichokchatchawan

    Nutrients　18　(16)　2680　2026/08/17

    DOI： 10.3390/nu18162680 　

  5. Psychiatric standardized claim ratios by rurality and deprivation in Japan: A nationwide ecological study with contextual suicide mortality Peer-reviewed

    Masahide Koda, Shuhei Nomura, Makoto Kaneko, Nahoko Harada

    Psychiatry and Clinical Neurosciences Reports　5　e70392　2026/08/10

    DOI： 10.1002/pcn5.70392 　

    ISSN： 2769-2558

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    <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aim</jats:title> <jats:p>We examined whether rurality was associated with psychiatric standardized claim ratios computed using medical‐institution location, and how these patterns related to area deprivation and residence‐based suicide mortality in Japan.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>We conducted a nationwide ecological study of 335 secondary medical areas. Rurality, measured with the Rurality Index for Japan, and a census‐based Area Deprivation Index were population‐weighted from municipalities. Psychiatric specialty therapy claims (April 2023 to March 2024) from Japan's national health‐insurance claims open data were expressed as standardized claim ratios: observed claims billed by institutions in each area divided by national age–sex expected claims. Suicide deaths (April 2022 to March 2025) were expressed as age–sex standardized mortality ratios. Ecological rate‐ratio trends were estimated with quasi‐Poisson models.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Outpatient claim ratios were lower in rural than urban areas but non‐monotonic (most urban, 108.4; fourth quintile, 76.9; and most rural, 81.3). Inpatient ratios peaked in the second quintile, and suicide mortality rose with rurality. Per 10‐point higher rurality score, outpatient volume was lower (rate ratio, 0.939; 95% confidence interval, 0.921–0.956) and remained lower after including deprivation (0.919; 0.896–0.942); the rurality–suicide association attenuated. Nearest‐three‐area pooling raised the most rural median outpatient ratio from 62.2 to 101.1.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>More rural areas had lower outpatient psychiatric claim volume billed by local institutions relative to national age–sex benchmarks, but this contrast narrowed after nearest‐area pooling, consistent with cross‐boundary care. These institution–location ratios should prompt local review with residence‐based and capacity data, not be read as evidence of under‐provision.</jats:p> </jats:sec>

  6. Disability and sexual and reproductive health outcomes among women in Cambodia: a cross-sectional analysis of the 2021–22 demographic and health survey Peer-reviewed

    Mariko Fukao, Haruka Sakamoto, Su Myat Han, Sayaka Horiuchi, Hanako Iwashita, Samith Mey, Shuhei Nomura

    Frontiers in Reproductive Health　8　2026/07/31

    Publisher: Frontiers Media SA

    DOI： 10.3389/frph.2026.1897583 　

    eISSN： 2673-3153

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    Background Women with disabilities may face communication, autonomy-related, provider-level, and structural barriers to sexual and reproductive health (SRH) services. Population-based evidence from low- and middle-income countries remains limited, particularly by functional domain. Objective To examine associations between disability and contraceptive knowledge, unmet need for family planning, and unintended pregnancy among women in Cambodia. Methods We analysed data from 19,485 women aged 15–49 years who participated in the 2021–22 Cambodia Demographic and Health Survey. Disability was measured using the Washington Group Short Set and classified by severity and functional domain. Knowledge of modern contraception was assessed among all women, unmet need among currently married or cohabiting women, and unintended pregnancy among currently married or cohabiting women with a recent live birth. Survey-weighted logistic regression was used to estimate crude and adjusted odds ratios, adjusting for age, education, wealth, residence, and marital status where applicable. Additional analyses examined functional-domain associations and stratified unintended pregnancy by age, education, and wealth. Results Overall, 16.5% of women reported at least some functional difficulty, including 1.0% with severe disability. Severe disability was associated with lower adjusted odds of knowing a modern contraceptive method (adjusted odds ratio 0.13, 95% confidence interval 0.06–0.29). Among currently married or cohabiting women, severe disability was associated with higher adjusted odds of unmet need for family planning (adjusted odds ratio 1.93, 95% confidence interval 1.06–3.49). Among married or cohabiting women with a recent live birth, mild disability was associated with higher adjusted odds of unintended pregnancy (adjusted odds ratio 1.37, 95% confidence interval 1.05–1.79); for severe disability, the confidence interval included the null (adjusted odds ratio 1.42, 95% confidence interval 0.39–5.18). Functional-domain analyses suggested lower knowledge and higher unintended pregnancy among women with communication, hearing, remembering/concentrating, or self-care difficulties. In descriptive stratified analyses, disability-related differences in unintended pregnancy were more pronounced among older women, women with less than primary education, and women in the poorest wealth quintile. Conclusions Disability-related SRH inequities in Cambodia vary by outcome, severity, and functional domain. Family-planning services should address communication access, supported decision-making, provider competence, privacy, and socioeconomic barriers.

  7. Global Burden of Elevated LDL-C: Findings From the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 LDL Cholesterol Collaborators

    JAMA　2026/07/29

    Publisher: American Medical Association (AMA)

    DOI： 10.1001/jama.2026.8628 　

    ISSN： 0098-7484

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    Importance Elevated low-density lipoprotein cholesterol (LDL-C) is a modifiable risk factor for cardiovascular disease, the leading cause of premature death worldwide. Assessing the LDL-C–related burden is critical for guiding prevention and treatment strategies. Objectives To estimate the global, regional, and national burden of ischemic heart disease and ischemic stroke attributable to elevated LDL-C (relative to 35-54 mg/dL) from 1990 to 2023 and to quantify the contributions of population growth, aging, risk-deleted burden, and exposure changes to burden trends. Design, Setting, and Population This comparative risk assessment, part of the Global Burden of Disease Study 2023, estimated population-level LDL-C exposure and associated health loss in 204 countries and territories. Mean LDL-C levels were estimated using spatiotemporal gaussian process regression based on 806 studies across 161 countries. Relative risks were derived from meta-analyses of 38 randomized clinical trials. Population-attributable fractions for deaths and disability-adjusted life-years (DALYs) were estimated by age and sex for adults aged 25 years or older from 1990 to 2023, with 95% uncertainty intervals. Exposure Population-level LDL-C concentrations. Main Outcomes and Measures Population-attributable fractions, counts, and rates (all ages and age standardized per 100 000) of LDL-C–attributable deaths and DALYs from ischemic heart disease and ischemic stroke, with uncertainty intervals. Results In 2023, elevated LDL-C accounted for 3.6 million deaths (95% uncertainty interval, 2.2-5.4 million; 6.0% of global mortality) and 90.7 million DALYs (95% uncertainty interval, 58.9-123.3 million; 3.2% of DALYs). Although global all-ages rates remained stable, age-standardized death and DALY rates decreased by 45.6% and 39.5%, respectively, since 1990. In 2023, age-standardized LDL-C–attributable DALY rates were highest in Eastern Europe and lowest in high-income Asia-Pacific. One-third of the global LDL-C burden occurred in India and China. Population growth and aging drove the increasing burden, with notable regional disparities in LDL-C exposure and risk-deleted DALY rates shifting toward middle-sociodemographic settings. Conclusions and Relevance Despite declining age-standardized rates, the absolute LDL-C burden has increased since 1990 due to demographic changes and has shifted toward middle-sociodemographic countries. Measurement and surveillance gaps persist. Strengthened prevention, diagnosis, and treatment access strategies are essential to mitigate the health burden of LDL-C.

  8. Mapping drivers of life expectancy change in Asia from 1990 to 2023 Peer-reviewed

    GBD 2023 Asia Life Expectancy Collaborators

    Nature　2026/07/22

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41586-026-10739-6 　

    ISSN： 0028-0836

    eISSN： 1476-4687

  9. Global, regional, and national trends in the morbidity gap and contributing diseases, injuries, and risk factors, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    Simon I Hay, Paul Nam, Haaris Saqib, Susan A McLaughlin, Catherine Bisignano, Samuel M Ostroff, Marie Ng, Shuhei Nomura, Austin E Schumacher, Christopher J L Murray

    The Lancet Public Health　11　(8)　e487-e505　2026/07/21

    Publisher: Elsevier BV

    DOI： 10.1016/s2468-2667(26)00098-8 　

    ISSN： 2468-2667

  10. Global, regional, and national burden of road injuries 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Road Injuries Collaborators

    The Lancet Public Health　2026/07/20

    Publisher: Elsevier BV

    DOI： 10.1016/s2468-2667(26)00141-6 　

    ISSN： 2468-2667

  11. Japan's health system toward 2040: structural challenges and a renewed social contract Peer-reviewed

    Lisa Yamasaki, Haruka Sakamoto, Hideki Hashimoto, Naoki Kondo, Osamu Kunii, Yusuke Tsugawa, Sarah Krull Abe, Satoshi Ezoe, Shinichi Egawa, Renzo R. Guinto, Ataru Igarashi, Angkana Lekagul, Kaung Suu Lwin, Mitsuru Mukaigawara, Ho Namkoong, Yoshitaka Nishino, Santosh Kumar Rauniyar, Eiko Saito, Kenji Shibuya, Keizo Takemi, Kun Tang, Takahiro Tabuchi, Hana Tomoi, Tomoko Suzuki, Shuhei Nomura

    The Lancet Regional Health - Western Pacific　72　101920　2026/07/15

    DOI： 10.1016/j.lanwpc.2026.101920 　

    ISSN： 2666-6065

  12. Japan's global health engagement in the Western Pacific: diagnosing structural inertia and a framework for human security diplomacy Peer-reviewed

    Haruka Sakamoto, Lisa Yamasaki, Sarah Krull Abe, Satoshi Ezoe, Shinichi Egawa, Renzo R. Guinto, Hideki Hashimoto, Ataru Igarashi, Angkana Lekagul, Kaung Suu Lwin, Mitsuru Mukaigawara, Ho Namkoong, Yoshitaka Nishino, Naoki Kondo, Osamu Kunii, Santosh Kumar Rauniyar, Eiko Saito, Kenji Shibuya, Keizo Takemi, Kun Tang, Takahiro Tabuchi, Hana Tomoi, Yusuke Tsugawa, Tomoko Suzuki, Shuhei Nomura

    The Lancet Regional Health - Western Pacific　72　101921　2026/07/15

    DOI： 10.1016/j.lanwpc.2026.101921 　

    ISSN： 2666-6065

  13. TICAD9 and the UHC Knowledge Hub: Strengthening Japan-Africa Health Cooperation Peer-reviewed

    Aminu Kende Abubakar, Usman Hafsat, Olukunmi Omobolanle Balogun, Shuhei Nomura

    International Journal of Health Policy and Management　15　9750　2026/07/07

    DOI： 10.34172/ijhpm.9750 　

  14. Associations between Antimicrobial-Resistant Gram-Negative Infections and Climate-Related Exposure in a Tertiary Medical Center in Central Luzon, Philippines Peer-reviewed

    Paul L. C. Chua, Emerald J. O’Brien, Shuhei Nomura, Sophearen Ith, Chris Fook Sheng Ng, Azenith May H. Rafanan, Julie Anne B. Cabantog, Masahiro Hashizume, Miguel Antonio Salazar

    Environment & Health　2026/07/01

    Publisher: American Chemical Society (ACS)

    DOI： 10.1021/envhealth.5c00842 　

    ISSN： 2833-8278

    eISSN： 2833-8278

  15. Association of municipal rurality and area deprivation with cause-specific mortality in Japan: a nationwide ecological study Peer-reviewed

    Masahide Koda, Nahoko Harada, Shuhei Nomura, Yusuke Tsugawa

    BMJ Public Health　4　(3)　e004913-e004913　2026/07/01

    Publisher: BMJ

    DOI： 10.1136/bmjph-2026-004913 　

    eISSN： 2753-4294

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    Introduction Rural–urban disparities in mortality persist across high-income countries but whether these differences reflect geographic barriers, socioeconomic disadvantage or both remains unclear. Disentangling these pathways is important for designing effective interventions but nationwide Japanese evidence that jointly models geographic remoteness and area deprivation in relation to cause-specific mortality remains limited. Methods This municipality-level ecological study analysed 4 078 801 deaths during 2017–2019 across 1890 municipalities in Japan. Rurality was measured using the Rurality Index for Japan, and socioeconomic deprivation using the Area Deprivation Index (ADI). Bayesian spatial Poisson models estimated rate ratios (RRs) for all-cause mortality and 34 cause-specific outcomes (35 outcomes in total) with and without ADI adjustment. Percentage attenuation was interpreted descriptively. Results After ADI adjustment, rural excess persisted for all-cause mortality overall (adjusted RR 1.010 (95% credible interval (CrI) 1.003 to 1.016)) and in females (1.009 (95% CrI 1.002 to 1.016), while the male estimate was close to the null. Rural excess also persisted for selected cardiovascular and cerebrovascular outcomes in the total population, including heart diseases, acute myocardial infarction, arrhythmias and conduction disorders, heart failure, cerebrovascular diseases and cerebral infarction (RRs 1.023–1.052), plus senility, unintentional injuries, traffic accidents and suicide. Aggregate malignant neoplasms, which overlapped with site-specific cancers, were near null in the total population, whereas tuberculosis, pneumonia, several site-specific cancers, asthma and liver disease showed urban excess, most notably tuberculosis (0.858 (95% CrI 0.814 to 0.905)). Conclusions Municipal rurality showed heterogeneous cause-specific associations with mortality after ADI adjustment. Higher rurality was associated with excess mortality for several time-sensitive or access-sensitive causes whereas infectious, respiratory, liver and site-specific cancer outcomes showed urban excess. Because the ecological design precludes causal inference about specific pathways reducing disparities requires cause-specific strategies addressing geographic access, socioeconomic disadvantage and urban-context risks, rather than uniform rural–urban policies.

  16. Global, regional, and national burden of tuberculosis and multidrug-resistant tuberculosis by HIV status, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 TB HIV Collaborators

    The Lancet Infectious Diseases　2026/07/01

    Publisher: Elsevier BV

    DOI： 10.1016/s1473-3099(26)00295-1 　

    ISSN： 1473-3099

  17. Why healthy life expectancy estimates diverge: insights from survey-based, administrative, and model-based metrics across Japanese prefectures, 2001–2019: a comparative ecological study Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Daisuke Yoneoka, Hana Tomoi, Lisa Yamasaki, Yuta Tanoue, Takayuki Kawashima, Aoi Kataoka, Yuri Ito, Naoki Kondo

    Population Health Metrics　24　(50)　2026/06/10

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12963-026-00488-z 　

    eISSN： 1478-7954

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    Abstract Background Healthy life expectancy (HALE) can be measured using different approaches, yet estimates may diverge. Understanding divergence sources could help identify which health dimensions current systems capture or miss. However, systematic subnational comparisons remain scarce. Methods We conducted a comparative ecological study across Japan’s 47 prefectures from 2001 to 2019. Three Ministry of Health, Labour and Welfare (MHLW) metrics—disability-free life expectancy based on activity limitation (DFLE-AL) and life expectancy in subjective health (LE-SH) derived from national surveys, and disability-free life expectancy based on activities of daily living (DFLE-ADL) derived from long-term care insurance records—were obtained from MHLW. Model-based HALE from the Global Burden of Disease (GBD) 2023 Study was extracted for corresponding years. We assessed cross-sectional concordance and examined associations with disease burden, risk factors, and socioeconomic indicators using fixed-effects panel regression. Results Over 2001–2019, DFLE-AL and LE-SH correlated with GBD HALE among males (r = 0.33 to 0.65) but weakly among females (r =  − 0.11 to 0.32); DFLE-ADL showed concordance for both sexes (r = 0.66 to 0.96). GBD HALE exceeded MHLW estimates in females (0.53 years for DFLE-AL, 0.23 for LE-SH) but not males (− 0.18, − 0.14). In fixed-effects analysis of MHLW-minus-GBD differences, mental disorders showed negative associations with DFLE-AL and LE-SH differences among males; high BMI and musculoskeletal disorders showed positive associations with DFLE-AL differences. Among females, population ageing showed positive associations with DFLE-AL, LE-SH, and DFLE-ADL differences. Conclusions MHLW metrics and GBD HALE capture complementary health dimensions and should not be treated as interchangeable. The consistent sex difference in concordance indicates that divergence between HALE metrics reflects differences in which health dimensions are emphasised—self-reported health states, objectively assessed functional status, or disease-based disability modelling—rather than a single, uniform construct of population health.

  18. From Vulnerability to Invisible Infrastructure: A Scoping Review of the Connor-Davidson Resilience Scale (CD-RISC) in Disasters for Super-Aging Society Peer-reviewed

    Hyejeong Park, Hiroyuki Sasaki, Motohiro Tsuboi, Shuhei Nomura, Shinichi Egawa

    The Tohoku Journal of Experimental Medicine　269　(2)　135-144　2026/06/04

    Publisher: Tohoku University Medical Press

    DOI： 10.1620/tjem.2026.j069 　

    ISSN： 0040-8727

    eISSN： 1349-3329

  19. Global burden of enteric infectious diseases, diarrhoeal diseases, and corresponding aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Diarrhoeal Disease and Enteric Infectious Diseases Collaborators

    The Lancet Infectious Diseases　2026/06/02

    Publisher: Elsevier BV

    DOI： 10.1016/s1473-3099(26)00194-5 　

    ISSN： 1473-3099

  20. Updated trends in the global prevalence and burden of mental disorders, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    Damian F Santomauro, Paul Anthony Miller, Jamileh Shadid, Sarah Wulf Hanson, Anh Vo, Darius Jake Roy, Hailey Hagins, Ana M Mantilla Herrera, James G Scott, Holly E Erskine, John J McGrath, Hasan Aalruz, Hedayat Abbastabar, Nadin M.I. Abdel Razeq, Ahmed Abdelrahman Abdelgalil, Ali Abdolizadeh, Deldar Morad Abdulah, Abisola Esther Abdulmalik, Meklit Girma Abebe, Mesfin Abebe, Habtamu Abebe Getahun, Roberto Ariel Abeldaño Zuñiga, Olifan Zewdie Abil, Richard Gyan Aboagye, Shady Abohashem, Abdullahi Tunde Aborode, Moaz Elsayed Abouelmagd, Mohammad T. Abuawwad, Aminu Kende Abubakar, Rana Kamal Abu-Farha, Sawsan Abuhammad, Ahmad Y Abuhelwa, Hana J Abukhadijah, Salahdein Aburuz, Meshack Achore, Lawan Hassan Adamu, Nuhu Lawan Adamu, Zenaw Debasu Addisu, Isaac Yeboah Addo, Tajudeen Adesanmi Adebisi, Babatope Oluwadamilare Adebiyi, David Adedia, Rufus Adesoji Adedoyin, Dhikroh Oriyomi Adekola, Saheed Ayodeji Adekola, Olumide Thomas Adeleke, Makinde Adebayo Adeniyi, Miracle Ayomikun Adesina, Usha Adiga, Mohd Adnan, Qorinah Estiningtyas Sakilah Adnani

    The Lancet　407　(10543)　2040-2064　2026/05/23

    DOI： 10.1016/s0140-6736(26)00519-2 　

    ISSN： 0140-6736

  21. Forecasting Stomach Cancer Burden from High Sodium Intake in Japan, 2022–2050: Scenario Analysis of Demographic Disparities Peer-reviewed

    Constanza De Matteu Monteiro, Daisuke Yoneoka, Shuhei Nomura

    Nutrients　18　(10)　1641　2026/05/21

    DOI： 10.3390/nu18101641 　

  22. Global, regional and national burden of ischemic heart disease attributable to suboptimal diet, 1990–2023: a Global Burden of Disease study Peer-reviewed

    GBD 2023 IHD & Dietary Risk Factors Collaborators

    Nature Medicine　32　1454-1478　2026/03/30

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41591-026-04250-8 　

    ISSN： 1078-8956

    eISSN： 1546-170X

  23. Global, regional, and national burden of meningitis, its risk factors, and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Meningitis & Antimicrobial Resistance Collaborators

    The Lancet Neurology　22　(5)　451-468　2026/03/27

    Publisher: Elsevier BV

    DOI： 10.1016/s1474-4422(26)00101-8 　

    ISSN： 1474-4422

  24. Diabetes and psychological distress posed greater risks than model-inferred risk of radiation-induced cancer after the Fukushima disaster: An application of the loss of happy life expectancy indicator Peer-reviewed

    Michio Murakami, Akihiko Ozaki, Kyoko Ono, Shuhei Nomura, Yoshitake Takebayashi, Masaharu Tsubokura

    Acta Psychologica　264　106563-106563　2026/03/26

    Publisher: Elsevier BV

    DOI： 10.1016/j.actpsy.2026.106563 　

    ISSN： 0001-6918

  25. Global, regional, and national levels and trends in maternal mortality, progress towards the Sustainable Development Goals, and mortality from COVID-19 infection in pregnant women, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Maternal Mortality Collaborators

    The Lancet Obstetrics, Gynaecology, & Women's Health　2　(5)　E375-E424　2026/03/26

    Publisher: Elsevier BV

    DOI： 10.1016/s3050-5038(26)00047-6 　

    ISSN： 3050-5038

  26. Global, regional, and national burden of breast cancer among females, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    Kayleigh Bhangdia, Miranda L May, Jonathan M Kocarnik, Natalie Pritchett, Andrew Crist, Louise Penberthy, Alistair Acheson, Lee Deitesfeld, Bhoomadevi A, Hasan Aalruz, Hazim S Ababneh, Ukachukwu O Abaraogu, Nasir Abbas, Samar Abd ElHafeez, Reda Abdel-Hameed, Wael M Abdel-Rahman, Siddig Ibrahim Abdelwahab, Sepideh Abdi, Arash Abdollahi, Meriem Abdoun, Deldar Morad Abdulah, Abdullah, Auwal Abdullahi, Toufik Abdul-Rahman, Kulmira Abdykerimova, Mesfin Abebe, Armita Abedi, Mehrandokht Abedini, Kedir Hussein Abegaz, Alemwork Abie, Dagninet Derebe Abie, Olumide Abiodun, Richard Gyan Aboagye, Hassan Abolhassani, Ulric Sena Abonie, Mohammed Mehdi Abrar, Zhanar Abu, Rana Kamal Abu Farha, Fuad Hamdi A Abuadas, Aminu Kende Abubakar, Bilyaminu Abubakar, Eman Abu-Gharbieh, Hana J Abukhadijah, Mai Abdel Haleem Abusalah, Dina Abushanab, Swetha Acharya, Juan Manuel Acuna, Lisa C Adams, Isaac Yeboah Addo, Babatope Oluwadamilare Adebiyi, David Adedia

    The Lancet Oncology　27　(3)　302-326　2026/03/02

    DOI： 10.1016/s1470-2045(25)00730-2 　

    ISSN： 1470-2045

  27. Burden of chronic respiratory disease in Asia, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    Hyesu Jo, Tae Hyeon Kim, Jaeyu Park, Jiyeon Oh, Min Seo Kim, Shehab Uddin Al Abid, Ripon Kumar Adhikary, Qorinah Estiningtyas Sakilah Adnani, Anurag Agrawal, Danish Ahmad, Khabir Ahmad, Sajjad Ahmad, Tauseef Ahmad, Aram Mahmood Ahmed, Haroon Ahmed, MD Faisal Ahmed, Naveed Ahmed, Syed Anees Ahmed, Mohammed Ahmed Akkaif, Syed Mahfuz Al Hasan, Khurshid Alam, Mohammed Usman Ali, Rafat Ali, Syed Shujait Ali, Syed Yusuf Ali, Sheikh Mohammad Alif, Syed Mohamed Aljunid, Md Al-Mamun, Awais Altaf, Kabilan Annadurai, Sumbul Ansari, Jesu Arockiaraj, Mahwish Arooj, Nurila Aryntayeva, Syed Mohammed Basheeruddin Asdaq, Muhammad Abdul Basit Ashraf, Syed Amir Ashraf, Tahira Ashraf, Yuni Asri, Anil Raj Assariparambil, Giridhara Rathnaiah Babu, Ashish D Badiye, Atif Amin Baig, Shankar M Bakkannavar, Biswajit Banik, Mainak Bardhan, Saurav Basu, Narasimha M Beeraka, Samiun Nazrin Bente Kamal Tune, Jeetendra Bhandari, Niroj Bhandari

    The Lancet Respiratory Medicine　14　(3)　233-255　2026/03

    DOI： 10.1016/s2213-2600(25)00404-7 　

    ISSN： 2213-2600

  28. Modeling incubation period and time of exposure using the four-parameter generalized gamma distribution Peer-reviewed

    Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Shuhei Nomura, Akifumi Eguchi

    Biostatistics & Epidemiology　10　(1)　2026/02/20

    DOI： 10.1080/24709360.2026.2619272 　

    ISSN： 2470-9360 2470-9379

  29. Comparative Effectiveness of Behavioural Sodium-Reduction Interventions for Intensive Systolic Blood Pressure Control in Populations with Elevated Blood Pressure: A Systematic Review and Network Meta-Analysis Peer-reviewed

    Prapichaya Prommas, Manae Uchibori, Santosh Kumar Rauniyar, Shuhei Nomura

    Nutrients　18　(3)　428　2026/01/28

    DOI： 10.3390/nu18030428 　

  30. Global, regional, and national burden of chronic respiratory diseases and impact of the COVID-19 pandemic, 1990–2023: a Global Burden of Disease study Peer-reviewed

    GBD 2023 Global Chronic Respiratory Disease and Covid Collaborators

    Nature Medicine　2026/01/06

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41591-025-04077-9 　

    ISSN： 1078-8956

    eISSN： 1546-170X

  31. Global burden of lower respiratory infections and aetiologies, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Lower Respiratory Infections and Antimicrobial Resistance Collaborators

    The Lancet Infectious Diseases　26　(4)　341-361　2025/12/15

    Publisher: Elsevier BV

    DOI： 10.1016/s1473-3099(25)00689-9 　

    ISSN： 1473-3099

  32. Cost–benefit analysis of pre-entry tuberculosis screening for incoming migrants to Japan: a focus on Nepalese migrants Peer-reviewed

    Yoko Iwaki, Takayuki Hayashi, Shuhei Nomura, Shoko Shimamura, Rohita Gauchan, Michael C. Huang

    Health Economics Review　2025/12/13

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s13561-025-00709-5 　

    eISSN： 2191-1991

  33. When disaster meets conflict: Bridging health, nutrition and equity in Myanmar Peer-reviewed

    Kaung Suu Lwin, Su Myat Han, Shuhei Nomura

    BMJ Global Health　10　e020067　2025/12/11

    DOI： 10.1136/bmjgh-2025-020067 　

  34. Quantifying the fatal and non-fatal burden of disease associated with child growth failure, 2000–2023: a systematic analysis from the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Child Growth Failure Collaborators

    The Lancet Child & Adolescent Health　10　(1)　22-38　2025/12/02

    Publisher: Elsevier BV

    DOI： 10.1016/s2352-4642(25)00303-7 　

    ISSN： 2352-4642

  35. Global, regional, and national burden of chronic kidney disease in adults, 1990–2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Chronic Kidney Disease Collaborators

    The Lancet　406　(10518)　2461-2482　2025/11/07

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01853-7 　

    ISSN： 0140-6736

  36. Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Disease and Injury and Risk Factor Collaborators

    The Lancet　406　(10513)　1873-1922　2025/10/12

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01637-x 　

    ISSN： 0140-6736

  37. Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Causes of Death Collaborators

    The Lancet　406　(10513)　1811-1872　2025/10/12

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01917-8 　

    ISSN： 0140-6736

  38. Global age-sex-specific all-cause mortality and life expectancy estimates for 204 countries and territories and 660 subnational locations, 1950–2023: a demographic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Demographics Collaborators

    The Lancet　406　(10513)　1731-1810　2025/10/12

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01330-3 　

    ISSN： 0140-6736

  39. The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Cancer Collaborators

    The Lancet　406　(10512)　1565-1586　2025/10/11

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01635-6 　

    ISSN： 0140-6736

  40. Sexual Inactivity in Japan: A Scoping Review Peer-reviewed

    Peter Ueda, Sari Toki, Shuhei Nomura, Alice Pacher, Cyrus Ghaznavi, Haruka Sakamoto

    The Journal of Sex Research　1-26　2025/10/02

    Publisher: Informa UK Limited

    DOI： 10.1080/00224499.2025.2564192 　

    ISSN： 0022-4499

    eISSN： 1559-8519

  41. Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023 Peer-reviewed

    Global Burden of Cardiovascular Diseases and Risks 2023 Collaborators

    JACC　86　(22)　2167-2243　2025/09/24

    Publisher: Elsevier BV

    DOI： 10.1016/j.jacc.2025.08.015 　

    ISSN： 0735-1097

  42. Decentralized pandemic response and health equity: an analysis of socioeconomic disparities in COVID-19 mortality in Japan Peer-reviewed

    Hasan Jamil, Aminu Abubakar Kende, Shuhei Nomura, Fumiya Inoue, Takao Suzuki, Stuart Gilmour

    Epidemiology and Health　e2025049-e2025049　2025/08/28

    Publisher: Korean Society of Epidemiology

    DOI： 10.4178/epih.e2025049 　

    eISSN： 2092-7193

  43. Global, regional, and national trends in routine childhood vaccination coverage from 1980 to 2023 with forecasts to 2030: a systematic analysis for the Global Burden of Disease Study 2023 Peer-reviewed

    GBD 2023 Vaccine Coverage Collaborators

    The Lancet　2025/06/24

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)01037-2 　

    ISSN： 0140-6736

  44. Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage Peer-reviewed

    GBD 2021 Global Subarachnoid Hemorrhage Risk Factors Collaborators

    JAMA Neurology　2025/05/23

    Publisher: American Medical Association (AMA)

    DOI： 10.1001/jamaneurol.2025.1522 　

    ISSN： 2168-6149

    More details Close

    Importance Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. Objective To estimate the worldwide burden of SAH. Design, Setting, and Participants Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. Exposures SAH and 14 modifiable risk factors. Main Outcomes and Measures Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor–specific population attributable fractions (PAFs). Results In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. Conclusions and Relevance Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH.

  45. Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Acute and Chronic Care Collaborators

    Nature Communications　16　(1)　2025/05/07

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41467-025-56910-x 　

    eISSN： 2041-1723

  46. Population aging exacerbates heat stroke-related ambulance transportations in Japan Peer-reviewed

    Qiang Guo, Lina Madaniyazi, Shuhei Nomura, Kai Chen, Masahiro Hashizume

    Environment International　199　109506-109506　2025/05/03

    Publisher: Elsevier BV

    DOI： 10.1016/j.envint.2025.109506 　

    ISSN： 0160-4120

  47. Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study Peer-reviewed

    GBD 2021 Dietary Iron Deficiency Collaborators

    Nature Medicine　2025/04/22

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41591-025-03624-8 　

    ISSN： 1078-8956

    eISSN： 1546-170X

  48. Heterogeneity in willingness to share personal health information: a nationwide cluster analysis of 20,000 adults in Japan Peer-reviewed

    Miho Sassa, Akifumi Eguchi, Keiko Maruyama-Sakurai, Takanori Fujita, Yumi Kawamura, Takayuki Kawashima, Yuta Tanoue, Daisuke Yoneoka, Hiroaki Miyata, Takanori Yamashita, Naoki Nakashima, Shuhei Nomura

    Archives of Public Health　83　(1)　2025/04/18

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s13690-025-01599-z 　

    eISSN： 2049-3258

  49. Excess mortality during and after the COVID-19 emergency in Japan: a two-stage interrupted time-series design Peer-reviewed

    Ganan Devanathan, Paul LC Chua, Shuhei Nomura, Chris Fook Sheng Ng, Nasif Hossain, Akifumi Eguchi, Masahiro Hashizume

    BMJ Public Health　3　(1)　e002357-e002357　2025/04/05

    Publisher: BMJ

    DOI： 10.1136/bmjph-2024-002357 　

    eISSN： 2753-4294

    More details Close

    Background The COVID-19 pandemic has had unprecedented impacts on mortality worldwide. This study aimed to estimate excess all-cause mortality in Japan from 2020 to 2023, stratified by age, sex and prefecture, to assess the evolving impact of the pandemic, particularly in the latter years. The study period extends beyond Japan ending the public health emergency. Methods Using national vital statistics data from 2015 to 2023, we employed a two-stage interrupted time series analysis to estimate excess mortality during the COVID-19 pandemic (2020–2023) compared with the prepandemic period (2015–2019). Models were adjusted for seasonality, long-term trends, temperature and influenza activity. We calculated excess deaths during (14 January 2020 to 7 May 2023) and after (8 May 2023 to 31 December 2023) the COVID-19 emergency. Results Japan experienced 219 516 excess deaths (95% empirical CI (eCI) 138 142 to 301 590) during the study period, corresponding to 3.7% (95% eCI 2.33 to 5.09) excess mortality. Excess mortality was negative in 2020 (−1.67%, 95% eCI −2.76 to −0.55), becoming positive in 2021 (2.19%, 95% eCI 0.9 to 3.49) and peaking in 2022 (7.55%, 95% eCI 5.96 to 9.13) before declining in 2023 (5.76%, 95% eCI 4.29 to 7.24). The &lt;60 age group consistently showed the highest percentage excess mortality. Males had slightly higher excess mortality than females. By 2022, all prefectures exhibited positive excess mortality. The relative risk peaked in late 2022, with a smaller peak in summer 2023, coinciding with the post-emergency period. Comparing this post-emergency period with prior years shows the highest percentage excess mortality in 2022. Rural prefectures, and those with lower influenza cases, showed reduced excess mortality during the latter and post-emergency period. Conclusion Despite initial success in mitigating excess deaths, Japan saw increasing excess mortality as the pandemic progressed, with continued elevation post-emergency. The varying impact across age groups and time highlights the complex factors affecting mortality. This study’s findings underline the importance of continuous monitoring of excess mortality as a key indicator for public health dynamics.

  50. Three decades of population health changes in Japan, 1990–2021: a subnational analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    Shuhei Nomura, Michio Murakami, Santosh Kumar Rauniyar, Naoki Kondo, Takahiro Tabuchi, Haruka Sakamoto, Yasuharu Tokuda, Nishali Patel, Jose Navarro de Pablo, Joseph L Dieleman, Angela Y Chang, Vegard Skirbekk, Sarah K Abe, Norito Kawakami, Erika Ota, Scott D Glenn, Chimedsuren Ochir, Hiroaki Miyata, Manami Inoue, Kenji Shibuya, Isaac Yeboah Addo, Mohammed Ahmed Akkaif, Syed Mahfuz Al Hasan, Waad Ali, Mohammad Al-Warda, Hany Aly, Anayochukwu Edward, Anyasodor, Jalal Arabloo, Ahmed Y. Azzam, Kavita Batra, Sonu Bhaskar, Samuel Adolf Bosoka, Ester Cerin, Vijay Kumar Chattu, Dong-Woo Choi, Bryan Chong, Samuel Demissie Darcho, Nicole Davis Weaver, Kuldeep Dhama, Robert Kokou Dowou, Temitope Cyrus Ekundayo, Ibrahim Faraha, El Bayoumy, Pietro Ferrara, Nuno Ferreira, Takeshi Fukumoto, Xiang Gao, Samer Hamidi, Simon I Hay, Yuta Hiraike, Mehdi Hosseinzadeh, Nayu Ikeda, Arit Inok, Md. Rabiul Islam, Masao Iwagami, Ammar Abdulrahman Jairoun, Mihajlo Jakovljevic, Inn Kynn Khaing, Mohammad Jobair Khan, Atulya Aman Khosla, Tea Lallukka, Thao Thi Thu Le, Munjae Lee, Seung Won Lee, Wei-Chen Lee, Raimundas Lunevicius, Medha Mathur, Hadush Negash Meles, Mohammadreza Mobayen, Jama Mohamed, Abdollah Mohammadian-Hafshejani, Yanjinlkham Munkhsaikhan, Christopher J L Murray, Ganesh R Naik, Samidi Nirasha, Kumari Navaratna, Phuong The Nguyen, Dieta Nurrika, Bogdan Oancea, Michael Safo Oduro, Takayoshi Ohkubo, Osaretin Christabel Okonji, Sok King Ong, Mahesh Padukudru P A., Jagadish Rao Padubidri, Romil R Parikh, Sungchul Park, Mahmoud Mohammed Ramadan, Shakthi Kumaran Ramasamy, Sheena Ramazanu, Elrashdy M., Moustafa Mohamed Redwan, Taeho Gregory Rhee, Cameron John Sabe, Vijaya Paul Samuel, Jennifer Saulam, Mohammad Ali Shamshirgaran, Premalatha K Shetty, Mika Shigematsu, Aminu Shittu, Emmanuel Edwar Siddig, Zhong Sun, Chandan Kumar Swain, Ruri Syailendrawati, Sree Sudha T Y., Jabeen Taiba, Masayuki Teramoto, Ngoc Ha Tran, Nguyen Tran Minh Duc, Dominique Vervoor, Muhammad Waqas, Kazumasa Yamagishi, Yuichiro Yano, Yuichi Yasufuku, Dong Keon Yon, Naohiro Yonemoto, Iman Zare, Zhiqiang Zhang, Hanqing Zhao, Claire Chenwen Zhong, Mohsen Naghavi

    Lancet Public Health　10　(4)　e321-e332　2025/04

    DOI： 10.1016/S2468-2667(25)00044-1 　

    ISSN： 2468-2667

  51. Weibull-Type Incubation Period and Time of Exposure Using γ-Divergence Peer-reviewed

    Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Shuhei Nomura, Akifumi Eguchi

    Entropy　27　(3)　2025/03/19

    DOI： 10.3390/e27030321 　

  52. Global, regional, and national prevalence of adult overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Adult BMI Collaborators

    The Lancet　2025/03/03

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)00355-1 　

    ISSN： 0140-6736

  53. Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Adolescent BMI Collaborators

    The Lancet　2025/03/03

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(25)00397-6 　

    ISSN： 0140-6736

  54. Global, regional, and national burden of suicide, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    Weaver, N.D., Bertolacci, G.J., Rosenblad, E., Ghoba, S., Cunningham, M., Ikuta, K.S., Moberg, M.E., Mougin, V., Han, C., Wool, E.E., Abate, Y.H., Adewuyi, H.O., Adnani, Q.E.S., Adzigbli, L.A., Afolabi, A.A., Agampodi, S.B., Ahinkorah, B.O., Ahmad, A., Ahmad, D., Ahmad, S., Ahmed, A., Ahmed, H., Al Hamad, H., Al-Ajlouni, Y., Al-Amer, R.M., Albashtawy, M., Aldhaleei, W.A., Ali, S.S., Ali, W., Alomari, M.A., Alsabri, M.A., Alvis-Guzman, N., Al-Worafi, Y.M., Amindarolzarbi, A., Amiri, S., Andrei, T., Anvari, S., Arabloo, J., Areda, D., Artamonov, A.A., Ashraf, T., Athari, S.S., Atout, M.M.W., Azzam, A.Y., Badiye, A.D., Baghcheghi, N., Bahramian, S., Banach, M., Barker-Collo, S.L., B{\"a}rnighausen, T.W., Barrow, A., Bashiri, A., Bashiru, H.A., Bastan, M.-M., Batra, K., Batra, R., Bayati, M., Benjet, C., Benzian, H., Bertuccio, P., Bhagavathula, A.S., Bhattacharjee, P., Bills, C.B., Boppana, S.H., Borges, G., Borhany, H., Bustanji, Y., dos Santos, F.L.C., Castelpietra, G., Caye, A., Cenderadewi, M., Chandika, R.M., Cha, drasekar, E.K., Charalampous, P., Chen, Y., Chimoriya, R., Chopra, H., Choudhari, S.G., Chu, D.-T., Chukwu, I.S., Chutiyami, M., Cowden, R.G., Dachew, B.A., Dadras, O., Dai, X., Dalal, K., Dandona, L., Dandona, R., Darcho, S.D., Soltani, R.D.C., D{\'a}vila-Cervantes, C.A., de la Torre-Luque, A., Debopadhaya, S., Degenhardt, L., Delgado-Enciso, I., Dervi?evi?, E., Diaz, M.J., Dongarwar, D., Doshi, O.P., Dsouza, H.L., Dumith, S.C., Duraisamy, S., Eboreime, E., Efendi, F., Ekholuenetale, M., Adel El Arab, R., Elhadi, M., El Nahas, G., Eltaha, C., Haque, S.E.E., Eskandarieh, S., Fahim, A., Faro, A., Fatehizadeh, A., Fazeli, P., Feizkhah, A., Fekadu, G., Ferreira, N., Fischer, F., Franklin, R.C., Fridayani, N.K.Y., Gajd{\'a}cs, M., Gandhi, A.P., Ganesan, B., Gebregergis, M.W., Gebrehiwot, M., Gebremeskel, T.G., Getie, M., Ghadimi, D.J., Ghailan, K.Y., Ghashghaee, A., Gholamrezanezhad, A., Goleij, P., Grada, A., Grivna, M., Guan, S.-Y., Gulati, S., Gupta, S., Guti{\'e}rrez, R.A., Guti{\'e}rrez-Murillo, R.S., Hamilton, E.B., Hanifi, N., Hasan, I., Tabatabaei, M.S.H.Z., Hay, S.I., Heidari, M., Hemmati, M., Hoan, N.Q., Hosseinzadeh, M., Hostiuc, S., Huang, J., Huynh, H.-H., Ibitoye, S.E., Ilesanmi, O.S., Ilic, I.M., Ilic, M.D., Immurana, M., Inok, A., Iwu, C.D., Jahrami, H., Jaka, S., Yengejeh, R.J., Ji, Z., Jin, S., Joseph, N., Joshua, C.E., Jozwiak, J.J., Kabir, Z., Kadashetti, V., Kanmodi, K.K., Kantar, R.S., Kapoor, N., Karaye, I.M., Karmakar, S., Kaur, H., Kerr, J.A., Khajuria, H., Khan, A., Khatab, K., Kheirallah, K.A., Kim, K., Kim, M.S., Shivakumar, S.K.M., Kolahi, A.-A., Koohestani, H.R., Krishna, V., Kugbey, N., Kulimbet, M., Kumar, G.A., Kumar, M., Kundu, S., Kyt{\"o}, V., Landires, I. and Le, N.H.H., Lee, D.W., Lee, W.-C., Lee, Y.H., Lim, S.S., Lin, J., Liu, R.T., L{\'o}pez-Gil, J.F., Lucchetti, G., Ma, Z.F., Maled, V., Malhotra, K., Malik, A.A., Marconi, A.M., Martinez-Piedra, R., Marzo, R.R., Mathangasinghe, Y., Maulik, P.K., Meles, H.N., Menezes, R.G., Meretoja, T.J., Mestrovic, T., Michalek, I.M., Miller, T.R., Mirza, M., Misganaw, A., Mittal, C., Mohamed, A.Z., Mohamed, N.S., Mohammadian-Hafshejani, A., Mokdad, A.H., Molinaro, S., Monasta, L., Ghalibaf, A.M., Morrison, S.D., Motappa, R., Mughal, F., Mulita, F., Munkhsaikhan, Y., Murray, C.J.L., Muthu, S., Myung, W., Nafei, A., Naghavi, P., Naik, G.R., Naik, G., Natto, Z.S., Naveed, M., Navid, S., Nayak, B.P., Nazri-Panjaki, A., Netsere, H.B., Neupane, S.P., Nguyen, H.A.H., Nguyen, N.N.Y., Nguyen, P.T., Nguyen, P.T., Nguyen, V.T., Nikoobar, A., Noguer, I., Nomura, S., Nri-Ezedi, C.A., Nu{\~n}ez-Samudio, V., Nzoputam, O.J., Oancea, B., Oduro, M.S., Oh, I.-H., Okeke, S.R., Oluwafemi, Y.D., Ong, S.K., Ordak, M., Orpana, H.M., Ortiz-Prado, E., Osuagwu, U.L., Padron-Monedero, A., Padubidri, J.R., Palma-Alvarez, R.F.F., Pandey, A., Pandey, A., Pantazopoulos, I., Park, S., Park, S., Pashaei, A., Patel, J., Pawar, S., Peprah, P., Peres, M.F.P., Petcu, I.-R., Philip, A.K., Phillips, M.R., Piracha, Z.Z., Pradhan, J., Prates, E.J.S., Pribadi, D.R.A., Puvvula, J., Qattea, I., Qian, G., Radhakrishnan, V., Raghav, P., Rahimibarghani, S., Rahimi-Movaghar, A., Rahimi-Movaghar, V., Rahman, M.M., Rahman, M., Rahman, M.A., Rahmanian, M., Rajpoot, P.L., Ramadan, M.M., Ramasamy, S.K., Rani, S., Rao, M., Rao, S.J., Rashidi, M.-M., Rastogi, P., Rathish, D., Rawaf, D.L., Reifels, L., Rezaeian, M., Rhee, T.G., Rickard, J., Roever, L., Rony, M.K.K., Chandan, S.N., Saddik, B.A., Sadeghian, F., Saeb, M.R., Saeed, U., Moghaddam, S.S., Safari, M., Sagoe, D., Sharif-Askari, N.S., Sahoo, P.M., Sahoo, S.S., Salamati, P., Salihu, D., Salimi, S., Salum, G.A., Sameen, S., Samy, A.M., Santric-Milicevic, M.M., Sarkar, C., Sarode, G.S., Sarode, S.C., Sathian, B., Schumacher, A.E., ?ekerija, M., Semreen, M.H., Sepanlou, S.G., Shafie, M., Shahid, S., Shaikh, A., Shaikh, M.A., Sharifan, A., Rad, J.S., Sharma, A., Sharma, V., Sheikhi, R.A., Shetty, M., Shetty, P.H., Shetty, P.K., Shivarov, V., Shool, S., Singh, P., Singh, P., Singh, S., Socea, B., Stein, D.J., Stein, M.B., Sun, J., Swain, C.K., Szarpak, L., Sree Sudha, T.Y., Tabatabaei, S.M., Tabche, C., Tareke, M., Temsah, M.-H., Thum, C.C., Tiruye, T.Y., Tovani-Palone, M.R., Tran, N.M., Tran, T.H., Duc, N.T.M., Tromans, S.J., Truyen, T.T.T.T., Tsegay, G.M., Tumurkhuu, M., Vahdati, S., Vaithinathan, A.G., Valdez, P.R., Vasankari, T.J., Veroux, M., Verras, G.-I., Vinayak, M., Vos, T., Walde, M.T., Wang, Y., Ward, J.L.L., Wickramasinghe, N.D., Wojewodzic, M.W., Yesodharan, R., Yi?it, A., Yin, D., Yip, P., Yon, D.K., Yonemoto, N., Yu, C., Zare, I., Zeariya, M.G.M., Zhang, H., Zhong, C.C., Zhu, B., Zhumagaliuly, A., Naghavi, M.

    Lancet Public Health　10　(3)　2025/03

    DOI： 10.1016/S2468-2667(25)00006-4 　

    ISSN： 2468-2667

  55. Perceptions and responses to COVID-19 through wastewater surveillance information and online search behavior: A randomized controlled trial Peer-reviewed

    Michio Murakami, Shuhei Nomura, Hiroki Ando, Masaaki Kitajima

    International Journal of Disaster Risk Reduction　118　105224　2025/02/15

    DOI： 10.1016/j.ijdrr.2025.105224 　

  56. Climate-related bilateral official development assistance (ODA) and vulnerability: A comparative study of allocation and effectiveness Peer-reviewed

    Santosh Kumar Rauniyar, Nagisa Shiiba, Lisa Yamasaki, Hiroaki Tomoi, Hana Tomoi, Maura Kitchens West, Atsushi Watanabe, Shuhei Nomura

    PLOS Climate　4　(2)　e0000382　2025/02/03

    DOI： 10.1371/journal.pclm.0000382 　

  57. The Unseen Aftermath: Associations Between the COVID-19 Pandemic and Shifts in Mortality Trends in Japan Peer-reviewed

    Hasan Jamil, Shuhei Nomura, Stuart Gilmour

    International Journal of Environmental Research and Public Health　22　(1)　74　2025/01/08

  58. Trading-Off Privacy and Willingness to Share Personal Health Information: A Survey of Municipal Employees in Fukuoka City, Japan Peer-reviewed

    Shuhei Nomura, Yasumasa Segawa, Cyrus Ghaznavi, Takanori Fujita, Keiko Maruyama-Sakurai, Manae Uchibori, Akifumi Eguchi, Masaharu Ishigaki, Kazuto Fujiwara, Masayuki Kido, Hiroaki Miyata, Takanori Yamashita, Naoki Nakashima

    Health　16　(12)　1315-1331　2024/12/31

    Publisher: Scientific Research Publishing, Inc.

    DOI： 10.4236/health.2024.1612091 　

    ISSN： 1949-4998

    eISSN： 1949-5005

  59. Changes in Healthcare Utilization in Japan in the Aftermath of the COVID-19 Pandemic: A Time Series Analysis of Japanese National Data Through November 2023 Peer-reviewed

    Yuta Tanoue, Alton Cao, Masahide Koda, Nahoko Harada, Cyrus Ghaznavi, Shuhei Nomura

    Healthcare　12　(22)　2307　2024/11/19

    DOI： 10.3390/healthcare12222307 　

  60. Robust estimation of the incubation period and the time of exposure using γ-divergence Peer-reviewed

    Yoneoka, D., Kawashima, T., Tanoue, Y., Nomura, S., Eguchi, A.

    Journal of Applied Statistics　52　(6)　1239-1257　2024/11/06

    DOI： 10.1080/02664763.2024.2420221 　

    ISSN： 0266-4763 1360-0532

  61. Global, regional, and national stillbirths at 20 weeks' gestation or longer in 204 countries and territories, 1990–2021: findings from the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Global Stillbirths Collaborators

    The Lancet　2024/11/04

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)01925-1 　

    ISSN： 0140-6736

  62. Changes in mortality during the COVID-19 pandemic in Japan: descriptive analysis of national health statistics up to 2022 Peer-reviewed

    Hirokazu Tanaka, Shuhei Nomura, Kota Katanoda

    Journal of Epidemiology　2024/10/27

    Publisher: Japan Epidemiological Association

    DOI： 10.2188/jea.je20240158 　

    ISSN： 0917-5040

    eISSN： 1349-9092

  63. Indirect and direct effects of nighttime light on COVID-19 mortality using satellite image mapping approach International-journal

    Daisuke Yoneoka, Akifumi Eguchi, Shuhei Nomura, Takayuki Kawashima, Yuta Tanoue, Masahiro Hashizume, Motoi Suzuki

    Scientific reports　14　(1)　25063-25063　2024/10/23

    DOI： 10.1038/s41598-024-75484-0 　

    More details Close

    The COVID-19 pandemic has highlighted the importance of understanding environmental factors in disease transmission. This study aims to explore the spatial association between nighttime light (NTL) from satellite imagery and COVID-19 mortality. It particularly examines how NTL serves as a pragmatic proxy to estimate human interaction in illuminated nocturnal area, thereby impacting viral transmission dynamics to neighboring areas, which is defined as spillover effect. Analyzing 43,199 COVID-19 deaths from national mortality data during January 2020 and October 2022, satellite-derived NTL data, and various environmental and socio-demographic covariates, we employed the Spatial Durbin Error Model to estimate the direct and indirect effect of NTL on COVID-19 mortality. Higher NTL was initially directly linked to increased COVID-19 mortality but this association diminished over time. The spillover effect also changed: during the early 3rd wave (December 2020 - February 2021), a unit (nanoWatts/sr/cm2) increase in NTL led to a 7.9% increase in neighboring area mortality (p = 0.013). In contrast, in the later 7th wave (July - September 2022), dominated by Omicron, a unit increase in NTL resulted in an 8.9% decrease in mortality in neighboring areas (p = 0.029). The shift from a positive to a negative spillover effect indicates a change in infection dynamics during the pandemic. The study provided a novel approach to assess nighttime human activity and its influence on disease transmission, offering insights for public health strategies utilizing satellite imagery, particularly when direct data collection is impractical while the collection from space is readily available.

  64. Determinants of sodium intake knowledge and attitude: a cross-national analysis of socio-economic and health factors Peer-reviewed

    Santosh Kumar Rauniyar, Yuta Tanoue, Cyrus Ghaznavi, Hitomi Hayabuchi, Toshihide Nishimura, Yukari Takemi, Shuhei Nomura

    Public Health Nutrition　27　(1)　e216　2024/10/22

    DOI： 10.1017/S1368980024001551 　

  65. Analysis of factors associated with public attitudes towards salt reduction: a multicountry cross-sectional survey Peer-reviewed

    Tanoue, Y., Rauniyar, S.K., Uchibori, M., Ghaznavi, C., Tomoi, H., Ueta, M., Prommas, P., Cao, A., Yoneoka, D., Kawashima, T., Eguchi, A., Nomura, S.

    BMJ Open　14　(10)　e086467　2024/10/16

    DOI： 10.1136/bmjopen-2024-086467 　

    ISSN： 2044-6055

  66. Forecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Tobacco Forecasting Collaborators

    The Lancet Public Health　9　(10)　e729-e744　2024/10

    Publisher: Elsevier BV

    DOI： 10.1016/s2468-2667(24)00166-x 　

    ISSN： 2468-2667

  67. Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Stroke Risk Factor Collaborators

    The Lancet Neurology　23　(10)　973-1003　2024/10

    Publisher: Elsevier BV

    DOI： 10.1016/s1474-4422(24)00369-7 　

    ISSN： 1474-4422

  68. Progress and scenario-based projections of health service availability and coverage towards UHC in the post-conflict and post-pandemic Iraq: a Bayesian hierarchical regression approach Peer-reviewed

    Hiroko Taniguchi, Md Mizanur Rahman, Ashraf Hussain, Shuhei Nomura, Ganan Devanathan, Masahiro Hashizume

    BMJ Open　14　(9)　e080492-e080492　2024/09/30

    Publisher: BMJ

    DOI： 10.1136/bmjopen-2023-080492 　

    ISSN： 2044-6055

    eISSN： 2044-6055

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    Background Two decades have passed since the beginning of the Iraq War in 2003. Iraq has long suffered from conflicts and instability, where the people have limited access to healthcare. The coronavirus disease (COVID-19) pandemic brought additional disruption to health service provision. Objectives At the midpoint towards universal health coverage (UHC) in 2030, this study aims to gain a better understanding of the trends of UHC progress in Iraq in the context of the conflicts and the COVID-19 pandemic and to indicate possible pragmatic options. Design This study employed Bayesian hierarchical regression models to estimate trends and projections of health service availability and coverage indicators up to 2030. Furthermore, for health service coverage, four scenarios were defined based on the availability of health services, and projections were made for each scenario up to 2030. Setting Our approach used the yearly data from the Ministry of Health and four nationally representative household surveys between 2000 and 2020. We evaluated the subnational-level progress in three health service availability indicators and 13 health service coverage indicators in 18 governorates in Iraq from 2000 to 2030. Results The findings from 2000 to 2020 revealed a lack of progress in the indicators of health facility and inpatient bed, and pronounced detrimental effects from major conflicts and the pandemic on all measured health service coverage indicators. Despite these setbacks, several health service coverage indicators demonstrated resilience and elasticity in their recovery. The projected trends for 2021 to 2030 indicated limited alternations in the health service availability. By 2030, five health service coverage indicators will achieve the designated 80% targets. A scenario-based analysis predicts improved coverage of antenatal care, and child immunisation and treatment if health service availability is bolstered to globally recommended standards. Under this scenario, several governorates—Anbar, Baghdad, Nainawa, Qadissiyah, Salahaddin, Thiqar and Wasit—presented improved health service coverage in more indicators. Conclusion Strengthened health service availability has the potential to significantly improve fragile health service coverage indicators and in more vulnerable governorates.

  69. Strengthening Public Health System Resilience to Disasters in Türkiye: Insights from a Scorecard Methodology Peer-reviewed

    Ismail Tayfur, Perihan Şimşek, Abdülkadir Gunduz, Mayumi Kako, Shuhei Nomura, Benjamin Ryan

    International Journal of Disaster Risk Reduction　104869-104869　2024/09/27

    Publisher: Elsevier BV

    DOI： 10.1016/j.ijdrr.2024.104869 　

    ISSN： 2212-4209

  70. Lifestyle differences in the metabolic comorbidity score of adult population from South Asian countries: a cross-sectional study Peer-reviewed

    Sabera Sultana, Shuhei Nomura, Chris Fook Sheng, Masahiro Hashizume

    AJPM Focus　100273-100273　2024/08/23

    Publisher: Elsevier BV

    DOI： 10.1016/j.focus.2024.100273 　

    ISSN： 2773-0654

  71. Health Information Seeking on the Internet Among Patients With and Without Cancer in a Region Affected by the 2011 Fukushima Triple Disaster: Cross-Sectional Study Peer-reviewed

    Yudai Kaneda, Akihiko Ozaki, Michio Murakami, Toyoaki Sawano, Shuhei Nomura, Divya Bhandari, Hiroaki Saito, Masaharu Tsubokura, Kazue Yamaoka, Yoshinori Nakata, Manabu Tsukada, Hiromichi Ohira

    JMIR Cancer　10　e49897　2024/08/21

    DOI： 10.2196/49897 　

  72. Factors influencing parental COVID-19 vaccination willingness for children in Japan Peer-reviewed

    Mami Ueta, Alton Cao, Michio Murakami, Hana Tomoi, Stuart Gilmour, Keiko Maruyama-Sakurai, Yoshihiro Takayama, Yoshitake Takebayashi, Masahiro Hashizume, Rauniyar Santosh Kumar, Hiroyuki Kunishima, Wataru Naito, Tetsuo Yasutaka, Satoshi Kaneko, Hiroaki Miyata, Shuhei Nomura

    Vaccine: X　100528-100528　2024/07/18

    Publisher: Elsevier BV

    DOI： 10.1016/j.jvacx.2024.100528 　

    ISSN： 2590-1362

  73. Factors associated with lifetime use of commercial sex work services among Japanese men aged 20–49: findings from a quasi-representative national survey, 2022 Peer-reviewed

    Cyrus Ghaznavi, Peter Ueda, Shuhei Nomura, Masahiro Ishikane, Shunsuke Uno, Haruka Sakamoto

    Sexually Transmitted Infections　sextrans-2023　2024/06/13

    Publisher: BMJ

    DOI： 10.1136/sextrans-2023-055971 　

    ISSN： 1368-4973

    eISSN： 1472-3263

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    Objectives Approximately half of Japanese men aged 20–49 years have purchased sexual services, but data concerning the use of commercial sex work (CSW) in Japan remain scarce. Methods We used online survey data from the National Inventory of Japanese Sexual Behavior conducted in 2022 (N=4000 Japanese men aged 20–49 years). We calculated the median number of paid sexual partners over the lifetime. We performed logistic regression analysis to determine the sociodemographic, anthropometric and attitudinal factors associated with any lifetime CSW use among men in Japan. Results The median number of paid sexual partners reported among men who had ever used CSW was 6 (IQR 3–17) across the lifetime; the corresponding value for those who had ever used CSW in the past year was 2 (IQR 1–4) over the last 12 months. In general, those reporting lifetime use of CSW were significantly more likely than their CSW-naïve counterparts to be older, be married, be heterosexual or bisexual, have higher income and have higher education. Those reporting higher self-rated attractiveness, high or low satisfaction with their sex lives, a desire to increase their frequency of sex and considering sex to be an important aspect of their lives were also found to have a higher likelihood of having used CSW. Conclusions High rates of CSW use in Japan likely reflect ease of access, low stigma with respect to use of sexual services and the diversity in the type of services offered. High-income, employed older men have more financial resources at their disposal to purchase services, which can be cost-prohibitive for part-time or unemployed young men with low incomes. These findings will serve as a launchpad for public health efforts directed at promoting safe sexual practices and improved sexually transmitted infection screening rates among users of CSW in Japan.

  74. The importance of methodological vigilance: Reevaluating suicide trends in Japan post‐2022 Peer-reviewed

    Masahide Koda, Nahoko Harada, Shuhei Nomura

    Psychiatry and Clinical Neurosciences Reports　3　(2)　2024/06/07

    Publisher: Wiley

    DOI： 10.1002/pcn5.214 　

    ISSN： 2769-2558

    eISSN： 2769-2558

  75. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Risk Factors Collaborators

    The Lancet　403　(10440)　2162-2203　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00933-4 　

    ISSN： 0140-6736

  76. Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Forecasting Collaborators

    The Lancet　403　(10440)　2204-2256　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00685-8 　

    ISSN： 0140-6736

  77. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Diseases and Injuries Collaborators

    The Lancet　403　(10440)　2133-2161　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00757-8 　

    ISSN： 0140-6736

  78. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Causes of Death Collaborators

    The Lancet　403　(10440)　2100-2132　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00367-2 　

    ISSN： 0140-6736

  79. Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Fertility and Forecasting Collaborators

    The Lancet　403　(10440)　2057-2099　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00550-6 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  80. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Demographics Collaborators

    The Lancet　403　(10440)　1989-2056　2024/05/16

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(24)00476-8 　

    ISSN： 0140-6736

  81. Characterizing Healthy Dietary Practices in Japan: Insights from a 2024 Nationwide Survey and Cluster Analysis Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Keiko Maruyama-Sakurai, Ruka Higashino, Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Yumi Kawamura, Rauniyar Santosh Kumar, Takanori Fujita, Hiroaki Miyata

    Nutrients　16　(10)　1412-1412　2024/05/08

    Publisher: MDPI AG

    DOI： 10.3390/nu16101412 　

    eISSN： 2072-6643

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    The increasing burden of lifestyle-related diseases highlights the need to address unhealthy dietary habits. This study aims to explore the latest dietary patterns in Japan following the COVID-19 pandemic, focusing on trends in health-promoting food choices. A web-based survey was conducted among 27,154 Japanese adults, selected via quota sampling to mirror national demographics. The study evaluated dietary diversity, measured through the Dietary Variety Score (Outcome 1), and the prioritization of nutritional and health considerations in food selection, assessed via a Likert scale (Outcome 2). Uniform Manifold Approximation and Projection (UMAP) and Ordering Points To Identify the Clustering Structure (OPTICS) algorithms were used to delineate patterns in health-centric food selections. OPTICS clustering revealed four distinct clusters for each outcome. Cluster 3, with a diverse diet, comprised older, predominantly female individuals with higher well-being and lower social isolation compared to Cluster 4, which lacked distinct dietary patterns. Cluster 3 also engaged more in snacking, treat foods, home cooking, and frozen meals. Similarly, a divide emerged between those prioritizing dietary considerations (Cluster C) and those indifferent to such aspects (Cluster D). The findings underscore the need for holistic post-COVID-19 public health initiatives addressing socioeconomic and cultural barriers to healthier dietary practices.

  82. Trust in governments, public health institutions, and other information sources as determinants of COVID-19 vaccine uptake behavior in Japan Peer-reviewed

    Alton Cao, Mami Ueta, Manae Uchibori, Michio Murakami, Hiroyuki Kunishima, Rauniyar Santosh Kumar, Prapichaya Prommas, Hana Tomoi, Stuart Gilmour, Haruka Sakamoto, Masahiro Hashizume, Wataru Naito, Tetsuo Yasutaka, Keiko Maruyama-Sakurai, Hiroaki Miyata, Shuhei Nomura

    Vaccine　2024/05

    Publisher: Elsevier BV

    DOI： 10.1016/j.vaccine.2024.04.081 　

    ISSN： 0264-410X

  83. Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021 Peer-reviewed

    GBD 2021 Tuberculosis Collaborators

    The Lancet Infectious Diseases　2024/03/19

    Publisher: Elsevier BV

    DOI： 10.1016/s1473-3099(24)00007-0 　

    ISSN： 1473-3099

  84. Comparing the risks of environmental carcinogenic chemicals in Japan using the loss of happy life expectancy indicator Peer-reviewed

    Michio Murakami, Kyoko Ono, Yoshitake Takebayashi, Masaharu Tsubokura, Shuhei Nomura

    Environmental Research　118637-118637　2024/03/08

    Publisher: Elsevier BV

    DOI： 10.1016/j.envres.2024.118637 　

    ISSN： 0013-9351

  85. A comprehensive assessment of deworming coverage among pregnant women in low- and middle-income countries, 2000–30 Peer-reviewed

    Miho Sassa, Daisuke Yoneoka, Chris Fook Sheng Ng, Alton Quan Cao, Ganan Devanathan, Masahiro Hashizume, Shuhei Nomura

    Journal of Global Health　14　2024/03/01

    Publisher: International Society of Global Health

    DOI： 10.7189/jogh.14.04002 　

    ISSN： 2047-2978

    eISSN： 2047-2986

  86. Prioritizing Strategies for Building the Resilience of Public Health Systems to Disasters Across Multiple Communities and Countries Peer-reviewed

    Benjamin J. Ryan, Mayumi Kako, Shelby Garner, Rok Fink, Ismail Tayfur, Jonathan Abrahams, Sanjaya Bhatia, Adriana Campelo, Matthew Fendt, Alicia Fontenot, Nahuel Arenas Garcia, Tim Hatch, Ryoma Kayano, LaShonda Malrey-Horne, Makiko MacDermot, Md Moshiur Rahman, Chaverle Noel, Shuhei Nomura, Jeremy P. Novak, Maria Opazo, Kendell Oliver, Luciana Peters, Sohel Rahman, Perihan Şimşek, Andrew Stricklin, Raymond Swienton, Bryan W. Brooks

    International Journal of Disaster Risk Science　15　(1)　1-17　2024/02/29

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1007/s13753-024-00537-x 　

    ISSN： 2095-0055

    eISSN： 2192-6395

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    Abstract The COVID-19 pandemic highlighted the urgent need to strengthen public health systems. In response, the United Nations Disaster Risk Reduction (UNDRR) Public Health System Resilience Scorecard (Scorecard) was applied in workshops across multiple countries. The aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system resilience. We conducted a workshop from 14 to 16 March 2023, at the UNDRR Global Education and Training Institute in Incheon, Republic of Korea. A sequential modified Delphi method was utilized to develop a set of prioritized resilience strategies. These were drawn from 70 strategies identified from 13 distinct workshops in eight countries. After two surveys, 23 strategies were finalized. Ten received ratings of “High” or “Very High” from 89% of participants. These related to the inclusion of public health risks in emergency plans, integrating multidisciplinary teams into public health, enabling local transport mechanisms, and improving the ability to manage an influx of patients. The Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system resilience. By leveraging this methodology, our study demonstrated how resilience strategies could inform disaster risk reduction funding, policies, and actions.

  87. Changes in Place of Death Among Patients With Dementia During the COVID-19 Pandemic in Japan: A Time-series Analysis

    Harada, N., Koda, M., Eguchi, A., Hashizume, M., Suzuki, M., Nomura, S.

    Journal of Epidemiology　34　(10)　2024/02/24

    DOI： 10.2188/jea.JE20230279 　

    ISSN： 0917-5040 1349-9092

  88. Excess suicides in Japan: a three-year post-pandemic assessment of gender and age disparities Peer-reviewed

    Haruka Sakamoto, Masahide Koda, Akifumi Eguchi, Kaori Endo, Takahiro Arai, Nahoko Harada, Takashi Nishio, Shuhei Nomura

    Psychiatry Research　115806-115806　2024/02/18

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2024.115806 　

    ISSN： 0165-1781

  89. Factors associated with barriers to healthcare access among ever-married women of reproductive age in Bangladesh: Analysis from the 2017–2018 Bangladesh Demographic and Health Survey Peer-reviewed

    Hitomi Hinata, Kaung Suu Lwin, Akifumi Eguchi, Cyrus Ghaznavi, Masahiro Hashizume, Shuhei Nomura

    PLOS ONE　19　(1)　e0289324-e0289324　2024/01/05

    Publisher: Public Library of Science (PLoS)

    DOI： 10.1371/journal.pone.0289324 　

    ISSN： 1932-6203

    eISSN： 1932-6203

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    Background Globally, women experience healthcare inequalities, which may contribute to excessive mortality rates at various stages of their lives. Though Bangladesh has achieved excellent progress in providing healthcare, the country still has some critical challenges that need immediate attention. The objective of this study is to examine the association between social determinants and barriers to accessing healthcare among ever-married women aged 15–49 in Bangladesh. Methods The study was conducted among 20,127 women aged 15–49, using data from the 2017–2018 Bangladesh Demographic and Health Survey. Four barriers to healthcare were considered: whether women face problems with permission, obtaining money, distance, and companionship. The multivariable logistic regression analysis was used, with a broad array of independent variables (such as age, and educational level) to identify the determinants of barriers to healthcare access. The associations were expressed as adjusted odds ratios (AOR) with a 95% confidence interval (CI). Results More than two-thirds (66.3%) of women reported having at least one perceived barrier to accessing healthcare. Women with a higher level of education (AOR = 0.49, 95% CI: 0.41–0.57), owning a mobile telephone (AOR = 0.78, 95% CI: 0.73–0.84), and those in the richest wealth quintile (AOR = 0.45, 95% CI: 0.38–0.52) had lower odds of having barriers to accessing healthcare. In addition, widowed (AOR = 1.53, 95% CI: 1.26–1.84), divorced (AOR = 1.91, 95% CI:1.47–2.48), or separated (AOR = 1.98, 95% CI: 1.46–2.69) women had higher odds of having a money barrier to accessing healthcare, than married women. Conclusions This study shows that individual-, household-, and community-level factors are associated with barriers to healthcare accessibility. To improve the state of women’s health in Bangladesh, it is vital to consider these socio-economic factors and implement fundamental measures, such as supporting the national health policy, empowering women’s socio-economic situation, and spreading the flexible way of healthcare access.

  90. Active and passive smoking and breast cancer in Japan: a pooled analysis of nine population-based cohort studies

    Wada, K., Nagata, C., Utada, M., Sakata, R., Kimura, T., Tamakoshi, A., Sugawara, Y., Tsuji, I., Sato, R., Sawada, N., Tsugane, S., Oze, I., Ito, H., Kitamura, T., Koyanagi, Y.N., Lin, Y., Matsuo, K., Abe, S.K., Inoue, M., Tanaka, S., Kimura, T., Sugawara, Y., Mizoue, T., Nomura, S., Takimoto, H., Tanaka, K., Charvat, H., Hidaka, A., Hirabayashi, M., Iwasaki, M., Kitamura, Y., Mori, N., Muto, M., Naito, M., Nakayama, T., Nishino, Y., Sadakane, A., Saito, E., Sasazuki, S., Shimazu, T., Shimizu, H., Sugiyama, K., Suzuki, H., Tsubono, Y., Wakai, K., Yamagiwa, Y., Yamaji, T.

    International Journal of Epidemiology　53　(3)　2024

    DOI： 10.1093/ije/dyae047 　

    ISSN： 0300-5771 1464-3685

  91. Insights from the COVID-19 pandemic: trends in development assistance committee countries’ aid allocation, 2011–2021 Peer-reviewed

    Nomura, S., Ghaznavi, C., Shimizu, K., Cao, A., Sassa, M., Uchibori, M., Santosh Kumar, R., Yamasaki, L., Tomoi, H., Sakamoto, H.

    Global Health Action　16　(1)　2258707　2023/12/31

    DOI： 10.1080/16549716.2023.2258707 　

    ISSN： 1654-9880

  92. Global Burden of Cardiovascular Diseases and Risks, 1990-2022 Peer-reviewed

    Global Burden of Cardiovascular Diseases and Risks Collaborators

    Journal of the American College of Cardiology　82　(25)　2350-2473　2023/12/19

    Publisher: Elsevier BV

    DOI： 10.1016/j.jacc.2023.11.007 　

    ISSN： 0735-1097

  93. Early Outcomes of Changes to Collection of Suicide Data in Japan Peer-reviewed

    Nahoko Harada, Masahide Koda, Shuhei Nomura

    JAMA Network Open　6　(12)　e2347543-e2347543　2023/12/14

    Publisher: American Medical Association (AMA)

    DOI： 10.1001/jamanetworkopen.2023.47543 　

    eISSN： 2574-3805

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    This cross-sectional study examines implications of updated categorizations for suicide data collection in Japan.

  94. The Efficacy of an mHealth App in Facilitating Weight Loss Among Japanese Fitness Center Members: Regression Analysis Study

    Akifumi Eguchi, Yumi Kawamura, Takayuki Kawashima, Cyrus Ghaznavi, Keiko Ishimura, Shun Kohsaka, Satoru Matsuo, Shinichiro Mizuno, Yuki Sasaki, Arata Takahashi, Yuta Tanoue, Daisuke Yoneoka, Hiroaki Miyata, Shuhei Nomura

    JMIR Formative Research　7　e48435-e48435　2023/11/08

    Publisher: JMIR Publications Inc.

    DOI： 10.2196/48435 　

    eISSN： 2561-326X

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    Background Self-tracking smartphone apps have emerged as promising tools to encourage healthy behaviors. In this longitudinal study, we used gym use data from members of a major fitness club that operates gyms throughout Japan from January 2014 to December 2019. Objective Our objective was to assess the extent to which a health and fitness self-tracking mobile app introduced to gym members on January 1, 2018, contributed to their weight loss. The app allows users to input information regarding diet, sleep, weight, and gym exercise so that they can receive personalized feedback from an artificial intelligence chatbot to improve their health behaviors. Methods We used linear regression to quantify the association between app use and weight loss. The primary outcome of the study was the weight loss achieved by each gym user, which was calculated as the difference between their initial and final weights in kilograms, as recorded in the app. Individuals who did not attend the gym or failed to use the mobile app at least twice during the study period were excluded from the analysis. The model accounted for age, gender, distance between the gym and the member’s residence, average weekly number of times a member used the gym, user’s gym membership length in weeks, average weekly number of times a member input information into the app, and the number of weeks that the app was used at least once. Results Data from 26,589 participants were analyzed. Statistically significant associations were detected between weight loss and 2 metrics related to app use: the average weekly frequency of use and the total number of weeks in which the app was used at least once. One input per week was found to be associated with a loss of 62.1 (95% CI 53.8-70.5) g, and 1 week of app use was associated with 21.7 (95% CI 20.5-22.9) g of weight loss from the day of the first input to that of the final input to the app. Furthermore, the average number of times that a member used the gym weekly was also shown to be statistically significantly associated with weight loss: 1 use per week was associated with 255.5 (95% CI 228.5-282.6) g of weight loss. Conclusions This empirical study demonstrated a significant association between weight loss among gym members and not only the frequency of weekly gym use but also the use of a health and fitness self-tracking app. However, further work is needed to examine the mechanisms through which mobile apps affect health behaviors and to identify the specific app features that are most effective in promoting weight loss.

  95. Impact of the COVID-19 pandemic on cancer death locations in Japan: an analysis up to February 2023 on excess mortality Peer-reviewed

    Shuhei Nomura, Marisa Nishio, Sarah Krull Abe, Akifumi Eguchi, Manami Inoue, Motoi Suzuki, Masahiro Hashizume

    Journal of Epidemiology　2023/10/21

    Publisher: Japan Epidemiological Association

    DOI： 10.2188/jea.je20230235 　

    ISSN： 0917-5040

    eISSN： 1349-9092

  96. Understanding factors related to healthcare avoidance for menstrual disorders and menopausal symptoms: a cross-sectional study among women in Japan

    Manae Uchibori, Akifumi Eguchi, Cyrus Ghaznavi, Yuta Tanoue, Mami Ueta, Miho Sassa, Shu Suzuki, Sayaka Honda, Yukiko Kawata, Miho Iida, Haruka Sakamoto, Shuhei Nomura

    Preventive Medicine Reports　102467-102467　2023/10/11

    Publisher: Elsevier BV

    DOI： 10.1016/j.pmedr.2023.102467 　

    ISSN： 2211-3355

  97. Strategies for Strengthening the Resilience of Public Health Systems for Pandemics, Disasters, and Other Emergencies Peer-reviewed

    Benjamin Ryan, Mayumi Kako, Rok Fink, Perihan Şimşek, Paul Barach, Jose Acosta, Sanjaya Bhatia, Mark Brickhouse, Matthew Fendt, Alicia Fontenot, Nahuel Arenas Garcia, Shelby Garner, Abdülkadir Gunduz, D. Mike, Hardin Jr, Tim Hatch, LaShonda Malrey-Horne, Makiko MacDermot, Ryoma Kayano, Joshua McKone, Chaverle Noel, Shuhei Nomura, Jeremy Novak, Andrew Stricklin, Raymond Swienton, Ismail Tayfur, Bryan Brooks

    Disaster Medicine and Public Health Preparedness　17　(5)　e479　2023/09/05

    DOI： 10.1017/dmp.2023.136 　

    ISSN： 1935-7893

    eISSN： 1938-744X

  98. Estimation of the time of exposure based on interval and censored data using the ε‐accelerated EM algorithm Peer-reviewed

    Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Shuhei Nomura, Akifumi Eguchi

    Statistics in Medicine　42　(25)　4542-4555　2023/08/22

    Publisher: Wiley

    DOI： 10.1002/sim.9874 　

    ISSN： 0277-6715

    eISSN： 1097-0258

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    Accurately estimating the timing of pathogen exposure plays a crucial role in outbreak control for emerging infectious diseases, including the source identification, contact tracing, and vaccine research and development. However, since surveillance activities often collect data retrospectively after symptoms have appeared, obtaining accurate data on the timing of disease onset is difficult in practice and can involve “coarse” observations, such as interval or censored data. To address this challenge, we propose a novel likelihood function, tailored to coarsely observed data in rapid outbreak surveillance, along with an optimization method based on an ‐accelerated EM algorithm for faster convergence to find maximum likelihood estimates (MLEs). The covariance matrix of MLEs is also discussed using a nonparametric bootstrap approach. In terms of bias and mean‐squared error, the performance of our proposed method is evaluated through extensive numerical experiments, as well as its application to a series of epidemiological surveillance focused on cases of mass food poisoning. The experiments show that our method exhibits less bias than conventional methods, providing greater efficiency across all scenarios.

  99. Estimating global changes in routine childhood vaccination coverage during the COVID-19 pandemic, 2020-2021 Peer-reviewed

    Cyrus Ghaznavi, Akifumi Eguchi, Kaung Suu Lwin, Daisuke Yoneoka, Yuta Tanoue, Rauniyar Santosh Kumar, Sayaka Horiuchi, Masahiro Hashizume, Shuhei Nomura

    Vaccine　2023/05/22

    Publisher: Elsevier BV

    DOI： 10.1016/j.vaccine.2023.05.034 　

    ISSN： 0264-410X

  100. Projection of morbidity and mortality due to breast cancer between 2020 and 2050 across 42 low- and middle-income countries Peer-reviewed

    Santosh Kumar Rauniyar, Masahiro Hashizume, Daisuke Yoneoka, Shuhei Nomura

    Heliyon　e16427-e16427　2023/05/19

    Publisher: Elsevier BV

    DOI： 10.1016/j.heliyon.2023.e16427 　

    ISSN： 2405-8440

  101. Promote global solidarity to advance health-system resilience: proposals for the G7 meetings in Japan Peer-reviewed

    The Lancet　401　(10385)　1319-1321　2023/04/05

    DOI： 10.1016/S0140-6736(23)00690-6 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  102. Modelling of salt intake reduction by incorporation of umami substances into Japanese foods: a cross-sectional study. International-journal Peer-reviewed

    Shiori Tanaka, Daisuke Yoneoka, Aya Ishizuka, Megumi Adachi, Hitomi Hayabuchi, Toshihide Nishimura, Yukari Takemi, Hisayuki Uneyama, Haruyo Nakamura, Kaung Suu Lwin, Kenji Shibuya, Shuhei Nomura

    BMC public health　23　(516)　516-516　2023/03/19

    DOI： 10.1186/s12889-023-15322-6 　

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    BACKGROUND: Evidence has demonstrated that excess sodium intake is associated with development of several non-communicable diseases. The main source of sodium is salt. Therefore, reducing salt intake in foods is an important global public health effort to achieve sodium reduction and improve health. This study aimed to model salt intake reduction with 'umami' substances among Japanese adults. The umami substances considered in this study include glutamate or monosodium glutamates (MSG), calcium diglutamate (CDG), inosinate, and guanylate. METHODS: A total of 21,805 participants aged 57.8 years on average from the National Health and Nutrition Survey was used in the analysis. First, we employed a multivariable linear regression approach with overall salt intake (g/day) as a dependent variable, adjusting for food items and other covariates to estimate the contribution of salt intake from each food item that was selected through an extensive literature review. Assuming the participants already consume low-sodium products, we considered three scenarios in which salt intake could be reduced with the additional umami substances up to 30%, 60% and 100%. We estimated the total amount of population-level salt reduction for each scenario by age and gender. Under the 100% scenario, the Japan's achievement rates against the national and global salt intake reduction goals were also calculated. RESULTS: Without compromising the taste, the 100% or universal incorporation of umami substances into food items reduced the salt intake of Japanese adults by 12.8-22.3% at the population-level average, which is equivalent to 1.27-2.22 g of salt reduction. The universal incorporation of umami substances into food items changed daily mean salt intake of the total population from 9.95 g to 7.73 g: 10.83 g to 8.40 g for men and 9.21 g to 7.17 g for women, respectively. This study suggested that approximately 60% of Japanese adults could achieve the national dietary goal of 8 g/day, while only 7.6% would meet the global recommendation of 5.0 g/day. CONCLUSIONS: Our study provides essential information on the potential salt reduction with umami substances. The universal incorporation of umami substances into food items would enable the Japanese to achieve the national dietary goal. However, the reduced salt intake level still falls short of the global dietary recommendation.

  103. Changes in cerebrovascular disease-related deaths and their location during the COVID-19 pandemic in Japan Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Cyrus Ghaznavi, Lisa Yamasaki, Santosh Kumar Rauniyar, Yuta Tanoue, Takayuki Kawashima, Daisuke Yoneoka, Shun Kohsaka, Motoi Suzuki, Masahiro Hashizume

    Public Health　(218)　176-179　2023/03/14

    Publisher: Elsevier BV

    DOI： 10.1016/j.puhe.2023.03.006 　

    ISSN： 0033-3506

  104. Comparing the risks of diabetes, psychological distress, and radiation-induced cancer exposure after the Fukushima disaster using the loss of happy life expectancy Peer-reviewed

    Michio Murakami, Akihiko Ozaki, Kyoko Ono, Shuhei Nomura, Yoshitake Takebayashi, Masaharu Tsubokura

    Acta Psychologica　264　106563　2023/03/07

    Publisher: openRxiv

    DOI： 10.1101/2023.05.01.23289327 　

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    Abstract After disasters, direct deaths and secondary health effects, such as diabetes and psychological distress, can occur. It is critical to compare the magnitudes of these risks to promote effective public health measures. In this study, we used the loss of happy life expectancy (LHpLE) to compare the risks associated with diabetes, psychological distress, and radiation-induced cancer after the 2011 Fukushima disaster. Two questionnaire surveys were conducted on people affected by the disaster to investigate the potential associations between diabetes and psychological distress, as well as breast cancer and reduced emotional happiness, with 680 and 582 participants, respectively. Additionally, we calculated the LHpLE owing to these risks. Although no significant reduction was found in emotional happiness due to diabetes or breast cancer, a significant reduction occurred due to psychological distress (0.265 and 0.476 for males and females, respectively). In the population aged 40–74 years, the LHpLE due to radiation-induced cancer, diabetes, and psychological distress were 0.0013, 0.14, and 0.21 years, respectively. This suggests that the association of LHpLE with diabetes and psychological distress was over two orders of magnitude greater than that associated with radiation-induced cancer. Within 7 years following the disaster, LHpLE due to diabetes increased, highlighting that diabetes is an ongoing issue. Therefore, this novel indicator of the LHpLE can provide a foundation for promoting effective public health measures following disasters.

  105. The impact of social isolation from COVID-19-related public health measures on cognitive function and mental health among older adults: A systematic review and meta-analysis Peer-reviewed

    Prapichaya Prommas, Kaung Suu Lwin, Yi Chi Chen, Misa Hyakutake, Cyrus Ghaznavi, Haruka Sakamoto, Hiroaki Miyata, Shuhei Nomura

    Ageing Research Reviews　85　101839-101839　2023/03

    Publisher: Elsevier {BV}

    DOI： 10.1016/j.arr.2022.101839 　

    ISSN： 1568-1637

  106. Public transportation network scan for rapid surveillance Peer-reviewed

    Tanoue, Y., Yoneoka, D., Kawashima, T., Uryu, S., Nomura, S., Eguchi, A., Makiyama, K., Matsuura, K.

    Biostatistics and Epidemiology　7　(1)　2023/01/02

    DOI： 10.1080/24709360.2022.2065628 　

    ISSN： 2470-9360 2470-9379

  107. Response to antiviral therapy for chronic hepatitis C and risk of hepatocellular carcinoma occurrence in Japan: a systematic review and meta-analysis of observational studies

    Yamagiwa, Y., Tanaka, K., Matsuo, K., Wada, K., Lin, Y., Sugawara, Y., Mizoue, T., Sawada, N., Takimoto, H., Ito, H., Kitamura, T., Sakata, R., Kimura, T., Tanaka, S., Inoue, M., Abe, S.K., Nomura, S.

    Scientific Reports　13　(1)　2023

    DOI： 10.1038/s41598-023-30467-5 　

    ISSN： 2045-2322

  108. Rights-based global health security through all-hazard risk management

    Huda, Q., Downey, E.L., Ardalan, A., Nomura, S., Rakesh, A.

    Modernizing Global Health Security to Prevent Detect and Respond　2023

    DOI： 10.1016/B978-0-323-90945-7.00007-5 　

  109. Body mass index and esophageal and gastric cancer: A pooled analysis of 10 population-based cohort studies in Japan

    Koyanagi, Y.N., Matsuo, K., Ito, H., Wang, C., Tamakoshi, A., Sugawara, Y., Tsuji, I., Ono, A., Tsugane, S., Sawada, N., Wada, K., Nagata, C., Takeuchi, T., Kitamura, T., Utada, M., Sakata, R., Mizoue, T., Abe, S.K., Inoue, M., Kimura, T., Sugawara, Y., Nomura, S., Takimoto, H., Oze, I., Lin, Y., Hidaka, A., Hirabayashi, M., Iwasaki, M., Kitamura, Y., Mori, N., Muto, M., Naito, M., Nakayama, T., Nishino, Y., Sadakane, A., Saito, E., Sasazuki, S., Shimazu, T., Shimizu, H., Sugiyama, K., Suzuki, H., Tamakoshi, A., Tanaka, K., Tanaka, S., Tsubono, Y., Wakai, K., Yamagiwa, Y., Yamaji, T.

    Cancer Science　114　(7)　2023

    DOI： 10.1111/cas.15805 　

    ISSN： 1347-9032 1349-7006

  110. Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study

    Lee, S., Son, Y., Hwang, J., Kim, M.S., Shin, J.I., Yon, D.K., Kassebaum, N.J., Abate, S.M., Abate, Y.H., Elhafeez, S.A., Abd-Elsalam, S., Abdoun, M., Abdulkader, R.S., Abdullahi, A., Abebe, M., Abedi, A., Abie, A., Abiodun, O., Aboagye, R.G., Abolhassani, H., Abouzid, M., Abreu, L.G., Abualruz, H., Abukhadijah, H.J., Aburuz, S., Abu-Zaid, A., Adamu, L.H., Adane, M.M., Addo, I.Y., Adegboye, O.A., Adekanmbi, V., Adetunji, C.O., Adeyeoluwa, T.E., Adnani, Q.E.S., Adzigbli, L.A., Afzal, S., Agampodi, S.B., Agyemang-Duah, W., Ahmad, A., Ahmad, M.M., Ahmad, S., Ahmad, T., Ahmed, A., Ahmed, A., Ahmed, H., Ahmed, M.S., Ahmed, S.A., Ajami, M., Akinosoglou, K., Akter, E., Al Awaidy, S., Al Hasan, S.M., Al Omari, O., Alajlani, M.M., Al-Aly, Z., Al-Amer, R.M., Albashtawy, M., Aldhaleei, W.A., Algammal, A.M., Alhalaiqa, F.N., Ali, A., Ali, A., Ali, L., Ali, M.U., Ali, S.S., Ali, W., Samakkhah, S.A., Alif, S.M., Al-Marwani, S., Al-Mekhlafi, H.M., Almustanyir, S., Alqahtani, J.S., Al-Raddadi, R.M.M., Alsabri, M.A., Altaany, Z., Altaf, A., Al-Tammemi, A.B., Altirkawi, K.A., Aly, H., Alzoubi, K.H., Amani, R., Amiri, S., Amu, H., Amusa, G.A., Ancuceanu, R., Andrei, T., Anuoluwa, B.S., Anuoluwa, I.A., Anvari, S., Anwar, S.L., Anyasodor, A.E., Arabloo, J., Arafat, M., Aravkin, A.Y., Areda, D., Aregawi, B.B., Aremu, A., Ariffin, H., Arkew, M., Ni, K.A., Ashemo, M.Y., Atata, J.A., Athari, S.S., Atout, M.M.W., Atreya, A., Aweke, A.M., Awoke, M.A., Quintanilla, B.P.A., Azhar, G.S., Azzam, A.Y., Babu, G.R., Baghcheghi, N., Bagheri, N., Bahramian, S., Baig, A.A., Bakkannavar, S.M., Balakrishnan, S., Balcha, W.F., Banik, P.C., Bansal, H., Bante, S.A., Basiru, A., Bastan, M.-M., Batra, K., Begum, T., Bello, M.B., Belo, L., Bensenor, I.M., Beressa, G., Berhie, A.Y., Bhagat, D.S., Bhala, N., Bhardwaj, N., Bhardwaj, P., Bhardwaj, P.V., Bhaskar, S., Bhat, A.N., Bhatti, J.S., Biswas, B., Bodhare, T., Bodunrin, A.O., Boloor, A., Bora, K., Borhany, H., Bouaoud, S., Bustanji, Y., Barsbay, M., Calina, D., C{\'a}mera, L.A., Cao, F., Cattafesta, M., Cegolon, L., Cembranel, F., Cenderadewi, M., Cercy, K.M., Chakraborty, C., Chakraborty, S., Chandika, R.M., Chattu, V.K., Chaurasia, A., Chen, H., Chi, G., Ching, P.R., Chirinos-Caceres, J.L., Cho, W.C.S., Chong, B., Chopra, H., Choudhari, S.G., Chu, D.-T., Chukwu, I.S., Concina, F., Criqui, M.H., Cruz-Martins, N., da Silva, A.G., Dadras, O., D?amico, E., Darcho, S.D., Das, S., Dash, N.R., Debopadhaya, S., Bo, C.D., Delgado-Enciso, I., Desai, H.D., Desta, F., Devegowda, D., Dhane, A.S., Dhulipala, V.R., Do, T.C., Do, T.H.P., Doaei, S., Dohare, S., D?oria, M., Doshi, O.P., Dowou, R.K., Dsouza, A.C., Dsouza, H.L., Duraisamy, S., Dutta, S., Edinur, H.A., Efendi, F., Eftekharimehrabad, A., Eghbali, F., Ekholuenetale, M., Bayoumy, I.F.E., Elbarazi, I., Elgohary, G.M.T., Elhadi, M., El-Huneidi, W., Elshaer, M., Elsohaby, I., Emeto, T.I., Fagbamigbe, A.F., Fahim, A., Fakhradiyev, I.R., Faris, M.E.M., Fauk, N.K., Fazeli, P., Feizkhah, A., Fekadu, G., Ferreira, N., Fischer, F., Florin, B.T., Folayan, M.O.O., Fomenkov, A.A., Fukumoto, T., Fux, B., Sridevi, G., Gadanya, M.A., Gaidhane, A.M., Galali, Y., Gandhi, A.P., Gardner, W.M., Gautam, R.K., Gebregergis, M.W., Gebrehiwot, M., Gebremariam, T.B., B, Geremew, H., Getacher, L., Getahun, G.K., Getie, M., Getie, S.A., Ghadimi, D.J., Ghailan, K.Y., Ghazy, R.M., Gholamalizadeh, M., Gholamrezanezhad, A., Gil, A.U., Giri, B.R., Girmay, A.A., Goulart, A.C., Gubari, M.I.M., Gunawardane, D.A., Gupta, A.K., Gupta, I., Gupta, R.D., Gupta, S., Gupta, V.K., Habibzadeh, F., Habibzadeh, P., Hadi, N.R., Hagins, H., Halim, S.A., Hamdy, N.M., Hamidi, S., Handal, A.J., Handiso, D.W., Hasaballah, A.I., Hasan, M.K., Hasani, H., Md, S.H., Hassan, I.I., Hassankhani, H., Hay, S.I., Hayat, K., Heidari, G., Hemmati, M., Hezam, K., Hiraike, Y., Hoan, N.Q., Holla, R., Md, M.H., Hosseinzadeh, M., Hostiuc, M., Hostiuc, S., Huang, J., Hundie, T.G., Hussain, J., Huynh, H.-H., Hwang, B.-F., Ibitoye, S.E., Ikeda, N., Ilesanmi, O.S., Ilic, I.M., Ilic, M.D., Immurana, M., Inbaraj, L.R., Inok, A., Iqhrammullah, M., Irham, L.M., Islam, M.R., Islam, S.M.S., Ismail, N.E., Isola, G., Iwu, C.D., Iyasu, A.N., Iyer, M., Vinothini, J., Jafarzadeh, A., Jahankhani, K., Jain, A., Jairoun, A.A., Jakovljevic, M., Yengejeh, R.J., Jamil, S., Jawaid, T., Jayanna, K., Jayaram, S., Jena, B.H., Jeswani, B.M., Jokar, M., Jonas, J.B., Jose, J., Joseph, N., Joshua, C.E., Joukar, F., Jozwiak, J.J., Kabir, A., Kabir, Z., Kadir, D.H.H., Kahe, F., Kalankesh, L.R., Kamireddy, A., Kanmodi, K.K., Kantar, R.S., Karami, J., Behnagh, A.K., Kauppila, J.H., Kaur, N., Kayode, G.A., Kayola, K.K., Kebede, A.D., Keikavoosi-Arani, L., Keiyoro, P.N., Khajuria, H., Khalaji, A., Khalid, N., Khalilian, A., Khan, M., Khanal, V., Khatatbeh, H., Khatatbeh, M.M., Kheirallah, K.A., Khidri, F.F., Khokhar, M., Khosla, A.A., Khosravi, M., Khusun, H., Kim, Y.J., Kimokoti, R.W., Kisa, A., Kisa, S., Shivakumar, S.K.M., Kolahi, A.-A., Kompani, F., Koohestani, H.R., Kosen, S., Krishan, K., Kuddus, M., Kulimbet, M., Kumar, D., Kumar, N., Kumar, V., Kundu, S., Om, P.K., Kyei-Arthur, F., Lahariya, C., Lal, D.K., Landires, I., Latief, K. and Le, N.H.H., and Le, T.T.T., Lee, M., Lee, S.W., Lee, W.-C., An, L., Li, M.-C., Lim, S.S., Lin, J., Liu, X., Lonimath, A., Francisco L{\'o}pez-Gil, J., Lopukhov, P.D., Lorenzovici, L., Lotufo, P.A., Lubinda, J., Amin, H.I.M., Ma, Z.F., Rad, E.M., Malik, A.A., Malta, D.C., Manla, Y., Manu, E., Marino, M., Martorell, M., Marzo, R.R., Mathangasinghe, Y., Mathews, E., Mathur, M., Maugeri, A., Mazidi, M., McHugh, T.A., Mehmood, A., Mehra, R., Mehta, K.M., Meto, T.M., Mekonnen, B.D., Meles, H.N., Melese, E.B., Mendez-Lopez, M.A., Mendoza, W., Mestrovic, T., Mettananda, C.D.K., Mettananda, S., Miazgowski, T., Michalek, I.M., Le, H.N.M., Mini, G.K., Mirghafourvand, M., Misganaw, A., Mittal, M., Mohamed, A.I., Mohamed, J., Mohamed, N.S., Mohammad, A.M., Mohammad-Alizadeh-Charandabi, S., Mohammadi, S., Mohammed, S., Mokdad, A.H., Vardanjani, H.M., Monasta, L., Moni, M.A., Ghalibaf, A.M., Moradi, M., Mosapour, A., Motappa, R., Khaneghah, A.M., Mubarik, S., Mukherjee, S., Mulita, F., Munjal, K., Munkhsaikhan, Y., Murray, C.J.L., Musina, A.-M., Mustafa, G., Muthu, S., Muzaffar, M., Nagarajan, A.J., Naghavi, P., Naik, G., Najdaghi, S., Najmuldeen, H.H.R., Nandu, K.T.K., Swamy, S.N., Davani, D.N., Nashwan, A.J., Natto, Z.S., Nauman, J., Naveed, M., Nayak, B.P., Nazri-Panjaki, A., Takop Nchanji, G., Nega, A.T., Nega, M.H., Negoi, I., Negoi, R.I., Nejadghaderi, S.A., Netsere, H.B., Nguefack-Tsague, G., Ngunjiri, J.W., Nguyen, D.H., Nguyen, H.T.H., Nguyen, N., Nguyen, N.N.Y., Nguyen, P.T., Van Thanh Nguyen, Niazi, R.K., Nikoobar, A., Noman, E.A., Nomura, S., Noor, S.T.A., Nawsherwan, N.A., Nouri, M., Nozari, M., Nri-Ezedi, C.A., Nurrika, D., Nzoputam, C.I., Nzoputam, O.J., Oguta, J.O., Ojo-Akosile, T.R., Okeke, S.R., Okekunle, A.P., Okonji, O.C., Olagunju, A.T., Olatubi, M.I., Bali, A.O., Ordak, M., Ortiz, A., Ortiz-Prado, E., Osuagwu, U.L., Ouyahia, A., Owolabi, M.O., Mahesh Padukudru, P.A., Padron-Monedero, A., Padubidri, J.R., Panda-Jonas, S., Pani, P., Papadopoulou, P., Pardhan, S., Parija, P.P., Parikh, R.R., Park, S., Passera, R., Patel, J., Pati, S., Patil, S., Patoulias, D., Pawar, S., Peng, M., Peprah, P., Pereira, G., Perianayagam, A., Perico, N., Philip, A.K., Piracha, Z.Z., Poddighe, D., Poluru, R., Pourtaheri, N., Pradhan, P.M.S., Pradhan, J., Prasad, M., Purohit, B.M., Puvvula, J., Qasim, N.H., Qattea, I., Qazi, A.S., Deepthi, R., Radhakrishnan, V., Raghav, P., Rahim, F., Rahimi-Movaghar, V., Rahman, M.M., Rahman, M.H., U, Rahman, M., Rahman, M.A., Rahmani, A.M., Rahmanian, M., Rahmanian, V., Rahmawaty, S., Raja, A., Raja, S., Rajendran, V., Rajput, P., Ramachandra, K., Ramadan, M.M., Ramasamy, S.K., Rana, K., Rana, R.K., Rane, A., Rao, C.R., Rao, M., Rao, S.J., Rashidi, M.-M., Rasouli-Saravani, A., Rathish, D., Rawaf, S., Raza, R.Z., Razo, C., Redwan, E.M.M.M., Remuzzi, G., Rengasamy, K.R.R., Rezaei, N., Rezaeian, M., Riaz, M., Rickard, J., Rocha, H.A.L., Roever, L., Rohilla, R., Ronfani, L., Rony, M.K.K., Rout, H.S., Roy, B., de Andrade Ruela, G., Rwegerera, G.M., Saad, A.M.A., Sabet, C.J., Sabour, S., Dhingra, M.S., Saddik, B.A., Saeed, U., Sharif-Askari, F.S., Sharif-Askari, N.S., Sahebkar, A., Sahoo, P.M., Sahoo, S.S., Mohammad Sajadi, S., Salami, A.A., Salaroli, L.B., Saleem, S., Salem, M.R., Samodra, Y.L., Samuel, V.P., Samy, A.M., Sanjeev, R.K., Santos, I.S., Saraswathy, S.Y.I., Saravanan, A., Sarkar, T., Sarode, G.S., Sarode, S.C., Sathian, B., Sathyanarayan, A., Satpathy, M., Sawhney, M., Sayeed, A., Schuermans, A., Selvaraj, S., Semreen, M.H., Sengupta, P., Sepanlou, S.G., Sethi, Y., Setiawan, C.H., Shafie, M., Shahid, S., Shahid, W., Shahwan, M.J., Shaikh, M.A., Shakeri, A., Sham, S., Shamim, M.A., Shams-Beyranvand, M., Shamsi, A., Shamsutdinova, A., Shanawaz, M., Shannawaz, M., Sharath, M., Sharifan, A., Rad, J.S., Sharma, A., Sharma, V., Shayan, M., Sheikhi, R.A., Shenoy, R.R., Shetty, M., Shetty, P.H., Shetty, P.K., Shetty, S., Shiri, R., Shittu, A., Shivarov, V., Shrestha, S., Siddig, E.E., Silva, L.M.L.R., Singh, B., Singh, H., Singh, J., Singh, J.A., Singh, N.P., Singh, P., Singh, P., Singh, S., Sobia, F., Solanki, R., Solanki, S., Soraneh, S., Sorensen, R.J.D., Srinivasamurthy, S.K., Subramaniyan, V., Susianti, H., Swain, C.K., Szarpak, L., Szeto, M.D., Sree Sudha, T.Y., Tabatabaei, S.M., Tabatabaeizadeh, S.-A., Tabche, C., Taiba, J., Talaat, I.M., Tampa, M., Tamuzi, J.L., Tarigan, I.U., Tariqujjaman, M., Tat, N.Y., Taye, B.T., Tefera, Y.M., Temsah, M.-H., Thapar, R., Tharwat, S., Thirunavukkarasu, S., Thomas, N.K., Ticoalu, J.H.V., Titova, M.V., Tiwari, K., Tovani-Palone, M.R., Tran, N.M., Tran, N.H., Tran, T.H., Trico, D., Truyen, T.T.T.T., Tualeka, A.R., Tumurkhuu, M., Udoakang, A.J., Ullah, S., Ullah, S., Umar, M., Unnikrishnan, B., Ushula, T.W., Vahabi, S.M., Vahdati, S., Vaithinathan, A.G., Valizadeh, R., Van den Eynde, J., Varghese, J., Vasankari, T.J., Vellingiri, B., Verras, G.-I., Vervoort, D., Vinayak, M., Volovat, S.R., Waheed, Y., Wang, Y., Weerakoon, K.G., Wild, H., Willeit, P., Woday, A.T., Wubie, Y.M., Xiaoyue, X., Yadav, V., Yarahmadi, A., Yaya, S., Yesuf, S.A., Yigezu, M., Yin, D., Yonemoto, N., Chuanhua, Y., Zaman, B.A., Zamora, N., Zare, I., Zeariya, M.G.M., Zeru, N.G., Zhang, H., Zhang, L., Zhong, C.C., Zhumagaliuly, A., Zia, H., Zoghi, G., Zyoud, S.H., Perumal, N., Zoeckler, L., Vilchis-Tella, V., McLaughlin, S.A.

    Cancer Research and Treatment　55　(1)　2023

    DOI： 10.4143/crt.2022.073 　

    ISSN： 1598-2998 2005-9256

  111. Annual prevalence of non-communicable diseases and identification of vulnerable populations following the Fukushima disaster and COVID-19 pandemic Peer-reviewed

    Murakami, M., Nomura, S.

    International Journal of Disaster Risk Reduction　84　2023

    DOI： 10.1016/j.ijdrr.2022.103471 　

    ISSN： 2212-4209

  112. Salt intake reduction using umami substance-incorporated food: a secondary analysis of NHANES 2017-2018 data International-journal Peer-reviewed

    Shuhei Nomura, Shiori Tanaka, Akifumi Eguchi, Takayuki Kawashima, Haruyo Nakamura, Kaung Suu Lwin, Lisa Yamasaki, Daisuke Yoneoka, Yuta Tanoe, Megumi Adachi, Hitomi Hayabuchi, Shosei Koganemaru, Toshihide Nishimura, Byron Sigel, Hisayuki Uneyama, Kenji Shibuya

    Public Health Nutrition　1-25　2022/12/01

    Publisher: Cambridge University Press (CUP)

    DOI： 10.1017/s136898002200249x 　

    ISSN： 1368-9800

    eISSN： 1475-2727

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    Abstract Objective: Excessive salt intake raises blood pressure and increases the risk of non-communicable diseases (NCDs), such as cardiovascular disease, chronic kidney disease, and stomach cancer. Reducing the sodium content of food is an important public health measure to control the NCDs. This study quantifies the amount of salt reduced by using umami substances, i.e., glutamate, inosinate, and guanylate, for adults in the United States (US). Design: The secondary data analysis was performed using data of the US nationally representative cross-sectional dietary survey, the National Health and Nutrition Examination Survey (NHANES) 2017-2018. Per capita daily salt intake corresponding to the NHANES food groups was calculated in the four hypothetical scenarios of 0%, 30%, 60%, and 90% market share of low-sodium foods in the country. The salt reduction rates by using umami substances were estimated based on the previous study results. Setting: The United States Participants: 4,139 individuals aged 20 years and older in the US Results: Replacing salt with umami substances could help the US adults reduce salt intake by 7.31–13.53% (7.50–13.61% for women; 7.18–13.53% for men), which is equivalent to 0.61–1.13g/day (0.54–0.98g/day for women; 0.69–1.30g/day for men) without compromising the taste. Approximately, 21.21–26.04% of the US adults could keep their salt intake below 5 g/day, the World Health Organization’s recommendation in the scenario where there is no low-sodium product on the market. Conclusions: This study provides essential information that the use of umami substances as a substitute for salt may help reduce the US adults’ salt intake.

  113. Green tea and coffee consumption and risk of kidney cancer in Japanese adults International-journal Peer-reviewed

    Yichi Chen, Sarah K. Abe, Manami Inoue, Taiki Yamaji, Motoki Iwasaki, Shuhei Nomura, Masahiro Hashizume, Shoichiro Tsugane, Norie Sawada, N. Sawada, S. Tsugane, M. Iwasaki, M. Inoue, T. Yamaji, R. Katagiri, Y. Miyamoto, H. Ihira, S. K. Abe, S. Tanaka, T. moriya, T. Minamizono, Y. Shirai, H. Kuniyoshi, T. Yoshimi, H. Sonoda, T. Tagami, T. Ando, T. Kimura, Y. Kokubo, K. Yamagishi, T. Mizoue, K. Nakamura, R. Takachi, J. Ishihara, H. Iso, T. Kitamura, I. Saito, N. Yasuda, M. Mimura, K. Sakata, M. Noda, A. Goto, H. Yatsuya, M. Mimura, T. Hanaoka, A. Hidaka, S. Sasazuki, H. Charvat, T. Shimazu, S. Budhathoki, M. Muto, T. Imatoh, J. Ogata, S. Baba, T. Mannami, A. Okayama, K. Miyakawa, F. Saito, A. Koizumi, Y. Sano, I. Hashimoto, T. Ikuta, Y. Tanaba, H. Sato, Y. Roppongi, T. Takashima, H. Suzuki, T. Sugie, Y. Miyajima, N. Suzuki, S. Nagasawa, Y. Furusugi, N. Nagai, Y. Ito, S. Komatsu, H. Sanada, Y. Hatayama, F. Kobayashi, H. Uchino, Y. Shirai, T. Kondo, R. Sasaki, Y. Watanabe, Y. Miyagawa, Y. Kobayashi, M. Machida, K. Kobayashi, M. Tsukada, Y. Kishimoto, E. Takara, T. Fukuyama, M. Kinjo, M. Irei, H. Sakiyama, H. Sakiyama, K. Imoto, H. Yazawa, T. Seo, A. Seiko, F. Ito, F. Shoji, R. Saito, A. Murata, K. Minato, K. Motegi, T. Fujieda, S. Yamato, K. Matsui, T. Abe, M. Katagiri, M. Suzuki, M. Doi, A. Terao, Y. Ishikawa, H. Sueta, H. Doi, M. Urata, N. Okamoto, F. Ide, H. Goto, R. Fujita, Y. Sou, H. Sakiyama, N. Onga, H. Takaesu, M. Uehara, T. Nakasone, M. Yamakawa, Y. Miyasato, F. Horii, I. Asano, H. Yamaguchi, K. Aoki, S. Maruyama, M. Ichii, M. Takano, Y. Tsubono, K. Suzuki, Y. Honda, S. Sakurai, N. Tsuchiya, M. Kabuto, M. Yamaguchi, Y. Matsumura, S. Sasaki, S. Watanabe, M. Akabane, T. Kadowaki, Y. Takashima, Y. Yoshida, S. Matsushima, S. Natsukawa, H. Sugimura, S. Tominaga, M. Iida, W. Ajiki, A. Ioka, S. Sato, M. Konishi, K. Okada, T. Sobue, Y. Kawaguchi, N. Hamajima, S. Akiba, T. Isobe, Y. Sato, T. Sobue, H. Shimizu, S. Kono, T. Sobue, E. Maruyama

    Scientific Reports　12　(1)　20274-20274　2022/11/24

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41598-022-24090-z 　

    eISSN： 2045-2322

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    Abstract The study aimed to evaluate the association between green tea and coffee consumption and the risk of kidney cancer using data from a large prospective cohort study in Japan (the Japan Public Health Center-based Prospective Study: JPHC Study). A total of 102,463 participants aged 40–69 were followed during 1,916,421 person-years (mean follow-up period, 19 years). A total of 286 cases of kidney cancer (199 in men, 87 in women) were identified. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) while adjusting for potential confounders. No statistically significant association between green tea intake and kidney cancer risk was found in the total population. Among women who consumed more than five cups of green tea per day, a statistically significant decreased risk was shown with a HR of 0.45 (95% CI: 0.23–0.89), compared to women who rarely consumed green tea. For coffee consumption, the association of kidney cancer risk was not statistically significant. This large prospective cohort study indicated green tea intake may be inversely associated with kidney cancer risk in Japanese adults, particularly in Japanese women.

  114. Reducing salt intake with umami: A secondary analysis of data in the UK National Diet and Nutrition Survey

    Haruyo Nakamura, Takayuki Kawashima, Lisa Yamasaki, Kaung Suu Lwin, Akifumi Eguchi, Hitomi Hayabuchi, Yuta Tanoe, Shiori Tanaka, Daisuke Yoneoka, Cyrus Ghaznavi, Hisayuki Uneyama, Kenji Shibuya, Shuhei Nomura

    Food Science &amp; Nutrition　0　1-11　2022/11/12

    Publisher: Wiley

    DOI： 10.1002/fsn3.3121 　

    ISSN： 2048-7177

    eISSN： 2048-7177

  115. Preventive Behaviors and Information Sources during COVID-19 Pandemic: A Cross-Sectional Study in Japan. International-journal Peer-reviewed

    Manae Uchibori, Cyrus Ghaznavi, Michio Murakami, Akifumi Eguchi, Hiroyuki Kunishima, Satoshi Kaneko, Keiko Maruyama-Sakurai, Hiroaki Miyata, Shuhei Nomura

    International journal of environmental research and public health　19　(21)　14511　2022/11/04

    DOI： 10.3390/ijerph192114511 　

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    BACKGROUND: individual preventive behaviors are one of the key measures needed to prevent the spread of COVID-19. This study sought to identify the factors associated with the adoption of COVID-19 preventive measures, focusing specifically on information sources. METHODS: we conducted a nationally representative cross-sectional survey of 30,053 Japanese adults in February 2021. The survey asked about socioeconomic, health-related, and psychological characteristics, attitudes toward immunization, and the use of information sources regarding COVID-19. We have constructed multivariable logistic regression to estimate the factors associated with the adoption of three preventive measures: 3Cs avoidance, hand hygiene and respiratory hygiene. RESULTS: socioeconomic variables, psychological variables, and the use of information sources are significantly associated with the adoption of preventive measures. The more information sources one uses, the more likely one is to adopt preventive measures. Trust in healthcare professionals is positively associated with adopting preventive measures. On the other hand, negative correlations between trust in social media and preventive behaviors were observed. CONCLUSIONS: encouraging access to multiple information sources, utilizing communication channels, and modifying messaging according to target groups are essential to promote COVID-19 preventive measures.

  116. Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021 Peer-reviewed

    Sarah Wulf Hanson, Cristiana Abbafati, Joachim G. Aerts, Ziyad Al-Aly, Charlie Ashbaugh, Tala Ballouz, Oleg Blyuss, Polina Bobkova, Gouke Bonsel, Svetlana Borzakova, Danilo Buonsenso, Denis Butnaru, Austin Carter, Helen Chu, Cristina De Rose, Mohamed Mustafa Diab, Emil Ekbom, Maha El Tantawi, Victor Fomin, Robert Frithiof, Aysylu Gamirova, Petr V. Glybochko, Juanita A. Haagsma, Shaghayegh Haghjooy Javanmard, Erin B. Hamilton, Gabrielle Harris, Majanka H. Heijenbrok-Kal, Raimund Helbok, Merel E. Hellemons, David Hillus, Susanne M. Huijts, Michael Hultström, Waasila Jassat, Florian Kurth, Ing-Marie Larsson, Miklós Lipcsey, Chelsea Liu, Callan D. Loflin, Andrei Malinovschi, Wenhui Mao, Lyudmila Mazankova, Denise McCulloch, Dominik Menges, Noushin Mohammadifard, Daniel Munblit, Nikita A. Nekliudov, Osondu Ogbuoji, Ismail M. Osmanov, José L. Peñalvo, Maria Skaalum Petersen, Milo A. Puhan, Mujibur Rahman, Verena Rass, Nickolas Reinig, Gerard M. Ribbers, Antonia Ricchiuto, Sten Rubertsson, Elmira Samitova, Nizal Sarrafzadegan, Anastasia Shikhaleva, Kyle E. Simpson, Dario Sinatti, Joan B. Soriano, Ekaterina Spiridonova, Fridolin Steinbeis, Andrey A. Svistunov, Piero Valentini, Brittney J. van de Water, Rita van den Berg-Emons, Ewa Wallin, Martin Witzenrath, Yifan Wu, Hanzhang Xu, Thomas Zoller, Christopher Adolph, James Albright, Joanne O. Amlag, Aleksandr Y. Aravkin, Bree L. Bang-Jensen, Catherine Bisignano, Rachel Castellano, Emma Castro, Suman Chakrabarti, James K. Collins, Xiaochen Dai, Farah Daoud, Carolyn Dapper, Amanda Deen, Bruce B. Duncan, Megan Erickson, Samuel B. Ewald, Alize J. Ferrari, Abraham D. Flaxman, Nancy Fullman, Amiran Gamkrelidze, John R. Giles, Gaorui Guo, Simon I. Hay, Jiawei He, Monika Helak, Erin N. Hulland, Maia Kereselidze, Kris J. Krohn, Alice Lazzar-Atwood, Akiaja Lindstrom, Rafael Lozano, Deborah Carvalho Malta, Johan Månsson, Ana M. Mantilla Herrera, Ali H. Mokdad, Lorenzo Monasta, Shuhei Nomura, Maja Pasovic, David M. Pigott, Robert C. Reiner, Grace Reinke, Antonio Luiz P. Ribeiro, Damian Francesco Santomauro, Aleksei Sholokhov, Emma Elizabeth Spurlock, Rebecca Walcott, Ally Walker, Charles Shey Wiysonge, Peng Zheng, Janet Prvu Bettger, Christopher J. L. Murray, Theo Vos

    JAMA　2022/10/10

    Publisher: American Medical Association (AMA)

    DOI： 10.1001/jama.2022.18931 　

    ISSN： 0098-7484

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    Importance Some individuals experience persistent symptoms after initial symptomatic SARS-CoV-2 infection (often referred to as Long COVID). Objective To estimate the proportion of males and females with COVID-19, younger or older than 20 years of age, who had Long COVID symptoms in 2020 and 2021 and their Long COVID symptom duration. Design, Setting, and Participants Bayesian meta-regression and pooling of 54 studies and 2 medical record databases with data for 1.2 million individuals (from 22 countries) who had symptomatic SARS-CoV-2 infection. Of the 54 studies, 44 were published and 10 were collaborating cohorts (conducted in Austria, the Faroe Islands, Germany, Iran, Italy, the Netherlands, Russia, Sweden, Switzerland, and the US). The participant data were derived from the 44 published studies (10 501 hospitalized individuals and 42 891 nonhospitalized individuals), the 10 collaborating cohort studies (10 526 and 1906), and the 2 US electronic medical record databases (250 928 and 846 046). Data collection spanned March 2020 to January 2022. Exposures Symptomatic SARS-CoV-2 infection. Main Outcomes and Measures Proportion of individuals with at least 1 of the 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after SARS-CoV-2 infection in 2020 and 2021, estimated separately for hospitalized and nonhospitalized individuals aged 20 years or older by sex and for both sexes of nonhospitalized individuals younger than 20 years of age. Results A total of 1.2 million individuals who had symptomatic SARS-CoV-2 infection were included (mean age, 4-66 years; males, 26%-88%). In the modeled estimates, 6.2% (95% uncertainty interval [UI], 2.4%-13.3%) of individuals who had symptomatic SARS-CoV-2 infection experienced at least 1 of the 3 Long COVID symptom clusters in 2020 and 2021, including 3.2% (95% UI, 0.6%-10.0%) for persistent fatigue with bodily pain or mood swings, 3.7% (95% UI, 0.9%-9.6%) for ongoing respiratory problems, and 2.2% (95% UI, 0.3%-7.6%) for cognitive problems after adjusting for health status before COVID-19, comprising an estimated 51.0% (95% UI, 16.9%-92.4%), 60.4% (95% UI, 18.9%-89.1%), and 35.4% (95% UI, 9.4%-75.1%), respectively, of Long COVID cases. The Long COVID symptom clusters were more common in women aged 20 years or older (10.6% [95% UI, 4.3%-22.2%]) 3 months after symptomatic SARS-CoV-2 infection than in men aged 20 years or older (5.4% [95% UI, 2.2%-11.7%]). Both sexes younger than 20 years of age were estimated to be affected in 2.8% (95% UI, 0.9%-7.0%) of symptomatic SARS-CoV-2 infections. The estimated mean Long COVID symptom cluster duration was 9.0 months (95% UI, 7.0-12.0 months) among hospitalized individuals and 4.0 months (95% UI, 3.6-4.6 months) among nonhospitalized individuals. Among individuals with Long COVID symptoms 3 months after symptomatic SARS-CoV-2 infection, an estimated 15.1% (95% UI, 10.3%-21.1%) continued to experience symptoms at 12 months. Conclusions and Relevance This study presents modeled estimates of the proportion of individuals with at least 1 of 3 self-reported Long COVID symptom clusters (persistent fatigue with bodily pain or mood swings; cognitive problems; or ongoing respiratory problems) 3 months after symptomatic SARS-CoV-2 infection.

  117. Effect of the Tokyo 2020 Summer Olympic Games on COVID-19 incidence in Japan: a synthetic control approach International-journal Peer-reviewed

    Daisuke Yoneoka, Akifumi Eguchi, Kentato Fukumoto, Takayuki Kawashima, Yuta Tanoue, Takahiro Tabuchi, Hiroaki Miyata, Cyrus Ghaznavi, Kenji Shibuya, Shuhei Nomura

    BMJ Open　12　(9)　e061444　2022/09/21

    DOI： 10.1136/bmjopen-2022-061444 　

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    BACKGROUND: The Tokyo 2020 Summer Olympic Games (23 July-8 August 2021) were held in the middle of Japan's fifth wave of COVID-19, when the number of cases was on the rise, and coincided with the fourth state of emergency implemented by the host city, Tokyo. AIM: This study aimed to assess whether the hosting of the Games was associated with a change in the number of COVID-19 cases in Japan using a synthetic control method. METHODS: A weighted average of control countries with a variety of predictors was used to estimate the counterfactual trajectory of daily COVID-19 cases per 1 000 000 population in the absence of the Games in Japan. Outcome and predictor data were extracted using official and open sources spanning several countries. The predictors comprise the most recent country-level annual or daily data accessible during the Games, including the stringency of the government's COVID-19 response, testing capacity and vaccination capacity; human mobility index; electoral democracy index and demographic, socioeconomic, health and weather information. After excluding countries with missing data, 42 countries were ultimately used as control countries. RESULTS: The number of observed cases per 1 000 000 population on the last day of the Games was 109.2 (7-day average), which was 115.7% higher than the counterfactual trajectory comprising 51.0 confirmed cases per 1 000 000 population. During the Olympic period (since 23 July), the observed cumulative number of cases was 61.0% higher than the counterfactual trajectory, comprising 143 072 and 89 210 confirmed cases (p=0.023), respectively. The counterfactual trajectory lagged 10 days behind the observed trends. CONCLUSIONS: Given the increasing likelihood that new emerging infectious diseases will be reported in the future, we believe that the results of this study should serve as a sentinel warning for upcoming mega-events during COVID-19 and future pandemics.

  118. Effect of the COVID-19 pandemic and state of emergency declarations on the relative incidence of legionellosis and invasive pneumococcal disease in Japan. International-journal Peer-reviewed

    Cyrus Ghaznavi, Masahiro Ishikane, Daisuke Yoneoka, Yuta Tanoue, Takayuki Kawashima, Akifumi Eguchi, Shuhei Nomura

    Journal of Infection and Chemotherapy　29　(1)　90-94　2022/09/16

    Publisher: Elsevier BV

    DOI： 10.1016/j.jiac.2022.08.016 　

    ISSN： 1341-321X

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    INTRODUCTION: During the COVID-19 pandemic, the incidence of many droplet-transmitted infections decreased due to increased mask-wearing and social distancing. Contrastingly, there has been concern that COVID-19 countermeasures, such as lockdowns, may increase legionellosis incidence via water stagnation. During the pandemic in Japan, four state of emergency declarations were imposed between 2020-2021, which makes it particularly suitable to test this hypothesis. METHODS: We use country-level surveillance data from the National Institute of Infectious Diseases to track the relative incidence of legionellosis compared to invasive pneumococcal disease (IPD) during the COVID-19 pandemic in Japan, with a focus on the periods just after state of emergency declarations were lifted. RESULTS: The absolute number of legionellosis and IPD cases decreased in 2020 and 2021 compared to previous years. The average relative incidence of legionellosis as well as the variance of the relative incidence significantly increased during the pandemic compared to previous years. There were no increases in the relative incidence of legionellosis during the periods immediately following emergency declaration liftings, but the relative incidence did increase considerably during the first two states of emergency. CONCLUSIONS: COVID-19 countermeasures appear more effective at decreasing the incidence of human-to-human transmitted infections, such as IPD, compared to environmentally-transmitted infections, such as legionellosis. Though no evidence was found to suggest that legionellosis cases increased after state of emergency declarations, public health efforts should continue to emphasize the importance of routine sanitation and water system maintenance to prevent water stagnation and Legionellaspp. contamination.

  119. Myanmar’s coup risks a flood of vaccinepreventable disease Peer-reviewed

    Lwin, K.S., Ghaznavi, C., Win, K.L., Gilmour, S., Hashizume, M., Nomura, S.

    Journal of Global Health　12　2022/09/03

    Publisher: International Global Health Society

    DOI： 10.7189/jogh.12.03060 　

    ISSN： 2047-2978 2047-2986

    eISSN： 2047-2986

  120. Excess deaths from non-COVID-19-related causes in Japan and 47 prefectures from January 2020 through May 2021 by place of death International-journal

    Shuhei Nomura, Akifumi Eguchi, Cyrus Ghaznavi, Yuta Tanoue, Takayuki Kawashima, Daisuke Yoneoka, Lisa Yamasaki, Motoi Suzuki, Masahiro Hashizume

    SSM - Population Health　19　101196-101196　2022/08/06

    Publisher: Elsevier BV

    DOI： 10.1016/j.ssmph.2022.101196 　

    ISSN： 2352-8273

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    Excess deaths, including all-causes mortality, were confirmed for the first time in Japan in April 2021. However, little is known about the indirect effects of COVID-19 on the number of non-COVID-19-related deaths. We then estimated the excess deaths from non-COVID-19-related causes in Japan and its 47 prefectures from January 2020 through May 2021 by place of death. Vital statistical data on deaths were obtained from the Ministry of Health, Labour and Welfare. Using quasi-Poisson regression models, we estimated the expected weekly number of deaths due to all-causes excluding COVID-19 (non-COVID-19) and due to respiratory disease, circulatory disease, malignant neoplasms, and senility. Estimates were made separately for deaths in all locations, as well as for deaths in hospitals and clinics, in nursing homes and elderly care facilities, and at home. We defined a week with excess deaths as one in which the observed number of deaths exceeded the upper bound of the two-sided 95% prediction interval. Excess death was expressed as a range of differences between the observed and expected number of deaths and the 95% upper bound of the two-sided predictive interval. The excess percentage was calculated as the number of excess deaths divided by the expected number of deaths. At the national level, excess deaths from non-COVID-19-related all-causes were observed during April 19 to May 16, 2021. The largest excess percentage was 2.73-8.58% (excess deaths 689-2161) in the week of May 3-9. Similar trends were observed for all four cause categories. The cause-of-death categories which contributed to the excesses showed heterogeneity among prefectures. When stratified by place of death, excess mortality tended to be observed in nursing homes and elderly care facilities for all categories, in hospitals and clinics for circulatory disease, and at home for respiratory disease, malignant neoplasms, and senility. A caution is necessary that for the lastest three months (March-May 2021), adjusted data were used to account for possible reporting delays.

  121. Eliciting national and subnational sets of disability weights in mainland China: Findings from the Chinese disability weight measurement study Peer-reviewed

    Xiaoxue Liu, Fang Wang, Chuanhua Yu, Maigeng Zhou, Yong Yu, Jinlei Qi, Peng Yin, Shicheng Yu, Yuchang Zhou, Lin Lin, Yunning Liu, Qiqi Wang, Wenling Zhong, Shaofen Huang, Yanxia Li, Li Liu, Yuan Liu, Fang Ma, Yine Zhang, Yuan Tian, Qiuli Yu, Jing Zeng, Jingju Pan, Mengge Zhou, Weiwei Kang, Jin-Yi Zhou, Hao Yu, Yuehua Liu, Shaofang Li, Huiting Yu, Chunfang Wang, Tian Xia, Jinen Xi, Xiaolan Ren, Xiuya Xing, Qianyao Cheng, Fangrong Fei, Dezheng Wang, Shuang Zhang, Yuling He, Haoyu Wen, Yan Liu, Fang Shi, Yafeng Wang, Panglin Sun, Jianjun Bai, Xuyan Wang, Hui Shen, Yudiyang Ma, Donghui Yang, Sumaira Mubarik, Jinhong Cao, Runtang Meng, Yunquan Zhang, Yan Guo, Yaqiong Yan, Wei Zhang, Sisi Ke, Runhua Zhang, Dingyi Wang, Tingting Zhang, Shuhei Nomura, Simon I. Hay, Joshua A. Salomon, Juanita A. Haagsma, Christopher J.L. Murray, Theo Vos

    The Lancet Regional Health - Western Pacific　26　100520-100520　2022/07/26

    Publisher: Elsevier {BV}

    DOI： 10.1016/j.lanwpc.2022.100520 　

    ISSN： 2666-6065

  122. Distributed lag interrupted time series model for unclear intervention timing: effect of a statement of emergency during COVID-19 pandemic. International-journal

    Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Shuhei Nomura, Akifumi Eguchi

    BMC medical research methodology　22　(202)　202-202　2022/07/25

    DOI： 10.1186/s12874-022-01662-1 　

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    BACKGROUND: Interrupted time series (ITS) analysis has become a popular design to evaluate the effects of health interventions. However, the most common formulation for ITS, the linear segmented regression, is not always adequate, especially when the timing of the intervention is unclear. In this study, we propose a new model to overcome this limitation. METHODS: We propose a new ITS model, ARIMAITS-DL, that combines (1) the Autoregressive Integrated Moving Average (ARIMA) model and (2) distributed lag functional terms. The ARIMA technique allows us to model autocorrelation, which is frequently observed in time series data, and the decaying cumulative effect of the intervention. By contrast, the distributed lag functional terms represent the idea that the intervention effect does not start at a fixed time point but is distributed over a certain interval (thus, the intervention timing seems unclear). We discuss how to select the distribution of the effect, the model construction process, diagnosing the model fitting, and interpreting the results. Further, our model is implemented as an example of a statement of emergency (SoE) during the coronavirus disease 2019 pandemic in Japan. RESULTS: We illustrate the ARIMAITS-DL model with some practical distributed lag terms to examine the effect of the SoE on human mobility in Japan. We confirm that the SoE was successful in reducing the movement of people (15.0-16.0% reduction in Tokyo), at least between February 20 and May 19, 2020. We also provide the R code for other researchers to easily replicate our method. CONCLUSIONS: Our model, ARIMAITS-DL, is a useful tool as it can account for the unclear intervention timing and distributed lag effect with autocorrelation and allows for flexible modeling of different types of impacts such as uniformly or normally distributed impact over time.

  123. Factors associated with reversals of COVID-19 vaccination willingness: Results from two longitudinal, national surveys in Japan 2021-2022 Peer-reviewed

    Cyrus Ghaznavi, Daisuke Yoneoka, Takayuki Kawashima, Akifumi Eguchi, Michio Murakami, Stuart Gilmour, Satoshi Kaneko, Hiroyuki Kunishima, Wataru Naito, Haruka Sakamoto, Keiko Maruyama-Sakurai, Arata Takahashi, Yoshihiro Takayama, Yuta Tanoue, Yoshiko Yamamoto, Tetsuo Yasutaka, Hiroaki Miyata, Shuhei Nomura

    The Lancet Regional Health - Western Pacific　100540-100540　2022/07/22

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2022.100540 　

    ISSN： 2666-6065

  124. Characterising reasons for reversals of COVID-19 vaccination hesitancy among Japanese people: One-year follow-up survey Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Daisuke Yoneoka, Michio Murakami, Cyrus Ghaznavi, Stuart Gilmour, Satoshi Kaneko, Takayuki Kawashima, Hiroyuki Kunishima, Wataru Naito, Haruka Sakamoto, Keiko Maruyama-Sakurai, Arata Takahashi, Yoshihiro Takayama, Yuta Tanoue, Yoshiko Yamamoto, Tetsuo Yasutaka, Hiroaki Miyata

    The Lancet Regional Health - Western Pacific　100541-100541　2022/07/22

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2022.100541 　

    ISSN： 2666-6065

  125. Changes in Health Care Access during the COVID-19 Pandemic: Estimates of National Japanese Data, June 2020–October 2021 International-journal

    Yuta Tanoue, Cyrus Ghaznavi, Takayuki Kawashima, Akifumi Eguchi, Daisuke Yoneoka, Shuhei Nomura

    International Journal of Environmental Research and Public Health　19　(14)　8810-8810　2022/07/20

    Publisher: MDPI AG

    DOI： 10.3390/ijerph19148810 　

    eISSN： 1660-4601

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    The COVID-19 pandemic has disrupted health care access around the world, both for inpatients and outpatients. We applied a quasi-Poisson regression to national, monthly data on the number of outpatients, number of inpatients, length of average hospital stay, and the number of new hospitalizations from March 2015 to October 2021 to assess how these outcomes changed between June 2020 to October 2021. The number of outpatient visits were lower-than-predicted during the early phases of the pandemic but normalized by the fall of 2021. The number of inpatients and new hospitalizations were lower-than-predicted throughout the pandemic, and deficits in reporting continued to be observed in late 2021. The length of hospital stays was within the predicted range for all beds, but when stratified by bed type, was higher than predicted for psychiatric beds, lower-than-predicted for tuberculosis beds, and showed variable changes in long-term care insurance beds. Health care access in Japan was impacted by the COVID-19 pandemic.

  126. Inter-Prefectural Travel and Network Connectedness During the COVID-19 Pandemic in Japan Peer-reviewed

    Cyrus Ghaznavi, Daisuke Yoneoka, Yuta Tanoue, Stuart Gilmour, Takayuki Kawashima, Akifumi Eguchi, Yumi Kawamura, Hiroaki Miyata, Shuhei Nomura

    Journal of Epidemiology　32　(11)　510-518　2022/07

    Publisher: Japan Epidemiological Association

    DOI： 10.2188/jea.je20220064 　

    ISSN： 0917-5040

    eISSN： 1349-9092

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    BackgroundIncreases in human mobility have been linked to rises in COVID-19 transmission. The pandemic era in Japan has been characterized by changes in inter-prefectural mobility across state of emergency declarations (SOE) and travel campaigns, but they have yet to be characterized.MethodsUsing Yahoo Japan mobility data extracted from the smartphones of more than 10 million Japanese residents, we calculated the monthly number of inter-prefectural travel instances, stratified by residential prefecture and destination prefecture. We then used this adjacency matrix to calculate two network connectedness metrics, closeness centrality and effective distance, that reliably predict disease transmission.ResultsInter-prefectural mobility and network connectedness decreased most considerably during the first SOE, but this decrease dampened with each successive SOE. Mobility and network connectedness increased during the Go To Travel campaign. Travel volume between distant prefectures decreased more than travel between prefectures with geographic proximity. Closeness centrality was found to be negatively correlated with the rate of COVID-19 infection across prefectures, with the strength of this association increasing in tandem with the infection rate. Changes in effective distance were more visible among geographically isolated prefectures (Hokkaido and Okinawa) than among metropolitan, central prefectures (Tokyo, Aichi, Osaka, and Fukuoka).ConclusionsThe magnitude of reductions in human mobility decreased with each subsequent state of emergency, consistent with pandemic fatigue. The association between network connectedness and rates of COVID-19 infection remained visible throughout the entirety of the pandemic period, suggesting that inter-prefectural mobility may have contributed to disease spread.

  127. Public transportation network scan for rapid surveillance

    Yuta Tanoue, Daisuke Yoneoka, Takayuki Kawashima, Shinya Uryu, Shuhei Nomura, Akifumi Eguchi, Koji Makiyama, Kentaro Matsuura

    Biostatistics &amp; Epidemiology　1-15　2022/06/02

    Publisher: Informa UK Limited

    DOI： 10.1080/24709360.2022.2069458 　

    ISSN： 2470-9360

    eISSN： 2470-9379

  128. Attributable risk of household solid fuel use and second-hand smoke associated with under-5 mortality in 46 low- and lower-middle-income countries, 2010–2020 International-journal Peer-reviewed

    Kaung Suu Lwin, Shuhei Nomura, Khin Thet Swe, Stuart Gilmour, Md Ashraful Alam, Masahiro Hashizume

    International Journal of Hygiene and Environmental Health　243　113986-113986　2022/06

    Publisher: Elsevier BV

    DOI： 10.1016/j.ijheh.2022.113986 　

    ISSN： 1438-4639

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    BACKGROUND: Household solid fuel use (including indoor and outdoor) and second-hand smoke (SHS) are considered to be major contributors of under-5 mortality (U5M) in low- and lower-middle-income countries (LMICs). This study provides a comprehensive assessment of their odds ratios and attributable mortality in LMICs. METHODS: We used the Demographic Health Surveys data for under-5 children in 46 LMICs (n = 778,532) from 2010 to 2020. Mixed effect multilevel logistic regressions were conducted to estimate the pooled adjusted odds ratio (aOR) for U5M due to solid fuel use, SHS and their combination compared to no exposure to them in 46 LMICs. The attributable mortality of solid fuel use, SHS, and their combination were assessed for each LMIC. FINDINGS: The pooled aOR of solid fuel use and SHS for U5M was estimated to be 1.27 (95% Confidence Interval (CI): 1.19-1.36) and 1.13 (95%CI: 1.06-1.25), respectively, whereas those of their combination was 1.40 (95%CI: 1.31-1.50). U5M attributable to indoor and outdoor solid fuel use was the highest in Myanmar (18.0%) and the Gambia (16.5%), respectively, while those attributable to SHS was the highest in Indonesia (9.8%). U5M attributable to the combination of solid fuel use and SHS was the highest in Timor-Leste (22.7%). INTERPRETATION: The combined effect of exposure to solid fuel and SHS had a higher risk of U5M than the individual risk. The use of clean fuel and tobacco control measures should be integrated with other child health promotion policies. FUNDING: This research was partially supported by a research grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (21H03203).

  129. Decreased incidence followed by comeback of pediatric infections during the COVID-19 pandemic in Japan. International-journal Peer-reviewed

    Cyrus Ghaznavi, Haruka Sakamoto, Takayuki Kawashima, Sayaka Horiuchi, Masahiro Ishikane, Sarah Krull Abe, Daisuke Yoneoka, Akifumi Eguchi, Yuta Tanoue, Masahiro Hashizume, Shuhei Nomura

    World journal of pediatrics : WJP　18　(8)　564-567　2022/05/31

    DOI： 10.1007/s12519-022-00575-9 　

  130. Changes in marriage, divorce and births during the COVID-19 pandemic in Japan International-journal Peer-reviewed

    Cyrus Ghaznavi, Takayuki Kawashima, Yuta Tanoue, Daisuke Yoneoka, Koji Makiyama, Haruka Sakamoto, Peter Ueda, Akifumi Eguchi, Shuhei Nomura

    BMJ Global Health　7　(5)　e007866　2022/05/16

    DOI： 10.1136/bmjgh-2021-007866 　

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    INTRODUCTION: Marriage, divorce and fertility are declining in Japan. There is concern that the COVID-19 pandemic may have accelerated the decrease in marriages and births while increasing the number of divorces. Changes in partnership behaviours and fertility have significant implications for mental health, well-being and population demographics. METHODS: Japanese vital statistical data were collected for December 2011-May 2021. We used the Farrington algorithm on the daily numbers of marriages, divorces and births (per month) in order to determine whether any given month between January 2017 and May 2021 had a significant excess or deficit. Analyses were conducted at the national and regional levels. RESULTS: During the pandemic, significant deficits in the national number of marriages were noted in January 2020, April 2020, May 2020, July 2020, September 2020 and April 2021. Regional marriage patterns reflected national trends. Divorces were noted to be in deficit during April 2020, May 2020 and May 2021 at the country level. Regional analyses mirrored national divorce trends with the exception of Shikoku, which showed no deficits during the pandemic. Significant deficits in the number of total births were noted in December 2020, January 2021 and February 2021. Regionally, birth deficits were concentrated in Chubu, Kansai and Kanto. After the start of the pandemic, no significant excesses in marriages, divorces or births were noted at the national or regional level. CONCLUSIONS: Marriages and divorces declined during the pandemic in Japan, especially during state of emergency declarations. There were decreased births between December 2020 and February 2021, approximately 8-10 months after the first state of emergency, suggesting that couples altered their pregnancy intention in response to the pandemic. Metropolitan regions were more affected by the pandemic than their less metropolitan counterparts.

  131. Assessment of Traffic Accidents in Japan during the COVID-19 Pandemic vs. Previous Years: A Preliminary Report Peer-reviewed

    Kazuki Shimizu, Peter Ueda, Cyrus Ghaznavi, Haruka Sakamoto, Shuhei Nomura

    Healthcare　10　(5)　860-860　2022/05/06

    Publisher: {MDPI} {AG}

    DOI： 10.3390/healthcare10050860 　

    eISSN： 2227-9032

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    Beginning in April 2020, social distancing measures were implemented to mitigate the COVID-19 pandemic in Japan. We assessed whether traffic accident rates had decreased from April 2020 to December 2021 as compared with previous years. The analysis included 2,934,477 traffic accidents, and the trend of decreasing rates of traffic accidents in recent years and seasonal fluctuations in traffic accidents were considered. The yearly change in the traffic accident rate between 2015 and 2019 was estimated, and the traffic accident rate in 2020 and 2021 was predicted. This was followed by the comparison of observed vs. predicted traffic accident rate. In 2020, the observed vs. expected rates of traffic accidents were lower in April to December 2020, and the rate of traffic accidents in Japan was 30–40% lower in April–May 2020 than would be expected based on trends from previous years. In 2021, rates of traffic accidents remained lower than expected between January and November, but the magnitude of decrease was not as pronounced. These findings could be explained by social distancing policies, including the declaration of the state of emergency, and the relaxation of public health and social measures over time.

  132. Pre- and post-COVID-19 all-cause mortality of Japanese citizens versus foreign residents living in Japan, 2015–2021 International-journal Peer-reviewed

    Cyrus Ghaznavi, Akifumi Eguchi, Yuta Tanoue, Daisuke Yoneoka, Takayuki Kawashima, Motoi Suzuki, Masahiro Hashizume, Shuhei Nomura

    SSM - Population Health　18　101114-101114　2022/05

    Publisher: Elsevier BV

    DOI： 10.1016/j.ssmph.2022.101114 　

    ISSN： 2352-8273

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    Immigrants in Japan face multiple health care challenges. There is limited research addressing how all-cause mortality differs between foreign residents and Japanese citizens, including the impact of the COVID-19 pandemic. We assessed whether all-cause mortality rates between Japanese citizens and foreign residents living in Japan differ, and whether these differentials changed after the start of the COVID-19 pandemic. We conducted a cross-sectional analysis using vital statistical data of all deaths among citizens and foreign residents that occurred within Japanese borders aggregated every 6 months between January 1, 2015 and June 30, 2021. Data were used to calculate sex-, region-, and 20-year age group-specific standardized mortality rates using the direct method based on the population distribution of Japanese citizens in 2021 by sex, region, and 20-year age groups. Chi-squared tests and linear regression were used to assess whether the pandemic was associated with changes in mortality rates among groups and changes in the mortality differentials between citizens and non-citizens, respectively. All-cause mortality increased monotonically with age for men and women. Men had higher mortality than women, regardless of age or nationality. All-cause mortality is lower among immigrants than Japanese citizens between the ages of 20-59, but higher under the age of 20 and over the age of 59. The pandemic was associated with significant changes in mortality in most groups, but no statistically significant changes in the mortality differentials between immigrants and Japanese citizens were detected. Young immigrants are generally healthier than their Japanese counterparts, in line with the healthy migrant hypothesis. Younger migrants are at higher risk of mortality, possibly due to increased vulnerability to psychologic stress. Older migrant mortality converged with citizen mortality, consistent with acculturation that occurs with longer duration of residence. The pandemic did not exacerbate health inequities for foreign residents with respect to mortality.

  133. Japan's development assistance for health: Historical trends and prospects for a new era

    Shuhei Nomura, Lisa Yamasaki, Kazuki Shimizu, Cyrus Ghaznavi, Haruka Sakamoto

    The Lancet Regional Health - Western Pacific　22　100403-100403　2022/05

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2022.100403 　

    ISSN： 2666-6065

  134. Salaries, degrees, and babies: Trends in fertility by income and education among Japanese men and women born 1943-1975-Analysis of national surveys. International-journal Peer-reviewed

    Cyrus Ghaznavi, Haruka Sakamoto, Lisa Yamasaki, Shuhei Nomura, Daisuke Yoneoka, Kenji Shibuya, Peter Ueda

    PloS one　17　(4)　e0266835　2022/04/28

    DOI： 10.1371/journal.pone.0266835 　

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    BACKGROUND: While fertility rates have decreased during the second half of the 20th century in Japan, little is known regarding trends in the number of children that men and women have across birth cohorts and whether these differ by education and income. METHODS: We used data from four rounds of the National Fertility Survey (1992, 2005, 2010 and 2015) and included men and women aged 40-49 years (16728 men and 17628 women). By 5-year birth cohorts, we assessed the distribution of number of children (0, 1, 2 and 3 or more) and total fertility (the mean number of children) at completed fertility (age 45-49 or 40-44 years depending on birth cohort). We assessed trends in these fertility outcomes in men and women separately, and by education (no university education; university education) for men and women and by reported annual income (0 to <3 000 000 JPY; 3 000 000 to <6 000 000 JPY; ≥6 000 000 JPY) for men. RESULTS: When comparing those born in 1943-1948 with those born in 1971-1975, the proportion with no children had increased from 14.3 to 39.9% for men and from 11.6 to 27.6% for women. This increase coincided with a decrease in the proportions of individuals with 2 or more children. Total fertility had decreased from 1.92 to 1.17 among men and from 1.96 to 1.42 among women. For men, those with a university degree were more likely to have children than those without a university degree in all birth cohorts except 1943-1947. Men with higher income were more likely to have children across birth cohorts. While the proportion who had children had decreased in all income groups, the decrease was steeper among those in the lowest income group. Among women born 1956-1970, those with a university degree were less likely to have children than those without a university degree; this difference was no longer seen among those born 1971-1975. For both men and women, trends in having children and total fertility across birth cohorts did not differ by educational status. CONCLUSIONS: The decline in the total fertility rate in Japan can be attributed to both an increasing proportion of the population who have no children and a lower number of children among those who have children. Men with lower education and income were less likely to have children and the disparity in the number of children that men have by income had increased in more recent birth cohorts. Among women, higher education was associated with lower fertility, although this pattern was no longer observed among those born in 1971-1975.

  135. Factors associated with the risk perception of COVID-19 infection and severe illness: A cross-sectional study in Japan International-journal Peer-reviewed

    Megumi Adachi, Michio Murakami, Daisuke Yoneoka, Takayuki Kawashima, Masahiro Hashizume, Haruka Sakamoto, Akifumi Eguchi, Cyrus Ghaznavi, Stuart Gilmour, Satoshi Kaneko, Hiroyuki Kunishima, Keiko Maruyama-Sakurai, Yuta Tanoue, Yoshiko Yamamoto, Hiroaki Miyata, Shuhei Nomura

    SSM - Population Health　18　101105-101105　2022/04/26

    Publisher: Elsevier BV

    DOI： 10.1016/j.ssmph.2022.101105 　

    ISSN： 2352-8273

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    Understanding COVID-19 risk perception may help inform public health messaging aimed at encouraging preventive measures and improving countermeasures against the pandemic. We conducted an online survey of 29,708 Japanese adults in February 2021 and estimated the associations between COVID-19 risk perception and a broad array of individual factors. Two logistic regressions were constructed to estimate factors associated with the risk perception of COVID-19 (defined as responding that one might become infected within the next 6 months), and of severe illness among those who responded that they might become infected (defined as responding that one would become severely ill). After adjusting for covariates, those with a higher perceived risk of the COVID-19 vaccine had higher odds of risk perception for both infection and severe illness. Interestingly, those with higher odds of risk perception of being infected were more likely to report obtaining their information from healthcare workers whereas those with lower odds were more likely to report obtaining their information from the Internet or the government; those with lower odds of risk perception of being severely ill were more likely to report obtaining their information from the Internet. The higher the trust level in the government as a COVID-19 information source, the lower the odds of both risk perception of being infected and becoming severely ill. The higher the trust levels in social networking services as a COVID-19 information source, the higher the odds of risk perception of becoming severely ill. Public health messaging should address the factors identified in our study.

  136. Recent changes in the reporting of STIs in Japan during the COVID-19 pandemic. International-journal Peer-reviewed

    Cyrus Ghaznavi, Yuta Tanoue, Takayuki Kawashima, Akifumi Eguchi, Daisuke Yoneoka, Haruka Sakamoto, Peter Ueda, Masahiro Ishikane, Naokatsu Ando, Yusuke Miyazato, Shuhei Nomura

    Sexually transmitted infections　99　(2)　124-127　2022/04/22

    DOI： 10.1136/sextrans-2021-055378 　

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    OBJECTIVES: The COVID-19 pandemic has had variable effects on the rates of STIs reported across the globe. This study sought to assess how the number of STI reports changed during the pandemic in Japan. METHODS: We used national infectious disease surveillance data from the National Institute of Infectious Diseases (Tokyo, Japan) for the period between January 2013 and December 2021. We compared reported rates of chlamydia, gonorrhoea, condyloma acuminata and genital herpes, as well as total notifications for HIV/AIDS and syphilis during the pandemic versus previous years in Japan. We used a quasi-Poisson regression to determine whether any given week or month between January 2018 and December 2021 had a significant excess or deficit of STIs. Notification values above or below the 95% upper and lower prediction thresholds were considered as statistically significant. The start of the pandemic was defined as January 2020. RESULTS: Chlamydia generally remained within predicted range during the pandemic period. Reporting of gonorrhoea was significantly higher than expected throughout early-to-mid 2021 but otherwise generally remained within predicted range prior to 2021. Condyloma, herpes and HIV/AIDS reporting were transiently significantly lower than expected throughout the pandemic period, but no significant periods of higher-than-expected reporting were detected. Syphilis showed widespread evidence of significantly lower-than-predicted reporting throughout 2020 but eventually reversed, showing significantly higher-than-predicted reporting in mid-to-late 2021. CONCLUSIONS: The COVID-19 pandemic was associated with variable changes in the reporting of STIs in Japan. Higher-than-predicted reporting was more likely to be observed in the later phases of the pandemic. These changes may have been attributable to pandemic-related changes in sexual behaviour and decreased STI clinic attendance and testing, but further research on the long-term impact of the pandemic on STIs is necessary.

  137. Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis Peer-reviewed

    Ryan M Barber, Reed J D Sorensen, David M Pigott, Catherine Bisignano, Austin Carter, Joanne O Amlag, James K Collins, Cristiana Abbafati, Christopher Adolph, Adrien Allorant, Aleksandr Y Aravkin, Bree L Bang-Jensen, Emma Castro, Suman Chakrabarti, Rebecca M Cogen, Emily Combs, Haley Comfort, Kimberly Cooperrider, Xiaochen Dai, Farah Daoud, Amanda Deen, Lucas Earl, Megan Erickson, Samuel B Ewald, Alize J Ferrari, Abraham D Flaxman, Joseph Jon Frostad, Nancy Fullman, John R Giles, Gaorui Guo, Jiawei He, Monika Helak, Erin N Hulland, Bethany M Huntley, Alice Lazzar-Atwood, Kate E LeGrand, Stephen S Lim, Akiaja Lindstrom, Emily Linebarger, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan Månsson, Ana M Mantilla Herrera, Ali H Mokdad, Lorenzo Monasta, Mohsen Naghavi, Shuhei Nomura, Christopher M Odell, Latera Tesfaye Olana, Samuel M Ostroff, Maja Pasovic, Spencer A Pease, Robert C Reiner Jr, Grace Reinke, Antonio Luiz P Ribeiro, Damian F Santomauro, Aleksei Sholokhov, Emma E Spurlock, Ruri Syailendrawati, Roman Topor-Madry, Anh Truc Vo, Theo Vos, Rebecca Walcott, Ally Walker, Kirsten E Wiens, Charles Shey Wiysonge, Nahom Alemseged Worku, Peng Zheng, Simon I Hay, Emmanuela Gakidou, Christopher J L Murray

    The Lancet　2022/04

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(22)00484-6 　

    ISSN： 0140-6736

  138. Toward a third term of Health Japan 21 – implications from the rise in non-communicable disease burden and highly preventable risk factors Peer-reviewed

    Nomura, S., Sakamoto, H., Ghaznavi, C., Inoue, M.

    Lancet Regional Health Western Pacific　21　100377-100377　2022/04

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2021.100377 　

    ISSN： 2666-6065

  139. Long-Term Mental Health Support after Natural Hazard Events: A Report from an Online Survey among Experts in Japan Peer-reviewed

    Kayano, R., Lin, M., Shinozaki, Y., Nomura, S., Kim, Y.

    International Journal of Environmental Research and Public Health　19　(5)　3022-3022　2022/03/04

    Publisher: {MDPI} {AG}

    DOI： 10.3390/ijerph19053022 　

    ISSN： 1661-7827 1660-4601

    eISSN： 1660-4601

  140. Global, regional, and national burden of diseases and injuries for adults 70 years and older: systematic analysis for the Global Burden of Disease 2019 Study Peer-reviewed

    GBD 2019 Ageing Collaborators

    BMJ　2022/03

  141. Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21 Peer-reviewed

    Haidong Wang, Katherine R Paulson, Spencer A Pease, Stefanie Watson, Haley Comfort, Peng Zheng, Aleks, r Y Aravkin, Catherine Bisignano, Ryan M Barber, Tahiya Alam, John E Fuller, Erin A May, Darwin Phan Jones, Meghan E Frisch, Cristiana Abbafati, Christopher Adolph, Adrien Allorant, Joanne O Amlag, Bree Bang-Jensen, Gregory J Bertolacci, Sabina S Bloom, Austin Carter, Emma Castro, Suman Chakrabarti, Jhilik Chattopadhyay, Rebecca M Cogen, James K Collins, Kimberly Cooperrider, Xiaochen Dai, William James Dangel, Farah Daoud, Carolyn Dapper, Am, a Deen, Bruce B Duncan, Megan Erickson, Samuel B Ewald, Tatiana Fedosseeva, Alize J Ferrari, Joseph Jon Frostad, Nancy Fullman, John Gallagher, Amiran Gamkrelidze, Gaorui Guo, Jiawei He, Monika Helak, Nathaniel J Henry, Erin N Hull, Bethany M Huntley, Maia Kereselidze, Alice Lazzar-Atwood, Kate E LeGr, Akiaja Lindstrom, Emily Linebarger, Paulo A Lotufo, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan M{\aa}nsson, Ana M Mantilla Herrera, Fatima Marinho, Alemnesh H Mirkuzie, Awoke Temesgen Misganaw, Lorenzo Monasta, Paulami Naik, Shuhei Nomura, Edward G O{\textquotesingle}Brien, James Kevin O{\textquotesingle}Halloran, Latera Tesfaye Olana, Samuel M Ostroff, Louise Penberthy, Robert C Reiner Jr, Grace Reinke, Antonio Luiz P Ribeiro, Damian Francesco Santomauro, Maria In{\^{e } }s Schmidt, David H Shaw, Brittney S Sheena, Aleksei Sholokhov, Natia Skhvitaridze, Reed J D Sorensen, Emma Elizabeth Spurlock, Ruri Syailendrawati, Roman Topor-Madry, Christopher E Troeger, Rebecca Walcott, Ally Walker, Charles Shey Wiysonge, Nahom Alemseged Worku, Bethany Zigler, David M Pigott, Mohsen Naghavi, Ali H Mokdad, Stephen S Lim, Simon I Hay, Emmanuela Gakidou, Christopher J L Murray

    The Lancet　2022/03

    Publisher: Elsevier {BV}

    DOI： 10.1016/s0140-6736(21)02796-3 　

    ISSN： 0140-6736

  142. Global warming and the Summer Olympic and Paralympic games: a perspective from the Tokyo 2020 Games Peer-reviewed

    Yamasaki, L., Nomura, S.

    Environmental Health and Preventive Medicine　27　(1)　7-7　2022/03

    Publisher: Japanese Society for Hygiene

    DOI： 10.1265/ehpm.21-00024 　

    ISSN： 1342-078X 1347-4715

    eISSN： 1347-4715

  143. Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design International-journal

    Daisuke Onozuka, Yuta Tanoue, Shuhei Nomura, Takayuki Kawashima, Daisuke Yoneoka, Akifumi Eguchi, Chris Fook Sheng Ng, Kentaro Matsuura, Shoi Shi, Koji Makiyama, Shinya Uryu, Yumi Kawamura, Shinichi Takayanagi, Stuart Gilmour, Takehiko I Hayashi, Hiroaki Miyata, Francesco Sera, Tomimasa Sunagawa, Takuri Takahashi, Yuuki Tsuchihashi, Yusuke Kobayashi, Yuzo Arima, Kazuhiko Kanou, Motoi Suzuki, Masahiro Hashizume

    International Journal of Epidemiology　51　(1)　75-84　2022/02/18

    Publisher: Oxford University Press (OUP)

    DOI： 10.1093/ije/dyab216 　

    ISSN： 0300-5771

    eISSN： 1464-3685

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    <title>Abstract</title> <sec> <title>Background</title> Coronavirus disease 2019 (COVID-19) continues to be a major global health burden. This study aims to estimate the all-cause excess mortality occurring in the COVID-19 outbreak in Japan, 2020, by sex and age group. </sec> <sec> <title>Methods</title> Daily time series of mortality for the period January 2015–December 2020 in all 47 prefectures of Japan were obtained from the Ministry of Health, Labour and Welfare, Japan. A two-stage interrupted time-series design was used to calculate excess mortality. In the first stage, we estimated excess mortality by prefecture using quasi-Poisson regression models in combination with distributed lag non-linear models, adjusting for seasonal and long-term variations, weather conditions and influenza activity. In the second stage, we used a random-effects multivariate meta-analysis to synthesize prefecture-specific estimates at the nationwide level. </sec> <sec> <title>Results</title> In 2020, we estimated an all-cause excess mortality of −20 982 deaths [95% empirical confidence intervals (eCI): −38 367 to −5472] in Japan, which corresponded to a percentage excess of −1.7% (95% eCI: −3.1 to −0.5) relative to the expected value. Reduced deaths were observed for both sexes and in all age groups except those aged &amp;lt;60 and 70–79 years. </sec> <sec> <title>Conclusions</title> All-cause mortality during the COVID-19 outbreak in Japan in 2020 was decreased compared with a historical baseline. Further evaluation of cause-specific excess mortality is warranted. </sec>

  144. Variation in the COVID-19 infection–fatality ratio by age, time, and geography during the pre-vaccine era: a systematic analysis Peer-reviewed

    Reed J D Sorensen, Ryan M Barber, David M Pigott, Austin Carter, Cory N Spencer, Samuel M Ostroff, Robert C Reiner Jr, Cristiana Abbafati, Christopher Adolph, Adrien Allorant, Joanne O Amlag, Aleksandr Y Aravkin, Steven D Bachmeier, Bree L Bang-Jensen, Catherine Bisignano, Sabina S Bloom, Rachel Castellano, Emma Castro, James K Collins, Haley Comfort, Xiaochen Dai, William James Dangel, Carolyn Dapper, Amanda Deen, Lucas Earl, Megan Erickson, Samuel B Ewald, Alize J Ferrari, Abraham D Flaxman, Joseph Jon Frostad, Nancy Fullman, Amiran Gamkrelidze, John R Giles, Gaorui Guo, Jiawei He, Monika Helak, Erin N Hulland, Bethany M Huntley, Maia Kereselidze, Alice Lazzar-Atwood, Kate E LeGrand, Akiaja Lindstrom, Emily Linebarger, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan Månsson, Ana M Mantilla Herrera, Fatima Marinho, Alemnesh H Mirkuzie, Ali H Mokdad, Lorenzo Monasta, Mohsen Naghavi, Hasan Nassereldine, Shuhei Nomura, Christopher M Odell, Latera Tesfaye Olana, Maja Pasovic, Spencer A Pease, Louise Penberthy, Grace Reinke, Antonio Luiz, P Ribeiro, Damian Francesco Santomauro, Aleksei Sholokhov, Natia Skhvitaridze, Emma Elizabeth Spurlock, Ruri Syailendrawati, Roman Topor-Madry, Anh Truc Vo, Theo Vos, Rebecca Walcott, Ally Walker, Stefanie Watson, Charles Shey Wiysonge, Nahom Alemseged Worku, Peng Zheng, Simon I Hay, Emmanuela Gakidou, Christopher J L Murray

    The Lancet　2022/02

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(21)02867-1 　

    ISSN： 0140-6736

  145. Fish in the sea: Number, characteristics, and partner preferences of unmarried Japanese adults - analysis of a national survey International-journal Peer-reviewed

    Cyrus Ghaznavi, Haruka Sakamoto, Shuhei Nomura, Anna Kubota, Daisuke Yoneoka, Kenji Shibuya, Peter Ueda

    Plos One　17　(2)　e0262528　2022/02

    DOI： 10.1371/journal.pone.0262528 　

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    BACKGROUND: A large proportion of adults in Japan remain unmarried even though they intend to marry during their lifetime. To provide data for policy makers and those searching for partners in the Japanese marriage market, we estimated the number and characteristics of unmarried women and men with marriage intention and assessed their partner preferences. Based on the findings, we hypothesized regarding potential mismatches between the individuals available in the marriage market and the type of partners they are looking for. METHODS: We used data from the National Fertility Survey (2015), a nationally representative survey in Japan, and included 20,344 participants aged 18-49 years, of which 6,568 were unmarried with marriage intention. We estimated the total number of unmarried women and men who intend to marry, extrapolated their characteristics to the Japanese population, and assessed their partner preferences, as well as their ideal age of marriage and the ideal age of their partner. RESULTS: In 2015, there were 8.48 million unmarried women and 9.83 million unmarried men aged 18-49 years with marriage intention in Japan. Surpluses of around 600,000 men were observed in non-densely inhabited areas (men-to-women ratio: 1.31) and in the Kanto region (1.23). Most of the women and men in the marriage market had annual incomes lower than 3,000,000 JPY (28,000 USD) and only 263,000 women (3%) and 883,000 men (9%) had an income of 5,000,000 JPY (47,000 USD) or more; 167,000 men (2%) had an income of 7,000,000 JPY (66,000 USD) or more, with roughly three-quarters of them having a university degree. When asked about eight items that one may consider in a potential partner, the proportion of women listing an item as "important" tended to be larger than those of men across all items (education, occupation, finances, personality, mutual hobbies, cooperation/understanding regarding one's work, and attitude towards/skills in housework and childrearing) except appearance. The largest differences were observed for finances (proportion of women vs. men listing the item as "important" or "would consider:" 94.0% vs. 40.5%, p<0.001), occupation (84.9% vs. 43.9%, p<0.001), and education (53.9% vs. 28.7%, p<0.001). While women, on average, preferred men who were around 1-3 years older than themselves, men preferred women around their own age until the age of 26 years, at which point men preferred women who were younger than themselves, with the preferred age difference increasing substantially with age. As such, the number of men preferring a younger partner was larger than the number of women who preferred an older partner. CONCLUSIONS: By providing data on the number, characteristics and partner preferences of individuals in the marriage market, our study could inform decisions for those searching for marriage partners in Japan. Moreover, we hypothesize that mismatches in geographical location, the supply-demand disparity for partners with higher income, and age preferences could partly explain the large number of Japanese women and men who remain unmarried despite intending to get married. Further studies are needed to assess if, and to what extent, the identified mismatches may affect marriage rates.

  146. Pandemic preparedness and COVID-19: an exploratory analysis of infection and fatality rates, and contextual factors associated with preparedness in 177 countries, from Jan 1, 2020, to Sept 30, 2021 Peer-reviewed

    Thomas J Bollyky, Erin N Hull, Ryan M Barber, James K Collins, Samantha Kiernan, Mark Moses, David M Pigott, Robert C Reiner Jr, Reed J D Sorensen, Cristiana Abbafati, Christopher Adolph, Adrien Allorant, Joanne O Amlag, Aleks, r Y Aravkin, Bree Bang-Jensen, Austin Carter, Rachel Castellano, Emma Castro, Suman Chakrabarti, Emily Combs, Xiaochen Dai, William James Dangel, Carolyn Dapper, Am, a Deen, Bruce B Duncan, Lucas Earl, Megan Erickson, Samuel B Ewald, Tatiana Fedosseeva, Alize J Ferrari, Abraham D Flaxman, Nancy Fullman, Emmanuela Gakidou, Bayan Galal, John Gallagher, John R Giles, Gaorui Guo, Jiawei He, Monika Helak, Bethany M Huntley, Bulat Idrisov, Casey Johanns, Kate E LeGr, Ian D Letourneau, Akiaja Lindstrom, Emily Linebarger, Paulo A Lotufo, Rafael Lozano, Beatrice Magistro, Deborah Carvalho Malta, Johan M{\aa}nsson, Ana M Mantilla Herrera, Fatima Marinho, Alemnesh H Mirkuzie, Ali H Mokdad, Lorenzo Monasta, Paulami Naik, Shuhei Nomura, James Kevin O{\textquotesingle}Halloran, Christopher M Odell, Latera Tesfaye Olana, Samuel M Ostroff, Maja Pasovic, Valeria Maria de Azeredo Passos, Louise Penberthy, Grace Reinke, Damian Francesco Santomauro, Maria In{\^{e } }s Schmidt, Aleksei Sholokhov, Emma Spurlock, Christopher E Troeger, Elena Varavikova, Anh T Vo, Theo Vos, Rebecca Walcott, Ally Walker, Simon D Wigley, Charles Shey Wiysonge, Nahom Alemseged Worku, Yifan Wu, Sarah Wulf Hanson, Peng Zheng, Simon I Hay, Christopher J L Murray, Joseph L Dieleman

    The Lancet　2022/02/01

    Publisher: Elsevier {BV}

    DOI： 10.1016/s0140-6736(22)00172-6 　

    ISSN： 0140-6736

  147. Excess deaths from COVID-19 in Japan and 47 prefectures from January through June 2021

    Nomura, S., Eguchi, A., Tanoue, Y., Yoneoka, D., Kawashima, T., Suzuki, M., Hashizume, M.

    Public Health　203　15-18　2022/02

    Publisher: Elsevier BV

    DOI： 10.1016/j.puhe.2021.11.023 　

    ISSN： 0033-3506 1476-5616

  148. Reasons for Suicide During the COVID-19 Pandemic in Japan International-journal Peer-reviewed

    Masahide Koda, Nahoko Harada, Akifumi Eguchi, Shuhei Nomura, Yasushi Ishida

    JAMA Network Open　5　(1)　e2145870-e2145870　2022/01/31

    Publisher: American Medical Association (AMA)

    DOI： 10.1001/jamanetworkopen.2021.45870 　

    eISSN： 2574-3805

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    Importance: Although the suicide rate in Japan increased during the COVID-19 pandemic, the reasons for suicide have yet to be comprehensively investigated. Objective: To assess which reasons for suicide had rates that exceeded the expected number of suicide deaths for that reason during the COVID-19 pandemic. Design, Setting, and Participants: This national, population-based cross-sectional study of data on suicides gathered by the Ministry of Health, Labor, and Welfare from January 2020 to May 2021 used a times-series analysis on the numbers of reason-identified suicides. Data of decedents were recorded by the National Police Agency and compiled by the Ministry of Health, Labor, and Welfare. Exposure: For category analysis, we compared data from January 2020 to May 2021 with data from December 2014 to June 2020. For subcategory analysis, data from January 2020 to May 2021 were compared with data from January 2019 to June 2020. Main Outcomes and Measures: The main outcome was the monthly excess suicide rate, ie, the difference between the observed number of monthly suicide deaths and the upper bound of the 1-sided 95% CI for the expected number of suicide deaths in that month. Reasons for suicide were categorized into family, health, economy, work, relationships, school, and others, which were further divided into 52 subcategories. A quasi-Poisson regression model was used to estimate the expected number of monthly suicides. Individual regression models were used for each of the 7 categories, 52 subcategories, men, women, and both genders. Results: From the 29 938 suicides (9984 [33.3%] women; 1093 [3.7%] aged <20 years; 3147 [10.5%] aged >80 years), there were 21 027 reason-identified suicides (7415 [35.3%] women). For both genders, all categories indicated monthly excess suicide rates, except for school in men. October 2020 had the highest excess suicide rates for all cases (observed, 1577; upper bound of 95% CI for expected number of suicides, 1254; 25.8% greater). In men, the highest monthly excess suicide rate was 24.3% for the other category in August 2020 (observed, 87; upper bound of 95% CI for expected number, 70); in women, it was 85.7% for school in August 2020 (observed, 26; upper bound of 95% CI for expected number, 14). Conclusions and Relevance: In this study, observed suicides corresponding to all 7 categories of reasons exceeded the monthly estimates (based on data from before or during the COVID-19 pandemic), except for school-related reasons in men. This study can be used as a basis for developing intervention programs for suicide prevention.

  149. Identification of optimum combinations of media channels for approaching COVID-19 vaccine unsure and unwilling groups in Japan International-journal Peer-reviewed

    Daisuke Yoneoka, Akifumi Eguchi, Shuhei Nomura, Takayuki Kawashima, Yuta Tanoue, Michio Murakami, Haruka Sakamoto, Keiko Maruyama-Sakurai, Stuart Gilmour, Shoi Shi, Hiroyuki Kunishima, Satoshi Kaneko, Megumi Adachi, Koki Shimada, Yoshiko Yamamoto, Hiroaki Miyata

    The Lancet Regional Health - Western Pacific　18　100330-100330　2022/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2021.100330 　

    ISSN： 2666-6065

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    BACKGROUND: Optimizing media campaigns for those who were unsure or unwilling to take coronavirus disease (COVID-19) vaccines is required urgently to effectively present public health messages aimed at increasing vaccination coverage. We propose a novel framework for selecting tailor-made media channels and their combinations for this task. METHODS: An online survey was conducted in Japan during February to March, 2021, with 30,053 participants. In addition to their sociodemographic characteristics, it asked the attitude toward vaccination and information sources (i.e., media channels) for COVID-19 issues. Multinomial logic regression was fitted to estimate the combinations of the media channels and their odds ratio (OR) associated with vaccination attitudes. FINDINGS: The proportion of respondents who were unsure or unwilling to take the vaccination was skewed toward younger generation: 58.1% were aged under 35, while 28.1% were 65 years or older. Media channels such as "Non-medical and Non-TV" and "Non-medical and Non-government" were associated with the unsure group: OR (95% Confidence intervals, (CI)) = 1.75 (1.62, 1.89) and 1.53 (1.44, 1.62), respectively. In addition, media channels such as "Newspapers or the Novel Coronavirus Expert Meeting", "Medical or Local government", and "Non-TV" were associated with the unwilling group: OR (95% CI) were 2.00 (1.47, 2.75), 3.13 (2.58, 3.81), and 2.25 (1.84, 2.77), respectively. INTERPRETATION: To effectively approach COVID-19 vaccine unsure and unwilling groups, generation-specific online and offline media campaigns should be optimized to the type of vaccine attitude. FUNDING: Funded by the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009) and the Japan Agency for Medical Research and Development (AMED) (JP20fk0108535).

  150. A prospective evaluation of AI-augmented epidemiology to forecast COVID-19 in the USA and Japan International-journal Peer-reviewed

    Sercan Ö. Arık, Joel Shor, Rajarishi Sinha, Jinsung Yoon, Joseph R. Ledsam, Long T. Le, Michael W. Dusenberry, Nathanael C. Yoder, Kris Popendorf, Arkady Epshteyn, Johan Euphrosine, Elli Kanal, Isaac Jones, Chun-Liang Li, Beth Luan, Joe Mckenna, Vikas Menon, Shashank Singh, Mimi Sun, Ashwin Sura Ravi, Leyou Zhang, Dario Sava, Kane Cunningham, Hiroki Kayama, Thomas Tsai, Daisuke Yoneoka, Shuhei Nomura, Hiroaki Miyata, Tomas Pfister

    npj Digital Medicine　4　(1)　146-146　2021/12

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41746-021-00511-7 　

    eISSN： 2398-6352

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    <title>Abstract</title>The COVID-19 pandemic has highlighted the global need for reliable models of disease spread. We propose an AI-augmented forecast modeling framework that provides daily predictions of the expected number of confirmed COVID-19 deaths, cases, and hospitalizations during the following 4 weeks. We present an international, prospective evaluation of our models’ performance across all states and counties in the USA and prefectures in Japan. Nationally, incident mean absolute percentage error (MAPE) for predicting COVID-19 associated deaths during prospective deployment remained consistently &lt;8% (US) and &lt;29% (Japan), while cumulative MAPE remained &lt;2% (US) and &lt;10% (Japan). We show that our models perform well even during periods of considerable change in population behavior, and are robust to demographic differences across different geographic locations. We further demonstrate that our framework provides meaningful explanatory insights with the models accurately adapting to local and national policy interventions. Our framework enables counterfactual simulations, which indicate continuing Non-Pharmaceutical Interventions alongside vaccinations is essential for faster recovery from the pandemic, delaying the application of interventions has a detrimental effect, and allow exploration of the consequences of different vaccination strategies. The COVID-19 pandemic remains a global emergency. In the face of substantial challenges ahead, the approach presented here has the potential to inform critical decisions.

  151. Alcohol intake and stomach cancer risk in Japan: A pooled analysis of six cohort studies

    Takashi Tamura, Kenji Wakai, Yingsong Lin, Akiko Tamakoshi, Mai Utada, Kotaro Ozasa, Yumi Sugawara, Ichiro Tsuji, Ayami Ono, Norie Sawada, Shoichiro Tsugane, Hidemi Ito, Chisato Nagata, Tetsuhisa Kitamura, Mariko Naito, Keitaro Tanaka, Taichi Shimazu, Tetsuya Mizoue, Keitaro Matsuo, Manami Inoue, Sarah K. Abe, Motoki Iwasaki, Michihiro Muto, Eiko Saito, Shiori Tanaka, Taiki Yamaji, Hadrien Charvat, Tetsuya Otani, Shizuka Sasazuki, Yoshikazu Nishino, Yoshitaka Tsubono, Shuhei Nomura, Hidekazu Suzuki, Isao Oze, Keiko Wada, Yuri Kitamura, Tomio Nakayama, Atsuko Sadakane

    Cancer Science　113　(1)　261-276　2021/11/28

    Publisher: Wiley

    DOI： 10.1111/cas.15172 　

    ISSN： 1347-9032

    eISSN： 1349-7006

  152. Age-appropriate vaccination coverage and its determinants in children aged 12–36 months in Nepal: a national and subnational assessment International-journal Peer-reviewed

    Santosh Kumar Rauniyar, Yoko Iwaki, Daisuke Yoneoka, Masahiro Hashizume, Shuhei Nomura

    BMC Public Health　21　(1)　2063-2063　2021/11

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12889-021-11841-2 　

    eISSN： 1471-2458

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    <title>Abstract</title><sec> <title>Background</title> Vaccination is one of the effective ways to develop immunity against potential life-threatening diseases in children in early age. This study is focused on analysing the age-appropriate vaccination coverage at national and subnational levels and identify the factors associated with age-appropriate coverage in Nepal. </sec><sec> <title>Methods</title> 460 children aged 12–36 months were included in the study. The data was obtained from Nepal Demographic and Health Survey (NDHS) 2016–17. Age-appropriate coverage of Bacillus Calmette-Guerin vaccine (BCG), oral polio vaccine (OPV) doses 1–3, pentavalent vaccine (PE) doses 1–3, and first dose of measles, mumps, and rubella vaccine (MMR) were estimated using Kaplan Meier method. Multilevel logistic regression with random intercept was used to identify the factors associated with age-appropriate vaccination. </sec><sec> <title>Results</title> The crude coverage of the vaccines included in the study ranged from 91.5% (95% CI, 88.5–93.7) for PE3 to 97.8% (95.8–98.7) for BCG. Although the crude coverage of all the vaccines was above 90%, the age-appropriate coverage was significantly low, ranging from 41.5% (36.5–46.6) for PE3 to 73.9% (69.2–78.1) for PE1. Furthermore, high disparity in timely vaccination coverage was observed at regional level. Compared to the age-appropriate vaccination coverage in other provinces, Province 2 had the lowest coverage of all, followed by that in Province 6. The timeliness of vaccination was significantly associated with subnational regions i.e., provinces and the season of childbirth. </sec><sec> <title>Conclusion</title> Although the immunization program in Nepal has achieved the target of 90% crude coverage of all the childhood vaccines, the age-appropriate coverage is significantly low which undermines the effectiveness of the vaccines administered. Thus, along with crude coverage, timeliness of the vaccines administered should be taken into consideration and thoroughly monitored at national and subnational levels. Provincial government should formulate tailored strategies to ensure the timely administration of the childhood vaccines. </sec>

  153. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic

    Santomauro, D.F., Mantilla Herrera, A.M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D.M., Abbafati, C., Adolph, C., Amlag, J.O., Aravkin, A.Y., Bang-Jensen, B.L., Bertolacci, G.J., Bloom, S.S., Castellano, R., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R.M., Collins, J.K., Dai, X., Dangel, W.J., Dapper, C., Deen, A., Erickson, M., Ewald, S.B., Flaxman, A.D., Frostad, J.J., Fullman, N., Giles, J.R., Giref, A.Z., Guo, G., He, J., Helak, M., Hulland, E.N., Idrisov, B., L, rom, A., Linebarger, E., Lotufo, P.A., Lozano, R., Magistro, B., Malta, D.C., M?nsson, J.C., Marinho, F., Mokdad, A.H., Monasta, L., Naik, P., Nomura, S., O{'}Halloran, J.K., Ostroff, S.M., Pasovic, M., Penberthy, L., Reiner Jr, R.C., Reinke, G., Ribeiro, A.L.P., Sholokhov, A., Sorensen, R.J.D., Varavikova, E., Vo, A.T., Walcott, R., Watson, S., Wiysonge, C.S., Zigler, B., Hay, S.I., Vos, T., Murray, C.J.L., Whiteford, H.A., Ferrari, A.J.

    Lancet　398　(10312)　1700-1712　2021/11

    Publisher: Elsevier BV

    DOI： 10.1016/S0140-6736(21)02143-7 　

    ISSN： 0140-6736 1474-547X

  154. Salt intake reduction using umami substance-incorporated food in the United States

    Shuhei Nomura, Shiori Tanaka, Akifumi Eguchi, Takayuki Kawashima, Daisuke Yoneoka, Yuta Tanoe, Megumi Adachi, Hitomi Hayabuchi, Shosei Koganemaru, Toshihide Nishimura, Byron Sigel, Hisayuki Uneyama, Kenji Shibuya

    2021/10/19

    DOI： 10.21203/rs.3.rs-966864/v1 　

  155. Global, regional, and national mortality among young people aged 10–24 years, 1950–2019: a systematic analysis for the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Adolescent Mortality Collaborators

    The Lancet　398　(10311)　1593-1618　2021/10

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(21)01546-4 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  156. Analysis of the relationship between the HbA1c screening results and the development and worsening of diabetes among adults aged over 40 years: a 4-year follow-up study of 140,000 people in Japan – the Shizuoka study International-journal Peer-reviewed

    Shuhei Nomura, Haruka Sakamoto, Santosh Kumar Rauniyar, Koki Shimada, Hiroyuki Yamamoto, Shun Kohsaka, Nao Ichihara, Hiraku Kumamaru, Hiroaki Miyata

    BMC Public Health　21　(1)　1880-1880　2021/10

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12889-021-11933-z 　

    eISSN： 1471-2458

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    <title>Abstract</title><sec> <title>Background</title> Hemoglobin A1c (HbA1c) levels are routinely measured during health check-ups and are used as an indicator of glycemic control in Japan. However, only a few studies have followed up individuals to assess the risk of diabetes development and worsening based on HbA1c screening results. This study evaluated the relationship between HbA1c screening results and the risk of diabetes development and worsening. </sec><sec> <title>Methods</title> Data were collected from the Shizuoka Kokuho Database, a Japanese administrative claims database of insured individuals aged &gt; 40 years. We included individuals available for follow-up from April 2012 to March 2018 who had not received any diabetes treatment before March 2014. HbA1c screening results were categorized into 4 groups based on the HbA1c levels at the 2012 and 2013 health check-ups: group A, those whose HbA1c levels were &lt; 6.5% in 2012 and 2013; group B, those whose HbA1c levels &gt; 6.5% in 2012 but &lt; 6.5% in 2013; group C, those whose HbA1c levels were &gt; 6.5% in 2012 and 2013; and group D, those whose HbA1c levels were &lt; 6.5% in 2012 and &gt; 6.5% in 2013. Logistic regression models were used to analyze diabetes development and worsening, defined as the initiation of diabetes treatment by March 2018 and the use of injection drugs by participants who initiated diabetes treatment by March 2018. </sec><sec> <title>Results</title> Overall, 137,852 individuals were analyzed. After adjusting for covariates, compared with group A, group B was more likely to initiate treatment within 4 years (odds ratio: 22.64; 95% confidence interval: 14.66–34.99). In patients who initiated diabetes treatment by March 2018, injection drugs were less likely used by group D than by group A (odds ratio: 0.28; 95% confidence interval: 0.12–0.61). </sec><sec> <title>Conclusions</title> Our study suggests that although HbA1c levels measured during health check-ups were correlated with the risk of diabetes development and worsening, HbA1c levels in a single year may not necessarily provide sufficient information to consider these future risks. </sec>

  157. Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050

    Angela E Micah, Ian E Cogswell, Brandon Cunningham, Satoshi Ezoe, Anton C Harle, Emilie R Maddison, Darrah McCracken, Shuhei Nomura, Kyle E Simpson, Hayley N Stutzman, Golsum Tsakalos, Lindsey E Wallace, Yingxi Zhao, Rahul R Zende, Cristiana Abbafati, Michael Abdelmasseh, Aidin Abedi, Kedir Hussein Abegaz, E S Abhilash, Hassan Abolhassani, Michael R M Abrigo, Tara Ballav Adhikari, Saira Afzal, Bright Opoku Ahinkorah, Sepideh Ahmadi, Haroon Ahmed, Muktar Beshir Ahmed, Tarik Ahmed Rashid, Marjan Ajami, Budi Aji, Yonas Akalu, Chisom Joyqueenet Akunna, Hanadi Al Hamad, Khurshid Alam, Fahad Mashhour Alanezi, Turki M Alanzi, Yosef Alemayehu, Robert Kaba Alhassan, Cyrus Alinia, Syed Mohamed Aljunid, Sami Almustanyir Almustanyir, Nelson Alvis-Guzman, Nelson J Alvis-Zakzuk, Saeed Amini, Mostafa Amini-Rarani, Hubert Amu, Robert Ancuceanu, Catalina Liliana Andrei, Tudorel Andrei, Blake Angell, Mina Anjomshoa, Carl Abelardo T Antonio, Catherine M Antony, Muhammad Aqeel, Jalal Arabloo, Morteza Arab-Zozani, Timur Aripov, Alessandro Arrigo, Tahira Ashraf, Desta Debalkie Atnafu, Marcel Ausloos, Leticia Avila-Burgos, Asma Tahir Awan, Getinet Ayano, Martin Amogre Ayanore, Samad Azari, Gulrez Shah Azhar, Tesleem Kayode Babalola, Mohammad Amin Bahrami, Atif Amin Baig, Maciej Banach, Nastaran Barati, Till Winfried Bärnighausen, Amadou Barrow, Sanjay Basu, Bernhard T Baune, Mohsen Bayati, Habib Benzian, Adam E Berman, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Sonu Bhaskar, Sadia Bibi, Ali Bijani, Virginia Bodolica, Nicola Luigi Bragazzi, Dejana Braithwaite, Nicholas J K Breitborde, Alexey V Breusov, Nikolay Ivanovich Briko, Reinhard Busse, Lucero Cahuana-Hurtado, Emily Joy Callander, Luis Alberto Cámera, Carlos A Castañeda-Orjuela, Ferrán Catalá-López, Jaykaran Charan, Souranshu Chatterjee, Soosanna Kumary Chattu, Vijay Kumar Chattu, Simiao Chen, Arrigo Francesco Giuseppe Cicero, Omid Dadras, Saad M A Dahlawi, Xiaochen Dai, Koustuv Dalal, Lalit Dandona, Rakhi Dandona, Dragos Virgil Davitoiu, Jan-Walter De Neve, Antonio Reis de Sá-Junior, Edgar Denova-Gutiérrez, Deepak Dhamnetiya, Samath Dhamminda Dharmaratne, Leila Doshmangir, John Dube, Elham Ehsani-Chimeh, Maysaa El Sayed Zaki, Maha El Tantawi, Sharareh Eskandarieh, Farshad Farzadfar, Tomas Y Ferede, Florian Fischer, Nataliya A Foigt, Alberto Freitas, Sara D Friedman, Takeshi Fukumoto, Nancy Fullman, Peter Andras Gaal, Mohamed M Gad, MA Garcia-Gordillo, Tushar Garg, Mansour Ghafourifard, Ahmad Ghashghaee, Asadollah Gholamian, Ali Gholamrezanezhad, Ghozali Ghozali, Syed Amir Gilani, Ionela-Roxana Glăvan, Ekaterina Vladimirovna Glushkova, Salime Goharinezhad, Mahaveer Golechha, Srinivas Goli, Avirup Guha, Veer Bala Gupta, Vivek Kumar Gupta, Annie Haakenstad, Mohammad Rifat Haider, Alemayehu Hailu, Samer Hamidi, Asif Hanif, Harapan Harapan, Risky Kusuma Hartono, Ahmed I Hasaballah, Shoaib Hassan, Mohamed H Hassanein, Khezar Hayat, Mohamed I Hegazy, Golnaz Heidari, Delia Hendrie, Ileana Heredia-Pi, Claudiu Herteliu, Kamal Hezam, Ramesh Holla, Sheikh Jamal Hossain, Mehdi Hosseinzadeh, Sorin Hostiuc, Tanvir M Huda, Bing-Fang Hwang, Ivo Iavicoli, Bulat Idrisov, Olayinka Stephen Ilesanmi, Seyed Sina Naghibi Irvani, Sheikh Mohammed Shariful Islam, Nahlah Elkudssiah Ismail, Gaetano Isola, Mohammad Ali Jahani, Nader Jahanmehr, Mihajlo Jakovljevic, Manthan Dilipkumar Janodia, Tahereh Javaheri, Sathish Kumar Jayapal, Ranil Jayawardena, Seyed Behzad Jazayeri, Ravi Prakash Jha, Jost B Jonas, Tamas Joo, Farahnaz Joukar, Mikk Jürisson, Billingsley Kaambwa, Rohollah Kalhor, Tanuj Kanchan, Himal Kandel, Behzad Karami Matin, Salah Eddin Karimi, Getinet Kassahun, Gbenga A Kayode, Ali Kazemi Karyani, Leila Keikavoosi-Arani, Yousef Saleh Khader, Himanshu Khajuria, Rovshan Khalilov, Mohammad Khammarnia, Junaid Khan, Jagdish Khubchandani, Neda Kianipour, Gyu Ri Kim, Yun Jin Kim, Adnan Kisa, Sezer Kisa, Stefan Kohler, Soewarta Kosen, Rajasekaran Koteeswaran, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, G Anil Kumar, Dian Kusuma, Demetris Lamnisos, Van Charles Lansingh, Anders O Larsson, Savita Lasrado, Long Khanh Dao Le, Shaun Wen Huey Lee, Yeong Yeh Lee, Stephen S Lim, Stany W Lobo, Rafael Lozano, Hassan Magdy Abd El Razek, Muhammed Magdy Abd El Razek, Mokhtar Mahdavi Mahdavi, Azeem Majeed, Alaa Makki, Afshin Maleki, Reza Malekzadeh, Ana Laura Manda, Fariborz Mansour-Ghanaei, Mohammad Ali Mansournia, Carlos Alberto Marrugo Arnedo, Adolfo Martinez-Valle, Seyedeh Zahra Masoumi, Richard James Maude, Martin McKee, Carlo Eduardo Medina-Solís, Ritesh G Menezes, Atte Meretoja, Tuomo J Meretoja, Mohamed Kamal Mesregah, Tomislav Mestrovic, Neda Milevska Kostova, Ted R Miller, GK Mini, Andreea Mirica, Erkin M Mirrakhimov, Bahram Mohajer, Teroj Abdulrahman Mohamed, Mokhtar Mohammadi, Abdollah Mohammadian-Hafshejani, Shafiu Mohammed, Modhurima Moitra, Ali H Mokdad, Mariam Molokhia, Mohammad Ali Moni, Yousef Moradi, Jakub Morze, Seyyed Meysam Mousavi, Christine Mpundu-Kaambwa, Moses K Muriithi, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Mukhammad David Naimzada, Vinay Nangia, Atta Abbas Naqvi, Aparna Ichalangod Narayana, Bruno Ramos Nascimento, Muhammad Naveed, Biswa Prakash Nayak, Javad Nazari, Rawlance Ndejjo, Ionut Negoi, Sandhya Neupane Kandel, Trang Huyen Nguyen, Justice Nonvignon, Jean Jacques Noubiap, Vincent Ebuka Nwatah, Bogdan Oancea, Foluke Adetola Ogunyemi Ojelabi, Andrew T Olagunju, Babayemi Oluwaseun Olakunde, Stefano Olgiati, Jacob Olusegun Olusanya, Obinna E Onwujekwe, Adrian Otoiu, Nikita Otstavnov, Stanislav S Otstavnov, Mayowa O Owolabi, Jagadish Rao Padubidri, Raffaele Palladino, Songhomitra Panda-Jonas, Eun-Cheol Park, Fatemeh Pashazadeh Kan, Shrikant Pawar, Hamidreza Pazoki Toroudi, David M Pereira, Arokiasamy Perianayagam, Konrad Pesudovs, Cristiano Piccinelli, Maarten J Postma, Sergio I Prada, Mohammad Rabiee, Navid Rabiee, Fakher Rahim, Vafa Rahimi-Movaghar, Mohammad Hifz Ur Rahman, Mosiur Rahman, Amir Masoud Rahmani, Usha Ram, Chhabi Lal Ranabhat, Priyanga Ranasinghe, Chythra R Rao, Priya Rathi, David Laith Rawaf, Salman Rawaf, Lal Rawal, Reza Rawassizadeh, Robert C Reiner Jr, Andre M N Renzaho, Bhageerathy Reshmi, Mavra A Riaz, Rezaul Karim Ripon, Anas M Saad, Mohammad Ali Sahraian, Maitreyi Sahu, Joseph S Salama, Sana Salehi, Abdallah M Samy, Juan Sanabria, Francesco Sanmarchi, João Vasco Santos, Milena M Santric-Milicevic, Brijesh Sathian, Miloje Savic, Deepak Saxena, Mehdi Sayyah, Falk Schwendicke, Subramanian Senthilkumaran, Sadaf G Sepanlou, Allen Seylani, Saeed Shahabi, Masood Ali Shaikh, Aziz Sheikh, Adithi Shetty, Pavanchand H Shetty, Kenji Shibuya, Mark G Shrime, Kanwar Hamza Shuja, Jasvinder A Singh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Shahin Soltani, Moslem Soofi, Emma Elizabeth Spurlock, Simona Cătălina Stefan, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-Seisdedos, Biruk Wogayehu Taddele, Yonas Getaye Tefera, Aravind Thavamani, Ruoyan Tobe-Gai, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Bach Xuan Tran, Lorainne Tudor Car, Anayat Ullah, Saif Ullah, Nasir Umar, Eduardo A Undurraga, Pascual R Valdez, Tommi Juhani Vasankari, Jorge Hugo Villafañe, Francesco S Violante, Vasily Vlassov, Bay Vo, Sebastian Vollmer, Theo Vos, Giang Thu Vu, Linh Gia Vu, Richard G Wamai, Andrea Werdecker, Mesfin Agachew Woldekidan, Befikadu Legesse Wubishet, Gelin Xu, Sanni Yaya, Vahid Yazdi-Feyzabadi, Vahit Yiğit, Paul Yip, Birhanu Wubale Yirdaw, Naohiro Yonemoto, Mustafa Z Younis, Chuanhua Yu, Ismaeel Yunusa, Telma Zahirian Moghadam, Hamed Zandian, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Zhi-Jiang Zhang, Arash Ziapour, Yves Miel H Zuniga, Simon I Hay, Christopher J L Murray, Joseph L Dieleman

    The Lancet　398　(10308)　1317-1343　2021/10

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(21)01258-7 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  158. Geographically weighted generalized Farrington algorithm for rapid outbreak detection over short data accumulation periods Peer-reviewed

    Daisuke Yoneoka, Takayuki Kawashima, Koji Makiyama, Yuta Tanoue, Shuhei Nomura, Akifumi Eguchi

    Statistics in Medicine　40　(28)　6277-6294　2021/09/07

    DOI： 10.1002/sim.9182 　

    ISSN： 0277-6715

    eISSN： 1097-0258

  159. Profiling of Androgen-Dependent Enhancer RNAs Expression in Human Prostate Tumors: Search for Malignancy Transition Markers International-journal Peer-reviewed

    Koichi Nishimura, Jinichi Mori, Takahiro Sawada, Shuhei Nomura, Alexander Kouzmenko, Kaori Yamashita, Yoshiaki Kanemoto, Tomohiro Kurokawa, Akira Hayakawa, Suguru Tokiwa, Michihisa Ochi, Hiroaki Shimmura, Shigeaki Kato

    Research and Reports in Urology　13　705-713　2021/09

    Publisher: Informa UK Limited

    DOI： 10.2147/rru.s328661 　

    eISSN： 2253-2447

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    INTRODUCTION: Although the ability of androgens to promote prostate cancer development has been known for decades, the molecular mechanisms of androgen receptor (AR) signaling in the tumorigenesis remain unclear. Enhancer RNAs (eRNAs) transcribed from strong enhancers, or super-enhancers (SEs), have recently emerged as a novel class of regulatory non-coding RNAs (ncRNAs) that facilitate transcription, including that of androgen target genes, through chromatin looping to position enhancers proximate to the promoters. The aim of this study was to assess androgen-dependent transcription in prostate tumors of eRNAs (designated as KLK3eRNAs) from the SE of the KLK3 gene encoding the prostate-specific antigen (PSA) protein, a clinical marker of prostate carcinogenesis. MATERIALS AND METHODS: The androgen-induced KLK3eRNAs were identified in the LNCaP human prostate cancer cell line. The expressions of these KLK3eRNAs together with KLK3 and AR mRNA transcripts were assessed by qRT-PCR in prostate tumor samples from five prostate cancer patients. RESULTS: Androgen-induced KLK3eRNAs have been identified in the LNCaP cells, and their expression was further analyzed in tumors of prostate cancer patients. Transcripts of the tested KLK3eRNAs have been detected in all clinical samples, but their expression patterns differed between individual tumor specimens. We found a statistically significant correlation between the levels of the KLK3 and AR mRNAs with those of the previously reported KLK3eRNAs, while such correlation was not observed for novel KLK3eRNAs described in our recent report. CONCLUSION: Presented data suggest that prostate tumor development may associate with epigenetic reorganization in the KLK3 genomic regulatory elements reflected by changes of the KLK3eRNA expression. Our findings support a potential of eRNAs profiling to be used as diagnostic marker.

  160. Reasons for being unsure or unwilling regarding intention to take COVID-19 vaccine among Japanese people: A large cross-sectional national survey International-journal Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Michio Murakami, Haruka Sakamoto, Keiko Maruyama-Sakurai, Stuart Gilmour, Shoi Shi, Hiroyuki Kunishima, Satoshi Kaneko, Megumi Adachi, Koki Shimada, Yoshiko Yamamoto, Hiroaki Miyata

    The Lancet Regional Health - Western Pacific　14　100223-100223　2021/09

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2021.100223 　

    ISSN： 2666-6065

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    BACKGROUND: Identifying and understanding reasons for being unsure or unwilling regarding intention to be vaccinated against coronavirus disease (COVID-19) may help to inform future public health messages aimed at increasing vaccination coverage. We analyzed a broad array of individual's psychological dispositions with regard to decision-making about COVID-19 vaccination in Japan. METHODS: A nationally representative cross-sectional web survey was conducted with 30053 Japanese adults aged 20 years or older at the end of February 2021. In addition to the question on the individual's intention to be vaccinated against COVID-19, respondents were asked about their sociodemographic, health-related, and psychological characteristics as well as information sources about COVID-19 and their levels of trust. Also, those who responded 'not sure' or 'no' regarding intention to take COVID-19 vaccine were asked why. Multinomial logistic regression with sparse group Lasso (Least Absolute Shrinkage and Selection Operator) penalty was used to compute adjusted odds ratios for factors associated with the intention (not sure/no versus yes). FINDINGS: The percentages of respondents who answered 'not sure' or 'no' regarding intention to be vaccinated against COVID-19 vaccine were 32.9% and 11.0%, respectively. After adjusting for covariates, the perceived risks of COVID-19, perceived risk of a COVID-19 vaccine, perceived benefits of a COVID-19 vaccine, trust in scientists and public authorities, and the belief that healthcare workers should be vaccinated were significantly associated with vaccination intention. Several sources of information about COVID-19 were also significantly associated with vaccination intention, including physicians, nurses, and television, medical information sites with lower odds of being unsure or unwilling, and internet news sites, YouTube, family members, and scientists and researchers with higher odds. The higher the level of trust in television as a source of COVID-19 information, the higher the odds of responding 'not sure' (odds ratio 1.11, 95% confidence interval 1.01-1.21). We also demonstrated that many respondents presented concerns about the side effects and safety of a COVID-19 vaccine as a major reason for being unsure or unwilling. To decide whether or not to get the vaccine, many respondents requested more information about the compatibilities between the vaccine and their personal health conditions, whether other people had been vaccinated, the effectiveness of vaccines against variants, and doctors' recommendations. INTERPRETATION: Our findings suggest that public health messaging based on the sociodemographic and psychological characteristics of those who are unsure or unwilling regarding intention to be vaccinated against COVID-19 vaccine may help to increase vaccine uptake amongst this population. FUNDING: The present work was supported in part by a grant from the Ministry of Health, Labour and Welfare of Japan (H29-Gantaisaku-ippan-009).

  161. Tracking development assistance for health: A comparative study of the 29 development assistance committee countries, 2011–2019 Peer-reviewed

    Nomura, S., Sakamoto, H., Ishizuka, A., Shibuya, K.

    International Journal of Environmental Research and Public Health　18　(16)　8519-8519　2021/08/12

    Publisher: MDPI AG

    DOI： 10.3390/ijerph18168519 　

    ISSN： 1661-7827 1660-4601

    eISSN： 1660-4601

  162. Mobility Patterns in Different Age Groups in Japan during the COVID-19 Pandemic: a Small Area Time Series Analysis through March 2021 Peer-reviewed

    Shuhei Nomura, Yuta Tanoue, Daisuke Yoneoka, Stuart Gilmour, Takayuki Kawashima, Akifumi Eguchi, Hiroaki Miyata

    Journal of Urban Health　98　(5)　635-641　2021/08/11

    DOI： 10.1007/s11524-021-00566-7 　

    ISSN： 1099-3460

    eISSN： 1468-2869

  163. Effect of emergency declaration on mental health during the COVID-19 pandemic in Japan: A social network service-based difference-in-differences approach

    Akifumi Eguchi, Daisuke Yoneoka, Shoi Shi, Yuta Tanoue, Takayuki Kawashima, Shuhei Nomura, Koji Makiyama, Shinya Uryu, Masayuki Sawada, Yumi Kawamura, Shinichi Takayanagi, Stuart Gilmour, Hiroaki Miyata

    Science Progress　104　(3)　003685042110297-003685042110297　2021/08

    DOI： 10.1177/00368504211029793 　

    ISSN： 0036-8504

    eISSN： 2047-7163

  164. Suicide by gender and 10-year age groups during the COVID-19 pandemic vs previous five years in Japan: an analysis of national vital statistics International-journal Peer-reviewed

    Akifumi Eguchi, Shuhei Nomura, Stuart Gilmour, Nahoko Harada, Haruka Sakamoto, Peter Ueda, Daisuke Yoneoka, Yuta Tanoue, Takayuki Kawashima, Takehiko I. Hayashi, Yuzo Arima, Motoi Suzuki, Masahiro Hashizume

    Psychiatry Research　305　114173-114173　2021/08

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2021.114173 　

    ISSN： 0165-1781

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    Using daily vital statistics data from the Japanese Ministry of Health, Labour and Welfare, we provide the first weekly and age-group-specific estimates of the additional suicide burden during the COVID-19 pandemic in Japan by gender, from January through November 2020. Our results indicate that compared with the previous five years, suicide cases in 2020 in Japan have increased from late July to November for women in all age groups and for men in the 20-29 and 80+ years age group. Targeted interventions based on age and gender might be more effective in reducing suicide during the COVID-19 pandemic in Japan.

  165. Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Under-5 Mortality Collaborators

    The Lancet　398　(10303)　870-905　2021/08

    Publisher: Elsevier BV

    DOI： 10.1016/s0140-6736(21)01207-1 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  166. Hospital admission for type 2 diabetes mellitus under the Universal Coverage Scheme in Thailand: A time- and geographical-trend analysis, 2009–2016 International-journal Peer-reviewed

    Tanapat Laowahutanon, Haruyo Nakamura, Hisateru Tachimori, Shuhei Nomura, Tippawan Liabsuetrakul, Apiradee Lim, Petch Rawdaree, Netnapis Suchonwanich, Hiroyuki Yamamoto, Aya Ishizuka, Kenji Shibuya, Hiroaki Miyata, Virasakdi Chongsuvivatwong

    PLOS ONE　16　(7)　e0253434-e0253434　2021/07/01

    Publisher: Public Library of Science (PLoS)

    DOI： 10.1371/journal.pone.0253434 　

    eISSN： 1932-6203

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    <sec id="sec001"> <title>Background</title> Descriptive analyses of 2009–2016 were performed using the data of the Universal Coverage Scheme (UCS) which covers nearly 70 percent of the Thai population. The analyses described the time and geographical trends of nationwide admission rates of type 2 diabetes mellitus (T2DM) and its complications, including chronic kidney disease (CKD), myocardial infarction, cerebrovascular diseases, retinopathy, cataract, and diabetic foot amputation. </sec> <sec id="sec002"> <title>Methods and findings</title> The database of T2DM patients aged 15–100 years who were admitted between 2009 and 2016 under the UCS and that of the UCS population were retrieved for the analyses. The admitted cases of T2DM were extracted from the database using disease codes of principal and secondary diagnoses defined by the International Classification of Diseases 9th and 10th Revisions. The T2DM admission rates in 2009–2016 were the number of admissions divided by the number of the UCS population. The standardized admission rates (SARs)were further estimated in contrast to the expected number of admissions considering age and sex composition of the UCS population in each region. A linearly increased trend was found in T2DM admission rates from 2009 to 2016. Female admission rates were persistently higher than that of males. In 2016, an increase in the T2DM admission rates was observed among the older ages relative to that in 2009. Although the SARs of T2DM were generally higher in Bangkok and central regions in 2009, except that with CKD and foot amputation which had higher trends in northeastern regions, the geographical inequalities were fairly reduced by 2016. </sec> <sec id="sec003"> <title>Conclusion</title> Admission rates of T2DM and its major complications increased in Thailand from 2009 to 2016. Although the overall geographical inequalities in the SARs of T2DM were reduced in the country, further efforts are required to improve the health system and policies focusing on risk factors and regions to manage the increasing T2DM. </sec>

  167. Developing and validating regression models for predicting household consumption to introduce an equitable and sustainable health insurance system in Cambodia Peer-reviewed

    Haruyo Nakamura, Floriano Amimo, Siyan Yi, Sovannary Tuot, Tomoya Yoshida, Makoto Tobe, Md. Mizanur Rahman, Daisuke Yoneoka, Aya Ishizuka, Shuhei Nomura

    International Journal of Health Planning and Management　36　(6)　1-12　2021/07

    DOI： 10.1002/hpm.3269 　

    ISSN： 0749-6753

    eISSN： 1099-1751

  168. Umami: An Alternative Japanese Approach to Reducing Sodium While Enhancing Taste Desirability Peer-reviewed

    Shuhei Nomura, Aya Ishizuka, Shiori Tanaka, Daisuke Yoneoka, Hisayuki Uneyama, Kenji Shibuya

    Health　13　(06)　629-636　2021/06/05

    Publisher: Scientific Research Publishing, Inc.

    DOI： 10.4236/health.2021.136047 　

    ISSN： 1949-4998 1949-5005

    eISSN： 1949-5005

  169. Comparative risk assessment of non-communicable diseases by evacuation scenario– a retrospective study in the 7 years following the Fukushima Daiichi nuclear power plant accident International-journal Peer-reviewed

    Shuhei Nomura, Michio Murakami, Akihiko Ozaki, Toyoaki Sawano, Claire Leppold, Yoshitaka Nishikawa, Hiroaki Saito, Tomoyoshi Oikawa, Masaharu Tsubokura

    Global Health Action　14　(1)　1918886-1918886　2021/06/01

    Publisher: Informa UK Limited

    DOI： 10.1080/16549716.2021.1918886 　

    ISSN： 1654-9716

    eISSN： 1654-9880

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    Background: As a result of the Fukushima Daiichi nuclear power plant accident, many residents evacuated and were exposed to changes in their living environment and socioeconomic status, and to persistent stressors. Past studies have suggested the potential for these circumstances to contribute to long-term changes to population health.Objective: The objective of this study was to gain a better understanding of long-term health effects of evacuation, by evaluating the risk of non-communicable diseases among evacuees from Minamisoma City (one of the closest municipalities to the power plant) until 2017.Methods: The study evaluated data from annual health check-ups for residents aged 40-74 years covered by National Health Insurance (who are largely self-employed) from 2010 to 2017 administered by Minamisoma City. Diabetes, hyperlipidemia, and hypertension were defined from the results of blood sampling. Annual changes in age-adjusted prevalence were estimated by evacuation scenario. We also performed an inverse-probability weighting (IPW) analysis to adjust for baseline covariates in 2010 and estimated the differences in the risk of diabetes, hyperlipidemia, and hypertension by evacuation scenario as of the 2017 health check-up in reference to the no-evacuation group.Results: A total of 1,837 individuals were considered in this study. Regardless of evacuation scenario, there was statistical evidence suggesting an upward and a downward trend in diabetes and hypertension from 2010 to 2017, respectively, while hyperlipidemia showed no remarkable change. IPW analyses demonstrated that disease risks in 2017 did not differ significantly among people with different evacuation scenarios.Conclusions: Region-specific factors played an important role in the health effects of the evacuation. Our findings have important implications for the need of an assessment of the health effects of evacuations in more localized manner. Further research in this area will strengthen the communities' preparedness for future disasters that require mass evacuation.

  170. Assessing factors associated with tb awareness in nepal: A national and subnational study Peer-reviewed

    Iwaki, Y., Rauniyar, S.K., Nomura, S., Huang, M.

    International Journal of Environmental Research and Public Health　18　(10)　5124-5124　2021/05/12

    Publisher: {MDPI} {AG}

    DOI： 10.3390/ijerph18105124 　

    ISSN： 1661-7827 1660-4601

    eISSN： 1660-4601

  171. Progress towards the development of research agenda and the launch of knowledge hub: The who thematic platform for health emergency and disaster risk management research network (health edrm rn) Peer-reviewed

    Kayano, R., Nomura, S., Abrahams, J., Huda, Q., Chan, E.Y.Y., Murray, V.

    International Journal of Environmental Research and Public Health　18　(9)　4959　2021/05/07

    DOI： 10.3390/ijerph18094959 　

    ISSN： 1661-7827 1660-4601

  172. Association between Daily Living Walking Speed and Lifestyle and Physiological Factors in Older, Female Pokémon GO Players Peer-reviewed

    Shuhei Nomura, Akifumi Eguchi, Daisuke Yoneoka, Takayuki Kawashima, Norimichi Hirahara, Yuta Tanoue, Stuart Gilmour, Hisateru Tachimori, Hiroaki Miyata

    Health　13　(05)　564-573　2021/05

    Publisher: Scientific Research Publishing, Inc.

    DOI： 10.4236/health.2021.135042 　

    ISSN： 1949-4998

    eISSN： 1949-5005

  173. National genotype prevalence and age distribution of human papillomavirus from infection to cervical cancer in Japanese women: a systematic review and meta-analysis protocol International-journal Peer-reviewed

    Matthew Palmer, Kota Katanoda, Eiko Saito, Cecilia Acuti Martellucci, Shiori Ostuki, Shuhei Nomura, Erika Ota, Julia M. L. Brotherton, Jane Hocking

    Systematic Reviews　10　(135)　135-135　2021/05

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s13643-021-01686-6 　

    eISSN： 2046-4053

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    <title>Abstract</title><sec> <title>Background</title> Despite prophylactic human papillomavirus (HPV) vaccination being a safe, effective and cost-effective public health intervention for the prevention of cervical cancer, the HPV vaccine is not actively recommended or promoted by the Ministry of Health Labour and Welfare in Japan. With already very low levels of cervical screening below 30%, and vaccination levels that are below levels that award any population effect at 0.3% of the eligible population, cervical cancer mortality is higher than other similar high-income countries at 4.4/100,000 (2900) deaths per year in 2015. There is limited population-based or nationally representative data for HPV genotype distribution in Japan, thus making an assessment of the burden of vaccine-preventable cervical cancer difficult. Therefore, this systematic review and meta-analysis aims to determine the HPV genotype prevalence and age distribution of HPV infection in women with a cytological or histological diagnosis of normal through cervical cancer in Japan. We anticipate this information will guide and enhance programme interventions to reduce vaccine-preventable cervical cancer mortality in Japan. </sec><sec> <title>Methods</title> PubMed, Embase and the Japan Medical Abstract Society Database will be searched from the date of establishment to March 2021 to identify original research articles that report the prevalence of HPV genotypes in Japanese women with normal cervical cytology, low grade, high grade and cancerous cervical lesions. No exclusion criteria relating to language or publication date will be applied. The quality of the studies will be assessed using the Joanna Briggs checklist for prevalence studies. Randomised control trials, cohort studies, cross-sectional and prevalence studies will be considered eligible. Study findings will be combined using a traditional random-effects or fixed-effects meta-analysis to summarise pooled prevalence and 95% confidence intervals depending on heterogeneity. Subgroup analyses and meta-regression will be used to investigate heterogeneity, and sensitivity analyses will be conducted to assess the robustness of the findings. </sec><sec> <title>Discussion</title> To our knowledge, this is the first systematic review protocol that includes both Japanese and English peer-reviewed articles for the determination of genotype-specific HPV prevalence in cytological or histological confirmed normal cervical specimens, low- and high-grade intraepithelial lesions and cervical cancers by age in Japan. We anticipate this information will guide and enhance programme interventions to reduce vaccine-preventable cervical cancer mortality in Japan. </sec><sec> <title>Systematic review registration</title> PROSPERO CRD42018117596 </sec>

  174. Overall health information exposure, its barriers and impacts on attitude toward healthcare among cancer patients. The long-term aftermath of the 2011 triple disaster in Fukushima, Japan: A single institution cross-sectional study International-journal Peer-reviewed

    Akihiko Ozaki, Michio Murakami, Shuhei Nomura, Toyoaki Sawano, Masaharu Tsubokura, Kyoko Ono, Yoshitake Takebayashi, Manabu Tsukada, Kazue Yamaoka, Yoshinori Nakata, Hiromichi Ohira

    Health Informatics Journal　27　(2)　146045822199642-146045822199642　2021/04

    Publisher: SAGE Publications

    DOI： 10.1177/1460458221996420 　

    ISSN： 1460-4582

    eISSN： 1741-2811

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    Disasters can hinder access to health information among cancer patients. However, little is known regarding overall health information exposure (HIE), its barriers and its impacts on attitudes toward healthcare among cancer patients in the long-term aftermath of disasters. The aims of this study were threefold: assess the extent of HIE; identify associations between family composition and a non-engagement with HIE; and examine the effects of HIE on attitudes toward healthcare among local cancer patients—5 years after the 2011 triple disaster (earthquake, tsunami, and nuclear disaster) in Fukushima, Japan. We conducted self-administered surveys with all cancer and non-cancer surgery department outpatients at Minamisoma Municipal General Hospital (MMGH), Minamisoma City, from October 2016 to January 2017. In total, 404 patients (263 cancer patients and 141 non-cancer patients) voluntarily participated in the study. The results revealed that a regular level of HIE occurred among 90.5% of the cancer patients. In cancer patients, family composition was not significantly associated with HIE, and HIE was not associated with attitude toward healthcare. In conclusion, most cancer patients visiting the MMGH surgical department were regularly engaged in HIE.

  175. Expected Scopes of Health Emergency and Disaster Risk Management (Health EDRM): Report on the Expert Workshop at the Annual Conference for the Japanese Association for Disaster Medicine 2020 Peer-reviewed

    Shuhei Nomura, Ryoma Kayano, Shinichi Egawa, Nahoko Harada, Yuichi Koido

    International Journal of Environmental Research and Public Health　18　(9)　4447-4447　2021/04

    Publisher: MDPI AG

    DOI： 10.3390/ijerph18094447 　

    eISSN： 1660-4601

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    The World Health Organization (WHO) and its partners established the WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (HEALTH EDRM RN) in 2016 to respond to the increasing burden of recent health emergencies and disasters. The mission of the HEALTH EDRM RN, whose secretariat is located at the WHO Kobe Centre (WKC), is to promote global research collaboration and strengthen research activities to inform policies and programs by generating new evidence to manage health risks associated with all types of emergencies and disasters. With the strong support and involvement of all WHO regional offices, the HEALTH EDRM RN now works with more than 200 global experts and partners to pursue its mission. The first Core Group Meetings of the HEALTH EDRM RN were held on 17–18 October 2019, and concluded with the HEALTH EDRM RN-activity priorities to (1) promote operational research to better meet the needs of emergency- and disaster-exposed individuals and communities and efforts to translate science to policies and programs and (2) strengthen the research capacity of the Health EDRM community. In collaboration with the Japanese Association for Disaster Medicine, the WKC held a workshop on 21 February 2020, in which 20 Japanese experts from different research fields participated to further discuss these two points. This paper summarizes the discussion at the workshop.

  176. How do Japanese rate the severity of different diseases and injuries?—an assessment of disability weights for 231 health states by 37,318 Japanese respondents International-journal Peer-reviewed

    Shuhei Nomura, Yoshiko Yamamoto, Daisuke Yoneoka, Juanita A. Haagsma, Joshua A. Salomon, Peter Ueda, Rintaro Mori, Damian Santomauro, Theo Vos, Kenji Shibuya

    Population Health Metrics　19　(21)　21-21　2021/04

    DOI： 10.1186/s12963-021-00253-4 　

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    BACKGROUND: Disability weights (DWs) are weight factors that reflect the severity of health states for estimates of disability-adjusted life years. A new set of global DWs was published for the Global Burden of Diseases and Injuries (GBD) 2013 study, which relied on sampling from various world regions, but included little data for countries in East Asia. This study aimed to measure DWs in Japan using comparable methods, and compare the results with previous estimates from the GBD 2013 DW study. METHODS: We conducted a web-based survey in 2019 to estimate DWs for 231 health states for the Japanese population. The survey included five new health states but otherwise followed the method of the GBD DW measurement study. The survey consisted of 15 paired comparison (PC) questions and 3 population health equivalence questions (PHE) per respondent. We analyzed PC data using probit regression and rescaled results to DW units between 0 (equivalent to full health) and 1 (equivalent to death). FINDINGS: We considered 37,318 nationally representative respondents. The values of the resulting DWs ranged from 0.707 (95% uncertainty interval (UI) 0.527-0.842) for spinal cord injury at neck level (untreated) to 0.004 (UI 0.001-0.009) for mild anemia. High correlation between Japanese DW and GBD 2013 DW was observed, but there was considerable disagreement. Out of 226 comparable health states, 55 (24.3%) showed more than a factor-of-two difference, of which 41 (74.6%) had a higher value in Japanese DW. Many of the health states with higher DW in the Japan study were injuries, including amputation and fracture, and hearing and vision loss, while mental, behavioral, and substance use disorders generally tended to be lower. CONCLUSIONS: This study has created an empirical basis for assessment of Japanese DWs of health status. The findings from this study based on the Japanese population suggest that there might be contextual differences in rating the severity of health states compared to previous surveys conducted elsewhere.

  177. Projections of disability-adjusted life years for major diseases due to a change in vegetable intake in 2017–2040 in Japan International-journal Peer-reviewed

    Shiori Tanaka, Daisuke Yoneoka, Aya Ishizuka, Peter Ueda, Keiji Nakamura, Hisayuki Uneyama, Naoki Hayashi, Kenji Shibuya, Shuhei Nomura

    BMC Public Health　21　(770)　770-770　2021/04

    DOI： 10.1186/s12889-021-10772-2 　

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    BACKGROUND: Low vegetable intake is one of the key dietary risk factors known to be associated with a range of health problems, including cardiovascular diseases (CVDs), cancer, and diabetes and kidney diseases (DKDs). Using data from Japan's National Health and Nutrition Surveys and the Global Burden of Diseases study in 2017, this study aimed to forecast the impact of change in vegetable intake on disability-adjusted life years (DALYs) between 2017 and 2040 for three diseases. METHODS: We generated a three-component model of cause-specific DALYs, including changes in major behavioural and metabolic risk predictors, the socio-demographic index and an autoregressive integrated moving average model to project future DALY rates for 2017-2040 using the data between 1990 and 2016. Data on Vegetable consumption and risk predictors, and DALY rate were obtained from Japan's National Health and Nutrition Surveys and the Global Burden of Diseases Study in 2017. We also modelled three scenarios of better, moderate and worse cases to evaluate the impact of change in vegetable consumption on the DALY rates for three diseases (CVDs, cancer, and DKDs). RESULTS: Projected mean vegetable intake in the total population showed a decreasing trend through 2040 to 237.7 g/day. A significant difference between the reference scenario and the better case scenario was observed with un-overlapped 95% prediction intervals of DALY rates in females aged 20-49 years (- 8.0%) for CVDs, the total population for cancer (- 5.6%), and in males (- 8.2%) and females (- 13.7%) for DKDs. CONCLUSIONS: Our analysis indicates that increased vegetable consumption would have a significant reduction in the burdens of CVDs, cancer and DKDs in Japan. By estimating the disease burden attributable to low vegetable intake under different scenarios of future vegetable consumption, our study can inform the design of targeted interventions for public health challenges.

  178. Military coup during COVID-19 pandemic and health crisis in Myanmar International-journal Peer-reviewed

    Su Myat Han, Kaung Suu Lwin, Khin Thet Swe, Stuart Gilmour, Shuhei Nomura

    BMJ Global Health　6　(4)　e005801-e005801　2021/04

    Publisher: BMJ

    DOI： 10.1136/bmjgh-2021-005801 　

    eISSN： 2059-7908

  179. Trends in suicide in Japan by gender during the COVID-19 pandemic, through December 2020 Peer-reviewed

    Shuhei Nomura, Takayuki Kawashima, Nahoko Harada, Daisuke Yoneoka, Yuta Tanoue, Akifumi Eguchi, Stuart Gilmour, Yumi Kawamura, Masahiro Hashizume

    Psychiatry Research　300　113913-113913　2021/04

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2021.113913 　

    ISSN： 0165-1781

    eISSN： 1872-7123

  180. COVID-19 and Heat Illness in Tokyo, Japan: Implications for the Summer Olympic and Paralympic Games in 2021. International-journal

    Kazuki Shimizu, Stuart Gilmour, Hiromi Mase, Phuong Mai Le, Ayaka Teshima, Haruka Sakamoto, Shuhei Nomura

    International journal of environmental research and public health　18　(7)　2021/03/31

    DOI： 10.3390/ijerph18073620 　

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    The 2020 summer Olympic and Paralympic Games in Tokyo were postponed to July-September 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. While COVID-19 has emerged as a monumental health threat for mass gathering events, heat illness must be acknowledged as a potentially large health threat for maintaining health services. We examined the number of COVID-19 admissions and the Tokyo rule for emergency medical care, in Tokyo, from March to September 2020, and investigated the weekly number of emergency transportations due to heat illness and weekly averages of the daily maximum Wet Bulb Globe Temperature (WBGT) in Tokyo in the summer (2016-2020). The peak of emergency transportations due to heat illness overlapped the resurgence of COVID-19 in 2020, and an increase of heat illness patients and WBGT has been observed. Respect for robust science is critical for the decision-making process of mass gathering events during the pandemic, and science-based countermeasures and implementations for COVID-19 will be warranted. Without urgent reconsiderations and sufficient countermeasures, the double burden of COVID-19 and heat-related illnesses in Tokyo will overwhelm the healthcare provision system, and maintaining essential health services will be challenging during the 2021 summer Olympic and Paralympic Games.

  181. Trends in Healthcare Access in Japan during the First Wave of the COVID-19 Pandemic, up to June 2020 International-journal Peer-reviewed

    Koji Makiyama, Takayuki Kawashima, Shuhei Nomura, Akifumi Eguchi, Daisuke Yoneoka, Yuta Tanoue, Yumi Kawamura, Haruka Sakamoto, Stuart Gilmour, Shoi Shi, Kentaro Matsuura, Shinya Uryu, Masahiro Hashizume

    International Journal of Environmental Research and Public Health　18　(6)　3271-3271　2021/03/22

    Publisher: MDPI AG

    DOI： 10.3390/ijerph18063271 　

    eISSN： 1660-4601

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    We evaluated the impact of the new coronavirus disease (COVID-19) on healthcare access in Japan in terms of the number of outpatients and hospitalized patients as well as the length of hospital stays, during the first wave of the pandemic, up to June 2020. This observational study evaluated the monthly average number of outpatients per day at hospitals, the average number of hospitalized patients per day, and the average length of hospital stays per patient, from December 2010 to June 2020, using the hospital reports data, which are open aggregated data on the utilization of hospitals from the Ministry of Health, Labour and Welfare. These numbers were compared with those from the same period of previous years, using a quasi-Poisson regression model. We found a nationwide decrease in the number of outpatients in general hospitals and hospitalized patients, particularly in long-term care beds in Japan, as well as the excess length of hospital stays among psychiatric care patients during the first wave of the COVID-19. This limited access to healthcare demonstrated the importance of the long-term health monitoring of vulnerable populations and the need for urgent management support to healthcare facilities in preparation for possible prolonged pandemics in the future.

  182. Excess All-Cause Deaths during Coronavirus Disease Pandemic, Japan, January–May 20201 International-journal Peer-reviewed

    Takayuki Kawashima, Shuhei Nomura, Yuta Tanoue, Daisuke Yoneoka, Akifumi Eguchi, Chris Fook Sheng Ng, Kentaro Matsuura, Shoi Shi, Koji Makiyama, Shinya Uryu, Yumi Kawamura, Shinichi Takayanagi, Stuart Gilmour, Hiroaki Miyata, Tomimasa Sunagawa, Takuri Takahashi, Yuuki Tsuchihashi, Yusuke Kobayashi, Yuzo Arima, Kazuhiko Kanou, Motoi Suzuki, Masahiro Hashizume

    Emerging Infectious Diseases　27　(3)　789-795　2021/03

    Publisher: Centers for Disease Control and Prevention (CDC)

    DOI： 10.3201/eid2703.203925 　

    ISSN： 1080-6040

    eISSN： 1080-6059

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    To provide insight into the mortality burden of coronavirus disease (COVID-19) in Japan, we estimated the excess all-cause deaths for each week during the pandemic, January-May 2020, by prefecture and age group. We applied quasi-Poisson regression models to vital statistics data. Excess deaths were expressed as the range of differences between the observed and expected number of all-cause deaths and the 95% upper bound of the 1-sided prediction interval. A total of 208-4,322 all-cause excess deaths at the national level indicated a 0.03%-0.72% excess in the observed number of deaths. Prefecture and age structure consistency between the reported COVID-19 deaths and our estimates was weak, suggesting the need to use cause-specific analyses to distinguish between direct and indirect consequences of COVID-19.

  183. Development and Worsening of Diabetes Among Adults Aged Over 40 Years: A 6-Year Follow-Up Study of 140,000 People in Japan – The Shizuoka Study

    Nomura S, Sakamoto H, Rauniyar SK, Shimada K, Yamamoto H, Kohsaka S, Ichihara N, Kumamaru H, Miyata H

    2021/02

    DOI： 10.21203/rs.3.rs-242898/v1 　

  184. Human papillomavirus vaccine effectiveness within a cervical cancer screening programme: cohort study

    C. Acuti Martellucci, S. Nomura, D. Yoneoka, P. Ueda, J. M.L. Brotherton, K. Canfell, M. Palmer, L. Manzoli, P. Giorgi Rossi, A. De Togni, C. Palmonari, A. Califano, E. Saito, M. Hashizume, K. Shibuya

    BJOG: An International Journal of Obstetrics and Gynaecology　128　(3)　532-539　2021/02

    DOI： 10.1111/1471-0528.16429 　

    ISSN： 1470-0328

    eISSN： 1471-0528

  185. Assessing the regional impact of Japan’s COVID-19 state of emergency declaration: a population-level observational study using social networking services International-journal Peer-reviewed

    Daisuke Yoneoka, Shoi Shi, Shuhei Nomura, Yuta Tanoue, Takayuki Kawashima, Akifumi Eguchi, Kentaro Matsuura, Koji Makiyama, Shinya Uryu, Keisuke Ejima, Haruka Sakamoto, Toshibumi Taniguchi, Hiroyuki Kunishima, Stuart Gilmour, Hiroshi Nishiura, Hiroaki Miyata

    BMJ Open　11　(2)　e042002-e042002　2021/02

    Publisher: BMJ

    DOI： 10.1136/bmjopen-2020-042002 　

    ISSN： 2044-6055

    eISSN： 2044-6055

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    <sec><title>Objective</title>On 7 April 2020, the Japanese government declared a state of emergency in response to the novel coronavirus outbreak. To estimate the impact of the declaration on regional cities with low numbers of COVID-19 cases, large-scale surveillance to capture the current epidemiological situation of COVID-19 was urgently conducted in this study. </sec><sec><title>Design</title>Cohort study. </sec><sec><title>Setting</title>Social networking service (SNS)-based online survey conducted in five prefectures of Japan: Tottori, Kagawa, Shimane, Tokushima and Okayama. </sec><sec><title>Participants</title>127 121 participants from the five prefectures surveyed between 24 March and 5 May 2020. </sec><sec><title>Interventions</title>An SNS-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was launched. It asks questions regarding postcode, personal information, preventive actions, and current and past symptoms related to COVID-19. </sec><sec><title>Primary and secondary outcome measures</title>Empirical Bayes estimates of age-sex-standardised incidence rate (EBSIR) of symptoms and the spatial correlation between the number of those who reported having symptoms and the number of COVID-19 cases were examined to identify the geographical distribution of symptoms in the five prefectures. </sec><sec><title>Results</title>97.8% of participants had no subjective symptoms. We identified several geographical clusters of fever with significant spatial correlation (r=0.67) with the number of confirmed COVID-19 cases, especially in the urban centres of prefectural capital cities. </sec><sec><title>Conclusions</title>Given that there are still several high-risk areas measured by EBSIR, careful discussion on which areas should be reopened at the end of the state of emergency is urgently required using real-time SNS system to monitor the nationwide epidemic. </sec>

  186. Impact of domestic travel restrictions on transmission of COVID-19 infection using public transportation network approach International-journal Peer-reviewed

    Yayoi Murano, Ryo Ueno, Shoi Shi, Takayuki Kawashima, Yuta Tanoue, Shiori Tanaka, Shuhei Nomura, Hiromichi Shoji, Toshiaki Shimizu, Huy Nguyen, Hiroaki Miyata, Stuart Gilmour, Daisuke Yoneoka

    Scientific Reports　11　(1)　3109-3109　2021/02

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1038/s41598-021-81806-3 　

    eISSN： 2045-2322

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    <title>Abstract</title>The international spread of COVID-19 infection has attracted global attention, but the impact of local or domestic travel restriction on public transportation network remains unclear. Passenger volume data for the domestic public transportation network in Japan and the time at which the first confirmed COVID-19 case was observed in each prefecture were extracted from public data sources. A survival approach in which a hazard was modeled as a function of the closeness centrality on the network was utilized to estimate the risk of importation of COVID-19 in each prefecture. A total of 46 prefectures with imported cases were identified. Hypothetical scenario analyses indicated that both strategies of locking down the metropolitan areas and restricting domestic airline travel would be equally effective in reducing the risk of importation of COVID-19. While caution is necessary that the data were limited to June 2020 when the pandemic was in its initial stage and that no other virus spreading routes have been considered, domestic travel restrictions were effective to prevent the spread of COVID-19 on public transportation network in Japan. Instead of lockdown that might seriously damage the economy, milder travel restrictions could have the similar impact on controlling the domestic transmission of COVID-19.

  187. Hypertensive disorders of pregnancy by oocyte donation pregnancy in Japanese women aged 40 years or older: a single-center retrospective cohort study Peer-reviewed

    Gekka, Y., Adachi, T., Oi, R., Nakayama, S., Kawana, Y., Takeda, Y., Nomura, S., Ozaki, A., Tanimoto, T., Sakamoto, H., Yamashita, T.

    Hypertension in Pregnancy　40　(1)　36-44　2021/01/02

    Publisher: Informa UK Limited

    DOI： 10.1080/10641955.2020.1861461 　

    ISSN： 1064-1955 1525-6065

    eISSN： 1525-6065

  188. Trends in emergency transportation due to heat illness under the new normal lifestyle in the COVID-19 era, in Japan and 47 prefectures International-journal Peer-reviewed

    Shinya Uryu, Yuta Tanoue, Shuhei Nomura, Kentaro Matsuura, Koji Makiyama, Takayuki Kawashima, Daisuke Yoneoka, Akifumi Eguchi, Yumi Kawamura, Stuart Gilmour, Haruka Sakamoto, Kazuki Shimizu, Chris Fook Sheng Ng, Masahiro Hashizume

    Science of The Total Environment　768　144723-144723　2021/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.scitotenv.2020.144723 　

    ISSN： 0048-9697

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    In Japan, in response to the spread of the new coronavirus disease (COVID-19), a 'new normal' in the era of the COVID-19 was proposed by the government, which calls for thorough wearing of masks as an infection control measure in the era of the COVID-19, but related heat illness has been a great concern this summer. We applied quasi-Poisson regression models to the daily number of emergency transportations due to heat illness from 2008 to 2020 from the Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications, Japan, to estimate the expected weekly number of emergency transportations from heat illness, with adjustment for their long-term trend and the weather conditions, including temperatures. We found that, at the national level, the number of heat illness emergency transports did not significantly increase or decrease from the annual trend in 2020. By prefecture, on the other hand, there were some prefectures in which the number of heat illness emergency transports was less than the average year, and most of them were in the week of August 10-16. By age group, the number of heat illness emergency transports in the 0-17 and 18-64 age groups was particularly low in some prefectures, and by severity, those in mild cases was particularly low. A caution is necessary that there is a possibility that a decrease in cases possibly associated with COVID-19 measures, such as, outdoor activity restrictions at schools/universities and cancellation of public events, may offset the possible increase in heat illness cases occurring elsewhere associated with wearing masks. Given that the end of the COVID-19 pandemic is not expected yet, continuous and appropriate awareness-raising activities to prevent heat-related illness remain important.

  189. Tracking sectoral allocation of official development assistance: a comparative study of the 29 Development Assistance Committee countries, 2011–2018 Peer-reviewed

    Nomura, S., Sakamoto, H., Ishizuka, A., Shimizu, K., Shibuya, K.

    Global Health Action　14　(1)　1903222-1903222　2021/01/01

    Publisher: Informa {UK} Limited

    DOI： 10.1080/16549716.2021.1903222 　

    ISSN： 1654-9880

    eISSN： 1654-9880

  190. Trends in suicide in Japan by gender during the COVID-19 pandemic, up to September 2020 International-journal Peer-reviewed

    Shuhei Nomura, Takayuki Kawashima, Daisuke Yoneoka, Yuta Tanoue, Akifumi Eguchi, Stuart Gilmour, Yumi Kawamura, Nahoko Harada, Masahiro Hashizume

    Psychiatry Research　295　113622-113622　2021/01

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2020.113622 　

    ISSN： 0165-1781

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    Suicide is an extreme consequence of the psychological burden associated with the coronavirus disease 2019 (COVID-19) counter-measures. A quasi-Poisson regression was applied to monthly suicide mortality data obtained from the National Police Agency to estimate the gender-specific excess/exiguous suicide deaths during the COVID-19 pandemic in Japan up to September 2020. We found excess suicide deaths among women in July, August and September, but not among men. Our results indicate the importance of COVID-19 related suicide prevention, especially for women. Timely access to mental health care and financial and social support is urgently needed, as is optimal treatment for mental illness.

  191. Ongoing debate on data governance principles for achieving Universal Health Coverage: a proposal to post-G20 Osaka Summit meetings Peer-reviewed

    Nomura, S., Sakamoto, H., Ishizuka, A., Katsuma, Y., Akashi, H., Miyata, H.

    Global Health Action　13　(1)　1859822-1859822　2020/12/31

    Publisher: Informa {UK} Limited

    DOI： 10.1080/16549716.2020.1859822 　

    ISSN： 1654-9880

    eISSN： 1654-9880

  192. Reduced burden from major diseases due to an increase in vegetable intake in Japan: projections of disability-adjusted life years, 2017-2040

    Tanaka S, Yoneoka D, Ishizuka A, Ueda P, Nakamura K, Uneyama H, Hayashi N, Shibuya K, Nomura S

    2020/12

    DOI： 10.21203/rs.3.rs-122329/v1 　

  193. Trends in deaths from road injuries during the COVID-19 pandemic in Japan, January to September 2020 International-journal Peer-reviewed

    Shuhei Nomura, Takayuki Kawashima, Daisuke Yoneoka, Yuta Tanoue, Akifumi Eguchi, Stuart Gilmour, Masahiro Hashizume

    Injury Epidemiology　7　(66)　66-66　2020/12

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s40621-020-00294-7 　

    eISSN： 2197-1714

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    <title>Abstract</title><sec> <title>Background</title> In Japan, the latest estimates of excess all-cause deaths through January to July 2020 showed that the overall (direct and indirect) mortality burden from the Coronavirus Disease 2019 (COVID-19) in Japan was relatively low compared to Europe and the United States. However, consistency between the reported number of COVID-19 deaths and excess all-cause deaths was limited across prefectures, suggesting the necessity of distinguishing the direct and indirect consequences of COVID-19 by cause-specific analysis. To examine whether deaths from road injuries decreased during the COVID-19 pandemic in Japan, consistent with a possible reduction of road transport activity connected to Japan’s state of emergency declaration, we estimated the exiguous deaths from road injuries in each week from January to September 2020 by 47 prefectures. </sec><sec> <title>Methods</title> To estimate the expected weekly number of deaths from road injuries, a quasi-Poisson regression was applied to daily traffic fatalities data obtained from Traffic Accident Research and Data Analysis, Japan. We set two thresholds, point estimate and lower bound of the two-sided 95% prediction interval, for exiguous deaths, and report the range of differences between the observed number of deaths and each of these thresholds as exiguous deaths. </sec><sec> <title>Results</title> Since January 2020, in a few weeks the observed deaths from road injuries fell below the 95% lower bound, such as April 6–12 (exiguous deaths 5–21, percent deficit 2.82–38.14), May 4–10 (8–23, 21.05–43.01), July 20–26 (12–29, 30.77–51.53), and August 3–9 (3–20, 7.32–34.41). However, those less than the 95% lower bound were also observed in weeks in the previous years. </sec><sec> <title>Conclusions</title> The number of road traffic fatalities during the COVID-19 pandemic in Japan has decreased slightly, but not significantly, in several weeks compared with the average year. This suggests that the relatively small changes in excess all-cause mortality observed in Japan during the COVID-19 pandemic could not be explained simply by an offsetting reduction in traffic deaths. Considering a variety of other indirect effects, evaluating an independent, unbiased measure of COVID-19-related mortality burden could provide insight into the design of future broad-based infectious disease counter-measures and offer lessons to other countries. </sec>

  194. Digitization of the approach to food and nutrition respecting individual health values Peer-reviewed

    Nomura, S., Miyata, H.

    Nutrition Reviews　78　(Supplement_3)　46-48　2020/11/30

    Publisher: Oxford University Press (OUP)

    DOI： 10.1093/nutrit/nuaa073 　

    ISSN： 0029-6643 1753-4887

    eISSN： 1753-4887

  195. Prediction of disability-adjusted life years for diseases due to low fruit intake in 2017–2040 in Japan International-journal Peer-reviewed

    Daisuke Yoneoka, Shuhei Nomura, Shiori Tanaka, Aya Ishizuka, Ueda Peter, Santosh Kumar Rauniyar, Keiji Nakamura, Hisayuki Uneyama, Naoki Hayashi, Kenji Shibuya

    Public Health Nutrition　24　(10)　1-11　2020/11/13

    Publisher: Cambridge University Press (CUP)

    DOI： 10.1017/s1368980020004541 　

    ISSN： 1368-9800

    eISSN： 1475-2727

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    <title>Abstract</title> <sec id="S1368980020004541_as1"> <title>Objective:</title> The current study aimed to predict disability-adjusted life years (DALY) rate in Japan through 2040 with plausible future scenarios of fruit intake for neoplasms, cardiovascular diseases (CVD) and diabetes and kidney diseases (DKD). </sec> <sec id="S1368980020004541_as2"> <title>Design:</title> Data from National Health and Nutrition Surveys and the Global Burden of Diseases study in 2017 were used. We developed an autoregressive integrated moving average model with four future scenarios. Reference scenario maintains the current trend. Best scenario assumes that the goal defined in Health Japan 21 is achieved in 2023 and is kept constant afterwards. Moderate scenario assumes that the goal is achieved in 2040. Constant scenario applies the same proportion of 2016 for the period between 2017 and 2040. </sec> <sec id="S1368980020004541_as3"> <title>Setting:</title> DALY rates in Japan were predicted for the period between 2017 and 2040. </sec> <sec id="S1368980020004541_as4"> <title>Participants:</title> Population aged more than than 20 years old. </sec> <sec id="S1368980020004541_as5"> <title>Results:</title> In our reference forecast, the DALY rates in all-ages group were projected to be stable for CVD and continue increasing for neoplasms and DKD. Age group-specific DALY rates for these three disease groups were forecasted to decrease, with some exceptions. Among men aged 20–49 years, DALY attributable to CVD differed substantially between the scenarios, implying that there is a significant potential for reducing the burden of CVD by increasing fruit intake at the population level. </sec> <sec id="S1368980020004541_as6"> <title>Conclusions:</title> Our scenario analysis shows that higher fruit intake is associated with lower disease burden in Japan. Further research is required to assess which policies and interventions can be used to achieve an increase in fruit intake as modelled in the scenarios of the current study. </sec>

  196. The herbivore’s dilemma: Trends in and factors associated with heterosexual relationship status and interest in romantic relationships among young adults in Japan—Analysis of national surveys, 1987–2015 International-journal Peer-reviewed

    Cyrus Ghaznavi, Haruka Sakamoto, Shuhei Nomura, Anna Kubota, Daisuke Yoneoka, Kenji Shibuya, Peter Ueda

    PLOS ONE　15　(11)　e0241571-e0241571　2020/11/09

    Publisher: Public Library of Science (PLoS)

    DOI： 10.1371/journal.pone.0241571 　

    eISSN： 1932-6203

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    <sec id="sec001"> <title>Background</title> It has been suggested that an increasing proportion of young adults in Japan have lost interest in romantic relationships, a phenomenon termed “herbivorization”. We assessed trends in heterosexual relationship status and self-reported interest in heterosexual romantic relationships in nationally representative data. </sec> <sec id="sec002"> <title>Methods</title> We used data from seven rounds of the National Fertility Survey (1987–2015) and included adults aged 18–39 years (18–34 years in the 1987 survey; sample size 11,683–17,675). Current heterosexual relationship status (married; unmarried but in a relationship; single) was estimated by sex, age group and survey year, with singles further categorized into those reporting interest vs. no interest in heterosexual romantic relationships. Information about same-sex relationships were not available. </sec> <sec id="sec003"> <title>Results</title> Between 1992 and 2015, the age-standardized proportion of 18-39-year-old Japanese adults who were single had increased steadily, from 27.4 to 40.7% among women and from 40.3 to 50.8% among men. This increase was largely driven by decreases in the proportion of married women aged 25–39 years and men aged 30–39 years, while those in a relationship had increased only slightly for women and remained stable for men. By 2015, the proportion of single women was 30.2% in those aged 30–34 years and 24.4% in those aged 35–39 years. The corresponding numbers for men were 39.3% and 32.4%. Around half of the singles (21.4% of all women and 25.1% of all men aged 18–39 years) reported that they had no interest in heterosexual romantic relationships. Single women and men who reported no interest in romantic relationships had lower income and educational levels and were less likely to have regular employment compared to those who reported such an interest. </sec> <sec id="sec004"> <title>Conclusions</title> In this analysis of heterosexual relationships in nationally representative data from Japan, singlehood among young adults had steadily increased over the last three decades. In 2015 around one in four women and one in three men in their thirties were unmarried and not in a heterosexual relationship. Half of the singles reported no interest in romantic relationships and these women and men had lower income and educational levels and were less likely to have regular employment. </sec>

  197. Trend change of the transmission route of COVID-19–related symptoms in Japan

    A. Eguchi, D. Yoneoka, S. Shi, Y. Tanoue, T. Kawashima, S. Nomura, K. Matsuura, K. Makiyama, K. Ejima, S. Gilmour, H. Nishiura, H. Miyata

    Public Health　187　157-160　2020/10

    Publisher: Elsevier BV

    DOI： 10.1016/j.puhe.2020.08.020 　

    ISSN： 0033-3506

  198. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Demographics Collaborators

    The Lancet　396　(10258)　1160-1203　2020/10

    DOI： 10.1016/s0140-6736(20)30977-6 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  199. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Risk Factors Collaborators

    The Lancet　396　(10258)　1223-1249　2020/10

    DOI： 10.1016/s0140-6736(20)30752-2 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  200. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Diseases and Injuries Collaborators

    The Lancet　396　(10258)　1204-1222　2020/10

    DOI： 10.1016/s0140-6736(20)30925-9 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  201. Five insights from the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Viewpoint Collaborators

    The Lancet　396　(10258)　1135-1159　2020/10

    DOI： 10.1016/s0140-6736(20)31404-5 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  202. Large-scale epidemiological monitoring of the COVID-19 epidemic in Tokyo Peer-reviewed

    Daisuke Yoneoka, Yuta Tanoue, Takayuki Kawashima, Shuhei Nomura, Shoi Shi, Akifumi Eguchi, Keisuke Ejima, Toshibumi Taniguchi, Haruka Sakamoto, Hiroyuki Kunishima, Stuart Gilmour, Hiroshi Nishiura, Hiroaki Miyata

    The Lancet Regional Health - Western Pacific　3　100016-100016　2020/10

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2020.100016 　

    ISSN： 2666-6065

  203. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019 Peer-reviewed

    GBD 2019 Universal Health Coverage Collaborators

    The Lancet　396　(10258)　1250-1284　2020/10

    DOI： 10.1016/s0140-6736(20)30750-9 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  204. Effect and cost-effectiveness of national gastric cancer screening in Japan: a microsimulation modeling study. International-journal Peer-reviewed

    Hsi-Lan Huang, Chi Yan Leung, Eiko Saito, Kota Katanoda, Chin Hur, Chung Yin Kong, Shuhei Nomura, Kenji Shibuya

    BMC medicine　18　(1)　257-257　2020/09/14

    DOI： 10.1186/s12916-020-01729-0 　

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    BACKGROUND: A national endoscopic screening program for gastric cancer was rolled out in Japan in 2015. We used a microsimulation model to estimate the cost-effectiveness of current screening guidelines and alternative screening strategies in Japan. METHODS: We developed a microsimulation model that simulated a virtual population corresponding to the Japanese population in risk factor profile and life expectancy. We evaluated 15 endoscopic screening scenarios with various starting ages, stopping ages, and screening intervals. The primary outcomes were quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratio. Cost-effective screening strategies were determined using a willingness-to-pay threshold of $50,000 per QALY gained. One-way sensitivity and probabilistic sensitivity analyses were done to explore model uncertainty. RESULTS: Using the threshold of $50,000 per QALY, a triennial screening program for individuals aged 50 to 75 years was the cost-effective strategy, with an incremental cost-effectiveness ratio of $45,665. Compared with no endoscopic screening, this strategy is predicted to prevent 63% of gastric cancer mortality and confer 27.2 QALYs gained per 1000 individuals over a lifetime period. Current screening guidelines were not on the cost-effectiveness efficient frontier. The results were robust on one-way sensitivity analyses and probabilistic sensitivity analysis. CONCLUSIONS: This modeling study suggests that the endoscopic screening program in Japan would be cost-effective when implemented between age 50 and 75 years, with the screening repeated every 3 years. These findings underscore the need for further evaluation of the current gastric cancer screening recommendations.

  205. Inequalities and risk factors analysis in prevalence and management of hypertension in India and Nepal: a national and subnational study. International-journal Peer-reviewed

    Santosh Kumar Rauniyar, Md Mizanur Rahman, Md Shafiur Rahman, Sarah Krull Abe, Shuhei Nomura, Kenji Shibuya

    BMC public health　20　(1)　1341-1341　2020/09/03

    DOI： 10.1186/s12889-020-09450-6 　

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    BACKGROUND: Hypertension is one of the leading risk factors for cardiovascular diseases in India and Nepal. Socio-economic disparity in these two countries has created wide gap in management of hypertension. However, inequalities in prevalence and management (awareness, treatment, and control) of hypertension is poorly assessed. This study analyzes the risk factors associated with prevalence and management of hypertension in India and Nepal and assesses the wealth-and education-based inequalities in them. METHODS: This study used data from the Demographic and Health Survey; a cross-sectional survey conducted between January 2015 to December 2016 in India and June 2016 to January 2017 in Nepal. A total of 787,713 individuals in India and 14,454 individuals in Nepal aged between 15 and 49 years were included in the study. Respondents were classified as being hypertensive if their systolic blood pressure (SBP) readings were at least 140 mmHg or diastolic blood pressure (DBP) readings were at least 90 mmHg, or if they reported currently taking anti-hypertensive medication. Multilevel logistic regression models with random intercepts at household-and community-levels were used to identify the risk factors associated with prevalence and management of hypertension. For inequality assessment, slope index and relative index of inequalities in prevalence and management of hypertension were estimated. RESULTS: Overall prevalence of hypertension in India and Nepal were 11.4% (95% confidence interval (CI), 11.4-11.5) and 19.6% (95% CI, 18.9-20.2), respectively. Less than one-third of the hypertensive population received treatment and below 20% among them had their blood pressure controlled. In both countries, wealth-and education-based inequalities in awareness, treatment, and control of hypertension were significantly high in urban and rural areas. CONCLUSION: Wealth- and education-based inequalities in prevalence and management of hypertension were high among different socio-economic groups at national and sub-national levels. Tailored strategies are required to effectively manage hypertension in different regions by considering socio-economic and demographic factors.

  206. Forecasting disability-adjusted life years for chronic diseases: reference and alternative scenarios of salt intake for 2017–2040 in Japan International-journal Peer-reviewed

    Shuhei Nomura, Daisuke Yoneoka, Shiori Tanaka, Aya Ishizuka, Peter Ueda, Keiji Nakamura, Hisayuki Uneyama, Naoki Hayashi, Kenji Shibuya

    BMC Public Health　20　(1)　1475-1475　2020/09

    Publisher: Springer Science and Business Media LLC

    DOI： 10.1186/s12889-020-09596-3 　

    eISSN： 1471-2458

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    <title>Abstract</title> <sec> <title>Background</title> In Japan, a high-sodium diet is the most important dietary risk factor and is known to cause a range of health problems. This study aimed to forecast Japan’s disability-adjusted life year (DALYs) for chronic diseases that would be associated with high-sodium diet in different future scenarios of salt intake. We modelled DALY forecast and alternative future scenarios of salt intake for cardiovascular diseases (CVDs), chronic kidney diseases (CKDs), and stomach cancer (SC) from 2017 to 2040. </sec> <sec> <title>Methods</title> We developed a three-component model of disease-specific DALYs: a component on the changes in major behavioural and metabolic risk predictors including salt intake; a component on the income per person, educational attainment, and total fertility rate under 25 years; and an autoregressive integrated moving average model to capture the unexplained component correlated over time. Data on risk predictors were obtained from Japan’s National Health and Nutrition Surveys and from the Global Burden of Disease Study 2017. To generate a reference forecast of disease-specific DALY rates for 2017–2040, we modelled the three diseases using the data for 1990–2016. Additionally, we generated better, moderate, and worse scenarios to evaluate the impact of change in salt intake on the DALY rate for the diseases. </sec> <sec> <title>Results</title> In our reference forecast, the DALY rates across all ages were predicted to be stable for CVDs, continuously increasing for CKDs, and continuously decreasing for SC. Meanwhile, the age group-specific DALY rates for these three diseases were forecasted to decrease, with some exceptions. Except for the ≥70 age group, there were remarkable differences in DALY rates between scenarios, with the best scenario having the lowest DALY rates in 2040 for SC. This represents a wide scope of future trajectories by 2040 with a potential for tremendous decrease in SC burden. </sec> <sec> <title>Conclusions</title> The gap between scenarios provides some quantification of the range of policy impacts on future trajectories of salt intake. Even though we do not yet know the policy mix used to achieve these scenarios, the result that there can be differences between scenarios means that policies today can have a significant impact on the future DALYs. </sec>

  207. Timeliness of routine vaccination among children and determinants associated with age-appropriate vaccination in Mongolia International-journal Peer-reviewed

    Santosh Kumar Rauniyar, Enkhtuya Munkhbat, Peter Ueda, Daisuke Yoneoka, Kenji Shibuya, Shuhei Nomura

    Heliyon　6　(9)　e04898　2020/09

    Publisher: Elsevier {BV}

    DOI： 10.1016/j.heliyon.2020.e04898 　

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    Introduction: Routine vaccination at the recommended age is crucial to minimize the risk of acquiring vaccine preventable diseases. This study aimed to assess the proportion of children receiving routine immunization at the recommended age and determinants of timely (age-appropriate) vaccination in Mongolia. Material and method: A total of 879 eligible children aged 12-23 months were included in this study. We investigated age-appropriate administration of Bacillus Calmette-Guerin vaccine (BCG); hepatitis B vaccine (Hep B); oral polio vaccine (OPV); pentavalent vaccine; and measles, mumps, and rubella vaccine (MMR) using Kaplan-Meier method. Multilevel logistic regression with random intercept at cluster level was used to assess the determinants of age-appropriate vaccination. Results: Overall, the crude vaccination coverage for routine vaccinations were above 90% for all vaccines except MMR1 which was 86.0% (95% CI, 83.6-88.2). While the first dose of almost all the vaccines given at birth; BCG, Hep B, and OPV0, were administered in a timely manner, a substantial proportion of second and third doses of these vaccines were not given in a timely manner with age-appropriate vaccination coverage ranging from 35.9% (32.8-39.1%) for MMR1 to 67.7% (64.5-70.7%) for OPV1 respectively. Factors associated with age-appropriate administration of the investigated vaccines included socio-economic status of household, religion of household heads, area of residence, owning mobile phone, and season of childbirth. For instance, children belonging to households from richer wealth quintile had higher possibilities of getting age-appropriate OPV1-OPV3, PE1-PE3 and MMR1 vaccines compared to those from the poorest household wealth quintile. Conclusion: Our findings suggest that the commonly used indicator 'crude vaccination coverage' could be supplemented by 'age-appropriate vaccination' to help to identify gaps in timely vaccinations and stimulate interventions in Mongolia. Factors such as household wealth quintile, place of residence and religion associated with timely vaccination in our study could be considered to promote effective intervention aiming to improve adequate vaccination coverage.

  208. Early SNS-Based Monitoring System for the COVID-19 Outbreak in Japan: A Population-Level Observational Study. Peer-reviewed

    Daisuke Yoneoka, Takayuki Kawashima, Yuta Tanoue, Shuhei Nomura, Keisuke Ejima, Shoi Shi, Akifumi Eguchi, Toshibumi Taniguchi, Haruka Sakamoto, Hiroyuki Kunishima, Stuart Gilmour, Hiroshi Nishiura, Hiroaki Miyata

    Journal of epidemiology　30　(8)　362-370　2020/08/05

    DOI： 10.2188/jea.JE20200150 　

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    BACKGROUND: The World Health Organization declared the novel coronavirus outbreak (COVID-19) to be a pandemic on March 11, 2020. Large-scale monitoring for capturing the current epidemiological situation of COVID-19 in Japan would improve preparation for and prevention of a massive outbreak. METHODS: A chatbot-based healthcare system named COOPERA (COvid-19: Operation for Personalized Empowerment to Render smart prevention And care seeking) was developed using the LINE app to evaluate the current Japanese epidemiological situation. LINE users could participate in the system either though a QR code page in the prefectures' websites or a banner at the top of the LINE app screen. COOPERA asked participants questions regarding personal information, preventive actions, and non-specific symptoms related to COVID-19 and their duration. We calculated daily cross correlation functions between the reported number of infected cases confirmed using polymerase chain reaction and the symptom-positive group captured by COOPERA. RESULTS: We analyzed 206,218 participants from three prefectures reported between March 5 and 30, 2020. The mean age of participants was 44.2 (standard deviation, 13.2) years. No symptoms were reported by 96.93% of participants, but there was a significantly positive correlation between the reported number of COVID-19 cases and self-reported fevers, suggesting that massive monitoring of fever might help to estimate the scale of the COVID-19 epidemic in real time. CONCLUSIONS: COOPERA is the first real-time system being used to monitor trends in COVID-19 in Japan and provides useful insights to assist political decisions to tackle the epidemic.

  209. An assessment of self-reported COVID-19 related symptoms of 227,898 users of a social networking service in Japan: Has the regional risk changed after the declaration of the state of emergency? Peer-reviewed

    Shuhei Nomura, Daisuke Yoneoka, Shoi Shi, Yuta Tanoue, Takayuki Kawashima, Akifumi Eguchi, Kentaro Matsuura, Koji Makiyama, Keisuke Ejima, Toshibumi Taniguchi, Haruka Sakamoto, Hiroyuki Kunishima, Stuart Gilmour, Hiroshi Nishiura, Hiroaki Miyata

    The Lancet Regional Health - Western Pacific　1　100011-100011　2020/08

    Publisher: Elsevier BV

    DOI： 10.1016/j.lanwpc.2020.100011 　

    ISSN： 2666-6065

  210. Travel restrictions and sars-cov-2 transmission: An effective distance approach to estimate impact Peer-reviewed

    Shoi Shi, Shiori Tanaka, Ryo Ueno, Stuart Gilmour, Yuta Tanoue, Takayuki Kawashima, Shuhei Nomura, Akifumi Eguchi, Hiroaki Miyata, Daisuke Yoneoka

    Bulletin of the World Health Organization　98　(8)　518-529　2020/08

    DOI： 10.2471/BLT.20.255679 　

    ISSN： 0042-9686

    eISSN： 1564-0604

  211. Time to Reconsider Diverse Ways of Working in Japan to Promote Social Distancing Measures against the COVID-19 Peer-reviewed

    Shuhei Nomura, Daisuke Yoneoka, Yuta Tanoue, Takayuki Kawashima, Shoi Shi, Akifumi Eguchi, Hiroaki Miyata

    Journal of Urban Health　97　(4)　457-460　2020/08/01

    DOI： 10.1007/s11524-020-00464-4 　

    ISSN： 1099-3460

    eISSN： 1468-2869

  212. Loss of working life years due to mortality, sickness absence, or ill-health retirement: A comprehensive approach to estimating disease burden in the workplace.

    Yosuke Inoue, Shuhei Nomura, Chihiro Nishiura, Ai Hori, Kenya Yamamoto, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Masafumi Eguchi, Takeshi Kochi, Toshiaki Miyamoto, Hiroko Okazaki, Teppei Imai, Akiko Nishihara, Takayuki Ogasawara, Naoko Sasaki, Akihiko Uehara, Makoto Yamamoto, Makiko Shimizu, Maki Konishi, Isamu Kabe, Tetsuya Mizoue, Seitaro Dohi

    Journal of epidemiology　2020/07/25

    DOI： 10.2188/jea.JE20190332 　

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    BACKGROUND: While much effort has focused on quantifying disease burden in occupational health, no study has simultaneously assessed disease burden in terms of mortality and morbidity. We aimed to propose a new comprehensive method of quantifying the disease burden in the workplace. METHOD: The data were obtained from the Japan Epidemiology Collaboration on Occupational Health (J-ECOH) Study, a large-scale prospective study of approximately 80,000 workers. We defined disease burden in the workplace as the number of working years lost among the working population during a 6-year period (April 2012 to March 2018). We calculated the disease burden according to consequences of health problems (i.e., mortality, sickness absence [SA], and ill-health retirement) and disease category. We also calculated the age-group- (20-39 and 40-59 years old) and sex-specific disease burden. RESULTS: The largest contributors to disease burden in the workplace were mental and behavioural disorders (47.0 person-years lost per 10,000 person-years of working years, i.e., per myriad [proportion]), followed by neoplasms (10.8 per myriad) and diseases of the circulatory system (7.1 per myriad). While mental and behavioural disorders made a greater contribution to SA and ill-health retirement compared to mortality, the latter two disorders were the largest contributors to the disease burden in the workplace due to mortality. The number of working years lost was greater among younger vs. older female participants, whereas the opposite trend was observed in males. CONCLUSIONS: Our approach is in contrast to those in previous studies that focused exclusively on mortality or morbidity.

  213. Contributions of information and communications technology to future health systems and Universal Health Coverage: application of Japan’s experiences

    Shuhei Nomura, Vera Siesjö, Göran Tomson, Wiebke Mohr, Eriko Fukuchi, Kenji Shibuya, Viroj Tangcharoensathien, Hiroaki Miyata

    Health Research Policy and Systems　18　(1)　2020/06

    Publisher: Springer Science and Business Media {LLC}

    DOI： 10.1186/s12961-020-00585-x 　

    ISSN： 1478-4505

  214. Cancer incidence attributable to tuberculosis in 2015: global, regional, and national estimates. International-journal Peer-reviewed

    Chi Yan Leung, Hsi-Lan Huang, Md Mizanur Rahman, Shuhei Nomura, Sarah Krull Abe, Eiko Saito, Kenji Shibuya

    BMC cancer　20　(1)　412-412　2020/05/12

    DOI： 10.1186/s12885-020-06891-5 　

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    BACKGROUND: Tuberculosis is associated with increased risk of cancer. However, the impact of tuberculosis on global cancer burden is unknown. METHODS: We performed random-effects meta-analyses and meta-regressions of studies reporting the association between tuberculosis and cancer risks by searching PubMed, Web of Science, Embase, Cochrane library, and CINAHL from inception to 1 June 2019. Population attributable fractions (PAFs) of cancer incidence attributable to tuberculosis were calculated using relative risks from our meta-analyses and tuberculosis prevalence data from Global Health Data Exchange by age, sex, and country. The study has been registered with PROSPERO (CRD42016050691). RESULTS: Fourty nine studies with 52,480 cancer cases met pre-specified inclusion criteria. Tuberculosis was associated with head and neck cancer (RR 2.64[95% CI 2.00-3.48]), hepatobiliary cancer (2.43[1.82-3.25]), Hodgkin's lymphoma (2.19[1.62-2.97]), lung cancer (1.69[1.46-1.95]), gastrointestinal cancer (1.62[1.26-2.08]), non-Hodgkin's lymphoma (1.61[1.34-1.94]), pancreatic cancer (1.58[1.28-1.96]), leukaemia (1.55[1.25-1.93]), kidney and bladder cancer (1.54[1.21-1.97]), and ovarian cancer (1.43[1.04-1.97]). We estimated that 2.33%(1.14-3.81) or 381,035(187145-623,404) of global cancer incidences in 2015 were attributable to tuberculosis. The PAFs varied by Socio-demographic Index (SDI)-ranging from 1.28% (0.57-2.31%) in the high-SDI countries to 3.51% (1.84-5.42%) in the middle-SDI countries. Individually, China and India accounted for 47% of all tuberculosis-related cancer cases. CONCLUSIONS: Tuberculosis is associated with increased risk of cancer at ten sites. The burden of tuberculosis attributable cancer skewed towards lower resource countries. Research priorities are to better understand regional disparities and underlying mechanism linking tuberculosis and cancer development.

  215. Mental health of family, friends, and co-workers of COVID-19 patients in Japan. International-journal Peer-reviewed

    Yuta Tanoue, Shuhei Nomura, Daisuke Yoneoka, Takayuki Kawashima, Akifumi Eguchi, Shoi Shi, Nahoko Harada, Hiroaki Miyata

    Psychiatry research　291　113067-113067　2020/05/06

    Publisher: Elsevier BV

    DOI： 10.1016/j.psychres.2020.113067 　

    ISSN： 0165-1781

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    As the coronavirus disease 2019 (COVID-19) pandemic rages on, the mental health of both the infected and non-infected is a rising concern. We used administrative survey data (16402 responses in the last two weeks) using a chatbot on LINE, the most popular social networking service (SNS) in Japan, to show that people with COVID-19 patients in a close setting had higher psychological distress level than those without. We believe that the results indicate an urgent need to prioritize the establishment and implementation of mental health and psychosocial support tailored to family, close relatives, and friends of COVID-19 patients.

  216. The relationship between fever rate and telework implementation as a social distancing measure against the COVID-19 pandemic in Japan Peer-reviewed

    Takayuki Kawashima, Shuhei Nomura, Yuta Tanoue, Daisuke Yoneoka, Akifumi Eguchi, Shoi Shi, Hiroaki Miyata

    Public Health　2020/05

    Publisher: Elsevier BV

    DOI： 10.1016/j.puhe.2020.05.018 　

    ISSN： 0033-3506

  217. Tracking Japan's development assistance for health, 2012-2016. International-journal

    Shuhei Nomura, Haruka Sakamoto, Maaya Kita Sugai, Haruyo Nakamura, Keiko Maruyama-Sakurai, Sangnim Lee, Aya Ishizuka, Kenji Shibuya

    Globalization and health　16　(1)　32-32　2020/04/15

    DOI： 10.1186/s12992-020-00559-2 　

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    BACKGROUND: Development assistance for health (DAH) is one of the most important means for Japan to promote diplomacy with developing countries and contribute to the international community. This study, for the first time, estimated the gross disbursement of Japan's DAH from 2012 to 2016 and clarified its flows, including source, aid type, channel, target region, and target health focus area. METHODS: Data on Japan Tracker, the first data platform of Japan's DAH, were used. The DAH definition was based on the Organisation for Economic Co-operation and Development's (OECD) sector classification. Regarding core funding to non-health-specific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for calculating imputed multilateral official development assistance (ODA). RESULTS: Japan's DAH was estimated at 1472.94 (2012), 823.15 (2013), 832.06 (2014), 701.98 (2015), and 894.57 million USD (2016) in constant prices of 2016. Multilateral agencies received the largest DAH share of 44.96-57.01% in these periods, followed by bilateral grants (34.59-53.08%) and bilateral loans (1.96-15.04%). Ministry of Foreign Affairs (MOFA) was the largest contributors to the DAH (76.26-82.68%), followed by Ministry of Finance (MOF) (10.86-16.25%). Japan's DAH was most heavily distributed in the African region with 41.64-53.48% share. The channel through which the most DAH went was Global Fund to Fight AIDS, Tuberculosis, and Malaria (20.04-34.89%). Between 2012 and 2016, approximately 70% was allocated to primary health care and the rest to health system strengthening. CONCLUSIONS: With many major high-level health related meetings ahead, coming years will play a powerful opportunity to reevaluate DAH and shape the future of DAH for Japan. We hope that the results of this study will enhance the social debate for and contribute to the implementation of Japan's DAH with a more efficient and effective strategy.

  218. Associations between parental socioeconomic position and health-seeking behaviour for diarrhoea and acute respiratory infection among under-5 children in Myanmar: a cross-sectional study. International-journal Peer-reviewed

    Kaung Suu Lwin, Shuhei Nomura, Daisuke Yoneoka, Peter Ueda, Sarah Krull Abe, Kenji Shibuya

    BMJ open　10　(3)　e032039　2020/03/26

    DOI： 10.1136/bmjopen-2019-032039 　

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    OBJECTIVES: To examine the associations of parental social and economic position with health-seeking behaviour for diarrhoea and acute respiratory infection (ARI) among under-5 children in Myanmar and explore potential underlying mechanisms. DESIGN: A cross-sectional study. SETTING: A secondary dataset from the nationwide 2015-2016 Myanmar Demographic and Health Survey (MDHS). PARTICIPANTS: All under-5 children in the sampled households with reported symptoms of diarrhoea and ARI during the 2-week period preceding the MDHS survey interview. PRIMARY AND SECONDARY OUTCOME MEASURES: Four parental health-seeking behaviours: 'seeking treatment', 'formal health provider', 'public provider' and 'private provider' were considered. Social and economic positions were determined by confirmatory factor analysis. Multilevel logistic regressions were employed to examine the associations of social and economic positions with health-seeking behaviours for diarrhoea and ARI. Mediation analyses were conducted to explore potential underlying mechanisms in these associations. RESULTS: Of the 4099 under-5 children from the sampled households in MDHS, 427 (10.4%) with diarrhoea and 131 (3.2%) with ARI were considered for the analyses. For diarrhoea, social position was positively associated with seeking treatment and private provider use (adjusted OR: 1.60 (95% CIs: 1.07 to 2.38) and 1.83 (1.00 to 3.34), respectively). Economic position was positively associated with private provider use for diarrhoea (1.57 (1.07 to 2.30)). Negative associations were observed between social and economic positions with public provider use for diarrhoea (0.55 (0.30 to 0.99) and 0.64 (0.43 to 0.94), respectively). Social position had more influence than economic position on parental health-seeking behaviour for children with diarrhoea. No evidence for a significant association of social and economic position with health-seeking for ARI was observed. CONCLUSIONS: Social and economic positions were possible determinants of health-seeking behaviour for diarrhoea among children; and social position had more influence than economic position. The results of this study may contribute to improve relevant interventions for diarrhoea and ARI among children in Myanmar.

  219. Impact of travel restrictions on importation of novel coronavirus infection: An effective distance approach Peer-reviewed

    Shoi Shi, Shiori Tanaka, Ryo Ueno, Stuart Gilmour, Yuta Tanoue, Takayuki Kawashima, Shuhei Nomura, Hiroaki Miyata, Daisuke Yoneoka

    Bulletin of the World Health Organization　2020/03/18

  220. Implementing a sustainable health insurance system in Cambodia: a study protocol for developing and validating an efficient household income-level assessment model for equitable premium collection. International-journal Peer-reviewed

    Haruyo Nakamura, Floriano Amimo, Siyan Yi, Sovannary Tuot, Tomoya Yoshida, Makoto Tobe, Shuhei Nomura

    International journal for equity in health　19　(1)　17-17　2020/01/31

    DOI： 10.1186/s12939-020-1126-8 　

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    BACKGROUND: As elsewhere in low- and middle-income countries, due to limited fiscal resources, universal health coverage (UHC) remains a challenge in Cambodia. Since 2016, the National Social Security Fund (NSSF) has implemented a social health insurance scheme with a contributory approach for formal sector workers. However, informal sector workers and dependents of formal sector workers are still not covered by this insurance because it is difficult to set an optimal amount of contribution for such individuals as their income levels are inestimable. The present study aims to develop and validate an efficient household income-level assessment model for Cambodia. We aim to help the country implement a financially sustainable social health insurance system in which the insured can pay contributions according to their ability. METHODS: This study will use nationally representative data collected by the Cambodia Socio-Economic Survey (CSES), covering the period from 2009 to 2019, and involving a total of 50,016 households. We will employ elastic net regression analysis, with per capita disposable income based on purchasing power parity as the dependent variable, and individual and community-level socioeconomic and demographic characteristics as independent variables. These analyses aim to create efficient income-level assessment models for health insurance contribution estimation. To fully capture socioeconomic heterogeneity, sub-group analyses will be conducted to develop separate income-level assessment models for urban and rural areas, as well as for each province. DISCUSSION: This research will help Cambodia implement a sustainable social health insurance system by collecting optimal amount of contributions from each socioeconomic group of the society. Incorporation of this approach into existing NSSF schemes will enhance the country's current efforts to prevent impoverishing health expenditure and to achieve UHC.

  221. The trajectories of local food avoidance after the Fukushima Daiichi nuclear plant disaster: A five-year prospective cohort study

    46　101513　2020/01/29

  222. Assessing the quality of cause of death data in six high-income countries: Australia, Canada, Denmark, Germany, Japan and Switzerland. International-journal Peer-reviewed

    Lene Mikkelsen, Kim Moesgaard Iburg, Tim Adair, Thomas Fürst, Michael Hegnauer, Elena von der Lippe, Lauren Moran, Shuhei Nomura, Haruka Sakamoto, Kenji Shibuya, Annelene Wengler, Stephanie Willbond, Patricia Wood, Alan D Lopez

    International journal of public health　65　(1)　17-28　2020/01

    DOI： 10.1007/s00038-019-01325-x 　

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    OBJECTIVES: To assess the policy utility of national cause of death (COD) data of six high-income countries with highly developed health information systems. METHODS: National COD data sets from Australia, Canada, Denmark, Germany, Japan and Switzerland for 2015 or 2016 were assessed by applying the ANACONDA software tool. Levels, patterns and distributions of unusable and insufficiently specified "garbage" codes were analysed. RESULTS: The average proportion of unusable COD was 18% across the six countries, ranging from 14% in Australia and Canada to 25% in Japan. Insufficiently specified codes accounted for a further 8% of deaths, on average, varying from 6% in Switzerland to 11% in Japan. The most commonly used garbage codes were Other ill-defined and unspecified deaths (R99), Heart failure (I50.9) and Senility (R54). CONCLUSIONS: COD certification errors are common, even in countries with very advanced health information systems, greatly reducing the policy value of mortality data. All countries should routinely provide certification training for hospital interns and raise awareness among doctors of their public health responsibility to certify deaths correctly and usefully for public health policy.

  223. Limited alignment of publicly competitive disease funding with disease burden in Japan. International-journal Peer-reviewed

    Shuhei Nomura, Daisuke Yoneoka, Shiori Tanaka, Ryoko Makuuchi, Haruka Sakamoto, Aya Ishizuka, Haruyo Nakamura, Anna Kubota, Kenji Shibuya

    PloS one　15　(2)　e0228542　2020

    DOI： 10.1371/journal.pone.0228542 　

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    OBJECTIVE: The need to align investments in health research and development (R&D) with public health needs is one of the most important public health challenges in Japan. We examined the alignment of disease-specific publicly competitive R&D funding to the disease burden in the country. METHODS: We analyzed publicly available data on competitive public funding for health in 2015 and 2016 and compared it to disability-adjusted life year (DALYs) in 2016, which were obtained from the Global Burden of Disease (GBD) 2017 study. Their alignment was assessed as a percentage distribution among 22 GBD disease groups. Funding was allocated to the 22 disease groups based on natural language processing, using textual information such as project title and abstract for each research project, while considering for the frequency of information. RESULTS: Total publicly competitive funding in health R&D in 2015 and 2016 reached 344.1 billion JPY (about 3.0 billion USD) for 32,204 awarded projects. About 49.5% of the funding was classifiable for disease-specific projects. Five GDB disease groups were significantly and relatively well-funded compared to their contributions to Japan's DALY, including neglected tropical diseases and malaria (funding vs DALY = 1.7% vs 0.0%, p<0.01) and neoplasms (28.5% vs 19.2%, p<0.001). In contrast, four GDB disease groups were significantly under-funded, including cardiovascular diseases (8.0% vs 14.8%, p<0.001) and musculoskeletal disorders (1.0% vs 11.9%, p<0.001). These percentages do not include unclassifiable funding. CONCLUSIONS: While caution is necessary as this study was not able to consider public in-house funding and the methodological uncertainties could not be ruled out, the analysis may provide a snapshot of the limited alignment between publicly competitive disease-specific funding and the disease burden in the country. The results call for greater management over the allocation of scarce resources on health R&D. DALYs will serve as a crucial, but not the only, consideration in aligning Japan's research priorities with the public health needs. In addition, the algorithms for natural language processing used in this study require continued efforts to improve accuracy.

  224. Reducing childhood malnutrition in Bangladesh: the importance of addressing socio-economic inequalities. International-journal Peer-reviewed

    Md Rashedul Islam, Md Shafiur Rahman, Md Mahfuzur Rahman, Shuhei Nomura, Angela de Silva, Pulani Lanerolle, Jenny Jung, Md Mizanur Rahman

    Public health nutrition　23　(1)　72-82　2020/01

    DOI： 10.1017/S136898001900140X 　

    ISSN： 1368-9800

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    OBJECTIVE: To obtain projections of the prevalence of childhood malnutrition indicators up to 2030 and to analyse the changes of wealth-based inequality in malnutrition indicators and the degree of contribution of socio-economic determinants to the inequities in malnutrition indicators in Bangladesh. Additionally, to identify the risk factors of childhood malnutrition. DESIGN: Cross-sectional study. A Bayesian linear regression model was used to estimate trends and projections of malnutrition. For equity analysis, slope index, relative index and decomposition in concentration index were used. Multilevel logistic models were used to identify risk factors of malnutrition. SETTING: Household surveys in Bangladesh from 1996 to 2014. PARTICIPANTS: Children under the age of 5 years. RESULTS: A decreasing trend was observed for all malnutrition indices. In 1990, predicted prevalence of stunting, wasting and underweight was 55·0, 15·9 and 61·8 %, respectively. By 2030, prevalence is projected to reduce to 28·8 % for stunting, 12·3 % for wasting and 17·4 % for underweight. Prevalence of stunting, wasting and underweight were 34·3, 6·9 and 32·8 percentage points lower in the richest households than the poorest households. Contribution of the wealth index to child malnutrition increased over time and the largest contribution of pro-poor inequity was explained by wealth index. Being an underweight mother, parents with a lower level of education and poorer households were the key risk factors for stunting and underweight. CONCLUSIONS: Our findings show an evidence-based need for targeted interventions to improve education and household income-generating activities among poor households to reduce inequalities and reduce the burden of child malnutrition in Bangladesh.

  225. Low dose of external exposure among returnees to former evacuation areas: a cross-sectional all-municipality joint study following the 2011 Fukushima Daiichi nuclear power plant incident. International-journal Peer-reviewed

    Shuhei Nomura, Michio Murakami, Wataru Naito, Tetsuo Yasutaka, Toyoaki Sawano, Masaharu Tsubokura

    Journal of radiological protection : official journal of the Society for Radiological Protection　40　(1)　1-18　2019/12/06

    DOI： 10.1088/1361-6498/ab49ba 　

    ISSN： 0952-4746

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    There is little information on the radiation dose levels of returnees to areas once designated as legal no-go zones, after evacuation orders were lifted subsequent to the 2011 Fukushima Daiichi nuclear power plant incident. This study used individual radiation dosimeter monitoring and a location history survey to conduct the most recent dose assessment of external exposure among returnees to former no-go zones. We specifically determined correlation and agreement between external doses and the air dose rate in residential areas and quantified both uncertainty and population variability of the observed data using Monte Carlo (MC) simulation methods. A total of 239 voluntary participants across ten municipalities were analysed; their representativeness of all affected municipal populations was confirmed in terms of air dose rate distribution in residential areas. We found that individual doses were statistically significantly correlated with the air dose rate based on government airborne monitoring. This implies that airborne monitoring can provide sufficient information for understanding dose levels among such returnees. The MC simulations demonstrated that the mean of the annual dose in 2019 (including natural background doses) was 0.93 (95% uncertainty interval 0.53-1.76) mSv, with limited variation between municipalities. As of 2019, this implies that doses from external exposure were very low among returnees and would be associated with a very low likelihood of physical effects according to current scientific consensus. However, these results should be taken with caution due to several study limitations, including selection and participation biases. Regardless, its findings will enhance societal debates about how both individual-dose and government airborne monitoring practices should operate in the future and how the government can improve the public outlook for radiation doses in incident-affected areas.

  226. A Comparative Survival Analysis Between Evacuees and Nonevacuees Among Dialysis Patients in Fukushima Prefecture After Japan's 2011 Fukushima Nuclear Incident. International-journal Peer-reviewed

    Shuhei Nomura, Yukie Matsuzaki, Yuko Sato, Jyunko Takasaki, Yuki Sonoda, Hiroaki Shimmura, Yuko Kodama

    Disaster medicine and public health preparedness　13　(5-6)　898-904　2019/12

    DOI： 10.1017/dmp.2019.4 　

    ISSN： 1935-7893

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    OBJECTIVE: There has been little research on the health consequences of evacuation in the disaster context. A comparative analysis of survival between evacuated and nonevacuated hospital dialysis patients was conducted following Japan's Fukushima Dai-ichi nuclear power plant incident, which occurred on March 11, 2011. METHODS: The study included 554 patients (mean age: 70.9) receiving dialysis therapy at one of the Tokiwakai Group hospitals-all of which are located in and around Iwaki City, approximately 50 km from the Fukushima nuclear plant-as of the incident date. The patients' survival after the incident was tracked until March 3, 2017. Significant differences in mortality rates between postincident evacuees and nonevacuees were tested using the Bayesian survival analysis with Weibull multivariate regression. RESULTS: Out of 554 dialysis patients, 418 (75.5%) were evacuated after the incident. The postincident mortality rate (adjusted for covariates) of evacuees was not statistically significantly different from that of nonevacuees. The hazard ratio was 1.17 (95% credible intervals: 0.77-1.74). CONCLUSIONS: If performed in a well-planned manner with satisfactory arrangements for appropriate selection of evacuees and their transportation, evacuation could be a reasonable option, which might save more lives of vulnerable people.

  227. Meat subtypes and colorectal cancer risk: A pooled analysis of 6 cohort studies in Japan

    Zobida Islam, Shamima Akter, Ikuko Kashino, Tetsuya Mizoue, Norie Sawada, Nagisa Mori, Yoko Yamagiwa, Shoichiro Tsugane, Mariko Naito, Akiko Tamakoshi, Keiko Wada, Chisato Nagata, Yumi Sugawara, Ichiro Tsuji, Keitaro Matsuo, Hidemi Ito, Yingsong Lin, Yuri Kitamura, Atsuko Sadakane, Keitaro Tanaka, Manami Inoue, Motoki Iwasaki, Tetsuya Otani, Norie Sawada, Taichi Shimazu, Shoichiro Tsugane, Taiki Yamaji, Hadrien Charvat, Shizuka Sasazuki, Akiko Tamakoshi, Yoshikazu Nishino, Yoshitaka Tsubono, Tetsuya Mizoue, Shuhei Nomura, Hidekazu Suzuki, Hidemi Ito, Keitaro Matsuo, Isao Oze, Kenji Wakai, Yingsong Lin, Chisato Nagata, Keiko Wada, Yuri Kitamura, Tomio Nakayama, Mariko Naito, Kotaro Ozasa, Atsuko Sadakane, Mai Utada, Keitaro Tanaka

    CANCER SCIENCE　110　(11)　3603-3614　2019/11

    DOI： 10.1111/cas.14188 　

    ISSN： 1347-9032

    eISSN： 1349-7006

  228. Radiation doses and decontamination effects in Minamisoma city: airborne and individual monitoring after the Fukushima nuclear accident. International-journal Peer-reviewed

    Michio Murakami, Shuhei Nomura, Masaharu Tsubokura, Yoshitake Takebayashi, Kana Yamamoto, Tomoyoshi Oikawa

    Journal of radiological protection : official journal of the Society for Radiological Protection　39　(4)　N27-N35-N35　2019/10/16

    DOI： 10.1088/1361-6498/ab4e5a 　

    ISSN： 0952-4746

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    After the Fukushima accident, airborne monitoring was implemented to measure airborne radiation. We examined the relationships between airborne and individual radiation monitoring and clarified the use of airborne monitoring to evaluate the effects of decontamination on residents' received doses. We used the air dose rate data from four airborne monitors conducted between 2013 and 2016, and the dose data from four individual monitors (in which a total of 18 392 adults and 3650 children participated), conducted in Minamisoma City during the same period. We examined the Pearson correlation coefficients between the airborne and individual monitoring data and estimated exposure ratios (ERs; ratios of individual dose to air dose rates) among adults and children. We also estimated the effects of decontamination on residents' doses based on airborne monitoring data, adjusting this for timing and dosing through propensity score matching, which were then compared to individual monitoring data. There were significant correlations between airborne and individual monitoring doses among adults and children, and more than 80% of residents showed a good estimation-observation agreement within a factor of two. The median of ERs was 0.304 and 0.250 among adults and children, respectively. There was a significant difference between the two. Effects of decontamination on residents' doses estimated from airborne monitoring were significantly lower than those estimated from individual monitoring. These findings suggest that airborne monitoring can be used to estimate representative radiation doses within residential areas. It may be a useful tool for enhancing communication among stakeholders and supporting individual and policy decisions; however, it is less sensitive for evaluating individual effects of decontamination than individual monitoring. Combined use of airborne and individual monitoring also showed a lower median of ERs in children than in adults and in a Japanese government's model, possibly due to prioritised decontamination for children and differences between their behavioral patterns.

  229. Risk factors and regional variations of malnutrition among children under 5 in Myanmar: cross-sectional analyses at national and subnational levels. International-journal Peer-reviewed

    Hnin Thiri Khaing, Shuhei Nomura, Daisuke Yoneoka, Peter Ueda, Kenji Shibuya

    BMJ open　9　(9)　e030894　2019/09/08

    DOI： 10.1136/bmjopen-2019-030894 　

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    OBJECTIVE: The levels, distributions of child malnutrition and its potential risk factors are not very well known in Myanmar. The objectives included in this study were: to estimate the current national and subnational prevalence of four types of malnutrition (stunting, wasting, underweight and overweight) among children under 5 in Myanmar; to identify potential risk factors associated with each type of malnutrition and to investigate how the identified risk factors' distributions explained the regional disparities in malnutrition prevalence. DESIGN/METHODS: Data from the Myanmar Demographic and Health Survey 2015-2016 were used to estimate the prevalence of four types of malnutrition at both national and subnational levels (15 regions). Logistic regression models were applied to examine the association between each type of malnutrition and its risk factors, including child's factors, parental social status and household conditions. The risk factor-adjusted prevalence of the malnutrition was estimated at the subnational level based on the estimated parameters from the regression models. RESULTS: The national prevalence of stunting, wasting, underweight and overweight in children under 5 was estimated to be 29.1% (95% CI 27.7% to 30.6%), 6.8% (6.0% to 7.6%), 18.3% (17.0% to 19.5%) and 1.5% (1.1% to 1.9%), respectively. Substantial regional variations in the prevalence of each type of malnutrition were observed. Several risk factors of each type of malnutrition were identified, including low birth weight (LBW) and inadequate maternal nutritional status. Except for overweight, regional variations largely persisted even after adjustment for the risk factors investigated. CONCLUSION: The prevalence of malnutrition among children under 5 is still high in Myanmar, most commonly stunting. Targeted interventions aimed at prevention of LBW, improving the maternal nutritional status, in addition to other sociodemographic conditions should be encouraged urgently. Further research is necessary to investigate the potential sources of regional variation in prevalence of malnutrition among children under 5 in the country.

  230. Breast Cancer Provider Interval Length in Fukushima, Japan, After the 2011 Triple Disaster: A Long-Term Retrospective Study. International-journal Peer-reviewed

    Akihiko Ozaki, Shuhei Nomura, Claire Leppold, Masaharu Tsubokura, Toyoaki Sawano, Manabu Tsukada, Tomohiro Morita, Tetsuya Tanimoto, Shigehira Saji, Shigeaki Kato, Kazue Yamaoka, Yoshinori Nakata, Hiromichi Ohira

    Clinical breast cancer　20　(2)　e127-e150　2019/09/06

    DOI： 10.1016/j.clbc.2019.07.008 　

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    BACKGROUND: Minimizing the interval from symptom onset to treatment commencement is essential for a favorable outcome among breast cancer (BC) patients. This study examined whether provider interval (time elapsed from first consultation to treatment initiation) lengthened among BC patients after Japan's 2011 earthquake, tsunami, and nuclear disaster in Fukushima. Factors associated with the length of postdisaster interval and whether the interval was associated with BC stage were also investigated. PATIENTS AND METHODS: So-so District (study site) was an area damaged by the 2011 disasters. Data of all BC patients who made their first medical consultation and received initial treatment at the core medical institutions in the area 5 years before or after the disaster were extracted from patient medical records. We used several regression approaches to fulfill our study objectives. RESULTS: We included 263 (140 predisaster and 123 postdisaster) patients. After adjustment for covariates, the interval did not significantly change after the disaster compared to before the disaster. Those with 4 or 5 cohabiting family members experienced a shorter interval after the disaster than those with 0 or 1 cohabiting family members (relative length, 0.47; 95% confidence interval, 0.28-0.78). Those with an interval of > 60 days had lower odds of stage III or IV cancer after the disaster than those with an interval of < 30 days (odds ratio, 0.09; 95% confidence interval, 0.01-0.84). CONCLUSION: Overall, provider interval did not lengthen after the disaster. However, those with fewer cohabiting family members might have experienced a longer total interval. Cancer stage may not necessarily reflect the influence of interval on patient outcome.

  231. Impact of decontamination on individual radiation doses from external exposure among residents of Minamisoma City after the 2011 Fukushima Daiichi nuclear power plant incident in Japan: a retrospective observational study. International-journal Peer-reviewed

    Masaharu Tsubokura, Michio Murakami, Yoshitake Takebayashi, Shuhei Nomura, Kyoko Ono, Akihiko Ozaki, Toyoaki Sawano, Yurie Kobashi, Tomoyoshi Oikawa

    Journal of radiological protection : official journal of the Society for Radiological Protection　39　(3)　854-871　2019/09

    DOI： 10.1088/1361-6498/ab280e 　

    ISSN： 0952-4746

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    Following the Fukushima incident, radiation doses from external exposure accounted for the majority of the total doses. Although countermeasures are being implemented, with the aim of reducing radiation exposure, little information is available on the effects of decontamination on individual doses among the residents of radioactively contaminated areas. To evaluate the effectiveness of the decontamination measures in reducing individual doses, and to examine the influence of the timing of decontamination and the district, data were analysed for 18 392 adults and 3 650 children in Minamisoma City, Fukushima, who participated in a voluntary screening programme using individual radiation dosimeters (Glass Badge) between June 2013 and September 2016. The dose reduction rates (DRR) were calculated for one year by comparing the first and last three-month measurement results between areas with and without decontamination. Using a regression approach and Monte Carlo simulation, the dose reduction rate by decontamination eliminating the effect of physical decay (DRRd') was also estimated as a function of the timing of the decontamination and the dose at the time of starting the decontamination. The annual DRR in areas with decontamination for both adults and children were significantly higher than those in areas without decontamination, depending on the timing of decontamination: 31%-36% for 2013-14 for adults in decontamination areas and 33%-35% for children in decontamination areas, compared to 12%-23% and 13%-23% for adults and children in areas without decontamination, respectively. There was a positive correlation between DRRd' and individual doses, and DRRd' was estimated at 30%-40% for adults and children with doses of 3 mSv y-1 in 2013 and 2014. This study demonstrated that decontamination does lower individual doses from external exposure. The higher the dose at the time of starting the decontamination, the greater the dose reduction rate by decontamination, regardless of the timing of the decontamination. Our study confirms that decontamination was useful for high-dose areas in the later phases of the incident.

  232. Internal exposure risk due to radiocesium and the consuming behaviour of local foodstuffs among pregnant women in Minamisoma City near the Fukushima nuclear power plant: a retrospective observational study. International-journal Peer-reviewed

    Kana Yamamoto, Shuhei Nomura, Masaharu Tsubokura, Michio Murakami, Akihiko Ozaki, Claire Leppold, Toyoaki Sawano, Morihito Takita, Shigeaki Kato, Yukio Kanazawa, Hiroshi Anbe

    BMJ open　9　(7)　e023654　2019/07/09

    DOI： 10.1136/bmjopen-2018-023654 　

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    OBJECTIVES: This study aimed to evaluate the internal cesium (Cs) level among pregnant women in Minamisoma City (the area straddling the evacuation zones) over a 5-year period after Japan's 2011 Fukushima nuclear accident and assess the status and transition of their food-acquiring preferences during this period. DESIGN: A retrospective observational study of a screening along with a questionnaire survey. SETTING: This study was conducted in an obstetrics and gynaecology service in Minamisoma City in Fukushima, Japan. PARTICIPANTS: Participants included pregnant women who applied for the voluntary internal radiation exposure screening programme. PRIMARY AND SECONDARY OUTCOME MEASURES: Internal radiation exposure was evaluated using the whole-body counter (WBC) in the screening programme. Data from a food acquisition preference questionnaire administered to the participants were analysed and compared across the 5-year period after adjusting for covariates. RESULTS: Overall, 804 screening programmes were conducted with 579 participants during the study period. All participants had internal contamination levels below the detection limit of the WBC unit (220 and 250 Bq/body for Cs-134 and Cs-137, respectively). Based on the most conservative assumption, their maximum annual effective doses by Cs-134 and Cs-137 together were estimated at 16 µSv/year. Contrary to limited internal contamination risks and counter-dose initiatives by the government, a considerable number of pregnant women were still concerned about consuming potentially contaminated local food products when purchasing them at supermarkets between 2012 (78.4%) and 2015 (75.0%). CONCLUSIONS: Health effects from post-accident internal radiation exposure were likely to be insignificant in pregnant women. National/local action is urgently needed to promote scientific understanding in pregnant women regarding limited internal exposure risks from local food products in the market. However, few mothers chose to participate in the internal radiation exposure screening programme, and thus, caution is required in interpreting the results of analyses.

  233. Long-term trends of hospital admissions among patients with cancer following the 2015 earthquake: a single institution observational study in Kathmandu, Nepal. International-journal Peer-reviewed

    Anup Uprety, Akihiko Ozaki, Asaka Higuchi, Bikal Ghimire, Toyoaki Sawano, Kenji Tsuda, Shuhei Nomura, Claire Leppold, Masaharu Tsubokura, Tetsuya Tanimoto, Yogendra Prasad Singh

    BMJ open　9　(6)　e026746　2019/06/28

    DOI： 10.1136/bmjopen-2018-026746 　

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    OBJECTIVES: Little is known regarding how natural disasters affect patients with cancer in low-income and middle-income countries. The objective of the present study was to assess the impact of the 2015 Nepal earthquake on the admission of patients with cancer at a core medical institution in Kathmandu. DESIGN, SETTING AND PARTICIPANTS: We considered all 3520 cancer patient admissions to Tribhuvan University Teaching Hospital, from 25 April 2013 to 24 April 2017 (2 years before and 2 years after the earthquake). OUTCOME MEASURES: The number of cancer patient admissions was calculated for each month. Using a negative binomial model, we estimated the incidence rate ratio (IRR) for admission numbers each month after the earthquake compared with the pre-earthquake baseline and investigated chronological change. RESULTS: The total admission number in the first month after the earthquake was decreased compared with that of the predisaster baseline (IRR=0.66, 95% CI 0.43 to 1.00), which largely reflected decreased admissions of patients from outside of the most disaster-affected districts. From the second month, the admission number consistently exceeded the predisaster baseline for the remaining postdisaster period. In contrast to the month of the disaster, the continuation of increased admissions was most prominent among those from outside of the most affected districts. CONCLUSIONS: After a transient decrease immediately following the 2015 Nepal earthquake, there was a long-term increase in cancer patient admissions in a core hospital in Kathmandu. These changes were seen most prominently in patients from outside the most disaster affected areas.

  234. Low dose from external radiation among returning residents to the former evacuation zone in Minamisoma City, Fukushima Prefecture. International-journal Peer-reviewed

    Shuhei Nomura, Tomoyoshi Oikawa, Masaharu Tsubokura

    Journal of radiological protection : official journal of the Society for Radiological Protection　39　(2)　548-563　2019/06

    DOI： 10.1088/1361-6498/ab0f87 　

    ISSN： 0952-4746

  235. Worsening Health Status among Evacuees: Analysis of Medical Expenditures after the 2011 Great East Japan Earthquake and Nuclear Disaster in Fukushima. Peer-reviewed

    Makoto Hasegawa, Michio Murakami, Shuhei Nomura, Yoshitake Takebayashi, Masaharu Tsubokura

    The Tohoku journal of experimental medicine　248　(2)　115-123　2019/06

    DOI： 10.1620/tjem.248.115 　

    ISSN： 0040-8727

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    After Fukushima disaster in 2011, the health status of the region's residents deteriorated. We analyzed the health status, care needs, and access to health services among evacuees and non-evacuees using healthcare expenditure (for self-employed and unemployed individuals aged < 75 years) and long-term care expenditure (mainly for individuals aged ≥ 65 years). Fukushima Prefecture was divided into four areas according to their evacuation status: non-EOAs (municipalities that did not include evacuation order areas (EOAs)); EOAs/non-EOAs (municipalities that included both EOAs and non-EOAs); short-term EOAs (municipalities where the EOA designation was lifted in most areas by fiscal year (FY) 2011); and long-term EOAs (municipalities where most EOA designations remained in place until the end of FY 2015). Increases in expenditure on healthcare and long-term care per capita in short-term and long-term EOAs were greater in FY 2015 than the average values in FYs 2008-2010. The increases in expenditure were higher in short-term and long-term EOAs than those in non-EOAs and EOAs/non-EOAs. The increases in dental health expenditure were attributed to enhanced accessibility to dental health facilities. Furthermore, the evacuations contributed to increases in healthcare and long-term care expenditure, independent of aging and improved accessibly to health facilities. Possible explanations for these increases include the poor health status of the evacuees following the evacuations, reduced availability of informal care provided by family members and neighbors, and reduced patient copayments. The findings highlight the necessity of health promotion among evacuees.

  236. Trends in heterosexual inexperience among young adults in Japan: analysis of national surveys, 1987-2015. International-journal Peer-reviewed

    Cyrus Ghaznavi, Haruka Sakamoto, Daisuke Yoneoka, Shuhei Nomura, Kenji Shibuya, Peter Ueda

    BMC public health　19　(1)　355-355　2019/04/08

    DOI： 10.1186/s12889-019-6677-5 　

    ISSN： 1471-2458

  237. JAPAN: EFFECTIVE SMOKEFREE LAWS URGENTLY NEEDED Peer-reviewed

    Nomura Shuhei, Sakamoto Haruka

    TOBACCO CONTROL　28　(2)　123-124　2019/03

    ISSN： 0964-4563

  238. Trends in comparative efficacy and safety of malaria control interventions for maternal and child health outcomes in Africa: a study protocol for a Bayesian network meta-regression exploring the effect of HIV and malaria endemicity spectrum. International-journal Peer-reviewed

    Floriano Amimo, Troy D Moon, Anthony Magit, Jahit Sacarlal, Ben Lambert, Shuhei Nomura

    BMJ open　9　(2)　e024313　2019/02/22

    DOI： 10.1136/bmjopen-2018-024313 　

    ISSN： 2044-6055

  239. Change of access to emergency care in a repopulated village after the 2011 Fukushima nuclear disaster: a retrospective observational study. International-journal Peer-reviewed

    Yoshitaka Nishikawa, Masaharu Tsubokura, Yoshimitsu Takahashi, Shuhei Nomura, Akihiko Ozaki, Yuko Kimura, Tomohiro Morita, Toyoaki Sawano, Tomoyoshi Oikawa, Takeo Nakayama

    BMJ open　9　(2)　e023836　2019/02/09

    DOI： 10.1136/bmjopen-2018-023836 　

    ISSN： 2044-6055

  240. Does Japan's national nutrient-based dietary guideline improve lifestyle-related disease outcomes? A retrospective observational cross-sectional study. International-journal Peer-reviewed

    Daisuke Yoneoka, Shuhei Nomura, Kayo Kurotani, Shiori Tanaka, Keiji Nakamura, Hisayuki Uneyama, Naoki Hayashi, Kenji Shibuya

    PloS one　14　(10)　e0224042　2019

    DOI： 10.1371/journal.pone.0224042 　

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    OBJECTIVE: The Japanese government has developed and promoted a national nutrient-based dietary guideline for preventing lifestyle-related chronic disease. However, its impact in a real-life setting has never been evaluated. We performed a critical appraisal of the guideline by examining the association between adherence to the guideline and lifestyle-related outcome indicators. METHODS: This is a retrospective observational cross-sectional study using nationally representative data on health and nutrition characteristics from the 2016 National Health and Nutrition Survey of Japan. We considered 3,861 participants aged ≥20 years, with evidence of low health risks of diabetes, hypertension, hyperlipidemia, and obesity. Five health outcome indicators (hemoglobin A1c (HbA1c), systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, and body mass index), were employed. A summary score was developed to reflect adherence to the recommended intake of seven nutrients defined by the guideline, including proteins, fat, saturated fatty acid, carbohydrate, dietary fiber, sodium, and potassium. Multivariate quartile regression approaches were employed to examine the association between the adherence score and the health outcome indicators, adjusting for the covariates. RESULTS: Overall, the proportion of those who adhered to the guideline (adherence rate) for all seven nutrients was only 0.3%. There was considerable variation in the adherence rate between the different nutrients, from 24.2% to 61.8%. After adjustment for covariates, in most health outcome indicators, regardless of age category and quartile, there was no clear association between the guideline adherence score and indicators. CONCLUSIONS: There is plenty of scope for improving the guideline. Nutrient impact on health may not necessarily depend on the amount of each nutrient in the diet. The significance and contribution of synergies between nutrients and complex interactions within foods to health outcomes need to be explored in future guideline updates.

  241. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    Collaborators, G. B. D. Causes of Death

    Lancet　392　(10159)　2170　2018/11/17

    DOI： 10.1016/S0140-6736(18)32203-7 　

    ISSN： 0140-6736

  242. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    Hmwe Hmwe Kyu, Degu Abate, Kalkidan Hassen Abate, Solomon M. Abay, Cristiana Abbafati, Nooshin Abbasi, Hedayat Abbastabar, Foad Abd-Allah, Jemal Abdela, Ahmed Abdelalim, Ibrahim Abdollahpour, Rizwan Suliankatchi Abdulkader, Molla Abebe, Zegeye Abebe, Olifan Zewdie Abil, Victor Aboyans, Aklilu Roba Abrham, Laith Jamal Abu-Raddad, Niveen M.E. Abu-Rmeileh, Manfred Mario Kokou Accrombessi, Dilaram Acharya, Pawan Acharya, Ilana N. Ackerman, Abdu A. Adamu, Oladimeji M. Adebayo, Victor Adekanmbi, Zanfina Ademi, Olatunji O. Adetokunboh, Mina G. Adib, Jose C. Adsuar, Kossivi Agbelenko Afanvi, Mohsen Afarideh, Ashkan Afshin, Gina Agarwal, Kareha M. Agesa, Rakesh Aggarwal, Sargis Aghasi Aghayan, Anurag Agrawal, Alireza Ahmadi, Mehdi Ahmadi, Hamid Ahmadieh, Muktar Beshir Ahmed, Sayem Ahmed, Amani Nidhal Aichour, Ibtihel Aichour, Miloud Taki Eddine Aichour, Tomi Akinyemiju, Nadia Akseer, Ziyad Al-Aly, Ayman Al-Eyadhy, Hesham M. Al-Mekhlafi, Rajaa M. Al-Raddadi, Fares Alahdab, Khurshid Alam, Tahiya Alam, Alaa Alashi, Seyed Moayed Alavian, Kefyalew Addis Alene, Mehran Alijanzadeh, Reza Alizadeh-Navaei, Syed Mohamed Aljunid, Ala'A Alkerwi, François Alla, Peter Allebeck, Jordi Alonso, Ubai Alsharif, Khalid Altirkawi, Nelson Alvis-Guzman, Leopold N. Aminde, Erfan Amini, Mohammadreza Amiresmaili, Walid Ammar, Yaw Ampem Amoako, Nahla Hamed Anber, Catalina Liliana Andrei, Sofia Androudi, Megbaru Debalkie Animut, Mina Anjomshoa, Mustafa Geleto Ansha, Carl Abelardo T. Antonio, Palwasha Anwari, Jalal Arabloo, Olatunde Aremu, Johan Ärnlöv, Amit Arora, Megha Arora, Al Artaman, Krishna K. Aryal, Hamid Asayesh, Zerihun Ataro, Marcel Ausloos, Leticia Avila-Burgos, Euripide F.G.A. Avokpaho, Ashish Awasthi, Beatriz Paulina Ayala Quintanilla, Rakesh Ayer, Peter S. Azzopardi, Arefeh Babazadeh, Hamid Badali, Kalpana Balakrishnan

    The Lancet　392　(10159)　1859-1922　2018/11/10

    DOI： 10.1016/S0140-6736(18)32335-3 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  243. Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: A systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    GBD 2017 Mortality Collaborators

    The Lancet　392　(10159)　1684-1735　2018/11/10

    DOI： 10.1016/S0140-6736(18)31891-9 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  244. Global, regional, and national incidence, prevalence, and years lived with disability for 354 Diseases and Injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    GBD 2017 Disease and Injury Incidence and Prevalence Collaborators

    The Lancet　392　(10159)　1789-1858　2018/11/10

    DOI： 10.1016/S0140-6736(18)32279-7 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  245. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    GBD 2017 Risk Factor Collaborators

    The Lancet　392　(10159)　1923-1994　2018/11/10

    DOI： 10.1016/S0140-6736(18)32225-6 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  246. Public Health Preparedness for and Response to Nuclear Disasters: An Editorial. International-journal Peer-reviewed

    Shuhei Nomura, Michio Murakami

    International journal of environmental research and public health　15　(11)　2018/11/08

    DOI： 10.3390/ijerph15112489 　

    ISSN： 1661-7827

  247. Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017 Peer-reviewed

    GBD 2017 Population and Fertility Collaborators

    The Lancet　392　(10159)　1995-2051　2018/11/01

    DOI： 10.1016/S0140-6736(18)32278-5 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  248. Bibliometric Study of Obstetrics Articles Published in the Journal of the American Medical Association, 1997-2016. International-journal Peer-reviewed

    Kana Yamamoto, Akihiko Ozaki, Shuhei Nomura, Yuki Senoo, Izumi Yoshida, Yuto Maeda, Mutsuko Ohnishi, Tetsuya Tanimoto, Masahiro Kami

    Cureus　10　(10)　e3448　2018/10/13

    DOI： 10.7759/cureus.3448 　

    ISSN： 2168-8184

  249. Progress towards universal health coverage in Myanmar: a national and subnational assessment. International-journal Peer-reviewed

    Su Myat Han, Md Mizanur Rahman, Md Shafiur Rahman, Khin Thet Swe, Matthew Palmer, Haruka Sakamoto, Shuhei Nomura, Kenji Shibuya

    The Lancet. Global health　6　(9)　e989-e997-e997　2018/09

    DOI： 10.1016/S2214-109X(18)30318-8 　

    ISSN： 2214-109X

  250. The Great East Japan Earthquake, Tsunamis, and Fukushima Daiichi Nuclear Power Plant Disaster: Lessons for Evidence Integration from a WADEM 2017 Presentation and Panel Discussion. International-journal Peer-reviewed

    Claire Leppold, Sae Ochi, Shuhei Nomura, Virginia Murray

    Prehospital and disaster medicine　33　(4)　424-427　2018/08

    DOI： 10.1017/S1049023X18000481 　

    ISSN： 1049-023X

  251. Balancing the risk of the evacuation and sheltering-in-place options: a survival study following Japan's 2011 Fukushima nuclear incident. International-journal Peer-reviewed

    Yuki Shimada, Shuhei Nomura, Akihiko Ozaki, Asaka Higuchi, Arinobu Hori, Yuki Sonoda, Kana Yamamoto, Izumi Yoshida, Masaharu Tsubokura

    BMJ open　8　(7)　e021482　2018/07/28

    DOI： 10.1136/bmjopen-2018-021482 　

    ISSN： 2044-6055

  252. Automatic anatomical classification of esophagogastroduodenoscopy images using deep convolutional neural networks. International-journal Peer-reviewed

    Hirotoshi Takiyama, Tsuyoshi Ozawa, Soichiro Ishihara, Mitsuhiro Fujishiro, Satoki Shichijo, Shuhei Nomura, Motoi Miura, Tomohiro Tada

    Scientific reports　8　(1)　7497-7497　2018/05/14

    DOI： 10.1038/s41598-018-25842-6 　

    ISSN： 2045-2322

  253. Call for a new epidemiological approach to disaster response. International-journal Peer-reviewed

    Michio Murakami, Shuhei Nomura, Masaharu Tsubokura

    Journal of epidemiology and community health　72　(4)　267-268　2018/04

    DOI： 10.1136/jech-2017-210397 　

    ISSN： 0143-005X

  254. Causes and risk factors for singleton stillbirth in Japan: Analysis of a nationwide perinatal database, 2013-2014. International-journal Peer-reviewed

    Rei Haruyama, Stuart Gilmour, Erika Ota, Sarah K Abe, Md Mizanur Rahman, Shuhei Nomura, Naoyuki Miyasaka, Kenji Shibuya

    Scientific reports　8　(1)　4117-4117　2018/03/07

    DOI： 10.1038/s41598-018-22546-9 　

    ISSN： 2045-2322

  255. Comparison of external doses between radio-contaminated areas and areas with high natural terrestrial background using the individual dosimeter 'D-shuttle' 75 months after the Fukushima Daiichi nuclear power plant accident. International-journal Peer-reviewed

    Masaharu Tsubokura, Shuhei Nomura, Izumi Yoshida, Toyoaki Sawano, Makoto Miyazaki, Satoru Tomita, Oikawa Tomoyoshi, Masami Watanabe

    Journal of radiological protection : official journal of the Society for Radiological Protection　38　(1)　273-285　2018/03

    DOI： 10.1088/1361-6498/aaa147 　

    ISSN： 0952-4746

  256. Support for UNRWA's survival

    Blanchet, K., El-Zein, A., Langer, A., Sato, M., Abdulrahim, S., Abouchacra, K., Afifi, R., Agnoletto, V., Akashi, H., Alameddine, M., Ansbro, ?, Ara{\'u}jo-Soares, V., Assefi, N., Baillie Smith, M., Bardus, M., Bhabha, J., Bjertness, E., Borghi, J., Busza, J., Cammett, M., Campbell, O., Chaaban, J., Chalmers, I., Checchi, F., Danaei, G., Dhaini, H., Diaconu, K., Diwan, I., Dominguez-Salas, P., Dubois, E., El Kak, F., El-Zein, A., Eng, E., Eyal, N., Fawzi, W., Feder, G., Fujiya, R., Furukawa, S., Furusawa, K., Futami, A., Germani, A., Ghattas, H., Giacaman, R., Goto, R., Grant, L., Greenough, P.G., Habib, R., Hagopian, A., Hajat, S., Hariga, F., Hatano, A., Hay, A., Holmboe-Ottesen, G., Horiuchi, S., Hsiao, W., Huber, D., Humble, D., Imano, T., Inoue, Y., Ishizuka, A., Ismail, R., Iwata, R., Jabbour, S., Jamal, D., Jamaluddine, Z., Jimba, M., Kabakian, T., Kamiya, Y., Karademas, E., Kashiwagi, K., Katsuma, Y., Kinjo, M., Kiriya, J., Kitamura, A., Kruk, M.E., Kubota, K., Leaning, J., Leng, M., Logam, L., Makhoul, J., Matsuno, A., Matsuo, Y., McCoy, D., McGovern, T., McKee, M., McPake, B., Melhem, N., Merriman, A., Michie, S., Millett, C., Mishima, C., Miyachi, T., Miyata, H., Moodie, R., Morioka, M., Mulholland, K., Mumtaz, G., Murphy, A., Nagasawa, E., Nagata, K., Najem Kteily, M., Nakamura, H., Nakkash, R., Nambu, M., Nava, M., Nelson, E.L., Nishikida, A., Nomura, S., Nozaki, S., Nuwayhid, I., O{'}Donnell, K., Ohashi, M., O{'}Laughlin, K., Palmer, J., Patel, P., Patel, R., Pham, P., Quezada-Yamamoto, H., Ramia, S., Rawaf, S., Rihani, M., Roberts, B., Roberts, L., Ruff, T.A., Sahyoun, N., Sakamoto, H., Salti, N., Sato, M., Sato, M., Sennett, R., Shallice, T., Shannon, P., Shiekh, S., Shin, K., Sibai, A.M., Sieverding, M., Singh, N., Sullivan, R., Takahara, T., Tanigawa, T., Taniguchi, H., Testa, A., Thomas, A., Tsutsumi, A., Uechi, M., Usuki, A., Valente de Almeida, S., Wareham, S., Watt, G., West, R., Wigg, P., Wigg, C., Wikler, D., Witter, S., Yassin, N., Yazdi, Y., Yoshino, Y., Yousafzai, A., Yudkin, J.S., Zaman, M.H., Zurayk, H.

    Lancet　392　(10152)　2018

    DOI： 10.1016/S0140-6736(18)32264-5 　

    ISSN： 0140-6736 1474-547X

  257. Demographic transition and factors associated with remaining in place after the 2011 Fukushima nuclear disaster and related evacuation orders. International-journal Peer-reviewed

    Tomohiro Morita, Shuhei Nomura, Tomoyuki Furutani, Claire Leppold, Masaharu Tsubokura, Akihiko Ozaki, Sae Ochi, Masahiro Kami, Shigeaki Kato, Tomoyoshi Oikawa

    PloS one　13　(3)　e0194134　2018

    DOI： 10.1371/journal.pone.0194134 　

    ISSN： 1932-6203

  258. Assessment of medium-term cardiovascular disease risk after Japan's 2011 Fukushima Daiichi nuclear accident: a retrospective analysis. International-journal Peer-reviewed

    Haruka Toda, Shuhei Nomura, Stuart Gilmour, Masaharu Tsubokura, Tomoyoshi Oikawa, Kiwon Lee, Grace Y Kiyabu, Kenji Shibuya

    BMJ open　7　(12)　e018502　2017/12/22

    DOI： 10.1136/bmjopen-2017-018502 　

    ISSN： 2044-6055

  259. Application of Convolutional Neural Networks in the Diagnosis of Helicobacter pylori Infection Based on Endoscopic Images. International-journal Peer-reviewed

    Satoki Shichijo, Shuhei Nomura, Kazuharu Aoyama, Yoshitaka Nishikawa, Motoi Miura, Takahide Shinagawa, Hirotoshi Takiyama, Tetsuya Tanimoto, Soichiro Ishihara, Keigo Matsuo, Tomohiro Tada

    EBioMedicine　25　106-111　2017/11

    DOI： 10.1016/j.ebiom.2017.10.014 　

    ISSN： 2352-3964

  260. Decontamination Work and the Long-term Increase in Hospital Visits for Hymenoptera Stings Following the Fukushima Nuclear Disaster. International-journal Peer-reviewed

    Akihiko Ozaki, Takeru Yokota, Shuhei Nomura, Masaharu Tsubokura, Claire Leppold, Tetsuya Tanimoto, Toru Miura, Kana Yamamoto, Toyoaki Sawano, Manabu Tsukada, Masahiro Kami, Yukio Kanazawa, Hiromichi Ohira

    Disaster medicine and public health preparedness　11　(5)　545-551　2017/10

    DOI： 10.1017/dmp.2016.194 　

    ISSN： 1935-7893

    eISSN： 1938-744X

  261. Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study. International-journal Peer-reviewed

    Tomohiro Morita, Shuhei Nomura, Masaharu Tsubokura, Claire Leppold, Stuart Gilmour, Sae Ochi, Akihiko Ozaki, Yuki Shimada, Kana Yamamoto, Manami Inoue, Shigeaki Kato, Kenji Shibuya, Masahiro Kami

    Journal of epidemiology and community health　71　(10)　974-980　2017/10

    DOI： 10.1136/jech-2016-208652 　

    ISSN： 0143-005X

    eISSN： 1470-2738

  262. Population health and regional variations of disease burden in Japan, 1990-2015: a systematic subnational analysis for the Global Burden of Disease Study 2015. International-journal Peer-reviewed

    Shuhei Nomura, Haruka Sakamoto, Scott Glenn, Yusuke Tsugawa, Sarah K Abe, Md M Rahman, Jonathan C Brown, Satoshi Ezoe, Christina Fitzmaurice, Tsuyoshi Inokuchi, Nicholas J Kassebaum, Norito Kawakami, Yosuke Kita, Naoki Kondo, Stephen S Lim, Satoshi Maruyama, Hiroaki Miyata, Meghan D Mooney, Mohsen Naghavi, Tomoko Onoda, Erika Ota, Yuji Otake, Gregory A Roth, Eiko Saito, Takahiro Tabuchi, Yohsuke Takasaki, Tadayuki Tanimura, Manami Uechi, Theo Vos, Haidong Wang, Manami Inoue, Christopher J L Murray, Kenji Shibuya

    Lancet (London, England)　390　(10101)　1521-1538　2017/09/23

    DOI： 10.1016/S0140-6736(17)31544-1 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  263. Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: Representativeness of the Monitoring Results in Fukushima, Japan. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Michio Murakami, Kyoko Ono, Yoshitaka Nishikawa, Tomoyoshi Oikawa

    International journal of environmental research and public health　14　(6)　2017/06/20

    DOI： 10.3390/ijerph14060656 　

    ISSN： 1661-7827

  264. Breast cancer patient delay in Fukushima, Japan following the 2011 triple disaster: a long-term retrospective study. International-journal Peer-reviewed

    Akihiko Ozaki, Shuhei Nomura, Claire Leppold, Masaharu Tsubokura, Tetsuya Tanimoto, Takeru Yokota, Shigehira Saji, Toyoaki Sawano, Manabu Tsukada, Tomohiro Morita, Sae Ochi, Shigeaki Kato, Masahiro Kami, Tsuyoshi Nemoto, Yukio Kanazawa, Hiromichi Ohira

    BMC cancer　17　(1)　423-423　2017/06/19

    DOI： 10.1186/s12885-017-3412-4 　

    ISSN： 1471-2407

  265. Birth Outcomes after the Fukushima Daiichi Nuclear Power Plant Disaster: A Long-Term Retrospective Study. International-journal Peer-reviewed

    Claire Leppold, Shuhei Nomura, Toyoaki Sawano, Akihiko Ozaki, Masaharu Tsubokura, Sarah Hill, Yukio Kanazawa, Hiroshi Anbe

    International journal of environmental research and public health　14　(5)　2017/05/19

    DOI： 10.3390/ijerph14050542 　

    ISSN： 1661-7827

  266. Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: A Population-Level Analysis of Monitoring Prevalence and Factors Associated with Monitoring Participation Behavior in Fukushima, Japan. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Akihiko Ozaki, Michio Murakami, Susan Hodgson, Marta Blangiardo, Yoshitaka Nishikawa, Tomohiro Morita, Tomoyoshi Oikawa

    International journal of environmental research and public health　14　(4)　2017/04/09

    DOI： 10.3390/ijerph14040397 　

    ISSN： 1661-7827

  267. Individual external doses below the lowest reference level of 1 mSv per year five years after the 2011 Fukushima nuclear accident among all children in Soma City, Fukushima: A retrospective observational study. International-journal Peer-reviewed

    Masaharu Tsubokura, Michio Murakami, Shuhei Nomura, Tomohiro Morita, Yoshitaka Nishikawa, Claire Leppold, Shigeaki Kato, Masahiro Kami

    PloS one　12　(2)　e0172305　2017

    DOI： 10.1371/journal.pone.0172305 　

    ISSN： 1932-6203

  268. Additional risk of diabetes exceeds the increased risk of cancer caused by radiation exposure after the Fukushima disaster. International-journal Peer-reviewed

    Michio Murakami, Masaharu Tsubokura, Kyoko Ono, Shuhei Nomura, Tomoyoshi Oikawa

    PloS one　12　(9)　e0185259　2017

    DOI： 10.1371/journal.pone.0185259 　

    ISSN： 1932-6203

  269. Degarelix treatment is compatible with diabetes and antithrombotic therapy in patients with prostate cancer. International-journal Peer-reviewed

    Suguru Tokiwa, Hiroaki Shimmura, Shuhei Nomura, Ryota Watanabe, Minoru Kurita, Naoto Yoshida, Kaori Yamashita, Yoshitaka Nishikawa, Alexander Kouzmenko, Shigeaki Kato

    Research and reports in urology　9　225-232　2017

    DOI： 10.2147/RRU.S146180 　

    ISSN： 2253-2447

  270. Non-communicable diseases in decontamination workers in areas affected by the Fukushima nuclear disaster: a retrospective observational study. International-journal Peer-reviewed

    Toyoaki Sawano, Masaharu Tsubokura, Akihiko Ozaki, Claire Leppold, Shuhei Nomura, Yuki Shimada, Sae Ochi, Manabu Tsukada, Tsuyoshi Nemoto, Shigeaki Kato, Yukio Kanazawa, Hiromichi Ohira

    BMJ open　6　(12)　e013885　2016/12/14

    DOI： 10.1136/bmjopen-2016-013885 　

    ISSN： 2044-6055

  271. Assessment of Nutritional Status of Iodine Through Urinary Iodine Screening Among Local Children and Adolescents After the Fukushima Daiichi Nuclear Power Plant Accident. International-journal Peer-reviewed

    Masaharu Tsubokura, Shuhei Nomura, Hajime Watanobe, Yoshitaka Nishikawa, Chiaki Suzuki, Sae Ochi, Claire Leppold, Hirokatsu Kinoshita, Shigeaki Kato, Yasutoshi Saito

    Thyroid : official journal of the American Thyroid Association　26　(12)　1778-1785　2016/12

    DOI： 10.1089/thy.2016.0313 　

    ISSN： 1050-7256

    eISSN： 1557-9077

  272. Factors affecting dilation force in balloon dilation of severe esophageal strictures: an experiment using an artificial stricture model. International-journal Peer-reviewed

    Yoshitaka Nishikawa, Hirokazu Higuchi, Osamu Kikuchi, Yasumasa Ezoe, Ikuo Aoyama, Atsushi Yamada, Masataka Kanki, Shuhei Nomura, Motoo Nomura, Takahiro Horimatsu, Manabu Muto

    Surgical endoscopy　30　(10)　4315-20　2016/10

    DOI： 10.1007/s00464-016-4749-5 　

    ISSN： 0930-2794

  273. School restrictions on outdoor activities and weight status in adolescent children after Japan's 2011 Fukushima Nuclear Power Plant disaster: a mid-term to long-term retrospective analysis. International-journal Peer-reviewed

    Shuhei Nomura, Marta Blangiardo, Masaharu Tsubokura, Sae Ochi, Susan Hodgson

    BMJ open　6　(9)　e013145　2016/09/28

    DOI： 10.1136/bmjopen-2016-013145 　

    ISSN： 2044-6055

  274. Impacts of the 2011 Fukushima nuclear accident on emergency medical service times in Soma District, Japan: a retrospective observational study. International-journal Peer-reviewed

    Tomohiro Morita, Masaharu Tsubokura, Tomoyuki Furutani, Shuhei Nomura, Sae Ochi, Claire Leppold, Kazuhiro Takahara, Yuki Shimada, Sho Fujioka, Masahiro Kami, Shigeaki Kato, Tomoyoshi Oikawa

    BMJ open　6　(9)　e013205　2016/09/28

    DOI： 10.1136/bmjopen-2016-013205 　

    ISSN： 2044-6055

  275. Sociodemographic patterning of long-term diabetes mellitus control following Japan's 3.11 triple disaster: a retrospective cohort study. International-journal Peer-reviewed

    Claire Leppold, Masaharu Tsubokura, Akihiko Ozaki, Shuhei Nomura, Yuki Shimada, Tomohiro Morita, Sae Ochi, Tetsuya Tanimoto, Masahiro Kami, Yukio Kanazawa, Tomoyoshi Oikawa, Sarah Hill

    BMJ open　6　(7)　e011455　2016/07/07

    DOI： 10.1136/bmjopen-2016-011455 　

    ISSN： 2044-6055

  276. Estimated association between dwelling soil contamination and internal radiation contamination levels after the 2011 Fukushima Daiichi nuclear accident in Japan. International-journal Peer-reviewed

    Masaharu Tsubokura, Shuhei Nomura, Kikugoro Sakaihara, Shigeaki Kato, Claire Leppold, Tomoyuki Furutani, Tomohiro Morita, Tomoyoshi Oikawa, Yukio Kanazawa

    BMJ open　6　(6)　e010970　2016/06/29

    DOI： 10.1136/bmjopen-2015-010970 　

    ISSN： 2044-6055

  277. Social determinants of mid- to long-term disaster impacts on health: A systematic review Peer-reviewed

    Shuhei Nomura, Alexander J. Q. Parsons, Mayo Hirabayashi, Ryo Kinoshita, Yi Liao, Susan Hodgson

    INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION　16　53-67　2016/06

    DOI： 10.1016/j.ijdrr.2016.01.013 　

    ISSN： 2212-4209

  278. Protecting human security: proposals for the G7 Ise-Shima Summit in Japan Peer-reviewed

    Kenji Shibuya, Shuhei Nomura, Hiromasa Okayasu, Satoshi Ezoe, Seigo Hara, Yuriko Hara, Takashi Izutsu, Takuma Kato, Shunsuke Mabuchi, Yujiro Maeda, Yuki Murakami, Hiroko Nishimoto, Tomoko Ono, Kayoko Shioda, Atsushi Sorita, Amina Sugimoto, Kazuo Tase, Akihito Watabe, Anne Smith, Sarah K. Abe, Stuart Gilmour, Lawrence O. Gostin, Gavin Yamey, Marco Schaeferhoff, Elina M. Suzuki, Jessica Kraus, Takashi Oshio, Reiko Hayashi, Naoki Kondo, Koichiro Shiba, Hideo Yasunaga, Yusuke Sasabuchi, Yohsuke Takasaki, Naoki Akahane, Shingo Kasahara, Munehito Machida, Satoshi Maruyama, Shuushou Okada, Tadayuki Tanimura, Tomohiko Sugishita, Ikuo Takizawa, Maki Ozawa, Yoshiharu Yoneyama, Hidechika Akashi, Chiaki Miyoshi, Hitoshi Murakami, Toshiro Kumakawa, Satoko Horii, Kenichiro Taneda, Hideaki Shiroyama, Yasushi Katsuma, Makiko Matsuo, Sayako Kanamori, Chiaki Sato, Kayo Yasuda, Jonas Kemp, B. T. Slingsby, Kei Katsuno, Bumpei Tamamura, Keizo Takemi, Hideki Hashimoto, Michael R. Reich

    LANCET　387　(10033)　2155-2162　2016/05

    DOI： 10.1016/S0140-6736(16)30177-5 　

    ISSN： 0140-6736

    eISSN： 1474-547X

  279. An evaluation of early countermeasures to reduce the risk of internal radiation exposure after the Fukushima nuclear incident in Japan. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Stuart Gilmour, Ryugo S Hayano, Yuni N Watanabe, Masahiro Kami, Yukio Kanazawa, Tomoyoshi Oikawa

    Health policy and planning　31　(4)　425-33　2016/05

    DOI： 10.1093/heapol/czv080 　

    ISSN： 0268-1080

  280. Postnuclear disaster evacuation and chronic health in adults in Fukushima, Japan: a long-term retrospective analysis. International-journal Peer-reviewed

    Shuhei Nomura, Marta Blangiardo, Masaharu Tsubokura, Akihiko Ozaki, Tomohiro Morita, Susan Hodgson

    BMJ open　6　(2)　e010080　2016/02/04

    DOI： 10.1136/bmjopen-2015-010080 　

    ISSN： 2044-6055

  281. Living in Contaminated Radioactive Areas Is Not an Acute Risk Factor for Noncommunicable Disease Development: A Retrospective Observational Study. International-journal Peer-reviewed

    Takeaki Ishii, Masaharu Tsubokura, Sae Ochi, Shigeaki Kato, Amina Sugimoto, Shuhei Nomura, Yoshitaka Nishikawa, Masahiro Kami, Kenji Shibuya, Yasutoshi Saito, Yukihide Iwamoto, Hidekiyo Tachiya

    Disaster medicine and public health preparedness　10　(1)　34-7　2016/02

    DOI： 10.1017/dmp.2015.102 　

    ISSN： 1935-7893

  282. Overview of health impacts caused by the Fukushima nuclear disaster and our opportunity to 'Build Back Better'

    Sae Ochi, Shigeaki Kato, Claire Leppold, Toyoaki Sawano, Shuhei Nomura, Tomohiro Morita, Masaharu Tsubokura, Tomoyoshi Oikawa, Ryuzaburo Shineha

    Proceedings of the 6th International Disaster and Risk Conference: Integrative Risk Management - Towards Resilient Cities, IDRC Davos 2016　481-484　2016

    Publisher: Global Risk Forum (GRF)

  283. Post-nuclear disaster evacuation and survival amongst elderly people in Fukushima: A comparative analysis between evacuees and non-evacuees. International-journal Peer-reviewed

    Shuhei Nomura, Marta Blangiardo, Masaharu Tsubokura, Yoshitaka Nishikawa, Stuart Gilmour, Masahiro Kami, Susan Hodgson

    Preventive medicine　82　77-82　2016/01

    DOI： 10.1016/j.ypmed.2015.11.014 　

    ISSN： 0091-7435

  284. Dependence of radiation dose on the behavioral patterns among school children: a retrospective analysis 18 to 20 months following the 2011 Fukushima nuclear incident in Japan. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Tomoyuki Furutani, Ryugo S Hayano, Masahiro Kami, Yukio Kanazawa, Tomoyoshi Oikawa

    Journal of radiation research　57　(1)　1-8　2016/01

    DOI： 10.1093/jrr/rrv051 　

    ISSN： 0449-3060

  285. Compliance with the proper use of an individual radiation dosimeter among children and the effects of improper use on the measured dose: a retrospective study 18-20 months following Japan's 2011 Fukushima nuclear incident. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Ryugo Hayano, Daisuke Yoneoka, Akihiko Ozaki, Yuki Shimada, Tomoyuki Furutani, Yukio Kanazawa, Tomoyoshi Oikawa

    BMJ open　5　(12)　e009555　2015/12/30

    DOI： 10.1136/bmjopen-2015-009555 　

    ISSN： 2044-6055

  286. Whole body counter assessment of internal radiocontamination in patients with end-stage renal disease living in areas affected by the Fukushima Daiichi nuclear power plant disaster: a retrospective observational study. International-journal Peer-reviewed

    Hiroaki Shimmura, Masaharu Tsubokura, Shigeaki Kato, Junichi Akiyama, Shuhei Nomura, Jinichi Mori, Tetsuya Tanimoto, Koichiro Abe, Shuji Sakai, Hiroshi Kawaguchi, Michio Tokiwa

    BMJ open　5　(12)　e009745　2015/12/07

    DOI： 10.1136/bmjopen-2015-009745 　

    ISSN： 2044-6055

  287. Long-Term Changes in Stroke-Related Hospital Admissions After the Fukushima Triple Disaster. International-journal Peer-reviewed

    Stuart Gilmour, Amina Sugimoto, Shuhei Nomura, Tomoyoshi Oikawa

    Journal of the American Geriatrics Society　63　(11)　2425-6　2015/11

    DOI： 10.1111/jgs.13812 　

    ISSN： 0002-8614

  288. Emergency medical service delay following Japan's 2011 Fukushima nuclear disaster Peer-reviewed

    MORITA Tomohiro, TSUBOKURA Masaharu, FURUTANI Tomoyuki, OCHI Sae, KATO Shigeaki, TSUBOKURA Seiji, KAMI Masahiro, TSUBOKURA Seiji, SHIMADA Yuki, FUJIOKA Masaru, OIKAWA Tomoyoshi, NOMURA Shuhei, TAKAHARA Kazuhiro

    日本救急医学会雑誌　26　(8)　353-353　2015/08/15

    Publisher: (一社)日本救急医学会

    ISSN： 0915-924X

    eISSN： 1883-3772

  289. Comparison between direct measurements and modeled estimates of external radiation exposure among school children 18 to 30 months after the Fukushima nuclear accident in Japan. International-journal Peer-reviewed

    Shuhei Nomura, Masaharu Tsubokura, Ryugo Hayano, Tomoyuki Furutani, Daisuke Yoneoka, Masahiro Kami, Yukio Kanazawa, Tomoyoshi Oikawa

    Environmental science & technology　49　(2)　1009-16　2015/01/20

    DOI： 10.1021/es503504y 　

    ISSN： 0013-936X

    eISSN： 1520-5851

  290. Absence of internal radiation contamination by radioactive cesium among children affected by the Fukushima Daiichi nuclear power plant disaster. International-journal Peer-reviewed

    Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Tomohiro Morita, Amina Sugimoto, Stuart Gilmour, Masahiro Kami, Tomoyoshi Oikawa, Yukio Kanazawa

    Health physics　108　(1)　39-43　2015/01

    DOI： 10.1097/HP.0000000000000167 　

    ISSN： 0017-9078

  291. An assessment of the characteristics and quality of diagnostic accuracy studies for positron emission tomography conducted in Japan: a systematic review. International-journal Peer-reviewed

    Shuhei Nomura, Akinori Hisashige, Daisuke Yoneoka, Mikiko Kanda, Karin Miyamoto, Miwako Segawa, Erika Ota, Kenji Shibuya

    EJNMMI research　5　6-6　2015

    DOI： 10.1186/s13550-015-0084-4 　

    ISSN： 2191-219X

  292. Managing Type 2 Diabetes Mellitus through Periodical Hospital Visits in the Aftermath of the Great East Japan Earthquake Disaster: A Retrospective Case Series. International-journal Peer-reviewed

    Yoshitaka Nishikawa, Yuji Fukuda, Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Yasutoshi Saito

    PloS one　10　(5)　e0125632　2015

    DOI： 10.1371/journal.pone.0125632 　

    ISSN： 1932-6203

  293. Assessment of the Annual Additional Effective Doses amongst Minamisoma Children during the Second Year after the Fukushima Daiichi Nuclear Power Plant Disaster. International-journal Peer-reviewed

    Masaharu Tsubokura, Shigeaki Kato, Tomohiro Morita, Shuhei Nomura, Masahiro Kami, Kikugoro Sakaihara, Tatsuo Hanai, Tomoyoshi Oikawa, Yukio Kanazawa

    PloS one　10　(6)　e0129114　2015

    DOI： 10.1371/journal.pone.0129114 　

    ISSN： 1932-6203

  294. Was the Risk from Nursing-Home Evacuation after the Fukushima Accident Higher than the Radiation Risk? International-journal Peer-reviewed

    Michio Murakami, Kyoko Ono, Masaharu Tsubokura, Shuhei Nomura, Tomoyoshi Oikawa, Tosihiro Oka, Masahiro Kami, Taikan Oki

    PloS one　10　(9)　e0137906　2015

    DOI： 10.1371/journal.pone.0137906 　

    ISSN： 1932-6203

  295. Whole-body counter survey results 4 months after the Fukushima Dai-ichi NPP accident in Minamisoma City, Fukushima. International-journal Peer-reviewed

    Ryugo S Hayano, Yuni N Watanabe, Shuhei Nomura, Tsuyoshi Nemoto, Masaharu Tsubokura, Tatsuo Hanai, Yuki Kumemoto, Satoshi Kowata, Tomoyoshi Oikawa, Yukio Kanazawa

    Journal of radiological protection : official journal of the Society for Radiological Protection　34　(4)　787-99　2014/12

    DOI： 10.1088/0952-4746/34/4/787 　

    ISSN： 0952-4746

    eISSN： 1361-6498

  296. Assessment of the risk of medium-term internal contamination in Minamisoma City, Fukushima, Japan, after the Fukushima Dai-ichi nuclear accident. International-journal Peer-reviewed

    Amina Sugimoto, Stuart Gilmour, Masaharu Tsubokura, Shuhei Nomura, Masahiro Kami, Tomoyoshi Oikawa, Yukio Kanazawa, Kenji Shibuya

    Environmental health perspectives　122　(6)　587-93　2014/06

    DOI： 10.1289/ehp.1306848 　

    ISSN： 0091-6765

    eISSN： 1552-9924

  297. Detection of 131I in a patient with thyroid cancer by internal radiation exposure screening using a whole-body counter in Fukushima. International-journal Peer-reviewed

    Masaharu Tsubokura, Shuhei Nomura, Takeaki Ishii, Masahiro Kami, Shigeaki Kato

    Clinical nuclear medicine　39　(3)　281-2　2014/03

    DOI： 10.1097/RLU.0000000000000338 　

    ISSN： 0363-9762

    eISSN： 1536-0229

  298. The immediate physical and mental health crisis in residents proximal to the evacuation zone after Japan's nuclear disaster: an observational pilot study. International-journal Peer-reviewed

    Masaharu Tsubokura, Kazuo Hara, Tomoko Matsumura, Amina Sugimoto, Shuhei Nomura, Masamitsu Hinata, Kenji Shibuya, Masahiro Kami

    Disaster medicine and public health preparedness　8　(1)　30-6　2014/02

    DOI： 10.1017/dmp.2014.5 　

    ISSN： 1935-7893

    eISSN： 1938-744X

  299. Are Japanese randomized controlled trials up to the task? A systematic review. International-journal Peer-reviewed

    Daisuke Yoneoka, Akinori Hisashige, Erika Ota, Karin Miyamoto, Shuhei Nomura, Miwako Segawa, Stuart Gilmour, Kenji Shibuya

    PloS one　9　(3)　e90127　2014

    DOI： 10.1371/journal.pone.0090127 　

    ISSN： 1932-6203

  300. Reduction of high levels of internal radio-contamination by dietary intervention in residents of areas affected by the Fukushima Daiichi nuclear plant disaster: a case series. International-journal Peer-reviewed

    Masaharu Tsubokura, Shigeaki Kato, Shuhei Nomura, Stuart Gilmour, Masahiko Nihei, Yu Sakuma, Tomoyoshi Oikawa, Yukio Kanazawa, Masahiro Kami, Ryugo Hayano

    PloS one　9　(6)　e100302　2014

    DOI： 10.1371/journal.pone.0100302 　

    ISSN： 1932-6203

  301. Measurement of internal radiation exposure among decontamination workers in villages near the crippled Fukushima Daiichi Nuclear Power Plant. International-journal Peer-reviewed

    Masaharu Tsubokura, Masahiko Nihei, Katsumi Sato, Shin Masaki, Yu Sakuma, Shigeaki Kato, Amina Sugimoto, Shuhei Nomura, Tomoko Matsumura, Makoto Miyazaki, Ryugo Hayano, Kenji Shibuya, Masahiro Kami, Taro Sasaki

    Health physics　105　(4)　379-81　2013/10

    DOI： 10.1097/HP.0b013e318297ad92 　

    ISSN： 0017-9078

  302. Interventions for reduction of stigma in people with HIV/AIDS Peer-reviewed

    Windy M.V. Wariki, Shuhei Nomura, Erika Ota, Rintaro Mori, Kenji Shibuya

    Cochrane Database of Systematic Reviews　2013　(6)　2013/06/18

    Publisher: John Wiley and Sons Ltd

    DOI： 10.1002/14651858.CD006735.pub2 　

    ISSN： 1469-493X

    eISSN： 1469-493X

  303. Mortality risk amongst nursing home residents evacuated after the Fukushima nuclear accident: a retrospective cohort study. International-journal Peer-reviewed

    Shuhei Nomura, Stuart Gilmour, Masaharu Tsubokura, Daisuke Yoneoka, Amina Sugimoto, Tomoyoshi Oikawa, Masahiro Kami, Kenji Shibuya

    PloS one　8　(3)　e60192　2013

    DOI： 10.1371/journal.pone.0060192 　

    More details Close

    BACKGROUND: Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees. METHODS: A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression. RESULTS: Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04-3.49). There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34-1.76) to 2.88 (95% CI: 1.74-4.76). No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07-3.49). CONCLUSION: High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.

  304. The relationship between media consumption and health-related anxieties after the Fukushima Daiichi nuclear disaster. International-journal Peer-reviewed

    Amina Sugimoto, Shuhei Nomura, Masaharu Tsubokura, Tomoko Matsumura, Kaori Muto, Mikiko Sato, Stuart Gilmour

    PloS one　8　(8)　e65331　2013

    DOI： 10.1371/journal.pone.0065331 　

    ISSN： 1932-6203

  305. Limited internal radiation exposure associated with resettlements to a radiation-contaminated homeland after the Fukushima Daiichi nuclear disaster. International-journal Peer-reviewed

    Masaharu Tsubokura, Shigeaki Kato, Masahiko Nihei, Yu Sakuma, Tomoyuki Furutani, Keisuke Uehara, Amina Sugimoto, Shuhei Nomura, Ryugo Hayano, Masahiro Kami, Hajime Watanobe, Yukou Endo

    PloS one　8　(12)　e81909　2013

    DOI： 10.1371/journal.pone.0081909 　

    ISSN： 1932-6203

  306. The voice of the most vulnerable: lessons from the nuclear crisis in Fukushima, Japan Peer-reviewed

    A. Sugimoto, S. Krull, S. Nomura, T. Morita, M. Tsubokura

    BULLETIN OF THE WORLD HEALTH ORGANIZATION　90　(8)　629-630　2012/08

    DOI： 10.2471/BLT.11.094474 　

    ISSN： 0042-9686

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Books and Other Publications 20

  1. 2026 Global Nutrition Report: Integrating food and health systems for climate-resilient nutrition

    Shibani Ghosh, Giacomo Zanello, Costanza Conti, Mariachiara Di Cesare, Cecilia Fabrizio, Eileen Kennedy, Shuhei Nomura, Marco Springmann

    PATH　2026/05/28

  2. Africa-Japan Common Vision on Health: Co-creating Health Security and Sustainable Growth

    Africa-Japan Common Vision on Health Working Group

    Japan Center for International Exchange　2025/08/21

  3. Subnational Dependency Ratios Adjusted by Health in the People’s Republic of China, India, Indonesia, Japan, Pakistan, and the Philippines, 1990–2021

    Shuhei Nomura, Jose Navarro, Vegard​ Skirbekk, Nishali Patel, Joseph​ Dieleman, Angela​ Chang

    Asian Development Bank Institute　2025/05

  4. Response to COVID-19: A Record (Continued) <2022-2024>

    Masahiro Hashizume, Shuhei Nomura, Motoi Suzuki

    Japan Public Health Association　2024/12/26

  5. 第3期「健康・医療戦略」策定に向けた提言―求められるグローバルな視点—

    Japan Center for International Exchange　2024/10

  6. Financing Global Health 2023: The Future of Health Financing in the Post-Pandemic Era

    Angela Micah, Joseph Dieleman, Katherine Leach-Kemon, Enis Bariş, Ian E. Cogswell, Hans Elliot, Brendan Lidral-Porter, Christopher J.L. Murray, Seong Nam, Shuhei Nomura, Nishali K. Patel, Carolyn Shyong, Juan Solorio, Golsum Tsakalos, Wesley Warriner, Asrat A. Wolde, Dereje Y. Yada, Yingxi Zhao, Bianca Zlavog

    2024/05/14

  7. Complex Landscape of Vaccine Hesitancy in Japan: A Public Health Challenge

    Shuhei Nomura, Mami Ueta, Alton Cao, Hana Tomoi

    Center for Asia-Pacific Resilience and Innovation　2024/05

  8. An incomplete picture: understanding the burden of long Covid

    Economist Impact

    Economist Impact　2024/04/28

  9. Modernizing Global Health Security to Prevent, Detect, and Respond

    Qudsia Huda, Erin L. Downey, Ali Ardalan, Shuhei Nomura, Ambrose Otau Talisuna, Ankur Rakesh

    Elsevier　2023/11/01

    ISBN: 9780323909457

  10. Promoting Global Solidarity to Advance Health System Resilience: Recommendations for the G7 Meetings in Japan

    Hiroshima Global Health Task Force (in alphabetical order: Keishi Abe, Sarah Krull Abe, Takanori Fujita, Yoshiaki Gu, Masahiro Hashizume, Chieko Ikeda, Masaki Inaba, Kazuaki Jindai, Naoki Kondo, Osamu Kunii, Makiko Matsuo, Hiroki Nakatani, Yoshitaka Nishino, Shuhei Nomura, Haruka Sakamoto, Hideaki Shiroyama, Tomoko Suzuki, Ayako Takemi, Kayo Takuma)

    2023/04/28

  11. Understanding the economic consequences of the covid-19 pandemic

    Economist Impact

    Economist Impact　2023/02/27

  12. Financing Global Health 2021: Global Health Priorities in a Time of Change

    Angela Micah, Joseph Dieleman, Kevin O'Rourke, Kayleigh Bhangdia, Ian Cogswell, Simon I. Hay, Dylan Lasher, Brendan Lidral-Porter, Emilie Maddison, Christopher J.L. Murray, Trang Nguyen, Shuhei Nomura, Nishali Patel, Paola Pedroza, Juan Solorio, Hayley Stutzman, Golsum Tsakalos, Wayne Wang, Wesley Warriner, Yingxi Zhao, Bianca Zlavog

    2023/01/23

    ISBN: 9781734130607

  13. Sustainability and Resilience in Japan’s Health System

    Shuhei Nomura, Matt McEnany, Joji Sugawara, Ryoji Noritake, Hiroaki Miyata

    Partnership for Health System Sustainability and Resilience (PHSSR)　2022/11

  14. 実践グローバルヘルス : 現場における実践力向上をめざして

    日本国際保健医療学会

    杏林書院　2022/04

    ISBN: 9784764405417

  15. Restructuring global health governance through global solidarity – Japanʼs role beyond the COVID-19 pandemic

    Global Health Governance Study Group

    Japan Center for International Exchange　2022/03

  16. Japan’s Global Health Diplomacy in the Post-COVID Era: The Paradigm Shift Needed on ODA and Related Policies

    Special Commission on Japan’s Strategy on Development Assistance for Health (DAH)

    Japan Center for International Exchange　2020/11

  17. WHO Guidance on Research Methods for Health Emergency and Disaster Risk Management

    Shuhei Nomura, Aya Ishizuka

    World Health Organization　2020/09

  18. Innovative Asia: Innovation Policy and the Implications for Healthcare and the Life Sciences

    Shuhei Nomura, Kenji Shibuya

    The National Bureau of Asian Research　2018/03

  19. Japan Health System Review

    2018/02

    ISBN: 9789290226260

  20. グローバルヘルス：日本の時代の到来 - 医学のあゆみ

    Shuhei Nomura, Munehito Machida, Kenji Shibuya

    医歯薬出版株式会社　2017/03

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Presentations 50

  1. Utilizing Frontier Technologies for a Healthy Society Invited

    Shuhei Nomura

    アジア太平洋強靭性研究基金会（CAPRI）主催「Global Innovation Reimagined Conference: AI Resilience」＠インターコンチネンタル 東京　2026/06/19

  2. 母子保健への投資の意義と投資効果 Invited

    野村周平

    公益社団法人セーブ・ザ・チルドレン・ジャパン主催「UHCハイレベルフォーラム院内集会－母子の命と健康を守る未来への投資」＠参議院議員会館　2025/12/05

  3. Global Health Landscape – Leveraging Insights from the Global Burden of Disease Study Invited

    2025/09/02

  4. Global Health Landscape – Leveraging Insights from the Global Burden of Disease Study Invited

    2025/08/15

  5. PHSSR（保健医療システムの持続可能性と強靭性を向上するためのパートナーシップ）政策ロードマップ Invited

    野村周平

    PHSSRサミット「より強靭な保健医療システムの共創」ーすべての人のためのトランスフォーム・ケア＠大阪万博　2025/06/30

  6. 国際シンポジウム "The Future Role of Pediatrics" Invited

    Shuhei Nomura

    第128回 日本小児科学会学術集会＠オンライン　2025/04/20

  7. Exploring Opportunities for Nutrition Improvement: Involving Multi-stakeholders with Differential Approaches Based on Diverse Country Experiences Invited

    Shuhei Nomura

    Nutrition for Growth (N4G) Summit 2025 ＠パリ日本文化会館　2025/03/26

  8. Health Communication amid Misinformation and Disinformation: Vaccine Hesitancy in Japan, Vietnam, and Taiwan Invited

    Shuhei Nomura

    アジア太平洋強靭性研究基金会（CAPRI）ラウンドテーブル＠オンライン　2025/02/19

  9. 人材育成 Invited

    野村周平

    第11回 日経・FT感染症会議@ホテルニューオータニ　2024/10/23

  10. Partnering for Sustainable Health Innovation Invited

    Shuhei Nomura

    Healthcare Denmark 主催「Tour de Health'24」＠ DI - Danish Industry　2024/10/01

  11. データで健康を拓く〜食と栄養政策におけるデータ駆動型アプローチ Invited

    野村周平

    第71回 日本栄養改善学会学術総会＠大阪公立大学　2024/09/07

  12. Disaster Resilience for Earthquakes, Typhoons, and Tsunamis Invited

    Shuhei Nomura

    アジア太平洋強靭性研究基金会（CAPRI）2024年次フォーラム＠ Taipei New Horizon　2024/05/06

  13. パンデミックとデータ駆動型社会 Invited

    野村周平

    慶應義塾大学医学部「信濃町データサイエンスフォーラム」＠慶應義塾大学　2024/03/14

  14. パンデミックとデータ駆動型社会 Invited

    野村周平

    大阪大学感染症総合教育研究拠点（CiDER）適塾セミナー＠大阪大学　2024/02/28

  15. Navigating the Methods Maze: A Roadmap for Replicable Research Writing Invited

    Shuhei Nomura

    WHO Scientific Writing Series ＠ オンライン　2024/02/28

  16. Quantitative Research Methods: Statistical Thinking and Research Process Invited

    Shuhei Nomura

    WHO Centre for Health Development Forum at the 29th Annual Meeting of Japanese Association for Disaster Medicine ＠みやこめっせ　2024/02/23

  17. Effective Ways to Write Research Funding Proposals Invited

    Shuhei Nomura

    第34回 日本疫学会学術総会＠びわ湖大津プリンスホテル　2024/02/01

  18. 減塩と疾病負荷：持続的食環境のためのコミットメントとステークホルダーの役割 Invited

    野村周平

    第34回 日本疫学会学術総会＠びわ湖大津プリンスホテル　2024/02/01

  19. Approaches to Social Implementation in Communities, Regions, and Nations, and the Alliances for It Invited

    Shuhei Nomura

    PMAC 2024 ＠ Centara Grand & Bangkok Convention Centre　2024/01/23

  20. Mismatch between International Aid and Issues as Seen Through Data Invited

    Shuhei Nomura

    PMAC 2024 ＠ Centara Grand & Bangkok Convention Centre　2024/01/23

  21. How to create the well-being world for all, affordable access to healthy products in polycrisis Invited

    Shuhei Nomura

    PMAC 2024 ＠ Centara Grand & Bangkok Convention Centre　2024/01/23

  22. データで読み解く 'NCDs × 食・栄養' の動向と展望 Invited

    野村周平

    日本リザルツ主催「GGG＋フォーラム」＠ルポール麹町　2023/11/28

  23. Battling the Silent Epidemic: Why We Can't Ignore NCDs – Insights from a Statistical Lens Invited

    Shuhei Nomura

    WHO Centre for Health Development Forum 2023 on Health Emergency and Disaster Risk Management ＠ WHO神戸センター　2023/11/14

  24. Health Beyond Borders – データで読み解くグローバルヘルス Invited

    野村周平

    WHO Centre for Health Development Forum 2023 "Build the world we want; A healthy future for all" @ WHO神戸センター　2023/10/01

  25. がんの疾病負荷の均てん化 世界の疾病負荷研究（GBD）のアプローチ Invited

    野村周平

    第82回 日本癌学会学術総会＠パシフィコ横浜　2023/09/21

  26. コロナ禍の死因別・人口動態別の超過死亡分析とその課題 Invited

    野村周平

    日本人口学会第75回大会＠南山大学　2023/06/11

  27. 結核対策への開発援助と疾病負荷の変遷 – 世界の疾病負荷研究（GBD）から Invited

    野村周平

    日本リザルツ主催「GGG＋フォーラム」＠ルポール麹町　2023/03/05

  28. 地球規模で再考する感染症対策 Invited

    野村周平

    医療政策サミット2023 @帝国ホテル　2023/02/18

  29. Developing a Food Compass system in Japan Invited

    Shuhei Nomura

    第22回 国際栄養学会議（IUNS-ICN）＠東京国際フォーラム　2022/12/07

  30. Health Effects of Dietary Risks – Evidence from the Global Burden of Disease Study Invited

    Shuhei Nomura

    第22回 国際栄養学会議（IUNS-ICN）＠東京国際フォーラム　2022/12/07

  31. Understanding and tackling inequalities in health Invited

    Shuhei Nomura

    2022 PHSSR Global Summit ＠ オンライン　2022/11/23

  32. 世界の疾病負荷研究：エビデンスを形成し、日本の政策を導く Invited

    野村周平

    第60回 日本癌治療学会学術集会＠大宮ソニックシティ　2022/10/20

  33. An Alternative Japanese Approach to Reducing Sodium while Enhancing Taste and Desirability Invited

    野村周平

    第29回 国際高血圧学会＠国立京都国際会館　2022/10/16

  34. National Disability Weights in Japan: Findings from the Japanese Disability Weight Measurement Study Invited

    Shuhei Nomura

    European Burden of Disease Network 主催「International Burden of Disease Conference」＠ Golden Tulip Zira Belgrade　2022/09/15

  35. アフリカと援助資金とUHC：変貌する状況とデータ駆動型アプローチ Invited

    野村周平

    日本リザルツ主催・日本・アフリカ連合（AU）友好議員連盟後援「TICAD8 プレイベント」＠ルポール麹町　2022/08/22

  36. 変貌する援助の流れ：公的資金の流れと援助構造のトレンド Invited

    野村周平

    世界銀行主催ラウンドテーブル＠世界銀行東京事務所　2022/06/22

  37. GGGを経由した援助資金の流れ Invited

    野村周平

    日本リザルツ主催「GGG＋フォーラム秋田2022」＠秋田キャッスルホテル　2022/06/19

  38. データ利活用の意義を社会全体で定着させるために Invited

    野村周平

    日本医療政策機構主催メディアセミナー「コロナ危機の先にある新しい社会とヘルスケア」＠大手町フィナンシャルシティグランキューブ　2022/05/17

  39. Pandemic and Data-Driven Society Invited

    Shuhei Nomura

    第62回 日本熱帯医学会大会＠オンライン　2021/11/05

  40. Disease Burden: Generating Evidence, Guiding Policy Invited

    Shuhei Nomura

    The 11th Conference of the. International Society for Integrated Disaster Risk Management @オンライン　2021/09/21

  41. A Case Study from Japan: A National BoD in Collaboration with the IHME Invited

    Shuhei Nomura

    サウジアラビア保健省主催ワークショップ＠オンライン　2021/09/08

  42. 災害と被災地科学と『人中心』のアプローチ：福島原発事故からのケーススタディ Invited

    野村周平

    WHO Centre for Health Development Forum at the 25th Annual Meeting of Japanese Association for Disaster Medicine @神戸国際会議場　2020/02/21

  43. Reformulating Japan’s Global Health ODA to Meet Changing Global Needs

    Shuhei Nomura

    PMAC 2020 UHCフォーラム 2020 ＠ Centara Grand & Bangkok Convention Centre　2020/01/30

  44. Improving Population Health in Japan: Opportunities and Challenges in the Era of Super-Aging Invited

    Shuhei Nomura

    国立台湾大学主催「Asia Forum of National Burden of Disease」＠国立台湾大学　2019/11/29

  45. 我が国の糖尿病の疾病負荷とリスク要因─世界の疾病負荷研究2017から─ Invited

    野村周平

    第56回 日本臨床生理学会総会＠大宮ソニックシティ　2019/10/27

  46. 世界の疾病負荷研究 – エビデンスを形成し、政策を導く Invited

    野村周平

    第42回 日本がん疫学・分子疫学研究会総会＠国立がん研究センター　2019/07/11

  47. The Global Burden of Disease Study: Measuring Progress and Guiding Policy Invited

    Shuhei Nomura

    WHO Thematic Platform for Health Emergency and Disaster Risk Management at the 21st WADEM Congress on Disaster and Emergency Medicine @ Brisbane Convention & Exhibition Centre　2019/05/09

  48. Improving Population Health in Japan: Opportunities and Challenges in the Era of Super-Aging Invited

    Shuhei Nomura

    Korea Institute of Health and Social Affairs 主催「The 19th Global Social Security Forum」＠ソウル・ホテル プレジデント　2019/02/13

  49. 世界の疾病負荷研究 Invited

    野村周平

    日本人口学会第70回大会＠明海大学　2018/06/02

  50. 疾病負荷と喫煙 – 我が国の都道府県レベル疾病負荷研究から Invited

    野村周平

    第82回 日本循環器学会学術集会総会＠大阪国際会議場　2018/03/24

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Research Projects 26

  1. Statistical Assessment Of Infectious Disease Risks Under Climate Change

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: Japan Institute for Health Security

    2026/04/01 - 2031/03/31

  2. A comprehensive assessment of the long-term effects of COVID-19 on population health in Japan

    ギルモー スチュアート, 野村 周平, NGUYEN THE, PHUONG, 米岡 大輔, 小野 洋平, 村野 弥生

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: St. Luke's International University

    2024/04 - 2029/03

  3. 新たな国際情勢を踏まえた我が国としての国際保健外交への提言に向けた研究

    梅田 珠実, 磯 博康, 橋爪 真弘, 城山 英明, 武見 綾子, 小松隆一, 詫摩 佳代, 野村 周平, 細澤 麻里子, 齋藤 英子

    2025/04 - 2028/03

  4. Municipal Data-Driven Approaches to Identifying Child Maltreatment Risks and Enhancing Early Intervention Strategies

    Yuka Suzuki, Hiroaki Miyata, Hisateru Tachimori, Shuhei Nomura, Keiko Sakurai

    Offer Organization: Japan Society for the Promotion of Science(JSPS)

    System: Grant-in-Aid for Scientific Research (C)

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: Keio University

    2025/04 - 2028/03

  5. Research on identifying factors related to the onset/progression of diabetes and kidney diseases and estimating their impact on population health outcomes in Japan.

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: Keio University

    2024/04 - 2027/03

  6. Natural Disasters and Health Crisis Management in the Reiwa Era: Advancing Research with a Focus on WHO Research Methodology Guidance

    原田 奈穂子 小坂 健 香田 将英 野村 周平 大塚 理加 西岡 大輔 笠岡 宜代 坪井 基浩 市川 学 冨尾 淳

    Offer Organization: Ministry of Health, Labour and Welfare

    Institution: Okayama University

    2024/04 - 2027/03

  7. Reevaluation and Utilization of Disease Burden in Japan: Prefectural Analysis in the Post-COVID-19 Era and Challenges to New Methodologies

    野村 周平, 田淵 貴大, 橋爪 真弘, 大田 えりか, 山本 依志子, 坂元 晴香, 鈴木 基, 齋藤 英子, 米岡 大輔, 井上 真奈美, 宮田 裕章, 西浦 博

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (A)

    Institution: Keio University

    2024/04 - 2027/03

  8. Research to Inform the Implementation of Rational Infection Prevention and Control Measures for the Next Pandemic

    Shuhei Nomura

    Offer Organization: The Cabinet Agency for Infectious Disease Crisis Management

    2025/04 - 2026/03

  9. An Empirical Study on Disease Burden for Developing a New Health System

    Shuhei Nomura

    Offer Organization: Japan Science and Technology Agency

    2022/10 - 2026/03

  10. Research on cancer risk assessment and cancer prevention guideline recommendations based on scientific evidence

    Shuhei Nomura

    Offer Organization: National Cancer Center Japan

    System: National Cancer Center Research and Development Fund

    Institution: The University of Tokyo

    2021/04 - 2025/03

  11. 新しい保健システム構築のための実証的な疾病負荷研究

    野村 周平

    Offer Organization: 科学技術振興機構

    Category: 戦略的な研究開発の推進/戦略的創造研究推進事業/さきがけ

    2022 - 2025

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    包括的で比較可能な保健指標「疾病負荷」は、保健政策の優先決定に重要な情報ですが、諸外国に比べ我が国での政策活用は限定的です。本研究は、これまで私が行ってきた疾病負荷研究を発展させ、コロナ危機の先にある、社会経済活動を維持しつつ、公平で強靭で持続可能な新しい国内外の保健システムの構築に疾病負荷を活用する基盤を確立し、そして我が国の喫緊の国内保健政策とグローバルヘルス政策の議論に資する知見を創出します。

  12. Research Towards Establishing a Multilayered Infectious Disease Surveillance System in the Era of Medical Digital Transformation

    Shuhei Nomura

    Offer Organization: Ministry of Health, Labour and Welfare

    Institution: National Institute of Infectious Diseases

    2023/04 - 2024/03

  13. Utilization and Empirical Analysis of Disease Burden for Health Care Challenges in the With/Post-COVID-19 Era

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: Keio University

    2021/04 - 2024/03

    More details Close

    This study comprehensively analyzed the impact of the novel coronavirus disease (COVID-19) on the burden of disease in Japan. Statistical modeling of infectious disease data was used to estimate excess mortality and predict the spread of infection. The study also analyzed the increase in the burden of non-communicable diseases during the COVID-19 pandemic and the associated risk factors, as well as trends in Japan's official development assistance in the health sector. An analysis using the latest framework of the Global Burden of Disease study showed that COVID-19 had a certain impact on life expectancy and healthy life expectancy. These findings provide valuable information to policymakers and the general public, presenting challenges and future prospects for health care policies in the with/post-COVID-19 era.

  14. Calculation of Happy Life Expectancy and Its Application to Environmental and Disaster-Related Health Risk Assessment

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (B)

    Institution: Fukushima Medical University

    2020/04 - 2023/03

    More details Close

    This study compared disaster- and environment-related health risk factors using happy life expectancy (HpLE) and loss of happy life expectancy (LHpLE). HpLE in Japan was 37.5 years for men and 49.1 years for women. LHpLE due to diabetes and psychological distress among people affected by the Fukushima disaster was about two orders of magnitude higher than that due to radiation-induced cancer. LHpLE due to environment-related health risk factors such as radon, arsenic, and PM2.5 was two to four orders of magnitude lower than that due to psychological distress under normal circumstances.

  15. Empirical research on health policy issues in Japan based on comprehensive burden of disease analysis

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (A)

    Institution: The University of Tokyo

    2019/04 - 2022/03

    More details Close

    This study provides a comprehensive analysis of the burden of disease in Japan, which contributes to national policies. The previous studies on burden of disease were further developed to produce the latest estimates of burden of disease in the country. While healthy life expectancy has been steadily increasing, the study recognized issues such as the rapid increase in the burden of disease due to chronic diseases such as diabetes and dementia including Alzheimer's disease related to aging, and the increase in risk factors contributing to these diseases, as well as the expansion of health inequalities. It is noteworthy that these chronic diseases and risk factors are associated with risk of serious illness and mortality due to COVID-19, suggesting an urgent need to strengthen public health efforts to build health systems that are more resilient to health crises such as COVID-19.

  16. Development of a Method for Evaluating Health System Performance by Prefecture in Japan

    Institution: The University of Tokyo

    2018/04 - 2021/03

  17. Research on cancer risk assessment and recommendations for prevention guidelines through active use of national and international research collaboration infrastructure

    Offer Organization: National Cancer Center Japan

    System: National Cancer Center Research and Development Fund

    Institution: The University of Tokyo

    2018/04 - 2021/03

  18. A comprehensive study on comparative risk assessment of disease burden in Japan and its application to health policy in Japan

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    Institution: The University of Tokyo

    2018/04 - 2021/03

    More details Close

    This study is a comprehensive and detailed analysis of risk factors for health outcomes in Japan. We estimated the distribution of various risk factors and their trends by prefecture, and also estimated the contribution of risk factors to various health outcome indicators by prefecture. We used all available data on risk factors and the latest statistical methods. The results of this study include the comprehensive estimates of the disease burden not only at the national level but also at the prefectural level, and its application to health policy in Japan.

  19. Exposure to Air Pollution in Japan and Its Impact on Health and Wellbeing

    Shuhei Nomura

    Offer Organization: Dyson Technology Limited

    Institution: The University of Tokyo

    2019/10 - 2020/09

  20. Research on nutritional dietary habits using DALYs as an indicator for extending healthy life expectancy

    Shuhei Nomura

    Offer Organization: Ajinomoto Co., Inc.

    Institution: The University of Tokyo

    2019/04 - 2020/09

  21. A Pursuit of Healthcare Promoting Well-being in Fukushima: Towards the full recovery from the 2011 Fukushima nuclear power plant accident

    Shuhei Nomura

    Offer Organization: The Toyota Foundation

    System: 共同研究助成

    Institution: Minamisoma Municipal General Hospital

    2018/05 - 2020/04

  22. Medium- and Long-Term Health Impact Assessment of the Nepal Earthquake: Towards a Disaster-Resilient Health Care System

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Bilateral Collaborations

    Institution: Institute for Global Health Policy Research

    2018/04 - 2020/03

  23. Research on Establishing an Effective Presence of Japan at the World Health Assembly, etc.

    Shuhei Nomura

    Offer Organization: Ministry of Health, Labour and Welfare

    Institution: The University of Tokyo

    2017/04 - 2019/03

  24. Comprehensive Study of Disease Burden and Its Utilization by Prefecture in Japan

    Shuhei Nomura

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (A)

    Institution: The University of Tokyo

    2016/04 - 2019/03

    More details Close

    This study is the first attempt in Japan to comprehensively analyze the burden of disease not at the national level but also at the prefectures, and apply it to concrete policy analysis. This year we expanded data collection, applied the latest statistical techniques, and improved methodologies. From 1990 to 2017, Japan's overall healthy life expectancy increased from 69.7 to 73.1 years. The top of present main cause of death is cerebrovascular disease and cardiovascular disease nationwide, and main cause of DALYs (Disability-adjusted life years) is back pain. Longevity leads to more disabilities (especially sensory and motor organs). In addition, the burden of degenerative diseases (Alzheimer's disease) is significant nationwide, and urgent measures are required.

  25. Assessment of the Mid- to Long-term Health Effects of Japan's 2011 Fukushima Nuclear Disaster: Toward disaster-resilient health care systems

    Shuhei Nomura

    Offer Organization: The Toyota Foundation

    System: Joint Research Grants

    Institution: Imperial College London

    2016/05 - 2018/04

  26. Long-term Prognosis in Hemodialysis Patients and Nuclear Disaster Evacuation, Following the 2011 Great East Japan Earthquake

    KODAMA YUKO, Shinmura Hiroaki, Takasaki Junko, Matsuzaki Yukie, Sato Yuko, Nomura Shuhei

    Offer Organization: Japan Society for the Promotion of Science

    System: Grants-in-Aid for Scientific Research

    Category: Grant-in-Aid for Scientific Research (C)

    2015/04/01 - 2018/03/31

    More details Close

    Patients with hemodialysis were assessed for their long-term impact of evacuation following the Great East Japan Earthquake and nuclear disaster. Data from a total of 573 individuals was analyzed. During the observation period from March 11, 2011 to March 3, 2017, 120 patients died. The mortality rate of non-evacuated patients was 0.14 per 1000 person-days, and 0.1 per 1000 person-days for evacuated patients. The older the patients, and their number of hospitalizations caused significantly higher mortality in both evacuated and non-evacuated patients. After adjustment for covariates, the research found no significant associations between mortality rate and evacuation. The findings suggest continued hemodialysis, the accuracy of triage, and planned evacuation can be an important factor for reducing the indirect health effects of a disaster. Additionally, it is important that local nurses learn general management and become educated regarding good healthcare.

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Teaching Experience 15

  1. Nogizaka School: Food and Nutrition Supporting Japan’s Model of Healthy Longevity　International University of Health and Welfare

  2. Global Health Course　University of Indonesia

  3. Human Security and Global Health　Tohoku University

  4. Public Health Management　Keio University

  5. Advanced International Nursing I　St. Luke's International University

  6. Global Health Policy I　The University of Tokyo

  7. Global Health Policy II　The University of Tokyo

  8. Social Design and Global Leadership　The University of Tokyo

  9. Introduction to Health and Medical Big Data　Shizuoka Graduate University of Public Health

  10. Introduction to Medical Science　Waseda University

  11. Global Health　The University of Tokyo

  12. Measuring Burden of Disease: Methods and Applications　National Taiwan University

  13. Health Technology II　Kanagawa University of Human Services

  14. Introduction to Environmental Chemistry　Tokyo University of Agriculture and Technology

  15. Introduction to Health Sciences　The University of Tokyo

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