Takayuki Kawaura

Comparison of Anatomic and Non-anatomic Hepatic Resection for Hepatocellular Carcinoma

The aim of the present study was to compare the prognostic impact of anatomic resection (AR) versus non‐anatomic resection (NAR) on patient survival after resection of a single hepatocellular carcinoma (HCC).

Analysis of medical care expenditure by Japanese prefecture using fuzzy robust regression model

In 2012, 15.13% of the total fiscal medical care expenditure was for lifestyle-related health care costs, which was approximately 179 billion yen. Lifestyle-related diseases are not only the biggest factor in reducing healthy life expectancy but also have the most significant impact on the national medical care expenditure. In addition, lifestyle-related diseases can be prevented by moderate daily exercise, a well-balanced diet, and not smoking. Our fuzzy robust regression model is a controllable model describing a target system. Therefore, our model is used to analyze the relation between medical care expenditure and selected lifestyle factors.

Japanese economic analysis using fuzzy autocorrelation model with fuzzy confidence intervals

Economic systems are complex because they are influenced by many factors such as policy impacts, human behaviour, and consciousness. When a system includes these factors, a fuzzy system approach plays a pivotal role in its analysis. A fuzzy autocorrelation model proposed by Yabuuchi et al. uses the concept of soft computing for the Box-Jenkins model. In a case study using a fuzzy autocorrelation model, fuzzy random variables were used for the fuzzy autocorrelation model, because of the unnatural behaviour of the predicted value. The results revealed an improvement in the predictive accuracy of the model. In this study, we validate the feasibility of the proposed approach by using the results of an analysis of the Japanese national consumer price index. In this analysis, we show that unnatural behaviour and ambiguities of the proposed model are improved by using fuzzy confidence intervals.

Analysis of the relation between health statistics and eating habits in Japanese prefectures using fuzzy robust regression model

In recent years, the Japanese Ministry of Health, Labour, and Welfare is working to improve citizen׳s lifestyle and social environment to improve their health. This is because of the following reasons. Diseases related to lifestyle such as malignant neoplasms, heart disease, and cerebrovascular disease account for about 60% of the deaths in 2013. In addition, 32% of all medical expenditures are made on lifestyle-related disease. Lifestyle-related diseases can be prevented by daily exercise, a well-balanced diet, and not smoking. This ministry is promoting measures such as dietary education, physical activity, and exercise. Improvement of diet is the easiest way to reduce the occurrence of lifestyle-related diseases. Thus, in this paper, we analyze the relation between health and diet using our fuzzy robust regression model.

Gerotranscendental Change in the Elderly: An Analysis of ‘Faith’ and ‘Leaving from Clinging to Self’

Recently, the number of elderly persons (65 years or older) has in-creased in Japan due to the aging of the general population. Recent changes in family structure have greatly increased the percentage of single-elderly households. Based on these social circumstances, participants were classified into living-alone (single-elderly households) and living-together (elderly households with a spouse only) groups to determine group differences in this study. Participants were 56 persons living in fee-based nursing homes for the elderly located in five prefectures in Japan. A questionnaire was developed based on Gerontranscendence: A Developmental Theory of Positive Aging by L. Tornstam to ask the elderly about eight gerontranscendence-related themes.

Reappraisal of previously reported meta-analyses on antibiotic prophylaxis for low-risk laparoscopic cholecystectomy: an overview of systematic reviews

Introduction Many researchers have addressed overdosage and inappropriate use of antibiotics. Many meta-analyses have investigated antibiotic prophylaxis for low-risk laparoscopic cholecystectomy with the aim of reducing unnecessary antibiotic use. Most of these meta-analyses have concluded that prophylactic antibiotics are not required for low-risk laparoscopic cholecystectomies. This study aimed to assess the validity of this conclusion by systematically reviewing these meta-analyses. Methods A systematic review was undertaken. Searches were limited to meta-analyses and systematic reviews. PubMed and Cochrane Library electronic databases were searched from inception until March 2016 using the following keyword combinations: ‘antibiotic prophylaxis’, ‘laparoscopic cholecystectomy’ and ‘systematic review or meta-analysis’. Two independent reviewers selected meta-analyses or systematic reviews evaluating prophylactic antibiotics for laparoscopic cholecystectomy. All of the randomised controlled trials (RCTs) analysed in these meta-analyses were also reviewed. Results Seven meta-analyses regarding prophylactic antibiotics for low-risk laparoscopic cholecystectomy that had examined a total of 28 RCTs were included. Review of these meta-analyses revealed 48 miscounts of the number of outcomes. Six RCTs were inappropriate for the meta-analyses; one targeted patients with acute cholecystitis, another measured inappropriate outcomes, the original source of a third was not found and the study protocols of the remaining three were not appropriate for the meta-analyses. After correcting the above miscounts and excluding the six inappropriate RCTs, pooled risk ratios (RRs) were recalculated. These showed that, contrary to what had previously been concluded, antibiotics significantly reduced the risk of postoperative infections. The rates of surgical site, distant and overall infections were all significantly reduced by antibiotic administration (RR (95% CI); 0.71 (0.51 to 0.99), 0.37 (0.19 to 0.73), 0.50 (0.34 to 0.75), respectively). Conclusions Prophylactic antibiotics reduce the incidence of postoperative infections after elective laparoscopic cholecystectomy.

A Study of Older People’s Socializing Form with Others: Comparative Analysis of “Living Alone” and “Living with a Spouse” Using Quantification Theory Type II

The Comprehensive Survey of Living Conditions conducted by Ministry of Health, Labor and Welfare has announced households with elderly people aged 65 years old and over increased to 44.7 % of all households in 2013. Furthermore, the population of elderly people living alone increased to 17.7 % of the all households in 2013. According to preceding studies and surveys, in the case of elderly people living alone, illness and loneliness lead to stress and other illnesses, and these people experience various difficulties in their everyday life. Although some local governments support elderly living alone, it is important to understand the psychological characteristics of the elderly is important. In this paper, we analyze the results of a survey of elderly people using a questionnaire based on L. Tornstam’s theory of Gerotranscendence. In this analysis, we analyze the questionnaire using quantification theory type II. An elderly living alone is focused on, and we compare “elderly living alone” with “elderly living with a spouse” in order to find utilizing ways to support elderly people.

Analysis of Japanese Health using Fuzzy Principal Component Analysis

Japanese population is 128 million, and the population of younger than 15 years old is less than elderly people at least 65 years old. Then, Japanese population pyramid is distorted. While the population under 65 years old has reduced, the population 65 years old and above have increased. Japanese major health insurance society has reported that lifestyle-related medical costs are about 1,791 billion yen in fiscal medical expenses total about 1,184 billion yen. It becomes about 15 % of the total. This is a great amount of costs which is able to be ignored. Therefore, we analyzed the relation between the medical expense and food intakes by a regression model, and the results have been reported in InMed-14. In addition, we have analyzed the relation between the numbers of outpatient and food intakes in five years by a regression model. It is because lifestyle is made by continuing food intakes. Although we have obtained the results by these analyzes, however we need to analyze the relationships between factors.Therefore, in this paper, we analyze the relation between these factors by a principal component analysis.

Clinical nurses' awareness structure of delirium — An analysis of spontaneous utterances in a group interview by DEMATEL method

Patients with delirium have a higher risk of falling and losing their lives. Therefore, delirium is known to be one of the factors that has a bad influence not only on treatment and nursing but also on the patients vital prognosis. However, no specific therapeutic agents for delirium or prophylaxes against it have been developed yet. Besides, it has been reported that delirium is one of the mental states that is tend to be passed over. Accordingly, it is very important to develop the staffs observation skills and to establish the nursing care system in order not to overlook delirium. In this study, we interviewed the clinical nurses working at Kansai Medical University Takii Hospital in a group setting. They are in contact on a routine basis with patients with delirium. Their spontaneous utterances about delirium are analyzed with the DEMATEL method. Their utterances are divided into two groups, that is, “causes of delirium” and “delirious patients behavior”. From each group, keywords and phrases are picked out and analyzed. Consequently, this study will reveal how the clinical nurses feel about delirium and delirious patients.