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Background and Objectives: Previously (2007), it was reported that ABO antibody titers in Japanese blood donors had decreased significantly compared to 20 years before. Here we evaluated whether further decrease of antibody titers had occurred in recent years, and the potential factors associated with changes in antibody titers., Materials and Methods: Serum/plasma from random blood donors in 2010 and 2021 (2010: 3369, 2021: 5796 donors) was classified into low, middle, and high ABO antibody titers according to the reactivity of diluted serum/plasma (2.5-fold and 20-fold) by an automated microplate system. The rates of low/high titer in the two periods were compared. Logistic regression and age-gender-BMI subgroup analyses were conducted to identify the factors that contributed to changes in antibody titers., Results: Compared to 2010, the rate of donors with high ABO antibody titers was　decreased in 2021 for both anti-A and anti-B (anti-A, 2010: 23.8%, 2021: 19.3%; anti-B, 2010: 23.8%, 2021: 16.4%). In logistic regression analysis, age was found to significantly affect both anti-A and anti-B antibody titers (anti-A, adjusted odds ratio 0.36, 95% CI 0.31-0.41; anti-B, 0.42, 0.37-0.47), and BMI (0.82, 0.73-0.92) and other time-related factors (0.79, 0.71-0.88) significantly affect anti-B antibody titers. Subgroup analysis revealed decreased rate of high anti-B titers in the higher age group in 2021., Conclusion: The rate of high ABO antibody titers, especially high anti-B titers, was significantly decreased in 2021, and our results suggested an association with aging and obesity of blood donors as well as other time-related factors., Competing Interests: Conflict of Interest The authors declare that they have no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Public assistance recipients in Japan are financially empowered by social welfare but are also exposed to social stigma. Therefore, when their status of receiving public assistance changes, the conditions of their social life likely change. We examined whether the social relationships of older adults receiving public welfare are influenced by either starting or terminating their use of public assistance. This study used the Japan Gerontological Evaluation Study panel data from 2013 to 2016. To measure social relationships, we used four indicators: the frequency of meeting with friends, the number of friends whom the participants had met with in the past month, their frequency of participating in sports clubs, and their frequency of participating in hobby clubs. In the analyses, changes in social relationships between 2013 and 2016 were used as the study outcomes. Linear regression analyses were conducted to examine if their social relationships changed before and after starting or terminating public assistance while adjusting for confounders. We found that people who stopped receiving public assistance experienced an increase in their frequency of meeting with friends (coefficient: 0.56; 95% CI: 0.06, 1.07), the number of friends (coefficient: 0.60; 95% CI: 0.20, 0.99), participation in sports clubs (coefficient: 0.91; 95% CI: 0.46, 1.39), and participation in hobby clubs (coefficient: 0.70; 95% CI: 0.26, 1.13) compared to those who continued to receive public assistance. Contrarily, the measured social relationships did not change after the participants started receiving public assistance. Our main findings were that terminating one's reception of public assistance increases informal socializing and social participation while starting public assistance does not interrupt pre-existing relationships. These findings contribute to the literature by adding that social relationships are not negatively influenced by either terminating or starting public assistance. Targeted promotions of social connections would effectively maintain the health statuses of low-income older adults., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Japan and South Korea represent "outliers" among rich nations with regard to having achieved high life expectancy but also ranking near the bottom on United Nations indices of gender equality. In the present study, we compared gender inequalities in self-rated health (SRH) across the life course captured in nationally representative surveys from South Korea and Japan. Our comparative analysis focused on the following questions, (1) Do Japan and South Korea exhibit similar patterns of gender inequalities in health as found in western settings (e.g. the "gender paradox" whereby women enjoy longer life expectancy, but worseself-rated health compared to men)? (2) Can gender differences in educational attainment and income account for gender differences in health in Japan & Korea? (3) Do gender inequalities in self-rated health differ over the life-course in Japan compared to South Korea?, Methods: Cross-sectional data were drawn from nationally representative surveys in South Korea and Japan. We analyzed data for 239,076 participants aged 20 years or older (226,105 in South Korea and 12,971 in Japan). We evaluated the gender gap in poor SRH between two countries using logistic regression models controlling for covariates sequentially., Results: (1) The absolute female/male gap in prevalence of poor SRH was much narrower in Japan compared to South Korea; (2) the prevalence ratios of poor SRH (women relative to men) were significantly higher in South Korea than in Japan after retirement age; (3) but the difference in the prevalence ratios of poor SRH by gender between two countries largely disappeared after adjusting for educational attainment & comorbidity., Conclusions: Each country needs to analyze their specific situations to understand what determines their population health status. In addition, there must exist other reasons for the"gender paradox" - i.e. why Japan & Korea have managed to achieve high longevity without gender equality., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Although Japan and South Korea share a number of commonalities, social security systems are very different. We opt to compare socioeconomic disparities in self-rated health between these two countries. The analytic sample included those aged 20 years and older from the nationally representative surveys in Japan (Comprehensive Survey of Living Conditions) and South Korea (Korean Community Health Survey). As socioeconomic status, we used income (quintiles of equivalized annual household income) and education (five categories). We measured socioeconomic inequalities using two indices; the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII), in each age group for each country. In Japan, we found relatively little evidence of socioeconomic inequalities in self-rated health over the life course, on either the absolute or relative scale. In Korea, the absolute inequality assessed by SII of self-rated poor health was higher in middle and old age groups compared to other age groups, while relative inequality measured by RII was significantly higher in younger ages. In Japan with more generous welfare system to the older generations, health inequality was relatively lower compared to Korea. The gaps in health status for Korean people suggest where social policy might direct their efforts in the future - (a) reducing inequalities in working-age people by addressing the gap between standard workers & non-standard workers; and (b) improving the financial conditions of older people by shoring up the social security system., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Japan and South Korea have among the highest suicide rates in the world. However, the age, gender, and time trends in each country differ substantially. Age-Period-Cohort (APC) analysis of suicide rates was conducted to better understand these differences. Using age- and gender-specific data on suicide between 1986 and 2015 in Japan and Korea, we implemented APC analysis to decompose the country-specific trends into age, calendar period, and birth cohort effects. APC analysis revealed three trends: (1) there was a sharp increase in suicide around retirement age in Korea but not in Japan (age effect); (2) there was a dramatic increase in suicide during the three decades of observation in Korea (period effect) whereas rates were more stable in Japan; and (3) the post-War generation in Japan (including baby boomer) had lower rates of suicide compared to generations born before 1916 or after 1961 (birth cohort effect), whereas suicide rate has increased linearly in each generation in Korea. Although Japan & Korea share high suicide rates, our APC analysis suggests divergent causes underlying these trends. Japanese suicide rates plateaued among the cohorts who experienced the post-War rapid economic growth (women born in 1951-1956 and men born in 1916-1961) (birth cohort effect) due to a strong social safety net for this cohort, while suicide rates in Korea continue to rise with each generation and is particularly elevated in post-retirement age. Japan and Korea need to pay more attention to suicide prevention in more recent birth cohorts., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Plasma removal by washing platelet concentrates (PCs) is effective in preventing adverse reactions to PC transfusions. The Japanese Red Cross Society (JRCS) started releasing washed PCs (WPCs) as a commercially approved blood product in September 2016. This retrospective multicenter study investigated the change in the number of transfused WPCs and the impact on the incidence of adverse reactions to PCs before and after the release. The numbers and types of transfused PCs and the adverse reactions to the PCs for a year before the start of the WPC release and for a year after the release were reported by 27 medical institutes in Japan. Transfusion information for approximately 8% of the amount of PCs supplied in Japan was analyzed during the study period. After the start of WPC release by the JRCS, the number of transfused WPCs doubled. The rate of adverse reactions to PCs decreased significantly (p = 0.0223), from 4.30% before the release to 4.05% after the release. The rates of adverse reactions to unwashed and WPCs were 4.13% and 0.84%, respectively. Allergic adverse reactions were significantly decreased after the release (3.60% before versus 3.37% after). No severe allergic reactions to WPCs were reported. The release of WPCs by the JRCS significantly reduced transfusion-related adverse reactions to PCs in Japan., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Plasma removal by washing is an effective approach to prevent transfusion reactions by platelet concentrates (PCs). Recently, washed PCs were released by the Japanese Red Cross Society (JRCS)., Materials and Methods: This retrospective multicenter study evaluated the efficacy and safety of released washed PCs (RWPCs) between September 2016 and January 2017 in Japan. The RWPCs were prepared by washing leukoreduced apheresis PCs with the platelet additive solution, BRS-A, using automated cell processors., Results: Clinical data were obtained from 91 patients and 1210 RWPC transfusions at 50 institutions. The median number of RWPC transfusions per patient was 8 (range, 1-91). RWPCs were used in 94.5% of the patients with a history of recurrent or severe transfusion reactions for preventing such reactions. Responses of RWPCs were evaluated as complete response (91.6%), partial response (8.2%), no-change (0.2%), and progression (0%) and overall response was equal across subgroups divided by patients' profiles. The median corrected count increment (CCI) at 1 and 24 h post-transfusion were 13.5 (range, 1.9-35.4) × 10 9 /L and 3.5 (range, -13 to 53.6) × 10 9 /L, respectively, and median CCI at 24 h was 5.5 (range, -13 to 53.6) × 10 9 /L in patients without risk factors associated with platelet transfusion refractoriness. Transfusion reactions to RWPCs were observed in only nine transfusions (0.7%), all of which were mild allergic reactions., Conclusion: This study demonstrated that RWPCs were effective and safe in patients with a history of transfusion reactions. Further prospective studies on efficacy together with cost-benefit analysis in RWPCs are needed., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Premedication before transfusion is commonly administered in clinical practice despite a lack of evidence for its efficacy. The aim of this study was to clarify the status of premedication and evaluate expert opinions regarding its use in Japanese medical institutions., Method: Between May and July 2016, we conducted a questionnaire survey on premedication before transfusion in 252 medical institutes that were certified by an academic society or employed transfusion experts., Results: A total of 141 institutes (54.2%) responded, and hematologists (n=113) comprised the most frequent respondents. The purpose of premedication was to prevent urticaria, pruritus, and fever, and washed blood products were used for anaphylactic shock or refractory transfusion reactions before. Drugs for premedication were intravenously administered either just before or 30min before transfusion. Both inpatients and outpatients were premedicated in a similar manner, and institutional guidelines were not established. More than half of the experts recognized premedication as efficient and necessary, and premedication for previous transfusion reactions was frequently implemented, particularly for platelet transfusion or in patients with hematological diseases. Some institutions administered one or more drugs for premedication from the first transfusion. Antihistamines and hydrocortisone were the most frequently used as premedication., Conclusion: Our study reports the current status of premedication for transfusion in Japan. Antihistamines and hydrocortisone were most commonly used for premedication despite a lack of evidence of their use. These findings may help clarify the indications for premedication and the use of washed blood products., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

As a national study, we evaluated the frequencies of irregular erythrocyte antibodies (Abs) by gender and history of transfusion or pregnancy. In total, data from 248,785 patients were analyzed, from whom 4222 irregular erythrocyte Abs were detected in 3554 cases (1.43%). Abs frequencies in these 4222 cases were as follows: anti-E, 26%; anti-Le(a), 26%; anti-P(1), 11%; anti-M, 6%; anti-E+c, 4%; anti-Fy(b), 4%; anti-Di(a), 3%; anti-Le(b), 3%; and anti-D, 2%. In pregnancy, anti-D (5%), anti-Jr(a) (3%) and anti-E+c (6%) Abs were, with statistical significance, more frequent. Among transfused patients, anti-E (38%), anti-E+c (8%), anti-Jk(a) (4%), anti-e+C (2%) and anti-E+Jk(a) (1%) Abs were, with statistical significance, more frequent., ((c) 2010 Elsevier Ltd. All rights reserved.)