Supplements purchase intention: young consumer's perspective

PurposeThis study aims to investigate the factors that influence young consumers' purchase intention towards dietary supplements (DS) in Malaysia.Design/methodology/approachThe supplement industry in Malaysia has been growing rapidly recently due to a paradigm shift in healthcare management, from curative to prevention. Thus, it has sparked interest to conduct a study on the factors that influence young consumers' purchase intentions towards DS. With a response rate of 74.5%, a survey questionnaire was used to elicit data from 149 Gen-Y respondents who consume supplements on a regular basis.FindingsThe results revealed that the influencing factors towards purchase decisions among these Gen-Y respondents aged between 17 and 25 are based on product knowledge and product quality. The implications of these findings and directions for future research are outlined at the end of this paper.Originality/valueThis study offers empirical insights from the perspective of an emerging digital economy on the factors that influence young consumers' purchase intentions towards DS in Malaysia.

Crisis and Literature in Contemporary Japan: From 3-11 to the COVID-19 Pandemic in Kanehara Hitomi's Fiction

It has been observed that ‘3–11' marked an inflection point in Japanese cultural discourse, after which there prevailed a broad malaise about the social faults and systemic inequities that the natural and nuclear disasters had exposed in their aftermath. Kanehara Hitomi's novel Motazaru Mono (Those without, 2015) explores this affective shift through her characters' struggles to contend with the upending of their worldviews and values since 2011. In turn, Kanehara's stories written during the COVID-19 pandemic's peak of 2020–2021 show characters responding to the global crisis through the lens of a generalized state of precarity that, I argue, harkens back to 3–11 and earlier. With reference to Lauren Berlant's notion of the ‘crisis ordinary' mentality, I analyze ‘Unsocial Distance' (June 2020), a love story between two youths who regard COVID-19 as an inconvenience rather than a true emergency. I then examine ‘Techno-break' (January 2021) which ends with the protagonist's mental and moral devolution in the socially distanced solitude she first enters as an anti-COVID measure. ‘Techno-break' advocates for confronting the tolls of the prolonged pandemic, and for addressing the deeper-seeded fault-lines of Japanese society that contribute to more recent challenges. [ FROM AUTHOR] Copyright of Japanese Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

A Prediction Model for Spot LNG Prices Based on Machine Learning Algorithms to Reduce Fluctuation Risks in Purchasing Prices

The ongoing Russia–Ukraine conflict has exacerbated the global crisis of natural gas supply, particularly in Europe. During the winter season, major importers of liquefied natural gas (LNG), such as South Korea and Japan, were directly affected by fluctuating spot LNG prices. This study aimed to use machine learning (ML) to predict the Japan Korea Marker (JKM), a spot LNG price index, to reduce price fluctuation risks for LNG importers such as the Korean Gas Corporation (KOGAS). Hence, price prediction models were developed based on long short-term memory (LSTM), artificial neural network (ANN), and support vector machine (SVM) algorithms, which were used for time series data prediction. Eighty-seven variables were collected for JKM prediction, of which eight were selected for modeling. Four scenarios (scenarios A, B, C, and D) were devised and tested to analyze the effect of each variable on the performance of the models. Among the eight variables, JKM, national balancing point (NBP), and Brent price indexes demonstrated the largest effects on the performance of the ML models. In contrast, the variable of LNG import volume in China had the least effect. The LSTM model showed a mean absolute error (MAE) of 0.195, making it the best-performing algorithm. However, the LSTM model demonstrated a decreased in performance of at least 57% during the COVID-19 period, which raises concerns regarding the reliability of the test results obtained during that time. The study compared the ML models' prediction performances with those of the traditional statistical model, autoregressive integrated moving averages (ARIMA), to verify their effectiveness. The comparison results showed that the LSTM model's performance deviated by an MAE of 15–22%, which can be attributed to the constraints of the small dataset size and conceptual structural differences between the ML and ARIMA models. However, if a sufficiently large dataset can be secured for training, the ML model is expected to perform better than the ARIMA. Additionally, separate tests were conducted to predict the trends of JKM fluctuations and comprehensively validate the practicality of the ML models. Based on the test results, LSTM model, identified as the optimal ML algorithm, achieved a performance of 53% during the regular period and 57% d during the abnormal period (i.e., COVID-19). Subject matter experts agreed that the performance of the ML models could be improved through additional studies, ultimately reducing the risk of price fluctuations when purchasing spot LNG. [ FROM AUTHOR] Copyright of Energies (19961073) is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Effect of Primary School Education on Preventive Behaviours during COVID-19 in Japan

Education plays a critical role in promoting preventive behaviours against the spread of pandemics. In Japan, handwashing education in primary schools was positively correlated with preventive behaviours against COVID-19 transmission for adults in 2020, during the early stages of COVID-19. The following year, the Tokyo Olympics were held in Japan, and a state of emergency was declared several times. Public perceptions of and risks associated with the pandemic changed drastically with the emergence of COVID-19 vaccines. We re-examined whether the effect of handwashing education on preventive behaviours persisted by covering a longer period of the COVID-19 pandemic than previous studies. A total of 26 surveys were conducted nearly once a month for 30 months from March 2020 (the early stage of COVID-19) to September 2022 in Japan. By corresponding with the same individuals across surveys, we comprehensively gathered data on preventive behaviours during this period. In addition, we asked about the handwashing education they had received in their primary school. We used the data to investigate how and to what degree school education is associated with pandemic-mitigating preventive behaviours. We found that handwashing education in primary school is positively associated with behaviours such as handwashing and mask wearing as a COVID-19 preventive measure but not related to staying at home. We observed a statistically significant difference in handwashing between adults who received childhood handwashing education and those who did not. This difference persisted throughout the study period. In comparison, the difference in mask wearing between the two groups was smaller but still statistically significant. Furthermore, there was no difference in staying at home between them. Childhood hygiene education has resulted in individuals engaging in handwashing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

Japanese University Students Usage of Global Networks During the Pandemic

This research study provides a case study of how the COVID-19 pandemic affected Japanese university students' views and attitudes on international topics and motivations for living and working abroad. During the pandemic, digital information, including social media, played a promi-nent role in how these students interacted and kept up with the news. We surveyed 204 students at a private university in Tokyo to help under-stand how the landscape of internationalization changed during the unique circumstances brought about by the pandemic. © 2023 James Nicholas Publishers.

Japanese Economic Performance after the Pandemic: A Sectoral Analysis

The COVID-19 crisis battered the Japanese economy. The purpose of this paper is to investigate whether the pandemic has left scars. To this end, it employs out-of-sample forecasting models and detailed stock market data for 30 sectors and disaggregated current account data for the 3 years after the first case occurred. The findings indicate that stock prices in sectors such as tourism, education, and cosmetics remain far below forecasted values after three years. Office equipment and semiconductor stock prices initially fell more than predicted but have since recovered. Other sectors such as bicycle parts and home appliances gained at first but are now performing as expected. Sectors such as home delivery and electronic entertainment continue to outperform. The results also indicate that income flows from Japanese investments abroad are much larger than forecasted, keeping the Japanese current account in surplus even as imports of oil and commodities have created persistent trade deficits. Since the travails of hard-hit sectors such as tourism reflect their exposure to the COVID-19 pandemic rather than bad choices made by firms, policymakers should consider employing cost-effective ways to stimulate economic activity in these sectors. © 2023 by the author.

Changes in social capital after the 2011 great east Japan earthquake-results of an awareness survey in Taro District, Miyako City, Iwate Prefecture

Ten years after the Great East Japan Earthquake, reconstruction projects are progressing in the affected areas and new towns are being formed. However, the recent spread of COVID-19 infection is thought to have affected interactions among residents. In this study, we conducted a multiple-choice questionnaire survey in the Taro district of Miyako City, Iwate Prefecture, which was severely damaged by the Great East Japan Earthquake, to investigate residents' social capital. Cross-tabulations, chi-square tests, and residual analysis revealed the following trends. First, most respondents indicated that the frequency of interaction with local residents and community activities decreased or remained the same after the earthquake. Second, Changes in residents' social capital compared to pre-disaster levels are significantly related to their social capital now, 10 years after the earthquake. Finally, respondents with no roommates and female respondents showed a higher rate of decline in social capital compared to pre-disaster levels. In the disaster-affected areas, the importance of social capital is becoming increasingly recognized for promoting future reconstruction community planning and inhibiting solitary death. It is necessary to respond to residents whose social capital is likely to decline more than before the disaster, such as women and those who live alone. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reseverd.

Reproduction of the Control Group in REMDACTA Trial Using the Millennial Medical Record, an Electric Health Record Database, in Japan

Objectives: Developing a control group of a clinical trial using real world data is desirable and ethically sound despite challenges pertaining to internal validity. To examine the internal validity, we reproduced the control group in a Randomized Controlled Trial (RCT) using Electric Health Record (EHR) data and evaluated the difference between the outcome of the original trial and that of the reproduced analysis. Method(s): We selected an RCT, REMDACTA trial, that was performed to evaluate the efficacy of tocilizumab plus remdesivir against placebo plus remdesivir in patients with severe COVID-19 pneumonia. We reproduced its control group (patients with severe COVID-19 pneumonia taking only remdesivir), using Japanese EHR data, Millennial Medical Record provided by Life Data Initiative. Target patients for the main analysis were those prescribed remdesivir within 2 days after admission and diagnosed with COVID-19 (defined by ICD-10 code, U07.1) and/or with COVID-19 pneumonia (defined by diagnosis name). Patients in the sub analysis included only those with COVID-19 pneumonia diagnosis. Among the target patients, those undergoing image inspection, oxygen administration, and not taking any medicines for pneumonia before the first remdesivir prescription were eligible for the analyses. Median length of stay was compared in the reproduced group and in REMDACTA trial. Result(s): The database included 676 and 110 target patients for the main and sub analyses, respectively. However, only 57 and 14 patients met the eligibility criteria for the main and sub analyses, respectively. The reduction in the number of patients is attributed to the criteria of image inspection and oxygen administration. Median length of stay in the reproduced group were 13 and 11 days in the main and sub analyses, respectively. In REMDACTA trial, 95% CI of median time was 11.0-16.0. Conclusion(s): We successfully reproduced the median time of the control group by EHR data.Copyright © 2023

Education on neuromuscular electrodiagnosis and neurological symptomatology

Neurological symptomatology is a crucial component of neurological expertise. The committee for fostering board-certified neurologists in the Japanese Society of Neurology (JSN) has hosted an educational activity for residents before the board examination, "The seminar for fostering board-certified neurologists" since 2004. In particular, the autumn seminar has been characterized by small group hands-on of neurological examinations and the evaluations of higher brain function. Besides this, hands-on seminar of neurological examinations by regional branches has been promoted by the JSN. In the Kanto Ko-shin-etsu branch, "The first hands-on seminar of neurological examinations" started in 2023 after a 3-year-suspension due to COVID-19. The most important educational activities in neuromuscular electrodiagnosis (EDx) is the "Neuromuscular diagnostics seminar" hosted since 2004 by the Japanese Society of Clinical Neurophysiology (JSCN). The majority of tutors and participants are neurologists. This seminar is also characterized by small-group, hands-on workshops. We have also run the overseas seminar, "Tokyo Super EMG hands-on," since 2013. These have undoubtedly contributed to enhancing the level of neuromuscular electrodiagnosis not only in Japan but also in other Asian countries. I have conducted studies on neurological symptomatology and neuromuscular electrodiagnosis, which are directly linked to enhancing clinical practice of neurologists through educational activities such as review articles or lectures. Due to the fact that symptomatology is crucial in neurological expertise, neurology is a basic specialty around the world except in Japan. In 2018, the JSN decided to aim to make neurology a basic specialty and continues to make efforts to attain this goal.Copyright © 2023 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd.

International Students' Perceptions towards Their Learning Experience in an International Network Seminar in Japan: During and Post the COVID-19 Pandemic

The COVID-19 pandemic has struck educational experience systems around the globe. This paper investigates and evaluates the student participants' perceptions who joined the international exchange seminar on global citizenship and peace held at a University in Hiroshima, Japan. Approximately seventy students and faculty members from nine to ten different universities from around the globe joined this summer program in August 2021 (online) and 2022 (face-to-face). This study is a mixed-method study. The first part consists of a quantitative analysis of BEVI data obtained from the students in the seminar before COVID-19 and after. The research concludes that there are no changes in the effects of what students learn. The second part consists of qualitative data. The data shows the perceptions of students of online teaching versus hybrid teaching. It compares the differences in participants' perceptions reported in students' feedback on the programs during and post-COVID-19. Our results confirm prominent differences exist in the students' perceptions of their learning experience during the pre-pandemic and post-pandemic periods. The findings indicate based on lessons learned post-pandemic, universities need to strive and define the meaning and purpose of international seminars, which enable students to experience a high level of intercultural social interaction online and face-to-face. As the world becomes more interconnected, virtual environments, such as the ones presented within the International Seminar in Hiroshima, Japan, are vital to facilitating intercultural teaching environments and the implications within this paper indicate that these virtual mediums can promote inclusion, leading to a more sustainable world.

A new strategy to integrate silver nanowires with waterborne coating to improve their antimicrobial and antiviral properties

PurposeThis study aims to focus on the preparation and characterization of the silver nanowire (AgNWs), as well as their application as antimicrobial and antivirus activities either with incorporation on the waterborne coating formulation or on their own.Design/methodology/approachPrepared AgNWs are characterized by different analytical instruments, such as ultraviolet-visible spectroscope, scanning electron microscope and X-ray diffraction spectrometer. All the paint formulation's physical and mechanical qualities were tested using American Society for Testing and Materials, a worldwide standard test procedure. The biological activities of the prepared AgNWs and the waterborne coating based on AgNWs were investigated. And, their effects on pathogenic bacteria, antioxidants, antiviral activity and cytotoxicity were also investigated.FindingsThe obtained results of the physical and mechanical characteristics of the paint formulation demonstrated the formulations' greatest performance, as well as giving good scrub resistance and film durability. In the antimicrobial activity, the paint did not have any activity against bacterial pathogen, whereas the AgNWs and AgNWs with paint have similar activity against bacterial pathogen with inhibition zone range from 10 to 14 mm. The development of antioxidant and cytotoxicity activity of the paint incorporated with AgNWs were also observed. The cytopathic effects of herpes simplex virus type 1 (HSV-1) were reduced in all three investigated modes of action when compared to the positive control group (HSV-1-infected cells), suggesting that these compounds have promising antiviral activity against a wide range of viruses, including DNA and RNA viruses.Originality/valueThe new waterborne coating based on nanoparticles has the potential to be promising in the manufacturing and development of paints, allowing them to function to prevent the spread of microbial infection, which is exactly what the world requires at this time.

The impact of COVID-19 on extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA): A single centre study

Objectives: The COVID-19 pandemic has been affecting everything including ECMO service. At the moment we have to equip PPE before ECPR and we thought it may influence on time to establish venoarterial ECMO and patient outcomes. Method(s): We compared OHCA-patients who underwent ECPR in our hospital before (January 2015 - March 2020) and after (April 2020 - December 2022) the Government of Japan declared a state of emergency in relation to COVID-19. Result(s): There were 32 and 9 patients in the pre- and post-COVID-19 pandemic sample. Of these, 9 (28.1%) vs. 5 (55.6%) survived extracorporeal life support (ECLS), p=0.23, and 4 (12.5%) vs. 2 (22.2%) had good neurologic outcomes (cerebral performance category 1- 2) after ECLS. Seven (21.9%) vs. 1 (12.5%) were discharged or transferred alive from the hospital (one patient of the post-COVID-19 cohort has been still hospitalised for rehabilitation), p>0.99. Mean values of low-flow time were respectively 67.3 minutes (SD 18.3) and 55.6 minutes (SD 17.1), p=0.091, and median values of time to establish ECMO from admission were respectively 32.5 minutes (IQR 15.8) and 26.0 minutes (IQR 4.0), p=0.23. Conclusion(s): There were no differences in time-toECMO or outcomes in patients who underwent ECPR for refractory OHCA before and after the COVID-19 pandemic.

Covid-19 Impacts and Building New Resilience: A Comparative Analysis between Japan and Philippines

In light of the world leaders' response to the critical time of pandemic, this paper offers first-hand evidence of the perceived impacts of pandemic and perceived resiliency in the context of health-quarantined communities in two Asian countries. The study utilized Partial Least Square Structural Equation Modeling (PLS-SEM) to determine perceived impacts of Covid 19 and to analyze comparatively the social resilience of two countries with opposing global economic statuses, the Philippines and Japan. Due to the global condition caused by the pandemic, the online survey was administered in both countries. Resiliency survey questions were tailored for suitability within the context of the coronavirus pandemic and for face validity. The instruments used in this study consist of a Japanese translation for ease of understanding of the community respondents in Japan. Data analysis using PLS-SEM revealed impacts of Covid-19 pandemic significantly influence the social resilience of communities in both countries. Impacts of Covid-19 outbreak similarly showed significant influence on building new normal resilience of communities in two countries. Resilience was anchored on reactive and proactive capacities of communities. Implications of this study contribute to the sustainable futures of the communities focusing on intervention models to mitigate the long-term impacts of the pandemic. Further research should be done on the development of policies and programs for government implementation to manage and mitigate social complexities brought about by the pandemic or other adversities. Linking through mediation analysis of resilience factors for sustainable development can be explored for future research © 2023, Journal for ReAttach Therapy and Developmental Diversities.All Rights Reserved.

A Project to Distribute Personal Protective Equipment to Homecare Agencies during the COVID-19 Pandemic: Its Association with the Sense of Security Improvement among Homecare Nurses/Helpers

During the early period of COVID-19 pandemic, there was a serious shortage of personal protective equipments (PPEs), which caused difficulty in homecare agencies to make home visits to those (possible) positive COVID-19 cases. An organization with the help of several foundations started a special program to distribute PPEs to those agencies in which there was a possible case or those cases that had close contact with the positive cases. This study examined whether this voluntary activity contributed to increasing the sense of security in providing care among homecare workers. We conducted a survey with homecare agencies that received PPEs from the program between July 2020 and February 2021. The participants were agency managers who applied for PPEs. We conducted the survey twice, before and after receiving PPEs. In the questionnaire, we asked about the overall sense of security in providing care for those infected with COVID-19, reasons for applying for PPE, symptoms of the client or his/her family who caused the PPE request, and the agency's and clients' characteristics. We analyzed the data from 802 responses. Before PPE distribution, the sense of security was associated with the focal client having a cognitive impairment (β = −0.096), having cough (β = −0.088), fatigue (β = −0.085), or headache (β = −0.078). Agencies that did not visits those (possibly) positive cases (β = −0.123) had lower sense of security. Overall, the mean sense of security increased after receiving PPE. Factors that contributed to the increase in sense of security included a lower sense of security before the application (β = −0.529), visiting clients without dyspnoea (β = −0.109), the agency that did not visit positive cases before the application (β = −0.089), and with higher satisfaction with the days of PPEs received (β = 0.144). These results underline the benefit of the special PPsE distribution program.

Europa y Japón: socios con valores comunes en un mundo incierto

En un escenario internacional cada vez más incierto, en el que todavía no se ha dejado atrás la pandemia de Covid-19, a lo que se suma la necesidad de gestionar la ilegítima invasión rusa de Ucrania, así como unas relaciones entre Estados Unidos y China cada vez más tensas, Europa y Japón han reafirmado sus vínculos históricos, económicos y políticos con dos acuerdos de asociación, uno de carácter económico y otro estratégico, en vigor desde 2019. El continente asiático se ha convertido, además, en el principal eje geopolítico del mundo, y Japón quiere tener un papel relevante en el nuevo escenario al que ha respondido mediante su iniciativa del Free and Open Indo-Pacific, a la que Europa ha respondido con ciertas reservas. ¿Deben Europa y Japón seguir profundizando en su relación? ¿Cuáles son los ámbitos susceptibles de mejora? El marco adecuado debe ser, en nuestra opinión, el "orden internacional basado en normas" del que ambos actores son claros defensores, y los valores comunes de democracia, Estado de Derecho y protección de derechos fundamentales que los unen.Alternate :In an increasingly uncertain international environment, in which we are still trying to put the Covid-19 pandemic behind us while trying to manage the illegitimate Russian invasion of Ukraine as well as the increasingly tense relations between the United States and China, Europe, and Japan have reaffirmed their historical, economic and political ties with two association agreements, one economic and the other strategic, in force since 2019. In addition, the Asian continent has become the geopolitical axis of the world, and Japan wants to play a relevant role through its Free and Open Indo-Pacific (FOIP) initiative, to which Europe has responded somewhat hesitantly. Should Europe and Japan continue to deepen their relationship? What are the areas for improvement? The appropriate framework, in our opinion, should be the "rules-based international order" of which the two actors are firm defenders, and the shared values of democracy, rule of law, and protection of fundamental rights that unite them.

Efforts to Optimize Clinical Trial Management by Revising Deviation Reports and Classifying Deviation Cases for Efficient Clinical Trial Quality Improvement at Asahikawa Medical University Hospital.

Face-to-face communication during on-site monitoring is important for clinical trial quality assurance. However, with the coronavirus disease early 2020 pandemic, medical institutions placed restrictions on hospital visits to secure their medical systems. Asahikawa Medical University Hospital similarly established restrictions on outpatient and inpatient visits and legal restrictions on outside vendors. Therefore, the frequency of on-site monitoring of clinical trials conducted at our hospital was reduced. Since there was no sign of convergence at the infection units even after 2 years, we investigated the frequency of on-site monitoring and the frequency of clinical trial deviations in the review of the system. In addition, although a clinical trial deviation report form (previous form)was prepared in the fiscal year 2019, there were many free descriptions, and many deviation reports were difficult to understand. Similarly, there were cases where deviations were not recorded on the deviation report form but only on article records (source documents), such as electronic medical records after consultation with the sponsor, and deviations were not recorded in a uniform format. Thus, the hospital experienced difficulty tabulating and classifying the number of deviation occurrences. Based on this experience, this report describes the progress of revising the clinical trial deviation report, clarifying the items to be included in the report, and establishing a system to clarify the process related to clinical trial deviation occurrences.Copyright: © 2023 the Japanese Society of Clinical Pharmacology and Therapeutics (JSCPT).

Manufacturing Innovation

(ProQuest: ... denotes non-USASCII text omitted.) The annual Global Innovation Index released in September 2021 ranked China twelfth, surpassing developed economies such as Japan, Israel, and Canada and raising fears in the United States amidst sluggish growth in North America and strong growth in the Asia Pacific region.1 Interestingly, the United States government responded by boycotting the Beijing Olympic Games, citing human rights abuses as the main reason.2 A tech war between China and the United States brewed beneath the diplomatic rancor over the attendance at the Olympic Games. Part I documents how the United States has assisted China's tech and intellectual property domination through President Nixon's historic visit to China, giving China Most Favorite Nation (MFN) status and ascending China to the World Trade Organization (WTO). [...]under Deng Xiaoping's leadership during the reform period, China rapidly developed its special economic zones (SEZs), laying the foundation for subsequent tech innovation and production. [...]broadcasting, telecommunications, office machines, computers, integrated circuits, and cell phones are among China's notable exports to the world.9 China dominates in commodities and raw materials, exporting refined petroleum, cotton, plywood, and tea.10 For agricultural products, China occupies the perch as the world's largest producer. Shenzhen rose as the largest among the four.18 Shenzhen, a small fishing locale in the southern part of China's southern province, Guangdong, served as the pioneer of Deng Xiaoping's embrace of economic reforms.19 A market-oriented economy took root in Shenzhen, allowing foreign companies and entities from Hong Kong and Macau to operate and allowing Chinese talents the freedom to leave their hometowns and move into the SEZs.20 Cheap labor proved to be another significant factor facilitating China's rise as a global manufacturer.21 In the 1980s, multinational corporations from Taiwan, Japan, and South Korea, as well as domestic Chinese companies, opened their factories in the SEZs and other cities in China to take advantage of the cheap and plentiful labor force.22 Indeed, when Deng Xiaoping began his pilot SEZs, China's young workers who wished to lift themselves out of poverty descended into the economic zones in search of better opportunities.23 Shenzhen grew from a population of 59,000 in 1980 to a population of 12,357,000 in 2020.24 The new migrants became the workers, participants, and stakeholders in the global manufacturing frontier.25 Because of the abundance of cheap labor, manufacturers in China have no difficulty keeping production prices low and pleasing consumers and businesses worldwide.26 China's currency manipulation is another factor propelling China to its domination in global manufacturing.27 The United States Congress attempted numerous times to introduce legislation to combat China's currency manipulation.28 China artificially devalued its currency through government control of the exchange rate and refused to let the Chinese Renminbi (RMB) float.29 Despite strong criticisms from the United States, China refuses to allow its currency to freely float.30 China's currency manipulations, according to critics, caused the widening of trade deficits between the United States and China.31 China's currency manipulation allows products to be manufactured at lower prices, hampering competitors and thereafter replacing them.32 In order to cope with China's currency practices, United States manufacturers facing their own existential crises must decide to either outsource jobs overseas or face large risks, including financial ruin.33 The United States lost millions of manufacturing jobs due to massive job outsourcing as the trade deficits between the United States and China continued to persist.34 Geopolitically, in shaping post-Cold-War powers, the United States decided to assist China in its transformation from a poverty-stricken country to a global manufacturer.

The Effect of the COVID- 19 Outbreak on Intensive Care in Northern Saitama, Japan

Background: The 2020 COVID- 19 pandemic had various effects on local healthcare. The aim of this study was to assess the extent to which local healthcare and healthcare workers were affected by the COVID- 19 pandemic. Method(s): In this observational study we examined and compared intensive care units (ICUs) before (2019) and during (2020) the COVID- 19 pandemic to assess its effects. Emergency patient data were obtained from the Saitama Prefecture Emergency Medical Information System. The effect of COVID- 19 on emergency care responses was compared with the admission and refusal of patients in 2019 and 2020. We also examined the number of patients who were admitted to ICUs and required surgery. The effect on ICUs was examined with the number of Nurses' incident reports and severity percentages calculated from the integrated team medical care and safety system. We also compared the overtime hours of physicians on the basis of employment records. Result(s): In 2019, 2,136 emergency requests were made to admit patients, and 1,811 patients (85%) were admitted. In contrast, in 2020, 2,371 emergency requests were made, and 1,822 patients (76%) were admitted, representing a decrease to 76% (p = 0.931). The percentage of patients for whom admission was refused was significantly greater in 2020 (506 patients, 21.3%) than in 2019 (303 patients, 14.1%;p = 0.0004). In 2020, the number of neurosurgical, cardiac, and vascular operations increased and, over time, the number of operations increased for all surgical units. The number of incidents reported in ICUs increased significantly from 396 in 2019 to 510 in 2020 (p = 0.001). Conclusion(s): Although intensive care management was restricted, the numbers of patients and physician overtime hours were greater during the COVID- 19 pandemic than before, and the resulting environment led to an increase in the number of incidents. The ICU environments must be proactively improved to prepare for more severe situations in the future.Copyright © 2022 Jikei University School of Medicine. All rights reserved.

Diversity in medical publications: a cross-sectional evaluation of COVID- 19 vaccine research

Objective: Representing diverse perspectives in medical publications is of great importance. We assessed diversity among investigators, study participants, authors and tweeters of recent publications on COVID-19 vaccine trials, a topic likely to have significant global implications. Research design and methods: Primary publications reporting on COVID vaccine randomized controlled trials (RCTs) were identified via PubMed (n=302 hits, 23 September 2022). The 100 articles with the greatest impact (Altmetric score) were selected for evaluation. National affiliation of authors and investigators, and demographics of participants were collected. Geographic locations of Tweets mentioning the publications were collected via Altmetric. Result(s): In our preliminary analysis, as expected, selected publications most frequently appeared in top-tier journals, e.g. New England Journal of Medicine (n=24) and Lancet (n=19), and had high Altmetric scores (median 886, range 30-29,153). Articles included authors from mean 2.2 countries, most frequently the USA (n=43 articles), the UK (n=31) and China (n=23). Investigators' locations were often not reported, but most frequent were the UK (n=2711 investigators), USA (n=1029) and South Africa (n=269). There was a gender balance among participants across the studies (mean 49.4% female). The most frequent ethnic groups were white, Hispanic and Asian. Tweets mentioning the publications most commonly came from the USA (8.1%), the UK (3.1%) and Japan (2.9%). Conclusion(s): Despite COVID-19 being a global health emergency, most authors, investigators and readers of high impact COVID-19 vaccine RCT publications were from a small group of countries, with some notable exceptions. Numerous studies did not report the geographic location of investigators or participant ethnicity. Consistent and transparent reporting would support the drive towards greater diversity and representation in medical research.