Providing reliable medical information via the Internet is a pivotal mission for the National Centers (NCs) in Japan. This paper reports on the current state of medical information dissemination via the Internet and the management systems at eight departments across six NCs, and explores strategies for optimizing their services of information delivery. We investigated these departments' establishment backgrounds, website content, quality control measures, and dissemination challenges. The rationale for establishing the departments and the types of medical information disseminated varied across the NCs. Regarding information quality control, most departments relied on reference materials with robust supporting evidence, with medical professionals-such as physicians, pharmacists, nurses, and individuals with PhDs―playing a central role in content preparation. However, only three departments had established editorial policies, and just one had a system for incorporating public peer review. The key factors in effective information dissemination, as perceived by practitioners, include identifying the public's needs and fostering accessible information environments. Challenges identified included a shortage of human resources for information development and difficulties adapting to the increasing diversification of information dissemination platforms, such as social media. Although all NCs leverage their specialized expertise to provide information, there is a lack of standardization in the quality control processes. To improve the reliability and accessibility of medical information, it is essential to establish standardized quality control processes, integrate public perspectives into content creation, secure dedicated personnel, and strengthen cross-NC collaboration, particularly in the era of social media and generative AI.

Over-the-counter (OTC) drug misuse and overdose among young people in Japan should be understood not only as a medication-safety issue but also as a public health and youth support issue situated at the intersection of psychological distress, self-harm, suicidality, help-seeking difficulties, digital environments, and fragmented care systems. Current responses, including emergency treatment for acute intoxication, psychiatric assessment, consultation services, school-based prevention, and retail regulation, remain important but often operate after crisis escalation or depend on young people's ability to present themselves through institutionally recognizable forms of help-seeking. In this Policy Forum article, we argue that Japan's response to OTC overdose should be redesigned as a low-threshold support architecture that connects early relational entry points with professional assessment, crisis escalation pathways, interagency collaboration, and safeguards for supporters. We also caution that peer support, while potentially valuable as an accessible first point of contact, should not be treated as a stand-alone intervention. Potential risks, including contagion-related concerns, exposure to distressing self-harm narratives, blurred role expectations, over-reliance on a single supporter, and safety-management failures, require explicit training, supervision, boundaries, and safeguarding protocols. We propose a three-zone framework comprising low-threshold entry points (Zone A), professional medical and interagency backup (Zone B), and sustainability infrastructure for supporters (Zone C). Rather than replacing clinical or regulatory responses, this architecture is intended to connect them with youth-accessible forms of support and to generate testable implementation models for future research.

Timely access to documentation is essential for meaningful participation in global health governance. At the World Health Organization (WHO), governing body documents for the World Health Assembly (WHA) and the Executive Board (EB) provide the basis on which Member States assess agenda items, consult domestically, and prepare their negotiating positions. In this sense, the timing of document release directly affects transparency, accountability, and quality of decision-making. This study examines trends in documentation timing between 2016 and 2026 using data from the WHO governing body documentation portal. The findings show a clear and sustained shortening of the interval between document release and opening of WHA sessions since 2021, reaching the lowest level observed during the study period. By contrast, timelines for the EB, which were affected during the COVID-19 period, have largely recovered, suggesting that earlier circulation remains feasible in practice. Although this analysis does not directly measure downstream effects, shorter preparation periods may constrain Member States' ability to review materials carefully, coordinate across institutions, and develop negotiation strategies. These constraints may be felt most strongly by countries with limited participation capacities, potentially widening existing disparities in participation. A recent case further illustrates how late document release can affect not only meeting procedures but also depth and coherence of discussions. Despite ongoing WHO governance reforms, the timeliness of documentation has received limited attention. Ensuring earlier circulation and closer adherence to existing timelines would be a practical step toward strengthening transparency, equity, and effectiveness in global health governance.

Emerging approaches in regenerative medicine for the treatment of diabetes have attracted attention. This meta-analysis aimed to evaluate the effectiveness of human induced pluripotent stem cell (hiPSC)-derived β-like cell/islet transplantation in animal models of diabetes. Studies using strictly controlled designs to assess hiPSC-derived β-like cell/islet transplantation were included. A reduction in blood glucose (BG) levels and improvement on the glucose tolerance test (GTT) served as indices to assess effectiveness. Twelve studies published between January 1, 2016 and December 31, 2025 were included. Pooled evidence indicates that transplantation of hiPSC-derived β-like cells/islets is associated with significant reductions in BG levels from four weeks to two months post-transplantation, with hypoglycemic effectiveness tending to increase over time. Improvements in glucose tolerance were also consistently observed. Overall, this meta-analysis synthesizes current preclinical evidence and identifies key areas where further research is needed to clarify translational and potential clinical applications.

Aspiration pneumonia is associated with significant morbidity and is a leading cause of mortality among older adults, with a disproportionately high burden in super-aged societies such as Japan. Despite international guidelines recommending a multidisciplinary team (MDT) approach, evidence supporting collaborative interventions remains fragmented. We conducted a scoping review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, to map multidisciplinary interventions for aspiration pneumonia prevention. MEDLINE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature were searched through December 2024 for studies involving three or more healthcare disciplines. Among the 309 identified studies, 10 met the inclusion criteria. All included studies targeted primary prevention in high-risk populations; none addressed recurrence prevention, despite 30-day recurrence rates reaching approximately 30%. MDTs consistently included physicians, nurses, and speech-language pathologists, whereas pharmacists (2/10) and dental professionals (2/10) were relatively underrepresented, despite robust evidence supporting interventions within these professional domains. Seven studies reported a significant reduction in the incidence of aspiration pneumonia; however, the only randomized controlled trial showed no effect on pneumonia. The current evidence base, predominantly comprising observational and quality improvement studies, should be interpreted as preliminary and heterogeneous in terms of study design and outcome measurement. Evidence gaps remain in secondary and tertiary prevention and optimal team composition. Future trials in patients with prior aspiration pneumonia should investigate whether incorporation of professionals from disciplines with established intervention effectiveness, such as pharmacists and dental professionals, into MDTs translates into improved aspiration pneumonia outcomes.

Digital health literacy (DHL) is increasingly important as health information, appointment systems, patient portals, and other services move online. However, evidence in older adults remains limited and is often based on online surveys that may underrepresent digitally disadvantaged groups. This in-person cross-sectional study examined factors associated with DHL among 91 community-dwelling older adults in Japan. Participants completed paper-based questionnaires and performance-based assessments, including a modified 15-item score from the Japanese Digital Health Literacy Instrument (DHLI-J), the Japanese version of the Montreal Cognitive Assessment (MoCA-J), and the Nine-Hole Peg Test (NHPT). Group comparisons, bivariate correlations, and hierarchical multiple regression analyses were performed, with structural equation modeling (SEM) as a supplementary analysis. Higher modified DHLI-J scores were associated with younger age, longer personal computer use, better cognitive function, better manual dexterity, greater digital confidence and interest, and better well-being. In the final regression model (adjusted R² = 0.37), older age was independently associated with lower modified DHLI-J scores, whereas better cognitive function and greater confidence in using digital devices were independently associated with higher scores. The exploratory supplementary SEM showed acceptable fit (χ²(11) = 13.96, p = 0.24; χ²/df = 1.27; comparative fit index (CFI) = 0.97; root mean square error of approximation (RMSEA) = 0.06) and indicated positive cross-sectional associations between digital attitudes and DHL and between DHL and well-being; these associations should not be interpreted as causal. These findings may inform user- and system-level strategies intended to reduce digital exclusion and support more equitable digital health access, although access to digital health services and equity outcomes were not measured.

Hypertension constitutes a major public health problem in Honduras. In 2019, 34% of Hondurans had hypertension, but only one-third achieved blood pressure control. In limited-resource settings, health system limitations complicate chronic disease oversight. This study aimed to identify individual and facility-level factors associated with blood pressure control among patients with hypertension attending primary care centers in Francisco Morazán, Honduras. A cross-sectional study was conducted with 486 patients with hypertension from eight primary health care centers. Medical records from the six months preceding the November-December 2024 collection period were evaluated to examine hypertension control factors (< 140/90 mmHg). Multivariable logistic regression and multilevel modeling were employed to identify associated factors. Seeking other medical care outside the primary clinic was associated with higher odds of blood pressure control (adjusted odds ratio (aOR) = 5.09; p < 0.001). Referral to higher levels of care (aOR = 0.11; p < 0.001) and morbid obesity (aOR = 0.14; p = 0.005) were associated with lower odds of achieving hypertension control. Being female and exhibiting higher perceived disease severity showed positive trends; however, these decreased after multilevel adjustment. None of the facility-level variables reached statistical significance. Several patient-level factors were associated with blood pressure control, whereas no statistically significant facility-level associations were detected in this sample. Because only eight health centers were included, the facility-level analysis should be considered exploratory. Reinforcing obesity management protocols and strengthening referral systems may contribute to improving hypertension management.

Between January 2025 and early 2026, the World Health Organization (WHO) faced three interrelated structural pressures: a budget shortfall exceeding US$1.05 billion triggered by the announced United States withdrawal; a weakening of strategic governance functions at the Executive Board (EB) and the Programme, Budget and Administration Committee (PBAC); and the parallel emergence, outside WHO, of multiple Global Health Architecture reform agendas, including the Lusaka Agenda, the Accra Reset, the UN80 Initiative, and the America First Global Health Strategy. This study presents an integrated governance analysis using four complementary data sources: participant observation of WHO governing-body sessions (EB158, February 2026; the 79th World Health Assembly, WHA79, May 2026); semi-structured interviews with 10 professional staff serving at WHO headquarters and in regional and country offices; policy mapping of relevant reform-agenda documents, classified into four domains; and a companion quantitative analysis of governing-body document release timing. Triangulation revealed late release of budget documents, an unprecedented proposal to draw over US$ 400 million from the Programme Support Cost, contested governance reform, field-level constraints in prioritization, human-resource management and financial accountability. The findings suggest a bidirectional problem in which constraints on Secretariat function and difficulties in substantive Member State deliberation reinforce each other, while reforms remain headquarters-centric and may contribute to implementation gaps at regional and country levels. As a policy implication, the forthcoming Director-General selection and the UN80-linked reform cycle offer an opportunity for governance reform. These developments may offer opportunities for WHO Member States, including Japan and the Global South, to strengthen WHO's coordinating role.

Since 2011, the Ministry of Health, Labour and Welfare (MHLW) has made the data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) available for research purposes. Recent trends in treatments and prognosis for intrahepatic cholangiocarcinoma (ICC) were analyzed using data from this comprehensive database. This repeated cross-sectional study employed NDB open data to determine the number of patients with ICC and those treated for ICC from fiscal years (FY) 2016 to 2020. The International Classification of Diseases version 10 (ICD-10) code of C22.1 (ICC) was used to define ICC patients. The number of patients diagnosed with ICC and treated in Japan did not change during the study period (FY2016: 1,119; FY2017: 1,136; FY2018: 1,213; FY2019: 1,185; FY2020: 1,194). The number of patients who underwent open liver resection (OLR) did not change either (FY2016: 748; FY2017: 771; FY2018: 807; FY2019: 760; FY2020: 753). On the other hand, patients who underwent laparoscopic liver resection (LLR) increased during the study period (FY2016: 84; FY2017: 118; FY2018: 143; FY2019: 171; FY2020: 195). This was primarily due to the increase in the number of patients who received laparoscopic liver resection larger than subsegmentectomy (FY2016, 57; FY2017, 81; FY2018, 98; FY2019, 101; FY2020, 133). The median postoperative survival was 5.25 years in the OLR group and was not reached in the LLR group. The national database analysis revealed that while the number of patients diagnosed with and treated for ICC has remained stable, the adoption of minimally invasive surgery has increased, possibly because of advancements in treatment techniques, resulting in good survival outcomes.

We report the surgical techniques and outcomes of hepatopancreatoduodenectomy (HPD) using indocyanine green fluorescence imaging (ICG-FI) for Bismuth type IIIb perihilar cholangiocarcinoma in a patient with right-sided ligamentum teres. ICG-FI was used in three ways: i) positive staining to delineate the liver transection line, ii) confirmation of vascular perfusion, and iii) visualization of the bile duct. Because the bile duct of the ventral region of the right paramedian sector (RPM) drained into the left hepatic duct, an extended left hepatectomy including resection of the ventral region of the RPM was planned. Although the anatomical anomaly made it difficult to identify the liver transection line between the ventral and dorsal regions of the RPM using landmarks such as the hepatic veins and the falciform ligament, positive staining of the dorsal region of the RPM enabled accurate delineation of the transection line. As there was suspected tumor invasion into the right side of the main portal vein, wedge resection and reconstruction with short-axis suturing were performed. Subsequently, fluorescence was observed to pass through both the right hepatic artery and the reconstructed portal vein uninterruptedly, indicating continuous blood flow. ICG-FI also facilitated identification of the right hepatic duct. It was divided at the root, and the resection margin was confirmed to be negative by intraoperative frozen-section examination. HPD was successfully completed, achieving R0 resection with an operative time of 789 minutes and blood loss of 650 mL. The patient developed a pancreatic fistula, which resolved with drain management and antibiotic therapy, and was discharged on postoperative day 36. Integrated use of ICG-FI provided useful adjunctive guidance in this technically challenging case.