The Government of Japan has conducted weekly national surveillance of notifiable infectious diseases for over 25 years. As of December 2025, 87 notifiable diseases are under surveillance, although the list has changed over time as new infections have emerged and others have been reclassified. Although weekly data are openly available, their formatting and preparation have been labour-intensive. An open-source R package, jpinfect, has the potential to improve data accessibility and analytical workflows for these datasets. In this study, we used the jpinfect package to summarize national surveillance data for 12 acari-borne diseases in Japan from week 14 of 1999 to week 52 of 2025, by prefecture and sex. In total, 18 295 acari-borne disease cases were reported nationwide. Eight diseases reported at least one case. Of these, scrub typhus (56.6%), Japanese spotted fever (32.9%) and severe fever with thrombocytopenia syndrome (6.7%) together accounted for more than 95% of all cases. Scrub typhus case numbers remained stable and widely distributed across the country, except for in the northern island of Hokkaido. Confirmed cases of the other two tick-borne diseases increased, notably in western Japan, but with new cases also reported in northern Japan. Lyme disease, relapsing fever and Q fever were sporadically reported at very low incidence levels (<0.2 per 100 000 population). In addition to providing an updated epidemiological overview of acari-borne diseases in Japan, this report highlights the potential of jpinfect to streamline the generation of national situation reports. The surveillance and analytical framework described here could serve as a model for other countries in the Western Pacific Region.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

war ; Armed Conflicts ; Nuclear Energy ; Atomic Energy ; Radiation ; Nuclear Weapons

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

The International Severe Asthma Registry (ISAR) was established in 2017 to advance the understanding of severe asthma and its management, thereby improving patient care worldwide. As the first global registry for adults with severe asthma, ISAR enabled individual registries to standardize and pool their data, creating a comprehensive, harmonized dataset with sufficient statistical power to address key research questions and knowledge gaps. Today, ISAR is the largest repository of real-world data on severe asthma, curating data on nearly 35,000 patients from 28 countries worldwide, and has become a leading contributor to severe asthma research. Research using ISAR data has provided valuable insights on the characteristics of severe asthma, its burdens and risk factors, real-world treatment effectiveness, and barriers to specialist care, which are collectively informing improved asthma management. Besides changing clinical thinking via research, ISAR aims to advance real-world practice through initiatives that improve registry data quality and severe asthma care. In 2024, ISAR refined essential research variables to enhance data quality and launched a web-based data acquisition and reporting system (QISAR), which integrates data collection with clinical consultations and enables longitudinal data tracking at patient, center, and population levels. Quality improvement priorities include collecting standardized data during consultations and tracking and optimizing patient journeys via QISAR and integrating primary/secondary care pathways to expedite specialist severe asthma management and facilitate clinical trial recruitment. ISAR envisions a future in which timely specialist referral and initiation of biologic therapy can obviate long-term systemic corticosteroid use and enable more patients to achieve remission.

Purpose: While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue. Methods: Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation. Results: Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant. Conclusions Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.

Purpose: While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue. Methods: Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation. Results: Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant. Conclusions Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.

Purpose: While pump manipulation is rarely problematic in male patients with artificial urinary sphincters (AUSs), the situation may differ in female patients due to anatomical or cultural factors. This study aimed to evaluate the prevalence of difficulties in pump manipulation among female AUS patients, identify associated risk factors, and explore management strategies for this challenging issue. Methods: Data were collected from all female patients who underwent a robotic AUS implantation at a single academic center between 2014 and 2022. The primary endpoint was temporary difficulties, defined by at least one other short hospitalization to learn pump manipulation. Results: Out of the 88 female AUS patients included in the study, 20 experienced initial difficulties manipulating the pump, accounting for 22.7% of the group. Temporary difficulties were reported by 16 patients (18.2%), while 4 patients (4.5%) had their devices permanently deactivated. Surgical reoperations to reposition the pump were necessary for 5 patients, representing 5.6% of the sample. The only variables significantly associated with temporary difficulties were longer operative time (183.4 minutes vs. 159.1 minutes, P=0.04) and the overall experience of the center (32 vs. 50, P=0.04). The sole variable significantly linked to serious difficulties was the overall experience of the center (11 vs. 47, P=0.004). Although the median age and body mass index were higher in the group with temporary difficulties, these differences were not statistically significant. Conclusions Difficulties in manipulating the pump are relatively common among female AUS patients. Most of these difficulties can be resolved through repeated patient education and careful follow-up. However, some may lead to serious complications. Raising awareness of this issue, along with ongoing patient education and meticulous follow-up, may help to minimize these consequences.