Japanese Management Research Articles

Investigating the Effect of Kaizen Management on Industrial Performance at Kathmandu Valley: Empirical Evidence of Japanese Management Theory

Background: Kaizen, originating from Miyazaki et al. (1986), emphasizes efficient work approaches, impacting global businesses. Despite its widespread adoption, Nepal faces queries regarding its efficacy and implementation challenges. Objective: This study examines the effect of Kaizen Management on Industrial Performance at Kathmandu Valley – one of the core business cities of South Asia as well as challenges of Kaizen Management by providing the managerial solution for effective Kaizen Management. Methods: Following the Japanese Management Theory (Theory Z), an explanatory research design is employed to identify causal relationships between variables in the study of Kaizen management. Based in the Kathmandu Valley, managers from 158 industries (35 from Bhaktapur, 62 from the Balaju Industrial Estate, and 61 from the Patan Industrial Estate) were selected using probability sampling techniques, and primary data were collected via survey methods using structured questionnaires. Results: Employee Skills & Efforts, Working Area Impact, and Follow-up Activities all have a significant impact on how Kaizen management is implemented. This finding provides theoretical support for Japanese Management Theory. According to the results, Kaizen management is a new idea that has to be given greater consideration in Nepalese industrial estates. Conclusion: Organizational rules and procedures need to be changed and amended more so that staff members, supervisors, and organizations may make significant strides in implementing Kaizen Management across industries in Kathmandu valley. Keywords: Kaizen Management, Industrial Estate, Structural Equation Modelling, Nepal Paper Type: Research Paper JEL Classification: J53, M11, M12, O32, G32

Japanese Cross-Cultural Management in Indian Business-to-Business Marketing Situations: A Study of Evolving Intra-Asian Differences in Cultural Values

ABSTRACT Purpose Extensive research has been conducted on cross-cultural comparisons between Eastern and Western organizational cultures in major trading domains. However, there is a lack of examination of intra-comparative management nuances within Asian regions. This research paper focuses on the under-explored topic of the values, beliefs, and attitudes (VBAs) that influence the outcomes of East Asian (e.g. Japan) marketing strategies and operations when implemented in South Asian (e.g. India) markets and organizational contexts. The study aims to analyze the impact of VBAs on marketing effectiveness and provide insights for marketers in cross-cultural settings. The article analyzes the customer satisfaction orientation (CSO) of Japanese business executives and draws insights that offer lessons related to cultural VBAs for overall marketing strategy and foreign investors. Methodology/approach The paper employs a social constructivist paradigm and gathers empirical research through multiple interviews. These facilitate novel and normally rare access and insights into Japanese business leaders’ lived experience of CSO in B2B Indian intercultural situations. Findings Interpretivist data analysis reveals several push-pull factors that influence CSO practice. The research identifies shared values such as long-termism and harmony that have the potential to boost CSO as a marketing strategy in India. Research implications The paper develops a conceptualization of cultural VBAs that lead to successful CSO practice in India and is of relevance to foreign investors. Practical implications This study suggests that East Asian marketers should carefully consider the impact of VBAs on their marketing strategies. Our research sheds light on the ongoing discussion on static versus evolving nature of culture and highlights the need to pay attention to cultural change, particularly congruence and confluence in workplace values. Originality The intercultural study contributes to the literature on international marketing strategy by highlighting the nature and importance of understanding traditional and evolving cultural VBAs for appreciating receptivity to adoption and thereby efficacy of home country marketing strategy.

Peer conformity and competition shape how business managers evaluate withdrawals from Russia amid the Ukraine War

States have long used economic sanctions in response to violations of international law as a strategy to restore order. Increasingly, firms also reject doing business with violators. In response to the war in Ukraine, hundreds of multinational corporations voluntarily withdrew from Russia, even when policymakers were still debating the extent of sanctions. How did firm managers evaluate whether to withdraw from the Russian market? Using a survey experiment with Japanese firm managers conducted three months after the Russian invasion of Ukraine in 2022, we explore how peer effects-information on what other firms are doing in response to the crisis-influence support for withdrawal of business activity with Russia. Our findings show that information about withdrawal by other firms from a diverse set of countries promotes peer conformity that increases support. In contrast, information about ongoing business with Russia by Chinese firms fosters competition that reduces support. Market exposure moderates these reactions, although the concern about peer behavior does not appear to be driven by a reputation mechanism. Our research provides insight into how business actors perceive the strategic interplay of peer influence and market dynamics in the context of geopolitical conflicts.

Theoretical Aspects of Applying Kaizen Principles in the Management of Support for Children in Difficulty

This paper develops a theoretical framework for the application of Kaizen principles in socio-economic support for children in difficulty. Rooted in Japanese management practices, Kaizen principles emphasize both continuous, incremental improvements and the elimination of inefficiencies in activities. The use of these principles in supporting vulnerable groups such as neglected and abandoned children, those exposed to violence, the homeless, or orphans, can improve the quality and efficiency of services through small, but permanent changes. Kaizen can create a more resilient and adaptable support system capable of meeting the evolving needs of children in difficulty, thus improving their quality of life.

Impact of the 2017 revised Japanese obstetric hemorrhage management guidelines on tranexamic acid use in patients undergoing cesarean delivery: an interrupted time series analysis

BackgroundTranexamic acid is one component of a complex management algorithm for postpartum hemorrhage. In Japan, the 2010 obstetric hemorrhage management guidelines was revised in 2017, adding the recommendation for the administration of tranexamic acid for postpartum hemorrhage. This research aims to delineate the temporal trends in tranexamic acid administration in patients undergoing cesarean deliveries and to examine the impact of the obstetric hemorrhage management guidelines implementation. MethodsAn interrupted time series analysis was conducted on data from patients who underwent cesarean deliveries from April 2012 to August 2021, sourced from Japan’s nationwide health insurance claims database. We examined the trends of tranexamic acid usage and blood transfusion use before and after the implementation of the revised guidelines in 2017. ResultsThe study cohort comprised 91 166 cesarean deliveries. Prior to the guideline implementation, the rate of tranexamic acid usage decreased. Post-guidelines implementation, there was a statistically significant increase in the rate of tranexamic acid use, with a quarterly percentage change of 0.48% (95% confidence interval: 0.36 to 0.60; P < 0.001). The guidelines implementation in 2017 was not significantly associated with a change in the rate of transfusions. ConclusionsThis interrupted time series analysis demonstrated a significant increase in the rate of tranexamic acid administration following the implementation of the revised guidelines, reversing the previously observed downward trend. Our findings could reflect the impact of the revised guideline on the use of tranexamic acid for postpartum hemorrhage, but this did not translate to fewer blood transfusions.

Digital Communication in Japanese Companies: The Corporate Blog. Current Trends, Challenges, and Future Perspectives

The present article examines the digital communication patterns exerted by domestic Japanese companies through Japanese-language blogging practices: main characteristics, current trends, challenges, and future tendencies at the intersection of Japanese corporate culture, communication, and the digital realm. After a concise literature review of Japanese corporate identity and predominant cultural features of Japanese management, we will conduct a qualitative content analysis on a selected corpus of Japanese language corporate blogs to investigate the digital corporate discourse (content, types of public, communication strategies, and techniques) on a national level and to inquire into the extent of the impact exerted by the digital evolution of media platforms and the emergence of new AI tools. The implications of the present research are twofold. First, the database we manually compiled contains only Japanese language sources, thus surpassing the linguistic barrier many Western academics confront when researching Asian countries and media content in Asian languages. Examining the Japanese language digital discourse of domestic companies in a post-pandemic globalized context bridges the unceasing gap between the West and the East, thus decentring the focal point from the Western companies and shifting the attention from English-language digital communication. Second, connecting the Japanese-language business discourse with domestic blogging platforms represents another aspect of particular importance neglected by previous research.

The Role of Institutional Logics in Shaping Sustainable Talent Management: A Comparative Study of Two South Korean Conglomerates

This research examines the evolution of human resource management (HRM) practices within Samsung and Lotte, two major South Korean conglomerates. Both companies have been profoundly influenced by the Japanese management paradigm, especially in areas like seniority-based promotion rooted in Confucian values. Drawing from institutional theory, the study elucidates how similar economic trajectories in South Korea and Japan fostered comparable institutional logics and pressures in HRM. However, as organizations navigate institutional shifts, their responses and resulting HRM adaptations can diverge. Utilizing a comparative approach through the lens of the institutional logic theory, key findings unveil as follows: (1) Samsung and Lotte’s HR practices exhibit a strong Japanese influence, highlighting cultural/historical context’s importance. (2) Despite similar pressures, the conglomerates developed distinct HR practices attributed to differing institutional logics. (3) Institutional logics play a pivotal role in shaping HRM and influencing organizational behavior. (4) Organizations adapt HR practices in response to institutional complexities, leading to practice divergence. (5) The study extends institutional theory’s application in understanding organizations’ varied responses to similar pressures. (6) Findings offer HR professionals insights on tailoring strategies based on contextual understanding. The study extends the application of institutional theory in deciphering varied organizational responses. Practically, it provides HR professionals guidance on contextually appropriate HRM strategies. Companies across Asia can leverage these insights to anticipate HR practice shifts and align them with evolving institutional frameworks.

Varieties of engagement: Japanese corporate leaders’ strategic relations with foreign shareholders and institutional change

PurposeApplying the concept of “entrepreneur managers” from dynamic capabilities theory to the question of how some Japanese managers develop and use their relationships with foreign investors, this article explores organizational contexts in which Japanese managers use foreign shareholders as resources to enhance firm capabilities in the global marketplace, deploy assets effectively and implement changes to traditional organizational customs. The article asks why and how some top managers implemented institutional changes and adopted customs that are common in the shareholder-based system while others did not.Design/methodology/approachWe conducted qualitative interviews with 11 inverstor relations (IR) managers of large, listed Japanese firms in Kyoto and Tokyo.FindingsFirst, by inviting a hedge fund partner and using their human capital and social capital, a Japanese CEO committed to strengthening his firm’s competencies in the global market and introduced changes that are common in the shareholder-based system. Second, a CEO with an MBA degree and exceptional communication skills in English and Japanese dedicated himself to executing much of the strategic advice suggested to him by foreign shareholders and altered some of his firm’s traditional Japanese management practices. Third, even though many Japanese firms welcomed and used foreign shareholders as advisors to help them streamline and/or acquire firm assets, their top leaders’ implementation of organizational changes was limited. Fourth, the top leaders of family-owned firms were reluctant to initiate dialogue with foreign investors.Originality/valueThis article adds some useful organizational context to existing scholarship on institutional theory by examining Japanese leaders’ strategic management in their relations with foreign investors. Using the concept of dynamic capabilities, it addresses the role of innovative strategic managers in firms’ institutional changes.

Descriptive epidemiology of prevalence of exercise habits among participants with hypertension: The National Health and Nutrition Survey 2013-2018.

The current Japanese hypertension management guidelines (2019) recommend regular exercise for all patients with hypertension. However, limited evidence is available regarding the prevalence of exercise habits in these patients. Therefore, we examined the proportion of participants who met the recommendations on exercise in the Japanese hypertension management guidelines (2019) using a nationally representative sample. Participants aged ≥20 years from the Japanese National Health and Nutrition Examination Survey conducted from 2013 to 2018 were included. Participants with hypertension were defined as those with blood pressure level ≥140/90 mmHg or those who used antihypertensive drugs. Adherence to the guideline recommendations, stratified by gender, age category, blood pressure level, and medication status, was examined. This study included 13,414 participants with hypertension (age 68.2 ± 11.7 years, 48.1% men). Among them, 31.8% of participants with hypertension (36.8% of men and 27.3% of women) met the guidelines. Regarding age, the 20-64 years age group had the lowest proportion of patients who met the guidelines (22.4%), followed by those in the 65-74 (37.7%) and ≥75 years age groups (34.5%). Adherence to the guidelines did not significantly differ according to blood pressure levels (<120/<80, 120-129/<80, 130-139/80-89, 140-159/90-99, and 160-179/100-109 mmHg) and presence of antihypertensive medications. One-third of participants with hypertension engaged in exercise as recommended by the current hypertension management guidelines. Promotion of exercise therapy and monitoring exercise habits among participants with hypertension is warranted.

The development and analysis of a Japanese modern comprehensive clinical data management training program

BackgroundClinical data management (CDM) collects, integrates, and makes data available. It plays a vital role in clinical research. However, there are few opportunities for Japanese clinical data managers to learn about its systematic framework, particularly in academic research organizations. While Japanese-language CDM training exists, its effectiveness in a Japanese context requires clarification. ObjectivesWe aimed to develop an advanced program of instruction for professionals to understand CDM and to determine the effectiveness of the training program. Methods and resultsWe developed an advanced program including risk-based monitoring and the Clinical Data Interchange Standards Consortium on a trial basis for clinical data managers to provide them with a comprehensive understanding of CDM. Fifty-two people attended the program and reported that they were highly satisfied with it. ConclusionsTo provide comprehensive CDM training in Japan, it is imperative to continue improving the content and develop an advanced program. Due to the recent tightening of clinical research regulations and the development and dissemination of various systems for conducting clinical research, the competency-based educational program requires further development.

Eğitim Yönetiminde Kaizen’in Kavramsal Çerçevesinin İncelenmesi

In today's world, the technology that is changing almost every day and developing rapidly is bringing with it inconceivable transformations. At the beginning of these transformation strategies, a collaborative management approach comes first. Collaborative management requires strategic integrity in a general sense. KAIZEN strategy, on the other hand, is the most important focus of the Japanese state's ability to cope with competition in the form of the most valuable concept in terms of the Japanese management system. KAIZEN, which is one of the most commonly used concepts in the Japanese government, appears in the form of a continuous development strategy that covers all working people. Innovations lean on technique, and the cost mechanics of acquiring the latest technique in a competitive workplace will also be in phase. At the same rate, the continuous increase in the manufacturing cost of the existing finished product is a conflict environment in which consumers need to ensure quality satisfaction, and the continuous development of the service process seems to be important costs and problems for companies. The importance of KAIZEN strategy method is also revealed in this focus, because it provides the solution of existing problems by creating a corporate culture in which the existence of problems in any enterprise is understood in every detail, coping with problems can be realized with the participation of every employee. Another important feature of the KAIZEN strategy method is that if the top management wants to make a lot of profit in the phase by ensuring the continuity of the power in the business field, it realizes that it is essential to meet the customer's needs in the most accurate way. Key Words: Educational Management, Kaizen, Conceptual Framework

Do Industrial Companies in Lebanon Have the Requirements to Apply Lean Accounting? An Exploratory Study of a Sample of LCPAs

Significant changes have occurred in the industrial sector, including the adoption of Japanese management ideas such as waste reduction, quality manufacturing, employee participation, and continuous development. This change is a result of heightened competition among businesses, which makes it necessary to look for novel accounting ideas in order to adapt to changing client demands and obtain a competitive edge. The study at hand aimed to identify the availability of necessary requirements to apply lean accounting in industrial companies in Lebanon. The researchers identified two types of components, administrative and procedural. The researchers conducted a five-point Likert style questionnaire suitable to the subject and objectives of the study, and a random sample of 400 LCPA’s was selected and the questionnaires were distributed among them. The sum of 389 questionnaires were retrieved, and all were valid for testing. The descriptive analytical approach was used to describe the variables of the study and analyze them. To test the hypotheses and analyze the data, the SPSS statistical program was used. The researchers hypothesize that industrial companies in Lebanon have the administrative capabilities to implement lean accounting. The study concluded that the industrial companies in Lebanon have the administrative and procedural requirements to apply lean accounting.

Eğitsel Süreçlerde Japon Yönetim Sisteminin Ana Bileşenlerinin İncelenmesi

The aim of this study is to examine the main components of kaize, the Japanese management system in educational processes. Kaizen, which should be considered as a vetire in educational processes, means a gradual and continuous development activity as a Japanese-specific management system. According to Kaizen, in order to achieve good results, it is necessary to be able to develop the path to it. Thus, an advantage will also be provided in the competition. Purposeful costing is the management of cost related to the stages at which the product is developed and regulated. If Kaizen is not costing; it is the stage that covers the continuous development activity by determining the targeted cost and reducing it to the cost level. The conceptual definition of kaize is essentially clear and simple. Kaizen means development. It is a continuous development activity that involves the employee in the lowest position from the top manager in a company. In addition to the application of Kaizen thinking in the company, it means the continuous development of lifestyle in cultural, personal relationships or family life. In addition to all these situations, Kaizen has been a social concept that allows qualitative movements to begin. Kaizen can be defined as continuous development activities and activities that cover every incision from the manager at the top of organizations to the employees at the lowest level. Kaizen is a process and a process, it is the effort and continuity of realizing what is good with tiny steps with a human at the focus. From the slogan of Kaizen, the word that the most beautiful with movement is the enemy of the best, addressing problems with transparency is the basic condition of this idea. Key Words: Educational Processes, Japanese Management System, Kaizen, Main Components

Clinical development of a blood biomarker using apolipoprotein-A2 isoforms for early detection of pancreatic cancer

BackgroundWe have previously reported apolipoprotein A2-isoforms (apoA2-is) as candidate plasma biomarkers for early-stage pancreatic cancer. The aim of this study was the clinical development of apoA2-is.MethodsWe established a new enzyme-linked immunosorbent sandwich assay for apoA2-is under the Japanese medical device Quality Management System requirements and performed in vitro diagnostic tests with prespecified end points using 2732 plasma samples. The clinical equivalence and significance of apoA2-is were compared with CA19-9.ResultsThe point estimate of the area under the curve to distinguish between pancreatic cancer (n = 106) and healthy controls (n = 106) was higher for apoA2-ATQ/AT [0.879, 95% confidence interval (CI): 0.832–0.925] than for CA19-9 (0.849, 95% CI 0.793–0.905) and achieved the primary end point. The cutoff apoA2-ATQ/AT of 59.5 μg/mL was defined based on a specificity of 95% in 2000 healthy samples, and the reliability of specificities was confirmed in two independent healthy cohorts as 95.3% (n = 106, 95% CI 89.4–98.0%) and 95.8% (n = 400, 95% CI 93.3–97.3%). The sensitivities of apoA2-ATQ/AT for detecting both stage I (47.4%) and I/II (50%) pancreatic cancers were higher than those of CA19-9 (36.8% and 46.7%, respectively). The combination of apoA2-ATQ/AT (cutoff, 59.5 μg/mL) and CA19-9 (37 U/mL) increased the sensitivity for pancreatic cancer to 87.7% compared with 69.8% for CA19-9 alone. The clinical performance of apoA2-is was blindly confirmed by the National Cancer Institute Early Detection Research Network.ConclusionsThe clinical performance of ApoA2-ATQ/AT as a blood biomarker is equivalent to or better than that of CA19-9.

Does health literacy influence health-related lifestyle behaviors among specialists of health management? A cross-sectional study

BackgroundNoncommunicable diseases (NCDs), such as health-related lifestyle diseases, are the leading cause of mortality and societal and economic burdens. Poor lifestyle behaviors, which are modifiable to improve health, can cause diseases, including NCDs. Health literacy has been recognized as an important determinant of health, and studies have shown that higher health literacy is associated with better health outcomes and positive health-related behaviors. However, few studies have investigated the association between health literacy and health-related lifestyle behaviors to understand the mechanistic link between them. Thus, this study investigated the extent to which health literacy at different levels influences health-related lifestyle behaviors.MethodsA cross-sectional study was conducted among Japanese health management specialists (N = 1,920). Functional, critical, and communicative health literacy were measured. Lifestyle behaviors (exercise, diet and nutrition, sleep, rest, smoking, and alcohol intake), in line with the Japanese National Health Promotion Program, were assessed and calculated into a total cumulative score of health-related lifestyle behaviors. Moreover, we analyzed the associations between the three levels of health literacy and lifestyle behaviors using regression analyses by adjusting for socio-psycho-demographic factors.ResultsMultiple linear regression analyses showed a significant association between the Japanese version of the European Health Literacy Survey Questionnaire and total health-related lifestyle scores (standardized β = 0.160, p < 0.001, R2 = 0.136) after adjusting for sociodemographic factors. Similarly, the association between communicative and critical health literacy and the total health-related lifestyle scores was significant (standardized β = 0.122, p < 0.001, R2 = 0.125). The analysis indicated that individuals who had higher level of health literacy (critical and communicative) than functional health literacy (Japanese version of the Newest Vital Sign score) had higher health-related lifestyle behaviors.ConclusionsA higher level of health literacy is associated with health-related lifestyle behaviors. Health literacy can be a target for interventions to achieve the national goal of lifestyle-related disease prevention and control.

Real-world experience with trastuzumab deruxtecan among patients with gastric cancer: 4 month-interim analysis of an all-patient post-marketing surveillance study in Japan.

273 Background: Interstitial lung disease (ILD) is an important identified risk in the Japanese risk management plan of trastuzumab deruxtecan (T-DXd). In Japan, all-patient post-marketing surveillance (PMS) is underway to investigate the risk of ILD among patients with gastric cancer treated with T-DXd in a real-world setting. We present an interim analysis of the large-scale all-patient PMS. Methods: This is an observational, multicenter, all-patient PMS (jRCT2001200001) with an observation period of 12 months that enrolled all patients treated with T-DXd for HER2-positive unresectable advanced or recurrent gastric cancer between Sep 2020 and Dec 2021. This interim analysis is based on safety data from the first 4 months of all enrolled patients. All potential ILD (identified based on the pre-specified list of AE terms) reported by physicians were adjudicated by an independent ILD adjudication committee (ILD-AC). The incidence of ILD was calculated from adjudicated drug-related ILD. Results: The interim analysis set included 1074 patients with median age of 70 years (range: 23-100). Of the 1074 patients, 1051 (97.9%) received T-DXd as third-line or later treatment. One hundred and eight patients (10.1%) had an Eastern Cooperative Oncology Group performance status (ECOG PS) 2 or greater, and 32 (3.0%), 3 (0.3%), and 23 (2.1%) patients had severe renal impairment (15≤ creatinine clearance (CL) &lt;30 mL/min), end-stage renal disease (CL &lt;15 mL/min), and ILD/radiation pneumonitis at baseline, respectively (all of which were defined as exclusion criteria in clinical trials of T-DXd). Median initial dose of T-DXd was 6.4 mg/kg (range: 3.1-6.4). Median treatment duration of T-DXd was 4.0 months (range: 0.7-4.0). During the first 4 months from the initial treatment, T-DXd was discontinued in 50.9% (547/1074) of patients. The most common reasons for treatment discontinuation were disease progression (n=390, 71.3%), adverse events other than ILD (n=76, 13.9%), and ILD (n=56, 10.2%). All potential ILD that occurred during the first 4 months were adjudicated by ILD-AC, and the incidence of all grades, grade ≥3, and grade 5 adjudicated drug-related ILD were 5.2% (n=56), 1.5% (n=16) and 0.7% (n=7), respectively. Of the 56 patients with adjudicated drug-related ILD, 54 (96.4%) discontinued T-DXd. The incidence of adjudicated drug-related ILD by time from initial treatment of T-DXd were 0.7% (7/1074) at ≤ 1 month, 2.0% (19/949) at 1-2 months, 2.7% (22/829) at 2-3 months, and 1.2% (8/652) at 3-4 months. Conclusions: The interim analysis revealed patient experiences and treatment profiles of T-DXd and the incidence of ILD during the first 4 months since initial treatment in a real-world setting in Japan. The final analysis including a risk factor analysis for ILD of the ongoing PMS is planned.

Abstract B007: Early detection and risk stratification of pancreatic cancer using apolipoprotein A2-isoforms as a blood biomarker

Abstract To reduce the mortality rate of pancreatic cancer, there is an urgent need to develop a biomarker that can efficiently screen for pancreatic cancer in blood tests. We had identified the unique processing of C-terminal amino acids of apolipoprotein A2 homodimers, we named it apolipoprotein A2-isoforms (apoA2-i). ApoA2-i consists of three isoforms with different C-terminal amino acids. Especially, we had reported that apoA2-ATQ/AT, known as the intermediate isoform, was significantly reduced in the bloodstream of pancreatic adenocarcinoma (PDAC) patients compared to healthy controls. However, previous reports were investigated using a research use only (RUO) reagent, which could not be used in clinical settings. We generated a novel ELISA for measuring apoA2-i under the Japanese medical device Quality Management System requirements, and measured the concentration of apoA2-i in 2,732 of plasma samples. The clinical equivariance and significance of apoA2i were evaluated by pre-specified endpoints. The point estimate of the area under the curve to distinguish between PDAC and healthy controls was higher for apoA2-ATQ/AT [0.879, 95% confidence interval (CI): 0.832–0.925] than for CA19-9 (0.849, 95%CI: 0.793–0.905) and achieved the primary endpoint. The cut-off apoA2-ATQ/AT of 59.5 μg/mL was defined based on 95% specificity in 2,000 healthy samples. The sensitivity of apoA2-ATQ/AT for detecting both stage I (47.4%) and I/II (50%) of PDAC was higher than that of CA19-9 (36.8% and 46.7%, respectively). The combination of apoA2-ATQ/AT (cut-off, 59.5 μg/mL) and CA19-9 (37 U/mL) increased the sensitivity for pancreatic cancer to 87.7% compared with 69.8% for CA19-9 alone. ApoA2-ATQ/AT has equivalent or better clinical performance to CA19-9 as a blood biomarker. Citation Format: Kazufumi Honda, Ayumi H. Kashiro, Michimoto Kobayashi, Keiko Takeuchi, Yuya Shizume, Takanori Oh, Chigusa Morizane, Susumu Hijioka, Satoshi Nara. Early detection and risk stratification of pancreatic cancer using apolipoprotein A2-isoforms as a blood biomarker [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr B007.

Changes in care managers' positive attitudes toward dying patients compared to that of nurses by one-day online advance care planning communication training.

Culturally appropriate communication training programs for a wide range of professions that can be used during infection epidemics are crucial for advance care planning implementation. Starting in 2018, the Japanese Ministry of Health, Labour and Welfare made a major policy change, and doctors, nurses, and social workers, and care managers were identified in the guidelines as the professions that promote advance care planning. Motivated by the lack of online programs for Japanese care managers, we proposed a new one-day program. This study aimed to determine the changes in the positive attitude of care managers toward dying patients compared to that of nurses, which has been used in past literature as an outcome of advance care planning educational interventions, after administering the program in Japan. Before-after comparison study. Care managers were recruited through our website, ACP-Piece, http://plaza.umin.ac.jp/~acp-piece/piece.html. A questionnaire survey concerning positive attitudes toward dying patients was administered before and after the program on 28 August 2021. Sixty-six subjects participated in the training and 60 participants, including 14 care managers, consented to the study and completed the questionnaire surveys before and after the program. The Frommelt attitude toward care of the dying scores for care managers increased after the program (p-values, confidence intervals, and effect sizes: p < 0.001, -11.90 to -4.388, -1.252). After training, care managers had a significantly higher maximum score occurrence than nurses. Older care managers with advance care planning experience may have had a higher maximum score occurrence compared to younger, inexperienced participants. To our knowledge, this is the first to demonstrate the increased positive attitude scores toward dying patients after online communication training for Japanese care managers. The limitations of this study include the lack of evidence regarding reasons for score changes, long-term score changes, and effectiveness for patients and their families.

Effects of intervention by trained care managers on advance care planning engagement among long-term care service users in Japan: a pre- and post-pilot comparative study across multiple institutions.

A majority of Japanese care managers lack medical qualifications, feel uncomfortable discussing future medical choices and believe that it is not their responsibility. As there is a paucity of care manager intervention studies, this study aimed to measure changes in advance care planning engagement among long-term care service users before and after intervention by care managers with communication training. A multi-institutional pre- and post-pilot comparative study. A multi-institutional pre- and post-trial study was performed from August 2022 to January 2023 (trial ID: 000048573). Nine trained care managers communicated with 30 long-term care service users regarding advance care planning, and the pre- and post-trial advance care planning engagement scores were compared. Additionally, the post-trial impact of events score was investigated. All 30 long-term care service users completed the trial. The advance care planning engagement score increased after the trial. The sample size was considered adequate for future trials. Years of experience as a care manager, impact of events score, and having a clinical frailty scale of ⩾5 were significant explanatory variables that affected the objective variable of the difference between pre- and post-trial advance care planning engagement score. This study on the impact of advance care planning communication interventions by trained care managers offers insights into determining appropriate sample sizes and identifying factors influencing future research outcomes. Advance care planning engagement of long-term care service users might change before and after intervention by care managers through advance care planning communication. University Hospital Medical Information (UMIN) Network Trial ID: 000048573.

The Second Wave of Look East Policy (Lep 2.0): Enhancing The Bilateral Relations Between Malaysia – Japan

Japan was among the first countries to establish diplomatic relations with Malaya (then Malaysia). On 9 September 1957, nine days after Malaya achieved independence, Japan opened its embassy in Kuala Lumpur. The introduction of the Look East Policy (LEP) in 1982 strengthened the existing Malaysia-Japan bilateral relations. The main objective of this study is to examine the nature of the bilateral relationship between Malaysia and Japan during the implementation of the Look East Policy (LEP) and to identify the mutual benefits obtained by both countries in the implementation of LEP 2.0. This study adopted a qualitative analysis method by conducting intensive interviews and focus group discussion involving 13 informants who were directly involved with the implementation of LEP. The study found that, among other things, while LEP made the good practice of the Japanese people as the main driving factor, it also included the Japanese work culture, discipline, ethics, integrity, accountability, management and strategic partners. Three decades after the implementation of LEP in Malaysia, LEP took up a notch with the introduction of the Second Wave of LEP in 2012. Otherwise known as LEP 2.0, it prioritised new areas in line with technological developments in the millennial era. In line with that, LEP 2.0 also focused on the context of mutual benefit (common interest) for both countries especially in Halal hub industry and tourism.