{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T12:59:37Z","timestamp":1777294777376,"version":"3.51.4"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Plasmapheresis is widely used in Japan; however, regional variation in its use and its association with specialist distribution remain unclear. We conducted a cross\u2010sectional study using the 9th National Database Open Data (fiscal year 2022) to assess regional variation in plasmapheresis use and examined its association with the distribution of nephrologists, dialysis specialists, and apheresis specialists. Plasmapheresis use was identified using the relevant receipt code, and age\u2010 and sex\u2010adjusted standardized claim ratios (SCRs) were calculated. Plasmapheresis use differed 6.5\u2010fold across regions, with SCRs ranging from 34.0 to 222.4. Multivariable\u2010adjusted negative binomial regression models showed that each additional board\u2010certified nephrologist per 100\u2009000 population was associated with a 1.11\u2010fold increase in the SCR (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.11; 95% confidence interval: 0.02\u20130.20;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.022). No significant associations were observed for board\u2010certified dialysis or apheresis specialists. These findings indicate substantial regional disparities and suggest that nephrologist distribution may influence plasmapheresis utilization in Japan.\n                  <\/jats:p>","DOI":"10.1002\/jca.70112","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T04:21:43Z","timestamp":1773634903000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Specialist Distribution and Regional Variation in Plasmapheresis Use in Japan: A Population\u2010Level Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9433-2249","authenticated-orcid":false,"given":"Ryuichi","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Teikyo University Chiba Medical Center  Ichihara 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