
The Central Japan International Medical Center Is Revolutionizing Cancer Care
Nestled in the heart of
Japan
, the brand-new Central Japan International Medical Center (CJIMC) stands as a beacon of excellence in global health care. With state-of-the-art facilities and highly advanced technology, coupled with an intense focus on quality of care, CJIMC is emerging as a premier destination for international patients seeking top-tier medical services in Asia.
'Having seen medical care from all over the world, I designed this medical center with a global approach, equipped to treat patients from all backgrounds. The facility is supposed to feel more like a hotel than a hospital,' explains Dr. Jitsuhiro Yamada, the chairperson of Central Japan International Medical Center and a past international president of Lions Clubs International.
CJIMC caters to patients of all backgrounds and nationalities — among them, medical tourists who come to Japan specifically to access cutting-edge care at a comparatively low cost. The facility offers a wide variety of services, including comprehensive health screenings and checkups, but what perhaps stands out most is its Proton Therapy Center, which is home to one of the world's most advanced and innovative radiation oncology treatment systems.
Varian ProBeam 360°
Revolutionizing Cancer Care
At the heart of CJIMC's Proton Therapy Center lies the Varian ProBeam 360°, a highly advanced proton therapy system
made in the US
. Unlike traditional radiation therapy (which uses X-ray and gamma ray particles), the ProBeam 360° uses a proton particle beam, which is able to accurately zero in on tumors; this allows for unparalleled precision in targeting cancerous cells while minimizing damage to surrounding healthy tissues, proving particularly effective for treating cancers in delicate locations.
'Cancer is the scariest diagnosis a patient can receive,' Dr. Yamada says. 'We've integrated the ProBeam 360°, a highly effective, third-generation proton therapy equipment.' This cutting-edge treatment is offered in very few locations worldwide. 'We're working hard to make it easier for international patients to receive cutting-edge cancer treatment here.'
Dr. Jitsuhiro Yamada
The Proton Therapy Center is led by Dr. Nobukazu Fuwa, one of Japan's most respected radiation oncology experts, and treatments are delivered on an outpatient basis. Each treatment session usually takes 10 to 15 minutes, meaning that patients spend just a fraction of their day in the hospital. Though it varies based on cancer type and severity, Dr. Yamada says that proton therapy can
sometimes
conclude in around 21 sessions
— for example, in the case of prostate cancer —
allowing patients to receive a full course of treatment in a single month.
It's an especially appealing option given the high costs of healthcare in America. 'With proton therapy that uses the American-made Varian system, even after purchasing round-trip airfare to Japan and getting gifts for your family here, the total cost would still be lower than just receiving treatment in the US,' notes Dr. Yamada.
Elmammo PET scanner
A Leading Force in Preventive Medicine
Beyond specialized treatment, CJIMC is also a hub for preventive care and comprehensive health screening. The hospital offers full-body checkup packages designed to detect health issues at their earliest, most treatable stages — including full-body cancer screenings, cardiovascular system screenings and brain screenings. As such, it's an ideal destination for health-conscious travelers seeking peace of mind.
The full-body cancer screening course includes an MRI, blood testing and a PET/CT scan, a combined imaging test that shows both the metabolic activity and detailed anatomy of one's body. In America, PET scans can cost several thousand dollars, and insurance can refuse to cover the examination if it's deemed not medically necessary.
CJIMC is also equipped with an Elmammo PET scanner, a PET imaging system dedicated exclusively to breast cancer detection. This groundbreaking technology delivers highly accurate results without the discomfort of traditional mammography, making it an extremely popular option for female patients.
International Support and Accessibility
Recognizing the increasing demand from international patients, CJIMC works with English-speaking coordinators to assist with every step, from scheduling and payment to medical interpretation and aftercare support. Patient privacy and comfort are a top priority, and the facility's staff work hard to ensure that every international visitor experiences seamless, compassionate and culturally sensitive care.
Although some overseas visitors may not be familiar with Gifu, it's centrally located and easy to reach from any of Japan's major cities. Situated just over an hour from Chubu Centrair International Airport and within easy reach of Nagoya, the hospital is easily accessible by high-speed rail, expressway or plane.
Moreover, Gifu's beautiful nature and rich cultural heritage offer a peaceful and restorative environment — ideal for recovery and rehabilitation. Patients can experience the tranquility of Japan's heartland while receiving world-class medical care.
Inuyama
Inuyama
Culture, History and Natural Beauty
The medical center is located in close proximity to a number of scenic and culturally rich locations,
which patients can explore once their treatment has concluded. Among them is the picturesque mountain village of Shirakawa-go, a UNESCO World Heritage Site famed for its traditional
gassho-zukuri
thatched-roof farmhouses — an enchanting, fairy tale-esque view. Nearby, the Okuhida region beckons with its dramatic 3,000-meter-class peaks and a wealth of natural hot springs, perfect for relaxation and recovery. Access is convenient: It takes just about 1 hour and 40 minutes by express train from the medical center to Takayama Station, which serves as the gateway to all these areas.
The town of Inuyama, which neighbors CJIMC, is also full of things to do. It's home to Inuyama Castle, one of the five national treasure castles in Japan alongside Himeji and Matsumoto castles. Its main keep offers panoramic views of the Kiso River. The area surrounding the castle retains its Edo-period charm, with narrow lanes lined with traditional merchant houses, quaint shops and local eateries. The castle town is domestically known for the Inuyama Festival in early April, where intricately decorated floats are paraded through the streets, illuminated by hundreds of lanterns.
Museum Meiji-Mura
Museum Meiji-Mura
Just a short distance from the castle, Museum Meiji-Mura is an open-air museum showcasing over 60 culturally significant buildings from the Meiji era. Among its treasures is the reconstructed main entrance of Tokyo's old Imperial Hotel, designed by Frank Lloyd Wright. Visitors can explore historic structures, ride a steam locomotive and wander through all 100 hectares of the whimsical park-museum steeped in nostalgia and historical significance.
Elevating Global Health Standards
As the world becomes more interconnected, the need for trusted, globally accessible health care providers continues to grow. With its fusion of cutting-edge technology, medical expertise and patient-centered care, Central Japan International Medical Center is poised to become a global leader in modern medicine.
Whether it's the quiet dignity of individualized care or the seamless integration of some of the world's most advanced medical innovations, CJIMC embodies the values that have long placed Japan at the forefront of health care globally. 'I always teach new doctors that the center of medicine is not the doctor, but the patient. Patients come to us troubled by illness, and it is our job as doctors to use our knowledge to support them,' says Dr. Yamada.
More Info
Central Japan International Medical Center
1-1 Kenkonomachi, Minokamo, Gifu 505-8510
T: +81 574-66-1100
cjimc-hp.com
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Japan Today
2 days ago
- Japan Today
Chronic stress contributes to cognitive decline and dementia risk: What you can do about it
By Jennifer E Graham-Engeland and Martin J Sliwinski The probability of any American having dementia in their lifetime may be far greater than previously thought. For instance, a 2025 study that tracked a large sample of American adults across more than three decades found that their average likelihood of developing dementia between ages 55 to 95 was 42%, and that figure was even higher among women, Black adults and those with genetic risk. Now, a great deal of attention is being paid to how to stave off cognitive decline in the aging population. But what is often missing from this conversation is the role that chronic stress can play in how well people age from a cognitive standpoint, as well as everybody's risk for dementia. We are professors at Penn State in the Center for Healthy Aging, with expertise in health psychology and neuropsychology. We study the pathways by which chronic psychological stress influences the risk of dementia and how it influences the ability to stay healthy as people age. Recent research shows that Americans who are currently middle-aged or older report experiencing more frequent stressful events than previous generations. A key driver behind this increase appears to be rising economic and job insecurity, especially in the wake of the 2007-2009 Great Recession and ongoing shifts in the labor market. Many people stay in the workforce longer due to financial necessity, as Americans are living longer and face greater challenges covering basic expenses in later life. Therefore, it may be more important than ever to understand the pathways by which stress influences cognitive aging. Social isolation and stress Although everyone experiences some stress in daily life, some people experience stress that is more intense, persistent or prolonged. It is this relatively chronic stress that is most consistently linked with poorer health. In a recent review paper, our team summarized how chronic stress is a hidden but powerful factor underlying cognitive aging, or the speed at which your cognitive performance slows down with age. It is hard to overstate the impact of stress on your cognitive health as you age. This is in part because your psychological, behavioral and biological responses to everyday stressful events are closely intertwined, and each can amplify and interact with the other. For instance, living alone can be stressful – particularly for older adults – and being isolated makes it more difficult to live a healthy lifestyle, as well as to detect and get help for signs of cognitive decline. Moreover, stressful experiences – and your reactions to them – can make it harder to sleep well and to engage in other healthy behaviors, like getting enough exercise and maintaining a healthy diet. In turn, insufficient sleep and a lack of physical activity can make it harder to cope with stressful experiences. Stress is often missing from dementia prevention efforts A robust body of research highlights the importance of at least 14 different factors that relate to your risk of Alzheimer's disease, a common and devastating form of dementia and other forms of dementia. Although some of these factors may be outside of your control, such as diabetes or depression, many of these factors involve things that people do, such as physical activity, healthy eating and social engagement. What is less well-recognized is that chronic stress is intimately interwoven with all of these factors that relate to dementia risk. Our work and research by others that we reviewed in our recent paper demonstrate that chronic stress can affect brain function and physiology, influence mood and make it harder to maintain healthy habits. Yet, dementia prevention efforts rarely address stress. Avoiding stressful events and difficult life circumstances is typically not an option. Where and how you live and work plays a major role in how much stress you experience. For example, people with lower incomes, less education or those living in disadvantaged neighborhoods often face more frequent stress and have fewer forms of support – such as nearby clinics, access to healthy food, reliable transportation or safe places to exercise or socialize – to help them manage the challenges of aging As shown in recent work on brain health in rural and underserved communities, these conditions can shape whether people have the chance to stay healthy as they age. Over time, the effects of stress tend to build up, wearing down the body's systems and shaping long-term emotional and social habits. Lifestyle changes to manage stress and lessen dementia risk The good news is that there are multiple things that can be done to slow or prevent dementia, and our review suggests that these can be enhanced if the role of stress is better understood. Whether you are a young, midlife or an older adult, it is not too early or too late to address the implications of stress on brain health and aging. Here are a few ways you can take direct actions to help manage your level of stress: -- Follow lifestyle behaviors that can improve healthy aging. These include: following a healthy diet, engaging in physical activity and getting enough sleep. Even small changes in these domains can make a big difference. -- Prioritize your mental health and well-being to the extent you can. Things as simple as talking about your worries, asking for support from friends and family and going outside regularly can be immensely valuable. -- If your doctor says that you or someone you care about should follow a new health care regimen, or suggests there are signs of cognitive impairment, ask them what support or advice they have for managing related stress. -- If you or a loved one feel socially isolated, consider how small shifts could make a difference. For instance, research suggests that adding just one extra interaction a day – even if it's a text message or a brief phone call – can be helpful, and that even interactions with people you don't know well, such as at a coffee shop or doctor's office, can have meaningful benefits. Walkable neighborhoods, lifelong learning A 2025 study identified stress as one of 17 overlapping factors that affect the odds of developing any brain disease, including stroke, late-life depression and dementia. This work suggests that addressing stress and overlapping issues such as loneliness may have additional health benefits as well. However, not all individuals or families are able to make big changes on their own. Research suggests that community-level and workplace interventions can reduce the risk of dementia. For example, safe and walkable neighborhoods and opportunities for social connection and lifelong learning – such as through community classes and events – have the potential to reduce stress and promote brain health. Importantly, researchers have estimated that even a modest delay in disease onset of Alzheimer's would save hundreds of thousands of dollars for every American affected. Thus, providing incentives to companies who offer stress management resources could ultimately save money as well as help people age more healthfully. In addition, stress related to the stigma around mental health and aging can discourage people from seeking support that would benefit them. Even just thinking about your risk of dementia can be stressful in itself. Things can be done about this, too. For instance, normalizing the use of hearing aids and integrating reports of perceived memory and mental health issues into routine primary care and workplace wellness programs could encourage people to engage with preventive services earlier. Although research on potential biomedical treatments is ongoing and important, there is currently no cure for Alzheimer's disease. However, if interventions aimed at reducing stress were prioritized in guidelines for dementia prevention, the benefits could be far-reaching, resulting in both delayed disease onset and improved quality of life for millions of people. Jennifer E Graham-Engeland is Professor of Biobehavioral Health, Penn State. Martin J Sliwinski is Professor of Human Development and Family Studies, Penn State. The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts. External Link © The Conversation


SoraNews24
5 days ago
- SoraNews24
'Matcha crisis' emerges as the world falls in love with powdered green tea
A matcha crisis isn't fun and games like Time Crisis. It's hard and grueling like Dino Crisis . Once the hidden gem of Japanese tea ceremonies and confectionery, the carefully ground green tea known as 'matcha' has taken the world by storm with its vibrant green color, complex taste that seems to complement sweetness perfectly, and health benefits. But now, those in the industry are starting to wonder if the ingredient can handle getting this big. ▼ I'm just going to keep telling myself this is healthy because it has matcha in it. In order to achieve the best color and flavor in matcha, the plants' exposure to sunlight needs to be carefully regulated. This means the very best matcha you're likely to find is grown on a small scale with a high degree of personal attention. Even with attempts to modernize and industrialize production, there are still limitations because certain processes like growing the plants and grinding the leaves need to be done very slowly in order to be done properly. Since production can't be sped up, it would have to be expanded in order to produce more, and seeing the potential for matcha exports, the government began subsidizing green tea production a couple years ago in the hopes of focusing Japan's shrinking agricultural labor force on the coveted ingredient. Meanwhile, China stepped into the game too a while back and is currently the leading producer of matcha in the world. However, much of that is sold in their own gigantic domestic market and since they focus more on efficiency in production, it could be said that the quality is lower. ▼ These green tea plants in Saitama Prefecture are being grown in full sunlight, which means they cannot be used for matcha. The recent trade chaos caused by U.S. President Donald Trump may give Japan a competitive edge against China as Japan is expected to get a more lenient deal in the very sizable American market. Unfortunately, that probably won't make a difference, because even despite Japan's efforts at more than doubling matcha production in the past 10 years, that still won't be enough to meet the increasingly ravenous worldwide demand for the stuff. According to a tea buyer in the U.K., sales of matcha-flavored drinks have tripled in the past year alone and have even surpassed that of the classic Earl Grey there. Some in other countries like the U.S. said they have completely given up coffee in favor of matcha. A vendor in Ireland remarked that Japan will probably need to increase its production by 10 times in the next five years in order to keep up. Considering the fact that farmers of all kinds are literally a dying breed in Japan, a 10-fold increase seems unlikely unless a radical solution can be found. Many in the industry are saying we're already in the midst of what they call a 'matcha crisis' with it being hard to secure, and if both supply and demand continue on their current course we may end up in a full-blown matcha supply shock. ▼ A news report on the matcha crisis… I feel bad for those girls who probably had no idea they would appear on Japanese TV with 'MATCHA CRISIS' underneath. This could cause prices to spike hard and throw the future of matcha as we know it into turmoil. With the demand being what it is, it would seem likely that buyers in other countries would turn to more quickly produced and inferior matcha both from Japan and China, lowering the bar for a drink and ingredient once only made with an extremely high degree of craftsmanship. Many online comments in Japan felt that rising prices would preemptively help protect the integrity of Japan's more finely produced matcha and put it on the level of a high-class ingredient that it deserves. 'Japan has been selling it too cheaply. It should be marketed as a high-end product because it is.' 'This could just be a fad too, like bubble tea or tiramisu. Increasing production for now is fine, but you need to be prepared for after.' 'I don't think matcha is a passing fad because it can be used in so many ways.' 'Why don't they sell it for more?' 'This global demand probably doesn't know what good matcha tastes like, so the market will be flooded with poor-quality stuff.' 'Raise prices and make more of it so we can get some money over here.' 'Alright, who told everyone that matcha is delicious?' 'Looks like taking matcha snacks as a present for my trip to Europe was the right choice.' 'I work at a store in a tourist-heavy area and everyone is buying matcha stuff.' 'The matcha used in the tea ceremony is very carefully made. I hope this wave of commercialism doesn't affect that.' Indeed, matcha might've done well to follow the sake model in which it is marketed as a luxury drink and tends to sell for a premium overseas due to the high degree of technique that often goes into making it. But in the end, it will probably splinter off into something like chocolate where you'll have a more clear-cut range of co-existing options from the exquisitely crafted and highly expensive kinds to the stuff they use to mass produce KitKats. Source: TV Asahi News, The Guardian, Kyodo, YouTube/ANNnewsCH Photos ©SoraNews24 ● Want to hear about SoraNews24's latest articles as soon as they're published? Follow us on Facebook and Twitter!


Yomiuri Shimbun
27-05-2025
- Yomiuri Shimbun
Trump's Tariffs Cloud the Future of a Medical Wonder
Iona Dutz/For The Washington Post Lina Windfelder, a mechatronic engineer, at work at Siemens Healthineers in Forchheim. FORCHHEIM, Germany – On the outskirts of this bucolic town, in a region known as 'das Medical Valley,' workers on a vast factory floor are assembling what they describe as the future: the game-changing scanners that can give doctors the most detailed images ever of what is happening inside the hearts, lungs and brains of their patients. One of the scanners, two decades in the making and called the 'Naeotom Alpha,' is unique, say its inventors at Siemens Healthineers, a global leader in CT technology. 'The image quality is incomparable,' boasts Jesús Fernández, head of CT product marketing at the company, comparing the device's technological leap to the difference between a 1970s television set and HDTV. Since the scanners started shipping four years ago, leading hospitals around the world have ordered them. The Food and Drug Administration called the Naeotom Alpha – after approving its use – 'the first major new technology for computed tomography imaging in nearly a decade.' Forty percent of the scanners are exported to the U.S. market. Now Siemens Healthineers, other medical device makers and their customers are reckoning with a new challenge: the impact of President Donald Trump's global tariffs. The Trump disruption – the possible winners and losers, and the pure chaos – is roiling global manufacturers, from carmakers to champagne vignerons, as companies scramble to reassess their global trade partners and complex supply chains while trying to divine the president's next move. High-end medical devices, including those made by American manufacturers, may be especially vulnerable as many machines are built of components from a dozen vendors around the world. Some scanners cost millions of dollars and are so cutting-edge that hospitals publish a press release when they arrive. In early April, Trump targeted the European Union with a 20 percent levy. Days later, he paused those tariffs for 90 days, leaving a 10 percent across-the-board tax for most European imports, including medical equipment. The pause was set to end at the beginning of July. But on Friday, Trump threatened a 50 percent tariff on all goods from the E.U., beginning June 1, while complaining that trade negotiations with the bloc are 'going nowhere.' The medical tech industry – which produces everything from simple syringes to robot surgeons – has pleaded with Trump officials and members of Congress to exempt their products. The tariffs are too broad, recklessly so, critics say, arguing that a medical device is not like an automobile, but a thing vital for human health. Opposition to tariffs on medical devices hasn't come just from Europe, but from the United States, too. Competition in the CT scanner market is already fierce among top manufacturers, which include two American companies, GE and Philips, alongside Canon in Japan and Germany-based Siemens. Scott Whitaker, the CEO of AdvaMed, a prominent U.S. lobbying association for the sector, warned that Trump's threat of broad-based tariffs would act as an excise tax. 'It will have a negative impact on innovation, cost jobs, and increase overall costs to the health care system,' he said in a statement. 'Historically, industries with a meaningful humanitarian mission have been exempted from broad tariffs, and as a result we have seen no to low tariffs on med-tech from all key trading partners.' The Trump tariffs on medical equipment will not only cost foreign manufacturers but American companies, too. In an annual report to shareholders, GE HealthCare warned in April that U.S. tariffs imposed on products from China, along with any future levies on products from Canada, Mexico or other countries, 'will likely result in additional costs to us.' It was still too early to say whether the price of the Naeotom Alpha would be impacted. Siemens Healthineers warned earlier this month that tariffs and the 'significantly increased volatility of the geopolitical environment will weigh on our business this year.' As a result, the company lowered the midpoint of its projected earnings per share. On the call with analysts, Jochen Schmitz, the chief financial officer, said 'the biggest impact is imports in the U.S. from Europe.' Akin Demehin, vice president of quality and safety policy at the American Hospital Association, said tariffs could disrupt supplies of medical equipment and lead to higher costs. 'All CT scanners require some maintenance,' he said. 'To the extent that those get caught up in overseas supplies and tariffs impact their availability and price, that can potentially impact what the maintenance of those machines looks like,' he said. A tool for saving lives In Germany, the Siemens Healthineers engineers describe their photon-counting CT scanner as a kind of medical wonder that can produce clearer, faster images for quicker diagnosis in a way that is less invasive for patients. It can help save lives, they say. Unlike conventional CT devices that measure the total energy contained in many X-rays at once, the Siemens devices deploy photon-counting detectors that capture each individual X-ray that passes through a patient's body, which results in more-detailed images. The typical patient can be scanned in just three seconds. The lower radiation compared with conventional CTs means the technology can also be used during pregnancies and on children and babies. Modern, conventional CT scanners primarily use solid-state crystal detectors made from a variety of materials. But for the photon-counting Naeotom model, Siemens Healthineers relies on cadmium telluride crystals, which the company now produces as well, including at the Forchheim plant. The intricacies of the process are kept tightly under wraps. In one room, identified as 'Kristallzüchtung,' or 'crystal growing,' fire in a tall black furnace emanates a soft glow. Inside, the synthesis of cadmium and tellurium that creates cadmium telluride is underway. 'Sometimes it feels a bit like alchemy,' said Paul Heimann, team lead of crystal growth. Siemens Healthineers is aiming for all its CTs to be photon-counting devices by 2040. Many in the industry will likely follow its path. Above the testing bays where the humming machines were being readied are star-spangled banners identifying the destination of both conventional and new photon-counting devices. 'U.S., U.S., U.S., U.S.,' points out David Engelstätter, head of CT production at the Forchheim plant. The Naeotom Alpha has already been purchased by several U.S. institutions, including the Mayo Clinic, New York University and Duke University, according to Siemens Healthineers. Some of the hospitals released jubilant press releases when the scanner was approved for use by the FDA. Asked to comment on the possible threat from tariffs, Duke said in a statement: 'We are always alert to market changes and are working to ensure we have the necessary equipment and supplies for optimal patient care.' NYU and Mayo declined to comment. Overall, the U.S. accounted for more than a quarter of Siemens Healthineers' business last year. Moving production, particularly of the unique photon-counting CTs, is out of the question, said Matthias Kraemer, head of corporate communications for Siemens Healthineers. It did not make business sense to have a lot of small factories churning out small numbers of devices, either in Germany or abroad, he said. 'We need that global scale.' The pioneers here in Bavaria say it is the patients who stand to suffer most from trade barriers. 'We all have family, friends, certainly sick friends or family members,' Engelstätter said on the shop floor. 'And then you think, what a shame it would be if I were in the U.S. right now and I were denied this screening – all due to external decisions.' Tax policy, not tariffs In the United States, hospitals are bracing for the impact of tariffs. Higher costs would have to be absorbed, or passed along to insurers – including the U.S. government – and patients. Some 46 percent of hospitals expect that tariffs will increase facility costs in 2025, while an additional 42 percent said they anticipate higher costs when their contracts for supplies are renewed next year, according to a recent Bank of America survey of 50 chief financial officers at hospitals. Of the finance chiefs who responded, 91 percent expected costs to go up for medical equipment and devices. In reporting earnings last month, two major American firms that make medical devices – Johnson & Johnson and Abbott Laboratories – both estimated that tariffs would cost them a few hundred million dollars this year. But they also reaffirmed that they still expect to make about the same amount of money for the full year as they previously projected. Joaquin Duato, Johnson & Johnson's CEO, said that if the goal is to incentivize more manufacturing in the U.S. in both medical technology and pharmaceuticals, 'the most effective answer is not tariffs, but tax policy.' CT scanners range in cost from about $500,000 for entry-level machines to more than $3 million for the highest-end versions. The impact from tariffs could vary widely depending on their individual characteristics, such as where they are manufactured and what countries provide the key components, according to supply-chain experts. But it may take time for hospitals to directly feel the effects of tariffs. Hospitals may have multiyear contracts for machines, services and repairs, sparing them from immediate impacts, said Josh Hilton, senior director for diagnostic imaging and radiation oncology at Premier, Inc., which contracts with manufacturers to supply hospital customers. Still, the uncertainty of tariffs can influence hospital spending. 'When things like this happen, the purse strings tend to tighten up a little bit,' Hilton said. Instead of replacing an aging CT scanner this year, a hospital may push back the expenditure to next year, he said. Jesús Rueda Rodríguez, director general of industrial policy at MedTech Europe, which lobbies for European manufacturers, described complex supply chains. 'Components arrive through the United States, China, Europe,' meaning 'we can get hit by tariffs not once but multiple times.' The devices are highly regulated by health safety authorities, he said, as are the factories. As a result, 'you can't just pack up and move,' he said. Lukas Kratz – one of 5,000 employees at the Forchheim site – is a team leader, overseeing the assembly of the photon-counting CTs. Unlike in large-scale automobile factories, much of the work here is still done by hand. Now 29, he began working for Siemens a decade ago after completing his training as an electronics engineer. 'It's not just one device we're working on; we have many variants with many options,' he said. 'It's very difficult to show just anyone how to do this.'