Comparison of Malaysia-Dubai approach for the Islamic dispute resolution system in Islamic finance

This paper aims to discuss the development of the dispute resolution system for Islamic finance by a cross-national perspective in the Islamic world. The mainstays of the Islamic financial market, nowadays, are the Gulf countries and Southeast Asia. In particular, the United Arab Emirates (UAE) and Malaysia are countries that have developed the industry since its inception. Therefore, this paper will focus on these two countries as case studies. As the market grew, disputes in the Islamic finance industry also increased and raised the question of how the jurisdiction for this new industry could be separated from that of conventional finance. There are discussions on how Islamic finance dispute cases should be dealt with. Malaysia has been working on these issues by focusing on Alternative Dispute Resolution (ADR) as the potential solution. On the other hand the UAE has established an epoch-making system, the ‘Dubai Approach’. This system has been used to settle not only disputes that were related to the financial crisis that occurred in Dubai in 2009, but also those related to Islamic finance transactions. Although the dispute resolution system for Islamic finance is in the developing stage, these two countries’ systems have unique features. Therefore, this paper will indicate the developing process for the dispute resolution system for Islamic finance

How should cardiac xenotransplantation be initiated in Japan?

The version of record of this article, first published in Surgery Today, is available online at Publisher’s website: https://doi.org/10.1007/s00595-024-02861-7.The world's first clinical cardiac xenotransplantation, using a genetically engineered pig heart with 10 gene modifications, prolonged the life of a 57-year-old man with no other life-saving options, by 60 days. It is foreseeable that xenotransplantation will be introduced in clinical practice in the United States. However, little clinical or regulatory progress has been made in the field of xenotransplantation in Japan in recent years. Japan seems to be heading toward a "device lag", and the over-importation of medical devices and technology in the medical field is becoming problematic. In this review, we discuss the concept of pig-heart xenotransplantation, including the pathobiological aspects related to immune rejection, coagulation dysregulation, and detrimental heart overgrowth, as well as genetic modification strategies in pigs to prevent or minimize these problems. Moreover, we summarize the necessity for and current status of xenotransplantation worldwide, and future prospects in Japan, with the aim of initiating xenotransplantation in Japan using genetically modified pigs without a global delay. It is imperative that this study prompts the initiation of preclinical xenotransplantation research using non-human primates and leads to clinical studies

The foremost and greatest barrier to end-stage heart failure treatment: the impact of caregiver shortage

The version of record of this article, first published in Journal of Artificial Organs, is available online at Publisher’s website: https://doi.org/0.1007/s10047-024-01463-x.We examined the number of patients abandoning cardiac replacement therapy due to the inability to secure a designated caregiver. At Osaka University Hospital Heart Center, when we receive a consultation for a patient with severe heart failure from another hospital, a heart failure team makes a visit to the referring hospital as soon as possible. We retrospectively analyzed this hospital-visit database. We received 199 severe heart failure consultations from 2016–2023. Issues identified during hospital visits included age ≥ 65 years (8%), inability to confirm the patient’s intention (8.5%), and explicit refusal of therapy (2.5%). Medical problems included multiple organ failure (18.1%), obesity (13.1%), diabetes (9.5%), malignancy (5.5%), chronic dialysis (1.0%), and other systemic diseases (12.6%). Adherence problems included poor medication compliance (3.5%), history of heavy drinking (2.5%), and smoking (2.0%). Social problems included inadequate family support in 16.1% of patients. Of the 199 patients, 95 (48.0%) proceeded to a heart transplant and LVAD indication review meeting at Osaka University Hospital. The remaining 104 patients (52.0%) did not proceed to the meeting. Reasons included improvement of heart failure with conservative treatment in 37 cases (35.6%), death before discussion in 21 cases (20.2%), medical contraindications in 18 cases (18.3%), lack of caregivers in 18 cases (18.3%; 9.5% of 199 cases), and patient refusal in 5 cases (4.8%). Approximately 10% of patients consulted at Osaka University Hospital Heart Center for severe heart failure abandoned cardiac replacement therapy due to the lack of caregivers

Collaborative agencies and quality discharge support for the long-term care inpatients with mental illness

Long-term hospitalization is a problem for psychiatric care in Japan. The purpose of this research was to clarify the demands placed on public health nurses’ (PHN) involved in the discharge of long-term inpatients (LIPs) with mental illness, and their lack of support. A questionnaire was mailed to 516 health centers, and 112 health centers replied. The response rate was 21.7 percent. The mail survey questionnaire was based on original questionnaire developed by the authors. Significant differences were found among collaborative agencies selected as essential for the discharge support project for the LIPs with mental illness. These differences were evident in the following question items on insufficiency of support : “Incompatibility with the policy of the public health center on discharge support” ; “Opposition to discharge of a LIPs with mental illness by hospital staff” ; and “Shortage of PHN in charge of the discharge support project for the LIPs with mental illness”. It was clarified that the discharge support project required not only the involvement of health and medical welfare personnel but also the cooperation of local human resources such as local residents, neighbor associations, social workers, real-estate agencies and others

Temporal recovery and prognostic factors for dysphagia following cardiovascular surgery: Retrospective analysis and development of predictive score

Hashida N., Hosokawa K., Kawamura A., et al. Temporal recovery and prognostic factors for dysphagia following cardiovascular surgery: Retrospective analysis and development of predictive score. Nutrition 127, 112534 (2024); https://doi.org/10.1016/j.nut.2024.112534.Objective: Dysphagia is a common complication associated with cardiovascular surgery (CVS). This study sought to better understand recovery timelines, identify risk factors, and create a prognostic model for oral intake restoration. Methods: This retrospective study included 134 patients who had CVS between April 2022 and March 2024. We assessed swallowing ability through fiberoptic endoscopic evaluation of swallowing (FEES). We randomly divided the patients’ data into a training dataset and a test dataset in a ratio of 70/30 and Kaplan–Meier analyses and Cox regression were used to assess predictors of total oral intake. We also created a scoring system using the estimated regression coefficients. Results: Most patients with CVS achieved total oral intake in 7–11 days after extubation. Over 168 h of intubation, the presence of penetration or aspiration, a poor FEES score (score > 6), and perioperative complications were significant risk factors for delayed total oral intake. The predicting score was calculated by adding the scores for each individual factor, including FEES score, penetration/aspiration, and preoperative complications. Scores ranged 0–8, categorizing patients into 0–2, 3–5, and 6–8 groups, clearly demonstrating that the higher the predicting score, the longer the time to total oral intake in both the training and the test dataset. Conclusions: All risk factors for unsuccessful or delayed total oral intake were intubation for more than a week, poor swallowing ability, and the presence of perioperative complications. The scoring system accurately predicts the restoration of oral intake following CVS

Safety confirmation of induced pluripotent stem cell-derived cardiomyocyte patch transplantation for ischemic cardiomyopathy: first three case reports

IntroductionWith the expected increase in patients with heart failure and ischemic 15 cardiomyopathy, the development of myocardial regenerative medicine using cell transplantation as a novel treatment method is progressing. This first-in-human clinical trial aimed to confirm the safety of cardiomyocyte patch transplantation derived from allogeneic induced pluripotent stem (iPS) cells based on the results of several preclinical studies.Study designThe inclusion criteria were left ventricular ejection fraction of 35% or less; heart failure symptoms of New York Heart Association class III or higher despite existing therapies such as revascularization; and a 1-year observation period that included a 3-month immunosuppressive drug administration period after transplantation of iPS cell-derived cardiomyocyte patches to evaluate adverse events, cardiac function, myocardial blood flow, heart failure symptoms, and immune response.ResultsIn the first three cases of this trial, no transplanted cell-related adverse events were observed during the 1-year observation period, and improvement in heart failure symptoms was observed. In addition, improvements in left ventricular contractility and myocardial blood flow were observed in two of the three patients. Regarding immune response, an increase in transplant cell-specific antibody titer was observed in all three patients after immunosuppressive drug administration. In one patient with poor improvement in cardiac function and myocardial blood flow, an increase in antibody titer against HLA-DQ was observed even before cell transplantation.ConclusionsOur case findings demonstrate that the transplantation of iPS cell-derived cardiomyocyte patches for ischemic cardiomyopathy can be safely performed; however, further investigation of the therapeutic effect and its relationship with an immune response is needed by accumulating the number of patients through continued clinical trials

World Health Organization Discontinues Its Drinking-Water Guideline for Manganese

Background: The World Health Organization (WHO) released the fourth edition of Guidelines for Drinking-Water Quality in July 2011. In this edition, the 400-µg/L drinking-water guideline for manganese (Mn) was discontinued with the assertion that because “this health-based value is well above concentrations of manganese normally found in drinking water, it is not considered necessary to derive a formal guideline value.

Phase II trial of docetaxel, cisplatin and fluorouracil followed by carboplatin and radiotherapy in locally advanced oesophageal cancer

This study was performed to assess the efficacy and safety of docetaxel, cisplatin and fluorouracil combination in patients with unresectable locally advanced oesophageal squamous cell carcinoma. Treatment consisted of docetaxel 60 mg m−2, cisplatin 75 mg m−2 on day 1 and fluorouracil 750 mg m−2 day−1 on days 2–5, repeated every 3 weeks for three cycles, followed by carboplatin 100 mg m−2 week−1 for 5 weeks and concurrent radiotherapy (45 Gy in 25 fractions, 5 days week−1). After radiotherapy, eligible patients either underwent an oesophagectomy or received high dose rate endoluminal brachytherapy (HDR-EBT). Thirty-one out of 37 enrolled patients completed the planned chemotherapy and 30 completed chemoradiation. After completion of chemotherapy, 49% (95% CI: 32.2–66.2) had a clinical response. Twelve patients (32%) underwent a resection, which was radical in 60% (postoperative mortality: 0%). A pathological complete response was documented in four patients (11% of enrolled, 30% of resected). The median survival was 10.8 months (95% CI: 8.1–12.4), and the 1- and 2-year survival rates were 35.1 and 18.9%, respectively. Grade 3–4 toxicities were neutropoenia 32%, anaemia 11%, non-neutropoenic infections 18%, diarrhoea 6% and oesophagitis 5%. Nine patients (24%) developed a tracheo-oesophageal fistula during treatment. Even if the addition of docetaxel to cisplatin and 5-fluorouracil (5-FU) seems to be more active than the cisplatin and 5-FU combination, an incremental improvement in survival is not seen, and the toxicity observed in this study population is of concern. In order to improve the prognosis of these patients, new drugs, combinations and strategies with a better therapeutic index need to be identified