Use of the index of pulmonary vascular disease for predicting long-term outcome of pulmonary arterial hypertension associated with congenital heart disease

AimsLimited data exist on risk factors for the long-term outcome of pulmonary arterial hypertension (PAH) associated with congenital heart disease (CHD-PAH). We focused on the index of pulmonary vascular disease (IPVD), an assessment system for pulmonary artery pathology specimens. The IPVD classifies pulmonary vascular lesions into four categories based on severity: (1) no intimal thickening, (2) cellular thickening of the intima, (3) fibrous thickening of the intima, and (4) destruction of the tunica media, with the overall grade expressed as an additive mean of these scores. This study aimed to investigate the relationship between IPVD and the long-term outcome of CHD-PAH.MethodsThis retrospective study examined lung pathology images of 764 patients with CHD-PAH aged <20 years whose lung specimens were submitted to the Japanese Research Institute of Pulmonary Vasculature for pulmonary pathological review between 2001 and 2020. Clinical information was collected retrospectively by each attending physician. The primary endpoint was cardiovascular death.ResultsThe 5-year, 10-year, 15-year, and 20-year cardiovascular death-free survival rates for all patients were 92.0%, 90.4%, 87.3%, and 86.1%, respectively. The group with an IPVD of ≥2.0 had significantly poorer survival than the group with an IPVD <2.0 (P = .037). The Cox proportional hazards model adjusted for the presence of congenital anomaly syndromes associated with pulmonary hypertension, and age at lung biopsy showed similar results (hazard ratio 4.46; 95% confidence interval: 1.45–13.73; P = .009).ConclusionsThe IPVD scoring system is useful for predicting the long-term outcome of CHD-PAH. For patients with an IPVD of ≥2.0, treatment strategies, including choosing palliative procedures such as pulmonary artery banding to restrict pulmonary blood flow and postponement of intracardiac repair, should be more carefully considered

Professional Development Program for Science Teachers in International Cooperation : Case Study in JICA Training Program for Young Leaders of the Islamic Republic of Afghanistan

The mission of Ochanomizu University, which has a history of women's education stretching back 130 years, is to support the growth of women, regardless of nationality or age, and the development of their qualifications and skills. Ochanomizu University has been conducting the Afghanistan Women Teacher's Training program on behalf of the Japan International Cooperation Agency (JICA) since FY2002. This is the tenth year of our project working to strengthen education for Afghanistan. We designed an appropriate training program for Afghanistan science teachers to improve the quality of science teaching in elementary and secondary schools. This study presents the curriculum of a professional development program for science teachers from Afghanistan containing science practices, lectures, and visiting an elementary school and Board of Education. In order to examine the effectiveness of this program, we carried out a survey using a questionnaire for 20 trained participants. The questionnaire results showed that participants felt that our program met their expectations regarding acquiring skills for ‘syllabus planning', ‘lesson planning' and ‘teaching methods.' Also, we found that the program has had a positive impact on the participants' attitudes toward improving the quality of science teaching in elementary and secondary schools