Effect of the Extent of Cardiac Damage on Transcatheter Aortic Valve Replacement Outcome: A New Aortic Stenosis Staging System

Severe aortic stenosis (AS) causes chronic pressure overload of the left ventricle (LV), resulting in progressive cardiac change that can extend beyond the LV. A new AS staging classification has been recently proposed encompassing the extent of cardiac changes in AS. The AS staging classification has important prognostic implications for clinical outcomes after aortic valve replacement. This article introduces the AS staging system and demonstrates the association of the extent of cardiac change with outcomes after transcatheter aortic valve replacement

Hymenobacter nivis sp nov., isolated from red snow in Antarctica

A novel aerobic bacterial strain, P3(T), was isolated from a red snow obtained from Antarctica. Cells of strain P3(T) were rod-shaped, non-motile, catalase-negative, oxidase-positive and Gramstain-negative. Growth was observed at temperatures ranging from 0 to 25 degrees C, with optimum growth at 15 degrees C. The pH range for growth was pH 5.3-7.8. The G+C content of the genomic DNA was 55.0 mol%. The major components in the fatty acid profile were iso-C-15: 0, summed feature 4 (iso-C-17:1 I and/or anteiso-C-17:1 B), anteiso-C-15:0 and summed feature 3 (isoC(16:1)omega 7c and/or iso-C(16:1 omega)6c). The predominant isoprenoid quinone was MK-7. Phylogenetic analysis based on the 16S rRNA gene sequence indicated that the novel isolate was a member of the genus Hymenobacter, and the strain showed highest sequence similarity (94 %) with Hymenpbacter glaciei VUG-A130(T), Hymenobacter soli PB17(T) and Hymenobacter antarcticus VUG-A42aa(T). On the basis of phylogenetic and phenotypic properties strain P3(T) represents a novel species of the genus Hymenobacter (for which the name Hymenobacter nivis sp. nov. is proposed. The types strain is P3(T) (= DSM 101755(T) = NBRC 111535(T))

Attitudes of the Japanese public and doctors towards use of archived information and samples without informed consent: Preliminary findings based on focus group interviews

BACKGROUND: The purpose of this study is to explore laypersons' attitudes toward the use of archived (existing) materials such as medical records and biological samples and to compare them with the attitudes of physicians who are involved in medical research. METHODS: Three focus group interviews were conducted, in which seven Japanese male members of the general public, seven female members of the general public and seven physicians participated. RESULTS: It was revealed that the lay public expressed diverse attitudes towards the use of archived information and samples without informed consent. Protecting a subject's privacy, maintaining confidentiality, and communicating the outcomes of studies to research subjects were regarded as essential preconditions if researchers were to have access to archived information and samples used for research without the specific informed consent of the subjects who provided the material. Although participating physicians thought that some kind of prior permission from subjects was desirable, they pointed out the difficulties involved in obtaining individual informed consent in each case. CONCLUSIONS: The present preliminary study indicates that the lay public and medical professionals may have different attitudes towards the use of archived information and samples without specific informed consent. This hypothesis, however, is derived from our focus groups interviews, and requires validation through research using a larger sample

Impacts of coronavirus disease 2019 school closures on Japanese school children

departmental bulletin pape

Detailed report of seminar in 2022

departmental bulletin pape

Dimensionality of Vitality: Reliability and Validity

This study revised vitality scale (VS) and examined its reliability and validity with 510 undergraduates. Exploratory factor analysis of thirty-six items and confirrmed factor analysis of eighteen parceled variables revealed the VS consisted of six factors: Vigor, flexibility, social withdrawal, activeness, mental toughness, and positiveness. Six subscales for these factors had sufficient internal consistency (α = .650 ‒ .917). To examine the validity of the VS, self-esteem scale and authenticity scale were modeled into the measurement model of these six factors. Significant path coefficients from self-esteem and authenticity to six factors were estimated. Its construct and concurrent validity was demonstrated in terms of the relationships with self-esteem and authenticity

Extracellular Myocardial Volume in Patients With Aortic Stenosis

BACKGROUND: Myocardial fibrosis is a key mechanism of left ventricular decompensation in aortic stenosis and can be quantified using cardiovascular magnetic resonance (CMR) measures such as extracellular volume fraction (ECV%). Outcomes following aortic valve intervention may be linked to the presence and extent of myocardial fibrosis. OBJECTIVES: This study sought to determine associations between ECV% and markers of left ventricular decompensation and post-intervention clinical outcomes. METHODS: Patients with severe aortic stenosis underwent CMR, including ECV% quantification using modified Look-Locker inversion recovery-based T1 mapping and late gadolinium enhancement before aortic valve intervention. A central core laboratory quantified CMR parameters. RESULTS: Four-hundred forty patients (age 70 ± 10 years, 59% male) from 10 international centers underwent CMR a median of 15 days (IQR: 4 to 58 days) before aortic valve intervention. ECV% did not vary by scanner manufacturer, magnetic field strength, or T1 mapping sequence (all p > 0.20). ECV% correlated with markers of left ventricular decompensation including left ventricular mass, left atrial volume, New York Heart Association functional class III/IV, late gadolinium enhancement, and lower left ventricular ejection fraction (p < 0.05 for all), the latter 2 associations being independent of all other clinical variables (p = 0.035 and p < 0.001). After a median of 3.8 years (IQR: 2.8 to 4.6 years) of follow-up, 52 patients had died, 14 from adjudicated cardiovascular causes. A progressive increase in all-cause mortality was seen across tertiles of ECV% (17.3, 31.6, and 52.7 deaths per 1,000 patient-years; log-rank test; p = 0.009). Not only was ECV% associated with cardiovascular mortality (p = 0.003), but it was also independently associated with all-cause mortality following adjustment for age, sex, ejection fraction, and late gadolinium enhancement (hazard ratio per percent increase in ECV%: 1.10; 95% confidence interval [1.02 to 1.19]; p = 0.013). CONCLUSIONS: In patients with severe aortic stenosis scheduled for aortic valve intervention, an increased ECV% is a measure of left ventricular decompensation and a powerful independent predictor of mortality

Patients' preferences for involvement in treatment decision making in Japan

BACKGROUND: A number of previous studies have suggested that the Japanese have few opportunities to participate in medical decision-making, as a result both of entrenched physician paternalism and national characteristics of dependency and passivity. The hypothesis that Japanese patients would wish to participate in treatment decision-making if adequate information were provided, and the decision to be made was clearly identified, was tested by interview survey. METHODS: The subjects were diabetic patients at a single outpatient clinic in Kyoto. One of three case study vignettes (pneumonia, gangrene or cancer) was randomly assigned to each subject and, employing face-to-face interviews, the subjects were asked what their wishes would be as patients, for treatment information, participation in decision-making and family involvement. RESULTS: 134 patients participated in the study, representing a response rate of 90%. The overall proportions of respondents who preferred active, collaborative, and passive roles were 12%, 71%, and 17%, respectively. Respondents to the cancer vignette were less likely to prefer an active role and were more likely to prefer family involvement in decision-making compared to non-cancer vignette respondents. If a physician's recommendation conflicted with their own wishes, 60% of the respondents for each vignette answered that they would choose to respect the physician's opinion, while few respondents would give the family's preference primary importance. CONCLUSIONS: Our study suggested that a majority of Japanese patients have positive attitudes towards participation in medical decision making if they are fully informed. Physicians will give greater patient satisfaction if they respond to the desire of patients for participation in decision-making

ダイガクセイ ノ キャリア ハッタツ ニオケル 2ツ ノ ヤクワリ : MTMM ニヨル カンヨ ト サンカ ニ カンレン スル ガクセイ ノ ヤクワリ ト ロウドウシャ ノ ヤクワリ ノ モデルカ

本研究では「キャリア」そのものが意味するものとして「役割」に着目し，大学生を対象として「学生」と「労働者」の役割における「関与」と「参加」の程度を捉える方法について検討を行った。多特性多方法による確認的因子分析モデルにより「学生」と「労働者」の役割，そして役割における「関与」と「参加」という特徴をそれぞれ分化して示すと同時に，これらの因子と諸変数の関連から「役割」が持つ意味，特徴を明確化することができた。これらの結果について議論した上で，「労働者」の役割において示される「仕事」の内容とその多様性，学年別の特徴の明確化，そしてキャリア発達に関連する諸能力との関係性などの残された課題について言及した