A Practice of “Fushizukuri Education”: Focusing on Rhythm Learning at Hiroshima Municipal Hesaka Elementary School

“Fushizukuri Education” is the most successful music education method in Japan, started in 1966 at Furukawa Elementary School in Hida area, Gifu Prefecture. This method was developed by a group of teachers who were not specialized in music. The characteristics of this method are as follows: (1) the curriculum consists of 30 phases, 102 steps; (2) adopting dual approach comprised of performance and music basics; (3) the learners themselves progress the class with minimum intervention by the teacher; (4) special emphasize is placed on hearing; (5) sufficient opportunities for solo singings and remarks are guaranteed for all learners, (6) the teacher’s remarks are minimized, and (7) the learners eventually demonstrate excellent musical and performance ability. This study aims to find how to install “Fushizukuri Education” effectively into current school music curricula in Japan. Both practical and experimental approaches are employed. Children participated in this study were the third graders at Hesaka Elementary School. The four classes were randomly divided into two groups comprised of two classes each. Children in one group learned using conventional staff notation system, whereas children in the other group learned using the “maru-fu” (circle notes) notation system. Rhythm learning activities were organized for both groups based on the “Fushizukuri Education” method. A pretest and a posttest were carried out in July and late September 2017, respectively. Both tests measured each child’s abilities of rhythm reproduction and rhythm reading. In the rhythm reading pretest, both groups were tested with one-line staff materials. In the rhythm reading posttest, the “maru-fu” group was tested with “maru-fu” materials, whereas the staff group was tested with one-line staff materials. Following results were obtained. (1) Both groups have developed abilities of rhythm reproduction and rhythm reading through rhythm learning activities, although the number of activities was not so many. (2) In the pretest, the staff group outperformed the “maru-fu” group on both reproduction task and reading task. (3) It is presumed that the learners have been familiarized with five-line or one-line staff notation system up to the third grade, whereas they might feel novelty in the “maru-fu” notation system. (4) Therefore, the “maru-fu” notation system should be used in the first grade.三村真弓教授退職記念号 Special Number Commemorating the Retirement of Professor Mayumi Mimur

Perceived eHealth Literacy and Learning Experiences Among Japanese Undergraduate Nursing Students

This study aimed to describe undergraduate nursing students\u27 perceived eHealth literacy and learning experiences of eHealth literacy in Japan and to clarify the relationship between these factors. We conducted a self-administered online questionnaire survey using a convenience sample of 353 Japanese undergraduate nursing students selected from three universities. Participants completed the eHealth Literacy Scale and questionnaires on learning experiences of eHealth literacy and some demographic factors. Participants had moderate perceived eHealth (mean [SD], 24.52 [5.20]). More than half the participants responded that they had no learning experiences of health or science literacy. We observed a positive correlation between the total mean eHealth literacy and learning experiences scores. Undergraduate nursing students in Japan had slightly lower perceived eHealth literacy than nursing students in other countries, hospital nurses, and even patients. Of the 353 participants in this study, 69.4% did not know “where to find helpful health resources on the Internet,” 80.2% of those lacked the skills “to evaluate health resources,” and 68.9% could not “differentiate the quality of health resources on the Internet”; few of the participants perceived themselves as having any experience in learning the six domains of eHealth literacy. Very few reported learning about health (43.3%) and scientific (21.8%) literacy. The low perceived eHealth literacy among participants might reflect lack of knowledge and confidence in eHealth literacy as well as their own low level of health-promoting behaviors; this might influence the quality of health education of clients and their families. Nursing educators should address the lack of eHealth literacy among undergraduate nursing students

The Diagnosis of Hypovascular Hepatic Lesions Showing Hypo-intensity in the Hepatobiliary Phase of Gd-EOB- DTPA-enhanced MR Imaging in High-risk Patients for Hepatocellular Carcinoma

The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter＝12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings

看護系大学生における外国人保健医療サービス提供に関する認識: 日本と韓国の大学における調査から

Aim: This study was performed to examine associations between nursing students’ knowledge and interest regarding foreign nationals’ medical health challenges and international exchange experience among Korean and Japanese undergraduate nursing students. Methods: An anonymous self-administered structured questionnaire survey was conducted among 200 Korean nursing students in April 2016, and 78 Japanese nursing students in August 2015; both groups were in their 4th year of study at a university. The questionnaire elicited responses related to knowledge and interest regarding foreign nationals’ medical health challenges in Korea or Japan, likelihood of caring for foreign nationals as nurses, and experience related to international exchange. Results: A total of 183（ 91.5%） Korean students and 68（ 91.9%） Japanese students participated in this study. Among Korean students, 120（ 65.6%） reported being aware of foreign nationals’ medical health challenges, while only 23 （33.8%） Japanese participants gave this response. There were significant differences in knowledge and interest scores regarding foreign nationals’ medical health challengesaccording to experience of international exchange in both Korean and Japanese study participants （Mann?Whitney U test, P = 0.001, P = 0.003, respectively）. Korean study participants demonstrated recognition of medical health care provision for foreign nationals as nurses regardless of international exchange experience leve（l Mann?Whitney U test, P = 0.841）, although international exchange experience level was significantly related to recognition of medical health care provision for foreign nationals as nurses among Japanese nursing students（ Mann?Whitney U test, P = 0.030）. Conclusions: Korea and Japan have similar characteristics, such as homogenous and monoculture countries until recently. However, this study demonstrated differences in sensitivity and recognition regarding medical healthcare provision for foreign nationals among Korean and Japanese nursing students. It is necessary to assess the factors responsible for this difference, to prepare nursing students for medical healthcare provision in the global society.目的?本研究は，韓国と日本の看護系大学生における外国人保健医療の知識・関心と国際交流経験の関連を検討することを目的としている．方法?韓国から2016年4月に200人，日本から2015年8月に78人の日本人看護系大学生，いずれも4年生を対象に無記名自記式質問紙による調査が実施された．質問紙内容は，外国人保健医療の知識・関心，将来的な看護職としての外国人保健医療提供可能性の自覚，国際交流経験について構成された．結果?韓国人学生183人（91.5％），日本人学生68人（91.9％）から有効回答を得た．韓国人学生中120人（65.6％）が外国人保健医療ニーズについて認識していたが，日本人学生では23人（33.8％）のみであった．両国の看護学生において，外国人保健医療の知識・関心は，国際交流経験の豊富さと関連していた（マンホイットニーU test， P＝0.001，P＝0.003）．韓国人学生は，国際交流経験の豊富さに関係なく，将来的な看護職としての外国人保健医療提供可能性の自覚をもっていたが（Mann－Whitney U test， P＝0.841），日本人学生では，国際交流経験の豊富さが将来的な看護職としての外国人保健医療提供可能性の自覚に統計的有意に関連していた（Mann－Whitney U test， P＝0.030）．結論?韓国も日本も最近まで単一民族・文化の国であったという類似の特徴を持つが，本調査では両国の看護学生において，外国人保健医療への感度や将来的な看護職としての外国人保健医療提供可能性の自覚に違いが認められた．今後，グローバル社会における外国人保健医療に対応していくために，両国のこういった違いに影響する関連要因について詳細に検証する必要がある

Local Recurrence and Complications after Percutaneous Radiofrequency Ablation of Hepatocellular Carcinoma : A Retrospective Cohort Study Focused on Tumor Location

We conducted a retrospective cohort study to investigate the predisposing factors for local recurrence and complications after percutaneous radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC). HCC patients (n＝397) consecutively treated with RFA (256 males, 141 females, median age 69 years) were enrolled. In these patients, 1,455 nodules (median size 17mm) were ablated. Predisposing factors for overall recurrence and local recurrence in the context of tumor location and complications were examined. Local recurrence was observed for 113 of the 1,455 nodules. The 1-, 3- and 5-year local recurrence rates were 2.2ｵ, 7.4ｵ and 9.5ｵ, respectively. A multivariate Cox proportional hazard analysis revealed that large tumor size (＞2cm), tumor location (adjacent to the major portal branch or hepatic vein), and small ablated margin (＜3mm) were independent predisposing factors for local recurrence after RFA (HR＝1.70-2.81). Tumor location (adjacent to the major portal branch, hepatic vein, or diaphragm) was also revealed as a risk factor for liver damage due to RFA. HCC adjacent to the major portal vein or hepatic vein was associated with a higher risk for local recurrence and for complications;therefore, special precautions are necessary when applying RFA to HCC near vessels even when the tumors are located at an easy-to-puncture site

Mutations in the hepatitis B virus preS2 region and abrogated receptor activity for polymerized human albumin.

The preS2 region of the hepatitis B virus (HBV) has been reported to have human polymerized albumin receptor (PAR) activity, which correlates with viral replication. Here, we studied the genomic sequence of the preS region from rare patients lacking PAR activity, despite active viral replication. PAR and DNA polymerase activity was identified in 178 HBe antigen-positive HBV carriers, and a significant correlation between 2 markers was shown, except in 2 hepatitis patients lacking PAR activity. Nucleotide sequences of the preS region of HBV from both patients were examined by direct sequencing of PCR products. In one patient, a 45-base deletion was found to overlap half of the putative polymerized human albumin binding site in the preS2 region. In the other patient, a point mutation at the first nucleotide of the start codon of the preS2 region of HBV was found. There was no such genomic change in the 3 control HBV sequences. These results indicate that the preS2 region is necessary for binding of polymerized human albumin, and this is the first report of naturally existing mutant virus with no or low PAR activity.</p

A case of VEXAS syndrome (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) with decreased oxidative stress levels after oral prednisone and tocilizumab treatment

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome has recently been described as an autoinflammatory disease associated with severe adult-onset inflammatory manifestations. The various clinical manifestations include recurrent high-grade fever, neutrophilic dermatoses, cutaneous vasculitis, chondritis of the ear and nose, pulmonary infiltrates, cytopenia, uveitis, gastrointestinal pain or inflammation, aortitis, hepatosplenomegaly, and hematological disorders. VEXAS syndrome is caused by somatic mutations of the ubiquitin-like modifier activating enzyme 1 (UBA1) gene in myeloid-lineage cells. It is characterized by vacuolated myeloid and erythroid progenitor cells seen by bone marrow biopsy. We report the case of a 64-year-old Japanese man with VEXAS syndrome. At age 63, he was referred to us with a recurrent erythema on the hands associated with a general fever of 38–40°C that had persisted for 4 or 5 days and had recurred about once a month for a year. The skin rash appeared 2 or 3 days after the onset of each fever episode. Computed tomography (CT) of the chest revealed bilateral hilar lymphadenopathy (BHL), and the mediastinal lymph nodes were swollen. Sarcoidosis was suspected but was ruled out by several tests. Laboratory examinations showed elevated inflammatory markers. Bone marrow examination showed the vacuolization of myeloid precursor cells. A skin biopsy revealed dense dermal, predominantly perivascular, infiltrates. These consisted of mature neutrophils admixed with myeloperoxidase-positive CD163-positive myeloid cells, lymphoid cells and eosinophils. Sequencing analysis identified the somatic UBA1 variant c.122T &gt; C, which results in p.Met41Thr. Treatment with oral prednisone (15 mg/day) and monthly intravenous tocilizumab injections (400 mg) completely resolved the symptoms. Neutrophils are a major source of reactive oxygen species, and the present case demonstrated numerous neutrophilic infiltrates. We hypothesize that the patient might have had elevated derivatives of reactive oxygen metabolites (d-ROMs). d-ROM quantification is a simple method for detecting hydroperoxide levels, and clinical trials have proven it useful for evaluating oxidative stress. In this study, we measured serum d-ROM before and after oral prednisone and tocilizumab treatment. The levels decreased significantly during treatment

A plastidial sodium-dependent pyruvate transporter (vol 476, pg 472, 2011)

Furumoto T, Yamaguchi T, Ohshima-Ichie Y, et al. A plastidial sodium-dependent pyruvate transporter (vol 476, pg 472, 2011). Nature. 2011;478(7368):274