Japanese Aesthetics and English Education in the Global Age

With the advent of the global information age, Japanese youth today are required to have authentic abilities to communicate with different peoples from different countries in the English language, rather than simply a good knowledge of practical and functional American English. Affective learners of English are created through aesthetic reading, especially English poetry, when moved or inspired by the authenticity of the content implying the profound but subtle meaning of human emotion in life. In this sense, the way of affective and aesthetic English learning follows the traditional Japanese appreciation of ephemeral beauty. As an authentic incentive to intellectual activities, this sensitivity leads to a deep, accurate, and rapid understanding of different peoples in the global world. American English education in Japan therefore should be aimed at a broader goal of English as a shared language for Internet-based communication, fostering a greater sense of traditional Japanese beauty for a more affective English-learner in the global community. Avec l’avènement de l’ère de la mondialisation, la jeunesse japonaise d’aujourd’hui est tenue d’avoir des capacités authentiques afin de communiquer avec différents peuples de différents pays dans la langue anglaise, plutôt que de simplement avoir une bonne connaissance, pratique et fonctionnelle, de l’anglais américain. Des apprenants affectifs de l’anglais sont stimulés par la lecture esthétique, particulièrement la poésie anglaise, lorsqu’ils sont émus ou inspirés par l’authenticité du contexte impliquant la signification profonde mais subtile de l’émotion humaine dans la vie. Dans ce sens, la manière affective et esthétique de l’apprentissage anglaise suit l’appréciation japonaise traditionnelle de la beauté éphémère. Comme incitation authentique aux activités intellectuelles, cette sensibilité mène à une compréhension profonde, précise et rapide de différents peuples dans le monde globalisé. L’éducation de l’anglais américain devrait alors viser à un objectif plus général de l’anglais non seulement comme langue partagée pour la communication par Internet, mais aussi favorisant un plus grand sens de beauté traditionnelle japonaise afin de produire des apprenants affectifs dans la communauté globale

Detection of viral RNA in diverse body fluids in an SFTS patient with encephalopathy, gastrointestinal bleeding and pneumonia: a case report and literature review

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that commonly has a lethal course caused by the tick-borne Huaiyangshan banyang virus [former SFTS virus (SFTSV)]. The viral load in various body fluids in SFTS patients and the best infection control measure for SFTS patients have not been fully established. CASE PRESENTATION: A 79-year-old man was bitten by a tick while working in the bamboo grove in Nagasaki Prefecture in the southwest part of Japan. Due to the occurrence of impaired consciousness, he was referred to Nagasaki University Hospital for treatment. The serum sample tested positive for SFTSV-RNA in the genome amplification assay, and he was diagnosed with SFTS. Furthermore, SFTSV-RNA was detected from the tick that had bitten the patient. He was treated with multimodal therapy, including platelet transfusion, antimicrobials, antifungals, steroids, and continuous hemodiafiltration. His respiration was assisted with mechanical ventilation. On day 5, taking the day on which he was hospitalized as day 0, serum SFTSV-RNA levels reached a peak and then decreased. However, the cerebrospinal fluid collected on day 13 was positive for SFTSV-RNA. In addition, although serum SFTSV-RNA levels decreased below the detectable level on day 16, he was diagnosed with pneumonia with computed tomography. SFTSV-RNA was detected in the bronchoalveolar lavage fluid on day 21. By day 31, he recovered consciousness completely. The pneumonia improved by day 51, but SFTSV-RNA in the sputum remained positive for approximately 4 months after disease onset. Strict countermeasures against droplet/contact infection were continuously conducted. CONCLUSIONS: Even when SFTSV genome levels become undetectable in the serum of SFTS patients in the convalescent phase, the virus genome remains in body fluids and tissues. It may be possible that body fluids such as respiratory excretions become a source of infection to others; thus, careful infection control management is needed

Associations between Chest CT Abnormalities and Clinical Features in Patients with the Severe Fever with Thrombocytopenia Syndrome

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus. It involves multiple organ systems, including the lungs. However, the significance of the lung involvement in SFTS remains unclear. In the present study, we aimed to investigate the relationship between the clinical findings and abnormalities noted in the chest computed tomography (CT) of patients with SFTS. The medical records of 22 confirmed SFTS patients hospitalized in five hospitals in Nagasaki, Japan, between April 2013 and September 2019, were reviewed retrospectively. Interstitial septal thickening and ground-glass opacity (GGO) were the most common findings in 15 (68.1%) and 12 (54.5%) patients, respectively, and lung GGOs were associated with fatalities. The SFTS patients with a GGO pattern were elderly, had a disturbance of the conscious and tachycardia, and had higher c-reactive protein levels at admission (p = 0.009, 0.006, 0.002, and 0.038, respectively). These results suggested that the GGO pattern in patients with SFTS displayed disseminated inflammation in multiple organs and that cardiac stress was linked to higher mortality. Chest CT evaluations may be useful for hospitalized patients with SFTS to predict their severity and as early triage for the need of intensive care

Clinical Differentiation of Severe Fever with Thrombocytopenia Syndrome from Japanese Spotted Fever

Severe fever with thrombocytopenia syndrome (SFTS) and Japanese spotted fever (JSF; a spotted fever group rickettsiosis) are tick-borne zoonoses that are becoming a significant public health threat in Japan and East Asia. Strategies for treatment and infection control differ between the two; therefore, initial differential diagnosis is important. We aimed to compare the clinical characteristics of SFTS and JSF based on symptomology, physical examination, laboratory data, and radiography findings at admission. This retrospective study included patients with SFTS and JSF treated at five hospitals in Nagasaki Prefecture, western Japan, between 2013 and 2020. Data from 23 patients with SFTS and 38 patients with JSF were examined for differentiating factors and were divided by 7:3 into a training cohort and a validation cohort. Decision tree analysis revealed leukopenia (white blood cell [WBC] < 4000/µL) and altered mental status as the best differentiating factors (AUC 1.000) with 100% sensitivity and 100% specificity. Using only physical examination factors, absence of skin rash and altered mental status resulted in the best differentiating factors with AUC 0.871, 71.4% sensitivity, and 90.0% specificity. When treating patients with suspected tick-borne infection, WBC < 4000/µL, absence of skin rash, and altered mental status are very useful to differentiate SFTS from JSF

Effects of overexpression of basic helix-loop-helix transcription factor Dec1 on osteogenic and adipogenic differentiation of mesenchymal stem cells

We recently reported that forced expression of basic helix-loop-helix transcription factor Dec1 accelerated chondrogenic differentiation of mesenchymal stem cells (MSC) in pellet cultures (M. Shen, E. Yoshida, W. Yan, T. Kawamoto, K. Suardita, Y. Koyano, K. Fujimoto, M. Noshiro and Y. Kato, 2002. J. Biol. Chem. 277:50112-50120). Since MSC have multilineage differentiation potential, we investigated the roles of Dec1 in osteogenic and adipogenic differentiation of human bone marrow-derived MSC. After osteogenic induction of MSC in medium containing dexamethasone, β- glycerophosphate, and ascorbic acid, Dec1 expression gradually increased from day 5 to day 14, while expression levels of Dec1 mRNA markedly decreased on days 3 and 7 after adipogenic induction. Infection with adenovirus expressing Dec1 raised mRNA levels of several bone characteristic molecules such as osteopontin, PTH receptor and alkaline phosphatase, even in the absence of the osteogenic-induction medium, although it had little effect on Runx2 expression or calcification. In the osteogenic-induction medium, Dec1 overexpression enhanced the expression of osteopontin and alkaline phosphatase and induced matrix calcification. Knockdown of Dec1 with siRNA suppressed the expression of osteoblastic phenotype by the induced MSC. Using MSC cultures, we also confirmed that forced expression of Dec1 suppressed adipogenic differentiation. These findings suggest that Dec1 modulates osteogenic differentiation of MSC by inducing the expression of several, but not all, bone-related genes

Compensation, insurance, and management of injuries in investigator-initiated clinical trials in Japan

Introduction: The recent revision of the Declaration of Helsinki strengthened the ethical obligation to provide compensation for harm of research subjects. However, the actual status of providing compensation has rarely been disclosed, especially in the situation of investigator-initiated clinical trials (IITs).Objectives: To figure out the actual situation of compensation for injured subjects of IITs in Japan and to identify the necessary steps to fulfill the ethical obligation of compensation.Method: We conducted two types of surveys of compensation in IITs in Japan over the past five years. A: questionnaire survey delivered to 1,700 institutions on (1) number and paid amount of compensation cases; number and amount of contract fees paid to insurance companies; and (2) institutional management system of compensation cases. B: complementary survey to the item (1) of the survey A, at two institutions, on contract fees paid to and insurance paid from insurance companies.Result: In the survey A, we found only two cases of compensation provided, but could not find any serious cases claiming payment from insurance companies, although we could not exclude possibility of undisclosed cases. In the survey B, at the two institutions, a substantial amount of contract fees has been paid to insurance companies without claiming insurance payment; however, the total amount for each institution is less than that expected for one case of a serious injury. Also we found that there remain several points to improve the institutional management system of compensation in IITs in Japan.Conclusion: To provide appropriate compensation for injured subjects of IITs, we need to develop an institutional management system, along with a system to gather statistical information of compensation cases, to achieve proper resource allocation. This system should also provide education for investigators and support staff to manage injury cases

Characteristics of High-Molecular-Weight Hyaluronic Acid as a Brain-Derived Neurotrophic Factor Scaffold in Periodontal Tissue Regeneration

Brain-derived neurotrophic factor (BDNF), for which bovine collagen-derived atelocollagen is used as a scaffold, enhances periodontal tissue regeneration. However, a scaffold that does not contain unknown ingredients is preferable. Since the synthesized high-molecular-weight (HMW)-hyaluronic acid (HA) is safe and inexpensive, we evaluated the efficacy of HMW-HA as a BDNF scaffold. CD44, a major receptor of HA, was expressed in cultures of human periodontal ligament cells, and HMW-HA promoted the adhesion and proliferation of human periodontal ligament cells, although it did not influence the mRNA expression of bone (cementum)-related proteins. The in vitro release kinetics of BDNF from HMW-HA showed that BDNF release was sustained for 14 days. Subsequently, we examined the effect of BDNF/HMW-HA complex on periodontal tissue regeneration in dogs. A greater volume of newly formed alveolar bone and a longer newly formed cementum were observed in the BDNF/HMW-HA group than in the HMW-HA group, suggesting that HMW-HA assists the regenerative capacity of BDNF, although HMW-HA itself does not enhance periodontal tissue regeneration. Neither the poly (lactic-co-glycolic acid) group nor the BDNF/poly (lactic-co-glycolic acid) group enhanced periodontal tissue regeneration. In conclusion, HMW-HA is an adequate scaffold for the clinical application of BDNF

Comparison of Efficacy of Antimicrobial Agents Among Hospitalized Patients With Mycoplasma pneumoniae Pneumonia in Japan During Large Epidemics of Macrolide-Resistant M. pneumoniae Infections: A Nationwide Observational Study

Background Mycoplasma pneumoniae strains with resistance to macrolides have been spreading worldwide. Here, we aimed to clarify which antimicrobial agent is a better treatment for patients with M. pneumoniae pneumonia in a setting with large epidemics of macrolide resistance. Methods Adult patients hospitalized with laboratory-confirmed M. pneumoniae pneumonia from 2010 to 2013 were identified from the Japanese Diagnosis Procedure Combination national database. Drug switching, length of stay (LOS), 30-day mortality, and total costs for patients who underwent macrolide, quinolone, and tetracycline therapy were compared using propensity score analyses. Results Eligible patients (N = 1650) from 602 hospitals were divided into the macrolide group (n = 508), quinolone group (n = 569), or tetracycline group (n = 573). We found that 52.8%, 21.8%, and 38.6% of patients in the macrolide, quinolone, and tetracycline groups, respectively, had to switch drugs (P <.0001). There was no significant difference in the LOS and the 30-day mortality rates among these 3 groups. Cost was highest in the quinolone group (P =.0062). The propensity score-matched pairs (n = 487×2) generated from the quinolone and tetracycline groups also showed a lower proportion of patients who require switches in the quinolone group than in the tetracycline group (21.2% vs 39.6%, P <.0001) but not in the LOS, mortality, and cost. Conclusions There were no significant differences in the LOS and mortality among any antimycoplasmal drugs as initial treatment for hospitalized M. pneumoniae pneumonia patients despite the lower switching rate in the quinolone group