Definition and recommended cultural considerations for advance care planning in Japan: A systematic review

Although Delphi studies in Western countries have provided a consensus for practices pertaining to advance care planning (ACP), their findings may not be applicable to Asian countries with distinct, family-oriented cultures. This systematic review aimed to synthesize the definitions of and evidence for ACP and analyze recommended practices in Japan. We conducted a systematic review using narrative synthesis in December 2018. Key words were searched from Ichushi-Web by NPO Japan Medical Abstracts Society, Citation Information by the National Institute of Informatics, and Japanese Institutional Repositories Online databases. In addition, in August 2019, we conducted hand searching using Google Scholar and Google. We included original Japanese articles that addressed factors regarding ACP (e.g. definitions, elements, roles and tasks, and timing of ACP). Data were synthesized using thematic analysis. The study protocol was registered prospectively (PROSPERO: CRD42020152391). Of the 3512 studies screened, 27 were included: 22 quantitative and 5 qualitative. Five-position statements/guidelines were added by hand searching. Definitions and several distinct practice patterns of ACP and the importance of families' roles were identified. Unique recommendations addressed the importance of properly eliciting patients' preferences that are the best for both patients and families, engaging the public to raise awareness of ACP, and developing policies and guidelines for ACP. We identified the definition of and unique recommendations for ACP based on Japanese cultural values and norms. Further research is needed to evaluate the recommendations provided in this systematic review

Current Limiting and Recovery Characteristics Under Load of Transformer Type SFCL with Rewound Structure Using BSCCO Wire in Model Power System

AbstractWe have proposed new design of a transformer type SFCL with primary and secondary superconducting coils which has rewound structure. For not so large fault current, the proposed SFCL limits the current by the inductive component by the normal transition of the flux shielding coil (secondary), and for larger fault current, it can give the resistive component additively by the normal transition of the primary coil. The recovery characteristics under load condition and repetitive limiting operation were experimentally investigated in a laboratory scale power system. The SFCL limited twice repetitive faults current and recovered quickly under load condition

Bioethics and the Experiences of Hansen’s Disease Survivors

Historically, Hansen’s disease patients suffered from discrimination because their physical features changed due to the bacterium Mycobacterium leprae (M. leprae) and made them “ugly” in the eyes of society. Former Japanese governments saw them as a national disgrace and forced them to reside in leprosaria. Since the law requiring isolation continued after the silver bullet was developed, survivors could not leave the leprosaria and return to society. Currently, survivors’ average age is 82 and they live in 13 national sanatoriums. When they pass away, the history of Hansen’s disease in Japan will end, so we must record their experiences. We conducted qualitative and inductive studies with survivors. In this chapter, we reconstruct them from the perspective of bioethics and propose several theories surrounding them: (1) How former leprosaria and medical administrations in Japan threatened bioethical principles; (2) the wisdom of aging survivors, who lived through extreme situations, and what real restoration of their rights might look like; and (3) the ethical dilemmas of how we will care for the survivors—who have multiple severe sequelae—until they all pass away. Finally, we will introduce our ethical nursing practices in relation to caring and understanding via holism

Genomic Analyses of Bifidobacterium moukalabense Reveal Adaptations to Frugivore/Folivore Feeding Behavior

Funding: This research was funded by the Japan Science and Technology Agency (JST) and Japan International Cooperation Agency (JICA), grant for the Science and Technology Research Partnership for Sustainable Development (SATREPS) “Conservation of Biodiversity in Tropical Forest through Sustainable Coexistence between Human and Wild Animals” (PI, Juichi Yamagiwa) and the study was also supported by Grants-in-Aid for Scientific Research (15K18775, Sayaka Tsuchida)”. Acknowledgments: We thank Ayumi Akiyoshi and Chiaki Hagiwara for technical assistance and Takahiro Yonezawa at Tokyo University of Agriculture for his valuable discussion about genetic evolution of Bifidobacterium. The authors are indebted for the sampling to Juichi Yamagiwa (Kyoto University), Yuji Takenoshita (Chubu Gakuin University), Shiho Fujita (Kagoshima University), Ludovic Ngok Banak and Alfred Ngomanda, the former and the actual Director of the Research Institute of Tropical Ecology (IRET)/National Center of Scientific Research and Technology (CENAREST) of Gabonese Republic. Takahiro Segawa was supported by Transdisciplinary Research Integration Center (TRIC) of the Research Organization of Information and Systems. Ortholog analyses were supported by Basis for Supporting Innovative Drug Discovery and Life Science Research program (2051). Computations were partially performed on the NIG (National Institute of Genetics) supercomputer at ROIS (Research Organization of Information and Systems) National Institute of Genetics.Peer reviewe

ケンキュウショ カツドウ ホウコク ガクセイ ルポ ニッカン メディア トーク ニッカン カンケイ 100ネン ニツイテ カンガエル

研究所活動報告KIGAS Activitie

TRPC6 regulates phenotypic switching of vascular smooth muscle cells through plasma membrane potential-dependent coupling with PTEN

Vascular smooth muscle cells (VSMCs) play critical roles in the stability and tonic regulation of vascular homeostasis. VSMCs can switch back and forth between highly proliferative synthetic and fully differentiated contractile phenotypes in response to changes in the vessel environment. Although abnormal phenotypic switching of VSMCs is a hallmark of vascular disorders such as atherosclerosis and restenosis after angioplasty, how control of VSMC phenotypic switching is dysregulated in pathologic conditions remains obscure. We found that inhibition of canonical transient receptor potential 6 (TRPC6) channels facilitated contractile differentiation of VSMCs through plasma membrane hyperpolarization. TRPC6-deficient VSMCs exhibited more polarized resting membrane potentials and higher protein kinase B (Akt) activity than wild-type VSMCs in response to TGF-β1 stimulation. Ischemic stress elicited by oxygen-glucose deprivation suppressed TGF-β1-induced hyperpolarization and VSMC differentiation, but this effect was abolished by TRPC6 deletion. TRPC6-mediated Ca2+ influx and depolarization coordinately promoted the interaction of TRPC6 with lipid phosphatase and tensin homolog deleted from chromosome 10 (PTEN), a negative regulator of Akt activation. Given the marked up-regulation of TRPC6 observed in vascular disorders, our findings suggest that attenuation of TRPC6 channel activity in pathologic VSMCs could be a rational strategy to maintain vascular quality control by fine-tuning of VSMC phenotypic switching.Fil: Numaga-Tomita, Takuro. No especifíca;Fil: Shimauchi, Tsukasa. Kyushu University; JapónFil: Oda, Sayaka. No especifíca;Fil: Tanaka, Tomohiro. No especifíca;Fil: Nishiyama, Kazuhiro. Kyushu University; JapónFil: Nishimura, Akiyuki. Kyushu University; JapónFil: Birnbaumer, Lutz. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; ArgentinaFil: Mori, Yasuo. No especifíca;Fil: Nishida, Motohiro. Kyushu University; Japó

Survey on the Family of the Recursive-Rule Extraction Algorithm

In this paper, we first review the theoretical and historical backgrounds on rule extraction from neural network ensembles. Because the structures of previous neural network ensembles were quite complicated, research on an efficient rule extraction algorithm from neural network ensembles has been sparse, even though a practical need exists for rule extraction in Big Data datasets. We describe the Recursive-Rule extraction (Re-RX) algorithm, which is an important step toward handling large datasets. Then we survey the family of the Recursive-Rule extraction algorithm, i.e. the Multiple-MLP Ensemble Re-RX algorithm, and present concrete applications in financial and medical domains that require extremely high accuracy for classification rules. Finally, we mention two promising ideas to considerably enhance the accuracy of the Multiple-MLP Ensemble Re-RX algorithm. We also discuss developments in the near future that will make the Multiple-MLP Ensemble Re-RX algorithm much more accurate, concise, and comprehensible rule extraction from mixed datasets

Bilateral Upper Arm Granulomas Induced by Leuprorelin Acetate Injection Mimicking Malignant Soft Tissue Tumors: A Case Report

Leuprorelin acetate is a common anticancer medication used for prostate cancer treatment. One of the local adverse reactions after leuprorelin injection is the development of reactive granulomas, typically presenting as subcutaneous nodules. In this case report, we describe a 73-year-old patient with prostate cancer who developed unusually large sized intramuscular reactive granulomas, which mimicked malignant soft tissue tumors. The patient, who had been receiving leuprorelin acetate treatment for the past 12 months, noticed painful masses in both upper arms. Based on the findings of magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography/computed tomography, a diagnosis of malignant soft tissue tumor was strongly suggested. However, further investigation through needle biopsy ultimately led us to the final diagnosis of reactive granuloma. The masses spontaneously resolved after discontinuation of leuprorelin injection. While reactive granulomas after leuprorelin injections are not rare, intramuscular cases are relatively uncommon. Despite using imaging studies as a rational initial approach in the diagnostic process, as we did in our case, their results turned out to be indistinguishable from those of malignant soft tissue tumors, thus highlighting the importance of pathological examination in confirming diagnosis, especially when a patient presents with atypical clinical manifestations

Generation of Tetrafluoroethylene–Propylene Elastomer-Based Microfluidic Devices for Drug Toxicity and Metabolism Studies

フッ素系エラストマー素材を用いた肝臓チップの開発と薬物代謝・毒性試験への応用. 京都大学プレスリリース. 2021-09-16.Drug testing on miniatured livers. 京都大学プレスリリース. 2021-09-17.Polydimethylsiloxane (PDMS) is widely used to fabricate microfluidic organs-on-chips. Using these devices (PDMS-based devices), the mechanical microenvironment of living tissues, such as pulmonary respiration and intestinal peristalsis, can be reproduced in vitro. However, the use of PDMS-based devices in drug discovery research is limited because of their extensive absorption of drugs. In this study, we investigated the feasibility of the tetrafluoroethylene–propylene (FEPM) elastomer to fabricate a hepatocyte-on-a-chip (FEPM-based hepatocyte chip) with lower drug absorption. The FEPM-based hepatocyte chip expressed drug-metabolizing enzymes, drug-conjugating enzymes, and drug transporters. Also, it could produce human albumin. Although the metabolites of midazolam and bufuralol were hardly detected in the PDMS-based hepatocyte chip, they were detected abundantly in the FEPM-based hepatocyte chip. Finally, coumarin-induced hepatocyte cytotoxicity was less severe in the PDMS-based hepatocyte chip than in the FEPM-based hepatocyte chip, reflecting the different drug absorptions of the two chips. In conclusion, the FEPM-based hepatocyte chip could be a useful tool in drug discovery research, including drug metabolism and toxicity studies

Hansen\u27s disease (leprosy) in Japan, 1947-2020: an epidemiologic study during the declining phase to elimination

Objectives: Leprosy, or Hansen’s disease was a major public health problem in Japan in the early 20th century. Today, the number of new cases has decreased significantly. We aimed to investigate the trends of leprosy in Japan over the past 73 years and the challenges faced in recent years. Methods: We assessed the data on newly registered cases of leprosy from 1947 to 2020. Results: A total of 10,796 newly registered cases of leprosy were reported during the study period, of which 7573 were registered in mainland Japan, 2962 in Okinawa, and 250 were of foreign origin. Most autochthonous cases were born before 1950 in mainland Japan and before 1975 in Okinawa. The number of nonautochthonous cases surpassed that of autochthonous cases in 1992. Nonautochthonous cases orig- inated from 26 countries, particularly Brazil and the Philippines. Three cases of antimicrobial resistance have been detected among nonautochthonous cases since 2004. Conclusion: Our data suggest that ongoing transmission of leprosy likely ceased in the 1940s in mainland Japan and in the 1970s in Okinawa. With the recent rise of nonautochthonous cases with globalization, continuous surveillance and effort s to maint ain leprosy services within the country are necessary even after reaching the state of elimination