Development of the Multidisciplinary Educational Materials on Locally-Caught Fish "Skipjack Tuna"

We developed the multidisciplinary educational materials on locally-caught fish "Skipjack tuna" and worked with 13-hour unit focusing on fisheries industry. Skipjack tuna is one of the most important fish as a food and fishery resource in Kochi. We focused on biology, distribution, and cuisine of Skipjack tuna, and translated multidisciplinary complex knowledge into appropriate levels for our target audience (fifth grader). Major element of the class practices was the learning cycle, which articulated three sequential instructional phases: introduction, cooperative learning, and overview. In introduction, students work with the materials to ask questions on Skipjack tuna (called "Katsuo Quiz"). In cooperative learning, students work in small groups to help one another and write what they have learnt in "Hidensho". In overview, teacher presents the overview to students to promote understandings. After one cycle is completed, the three phases are repeated with new material to revisit and encourage deep understandings of Skipjack tuna and fisheries industry. Collaborative and interactive relationships among university, industry, and learner (consumer) were also the central components in our study. It was suggested that the materials and practices in this study would promote deep understanding of Skipjack tuna. That might lead to promote fish consumption and revitalize local economy

Superiority of proatrial natriuretic peptide in the prognostic power in patients with acute decompensated heart failure on hospital admission: comparison with B-type natriuretic peptide and other natriuretic peptide forms

Aims: There are significant differences in how atrial (A-type) and B-type natriuretic peptide (ANP and BNP) are secreted and metabolised, but there is little information available about the relative clinical significance of the two peptides. The aim of the present study was to investigate: (1) the association between the circulating level of each ANP molecular form and patient clinical background and (2) their prognostic power for patients with acute decompensated heart failure (ADHF). Methods: We used specific chemiluminescence enzyme immunoassays to prospectively evaluate the levels of six bioactive molecular forms of ANP (pro-ANP, β-ANP and total ANP) and BNP (pro-BNP, N-terminal pro-BNP (NT-pro-BNP) and total BNP) in plasma samples collected from 173 patients with ADHF on their hospital admission. Results: We found that pro-ANP levels were strongly associated with left ventricular (LV) size and ejection fraction (p<0.001), but were not associated with left atrial size. Percent pro-ANP ([pro-ANP/total ANP]x100) was also associated with LV size and function. During the follow-up term (median: 469 days), composite adverse events (all causes of death or rehospitalisation for HF) occurred in 67 patients (38.7 %). Pro-ANP was significantly associated with composite adverse events even after adjusting by estimated glomerular filtration rate (eGFR) (p<0.05). In contrast, NT-pro-BNP was not independent of eGFR in the multivariate analysis. Conclusion: Circulating levels of pro-ANP are strongly associated with LV function and clinical outcomes of patients with ADHF. These findings suggest that during the acute phases of HF, pro-ANP has a prognostic power comparable with NT-pro-BNP independently of renal function

Change in the NT‐proBNP/Mature BNP Molar Ratio Precedes Worsening Renal Function in Patients With Acute Heart Failure: A Novel Predictor Candidate for Cardiorenal Syndrome

Background: Early detection for worsening renal function (WRF) is indispensable in patients with acute decompensated heart failure (HF). We tested the hypothesis that the difference in the circulating levels of each B‐type or brain natriuretic peptide (BNP) molecular form is associated with the occurrence of WRF. Methods and Results: Circulating levels of proBNP, the NT‐proBNP (N‐terminal proBNP), and total BNP (proBNP+mature BNP) were prospectively measured in patients with acute decompensated HF using specific and sensitive enzyme immunochemiluminescent assays. An estimated mature BNP (emBNP) concentration was calculated by subtracting proBNP levels from total BNP levels. WRF was defined as a >20% decrease in the estimated glomerular filtration rate during the hospitalization. One‐way repeated‐measures ANOVA was used to compare the changes of variables between the patients with and without WRF. In patients with acute decompensated HF (New York Heart Association class III–IV; 96%) hospitalized for HF, NT‐proBNP levels did not differ during the hospitalization between patients with and without WRF (n=42 and 140, respectively). By contrast, emBNP levels were lower in patients with WRF than in those without WRF on day 3 after admission. NT‐proBNP/emBNP molar ratios were elevated on day 3 after admission in the patients with WRF, before estimated glomerular filtration rate declined, but were unchanged in patients without WRF. On day 3 after hospital admission, NT‐proBNP/emBNP ratios were strongly associated with percentage decreases in estimated glomerular filtration rate. Conclusions: These findings suggest that elevation of NT‐proBNP/emBNP ratio precedes WRF in patients with acute HF and can be a potentially useful biomarker for risk stratification of cardiorenal syndrome