Effectiveness of the educational training program for Japanese chief residents: A one-year pilot study.

Background: Multi-institutional faculty development programs for chief residents were lacking in Japan. This study evaluated the effectiveness of the program for enhancing the knowledge and behaviors of chief residents at the national level.

Methods: Six participants completed self-assessment questionnaires at three points: before, immediately after, and 6 months post-program.

Association between chronic diseases and severe periodontal disease progression: A retrospective cohort study in a city of Japan.

Background: Chronic periodontal disease primarily causes tooth loss and oral frailty and is linked to chronic conditions such as diabetes mellitus. However, its progression and broader studies on chronic diseases have not been well explored. This study aimed to investigate this association using claims data.

Pyloric Atresia in a Neonate With Epidermolysis Bullosa: A Case Report.

When surgery is performed in patients with EB, risks of blisters and epidermal detachment are always present. The Heineke-Mikulicz pyloroplasty cannot always be performed because of anatomical constraints. In such cases, it is necessary to select a more time-consuming surgical procedure (i.

Ectopic expression of the mitochondrial protein COXFA4L3 in human sperm acrosome and its potential application in the selection of male infertility treatments.

Purpose: Spermatogenesis requires a large amount of energy, which is primarily produced by the mitochondrial electron transfer chain. Mitochondrial dysfunction affects male infertility, suggesting a relationship between the electron transfer chain and male infertility. COXFA4L3 (C15ORF48) is an emerging subunit protein of cytochrome oxidase specifically expressed in germ cells during spermatogenesis, and it may be involved in male infertility.

The effects of resident work hours on well-being, performance, and education: A review from a Japanese perspective.

This article examines the impact of working-hour restrictions on the well-being, performance, and education of medical residents in Japan. Despite Japan's plan to introduce new regulations for resident working hours by 2024, there is still an ongoing debate regarding their appropriateness. This review provides a comprehensive overview of the current regulations of resident working hours worldwide, with a specific focus on weekly hours.

The environmental impact of inhaler replacement: A carbon footprint and economic calculation of the National Database of Health Insurance Claims in Japan.

Background: Drugs are a major source of greenhouse gas (GHG) emissions from healthcare systems. Pressurized metered-dose inhalers (pMDIs) have raised concerns over their environmental impact due to GHG emissions. Evaluations and reduction strategies for GHGs have been primarily studied in Europe, but not in other regions, including Japan.

Crowned dens syndrome: A case series of 72 patients at eight teaching hospitals in Japan.

Background: Crowned dens syndrome (CDS) is characterized by calcification around the odontoid process, accompanied by neck pain. Although CDS is supposedly rare, we regularly diagnose and manage this condition, indicating a perception gap between previous studies and our experience. The purpose of this study was to determine the annual incidence of CDS, time to diagnosis in CDS, as well as the features of CDS.

Rapid airway stenosis due to ruptured occipital artery in a patient with neurofibromatosis type I.

Background: Neurofibromatosis type I is rarely associated with vascular abnormalities. Here, we report a case of rapid airway stenosis caused by a ruptured occipital artery that was treated with surgical airway management.

Case Presentation: A 40-year-old woman, with no medical history, presented with a chief complaint of a sudden neck pain on the left side.

Impact of duty hours on competency-related knowledge acquisition among community hospital residents.

Background: The effect of duty hour (DH) restrictions on postgraduate residents' acquisition of clinical competencies is unclear. We evaluated the relationship between DHs and competency-related knowledge acquisition using the General Medicine In-training Examination (GM-ITE).

Methods: We conducted a multicenter, cross-sectional study of community hospital residents among 2019 GM-ITE examinees.

What kinds of work do Japanese primary care physicians who derive greater positive meaning from work engage in? A cross-sectional study.

Background: Despite the increasing need for primary care physicians (PCPs) around the world, few physicians choose it as a career. PCPs who can find meaning and enjoyment in their work can be role models for medical students and professionals, which may encourage more physicians to specialize in primary care. We aimed to compare the kinds of work that Japanese PCPs who derive greater positive meaning from work engage in versus those who derive less positive meaning from work.

A device for assessing microbial activity under ambient hydrostatic pressure: The in situ microbial incubator (ISMI).

Microbes in the dark ocean are exposed to hydrostatic pressure increasing with depth. Activity rate measurements and biomass production of dark ocean microbes are, however, almost exclusively performed under atmospheric pressure conditions due to technical constraints of sampling equipment maintaining in situ pressure conditions. To evaluate the microbial activity under in situ hydrostatic pressure, we designed and thoroughly tested an in situ microbial incubator (ISMI).

Protective Role of Endothelial Fibulin-4 in Valvulo-Arterial Integrity.

Background Homeostasis of the vessel wall is cooperatively maintained by endothelial cells (ECs), smooth muscle cells, and adventitial fibroblasts. The genetic deletion of fibulin-4 () in smooth muscle cells () leads to the formation of thoracic aortic aneurysms with the disruption of elastic fibers. Although is expressed in the entire vessel wall, its function in ECs and relevance to the maintenance of valvulo-arterial integrity are not fully understood.

Electrophysiological features of repetitive focal Purkinje ventricular arrhythmias originating from the proximal cardiac conduction system.

Background: Focal Purkinje ventricular arrhythmias (VAs) might originate from the vicinity of the proximal portion of the cardiac conducting system. This study aimed to clarify the features associated with focal Purkinje VAs originating from the proximal conduction system.

Methods: A total of 18 patients with focal Purkinje VAs undergoing radiofrequency catheter ablation (RFCA) were retrospectively examined and divided into the proximal type or the non-proximal type.

The ontogenetic dietary shift from non-dangerous to dangerous prey in predator-eating predators under capture risk.

Evaluating the patterns and generality of ontogenetic dietary shifts (ODSs) contributes to understanding prey-predator interactions and food web dynamics. Numerous studies have focused on predators that target distinctively lower trophic-level organisms. However, the ODS of predators that routinely prey on organisms at similar trophic levels (i.

Angioleiomyoma of the right forefoot.

We describe a rare case of angioleiomyoma in the foot of a middle-aged man.

Diagnostic accuracy of the Single-item Measure of Burnout (Japanese version) for identifying medical resident burnout.

Background: Burnout is a psychological syndrome consisting of emotional exhaustion, cynicism, and decreased professional efficacy. The Maslach Burnout Inventory (MBI) is widely used as the standard measure. However, the MBI is lengthy and not free to use, which makes it a less than ideal tool for regularly assessing burnout.

Aspiration pneumonia associated with achalasia.

In this case, a chest computed tomography scan of a young patient with pneumonia revealed esophageal obstruction, which led to the diagnosis of aspiration pneumonia due to achalasia. This report highlights achalasia and other gastrointestinal obstructions as one of the causes of aspiration pneumonia.

Usefulness of argon plasma coagulation for bleeding around hepaticojejunal anastomosis.

Ectopic varices due to extrahepatic portal vein obstruction (EHO) after hepaticojejunostomy have been previously reported. However, few case reports have described angiodysplasia-like lesions due to EHO around the hepaticojejunal anastomosis because they comprise small vessels in the mucosal surface and cannot be detected by contrast-enhanced computed tomography. Physicians need to insert the endoscope into the long afferent limb to diagnose angiodysplasia-like lesions around the hepaticojejunal anastomosis.

as an emerging pathogen for bacteremia among the elderly.

We report a patient of an 82-year-old woman with occult bacteremia without a clear entry site. is part of the normal human flora but can cause severe systemic infections such as infective endocarditis on rare occasions. In this patient, physical examination showed no localized symptoms, and a transthoracic echocardiogram showed no vegetation on the heart valves.

Tuberculous meningitis with good outcome following appropriate timing of ventriculoperitoneal shunting for hydrocephalus.

Background: Tuberculous meningitis is often associated with hydrocephalus. However, the appropriate timing for shunt placement to treat hydrocephalus remains controversial.

Case Presentation: A 43-year-old man presented with high fever and disturbance of consciousness.

Untreated Hypertension and Subsequent Incidence of Colorectal Cancer: Analysis of a Nationwide Epidemiological Database.

Background Studies of the association of hypertension with incident colorectal cancer (CRC) may have been confounded by including individuals taking antihypertensive medication, at high risk for CRC (ie, colorectal polyps and inflammatory bowel disease), or with shared risk factors (eg, obesity and diabetes). We assessed whether adults with untreated hypertension are at higher risk for incident CRC compared with those with normal blood pressure (BP), and whether any association is evident among individuals without obesity or metabolic abnormalities. Methods and Results Analyses were conducted using a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2 220 112; mean age, 44.