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Lung Hyperinflation Is Associated with Pulmonary Exacerbations in Adults with Cystic Fibrosis

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Open Journal of Respiratory Diseases 2016年第2期6卷 25-34页

作者： Kosal Seng lynn fukushima Pooja Patel Arteen Pirverdian Adupa Rao Joseph Milic-Emili Ahmet Baydur Division of Geriatric Hospital Palliative and General Internal Medicine Los Angeles CA USA Division of Pulmonary and Critical Care Medicine Keck School of Medicine University of Southern California Los Angeles CA USA Department of Physiology McGill University (Emeritus) Montreal Quebec Canada

Background: Forced expiratory volume 1 second (FEV1) has traditionally been used as a readily available marker of health in adult cystic fibrosis (CF). However, due to the obstructive nature of this disease, it is possible that lung hyperinflation could be more closely related to disease severity than is FEV1. The purpose of this study was to determine if hyperinflation is more closely associated with quality of life, functional status, and pulmonary exacerbations than FEV1 in patients with CF. Methods: Sixty-eight adult patients with CF were evaluated in this retrospective study. We used IC and functional residual capacity (FRC) and their ratios to total lung capacity (TLC) as measures of lung hyperinflation. We used bivariate correlations and backwards regression analysis to assess possible associations between FEV1, lung hyperinflation, and measures of disease severity including questionnaire based quality of life, pulmonary exacerbation frequency, and mortality. The respiratory component of the Cystic Fibrosis Questionnaire–Revised (CRQ-R-Respiratory) was used as a measure of quality of life. Results: Both FEV1 and IC were negatively correlated with pulmonary exacerbations over a 3 year period (p = 0.004, r2 = 0.127;p < 0.001, r2 = 0.307, respectively), while FRC/TLC correlated positively with exacerbations (p = 0.007). Backwards regression analysis showed that among pulmonary function variables, IC had the strongest relationship with exacerbations over 3 years. A lower CFQ-R-Respiratory score was associated with greater mortality (p = 0.005). However, no statistically significant relationships were found between lung function and mortality. Conclusions: FEV1 and lung hyperinflation-as measured by IC and FRC/TLC-are both associated with pulmonary exacerbation frequency. This suggests that chronic dynamic hyperinflation contributes significantly to disease severity in adult cystic fibrosis.

关键词： Cystic Fibrosis Hyperinflation Inspiratory Capacity Quality of Life

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de Oliveira Vidal Luiz Fernando Alvarenga Ribeiro Marco Antonio de Carvalho-Filho Fernanda Bono fukushima Internal Medicine Department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology Department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?

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World Journal of Gastroenterology 2024年第10期30卷 1368-1376页

作者： Nobukazu Agatsuma Takahiro Utsumi Yoshitaka Nishikawa Takahiro Horimatsu Takeshi Seta Yukitaka Yamashita Yukari Tanaka Takahiro Inoue Yuki Nakanishi Takahiro Shimizu Mikako Ohno Akane fukushima Takeo Nakayama Hiroshi Seno Department of Gastroenterology and Hepatology Kyoto University Graduate School of MedicineKyoto 606-8507Japan Department of Gastroenterology and Hepatology Japanese Red Cross Wakayama Medical CenterWakayama 640-8558Japan Department of Health Informatics Kyoto University School of Public HealthKyoto 606-8501Japan Institute for Advancement of Clinical and Translational Science(iACT) Kyoto University HospitalKyoto 606-8507Japan Medical Support Section Medical Affairs DivisionKyoto University HospitalKyoto 606-8507Japan

BACKGROUND Colorectal cancer(CRC)is a global health concern,with advanced-stage diagnoses contributing to poor *** efficacy of CRC screening has been well-established;nevertheless,a significant proportion of patients remain unscreened,with>70%of cases diagnosed outside *** identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources,the association between the diagnostic routes and identification of these subgroups has been less *** the Japanese cancer registry,the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related *** To clarify the stage at CRC diagnosis based on diagnostic *** We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two *** diagnostic routes were primarily classified into three groups:Cancer screening,follow-up,and *** early-stage was defined as Stages 0 or *** and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups,referencing the follow-up *** adjusted covariates were age,sex,and tumor *** Of the 2083 patients,715(34.4%),1064(51.1%),and 304(14.6%)belonged to the follow-up,symptomatic,and cancer screening groups,*** the 2083 patients,CRCs diagnosed at an early stage were 57.3%(410 of 715),23.9%(254 of 1064),and 59.5%(181 of 304)in the follow-up,symptomatic,and cancer screening groups,*** symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group[P<0.001,adjusted odds ratio(aOR),0.23;95%confidence interval(95%CI):0.19-0.29].The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening gro

关键词： Colorectal neoplasms Cancer registry Diagnostic route Cancer screening Stage at diagnosis

Influences of Horticultural Therapy and Functional Recovery Training at a Day-Care Center for the Elderly and Text Mining of Care Records by AI

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Open Journal of Therapy and Rehabilitation 2024年第2期12卷 117-131页

作者： Seigo Koura Shinya Matsutani Kazuho Nagao Yu fukushima Akiko Ikeda Takeshi Oshikawa Tomohiro Inagaki Kentaro Higashi Faculty of Graduate School Postdoctoral Course in Health Care Medicine Nishikyusyu University Kanzaki Japan Social Welfare Corporation Kanjikai Miyakonojyo Japan Sophia Phyto-Therapy College Tokyo Japan

Background: In Japan, due to the COVID-19 pandemic, various behavioral restrictions were implemented from March 2020, resulting in an increased number of elderly people with reduced participation in care and rehabilitation. As a result, the decline in motor and cognitive functions became more pronounced. Purpose: The study examined how activities combining passive horticultural therapy, which is always introduced, with active functional recovery training, which is used in the functional recovery training of patients with hemiplegia, influence the behavior of elder people using the facility. Methods: 36 elder people with care need 1 or 2 who regularly used the day-care facilities after the pandemic ended and who agreed to participate in the study was included. The assessment data were every three months from December 2021 to December 2023 after the COVID-19 pandemic, the MMSE and Moca-J, TMIG-Index, and GDS15. AI-based text mining was used to compare changes in visit reports before and after the introduction of the Posture Chart and Red Code, and the relationship between the language used. Results: The results of MMSE and Moca-J were both significantly higher in Group B and C than in Group A. TIMG assessment, was significantly higher in Group B and C than in Group A, and Group C was significantly higher than Group B. The GDS, an assessment of depression in old age, tended to be significantly higher in Group A than in Groups B and C. In the “Co-Occurrence Network Analysis” shown after the introduction of the latest functional recovery training equipment such as the Red Cord, its results showed a high association between the words Bathing and CARE and words such as POSTURE, Red-Code, and AI, App, which are used in functional training and rehabilitation, and their analysis. Conclusion: At day-care facilities specializing in functional recovery training and rehabilitation, a combination of horticultural therapy and the latest functional training equipment found to help m

关键词： Horticultural Therapy Hand Care Treatment Senior Day-Care Center Functional Recovery Training KH-Corder

Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

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World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai Toshihiko Yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of Hepato-Biliary-Pancreatic Surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of *** use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative ***,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after *** To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after *** The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively *** were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower *** factors,including demographic data and perioperative D-dimer values,were compared between the two *** operating characteristic curve analysis was performed to determine the D-dimer cutoff *** and multivariate analyses were performed using logistic regression analysis to identify significant *** In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE *** the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after *** Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

Bioinformatic approach for understanding the heterogeneity of cholangiocytes

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World Journal of Gastroenterology 2006年第22期12卷 3481-3486页

作者： Koji fukushima Yoshiyuki Ueno Division of Gastroenterology Tohoku University Graduate School of Medicine SeiryoAobakuSendai980-8574Japan

It is remarkable that microarray technologies have nearly reached a pinnacle. Establishment of further analysis and management of enormous data derived from microarray technology is currently the highest priority. The heterogeneous functions of cholangiocytes regulate the pathophysiology of the biliary epithelium in relation to secretory, proliferative and apoptotic activities. Distinct expression profiles of two murine cholangiocyte lines, termed small and large have been revealed by microarray analysis. The features of the two cholangiocyte cell lines, categorized partly according to gene ontology, indicate the specific physiological role of each cell line. The large cholangiocytes are characterized as “transport” and “immune/ inflammatory responses” In contrast, small cholangiocytes are associated with properties of limited physiological functional ability and proliferating/migrating potential with specific molecules like Eph receptors, comparable to mesenchymal cells. ＇Omic study will be of great help in understanding the heterogeniety of cholangiocytes.

关键词： Cholangiocytes Heterogeneity

Annular Supersonic Swirling Flows with Heterogeneous Condensation

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Journal of Thermal Science 2016年第6期25卷 518-525页

作者： Yusuke fukushima Shigeru MATSUO Norimasa SHIOMI Toshiaki SETOGUCHI Graduate School of Science & Engineering Saga University Department of Advanced Technology Fusion Saga University Department of Mechanical Engineering Saga University Institute of Ocean Energy Saga University

In recent years,separating and extracting technologies of condensate gas have been developed by combining a swirl flow with non-equilibrium condensation phenomena of condensate gas generated in a supersonic *** technology can reduce the size of the device and does not use ***,there are many unresolved problems for performance of the separation,extraction and operating *** it is necessary to research further in order to improve the performance of the *** the present study,the numerical study was carried out to clarify the effect of the heterogeneous condensation on the characteristics of the swirling flow field in a supersonic annular nozzle,and the differences between homogeneous condensation and heterogeneous condensation in the flow *** the results,it is found that the condensation flow with a swirl affects the position of sonic line,the generating position of condensate and the radial distribution ratio of liquid phase.

关键词： condensation supersonic heterogeneous condensate viscosity chemicals generating annular nozzle regardless

A host lncRNA regulates the innate immune response to an RNA virus

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Cellular & Molecular Immunology 2019年第10期16卷 841-842页

作者： Kiyoharu fukushima Hiroshi Kida Department of Respiratory Medicine National Hospital Organization Osaka Toneyama Medical CenterOsakaJapan

TO THE EDITOR Recent studies have shown that more than 70%of the mammalian genome is transcribed into RNAs;however,most of these RNAs do not encode proteins and are thus called noncoding RNAs(ncRNAs).

关键词： immune EDIT innate

Specific targeting of lung ILC2s via NRP1 in pulmonary fibrosis

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Cellular & Molecular Immunology 2022年第8期19卷 869-871页

作者： Takuro Nii Kiyoharu fukushima Hiroshi Kida Department of Respiratory Medicine National Hospital Organization Osaka Toneyama Medical Center5-1-1 ToneyamaOsakaJapan Department of Respiratory Medicine and Clinical Immunology Osaka University Graduate School of Medicine2-2 YamadaokaSuitaOsakaJapan Laboratory of Host Defense World Premier Institute Immunology Frontier Research Center(WPI-IFReC)Osaka University3-1 YamadaokaSuitaOsakaJapan Department of Host Defense Research Institute for Microbial Diseases(RIMD)Osaka UniversityOsaka565-0871Japan Global Center for Medical Engineering and Informatics 2-2 YamadaokaSuitaOsakaJapan

Innate lymphoid cells are predominantly tissue-resident immune cells that have diverse functions similar to T-cell subsets and regulate tissue homeostasis and innate immunity without specific antigen recognition. Prev... 详细信息

关键词： ILC2s immunity homeostasis