{"title":"Design, Rational, and Baseline Characteristics of the SONIC-HF Multicenter Registry.","authors":"Nobuyuki Kagiyama, Kentaro Kamiya, Misako Toki, Hiroshi Saito, Kentaro Iwata, Yuya Matsue, Kenji Yoshioka, Kazuya Saito, Azusa Murata, Akihiro Hayashida, Junya Ako, Takeshi Kitai, Emi Maekawa","doi":"10.31662/jmaj.2024-0364","DOIUrl":"10.31662/jmaj.2024-0364","url":null,"abstract":"<p><strong>Introduction: </strong>Skeletal muscle mass and function are crucial for assessing physical frailty, sarcopenia, and cachexia, which significantly impact the prognosis of geriatric patients with heart failure (HF). Ultrasound-based assessment of skeletal muscles offers a non-invasive, real-time alternative to traditional methods. The <i>compariSON of various methods In evaluatIon of sarCopenia in patients with Heart Failure</i> study (SONIC-HF) aimed to evaluate the feasibility and prognostic impact of ultrasound-based muscle assessment in geriatric patients with HF.</p><p><strong>Methods: </strong>This multicenter, prospective cohort study enrolled patients with HF aged ≥65 years who could ambulate independently at discharge. Certified observers assessed muscle thickness (biceps, quadriceps, rectus femoris, and diaphragm) using ultrasound at rest and during contraction. The primary endpoint was all-cause mortality. Secondary endpoints included HF hospitalization, unplanned hospital visits, and cardiovascular and non-cardiovascular mortality.</p><p><strong>Results: </strong>Of the 692 enrolled patients (median age 81 [interquartile range 74-86] years, 57.6% women, left ventricular ejection fraction 45% [32%-60%]), ultrasound-based muscle assessments were completed in 606 patients. Interobserver reliability was excellent (intraclass correlation coefficient 0.84-0.99). Median muscle thicknesses at rest and during contraction were: diaphragm 1.9 (1.6-2.3) mm and 2.9 (2.3-3.8) mm; biceps 19.6 (15.9-23.1) mm and 25.3 (21.3-29.5) mm; quadriceps 19.0 (15.0-23.5) mm and 24.8 (19.9-29.5) mm; rectus femoris 9.7 (7.1-12.3) mm and 12.1 (9.6-15.0) mm. The median follow-up time was 733.5 (438-882) days.</p><p><strong>Conclusions: </strong>The SONIC-HF registry will provide valuable insights into the feasibility and prognostic implications of ultrasound-based muscle assessment in geriatric patients with HF.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"552-559"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JMA journalPub Date : 2025-04-28Epub Date: 2025-03-21DOI: 10.31662/jmaj.2025-0068
Hideo Yasunaga
{"title":"Easier Access to Acute Care and Lower Stroke Mortality: What is Next?","authors":"Hideo Yasunaga","doi":"10.31662/jmaj.2025-0068","DOIUrl":"10.31662/jmaj.2025-0068","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"430-431"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JMA journalPub Date : 2025-04-28Epub Date: 2025-04-04DOI: 10.31662/jmaj.2024-0340
Takayoshi Sasako, Yann Ilboudo, Yiheng Chen, Kevin Y H Liang, Satoshi Yoshiji, J Brent Richards
{"title":"The Influence of Trinucleotide Repeats in the Androgen Receptor Gene and Testosterone Level on Circulating Proteins in Male Participants: Proteomics Analysis Using the UK Biobank Data.","authors":"Takayoshi Sasako, Yann Ilboudo, Yiheng Chen, Kevin Y H Liang, Satoshi Yoshiji, J Brent Richards","doi":"10.31662/jmaj.2024-0340","DOIUrl":"10.31662/jmaj.2024-0340","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"591-595"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rapidly Rising Preference among New-entry Medical Students for Using Generative Artificial Intelligence in Reflective Reports.","authors":"Chihiro Kawakami, Osamu Nomura, Miyuki Takahashi, Ritsuki Takaha, Takayasu Ito, Hiroaki Ushikoshi, Takuya Saiki","doi":"10.31662/jmaj.2024-0390","DOIUrl":"10.31662/jmaj.2024-0390","url":null,"abstract":"<p><strong>Introduction: </strong>As artificial intelligence (AI) continues to proliferate, it becomes imperative that medical students are not only instructed in the use of AI but also afforded regular opportunities to interact with it throughout their medical education. In 2023 and 2024, an art-based reflective reports assignment was implemented among new-entry students of the medical program at a university in Japan. The assignment required students to use generative AI within their submissions. The objective of this study was to assess the perceptions of these students regarding the use of generative AI in their reflective reports over the course of two academic years.</p><p><strong>Methods: </strong>First-year medical students were tasked with submitting an art-based reflective report about their experiences during the community-based inquiry learning session. The assignment was a component of their reflective competencies assessment. We conducted a survey of the 2023 and 2024 student cohorts and examined their perceptions of using generative AI using a five-point Likert scale. We compared the survey responses of the two cohorts using the t-test.</p><p><strong>Results: </strong>The participants exhibited a notably higher mean score for positive perceptions toward generative AI in 2024 compared with 2023 (3.8 versus 2.9 points; p < 0.01). In addition, the proportion of participants who expressed a preference for using generative AI was significantly higher in 2024 than in 2023 (32.0% versus 17.4%; p = 0.02).</p><p><strong>Conclusions: </strong>A substantial and rapid increase has been observed in the proportion of medical students indicating a preference for using generative AI. The joint adoption of generative AI by medical students and faculties signifies a significant and urgently required development in AI use within medical education.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"465-469"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JMA journalPub Date : 2025-04-28Epub Date: 2025-04-21DOI: 10.31662/jmaj.2024-0246
Etsuji Suzuki
{"title":"Unraveling Causality: Innovations in Epidemiologic Methods.","authors":"Etsuji Suzuki","doi":"10.31662/jmaj.2024-0246","DOIUrl":"10.31662/jmaj.2024-0246","url":null,"abstract":"<p><p>For several decades, the counterfactual model and the sufficient cause model have shaped our understanding of causation in biomedical science and, more recently, the link between these two models has enabled us to obtain a deeper understanding of causality. In this article, I provide a brief overview of these fundamental causal models using a simple example. The counterfactual model focuses on one particular cause or intervention and gives an account of the various effects of that cause. By contrast, the sufficient cause model considers sets of actions, events, or states of nature which together inevitably bring about the outcome under consideration. In other words, the counterfactual framework addresses the question \"what if?\" while the sufficient cause framework addresses the question \"why does it happen?\" Although these two models are distinct and address different causal questions, they are closely related and used to elucidate the same cause-effect relationships. Importantly, the sufficient cause model makes clear that causation is a multifactorial phenomenon, and it is a \"finer\" model than the counterfactual model; an individual is of one and only one response type in the counterfactual framework, whereas an individual may be at risk of none, one, or several sufficient causes. Understanding the link between the two causal models can provide greater insight into causality and can facilitate the use of each model in appropriate contexts, highlighting their respective strengths. I will briefly present three topics of interest from our research: the relationship between the concepts of confounding and of covariate balance; distinctions between attributable fractions and etiologic fractions; and the identification of operating mediation and mechanism. It is important to scrutinize observed associations in a complementary manner, using both the counterfactual model and the sufficient cause model, employing both inductive and deductive reasoning. This holistic approach will better help us to unravel causality.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"323-337"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JMA journalPub Date : 2025-04-28Epub Date: 2025-01-31DOI: 10.31662/jmaj.2024-0295
Takaki Kobayashi, Soichiro Saeki
{"title":"What Is Required for the Future of Medical Education and Healthcare?","authors":"Takaki Kobayashi, Soichiro Saeki","doi":"10.31662/jmaj.2024-0295","DOIUrl":"10.31662/jmaj.2024-0295","url":null,"abstract":"<p><p>The COVID-19 pandemic has profoundly transformed medical education, shaping students' career aspirations and impacting their mental well-being. A global survey among medical students conducted in 2023 revealed that over half of medical and nursing students are inclined toward nonclinical careers, while a substantial majority express concerns regarding their mental health. These insights underscore the urgent need to broaden educational trajectories beyond direct patient care and prioritize the psychosocial welfare of students. We explore the implications of these shifts, emphasizing the rising interest in public health and research as viable alternative career paths. Medical schools in Japan are increasingly introducing healthcare policy and administration courses, offering students opportunities to assume public health and research roles. Moreover, medical education must adapt to mitigate the pressures associated with future workloads and extensive academic demands by integrating digital technologies, such as artificial intelligence and virtual reality, into the curriculum. Furthermore, enhancing career guidance and expanding international exchange programs will cultivate a more versatile talent pool and equip students for diverse career trajectories in healthcare. By accommodating clinical and nonclinical interests and addressing student mental health, the future of medical education can elevate healthcare quality and advancing public health outcomes. Ultimately, a holistic and multifaceted approach to medical education is crucial for nurturing professionals adept at confronting the challenges of future pandemics and pioneering innovations in healthcare.</p>","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"580-583"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JMA journalPub Date : 2025-04-28Epub Date: 2025-03-21DOI: 10.31662/jmaj.2025-0076
Ryuji Hamamoto
{"title":"Editorial for Innovative Artificial Intelligence System in the Children's Hospital in Japan.","authors":"Ryuji Hamamoto","doi":"10.31662/jmaj.2025-0076","DOIUrl":"10.31662/jmaj.2025-0076","url":null,"abstract":"","PeriodicalId":73550,"journal":{"name":"JMA journal","volume":"8 2","pages":"361-362"},"PeriodicalIF":1.5,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}