In order to evaluate the effect of muscle pump on blood circulation at the start and end of exercise, cardiac responses to pedaling exercise at 75 watt in the supine position were investigated under lower body negative pressure (LBNP) of -60mmHg. Six healthy male college students volunteered for subjects. Cardiac output (Q), stroke volume (SV), thoracic impedance (ZO) and heart rate (HR) were determined by using ensemble-averaged impedance cardiogram and ECG.
The results obtained were as follows.
1) By the initiation of exercise under LBNP, SV and Q promptly and more markedly increased and ZO decreased than the control experiment which were done under normal pressure. These changes were suggested to be caused by mobilization of previously pooled blood in the legs by muscle pump. Effects of muscle pump arrived to a plateau within about 30 sec after the start of exercise. And these effects were immediately disappeard by the cessation of exercise.
2) By the release of LBNP during resting condition, the same changes were observed in SV, Q and ZO as in the start of exercise under LBNP. However HR decreased in the case while it increased in the case of exercise in LBNP. This difference in HR might be the result of the chronotropic effects by the exercise.
3) In the very early phase of exercise in the control exercise, SV decreased and ZO increased. These changes were probably caused by superiority of chronotropic action by the exercise to increase in venous return in this position.
These results led us to a conclusion that the effect of muscle pump appeares immediately by the start of the exercise and it arrives at plateau within about 30 sec. This effect is immediately disappeared by the cessation of exercise.

The incidence of fluorosis, believed to arise from the burning of coal, has been frequently reported in the highlands in the southern part of China. With a lot of rain and a climate of low temperature, the hilly region produces coal and inhabitants use it as a fuel for cooking and heating. The fossil fuel used by them is mostly powdery. It is mixed with dirt and rolled up into bolls. In that way,the people make the briquettes that burn a long time.Ordinary houses have no chimneys to belch forth smoke, so that it stagnates indoors for a while. Soot and smoke, before flowing out via the openings in the roof shingle of the loft, spoils farm produce stored there. Because the smoke contains high concentrations of fluoride derived from coal and dirt, it is believed that eating farm produce exposed to the smoke is one of the major factors for fluoride poisoning. Many researchers have thus far analyzed farm products for fluoride content and confirmed that high levels of fluoride were contained in their samples.In the present study, we measured fluoride concentrations in some samples of corn and capsicum produced in a rural area of Sichuan, China on one hand and on the other examined the water-solubility of fluoride. Furthermore, screening tests for chronic endemic dental fluorosis were performed on students to survey the fluoride contamination in the past as compared with the present state.Incidentally, indoor air-borne fluoride concentrations in this area averaged out at0.047mg F/m3 (15 times as high as the mean in a community that was free of fluoride contamination). The fluoride content of the drinking water from a spring in the nearby hill, measured with use of a fluoride-specific electrode method,was within the range from 0.2 to 0.3μg/ml.
Fluorides ; Fluoride measurement ; China ; Coal ; Levels

The expansion of life-style related diseases, such as metabolic syndrome (MS) and type 2 diabetes mellitus (T2DM), appears to be unstoppable. It is also difficult to cease their complications in spite of many antidiabetic medications or intervention of public administration. We and our collaborators found that physical medicine using simultaneous stimulation of heat with mild electric current activates heat shock response, thereby reducing visceral adiposity, insulin resistance, chronic inflammation and improving glucose homeostasis in mice models of T2DM, as well as in humans with MS or T2DM. This combination therapy exerts novel action on insulin signaling, beta-cell protection and body compositions, and may provide a new therapeutic alternative in diabetic treatment strategy.
Adiposity ; Animals ; Body Composition ; Cytoprotection ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Glucose ; Heat-Shock Response* ; Homeostasis ; Hot Temperature* ; Humans ; Inflammation ; Insulin Resistance* ; Insulin* ; Mice ; Physical and Rehabilitation Medicine

A China-Japan joint project was carried out to study the incidence of fluorosis caused by coal burning in China from 1995 to 1997.
The health survey covered a control area and two flourosis areas. In those research areas, drinking water was not polluted with fluorides. The survey was designed to analyze the health status of people exposed to fluorides and evaluate the relationships between the dose and incidence of fluorosis. The concentration of airborne pollutants in both indoor and outdoor air was measured. The concentration of fluoride in the urine was analyzed and definite diagnoses for dental fluorosis and skeletal fluorosis were determined.
As a result, the incidence of coal burning fluorosis was confirmed in studied areas. Moreover, the fluorosis was caused not only by the direct inhalation of the airbone fluorides in indoor air but also by the intake of cereals polluted with fluorides. Fluoride was contained in both coal and soil. Therefore the mixture of coal and soil used for the adjustment of fire energy contributed to the air pollution to a great extent. The typical polluted crops were red pepper, corn and potato. An extremely high concentration of fluoride in the urine of residents in the polluted areas was detected.

The Model Core Curriculum (Core Curriculum) is a "model" that systematically organizes the "core" parts of a university "curriculum," which all universities should work on in common. This section describes the part of the Core Curriculum revision that is related to digital transformation (DX). In order to disseminate the Core Curriculum, prepare for future changes, and support the collaborative work of many experts, the DX of the Core Curriculum included the introduction of data and the digitalization of the Core Curriculum work process. The digitization of the core curricula has made it possible to search for and browse through them on a website, distribute them in multiple formats such as Excel files and csv files, and link them to various software such as electronic syllabi and data analysis software. The digitalization of the work process has enabled multiple members to revise the core curricula in parallel. In the future, more personnel will need to support the introduction of such digital technology and a wider range of data.

The faculty development for clinical supervisor teaching residents (FD) was held for two nights on site in Japan. However, corona pandemic made it difficult to conduct the FD on site, thus we conducted it completely online. To avoid participants’ burden of long hours of synchronous online learning, we adopted a flipped classroom in which assignments in asynchronous online learning was used in discussion in synchronous learning. Assignments were issued sequentially five weeks prior to the synchronous session, and the synchronous session was held from 5:00 p.m. on Friday, November 13, 2020 to Saturday, November 14, 2020 for 45 participants. All participants completed the course by submitting all the assignments. The online flipped classroom utilizing assignments has a potential to significantly reduce the time constraints on busy clinicians.

We conducted a case conference to solve problems in teaching practices and for clinician teachers to discuss various issues occurring in the field. The conference was based on the presentation of individual educational practice cases from faculty development workshops approved by the Ministry of Health, Labor and Welfare. We prepared two months before the event and dealt with four cases on the day of the event. During the discussion, we tried to link educational problems with a theory or a conceptual framework in medical education so that participants, including case presenters, would have a better understanding of clinical training settings. In addition, communication across disciplines was facilitated through discussions. This attempt has the potential to contribute to the development of a community of practice related to cross-disciplinary education. The key to success for this case conference was the "interpreter" role. The person in that role considers the background and context of practice and links practice with theory appropriately. In addition, faculty development for educators who can play the role will also be an issue in the future.