Todo Yoshimasu was one of the Kampo doctors of the Koho school in the Edo period, and created the basic structure of the modern traditional Japanese Kampo medicine. His achievements are still recognized today. His oldest son, Nangai Yoshimasu, is also credited with inheriting and developing the medical techniques established by his father. Todo’s descendants continued to be involved in the medical profession. In this paper, we first report that the building of the Yoshimasu clinic still exists in Tsuwara, Kurayoshi City, Tottori Prefecture, where Shiho Yoshimasu, the fifth-generation descendant of Todo, and his son Ryozo practiced medicine. We also found the tombstones there for Tetsutaro (Shiho), Yutaro, Ryozo, Tamenori, and Teruo of the Yoshimasu family. In conclusion, one of the origins of the Yoshimasu’s, a well-known family of doctors in Japan, is in Tottori. Therefore, Tsuwara, Kurayoshi City, Tottori Prefecture is an important place to describe Todo Yoshimasu. Here, we revealed the Yoshimasu family in Tottori based on new materials.

Globally, there are currently three major competency models for healthcare professions education: CanMEDS 2015 in Canada, Accreditation Council for Graduate Medical Education Six-Competency model in the United States, and Tomorrow's Doctors in the United Kingdom. An investigation by the Revision Committee for the Japanese National Model Core Curriculum revealed that these competency models had been utilized in seven countries. In each country investigated for revision, medical schools were allowed to implement these major competency models flexibly. Although each university has a high degree of freedom in curriculum design and educational delivery, each country is regulated by a quality assurance system that requires accreditation by the World Federation for Medical Education (WFME) and other organizations. The 2022 Revision of the Japanese National Model Core Curriculum has also been translated into English and released to the global audience in the field.

Pain of yin pattern is difficult to treat with Western medicine. We report four cases of shoulder periarthritis of yin pattern, as defined in Kampo, successfully treated with Kampo medicine. All three of these patients were women, aged 59, 74, and 62, respectively, at the end of the treatment series. All of them were diagnosed with shoulder periarthritis of yin pattern through interviews and were administered a combination of kakkonto and sokeikakketsuto after dokkatsukakkonto based on the classic description; their pain was then relieved. According to the classical interpretation, jufu is a clinical state of pain in the four extremities of people with yin pattern, for which dokkatsukakkonto is effective. We discussed the prescription directions for dokkatsukakkonto.

In Japan, the standards for establishing universities were revised in September 2022. Universities have accumulated considerable experience through the COVID-19 pandemic, including in distance education. In this revision, the Ministry of Education, Culture, Sports, Science, and Technology has opened the door to implementing educational methods and credit recognition that were not permitted under the current ministry ordinances, as a 'special system' (Tokurei-seido). It is necessary for universities to accumulate the results of social experiments, such as the 'special system' (Tokurei-seido), and utilize them in future revisions of the standards.　Overseas, the pandemic has spurred debates about whether medical students should be considered learners who need protection or as essential workers. In the UK, medical students graduated early and transitioned to clinical training sooner during the pandemic. This trend was in contrast to the United States, where medical students were isolated from clinical practices. The pandemic has disrupted the sequence of basic sciences, clinical sciences, and clinical clerkships. Medical students were unable to gain sufficient clinical experience during clinical clerkships. Despite the lack of study time in classrooms and clerkship rotations in clinical settings, medical students were promoted, graduated, and transitioned to clinical training. In this context, there are discussions about competency-based, time-variable (CBTV) education, which focuses on the competencies learners acquire rather than the amount of instructional time.

Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important；however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61［23-88］years；female/male, 9/19, body mass index, 25.0［18.0-33.6］kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points；P＜.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P＜.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.

Methods: Thirty patients with ASD aged ≥50 years who were admitted to our hospital between July 2016 and September 2019 were included in this study. X-ray parameters (i.e., sagittal vertical axis, pelvic tilt, and pelvic incidence minus lumbar lordosis) were evaluated from the full-length standing radiographs of the subjects. Trunk and hip extensor strength was evaluated using a hand-held dynamometer. Dynamic postural changes (i.e., sagittal trunk shift during standing, sagittal trunk shift during gait, and delta sagittal trunk shift) were assessed using a three-dimensional motion analysis system. The relationships between dynamic postural change and various X-ray parameters, as well as trunk and hip extensor strength, were examined using multivariable analysis. Results: Multivariable analysis showed that hip extensor strength is the factor most strongly associated with dynamic postural change among the X-ray parameters and physical functions assessed in this study (β=−0.41, R2=0.12). Conclusions We demonstrated the association between dynamic postural change and hip extensor strength in patients with ASD. Our results may be useful to healthcare providers treating patients with ASD. Interventions for dynamic postural change in patients with ASD should focus on hip extensor strength.

Patients with severe coronavirus disease 2019 (COVID-19) have poor prognosis, with many cases being difficult to treat and many reports of neurological complications in patients who have been in the intensive care unit for a long time. Rehabilitation of patients with severe COVID-19 is important；however, no rehabilitation program has shown effectiveness. Thus, this study aimed to investigate the effects of a rehabilitation program developed and used at our hospital for patients with severe COVID-19. We enrolled 28 patients with severe COVID-19 (age 61［23-88］years；female/male, 9/19, body mass index, 25.0［18.0-33.6］kg/m2). We assessed the medical research council scoring (MRC) of the patients at the time of entry and exit from the ordinary ward using Wilcoxon signed-rank tests. MRC was significantly improved after exiting the ordinary ward compared with that on entering the ordinary ward (43 vs. 50 points；P＜.001). Moreover, Barthel index improved significantly after exiting the ordinary (32.5 vs. 77.5 points, P＜.001). Therefore, our acute rehabilitation treatment for patients with severe COVID-19 may be effective in improving their muscle strength and daily living.

Methods: Thirty patients with LSS scheduled for spine surgery participated in this study. Lower limb pain was assessed using the Visual Analog Scale (VAS), and the patients were divided into two groups based on the mean scores (patients with scores above and below the mean were classified as the high-VAS and low-VAS groups, respectively). The kinematics of the spine, pelvis, and hip joints during gait were then measured using a 3D motion analysis system. Student paired t -tests were used to compare the angles of the spine, pelvis, and hip during gait between the two groups. Results: Compared to those in the low-VAS group, the spine was significantly extended and bent toward the more painful lower limb side, and the pelvis was significantly anteriorly tilted among individuals in the high-VAS group. Conclusions Patients with LSS experiencing severe pain in their lower limb tend to keep the spine in a more extended position, bend laterally toward the painful side, and have an anteriorly tilted pelvic posture. The dynamic spinal and pelvic alignment was closely related to the intensity of the lower limb pain.