著者

Saori Nonaka Tetsuya Makiishi Yoshito Nishimura Kazuya Nagasaki Kiyoshi Shikino Masashi Izumiya Mitsuru Moriya Michito Sadoahra Yoichi Ohtake Akira Kuriyama

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.8118-21, (Released:2021-12-18)

参考文献数

43

被引用文献数

6

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Objective To evaluate the change in the prevalence of burnout during the COVID-19 pandemic among internists and primary care physicians in Japan, and to identify factors associated with the exacerbation of burnout among these populations during this period. Methods This was a cross-sectional study based on two web-based surveys conducted in January 2020 (before the declaration of the COVID-19 pandemic) and June 2020 (during the pandemic). The participants were internists and primary care physicians of the Japanese Chapter of the American College of Physicians. The main outcome was the change in the prevalence of burnout between before and during the "first wave" of the pandemic. We also examined factors associated with the exacerbation of burnout during this period. Results Among the 283 respondents in the first survey and 322 in the second survey, 98 (34.6%) and 111 (34.5%) reported symptoms of burnout, respectively. In June 2020, 82 respondents (25.5%) reported that their level of burnout exacerbated compared to January 2020. Only the experience of self-quarantine was associated with the exacerbation of burnout (odds ratio [OR] 3.12; 95% confidence interval [CI] 1.49-6.50; P=0.002), while being a woman, being a resident physician, and an experience of having worked in a prefecture under a state of emergency were not. Conclusions No marked change in the prevalence of burnout among internists and primary care physicians in Japan was observed during the COVID-19 pandemic as a whole. However, self-quarantine was associated with the exacerbation of the burnout level.

著者

Yoshito Nishimura Midori Filiz Nishimura Yasuharu Sato

出版者

The Japanese Society for Lymphoreticular Tissue Research

雑誌

Journal of Clinical and Experimental Hematopathology (ISSN:13464280)

巻号頁・発行日

pp.21037, (Released:2022-04-27)

参考文献数

59

被引用文献数

8

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Since thrombocytopenia, anasarca, fever, reticulin fibrosis, renal insufficiency, and organomegaly (TAFRO) syndrome was first proposed in 2010, there has been considerable progress in this area, particularly regarding its association with idiopathic multicentric Castleman disease (iMCD). TAFRO syndrome is a heterogeneous category with a constellation of symptoms that can develop in the setting of infection, rheumatologic disorder, malignancy, and iMCD. Now, iMCD with TAFRO symptoms is subtyped as iMCD-TAFRO. However, confusion between TAFRO syndrome and iMCD-TAFRO remains. In this article, we discuss the current understanding and future research agenda of TAFRO syndrome and iMCD-TAFRO from the perspective of its new validated international definition.

著者

Yoshito Nishimura Asami Nishikori Haruki Sawada Torrey Czech Yuki Otsuka Midori Filiz Nishimura Hiroki Mizuno Naoki Sawa Shuji Momose Kumiko Ohsawa Fumio Otsuka Yasuharu Sato

出版者

The Japanese Society for Lymphoreticular Tissue Research

雑誌

Journal of Clinical and Experimental Hematopathology (ISSN:13464280)

巻号頁・発行日

pp.21038, (Released:2022-03-05)

参考文献数

38

被引用文献数

4

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Idiopathic multicentric Castleman disease (iMCD) is a systemic disorder characterized by systemic inflammation and organ dysfunction associated with an increase in pro-inflammatory cytokines. Some patients with iMCD are positive for autoantibodies, although their significance and relationship with specific associated autoimmune diseases are unclear. This study retrospectively analyzed the clinicopathological features of iMCD patients focusing on autoantibodies. Among 63 iMCD patients in our database, 19 were positive for at least one autoantibody. Among the 19, we identified five with plasma cell type (PC)-iMCD lymph node histopathology and positive anti-phospholipid antibodies. These patients were likely to have thrombocytopenia, anasarca, fever, reticulin fibrosis or renal insufficiency, organomegaly (TAFRO) symptoms, and thrombotic events. The present study suggests that patients with undiagnosed or atypical autoimmune diseases, including anti-phospholipid syndrome (APS), were treated for iMCD. APS may present with thrombocytopenia or even multi-organ failure, which overlap with clinical presentations of iMCD. Due to differences in the treatment regimen and follow-up, recognition of the undiagnosed autoimmune disease process in those suspected of iMCD is essential. Our study highlights the importance of complete exclusion of differential diagnoses in patients with iMCD in their diagnostic workup.

著者

Kazuya Nagasaki Kiyoshi Shikino Yoshito Nishimura Akira Kuriyama Saori Nonaka Masashi Izumiya Tetsuya Makiishi

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.6749-20, (Released:2021-02-22)

参考文献数

29

被引用文献数

9

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Objective The Mini-Z 2.0 is a new, simple, and nonproprietary tool for assessing physician well-being and burnout. To date, a non-English version of the Mini-Z 2.0 survey has not been validated. Therefore, we aimed to develop a Japanese version of the Mini-Z 2.0 and to evaluate its validity and reliability using survey data from physicians affiliated with an internal medicine academic society. Methods The Mini-Z 2.0 survey was translated into Japanese using a forward-backward translation method. The participants belonged to the American College of Physicians' Japan Chapter. The translated version of the Mini-Z 2.0 survey was distributed to participants using an electronic mailing list. Convergent validity was assessed between burnout and other items using Pearson's product-moment statistic. Structural validity was evaluated using an exploratory factor analysis and confirmatory factor analysis, and reliability was assessed using internal consistency. Results Of the 1,255 physicians and medical residents contacted, 283 responded (22.5%). Burnout was present in 34.6% of the participants, with 48.8% reporting high stress levels. Convergent validity was demonstrated, with satisfactory correlations between burnout and satisfaction, value alignment, work control, and stress. An exploratory factor analysis identified two factors (i.e. Well-Being and Relationships and Work-Related Stressors); however, the three models evaluated using the confirmatory factor analysis revealed a poor fit. Cronbach's alpha for the sample was 0.80. Conclusion The Japanese version of the Mini-Z 2.0 demonstrated good internal consistency and convergent validity. Despite its inadequate structural validity, it can be used to measure physician well-being and related workplace conditions in Japan.

著者

Yoshito NISHIMURA Yu TAMURA Kazuhisa HARA

出版者

The Japan Society of English Language Education

雑誌

全国英語教育学会紀要 (ISSN:13448560)

巻号頁・発行日

vol.28, pp.209-224, 2017-03-31 (Released:2018-04-10)

参考文献数

27

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Syntactic complexity has traditionally been measured by “macro-perspective measures,” which provide a paucity of angles from which to examine how learners actually elaborate a sentence. Mixing up a large variety of clauses with only “the number of clauses” or “subordination ratios” could lead to overlooking desired relationships between complexity and proficiency or task manipulation and linguistic performance. The current study attempted to capture the features of writing syntactically complex sentences through “micro-perspective measures,” such as clause types (main clauses, coordinate clauses, adverbial clauses, relative clauses, complement clauses, and non-finite clauses), and differences in learner proficiency levels. Participants were 28 Japanese EFL learners. Proficiency was operationalized via argumentative essay scores. To elicit syntactic knowledge, we offered the participants a specialized task that restricted the number of sentences in describing a plot consisting of six related illustrations. The results revealed that coordinate clauses, relative clauses, and non-finite clauses are more frequently produced in elaborating syntactic structures, irrespective of the writer’s proficiency level. Our findings also indicated that non-finite clauses are a more practical expedient for proficient learners than less proficient ones. Some pedagogical implications are also discussed.