Browsing by Subject "Japan"
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Item Open Access A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan.(European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2018-03) Yagi, Mitsuru; Ames, Christopher P; Keefe, Malla; Hosogane, Naobumi; Smith, Justin S; Shaffrey, Christopher I; Schwab, Frank; Lafage, Virginie; Shay Bess, R; Matsumoto, Morio; Watanabe, Kota; International Spine Study Group (ISSG)Purpose
Information about the cost-effectiveness of surgical procedures for adult spinal deformity (ASD) is critical for providing appropriate treatments for these patients. The purposes of this study were to compare the direct cost and cost-effectiveness of surgery for ASD in the United States (US) and Japan (JP).Methods
Retrospective analysis of 76 US and 76 JP patients receiving surgery for ASD with ≥2-year follow-up was identified. Data analysis included preoperative and postoperative demographic, radiographic, health-related quality of life (HRQOL), and direct cost for surgery. An incremental cost-effectiveness ratio (ICER) was determined using cost/quality-adjusted life years (QALY). The cost/QALY was calculated from the 2-year cost and HRQOL data.Results
JP exhibited worse baseline spinopelvic alignment than the US (pelvic incidence and lumbar lordosis: 35.4° vs 22.7°, p < 0.01). The US had more three-column osteotomies (50 vs 16%), and shorter hospital stay (7.9 vs 22.7 days) (p < 0.05). The US demonstrated worse postoperative ODI (41.3 vs. 33.9%) and greater revision surgery rate (40 vs 10%) (p < 0.05). Due to the high initial cost and revision frequency, the US had greater total cost ($92,133 vs. $49,647) and cost/QALY ($511,840 vs. $225,668) at 2-year follow-up (p < 0.05).Conclusion
Retrospective analysis comparing the direct costs and cost-effectiveness of ASD surgery in the US vs JP demonstrated that the total direct costs and cost/QALY were substantially higher in the US than JP. Variations in patient cohort, healthcare costs, revision frequencies, and HRQOL improvement influenced the cost/QALY differential between these countries.Item Open Access A nationwide survey of intravenous antimicrobial use in intensive care units in Japan.(International journal of antimicrobial agents, 2018-04) Ohnuma, Tetsu; Hayashi, Yoshiro; Yamashita, Kazuto; Marquess, John; Lefor, Alan Kawarai; Sanui, Masamitsu; Japanese Survey of AntimiCRobial Use in ICU PatienTs (JSCRIPT) investigatorsAlthough most patients in the intensive care unit (ICU) receive antibiotics, little is known about patterns of antibiotic use in ICUs in Japan. The objective of this study was to evaluate the pattern of antibiotic use in ICUs. A nationwide one-day cross-sectional surveillance of antibiotic use in the ICU was conducted three times between January 2011 and December 2011. All patients aged at least16 years were included. Data from 52 ICUs and 1148 patients were reviewed. There were 1028 prescriptions for intravenous antibiotics. Of 1148 patients, 834 (73%) received at least one intravenous antibiotic, and 575 had at least one known site of infection. Respiratory and intra-abdominal infections were the two most common types. Of 1028 prescriptions, 331 (34%) were for surgical or medical prophylaxis. Excluding prophylaxis, carbapenems were the most commonly prescribed agent. Infectious disease consultations, pre- and post-prescription antimicrobial stewardship, and ICU-dedicated antibiograms were available in 44%, 52%, 77%, and 21% of the ICUs, respectively. In logistic regression analysis adjusting for patient characteristics, treatment in a university hospital (adjusted odds ratio, 1.72; 95% CI, 1.05-2.84; P = 0.033) and an open ICU (adjusted odds ratio, 2.30; 95% CI, 1.02-5.17; P = 0.044) were significantly associated with greater likelihood of carbapenem use. An increase in the number of closed ICUs and more intensive care specialists may reduce carbapenem use in Japanese ICUs. Large-scale epidemiological studies of antimicrobial resistance in the ICU are needed.Item Open Access At the Conflux(2017) Tierney, Justin Mark1. At the Conflux
At the Conflux is a three part musically driven time-lapse film that tours Japan by road and rail. It is an exploration of its sprawling nocturnal cityscapes crisscrossed by thruways, its urban grid illuminated by fiery-hued highways pulsing through the city like arteries circulating blood, its towering skyscrapers watching over all, unmoved—soaring sentinels of steel and glass, its patterns of people rhythmically engaging with the machinery of modern life. A spacious Japanese flavored soundscape contrasts with the frenetic energy of the imagery. Piano, violin, trumpet, trombone and upright bass lines are decorated with snippets of field recordings captured in Tokyo and Osaka.
2. Craft and Expression Entwined in the Music of Martin Bresnick
The music of Martin Bresnick is filled with allusions to literature, history, politics, and music of the past. These extramusical references are often combined with complex musical structures. Symmetries and serial operations are staples of his craft. These two aspects of his work often exist in different conceptual realms. However, from the early 1990s onwards, there is a trend in Bresnick’s music in which technical elements entwine with expressive aims. This short article explores the relationship between compositional technique and referentiality through two exemplary works, the String Quartet No. 2, Bucephalus (1984) and The Bucket Rider (1995) with a brief exploration of the aesthetic of Arte Povera, an avant-garde art movement of the 1960s and 1970s Bresnick used as the title of the set of pieces to which The Bucket Rider belongs.
Item Open Access Automated graves: The precarity and prosthetics of caring for the dead in Japan(International Journal of Cultural Studies, 2021-07-01) Allison, AOnce dependent on family to bury and memorialize the dead, caring for the deceased has become increasingly precarious in the wake of a decreasing and aging population, a trend towards single households, and downsizing of social relationality—including the temple parishioner system once key in mortuary rituals. In the new “ending” marketplace emerging today to help Japanese manage this precarity, automated graves offer customers a convenient burial spot in an urban ossuary where ashes, interred in a deposit box, are automatically transferred to a grave upon visitation. Based on ethnographic fieldwork, the article examines the just-in-time delivery system at work in automated graves, arguing that the mechanism serves as a social prosthesis, propping up the allure of social caring for the dead, even for those whose ashes are never visited by human relations. With over 30 such institutions now operating in Japan, automated graves are a sign of changing sociality between the living and the dead.Item Open Access Ballistic Missile Defense in Japan: Process-Tracing a Historical Trajectory(2014-12-17) Van, ShanelleWhy did Japan deploy ballistic missile defense when and how it did? The prevailing view characterizes Japan’s BMD decision as a response to North Korea’s 1998 Taepodong missile launch. But “Ballistic Missile Defense in Japan: Process-Tracing a Historical Trajectory” contests this simple assumption of causation. The thesis first pieces together a more comprehensive historical narrative from contemporary sources and interviews with formal officials. Analysis of this newly revised timeline then demonstrates that focusing events like the Taepodong incident were but one of several factors driving BMD; others included alliance pressures, bureaucratic leadership, and defense industry profitability. These findings are more important now than ever as the United States pivots towards Asia and transitions to relying on Japan as an equal military partner. Understanding the history of missile defense in Japan leads to the heart of how and why the United States’ close ally makes its national security decisions, and thus allows both parties to forge a better alliance.Item Open Access Beyond the Convent Walls: The Local and Japan-wide Activities of Daihongan’s Nuns in the Early Modern Period (c. 1550–1868)(2016) Mitchell, Matthew StevenThis dissertation examines the social and financial activities of Buddhist nuns to demonstrate how and why they deployed Buddhist doctrines, rituals, legends, and material culture to interact with society outside the convent. By examining the activities of the nuns of the Daihongan convent (one of the two administrative heads of the popular pilgrimage temple, Zenkōji) in Japan’s early modern period (roughly 1550 to 1868) as documented in the convent’s rich archival sources, I shed further light on the oft-overlooked political and financial activities of nuns, illustrate how Buddhist institutions interacted with the laity, provide further nuance to the discussion of how Buddhist women navigated patriarchal sectarian and secular hierarchies, and, within the field of Japanese history, give voice to women who were active outside of the household unit around which early modern Japanese society was organized.
Zenkōji temple, surrounded by the mountains of Nagano, has been one of Japan’s most popular pilgrimage sites since the medieval period. The abbesses of Daihongan, one Zenkōji’s main sub-temples, traveled widely to maintain connections with elite and common laypeople, participated in frequent country-wide displays of Zenkōji’s icon, and oversaw the creation of branch temples in Edo (now Tokyo), Osaka, Echigo (now Niigata), and Shinano (now Nagano). The abbesses of Daihongan were one of only a few women to hold the imperially sanctioned title of eminent person (shōnin 上人) and to wear purple robes. While this means that this Pure Land convent was in some ways not representative of all convents in early modern Japan, Daihongan’s position is particularly instructive because the existence of nuns and monks in a single temple complex allows us to see in detail how monastics of both genders interacted in close quarters.
This work draws heavily from the convent’s archival materials, which I used as a guide in framing my dissertation chapters. In the Introduction I discuss previous works on women in Buddhism. In Chapter 1, I briefly discuss the convent’s history and its place within the Zenkōji temple complex. In Chapter 2, I examine the convent’s regular economic bases and its expenditures. In Chapter 3, I highlight Daihongan’s branch temples and discuss the ways that they acted as nodes in a network connecting people in various areas to Daihongan and Zenkōji, thus demonstrating how a rural religious center extended its sphere of influence in urban settings. In Chapter 4, I discuss the nuns’ travels throughout the country to generate new and maintain old connections with the imperial court in Kyoto, confraternities in Osaka, influential women in the shogun’s castle, and commoners in Edo. In Chapter 5, I examine the convent’s reliance upon irregular means of income such as patronage, temple lotteries, loans, and displays of treasures, and how these were needed to balance irregular expenditures such as travel and the maintenance or reconstruction of temple buildings. Throughout the dissertation I describe Daihongan’s inner social structure comprised of abbesses, nuns, and administrators, and its local emplacement within Zenkōji and Zenkōji’s temple lands.
Exploring these themes sheds light on the lives of Japanese Buddhist nuns in this period. While the tensions between freedom and agency on the one hand and obligations to patrons, subordination to monks, or gender- and status-based restrictions on the other are important, and I discuss them in my work, my primary focus is on the nuns’ activities and lives. Doing so demonstrates that nuns were central figures in ever-changing economic and social networks as they made and maintained connections with the outside world through Buddhist practices and through precedents set centuries before. This research contributes to our understanding of nuns in Japan’s early modern period and will participate in and shape debates on the roles of women in patriarchal religious hierarchies.
Item Open Access Cartoon and Massacre: Japanese Empire in China, Korea, and Taiwan(2008-04-27) Nguyen, Dewey DuyThis paper examines the controversial legacy of the Japanese empire in East Asia using cartoons from Tokyo Puck and articles from The Japan Times and Mail to trace and analyze the development of Japanese imperialism in the early 20th century. It attempts to connect historical events like the Sino-Japanese War, the Nanjing Massacre, and the colonization of Taiwan with modern day issues like the Yasukuni Shrine and Asian comfort women. The paper argues that Japanese imperialism in East Asia is complex and cannot be viewed through black and white lens; while often characterized by brutality and exploitation, Japan also brought development, the prime example being the island of Taiwan. The paper then posits several reasons why modern day Japan has yet to come to terms with its imperial past and makes policy suggestions for the future.Item Open Access Comparable satisfaction and clinical outcomes after surgery for adolescent idiopathic scoliosis in the adult (AISA) between the US and Japan.(Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association, 2023-01) Yagi, Mitsuru; Ames, Christopher P; Hosogane, Naobumi; Smith, Justin S; Shaffrey, Christopher I; Schwab, Frank J; Lafage, Virginie; Bess, Shay; Matsumoto, Morio; Watanabe, Kota; International Spine Study Group (ISSG)Background
The impact of ethnicity on the surgery outcomes of adolescent idiopathic scoliosis in the adult (AISA) is poorly understood. This study aimed to compare the surgery outcomes for AISA between the United States (US) and Japan (JP).Methods
171 surgically treated AISA (20-40y) were consecutively collected from 2 separate multicenter databases. Patients were propensity-score matched for age, gender, curve type, levels fused, and 2y postop spinal alignment. Demographic and radiographic parameters were compared between the US and JP at baseline and 2y post-op.Results
A total of 108 patients were matched by propensity score (age; US vs. JP: 29 ± 6 vs. 29 ± 7y, females: 76 vs. 76%, curve type [Schwab-SRS TypeT; TypeD; TypeL; TypeN]: 35; 35; 30; 0 vs. 37; 33; 30; 0%)] levels fused: 10 ± 4 vs. 10 ± 4, 2y thoracic curve:17 ± 13 vs. 17 ± 12°, 2y CSVL: 10 ± 8 vs. 11 ± 9 mm). Similar clinical improvement was achieved between US and JP (function; 4.2 ± 0.9 vs 4.3 ± 0.6, p = 0.60, pain; 3.8 ± 0.9 vs 4.1 ± 0.8, p = 0.13, satisfaction; 4.3 ± 0.9 vs 4.2 ± 0.7, p = 0.61, total; 4.0 ± 0.8 vs 4.1 ± 0.5, p = 0.60). The correlation analyzes indicated that postoperative SRS-22 subdomains correlated differently with satisfaction (all subdomains moderately correlated with satisfaction in the US while only pain and mental health correlated moderately with satisfaction in JP ([function: r = 0.61 vs 0.29, pain: r = . 72 vs 0.54, self-image: r = 0.72 vs 0.37, mental health: r = 0.64 vs 0.55]).Conclusions
Surgery for AISA was similarly effective in the US and JP. Satisfaction for spinal surgery among patients in different countries may not be different unless the procedure limits an individual's unique lifestyle that the patient expected to resume.Item Open Access Correlation of the Modified Japanese Orthopedic Association With Functional and Quality-of-Life Outcomes After Surgery for Degenerative Cervical Myelopathy: A Quality Outcomes Database Study.(Neurosurgery, 2022-12) Yee, Timothy J; Upadhyaya, Cheerag; Coric, Domagoj; Potts, Eric A; Bisson, Erica F; Turner, Jay; Knightly, Jack J; Fu, Kai-Ming; Foley, Kevin T; Tumialan, Luis; Shaffrey, Mark E; Bydon, Mohamad; Mummaneni, Praveen; Chou, Dean; Chan, Andrew; Meyer, Scott; Asher, Anthony L; Shaffrey, Christopher; Gottfried, Oren N; Than, Khoi D; Wang, Michael Y; Buchholz, Avery L; Haid, Regis; Park, Paul; Park, PaulBackground
The modified Japanese Orthopedic Association (mJOA) score is a widely used and validated metric for assessing severity of myelopathy. Its relationship to functional and quality-of-life outcomes after surgery has not been fully described.Objective
To quantify the association of the mJOA with the Neck Disability Index (NDI) and EuroQol-5 Dimension (EQ-5D) after surgery for degenerative cervical myelopathy.Methods
The cervical module of the prospectively enrolled Quality Outcomes Database was queried retrospectively for adult patients who underwent single-stage degenerative cervical myelopathy surgery. The mJOA score, NDI, and EQ-5D were assessed preoperatively and 3 and 12 months postoperatively. Improvement in mJOA was used as the independent variable in univariate and multivariable linear and logistic regression models.Results
Across 14 centers, 1121 patients were identified, mean age 60.6 ± 11.8 years, and 52.5% male. Anterior-only operations were performed in 772 patients (68.9%). By univariate linear regression, improvements in mJOA were associated with improvements in NDI and EQ-5D at 3 and 12 months postoperatively (all P < .0001) and with improvements in the 10 NDI items individually. These findings were similar in multivariable regression incorporating potential confounders. The Pearson correlation coefficients for changes in mJOA with changes in NDI were -0.31 and -0.38 at 3 and 12 months postoperatively. The Pearson correlation coefficients for changes in mJOA with changes in EQ-5D were 0.29 and 0.34 at 3 and 12 months.Conclusion
Improvements in mJOA correlated weakly with improvements in NDI and EQ-5D, suggesting that changes in mJOA may not be a suitable proxy for functional and quality-of-life outcomes.Item Open Access Cross-cultural variability of component processes in autobiographical remembering: Japan, Turkey, and the USA.(Memory, 2007-07) Rubin, David C; Schrauf, Robert W; Gulgoz, Sami; Naka, MakikoAlthough the underlying mechanics of autobiographical memory may be identical across cultures, the processing of information differs. Undergraduates from Japan, Turkey, and the USA rated 30 autobiographical memories on 15 phenomenological and cognitive properties. Mean values were similar across cultures, with means from the Japanese sample being lower on most measures but higher on belief in the accuracy of their memories. Correlations within individuals were also similar across cultures, with correlations from the Turkish sample being higher between measures of language and measures of recollection and belief. For all three cultures, in multiple regression analyses, measures of recollection were predicted by visual imagery, auditory imagery, and emotions, whereas measures of belief were predicted by knowledge of the setting. These results show subtle cultural differences in the experience of remembering.Item Open Access Cross-national comparison of sex differences in health and mortality in Denmark, Japan and the US.(Eur J Epidemiol, 2010-07) Oksuzyan, Anna; Crimmins, Eileen; Saito, Yasuhiko; O'Rand, Angela; Vaupel, James W; Christensen, KaareThe present study aims to compare the direction and magnitude of sex differences in mortality and major health dimensions across Denmark, Japan and the US. The Human Mortality Database was used to examine sex differences in age-specific mortality rates. The Danish twin surveys, the Danish 1905-Cohort Study, the Health and Retirement Study, and the Nihon University Japanese Longitudinal Study of Aging were used to examine sex differences in health. Men had consistently higher mortality rates at all ages in all three countries, but they also had a substantial advantage in handgrip strength compared with the same-aged women. Sex differences in activities of daily living (ADL) became pronounced among individuals aged 85+ in all three countries. Depression levels tended to be higher in women, particularly, in Denmark and the HRS, and only small sex differences were observed in the immediate recall test and Mini-Mental State Exam. The present study revealed consistent sex differentials in survival and physical health, self-rated health and cognition at older ages, whereas the pattern of sex differences in depressive symptoms was country-specific.Item Open Access Denying Difference: Japanese Identity and the Myth of Monoethnic Japan(2015-07-09) Powell, Jaya Z.In this thesis, I tackle the notion of identity within the very specific sociocultural space of Japan. I critique the conception of Japanese identity as it has emerged in concert with the West through the 19th and 20th centuries. Though there exists a plurality of identities in Japan, there also exists a dominant ideology that selectively denies difference in favor of a monolithic “Japanese” people. Tracing the historical factors leading to its creation, I examine the (naturalized) exclusionary practices that serve to mediate the perception and marginalization of certain bodies within Japan. I bring this problematized “Japanese identity” into the zone of close contact with the experiences of black women in contemporary Japan. Using the methodology of black feminist autoethnography, I explore the ways in which one specific “non-Japanese” body is marked out and not permitted to fully participate in this Japanese space. My own autoethnographic analysis is placed in concert with stories gleaned from other diasporic black women. I choose black women because our stories have a history of invisibility and erasure, and our bodies represent the “extreme Other” with respect to conceptions of Japaneseness. I conclude by returning to the persistent challenge that marks this thesis: the critique of the carefully nurtured ideology of Japan as a homogeneous nation. I argue that Japan has been multiethnic since at least the late 19th century, and that ideas of monolithic Japanese identities were developed in reaction to Western threats, and further that these notions of “Japaneseness” can – and should – be deconstructed. In striving for a more inclusive definition of “Japanese,” we allow for a much larger number of people to coexist within this Japanese sociocultural space in relative harmony.Item Open Access Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial.(The Lancet. Respiratory medicine, 2021-12) Kalil, Andre C; Mehta, Aneesh K; Patterson, Thomas F; Erdmann, Nathaniel; Gomez, Carlos A; Jain, Mamta K; Wolfe, Cameron R; Ruiz-Palacios, Guillermo M; Kline, Susan; Regalado Pineda, Justino; Luetkemeyer, Anne F; Harkins, Michelle S; Jackson, Patrick EH; Iovine, Nicole M; Tapson, Victor F; Oh, Myoung-Don; Whitaker, Jennifer A; Mularski, Richard A; Paules, Catharine I; Ince, Dilek; Takasaki, Jin; Sweeney, Daniel A; Sandkovsky, Uriel; Wyles, David L; Hohmann, Elizabeth; Grimes, Kevin A; Grossberg, Robert; Laguio-Vila, Maryrose; Lambert, Allison A; Lopez de Castilla, Diego; Kim, EuSuk; Larson, LuAnn; Wan, Claire R; Traenkner, Jessica J; Ponce, Philip O; Patterson, Jan E; Goepfert, Paul A; Sofarelli, Theresa A; Mocherla, Satish; Ko, Emily R; Ponce de Leon, Alfredo; Doernberg, Sarah B; Atmar, Robert L; Maves, Ryan C; Dangond, Fernando; Ferreira, Jennifer; Green, Michelle; Makowski, Mat; Bonnett, Tyler; Beresnev, Tatiana; Ghazaryan, Varduhi; Dempsey, Walla; Nayak, Seema U; Dodd, Lori; Tomashek, Kay M; Beigel, John H; ACTT-3 study group membersBackground
Functional impairment of interferon, a natural antiviral component of the immune system, is associated with the pathogenesis and severity of COVID-19. We aimed to compare the efficacy of interferon beta-1a in combination with remdesivir compared with remdesivir alone in hospitalised patients with COVID-19.Methods
We did a double-blind, randomised, placebo-controlled trial at 63 hospitals across five countries (Japan, Mexico, Singapore, South Korea, and the USA). Eligible patients were hospitalised adults (aged ≥18 years) with SARS-CoV-2 infection, as confirmed by a positive RT-PCR test, and who met one of the following criteria suggestive of lower respiratory tract infection: the presence of radiographic infiltrates on imaging, a peripheral oxygen saturation on room air of 94% or less, or requiring supplemental oxygen. Patients were excluded if they had either an alanine aminotransferase or an aspartate aminotransferase concentration more than five times the upper limit of normal; had impaired renal function; were allergic to the study product; were pregnant or breast feeding; were already on mechanical ventilation; or were anticipating discharge from the hospital or transfer to another hospital within 72 h of enrolment. Patients were randomly assigned (1:1) to receive intravenous remdesivir as a 200 mg loading dose on day 1 followed by a 100 mg maintenance dose administered daily for up to 9 days and up to four doses of either 44 μg interferon beta-1a (interferon beta-1a group plus remdesivir group) or placebo (placebo plus remdesivir group) administered subcutaneously every other day. Randomisation was stratified by study site and disease severity at enrolment. Patients, investigators, and site staff were masked to interferon beta-1a and placebo treatment; remdesivir treatment was given to all patients without masking. The primary outcome was time to recovery, defined as the first day that a patient attained a category 1, 2, or 3 score on the eight-category ordinal scale within 28 days, assessed in the modified intention-to-treat population, defined as all randomised patients who were classified according to actual clinical severity. Safety was assessed in the as-treated population, defined as all patients who received at least one dose of the assigned treatment. This trial is registered with ClinicalTrials.gov, NCT04492475.Findings
Between Aug 5, 2020, and Nov 11, 2020, 969 patients were enrolled and randomly assigned to the interferon beta-1a plus remdesivir group (n=487) or to the placebo plus remdesivir group (n=482). The mean duration of symptoms before enrolment was 8·7 days (SD 4·4) in the interferon beta-1a plus remdesivir group and 8·5 days (SD 4·3) days in the placebo plus remdesivir group. Patients in both groups had a time to recovery of 5 days (95% CI not estimable) (rate ratio of interferon beta-1a plus remdesivir group vs placebo plus remdesivir 0·99 [95% CI 0·87-1·13]; p=0·88). The Kaplan-Meier estimate of mortality at 28 days was 5% (95% CI 3-7%) in the interferon beta-1a plus remdesivir group and 3% (2-6%) in the placebo plus remdesivir group (hazard ratio 1·33 [95% CI 0·69-2·55]; p=0·39). Patients who did not require high-flow oxygen at baseline were more likely to have at least one related adverse event in the interferon beta-1a plus remdesivir group (33 [7%] of 442 patients) than in the placebo plus remdesivir group (15 [3%] of 435). In patients who required high-flow oxygen at baseline, 24 (69%) of 35 had an adverse event and 21 (60%) had a serious adverse event in the interferon beta-1a plus remdesivir group compared with 13 (39%) of 33 who had an adverse event and eight (24%) who had a serious adverse event in the placebo plus remdesivir group.Interpretation
Interferon beta-1a plus remdesivir was not superior to remdesivir alone in hospitalised patients with COVID-19 pneumonia. Patients who required high-flow oxygen at baseline had worse outcomes after treatment with interferon beta-1a compared with those given placebo.Funding
The National Institute of Allergy and Infectious Diseases (USA).Item Open Access Elements of Okinawan Trauma in the Literature of Medoruma Shun(2013-08-10) Flaherty, ChristopherThis thesis surveys a selection of fiction and non-fiction by Okinawan author and activist, Medoruma Shun. The attempt is to explore Medoruma's unique depiction of the continuous effects of the Battle of Okinawa on Okinawa and Okinawan people up to the present.Item Open Access Endless Question: Youth Becomings and the Anti-Crisis of Kids in Global Japan(2014) Dixon, Dwayne EmilYoung people in Japan contend with shifting understandings of family and friends, insecure jobs, and changing frames around global and national identities. The category of youth itself is unsettled amid a long period of social and economic change and perceived widely as crisis. Within contested social categories of youth, how do young Japanese people use the city, media, and body practices to create flexible, meaningful sociality across spaces of work, education, and play? What do youthful sociality and practices reveal about globally oriented connections and how do they inform conceptions of the future, kinship, gender, and pluralized identities? In short, what is the embodied and affective experience of being young as the category itself is increasingly unstable and full of risks? These questions shape the contours of this project.
This dissertation considers youth through its becoming, that is, the lived enactment of youth as energy, emotion, and sensibility always in motion and within range of cultural, spatial, bodily, and technological forces. Three groups of young people in this layered latitudinal study demonstrate various relations to the city street, visual media, globalized identities, contingent work within affect and cultural production, and education. The three groups are distinctly different but share surprising points of connection.
I lived alongside these three groups to understand the ways young people are innovating within the shifting form of youth. I skated with male skateboarders in their teens to early 30s who created Japan's most influential skate company; I taught kids attending a specialized cram school for kikokushijo (children who have lived abroad due to a parent's job assignment); I observed and hung out with young creative workers, the photographers, web designers, and graphic artists who produce the visual and textual content and relationships composing commercial "youth culture."
My project examines how these young people redefine youth through bodily practices, identities, and economic de/attachments. The skaters' embodied actions distribute/dissipate their energies in risky ways outside formal structures of labor. The kikokushijo children, with their bi-cultural fluency produced in circuits of capitalist labor, offer a desirable image of a flexible Japanese future while their heterogeneous identities appear threatening in the present. The creative workers are precariously positioned as "affective labor" within transglobal (youth) cultural production, working to generate visual and textual content constant stressful uncertainties. All three groups share uneasy ground with capitalist practices, risky social identities, and crucially, intimate relations with city space. In attending to their practices through ethnographic participation and video, this dissertation explores questions concerning youthful relations to space produced in material contacts, remembered geographies of other places and imaginary urban sites.
The dissertation itself is electronic and non-linear; a formal enactment of the drifting contact between forms of youth. It opens up to lines of connection between questions, sites, events, and bodies and attempts an unfolding of affect, imagination, and experience to tell stories about histories of gender and labor, city life, and global dreams. It asks if the globalized forms of Japanese youth avoid the risks of the impossible secure for the open possibilities of becoming and thus refuse containment by crisis?
Item Open Access Ethnic Variations in Radiographic Parameters and SRS-22 Scores in Adult Spinal Deformity: A Comparison Between North American and Japanese Patients Above 50 Years of Age With Minimum 2-Year Follow-up.(Clinical spine surgery, 2018-06) Hosogane, Naobumi; Ames, Christopher; Matsumoto, Morio; Yagi, Mitsuru; Matsuyama, Yukihiro; Taneichi, Hiroshi; Yamato, Yu; Takeuchi, Daisaku; Schwab, Frank; Shaffrey, Christopher; Smith, Justin S; Bess, Shay; Lafage, Virginie; International Spine Study GroupStudy design
Retrospective review of North American and Japanese adult spinal deformity (ASD) database.Objective
To investigate the ethnical differences in radiographic parameters and Scoliosis Research Society (SRS)-22 between North American and Japanese ASD.Summary of background data
Previous comparison study between North American and Japanese ASD patients has revealed Japanese patients had marked pelvic tilt deformity and had lower Oswestry Disability Index scores corresponding to established thresholds of radiographic deformity. However, the subjects of the previous study included relatively younger ASD patients (above 18 y) of idiopathic origin.Materials and methods
Total 282 ASD patients older than 50 years, 211 patients from North America (United States) and 71 patients from Japan (JP), with minimum 2-year follow-up postoperatively were included in the study. Radiologic parameters were compared at the baseline and at 2-year follow-up. SRS-22 score was used for the comparison of clinical outcome.Results
At baseline, Japan showed significantly worse sagittal alignment such as smaller lumbar lordosis (LL), larger pelvic incidence (PI), and larger sagittal vertical axis than United States. However, Japan had significantly fewer levels fused than United States (US, 12.66±4.6; JP, 8.49±2.7). At 2 years after the surgery, Japan still had significantly worse residual sagittal deformity. Comparison of SRS-22 scores revealed Japan had better pain but worse functional domain scores at baseline which improved to comparable levels to the United States at 2 years. Self-image and mental health scores in Japan were significantly worse both at baseline and at 2 years. Analysis of factors affecting SRS-22 satisfaction score at 2 years revealed that previous spinal fusion surgery in the United States and LL, PI-LL, and sagittal vertical axis at 2 years in Japan had significant correlation.Conclusions
These similarities and discrepancies may be influenced by the cultural or lifestyle differences between both nations and should be considered when interpreting the results of ASD studies among different ethnicities.Item Open Access Fierce Practice, Courageous Spirit, and Spiritual Cultivation: The Rise of Lay Rinzai Zen in Modern Japan(2020) Mendelson, RebeccaIn this dissertation, I examine the development of lay Rinzai Zen in modern Japan, a transformation that entailed a large-scale opening of Zen practices to non-clerics and eventually contributed to Zen’s worldwide spread. I detail the historical shift between 1868 and 1945, which saw the emergence of hundreds of lay Zen groups throughout Japan, the proliferation of literature targeting a popular audience, and a new paradigm of practice amidst imperial Japan’s changing zeitgeist. Although Rinzai Zen was only one of thirteen Buddhist schools in Japan at the time, lay Rinzai Zen became disproportionately significant through its dissemination among educated, relatively elite young men, and through the success of its popularizers in associating modern lay Rinzai Zen with “traditional” Buddhism and Japanese culture itself.
In order to investigate this phenomenon, I conducted archival research, focusing on the following genres: contemporaneous periodicals and books aimed at a popular Zen audience, and the publications of lay Zen groups, such as their commemorative histories that included detailed activity logs, personal testimonials, and institutional histories. In my analysis, I integrate the dimensions of intellectual and social history (e.g., situating modern lay Rinzai Zen practitioners in imperial Japan) with religious and doctrinal concerns (e.g., situating modern Rinzai Zen in traditional Zen narratives). Although I consider teachers’ prescriptions for ideal Zen practice, I emphasize the perspective of ordinary practitioners from a variety of practice contexts in order to examine the nature of Rinzai Zen’s popularization in modern Japan: the emergence of lay groups, the religious practices in which practitioners engaged, the ways in which lay practitioners articulated their motivations, and how such motivations reflected the historical context.
My conclusions include the following: First, the scale of the lay Rinzai movement in modern Japan was far larger than research until this point suggests, in terms of numbers of groups and practitioners and the amount of popular literature. Given the diversity among the emerging Rinzai lay groups, I propose a typology to highlight the groups’ qualitative differences, ranging from more “traditional” to more radically divergent from normative Rinzai. Second, I found that even while the lay Zen audience expanded to an unprecedented level in Japan, the average lay Rinzai practitioner was educated and relatively elite; therefore, Rinzai Zen’s popularization did not amount to full democratization. Moreover, students and other youth played a sizable and significant role in modern lay Rinzai. Third, I show that despite divergent ideology and rhetoric among modern lay Rinzai Zen groups and figures, a specific pattern of activities became standard among nearly all such groups. This pattern centered on sitting meditation, kōan practice, encountering the master one-on-one, dharma discourses, and practice intensives, with far less emphasis on aspects that have been historically important in Rinzai monastic training, such as ritual, liturgy, manual labor, and literary study in advanced kōan practice. This new lay Rinzai pattern functioned to increase an emphasis on personal experience and kōan practice. Finally, in contrast to idealized notions about pursuing Zen primarily for the sake of enlightenment, most modern lay Rinzai practitioners examined here pursued Zen for this-worldly benefits, such as improved health, improved swordsmanship abilities, or as a means of strengthening the Japanese nation. Such goals were particularly expressed following 1905, amidst the nationalism and interest in personal cultivation movements that surged after Japan’s victory in the Russo-Japanese War. Moreover, for many practitioners, there was a convergence among lay Rinzai practice, nation-protecting self-cultivation movements, “way of the warrior” rhetoric, and modern Japanese ideals of masculinity: a convergence that likely attracted many practitioners but was inherently at odds with Zen’s rhetoric of equality.
Item Open Access Filling the Emptiness of a Stunned Inner Silence: Survivors' Memoirs of Japanese Internment Camps in Indonesia during World War II(2010-05-21T20:17:52Z) Emery, LindsayWar stories are so often reported with the number of victims. Statistics break down the logistics into birthplace, military versus nonmilitary, or even men versus women. With constant exposure, readers are numb to the significance of these numbers; one cannot fully grasp the fear, pain, suffering, or sadness that accompanied the over 15,000 Allied prisoners of war that died building the Burma Railroad or the six million Jews murdered by the Nazis. This desensitization results in indifference or ignorance. Perhaps what may be more impactful and memorable is to read war stories from the view and experience of the survivors. The surviving prisoners of war have memories and stories that provide insight and force the reader to feel and experience the memory; an understanding that is impossible to gain from war victim statistics. This thesis analyzes written narratives of Dutch women and children survivors of the Japanese internment camps in Indonesia during World War II in an attempt to give coherence and presence to the fragmentary existence of their experience. The fragments of these individuals exemplify the tragedy, disappointment, emotional anxiety, difficulty in articulating their story and isolation from the outside world felt by each survivor in their distinct experiences. These stories reevaluate how this experience has shaped the survivors as individuals despite the unaware, unwelcoming, and unperturbed observers of the outside world. By assembling these various memoirs we can construct an image of the larger, collective experience of the internees and fill the void that each story individually cannot fill.Item Open Access Genome-wide analysis identifies novel susceptibility loci for myocardial infarction.(European heart journal, 2021-03) Hartiala, Jaana A; Han, Yi; Jia, Qiong; Hilser, James R; Huang, Pin; Gukasyan, Janet; Schwartzman, William S; Cai, Zhiheng; Biswas, Subarna; Trégouët, David-Alexandre; Smith, Nicholas L; INVENT Consortium; CHARGE Consortium Hemostasis Working Group; GENIUS-CHD Consortium; Seldin, Marcus; Pan, Calvin; Mehrabian, Margarete; Lusis, Aldons J; Bazeley, Peter; Sun, Yan V; Liu, Chang; Quyyumi, Arshed A; Scholz, Markus; Thiery, Joachim; Delgado, Graciela E; Kleber, Marcus E; März, Winfried; Howe, Laurence J; Asselbergs, Folkert W; van Vugt, Marion; Vlachojannis, Georgios J; Patel, Riyaz S; Lyytikäinen, Leo-Pekka; Kähönen, Mika; Lehtimäki, Terho; Nieminen, Tuomo VM; Kuukasjärvi, Pekka; Laurikka, Jari O; Chang, Xuling; Heng, Chew-Kiat; Jiang, Rong; Kraus, William E; Hauser, Elizabeth R; Ferguson, Jane F; Reilly, Muredach P; Ito, Kaoru; Koyama, Satoshi; Kamatani, Yoichiro; Komuro, Issei; Biobank Japan; Stolze, Lindsey K; Romanoski, Casey E; Khan, Mohammad Daud; Turner, Adam W; Miller, Clint L; Aherrahrou, Redouane; Civelek, Mete; Ma, Lijiang; Björkegren, Johan LM; Kumar, S Ram; Tang, WH Wilson; Hazen, Stanley L; Allayee, HoomanAims
While most patients with myocardial infarction (MI) have underlying coronary atherosclerosis, not all patients with coronary artery disease (CAD) develop MI. We sought to address the hypothesis that some of the genetic factors which establish atherosclerosis may be distinct from those that predispose to vulnerable plaques and thrombus formation.Methods and results
We carried out a genome-wide association study for MI in the UK Biobank (n∼472 000), followed by a meta-analysis with summary statistics from the CARDIoGRAMplusC4D Consortium (n∼167 000). Multiple independent replication analyses and functional approaches were used to prioritize loci and evaluate positional candidate genes. Eight novel regions were identified for MI at the genome wide significance level, of which effect sizes at six loci were more robust for MI than for CAD without the presence of MI. Confirmatory evidence for association of a locus on chromosome 1p21.3 harbouring choline-like transporter 3 (SLC44A3) with MI in the context of CAD, but not with coronary atherosclerosis itself, was obtained in Biobank Japan (n∼165 000) and 16 independent angiography-based cohorts (n∼27 000). Follow-up analyses did not reveal association of the SLC44A3 locus with CAD risk factors, biomarkers of coagulation, other thrombotic diseases, or plasma levels of a broad array of metabolites, including choline, trimethylamine N-oxide, and betaine. However, aortic expression of SLC44A3 was increased in carriers of the MI risk allele at chromosome 1p21.3, increased in ischaemic (vs. non-diseased) coronary arteries, up-regulated in human aortic endothelial cells treated with interleukin-1β (vs. vehicle), and associated with smooth muscle cell migration in vitro.Conclusions
A large-scale analysis comprising ∼831 000 subjects revealed novel genetic determinants of MI and implicated SLC44A3 in the pathophysiology of vulnerable plaques.Item Open Access Hospital mortality of patients aged 80 and older after surgical repair for type A acute aortic dissection in Japan.(Medicine, 2016-08) Ohnuma, Tetsu; Shinjo, Daisuke; Fushimi, KiyohideTo evaluate whether patients aged 80 and older have higher risk of hospital mortality after repair of type A acute aortic dissection (TAAAD).Emergency surgery for TAAAD in patients aged 80 and older remains a controversial issue because of its high surgical risk.Data from patients who underwent surgical repair of TAAAD between April 2011 and March 2013 were retrospectively extracted from the Japanese Diagnosis Procedure Combination database. The effect of age on hospital mortality was evaluated using multivariate logistic regression analysis.A total of 5175 patients were enrolled. The mean age of patients was 67.1 ± 13.0 years, and the male:female ratio was 51:49. Patients aged 80 and older more frequently received tracheostomy than their younger counterparts (9.5% vs 5.4%, P <0.001). Intensive care unit and hospital stays were significantly longer in the elderly cohort versus the younger cohort (7.6 vs 6.7 days, P <0.001, and 42.2 vs 35.8 days, P <0.001, respectively). Logistic regression analysis showed that age ≥80 years was significantly associated with a higher risk of hospital mortality (adjusted odds ratio, 1.62; 95% confidence interval, 1.28-2.06; P <0.001). In linear regression analysis, age ≥80 years was also significantly associated with longer hospital stay (P = 0.007).In a large, nationwide, Japanese database, patients aged 80 and older were at increased risk of hospital mortality and length of hospital stay.