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Additional file 1: Supplementary Figure S1. Pearson’scorrelation coefficients matrix.The size and color of the circles reflect correlation coefficients for eachcombination of the correlation analysis.

Additional file 2: Supplementary tables and a figure.

Additional file 1. English translation of the questionnaire for the study.

Strategies to increase appropriateness of EoL care, such as shared decision making (SDM), and advance care planning (ACP) are internationally embraced, especially since the COVID-19 pandemic. However, individuals preferences regarding EoL care may differ internationally. Current literature lacks insight in how preferences in EoL care differ between countries and continents. This study's aim is to compare Dutch and Japanese general publics attitudes and preferences toward EoL care, and EoL decisions. Methods: a cross-sectional survey design was chosen. The survey was held among samples of the Dutch and Japanese general public, using a Nationwide social research panel of 220.000 registrants in the Netherlands and 1.200.000 in Japan. A quota sampling was done (age, gender, and living area). N = 1.040 in each country. More Japanese than Dutch citizens tend to avoid thinking in advance about future situations of dependence (26.0% vs 9.4%; P = .000); say they would feel themselves a burden for relatives if they would become dependent in their last phase of life (79.3% vs 47.8%; P = .000); and choose the hospital as their preferred place of death (19.4% vs 3.6% P = .000). More Dutch than Japanese people say they would be happy with a proactive approach of their doctor regarding EoL issues (78.0% vs 65.1% JPN; P = .000). Preferences in EoL care substantially differ between the Netherlands and Japan. These differences should be taken into account a) when interpreting geographical variation in EoL care, and b) if strategies such as SDM or ACP – are considered. Such strategies will fail if an international “one size fits all” approach would be followed.

Additional file 1. Table. Original core questions

Additional file 2. STROBE checklist

当院では新採用者に対し｢標準採血法｣技術演習を行っている. 本稿では平成24年度採用の看護師46名, 臨床研修医18名を対象とした技術演習に関して, その内容と評価結果を報告する. 対象者には, 感染管理ベストプラクティス｢標準採血法｣のDVD 視聴とイラスト手順書を用いた技術演習を行った. 更に, 前述の46名の看護師に対しては客観的臨床能力試験：OSCE を行った. 演習6カ月後にチェックリストで自己評価・他者評価を行った. 分析方法は2群の比較はχ^2検定, 多群の比較はBonferroni 法による多重比較検定で行い, p＜0.05を有意差ありとした.結果, 他者評価では臨床研修医の｢患者確認｣の遵守率が低く, 看護師との比較では手順2 ｢リストバンドと採血管照合｣(p＜0.001), 手順9 ｢手袋を脱いで手指衛生｣(p＝0.034) で有意差を認めた. 臨床研修医で遵守率低値の要因として｢指導内容の違い｣が考えられ, 今後は技術習得のための時間確保, 評価, OSCE の実施など継続した指導が必要であると考える., We require new employees to implement “Standard blood collection method” technical practice. This paper relates to the technical practice implemented in regard to nurses (n＝46) and clinical trainee doctors (n＝18) employed during fiscal year 2012, and is a report of the contents and evaluation results of said practice. The subjects of the study were first shown the DVD entitled “Standard blood collection method”, which deals with best practice in infection control, and implemented technical practice from steps 1 through to 9 using an illustrated procedure document. Additionally, an objective structured clinical examination (OSCE) was implemented in regard to the aforementioned 46 nurses. Six months after the practice, self evaluation and peer evaluations were performed using a checklist. The analysis method involved the chi-square test, and Bonferroni method with p＜0.05 significant. As a result, in peer evaluation, the clinical trainee doctors scored a low rate of adherence to “patient confirmation”, and in comparison to nurses, demonstrated a significant difference in procedure 2 (“compare wristband and blood collection tube”) (p＜0.001) and procedure 9 (“remove gloves and sanitize hands”) (p＝0.034). It was believed that a factor in the low rate of adherence by clinical trainee doctors was a “difference in training content”. It is considered that in the future, ongoing guidance will be required, including ensuring time for technical skill acquisition, and implementing evaluations and OSCE.

The EndoBarrier has a weak point caused by a Teflon membrane, which completely inhibits the movement of water and food. We developed a new type of gastro jejunal inner lumen bypass device (GJB) using an artificial net that has a hole instead of a membrane. We inserted a net in the gastric antrum-duodenum–jejunum via open laparotomy. The growth of pigs with long nets was suppressed compared with the sham operation. However, there were no differences in blood biochemistry or anatomical findings at autopsy between the groups. As a result, GJB can control the growth of pigs without requiring dietary restriction.

Chronic intestinal pseudoobstruction (CIPO) is a serious complication in patients with connective tissue disease (CTD) and is sometimes life-threatening or fatal despite intensive medical treatment. Here, we report a patient with dermatomyositis (DM) and anti-EJ autoantibody who developed CIPO that was improved by octreotide. Because her abdominal pain and bloatedness were so severe and persistent, we introduced octreotide to relieve symptoms. In this case, continuous intravenous administration as well as long-acting subcutaneous injection of octreotide was effective for treating CIPO.

Here, we report a patient with sarcoidosis who developed edematous erythema and interstitial lung disease. At the initial visit, clinically amyopathic dermatomyositis (CADM) with rapidly progressive interstitial lung disease (RP-ILD) was suspected because he had progressive dyspnea but no muscle weakness. The presence of anti-CADM-140/MDA5 autoantibodies was immediately assessed to facilitate a precise diagnosis, with negative results. Thereafter, skin and transbronchial lung biopsies revealed noncaseating granuloma with Langhans giant cells in both specimens, leading to a diagnosis of sarcoidosis. In this case, clinical features of skin and lung were unable to distinguish DM (including CADM) from sarcoidosis, but the lack of anti-CADM-140/MDA5 antibody was useful for differentiating CADM with RP-ILD mimicking sarcoidosis from bona fide sarcoidosis.

A 57-year-old woman with rheumatoid arthritis (RA) and limited systemic sclerosis (lSSc) was suspected to have lymphadenopathy and primary biliary cirrhosis (PBC). Lymph node biopsy showed reactive follicular lymphadenopathy with intrafollicular plasmacyte infiltration that was interleukin-6 positive by immunohistostaining. Because of gradually worsening arthritis, tocilizumab was administered and arthritis improved markedly. Interestingly, lymphadenopathy and PBC improved simultaneously. This suggested that interleukin-6 might play an important role in reactive lymphadenopathy and PBC associated with RA/lSSc.