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Purpose: This study examined the factors that facilitated and obstructed the dissemination of a physical education lesson study (PELS) project in Peru, conducted in collaboration with Japan. Design/methodology/approach: Adopting a qualitative approach, five Peruvian stakeholders in the field of physical education (PE) were interviewed. All the interviews were transcribed. The data were analysed using the Steps for Coding and Theorization (SCAT). Findings: The factors that obstructed the dissemination of PELS were lack of mutual observation of lessons among teachers and the resistance of teachers to the project due to the term "study" in "lesson study". Conversely, online dissemination of PELS may significantly improve its position in Peru. Disseminating PELS through small group practice and deploying it in the field of education through stakeholder collaboration comprised facilitating factors. Originality/value: This study could facilitate an understanding of Peruvian educational and PE culture and have ripple effects on the practice and dissemination of LS in other countries and subject areas.

Introduction: Robotic‐assisted surgery has become increasingly popular because of its potential benefits. Anatomical liver resection (ALR) is a valuable strategy in hepatocellular carcinoma (HCC) management. ALR with indocyanine green (ICG) fluorescence navigation was reported as an effective solution for segment identification. We reported a simple and convenient "preoperative positive staining technique" for laparoscopic ALR to overcome some limitations. To our knowledge, this is the first report of robotic‐assisted surgery in which ALR was performed using this technique. Materials and Surgical Technique: A 69‐year‐old man presented with a 12‐mm HCC in segment 8. Preoperative three‐dimensional simulation images showed that the fourth‐order branch of the portal vein was a tumor‐bearing portal pedicle. After anesthesia induction, 1 mL of 0.025 mg/mL ICG was injected percutaneously into this branch under B‐mode ultrasound guidance before pneumoperitoneum. A robotic laparoscope was inserted. The preoperative positive staining area was clearly stained on the liver surface with the Firefly mode on the da Vinci Xi system. Based on the demarcation line, the liver parenchymal resection was started. The ICG fluorescence staining area was checked frequently on the resected side of the liver transection plane. Subsequently, the fourth‐order portal branch was identified with the ICG fluorescence technique and ligated. Finally, the specimen was resected. The operation took 352 min, with 10 mL of blood loss, and was completed without any operative problems. Discussion: Although many cases are required, the proposed preoperative positive staining technique appears useful for accurate and precise surgery given the increasing application of robotic‐assisted hepatectomy. [ABSTRACT FROM AUTHOR]

Hikikomori (a severe form of social withdrawal) is a serious mental health issue. A family approach is the initial step to support hikikomori; thus effective family intervention programs are warranted. We recently developed a 5‐day family intervention program (120 min weekly) based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). In the present study, we modified the 5‐day program to a 3‐day program (180 min fortnightly), and examined the effectiveness of the 3‐day program using a single‐arm procedure. Data of 23 parents (four fathers and 19 mothers; age = 62.0 ± 9.1 years) were analyzed. Mental health conditions among participants themselves improved at the 4‐month follow‐up, but the confidence in hikikomori support declined and stigma toward mental health problems did not change. However, short‐term improvements in perceived skills in approaching hikikomori sufferers were detected. Hikikomori sufferers' actual behavioral changes, such as social participation or utilization of support, were also observed (six out of 20 hikikomori sufferers). Preliminary effectiveness was confirmed for the 3‐day program. Further revision of the program and a validation study with controls are required. [ABSTRACT FROM AUTHOR]

BackgroundParticipants and settingResearch designFindingsIn recent years, the number of Japanese Language Learner (JLL) students, or children who speak a language other than Japanese and require Japanese language instruction, has been rapidly increasing in Japanese schools. Successful inclusion of students who use Japanese as a second language in the classroom creates opportunities for all students to engage with multiple languages and learn new cultures, backgrounds, history, and aspects of diversity that help them strengthen their overall cognitive abilities [Sato, T., and S. R. Hodge. 2009. “Asian International Doctoral Students’ Experiences at Two American University: Assimilation, Accommodation, and Resistance.” Journal of Diversity in Higher Education 2(3): 136-148]. In particular, physical education (PE) is considered an academic subject that can be a powerful tool to promote peace, tolerance, and understanding by bringing people together across boundaries, cultures, and religions by promoting the concepts of teamwork, fairness, discipline, and respect for the opponent in a game or activity [Beutler, I. 2008. “Sport Serving Development and Peace: Achieving the Goals of the United Nations Through Sport.” Sport in Society 11 (4): 359–369]. The purpose of this study is to describe and explain Japanese high school health and physical education (HPE) teachers’ positioning of themselves and others, as shown through a storyline, when they teach and assist Japanese Language Learner (JLL) students in academic and social contexts.Seven HPE teachers participated in this study by sharing their thoughts, opinions, and experiences related to teaching JLL students in PE. The teachers had between 3 and 23 years of experience teaching PE, and 2–9 years of experience teaching JLL students in high school PE.This study utilized a descriptive-qualitative design using an in-depth, semi-structured interview approach [Seidman, I. 2019. Interviewing as Qualitative Research: A Guide for Researchers in Education and the Social Sciences. 5th ed. New York: Teacher College Press]. A constant comparative analysis method was used to analyze the data. In this study, the process of constantly comparing data from several sources led to tentative categories that were compared to each other and to other data in order to construct categories. In this study, meaningful narrative phrases were those related to PE pedagogical content and teacher development.Explainable by concepts in positioning theory [Harré, R., and L. van Langenhove. 1999. “The Dynamics of Social Episodes.” In Positioning Theory: Moral Contexts of Intentional Action, edited by R. Harré, and L. van Langenhove, 1–13. Oxford: Blackwell], three major interrelated and complex themes emerged from the data analysis: (a) teachers’ positioning in securing a safe learning environment for JLL students in PE, (b) teachers’ dilemma in assessing JLL students’ learning outcomes based on performance assessments and written exams in PE, and (c) teachers’ positioning in their responsibilities as both teacher and host parent. To enhance the quality of PE classes, school districts need clear and focused goals related to assessment and evaluation, instructional planning, and responsibilities involved in teaching JLL students. [ABSTRACT FROM AUTHOR]

Hikikomori (a severe form of social withdrawal) is a serious mental health issue. A family approach is the initial step to support hikikomori; thus effective family intervention programs are warranted. We recently developed a 5‐day family intervention program (120 min weekly) based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). In the present study, we modified the 5‐day program to a 3‐day program (180 min fortnightly), and examined the effectiveness of the 3‐day program using a single‐arm procedure. Data of 23 parents (four fathers and 19 mothers; age = 62.0 ± 9.1 years) were analyzed. Mental health conditions among participants themselves improved at the 4‐month follow‐up, but the confidence in hikikomori support declined and stigma toward mental health problems did not change. However, short‐term improvements in perceived skills in approaching hikikomori sufferers were detected. Hikikomori sufferers' actual behavioral changes, such as social participation or utilization of support, were also observed (six out of 20 hikikomori sufferers). Preliminary effectiveness was confirmed for the 3‐day program. Further revision of the program and a validation study with controls are required. [ABSTRACT FROM AUTHOR]

This preliminary study is the first to demonstrate that AI can precisely identify loose connective tissue during laparoscopic cholecystectomy and ICG fluorescent cholangiography. Tashiro and colleagues conclude that this novel real-time navigation modality fusing AI and ICG fluorescent imaging may enhance safety and provide more reliable laparoscopic or robotic surgery., (© 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.)

Background/aim: Indocyanine green (ICG) fluorescence is useful in laparoscopic hepatectomy (LH) for tumor identification and staining, as well as determination of resection margins. At our Institution, patient-specific, three-dimensional simulations and rehearsal of surgical strategies are carried out preoperatively. We describe cases in which ICG administered preoperatively became stagnated and fluoresced in an area similar to the preoperatively established resection area and the pathological findings in these cases., Patients and Methods: Four patients who underwent LH at our hospital between 2020 and 2023 (due to hepatocellular carcinoma in two and colorectal liver metastasis in two) were enrolled in the present study. The ICG-fluorescing liver segments were resected laparoscopically and their pathological characteristics were examined using a fluorescence microscope., Results: In four cases, the areas of ICG fluorescence seen intraoperatively were due to stasis of preoperatively administered ICG, which fortuitously was equivalent to the planned resection area in the preoperative patient-specific simulation. The fluorescent areas were resected; there were no cases of bile leakage or recurrence. Fluorescence microscopy revealed areas with diffuse ICG fluorescence in normal hepatocytes on the tumor's peripheral side., Conclusion: It was suggested that resection of the liver area that was fluorescent due to stagnation of preoperatively administered ICG was rational and justified both anatomically and oncologically. This resection may also contribute to the prevention of bile leakage and recurrence., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Background: Probe-based confocal laser endomicroscopy (pCLE) can visualize microscopic structures at high resolution but has not yet yielded definitive diagnostic features of gallbladder malignancy, as opposed to benign changes., Patients and Methods: A total of 73 patients had their gallbladder evaluated with pCLE performed on resected benign and malignant gallbladder surgical specimens, which were sprayed with fluorescein. Malignant and benign features of pCLE findings were identified on the basis of Miami and Paris Classifications. Standard histopathological diagnoses and individual patient pCLE findings of gallbladder lesions were correlated., Results: Of the 73 consecutive patients that had their gallbladder evaluated ex vivo with pCLE, 11 were identified with gallbladder malignancy. pCLE identified features of gallbladders examined ex vivo, including the presence of thick dark bands and dark clumps, which together correlated with histopathologically-determined biliary malignancy at 100% sensitivity. Thick white bands and visualized epithelium, also identified with pCLE, together correlated with histopathologically-determined malignancy at 100% specificity., Conclusion: pCLE can be used for real-time differentiation of cancerous/non-cancerous regions in the gallbladder using the diagnostic criteria identified in the present study., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)