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This article discusses the use of Zokumeito (ZMT), a traditional medicine, for the rapid recovery of consciousness and physical function in a patient with cerebral infarction. ZMT is a combination of various herbs and is not available as an extract, so the authors prescribed similar medicines that contained some of the same ingredients. The patient, a 91-year-old male, showed significant improvement in his condition after starting the treatment, including increased vocalizations, the ability to sit in a wheelchair, and eventually being able to eat and drink without assistance. The authors note that further research is needed to fully understand the effects of ZMT in stroke patients. [Extracted from the article]

The processes that occur during the initial stages of nitridation of the As-stabilized GaAs(001)-2x4 surface by active nitrogen species have been investigated using Auger electron spectroscopy. Nitridation is found to occur in two distinct steps, the first being the formation of 1ML of nitrogen, followed by the formation of the disordered GaAsN stage. Subsequence thermal annealing at 600 degrees C results in the desorption of arsenic and leads to the crystallization of the GaAsN stage into a cubic CaN layer around 20 A thick.

Objective: This study aimed to assess the effectiveness of Kampo-sommelier practice, an active learning program on crude drugs used in Kampo formulations. Methods: The participants were fourth-year Tokai University School of Medicine students as of 2017. Eighteen small teams attended a 20-minute Kampo-sommelier practice session and were provided 10 kinds of crude drugs (Licorice, Cinnamon, Ginger, etc.) in three forms, original, cut, and powdered, while blinded to the drugs. Each team was asked to distinguish each drug in terms of form, scent, flavor, and color with reference to described characteristics. The ability to match the names of the drugs with their descriptions was assessed in the participants one month later, and also in human science "A" and medicine "B" students, without prior education, and pharmacy "C" students, with professional education. Results: The 117 participants received an average score of 6.2 ± 2.4 (mean ± S.D.) out of 10, which was significantly higher than 3.4 ± 1.8 in 97 "A" students and 3.1 ± 2.4 in 85 "B" students and lower than 8.4 ± 2.1 in 135 "C" students (p < 0.05 for all). Conclusions: The effectiveness of this team-based learning approach is suggested by the significantly higher scores of the participants. [ABSTRACT FROM AUTHOR]

Cites a study which used Auger electron spectroscopy, to investigate the processes which occur during nitridation of the GaAs(001) surface. Details on the formation of Ga-N and As-N bonds on the GaAs(001) surface; Effects of thermal annealing on Auger spectra; In-depth look at the results of the study.

Introduction: Non-alcoholic fatty liver disease, now known as metabolic dysfunction-associated steatotic liver disease (MASLD), is a phenotype of the metabolic syndrome in the liver and is clearly associated with metabolic abnormalities such as hyperglycaemia and dyslipidaemia. Although the prevalence of MASLD is increasing worldwide, there is currently no consensus on the efficacy and safety of the drugs used to treat MASLD/metabolic dysfunction-associated steatohepatitis (MASH). Pemafibrate, a selective peroxisome proliferator-activated receptor alpha modulator, was designed to have higher peroxisome proliferator-activated receptor alfa (PPARα) agonist activity and selectivity than existing PPARα agonists, and in development trials, without increasing creatinine levels, lipid parameters and alanine aminotransferase (ALT) were significantly improved. Thus, pemafibrate may effectively ameliorate the pathogenesis and metabolic abnormalities in MASLD/MASH. In this trial, we evaluated the efficacy and safety of pemafibrate in patients with MASLD/MASH., Methods and Analysis: This trial was designed as an open-label, three-arm, randomised controlled study. After obtaining informed consent, patients aged 20-80 years who met the selection criteria were enrolled. Patients were randomised to receive pemafibrate 0.4 mg/day, 0.2 mg/day or fenofibrate (n=120 per group). The duration of treatment was 48 weeks. The primary endpoint was a change in ALT levels after 24 weeks of administration. Secondary endpoints included changes from baseline in liver fibrosis markers (fibrosis-4 index, type IV collagen 7s, enhanced liver fibrosis and Mac-2 binding protein glycosylation isomer) at 48 weeks as well as changes in liver fat mass and liver stiffness measured by MRI and ultrasound (US) at centres equipped with MRI and US capabilities., Ethics and Dissemination: Ethical approval was obtained from the Yokohama City University Certified Institutional Review Board before participant enrolment (CRB20-014). The results of this study will be submitted for publication in international peer-reviewed journals and the key findings will be presented at international scientific conferences. Participants wishing to understand the results of this study will be contacted directly on data publication., Trial Registration Number: This trial was registered in the Japan Registry of Clinical Trials (number: jRCTs031200280)., Protocol Version: V.1.9, 23 November 2023., Competing Interests: Competing interests: ANa received grants and research support from Gilead, Mylan EPD, EA Pharma, Kowa, Taisho and Biofermin. ANa is a consulting advisor for Gilead, Boehringer Ingelheim, BMS, Kowa, Astellas, EA Pharma and Mylan EPD. The other authors declare no conflict of interest., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: No report of newly enrolled medical students discusses their attitudes toward traditional Japanese medicine (TJM), Kampo medicine, or acupuncture and moxibustion (AM), or their changes over the course of medical school. This study evaluates these changing attitudes., Methods: At Tokai University School of Medicine, from 2006 through 2015, 852 students were analyzed 3 times, pre-1st-year introduction Kampo lecture, pre-4th-year 6-hour lectures, and post-3-hour experience-based learning (EBL) course. The 7-item questionnaire included: general impression about Kampo medicine, interest, learning motivation, future involvement, and image, interest in AM, and learning motivation., Results: Their attitudes toward TJM became positive during the 3 years even without TJM education. The 4th-year TJM lectures and EBL course significantly changed their attitudes toward more positive. Females' attitudes were more positive regarding TJM from the 1st year than were the males which became more positive after the EBL course. Students with TJM learning or work experience had positive attitudes from their 1st year and throughout medical school. Students with less positive attitudes became more active in TJM and positive at graduation., Conclusion: Appropriate TJM education and standard medical education in preclinical years of medical school has helped make students' attitudes toward Kampo medicine and AM more positive.

Objective: To examine how Kampo education in Japanese medical schools changed between 2011 and 2019., Methods: We administered nationwide postal questionnaire surveys about current characteristics of Kampo medicine education in all 82 Japanese medical schools, directed to the persons responsible for Kampo education at each university. One survey was conducted in 2011 and one in 2019. Analysis used Welch's t-test and a chi-squared test., Results: The average class meeting time was shorter in 2019 than in 2011. The proportion of class meetings that were about Kampo saw a statistically significant increase in the third year and a significant decrease in the fourth and sixth years of medical school. Curriculum standardisation, preparation of simple textbooks, and fostering Kampo medicine instructors were the primary problems in both years. The proportion of mainstream medical education contents focusing on traditional Japanese Kampo medicine did not change over time, nor did the percentage of those considering using standardised textbooks. Other changes were statistically nonsignificant., Conclusion: In Japanese medical schools, the number of class meetings teaching Kampo medicine has increased; however, this number is not statistically significant. Persistent problems in Kampo education, including curriculum standardisation, need to be addressed.

Objectives: Japanese traditional (Kampo) medicine has its own theories that are quite different from those of Western medicine. For many students and medical doctors, mastering it is a painstaking task. We examined the similarities in clinical reasoning between Western and Kampo medicine, and developed an easy-to-understand method to teach Kampo theories enabling physicians to make accurate diagnoses and choose suitable Kampo formulae., Methods: We developed a teaching method for Kampo medicine along clinical reasoning for beginners and evaluate its availability and effectiveness in an actual team-based learning class., Results: A Kampo diagnostic procedure similar to that in Western medicine was developed. In this method, some Kampo formulae, are chosen according to the chief complaint, concomitant symptoms, characteristics, and distribution and exacerbation factors. Subsequently, from a point of view of the chosen Kampo formulae, patients' signs and symptoms are matched to find the most suitable formula. Students chose the same suitable formula among 6 groups and gained confidence to choose the correct Kampo formulae., Conclusions: A new Kampo educational method was developed that raises students' and physicians' confidence in making diagnoses and prescribing Kampo medicines.

Objective: Acupuncture and moxibustion are categories of Japanese traditional medicine (Kampo). Precise teaching of Kampo is one of the important issues in medical education, and therefore acupuncture and moxibustion education has been applied to students in Tokai University School of Medicine. To investigate and compare the awareness the medical students have of acupuncture and moxibustion before and after the education, we conducted questionnaire surveys., Methods: The questionnaires were distributed to 117 fourth-year students before and after the education., Results: Of the 117 students issued surveys, 111 responded before, 115 after, and 109 both before and after the education program. Before the education, 79% of the respondents were interested in acupuncture and moxibustion, and 67%, 73%, and 80% thought they were effective, necessary, and worth learning. These results were increased to 92%, 95%, 94% and 97% after the education, respectively (p<0.001 in all four comparisons). Although 9% said they would perform acupuncture and moxibustion in their routines proactively before the education, after the education this increased to 24% (p<0.001), and 43% supposed that they would definitely introduce patients to acupuncturists., Conclusion: Medical students' awareness improved after the education, which demonstrated importance of the acupuncture and moxibustion education in medical school.

Objective: The aim of this study was to develop a method of removing sennoside to reduce the cathartic effect of rhubarb while conserving its other pharmacological activities., Methods: Rhubarb powder was steam autoclaved at 121°C and 0.14 MPa for 20, 60, or 120 minutes, and HPLC analysis was conducted to determine levels of rhubarb components. Mice were fed non-autoclaved or 20-minute-autoclaved rhubarb extracts. Feces were collected and weighed over a 24-hour period. India ink was orally administered to determine the distance of fecal migration through the intestinal tract., Results: Autoclaving 20, 60, and 120 minutes decreased sennoside A and B to trace levels but only autoclaving 20 minutes conserved most of the (+)-catechin, (-)-epicatechin, and (-)-epicatechin gallate contents (i.e., 69%, 90%, 88%, respectively). Therefore only rhubarb autoclaved for 20 minutes was used in subsequent experiments. Fecal output (in g) in mice treated with water (control), autoclaved rhubarb, and non-autoclaved rhubarb was 2.78 ± 0.07, 3.30 ± 0.13 (p = 0.348), and 3.81 ± 0.07 (p = 0.005). India ink migration was far less in mice treated with autoclaved rhubarb vs non-autoclaved rhubarb., Conclusion: Steam autoclaving the rhubarb for 20 minutes reduces sennoside levels and its cathartic activity while conserving its other pharmacological activities.