Background:As part of work-style reform for physicians, task shifting to non-physician healthcare professionals has been promoted in Japan. We previously reported task shifting results for percutaneous coronary interventions (PCI), but the status in arrhythmia treatment remains unclear. Methods and Results:This subanalysis of a survey conducted by the Japanese Circulation Society Chugoku-Shikoku Branch examined task shifting in facilities performing both cardiac ablations and PCIs. A 30-item questionnaire was sent in March 2024 to 93 facilities managing acute coronary syndrome. Among 81 responding facilities (87.1% response rate), 51 performed cardiac ablations. Approximately 40% had only 1 ablation operator. The engagement rate as second operators was lower for ablations than for PCI (21.6% vs. 29.4%, P<0.001). Task shifting implementation showed no significant difference based on ablation operator numbers (N=1: 30.0% vs. N≥2: 16.1%, P=0.304), whereas facilities with fewer PCI operators had higher task shifting rates (P=0.026). Clinical engineers were the predominant profession in task shifting for both procedures. Conclusions:Task shifting of sterile procedures was limited in ablation facilities compared with PCI, reflecting the procedural characteristics such as single-operator feasibility and mapping-intensive workflows. With substantial workload demands, continued collaboration with highly specialized medical staff is essential, along with appropriate incentives and attention to work-life balance.
Seasonal variations in blood pressure (BP) and cardiovascular risk represent one of the most consistently reproduced yet under-recognized phenomena in hypertension research. In Japan, where winter temperatures can fluctuate sharply in both outdoor and indoor environments, the burden of winter-associated cardiovascular events is strikingly visible in epidemiological data. The so-called “heat shock” phenomenon is defined as acute cardiovascular events triggered by sudden temperature changes. Recent statements by the Japanese Society of Hypertension, including the initiative “Morning BP Action in Winter,” emphasize that winter mornings constitute a uniquely hazardous physiological “heat shock” window—one in which sympathetic activation, thermal stress, and behavioral triggers converge to sharply elevate BP and precipitate acute cardiovascular events. This editorial commentary expands on the scientific rationale, clinical implications, and public health significance of this initiative, aiming to contextualize winter morning BP management as an essential preventive strategy.
Snow scorpionflies (Boreus; Mecoptera: Boreidae) are cold-adapted insects that are active on snow, yet basic ecological and phylogenetic information remains scarce for species from East Asia and the Russian Far East. In the Japanese archipelago, Boreus jezoensis Hori and Morimoto (1996) is the only recorded species of the genus and has been known solely from its type locality, Mt. Hirayama (Hokkaido), with no subsequent confirmed records. We conducted field surveys in montane areas of Hokkaido, including the type locality; 26 adult Boreus individuals were identified from exposed moss patches adjacent to snow. Morphological examinations confirmed that specimens from both mountains are B. jezoensis, representing the second record of the species and providing a new locality record approximately 170 km from the type locality. We also generated the first mitochondrial cytochrome c oxidase subunit I (COI) sequences for B. jezoensis and reconstructed a preliminary COI phylogeny of Boreus. The B. jezoensis samples formed a strongly supported clade with low genetic divergence between the two populations. Together, these findings extend the known distribution of B. jezoensis, provide foundational DNA barcode resources for East Asian Boreus, and offer basic ecological information for this poorly known species.
Releases of anthropogenic radionuclides can cause acute and long-term effects to organisms, reducing survival and recruitment and potentially leading to population-level and ecosystem-wide consequences. Acute radiotoxicity is known to induce oxidative stress, DNA damage, immunosuppression, and reproductive failure. Human biomedical studies of acute radiation exposure have demonstrated severe reproductive consequences including ovarian toxicity, sterilization, and premature reproductive senescence. Yet, little is known about the reproductive effects of chronic exposure to low-dose rates of ionizing radiation in humans or wild mammals. Here, we present the most comprehensive assessment to date of reproductive health in a free-ranging large mammal inhabiting a landscape with widespread radiation contamination. We evaluated the reproductive consequences of multigenerational, chronic low-dose radiation exposure within the Fukushima Difficult-to-Return-to-Zone (DRZ), which received the highest fallout from the 2011 nuclear accident. We hypothesized that female wild boar with higher radiation exposure would exhibit reduced lifetime reproductive potential compared to boar exposed to less contamination. Specifically, we predicted that individuals exposed to higher dose rates would have fewer ovarian follicles and lower concentrations of reproductive hormones. We found no evidence that low dose environmental radiation negatively affected follicle abundance or hormone concentrations. Thus, despite chronic, low-dose exposure to radiation experienced by wild boar within the DRZ, these exposures appear to be insufficient to result in diminished reproductive function or capacity and are unlikely to trigger cascading impacts to population dynamics.
ABSTRACT Aim Haemophilia carriers (HCs) have historically been regarded as asymptomatic or only mildly affected, resulting in under‐recognition of bleeding symptoms and unmet healthcare needs. Although advances in healthcare and access to information have changed the experience of haemophilia, little is known about how illness‐related uncertainty differs across generations. Guided by Mishel's Uncertainty in Illness Theory, this study compared illness‐related uncertainty between a younger generation of HCs and a previously studied maternal cohort. Methods Semi‐structured interviews were conducted with nine female HCs who were adolescents and adults (17–39 years). Data were analysed thematically, and themes were deductively mapped onto Mishel's uncertainty in illness theory. The findings were conceptually compared with previously published qualitative data from 20 mothers whose daughters were haemophilia carriers. The mothers were aged 32–63 years and were interviewed in 2017. Results Younger HCs had greater access to haemophilia‐related information, specialist care, and patient organizations than the maternal cohort, enabling greater understanding of bleeding symptoms and genetic risk. Greater knowledge did not eliminate uncertainty but shifted its focus to disclosure to partners, reproductive decision‐making, and future caregiving responsibilities. In contrast, uncertainty in the maternal cohort centred on limited awareness of carrier status, reproductive experiences, and sociocultural expectations surrounding caregiving. Conclusion Illness‐related uncertainty in HCs changed rather than simply diminished across generations. Support for HCs should combine medical information, emotional support, and shared decision‐making tailored to the life stage and sociocultural context. Plain language summary Haemophilia is an inherited bleeding disorder that mainly affects boys and men, but girls and women who carry the haemophilia gene may also experience bleeding symptoms and concerns related to inheritance. Healthcare and access to information about haemophilia have improved considerably over time, but little is known about whether these changes have affected the concerns experienced by haemophilia carriers across generations. We interviewed nine female haemophilia carriers aged 17–39 years and compared their experiences with previously published findings from 20 mothers whose daughters were haemophilia carriers. The mothers were interviewed in 2017. Compared with the previously published findings, younger carriers had greater access to information, specialist healthcare, patient organizations, and family support, which helped them better understand bleeding symptoms and the possibility of passing haemophilia on to their children. However, greater knowledge did not simply remove uncertainty. Instead, younger carriers began to consider possible future challenges earlier in life, including when and how to tell a partner about haemophilia, decisions about pregnancy and having children, and the possibility of caring for a child with haemophilia. In contrast, women in the older group often experienced uncertainty after pregnancy or childbirth, when haemophilia became directly relevant to their lives. These findings suggest that uncertainty has changed across generations rather than disappeared. Therefore, support for haemophilia carriers should provide not only clear medical information but also emotional support and help with decisions about relationships, pregnancy, and family life at different stages of life.
