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The percentage of female faculty members in university hospitals remain low in Japan. This is especially true for the posts of lecturer and above. It remains difficult for women to continue working at university hospitals after going through various life events. However, this situation is definitely changing. There are many challenging and rewarding jobs that can only be found in university hospitals, and I hope that many female doctors will consider a career in a university as one of their options.My own career path at a hospital evolved into multicenter joint research by advancing clinical research on the theme of clinicopathological study, and falls in the clinical field after the period of life events. Even if your work is temporarily delayed during a life event, you do not have to worry as you can fully recover by continuing what you think is important. A variety of approaches, including leadership education, are essential for female physicians to continue their work without burnout.The COVID-19 pandemic, caused by a new type of coronavirus, has increased the difficulty of studying abroad for basic research. However, the associated system has changed in response to the coronavirus disaster. In addition, a framework has been built to enable research to be conducted even under a new lifestyle. Although there are many differences betwee studying abroad currently and before the pandemic, you should not give up on your dreams; I encourage you to open the door and challenge yourself.The COVID-19 pandemic has had a significant impact on neurology residency education and services in the United States. The responsibility of residents was shifted from traditional house staff to frontline providers in the face of the pandemic. As such, a dynamic and rapid transformation was required, involving the development of strong leadership and teamwork skills, while protecting patients and providers from infection and ensuring the quality of education and training. Because of the increased demand from inpatient care and the risk of potential exposure to the virus, a modified rotation schedule was implemented by removing residents from outpatient clinics and minimizing their role in inpatient services. In order to maintain social distances, didactic lectures were conducted only via online platforms, and outpatients were only provided telemedicine. Although the pandemic has taken some of the in-person educational opportunities from residents, innovative changes including video conferences and telemedicine will likely continue to be used as a useful mode of medical training for residents. Herein, the author reports the changes made to the neurology residency program in response to the COVID-19 pandemic, as well as the evolution of leadership roles during this unprecedented time.Recently the number of Japanese physicians and researchers studying at universities or research institutions abroad has been decreasing; however, the importance of studying abroad has not changed in the field of medicine and science where globalization is still progressing. Studying abroad is a unique opportunity to experience the diversity and universality of the world. In addition, foreign studies can promote international personal relationships, acquisition of cutting edge research methods and clinical techniques, and improvement of English skills.Obtaining a degree is not the sole purpose of graduate school. Through the research for your thesis, you will learn scientific approaches, including how to formulate a research question, perform information analysis, study planning and execution, discussion, and publication. This knowledge, together with communication skills and the network constructed in graduate school, will enrich your future career. The activities in graduate school also include cutting-egde education on topics outside your expertise, collaboration with other researchers, international collaboration, and industry-academia collaboration, among others. As for your research topic in graduate school, your motivation for study is very important; moreover, it is also important to discuss research resources, including funding, facilities, materials, data, supporting staff, and collaborators, with your mentors. However, being a student after several years of clinical training has certain disadvantages, such as an unstable social status. Considering the diverse career paths of neurologists, the advantages and disadvantages of graduate school should be thoroughly considered when deciding to enter."Nontechnical skills," such as resilience, communication, management, information literacy, and educational capability, are required to be an the effective neurologist. Neurology residents should learn nontechnical skills in their residency programs.The appearance of slides and posters is important to allow an effective and easy-to-understand presentation. It is desirable to limit the amount of information shown on one slide, paying attention to the layout, colors, fonts, etc., and to create easy-to-read slides. At the beginning of the presentation, it is recommended to show the outline of the whole presentation, and to assemble the contents by connecting short words and sentences. In addition, to make a presentation that is easy for the audience to understand, it is necessary to practice thoroughly in advance and to be familiar with the content of the presentation.Dr. Koan Ogata is recognized as a key founder of modern Japanese medicine, and he greatly respected the words of Professor Christoph Hufeland at Berlin University. Professor Hufeland noted the importance of writing a case report for every doctor who consults patients during the day and writes case reports at night. Both Professor Hufeland and Dr. Ogata thought that writing these records would truly train young doctors as writers, while educating other doctors worldwide as readers. In this short paper, the way to realize such behavior is described according to the increasing experiences gathered at the Okayama University where Dr. Ogata was born.Reading articles is extremely important for preparing and promoting research and answering questions in daily clinical practice. In this section, we introduce literature search services and organize the use of PubMed. Next, we outline the literature structure and introduce essential points for reading English papers, such as paragraph reading and tenses. Finally, we explain how to organize papers, especially guidelines for writing papers, and discuss the importance of critical review when applying papers to daily clinical practice.Clinical competence is the spirit to discover something useful for the diagnosis or management of patients in a clinical setting. It requires a lively interest in humanity, careful observations, and deductive abilities. To acquire clinical competence, it is most important to observe the patients' various phenomena plainly rather than theoretically. For easy reference, I present Charles Miller Fisher's favorite sayings and my related experiences.Cyclobenzaprine is a tricyclic dimethylpropanamine skeletal muscle relaxant, which is used clinically to decrease muscle spasm and hypercontractility, as well as acute musculoskeletal pain. Although the absolute mechanism of action of cyclobenzaprine remains elusive, it is known to mediate its effects centrally via inhibition of tonic somatic motor function, likely through modulation of noradrenergic and serotonergic systems. https://www.selleckchem.com/products/ml323.html While cyclobenzaprine is effective as a muscle relaxant, greater than 30% of patients experience drowsiness and sedative-hypnotic effects, yet the mechanisms that cause this adverse effect are also undescribed. Based on this common adverse effect profile and the structural similarity of cyclobenzaprine to tricyclic antidepressants, as well as ethanolamine first-generation antihistamines, we hypothesized that cyclobenzaprine facilitates sedative effects via off-target antagonism of central histamine H1 receptors (H1Rs). Here, for the first time, we present data that demonstrate that cyclotamine H1 receptor. This effect likely modulates the high degree of sedation that patients experience.

Percutaneous coronary intervention (PCI), the preferred coronary reperfusion strategy, induces endothelial trauma which may mount an inflammatory response. This has been shown to increase the likelihood of further major adverse cardiovascular events (MACE). Colchicine, a cheap and widely used anti-inflammatory has shown promise in improving cardiovascular outcomes. We aimed to perform a systematic review and meta-analysis to study the effects of colchicine in patients with symptomatic coronary artery disease (CAD) who have undergone PCI.

We systematically reviewed and meta-analysed 7 randomised controlled trials including a total of 6660 patients (colchicine group 3347, control group 3313; mean age=60.9±10). Six studies included participants who had a ≤13.5-day history of acute coronary syndrome (ACS). One study included patients with both ACS and chronic coronary syndrome. The follow-up of studies ranged from 3 days to 22.6 months.

The use of colchicine in patients who underwent PCI significantly reduced MACE outcomes (risk ratio 0.73 (95% CI 0.61 to 0.87); p=0.0003) with minimal heterogeneity across the analysis (I

=6%; P for Cochran Q=0.38). These results were driven mainly by the reduction in repeat vessel revascularisation, stroke and stent thrombosis. The number needed to treat to prevent one occurrence of MACE was 41.

Colchicine significantly reduced the risk of MACE in patients with CAD who underwent PCI, mostly in the reduction of repeat vessel revascularisation, stroke and stent thrombosis. The efficacy of colchicine should be further studied by distinguishing its use alongside different stent types and dosing regimens.

CRD42021245699.

CRD42021245699.Thicker carotid intima-media thickness (CIMT) has been a valid predictor for atherosclerosis development. A significant association between environmental tobacco smoke (ETS) and thickening of CIMT has been demonstrated in adults, whereas such association has scarcely been reviewed in paediatric population. The dominate electronic databases, including MEDLINE (Ovid), PubMed, Embase, CINAHL, Web of Science, Scopus, were searched from inception. Reference lists of retrieved articles were further scanned as to avoid any missing literatures. Newcastle-Ottawa scale was used to assess the quality of the included studies. Qualitative synthesis analyses were performed on the selected studies. 331 articles were retrieved, and 4 were finally selected. All four studies investigated the association between postnatal ETS and CIMT in children, and three of them reported a statistically significant positive association. Three studies investigated the association between prenatal maternal ETS and CIMT, and one of the three found a positive association. Two studies explored the association between postnatal maternal ETS and CIMT, one reported a positive association. Two studies used serum cotinine measurement to quantify ETS and demonstrated potential dose-response relationship with CIMT. ETS exposure may play an independent role in the development of cardiovascular risks in healthy children and adolescents. In the consideration of the great burden of respiratory and cardiovascular diseases, there is an urgent need of effective surveillance for paediatric population's ETS exposure to reduce smoke exposure.

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