Within a tradition of a dual regular and special education system in Japan, the Government is promoting education reform that encourages an inclusive approach to education. This research investigates whether teachers are being trained for successful inclusion in Japan by reviewing the perceptions of all preservice teachers in one university regarding their readiness for becoming inclusive practitioners. A move towards an inclusive approach to education in Japan is being promoted through collaboration and support between teachers trained in regular and special education. Thus, different perceptions of preservice teachers preparing to work either in elementary schools or in special schools are a particular focus of this research. Discussion considers the need for better teacher preparation due to the very low understandings of inclusion and Japanese pre-service teachers' perceived lack of skills, knowledge, experience, or training for an inclusive approach.

Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure (PAP). Although rightheart catheterization is the gold standard method for the diagnosis of PH by definition, various less-invasive imaging tests have been used for screening, detection of underlying diseases-causing PH, and monitoring of diseases. Among them, 4D flow MRI is an emerging and unique imaging test that allows for comprehensive visualization of blood flow in the right heart and proximal pulmonary arteries. The characteristic blood flow pattern observed in patients with PH is vortical flow formation in the main pulmonary artery. Recent studies have proposed the use of these findings to determine not only the presence of PH but also estimate the mean PAP. Other applications of 4D flow MRI for PH include measurement of wall shear stress, helicity, and 3D flow balance in the pulmonary arteries. It is worth noting that 4D flow has also the potential for longitudinal followups. In this review, the clinical definition of PH, summary of conventional imaging tests, characteristics of pulmonary arterial flow as shown by 4D flow MRI, and clinical application of 4D flow MRI in the management of patients with PH will be discussed.

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Objective Regional differences in cardiac magnetic resonance, which can reveal catecholamine-induced myocardial injury in patients with pheochromocytoma, have not yet been assessed using 3T magnetic resonance imaging. We evaluated these differences using myocardial T1-mapping and strain analysis. Design and Methods We retrospectively reviewed 16 patients newly diagnosed with catecholamine-producing tumors (CPT group) and 16 patients with essential hypertension (EH group), who underwent cardiac magnetic resonance imaging between May 2016 and March 2018. We acquired 3T magnetic resonance cine and native T1-mapping images and performed feature-tracking-based strain analysis in the former. Results Global cardiac function, morphology, global strain and peak strain rate were similar, but end-diastolic wall thickness differed between groups (CPT vs EH: 10.5 ± 1.7 vs 12.6 ± 2.8 mm; P < 0.05). Basal, but not apical, circumferential strain was significantly higher in the CPT than the EH group (19.4 ± 3.2 vs 16.8 ± 3.6 %; P < 0.05). Native T1 values were significantly higher in CPT than in EH patients, in both the basal septum (1307 ± 48 vs 1241 ± 45 ms; P < 0.01) and the apical septum (1377 ± 59 vs 1265 ± 58 ms; P < 0.01) mid-walls. In the CPT, but not in the EH group, native T1 values in the apical wall were significantly higher than those in the basal wall (P < 0.01). Conclusion 3T magnetic resonance-based T1-mapping can sensitively detect subclinical catecholamine-induced myocardial injury; the influence of catecholamines may be greater in the apical than in the basal wall.

Magnetic resonance imaging (MRI) plays an important role in evaluation of the cardiovascular system. Two-dimensional phase-contrast MRI has been used to assess regional blood flow parameters such as flow velocity and volume and regurgitant fraction. Recently, fourdimensional (4D) flow MRI that acquires three-dimensional (3D) velocity and encodes volume coverage has been developed and applied to various clinical settings. 4D flow MRI allows retrospective flow measurement at any cross-section and 3D flow visualization through postprocessing. More advanced flow parameters based on fluid dynamics have been proposed and applied to 4D flow MRI to further understand flow mechanisms that might be related to the evolution and progression of cardiovascular diseases. The purpose of this review is to introduce the basics of 4D flow image acquisition and postprocessing, and its clinical application to selected cardiovascular diseases.

Background It is unclear whether deep-learning–based super-resolution technology (SR) or compressed sensing technology (CS) can accelerate magnetic resonance imaging (MRI) . Purpose To compare SR accelerated images with CS images regarding the image similarity to reference 2D- and 3D gradient-echo sequence (GRE) brain MRI. Material and Methods We prospectively acquired 1.3× and 2.0× faster 2D and 3D GRE images of 20 volunteers from the reference time by reducing the matrix size or increasing the CS factor. For SR, we trained the generative adversarial network (GAN), upscaling the low-resolution images to the reference images with twofold cross-validation. We compared the structural similarity (SSIM) index of accelerated images to the reference image. The rate of incorrect answers of a radiologist discriminating faster and reference image was used as a subjective image similarity (ISM) index. Results The SR demonstrated significantly higher SSIM than the CS (SSIM=0.9993–0.999 vs. 0.9947–0.9986; P < 0.001). In 2D GRE, it was challenging to discriminate the SR image from the reference image, compared to the CS (ISM index 40% vs. 17.5% in 1.3×; P = 0.039 and 17.5% vs. 2.5% in 2.0×; P = 0.034). In 3D GRE, the CS revealed a significantly higher ISM index than the SR (22.5% vs. 2.5%; P = 0.011) in 2.0 × faster images. However, the ISM index was identical for the 2.0× CS and 1.3× SR (22.5% vs. 27.5%; P = 0.62) with comparable time costs. Conclusion The GAN-based SR outperformed CS in image similarity with 2D GRE for MRI acceleration. In addition, CS was more advantageous in 3D GRE than SR.

Objectives: The aim was to investigate the time savings and plane accuracy of multivendor head computed tomography (CT) using the intelligent work aid with automatic reformatting of the axial head image at the orbitomeatal line. Materials and Methods: We retrospectively reviewed 781 head CTs (median, 70 years; 441 men) collected by CT systems from 3 vendors. In addition to the orbitomeatal line image reformatted by a CT specialist as a reference, we obtained the fully automated orbitomeatal line image using the intelligent work aid. We calculated the offset angle from the reference of the automatically reformatted image. We defined the large offset angle groups as those with an offset angle greater than 3 degrees. Multivariate logistic regression was used to determine the independent factors for the large offset angle groups. We compared the postprocessing times measured using the intelligent work aid or by a CT specialist. Results: With the intelligent work aid, 99.7% of CTs were automatically reformatted to the orbitomeatal line without error. Furthermore, 88.1% of CTs were within the 3 degrees' offset angle when compared with the reference produced by a CT specialist. The median offset angle from the reference was 1.41 degrees. Multivariate analysis showed that the offset angle of the positioning plane was an independent factor (odds ratio, 1.045; P = 0.005) for predicting the large offset angle group. Furthermore, this technique was 4 times faster (6.4 ± 0.7 seconds) than a CT specialist (25.6 ± 6.4 seconds). Conclusions: The intelligent work aid can generate a fast and precise head CT image aligned at the orbitomeatal line, even in real-world clinical CTs. However, precise positioning remains essential.

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