I, Professor Nobuaki Tanaka, gave a Farewell Lecture on February 29, 2024. First, I talked about the episode that led me to start researching aortic stenosis, and reflected on my own lectures on this topic to students aiming to become medical laboratory scientist. Lastly, I spoke to students majoring in medical laboratory scientist about the importance of practical clinical training.

Purpose: We investigated sex differences in heart rate variability (HRV; a non-invasive indicator of autonomic nervous system) and its frequency-specific responses to whole-body vibration (WBV) at three distinct frequencies among elderly subjects. Methods: Data from 11 males and 13 females were analyzed across four randomized sessions of exposure: WBV at 15, 20, or 25 Hz with a 4 mm peak-to-peak displacement, or control (0 Hz) condition comprising three bouts of 1-minute exposure with 1-minute between-bout rests. HRV measurements were taken before and during the exposure. Results: At baseline, low-frequency power/LF (ms^{2}) were significantly lower in females than males (P < 0.05). During exposure, LF (ms^{2}), high-frequency power (ms^{2}), standard deviation of normal-to-normal intervals, root mean square of successive differences between RR intervals, standard deviation of the Poincaré plot perpendicular to the line-of-identity, and standard deviation of the Poincaré plot along the line-of-identity significantly increased at 20 Hz for males and 25 Hz for females (P < 0.05 to 0.005) compared to respective baselines. Conclusions: Elderly females tend to exhibit reduced autonomic nervous system function compared to males. Furthermore, our results indicate that WBV at 20 Hz for males and 25 Hz for females may be considered beneficial for enhancing HRV in the elderly.

Dementia, a leading cause of death, often initiates with spatial cognitive impairment. Assisting spatial cognition may not only address challenges faced by individuals with spatial cognitive impairment but also facilitate the prevention of dementia. While previous studies have explored voice navigation for the visually impaired, its utility for those without visual impairment remains unexamined. To provide insights for spatial navigation in the elderly, in the present study, we evaluated the usefulness of voice navigation in healthy university students. In a randomized controlled trial, forty students were assigned to either a paper map only group or a paper map and Google Maps voice navigation group and instructed to navigate a predetermined 800-meter route in a park. The effectiveness of voice navigation was evaluated through various means, including time taken to reach the destination, accuracy of the route followed, and participantsʼ experience. The results show that the two groups did not differ in terms of goal completion and time consumed. Nor did they differ in feelings of drowsiness, instability, uneasiness, pleasure, and relaxation. However, participants in the paper map only group demonstrated a decrease in local pain and eyestrains together with improved feelings of vigor at the goal compared to the start, which was absent in participants using both paper map and voice navigation. Although the effectiveness of the voice navigation was not confirmed, our study did provide important insights regarding in what ways voice navigation can be improved. Moreover, we were able to observe mood improvements in participants with a paper map only, which may indicate the effect of physical activity and exposure to the natural environment.

Access to high-quality care at the end-of-life is a fundamental human right; therefore, it is necessary to examine how end-of-life care should be taught in nursing education to prepare for a super-aging society. Japan and Hong Kong are both in the East Asian region and are facing similar super-aging challenges, such as increased mortality and declining birth rates. This paper explores the literature on this topic and discusses how end-of-life care is taught in undergraduate nursing education in both Japan and Hong Kong. A comprehensive literature search was performed using end-of-life care keywords. Subsequently, the authors engaged in a discourse on expert perspectives, insights, and results from the literature. It is necessary to bridge the gap between the desired manner of spending oneʼs final days and the practical reality of considering patientsʼ best interests by referring to the existing policies, laws, guidelines, and frameworks of healthcare systems. This study suggests the importance of understanding patientsʼ views on life, death, values, and cultural backgrounds and educating healthcare personnel to apply these principles flexibly in their practice.