SCRC

答えはいつも風に吹かれている

[SCRC @TT8N1st]

@masudanaika ほほう

[SCRC @TT8N1st]

the Tiger - "Respect" (Aretha Franklin カバー) - ニクオン2026 / 錦糸公園 2026-05-23 https://t.co/77TLVby42S @YouTubeより

[SCRC @TT8N1st]

ほぼの駅

[Dr. Filippo Cademartiri @FCademartiri]

🫀⚠️ We’ve been selecting patients for revascularization… wrong.
👉 ischemia = treat... not really?

For years the rule was simple:
👉 find ischaemia
👉 fix the artery

But what if ischaemia is NOT the key?

This editorial on CTO-PCI says something uncomfortable:
👉 Ischaemia does NOT predict outcomes.
Even when:
👉 ≥10% ischaemic burden
👉 PET or SPECT proven

There was:
❌ no reduction in death
❌ no reduction in hard events

So what actually improves?
👉 Symptoms.
👉 Quality of life.
That’s it.

Let that sink in.

We are:
👉 opening complex CTOs
👉 taking procedural risks
👉 chasing ischaemia
But:
⚠️ Ischaemia is NOT driving prognosis.

The real paradigm shift
From: ❌ Ischaemia-driven cardiology
To: 👉  Patient-driven cardiology

The new selection logic:
👉 refractory angina
👉 functional limitation
👉 patient suffering
FIRST.

Imaging?

Still crucial—but:
👉 as a SUPPORT tool, not the decision-maker

Even the paper states it clearly:
👉 Ischaemia alone is an insufficient arbiter for revascularization
And there’s a deeper problem

We love measurable things:
👉 % ischaemia
👉 flow reserve
👉 perfusion maps
But we ignore:
👉 symptoms
👉 daily function
👉 real patient experience

My take
This is the same cognitive error we see everywhere:
👉 We treat numbers
instead of
👉 treating patients

Final thought
If your indication for CTO-PCI is:
👉 “there is ischaemia”
You’re already outdated.
The future is brutally simple:
👉 No symptoms → think twice
👉 Symptoms → act
⚡ Because in modern cardiology:
The most important endpoint is not the image.
It’s the patient.

#Cardiology #CTO #PCI #Ischaemia #Imaging #PrecisionMedicine #CardiacCT #CardiacPET

[SCRC @TT8N1st]

Mac Mini M5 LEAKS! June Release Date? https://t.co/NYAkqEF6MA @YouTubeより

[japan-architects @JapanArchitects]

【旧香川県立体育館】民間資金での再生の提案を協議せずに解体に突き進む県の姿勢について松隈洋がコメント　
・県の建築文化への姿勢がちぐはぐ
・(松隈がプロポ評価委員長の)あなぶきアリーナがベルサイユ賞を受賞した絶好のタイミング。併存の可能性を探るべき
KSB NEWS: https://t.co/9moiXclW58

[Dr. Filippo Cademartiri @FCademartiri]

🫀🏃‍♂️ Exercise Physiology: Why Fitness Is a Vital Sign

Cardiorespiratory fitness (CRF) isn’t just about performance — it’s one of the strongest predictors of cardiovascular and all-cause mortality. In fact, the American Heart Association recommends treating CRF as a clinical vital sign.

At the center of CRF is VO₂ max — the gold standard measure of maximal oxygen uptake. It reflects the integrated function of:

❤️ Heart (cardiac output)
🫁 Lungs (ventilation & gas exchange)
🩸 Blood (oxygen delivery)
💪 Muscle (mitochondrial extraction & utilization)

Using the Fick equation, oxygen consumption = cardiac output × arteriovenous O₂ difference. In simple terms: how much blood the heart pumps × how much oxygen muscles extract.

📉 Without training, VO₂ max declines ~1% per year with aging — but this decline is attenuated by sustained physical activity.

🔥 Fuel dynamics matter:
At low intensity → fat predominates
At higher intensity → carbohydrates take over
The “crossover” reflects neurohormonal and metabolic shifts.

🧠 Thresholds define performance:
• Ventilatory threshold = sustainable steady-state intensity
• Lactate threshold ≠ “fatigue toxin” — lactate is a metabolic shuttle, not waste
• VE/VCO₂ slope = powerful prognostic marker in heart failure

💓 During exercise, cardiac output can increase ≥5-fold. Stroke volume adaptation — not heart rate — is the primary training-driven cardiac improvement.

🫁 In healthy individuals, lungs rarely limit maximal exercise — it’s usually the heart and peripheral extraction.

🔎 Bottom line:
Exercise is not a single-organ phenomenon. It is a fully integrated systems test of human physiology — and one of the most powerful tools in prevention medicine.

Fitness is not optional biology. It’s measurable resilience.

[SCRC @TT8N1st]

AIの御信託によりこんなことになった

[SCRC @TT8N1st]

ScanSnap で取り込んだ資料をAutomatorでID別に自動仕分けして、OpenDolphin pdfフォルダに放り込める用にした。IDと関係ない資料は、paperless-ngxへ取り込まれる。AI様様である

[SCRC @TT8N1st]

OpenDolphinを実マシンからVMへ移行。
眠っていたMac Pro 2013に、proxmox入れてみた。

[Northwell Health @NorthwellHealth]

Patients love our virtual cardiac rehab program, which provides guided exercises to people who have undergone major heart surgery. The best part: It can be done right at home. ❤️💻🏡 Learn more: https://t.co/7nSrp7ZXNk

[SCRC @TT8N1st]

尾瀬ヶ原はニッコウキスゲの群生が見事でした

[SCRC @TT8N1st]

肝心、共通の課題 https://t.co/wFhP30NSkJ

[SCRC @TT8N1st]

https://t.co/EPuzRYND74

[SCRC @TT8N1st]

Listen to "心臓リハビリテーション（CR）の進化、メカニズム、そして臨床的効果" by 心リハAI：論文トーク. https://t.co/XN4JUSQp1d

[SCRC @TT8N1st]

全くもって暑い
#GeForceSummer

[SCRC @TT8N1st]

https://t.co/ck5FEoUzjW

[SCRC @TT8N1st]

アメリカでは予算が枯渇すると公務員の給与が支払われなくなり行政サービスがストップ政府封鎖が行われます。
翻って日本では役人の給与は守られて皺寄せは米不足米の価格高騰やら医療費削減医療サービスの低下などに押しつけられます。

[SCRC @TT8N1st]

その日こそ、医療の本質に専念できる、医療のindependence day なのです。か、な。え？

[SCRC @TT8N1st]

電子カルテに音声入力とか自分としては必要とは思いません。修正の方が大変だから。必要なのは厚生局とかが求めてる本質ではないどーでもいいカルテ記載を肩代わりしてくれる機能なんです。