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Most nursing simulation programs focus on persons’ healthcare needs in hospital settings, and little is known about how to identify them in home settings. This study aims to develop and validate a virtual reality (VR) simulation program for nursing students to improve their clinical reasoning skills and confidence in assessing persons’ healthcare needs in home settings. We developed a VR simulation program based on a literature review and expert discussion. In Phase 1, home visit nurses or public health nurses will validate the program through their interviews in 2022. In Phase 2, we will conduct a pilot and main single-blinded randomized trial for nursing students to confirm the effectiveness from 2022 and 2023. Participants will be randomly allocated into an intervention group using VR simulations and a control group receiving videos regarding three kinds of community residents’ lives [1:1]. After obtaining informed consent, the students will submit their anonymous data to the researchers to prevent associating their grade evaluation. The primary outcome will be their clinical reasoning skills. The second outcome will include their satisfaction and self-confidence. This study will examine the effectiveness of improving their clinical reasoning skills and confidence in assessing persons’ healthcare needs in home settings.

Silverfish are known as one of the major pests which feed on paper and starch-based materials and can cause serious problems in museums, libraries and archives.Ctenolepisma calvum (Ritter, 1910) was first recorded from Ceylon (now Sri Lanka) and has also been known from Central American countries including Guyana and Cuba. Recently, its rapid spread to European countries, including Austria, Czech, Germany and Norway, has been reported. In addition, there are unverified records of C. calvum from 17 more countries in the on-line citizen-science platforms iNaturalist.We report C. calvum in Japan for the first time, from Hokkaido, Miyagi, Tokyo, Fukuoka and Nagasaki Prefectures. The specimens in Japan were observed in detail by stereomicroscope, optical microscope and scanning electron microscope. The occurrence of this species is a serious problem from the viewpoint of protection of cultural properties. We also registered their mitochondrial cytochrome oxidase I (COI) gene in EMBL/GenBank/DDBJ.

Ctenolepisma calvum (Ritter, 1910) (Zygentoma: Lepismatidae) is a primitive wingless insect that causes damage to paper, and it is regarded as a pest of collections in museums, archives, and libraries. This species was recently discovered in Japan for the first time and may have already spread over large areas of Japan, but, currently, no information is available on the biological characteristics of C. calvum in Japan. In this study, we observed the processes of development and reproduction of C. calvum found in Japan at room temperature. Oviposition was observed from April to November, with a peak in early June. The average egg period was 56.9 days at average temperatures above 24.0 °C, and was 72.4 days at average temperatures below 24.0 °C. The 1st, 2nd, and 3rd instars lasted 4.7 days, 13.2 days, and 26.1 days on average, respectively, at average temperatures above 22.0 °C. Average instar periods were 23–28 days in 4th–7th instars and tended to increase in later instars. Instar periods also increased when the average temperature was 22.0 °C or lower. In individual rearing, the longest-living individual lived for approximately two years, up to the 15th instar. The head width grew at an approximate ratio of 1.1 per molt. First oviposition occurred at the 10th or 11th instar. Individually observed females oviposited once or twice a year, laying 6–16 eggs at one time, but females at least two years old laid 78.2 eggs per year on average in a mass-culture cage. Through this study, only females were found, and the mature females produced their progenies parthenogenetically.

Abstract.: Osteoclasts (OCLs) are multinucleated bone-resorbing cells that are differentiated by stimulation with receptor activator of nuclear factor kappa-B ligand (RANKL) and macrophage colony-stimulating factor. We recently demonstrated that regulation of heme-oxygenase 1 (HO-1), a stress-induced cytoprotective enzyme, also functions in OCL differentiation. In this study, we investigated effects of fisetin, a natural bioactive flavonoid that has been reported to induce HO-1 expression, on the differentiation of macrophages into OCLs. Fisetin inhibited the formation of OCLs in a dose-dependent manner and suppressed the bone-resorbing activity of OCLs. Moreover, fisetin-treated OCLs showed markedly decreased phosphorylation of extracellular signal-regulated kinase, Akt, and Jun N-terminal kinase, but fisetin did not inhibit p38 phosphorylation. Fisetin up-regulated mRNA expression of phase II antioxidant enzymes including HO-1 and interfered with RANKL-mediated reactive oxygen species (ROS) production. Studies with RNA interference showed that suppression of NF-E2–related factor 2 (Nrf2), a key transcription factor for phase II antioxidant enzymes, rescued fisetin-mediated inhibition of OCL differentiation. Furthermore, fisetin significantly decreased RANKL-induced nuclear translocation of cFos and nuclear factor of activated T cells cytoplasmic-1 (NFATc1), which is a transcription factor critical for osteoclastogenic gene regulation. Therefore, fisetin inhibits OCL differentiation through blocking RANKL-mediated ROS production by Nrf2-mediated up-regulation of phase II antioxidant enzymes. Keywords:: osteoclast, fisetin, reactive oxygen species (ROS), NF-E2–related factor 2 (Nrf2), nuclear factor of activated T cells cytoplasmic-1 (NFATc1)

This retrospective cohort study was conducted to demonstrate how allocation of nurses specialized in HIV care influences clinical outcomes of antiretroviral therapy (ART) for people living with HIV (PLWH). Methods: The medical records of 116 PLWH who started ART between January 2002 and December 2004 were analyzed. Occurrence of viral suppression and viral relapse after suppression achievement and their time from baseline were observed as clinical outcomes related to ART. Clinical outcomes were obtained from medical records between January 2002 and December 2006. PLWH were classified into two groups according to allocation (n = 95, nurse allocated group) or nonallocation (n =21, nurse nonallocated group) of nurses specialized in HIV. Results: Survival analysis showed that HIV viral load was suppressed more rapidly and continuously in nurse allocated group than nonallocated group (p < .0001). Viral relapse after suppression achievement occurred easily in nurse nonallocated group than allocated group (p = .003). Conclusions: The present findings demonstrated that the role of specialized nurses is critically important from the viewpoint of clinical outcome.