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Colostrum is the first food for newborns and it contains various crucial immune factors. The concentrations of immune factors in breast milk may change depending on maternal characteristics such as body mass index, collection day, and age at first pregnancy. In this exploratory study, we investigated the association between TGF-β1, TGF-β2, and IgA in colostrum and rarely studied factors that affect breast milk components, including the use of labor-inducing medication, colostrum secretion, sex of newborns, breast or nipple problems, and nipple care. Breast milk samples were collected from 42 mothers and analyzed for TGF-β1, TGF-β2, and IgA. The results suggest that parity and mode of delivery may be correlated with the concentrations of immune factors in colostrum. However, we found no association between the immune factors in colostrum and the use of labor-inducing medications, colostrum secretion, sex of newborns, breast or nipple problems, and nipple care. These findings have some implications for further analysis of the effects of immune factors in breast milk on the prognosis of allergies in children.

We sequenced the entire genome of isolates SMoV T1 and T2 of strawberry mottle virus (SMoV) from strawberry cultivar UC-5 grown in Tochigi, Japan. Homology and molecular phylogenetic analyses revealed that SMoV T1 and T2 are close homologs of previously reported Canadian and Czech strains. This is the first report describing the complete genome sequences of SMoV isolated in Japan and the construction of infectious SMoV clones. The stability of infectious clones in strawberry is discussed.

Some diopsid flies have sexually dimorphic eye stalks that are assumed to require considerable nutrition for growth but are advantageous in competition and courtship. According to the handicap theory, the eye span in some dimorphic species serves as a reliable signal of individual quality to an opponent. However, it is not well understood how well eye span represents energy source storage. In this study, we focused on two species: Sphyracephala detrahens, which has weak dimorphism, and Cyrtodiopsis dalmanni, which has moderate dimorphism. We found that the eye stalks of the former species contained more fat bodies than those of the latter species. When the flies were starved, the fat body cells in the eye stalks underwent autophagy. A strong positive correlation was consistently found between eye span and starvation tolerance for S. detrahens, while a weak correlation was found for C. dalmanni. Furthermore, starvation decreased the contest winning rate between S. detrahens pairs with similar eye spans. These findings suggest that the presentation of resource holding potential may be larger than the actual storage ability and that the fidelity of nutritional storage signaling varies; the signal presented by S. detrahens is more reliable than that presented by C. dalmanni.

BMP signaling has been found to have tumor-promoting as well as tumor-suppressing effects in different types of tumors. In this study, we investigated the effects of BMP signaling and of BMP inhibitors on ovarian cancer (OC) cells in vitro and in vivo. High expression of BMP receptor 2 (BMPR2) correlated with poor overall survival of OC patients in the TCGA dataset. Both BMP2 and BMPR2 enhanced OC cell proliferation, whereas BMP receptor kinase inhibitors inhibited OC cell growth in cell culture as well as in a mouse model. BMP2 also augmented sphere formation, migration, and invasion of OC cells, and induced EMT. High BMP2 expression was observed after chemotherapy of OC patients in the GSE109934 dataset. In accordance, carboplatin, used for the treatment of OC patients, increased BMP2 secretion from OC cells, and induced EMT partially via activation of BMP signaling. Our data suggest that BMP signaling has tumor-promoting effects in OC, and that BMP inhibitors might be useful therapeutic agents for OC patients. Considering that carboplatin treatment augmented BMP2 secretion, the possibility to use a combination of BMP inhibitors and carboplatin in the treatment of OC patients, would be worth exploring. De två sista författarna delar sistaförfattarskapet

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), severe drug reactions, are often misdiagnosed due to their rarity and lack of information on differential diagnosis. The objective of the study was to develop an electronic medical record (EMR)-based algorithm to identify patients with SJS/TEN for future application in database studies. From the EMRs of a university hospital, two dermatologists identified all 13 patients with SJS/TEN seen at the Department of Dermatology as the case group. Another 1472 patients who visited the Department of Dermatology were identified using the ICD-10 codes for diseases requiring differentiation from SJS/TEN. One hundred of these patients were then randomly sampled as controls. Based on clinical guidelines for SJS/TEN and the experience of the dermatologists, we tested 128 algorithms based on the use of ICD-10 codes, clinical courses for SJS/TEN, medical encounters for mucocutaneous lesions from SJS/TEN, and items to exclude paraneoplastic pemphigus. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic odds ratio (DOR) of each algorithm were calculated, and the optimal algorithm was defined as that with high PPV and maximal sensitivity and specificity. One algorithm, consisting of a combination of clinical course for SJS/TEN, medical encounters for mucocutaneous lesions from SJS/TEN, and items to exclude paraneoplastic pemphigus, but not ICD-10 codes, showed a sensitivity of 76.9%, specificity of 99.0%, PPV of 40.5%, NPV of 99.8%, and DOR of 330.00. We developed a potentially optimized algorithm for identifying SJS/TEN based on clinical practice records. The almost perfect specificity of this algorithm will prevent bias in estimating relative risks of SJS/TEN in database studies. Considering the small sample size, this algorithm should be further tested in different settings.

To evaluate the effectiveness of 1-h practical chest compression-only cardiopulmonary resuscitation (CPR) training with or without a preparatory self-learning video.Participants were randomly assigned to either a control group or a video group who received a self-learning video before attending the 1-h chest compression-only CPR training program. The primary outcome measure was the total number of chest compressions during a 2-min test period.214 participants were enrolled, 183 of whom completed this study. In a simulation test just before practical training began, 88 (92.6%) of the video group attempted chest compressions, while only 58 (64.4%) of the control group (p0.001) did so. The total number of chest compressions was significantly greater in the video group than in the control group (100.5+/-61.5 versus 74.4+/-55.5, p=0.012). The proportion of those who attempted to use an automated external defibrillator (AED) was significantly greater in the video group (74.7% versus 28.7%, p0.001). After the 1-h practical training, the number of total chest compressions markedly increased regardless of the type of CPR training program and inter-group differences had almost disappeared (161.0+/-31.8 in the video group and 159.0+/-35.7 in the control group, p=0.628).1-h chest compression-only CPR training makes it possible for the general public to perform satisfactory chest compressions. Although a self-learning video encouraged people to perform CPR, their performance levels were not sufficient, confirming that practical training as well is essential. (UMIN000001046).

Background: To date, medical schools and clinical training hospitals in Japan that require students to show immunity for measles, mumps, rubella, varicella (chickenpox), and hepatitis B prior to the commencement of residency are limited. Methods: This qualitative study used focus group interviews to elucidate why medical students do not undergo vaccination. A total of three groups were identified and interviewed: group A (two men, three women), group B (two men, two women), group C (three men, two women). All recorded interviews were transcribed verbatim and analyzed according to the constant comparative method with a series of codes and categories. Results: Findings elucidated that vaccination for medical students is not mandatory in Japan. Analysis found that the factors that influence willingness to be vaccinated can be divided into three dimensions (individual level, university/regional hospital level, governmental level) and two primary categories (cost of vaccination, awareness of vaccination) consisting of 10 codes. These factors did not exist in isolation, but have mutually overlapping areas. Conclusions: Vaccination against vaccine-preventable diseases is essential to a hospital’s infectious-disease countermeasures and cannot continue to be overlooked by physicians (at the individual level), by universities and residency programs (at the community level) nor by the government (at the national level).

Objective : Complex physical therapy (CPT) has recently become the therapeutic focus for managing secondary lymphedema. Although it is advisable to perform CPT every day, only a few of our patients with lymphedema currently maintain this regimen. The aims of our study were to (1) assess the self-care practices that were employed by our patients with secondary lower extremity lymphedema, and to (2) determine the relationship between self-care continuation and self-efficacy in these patients. Methods : This cross-sectional study was conducted at Kyoto University Hospital’s Consultation Room for Women’s Mental and Physical Health, and evaluated patients with secondary lower extremity lymphedema. A total of 118 patients were invited to anonymously complete a self-administered questionnaire regarding their demographic information, current self-care habits for manual lymphatic drainage and compression therapy, and self-efficacy rating. We used this data to compile descriptive statistics and compare the differences in the respondents self-efficacy scale scores, according to their continuation of self-care status. Results : Approximately 64% of the invited patients returned the questionnaires, and 30% of these patients reported not continuing self-care, mainly because of the “cumbersome” and “time-consuming” procedures and the belief that self-care “did not result in much improvement”. There was no significant difference in the self-efficacy scale scores between the groups that did or did not continue self-care, although the scores tended to be higher in the groups that continued self-care. Conclusions : These findings indicate that patients with lymphedema should be educated regarding the benefits of self-care, as a large percentage of these patients ultimately discontinued self-care. Therefore, these patients should be informed that only minor apparent changes in lymphedema state are expected, in order to better understand the effects of daily self-care.

Objective Little is known about caregiver experiences during the end-of-life period. Our objective was to characterize caregiver perceptions of their experiences in cancer survivorship with special reference to the end-of-life stage considering depression in bereavement. Methods Qualitative research using in-depth interviews of 34 caregivers from two palliative care units in Japan. Data were analyzed inductively using framework analysis. Depression and personality traits were measured using the Center for Epidemiological Studies Depression (CES-D) and Sense of Coherence (SOC) scales, respectively. Results Caregiver perceptions were characterized along two axes. One axis involved four caregiver–cancer patient relationships: strengthening, reconstruction, intimacy-maintained, and estrangement-maintained. The core concept was transformation of relationships: caregivers reappraised aspects of caregiver–patient interactions through caregiving. The other axis involved subjective caregiving experiences divided into five concepts: spontaneity of care, discussing death, sympathy for patient emotions, impressions on first witnessing death, and introspective reflections in bereavement. Strengthening and reconstruction relationships appeared similar among the four relationship types, but only the former tended to overcompensate by sacrificing private time. Although median CES-D scores in each relationship type were under the cutoff for possible depression, four of eight caregivers suspected to have depressive tendencies belonged to the strengthening type. The mean SOC score for all caregivers was intermediate relative to scores previously reported in Japanese studies. Conclusions While caregivers' subjective experiences can be classified, their relationship to depression in bereavement needs future research. The present findings indicate that caregivers should also be considered in clinicians' views of cancer survivorship. Copyright © 2011 John Wiley & Sons, Ltd.

[Introduction] Despite present efforts to train the general public in CPR, the proportion of bystander CPR is still low. Length of CPR training program and complexity of CPR skills may be barriers to bystander CPR performance. Recently, simple video self-learning has been shown to be an effective CPR training technique. [Objective] To evaluate the effectiveness of cardiac-only CPR training program by a self-learning video, a 1-hour practical course, or both. [Method] Designs : A randomized controlled trial. Participants: General public aged 18 years or older. Intervention: In the video (V) group, participants received the self-learning video before CPR training and then attended a 1-hour cardiac-only CPR training program; in the control (C) group participants attended the training program without a self-learning video. Data collection: Before and immediately after the training, a 2 minute scenario-based test was conducted and CPR skills were recorded. Outcomes: The primary outcome measure was the number of correct chest compressions immediately after the training. We also calculated the achievement of correct chest compressions, which meant the proportion of correct chest compressions in relation to the ideal number of chest compressions based on 2005 CPR guideline. [Result] 214 participants were randomly assigned to V (108) and C (106) groups. Before the training, the proportion of attempting chest compression, attempting AED operation, and calling for an AED, and the total number of chest compressions were significantly grater in the V group. After the training, all measured CPR skills of both groups improved substantially compared with pre-training skills, but there were no differences between groups (Table ). [Conclusion] A self-learning video improved CPR skills. However, a 1-hour practical training course was substantially more effective and the addition of a self-learning video did not improve its effectiveness. Table: CPR Skills of Pre- and Post-training

We previously reported that bone morphogenetic protein (BMP) signaling promotes tumorigenesis in gynecologic cancer cells. BMP2 enhances proliferation of ovarian and endometrial cancer cells via c-KIT induction, and triggers epithelial-mesenchymal transition (EMT) by SNAIL and/or SLUG induction, leading to increased cell migration. However, the downstream effectors of BMP signaling in gynecological cancer cells have not been clearly elucidated. In this study, we performed RNA-sequencing of Ishikawa endometrial and SKOV3 ovarian cancer cells after BMP2 stimulation, and identified TNFRSF12A, encoding fibroblast growth factor-inducible 14 (FN14) as a common BMP2-induced gene. FN14 knockdown suppressed BMP2-induced cell proliferation and migration, confirmed by MTS and scratch assays, respectively. In addition, FN14 silencing augmented chemosensitivity of SKOV3 cells. As a downstream effector of BMP signaling, FN14 modulated both c-KIT and SNAIL expression, which are important for growth and migration of ovarian and endometrial cancer cells. These results support the notion that the tumor promoting effects of BMP signaling in gynecological cancers are partially attributed to FN14 induction.