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This study aimed to evaluate the effects of a virtual reality intervention for dementia care education in Japanese acute care nurses. Non-randomised controlled trial was used to assess the effectiveness of the intervention pre- and post-intervention and at a 1-month follow-up. This study enrolled 20 and 19 nurses in the intervention and control groups, respectively. Generalized estimating equation analyses revealed significant differences in scores on the Dementia Nursing Competency Scale in Acute Hospitals and Staff Experiences of Working with Dementia Residents questionnaire in the intervention group. A post hoc test revealed significantly higher scores on the Dementia Nursing Competency Scale in Acute Hospitals at 1 month after compared with pre-intervention. Staff Experiences of Working with Dementia Residents questionnaire scores were significantly lower at pre- than that at post-intervention and 1 month after intervention. These findings could improve competency of dementia nursing care and attitudes toward people with dementia.

AIM AND OBJECTIVES The purpose of this study was to investigate which factors are associated with the quality of dementia care in acute care hospitals. BACKGROUND The number of people with dementia who are admitted to acute care hospitals is increasing. Improving the quality of dementia care in acute care hospitals is an important issue. Prior studies have demonstrated that not only knowledge and nursing experience, but also psychological factors and the nursing practice environment are related to high-quality care on general wards. DESIGN Cross-sectional hypothesis-testing design. METHODS Participants were nurses providing care to people with dementia at acute care hospitals. Questionnaires were distributed to 300 acute care hospitals in Japan, 10 copies each and 773 valid responses were received. Based on the hypothesis model, variables were tested using multiple regression analysis. The model described the relationship between quality of care, personal attributes and the nursing practice environment. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used. RESULTS Almost 90% of the study sample was female, the mean age was 37.4 ± 9.3 years, and the mean nursing experience was 14.0 ± 8.7 years. The results showed that nursing foundations for quality of care, staffing and resource adequacy, specialist consultation, promoting systematic recreation and exchange, knowledge, and feelings towards people with dementia were associated with the quality of dementia care in acute care hospitals. The adjusted coefficient of determination was 0.367. CONCLUSION This study identified factors associated with the quality of dementia care in acute care hospitals. Knowledge and feelings towards people with dementia are important, and the nursing practice environment plays an important role in improving the quality of dementia care. RELEVANCE TO CLINICAL PRACTICE Not only improving nurse's practical ability but also a supportive nursing practice environment enhances the quality of dementia care in acute care hospitals.

Although growth/differentiation factor 11 (GDF11), growth/differentiation factor 8 (GDF8), and their circulating antagonists, which include GDF11 and GDF8 propeptides, follistatin (FST), WFIKKN1, and WFIKKN2, have been shown to influence skeletal muscle and aging in mice, the relationship of these circulating factors with human phenotypes is less clear. This study aimed to characterize the relationship between plasma GDF8, GDF11, FST, WFIKKN1, and WFIKKN2 concentrations with the decline of grip strength in 534 adults, ≥65 years, who participated in the Baltimore Longitudinal Study of Aging and had grip strength measured over time. Plasma GDF8 and GDF11 mature proteins, GDF8 and GDF11 propeptides, FST (isoform FST315 and cleaved form FST303), WFIKKN1, and WFIKKN2 concentrations were measured using selected reaction monitoring-tandem mass spectrometry at baseline. Grip strength was measured at baseline and at follow-up visits (median follow-up 8.87 years). Mean (standard deviation) grip strength declined in men and women by -0.84 (2.45) and -0.60 (1.32) kg/year, respectively. Plasma GDF8 and GDF11 mature proteins, GDF8 and GDF11 propeptides, FST315, FST303, WFIKKN1, and WFIKKN2 concentrations were not independently predictive of the decline of grip strength in men or women in multivariable linear regression analyses that adjusted for potential confounders. In conclusion, circulating GDF8, GDF11 and their antagonists do not appear to influence the decline of grip strength in older men or women.

Background Improving the health and well-being of family caregivers of people with dementia has become an increasingly important public health and policy issue in China. The aims of this study were to clarify the factors associated with the well-being of family caregivers of people with dementia in China. Methods Data were collected from a sample of 132 family caregivers who volunteered to study and live together with people with dementia who had been treated as outpatients in three hospitals in China. The survey included questions on the family caregivers' characteristics, satisfaction with family support, positive aspects of caregiving, preparedness of caregiving, and characteristics of people with dementia. Multiple linear regression analysis was carried out to identify factors associated with the well-being of family caregivers. Results The mean age of the family caregivers (68.2% women) was 46.8 ± 14.9 years. The results of multiple linear regression analysis indicated that positive aspects of caregiving (β = 0.352, P

In accordance with a previous report on cystic kidneys induced in rat neonates when dosed with p-cumylphenol (PCP) for 18 days from postnatal day (PND) 4, 3 rat neonates were dosed with PCP once a day for 14 days, either from PND 14, 21, 28, 35, or 42 as W2, W3, W4, W5, and W6 groups, respectively, to investigate whether dosing periods in different PNDs influenced the development of cystic renal tubules. The lesion was striking in the W2 group and at a lesser magnitude in the W3 group, whereas either kidney was unaffected when dosing was initiated beyond PND 28. These findings, together with the results from the previous study, suggested that PND 14-28 is a critical dosing period for PCP to develop cystic kidneys in rat neonates. The lining epithelium of the cystic tubules was immunohistochemically positive for AQP2. This finding and the anatomical location indicated that the cystic tubules were of collecting duct origin. Either obstruction, fluid accumulation, or reparative hyperplasia of the lining epithelium was unlikely to be involved in the formation of cystic tubules lined with a monolayer of cuboidal or columnar epithelium with a high nuclear density. Thus, the follow-up investigation on PCP suggested a critical dosing period of PND 14-28 in rat neonates for the development of cystic dilation of renal collecting ducts. This study further supports that additive hyperplasia of the lining epithelium is a fundamental basis of this unique lesion.

Objective: To examine the effect of employment status on sleep, care burden, and negative affect among family caregivers (FCs) at home. Methods: An intensive longitudinal design was applied in which 25 FCs underwent in-home assessments for up to 56 days. At baseline, demographic data and employment status were collected. FCs wore a wrist-worn device with an accelerometer to assess objective total sleep time (TST) for consecutive 24-hour periods. FCs answered the Zarit Burden Interview (ZBI) and Positive and Negative Affect Schedule (PANAS) every night before sleep. Linear mixed model analysis was used to examine the effect of objective sleep status on ZBI and PANAS scores the following day. Results: Mean participant age was 66.3 ± 10.8 years (72.0% female), and mean survey period was 29.1 ± 9.6 days (866 observations). Mean TST of FCs was 5.7 ± 1.4 hours. In total, 32.0% of FCs were employed either full- or part-time. TST of employed FCs was significantly associated with care burden and negative affect (B = −0.4 and −1.3, respectively); however, positive affect was not associated with TST. FCs who were unemployed experienced less care burden and negative affect (rate of change: −7.7 and −8.0, respectively). Additionally, TST of unemployed FCs was associated with negative affect; thus, when they slept 1 hour longer than their mean TST, they experienced less negative affect the following day. Conclusion: A reduction in TST could lead to increased care burden and more severe negative affect the following day, which may be moderated by employment status.

Aims/Introduction This 6‐month, single‐center, prospective, open‐labeled, randomized trial was designed to investigate whether physicians’ diabetes self‐management education using an education tool developed by the Japan Association of Diabetes Education and Care and a self‐monitoring of blood glucose (SMBG) analyzer improves glycemic control in individuals with type 2 diabetes receiving insulin and SMBG. Materials and Methods Participants were randomized into intervention (I) and control (C) groups. Both groups received physicians’ diabetes self‐management education at each hospital visit, whereas the Japan Association of Diabetes Education and Care education tool and the SMBG readings analyzer was used in group I, but not group C. All participants filled out a diabetes treatment‐related quality of life form and an original questionnaire on SMBG use with five questions (Q1–Q5) before and after the study period. Results A total of 76 individuals were recruited and randomized. Glycated hemoglobin (HbA1c) was significantly improved during the study period in group I, whereas no significant change was observed in group C. The change in HbA1c was greater in group I, although it did not reach statistical significance. The diabetes treatment‐related quality of life total score was not changed in either group. Interestingly, the score of Q1 (“How important is SMBG to you?”) in the SMBG questionnaire was unchanged in group I, whereas it was significantly decreased in group C. HbA1c change was independently associated with changes in insulin dose and SMBG Q1 score. Conclusion Greater HbA1c‐lowering by physicians’ diabetes self‐management education using the Japan Association of Diabetes Education and Care education tool and SMBG analyzer in individuals with type 2 diabetes receiving insulin and SMBG was suggested, but not confirmed., Use of the newly developed Japan Association of Diabetes Education and Care Diabetes Education Card System Program with a self‐monitoring of blood glucose readings analyzer improves glycated hemoglobin, likely by facilitating patient–physician interaction in individuals receiving insulin and self‐monitoring of blood glucose.

5-Fluorouracil (5-Fu) is a DNA-damaging agent and teratogenic in rodents. This study aimed to investigate its influence on neural progenitor cells (NPCs) in the developing fetal rat brain. Dams were intraperitoneally injected with 5-Fu (50 mg/kg b.w.) on gestation day 13 and its effects on fetal NPCs were observed from 3 to 72 hours after treatment (HAT), via periodic examination at six intervals. In NPCs of the fetal brain, the p53-labeling index (LI%) was markedly elevated at 3 HAT. Pyknosis and cleaved caspase-3-LI% also increased at 3 HAT, reaching peak values at 9 and 12 HAT. These parallel changes suggested the induction of apoptosis through a p53-mediated pathway. Pyknotic NPCs were distributed across the ventricular zone (VZ) of the telencephalic wall until 12 HAT, and became localized in the medial and dorsal layers at 12 and 48 HAT. Significant decreases in the numbers of mitotic NPCs and BrdU-LI% were noted from 3 HAT and 24 HAT, respectively. BrdU-positive NPCs were located in the ventral and middle layer at 24 and 48 HAT. p21-positive cells were detected at 12 and 24 HAT. The present results demonstrated that p53-mediated apoptosis was induced in all phases of the cell cycle of the NPCs in the early stage after 5-FU treatment. Furthermore, apoptosis of NPCs and suppression of cell proliferative activity are the events that take place in parallel leading to prominent reduction in the width of the telencephalic wall.

Type 2 diabetes mellitus (T2DM), common in older people, is an important reason for muscle loss in Japanese and Taiwanese populations. However, little is known about the association between lifestyle behaviours and muscle quality. We aimed to compare the lifestyle behaviours of Japanese and Taiwanese older adults with T2DM and to the identify lifestyle factors associated with muscle quality.This cross-sectional study was conducted among community-dwelling individuals with T2DM aged ≥65 years in Taiwan and Japan. Totally, 114 Japanese and 226 Taiwanese participants were enrolled in the study. Outcomes were measured by blood biochemical examinations, body composition analyses and structured self-reported questionnaires to assess lifestyle behaviours and muscle quality. Linear regression models were used to examine the relationship between lifestyle factors and muscle quality using SPSS version 27.0 with a statistical significance level of P 0.05.Japanese subjects were more likely to be smokers and alcohol consumers, and they were less likely to have well-balanced diets and engage in more physical activity as compared to Taiwanese subjects. The muscle quality in the Japanese subjects was significantly poorer than that in the Taiwanese subjects. Physical activity, dietary habits and smoking were associated with muscle quality, after adjusting for age, gender and body mass index.Physical activity of insufficient intensity, unhealthy dietary habits and smoking could be risk factors for poor muscle quality. These findings can contribute to the development of effective strategies to improve muscle quality in community-dwelling older Asian people with T2DM.

Unilaterally swollen eyes were histopathologically characterized in four MG-W gerbils. The primary lesions resided in the anterior segment of the eye where neural crest cells play a critical role in embryonic development. They included indistinct filtration angle, unformed canal of Schlemm, hypoplastic iris, and ciliary body. The findings noted in the retina, optic nerve, optic tract, and lateral geniculate nucleus were consistent with the lesions induced following the persistent elevation of intraocular pressure as a result of insufficient drainage of aqueous humor. Thus, the present cases observed in the eyes of MG-W gerbils exemplified the anterior segment dysmorphogenesis associated with inadequate neural crest migration or differentiation, leading to subsequent glaucoma.

To clarify the association between lifestyle changes as a result of coronavirus disease 2019 containment measures and changes in metabolic and glycemic status in patients with diabetes, a cross‐sectional, single‐center, observation study was carried out. A self‐reported questionnaire was provided to ascertain the frequency of various lifestyle activities before and after the coronavirus disease 2019 containment measures in Japan. Among 463 patients, change in glycated hemoglobin was significantly associated with change in bodyweight. After stratification by age 65 years, binary logistic regression analysis showed that increased frequency of snack eating increased bodyweight (odds ratio 1.709, P = 0.007) and glycated hemoglobin (odds ratio 1.420, P = 0.025) in the younger group, whereas in the older patients, reduced walking activities resulted in weight gain (odds ratio 0.726, P = 0.010). In conclusion, changes in eating behavior and physical activity increased bodyweight and reduced glycemic control among diabetes patients, but by different processes depending on age under the coronavirus disease 2019 containment measures in Japan., We investigated lifestyle changes during the coronavirus disease 2019 containment measures, and its relationship with glycemic control and body weight change.

Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. We examined the relationship between plasma GDF-15 concentrations at baseline in 708 nonanemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased the risk of developing anemia (hazards ratio 1.15, 95% confidence interval 1.09, 1.21, p < .0001) compared to those in the lower 3 quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Circulating GDF-15 is an independent predictor for the development of anemia in older adults.

To examine the biological and morphological features of tubular aggregates (TAs) in the skeletal muscles of non-obese diabetic/Cg-PrkdcscidIl2rgtm1Sug /ShiJic (NOG) mice, 73 male and 72 female specific-pathogen-free NOG mice were examined at 7, 18, 22, 26, and 52 weeks of age. TAs were observed as intracytoplasmic eosinophilic materials of the femoral muscles in males at 18, 22, 26, and 52 weeks of age and in females at 52 weeks of age; gender-related differences were noted in the onset time and lesion degree. Intracytoplasmic materials were positive for Gomori's trichrome stain. Electron microscopy revealed that TAs were composed of an accumulation of dilated sarcoplasmic reticulum. In addition, TAs were observed in the femoral and gastrocnemius muscles, but not in the soleus and diaphragm muscles, suggesting that TAs are present in fast muscle fibers. The morphology of TAs and the type of myofibers involved, as well as the gender difference in NOG mice were essentially the same as those of TAs observed in C57BL/6J and MRL+/+ mice.

5-Fluorouracil (5-FU) is widely used as a chemotherapeutic agent that blocks DNA synthesis and replication by inhibiting thymidylate synthetase. This study aimed to elucidate 5-FU-induced changes in the external granular cells (EGCs) in the cerebellum of infant rats and the possible underlying mechanism. Six-day-old infant rats were injected subcutaneously with 40 mg/kg of 5-FU, and their cerebellums were examined at 6, 9, 12, and 24 h after treatment (HAT), and 2, 4, and 10 d after treatment (DAT). The width of the external granular layer (EGL) decreased from 24 HAT to 4 DAT in the 5-FU group compared to that in the control group. However, the width in the 5-FU group was comparable to that of the control group at 10 DAT. The number of apoptotic cells, cleaved caspase 3-labeling index (LI%), p21

Although comprehensive genomic profiling (CGP) tests have been covered under the Japanese national health insurance program since 2018, the utility and issues of CGP tests have not been clarified. We retrospectively reviewed 115 patients with incurable pancreatic cancer (IPC) who underwent CGP tests in a Japanese cancer referral center from November 2019 to August 2021. We evaluated the results of CGP tests, treatments based on CGP tests, and survival time. Eight cases (6.9%) were diagnosed as tumor mutation burden-high (TMB-H) and/or microsatellite instability-high (MSI-H). The gene mutation rates of KRAS/TP53/CDKN2A/SMAD4 were 93.0/83.0/53.0/25.2%, respectively. Twenty-five patients (21.7%) had homologous recombination deficiency (HRD)-related genetic mutations. Four patients (3.5%) having TMB-H and/or MSI-H were treated with pembrolizumab, and only two patients (1.7%) participated in the clinical trials. Patient characteristics were not significantly different between patients with and without HRD-related gene mutations. The median OS was significantly longer in the HRD (+) group than in the HRD (−) group (749 days vs. 519 days, p = 0.047). In multivariate analysis, HRD-related gene mutation was an independent prognostic factor associated with favorable OS. CGP tests for patients with IPC have the potential utility of detecting HRD-related gene mutations as prognostic factors as well as a therapeutic search.

This study aimed to evaluate the factors related to the mental health of foreign care workers in Japan’s long-term care (LTC) facilities and compare their results with those of native care workers. We conducted a cross-sectional survey covering 80 LTC facilities across Japan between August and November 2021. The survey mainly included mental health, workload, reward, sense of coherence, loneliness, COVID-19-specific factors and sociodemographic variables. The results show that workload was a distinct feature associated with the mental health of foreign care workers (n = 172) when compared with those of native care workers (n = 154). In addition, we found that the relationship between cultural adaptation and mental health in a sample of foreign care workers was mediated by loneliness and sense of coherence (SOC). Finally, we found that reward, loneliness, SOC, and COVID-19-specific factors had significant impacts on the mental health of both foreign and native care workers. These findings highlight the importance of support measures from the workplace for foreign care workers. Workplace interventions that focus on workload, reward, and sense of coherence strategies are required to address mental health improvement and may still be of value in dealing with the continuing COVID-19 pandemic.

To evaluate the safety of triptan use during pregnancy in a Japanese population, we descriptively analyzed the data on pregnancy and fetal outcomes from 128 pregnant women using triptans for migraine treatment at two Japanese facilities that provided counseling on drug exposure in pregnancy between 2001 and 2017. The risks of miscarriage, low birth weight, and preterm birth were similar to those reported in the demographic statistics in Japan. The incidence proportion of malformation was also within the baseline risk range. Accumulated data suggest that exposure to triptans during pregnancy does not clearly increase the risk of negative pregnancy and fetal outcomes. This finding can help reduce anxiety in pregnant women with migraines who are taking triptans.

Support for family caregivers (FCs) caring for older people with dementia in the home settings is a common issue in developed countries. Previous studies have reported that the increase in the burden of FCs not only causes health problems, but also makes it difficult to continue care at home and causes serious problems such as abuse. However, it is not clear how FCs’ stress, which leads to increased burden, fluctuates within a day through daily care activities. The aim of this study was to explore care activities that influence the increase in FCs’ stress. We recruited one dyad of an older adult with dementia over the age of 65 and a FC. Data collection was performed for consecutive 7 days throughout 24 hours. We adopted hamon® developed by Mitsufuji Corp. Japan to measure Heart Rate Variability (HRV)-based stress. Moreover, we asked a FC to talk with Virtual Agent on a laptop freely to understand when and what kind of care activities were done and how FC’s feelings were. Kruskal-Wallis’s test and Bonferroni’s multiple comparison test were used to compare differences in stress in the care contents. Results showed that sleeping care, which is composed of such as assistance in using the toilet and changing clothes, gives more stress to FC, compared with morning care which includes such as assistance in changing clothes, eating breakfast, and taking medicine (p=0.042). this finding is beneficial for considering how to reduce FC’s stress on daily care activities.

Oxidative folding of extracellular proteins is pivotal for the biogenesis of bacterial virulence factors. Escherichia coli DsbA catalyzes disulfide bond formation in extracellular proteins and in multicomponent architectures on the cell surface. The present study assessed the significance of the redox properties of DsbA by exploiting the plaque-forming ability of bacteriophage M13, which specifically recognizes F-pili during infection of the host cell. A library of mutant dsbA genes was constructed by randomizing the dipeptide XX sequence in the active-site redox motif CXXC and then screened for mutants that altered plaque yield and appearance. In total, 24 dsbA mutant alleles produced substantially different degrees of complementation, and one mutant dsbA gene that encodes a CDIC sequence produced over 40-fold more clear plaques than wild type dsbA. The redox potential of purified DsbA [CDIC] was −172 mV, representing a less-oxidizing catalysis than the wild type DsbA (−122 mV), but one that is closer to yeast protein disulfide isomerase (−175 mV). DsbA [CDIC] exhibited a greater ability to refold fully denatured glutathionylated ribonuclease A than the wild type enzyme and a DsbA [CRIC] mutant, which has the same redox potential of −172 mV. Homology modeling and molecular dynamics simulation suggest that the CDIC mutant may have an enlarged substrate-binding cleft near the redox center, which confers kinetic advantages when acting on protein substrates.

BACKGROUND Although diets rich in carotenoids are associated with reduced risk of cardiovascular disease, age-related macular degeneration, disability, and other adverse aging outcomes, the underlying biological mechanisms are not fully elucidated. OBJECTIVES To characterize the plasma proteome fingerprint associated with circulating carotenoid and retinol concentrations in older adults. METHODS In 728 adults, ≥65 years, participating in the Invecchiare in Chianti (InCHIANTI) Study, plasma α-carotene, β-carotene, β-cryptoxanthin, lutein, zeaxanthin, and lycopene were measured using high performance liquid chromatography. The SOMAscan assay was used to measure 1301 plasma proteins. Multivariable linear regression models were used to examine the relationship of individual carotenoids and retinol with plasma proteins. A false discovery rate approach was used to deal with multiple comparisons using a q-value

This study aimed to examine the relationship between one&rsquo, s physical status related to non-communicable diseases (NCDs) and social isolation, and to identify lifestyle behaviors for the prevention of NCDs associated with social isolation among community-dwelling older adults in Japan. A cross-sectional study was conducted to investigate lifestyle behaviors for NCD prevention associated with social isolation in Japanese adults aged 60 years and above in a community setting. Out of 57 participants, 17.5% were not socially participative, 66.7% hardly ever, 29.8% sometimes, and 3.5% often felt loneliness. Non-social participation and loneliness were negatively related to the frequency of vegetable and fruit intake. Additionally, loneliness was positively associated with one&rsquo, s duration of smoking and current smoking habits, and negatively associated with the frequency of moderate-intensity activities, with marginal significance. Those with non-social participation or loneliness were less likely to eat a healthy diet and live a smoke-free lifestyle. The findings of this study suggest that a mutual health support system in the community and the development of community-based approaches for the prevention of NCDs among Japanese older adults are needed.

INTRODUCTION: Chronic kidney disease (CKD) is an important cause of disability and death, but its pathogenesis is poorly understood. Plasma metabolites can provide insights into underlying processes associated with CKD. OBJECTIVES: To clarify the relationship of plasma metabolites with CKD and renal function in human. METHODS: We used a targeted metabolomics approach to characterize the relationship of 450 plasma metabolites with CKD and estimated glomerular filtration rate (eGFR) in 616 adults, aged 38–94 years, who participated in the Baltimore Longitudinal Study of Aging. RESULTS: There were 74 (12.0%) adults with CKD. Carnitine, acetylcarnitine, propionylcarnitine, butyrylcarnitine, trigonelline, trimethylamine N-oxide (TMAO), 1-methylhistidine, citrulline, homoarginine, homocysteine, sarcosine, symmetric dimethylarginine, aspartate, phenylalanine, taurodeoxycholic acid, 3-indolepropionic acid, phosphatidylcholines (PC).aa.C40:2, PC.aa. C40:3, PC.ae.C40:6, triglycerides (TG) 20:4/36:3, TG 20:4/36:4, and choline were associated with higher odds of CKD in multivariable analyses adjusting for potential confounders and using a false discovery rate (FDR) to address multiple testing. Six acylcarnitines, trigonelline, TMAO, 18 amino acids and biogenic amines, taurodeoxycholic acid, hexoses, cholesteryl esters 22:6, dehydroepiandrosterone sulfate, 3-indolepropionic acid, 2 PCs, 17 TGs, and choline were negatively associated with eGFR, and hippuric acid was positively associated with eGFR in multivariable analyses adjusting for potential confounders and using a FDR approach. CONCLUSION: The metabolites associated with CKD and reduced eGFR suggest that several pathways, such as the urea cycle, the arginine-nitric oxide pathway, the polyamine pathway, and short chain acylcarnitine metabolism are altered in adults with CKD and impaired renal function.

Home visit nurses (HVNs) are crucial in psychiatric home visit nursing (PHVN) in Japan. However, little is known about violence toward HVNs in PHVN and non–PHVN settings. The current study aimed to clarify nurses' experiences of violence in these settings, their implementation of preventive measures, and related associations. Questionnaires were distributed to HVNs who provided PHVN and non–PHVN services. Sixty-nine (38%) of 184 participants had experienced at least one form of violence during the past 12 months, and 87 (47%) had experienced violence during their PHVN career. In non–PHVN settings, violence was experienced by 94 (51%) participants in the past 12 months and 119 (65%) participants during their career. Low use of preventive measures was found. The management of visiting schedules and confirmation of HVNs' locations during visits were negatively associated with exposure to violence in PHVN settings. It is important to promote measures to prevent high exposure to violence, emphasize the monitoring of visits, and have nursing agencies clarify HVNs' concerns in PHVN settings. [ Journal of Psychosocial Nursing and Mental Health Services, 57 (4), 40–48.]

This study explores coping with STIs and related factors including knowledge, sexual behavior, and sex education among Korean adolescents. Anonymous self-administered questionnaires were distributed to 135 male and 150 female high school students. The results showed that 2.1% of participants had had sexual experience. Males had less information than females (p

Under an increasing number of people with dementia worldwide, the number of patients with dementia in acute settings is also growing. For patients with dementia to receive treatment with peace of mind, nurses should have competency in caring for patients with dementia. Thus, the aims of this study were to develop the Dementia Nursing Competency Scale in Acute Hospitals version 2 (DNCS-AH-v2) and to evaluate its psychometric properties. The draft was distributed to a convenience sample of 3000 nurses at 300 acute hospitals. After confirming the ceiling effect and the floor effect, reliability and validity were verified using Cronbach’s alpha, I-T correlation, test-retest reliability, G-P analysis, and exploratory and confirmatory factor analyses. This study was approved by the Institutional Review Board of Kobe University. Of a total of 3000 nurses, 878 (29.3%) responded to the questionnaire and 773 (25.8%) valid responses were analyzed. Mean age and mean working experience of the participants were 37.4 ± 9.3 and 14.0 ± 8.7 years, respectively. The 27-item DNCS-AH-v2 was developed with five factors scored on a six-point Likert scale. Cronbach’s alpha was .925, I-T correlation was between .46 and .68 (p

The aim of this study was to investigate the prevalence of sarcopenia and its associated risk factors among elderly with diabetes in Japan and Taiwan. A cross-sectional study was conducted through convenience sampling. This study was approved by the institutional review boards of Kobe University Graduate School of Health Sciences (No. 543) and Taipei Medical University (No. N201905065). Of the 114 Japanese participants (24.9% females) and 226 Taiwanese participants (75.1% females), the mean age were 73.7±6.9 years and 74.2±6.6 years, respectively. Sarcopenia was found in 10.6% in Japan and 11.1% in Taiwan with no significant difference between both countries. Older age, poor relationships with neighbors, and poor consciousness for health management were significantly associated with sarcopenia in both countries. Additionally, Japanese participants with sarcopenia had significantly longer duration of diabetes, higher level of emotional distress assessed by the Problem Areas In Diabetes (PAID) scale, and lower level of total protein, but no significant differences were shown in Taiwanese participants. Binomial logistic regression analyses were performed to detect risk factors related to sarcopenia. After adjusting for age, sarcopenia was found to be significantly associated with poor consciousness for health management in Japanese participants (OR:0.12 P=0.02) and significantly associated with poor relationships with neighbors and poor consciousness for health management in Taiwanese participants (OR:0.18 P=0.008 and OR:0.45 P=0.04, respectively). These findings are expected to contribute to the development of effective strategies for preventing sarcopenia among elderly with diabetes in Japan and Taiwan.

Environmentally friendly polymer membranes for dye contamination removal were prepared from edible calcium alginate. The stable gel structure was formed by molecular chains of sodium alginate cross-linked by chelate-formation with calcium ions. To improve the water permeability of the membranes and make them suitable for membrane separation processes, their mass transfer channels were precisely regulated to form fine voids via the addition of oligoethylene glycol (OEG) or polyethylene glycol (PEG) to a casting polymer solution and subsequent removal of the OEG or PEG from the membranes by a washing process after cross-linking. Fourier transform infrared spectroscopy confirmed that the chemical properties of the membranes with voids formed by OEG or PEG were the same as the properties of the original calcium alginate membrane without void forming. Despite their same chemical properties, the performance of the membranes clearly differed. The effect of the different void structures on the mass transfer channels was investigated using pure water permeation, Methyl Orange dye rejection, and volumetric void fraction measurements, as well as morphological observations by field-emission scanning electron microscopy. The membrane with voids formed by OEG exhibited to an increase in water permeability compared with the original membrane, whereas the molecular separation performance was maintained within the nanofiltration region. Meanwhile, the membrane with voids formed by PEG was suitable for use in high-flux ultrafiltration processes for pretreating wastewater. The biocompatible membranes with tailorable separation ability presented herein are candidates for use in purification processes for recovering dye-polluted water resources.

To examine the biological and morphological features of tubular aggregates (TAs) in the skeletal muscles of non-obese diabetic/Cg-PrkdcscidIl2rgtm1Sug/ShiJic (NOG) mice, 73 male and 72 female specific-pathogen-free NOG mice were examined at 7, 18, 22, 26, and 52 weeks of age. TAs were observed as intracytoplasmic eosinophilic materials of the femoral muscles in males at 18, 22, 26, and 52 weeks of age and in females at 52 weeks of age; gender-related differences were noted in the onset time and lesion degree. Intracytoplasmic materials were positive for Gomori’s trichrome stain. Electron microscopy revealed that TAs were composed of an accumulation of dilated sarcoplasmic reticulum. In addition, TAs were observed in the femoral and gastrocnemius muscles, but not in the soleus and diaphragm muscles, suggesting that TAs are present in fast muscle fibers. The morphology of TAs and the type of myofibers involved, as well as the gender difference in NOG mice were essentially the same as those of TAs observed in C57BL/6J and MRL+/+ mice.

Background H19 and IGF2 genes are imprinted and involved in regulating fetal and placental growth. The H19 differentially methylated region (DMR) is paternally methylated and maternally unmethylated and regulates the imprinted expression of H19 and IGF2. Epimutation at the H19-DMR in humans results in congenital growth disorders, Beckwith-Wiedemann and Silver-Russell syndromes, when erroneously its maternal allele becomes methylated and its paternal allele becomes unmethylated, respectively. Although H19 and IGF2 have been assessed for their involvement in pregnancy complications including fetal growth restriction (FGR) and pregnancy-induced hypertension (PIH)/hypertensive disorder of pregnancy (HDP) intensively in the last decade, it is still not established whether epimutation at the H19-DMR in the placenta results in pathogenic conditions in pregnancy. We aimed to assess the frequency of H19-DMR epimutation and its effects on the allelic expression patterns of H19 and IGF2 genes among normal and abnormal pregnancy cases. Results We enrolled two independently collected sets of placenta samples from normal pregnancies as controls and common pregnancy complications, FGR and PIH (HDP). The first set consisted of 39 controls and 140 FGR and/or PIH cases, and the second set consisted of 29 controls and 62 cases. For these samples, we initially screened for DNA methylation changes at H19-DMR and IGF2-DMRs by combined bisulfite restriction analysis, and further analyzed cases with methylation changes for their allelic methylation and expression patterns. We identified one case each of FGR and PIH showing hypomethylation of H19-DMR and IGF2-DMRs only in the placenta, but not in cord blood, from the first case/control set. For the PIH case, we were able to determine the allelic expression pattern of H19 to be biallelically expressed and the H19/IGF2 expression ratio to be highly elevated compared to controls. We also identified a PIH case with hypomethylation at H19-DMR and IGF2-DMRs in the placenta from the second case/control set. Conclusions Placental epimutation at H19-DMR was observed among common pregnancy complication cases at the frequency of 1.5% (3 out of 202 cases examined), but not in 68 normal pregnancy cases examined. Alteration of H19/IGF2 expression patterns due to hypomethylation of H19-DMR may have been involved in the pathogenesis of pregnancy complications in these cases. Electronic supplementary material The online version of this article (10.1186/s13148-019-0712-3) contains supplementary material, which is available to authorized users.