Smoking Exposure Is Associated with Serum Vitamin D Deficiency in Children: Evidence from the Japan Environment and Children’s Study

Tobacco smoke exposure is known to lower serum 25-hydroxyvitamin D (25(OH)D) concentrations. This study evaluated the association between passive smoking and vitamin D deficiency (VDD) in young children using data from the Japan Environment and Children’s Study (JECS), the largest birth cohort study in Japan. Information on parental smoking status was extracted from a survey of JECS for children aged 1.5 years and data for serum 25(OH)D concentrations were obtained from blood tests in the Sub-Cohort Study of JECS performed at age 2 years. Logistic regression and linear models were fitted to evaluate the association between these variables. Data were analyzed for 4593 children. After adjusting for covariates, smoke exposure was significantly associated with increased incidence of VDD (OR 1.35; 95% CI, 1.14–1.59) according to the logistic model. The linear model indicated that passive smoking negatively predicted de-seasonalized serum 25(OH)D concentrations (β −0.5; 95% CI −0.95 to −0.08) in children aged 2 years. The results suggest that smoke exposure is a risk factor for VDD in children. Given that VD plays a crucial role in bone metabolism and the immune system, our findings are significant for clinical and public health.     

Transmembrane Helix Assembly by Max–Min Ant System Algorithm

Because of the rapid progress in biochemical and structural studies of membrane proteins, considerable attention has been given on developing efficient computational methods for solving low‐to‐medium resolution structures using sparse structural data. In this study, we demonstrate a novel algorithm, max–min ant system (MMAS), designed to find an assembly of α‐helical transmembrane proteins using a rigid helix arrangement guided by distance constraints. The new algorithm generates a large variety with finite number of orientations of transmembrane helix bundle and finds the solution that is matched with the provided distance constraints based on the behavior of ants to search for the shortest possible path between their nest and the food source. To demonstrate the efficiency of the novel search algorithm, MMAS is applied to determine the transmembrane packing of KcsA and MscL ion channels from a limited distance information extracted from the crystal structures, and the packing of KvAP voltage sensor domain using a set of 10 experimentally determined constraints, and the results are compared with those of two popular used stochastic methods, simulated annealing Monte Carlo method and genetic algorithm.     

Factors related to ikigai among older residents participating in hillside residential community-based activities in Nagasaki City, Japan

Objective: The present study aims to investigate the factors related to self-rated ikigai (purpose in life) among older residents participating in hillside residential community-based activities in Nagasaki City.Methods: A self-administered anonymous questionnaire survey was carried out with older residents participating in two hillside residential community-based activities in Nagasaki City, Japan. The questionnaire included questions on sociodemographic information (age, sex, family structure, education, and self-rated economic satisfaction), self-rated health, mental health status measured using Geriatric Depression Scale-15 (GDS-15), and self-rated ikigai score that was estimated using a visual analog scale.Results: A total of 32 older residents (7 males, 25 females) participated in the questionnaire survey. Although self-rated ikigai score was not associated with sociodemographic factors, there were associations between the score, self-rated health (P=0.001), and mental health (GDS-15) (P=0.015). Statistically significant correlations between self-rated ikigai score and social participation (ρ=0.426, P=0.017), self-rated health (ρ=−0.485, P=0.007), and mental health (GDS-15) (ρ=−0.523, P=0.007) were observed.Conclusion: Increasing social participation may increase individual ikigai, preventing poor self-rated health and low mental health status in older people. Maintaining their social participation in the community might be effective for the health promotion of older residents in hillside residential areas of Nagasaki City.     

Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists

Aim Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion. Background The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation. Method A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert‐type attitudinal scales, designed specifically for the study. Results and conclusions Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing. Implications for nursing management While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers new understandings on the views of senior clinicians concerning nurse prescribing at a time of ongoing professional policy iteration and practice change in the area.     

Modified epiphyseal index for MRI in Legg-Calve-Perthes disease (LCPD)

On radiographs flattening of the femoral head is evaluated by the Epiphyseal Index (EI). Using the ability of MRI to show articular cartilage and the physis clearly, we wish to propose the use of an Epiphyseal Index for MRI (EIM) and demonstrate the value in LCPD. Fifteen patients were examined using 1.5T MR scanner and T1-weighted coronal images were obtained. EIM was calculated as a ratio of height and width of cartilaginous contour surrounding epiphysis, and was compared between normal and the three radiographic stages. EIM of normal hips were ranged from 0.39 to 0.60 and had a tendency to decrease with increasing age. All cases of Stage 1 (avascular necrosis) were within the normal range (n=4, mean=0.51, SD=0.045). EIM of Stage 2 (fragmentation,n=15, mean=0.31, SD=0.055) were smaller than that of Stage 1. Stag 2 and 3 (residual,n=12, mean=0.31, SD=0.077) could not be distinguished by EIM. EIM was useful to show the flattening of epiphysis with growth and very important for differenciation between Stage 1 and 2 LCPD.     

Autoradiographic localization and pharmacological characterization of [3H]tandospirone binding sites in the rat brain.

The regional distribution and pharmacological properties of [3H]tandospirone binding sites in the rat brain were investigated using quantitative autoradiography. [3H]Tandospirone binding was notably high in the dentate gyrus and CA1 area of the hippocampus, lateral septum, entorhinal cortex, interpeduncular nucleus and dorsal raphe nucleus. The distribution profiles of [3H]tandospirone binding sites significantly correlated with that of serotonin (5-HT)1A receptors identified using [3H]8-OH-DPAT. In competitive binding studies, [3H]tandospirone binding was inhibited by 5-HT, 8-OH-DPAT, pindolol, buspirone and N-(a,a,a-trifluoro-m-tolyl)-piperazine. The potencies of these ligands correlated with their affinities for 5-HT1A receptors. In addition, there was no significant difference in the dissociation constant of [3H]tandospirone binding between the dentate gyrus, CA1 area, dorsal raphe nucleus, lateral septum and entorhinal cortex (about 10 nM) suggesting that [3H]tandospirone binds to 5-HT1A receptors with same affinities in these brain structures. The distribution pattern of binding sites for [3H]tandospirone was also compared with that of benzodiazepine receptors identified using [3H]fludiazepam to find common effector sites for different types of anxiolytics. Some similarities were observed. It is evident in the hippocampal formation that an overlap of intense binding occurred. 5-HT1A receptors in the hippocampus may participate in the anxiolytic effects of tandospirone.     

Pulsatile secretion of prolactin and luteinizing hormone and their synchronous relationship during the human menstrual cycle

Recent investigations have demonstrated the pulsatile nature of prolactin (PRL) secretion and the synchronous relationship between PRL and LH pulses in normal and hypogonadal women. The present study was designed to confirm this synchrony and to investigate the characteristics of PRL pulses at different stages of the menstrual cycle. Blood samples were obtained at 10-minute intervals, beginning at 10.00 hours, for a duration of 4-7 hours, from women during the follicular (n = 11), preovulatory (n = 2) and luteal (n = 10) phases. Detectable pulses in plasma PRL concentrations were present in almost all subjects during each phase of the cycle. During the total 121-hour blood sampling throughout the 3 phases, 62 PRL pulses and 74 LH pulses were detected and about 80% of the PRL pulses were observed to coincide with LH pulses. The mean (+/- SD) pulse frequency of PRL was significantly lower during the luteal phase (0.28 +/- 0.17 pulses/hour) than during the follicular (0.64 +/- 0.25 pulses/hour) and preovulatory (0.72 +/- 0.16 pulses/hour) phases, while the mean pulse amplitude of PRL was significantly greater during the luteal phase (6.8 +/- 2.3 ng/ml) than during the follicular (3.6 +/- 1.2 ng/ml) and preovulatory (4.1 +/- 1.0 ng/ml) phases. These changes in pulse frequency and amplitude were also observed in LH pulses between the follicular and luteal phases, except at the LH surge, when LH pulse amplitude increased markedly, but that of PRL did not alter. Furthermore, a positive linear correlation between the pulse frequency of PRL and LH (r = 0.74, p less than 0.001) was found throughout the 3 phases of the cycle. These results demonstrate that a marked degree of synchrony between PRL and LH pulses is observed during the menstrual cycle and suggest that the frequency and amplitude of PRL pulses vary from the follicular to luteal phases, except at the LH surge, almost in parallel with those of LH pulses.     

Knowledge of diagnosis, treatment and its side-effects in patients receiving chemotherapy for cancer

In the past, receiving a diagnosis of cancer was tantamount to being told one was going to die, and because it was feared that patients would not be able to cope with this knowledge, doctors frequently withheld information from patients about their diagnosis. With recent adcances than ever. However, a review of the literature appeatrs to indicate that patients still have knowledge deficits with regard to their diagnosis, treatment and its side -effects.
A study of 30 patients receiving chemotherapy for cancer was undertaken to determine their knowledge about their diagnosis, Treatment and its side-effects. The vast majority knew their diagnosis, the number of treatments involved and the purpose of their treatment. However, the patients in this study displayed a poor knowledge of the potential side-effects of their chemotherapy and of the names of the drugs they were receiving as part of their chemotherapy.     

Inflammatory reaction and laboratory tests: hematologic examination

The leukocyte count, the differential leukocyte count and the erythrocyte sedimentation rate (ESR) are the more commonly used tests for diagnosing or managing an inflammatory process. Measurements of acute-phase proteins has an advantage over that of the leukocyte count and ESR. Especially microscopic examination of peripheral blood smear can be time consuming, but the simple and inexpensive technique is still clinically useful when a high grade bacteremia is likely to be present. Although the results are examiner dependent, it should be reliable in the proper clinical setting. In the guidelines for the selection of laboratory tests for monitoring the acute phase response, published in 1988, the International Committee for Standardization in hematology (ICSH) considered the biohazzard of ESR. Therefore the ESR should not routinely be performed on blood samples from patients who show a positive test for hepatitis virus or human immunodeficiency virus. The subcommittee for laboratory tests in daily care situations in Japan Society of Clinical Pathology published the "Essential Laboratory Tests" in 1989. We conclude that the differential leukocyte counts and the ESR should be used to follow the activity and response to treatment of certain inflammatory disorders when other objective indicators are not available.     

Diagnostic utility of transbronchial lung cryobiopsy: Two cases of anti-aminoacyl-tRNA synthetase syndrome with respiratory failure

Transbronchial lung cryobiopsy (TBLC) is a useful and safe method for the diagnosis of interstitial lung disease (ILD). Herein, we describe the cases of two patients who developed ILD from anti-aminoacyl-tRNA synthetase syndrome with respiratory failure. TBLC was performed instead of surgical lung biopsy. There were no complications, and sufficient specimens were harvested to make the precise histopathological diagnosis. TBLC should be considered as a critical approach for the histopathological diagnosis of ILD in patients who cannot undergo surgical lung biopsy because of respiratory failure.