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Simple Summary: Retained placenta (RP) is one of the most periparturient diseases of dairy cows, in which the placenta is not expelled from the body within 24 h of calving. This condition increases the risk of other periparturient diseases and decreased milk production and reproductive efficiency. In order to reliably predict PR, this study focused on the activity of lecithin:cholesterol acyltransferase (LCAT) and compared its usefulness in the prepartum prediction of PR with the concentration of non-esterified fatty acids (NEFA). LCAT is an enzyme synthesized in the liver that converts free cholesterol to cholesteryl esters, which is known to be acutely related to and reduced by periparturient diseases. NEFA is a fatty acid that increases in the blood when animals are in negative energy balance and has been reported as a useful prepartum predictor of some perinatal diseases. This study was carried out at a single farm with approximately 200 Holstein parous cows from February 2010 to February 2016. Twenty-seven parous cows between 2 and 21 days (close-up stage) before their expected calving dates that developed RP (RP group) were assessed. They were compared with 60 clinically healthy cows (controls) that did not develop RP and were matched with the RP group for sampling period and parity. The results of this study were as follows: LCAT showed adequate discriminative ability of PR occurrence comparable to that of NEFA. However, LCAT or NEFA plus RFS showed higher discrimination ability than both alone. These results indicate that LCAT has a useful ability to predict the occurrence of RP. The purpose of this study was to investigate the usefulness of the activity of lecithin:cholesterol acyltransferase (LCAT), the enzyme responsible for esterification of cholesterol in plasma, as a predictor of retained placenta (RP) in close-up cows, compared with the non-esterified fatty acids (NEFA) concentration. This study was conducted as a case–control study between February 2010 and February 2016, on a single farm with approximately 200 Holstein parous cows in Hokkaido, Japan. Of the 1187 dairy cattle that calved, 835 dairy cattle were enrolled that underwent routine regular health examinations including blood sampling, body condition score (BCS) and the rumen fill score (RFS) at the close-up stage between 2 and 21 days before their expected calving dates. Of these, 27 cows that were multiparous and had RP were designated as the RP group. The controls were 60 clinically healthy cows that did not develop RP and were matched for the sampling period and parity with the RP group. The LCAT activity and NEFA concentration were significantly (p < 0.01) lower and higher, respectively, in the RP group than in controls. There was no significant difference in cholesteryl esters, free cholesterol concentrations and BCS between the two groups. However, RFS was significantly (p < 0.01) lower in the RP group than in the controls. Cows with LCAT activity of <450 U were 3.6 times more likely to develop RP than those with higher values, whereas those with NEFA levels above 0.4 mEq/L were 5.4 times more likely to. The area under the curve of receiver operator characteristic curves showed that LCAT activity was as efficient as the NEFA concentration in the diagnostic prediction of RP, suggesting it to be a useful predictor. Logistic regression analysis with LCAT or NEFA and RFS as explanatory variables resulted in a model with higher predictive accuracy than with each alone, indicating RFS to be a possible factor in predicting RP. [ABSTRACT FROM AUTHOR]

Background: Skin disorders are the most common side effect associated with epidermal growth factor receptor‐tyrosine kinase inhibitor (EGFR‐TKI) therapy. It is important to manage skin lesions. Adapalene has been used to treat skin lesions caused by EGFR‐TKIs in some cases. The aim of this study was to investigate the functional mechanism of adapalene in erlotinib‐induced skin disorder. Methods: To analyze the effect of adapalene on skin rash, afatinib and adapalene were administered to mice. The relationship between the concentration of adapalene and skin disorders was also examined by analyzing AQP3 expression. A skin lesion model was experimentally established in human skin keratinocytes (HaCaT) by using erlotinib with TNF‐α and IL‐1β. We used qRT–PCR to analyze chemokine‐induced inflammation and western blotting to analyze the effects of adapalene on the NF‐κB signaling pathway. Antimicrobial peptides and adhesion factors were also examined using qRT–PCR. Results: Mice administered 0.01% adapalene had less skin inflammation than mice treated with afatinib alone. The expression level of AQP3 decreased in an adapalene concentration‐dependent manner. The mRNA levels of proinflammatory cytokines such as CCL2 and CCL27 in HaCaT cells were significantly reduced by adapalene. The expression of an antimicrobial peptide, hBD3, was upregulated after adapalene treatment. Adhesion factors, such as E‐cadherin, were significantly downregulated by EGFR‐TKI and significantly upregulated by adapalene treatment. Western blot analysis suggested that erlotinib‐induced phosphorylation of p65 was decreased by adapalene. Conclusion: We suggest that adapalene may be a possible treatment option for skin disorders induced by EGFR‐TKIs. [ABSTRACT FROM AUTHOR]

Background: Human resource management may become complex for community pharmacists owing to recent changes in work volume and content. Few studies have examined job satisfaction, well-being, and quality of work life (QWL) among community pharmacists in Japan. This study focused on QWL, a more comprehensive concept than job satisfaction, and aimed to develop the QWL questionnaire for Japanese community pharmacists (the QWLQ for JCP) and assess its reliability and validity. Methods: A questionnaire survey was conducted among 2027 pharmacists who worked in pharmacies with the cooperation of 20 corporations running pharmacies. Collected data were subjected to principal component factor analysis with Promax rotation via SPSS Windows version 28. Results: The factor analysis used data from 1966 pharmacists. In total, five significant components, which formed the basis of the QWLQ for JCP, were identified. These included "Influence of work on mind and body," "Relationships with colleagues," "Relationship with the boss," "Meaning of existence in the workplace," and "Pride in work." Cronbach's alpha, which expressed reliability, ranged from 0.585 to 0.854 for all the subscales. Conclusion: The QWLQ for the JCP significantly explained the concept of QWL, which indicated that its validity was sufficient. [ABSTRACT FROM AUTHOR]

Ultrathin bronchoscopy has been reported to have a higher diagnostic yield than thin bronchoscopy for small peripheral lung lesions in transbronchial biopsy under radial endobronchial ultrasonography (EBUS). However, data comparing the number of tumor cells in non-small cell lung cancer (NSCLC) are limited. We retrospectively compared the number of NSCLC tumor cells in peripheral lung lesions obtained using an ultrathin bronchoscope and a thin bronchoscope with radial EBUS between April 2020 and October 2021. In all patients, we used virtual bronchoscopic navigation (VBN) software, and guide sheaths were used in thin bronchoscopy cases. A total of 175 patients were enrolled in this study. Ultrathin bronchoscopy cases (n = 69) had lesions with a smaller diameter that are more peripherally located compared to thin bronchoscopy cases (n = 106) (median, 25.0 vs. 26.5 mm, mean bronchial generations accessed by bronchoscopy; 4.4±1.2 vs. 3.8±1.0, respectively; p<0.010). There were no significant differences in the overall diagnostic yield (ultrathin vs. thin bronchoscopy cases, 68.1% vs. 72.6%, p = 0.610) or diagnostic yield in only lung cancer cases (78.6% vs. 78.5%, p = 1.000). In histologically NSCLC cases (n = 102), the maximum number of tumor cells per slide as the primary endpoint was similar (average, 307.6±246.7 vs. 328.7±314.9, p = 0.710). The success rate of the Oncomine™ analysis did not differ significantly (80.0% vs. 55.6%, p = 0.247). The yield of NSCLC tumor cells was not different between the samples obtained by the ultrathin bronchoscope and those obtained by the thin bronchoscope. [ABSTRACT FROM AUTHOR]

Background: In Japan, non-pharmacists who are accredited as registered salespersons can sell over-the-counter (OTC) drugs, and they play a very important role in supporting proper OTC drug use by consumers. The purpose of this study was to evaluate information provided to and information collected from consumers, and cooperation with pharmacists during OTC drug sales by registered salespersons, and to clarify their related concerns and behaviors.Methods: A cross-sectional questionnaire-based survey of 385 registered salespersons working at 56 drugstores throughout Japan was conducted. Based on the questionnaire survey, the frequency of information provision/collection in various categories was determined for the registered salespersons. The relation between concerns of registered salespersons relating to OTC drug sales and the frequency of information provision/collection was examined. The frequency of consultation of registered salespersons with a pharmacist was calculated for registered salespersons with/without in-store pharmacists. The χ-square test or Fisher's exact test was performed to assess the significance of differences.Results: Two hundred and seven registered salespersons (53.7%) responded completely. A greater number of OTC drug purchasers per day was associated with a greater frequency of information provision about "side effects" and information collection about "favorite items" (alcohol, tobacco, health foods, etc.) (p < 0.05). One hundred and thirty-nine (67.2%) participants had concerns about "interactions between OTC drugs and prescription drugs", and these concerns were related to the frequency of information provision/collection (p < 0.05). Regarding the frequency of consultation with a pharmacist, 35 of 46 participants (76.1%) working with pharmacists answered "always" or "usually", whereas only 19 of 161 participants (11.8%) working without full-time pharmacists answered "always" or "usually". More than half of the registered salespersons thought that cooperation with a pharmacist was necessary when they were "asked about concomitant use with prescription drugs" or "told that side effects happened."Conclusions: The results of this study show that experienced registered salespersons selling OTC drugs are more likely to collect information from consumers and to provide information to consumers. It appears to be important for registered salespersons to cooperate with pharmacists in order to provide and collect appropriate information about concomitant medications. [ABSTRACT FROM AUTHOR]

Background: Adequate tumor tissue is required to make the best treatment choice for non-small cell lung cancer (NSCLC). Transbronchial biopsy (TBB) by endobronchial ultrasonography with a guide sheath (EBUS-GS) is useful to diagnose peripheral lung lesions. The data of tumor cell numbers obtained by two different sizes of GSs is limited. We conducted this study to investigate the utility of a large GS kit to obtain many tumor cells in patients with NSCLC. Methods: Patients with a peripheral lung lesion and suspected of NSCLC were prospectively enrolled. They underwent TBB with a 5.9-mm diameter bronchoscope with a large GS. When the lesion was invisible in EBUS, we changed to a thinner bronchoscope and TBB was performed with a small GS. We compared the tumor cell number prospectively obtained with a large GS (prospective large GS group) and those previously obtained with a small GS (small GS cohort). The primary endpoint was the tumor cell number per sample, and we assessed characteristics of lesions that could be obtained by TBB with large GS. Results: Biopsy with large GS was performed in 55 of 87 patients (63.2%), and 37 were diagnosed with NSCLC based on histological samples. The number of tumor cells per sample was not different between two groups (658±553 vs. 532±526, estimated difference between two groups with 95% confidence interval (CI); 125 (-125–376), p = 0.32). The sample size of the large GS group was significantly larger than that of the small GS cohort (1.75 mm2 vs. 0.83 mm2, estimated difference with 95% CI; 0.92 (0.60–1.23) mm2, p = 0.00000019). The lesion involving a third or less bronchus generation was predictive factors using large GS. Conclusions: The sample size obtained with large GS was significantly larger compared to that obtained with small GS, but there was no significant difference in tumor cell number. The 5.9-mm diameter bronchoscope with large GS can be used for lesions involving a third or less bronchus generation. [ABSTRACT FROM AUTHOR]

Background: Registered dietitians are rarely employed at community pharmacies in Japan, even though dietetic advice might benefit some patients.Objective: To clarify the present status of dietetic consultation provided by registered dietitians and their collaboration with pharmacists in community pharmacies.Methods: We conducted a cross-sectional questionnaire-based survey of pharmacists and registered dietitians who work in community pharmacies. The surveyed items were: frequency of dietetic consultation, awareness of one's knowledge and ability to conduct dietetic consultation, concerns, pharmacists' recognition of the need for nutritional support at community pharmacies, and cooperation between registered dietitians and pharmacists.Results: Sixty-six registered dietitians, 53 pharmacists in pharmacies with registered dietitians/dietitians, and 110 pharmacists in pharmacies without registered dietitians/dietitians responded. The frequency of dietetic consultation regarding obesity and hypertension was significantly higher for registered dietitians than for pharmacists. The ability to conduct dietetic consultation regarding diseases/conditions such as kidney disease not requiring dialysis, hyperuricemia, gout, obesity and hypertension was also significantly higher for dietitians than pharmacists. More than 70% of pharmacists recognized the importance of nutritional support at community pharmacies, while 56.1% of registered dietitians noted that they were not able to fully utilize their occupational abilities. Registered dietitians were divided into two groups: registered dietitians who answered that they were able to utilize their occupational abilities and those that answered they were not. The former group was more likely to ask pharmacists about patients' medication for dietetic consultation and to be asked to provide dietetic consultation to patients. The latter group was more likely to find difficulty in scheduling dietetic consultation.Conclusion: Our results suggest that registered dietitians in community pharmacies have a greater explanatory ability than pharmacists concerning nutritional and dietary management for patients. It may be important for pharmacists to improve cooperation with registered dietitians by providing more opportunities for dietetic consultation. [ABSTRACT FROM AUTHOR]

Background: Tablets and capsules are the most common dosage forms. However, ease of use and/or swallowing influences patients' compliance. Objective: To identify patients' preferences regarding the three-dimensional size of medical tablets/capsules. Methods: Eighteen cylindrical-, oblong-, and oval-shaped model formulations having different sizes were prepared by three-dimensional printing using polylactic acid. Participants (40 patients visiting a pharmacy in Japan) evaluated the difficulty of picking up and swallowing these model formulations by touching/observing them, and completed a questionnaire. The visual analogue scale (VAS) was used to evaluate each sample, and the relationship of VAS scores to the major axis, thickness, I2 (the sum of major/minor axes) and I3 (the sum of major/minor axes and thickness) of the model formulations was evaluated by ANOVA followed by Tukey's test. Results: Female participants showed lower VAS scores (less difficult) for picking difficulty compared with male participants, and those taking many drugs showed higher VAS scores (more difficult) for swallowing difficulty compared with those taking fewer drugs. Otherwise, age, gender, disease status, number of drugs usually taken, and ingestion problems did not greatly influence the evaluation. Overall, larger model formulations showed less picking difficulty, but greater swallowing difficulty. Model formulations 2 mm thick or less were harder to pick up, whereas those 6 mm thick or more were harder to swallow. I3 values greater than 20– 22 mm were associated with a negative evaluation by participants. Conclusion: Participants in this study preferred model formulations with an I3 value below 22 mm and a thickness of 2– 6 mm. [ABSTRACT FROM AUTHOR]

Background: Medical tablets and capsules are superior with regard to portability and are the most common dosage form in Japan. However, their large size often results in difficulties during ingestion, sometimes leading to reduced medication adherence. Objective: The authors used postmarketing surveillance data to determine the threshold size of medical tablets and capsules that patients feel are too large to ingest. Patients and Methods: The marketing specialists of Toho Pharmaceutical Co., Ltd. collected opinions of patients and medical workers (November 2014–April 2016). Regarding 709 reports from patients stating that the tablet or capsule for too large for ingestion, a dataset was prepared from package inserts of the reported drugs. Two analyses were conducted: histogram analysis of size distribution and geometric analysis using linear approximation. Six indices of tablet/capsule size were considered: length; length + width; length + width + depth; length × width; length × width × depth; and weight. Results: Histogram analysis revealed that length + width + depth is an excellent index of tablet/capsule size, and negative reports on tablet/capsule size drastically increase when this index is ≥ 21 mm. Geometric analysis using linear approximation also revealed similar results. Conclusion: The threshold size of tablets/capsules that patients feel are too large to ingest is length + width + depth = 21 mm. Therefore, when designing or altering tablets/capsules, if length + width + depth is ≥ 21 mm, the drug should be scored, split into smaller doses, or redesigned as an orally disintegrating formulation. [ABSTRACT FROM AUTHOR]

Background: Press-through-package (PTP) sheets are common forms of packaging for medicines in Japan. However, patients and/or pharmacists have reported difficulty in extracting tablets or capsules from some PTP sheets. Objective: We used postmarketing surveillance data to identify the characteristics of PTP sheets that patients and pharmacists feel are "hard to use". Methods: Marketing specialists of Toho Pharmaceutical Co., Ltd. canvassed patients and medical workers during November 2014–April 2016. Among 1,129 anonymous reports of products being "hard to use", we identified 39 products with 5 or more reports (Problem group). We compared the sizes of the drugs and PTP pockets, the size ratio, the material used for the front of PTPs, the shape of the pockets, the thickness of the pocket wall, and the force needed to release the drug from the PTP (press-out force: POF) in this Problem group with those in a Control group of 97 problem-free products. Results: Logistic regression analyses revealed that a bigger pocket, a smaller drug size and a smaller drug-pocket size ratio increase the risk of being "hard to use". Regarding the material, aluminum, PCTFE and PE increase the risk, while PP and PVC decrease the risk. Other factors had no significant influence. Conclusion: Pockets in PTP sheets should be designed so as to minimize the gap between the drug and the pocket, and PP or PVC should be used as the front material instead of aluminum, PCTFE or PE. Our results suggest that marketing specialists can play effective roles in postmarketing surveillance. [ABSTRACT FROM AUTHOR]

Aim: Falls are a significant problem for older people, but are few studies of the risk of falling in residents of nursing homes in Japan. We aimed to investigate the risk factors for falls and the association of medication use and falls in nursing home residents in Japan. Methods: This case–control study reviewed the records of residents of who were ≥ 65 years of age and had fallen in 2012 and an age-, sex-, and facility-matched control group selected from 58 nursing homes in Japan. The odds ratios of potential risk factors and current medications were determined by conditional logistic regression. Results: A total of 1832 residents (916 cases and 916 controls) were included. Falls were significantly associated with an inability to walk without assistance or stand up without assistance, need for toileting assistance, visual impairment, insomnia, and dementia. Current prescription of antithrombotic, nonsteroidal anti-inflammatory, or antiparkinson drugs, muscle relaxants, antiepileptics, antipsychotics, antidepressants, opioids, selective serotonin reuptake inhibitors, and memantine was also associated with increased risk of falling. Conclusions: Many medications were associated with falls in nursing homes residents in Japan. To prevent these falls, caregivers should provide adequate care, and healthcare professionals should consider switching or dose reduction for these medications. [ABSTRACT FROM AUTHOR]

Aim We encountered a case of fetal toxicity due to ductus arteriosus (DA) constriction in a 36-week pregnant woman who had applied multiple ketoprofen patches. The aim of the present study was to present the case and develop a model to predict quantitatively the fetal toxicity risk of transdermal administration of ketoprofen. Methods Human placenta perfusion studies were conducted to estimate transplacental pharmacokinetic (PK) parameters. Using a developed model and these parameters, human fetal plasma concentration profiles of ketoprofen administered to mothers were simulated. Using pregnant rats, DA constriction and fetal plasma drug concentration after ketoprofen administration were measured, fitted to an Emax model, and extrapolated to humans. Results Transplacental transfer value at the steady state of ketoprofen was 4.82%, which was approximately half that of antipyrine (passive marker). The model and PK parameters predicted almost equivalent mother and fetus drug concentrations at steady state after transdermal ketoprofen administration in humans. Maximum DA constriction and maximum plasma concentration of ketoprofen after administration to rat dams were observed at different times: 4 h and 1 h, respectively. The model accurately described the delay in DA constriction with respect to the fetal ketoprofen concentration profile. The model with effect compartment and the obtained parameters predicted that use of multiple ketoprofen patches could potentially cause severe DA constriction in the human fetus, and that fetal toxicity might persist after ketoprofen discontinuation by the mother, as observed in our case. Conclusion The present approach successfully described the sustained fetal toxicity after discontinuing the transdermal administration of ketoprofen. [ABSTRACT FROM AUTHOR]

S100A11, a small Ca binding protein, acts extracellularly as a mediator of cancer progression. That raises the question of how a protein that lacks the classical secretory signal is able to be secreted outside cells without being damaged. Some insights into this question have been obtained, and there has been accumulating evidence indicating a pivotal role of a non-classical vesicle-mediated pathway using lysosomes or peroxisomes for the protein secretion. To obtain a more precise insight into the secretory mechanism of S100A11, we first screened representative cancer cells exhibiting significantly active secretion of S100A11. From the results of profiling, we turned our attention to aggressive cancer mesothelioma cells. In mesothelioma cells, we found that abundant dimeric S100A11 was produced selectively in the peroxisome after transportation of monomeric S100A11 through an interaction with PEX14, a peroxisome membrane protein, resulting in peroxisomal secretion of dimerized S100A11. In an extracellular environment in vitro, dimerized S100A11 promoted mesothelial cell invasion indirectly with the help of fibroblast cells. Overall, the results indicate that the peroxisome functions as an essential vesicle for the production of dimerized S100A11 and the subsequent secretion of the protein from mesothelioma cells and that peroxisome-mediated secretion of dimerized S100A11 might play a critical role in mesothelioma progression in a tumor microenvironment. [ABSTRACT FROM AUTHOR]

Colloidal assemblies of inorganic nanoparticles dispersed in liquid media hold particular promise for the creation of a unique class of functional materials with innovative applications. In the present report, 'compound-eye'-like core-shell and Janus-type silica and amino-terminated 1,2-polybutadiene (PB-NH2) and polystyrene (PS) composite microspheres are successfully prepared by simply mixing an aqueous dispersion of silica particles into a tetrahydrofran (THF) solution of PB-NH2, and PB-NH2 and PS blends, followed by evaporation of the THF. This co-precipitation process provides a new approach for producing organic-inorganic composite particles without the need for surface modification of the inorganic nanoparticles. [ABSTRACT FROM AUTHOR]

Purpose: Falls are an important public health problem in older people. Medication use is considered a risk factor for falls. This study systematically reviewed recent studies to determine the medications that might be associated with the risk of falling in older people. Methods: We conducted a systematic review of prospective and retrospective studies identified through the MEDLINE and CINAHL databases that quantitatively assessed the contribution of medications to falls risk in participants ≥60 years old published in English between May 2008 and April 2013. Results: The search identified 1,895 articles; 36 articles met the inclusion criteria. Of the 19 studies that investigated the effect of polypharmacy on the risk of falling, six studies reported that the risk of falling increased with polypharmacy. Data on the use of antihypertensive medications including calcium channel blockers, beta-blockers, and angiotensin system blocking medications were collected in 14 studies, with mixed results. Twenty-nine studies reported an association between the risk of falls and psychotropic medications including sedatives and hypnotics, antidepressants, and benzodiazepines. Conclusions: The use of sedatives and hypnotics and antidepressants including tricyclic antidepressants, selective serotonin reuptake inhibitors, and serotonin norepinephrine reuptake inhibitors appears to be related with an increased risk of falls. It is not clear if the use of antihypertensive medications is associated with the risk of falls in older people. [ABSTRACT FROM AUTHOR]

A simple fabrication method is demonstrated for surface-enhanced Raman scattering (SERS)-active plasmonic nanoballs, which consisted of Au nanoparticles (NPs) and core-shell polystyrene and amino-terminated poly(butadiene) particles, by heterocoagulation and Au NP diffusion. The amount of Au NPs introduced into the core-shell particles increases with the concentration of Au NPs added to the aqueous dispersion of the core-shell particles. When the amount of Au NPs increases, closely packed, three-dimensionally arranged and close-packed Au NPs arrays are formed in the shells. Strong SERS signals from para-mercaptophenol adsorbed onto composite particles with multilayered Au NPs arrays are obtained by near-infrared (NIR) light illumination. [ABSTRACT FROM AUTHOR]

Background: Little is known about the combined risk of socioeconomic status and psychosocial environment for insomnia. Purpose: The purpose of this study was to investigate the combined risk of employment level and psychosocial work environment for insomnia in a large Japanese male working population. Method: We investigated 5,951 male employees aged 34-59 years from two local governments in Japan. Data were obtained from a questionnaire distributed in advance of their annual health check-up. Employment level was categorized as higher-level non-manual workers, lower-level non-manual workers, and manual workers. Psychosocial work environment was assessed using the Demand-Control Model and the Effort-Reward Imbalance Model (ERI). Insomnia was assessed using the Athens Insomnia Scale. Results: The results showed that 1,382 (23.2 %) participants suffered from insomnia. Lower employment level was significantly associated with a higher risk of insomnia. Job strain (ratio of job demand to job control), E/R (ratio of job effort to job reward), and OC (over commitment) were also significantly associated with insomnia. The relative excess risk due to the interaction between employment level and psychosocial environment (job strain, E/R, and OC) was 0.09 (95 % CI −0.57 to 0.76), 2.61 (0.74 to 4.48), and 3.14 (0.82 to 5.45), respectively; synergy index = 1.07 (0.66 to 1.74), 1.99 (1.37 to 2.90), and 2.25 (1.46 to 3.46), respectively. Conclusion: We found supra-additive interactions between employment level and psychosocial environment, assessed by the ERI (E/R and OC). Our findings suggested that lower level workers are more vulnerable to an adverse psychosocial environment than those at a higher level. [ABSTRACT FROM AUTHOR]

Background: Previous studies have demonstrated that sleep duration is closely associated with metabolic risk factors. However, the relationship between habitual sleep duration and blood pressure values in Japanese population has not been fully established. Methods: We performed a cross-sectional study of 1,670 Japanese male subjects to clarify the relationship between habitual sleep duration and blood pressure values. The study subjects were divided into four groups (<6, 6-, 7-, and ≥8 h) according to their nightly habitual sleep duration. Results: The rate of subjects with <6, 6-, 7-, and ≥8 h sleep duration was 12.0, 37.6, 38.2, and 12.2 %, respectively. Compared with the group with 7-h sleep duration (referent), the <6 and ≥8 h groups had significantly greater systolic and diastolic blood pressure values. The rate of hypertensive subjects, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, with sleep duration of <6, 6-, 7-, and ≥8 h was 13.4, 5.7, 7.5, and 13.8 %, respectively. Compared with the group with 7-h sleep duration (referent), the multivariate odds ratios (95 % confidence interval) of the groups with <6 and ≥8 h for hypertension was 2.43 (1.40-4.20, P < 0.01) and 2.28 (1.31-3.95, P < 0.01), respectively, adjusted for conventional cardiovascular risk factors. Conclusion: The present study demonstrates that both long and short habitual sleep duration were significantly associated with high blood pressure values and hypertension occurrence in Japanese male subjects. [ABSTRACT FROM AUTHOR]

Objective The aim was to determine whether mini mental state examination (MMSE) scores improved in older participants of a Functioning Improvement Tool (FIT) home-visit program. Methods Two hundred fifty-two participants aged 65 years or older living at home and receiving preventive services or a community long-term care prevention project according to the Japanese social long-term care insurance system were enrolled and randomly assigned to an intervention group ( n = 128) or a control group ( n = 124). Intervention group subjects received a 60-min FIT home-visit program for 3 months, which included guidance, assistance, and help in writing and teaching calculation in order to complete the FIT. Control subjects did not receive any home visits. Cognitive function was evaluated by MMSE. Analysis of covariance was used to examine the effects of the FIT adjusting for baseline MMSE scores, age, and sex. Results Fifty-three subjects were excluded because of withdrawal, hospitalization, death, relocation, or missing data of MMSE; 199 subjects (60 men, 139 women; age 78.6 ± 7.4 years) were analyzed. The baseline MMSE scores did not differ between the intervention and control groups (24.2 ± 4.3 vs. 24.1 ± 4.7, p = 0.90). After the study period, the change in the MMSE score was significantly better in the intervention group than in the control group (0.8 ± 0.3 vs. −0.1 ± 0.2, p = 0.04). Stratified analyses showed that the intervention strategy was most effective in subjects with mild cognitive decline, with baseline MMSE scores from 18 to 23 points (1.9 ± 0.5 vs. −0.1 ± 2.8, p = 0.04). Conclusions Our FIT home-visit program improved MMSE scores in older participants with mild cognitive decline. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose: A higher prevalence of insomnia in females has been consistently demonstrated across countries and cultures. The aim of this study was to clarify whether gender differences in insomnia could be explained by gender differences in paid work and family responsibilities. Methods: Participants were employees at two local governments in Hokkaido, Japan, who underwent annual health checkups from April 2003 to March 2004. All data were obtained via self-administered questionnaires. Insomnia was evaluated by the Athens Insomnia Scale. For work and family characteristics, occupation, working hours, days off, shift work, visual display terminal (VDT) work, occupational stress, marital status, hours spent on household tasks, childcare, and caregiving were chosen. Data from 7,451 participants (5,951 men and 1,500 women) were analyzed. Logistic regression analysis examined how much paid work and family responsibilities explained gender differences in insomnia. Results: The prevalence of insomnia in female subjects (31.0%) was significantly larger than in males (23.2%), but the gender difference disappeared after adjustment for paid work and family responsibilities. The results of stratified analyses revealed that significant gender differences were found only among workers with comparatively favorable work and family conditions, such as non-shift work, less than 6 h/day of VDT work, exposure to low levels of occupational stress, household tasks for less than 1 h/day, and not living with persons who needed care and support. Conclusions: These results suggest that gender differences in insomnia are explained, in the main, by gender differences in work and family characteristics. [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in full-term pregnant women leads to fetal or neonatal toxicity. However, the differences in fetal toxicity among NSAIDs remain to be fully investigated. • Therefore, the ability to predict fetal toxicity of NSAIDs quantitatively at full-term pregnancy would be of clinical value. WHAT THIS STUDY ADDS • This study presents a novel approach to predict quantitatively the fetal risk of NSAIDs administered to the mother. • This study shows that the fetal risk of diclofenac is higher than that of salicylic acid and antipyrine using the novel method. • Human placental perfusion study and pharmacokinetic/pharmacodynamic analysis may provide basic data for predicting human fetal toxicity of drugs. AIM The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in full-term pregnant women leads to fetal or neonatal toxicity, such as constriction of the ductus arteriosus (DA) and persistent pulmonary hypertension in the newborn. The aim of this study was to predict quantitatively the fetal toxicity of three NSAIDs (antipyrine, salicylic acid and diclofenac) using the transplacental pharmacokinetic parameters obtained from our previous placental perfusion studies. METHODS Human fetal plasma concentration profile after oral administration of each NSAID to the mother was estimated using the transplacental pharmacokinetic parameters and pharmacokinetic parameters in adult women. The fetal plasma concentration-response relationship for the three NSAIDs was estimated by pharmacokinetic/pharmacodynamic analysis of the results of previous studies investigating the effects of NSAIDs on the ratio of inner diameter of the DA to that of the pulmonary artery (DA/PA) in rats and the plasma concentration profiles of NSAIDs in pregnant rats. RESULTS The risk of constriction of the DA was well predicted by the model. Mean DA/PA ratio after oral administration of diclofenac to the mother was estimated to be 39.0%, whereas both of the corresponding values after oral administration of antipyrine and salicylic acid were estimated to be 5.9%. These results suggest that the fetal risk of diclofenac is higher than those of salicylic acid and antipyrine. CONCLUSIONS This study presents a novel approach to predict quantitatively the fetal risk of NSAIDs administered to the mother. Human placental perfusion study and pharmacokinetic/pharmacodynamic analysis may provide basic data for predicting human fetal toxicity of drugs. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether a difference in the risk for diabetes exists in Japanese workers with regard to sleep duration/quality and the presence or absence of a family history of diabetes (FHD).Research Design and Methods: The researchers conducted a prospective, occupational-based study of local government employees in Sapporo, Japan. Between April 2003 and March 2004, 3,570 nondiabetic participants, aged 35-55 years, underwent annual health checkups and completed a self-administered questionnaire that included information on sleep duration/quality and FHD at baseline. Having diabetes was defined as taking medication for diabetes or a fasting plasma glucose level of ≥126 mg/dL at follow-up (2007-2008).Results: A total of 121 (3.4%) new cases of diabetes were reported. In multivariate logistic regression models of workers without an FHD, and after adjustment for potential confounding factors, the odds ratio (95% CI) for developing diabetes was 5.37 (1.38-20.91) in those with a sleep duration of ≤5 h compared with those with a sleep duration of >7 h. Other risk factors were awakening during the night (5.03 [1.43-17.64]), self-perceived insufficient sleep duration (6.76 [2.09-21.87]), and unsatisfactory overall quality of sleep (3.71 [1.37-10.07]). In subjects with an FHD, these associations were either absent or weaker.Conclusions: The current study shows that poor sleep is associated with a higher risk of developing diabetes in workers without an FHD. Promoting healthy sleeping habits may be effective for preventing the development of diabetes in people without an FHD. [ABSTRACT FROM AUTHOR]

OBJECTIVE--To investigate whether a difference in the risk for diabetes exists in Japanese workers with regard to sleep duration/quality and the presence or absence of a family history of diabetes (FHD). RESEARCH DESIGN AND METHODS--The researchers conducted a prospective, occupational-based study of local government employees in Sapporo, Japan. Between April 2003 and March 2004, 3,570 nondiabetic participants, aged 35-55 years, underwent annual health checkups and completed a self-administered questionnaire that included information on sleep duration/quality and FHD at baseline. Having diabetes was defined as taking medication for diabetes or a fasting plasma glucose level of $126 mg/dL at follow-up (2007-2008). RESULTS--A total of 121 (3.4%) new cases of diabetes were reported. In multivariate logistic regression models of workers without an FHD, and after adjustment for potential confounding factors, the odds ratio (95% CI) for developing diabetes was 5.37 (1.38-20.91) in those with a sleep duration of ≤5 h compared with those with a sleep duration of .7 h. Other risk factors were awakening during the night (5.03 [1.43-17.64]), self-perceived insufficient sleep duration (6.76 [2.09-21.87]), and unsatisfactory overall quality of sleep (3.71 [1.37-10.07]). In subjects with an FHD, these associations were either absent or weaker. CONCLUSIONS--The current study shows that poor sleep is associated with a higher risk of developing diabetes in workers without an FHD. Promoting healthy sleeping habits may be effective for preventing the development of diabetes in people without an FHD. [ABSTRACT FROM AUTHOR]

Objectives: Cardiovascular morbidity and mortality are closely associated with hypertension, however, predictors of incident hypertension have not been fully established. We have conducted a study aimed at evaluating whether brachial-ankle pulse wave velocity (baPWV) is a predictor of incident hypertension. Methods: The relation between baPWV, a noninvasive index of aortic stiffness, and incident hypertension was evaluated in a cohort of 2,278 Japanese normotensive male subjects with a follow-up of 3 years. Results: Of the 2, 278 study participants, 151 (6.6%) had incident hypertension during the follow-up. After adjustment for variables, including age, gender, body mass index (BMI), smoking habit, alcohol consumption, diabetes mellitus, hyperlipidemia, family history of hypertension, heart rate, systolic blood pressure, low-density lipoprotein cholesterol, triglyceride, and fasting plasma glucose, multiple logistic regression analysis revealed that baPWV was a significant and independent predictor of incident hypertension with an adjusted odds ratio 1.45 (95% confidence interval 1.17-1.79, P < 0.01). In addition, baPWV values >1,380 cm/s indicated a high risk for incident hypertension. Conclusions: Among the Japanese normotensive male subjects participating in this study, BaPWV was a significant and independent predictor of incident hypertension. This result suggests that BaPWV could be a useful screening method to identify normotensive individuals who should be targeted for interventions aimed at preventing the incident hypertension. [ABSTRACT FROM AUTHOR]

The article discusses a study that examines the efficacy of predicting multiple metabolic risk factors using waist circumference among middle-aged Japanese subjects. The researchers examine the data from 6,033 participants and determine the significant relationship between waist circumference values and the metabolic risk factors. Study reveals that multiple metabolic risk factors can be predicted through waist circumference.

The purpose of this article is to report the first case of markedly increased anticoagulant activity of warfarin when used in combination with doxifluridine, given as a replacement for capecitabine. International normalized ratio (INR) of a 73-year-old female patient receiving warfarin was increased after starting chemotherapy using oral fluoropyrimidines (capecitabine or doxifluridine). Since the concomitant use of warfarin and the oral fluoropyrimidines was unavoidable in this case, the warfarin dosage was adjusted to keep INR within goal range (1.7–2.7). To evaluate the effects of the oral fluoropyrimidines on the anticoagulant activity of warfarin, the INR/Dose (warfarin dose in mg/day) was used. To keep INR within goal range, the maintenance dosage of warfarin was reduced during the treatment with doxifluridine as well as capecitabine. It was finally reduced from 5 mg daily in the absence of oral fluoropyrimidines to 1.5 mg daily during the concomitant use of doxifluridine (600 mg daily). In contrast, the higher INR/Dose (1.03–1.66) was continued during the concomitant use of warfarin and doxifluridine compared with the INR/Dose before the start of chemotherapy (about 0.5). These results clearly indicate that the anticoagulant activity of warfarin was markedly increased by the concomitant use of doxifluridine as well as capecitabine. It is important that physicians closely monitor anticoagulant activity in patients concomitantly receiving doxifluridine and warfarin, and appropriately adjust the dose of warfarin. [ABSTRACT FROM AUTHOR]

To accommodate real-time multimedia application while satisfying application-level QoS requirements in a wireless ad-hoc network, we need QoS control mechanisms. We proposed a new routing mechanism for a wireless ad-hoc network composed of nodes equipped withmultiple network interfaces. By embedding information about channel usage in controlmessages of OLSRv2, each node obtains a view of topology and bandwidth information of the whole network. Based on the obtained information, a source node determines a logical path with the maximum available bandwidth to satisfy application-level QoS requirements. In this paper, we evaluated feasibility of the proposal through simulation and practical experiments and confirmed that our proposal effectively transferred multimedia packets over a logical path avoiding congested links. The load on a network is well distributed and the network can accommodate more sessions than OLSRv2 and QOLSR. [ABSTRACT FROM AUTHOR]

Background: In Japan, staff who are not doctors or nurses can assist the elderly in residential care facilities to take their pre-packaged medicines. Therefore, there is a potential risk of incidents specific to staffs. The aim of this study was to clarify the causes of incidents related to medication assistance by staff in residential care facilities.Method: Semi-structured interviews with staff involved in medication incidents in long-term care facilities, focusing on how and why each incident happened, were conducted. The interview covered basic information about the subject and resident, the circumstances under which the incident had occurred, contributing factors, and countermeasures put in place. Verbatim transcripts of the interviews were prepared. Based on thematic analysis, codes and themes were created.Results: Twelve subjects participated in this study. All subjects were staffs (not doctors or nurses) in long-term care facilities. All incidents covered in this study were incidents in which the wrong resident was given the medication. The incidents arose because of "not following procedures", such as lack of "self-check of residents' faces/residents' names/residents' medicine envelopes" or "double-check with other staff" or "using a device for medication intake". Contributory factors were grouped into four categories: individual resident factor items such as "decreased ability to understand their medication" or "refusal to take medicines", individual staff factor items such as "lack of knowledge related to medication" or "mental burden" or "experience in medication assistance", team factor items such as "failure to communicate with other staff", work environment factor items such as "presence of other residents" or "other work besides medication assistance" or "not enough time" or "little understanding of fostering a safety culture at the facility".Conclusion: This study identified four categories of contributory factors that may lead to incidents during medication assistance by caregivers for residents of care homes. These findings should be helpful for risk management in residential care facilities where staff usually provide medication assistance. Separation of meal times and medication assistance, and professional review to stagger the timing of administration of residents' medication may be effective in reducing incidents. [ABSTRACT FROM AUTHOR]

A high-sensitivity CMOS image sensor using gain-adaptive column amplifiers is presented and tested. The use of high gain for the column amplifier reduces input-referred random noise, and when coupled with a column-based digital noise cancellation technique, also reduces fixed pattern noise. An experimental application of the circuit using 0.25-μm CMOS technology with pinned photodiodes gave an rms random noise of 263 μV and an rms fixed pattern noise of 50 μV. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the effect of a home visit program using a Functioning Improvement Tool (FIT) compared with a home visit using conversation alone. Methods: Twenty-eight participants (mean age, 78.6 ± 7.5 years) were randomly assigned to an intervention (n = 13) or control (n = 15) group for 3 months. The intervention group received a 60-minute FIT home visit program; the control group received a 30-minute home visit using common conversational techniques. Measures were Mini-Mental State Examination, Frontal Assessment Battery (FAB) and Geriatric Depression Scale. Results: The FAB score was significantly improved in the intervention group compared with the control group (2.5 vs −0.5, P = 0.02). Conclusions: Our FIT home visit program improved cognitive function. Further studies with larger samples and longer follow-up periods are needed to assess the long-term effectiveness of a FIT home visit program on cognition. [ABSTRACT FROM AUTHOR]

Front Cover: Compound‐eye‐like, Janus and core‐shell type structures are formed by simple mixing of aqueous dispersion of silica nanoparticles into volatile organic solvent solution of amino‐terminated followed by evaporation of organic solvent. Further details can be found in the article by Hiroki Satoh and Hiroshi Yabu on page 279. [ABSTRACT FROM AUTHOR]

Composite microparticles containing densely packed gold nanoparticles on their shells are successfully prepared by simple self‐assembling method, as shown by H. Yabu and co‐workers on page 441. These microparticles show strong surface‐enhanced Raman scattering properties. [ABSTRACT FROM AUTHOR]

Organic–inorganic composite microparticle having interior nanostructures is one of the promising materials for creating a novel class of functional materials. In this paper, we show a simple co-precipitation method for silica nanoparticles and polymer composite particles by mixing water with water dispersed silica nanoparticles into tetrahydrofran THF solution of amino-terminated poly(butadiene) (PB) and evaporation of THF. High loading of inorganic nanoparticles into polymer particles was achieved and this high loading of inorganic nanoparticles was also an advantage for creating highly porous polymer particles by removal of inorganic part with HF. Interior structures of composite particles can be controlled by phase-separation of polymers. [ABSTRACT FROM AUTHOR]