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Candidemia, linked to high mortality rates, requires prompt antifungal therapy for better outcomes. Treatment is structured as an action bundle, which is beneficial when followed closely. However, the Japanese action bundle lacks detailed guidance on severe complications like endocarditis or ocular issues. To address this, we adjusted the action bundle and assessed outcomes with and without AFT intervention. We strengthened protocols for blood cultures and organ assessments, and the AFT contacted the primary physician when yeast-like fungi were detected in the patient's blood culture bottles. Analyzing 204 candidemia cases from 2008-2021, we observed increased adherence and reduced mortality post-AFT intervention. Ophthalmology consultations rose significantly, but many patients had only one visit, suggesting inadequate follow-up. If endophthalmitis is diagnosed, a change in the treatment approach may be necessary. There is a possibility that abnormal ocular findings will be detected during subsequent visits, which highlights the need for improvement in ophthalmology follow-up rates as a future challenge for our AFT activities.

Functional neural circuits in the cerebral cortex are established through specific neural connections between excitatory and various inhibitory cell types. However, the molecular mechanisms underlying synaptic partner recognition remain unclear. In this study, we examined the impact of clustered protocadherin-γ ( cPcdhγ ) gene deletion in parvalbumin-positive (PV + ) cells on intralaminar and translaminar neural circuits formed between PV + and pyramidal (Pyr) cells in the primary visual cortex (V1) of male and female mice. First, we used whole-cell recordings and laser-scan photostimulation with caged glutamate to map excitatory inputs from layer 2/3 to layer 6. We found that cPcdhγ -deficient PV + cells in layer 2/3 received normal translaminar inputs from Pyr cells through layers 2/3-6. Second, to further elucidate the effect on PV + -Pyr microcircuits within intralaminar layer 2/3, we conducted multiple whole-cell recordings. While the overall connection probability of PV + -Pyr cells remained largely unchanged, the connectivity of PV + -Pyr was significantly different between control and PV + -specific cPcdhγ -conditional knock-out ( PV-cKO ) mice. In control mice, the number of reciprocally connected PV + cells was significantly higher than PV + cells connected one way to Pyr cells, a difference that was not significant in PV-cKO mice. Interestingly, the proportion of highly reciprocally connected PV + cells to Pyr cells with large unitary IPSC (uIPSC) amplitudes was reduced in PV-cKO mice. Conversely, the proportion of middle reciprocally connected PV + cells to Pyr cells with large uIPSC amplitudes increased compared with control mice. This study demonstrated that cPcdhγ in PV + cells modulates their reciprocity with Pyr cells in the cortex., Competing Interests: The authors declare no competing financial interests., (Copyright © 2023 Kawamura et al.)

This study developed a Japanese version of the Family Poly-Victimization Screen (FPS-J) and assessed its validity. A cross-sectional study using self-report questionnaires was conducted with parents of children in Tokyo, Japan, from January to February 2022. To test the validity of the FPS-J, we used the Japanese versions of the revised Conflict Tactics Scale Short Form (J-CTS2SF) as the gold standard for intimate partner violence (IPV), the Conflict Tactics Scale Parent-Child (J-CTS-PC) for child abuse (CAN), the Conflict Tactics Scale (J-MCTS) for elder abuse, the K6-J for depression and anxiety, the PCL5-J for post-traumatic stress disorder, and the J-KIDSCREEN for Health-related Quality of Life among children. Data from 483 participants (response rate: 22.6%) were used. The J-CTS2SF and J-CTS-PC scores were significantly higher among the IPV/CAN-victim groups than in the non-victimized groups classified by the FPS-J ( p < 0.001). The JMCTS scores did not differ significantly between the victim and non-victim groups ( p = 0.44), but the PCL5-J, K6-J, and J-KIDSCREEN-10 scores were either significantly higher or lower among victims of violence than among the non-victim groups ( p < 0.05). This study suggests the validity of parts of the FPS-J, especially the IPV against respondents and CAN by respondents.

Head space (HS)-GC-MS was used to analyze possible migration of volatile compounds from polyethylene terephthalate (PET) bottles for soft drinks, and a total of six compounds were identified. Next, a rapid, simple, and accurate simultaneous method was established using purge-and-trap (PT)-GC-MS, to quantify their amounts in the liquid contents after short- and long-term storage in PET bottles. Starting with brand-new PET bottles, the maximum migration of 2-methyl-1,3-dioxolane into distilled water and 50 % aqueous ethanol after 2 years at 25 °C were 2.3 and 19 ng/mL, respectively. In commercially available bottled mineral water sold inside and outside Japan, we were able to detect 2-methyl-1,3-dioxolane in the same way. While nonanal was also detected in some products, 2-methyl-1,3-dioxolane was confirmed as the main volatile compound. Finally, the human exposure to 2-methyl-1,3-dioxolane was estimated based on the per capita intake of soft drinks in Japan and the migration amount in this study., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Migration test of food utensils, containers, and packaging is an important test method for confirming the safety and their compliance to the standards. However, there is little report on inter-laboratory study which was performed to evaluate the entire migration test, including migration operations and quantification. An interlaboratory study was performed participating 22 laboratories using 8 types of model synthetic resin samples containing 10 substances with a wide range of Log P ow values to evaluate the accuracy of the entire migration test. As a result, most of HorRat (r) values met the target criteria (0.3

A simple and rapid analytical method was developed for the determination of formaldehyde (FA) and acetaldehyde (AA) contents in water. FA and AA were derivatized by 2,4-dinitrophenylhydrazine in an LC vial for 20 min at room temperature, about 25 °C, and analyzed using LC-MS/MS. The calibration curve exhibited excellent linearity for FA and AA concentrations of 2-150 ng/mL. Recovery tests using ultra-pure water and commercially available PET-bottled mineral water samples showed good trueness and precision. We determined the FA and AA contents in 105 PET-bottled mineral water samples on the Japanese market using this method. FA was detected in 61% of the samples at levels from 2.6 to 31.4 ng/mL, while AA was detected in 68% at levels from 5.3 to 143.5 ng/mL. These results demonstrate that the concentrations of FA and AA in PET-bottled mineral water on the Japanese market have not changed significantly over the last decade., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Youth in developed countries face the contradictory health problems of obesity and an excessive desire for weight loss. Developing a better health attitude for college students is essential as this period of life establishes future lifestyle and habits. Online interaction on social media can help to improve eating habits by creating dietary diaries through a smartphone app; however, the effects of such interactions for college students have not been examined to date., Objective: The aim of this study was to evaluate the potential effectiveness of social media interactions with the use of dietary diaries on a smartphone app to motivate college students in raising self-awareness of their eating habits., Methods: Forty-two college students in the greater Tokyo area of Japan participated in the study by creating dietary diaries online through a smartphone app and then followed/interacted with each other using social media for 7 consecutive days in September to November 2017. Online surveys were administered at baseline, immediately after creating the dietary diaries, and at 1-month follow up. Participants rated their degree of interest and self-evaluation of eating habits using 7-point scales, and answered multiple choice questions related to their thoughts in choosing meals/drinks among 10 topics. Free descriptions about their overall experience throughout the project were also collected in the follow-up survey., Results: Data from 38 participants who completed all processes were analyzed. Over time, the mean score for degree of interest in eating habits increased from 4.6 to 6.2 (P<.001), while the self-evaluation score decreased from 4.5 to 3.6 (P<.001); these significant differences remained after 1 month (5.3, P=.002; 4.1, P=0.04, respectively). A weak negative correlation (P=.009) was observed between scores for degree of interest and self-evaluation. Participants with lower scores for degree of interest at baseline tended to increase their interest level by more than 2 points above the average (P<.001). Participants gradually thought more about their eating habits from various perspectives when choosing a meal/drink, particularly with respect to maintaining well-balanced diets and introducing diverse ingredients. Participants evaluated their experiences as interesting/fun and reported familiarity with using the smartphone app and social media as the preferred method to keep track of their eating. All participants welcomed communication with fellow participants on social media and motivated each other, in addition to monitoring their eating habits through online dietary diaries. Some participants experienced difficulty, especially when they were busy or faced a lack of internet access., Conclusions: Through interactions on social media, college students experienced encouragement and developed an interest and critical thinking with respect to their eating habits. This approach, which embraces peer education and peer support with social media, holds promise for the future of youth health promotion. Further examination will be needed to explore how to sustain this level of heightened awareness., (©Masako Watanabe-Ito, Emiko Kishi, Yoko Shimizu. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 31.03.2020.)

Multilayer laminated films may contain organic solvents derived from adhesives, printing inks and so on. A headspace-GC/MS analysis method for the simultaneous determination of 30 substances such as toluene, xylene, acetone, methyl ethyl ketone, ethyl acetate, butyl acetate, methanol, ethanol, was developed. A N,N-dimethyl formamide solution containing an internal standard substance was added to the sample. After leaving overnight at room temperature, the headspace gas was analyzed by GC/MS. This method was applicable to a laminate film made of various materials. The organic solvents such as toluene, ethyl acetate, and heptane were detected from 6 out of 42 food packaging bags made from laminated film on Japanese market using this method.

Objective: This study aimed to evaluate the educational improvement outcomes after introducing undergraduate public health nursing electives from the perspective of students, teachers, and public health nurses., Design and Sample: Post-test design with control group was used. We surveyed three groups of participants on the relevance of achieved skill items. These groups were as follows: fourth-year students, teaching staff from seven universities, and public health nurses from special districts of Tokyo who had pioneered the introduction of public health nursing electives., Measures: The three participant groups were surveyed in 2013 and 2014 to compare the students' levels of achievement in the 98 skill items presented by the Japanese Ministry of Health, Labour, and Welfare. Practical training introduced educational reform in 2014. Anonymous self-administrated questionnaires were used., Results: The mean achievement rates of the 98 items in 2013 and 2014 were 67.9% and 72.6%, respectively, for students; 40.9% and 59.7% for teachers; and 44.4% and 59.4% for PHNs. A significant difference was observed between ratios of 2013 and 2014 in all three groups., Conclusions: The results demonstrated that the introduction of educational reform increased the achievement rates of students through the electives., (© 2018 Wiley Periodicals, Inc.)

Six nanosilver-labelled products and five silver ion (Ag(+))-labelled products were investigated to measure the migration of Ag from food-contact plastics, including nanosilver into various food simulants. The products were obtained in Japanese markets in 2012. Zinc (Zn), another major antimicrobial agent, and three harmful metals, cadmium (Cd), lead (Pb) and arsenic (As), were also examined. Ag and Zn were detected in all six nanosilver products at concentrations of 21-200 and 8.4-140 mg kg(-1), respectively. These metals were also detected in all five Ag(+) products at the same level as nanosilver products. Cd, Pb and As were not detected in any sample. Migrations of Ag and Zn were highest in 4% acetic acid, but also observed in water and 20% ethanol. Big differences were not observed in the migration ratio between nanosilver products and Ag(+) products. The ultrafiltration experiments suggested that the Ag that migrated from nanosilver products into 4% acetic acid was in its ionic form, while that into water and 20% ethanol was in its nanoparticle form.

The nontuberculous mycobacteria (NTM) cause miscellaneous disorders in humans, especially in the lungs, which present with a variety of radiological features. To date, knowledge of the pathogenic role of the Mycobacterium avium-intracellulare complex (MAC) in the human lung and the definitive criteria for initiating multidrug therapy are still lacking. However, there is little doubt that clarithromycin is the most efficacious drug among the various treatment regimens for lung NTM. In this study, with the use of a bridged nucleic acid (BNA) probe a detection system based on a real-time PCR (BNA-PCR) for the identification of the point mutations at position 2058 or 2059 in domain V of the 23S rRNA gene responsible for clarithromycin resistance was developed and has been assessed using MAC isolates from clinical samples. Out of 199 respiratory specimens, the drug susceptibility test demonstrated 12 strains resistant to clarithromycin, while the BNA-PCR showed 8 strains carrying the point mutation at position 2058 or 2059 of the 23S rRNA gene. This system revealed that there were mycobacterial strains resistant to clarithromycin which do not carry previously identified resistance genes. This paper documents a novel system for detecting clarithromycin-resistant strains and demonstrates that although these mutations are tacitly assumed to account for >90% of the reported resistant mutants, there is a significant fraction of resistant mutants that do not harbor these mutations. Therefore, unknown mechanisms affecting clarithromycin resistance remain to be elucidated., (Copyright © 2016, American Society for Microbiology. All Rights Reserved.)

Objective To equip public health nurses (PHNs) with higher qualifications, PHN education is shifting from an integrated curriculum for PHNs and registered nurses to a specific elective system of undergraduate or postgraduate programs. Most colleges in the special wards of Tokyo introduced the elective system in 2014 before the remaining areas. The outcomes of this must be evaluated. This study aimed to evaluate the achievement levels and practical experiences of PHN students at seven colleges in the special wards before and after introduction of the PHN course as an elective.Method Self-administered, anonymous questionnaires were completed by senior PHN students at seven colleges in the special wards who underwent training in 2013, the last year of an integrated curriculum, and in 2014, the first year of the elective system. The target numbers of participants were 663 in 2013 and 136 in 2014 with 20 students from each school exposed to the elective system. Our study focused on whether they achieved the 98 "technical items of PHN training and achievement levels at the time of graduation" required by the Ministry of Health, Labour and Welfare. The study also determined whether participants obtained practical experience in 15 items developed by the special wards based on the standards set for training.Results In 2013, there were 348 total responses (52.5%) and 310 valid responses. In 2014, there were 136 total responses (88.2%) and 120 valid responses. The average achievement rate at which the student answered, "I was able to arrive at it," at an arrival degree level for the 98 technical items was 72.6% in 2014, an increase compared to the 67.9% obtained in 2013. Moreover, the average practical experience rate at which the student answered, "I was able to have an experience," regarding the 15 items was 85.7% in 2014, which constituted an increase compared to 70.5% attained in 2013. However, the number of items with an achievement rate of more than 80% remained at 31 (31.6%) in 2014.Conclusion Increasing percentages of average achievement and experience rate suggest that the lecture and training have improved, and highly motivated students could have been selected in the PHN program. However, students did not achieve the target rate for many of the items. Thus, there was a time limit to experience the technical item/the experience item.

A method using high-performance liquid chromatograph (HPLC) was developed for the identification of colorants migrated from colored modeling clays, which are popular toys for children. Twelve permitted dyes and 25 non-permitted dyes were analyzed in 20 clays (10 wheat clays, 2 rice clays, 2 corn clays, 3 paper clays and 3 resin clays). As a result, 13 products which were labeled for children's use (under 6 years old) met the specifications of the Japanese Food Sanitation Law, while non-permitted colorants were eluted from 2 products. In additon, unknown colorants were eluted from 3 products for people over 6 years old, although these are not covered by the Japanese regulation. It was suggested that some type of clays contained pigments, which are generally used in printing ink and plastics.

We have developed and validated an inductively coupled plasma-mass spectrometry (ICP-MS) method for the simultaneous analysis of minerals and toxic elements in foods. Food samples were digested by microwave irradiation to prepare solutions for measurement by ICP-MS. Optimal gas mode and internal standard for each element were selected as appropriate. The method was validated for eighteen elements in total using three certified standard reference materials, namely, Typical Japanese Diet, Rice Flour-Unpolished and Infant/Adult Nutritional Formula, according to the guidelines of the Ministry of Health, Labour and Welfare of Japan. The trueness and precision of the method were all within the acceptable limits, except for Na in Rice Flour-Unpolished.

Objective: The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative., Design and Sample: A cross-sectional qualitative design was used. Public health nurses conducted comprehensive semi-structured interviews during home visits with residents. A total of 5,082 residents from the affected town., Measures: These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions., Results: A total of 281 residents needed some kind of assistance and were identified as "requiring early intervention (within two weeks)" or "requiring assistance (within 12 weeks)." The most common health issue requiring early intervention was "interruption of treatment" (25.0%), followed by "need for mental care." The most frequent health issue requiring assistance within 12 weeks was the "need for mental health care" (39.7%), followed by "interruption of treatment," and "need for nursing care.", Conclusions: During a disaster, it is imperative to identify cases requiring early intervention. Home-visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems., (© 2015 Wiley Periodicals, Inc.)