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Background: Effective communication has potential benefits for children, their families, and healthcare professionals. Although communication skills training programs are essential for healthcare professionals, their effects remain unclear., Aim: This review summarized existing communication skills training programs and evaluated their impact on healthcare professionals' behavior and the health outcomes of children with life-threatening conditions and their families., Design: This systematic review was performed in accordance with the Cochrane Handbook version 6.4., Data Sources: On January 21, 2024, we searched the following databases: Cochrane Central Register of Controlled Trials, PubMed, MEDLINE, Embase, PsycINFO, and CINAHL. The included studies' risk of bias was assessed using a revised Cochrane risk-of-bias tool for randomized controlled trials 2. Owing to insufficient data and high heterogeneity, we could not perform a meta-analysis, so the findings were described narratively., Results: We identified nine studies, which included various diseases, training programs, and outcome measurement tools and timings. Among the nine studies, five of the six studies that assessed healthcare professionals' behaviors reported that the interventions had improved them (low certainty of evidence). Only two studies reported on the quality of life and anxiety experienced by children and their families, with no clear difference between intervention and control groups., Conclusions: Communication skills training for healthcare professionals may improve their behaviors toward children with life-threatening conditions and their families. Measurement tools and timings must be standardized. Future research should develop training programs and assess their impact on children and their families, incorporating the perspective of children., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cobalt (Co) contamination in soils potentially affects human health through the food chain. Although rice (Oryza sativa) as a staple food is a major dietary source of human Co intake, it is poorly understood how Co is taken up by the roots and accumulated in rice grain. In this study, we physiologically characterized Co accumulation and identified the transporter for Co 2+ uptake in rice. A dose-dependent experiment showed that Co mainly accumulated in rice roots. Further analysis with LA-ICP-MS showed Co deposited in most tissue of the roots, including exodermis, endodermis and stele region. Co accumulation analysis using mutants defective in divalent cation uptake showed that Co 2+ uptake in rice is mediated by the Mn 2+ /Cd 2+ /Pb 2+ transporter OsNramp5, rather than OsIRT1 for Fe 2+ and OsZIP9 for Zn 2+ . Knockout of OsNramp5 enhanced tolerance to Co toxicity. Heterologous expression of OsNramp5 showed transport activity for Co 2+ in Saccharomyces cerevisiae. Co 2+ uptake was inhibited by either Mn 2+ or Cd 2+ supply. At the reproductive stage, the Co concentration in the straw and grains of the OsNramp5 knockout lines was decreased by 41%-48% and 28%-36%, respectively, compared with that of the wild-type rice. The expression level of OsNramp5 in the roots was not affected by Co 2+ . Taken together, our results indicate that OsNramp5 is a major transporter for Co 2+ uptake in rice, which ultimately mediates Co accumulation in the grains., (© 2024 The Author(s). Plant, Cell & Environment published by John Wiley & Sons Ltd.)

This study aims to delineate the characteristics and clinical trajectories of suicide attempts and self-harm, and its gender and age differences among children. This nationwide retrospective cross-sectional study utilized data extracted from the Japanese Diagnosis Procedure Combination inpatient database spanning 2016 to 2017. Children aged 7-17 years admitted to acute care hospitals for suicide attempts and self-harm, were identified. Patient characteristics included age, gender, suicide method, and comorbid psychiatric disorders. Trajectory information included the duration of hospital stay, admission ward, psychiatric/psychological interventions, in-hospital mortality, and healthcare expenditure. Data analysis encompassed 1,704 children hospitalized for suicide attempts and self-harm. Among these, 49.4% were junior high school age, 69.0% for female, and 28.4% for underweight. Overdose emerged as the most prevalent method for suicide attempts and self-harm (49.9%). Notably, 66.0% did not receive a diagnosis of any mental illness, and 56.3% did not undergo psychiatric/psychological care during their hospitalization. Boys were more likely to use high-lethality suicide methods, such as hanging ( p < 0.001), and die during hospitalization ( p < 0.001). Conversely, girls were more likely to use low-lethality suicide methods, such as drug overdose ( p < 0.001), and receive psychiatric/psychological intervention during hospitalization ( p = 0.015). Children aged 7-12 years were more likely to use high-lethality suicide methods, such as hanging ( p < 0.001), and be diagnosed with attention-deficit/hyperactivity disorder ( p < 0.001) and less likely to receive psychiatric/psychological intervention ( p = 0.005) compared with other age groups. These findings suggest the importance of developing gender and age sensitive health policies, systems, and interventions to prevent child suicide., Competing Interests: The authors have no conflicts of interest to disclose., (2024, National Center for Global Health and Medicine.)

Plants accumulate silicon to protect them from biotic and abiotic stresses. Especially in rice (Oryza sativa), a typical Si-accumulator, tremendous Si accumulation is indispensable for healthy growth and productivity. Here, we report a shoot-expressed signaling protein, Shoot-Silicon-Signal (SSS), an exceptional homolog of the flowering hormone "florigen" differentiated in Poaceae. SSS transcript is only detected in the shoot, whereas the SSS protein is also detected in the root and phloem sap. When Si is supplied from the root, the SSS transcript rapidly decreases, and then the SSS protein disappears. In sss mutants, root Si uptake and expression of Si transporters are decreased to a basal level regardless of the Si supply. The grain yield of the mutants is decreased to 1/3 due to insufficient Si accumulation. Thus, SSS is a key phloem-mobile protein for integrating root Si uptake and shoot Si accumulation underlying the terrestrial adaptation strategy of grasses., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Circumcision-a common pediatric procedure-can cause significant pain and anxiety. Virtual reality has been proposed as a nonpharmacological intervention to alleviate these negative experiences., Objective: This systematic review and meta-analysis was conducted to evaluate the effects of virtual reality interventions on pain and anxiety in children undergoing circumcision., Methods: This study comprehensively searched PubMed, Embase, and Cochrane Library for articles published from database inception to October 2, 2023. Randomized controlled trials that investigated the effects of virtual reality interventions on pain and anxiety during circumcision in children were included. The Cochrane risk-of-bias tool was used to appraise the included studies. The primary outcomes were pain and anxiety scores., Results: Three randomized controlled trials and four data sets involving a total of 224 children were included in our meta-analysis. Virtual reality interventions significantly reduced children's pain and anxiety scores., Conclusions: Virtual reality interventions are promising nonpharmacological strategies for alleviating children's pain and anxiety during circumcision. Pediatric healthcare professionals use virtual reality interventions to create a child-friendly and healthy healthcare environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Soil salinity significantly limits rice productivity, but it is poorly understood how excess sodium (Na + ) is delivered to the grains at the reproductive stage. Here, we functionally characterized OsHAK4, a member of the clade IV HAK/KUP/KT transporter subfamily in rice. OsHAK4 was localized to the plasma membrane and exhibited influx transport activity for Na + , but not for K + . Analysis of organ- and growth stage-dependent expression patterns showed that very low expression levels of OsHAK4 were detected at the vegetative growth stage, but its high expression in uppermost node I, peduncle, and rachis was found at the reproductive stage. Immunostaining indicated OsHAK4 localization in the phloem region of node I, peduncle, and rachis. Knockout of OsHAK4 did not affect the growth and Na + accumulation at the vegetative stage. However, at the reproductive stage, the hak4 mutants accumulated higher Na + in the peduncle, rachis, husk, and brown rice compared to the wild-type rice. Element imaging revealed higher Na + accumulation at the phloem region of the peduncle in the mutants. These results indicate that OsHAK4 plays a crucial role in retrieving Na + from the phloem in the upper nodes, peduncle, and rachis, thereby preventing Na + distribution to the grains at the reproductive stage of rice., (© 2024 The Author(s). The Plant Journal published by Society for Experimental Biology and John Wiley & Sons Ltd.)

Background: Demographic changes and a low birth rate have led to a workforce shortage in Japan. To address this issue, the government has promoted engagement of female employment. However, increased female employment can impact women's health. Using Internet of Things (IoT) and apps to manage women's health has gained attention, but few studies have focused on working women., Objective: This study aimed to clarify the current situation of working women and their use of IoT or apps to manage their health., Methods: A large-scale, nationwide internet survey was conducted among 10,000 female participants aged from 20 years to 64 years in Japan. Participants were recruited from a marketing research company's active survey panel of 5.24 million members. The survey included questions about health status, sociodemographic factors, psychological characteristics, and the use of IoT or apps for health management. We compared perceived health status and reasons for current IoT use using t tests and assessed participant characteristics that predicted IoT use using the C5.0 decision tree algorithm. Ethical approval was granted by St. Luke's International University., Results: Among participants, 14.6% (1455/10,000) currently used IoT or apps, 7% (695/10,000) used them previously, and 78.5% (7850/10,000) had never used them. Current users (42.7 years old) were older than past users (39.7 years old). Discrepancies were observed between participants' perceived health problems and the purpose for using IoT or apps, with 21.3% (2130/10,000) of all women reporting they experienced menstrual symptoms or disorders but only 3.5% (347/10,000) used IoT or apps to manage the same symptom. On the other hand, current users were more likely to use IoT or apps to manage nutrition-related problems such as underweight or obesity (405/1455, 27.8%). Device use was highest among current users, with 87.3% (1270/1455) using smartphones, 19.7% (287/1455) using smartwatches, and 13.3% (194/1455) using PCs. Decision tree analysis identified 6 clusters, the largest consisting of 81.6% (5323/6523) of non-IoT users who did not exercise regularly, while pregnant women were more likely to use IoT or apps., Conclusions: Our findings highlight the idea that woman with particular health problems (ie, menstrual symptoms or disorders and premenstrual syndrome) have lower use of IoT or apps, suggesting an unmet need for IoT and apps in specific areas., (©Kirio Sasayama, Etsuko Nishimura, Noyuri Yamaji, Erika Ota, Hisateru Tachimori, Ataru Igarashi, Naoko Arata, Daisuke Yoneoka, Eiko Saito. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 31.07.2024.)

Rice (Oryza sativa) as a staple food is a potential intake source of antimony (Sb), a toxic metalloid. However, how rice accumulates this element is still poorly understood. Here, we investigated tissue-specific deposition, speciation, and transport of Sb in rice. We found that Sb(III) is the preferential form of Sb uptake in rice, but most Sb accumulates in the roots, resulting in a very low root-to-shoot translocation (less than 2%). Analysis of Sb deposition with laser ablation-inductively coupled plasma-mass spectrometry showed that most Sb deposits at the root exodermis. Furthermore, we found that Sb is mainly present as Sb(III) in the root cell sap after uptake. Further characterization showed that Sb(III) uptake is mediated by Low silicon rice 1 (Lsi1), a Si permeable transporter. Lsi1 showed transport activity for Sb(III) rather than Sb(V) in yeast (Saccharomyces cerevisiae). Knockout of Lsi1 resulted in a significant decrease in Sb accumulation in both roots and shoots. Sb concentration in the root cell sap of two independent lsi1 mutants decreased to less than 3% of that in wild-type rice, indicating that Lsi1 is a major transporter for Sb(III) uptake. Knockout of Lsi1 also enhanced rice tolerance to Sb toxicity. However, knockout of Si efflux transporter genes, including Lsi2 and Lsi3, did not affect Sb accumulation. Taken together, our results showed that Sb(III) is taken up by Lsi1 localized at the root exodermis and is deposited at this cell layer due to lack of Sb efflux transporters in rice., Competing Interests: Conflict of interest statement. None declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Society of Plant Biologists.)

Plants take up metals, including essential micronutrients [iron (Fe), copper (Cu), zinc (Zn), and manganese (Mn)] and the toxic heavy metal cadmium (Cd), from soil and accumulate these metals in their edible parts, which are direct and indirect intake sources for humans. Multiple transporters belonging to different families are required to transport a metal from the soil to different organs and tissues, but only a few of them have been fully functionally characterized. The transport systems (the transporters required for uptake, translocation, distribution, redistribution, and their regulation) differ with metals and plant species, depending on the physiological roles, requirements of each metal, and anatomies of different organs and tissues. To maintain metal homeostasis in response to spatiotemporal fluctuations of metals in soil, plants have developed sophisticated and tightly regulated mechanisms through the regulation of transporters at the transcriptional and/or posttranscriptional levels. The manipulation of some transporters has succeeded in generating crops rich in essential metals but low in Cd accumulation. A better understanding of metal transport systems will contribute to better and safer crop production.

Iron (Fe) needs to be delivered to different organs and tissues of above-ground parts for playing its multiple physiological functions once it is taken up by the roots. However, the mechanisms underlying Fe distribution are poorly understood. We functionally characterized OsOPT7, a member of oligo peptide transporter family in terms of expression patterns, localization, transport activity and phenotypic analysis of knockdown lines. OsOPT7 was highly expressed in the nodes, especially in the uppermost node I, and its expression was upregulated by Fe-deficiency. OsOPT7 transports ferrous iron into the cells coupled with proton. Immunostaining revealed that OsOPT7 is mainly localized in the xylem parenchyma cells of the enlarged vascular bundles in the nodes and vascular tissues in the leaves. Knockdown of OsOPT7 did not affect the Fe uptake, but altered Fe distribution; less Fe was distributed to the new leaf, upper nodes and developing panicle, but more Fe was distributed to the old leaves. Furthermore, knockdown of OsOPT7 also resulted in less Fe distribution to the leaf sheath, but more Fe to the leaf blade. Taken together, OsOPT7 is involved in the xylem unloading of Fe for both long-distance distribution to the developing organs and local distribution within the leaf in rice., (© 2024 The Authors New Phytologist © 2024 New Phytologist Foundation.)

To play essential roles of manganese (Mn) in plant growth and development, it needs to be transported to different organs and tissues after uptake. However, the molecular mechanisms underlying Mn distribution between different tissues are poorly understood. We functionally characterized a member of rice natural resistance-associated macrophage protein (NRAMP) family, OsNramp5 in terms of its tissue specificity of gene expression, cell-specificity of protein localization, phenotypic analysis of leaf growth and response to Mn fluctuations. OsNramp5 is highly expressed in the leaf sheath. Immunostaining revealed that OsNramp5 is polarly localized at the proximal side of xylem parenchyma cells of the leaf sheath. Both the gene expression and protein abundance of OsNramp5 are unaffected by different Mn concentrations. Knockout of OsNramp5 decreased the distribution of Mn to the leaf sheath, but increased the distribution to the leaf blade at both low and high Mn supplies, resulting in reduced growth of leaf sheath. Furthermore, expression of OsNramp5 under the control of root-specific promoter in osnramp5 mutant complemented Mn uptake, but could not complement Mn distribution to the leaf sheath. These results indicate that OsNramp5 expressed in the leaf sheath plays an important role in unloading Mn from the xylem for the local distribution in rice., (© 2023 The Authors New Phytologist © 2023 New Phytologist Foundation.)

Rice is a staple food for half of the world's population, but it is a poor dietary source of calcium (Ca) due to the low concentration. It is an important issue to boost Ca concentration in this grain to improve Ca deficiency risk, but the mechanisms underlying Ca accumulation are poorly understood. Here, we obtained a rice (Oryza sativa) mutant with high shoot Ca accumulation. The mutant exhibited 26%-53% higher Ca in shoots than did wild-type rice (WT) at different Ca supplies. Ca concentration in the xylem sap was 36% higher in the mutant than in the WT. There was no difference in agronomic traits between the WT and mutant, but the mutant showed 25% higher Ca in the polished grain compared with the WT. Map-based cloning combined with a complementation test revealed that the mutant phenotype was caused by an 18-bp deletion of a gene, OsK5.2, belonging to the Shaker-like K + channel family. OsK5.2 was highly expressed in the mature region of the roots and its expression in the roots was not affected by Ca levels, but upregulated by low K. Immunostaining showed that OsK5.2 was mainly expressed in the pericycle of the roots. Taken together, our results revealed a novel role for OsK5.2 in Ca translocation in rice, and will be a good target for Ca biofortification in rice., (© 2023 Institute of Botany, Chinese Academy of Sciences.)

Objective: Effective communication about cancer with children is a significant challenge for healthcare professionals and families. This study aimed to create a picture book as a tool for facilitating communication about cancer and to assess its feasibility. It also demonstrated the use of mixed methods and convergent designs for intervention development., Methods: The study included healthcare professionals ( n = 14), children without cancer (aged 4-8 years; n = 21) and their families ( n = 18), as well as children with various types of cancer, undergoing maintenance therapy or follow-up (aged 4-12 years; n = 3) and their families ( n = 3). Quantitative and qualitative data were separately analyzed, and meta-inferences were made using a joint display. The picture book was refined based on feedback from healthcare professionals, and a similar iterative process was carried out with children and their families., Results: Over 85% of the participants considered the picture book, along with a side book, feasible. The picture book was found to be helpful for discussing the topic of cancer with children. It also significantly improved the knowledge of children without cancer ( P  < 0.01). Most children expressed interest in reading it and believed it was useful for talking to others about cancer. However, some concerns were raised regarding the context and expressions in the picture book., Conclusions: This study successfully assessed the feasibility of the developed picture book using a mixed methods approach, offering valuable insights into its implementation and refinement. Further research is needed to evaluate the effectiveness of its use and gather user feedback., (© 2023 The Authors.)

Silicon (Si) is the most abundant mineral element in the earth's crust. Some plants actively accumulate Si as amorphous silica (phytoliths), which can protect plants from stresses. Here, we report a gene (SIET4) that is required for the proper accumulation and cell-specific deposition of Si in rice and show that it is essential for normal growth. SIET4 is constitutively expressed in leaves and encodes a Si transporter. SlET4 polarly localizes at the distal side of epidermal cells and cells surrounding the bulliform cells (motor cells) of the leaf blade, where Si is deposited. Knockout of SIET4 leads to the death of rice in the presence but not absence of Si. Further analysis shows that SIET4 knockout induces abnormal Si deposition in mesophyll cells and the induction of hundreds of genes related to various stress responses. These results indicate that SIET4 is required for the proper export of Si from leaf cells to the leaf surface and for the healthy growth of rice on land., (© 2023. Springer Nature Limited.)

Rice grain is a poor dietary source of zinc (Zn) but the primary source of cadmium (Cd) for humans; however, the molecular mechanisms for their accumulation in rice grain remain incompletely understood. This study functionally characterized a tonoplast-localized transporter, OsMTP1. OsMTP1 was preferentially expressed in the roots, aleurone layer, and embryo of seeds. OsMTP1 knockout decreased Zn concentration in the root cell sap, roots, aleurone layer and embryo, and subsequently increased Zn concentration in shoots and polished rice (endosperm) without yield penalty. OsMTP1 haplotype analysis revealed elite alleles associated with increased Zn level in polished rice, mostly because of the decreased OsMTP1 transcripts. OsMTP1 expression in yeast enhanced Zn tolerance but did not affect that of Cd. While OsMTP1 knockout resulted in decreased uptake, translocation and accumulation of Cd in plant and rice grain, which could be attributed to the indirect effects of altered Zn accumulation. Our results suggest that rice OsMTP1 primarily functions as a tonoplast-localized transporter for sequestrating Zn into vacuole. OsMTP1 knockout elevated Zn concentration but prevented Cd deposition in polished rice without yield penalty. Thus, OsMTP1 is a candidate gene for enhancing Zn level and reducing Cd level in rice grains., (© 2023 The Authors. New Phytologist © 2023 New Phytologist Foundation.)

Silicon (Si) is important for stable and high yields in rice (Oryza sativa), a typical Si hyperaccumulator. The high Si accumulation is achieved by the cooperation of 2 Si transporters, LOW SILICON 1 (OsLsi1) and OsLsi2, which are polarly localized in cells of the root exodermis and endodermis. However, the mechanism underlying their polar localization is unknown. Here, we identified amino acid residues critical for the polar localization of OsLsi1. Deletion of both N- and C-terminal regions resulted in the loss of its polar localization. Furthermore, the deletion of the C-terminus inhibited its trafficking from the endoplasmic reticulum to the plasma membrane. Detailed site-directed mutagenesis analysis showed that Ile18 at the N-terminal region and Ile285 at the C-terminal region were essential for the polar localization of OsLsi1. Moreover, a cluster of positively charged residues at the C-terminal region is also required for polar localization. Phosphorylation and Lys modifications of OsLsi1 are unlikely to be involved in its polar localization. Finally, we showed that the polar localization of OsLsi1 is required for the efficient uptake of Si. Our study not only identified critical residues required for the polar localization of OsLsi1, but also provided experimental evidence for the importance of transporter polarity for efficient nutrient uptake., Competing Interests: Conflict of interest statement. All authors state no conflict of interest concerning this paper., (© American Society of Plant Biologists 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: The evaluation of hospital performance often receives great attention. Hospitals refer to patient ratings to undertake quality-improvement activities. However, little is known about the factors that contribute the most to these patient ratings. This study aimed to investigate the association of relevant factors, such as doctors' and nurses' performance, with patients' ratings of hospitals, using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS Ⓡ ) questionnaire., Methods: A cross-sectional study was conducted among patients who were hospitalized in Japan, from January 2020 to September 2021. Patients' hospital rating scale scores between 0 and 10 were collected and dichotomized. A score of 8 or higher was defined as a high rating. A multivariate logistic regression analysis was conducted to investigate the association between patients' ratings of the hospital and other items in the HCAHPS Ⓡ questionnaire., Results: The frequency of patients' high and poor hospital ratings were 207 (69%) and 93 (31%), respectively, of 300 respondents. A significant association was observed for the patient's age (adjusted odds ratio (AOR): 1.02; 95% confidence interval (CI): 1.00-1.04), doctor's communication (AOR: 10.47; 95% CI: 3.17-34.58), and discharge planning (AOR: 3.53; 95% CI: 1.96-6.36) with a positive patient rating of the hospital., Conclusions: An emphasis on doctor communication and discharge planning is essential in improving patients' ratings of hospitals. Further research is needed to determine the factors that contribute the most to patients' ratings of hospitals., Competing Interests: None, (Copyright © Japan Medical Association.)

Background: Women often experience many unique health issues and conditions throughout their working lives. The Internet of Things (IoT) is a system of interrelated digital devices that can enable data exchanges over a network without human-to-human or human-to-computer interaction. The usage of applications and IoT in improving women's health has recently increased worldwide. However, there has been no consensus on the effectiveness of IoT in improving women's health outcomes., Objective: This systematic review and network meta-analysis (NMA) aims to assess and synthesize the role of apps and the IoT in improving women's health and to identify the ranking of interventions for ensuring better results for each stated outcome., Methods: Our systematic review and NMA will be conducted in accordance with the guidelines of the Cochrane Handbook. We will comprehensively search the following electronic databases: PubMed (including MEDLINE), Cochrane Central Register of Controlled Trials, Embase, Cumulative Index to Nursing and Allied Health Literature (ie, CINAHL), PsycINFO, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry, along with other resources to identify relevant randomized controlled trials that have assessed the effects of various apps and the IoT with regard to improving working-aged women's health in high-income countries. We will segment and analyze the results of the included studies based on age categories (women undergoing a preconception period, those undergoing gestational and postpartum periods, and menopausal and pre- and postmenopausal women) and the medical history (women who have a specific medical condition-eg, cancer or diabetes-and women who do not have them) separately. Two independent reviewers will perform the study selection, data extraction, and quality assessment. Our primary outcomes include health status, well-being, and quality of life. We will perform pairwise meta-analysis and NMA to estimate the direct, indirect, and relative effects of apps and the IoT on women's health outcomes. We will also assess the hierarchy of interventions, statistical inconsistencies, and certainties of evidence for each outcome., Results: We plan to conduct the search in January 2023 and are currently discussing search strategies with the literature search specialists. The final report is planned for submission to a peer-reviewed journal in September 2023., Conclusions: To the best of our knowledge, this review will be the first to identify the ranking of IoT intervention for ensuring working-aged women's health outcomes. These findings may be of great use to researchers, policy makers, and others with an interest in the field., Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42022384620; https://www.crd.york.ac.uk/prospero/display&#95;record.php?RecordID=384620., International Registered Report Identifier (irrid): PRR1-10.2196/45178., (©Noyuri Yamaji, Aya Nitamizu, Etsuko Nishimura, Daichi Suzuki, Kiriko Sasayama, Md. Obaidur Rahman, Eiko Saito, Daisuke Yoneoka, Erika Ota. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 04.04.2023.)

This systematic review aimed to identify the benefits and possible harms of tocolytic therapy for preterm labour management in the context of pregnant women with extremely preterm birth, multiple gestations, or growth-restricted foetuses. A comprehensive search using MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, CINAHL, and the WHO Global Index Medicus databases was conducted from 10 to 15 July 2021. We included randomized controlled trials and non-randomized studies that assessed the effects of tocolysis compared with placebo or no treatment. We found 744 reports and, finally, nine studies (three randomized controlled trials and six cohort studies) pertaining to women with <28 weeks of gestation were included. No eligible studies were identified among women with a multiple pregnancy or a growth-restricted foetus. A meta-analysis of the trial data showed that there were no clear differences in perinatal death nor for a delay in birth. Non-randomized evidence showed that tocolysis delayed birth by 7 days, though there was no clear difference for preterm birth. In summary, it remains unclear whether tocolytic therapy for inhibiting preterm labour is beneficial for these subgroups of women and their newborns. Further well-designed randomized controlled trials and observational studies are needed to address the lack of evidence regarding tocolytic agents in these populations.

Aim: The aims of the study were to synthesize the role of technology-based healthcare interventions (TBIs) and to identify the most effective interventions for the best functional maternal and child health (MCH) outcomes among low-risk pregnant women in low- and middle-income countries (LMICs)., Design: A systematic review and network meta-analysis (NMA)., Methods: We will perform a comprehensive search in electronic databases and other resources to identify relevant randomized controlled trials. Two reviewers will independently perform study selection, data extraction and quality assessment. Our primary outcomes include proportion of recommended antenatal care visits, skilled delivery care, postnatal care visits and exclusive breastfeeding practices. We will use pairwise random-effects meta-analysis and NMAs to estimate direct, indirect and relative effects using the relevant intervention classifications for each outcome separately. We plan to assess hierarchy of interventions, statistical inconsistency and certainty of evidence., Results: This review will compare the effectiveness of different form of TBIs on a comprehensive range of MCH outcomes and will provide the outcome-specific reliable evidence of the most effective interventions on improving MCH in LMICs. The review findings will guide researchers, stakeholders or policymakers on the potential use of TBIs in the given contexts that could achieve the best functional MCH outcomes in LMICs., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Introduction: Because excessive physical stress is harmful, reducing pain and discomfort in premature neonates during mechanical ventilation is a major challenge for physicians. There are no consensus and systematic review on the use of fentanyl, the most commonly used pain reliever in preterm neonates during mechanical ventilation. We aim to compare the benefits and harms of fentanyl versus placebo or no drug for preterm neonates receiving mechanical ventilation., Methods: A systematic review of randomized controlled trials (RCTs) was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions. The systematic review was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Scientific databases such as MEDLINE, Embase, CENTRAL, and CINAHL were searched. All preterm infants on mechanical ventilation and enrolled in an RCT of fentanyl versus control were included., Results: Of 256 reports initially retrieved, 4 reports met the eligibility criteria. Fentanyl was not associated with mortality risk compared to the control (risk ratio: 0.72, 95% confidence intervals [CIs]: 0.36-1.44). No increase in ventilation duration (mean difference [MD]: 0.04, 95% CIs: -0.63-0.71) and no effect on hospital stay length (MD: 4.00, 95% CIs: -7.12-15.12) were found. Fentanyl intervention does not affect any other morbidities, including bronchopulmonary dysplasia, periventricular leukomalacia, patent ductus arteriosus, intraventricular hemorrhage (IVH), severe IVH, sepsis, and necrotizing enterocolitis., Conclusion: The present systematic review and meta-analysis failed to demonstrate the benefit of administering fentanyl to preterm infants on mechanical ventilation in mortality and morbidities. Follow-up studies are required to investigate the long-term neurodevelopment of the children., (© 2023 S. Karger AG, Basel.)

Bonding is crucial to perinatal mental health. Despite an extensive body of literature on maternal bonding, few studies have focused on paternal bonding. This scoping review aimed to clarify the current state of the concept of paternal-infant/fetus bonding. The eligibility criteria were drawn from the population concept and context elements to answer the following questions: "what is paternal bonding?" and "what are the constructs of the concept of paternal bonding?" The review comprised 39 studies. Paternal bonding was associated with both positive and negative paternal behavior and thought and may be determined based on fathers' beliefs and rearing history. Most studies showed that father-child interaction is one of the factors promoting paternal bonding. However, fathers generally felt more distant from their babies post-delivery than mothers. Only a few studies originally defined paternal bonding; most relied on the definitions of maternal bonding. We found different descriptions lacking consensus. Few studies examined the differences between paternal and maternal bonding. No consensus exists on the concept, constructs, and assessment of paternal bonding. The causal relationship between paternal bonding and other variables is unexplored. Future studies should explore fathers' perspectives and experiences, focusing on the unknown aspects of paternal bonding identified in this review.

FE UPTAKE-INDUCING PEPTIDE1 (FEP1), also named IRON MAN3 (IMA3) is a short peptide involved in the iron deficiency response in Arabidopsis thaliana. Recent studies uncovered its molecular function, but its physiological function in the systemic Fe response is not fully understood. To explore the physiological function of FEP1 in iron homoeostasis, we performed a transcriptome analysis using the FEP1 loss-of-function mutant fep1-1 and a transgenic line with oestrogen-inducible expression of FEP1. We determined that FEP1 specifically regulates several iron deficiency-responsive genes, indicating that FEP1 participates in iron translocation rather than iron uptake in roots. The iron concentration in xylem sap under iron-deficient conditions was lower in the fep1-1 mutant and higher in FEP1-induced transgenic plants compared with the wild type (WT). Perls staining revealed a greater accumulation of iron in the cortex of fep1-1 roots than in the WT root cortex, although total iron levels in roots were comparable in the two genotypes. Moreover, the fep1-1 mutation partially suppressed the iron overaccumulation phenotype in the leaves of the oligopeptide transporter3-2 (opt3-2) mutant. These data suggest that FEP1 plays a pivotal role in iron movement and in maintaining the iron quota in vascular tissues in Arabidopsis., (© 2022 John Wiley & Sons Ltd.)

Aim: The purpose of this study was to determine whether cognitive behavioral therapy (CBT) started in pregnancy can prevent depression and anxiety., Methods: We conducted an overview review by selecting systematic reviews (SRs) that compared CBT with usual care, no CBT, or interventions other than CBT in perinatal women. We restricted the review to studies that included randomized controlled trials. The results of included SRs were descriptively integrated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Results: Seven SRs met our eligibility criteria. One SR was limited to CBT interventions, whereas others included psychoeducation and interpersonal psychotherapy. There was some variation in the number of sessions and timing of CBT, and whether there was a postpartum intervention. Five SRs showed that CBT reduced depression compared with usual care, an educational intervention, or no intervention. One SR that analyzed the effect on anxiety found that psychotherapy, including CBT, reduced anxiety compared with usual care or no intervention., Discussion: CBT starting from pregnancy may be effective as a preventive intervention for postpartum depression and anxiety, although the degree of effectiveness varied., Conclusions: This overview review aimed to clarify whether CBT is effective in preventing depression and anxiety from pregnancy. CBT may be effective in reducing perinatal depression and anxiety., (© 2022 Japan Academy of Nursing Science.)

Background: Although communication tools might guide healthcare professionals in communicating with children about cancer, it is unclear what kind of tools are used. This scoping review aimed to map the communication tools used in cancer communication among children with cancer, families, and healthcare professionals., Methods: A comprehensive search using PubMed (including MEDLINE), Embase, CENTRAL, PsycINFO, and CINAHL was conducted on 1 August 2021. We mapped communication tools and their impacts., Results: We included 25 studies (9 experimental studies and 16 feasibility studies) of 29 reports and found 21 communication tools. There was a lack of communication tools that were (1) accessible and validated, (2) designed for healthcare professionals, (3) targeted children, families, and healthcare professionals, and (4) were designed to meet the needs of children and families. Experimental studies showed that the communication tools improved children's knowledge and psychological outcomes (e.g., health locus of control, quality of life, self-efficacy)., Conclusion: We mapped communication tools and identified areas that needed further research, including a lack of tools to guide healthcare professionals and share information with children and families. Further research is needed to develop and evaluate these communication tools. Moreover, it is necessary to investigate how communication tools support children, families, and healthcare professionals.

Glycosyltransferases (GTs) form a large family in plants and are important enzymes for the synthesis of various polysaccharides, but only a few members have been functionally characterized. Here, through mutant screening with gene mapping, we found that an Oryza sativa (rice) mutant with a short-root phenotype was caused by a frame-shift mutation of a gene (OsGT14;1) belonging to the glycosyltransferase gene family 14. Further analysis indicated that the mutant also had a brittle culm and produced lower grain yield compared with wild-type rice, but the roots showed similar root structure and function in terms of the uptake of mineral nutrients. OsGT14;1 was broadly expressed in all organs throughout the entire growth period, with a relatively high expression in the roots, stems, node I and husk. Furthermore, OsGT14;1 was expressed in all tissues of these organs. Subcellular observation revealed that OsGT14;1 encoded a Golgi-localized protein. Mutation of OsGT14;1 resulted in decreased cellulose content and increased hemicellulose, but did not alter pectin in the cell wall of roots and shoots. The knockout of OsGT14;1 did not affect the tolerance to toxic mineral elements, including Al, As, Cd and salt stress, but did increase the sensitivity to low pH. Taken together, OsGT14;1 located at the Golgi is required for growth of both roots and shoots in rice through affecting cellulose synthesis., (© 2022 Society for Experimental Biology and John Wiley & Sons Ltd.)

Global contamination of soils with toxic cadmium (Cd) is a serious health threat. Here we found that a tandem duplication of a gene encoding a manganese/Cd transporter, OsNramp5, was responsible for low-Cd accumulation in Pokkali, an old rice cultivar. This duplication doubled the expression of OsNramp5 gene but did not alter its spatial expression pattern and cellular localization. Higher expression of OsNramp5 increased uptake of Cd and Mn into the root cells but decreased Cd release to the xylem. Introgression of this allele into Koshihikari, an elite rice cultivar, through backcrossing significantly reduced Cd accumulation in the grain when cultivated in soil heavily contaminated with Cd but did not affect both grain yield and eating quality. This study not only reveals the molecular mechanism underlying low-Cd accumulation but also provides a useful target for breeding rice cultivars with low-Cd accumulation., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Background: Despite the potential benefits of effective communication, telling a child that they have a life-threatening condition is one of the most daunting challenges. This study aimed to explore the information needs of children with leukemia from the perspectives of children and their parents at the time of diagnosis., Methods: We conducted an exploratory qualitative study using semi-structured individual interviews with children diagnosed with leukemia between seven and 13 years old (n = 7) and their parents (n = 9). Children and parents' interview data were analyzed using thematic analysis., Results: We identified three themes for the information needs of children with leukemia, 1) beginning to cope, 2) avoiding disclosure - protecting child, and 3) informational support. The children and their parents needed to receive understandable information at the best time to cope with cancer. However, the children and parents expressed different views about children's information needs. The children needed clear information about the disease, treatment, hospitalization, and the benefits of hospitalization from the time of diagnosis. In contrast, the parents felt they should not tell their children about the disease if they were in shock by their child's cancer diagnosis. Moreover, the parents believed that information that would be incomprehensible to the child and distress should be avoided to protect their children., Conclusions: While the information needs of children with leukemia are varied, children and their parents need the information to cope with cancer. However, if the parents believe that the information would be distressful, they might manage communication with their children. Healthcare professionals should explore the motivations behind parents' attitudes against communication with children and confront conflict. Healthcare professionals also should communicate with the children and their parents to understand their information needs and respect children's views., (© 2022. The Author(s).)