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Introduction: This study lays the groundwork for the Occupational Therapy Intervention Process Model (OTIPM) run by occupational therapy practitioners for patients with stroke. We explored the feasibility of a treatment approach based on the OTIPM for patients with stroke and the clinical feasibility of evaluating the degree of a collaborative relationship between patients and occupational therapists. Method: This pilot trial was conducted as a one-group pre-test–post-test study and two-group comparison on 16 patients with stroke in the convalescence stage. We used the Canadian Occupational Performance Measure (COPM), Assessment of Motor and Process Skills (AMPS), Functional Independence Measure, Japan Stroke Scale of Motor Function, and the Collaborative Relationship Scale between clients and occupational therapists to assess outcomes. Results: Patients demonstrated a significant improvement on the outcome measures after intervention. Moreover, the good collaborative relationship group demonstrated significantly higher process skills in AMPS and satisfaction in COPM than the poor collaborative relationship group. Conclusion: This preliminary study revealed that short-term OTIPM for patients with stroke may be a feasible clinical practice. In addition, evaluating the degree of the difference in the collaborative relationship between patients and occupational therapists would be a feasible clinical practice.

Background: In this trial we combined the effect of purposeful activity and electrical stimulation therapy (PA-EST) to promote transition of severely hemiparetic upper limb to auxiliary upper limb in chronic stroke survivors in a single-case study. Objective: The purpose of this study was to examine the effect of PA-EST on the upper limb motor function in a crossover randomized controlled trial. Methods: The study included eight stroke survivors (age: 63.1±10.9 years) who were receiving home-based visiting occupational therapy. The average time since stroke onset was 8.8±5.6 years. All participants had severely hemiparetic upper limb, with the Fugl–Meyer Assessment upper extremity (FMA-U) score of 21.3±8.5. Participants were randomly assigned to group A or B. Group A received PA-EST for 3 months (phase 1), followed by standard stretching and exercise for 3 months (phase 2), whereas group B had the inverse order of treatments. To avoid carry-over effect, 1-month washout period was provided between the phase 1 and 2. Two-way analysis of variance (ANOVA) with repeated measures was used for the analysis. The primary outcome was FMA-U, and the secondary outcomes were, Motor Activity Log (MAL; amount of use [AOU] and quality of movement [QOM]), and Goal attainment scale-light (GAS-light). Results: Repeated measures-ANOVA revealed a significant interaction between type of intervention and time for FMA-U (F = 16.303, P = 0.005), MAL AOU (F = 7.966, P = 0.026) and QOM (F = 6.408, P = 0.039), and GAS-light (F = 6.905, P = 0.034), where PA-EST was associated with significantly improved motor function and goal achievement compared with standard stretching. Conclusions: The PA-EST may have greater effects than stretch/exercise in the recovery of hand function as reflected in FMA-U, MAL, and GAS-light. Our results suggest that PA-EST is an important and useful home-based rehabilitation program for promoting the use of the severely hemiparetic upper limb in chronic stroke survivors.

Case Report, 成人脳性麻痺により、 活動と参加を制限、 制約された対象者に対し、 合目的的活動と電気刺激療法を組み合わせた訪問作業療法を実施した。 その結果、 麻痺側の痙性が軽減され寝返り動作の再獲得およびリーチ動作のコントロールの向上が観察された。 また、 本事例と母親の希望である馬に乗ることができたので報告する。 開始当初の本事例は、 情動反応により一時的に全身の筋を過剰に緊張させ、 上肢動作の一連の流れを視線で追うことができなかった。 合目的的活動と電気刺激療法を約1年間実施した後、 情動反応による全身の過剰な筋緊張が緩和され上肢動作の追視が確認された。 それによって、 電気刺激と合目的的活動が、 全身の筋緊張のコントロールの改善に寄与することが示唆された。

Background: Indonesian occupational therapists (OTs), despite being few in numbers, face a high demand for quality care due to the high prevalence of Autism Spectrum Disorders (ASD). Hence, there is a need to investigate how Indonesian Occupational Therapists render services for individuals with ASD. Objectives: The objectives of this study were to describe Indonesian occupational therapy (OT) practice and identify the challenges in rendering services for individuals with ASD. Methods: This cross-sectional study employed an online survey with structured and open-ended questions to collect data from Indonesian Occupational Therapists who work with persons with ASD. Descriptive statistics and thematic analysis were used to analyze data. Results: Survey was completed with an 88% response rate. Sensory Integration and Sensory Profile are the most common frame of reference and standardized assessment, respectively. Challenges identified were: translating theory into practice, being creative and skillful, improving competence for effective collaboration, supporting parental involvement, and overcoming stigma. Conclusion: This study clarified the nature of current Indonesian Occupational Therapy practice for individuals with ASD and the challenges faced by Indonesian Occupational Therapists in rendering services for persons with ASD., 東京都立大学学位論文甲第1151号 副論文

Original Article, Owing to the after-effects of stroke, people with severe hemiplegia in the upper limbs who live at home are no longer used by the experience of paralysis. If the paralysed upper limb is not used, posture imbalance easily occurs, and the risk of falling is high. The use of the paralysed upper limb for daily activities is one of the basic problems in such patient. The objective of this study was to develop a programme that combines the purposeful activities and electrostimulation therapy at day care centre so as to promote the transition from useless upper limb to auxiliary upper limb. This report is a case study of purpose-based electrostimulation therapy administered to patients in a day care centre who had chronic severe hemiplegia in the upper limbs.脳卒中の後遺症により、 在宅で生活している重度の片麻痺上肢をもった人は、 麻痺側上肢の失敗体験や使用しない経験によって、 麻痺側を不使用となる。 長期に非麻痺側上肢のみを使う経験が続けば、 麻痺側上肢を使用せず使われない手として学習される。 特に、 通所施設では、 療法士が少ない現状であるため、 麻痺側上肢を維持や管理を目標とすることが多い。 麻痺側上肢が使われないと姿勢バランスを崩しやすく、 転倒の危険性が高くなる。 麻痺側上肢の使用は、 その後の日常生活の運動や健康において、 基礎的な課題の一つといえる。 我々は、 慢性重度麻痺側上肢に対して本人の合目的的活動を明確にし、 電気刺激装置の刺激を組み合わせることで、 麻痺側上肢を生活のなかで参加させるプログラムを提案してきた(Minami et al., 2018)。 本報告は, 通所施設で合目的的活動と電気刺激療法を併用したプログラムを慢性重度麻痺上肢に実施し、 廃用的上肢から補助的上肢に移行に至る基礎的能力を高めるプログラム開発である。

Importance: The Canadian Occupational Performance Measure (COPM) is widely used in clinical practice and research. However, the measurement properties of the COPM were not reviewed using rigorous systematic methodology. Objective: To evaluate the measurement properties of the COPM. Data Sources: MEDLINE, Web of Science, Scopus, OTseeker, and Cochrane Library. Study Selection and Data Collection: We used the updated COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist to evaluate the measurement properties of the COPM reported in relevant studies. Findings: Our search identified 35 articles that reported measurement properties for the COPM with samples that differed in age, country, diagnosis, and disease stage. For content validity, the evidence was inconsistent and of low quality; no studies assessed structural validity. For reliability, the internal consistency was indeterminate and of low quality. One study reported indeterminate and very low quality evidence for cross-cultural validity. According to the evidence reported in these studies, the COPM has inconsistent and moderate reliability, construct validity, and responsiveness and insufficient and high-quality evidence for criterion validity. Conclusions and Relevance: Our review of the evidence using the COSMIN Risk of Bias checklist indicates that the Canadian Occupational Performance Measure lacks high-quality validation. What This Article Adds: High-quality validation of the Canadian Occupational Performance Measure is lacking. Further examination of its measurement properties using updated relevant guidelines is required.

The Assessment of Readiness for Mobility Transition (ARMT) questionnaire assesses individuals’ emotional and attitudinal readiness related to mobility as they age. This study aimed to examine the reliability and validity of the Japanese version of the ARMT (ARMT-J). The ARMT-J and related variables were administered to 173 patients and staff members undergoing rehabilitation at hospitals in Japan. Construct validity was first examined using confirmatory factor analysis (CFA) to confirm cross-cultural validity. For structural validity, the optimal number of factors was confirmed using a Velicer’s minimum average partial test and parallel analysis, followed by exploratory factor analysis (EFA). Finally, a CFA was performed using the most appropriate model. Internal consistency, test–retest reliability, standard error of measurement (SEM), and smallest detectable change (SDC) were assessed for reliability. The CFA fit for the factor structure of the original ARMT was low. Therefore, the EFA was conducted with two to four factors. The optimal factor structure was three factors, with a Cronbach’s alpha coefficient and Cohen’s weighted kappa coefficient of 0.85 and 0.76, respectively. The intraclass correlation coefficient (ICC) of the test–retest was 0.93, the SEM was 0.72, and the SDC was 2.00. The model fit was good for the ARMT-J, with a three-factor structure.

The upper limit of sensitivity enhancement in a multipass process was investigated. In the calculation of 3.7 × 1013 ray-trace analysis, the sensitivity enhancement was increased to 13 510 for the mirror diameter of 75 mm with the mirror diameter. In the experiment, the sensitivity was enhanced by a factor of 1790 ± 160 for an effective mirror diameter of 50 mm, which was one-third of the numerical prediction. The lower enhancement could be attributed to the insufficient spatial and angular resolution of alignment optics. Therefore, this multipass cell has the potential to improve the sensitivity by three to four orders of magnitude.

Objective: To verify the effect of adjusting the challenge–skill balance with respect to rehabilitation process. Design: A single-blind, two-arm, parallel-group, randomized controlled trial. Setting: Recovery rehabilitation unit of Harue Hospital, Japan. Subjects: The trial included 72 clients (mean (SD): age, 74.64 (9.51) years; Functional Independence Measure score, 98.26 (15.27)) with cerebral or spinal disease or musculoskeletal disease. Interventions: Clients were randomly divided into two groups: the experimental group, who received occupational therapy with adjustment of the challenge–skill balance, and the control group who received conventional occupational therapy. Time from admission to discharge was considered the implementation period; the final evaluation was conducted at three months after discharge. Main measures: The primary outcome was subjective quality of life (Ikigai-9). Secondary outcomes were the health-related quality of life (EuroQol–5 Dimensions, Five Levels (EQ-5D-5L)), the Flow State Scale for Occupational Tasks, and the Functional Independence Measure. A cost-effectiveness analysis was conducted using total cost and quality-adjusted life-year based on the EQ-5D-5L. Results: Significant differences were observed between the experimental and control groups with respect to the Ikigai-9 score ( P = 0.008) and EQ-5D-5L ( P = 0.038), and the effect sizes were 0.76 (95% confidence interval [CI]: 0.27–1.24) and 0.62 (95% CI: 0.14–1.10), respectively. No significant between-group differences in other outcomes were observed, for example, the Functional Independence Measure score improved in both experimental and control groups (119.80 (5.50) and 118.84 (6.97), respectively. The incremental cost-effectiveness ratio was US$5518.38. Conclusions: Adjusting the challenge–skill balance may be a useful approach to improve the participant’s subjective quality of life in the rehabilitation process.

首都大学東京学位論文甲第967号副論文

Background: This study attempts to determine whether a program focused on improving literacy in daily living is effective in preventing physical frailty, and to compare standard treatments for physical frailty. Methods: This study was designed as a pilot intervention study involving two groups. Twenty-five older adults aged 65 to 85 in Ward A, Tokyo, were randomly assigned to the literacy group or the exercise group on a regional basis and were given a 60- to 90-minute program twice a month, eight times over four months. The literacy group mainly used video materials to monitor learning, and the exercise group used a multifactor exercise program. Results: The LSI-Z, GAS-L, Maximum 5 m walking time, and TUG tests showed the main effects before and after the intervention in both groups (p < 0.05, p < 0.01). The WHOQOL26, Maximum 5 m walking time, and TUG tests also showed the main effects across both groups (p < 0.05). Conclusion: Both programs, when implemented independently, showed specific effects on subjective well-being, occupational performance, and physical fitness. However, QOL and physical fitness were significantly higher in the exercise group than in the literacy group. These results should be considered with caution because of the limited sample size of this pilot study.

While many health-care issues and technological solutions are viewed locally, developing new technological solutions might benefit from lessons learned globally. The aim of this study was to develop a shared international research agenda of health-care ICT, applied to rehabilitation and daily living support. This study was focused on sensor technology and social robots used for supporting older persons in the Netherlands (Amsterdam) and Japan (Tokyo). Three researchers from Amsterdam University of Applied Sciences visited Japan and four researchers from Tokyo Metropolitan University visited the Netherlands and conducted field-visits and mutual presentations. Using a nominal group technique (NGT) facilitated the expert panel deliberations. Research priorities were identified qualitatively through in-action critical reflection on emerging ideas, and quantitatively by ranking of identified knowledge gaps (using the Mentimeter© app). The resulting joint research agenda identified topics around the utility of sensor monitoring and processes of acceptance of health-care ICT among older persons and occupational therapists. The agenda was complemented by formulating underlying assumptions prescribing such research to be embedded in real-life situations with the participation of stakeholders.

Objective: The success of a client-centred practice depends on the relationship between the client and therapist and on their ability to make constructive decisions together, particularly in the field of occupational therapy. The aim of this study was to develop a Occupational Therapy Collaborative Relationship Scale (OTCRS) to measure the quality of such interaction. Methods: This work included constructing a draft questionnaire and testing its validity and reliability. A Rasch analysis was applied to determine its validity, and several tests were used to confirm its internal consistency. Results: After reviewing more than 130 scientific papers and books, we built explicit selection criteria for issues to be addressed in this instrument, and we developed 40 questions to be included. These were analysed using a standard content validation process and a Rasch analysis to examine confirmation validity. A nine-item scale was finalised for testing (OTCRS-9). This review process revealed the validity, high internal consistency, and item/person separation reliability of OTCRS-9. Conclusion: This study presents only the initial phase of scale development. As suggested by the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN), the OTCRS-9 score should be tested further for validity and reliability and should also be conducted in subjects of other ethnicities to improve its generalizability.

Due to explosive growth in mobile applications and services with different requirements, the concept of mobile edge computing (MEC) has emerged. For MEC, a mobile user (MU) and a MEC server need to exchange tasks using limited radio resources. Furthermore, when multiple MUs possess tasks, the MEC server has to handle multiple tasks simultaneously. Thus, the radio and computing resources need to be allocated to MUs by taking into account the wireless channel condition and the computing power of MUs and the MEC server. In this paper, a radio resource and computing resource allocation scheme is proposed to minimize the total processing completion time of all the tasks. Each task is assumed to be divided into local task and offload task. The local task is processed by each MU while the offload task is processed by a MEC server. We first formulate the optimization problem to minimize the total processing completion time of all tasks. To solve the formulated optimization problem, we propose a two-step radio and computing resources allocation scheme which iteratively performs bisection search method and Johnson's algorithm. The numerical results elucidate that the proposed scheme can reduce the total processing completion time by about 25% on average compared to the conventional schemes when multiple MUs have divisible tasks.

Hirofumi Nagayama,1 Norikazu Kobayashi,2 Yu Ishibashi,2 Ryuji Kobayashi,2 Chika Murai,3 Keita Yamauchi4 1Department of Occupational Therapy, Kanagawa University of Human Services, Yokosuka, Japan; 2Division of Occupational Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Arakawa, Japan; 3Department of Occupational Therapy, Ishikawa Prefectural Takamatsu Hospital, Kahoku, Japan; 4Graduate School of Health Management, Keio University, Fujisawa, Japan Purpose: The purpose of this pilot study was to determine the effectiveness and costs of the occupation-based practice for community dwelling frail elderly. Design: Pilot pre-post design without a control group. Setting: A care management center involving 37 local elderly. Subject: The final analysis included 26 frail elderly in a community dwelling center. Intervention: The intervention was occupation-based practice involving setting of client-centered goals, observation of real living situations, and provision of advice on the individual problem of real occupation. Outcome: The outcome was the Frenchay Activities Index (FAI), which is used to evaluate the instrumental activities of daily living (IADL). Additionally, the frequency, duration, and cost of the intervention were calculated. Results: Regarding the FAI score before and after the interventions, there were significant improvements in all items except work (P

Background: In cycling tumour cells, the binary cyclin-dependent kinase Cdk4/cyclin D or Cdk2/cyclin E complex is inhibited by p21 following DNA damage to induce G1 cell-cycle arrest. However, it is not known whether other proteins are also recruited within Cdk complexes, or their role, and this was investigated. Methods: Ovarian A2780 tumour cells were exposed to the platinum-based antitumour agent 1R,2R-diaminocyclohexane(trans-diacetato)(dichloro)platinum(IV) (DAP), which preferentially induces G1 arrest in a p21-dependent manner. The Cdk complexes were analysed by gel filtration chromatography, immunoblot and mass spectrometry. Results: The active forms of Cdk4 and Cdk2 complexes in control tumour cells have a molecular size of ∼140 kDa, which increased to ∼290 kDa when inhibited following G1 checkpoint activation by DAP. Proteomic analysis identified Cdk, cyclin, p21 and proliferating cell nuclear antigen (PCNA) in the inhibited complex, and biochemical studies provided unequivocal evidence that the increase in ∼150 kDa of the inhibited complex is consistent with p21-dependent recruitment of PCNA as a trimer, likely bound to three molecules of p21. Although p21 alone was sufficient to inhibit the Cdk complex, PCNA was critical for stabilising p21. Conclusion: G1 Cdk complexes inhibited by p21 also recruit PCNA, which inhibits degradation and, thereby, prolongs activity of p21 within the complex.

Objective/Background This qualitative analysis aimed to provide valuable insight into the occupational experiences of and psychological adjustments by family members who act as palliative caregivers. In addition, we also aimed to investigate and clarify these complex experiences and formulate results that are both meaningful and important to the families themselves. Methods Families who had lost a family member (n = 9) and were part of a palliative treatment support programme were identified through introductions from healthcare workers. They were individually interviewed using both casual questioning and semistructured questionnaires. The data were analysed using the grounded theory approach. Results The following six core categories were identified using grounded theory analysis: (a) being overwhelmed by pressure, (b) occupation while living with the illness, (c) living without being overwhelmed by anxiety, (d) having difficulties in regulating emotions, (e) comforting memories of the occupational experiences, and (f) leading to a change in emotions. Conclusion Occupational experiences can play a significant role in the psychological adjustment of families of terminally ill cancer patients.

This study was performed to investigate the relationship between mental state (especially flow experience [Flow Experience Checklist of Ishimura]) health-related quality of life (Medical Outcome Study 8-Item Short-Form Health Survey), and stress (salivary amylase concentrations). The subjects were 119 healthy elderly persons living in rural areas who participated in a "meeting for the elderly" at a nursing home in Kagawa Prefecture, Japan. The subjects were classified into apathetic, anxious, relaxed, and flow groups. It was found that physical health was significantly better when performing important daily activities in the group who experienced flow and the relaxed group than in the group that was in an apathetic state. However, no significant relationship was observed between the degree of flow experience and stress. The present findings suggested that interventions which make the activities of daily life either "high-challenge, high-skill" situations or "low-challenge, high-skill" situations could have a positive influence on the physical health of community-living elderly Japanese. A longitudinal study should be performed in the future.

IntroductionOccupational therapy (OT) is defined as the promotion of client health and well-being through a client-centred practice. However, there is a tendency to rely on the therapist’s experiences and values, and there is a difference between the client’s and therapist’s perceptions regarding the current activity that the client is engaged in. In previous studies that have applied ‘flow’, activities supported by OT in elderly people were analysed, indicating a difference in recognition. Therefore, we thought that more effective OT could be implemented by adjusting the challenge–skill (ACS) balance, and we invented a novel process termed as ACS balance for OT. The purpose of this study is to verify the effect of ACS-OT on clients in the recovery rehabilitation unit and to prepare a protocol for randomised controlled trial (RCT) implementation.Method and analysisThis single-blind RCT will recruit 80 clients aged 50–99 years admitted to the recovery rehabilitation unit who meet eligibility criteria. Clients will be randomly allocated to receive ACS-OT or standard OT. Both interventions will be performed during the clients’ residence at the unit. The primary outcome measure will be subjective quality of life and will be measured at entry into (pre) and at discharge from (post) the unit and at 3 months afterwards (follow-up). Outcomes will be analysed using a linear mixed model fitted with a maximum likelihood estimation.Ethics and disseminationThis protocol has been approved by the ethics review committee of the Tokyo Metropolitan University (No.17020). Results of this trial will be submitted for publication in a peer-reviewed journal.Trial registration numberUMIN-CTR number, UMIN000029505; Pre-results.

Alternative translation initiation is a mechanism whereby functionally altered proteins are produced from a single mRNA. Internal initiation of translation generates N-terminally truncated protein isoforms, but such isoforms observed in immunoblot analysis are often overlooked or dismissed as degradation products. We identified an N-terminally truncated isoform of human Dok-1 with N-terminal acetylation as seen in the wild-type. This Dok-1 isoform exhibited distinct perinuclear localization whereas the wild-type protein was distributed throughout the cytoplasm. Targeted analysis of blocked N-terminal peptides provides rapid identification of protein isoforms and could be widely applied for the general evaluation of perplexing immunoblot bands.

Autophagy, an evolutionarily conserved response to stress, has recently been implicated in cancer initiation and progression, but the detailed mechanisms and functions have not yet been fully elucidated. One major obstacle to our understanding is lack of an efficient and robust method to specifically monitor autophagic cells in cancer specimens. To identify molecular events associated with autophagy, we performed cDNA microarray analysis of autophagic glioblastoma cell lines. Based on the analysis, we raised a polyclonal antibody against isoform B of human microtubule-associated protein 1 light chain 3 (LC3B). Application of the anti-LC3B antibody revealed the presence of autophagic cells in both in vitro and in vivo settings. Of the 65 glioblastoma tissues, 31 had highly positive cytoplasmic staining of LC3B. The statistical interaction between cytoplasmic staining of LC3B and Karnofsky Performance Scale score was significant. High expression of LC3B was associated with an improved outcome for patients with poorer performance, whereas, for patients with normal performance, survival was better for patients with low staining than with high staining of LC3B. Anti-LC3B antibody provides a useful tool for monitoring the induction of autophagy in cancer cells and tissues.

Escherichia coli phage-shock protein A (PspA), a 25.3 kDa peripheral membrane protein, is induced under the membrane stress conditions and is assumed to help maintain membrane potential. Here, we report that purified PspA, existing as a large oligomer, is really able to suppress proton leakage of the membranes. This was demonstrated for membrane vesicles prepared from the PspA-lacking E. coli mutants, and for membrane vesicles damaged by ethanol and Triton X-100 prepared from the mutant and the wild-type cells. PspA also suppressed proton leakage of damaged liposomes made from E. coli total lipids. Furthermore, we found that PspA bound preferentially to liposomes containing phosphatidylserine and phosphatidylglycerol. All these effects were not observed for monomer PspA that was prepared by refolding of urea-denatured PspA. These results indicate that oligomers of PspA bind to membrane phospholipids and suppress proton leakage.

We used electron microscopy to examine the structure of human DNA pol gamma, the heterotrimeric mtDNA replicase implicated in certain mitochondrial diseases and aging models. Separate analysis of negatively stained preparations of the catalytic subunit, pol gammaA, and of the holoenzyme including a dimeric accessory factor, pol gammaB(2), permitted unambiguous identification of the position of the accessory factor within the holoenzyme. The model explains protection of a partial chymotryptic cleavage site after residue L(549) of pol gammaA upon binding of the accessory subunit. This interaction region is near residue 467 of pol gammaA, where a disease-related mutation has been reported to impair binding of the B subunit. One pol gammaB subunit dominates contacts with the catalytic subunit, while the second B subunit is largely exposed to solvent. A model for pol gamma is discussed that considers the effects of known mutations in the accessory subunit and the interaction of the enzyme with DNA.

Squamous cell carcinoma in the lung originates from bronchial epithelial cells that acquire increasingly abnormal phenotypes. Currently, no known biomarkers are clinically efficient for the early detection of premalignant lesions and lung cancer. We sought to identify secreted molecules produced from squamous bronchial epithelial cells cultured with organotypic culture methods. We analyzed protein expression patterns in the apical surface fluid (ASF) from aberrantly differentiated squamous metaplastic normal human tracheobronchial epithelial (NHTBE) and mucous NHTBE cells. Comparative two-dimensional PAGE analysis revealed 174 unique proteins in the ASF of squamous NHTBE cells compared with normal mucociliary differentiated NHTBE cells. Among them, 64 well-separated protein spots were identified by liquid chromatography-tandem mass spectrometry, revealing 22 different proteins in the ASF from squamous NHTBE cells. Expression of six of these proteins [SCC antigen 1 (SCCA1), SCC antigen 2 (SCCA2), S100A8, S100A9, Annexin I, and Annexin II] in the squamous NHTBE cells was further confirmed with immunoblot analysis. Notably, SCCA1 and SCCA2 were verified as being expressed in squamous metaplastic NHTBE cells but not in normal mucous NHTBE or normal bronchial epithelium. Moreover, SCCA1 and SCCA2 expression increased in in vitro lung carcinogenesis model cell lines with increasing malignancy. In summary, we identified proteins that are uniquely secreted from squamous metaplastic primary human bronchial epithelial cells cultured by the organotypic air-liquid interface method. These ASF proteins may be used to detect abnormal lesions in the lung without collecting invasive biopsy specimens. [Cancer Res 2007;67(14):6565–73]

The aim of this study was to identify factors related to the health-related quality of life (HRQOL) of caregivers providing continuing home care for the impaired elderly focusing mainly on care managers' support given to caregivers. Two interviews over a course of 12 months were conducted with 42 caregivers. The questionnaire items for the caregivers included demographic variables, HRQOL, the satisfaction level of care managers, coping ability, and depressive state. For the impaired elderly, the questionnaire items included demographic variables, abilities of activities of daily living, dementia assessment, and depressive state. The mean age of the caregivers was 66.1+/-8.8. By logistic regression analysis with HRQOL as a dependent variable, the caregivers' physical QOL was significantly related to the depressive state of impaired elderly and the caregivers' satisfaction with their care manager, whereas the caregivers' mental QOL was significantly related to the caregivers' sense of coherence and satisfaction with their care manager. These results suggest that the care managers' support to caregivers who provide continuing home care is important for caregivers' HRQOL.

The mammalian adaptor protein Alix [ALG-2 (apoptosis-linked-gene-2 product)-interacting protein X] belongs to a conserved family of proteins that have in common an N-terminal Bro1 domain and a C-terminal PRD (proline-rich domain), both of which mediate partner protein interactions. Following our previous finding that Xp95, the Xenopus orthologue of Alix, undergoes a phosphorylation-dependent gel mobility shift during progesteroneinduced oocyte meiotic maturation, we explored potential regulation of Xp95/Alix by protein phosphorylation in hormone-induced cell cycle re-entry or M-phase induction. By MALDI–TOF (matrix-assisted laser-desorption ionization–time-of-flight) MS analyses and gel mobility-shift assays, Xp95 is phosphorylated at multiple sites within the N-terminal half of the PRD during Xenopus oocyte maturation, and a similar region in Alix is phosphorylated in mitotically arrested but not serum-stimulated mammalian cells. By tandem MS, Thr745 within this region, which localizes in a conserved binding site to the adaptor protein SETA [SH3 (Src homology 3) domain-containing, expressed in tumorigenic astrocytes] CIN85 (α-cyano-4-hydroxycinnamate)/SH3KBP1 (SH3-domain kinase-binding protein 1), is one of the phosphorylation sites in Xp95. Results from GST (glutathione S-transferase)-pull down and peptide binding/competition assays further demonstrate that the Thr745 phosphorylation inhibits Xp95 interaction with the second SH3 domain of SETA. However, immunoprecipitates of Xp95 from extracts of M-phase-arrested mature oocytes contained additional partner proteins as compared with immunoprecipitates from extracts of G2-arrested immature oocytes. The deubiquitinase AMSH (associated molecule with the SH3 domain of signal transducing adaptor molecule) specifically interacts with phosphorylated Xp95 in M-phase cell lysates. These findings establish that Xp95/Alix is phosphorylated within the PRD during M-phase induction, and indicate that the phosphorylation may both positively and negatively modulate their interaction with partner proteins.