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Aim: The aim of this qualitative meta‐synthesis was to discover the factors impacting on missed nursing care of nurses through systematic thinking. Background: Although nurses are responsible for high‐quality care, missed nursing care is common, endangering patient safety. Understanding of the causes related to missed nursing care could help nursing managers improve the quality of nursing care. Design: A qualitative meta‐synthesis guided by the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA). Methods: As a method designed to contribute to knowledge development, meta‐synthesis allows for integration of qualitative study findings using thematic synthesis. Six databases were searched up to October 2021; nine studies met the inclusion and quality assessment criteria and meta‐synthesis were conducted. Results: Three themes related to the causes why nurses missed nursing care were found. The themes included intrinsic resources (professional and ethical values, ambiguous nurse role, prioritization, education system, and knowledge), system structure (staff and resources shortage, heavy workload but limited time, and organizational management failure), and social environment (communication, working relationship and skill mix, and inappropriate ward layout). Conclusion: The phenomenon of missed nursing care is a global tissue, with variations in its elements but also notable similarities. Meta‐synthesis provides evidence of intrinsic and extrinsic factors that contribute to missed nursing care. Relevance to Clinical Practice: Recognizing and understanding the causes of missed nursing care is essential for nursing managers to ensure patient safety and the provision of high‐quality care. [ABSTRACT FROM AUTHOR]

Patient-reported outcomes (PROs) are frequently used in a variety of settings, including clinical trials and clinical practice. The definition of PRO and quality of life (QOL) and their relationship have been concluded through discussions among experts that has been the premise of PRO guidelines are not clearly stated in the guidelines. Therefore, the definition of PRO, especially in relation to QOL, is sometimes explained simply, as "PRO includes QOL," but this complicated matters. This study investigated the perceptions of PRO among various stakeholders (including patients and their families, the industry, clinicians, regulatory or health technology assessment personnel, and academic researchers) in Japan to clarify its definitions and that of QOL, including their relationship. We conducted a two-step survey: a qualitative interview survey and a web-based survey to ensure the validity of the survey. During the interviews, eight stakeholders described their perceptions and thoughts on PRO and its relationship to QOL, and their experience of using PRO. Overall 253 clinicians, 249 company employees, and 494 patients participated in the web survey to confirm how the findings of the interview survey supported the results. In the interview survey, patient advocates described various perspectives of PRO and QOL, including unexpected dynamic relationships, while the most other stakeholders explained PRO and QOL with the language used in the guidelines, but their responses were split. The web-based survey revealed that all stakeholders had a lower awareness of PRO than QOL. The most common perception of PRO, especially in the relationship to QOL, was "they did not fully overlap." Although there were differences in perceptions of the relationship between PRO and QOL among clinicians, company employees, and patients, all perceived PRO as a tool to facilitate communication in clinical practice. The present results are inconsistent with the simplified explanation of PRO, but consistent with the original PRO guideline definitions, which also considered the role of PRO in clinical practice. To make PRO a more potent tool, all stakeholders using PRO should confirm its definition and how it differs from QOL, have a unified recognition in each PRO use, and avoid miscommunication. [ABSTRACT FROM AUTHOR]

Background: The concept of career identity is integral to nursing practices and forms the basis of the nursing professions. Positive career identity is essential for providing high-quality care, optimizing patient outcomes, and enhancing the retention of health professionals. Therefore, there is a need to explore potential influencing variables, thereby developing effective interventions to improve career identity. Objectives: To investigate the relationship between moral distress, moral courage, and career identity, and explore the mediating role of moral courage between moral distress and career identity among nurses. Design: A quantitative, cross-sectional study. Methods: A convenient sample of 800 nurses was recruited from two tertiary care hospitals between February and March 2022. Participants were assessed using the Moral Distress Scale-revised, Nurses' Moral Courage Scale, and Nursing Career Identity Scale. This study was described in accordance with the STROBE statement. Ethical consideration: Research ethics approval was obtained from the researcher's university and hospital where this study was conducted prior to data collection. Findings: Moral distress is negatively associated while moral courage is positively associated with career identity among nurses. Moral courage partially mediates the relationship between moral distress and career identity (β = −0.230 to −0.163, p < 0.01). Discussion: The findings reveal a relationship between moral distress, moral courage, and career identity among nurses. Conclusion: By paying attention to nurses' moral distress and courage, healthcare providers can contribute to the development of effective interventions to improve career identity, and subsequently performance, among nurses. [ABSTRACT FROM AUTHOR]

Abstract Electron tracking based Compton imaging is a key technique to improve the sensitivity of Compton cameras by measuring the initial direction of recoiled electrons. To realize this technique in semiconductor Compton cameras, we propose a new detector concept, Si-CMOS hybrid detector. It is a Si detector bump-bonded to a CMOS readout integrated circuit to obtain electron trajectory images. To acquire the energy and the event timing, signals from N-side are also read out in this concept. By using an ASIC for the N-side readout, the timing resolution of few μs is achieved. In this paper, we present the results of two prototypes with 20 μm pitch pixels. The images of the recoiled electron trajectories are obtained with them successfully. The energy resolutions (FWHM) are 4. 1 keV (CMOS) and 1. 4 keV (N-side) at 59.5 keV. In addition, we confirmed that the initial direction of the electron is determined using the reconstruction algorithm based on the graph theory approach. These results show that Si-CMOS hybrid detectors can be used for electron tracking based Compton imaging. [ABSTRACT FROM AUTHOR]

Abstract: Boric acid inhibited the acid-catalyzed depolymerization of cellulose in sulfolane, a non-aqueous medium, at high temperature. Formation of the dehydration products such as levoglucosenone, furfural, and 5-hydroxymethyl furfural were also effectively inhibited. Similar inhibition was observed for cellooligosaccharides and starch, although the glucosidic bonds in methyl glucopyranosides and methyl cellobioside were cleaved to form α-d-glucofuranose cyclic 1,2:3,5-bisborate. [Copyright &y& Elsevier]

Abstract: APH-1 is one of the four essential components of the presenilin-γ-secretase complex and has two human homologs, APH-1a, and APH-1b, both of which are seven-pass membrane proteins. Here, we identified a novel splice variant of human APH-1b. This variant lacks exon 4, which encodes the entire fourth transmembrane domain. The mRNA expression of this variant was detected in most tissues at low levels. In transiently transfected cells, protein expression of the APH-1b variant was much lower than that of the wild-type. Furthermore, exogenous expression of the APH-1-interacting protein, nicastrin, significantly increased the variant protein levels. These data suggest that the APH-1b variant protein is destabilized, and implies that the fourth transmembrane domain plays an important role in the protein stability and function of APH-1. [Copyright &y& Elsevier]

Abstract: APH-1 is a polytopic membrane protein that functions as a component of presenilin–γ-secretase complexes. Two homologous genes of APH-1 exist in humans, APH-1a and APH-1b, and alternative splicing of the former generates two isoforms, APH-1aS and APH-1aL. We performed semi-quantitative reverse transcription-PCR analysis to investigate mRNA expression of these three APH-1 forms in human cell lines and tissues. We found that both APH-1a and APH-1b were expressed in almost all tissues, and that APH-1aS was 1.5–3 times more abundantly expressed than APH-1aL. We examined the effect of small interfering RNA-mediated knock down of APH-1a or APH-1b on APH-1 mRNA expression and presenilin complex protein expression. We found that knock down of APH-1a, but not APH-1b, resulted in impaired maturation of nicastrin and reduced expression of presenilin 1, presenilin 2, and PEN-2 proteins. These findings indicate that APH-1a plays an essential role in the formation of presenilin–γ-secretase complexes. [Copyright &y& Elsevier]

Treatment of 1-chlorocyclopropyl phenyl sulfoxides with isopropylmagnesium chloride at low temperature gave magnesium cyclopropylidenes. The reaction of the generated carbenoids with lithium α-sulfonyl carbanions was found to afford alkylidenecyclopropanes in moderate to good yields. This reaction offers a novel, unprecedented, and versatile method for a synthesis of several alkylidenecyclopropanes from olefins in relatively short steps. [Copyright &y& Elsevier]

Aims Immunohistochemistry for mismatch repair ( MMR) proteins is being increasingly used to examine MMR status in tumours. The aim of the present article was to report the case of a colon cancer patient with Lynch syndrome who showed unusual cytoplasmic MMR protein localization. Methods and results Histologically, the colon cancer was diagnosed as medullary carcinoma associated with prominent tumour-infiltrating lymphocytes and a Crohn's-like reaction. Immunohistochemistry revealed cytoplasmic and nuclear expression of MSH2 in non-neoplastic cells, and exclusively cytoplasmic expression in tumour cells. MSH6 expression was nuclear in non-neoplastic cells, but was lost in tumour cells. Nuclear expression of MLH1 and PMS2 was retained in both non-neoplastic and tumour cells. The tumour was microsatellite instability-high, which is indicative of defective MMR function. A subsequent germline mutation analysis identified a genomic deletion spanning the 3′ region of EPCAM and the 5′ region of MSH2, resulting in an in-frame fusion of EPCAM and MSH2. Conclusions The unusual cytoplasmic immunoreactivity of MSH2 was considered to be attributable to the non-functional EPCAM-MSH2 fusion product. The present case illustrates that not only loss of expression, but also abnormal localization, of MMR proteins is indicative of a defective MMR system. [ABSTRACT FROM AUTHOR]

SUMMARY The main subject of this investigation is to perform research and development and verification experiments on underwater communications (underwater visible light communications; VLCs) under the assumption that VLC can be used for tourism and environmental protection under the ocean conditions of the Okinawa region (Zamami village), which is one of the most popular diving spots, with the most transparent water and abundant coral and fish. Radio is rarely used as a communications tool underwater because the attenuation rate of radio signals is high. The only communications tool now available under water is sonic (ultrasonic) communications, although it has not spread among divers because it is subject to noise from reflections of the water surface or the sea floor, and its use is not simple. Another disadvantage of this mode of communication is that it is very difficult to identify the speaker when several divers are present in the same area. With the underwater VLC device, most of the underwater communications problems are already solved, for the following reasons: (1) the device is easy to move and does not involve cables; (2) it is much easier to capture another person's words because communication does not diverge as sonic communication does; (3) conversation is much easier since the other party can recognize the speaker visually. [ABSTRACT FROM AUTHOR]

β-Secretase β-site APP cleaving enzyme 1 (BACE1), is a membrane-bound aspartyl protease necessary for the generation of amyloid β-protein (Aβ), which accumulates in the brains of individuals with Alzheimer's disease (AD). To gain insight into the mechanisms by which BACE1 activity is regulated, we used proteomic methods to search for BACE1-interacting proteins in human neuroblastoma SH-SY5Y cells, which overexpress BACE1. We identified reticulon 4-B (RTN4-B; Nogo-B) as a BACE1-associated membrane protein. Co-immunoprecipitation experiments confirmed a physical association between BACE1 and RTN4-B, RTN4-C (the shortest isoform of RTN-4), and their homologue reticulon 3 (RTN3), both in SH-SY5Y cells and in transfected human embryonic kidney (HEK) 293 cells. Overexpression of these reticulons (RTNs) resulted in a 30–50% reduction in the secretion of both Aβ40 and Aβ42 from HEK293 cells expressing the AD-associated Swedish mutant amyloid precursor protein (APP), but did not affect Aβ secretion from cells expressing the APP β-C-terminal fragment (β-CTF), indicating that these RTNs can inhibit BACE1 activity. Furthermore, a BACE1 mutant lacking most of the N-terminal ectodomain also interacted with these RTNs, suggesting that the transmembrane region of BACE1 is critical for the interaction. We also observed a similar interaction between these RTNs and the BACE1 homologue BACE2. Because RTN3 and RTN4-B/C are substantially expressed in neural tissues, our findings suggest that they play important roles in the regulation of BACE1 function and Aβ production in the brain. [ABSTRACT FROM AUTHOR]

Hard X-ray astronomical observatories in orbit suffer from a significant amount of background due to radioactivation induced by cosmic-ray protons and/or geomagnetically trapped protons. Within the framework of a full Monte Carlo simulation, we present modeling of in-orbit instrumental background which is dominated by radioactivation. To reduce the computation time required by straightforward simulations of delayed emissions from activated isotopes, we insert a semi-analytical calculation that converts production probabilities of radioactive isotopes by interaction of the primary protons into decay rates at measurement time of all secondary isotopes. Therefore, our simulation method is separated into three steps: (1) simulation of isotope production, (2) semi-analytical conversion to decay rates, and (3) simulation of decays of the isotopes at measurement time. This method is verified by a simple setup that has a CdTe semiconductor detector, and shows a 100-fold improvement in efficiency over the straightforward simulation. To demonstrate its experimental performance, the simulation framework was tested against data measured with a CdTe sensor in the Hard X-ray Imager onboard the Hitomi X-ray Astronomy Satellite, which was put into a low Earth orbit with an altitude of 570 km and an inclination of 31 ° , and thus experienced a large amount of irradiation from geomagnetically trapped protons during its passages through the South Atlantic Anomaly. The simulation is able to treat full histories of the proton irradiation and multiple measurement windows. The simulation results agree very well with the measured data, showing that the measured background is well described by the combination of proton-induced radioactivation of the CdTe detector itself and thick Bi 4 Ge 3 O 12 scintillator shields, leakage of cosmic X-ray background and albedo gamma-ray radiation, and emissions from naturally contaminated isotopes in the detector system. [ABSTRACT FROM AUTHOR]

Background: Lynch syndrome is an autosomal dominant inherited disease caused by germline mutations in mismatch repair genes. Analysis for microsatellite instability (MSI) and immunohistochemistry (IHC) of protein expressions of disease-associated genes is used to screen for Lynch syndrome in endometrial cancer patients. When losses of both MLH1 and PMS2 proteins are observed by IHC, MLH1 promoter methylation analysis is conducted to distinguish Lynch syndrome-associated endometrial cancer from sporadic cancer.Case Presentation: Here we report a woman who developed endometrial cancer at the age of 49 years. She had a family history of colorectal cancer (first-degree relative aged 52 years) and stomach cancer (second-degree relative with the age of onset unknown). No other family history was present, and she failed to meet the Amsterdam II criteria for the diagnosis of Lynch syndrome. Losses of MLH1 and PMS2, but not MSH2 and MSH6, proteins were observed by IHC in endometrial cancer tissues. Because MLH1 promoter hypermethylation was detected in endometrial cancer tissue samples, the epigenetic silencing of MLH1 was suspected as the cause of the protein loss. However, because of the early onset of endometrial cancer and the positive family history, a diagnosis of Lynch syndrome was also suspected. Therefore, we provided her with genetic counseling. After obtaining her consent, MLH1 promoter methylation testing and genetic testing of peripheral blood were performed. MLH1 promoter methylation was not observed in peripheral blood. However, genetic testing revealed a large deletion of exon 5 in MLH1; thus, we diagnosed the presence of Lynch syndrome.Conclusions: Both MLH1 germline mutation and MLH1 promoter hypermethylation may be observed in endometrial cancer. Therefore, even if MLH1 promoter hypermethylation is detected, a diagnosis of Lynch syndrome cannot be excluded. [ABSTRACT FROM AUTHOR]

Background: The valuation study of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L) involved composite time trade-off (cTTO) and a discrete choice experiment (DCE). The DCE scores must be anchored to the quality-of-life scale from 0 (death) to 1 (full health). Nevertheless, the characteristics of the statistical methods used for converting the EQ-5D-5L DCE results by using TTO information are not yet clearly known.Objectives: To present the Japanese DCE value set of the EQ-5D-5L and compare three methods for converting latent DCE values.Methods: The survey sampled the general population at five locations in Japan. 1098 respondents were stratified by age and sex. To obtain and compare the value sets of the EQ-5D-5L, the cTTO and DCE data were analyzed by a linear mixed model and conditional logit, respectively. The DCE scores were converted to the quality-of-life scale by anchoring to the worst state using cTTO, mapping DCE onto cTTO, and a hybrid model.Results: The data from 1026 respondents were analyzed. All the coefficients in the cTTO and DCE value sets were consistent throughout all the analyses. Compared with the cTTO algorithm, the mapping and hybrid methods yielded very similar scoring coefficients. The hybrid model results, however, produced a lower root mean square error and fewer health states with errors exceeding 0.05 than did the other models. The DCE anchored to the worst state overestimated the cTTO scores of almost all the health states.Conclusions: Japanese value sets based on DCE were demonstrated. On comparing the observed cTTO scores, we found that the hybrid model was slightly superior to the simpler methods, including the TTO model. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to measure the population norms for the Japanese versions of preference-based measures (EQ-5D-3L, EQ-5D-5L, and SF-6D). We also considered the relations between QOL score in the general population and socio-demographic factors.Methods: A total of 1143 adult respondents (aged ≥ 20 years) were randomly sampled from across Japan using data from the Basic Resident Register. The health status of each respondent was measured using the EQ-5D-3L, EQ-5D-5L, and SF-6D, and responses regarding socio-demographic data as well as subjective diseases and symptoms were obtained. The responses were converted to a QOL score using Japanese value sets.Results: The percentages of respondents with full health scores were 68 % (EQ-5D-3L), 55 % (EQ-5D-5L), and 4 % (SF-6D). The QOL score measured using the SF-6D was significantly lower than those measured using either EQ-5D score. The QOL score was significantly lower among respondents over the age of 60 years, those who had a lower income, and those who had a shorter period of education. Intraclass correlation coefficient showed a poor agreement between the EQ-5D and SF-6D scores. The differences in QOL scores between respondents with and those without any disease were 0.064 for the EQ-5D-3L, 0.061 for the EQ-5D-5L, and 0.073 for the SF-6D; these differences are regarded as between-group minimal important differences in the general population.Conclusion: The Japanese population norms of three preference-based QOL measures were examined for the first time. Such information is useful for economic evaluations and research examining QOL score. [ABSTRACT FROM AUTHOR]

The Soft Gamma-ray Detector (SGD) is one of the instrument payloads onboard ASTRO-H, and will cover a wide energy band (60–600 keV) at a background level 10 times better than instruments currently in orbit. The SGD achieves low background by combining a Compton camera scheme with a narrow field-of-view active shield. The Compton camera in the SGD is realized as a hybrid semiconductor detector system which consists of silicon and cadmium telluride (CdTe) sensors. The design of the SGD Compton camera has been finalized and the final prototype, which has the same configuration as the flight model, has been fabricated for performance evaluation. The Compton camera has overall dimensions of 12 cm×12 cm×12 cm, consisting of 32 layers of Si pixel sensors and 8 layers of CdTe pixel sensors surrounded by 2 layers of CdTe pixel sensors. The detection efficiency of the Compton camera reaches about 15% and 3% for 100 keV and 511 keV gamma rays, respectively. The pixel pitch of the Si and CdTe sensors is 3.2 mm, and the signals from all 13,312 pixels are processed by 208 ASICs developed for the SGD. Good energy resolution is afforded by semiconductor sensors and low noise ASICs, and the obtained energy resolutions with the prototype Si and CdTe pixel sensors are 1.0–2.0 keV (FWHM) at 60 keV and 1.6–2.5 keV (FWHM) at 122 keV, respectively. This results in good background rejection capability due to better constraints on Compton kinematics. Compton camera energy resolutions achieved with the final prototype are 6.3 keV (FWHM) at 356 keV and 10.5 keV (FWHM) at 662 keV, which satisfy the instrument requirements for the SGD Compton camera (better than 2%). Moreover, a low intrinsic background has been confirmed by the background measurement with the final prototype. [ABSTRACT FROM AUTHOR]

Abstract: We have developed a new Compton camera based on silicon (Si) and cadmium telluride (CdTe) semiconductor double-sided strip detectors (DSDs). The camera consists of a Si-DSD and four layers of CdTe-DSDs all of which have common electrode configuration segmented into 128 strips on each side with pitches of . In order to realize high angular resolution and to reduce size of the detector system, a stack of DSDs with short stack pitches of 4mm is utilized to make the camera. Taking advantage of the excellent energy and position resolutions of the semiconductor devices, the camera achieves high angular resolutions of 4.5° at 356keV and 3.5° at 662keV. To obtain such high resolutions together with an acceptable detection efficiency, we demonstrate data reduction methods including energy calibration using Compton scattering continuum and depth sensing in the CdTe-DSD. We also discuss imaging capability of the camera and show simultaneous multi-energy imaging. [Copyright &y& Elsevier]

Abstract: We have developed an integrated response generator based on Monte Carlo simulation for Compton cameras composed of silicon (Si) and cadmium telluride (CdTe) semiconductor detectors. In order to construct an accurate detector response function, the simulation is required to include a comprehensive treatment of the semiconductor detector devices and the data processing system in addition to simulating particle tracking. Although CdTe is an excellent semiconductor material for detection of soft gamma rays, its ineffective charge transport property distorts its spectral response. We investigated the response of CdTe pad detectors in the simulation and present our initial results here. We also performed the full simulation of prototypes of Si/CdTe semiconductor Compton cameras and report on the reproducibility of detection efficiencies and angular resolutions of the cameras, both of which are essential performance parameters of astrophysical instruments. [ABSTRACT FROM AUTHOR]

Abstract: Interleukin (IL)-18, which is elevated in the plasma during acute rejection after organ transplantation, is known to induce the expression of intercellular adhesion molecule (ICAM)-1, B7.1, B7.2, CD40 and CD40 ligand (CD40L) on monocytes, the production of interferon (IFN)-γ and IL-12 and the proliferation of lymphocytes during the human mixed lymphocyte reaction (MLR). Ciprofloxacin (CIP), which is useful for the clinical treatment of infections due to its antibacterial properties after transplantation, was shown to suppress the IFN-γ and IL-12 production, the lymphocyte proliferation and the ICAM-1, B7.1, B7.2 and CD40 expression on monocytes during MLR in the presence of IL-18. CIP also induced the production of prostaglandin (PG) E2. In order to determine whether the effects of CIP on the expression of the activation markers were due to CIP-dependent production of PGE2, we examined the effect of cyclooxygenase (COX)-2 and protein kinase A (PKA) inhibitors on the actions of CIP. Thereby, the inhibitors were found to abolish the actions of CIP. These results therefore suggest that CIP might exert its immune modulatory effects via the production of PGE2. [Copyright &y& Elsevier]

Abstract: α-Allenylcyclopropanedicarboxylates, for which a novel synthetic method has been devised by conjugate addition of a copper hydride (Stryker) reagent to α-cyclopropylpropargylic esters, have been newly found to be smoothly converted to methylenecyclopentene derivatives under mild reaction conditions by further treatment with the copper hydride reagent. The mechanistic pathway is discussed. [Copyright &y& Elsevier]