The TGF-ß/UCHL5/Smad2 Axis Contributes to the Pathogenesis of Placenta Accreta.

Placenta accreta is a high-risk condition causing obstetric crisis and hemorrhage; however, its pathogenesis remains unknown. We aimed to identify the factors contributing to trophoblast invasiveness and angiogenic potential, which in turn drive the pathogenesis of placenta accreta. We focused on the transforming growth factor (TGF)-ß1-Smad pathway and investigated the intrinsic relationship between the time- and dose-dependent inhibition of the ubiquitinating enzyme UCHL5 using bAP15, a deubiquitinase inhibitor, after TGF-ß1 stimulation and the invasive and angiogenic potential of two cell lines, gestational choriocarcinoma cell line JEG-3 and trophoblast cell line HTR-8/SVneo. UCHL5 inhibition negatively regulated TGF-ß1-induced Smad2 activation, decreasing extravillous trophoblast invasiveness. Smad1/5/9 and extracellular signal-regulated kinase (ERK) were simultaneously activated, and vascular endothelial growth factor was secreted into the trophoblast medium. However, extravillous trophoblast culture supernatant severely impaired the vasculogenic potential of human umbilical vein endothelial cells. These results suggest that the downstream ERK pathway and Smad1/5/9 potentially regulate the TGF-ß1-Smad pathway in extravillous trophoblasts, whereas Smad2 contributes to their invasiveness. The abnormal invasive and angiogenic capacities of extravillous cells, likely driven by the interaction between TGF-ß1-Smad and ERK pathways, underlie the pathogenesis of placenta accreta.

Employment in old age and all-cause mortality: A systematic review.

Social participation promotes and maintains the health of older adults. Working is a type of social participation; however, the effect of employment in old age on health outcomes has not been established. This study aimed to review the relationship between employment in old age (≥60 years) and all-cause mortality. For this systematic review, a computerized search was performed using PubMed, CINAHL and PsycINFO for prospective studies published through June 2020. The observational studies were extracted according to the study participants, indicators, follow-up period, statistical approach and main results. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Of the 37 832 records identified, 14 studies were included in the systematic review based on the inclusion and exclusion criteria. Eight studies were derived from Asian countries (four from Japan, two from Taiwan and one from Thailand and South Korea), three were from the United States, two were from Israel and one was from Brazil. The baseline data of 13 studies were collected before 2000. Thirteen of the 14 studies reported any association between employment in later life and a lower risk of mortality. Four studies examined the sex-related differences in the effect of later-life employment on all-cause mortality, but the association was controversial. Overall, we revealed that working in old age would lower mortality risk. Although more findings based on recent data are required, this study indicates that working later in life is beneficial for promoting and maintaining health. Geriatr Gerontol Int 2022; 22: 705-714.

[Longitudinal association between work and self-rated health in older adults: a systematic review].

Objective　Japan's shortage in labor force due to a declining birth rate and aging population has led to the rapid development of various systems and work environments to promote the employment of older adults. With increasing expectations for the active participation of older adults in the labor market, it is necessary to clarify the relationship between work and physical and mental health in this population, as well as the challenges they face. In particular, self-rated health is an important health indicator that captures the overall health status of older adults, which is strongly related to the decline in life functions and the increase in healthy life expectancy. In this study, we examined the longitudinal association between work and self-rated health perception among older adults.Methods　A literature search was conducted using PubMed, PsycINFO, CINAHL, and the Japana Centra Revuo Medicina (Igaku Chuo Zasshi in Japanese). The keywords selected for the search were "older adult," "employment," and "self-rated health." The inclusion criteria were i) the baseline age of study subjects was 60 years or older, ii) employment was used as an independent variable and self-rated health was used as a dependent variable, and iii) studies were longitudinal. The quality of the selected literature was assessed using the Newcastle-Ottawa Scale (NOS).Results　As a result of the review, a total of five studies were accepted. Four studies were from Japan and one was from the United States. The NOS scores showed that all selected studies were of high quality, scoring 6 or 7 on a 9-point scale. Three of the five studies reported that older adults who were working had higher self-rated health than those who were not working. Two of the five studies reported no significant association between employment and self-rated health among older adults.Conclusion　This systematic review suggested a significant relationship between work and self-rated health among older adults. However, the number of studies that focused on the longitudinal effect of employment was limited. Employment in later life is becoming increasingly common, therefore further evidence on its effect on health should be gathered.

Older assistant workers in intermediate care facilities, and their influence on the physical and mental burden of elderly care staff.

BACKGROUND: As there is a shortage of care staff in elderly care homes, seniors are expected to work as assistants to help the care staff. This study examined the influence of older assistant workers in intermediate elderly care facilities on care staff, specifically focusing on emotional exhaustion which is a sign of burnout. These facilities provide long-term nursing and supportive care to older residents. METHODS: Data from a mail survey of intermediate elderly care facilities with older assistant workers were analyzed. Care staff were asked about the advantages and disadvantages of introducing older assistant workers in elderly care work, and their degree of emotional exhaustion. We also assessed work self-evaluations of older assistant workers, including the benefits of the work, and physical and mental burdens. RESULTS: A significantly large number of care staff reported improvements in workload with the employment of older assistant workers. Intermediate elderly care facilities enrolling more older assistant workers showed lower mean emotional exhaustion among care staff, independent of possible covariates. While older assistant workers felt that their work contributed to helping both care users and staff, they also reported a mental burden. CONCLUSIONS: Our results suggest that older assistant workers can play a significant role in reducing the physical and mental burden of intermediate elderly care facility staff. Thus, employing older assistant workers can be an effective approach to addressing shortages of care staff in elderly care homes.

Effect of short-term fatigue, induced by high-intensity exercise, on the profile of the ground reaction force during single-leg anterior drop-jumps.

[Purpose] Fatigue may be an important contributing factor to non-contact anterior cruciate ligament injuries in sports. The purpose of this study was to evaluate the effects of controlled lower limb fatigue, induced by a short-term, high-intensity exercise protocol, on the profile of the ground reaction force during landings from single-leg anterior drop-jumps. [Subjects and Methods] Twelve healthy males, 18 to 24 years old, performed single-leg anterior drop-jumps, from a 20 cm height, under two conditions, 'fatigue' and 'non-fatigue'. Short-term fatigue was induced by high-intensity interval cycling on an ergometer. Effects of fatigue on peak vertical ground reaction force, time-to-peak of the vertical ground reaction force, and loading rate were evaluated by paired t-test. [Results] Fatigue shortened the time-to-peak duration of the vertical ground reaction force by 10% (non-fatigue, 44.0 ± 16.8 ms; fatigue, 39.6 ± 15.8 ms). Fatigue also yielded a 3.6% lowering in peak vertical ground reaction force and 9.4% increase in loading rate, although these effects were not significant. [Conclusion] The effects of fatigue in reducing time-to-peak of the vertical ground reaction force during single-leg anterior drop-jumps may increase the risk for non-contact anterior cruciate ligament injury in males.