Experience of students who participated in psychiatric nursing educational program aiming at competency development.

Purpose: To clarify experience of students who participated in psychiatric nursing educational program aiming at competency development. Methods: We conducted a semi-structured interview with five students who participated in a psychiatric nursing educational program and analyzed the results qualitatively and descriptively. Results: We generated 19 categories and 39 subcategories. The students reached [acquisition of diversity and multi-phase viewpoint] through team discussion and attempted to understand patients holistically, including [acquisition of patient's viewpoints]. Moreover, they formed supportive relationships while [repeating trial and error] and gained self-understanding based on [egocentrism awareness]. Conclusion: Participation in this program increased students' preparedness for psychiatric nursing practical training, believed to contribute to competency development. Some students had difficulty relating to patients and hesitated to express negative emotions while establishing supportive relationships. This indicates the need for an educational approach that encourages students to express negative emotions easily.

Literature reviews on coping behavior of women with menopausal symptoms and menopausal disorders.

Objective: Examined literature on coping behaviors of women with menopausal symptoms and/or menopausal disorders to clarify their current situation and to get advice for future undertakings. Methods: The subjects of the survey were from documents on coping behaviors of women with menopausal symptoms and menopausal disorders published in Japan during the period from 2000 to July 2022. The investigations were acquired from Japan Medical Abstracts Society, CiNii, PubMed, by mixing the keywords "menopausal symptoms" or "menopausal disorders" and "measures" or "self-care" or "self-administration" in Japanese. Ultimately, we obtained 10 cases from Japan Medical Abstracts Society and 5 cases from CiNii. We focused on 13 cases for this analysis. Results: As a result of analyzing the contents of coping behaviors of women with menopausal symptoms and menopausal disorders, 6 categories [Adjusting daily life behaviors], [Taking measures for the symptoms], [Adjusting in my own way], [Connecting to others], [Thinking optimistically] and [Doing nothing] consisting of 18 subcategories were obtained. Conclusion: Women reconciled positively with menopause by themselves, even though they had menopausal symptoms and menopausal disorders. In future endeavors, psychology education will be obtained by clarifying the process of reaching it, and the possibility of raising the well-being of menopausal women will be enhanced. It has been revealed that there are women adopting coping behaviors suitable for themselves, while there are women who are tolerant even if the symptoms are severe, or those who do not consult specialists for menopausal symptoms. We believe that the findings are useful for promoting the coping behaviors of women with menopausal symptoms and menopausal disorders and educating them to prevent aggravation and prolongation of symptoms by clarifying the reasons why they do not take action to relieve their menopausal symptoms.

Influence of SOS-inducing agents on the expression of ArtAB toxin gene in Salmonella enterica and Salmonella bongori.

Salmonella enterica subspecies enterica serovar Typhimurium (S. Typhimurium) definitive phage type 104 (DT104), S. enterica subspecies enterica serovar Worthington (S. Worthington) and S. bongori produce ArtA and ArtB (ArtAB) toxin homologues, which catalyse ADP-ribosylation of pertussis toxin-sensitive G protein. ArtAB gene (artAB) is encoded on prophage in DT104 and its expression is induced by mitomycin C (MTC) and hydrogen peroxide (H2O2) that trigger the bacterial SOS response. Although the genetic regulatory mechanism associated with artAB expression is not characterized, it is thought to be associated with prophage induction, which occurs when the RecA-mediated SOS response is triggered. Here we show that subinhibitory concentration of quinolone antibiotics that are SOS-inducing agents, also induce ArtAB production in these Salmonella strains. Both MTC and fluoroquinolone antibiotics such as enrofloxacin-induced artA and recA transcription and artAB-encoding prophage (ArtAB-prophage) in DT104 and S. Worthington. However, in S. bongori, which harbours artAB genes on incomplete prophage, artA transcription was induced by MTC and enrofloxacin, but prophage induction was not observed. Taken together, these results suggest that SOS response followed by induction of artAB transcription is essential for ArtAB production. H2O2-mediated induction of ArtAB prophage and efficient production of ArtAB was observed in DT104 but not in S. Worthington and S. bongori. Therefore, induction of artAB expression with H2O2 is strain-specific, and the mode of action of H2O2 as an SOS-inducing agent might be different from those of MTC and quinolone antibiotics.

Effect of attenuation of fibroblast growth factor receptor 2b signaling on odontoblast differentiation and dentin formation.

Attenuation of fibroblast growth factor receptor (FGFR) 2b signaling suppresses the differentiation of oral epithelial stem cells to ameloblasts, their survival and viability remaining unaffected; however, its effect on dentin formation is unknown. This study aimed to clarify the effect of attenuation of FGFR2b signaling on odontoblast differentiation and dentin formation. Initially, we used a murine rtTA transactivator/tetracycline promoter system for inducible and reversible attenuation of FGFR2b signaling in adult mice. Experimental animals overexpressed soluble FGFR2b (sFGFR2b), and wild-type controls were selected from the same litter (WT group). Histological analysis of CMV mice confirmed the obliteration of the enamel and ameloblast layer, and micro CT analysis revealed a significant increase in dentin thickness in CMV mice rather than in WT mice (P < 0.05). On analyzing the expression of dentin-related differentiation factors, DSPP, nestin, and OCN were upregulated in CMV mice compared to WT mice after 2 weeks of attenuation of FGFR2b signaling. Thereafter, on overexpressing sFGFR2b in dental pulp stem cells, RUNX2 and ALP were upregulated; however, DSPP, nestin, and OCN were downregulated in CMV mice compared to WT mice. The present results show that attenuation of FGFR2b signaling in the oral epithelium specifically induced odontoblast differentiation and promotes early-stage dentin calcification in dental pulp tissue.

Manganese Ion Increases LAB-yeast Mixed-species Biofilm Formation.

Remarkable LAB-yeast mixed-species biofilm was formed by lactic acid bacteria (LAB) Lactobacillus plantarum ML11-11 isolated from Fukuyama pot vinegar and Saccharomyces cerevisiae. This mixed-species biofilm formation increased in proportion to the YPD medium concentration but decreased in proportion to the MRS medium concentration. The effect of MRS components on mixed-species biofilm formation was investigated in a YPD medium environment, and it was clarified that beef extract (one of the MRS medium components) decreased mixed-species biofilm formation. On the other hand, manganese sulfate (another component in MRS) remarkably increased both LAB single- and LAB-yeast mixed-species biofilm formation. LAB single- and mixed-species biofilm formation were increased in proportion to the manganese sulfate concentration up to 1 mM and 100 µM, respectively. The growth of L. plantarum ML11-11 was increased significantly by the addition of 10 µM manganese sulfate and was resistant to higher concentration of up to 100 mM, but growth of S. cerevisiae was sensitive to manganese ion above 100 µM. These results suggested that mixed-species biofilm formation could be controlled artificially by controlling the manganese ion level.

Nucleotide excision repair gene polymorphisms may predict acute toxicity in patients treated with chemoradiotherapy for bladder cancer.

AIMS: Platinum-based chemoradiotherapy (CRT) as bladder conservation therapy has shown promising results for muscle-invasive bladder cancer. However, treatment-related toxicity remains a major consideration in therapeutic planning. Some common polymorphisms in genes involved in DNA repair (encoding enzymes that repair DNA damaged by platinum agents and ionizing radiation) are reported to result in modulation of the repair capacity. We investigated associations between functional genetic polymorphisms involved in DNA repair and acute toxicity of CRT to determine the predictive value of these polymorphisms for toxicity. MATERIALS & METHODS: The study group comprised of 101 bladder cancer patients treated with platinum-based CRT, and seven polymorphisms in XPC (Lys939Gln, rs2228001), XPD (Lys751Gln, rs13181), XPG (Asp1104His, rs17655), XRCC1 (Arg399Gln, rs25487), XRCC3 (Thr241Met, rs861539), TP53 (Arg72Pro, rs1042522) and MDM2 (SNP309, T>G, rs2279744) were genotyped. RESULTS: More than two total variant alleles in nucleotide excision repair genes, including XPC, XPD and XPG, were significantly associated with grade 3 or 4 neutropenia (adjusted odds ratio [aOR]: 6.8; 95% CI: 2.0-26; p = 0.0026). There were no significant associations between any genotypes and grade 2 or greater nausea/vomiting or diarrhea. Any grade 3 or 4 hematological toxicity was significantly associated with the Gln/Gln or Lys/Gln + Gln/Gln genotypes of XPC compared with Lys/Lys (aOR: 10; 95% CI: 2.0-65; p = 0.0070 or aOR: 6.3; 95% CI: 1.9-29; p = 0.0069; respectively). CONCLUSION: These results suggest that nucleotide excision repair gene polymorphisms, especially in XPC, might potentially be predictive factors for acute toxicity of CRT for bladder cancer, helping individual patient selection for bladder conservation therapy. However, further studies with larger sample sizes are needed to draw final conclusions.

DNA repair gene polymorphisms may be associated with prognosis of upper urinary tract transitional cell carcinoma.

Upper urinary tract transitional cell carcinoma (UUT-TCC) is quite an uncommon disease, and its prognosis differs among individuals irrespective of tumor stage. DNA repair gene polymorphisms are reported to result in the modulation of the repair capacity and might influence the prognosis of UUT-TCC. We examined the associations between functional polymorphisms in five DNA repair genes, and the prognosis of UUT-TCC in 103 UUT-TCC patients. Variant alleles in xeroderma pigmentosum complementation group C, more than three total variant alleles in all DNA repair genes studied and more than two total variant alleles in three nucleotide excision repair genes were independently associated with improved overall and disease-specific survival of UUT-TCC patients in multivariate analysis (P = .0063 and P = .0005 for xeroderma pigmentosum complementation group C, P = .016 and P = .0016 for all genes, and P = .0053 and P = .018 for nucleotide excision repair genes, respectively). These results suggest that some DNA repair gene polymorphisms may preoperatively be valuable as prognostic factors for UUT-TCC beyond tumor stage and grade, helping to provide optimal treatment strategies for individual patients.

[Examination of formula for enhanced dynamic wedge factors in half fields].

The method presented by Liu et al. in 1998 has generally been used in Japan to calculate the wedge factor of the enhanced dynamic wedge (EDW). When the points used to evaluate the dose exist outside the central beam axis in the half field (HF), however, a difference of about 3% can occur between the values calculated by this method and the measured values. In 2003, Liu et al. presented a new general formula for calculating MU using the EDW. We modified the formula for calculating the wedge factor by combining the conventional calculation formula and the formula of Liu et al., presented in 2003, and compared the calculated values of the wedge factor of the EDW in the HF with the measured values. Our formula employs a very simple method in which only the normalized golden segmented treatment table (NGSTT) on the center of the radiation field and the central beam axis are added to the existing formula. The values calculated by our formula and the measured values were consistent within 1% in most combinations of energy, wedge angle, and size of radiation field. When the EDW was used for irradiation to the tangent line of the HF breast, in particular, the values calculated by our formula and the measured values were consistent within 0.5%, and it was possible to calculate the wedge factor with a higher degree of accuracy than that calculated with the existing formula.

[Examination of phantom scatter factors in irregular fields with enhanced dynamic wedge].

Use of an enhanced dynamic wedge (EDW) changes the size of the irradiation field in real time because of the shift of the flexible aperture during irradiation. Therefore, when EDW is used, it is speculated that the scatter factors proposed by Khan et al. may differ from that obtained in an open irradiation field. The aim of the present study was to investigate whether the total scatter factors (S(cp)) can also be separated into the collimator scatter factors (S(c)) and phantom scatter factors (S(p)) when using EDW, and whether S(p) in an irregular irradiation field using EDW and one without the use of EDW can likewise be handled. Results indicated that the values of S(cp) and S(c) in a square or rectangular irradiation field using EDW tended to differ from those in an open irradiation field, whereas S(p) was almost the same, with a slight variation of about 0.5%, indicating that S(cp) could be separated into S(c) and S(p). However, for an irregular irradiation field, the variations in S(p) exceeded 1% in some cases irrespective of the use or non-use of EDW. Depending on the size and geometry of the irradiation field, it was within the range of the degree of uncertainty of 2.5% in the evaluation of output radiation dosage, which was described in AAPM Report 13. Therefore, the theory proposed by Khan et al. was found to be valid also for an irregular irradiation field using EDW, which could be handled in the same manner as in the irregular irradiation field without using EDW.

Left Atrial Systolic Performance in the Presence of Elevated Left Ventricular End-Diastolic Pressure: Evaluation by Transesophageal Pulsed Doppler Echocardiography of Left Ventricular Inflow and Pulmonary Venous Flow Velocities.

We recorded left ventricular inflow (LVIF) and pulmonary venous flow (PVF) velocities by transesophageal pulsed Doppler echocardiography in 25 patients with a ratio of peak atrial systolic to early diastolic LVIF velocity of <1 and a left ventricular end-diastolic pressure (LVEDP) of 15 mmHg or greater, as well as in 30 normal subjects. The group consisted of 14 patients with prior myocardial infarction, 7 with dilated cardiomyopathy, and 4 with cardiac amyloidosis, and were divided into: (1) group A (n = 7): peak atrial systolic LVIF velocity of 40 cm/sec or greater; (2) group B (n = 7): peak atrial systolic LVIF velocity of <40 cm/sec and peak atrial systolic PVF velocity of 30 cm/sec or greater; and (3) group C (n = 11): peak atrial systolic LVIF velocity of <40 cm/sec and peak atrial systolic PVF velocity of <30 cm/sec. Although LVEDPs in groups B and C were significantly greater than in group A, there was no difference between groups B and C. The mean pulmonary capillary wedge pressure (mPCWP) in group C was significantly greater than in groups A and B, but there was no difference between groups A and B. The difference between LVEDP and mPCWP (LVEDP - mPCWP) in group B was significantly higher than in groups A and C. Dilatation of the left atrium (LA) was seen in all three groups, particularly in groups B and C. There were no differences in peak atrial systolic LVIF velocity and LA volume change during atrial contraction between group A and the control group, and there were no differences in LA volume change and peak second systolic PVF velocity between groups A and B. LA volume change and peak second systolic PVF velocity were significantly less in group C than in groups A and B. Among the four patients whose courses could be observed after medical treatment with diuretic and vasodilator, one changed from group B to A, one from group B to C, one from group C to A, and one remained in group C. Thus, recording of peak atrial systolic LVIF and PVF by transesophageal pulsed Doppler echocardiography permits detailed evaluation of LA systolic performance in the presence of elevated LVEDP. These two variables provide important information for less invasive differentiation of LA afterload mismatch from LA myocardial failure.

A Case of Cardiac Amyloidosis Presenting with Mid- to Late Diastolic Retrograde Flow from the Left Atrium to the Pulmonary Vein: Transesophageal Pulsed Doppler Echocardiographic Observations.

A patient of cardiac amyloidosis was found to have mid- to late diastolic retrograde flow from the left atrium (LA) to the pulmonary vein. Congo-red staining was positive for amyloid in the rectal tissue. M-mode and two-dimensional echocardiograms revealed symmetric hypertrophy and typical speckled pattern of the left ventricle (LV). The LV pressure curve showed a dip and plateau configuration during diastole, and end-diastolic pressure was 28 mmHg. In addition, the LV pressure was high at mid-diastole, surpassing the pulmonary capillary wedge pressure from mid- to late diastole. The transmitral flow velocity revealed "restrictive" pattern, and the pulmonary venous flow velocity showed retrograde flow from the LA to the pulmonary vein during mid-diastole and atrial systole. It is suggested that recording of the pulmonary venous flow velocity by transesophageal pulsed Doppler echocardiography is useful for understanding the mechanism of the development of pulmonary congestion or edema. (ECHOCARDIOGRAPHY, Volume 13, November 1996)