Synthesis of the matriglycan hexasaccharide, -3Xylα1-3GlcAß1-trimer and its interaction with laminin.

Matriglycan, a polysaccharide that is a pivotal part of the core M3 O-mannosyl glycan composed of the repeating disaccharide -3Xylα1-3GlcAß1-, interacts with laminin to stabilize muscle tissue. We herein report the synthesis of matriglycan-repeating hexasaccharides equipped with an alkyne linker to form glycoconjugates. The key step in the formation of an α-linked xylosyl glycoside was resolved by solvent-specific separation from an anomeric mixture. Successful glycan elongation was regio- and stereoselectively performed to obtain (-3Xylα1-3GlcAß1)3-O(C2H4O)3CH2CCH and the biotin conjugate. We also investigated interactions between matriglycan hexasaccharides and laminin-G-like domains 4 and 5 of laminin-α2 using saturation transfer difference-NMR. The dissociation constant obtained from bio-layer interferometry was estimated to be 7.5 × 10-8 M. These results indicate that a chemical approach may be applied to the reconstruction of muscle tissue.

Effects of individualized dietary advice compared with conventional dietary advice for adults with type 2 diabetes: A randomized controlled trial.

BACKGROUND AND AIMS: To investigate the superiority of individualized dietary advice based on dietary assessment for patients with type 2 diabetes. METHODS AND RESULTS: A total of 136 Japanese adults with type 2 diabetes were randomized into either individualized or conventional dietary advice groups after dietary assessment using a self-administered brief-type diet history questionnaire. Both participants received three 30-min face-to-face dietary advice sessions by dietitians at 1, 3, and 5 months from study entry. The individualized group received dietary advice based on individual dietary intakes. The conventional group received dietary advice using generalized pamphlets. The primary outcome was the change in HbA1c over 6 months, and secondary outcomes were changes in weight, serum triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and dietary intakes. In total, 126 participants were included in the analysis. After adjustment for age, sex, and baseline measurements, HbA1c significantly decreased larger in the individualized group [-1.1%, (95% CI: -1.3 to -0.8)] than the conventional group [-0.7% (95% CI: -1.0 to -0.4)] (P = 0.0495). The individualized group significantly decreased weight, serum triglyceride, and LDL-C, and significantly increased HDL-C, without a significant difference to the conventional group. In dietary changes, the individualized group decreased intakes of energy, confectioneries, meats, oil and fats, and sugar-sweetened beverages. The conventional group decreased alcohol intake and increased total fat and saturated fatty acid intakes. CONCLUSIONS: Individualized dietary advice among patients with type 2 diabetes was superior to conventional dietary advice in lowering HbA1c. TRIAL REGISTRATION: UMIN000037268 (https://www.umin.ac.jp/ctr/index.htm) in July 4, 2019.

Stereo- and Regioselective Synthesis of O-Mannosyl Glycan Containing Matriglycan and a Part of Tandem Ribitol Phosphate.

We herein successfully synthesized two pivotal structures of O-mannosyl glycan: (1) the matriglycan-repeating tetrasaccharide Xylα1-3GlcAß1-3Xylα1-3GlcAß and (2) the link between matriglycan and a part of tandem ribitol phosphate, Xylα1-3GlcAß1-4Xylß1-4Rbo, in a regio- and stereocontrolled manner. The disaccharide unit with the α-linkage of xylose was obtained by adopting the conformational fixation of the xylopyranoside ring and a specific solvation system of diastereoselective solubility.

Mediastinal, subcutaneous and multiple muscular abscesses caused by group B streptococcus serotype VIII in a type 2 diabetes mellitus patient.

We report a case of mediastinal subcutaneous and multiple muscular abscesses caused by group B streptococcus serotype VIII in a type 2 diabetes mellitus patient. The patient arrived at the hospital with the chief complaint of immobility, and blood examination results suggested an acute infection and poorly controlled diabetes mellitus. Group B streptococcal bacteria were cultured from the patient's blood, and identified as serotype VIII upon further analysis. The patient recovered without any sequelae after percutaneous drainage, antibiotic therapy, and intensive glycemic control. Although the incidence of group B streptococcal infection in non-pregnant adults has recently increased in many developed countries, information on serotype VIII infection is quite limited. The reason is that serotype VIII group B streptococci are a Japan-specific serotype, and rarely cause invasive infections, even in Japan. Therefore, further surveillance and case reports should be documented in the future.

Evaluation of repositioning care provided by non-professionals using a caregiver-assistive device: an experimental study.

As the population ages in Japan and worldwide, the number of informal caregivers, such as family members, providing nursing care to older individuals is increasing. Among caregiving tasks, repositioning care, which causes lower back pain, is frequent and burdensome for caregivers. Therefore, we developed a position-changing device that can adjust and support the care recipient's body in the lateral position. This was a feasibility study of the device-assisted care provided by non-professionals using the device we developed. Of the 40 healthy volunteers enrolled, 17 simulated caregivers and 17 simulated care recipients finally participated in the study. One caregiver and one care recipient were paired to engage in two types of care: device-assisted care and manual care. Furthermore, the care provided by the caregiver and received by the care recipient were evaluated. Non-professionals were able to use the device successfully and safely after a short period of practice, and both caregivers and care recipients rated the device-assisted care positively. The study results suggest that informal caregivers can also provide safe and comfortable care that is less burdensome than manual care by using a caregiver-assistive device.

A Case of Eating Disorder Diagnosed As Orthorexia Nervosa.

A 13-year-old girl presented to our hospital with chief complaints of rapid weight loss, fatigue, discomfort, chills in the extremities, and alopecia. We initially suspected anorexia nervosa (AN). However, she did not express fear of gaining weight or have a distorted perception of her weight or body shape; thus, her presentation was not typical of AN. We also suspected avoidant/restrictive food intake disorder (ARFID), but she did not exhibit any food-avoidance behaviors. However, she was obsessed with nutrition control, so we diagnosed her with orthorexia nervosa (ON). She was hospitalized, given education on proper nutrition, and her eating behavior subsequently improved. After discharge, we administered the ORTO-15, which assesses the propensity for ON, and her score met the diagnostic criteria for ON. The incidence of ON has increased during the COVID-19 pandemic. In this case, her obsession was brought about by information she read in magazines and on social media that promoted an unbalanced diet centered almost exclusively on vegetables. Pediatricians should raise awareness of misinformation regarding children's health to ensure healthy growth.

Development and evaluation of a new assistive device for low back load reduction in caregivers: an experimental study.

Low back pain among healthcare professionals is associated with the manual handling of patients. Some bed features for turning and repositioning have been developed; however, the load during patient care remains heavy. We developed a device to reduce low back load in caregivers during patient bedside care and evaluated it objectively and subjectively from a caregiver's perspective using a randomised crossover study. Overall, 28 clinical nurses and care workers were randomly assigned to two interventional groups: administering care with (Device method) and without (Manual method) the device in an experimental room. We measured the caregiver's trunk flexion angle using inertial measurement units and video recording during care and then defined a trunk flexion angle of > 45° as the threshold; the variables were analysed using linear mixed models. Subsequently, participants responded to a survey regarding the usability of the device. Trunk flexion time and percentage of time were 26.5 s (95% confidence interval: 14.1 s, 38.9 s) (p < 0.001) and 23.0% (95% confidence interval: 16.4%, 29.6%) (p < 0.001) lower, respectively, in the Device group than in the Manual group. Furthermore, caregivers evaluated the care they could administer with the device as being better than that associated with manual care.

A Scoping Review of Epidemiological Studies on Intake of Sugars in Geographically Dispersed Asian Countries: Comparison of Dietary Assessment Methodology.

Previous systematic reviews, which focused on sugar intake and its relation with health issues, were mainly conducted in Western countries, not Asian countries characterized by differences in dietary habits and disease prevalence. The scarcity of Asian studies may be attributed to the lack of assessment tools for estimating sugar intake. To provide an overview of the epidemiological studies on sugar intake in Asian countries, with a primary focus on dietary assessment methodology for estimating sugar intake, we conducted a scoping review of the epidemiological studies estimating sugar intake in Asian countries (the United Nations' definition) and Taiwan using PubMed and Web of Science. Study quality was evaluated based on its assessment of sugar intake in the whole diet, dietary assessment methods, and data sources used for estimating sugar content. We identified 143 studies from 136 publications from Eastern (n = 63), Southern (n = 30), South-Eastern (n = 26), and Western (n = 24) Asia. Total sugars were investigated in 95 studies, while 23-30 studies investigated sucrose, fructose, added sugars, and free sugars. The main aim of the selected studies was assessment of diet-disease relations (n = 85) and estimation of dietary intake (n = 40), and 62 studies assessed sugars as the primary exposure/outcome. A total of 120 studies assessed sugar intake in the whole diet, and 62 studies used validated FFQs or multiple-day dietary assessment methods. Only 41 studies used country-specific comprehensive food-composition databases or directly measured sugar content. Only 17 studies reported high-quality data. This review elucidated a sufficient number of epidemiological studies estimating sugar intake across Asian countries; however, most studies reported low-quality data. The results from our review showed that both feasible and validated dietary assessment methods, as well as comprehensive country-specific sugar-composition databases, are essential for producing high-quality studies with accurate sugar intake to examine its association with health outcomes.

Evaluation of the effectiveness of the sliding sheet in repositioning care in terms of working time and subjective fatigue: A comparative study with an experimental design.

BACKGROUND: Manual patient handling is a major cause of low back pain among healthcare staff. The sliding sheet is an assistive device designed to aid healthcare staff performing patient repositioning in bed. The use of sliding sheets in healthcare facilities is currently relatively rare because of the perceived additional time required compared with non-assisted handling. However, the details of the time difference between techniques and the barriers to the use of sliding sheets have not been examined in depth. OBJECTIVES: We sought to evaluate differences in working time and subjective fatigue between the use of sliding sheets and non-assisted handling techniques for patient repositioning, in order to understand the factors preventing the use of sliding sheets among nurses. DESIGN: We conducted a comparative study with an experimental design. SETTINGS: The study was conducted in the nursing practice room at a university in Japan. PARTICIPANTS: We recruited 30 pairs of nurses and care receivers. All nurses were under 60 years old, with experience in lateral turning and repositioning in the process of changing diapers in clinical settings. Those with a previous or current medical history of low back pain were excluded. Care receivers were older adults (65-80 years old). We excluded adults with bedsores, body mass index values >30, or restricted joint motion due to femoral trochanteric fracture or compression fracture. Thus, 27 pairs were included in the final analysis. METHODS: The care receivers were instructed to behave as if they were bedridden patients with no limb movement, and as if they had contracture and difficulty communicating. Nurses repositioned the patient using three techniques assigned as interventions in random order: repositioning by one person using a sliding sheet (Sheet), repositioning by two people without a sliding sheet (Double), and repositioning by one person without a sliding sheet (Single). Working time was the primary endpoint for comparative analysis among the three technique conditions. RESULTS: The results revealed that the Sheet technique required significantly more time than the non-assisted techniques. However, when total staff time was taken into consideration, the Sheet technique outperformed the Double technique. Moreover, the Sheet technique was associated with significantly lower levels of subjective fatigue, compared with the Double technique. CONCLUSIONS: The use of a sliding sheet can substantially reduce caregiver burden when performing patient repositioning, and requires less staff time than manual techniques involving more than one caregiver.