Survey of Pharmacists' Knowledge, Attitudes, and Practices (KAP) concerning COVID-19 Infection Control after Being Involved in Vaccine Preparation: A Cross-Sectional Study.

Vaccination is crucial for preventing the spread of COVID-19. Vaccination for COVID-19 was implemented in Japan in community units, and community pharmacists were engaged in vaccine preparation. Capturing the knowledge, attitudes, and practices (KAP) of pharmacists regarding COVID-19 infection control is important for developing future community health action strategies and plans. We conducted a cross-sectional study among 141 pharmacists who were members of a pharmacist association in the Shinagawa Ward of Tokyo (1-31 July 2021) using a Google online questionnaire. The questionnaire included demographic information and KAP questions regarding COVID-19. A correlation test was used for analyzing KAP scores. Significant correlations were found among all KAP scores. Stepwise logistic regression analysis showed "age" as a significant knowledge factor and "marriage", "pharmacist careers", "information source: official government website", and "information source: word of mouth from family and friends" as significant attitude factors. Good KAP scores were recorded in this study, indicating increased comprehension of infection control measures and increased knowledge scores, as pharmacy pharmacists were practically involved in COVID-19 infection control measures through vaccine preparation. Policymakers should understand the value of pharmacists as healthcare professionals and should enhance public health through the effective use of pharmacists.

Psychological and Physical Changes Caused by COVID-19 Pandemic in Elementary and Junior High School Teachers: A Cross-Sectional Study.

This study aimed to determine psychological and physical differences in elementary and junior high school teachers during COVID-19. This questionnaire-based cross-sectional study was conducted among 427 teachers in Tokyo, Japan (between 15 and 30 October 2020). The questionnaire explored school type (elementary and middle schools), sex, age, and COVID-19 changes (psychological changes, physical changes, impact on work, and infection control issues perceived to be stressed). Post hoc tests for I cannot concentrate on work at all, found a significant difference for no change-improved and male teacher in elementary school female teacher in junior high school (p = 0.03). Regarding stress situation due to implementation of COVID-19 infection control, there were significant differences for disinfection work by teachers between male teachers in elementary school female teachers in junior high school (p = 0.04) and female teachers in elementary school female teachers in junior high school (p = 0.03). COVID-19 produced differences in psychological and physical changes between male and female teachers in elementary and junior high schools. Some experienced psychological and physical stress, whereas others showed improvement. Given that teachers' mental health also affects students' educational quality, it is important to understand and improve teachers' psychological and physical circumstances and stress.

Causes of anxiety among teachers giving face-to-face lessons after the reopening of schools during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Coronavirus infections are spreading rapidly worldwide, and primary and middle schools are closed in many countries. After the state of emergency was lifted in Japan, schools have reopened, and teachers are conducting face-to-face classes while maintaining safety precautions. This study aimed to assess the factors contributing to infection-related anxiety and educational anxiety among teachers conducting face-to-face classes during the COVID-19 pandemic after schools reopened. METHODS: This questionnaire-based cross-sectional study was conducted with 263 primary and middle school teachers in the Shinagawa area of Tokyo (October 10-30, 2020). The questionnaire assessed the type of school (primary or middle school), sex, age, and factors contributing to infection-related anxiety and educational anxiety that arose from the pandemic. The levels of anxiety and the factors contributing to anxiety were assessed using a 5-point Likert scale ranging from 1 (not at all) to 5 (very anxious). RESULTS: In an analysis of the data of 237 participants excluding the missing data, many teachers reported feeling infection- and education-related anxiety. A majority of the participants were women (n = 152, 64.1%), and the mean age of the participants was 39.8 ± 11.3 years. A stepwise multiple regression analysis identified six factors for infection-related anxiety as significant (R2 = 0.61, p < 0.001). Among these variables, the largest partial regression coefficient value was reported for the following reason: "I feel anxious because we cannot ensure the safety of teachers themselves or of their families" (ß = 0.37, p < 0.001). For educational anxiety, four of six reasons were identified as significant (R2 = 0.64, p < 0.001). Among these, "anxiety about the students' home situations" (ß = 0.41, p < 0.001) and "delay in education (students' side)" (ß = 0.27, p < 0.001) had stronger associations with anxiety compared to the others. CONCLUSION: In-person education during the COVID-19 pandemic has caused teachers to experience anxiety. This report provides useful information by highlighting the reasons for infection-related anxiety and educational anxiety that teachers experience in face-to-face classes during a pandemic. Even if the coverage of a COVID-19 vaccine becomes widespread worldwide, we will still be combating COVID-19 infections for at least a few years. Given concerns regarding such infections, to ensure students' right to education, it is essential to understand why teachers feel anxious and to determine appropriate measures to decrease such anxiety.

Factors Associated With Medication Compliance in Elderly Patients With Type 2 Diabetes Mellitus: A Cross-Sectional Study.

The average age of patients with type 2 diabetes in Japan is over 70 years. Elderly patients tend to have poor medication compliance, therefore, it is important to understand their individual situations to improve medication compliance, the treatment of their diabetes, and their quality of life (QOL). This study aimed to identify factors associated with medication compliance in elderly type 2 diabetic patients. A cross-sectional study based on questionnaires was conducted on type 2 diabetes patients aged 65 years or older. The participants were recruited from patients who visited three dispensing pharmacies in the Shinagawa area of Tokyo between March 1 and September 30, 2019. The questionnaire consisted of patient information (sex, age, medication compliance status, knowledge of drug effects, and side effects), 12-Item Short Form Survey quality of life rating scale (SF-12), and Diabetes Treatment Satisfaction Questionnaire (DTSQ). Factors related to medication compliance were then evaluated. In all, there were 47 respondents: 31 males and 16 females. Four factors were found to be associated with medication compliance in elderly type 2 diabetic patients: medication storage (P = 0.01), knowledge of drug effects (P < 0.001), knowledge of side effects (P = 0.026), and physical functioning: (PF) (P = 0.045), a subscale of SF-12. Furthermore, the strength of the association between these four factors and medication compliance was calculated using Cramer's V coefficient of association. Knowledge of drug effects was the most strongly associated (knowledge of drug effects: V = 0.559; knowledge of side effects: V = 0.464; medication storage: V = 0.451; PF: V = 0.334). Because diabetes mellitus has no subjective symptoms and treatment effects are not felt to a great extent, it is difficult to motivate patients to consistently adhere to medication. When pharmacists provide medication guidance to elderly patients with type 2 diabetes mellitus, it is important to provide sufficient information to ensure they fully understand the drug effects to maintain medication compliance.

Cross-resistance of cadmium-resistant cells to manganese is associated with reduced accumulation of both cadmium and manganese.

The mechanism of cellular entry of cadmium remains unclear. We have previously established cadmium-resistant cells from mouse embryonic cells of metallothionein (MT)-null mice, and demonstrated that the down-regulation of a zinc transporter, Zrt/Irt-related protein (ZIP) 8, was responsible for the reduced cadmium incorporation into cells. In the present study, we developed cadmium-resistant cells (A+70 and B+70) from mouse embryonic cells of MT-expressing wild-type mice. The LC50 values of CdCl2 for A+70 and B+70 cells were about 200 µM while that of the parental cells was 30 µM. We found that the cadmium resistance of these cells was conferred not only by enhanced expression of MT, but also by a decrease in cadmium accumulation. Since the uptake rates of cadmium into A+70 and B+70 cells were lowered, we determined the expression levels of the metal transporters and channels potentially involved in the cellular uptake of cadmium. We found a down-regulation of multiple transport systems, including ZIP8, divalent metal transporter 1 (DMT1), and α1 subunits of L-type (Ca(V)1.2) and T-type (Ca(V)3.1) voltage-dependent calcium channels, in A+70 and B+70 cells. Furthermore, A+70 and B+70 cells exhibited cross-resistance to cytotoxicity of MnCl2, probably due to a marked decrease in manganese uptake in these cells. These results suggest that the suppressed expression of ZIP8 and DMT1, which are known to have affinities for both cadmium and manganese, may be responsible for the reduction in the uptake, and consequently the cytotoxicity, of cadmium and manganese in A+70 and B+70 cells.

The role of zinc transporters in cadmium and manganese transport in mammalian cells.

To understand the mechanism of cadmium accumulation, it is important to know the precise mechanisms of transport systems for other metals. Recently, utilization of genomics and metallomics has clarified the involvement of specific metal transporter(s) in cadmium uptake. Studies with metallothionein (MT)-null cadmium-resistant cells have revealed the involvement of the manganese/zinc transport system in cadmium uptake. Genomic studies of strain differences in sensitivity to cadmium-induced testicular hemorrhage revealed that a zinc transporter, Zrt-, Irt-related protein (ZIP) 8 encoded by slc39a8, is responsible for the strain difference. Ectopic expression of ZIP8 in various cells enhanced the uptake of cadmium, manganese, and zinc. ZIP8-transgenic mice showed high expression of ZIP8 in the vasculature of testis and apical membrane of proximal tubules in kidney, and exhibited enhanced cadmium accumulation and toxicity when treated with cadmium. The expression of ZIP8 was found to be down-regulated in MT-null cadmium-resistant cells, in which the uptake rates of both cadmium and manganese were decreased. These data suggest that ZIP8 plays an important role in the uptake of both cadmium and manganese in mammalian cells. The role of ZIP14 in the uptake of cadmium and manganese is also discussed.

Association of single-nucleotide polymorphisms in MTMR9 gene with obesity.

Genetic factors are clearly involved in the development of obesity, but the genetic background of obesity remains largely unclear. Starting from 62 663 gene-based single-nucleotide polymorphisms (SNPs) in three sequential case-control association studies, we identified a replicated association between the obesity phenotype (BMI > or =30 kg/m(2)) and a SNP (rs2293855) located in the myotublarin-related protein 9 (MTMR9) gene in the chromosomal segment 8p23-p22. P-values (minor allele dominant model) of the first set (93 cases versus 649 controls) and the second set (564 cases versus 562 controls) were 0.008 and 0.0002, respectively. The association was replicated in the third set [394 cases versus 958 controls, P = 0.005, odds ratio (95% CI) =1.40 (1.11-1.78)]. The global P-value was 0.0000005. A multiple regression analysis revealed that gender, age BMI and rs2293855 genotype (minor allele dominant model) were significantly associated with both systolic and diastolic blood pressures. MTMR9 was shown to be the only gene within the haplotype block that contained SNPs associated with obesity. Both the transcript and protein of MTMR9 were detected in the rodent lateral hypothalamic area as well as in the arcuate nucleus, and the protein co-existed with orexin, melanin concentrating hormone, neuropeptide Y and proopiomelanocortin. The levels of MTMR9 transcript in the murine hypothalamic region increased after fasting and were decreased by a high-fat diet. Our data suggested that genetic variations in MTMR9 may confer a predisposition towards obesity and hypertension through regulation of hypothalamic neuropeptides.

Gap-junctional communication is required for mitotic clonal expansion during adipogenesis.

OBJECTIVE: Gap-junctional communication (GJC) plays critical roles in cell growth and differentiation. Several studies have demonstrated the involvement of GJC in myogenesis and osteogenesis; however, the role of GJC in adipogenesis has not been fully studied. Thus, we investigated the role of GJC in adipogenesis. RESEARCH METHODS AND PROCEDURES: 3T3-L1 preadipocytes were differentiated in the presence of gap junction inhibitor, 18-alpha-glycyrrhetinic acid (AGA), and accumulation of cytoplasmic triglycerides was measured. 3T3-L1 cells were transfected with 100 nM small interfering RNA duplexes targeting connexin (Cx) 43. The mRNA levels of CCAAT/enhancer-binding protein (C/EBP) alpha, peroxisome proliferator-activated receptor gamma, glucose transporter 4, C/EBPbeta, and Cx43 were measured by real-time polymerase chain reaction. The protein levels of C/EBPbeta were quantitated by Western blotting. The cell proliferation was measured by counting cell numbers, and DNA synthesis was measured by bromodeoxyuridine incorporation. RESULTS: AGA inhibited adipocyte differentiation dose-dependently. The lipid accumulation and the mRNA levels of C/EBPalpha, peroxisome proliferator-activated receptor gamma, and glucose transporter 4 were markedly reduced in AGA-treated adipocytes. The mRNA levels of C/EBPbeta did not decrease; however, C/EBPbeta [liver-enriched transcriptional activator protein (LAP)] expression and the C/EBPbeta (LAP)-to-C/EBP [liver-enriched transcriptional inhibitory protein (LIP)] ratio were reduced by AGA treatment. The increase in both cell number and DNA synthesis, which occurs during mitotic clonal expansion, was reduced by AGA in a dose-dependent fashion. The major component of gap junctions in 3T3-L1 cells was Cx43. Down-regulation of Cx43 using small interfering RNA reduced the expression of C/EBPbeta (LAP) and inhibited adipogenesis. DISCUSSION: Our data suggest that GJC plays some important roles in adipogenesis through inhibiting mitotic clonal expansion and modulating C/EBPbeta (LAP) expression.

Functional single-nucleotide polymorphisms in the secretogranin III (SCG3) gene that form secretory granules with appetite-related neuropeptides are associated with obesity.

CONTEXT: Genetic factors are important for the development of obesity. However, the genetic background of obesity still remains unclear. OBJECTIVE: Our objective was to search for obesity-related genes using a large number of gene-based single-nucleotide polymorphisms (SNPs). DESIGN AND SETTING: We conducted case-control association analyses using 94 obese patients and 658 controls with 62,663 SNPs selected from the SNP database. SNPs that possessed P < or = 0.02 were further analyzed using 796 obese and 711 control subjects. One SNP (rs3764220) in the secretogranin III (SCG3) gene showed the lowest P value (P = 0.0000019). We sequenced an approximately 300-kb genomic region around rs3764220 and discovered SNPs for haplotype analyses. SCG3 was the only gene within a haplotype block that contained rs3764220. The functions of SCG3 were studied. PATIENTS: Obese subjects (body mass index > or = 30 kg/m(2), n = 890) and control subjects (general population; n = 658, body mass index < or = 25 kg/m(2); n = 711) were recruited for this study. RESULTS: Twelve SNPs in the SCG3 gene including rs3764220 were in almost complete linkage disequilibrium and significantly associated with an obesity phenotype. Two SNPs (rs16964465, rs16964476) affected the transcriptional activity of SCG3, and subjects with the minor allele seemed to be resistant to obesity (odds ratio, 9.23; 95% confidence interval, 2.77-30.80; chi(2) = 19.2; P = 0.0000067). SCG3 mRNA and immunoreactivity were detected in the paraventricular nucleus, lateral hypothalamic area, and arcuate nucleus, and the protein coexisted with orexin, melanin-concentrating hormone, neuropeptide Y, and proopiomelanocortin. SCG3 formed a granule-like structure together with these neuropeptides. CONCLUSIONS: Genetic variations in the SCG3 gene may influence the risk of obesity through possible regulation of hypothalamic neuropeptide secretion.

Cellular cadmium uptake mediated by the transport system for manganese.

The mechanism of cellular cadmium (Cd) uptake has been poorly understood. Recently, we developed Cd-resistant cell lines from metallothionein null mouse cells and showed that the Cd resistance of these cells was conferred primarily by a reduced Cd accumulation. Surprisingly, the uptake rate of manganese (Mn) was also markedly reduced in Cd-resistant cells. Subsequent studies on the kinetics of Cd and Mn uptake by Cd-resistant and parental cells revealed that the Mn transport system with high affinity for Mn is used for cellular Cd uptake, and that this pathway is suppressed in Cd-resistant metallothionein null cells. This is the first indication that the transport system for Mn is used for Cd uptake in mammalian cells. Divalent metal transporter 1 (DMT1) is the only known mammalian transporter involved in the uptake of both Cd and Mn. However, the high-affinity Mn/Cd transport system we found seems to be distinct from DMT1 because of the difference in optimal pH and substrate specificity. On the other hand, various types of Mn transporters have been shown to play an important role in cellular Cd uptake in non-mammalian species such as yeast, plants and bacteria, suggesting the existence of Mn transporters other than DMT1 in mammals.