Investigation of the possibility of using an augmented reality-based endotracheal aspiration simulation tool for nursing education.

AIM: We developed an augmented reality technology-based endotracheal aspiration simulation tool (the AR tool) consisting of three modes: a mode for nursing students to learn endotracheal aspiration by themselves (learning mode); a mode for repeated practice (practice mode); and a mode for confirmation testing (test mode). This study aimed to compare the learning outcomes of the AR tool with traditional training mannequins and identify potential uses and improvements of the AR tool. METHODS: We invited students, and faculty members from the three universities who agreed to cooperate in conducting this study. Fifty-four students and nine faculty members agreed to participate in this study. The students were divided into two groups. One group was to study with the AR tool and the other group was to study with the traditional half-body training mannequin for suction. The students in both groups were asked to demonstrate endotracheal aspiration on another full-body type training mannequin which could be used as a patient with a tracheostomy (Skill test). Group interviews with faculty members focused on the topic of the AR tool's potential use in nursing education and improvement needed. RESULTS: There was little significant difference in the skill test results of endotracheal aspiration of students in both groups. The students and faculty members both expressed an interest in the AR tool. They said it was suitable for self-study of endotracheal aspiration. CONCLUSIONS: This AR tool is an effective teaching tool for learning the sequence of endotracheal suctioning, although there are some areas that need improvement.

A Qualitative Study of Impacts of the COVID-19 Pandemic on Lives in Adults with Attention Deficit Hyperactive Disorder in Japan.

(1) Background: COVID-19 may deteriorate some aspects among individuals with attention deficit hyperactivity disorder (ADHD). Although some positive aspects were reported during the pandemic, it remains unclear how COVID-19 qualitatively influences their living context; (2) Methods: this study employed interviews with four participants with ADHD during the declaration of emergency issued in Japan. The study was a part of ongoing coaching as a psychosocial intervention for ADHD, which was initiated long before the pandemic. The data were the answers to the question: "how are things going with participants during this pandemic?". In a qualitative analysis, the researchers coded the data to identify different themes and sub-themes; (3) Results and Discussion: the qualitative data analysis yielded five themes: (1) Terrible feeling caused by frustration, stress, and anger; (2) Closeness due to the internal difficulties and conflict; (3) Deteriorating ADHD symptoms and executive function related matters; (4) Condition is the same as usual; and (5) Positive aspects associated with the self-lockdown. As a whole, these results show that the COVID-19 pandemic could be a factor in inducing psychological distress in the participants who adjust relatively better at work/school but did not do well at home before the pandemic; (4) Conclusions: this study indicates the need for special support for individuals with ADHD, especially those who originally had difficulties at home.

Low-carbohydrate diet by staple change attenuates postprandial GIP and CPR levels in type 2 diabetes patients.

AIMS: The aim of this study is to investigate the effects of a low-carbohydrate staple food (i.e., low-carbohydrate bread) on glucose and lipid metabolism and pancreatic and enteroendocrine hormone secretion in comparison with meals containing normal-carbohydrate bread, without consideration of the carbohydrate content of the side dishes. METHODS: T2DM patients (n = 41) were provided meals containing low-carbohydrate bread (LB) together with side dishes or normal-carbohydrate bread (NB) together with side dishes every other day as a breakfast. Blood glucose levels were evaluated by using a continuous glucose monitoring system; blood samples were collected before and 1 and 2 h after the breakfast. RESULTS: Postprandial blood glucose levels, plasma insulin, plasma glucose-dependent insulinotropic polypeptide (GIP) and plasma triglyceride were significantly lower and plasma glucagon levels were significantly higher in LB compared with those in NB. Plasma glucagon-like peptide-1 (GLP-1) levels did not differ in the LB and NB groups. CONCLUSIONS: These results indicate that changing only the carbohydrate content of the staple food has benefits on glucose and lipid metabolism in T2DM patients concomitant with the decrease of insulin and GIP secretion, which ameliorate body weight gain and insulin resistance.

Psychometric properties of the self-rating organization scale with adult samples.

Organization skills are defined broadly to include both materials and temporal features. Given its symptoms and neurobiological features, attention-deficit hyperactivity disorder (ADHD) should be susceptible to impairment in organization. A valid organization scale is imperative to assess and intervene individuals with ADHD. However, there is no validated organization scale in Japan. Referring to existing scales and clinical experience, the self-rating organization scale (SOS) was developed and tested in terms of its psychometric properties with 1,017 adults and students including 47 adults with ADHD. Additionally, cutoffs for disorganization were set for clinical utility. Three factors (materials disorganization, temporal disorganization, and mess) were extracted by factor analyses. The index for reliability and validity of the SOS was acceptable. The factor "mess" could reflect the unique aspect of the Japanese environment. Further study is needed to enhance the clinical utility of the SOS.

Nutritional status of calcium and other bone-related nutrients in Japanese type 2 diabetes patients.

OBJECTIVES: Traditional Japanese food appears to be healthy but contains a small amount of milk products. Type 2 diabetes (T2DM) patients commonly reduce their energy intake to control their blood glucose levels. However, nutritional guidance for diabetes does not emphasize calcium (Ca) consumption. The aim of this study is to estimate the nutritional status of Ca and other nutrients, which affect bone and Ca metabolism, in T2DM patients. METHODS: This observational study was conducted with Japanese T2DM patients (n = 96; M/F = 50/46; age: 61.6 ± 10.1 years). We estimated nutrient intake using a simple food frequency questionnaire. RESULTS: Median total energy intake was 1750 kcal/day (1440-1970). Their median daily intake of Ca, vitamin D, and vitamin K was 451 mg (336-560), 10.2 µg (8.5-12), and 206 µg (84-261), respectively. Only 17.7% of the study subjects were found to take more than 600 mg/day of Ca. Protein and salt intake was 78 (64-90) and 10.6 (9.3-12.2) g/day, respectively. Male subjects had more salt, less Ca and vitamin K than female. Daily Ca intake was positively associated with total energy, protein, and lipid intake but not with carbohydrates. Vitamin D intake correlated only with protein intake. CONCLUSIONS: The daily Ca intake of Japanese T2DM patients appears to be insufficient and could depend on protein and lipid intake. Additionally, these patients should have specific recommendations to ensure sufficient intake of Ca with protein and lipid during energy restriction.

Structural basis of Cu, Zn-superoxide dismutase amyloid fibril formation involves interaction of multiple peptide core regions.

Cu, Zn-superoxide dismutase (SOD1), an enzyme implicated in the progression of familial amyotrophic lateral sclerosis (fALS), forms amyloid fibrils under certain experimental conditions. As part of our efforts to understand ALS pathogenesis, in this study we found that reduction of the intramolecular disulfide bond destabilized the tertiary structure of metal free wild-type SOD1 and greatly enhanced fibril formation in vitro. We also identified fibril core peptides that are resistant to protease digestion by using mass spectroscopy and Edman degradation analyses. Three regions dispersed throughout the sequence were detected as fibril core sequences of SOD1. Interestingly, by using three synthetic peptides that correspond to these identified regions, we determined that each region was capable of fibril formation, either alone or in a mixture containing multiple peptides. It was also revealed that by reducing the disulfide bond and causing a decrease in the structural stability, the amyloid fibril formation of a familial mutant SOD1 G93A was accelerated even under physiological conditions. These results demonstrate that by destabilizing the structure of SOD1 by removing metal ions and breaking the intramolecular disulfide bridge, multiple fibril-forming core regions are exposed, which then interact with each another and form amyloid fibrils under physiological conditions.

Attention deficit and attention training in early twentieth-century Japan.

Yuzero Motora (1856-1912), regarded as the first professional Japanese psychologist, tried to address students' attention difficulties through attention training methods of his own design. His reports contain the first description of ADHD-like symptoms in the history of Japan. Motora viewed "distractibility" as the irregular transition of attention. Students with low scores and attention difficulties who participated in Motora's exercises showed improvement in arithmetic, psychological testing, and certain aspects of daily life. This article describes Motora's theoretical conception of attention and attention training methodology, the history of attention deficit and attention training, and the significance of Motora's experiments.