[Core values and competencies of public health nurses: A Delphi survey].

Objectives　This study aimed to clarify the core values and competencies of public health nurses (PHNs) who contribute to improve health issues in transitioning societies, based on a consensus among PHN-related organizations, including practitioners and education researchers.Methods　A draft defining the core values and competencies of PHNs was developed through five consultation sessions with 20 executives and nominees of organizations in each area of PHN practice, education, and research to collect, categorize, and refine the items. The expert panel comprised 534 nominees from six PHN-related organizations, and three rounds of Delphi surveys were conducted. The consensus criteria were ≥70% for agreement and ≥80% for firm agreement.Results　In the first round, 272 expert panel nominees (50.9%) responded, and 217 responded in all rounds. The draft was revised based on the feedback from each round. By round 3, >90% agreed on the core value and competency frameworks and definitions.Conclusion　The Delphi survey revealed the three core value frameworks and definitions of "social justice in health," "human rights and autonomy," and "health and safety" and eight core competencies of "professional autonomy and responsibility," "scientific research and use of information science and technology," "population-based assessment and analysis," "practices for health enhancement and prevention," "building systems to improve public health," "management of healthy community development," "person/community-centered collaboration and cooperation," and "communication for consensus and solutions," with a firm agreement. Eventually, these frameworks would be the bases for creating national standards of practice, education, and research to satisfy the consensus levels of PHNs and PHN-related organizations.

Association between the Monthly Visit Behavior and CPAP Adherence in OSAS Patients.

Objective Obstructive Sleep Apnea Syndrome (OSAS) causes multiple breathing interruptions during sleep and increases mortality if left untreated. Continuous positive airway pressure (CPAP) therapy improves the prognosis of OSAS; however, patient adherence is often poor. This study investigated the relationship between monthly hospital visits and CPAP adherence to CPAP therapy in patients with OSAS. Methods We studied 119 patients (93 men and 26 women) at the Minami Kyoto Hospital between June 2022 and May 2023. CPAP adherence was measured daily. Hospital/clinic visits were categorized as "Last minute visits at the end of the month" (≥25th of the month) and analyzed in relation to CPAP adherence. Results The average duration of CPAP use duration were 5 h, 47 min, and 43 s. Patients visiting on or after the 25th of month had significantly lower CPAP use (4 h, 17 min, 05 s) compared to those visiting before the 25th of month (6 h, 01 min, 47 s, p=0.003). No significant correlation was found between the visit frequency and adherence to CPAP therapy, with a lower visit frequency unexpectedly corresponding to longer CPAP use (p=0.04). Conclusion The timing of monthly clinic visits significantly affected CPAP adherence, with late-month visits associated with poorer adherence. Visit frequency showed no clear correlation with adherence, suggesting that other factors may have influenced CPAP use. Further supportive interventions can enhance adherence and improve the treatment outcomes.

[Development of the HDL-C and LDL-C direct methods and the subsequent evolution].

Today, more than a decade after the development of direct methods for determining HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) concentrations, there are calls to review the reagents in response to discrepancies in patient samples with increased levels of atypical lipoproteins, such as apoE-rich HDL, IDL, Lp-X, and Lp-Y. Seven direct HDL-C assays showed different reactions toward apoE-rich HDL in sera from patients with CETP deficiency and cholestasis. On the other hand, the reactivity of the direct LDL-C assays to serum samples with elevated levels of IDL, Lp-X, and Lp-Y varied considerably between assay kits from each manufacturer. We have also examined the anti-atherogenic functions of apoE-rich HDL from the serum of healthy individuals and patients with CETP deficiency and cholestasis. The ability of apoE-rich HDL to remove cholesterol from cholesterol-loaded macrophages showed that the apoE-rich HDL from CETP-deficient serum took up more cholesterol than apoE-poor HDL (p < 0.01), but no significant differences were observed for apoE-rich HDL from patients with cholestasis.

Wogonin, a plant flavone, potentiates etoposide-induced apoptosis in cancer cells.

Etoposide, a podophylotoxin anticancer agent, induces apoptotic cell death in normal and cancer cells. Etoposide-induced apoptosis plays a role in not only anticancer effect but also adverse reaction, such as myelosuppression. Since we have found that wogonin, a flavone found in Scutellaria baicalensis Georgi, prevents thymocyte apoptosis induced by various compounds including etoposide, we examined the effect of this flavone on etoposide-induced apoptosis in cancer cells. Although 100 muM wogonin itself significantly increased DNA fragmentation in HL-60 cells, this change was not observed in Jurkat cells. On the other hand, this flavone significantly potentiated etoposide-induced apoptosis in Jurkat and HL-60 cells. Similarly, wogonin accelerated etoposide-induced cell death in lung cancer cells. Since wogonin had no effect on the action of other anticancer agents, such as 5-FU and cisplatin, this flavone seems to accelerate only etoposide-induced apoptotic cell death in cancer cells. These results suggest that the modification of etoposide-induced apoptosis by wogonin may be available to reduce the adverse reaction of this agent.

Pathological findings and probable causes of the death of Stejneger's beaked whales (Mesoplodon stejnegeri) stranded in Japan from 1999 and 2011.

One hundred and twenty stranding events of Stejneger's beaked whales were reported in Japan between 1999 and 2011. The purpose of this study is to introduce pathological data and to discuss probable causes of death for 44 Stejneger's beaked whales among them. The significant pathological findings were the pulmonary edema, parasitic granulomatous nephritis, emaciation, amyloidosis, suppurative bronchopneumonia and so on. The probable causes of death were categorized as noninfectious in 43 of the cases, which included drowning, starvation and secondary amyloidosis. One individual was diagnosed with septicemia, which was the only example of an infectious disease. Because we could not always perform advanced analyses, such as microbiology tests, biotoxin examinations or contaminant analyses, the finality of our findings may be impaired. However, the present study has broad implications on the causes of death of Stejneger's beaked whales of the seas around Japan, which are valuable for the future studies and for the detection of emerging diseases.