Nagoya Gakuin University

A simple suspension method is used in medical practice to administer several orexin receptor antagonists for patients with dysphagia; however, detailed suspension and passage through catheter evaluations have not been performed. Therefore, to safely administer orexin receptor antagonists using the simple suspension method in patients with dysphagia, this study evaluated the disintegration, suspension, passage through the catheter, and drug recovery after passage of Belsomra® 20 mg (suvorexant), Dayvigo® 10 mg (lemborexant), and Quviviq® 50 mg (daridorexant) tablets through a catheter. Disintegration and suspension of Belsomra® 20 mg, Dayvigo® 10 mg, and Quviviq® 50 mg tablets, and passage through the catheter were visually confirmed. Drug recovery after passage through the catheter was quantified using liquid chromatography-mass spectrometry. In this study, there was no disintegration and suspension of Belsomra® 20 mg tablets. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets demonstrated disintegration and suspension, including passage through the catheter after rapid and complete disintegration. Drug recovery after catheter passage was >80% for Dayvigo® 10 mg without flushing and for Quviviq® 50 mg after two flushes. As the disintegration and suspension properties of Belsomra® 20 mg tablet could not be confirmed, the conventional simple suspension method is not suitable for this product. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets showed potential suitability for the simple suspension method.

The hyoid lesser horn (LH) forms a transient joint with the greater horn in human fetuses. The chondroglossus muscle attaches to the LH; however, its morphology remains unclear. We hypothesized that the muscles involved in LH accelerate joint formation. We examined 34 human fetuses with crown-rump length of 39-230mm. The LH joint was bilaterally absent in eight fetuses; the largest specimen "without" joints was 110mm crown-rump length, whereas the smallest specimen "with" joints was 55mm. The chondroglossus was identified as oblique muscle fibers attached to the LH medial aspect (23/34). The chondroglossus, Adjacent to the transverse lingual muscle (TLM), the chondroglossus ran supero-antero-medially to join the genioglossus. The TLM (21/34) and middle pharyngeal constrictor (pars chondropharyngica; 21/34) originated from the LH. The latter ran posteriorly from the LH medial to the hypoglossal nerve, whereas the middle constrictor arose largely from the greater horn. Notably, without LH attachment, the anterior margin of the mylohyoideus muscle (MPCM) was connected to the TLM using thick fascia wrapped around the LH. Therefore, LH disrupts the muscular ring surrounding the oropharynx. The variation in joint formation timing (9-16 weeks gestational age) suggests that the chondroglossus, TLM, and MPCM development do not require joint movement. Alternatively, an elongated greater horn may provide joint-like space.

Aim: Early vancomycin-associated acute kidney injury (AKI) identification is important during the initial dosing period when non–steady-state pharmacokinetic exposure may influence nephrotoxicity risk. We aimed to conduct a multicentre retrospective cohort study of hospitalised adult patients who received vancomycin at three tertiary care hospitals in Japan between April 2019 and March 2024. Methods: Early area under the concentration–time curve (AUC) metrics, trough concentrations, concomitant medications, and comorbidities were used to develop and compare machine learning models to predict vancomycin-associated AKI. Eleven algorithms were evaluated using a nested cross-validation framework to minimise optimistic bias and prevent data leakage. Results: Among 442 patients (median age 72 years), AKI occurred in 5.7%. Across models, day 2 AUC and trough concentration consistently emerged as the most influential predictors, followed by concomitant use of piperacillin/tazobactam, diuretics, and vasopressors. The random forest model showed the best overall discriminative performance (area under the receiver operating characteristic curve 0.89; area under the precision–recall curve 0.47). Shapley additive explanations revealed nonlinear increases in AKI risk at approximately day 2 AUC ≥ 550 mg·h/L and trough concentration ≥ 20 μg/mL. These findings indicate that early vancomycin exposure, particularly cumulative exposure within the first 48 h, is strongly associated with AKI risk. Conclusion: Machine learning models incorporating early AUC metrics with trough concentrations may provide a clinically informative framework for early risk stratification during vancomycin therapy and support further evaluation of early AUC-guided dosing strategies with trough concentrations as complementary exposure markers.

Mannose supplementation has emerged as a promising strategy to exploit the hidden vulnerabilities of cancer cells. However, the mannose-dependent effect on cellular functions remains unclear. Here, we investigated the collateral impact of mannose supplementation on the metastatic potential of osteosarcoma. Analysis of a paired osteosarcoma dataset showed significant upregulation of GPI in tumors compared with matched normal tissue, whereas other glycolysis- and mannose-metabolism genes showed non-significant upward trends. By using osteosarcoma cell lines, MG-63 carrying a pronounced epithelial-to-mesenchymal transition phenotype showed a dose-dependent inhibition of proliferation upon mannose supplementation. We also found that mannose-induced attenuation of cell growth was further enhanced, accompanied by marked reductions in migration and invasion ability. Consistently, qPCR analysis indicated that mannose supplementation downregulated key genes associated with metastasis. Collectively, our data reveal that mannose inhibits osteosarcoma not merely by dampening glycolysis but also by triggering, in part, MPI-linked mannose metabolism, which disrupts key drivers of motility-associated phenotypes. Together, these data show that pharmacologic mannose supplementation modulates cell growth- and motility-associated phenotypes in osteosarcoma cell models, accompanied by changes in epithelial-to-mesenchymal transition-associated transcripts.

Background Recently, health professional education uses visual art observation to promote various observation-related technical skills. This article maps the studies on such interventions, scrutinizes what they measured as observational skills, and discusses their effectiveness. Methods Following the PRISMA Extension for Scoping Reviews, a scoping review was conducted. Publications from 2001 on were identified by searching four databases and by hand searching. The author screened each publication using the pre-designed eligibility criteria: participants were novice healthcare learners enrolled in visual art observation training; the study aimed to evaluate the effect of the intervention on technical skills related to observation; the skills were objectively measured. The author extracted relevant information from the included papers without additional inquiry into the study authors. The extracted information was illustrated in both a tabular and descriptive format. Results 3,157 publications were identified, of which 18 articles were included. Few studies had valid and reliable experiments. The relatively valid evidence is that the participants listed more elements or signs for artistic or medical images. Conclusions Sound evidence is lacking for all the technical skills intended to be fostered. Observation skills for artistic images have not been demonstrated to transfer to technical skills. Nor do the studies show that they promoted accurate diagnoses and reduced misdiagnoses. Additionally, the evidence on verbalizing skills is not isolated from the impact of discussions and is unclear regarding its transfer to actual communication. For the others, there are not enough valid studies on technical skills. This is true for studies that directly examine promoting accurate diagnosis or reducing misdiagnosis. Moreover, there may be promising alternatives to visual art observations for cultivating such technical skills, but no comparative studies were conducted.

This study investigated the relationship between psychological needs satisfaction and frustration (BPNSF) and the adoption of (de)motivating teaching styles among Japanese physical education teachers. A quantitative survey was distributed to 295 teachers, and qualitative interviews were conducted with four teachers. Three clusters of teachers were identified based on their BPNSF characteristics: High BPNS (basic psychological needs satisfaction), High BPNF (basic psychological needs frustration), and Moderate BPNS/BPNF. Teachers in the High BPNS cluster adopted more motivating and less demotivating styles, while those in the High BPNF cluster adopted more demotivating and less motivating styles. • Teachers with high BPNS adopted more motivating teaching styles. • High BPNF teachers tended to use demotivating styles. • Workplace support fosters autonomy, competence, and relatedness in teaching. • Balancing professional growth and teaching responsibilities poses challenges. • Findings emphasise the need for supportive environments in teacher development.

To scale up mental health services in low‐ and middle‐income countries (LMICs), understanding mental disorders in the local culture is critical. “Vignettes” are short texts describing a hypothetical character or situation to which respondents give their opinion, and are a potentially useful technique to explore perceptions of mental disorders in the context. We aimed to review how studies using vignettes have been conducted to understand mental disorders in LMICs in the East Asia and the Pacific region. Medline, PsycInfo, EMBASE, CINAHL, and CENTRAL were searched for articles published by April 2024. We included studies that used vignettes to assess mental disorders in LMICs in the region. We excluded studies that used vignettes that did not intend to elicit participants' opinions on the vignettes. A scoping review was conducted according to Preferred Reporting Items for Systematic reviews and Meta‐Analyses extension for Scoping Reviews (PRISMA‐ScR) guidelines. Two researchers performed title/abstract and full‐text screening, and one researcher extracted data. The database search yielded 1547 articles, and 55 articles were included in the review. The majority of the studies used an observational, quantitative design. The most common disorders studied using vignettes were depressive disorders, schizophrenia, and anxiety disorders. The main purposes of using vignettes were to explore the identification of mental disorders, explanatory models, help‐seeking, and stigma of mental disorders. Two‐thirds of the studies used vignettes and questions to elicit opinions on vignettes that originated from previous studies. Enhanced vignette utilization to understand mental disorders in the context contributes to generate knowledge for the promotion of mental health services in LMICs.

Eucommia ulmoides Oliv. is a deciduous tree that can grow up to 20 m in height. The bark of the tree has been listed in the Chinese pharmaceutical book “Shennong Ben Cao Jing” since 300 AD. In the 1970s, Eucommia leaf tea, known as Tochu-cha in Japanese, was developed from roasted Eucommia leaves in Japan and is considered as a healthy tea. The antihypertensive, diuretic, anti-stress, insulin resistance improvement and anti-obesity effects of Eucommia leaf extract have been reported. However, the identification and properties of the active components as well as the underlying mechanism of action are largely unknown. This review summarizes studies involving the oral administration of geniposidic acid, a major iridoid component of Eucommia leaf extract which increases plasma atrial natriuretic peptide (ANP) on the atria of spontaneously hypertensive rats (SHR) by activating the glucagon-like peptide-1 receptor (GLP-1R). Changes in the gut microbiota play an important role in the efficacy of asperuloside, another component of the Eucommia leaf extract, which improves obesity and related sequelae, such as insulin resistance and glucose intolerance in rodents and humans. In addition, it was shown that ANP secretion by geniposidic acid also shows an anti-obesity effect with improvement of insulin resistance in rodents. This review focuses on the mechanisms underlying the antihypertensive and anti-obesity effects of the Eucommia leaf extract and summarizes the differences of mechanisms in their effects on rodents and humans. This review discussed the potential benefits of Eucommia leaf extract, geniposidic acid, and asperuloside in managing metabolic disorders, hypertension, obesity, and diabetes in rodent models. However, to demonstrate these effects in the case of humans, a combination of a potent cAMP-PDE (cyclic Adenosine Monophosphate-Phosphodiesterase) inhibitor with Eucommia leaf extract may be necessary, which requires further human clinical evaluation in the future.

This study assessed the effects of a rugby-specific concussion awareness program on improving the recognition of relevant symptoms and knowledge of concussion in male collegiate rugby union players. Thirty-one collegiate rugby union players from Japan were offered a concussion awareness program; they responded to a questionnaire assessing symptom recognition and knowledge of concussion three times (before, immediately after, and four weeks after the implementation of the program). Immediately after the program, the recognition score of suspected concussion symptoms was higher compared to before and four weeks later, when it was still higher than before the program, but not statistically significant. In addition, more players selected the correct answers about rugby-specific concussion topics after the program. Our findings suggest that while concussion awareness is expected to improve immediately, this effect was not maintained after four weeks. Therefore, concussion awareness opportunities should be scheduled regularly, such as at the start of each season, before the beginning of competition season, and when new players join the team.