Tenri University

Anti-synthetase syndrome is an autoimmune disorder associated with anti-aminoacyl-tRNA synthetase antibodies, including anti-Jo-1. However, antibody positivity alone is insufficient for the diagnosis because overlapping features with other diseases may lead to a misdiagnosis. We herein report a 69-year-old woman initially suspected of having anti-synthetase syndrome due to anti-Jo-1 antibody positivity and muscle weakness. Additional findings, including mononeuritis multiplex, purpura, crescentic glomerulonephritis, and strongly positive myeloperoxidase-antineutrophil cytoplasmic antibodies, led to a diagnosis of microscopic polyangiitis. Although anti-Jo-1 antibodies are highly specific, false-positive results can occur. This case highlights the need for a comprehensive evaluation beyond antibody testing to avoid diagnostic errors.

<title>Abstract</title> Purpose This study was conducted to confirm the actual opioid conversion ratios (CRs) and opioid rotation ratios (ORRs) in clinical practice in Japan. Methods A cross-sectional survey was conducted between March 7th to 20th, 2024, targeting palliative care physicians and pharmacists in the following three societies: Japanese Society for Palliative Medicine, Japanese Society for Pharmaceutical Palliative Care and Sciences, and Japanese Association of Supportive Care in Cancer. The primary endpoint was to determine the CRs and ORRs used by participants, which were measured in the survey. Results 433 responses (68.1% physicians and 31.9% pharmacists) were received. 30.3% conducted &gt; 30 opioid rotations in the past 6 months. For most CRs and ORRs obtained from all the participants, values for the median, first quartile, third quartile, and mode were consistent. Among groups of professions and number of opioid rotations frequency, there were no differences in the median opioid ratios involving morphine, hydromorphone and oxycodone. However, there were significant differences in the ORRs involving intravenous (IV) fentanyl, specifically in the rotation ratios between IV fentanyl and IV morphine. Conclusion There was great consistency in the CRs and ORRs used by physicians and pharmacists in palliative care in Japan. This would suggest that education on the ratios is well established for medical professionals in Japan.

Cancer is a common health problem worldwide. Early cancer education for adolescents and young adults (AYAs) is important for the prevention or early detection of cancer. In this questionnaire-based cross-sectional study, we examined the cancer awareness among parents of AYAs. Japanese adults with junior or senior high school children were included in this study. The cancer awareness measure (CAM) was used to assess cancer awareness, and the survey was conducted in December 2021. Warning signs, barriers to seeking help, and risk factors were surveyed using an online anonymous questionnaire. In addition, personal information, the presence of other cancer survivors, attendance at cancer seminars, conversations with children about cancer, interest in cancer education for children, and previous cancer screening were surveyed. A t-test or Spearman correlation coefficient was used to compare the total CAM scores for the individual factors. The relationship between cancer-screening behavior and individual factors was analyzed using the χ2 test. In addition, multiple regression analysis or logistic regression analysis was used to identify the factors influencing cancer awareness or cancer-screening behavior. Responses were obtained from the 612 participants. The mean CAM score was 3.7 for cancer warning signs, 4.3 for barriers to seeking help, and 6.5 for risk factors. Cancer warning signs were associated with gender and the presence of a spouse, family member, or friend who had experienced cancer. Barriers to seeking help were associated with age, gender, and education, while risk factors were associated with gender, education, and conversations about cancer with children. Moreover, these scores were associated with each cancer screening behavior. Cancer awareness among Japanese adults with AYAs was influenced by gender, academic background, occupation, the presence of cancer survivors around them, and whether they had conversations about cancer with their children, as well as their cancer screening behavior.

緑茶を淹れて飲む食文化は日常から失われつつある。そうした中で，家庭科調理実習の授業で行われるお茶教室は食文化への挑戦の機会として有用であることが報告されている。本研究では，小学生の家庭科の授業として行われたお茶教室の感想文をテキストマイニングにより分析した。その結果，教員の視点では，教育的意義としての知識や技術の習得を重視し，一方で受講生の視点では，緑茶を淹れるごとに変化する味覚の体験を重視することが明らかになった。この結果を基に，食文化の継承という観点から，教育の中で発達段階に応じたお茶教室プログラムを実施することで，持続的なお茶に触れる機会と興味関心の醸成が可能になることを考察した。

This study aimed to assess the localization of chondroitin sulfate (CS), a primary extracellular matrix component, in the stromal region of endometrial carcinoma (EC). Immunostaining was performed on 26 endometrial endometrioid carcinoma (EEC) samples of different grades and 10 endometrial serous carcinoma (ESC) samples to evaluate CS localization. This was further confirmed by Alcian Blue (AB) staining as well. In the G1-EEC samples, CS showed reactivity with fibrovascular stroma, supporting closely packed glandular crowding and papillary structures. As the grade increased, the original interstitial structure was re-established, and the localization of CS in the perigulandular region decreased. In the ESC samples, the thick fibrous strands supporting the papillary architecture showed reactivity with CS; however, the delicate stromal region branching into the narrow region showed poor reactivity. The AB staining results showed similar characteristics to the immunostaining ones. The characteristic localization of CS in various EC types was elucidated. The present study provides new information on endometrial stromal assessment.

Surgical management can be considered in patients with allergic rhinitis (AR) refractory to drug therapy, posterior nasal neurectomy (PNN) is one of the procedures. We developed a unique and simplified method for PNN, we called modified PNN (MPPN) and investigated the improvement in nasal symptoms after MPNN surgery for allergic rhinitis, other surgical outcomes, and surgical complications. In MPNN, following sufficient coagulation of the mucosa along the base of the inferior nasal turbinate, a full thickness mucoperiosteal incision up to the bony turbinate was performed using energy devices. Surgical manipulations to confirm the posterior nasal nerve, such as elevation of the mucosa, are not necessary with MPNN. MPNN was a simple and safe procedure, and no serious surgical complications were observed. Significant improvement in postoperative nasal symptoms and reduction in medication use compared to preoperative conditions.

Extended-spectrum β-lactamase (ESBL)-producing Enterobacterales have become a global concern owing to increased infections, high mortality, and limited antibiotic treatment options. Carbapenems (CPMs) are effective against ESBL-producing Enterobacterales, but their overuse leads to the emergence of multidrug-resistant bacteria. Cefmetazole (CMZ) is effective in vitro; however, its clinical efficacy remains unclear. We retrospectively reviewed patients who were treated with CMZ or CPMs for bacteremia caused by ESBL-producing Enterobacterales between 1 April 2014 and 31 September 2022 at Tenri Hospital. The primary outcome measure was 90-day mortality. We also evaluated resistance genes and sequence types of ESBL-producing Enterobacterales. In total, 156 patients were enrolled in this study. Ninety patients (58%) received CMZ therapy. Patients in the CMZ group were significantly older than those in the CPM group (median [IQR], 79 years [71-86] vs 74 years [64-83]; P = .001). The severity of the Pitt bacteremia score of the CMZ group was lower than that in the CPM group (0 [0-2] vs 2 [0-2], P = .042). Six patients (7%) in the CMZ group and 10 (15%) in the CPM group died by day 90 (P = .110). Charlson Comorbidity Index and prevalence of sequence 131 between the groups were statistically insignificant. Our findings suggest that CMZ is a well-tolerated alternative to CPM for treating bacteremia caused by ESBL-producing Enterobacterales.

Një analizë e teksteve arabe të njëqind viteve të fundit ka treguar se libri shkollor i një grupi autorësh: Sikiriç, Pashiç dhe Hanxhiç ka mbetur në përdorim për një kohë mjaft të gjatë, aq sa gjuha në të cilën është shkruar gramatika, është e vjetruar. Në periudhën pas viteve 1990, mësimi në medrese filloi të bëhej sipas librit të Haliloviçit, i cili, sipas autorit, ishte hartuar, para së gjithash, si tekst mësimor që përdoret për të mundësuar bisedën, për të zhvilluar aftësinë e nxënësit për përballimin e rrethanave të përditshme. Pas mësimit të koncepteve themelore, aftësitë gjuhësore janë të lehta për t'u përmirësuar, me terminologji fetare dhe shkencore. Programi shkollor i medresesë e rekomandon këtë libër shkollor si themelor, bashkë me disa libra arabë që mësuesi mund t'i përdorë sipas nevojës. Zhvillimi i teknologjive digjitale ka mundësuar përqasje të papenguar në informacione dhe të dhëna të shumta, të cilat, ndër të tjera, kanë ndihmuar në afrimin e gjuhëve të huaja me studentët. Sot gjenden platforma të ndryshme për mësimin e gjuhëve të huaja që, përveç gramatikave ekzistuese, lehtësojnë mësimin e gjuhëve të huaja dhe disa prej tyre janë renditur në kumtesa. Zhvillimi i shpejtë teknologjik në botë duhet të jetë një nxitje për të përshtatur tekstet e tanishme me kohët dhe terminologjinë bashkëkohore, ose për të përgatitur një libër të ri shkollor, në mënyrë që, nga njëra anë të shmanget ekzistenca e një libri shkollor të përdorur prej 60 vitesh, nga ana tjetër, të mbahet ritmi i kohës. Përmbajtjet e shumta të internetit fetare ose laike mund të shërbejnë si burime të dobishme për të mësuar gjuhën arabe. Raporti i fetares dhe laikes në librat e gjuhës arabe për medresetë nuk përbën shqetësim për mësimin e kësaj gjuhe. Duke qenë se nxënësit përgatiten për fakultete të fushave të ndryshme profesionale, ata munden që, përmes të dhënave të vlefshme të librave shkollorë, të përmirësojnë njohuritë e tyre në drejtimin e dëshiruar. Të gjitha njohuritë, si fetare, ashtu edhe laike, mund t’u shërbejnë qëllimeve të dobishme.

The Japanese word “jiba” includes such literal meanings as “place,” “land” and “location.” To Tenrikyo followers, however, “Jiba,” refers to the sacred spot at the center of the Main Sanctuary of Church Headquarters of Tenrikyo. Furthermore, Tenrikyo followers use such terms as “yashiki” (residence) and “oyasato” (parental home) while referring to “Jiba.” These references also include larger areas surrounding the sacred spot. According to the Tenrikyo Dictionary, in the Osashizu (“Divine Directions”), considered as one of three main Tenrikyo Scriptures, Jiba is described as “the object and center of the Tenrikyo faith. It is the place of origin where God created humankind,” the place “where God resides” and the place “that is the source of universal salvation,” and it is seen by followers as the parental home of all humanity. In the church-recognised autobiography, The Life of Oyasama, Foundress of Tenrikyo, it states that those who came to see the foundress in Jiba had their hearts filled with joy and brightness and they became enveloped in an indescribable peace. Therefore, they started calling a visit to Jiba, or a coming to worship at the “Home of the Parent,” as “Ojibagaeri,” meaning a “returning to Jiba.” This represents their personal and warm feeling towards the sacred spot of Jiba. In this chapter, I would like to present and discus the characteristics of “Ojibagaeri,” the Tenrikyo pilgrimage directed towards the “sacred” locus of Jiba.

This chapter examines Tajik women’s attitudes towards family life, employment and power relationship in a household. For investigation the authors conducted a small survey on 40 Tajik women. The authors also utilized large-scale surveys on women in the country for generalization of findings and those in Central Asian States for comparison. There was no research like the authors where they look not only at the gender situation in Tajikistan but at the balance of the gender roles in the workplace and in family life based on surveying of, though a limited number of respondents, this country and numerous surveys. The chapter aims at filling this gap in the research field. Although Tajik women stick to traditional gender role values and household power relationship with their partners, and gender equality is hard to be attained in the near future, the effects of education attainment level on women’s attitude toward gender issues are positive and enhancing educational level of girls likely result in positive impacts on Tajik women’s situations.