Impact of behavioral/developmental disorders comorbid with conduct disorder

Aims: The aim of the present study was to verify the comorbidity of conduct disorder (CD) and behavioral/developmental disorders in children and adolescents, and to examine the traits of CD comorbid with them. Methods: Subjects were 64 children (60 boys, four girls) who were resident at three institutions for delinquent children or who were conduct-disordered outpatients of a university hospital aged under 18 years. A diagnostic interview was carried out by experienced child psychiatrists and the intelligence score and the Adverse Childhood Experiences score were measured by a licensed psychologist. Results: A total of 57 children were diagnosed as having CD, of whom 26 (45.6%) were diagnosed with comorbid attention-deficit-hyperactivity disorder (ADHD), 12 were diagnosed with comorbid pervasive developmental disorder (PDD, 21,1%), and 19 (33.3%) had no comorbidity of either disorder. Six children (18.8% of CD comorbid with ADHD) met the criteria for both ADHD and PDD. The group with comorbid PDD was significantly younger at onset (F = 6.51, P = 0.003) and included unsocialized type more frequently (KH2 = 6.66, P = 0.036) compared with the other two groups. Conclusions: Clinicians should be aware that not only ADHD but also PDD may be comorbid with CD. Establishment of the correct diagnosis is important because recognizing the presence of PDD will enable us to provide appropriate treatment and guidance, which may improve prognosis.ArticlePSYCHIATRY AND CLINICAL NEUROSCIENCES. 63(6):762-768 (2009)journal articl

Factors associated with motivation and hesitation to work among health professionals during a public crisis: a cross sectional study of hospital workers in Japan during the pandemic (H1N1) 2009

<p>Abstract</p> <p>Background</p> <p>The professionalism of hospital workers in Japan was challenged by the pandemic (H1N1) 2009. To maintain hospital function under critical situations such as a pandemic, it is important to understand the factors that increase and decrease the willingness to work. Previous hospital-based studies have examined this question using hypothetical events, but so far it has not been examined in an actual pandemic. Here, we surveyed the factors that influenced the motivation and hesitation of hospital workers to work in Japan soon after the pandemic (H1N1) 2009.</p> <p>Methods</p> <p>Self-administered anonymous questionnaires about demographic character and stress factors were distributed to all 3635 employees at three core hospitals in Kobe city, Japan and were collected from June to July, 2009, about one month after the pandemic (H1N1) in Japan.</p> <p>Results</p> <p>Of a total of 3635 questionnaires distributed, 1693 (46.7%) valid questionnaires were received. 28.4% (N = 481) of workers had strong motivation and 14.7% (N = 249) had strong hesitation to work. Demographic characters and stress-related questions were categorised into four types according to the odds ratios (OR) of motivation and hesitation to work: some factors increased motivation and lowered hesitation; others increased motivation only; others increased hesitation only and others increased both motivation and hesitation. The strong feeling of being supported by the national and local governments (Multivariate OR: motivation; 3.5; CI 2.2-5.4, hesitation; 0.2; CI 0.1-0.6) and being protected by hospital (Multivariate OR: motivation; 2.8; CI 2.2-3.7, hesitation; 0.5; CI 0.3-0.7) were related to higher motivation and lower hesitation. Here, protection included taking precautions to prevent illness among workers and their families, providing for the care of those who do become ill, reducing malpractice threats, and financial support for families of workers who die on duty. But 94.1% of the respondents answered protection by the national and local government was weak and 79.7% answered protection by the hospital was weak.</p> <p>Conclusions</p> <p>Some factors have conflicting effects because they increase both motivation and hesitation. Giving workers the feeling that they are being protected by the national and local government and hospital is especially valuable because it increases their motivation and lowers their hesitation to work.</p

Human AK2 links intracellular bioenergetic redistribution to the fate of hematopoietic progenitors

AK2 is an adenylate phosphotransferase that localizes at the intermembrane spaces of the mitochondria, and its mutations cause a severe combined immunodeficiency with neutrophil maturation arrest named reticular dysgenesis (RD). Although the dysfunction of hematopoietic stem cells (HSCs) has been implicated, earlier developmental events that affect the fate of HSCs and/or hematopoietic progenitors have not been reported. Here, we used RD-patient-derived induced pluripotent stem cells (iPSCs) as a model of AK2-deficient human cells. Hematopoietic differentiation from RD-iPSCs was profoundly impaired. RD-iPSC-derived hemoangiogenic progenitor cells (HAPCs) showed decreased ATP distribution in the nucleus and altered global transcriptional profiles. Thus, AK2 has a stage-specific role in maintaining the ATP supply to the nucleus during hematopoietic differentiation, which affects the transcriptional profiles necessary for controlling the fate of multipotential HAPCs. Our data suggest that maintaining the appropriate energy level of each organelle by the intracellular redistribution of ATP is important for controlling the fate of progenitor cells

Drug Repositioning for Cardiac Arrest

The survival rate of cardiac arrest patients is less than 10%; therefore, development of a therapeutic strategy that improves their prognosis is necessary. Herein, we searched data collected from medical facilities throughout Japan for drugs that improve the survival rate of cardiac arrest patients. Candidate drugs, which could improve the prognosis of cardiac arrest patients, were extracted using “TargetMine,” a drug discovery tool. We investigated whether the candidate drugs were among the drugs administered within 1 month after cardiac arrest in data of cardiac arrest cases obtained from the Japan Medical Data Center. Logistic regression analysis was performed, with the explanatory variables being the presence or absence of the administration of those candidate drugs that were administered to ≥10 patients and the objective variable being the “survival discharge.” Adjusted odds ratios for survival discharge were calculated using propensity scores for drugs that significantly improved the proportion of survival discharge; the influence of covariates, such as patient background, medical history, and treatment factors, was excluded by the inverse probability-of-treatment weighted method. Using the search strategy, we extracted 165 drugs with vasodilator activity as candidate drugs. Drugs not approved in Japan, oral medicines, and external medicines were excluded. Then, we investigated whether the candidate drugs were administered to the 2,227 cardiac arrest patients included in this study. The results of the logistic regression analysis showed that three (isosorbide dinitrate, nitroglycerin, and nicardipine) of seven drugs that were administered to ≥10 patients showed significant association with improvement in the proportion of survival discharge. Further analyses using propensity scores revealed that the adjusted odds ratios for survival discharge for patients administered isosorbide dinitrate, nitroglycerin, and nicardipine were 3.35, 5.44, and 4.58, respectively. Thus, it can be suggested that isosorbide dinitrate, nitroglycerin, and nicardipine could be novel therapeutic agents for improving the prognosis of cardiac arrest patients

Abrupt rotation of the rashba spin to the direction perpendicular to the surface

金沢大学理工研究域数物科学系The polarization vector of the Rashba spin, which must be parallel to the two-dimensional (2D) plane in an ideal system, is found to change abruptly and definitely to the direction perpendicular to the surface at the K̄ point of the Brillouin zone of a real hexagonal system, the Tl/Si(111)-(1×1) surface. This finding obtained experimentally by angle-resolved and spin-resolved photoemission measurements is fully confirmed by a first-principles theoretical calculation. We found that the abrupt rotation of the Rashba spin is simply understood by the 2D symmetry of the hexagonal structure. © 2009 The American Physical Society

食生活の多様性とうつ病および自殺の有病率との関連 ―26年間の国際比較研究―

Purpose: This study aimed to determine the associations of dietary diversity with depression and suicide rates by an ecological analysis using 26-years worldwide statistics.Methods: Average food supply and energy supply by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database (FAOSTAT). Dietary diversity scores were calculated from food group classifications. Age-standardized depression prevalence and suicide rates per 100,000 people by country were obtained from the Global Burden of Disease (GBD) 2017 database. The association between food diversity scores and depression prevalence and suicide rates was analyzed by a mixed effects model controlling for covariates in 137 countries with populations of 1 million or greater.Results: A significant negative association was found in the analysis of the relationship between dietary diversity and the prevalence of major depression in the model controlled for all covariates [β (se) = –225.6 (61.9), p < 0.001]. In addition, a significant negative association between dietary diversity and the suicide rate was also found in the model controlled for all covariates [β (se) = –3.08 (1.50), p < 0.05].Conclusion: Dietary diversity was significantly negatively associated with the rates of major depression and suicide. Diets rich in foods may reduce the prevalence of depression and suicide rate.【目的】本研究は、26年間の世界的な統計を用いた生態学的分析により、食生活の多様性とうつ病や自殺率との関連を明らかにすることを目的とした。【方法】生産と家庭間の喪失を除く国別平均食料供給量とエネルギー供給量を国連食糧農業機関統計局データベース（FAOSTAT）から入手した。食物群分類から食事多様性スコアを算出した。年齢標準化された国別の人口10万人当たりのうつ病有病率と自殺率は、Global Burden of Disease（GBD）2017データベースから取得した。人口100万人以上の137カ国を対象に、食品多様性スコアとうつ病有病率および自殺率との関連を、共変量を制御した混合効果モデルで解析した。【結果】食生活の多様性とうつ病の有病率との関係を分析したところ、すべての共変量を調整したモデルにおいて、有意な負の関連が認められた［β（se）＝－225.6（61.9）、p < 0.001］。さらに、食生活の多様性と自殺率との間の有意な負の関連も、すべての共変量を調整したモデルで認められた［β（se）= －3.08（1.50）、p < 0.05］。【結論】食生活の多様性は、うつ病および自殺の発生率と有意に負の関連があった。食物を豊富に含む食事は、うつ病や自殺を減少させる可能性がある

Pretreatment glasgow prognostic score predicts survival among patients administered first-line atezolizumab plus carboplatin and etoposide for small cell lung cancer

BackgroundThere are no established predictive biomarkers for the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with small-cell lung cancer (SCLC). Therefore, the current study aimed to investigate whether the Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio (NLR), and body mass index (BMI) can predict the effectiveness of first-line atezolizumab plus carboplatin and etoposide therapy in patients with extensive-disease SCLC.MethodsWe reviewed data from 84 patients who received first-line atezolizumab plus carboplatin and etoposide therapy for SCLC at nine Japanese institutions between August 2019 and May 2021. Further, we evaluated the prognostic value of the GPS, NLR, and BMI. The Kaplan–Meier and Cox proportional hazard models were used to examine differences in progression-free survival (PFS) and overall survival (OS). Moreover, the GPS, NLR, and BMI consisted of C-reactive protein and albumin concentrations, neutrophil and lymphocyte counts, and body weight and height, respectively.ResultsThe response rate was 72.6% (95% confidence interval: 63.0–82.1%). The median PFS and OS from the initiation of treatment were 5.4 (95% CI: 4.9–5.9) months and 15.4 (95% CI: 11.4–16.8) months, respectively. The GPS independently predicted the effectiveness of first-line atezolizumab plus carboplatin and etoposide treatment, as a favorable GPS (GPS 0–1) was correlated with significantly better PFS and OS rates compared to a poor GPS (GPS 2) (PFS: 5.8 vs. 3.8 months, p = 0.0005; OS: 16.5 vs. 8.4 months, p&lt;0.0001).ConclusionsThis is the first analysis to evaluate the association between the GPS, NLR, and BMI and the treatment effectiveness of survival among patients receiving first-line atezolizumab plus carboplatin and etoposide therapy for SCLC. Among patients receiving this treatment for SCLC, GPS was significantly associated with the PFS and OS rates, suggesting that GPS might be useful for evaluating therapeutic outcomes in these patients

Canonical versus non-canonical transsynaptic signaling of neuroligin 3 tunes development of sociality in mice

社会性の発達を調節する新たな機構を発見. 京都大学プレスリリース. 2021-03-26.Neuroligin 3 (NLGN3) and neurexins (NRXNs) constitute a canonical transsynaptic cell-adhesion pair, which has been implicated in autism. In autism spectrum disorder (ASD) development of sociality can be impaired. However, the molecular mechanism underlying NLGN3-mediated social development is unclear. Here, we identify non-canonical interactions between NLGN3 and protein tyrosine phosphatase δ (PTPδ) splice variants, competing with NRXN binding. NLGN3-PTPδ complex structure revealed a splicing-dependent interaction mode and competition mechanism between PTPδ and NRXNs. Mice carrying a NLGN3 mutation that selectively impairs NLGN3-NRXN interaction show increased sociability, whereas mice where the NLGN3-PTPδ interaction is impaired exhibit impaired social behavior and enhanced motor learning, with imbalance in excitatory/inhibitory synaptic protein expressions, as reported in the Nlgn3 R451C autism model. At neuronal level, the autism-related Nlgn3 R451C mutation causes selective impairment in the non-canonical pathway. Our findings suggest that canonical and non-canonical NLGN3 pathways compete and regulate the development of sociality