Causal relations of health indices inferred statistically using the DirectLiNGAM

Causal relations among many statistical variables have been assessed using a Linear non-Gaussian Acyclic Model (LiNGAM). Using access to large amounts of health checkup data from Osaka prefecture obtained during the six fiscal years of years 2012–2017, we applied the DirectLiNGAM algorithm as a trial to extract causal relations among health indices for age groups and genders. Results show that LiNGAM yields interesting and reasonable results, suggesting causal relations and correlation among the statistical indices used for these analyses

Functional expansion of a TCA cycle operon mRNA by a 3′ end-derived small RNA

Global RNA profiling studies in bacteria have predicted the existence of many of small noncoding RNAs (sRNAs) that are processed off mRNA 3′ ends to regulate other mRNAs via the RNA chaperones Hfq and ProQ. Here, we present targets of SdhX (RybD), an Hfq-dependent sRNA that is generated by RNase E mediated 3′ processing of the ∼10 000-nt mRNA of the TCA cycle operon sdhCDAB-sucABCD in enteric bacteria. An in silico search predicted ackA mRNA, which encodes acetate kinase, as a conserved primary target of SdhX. Through base pairing, SdhX represses AckA synthesis during growth of Salmonella on acetate. Repression can be achieved by a naturally occurring 38-nucleotide SdhX variant, revealing the shortest functional Hfq-associated sRNA yet. Salmonella SdhX also targets the mRNAs of fumB (anaerobic fumarase) and yfbV, a gene of unknown function adjacent to ackA. Instead, through a slightly different seed sequence, SdhX can repress other targets in Escherichia coli, namely katG (catalase) and fdoG (aerobic formate dehydrogenase). This study illustrates how a key operon from central metabolism is functionally connected to other metabolic pathways through a 3′ appended sRNA, and supports the notion that mRNA 3′UTRs are a playground for the evolution of regulatory RNA networks in bacteria

LDL-C/HDL-C Ratio Predicts Carotid Intima-Media Thickness Progression Better Than HDL-C or LDL-C Alone

High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) are strong predictors of atherosclerosis. Statin-induced changes in the ratio of LDL-C to HDL-C (LDL-C/HDL-C) predicted atherosclerosis progression better than LDL-C or HDL-C alone. However, the best predictor of subclinical atherosclerosis remains unknown. Our objective was to investigate this issue by measuring changes in carotid intima-media thickness (IMT). A total of 1,920 subjects received health examinations in 1999, and were followed up in 2007. Changes in IMT (follow-up IMT/baseline IMT × 100) were measured by ultrasonography. Our results showed that changes in IMT after eight years were significantly related to HDL-C (inversely, P < 0.05) and to LDL-C/HDL-C ratio (P < 0.05). When the LDL-C/HDL-C ratios were divided into quartiles, analysis of covariance showed that increases in the ratio were related to IMT progression (P < 0.05). This prospective study demonstrated the LDL-C/HDL-C ratio is a better predictor of IMT progression than HDL-C or LDL-C alone

A公立短期大学看護師養成課程卒業生・専攻科修了生の病院における看護実践能力に関する看護管理者の評価

A公立短期大学看護師養成課程卒業生及び専攻科修了生が就職している病院における看護実践能力について、看護管理者の評価を明らかにすることを目的とし、無記名自記式調査を実施した。その結果、全ての項目において平均値3.0以上、23項目中22項目の中央値が4.0（「そう思う（5点）」～「そう思わない（1点）」であり、概ね肯定的であった。看護実践の項目をみると、倫理的実践能力や人間関係形成能力の平均値は高い傾向であり、自己研さん能力や看護職としての自信はやや低い傾向であった。今後の課題として、看護基礎教育における自己研鑽力の育成について強化していく取り組みが必要であることが示唆された

A公立短期大学助産課程修了生の助産実践能力の自己評価と影響する要因

A県内に助産師として就職したA公立短期大学専攻科助産学専攻の修了生（1年課程）について助産実践能力の自己評価の現状と影響する要因について明らかにすることを目的に、無記名自記式質問紙調査を行った。49名からの回答を得（回収率40.5％）、48名分を分析対象とした。厚生労働省の「助産師の卒業時の到達目標と到達度」を用いた助産実践能力の自己評価の得点が高かったのは「母子の命の尊重」1.98（±.51）、「産褥期の診断とケア」1.88（±.50）、「出産・育児期のケア」1.86（±.62）で、低かったのは「ライフステージ各期の性・生殖のケア」0.80（±.52）、「助産業務管理」0.93（±.61）、「地域母子保健におけるケア」1.14（±.52）であった。また、多重ロジスティック回帰分析の結果、助産師実践能力の自己評価は、病床数が少ない（p＜.05）、配偶者がある（p＜.01）が有意に影響し、勤務年数、家族の形態、出産経験、看護師クリニカルラダー制度の影響は認めなかった

[実践報告] A大学成人看護学実習における看護技術経験に関する４年間の継続調査

４年間のＡ大学成人看護学実習における学生の看護技術経験のデータより実際の技術経験状況を明らかにし、成人看護学領域内でどのように構造的に教授していくか教育方略について検討する。【研究方法】調査対象は、Ａ大学看護学部成人看護学実習看護技術経験表とした。技術経験表の各項目を単純集計し、パイロットスタディから本調査第３期の４年間の継続調査の累積計について経験頻度（率）を算出した。事前に研究者の所属する研究機関の研究倫理審査委員会より承認を得た後に実施した。【結果】４年間の継続調査における成人看護学実習終了後の学生289名の技術経験表を分析した。技術経験表から学内演習項目を除外し50％以上経験している項目数の方が経験していない項目数より多い大項目は６つであった。患者・状況特性による項目のうち50％以上経験している項目は、学内演習項目を除外した項目とほぼ同様の結果だった。学内演習項目を除外し50％以上経験していない項目は、排泄援助技術、活動・休息援助技術、呼吸循環を整える技術、褥瘡管理技術、与薬の技術、症状・生体機能管理技術、安全管理技術の７つだった。【考察】現在、臨地実習では学生が多くの看護技術を経験することは難しい。卒後研修である新人看護職員研修も視野に入れ、学士課程において卒業時に担保できる看護技術項目の精選が必要である。そして、看護技術経験の場でもある成人看護学領域における講義や学内演習の充実が求められる。臨地実習では、確実に実施できる看護技術をこれまでの指導者・教員との連携など教育的配慮のもと機会を逃すことなく、学習体験の意味づけを継続していくことが必要である。４年間の研究結果を踏まえ、A大学のDPや成人看護学の独自性を活かした到達目標と臨地実習病院の特徴を踏まえ、現状に合った看護技術内容を精選し、教授していくことが求められる。To determine the actual condition for nursing-skill experiences in adult nursing clinical practices of the students of College A, and to examine how to systematically teach students in the adult nursing education program at the university.[Method] We investigated the results from questionnairs completed by students of the nursing department in College A. We simply tallied the number of each item from the nursing skill experience questionnaire, and worked out the frequency of the experience based on the accumulation in the four-year study. This study was conducted after obtaining the approval from the Research Ethics Review Board of the affi liated research institutions. [Result] We analyzed the skill experience questionnaire of 289 students who finished the clinical practicum for adult nursing in four years. There are thirteen items. We discovered that in off -campus clinical practicum there were six items in which more than 50% of students had those experiences. Items regarding characteristics of patients and situations in which 50% of students had experience were almost the same number as those who attended off-campus clinical practicum.[Consideration] Today, it is diffi cult for students to experience many nursing-skills in clinical practicum. We should carefully select the nursing-skills and secure them in the university program, and consider the training program for new nurses after their graduation. We also should develop improved lectures in adult the nursing education program and on-campus clinical practicum. We should continuously conduct clinical practicum for students to acquire nursingskills in cooperation with the present trainers and teachers. In the light of the four-year study, Diploma Policy of University A and the attainment target of adult nursing education, we need to teach the best nursing-skills suited to the present conditions

[その他] Ａ大学成人看護学実習における看護技術経験の経時的推移

要旨：【研究目的】Ａ大学成人看護学実習のうち急性期実習（成人Ⅰ）と慢性期実習（成人Ⅱ）における３年目にあたる本調査第２期看護技術経験の実際と経時的推移を明らかにする。【研究方法】調査対象は、Ａ大学看護学部成人看護学実習看護技術経験表とした。経験表の各項目は単純集計し、パイロットスタディ、本調査第１期、本調査第２期の３年間の技術経験の推移を表記した。事前に研究者の所属する研究機関の研究倫理審査委員会より承認を得た後に実施した。【結果】成人看護学実習終了後の学生83名の看護技術経験表を分析した。技術経験について成人Ⅰ・成人Ⅱともに50％以上の学生が実施できた項目は、環境調整技術、感染予防の技術、安楽確保の技術であった。３年間の経時的推移は、30％以上の変化があった項目は２項目のみで、他のほとんどの項目は３年間での変化が30％未満であり、変化を認められなかった。【考察】３年間の変化は少なく、これまで教育的介入を行い教員と臨地実習指導者が協力した上で最大限の技術経験を提供し、３年間の経験の水準を保っていると考えられる

島根県西部地区出身看護学生の就職先選択要因に関する調査

島根県西部地区出身の看護学生の就職先選択要因について明らかにすることを目的とし、過去5年間に島根県立大学短期大学部看護学科を卒業した西部地区就職者4名、東部地区就職者9名の合計13名にインタビュー調査を行った。就職先を選択した要因、西部地区の病院に就職しなかった要因、就職先を選択して良かったこと、西部地区への就職率増加につながると思うこと、島根県立大学に求める支援の５つの視点に沿って分析した。その結果から、病院との連携をさらに図りながら現在のキャリア支援を継続していくとともに、卒業後のフォローアップ体制についてもさらに検討していく必要があると考える

Antibacterial tooth surface created by laser-assisted pseudo-biomineralization in a supersaturated solution

A technique for implementing biocompatible and antibacterial functions to a targeted region on tooth surfaces has potential in dental treatments. We have recently demonstrated pseudo-biomineralization, i.e., the growth of an apatite layer on a human dentin substrate by a laser-assisted biomimetic (LAB) process, based on pulsed laser irradiation in a supersaturated CaP solution. In this study, pseudo-biomineralization was induced in the presence of fluoride ions using the LAB process in order to fabricate an antibacterial fluoride-incorporated apatite (FAp) layer on the dentin surface. After processing for 30 min, a micron-thick FAp layer was formed heterogeneously at the laser-irradiated solid-liquid interface via pseudo-biomineralization. A time-course study revealed that the LAB process first eliminated the pre-existing organic layer, while allowing fluoride incorporation into the dentin surface within 1 min. Within 5 min, FAp nanocrystals precipitated on the dentin surface. Within 30 min, these nanocrystals acquired a pillar-like structure that was weakly oriented in the direction normal to the substrate surface to form a dense micron-thick layer. This layer was integrated seamlessly with the underlying dentin without any apparent gaps. The FAp layer exhibited antibacterial activity against a major oral bacterium, Streptococcus mutans. The proposed LAB process is expected to be a useful new tool for tooth surface functionalization via facile and area-specific pseudo-biomineralization

Fluoridated Apatite Coating on Human Dentin via Laser-Assisted Pseudo-Biomineralization with the Aid of a Light-Absorbing Molecule

A simple, area-specific coating technique for fluoridated apatite (FAp) on teeth would be useful in dental applications. Recently, we achieved area-specific FAp coating on a human dentin substrate within 30 min by a laser-assisted biomimetic (LAB) process; pulsed Nd:YAG laser irradiation in a fluoride-containing supersaturated calcium phosphate solution (FCP solution). The LAB-processed, FAp-coated dentin substrate exhibited antibacterial activity against a major oral bacterium, Streptococcus mutans. In the present study, we refined the LAB process with a combination of a dental diode laser and a clinically approved light-absorbing molecule, indocyanine green (ICG). A micron-thick FAp layer was successfully formed on the dentin surface within only 3 min by the refined LAB process, i.e., dental diode laser irradiation in the FCP solution following ICG treatment. The ICG layer precoated on the dentin substrate played a crucial role in inducing rapid pseudo-biomineralization (FAp layer formation) on the dentin surface by absorbing laser light at the solid-liquid interface. In the refined LAB process, the precoated ICG layer was eliminated and replaced with the newly formed FAp layer composed of vertically oriented pillar-like nanocrystals. Cross-sectional ultrastructural analysis revealed a smooth interface between the FAp layer and the dentin substrate. The refined LAB process has potential as a tool for the tooth surface functionalization and hence, is worth further process refinement and in vitro and in vivo studies