知的障害の軽い子どもの教育的能力診断の開発と実践による検証

金沢大学教育学部本研究の内容は、子どもの能力の評価・測定にかかわる部分と実際の指導にかかわる部分とからなる。評価・測定に関しては、運動系・感覚系・言語系に関して検討を加えた。特に、運動系と言語系の評価を有機的に結びつける試みとして、立ち幅跳び等の運動行動について、言語教示のみに基づいて行う場合と、目標点を提示して行う場合とで測定が行われた。その結果、まず、一般的には、目標点を提示して測定を行うほうが、高い成績が得られることが示された。一方、同時に計測した言語の行動調整に関する成績と、教示のみに基づいて行う場合と目標点を提示して行う場合の成績の差異との関係を検討したところ、その差には言語による行動調整がどの程度可能であるかということがきわめて密接に関係しており、それが、不十分な場合ほど、その差は大きいことが明らかになった。しかし、言語による行動調整が不十分な場合でも本来の運動能力が低いと考えられる場合(たとえば、ダウン症児)には、目標点であっても必ずしも高い成績は引き出しえないことも示された。実際の指導法に関して特に注目すべき知見として得られたものを挙げると、まず、吃音を示す年長幼児に遊戯的にかかわりながら行う発話モデリングを意識した指導から、発話モデリングは、3-4歳の年少の幼児の場合には効果的であるものの、年長幼児の場合には必ずしも効果的ではないことが示された。また、自己中心的行動などの不適切行動を示す学習障害児に対する指導からは、自分以外の人間が示す自己中心的行動を観察させ、その評価を求めたり、自己中心的行動をしめす人物が登場する劇を演じたりすることで、不適切行動の減少が生じ、自己の対象化並びに意識化を促すような働きかけ・指導の重要性が示された。研究課題/領域番号:08680276, 研究期間(年度):1996出典：研究課題「知的障害の軽い子どもの教育的能力診断の開発と実践による検証」課題番号08680276（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-08680276/）を加工して作

Case report: Recovery from refractory myasthenic crisis to minimal symptom expression after add-on treatment with efgartigimod

Myasthenic crisis, a life-threatening exacerbation of myasthenia gravis, is a significant clinical challenge, particularly when refractory to standard therapies. Here, we described a case of myasthenic crisis in which the patient transitioned from refractory myasthenic crisis to minimal symptom expression after receiving add-on treatment with efgartigimod, a novel neonatal Fc receptor antagonist. A 54 years-old woman who was diagnosed with anti-acetylcholine receptor antibody-positive myasthenia gravis experienced respiratory failure necessitating mechanical ventilation. Despite aggressive treatment with plasmapheresis, intravenous immunoglobulins, and high-dose corticosteroids, her condition continued to deteriorate, culminating in persistent myasthenic crisis. Efgartigimod was administered as salvage therapy. Remarkable improvement in neuromuscular function was observed within days, allowing for successful weaning from mechanical ventilation. Over the subsequent weeks, the patient’s symptoms continued to ameliorate, ultimately reaching a state of minimal symptom expression. Serial assessments of her serum anti-acetylcholine receptor antibody titer showed a consistent decline in parallel with this clinical improvement. This case highlights efgartigimod’s potential as an effective therapeutic option for refractory myasthenic crisis, offering new hope for patients facing this life-threatening condition

Crucial role of nitric oxide synthases system in endothelium-dependent hyperpolarization in mice

The endothelium plays an important role in maintaining vascular homeostasis by synthesizing and releasing several relaxing factors, such as prostacyclin, nitric oxide (NO), and endothelium-derived hyperpolarizing factor (EDHF). We have previously demonstrated in animals and humans that endothelium-derived hydrogen peroxide (H2O2) is an EDHF that is produced in part by endothelial NO synthase (eNOS). In this study, we show that genetic disruption of all three NOS isoforms (neuronal [nNOS], inducible [iNOS], and endothelial [eNOS]) abolishes EDHF responses in mice. The contribution of the NOS system to EDHF-mediated responses was examined in eNOS−/−, n/eNOS−/−, and n/i/eNOS−/− mice. EDHF-mediated relaxation and hyperpolarization in response to acetylcholine of mesenteric arteries were progressively reduced as the number of disrupted NOS genes increased, whereas vascular smooth muscle function was preserved. Loss of eNOS expression alone was compensated for by other NOS genes, and endothelial cell production of H2O2 and EDHF-mediated responses were completely absent in n/i/eNOS−/− mice, even after antihypertensive treatment with hydralazine. NOS uncoupling was not involved, as modulation of tetrahydrobiopterin (BH4) synthesis had no effect on EDHF-mediated relaxation, and the BH4/dihydrobiopterin (BH2) ratio was comparable in mesenteric arteries and the aorta. These results provide the first evidence that EDHF-mediated responses are dependent on the NOSs system in mouse mesenteric arteries

The Amelioration of Renal Damage in Skp2-Deficient Mice Canceled by p27 Kip1 Deficiency in Skp2−/− p27−/− Mice

SCF-Skp2 E3 ubiquitin ligase (Skp2 hereafter) targets several cell cycle regulatory proteins for degradation via the ubiquitin-dependent pathway. However, the target-specific physiological functions of Skp2 have not been fully elucidated in kidney diseases. We previously reported an increase in Skp2 in progressive nephropathy and amelioration of unilateral ureteral obstruction (UUO) renal injury associated with renal accumulation of p27 in Skp2−/− mice. However, it remains unclear whether the amelioration of renal injury in Skp2−/− mice is solely caused by p27 accumulation, since Skp2 targets several other proteins. Using Skp2−/−p27−/− mice, we investigated whether Skp2 specifically targets p27 in the progressive nephropathy mediated by UUO. In contrast to the marked suppression of UUO renal injury in Skp2−/− mice, progression of tubular dilatation associated with tubular epithelial cell proliferation and tubulointerstitial fibrosis with increased expression of collagen and α-smooth muscle actin were observed in the obstructed kidneys in Skp2−/−p27−/− mice. No significant increases in other Skp2 target proteins including p57, p130, TOB1, cyclin A and cyclin D1 were noted in the UUO kidney in Skp2−/− mice, while p21, c-Myc, b-Myb and cyclin E were slightly increased. Contrary to the ameliorated UUO renal injure by Skp2-deficiency, the amelioration was canceled by the additional p27-deficiency in Skp2−/−p27−/− mice. These findings suggest a pathogenic role of the reduction in p27 targeted by Skp2 in the progression of nephropathy in UUO mice

Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health

Objective: this study developed a people-centered care (PCC) partnership model for the aging society to address the challenges of social changes affecting people’s health and the new role of advanced practice nurses to sustain universal health coverage. Method: a people-centered care partnership model was developed on the basis of qualitative meta-synthesis of the literature and assessment of 14 related projects. The ongoing projects resulted in individual and social transformation by improving community health literacy and behaviors using people-centered care and enhancing partnership between healthcare providers and community members through advanced practice nurses. Results: people-centered care starts when community members and healthcare providers foreground health and social issues among community members and families. This model tackles these issues, creating new values concerning health and forming a social system that improves quality of life and social support to sustain universal health care through the process of building partnership with communities. Conclusion: a PCC partnership model addresses the challenges of social changes affecting general health and the new role of advanced practice nurses in sustaining UHC.Objetivo: este estudio desarrolló un modelo de alianza para el cuidado centrado en las personas (CCP) para una sociedad envejecida, que haga frente a los retos de los cambios sociales que afectan a la salud de las personas y el nuevo papel de las enfermeras de práctica avanzada para apoyar la cobertura universal de salud. Método: un modelo de alianza para el cuidado centrado en las personas fue desarrollado sobre la base de la meta-síntesis cualitativa de la literatura y la evaluación de 14 proyectos relacionados. Los proyectos en curso dieron lugar a la transformación individual y social mejorando la “alfabetización sanitaria” de la comunidad y los comportamientos, utilizando los cuidados centrados en las personas y aumentando la colaboración entre los profesionales sanitarios y miembros de la comunidad a través de las enfermeras de práctica avanzada. Resultados: el cuidado centrado en las personas comienza cuando los miembros de la comunidad y los profesionales sanitarios ponen en primer plano a la salud y las cuestiones sociales entre los miembros de la comunidad y las familias. Este modelo aborda estas cuestiones, creando nuevos valores relativos a la salud y formando un sistema social que mejora la calidad de vida y el apoyo social para hacer sostenible la atención sanitaria universal a través del proceso de construcción de alianzas con las comunidades. Conclusión: un modelo de alianza para CCP responde a los desafíos de los cambios sociales que afectan a la salud en general y al nuevo papel de las enfermeras de práctica avanzada en el sostenimiento de la Cobertura Universal en Salud (CUS).Objetivo: o estudo desenvolveu um modelo de parceria de cuidados centrados nas pessoas (CCP) para uma sociedade que está envelhecendo, com o fim de enfrentar os desafios das mudanças sociais que afetam a saúde das pessoas e o novo papel da prática avançada de enfermagem para sustentar a cobertura universal de saúde. Método: um modelo de parceria de cuidados centrados nas pessoas foi desenvolvido com base na meta-síntese qualitativa da literatura e a avaliação de 14 projetos relacionados. Os projetos em curso resultaram na transformação individual e social, melhorando a alfabetização de saúde da comunidade e comportamentos que usam o cuidado centrado nas pessoas e aumentando a parceria entre os profissionais de saúde e membros da comunidade por meio da prática avançada de enfermagem. Resultados: o cuidado centrado nas pessoas começa quando os membros da comunidade e os profissionais de saúde colocam em primeiro plano as questões sociais entre os membros da comunidade e das famílias. Esse modelo aborda essas questões, a criação de novos valores relativos à saúde e forma um sistema social que melhora a qualidade de vida e dá apoio social para sustentar o sistema de saúde universal por meio da construção de parcerias com as comunidades. Conclusão: um modelo de parceria CCP aborda os desafios das mudanças sociais que afetam a saúde geral e o novo papel das enfermeiras de prática avançada em sustentar a UHC

絶食時の持久力トレーニングが骨格筋重量及びその他臓器組織重量に及ぼす影響

This experiment considered the influence on the weight of body organs, when endurancetraining was performed by a fasting state without ingestion of a nutrient. Female ICR mice (27.2g ~ 36.7g weight)were used. These mice were classified into four groups shown below, with five animals in each group. (1) Food intake and training group, (2) Food intake and nontraining group (3) non-food intake and training group (4) non-food intake and non- training group. The experiment was conducted for four days. The mice were kept in individual cages at a room temperature of 24℃. Drinking water was given freely. Four days later, mice weresacrificed by blood removal under anesthesia, and then each of the organs and tissues were collected from each mouse. Each weight was measured by electromagnetism type measure. Endurance exercise was performed using a mouse device rotating momentum. Measurement of momentum was made of a fixed time every day and the mileage was calculated. As a result ofobserving the influence which it has on weight in each internal-organ of body, the influence by a meal reflected the weight of internal organs strongly. Both a meal and movement influenced the weight of the soleus muscle. In the case of plantaris, it was the same as that of a soleus muscle. However, as for plantaris, as compared with the soleus muscle, the influence of a mealwas more strongly observed from comparison of B group and D group. The influence of a meal was reflecting strongly each weight of the heart, kidney, spleen, liver, and fat. Group A lower value indicates the average weight of the spleen when groups B, and A, were compared, statistically significant. Brain weight was not affected by diet and exercise

血液透析患者のセルフケアにつながる見通し構造モデルの作成

Purpose: Hemodialysis patients create perspectives based on their current medical condition, ranging from acute exacerbation or terminal manifestation, and we believe that such perspectives may serve as the foundation of patient self-care. We developed a questionnaire to clarify the aspect of perspective in hemodialysis patients, and aimed to structuralize the relationship between their perspectives and self-care agency (SCAQ) and other associated factors.Method: Based on the chronic illness trajectory framework, we developed a ２５-item questionnaire regarding perspective for patients on hemodialysis, to identify factor structure through exploratory factor analysis. We also used structural equation modeling (SEM) to develop a structural model. Results: We obtained a total of １０４ valid responses. From the questionnaire, １７ out of ２５ items were extracted to develop questions comprising a five-factor structure, with a ６３.９４３% contribution ratio. The five factors included "perspective of uncontrollable sickness" as the first factor, followed by "perspective of getting one\u27s own life back”, "perspective of life going on as a hemodialysis patient", "perspective of maintaining socialization or pastimes”, and " perspective of recovery from sickness”. The structural model consisted of eight items: four factors from the questionnaire, as well as physical symptoms, age, cohabitating individuals, and SCAQ. The measurement of fit had chi-squared value = １５１.７２４ (P-value = ０.０６７), GFI = ０.８６５, AGFI = ０.８１９, CFI = ０.９４３, and RMSEA = ０.０４３, meeting the criteria as a model. Of the five factors, two ("perspective of getting one\u27s own life back" and "perspective of life going on as a hemodialysis patient") showed significant effects on self-care agency. In addition, the factor "perspective of maintaining socialization or pastimes" was demonstrated to enhance those two factors. Discussion: Our findings indicate a relationship between the structural model and the items extracted for effective perspective for self-care in patients on hemodialysis

絶食時のレジスタンストレーニングが骨格筋及びその他臓器組織重量に及ぼす影響

Experiments were conducted as part of research into the nutrition at the time of resistance training. Animals were used 20 female ICR mice. As a muscle hypertrophy model, the tenotomy method which Denny-Brown developed was used. The mice were classified into four groups(five in each group). (1) Food intake and tenotomy group, (2) Food intake and nontenotomy group (3) Non-food intake and tenotomy group (4) Non-food intake and non-tenotomy group The experiment was conducted for five days. The mice were kept in individual cages at a room temperature of 24℃. Drinking water was given freely. Non-food intake group was put on a fast from next day after the tenotomy. Five days later, mice were sacrificed by blood removal under anesthesia, and then each of the organs and tissues were collected from each mouse. As a result of considering the influence of fasting on the hypertrophy rate of a soleusand plantaris muscle, the statistical significant difference between the average value of each muscle weight was not seen.The result compared each organ weight of Food intake and tenotomy group, and non-foodintake and tenotomy group, Significant difference was observed between the mean values of groups, non-food intake and tenotomy group were lower. The result compared each organ weight of Food intake and non-tenotomy group, and non-food intake and non-tenotomy group, significant difference was observed between the mean values of both groups, And non-foodintake and non-tenotomy group were lower. As for brain weight, the significant difference was not seen between the average value of the four groups. Form the above experimental results, the presence of food has not been implicated in skeletal muscle hypertrophy, but the increase or decrease the weight of each organ were found to be significantly involved