Review and considerations for research on resilience: Environmental factors and meaning making

Research in psychology has traditionally focused on individuals experiencing crisis and adversity in an attempt to understand the various mental illnesses resulting from such events. However, in recent years, the importance of individual adaptability has been increasingly emphasized. Resilience, which focuses on the “individual characteristics necessary for recovery” and the “recovery process” has been the subject of much recent research attention. However, because the history of resilience research is relatively short and its definition is not yet unified among researchers, resilience is currently not organized as a comprehensive research field. The current study sought to clarify trends in resilience research in Japan and to clarify future issues and prospects, after examining the various definitions of resilience. Resilience research often regards resilience as a trait necessary for recovery and a process resulting from the interaction of protective factors that are internal and external to the individual. In addition, resilience studies are characterized by considering an individual’s adaptive state and degree of psychiatric dysfunction as indicators of recovery. Resilience research in Japan has often focused on individual characteristics. It is important to examine dynamic interactions between individual and environmental factors, considering social background and the contextual nature of the recovery process. In addition, it may be necessary to capture recovery not only in terms of the degree of symptoms, but also to examine the aspects of recovery of individuals in detail from the perspective of “meaning making”

助産診断技術論演習におけるシミュレーション教育方法の実践報告

　分娩期における助産診断・技術の習得を目指したシミュレーション教育の方法として，模擬患者，シミュレーター，オリジナル教材，映像の活用を組み合わせた助産診断技術論演習の実際について報告する．本演習授業である30コマのうち，分娩期の助産診断・技術に関する演習を12コマ実施した．4コマで1事例の演習を行い，3事例の設定をした．単元の流れは，①事例を提示，②初期診断を行い，ベッドサイドでの情報収集項目を整理，③模擬産婦から情報収集，④アセスメントにより，分娩進行の助産診断および助産ケアの計画立案，ならびにベッドサイドで得る情報項目の確認，⑤模擬産婦へ助産ケアの実施，ならびに情報収集を行う．これら，一連の助産過程を実施し，その場面を撮影して学習教材の一部とした．また，シミュレーターを組み合わせて活用し，作成したオリジナル教材を用いた．その結果，教員からみた学生は，分娩進行やその過程についてイメージを描くことができ，正常経過の分娩進行に対する知識が得られ，助産ケアが実施できたと思われた．また，本演習のシミュレーション教育により，コミュニケーション能力と事例に関する知識，技術の向上が示唆された

肝細胞癌においてmiR125b-5pはAtaxin1による上皮間葉転換を介してソラフェニブ耐性を示す

The mechanism of resistance to sorafenib in hepatocellular carcinoma (HCC) remains unclear. We analyzed miRNA expression profiles in sorafenib-resistant HCC cell lines (PLC/PRF5-R1/R2) and parental cell lines (PLC/PRF5) to identify the miRNAs responsible for resistance. Drug sensitivity, migration/invasion capabilities, and epithelial-mesenchymal transition (EMT) properties were analyzed by biochemical methods. The clinical relevance of the target genes to survival in HCC patients were assessed using a public database. Four miRNAs were significantly upregulated in PLC/PRF5-R1/-R2 compared with PLC/PRF5. Among them, miR-125b-5p mimic-transfected PLC/PRF5 cells (PLC/PRF5-miR125b) and showed a significantly higher IC50 for sorafenib compared with controls, while the other miRNA mimics did not. PLC/PRF5-miR125b showed lower E-cadherin and higher Snail and vimentin expression—findings similar to those for PLC/PRF5-R2—which suggests the induction of EMT in those cells. PLC/PRF5-miR125b exhibited significantly higher migration and invasion capabilities and induced sorafenib resistance in an in vivo mouse model. Bioinformatic analysis revealed ataxin-1 as a target gene of miR-125b-5p. PLC/PRF5 cells transfected with ataxin-1 siRNA showed a significantly higher IC50, higher migration/invasion capability, higher cancer stem cell population, and an EMT phenotype. Median overall survival in the low-ataxin-1 patient group was significantly shorter than in the high-ataxin-1 group. In conclusion, miR-125b-5p suppressed ataxin-1 and consequently induced Snail-mediated EMT and stemness, leading to a poor prognosis in HCC patients.The mechanism of resistance to multikinase inhibitors in hepatocellular carcinoma (HCC) remains unclear. We analyzed miRNA expression profiles in sorafenib-resistant HCC cell lines (PLC/PRF5-R1/R2) and parental cell lines (PLC/PRF5) to identify the responsible miRNAs and target genes involved in the mechanism of resistance. Four miRNAs were significantly upregulated. Among them, we found that miR-125-5p induced sorafenib resistance in HCC cells and in a mouse model. We also revealed that miR-125-5p suppressed ataxin-1 as a target gene and consequently induced Snail-mediated epithelial-mesenchymal transition (EMT) and cancer stemness. Moreover, we demonstrated that ataxin-1 expression has an impact on the prognosis of patients with HCCs. In the future, by comparing the expression status of miR-125b-5p/ataxin-1 and the effect of sorafenib in the clinical setting, it is expected that miR-125b-5p will be established as an effective drug selection marker for treatment selection in patients with HCC

Bevacizumab increases the sensitivity of olaparib to homologous recombination-proficient ovarian cancer by suppressing CRY1 via PI3K/AKT pathway

PARP inhibitors have changed the management of advanced high-grade epithelial ovarian cancer (EOC), especially homologous recombinant (HR)-deficient advanced high-grade EOC. However, the effect of PARP inhibitors on HR-proficient (HRP) EOC is limited. Thus, new therapeutic strategy for HRP EOC is desired. In recent clinical study, the combination of PARP inhibitors with anti-angiogenic agents improved therapeutic efficacy, even in HRP cases. These data suggested that anti-angiogenic agents might potentiate the response to PARP inhibitors in EOC cells. Here, we demonstrated that anti-angiogenic agents, bevacizumab and cediranib, increased the sensitivity of olaparib in HRP EOC cells by suppressing HR activity. Most of the γ-H2AX foci were co-localized with RAD51 foci in control cells. However, most of the RAD51 were decreased in the bevacizumab-treated cells. RNA sequencing showed that bevacizumab decreased the expression of CRY1 under DNA damage stress. CRY1 is one of the transcriptional coregulators associated with circadian rhythm and has recently been reported to regulate the expression of genes required for HR in cancer cells. We found that the anti-angiogenic agents suppressed the increase of CRY1 expression by inhibiting VEGF/VEGFR/PI3K pathway. The suppression of CRY1 expression resulted in decrease of HR activity. In addition, CRY1 inhibition also sensitized EOC cells to olaparib. These data suggested that anti-angiogenic agents and CRY1 inhibitors will be the promising candidate in the combination therapy with PARP inhibitors in HR-proficient EOC

Early support for university students with ADHD tendencies

近年，注意欠如/ 多動性障害（ADHD）の大学生の存在が注目されるようになってきている。ADHD の主症状には，不注意，多動性，衝動性があるが，多動性は成長とともに軽減するため，成人例は小児例と比較して不注意が目立つ傾向が多く，大学生においては，学業不振が顕著となりやすい。ADHD に関する社会的な認知度も少しずつ高まりつつあるが，学生生活に困難さを感じながらも，相談に至らない学生は少なくない。われわれは，大学生を対象にADHD の症状に関するアンケート調査を実施した。不注意さや集中力の困難さ，落ち着きのなさにより，大学生活で困る頻度が高いと回答した学生も多く，ADHD の症状を有する学生の存在も考えられる。ADHD に関する知識を得ることで，ADHD の学生が自分自身の特性の気づきにつながることもあり，学生や教職員に対してADHD の知識や情報の提供，早期の相談を呼びかけていくことが必要であると思われる。Recently, problems in adults with attention-deficit/hyperactivity disorder (ADHD) has been an attention-getting topic in campus mental health. ADHD is characterized by inattention and/or hyperactivity-impulsivity symptoms. Adult ADHD is especially characterized by inattention. Poor academic performance is significant in university students with ADHD. Comorbidities with other psychiatric disorders are common and can lead to further impairments. Social recognition about ADHD is increasing little by little, but there is little consultation from students who are troubled with inattention. In this study, a questionnaire about ADHD was conducted to university students. Many students were troubled by inattention and/or hyperactivity-impulsivity which made their lives difficult. On campus, it would be important to provide the students with appropriate information about ADHD, and to offer them with early support

Considering the support of university students with autistic spectrum characteristics from point of view of resilience

レジリエンスとは，高リスク環境要因に対する抵抗力，あるいはストレスや逆境の克服を意味する。私たちは，自閉症スペクトラム（autism spectrum disorder: ASD）の併存症を発症することへの防御，または適応への回復，という意味でレジリエンスをとらえ，調査を行った。対象は，2015年4月から2017年10月までに当センターに来談した，ASD特性を持つ大学生74名（男子43名，女子31名）である。方法は，併存症，不登校や休学の有無，トラブル等の有無，レジリエンス因子等について検討した。レジリエンス因子としては，保護者や教員，友人のサポート，障害の受容，趣味をもつこと，関係性の希求があげられた。友人のサポートがない学生にトラブルが有意に多く，真面目な学生や趣味を持たない学生に不適応問題が有意に多かった。このことから，レジリエンスを強化する支援としては，サポート環境（特に友人）を整えること，趣味や自分に合ったサークル，バイトをすすめることがポイントであると思われた。Resilience means resistance to high-risk environmental factors or overcoming stress and adversity. We interpreted resilience as a defense against the onset of the comorbidity of autism spectrum disorder (ASD), or recovery to adaptation, and examined it. The subjects were 74 university students with characteristics of ASD (43 men and 31 women) who visited our center from April 2015 to October 2017. We examined such factors as the subjects’ comorbidities, presence or absence at school due to truancy or other short absences, troubles experienced, and resilience factors, which included support by parents, teachers, and friends, acceptance of disabilities, having a hobby, and the desire for a relationship. Students who did not have the support of friends experienced significantly more troubles, and students who were serious or who did not have a hobby had significantly more school absences. Key points in dealing with such students appear to be to support reinforcement of resilience, to arrange a support environment (especially friends), and to recommend hobbies, club activities, and part-time jobs