fNIRS-Based Clinical Assessment of ADHD Children

While a growing body of neurocognitive research has explored the neural substrates associated with attention deficit hyperactive disorder (ADHD), an objective biomarker for diagnosis has not been established. The advent of functional near-infrared spectroscopy (fNIRS), which is a noninvasive and unrestrictive method of functional neuroimaging, raised the possibility of introducing functional neuroimaging diagnosis for young ADHD children. In search of a stable and clinically applicable biological marker, here in this chapter, we first discuss a plausible solution to enable the objective monitoring of the acute effects of ADHD medications at the group level. Subsequently, we discuss our successful visualization of differential neural substrates between ADHD and healthy control children for inhibitory control at the individual level, which reached an optimized classification parameter with a value of 85% and a sensitivity of 90%. These findings led us to postulate that fNIRS-based examination would allow the identification of an objective neuro-functional biomarker to diagnose and determine the appropriate treatment for ADHD children. We believe that such a novel technical application would evoke wide interest from neuroimaging researchers

Effects of a high-fat diet on the electrical properties of porcine atria

AbstractBackgroundBecause obesity is an important risk factor for atrial fibrillation (AF), we conducted an animal study to examine the effect of a high-fat diet (HFD) on atrial properties and AF inducibility.MethodsTen 8-week-old pigs (weight, 18–23kg) were divided into two groups. For 18 weeks, five pigs were fed a HFD (HFD group) and five were fed a normal diet (control group). Maps of atrial activation and voltages during sinus rhythm were created for all pigs using the EnSite NavX system. Effective refractory period (ERP) and AF inducibility were also determined. When AF was induced, complex fractionated atrial electrogram (CFAE) mapping was performed. At 18 weeks, hearts were removed for comparing the results of histological analysis between the two groups. Body weight, lipid levels, hemodynamics, cardiac structures, and electrophysiological properties were also compared.ResultsTotal cholesterol levels were significantly higher (347 [191–434] vs. 81 [67–88]mg/dL, P=0.0088), and left atrium pressure was higher (34.5 [25.6–39.5] vs. 24.5 [21.3–27.8]mmHg, P=0.0833) in the HFD group than in the control group, although body weight only increased marginally (89 [78–101] vs. 70 [66–91]kg, P=0.3472). ERPs of the pulmonary vein (PV) were shorter (P<0.05) and AF lasted longer in the HFD group than in the control group (80 [45–1350] vs. 22 [3–30]s, P=0.0212). Neither CFAE site distribution nor histopathological characteristics differed between the two groups.ConclusionsThe shorter ERPs for the PV observed in response to the HFD increased vulnerability to AF, and these electrophysiological characteristics may underlie obesity-related AF

Glucagon-like Peptide-1 Suppresses the Proliferation and Migration of Vascular Smooth Muscle Cells: Implications for Preventive Effects on Atherosclerosis

Our group previously demonstrated the suppressive effect of glucagon-like peptide-1 (GLP-1) on macrophage-driven atherosclerosis in apolipoprotein E-deficient (apoE-/-) mice. In the present study we investigated the suppressive effect of GLP-1 on the atherogenic phenotype of vascular smooth muscle cells (VSMCs) in vivo using apoE-/- mice, and the proliferation and migration of human VSMCs in vitro. A 4-week infusion of GLP-1 in 17-week-old apoE-/- mice significantly reduced the proliferative VSMC phenotype stained with SMemb. Platelet-derived growth factor (PDGF) -BB significantly stimulated the proliferation of human aortic VSMCs by three fold. Both 0.1 and 1nmol/l GLP-1 significantly suppressed the PDGF-induced VSMC proliferation, and this suppressive effect was significantly abolished by the GLP-1 receptor antagonist exendin (9-39) (50nmol/l). The GLP-1 receptor agonists liraglutide (100nmol/l) and exendin-4 (100nmol/l) mimicked GLP-1, significantly suppressing PDGF-induced VSMC proliferation. PDGF-BB significantly stimulated the migration of human aortic VSMCs by 1.7 -fold, and this effect was significantly suppressed by 1nmol/l GLP-1. These findings suggest that GLP-1-related treatments may prevent the progression of atherosclerotic lesions by suppressing the proliferation and migration of VSMCs, which are characteristic features of atherosclerosis

Neurogenic Dumbbell Tumor Resected by Combined Posterior and Thoracoscopic Approaches

The patient was a 51-year-old female with a chief complaint of numbness of the right thigh. A dumbbell tumor compressing the 11th thoracic spinal cord was present in the posterior mediastinum on chest computed tomography and myelography. In surgery, the tumor in the spinal canal was resected by a posterior approach, and the residual tumor was completely excised by thoracoscopic surgery. The tumor measured 78 48 mm, and histopathologically diagnosed as schwannoma. The surgical procedure for neurogenic dumbbell tumors should be decided based on Eden’s classification. For types II and III, such as this patient, excision of the tumor in the spinal canal should be performed to avoid spinal cord damage, followed by thoracoscopic complete resection. Thoracoscopic surgery was applicable even though the tumor was large

Distinct Methylphenidate-Evoked Response Measured Using Functional Near-Infrared Spectroscopy During Go/No-Go Task as a Supporting Differential Diagnostic Tool Between Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder Comorbid Children

Attention deficit/hyperactivity disorder (ADHD) has been frequently reported as co-occurring with autism spectrum disorder (ASD). However, ASD-comorbid ADHD is difficult to diagnose since clinically significant symptoms are similar in both disorders. Therefore, we propose a classification method of differentially recognizing the ASD-comorbid condition in ADHD children. The classification method was investigated based on functional brain imaging measured by near-infrared spectroscopy (NIRS) during a go/no-go task. Optimization and cross-validation of the classification method was carried out in medicated-naïve and methylphenidate (MPH) administered ADHD and ASD-comorbid ADHD children (randomized, double-blind, placebo-controlled, and crossover design) to select robust parameters and cut-off thresholds. The parameters could be defined as either single or averaged multi-channel task-evoked activations under an administration condition (i.e., pre-medication, post-MPH, and post-placebo). The ADHD children were distinguished by significantly high MPH-evoked activation in the right hemisphere near the midline vertex. The ASD-comorbid ADHD children tended to have low activation responses in all regions. High specificity (86 ± 4.1%; mean ± SD), sensitivity (93 ± 7.3%), and accuracy (82 ± 1.6%) were obtained using the activation of oxygenated-hemoglobin concentration change in right middle frontal, angular, and precentral gyri under MPH medication. Therefore, the significantly differing MPH-evoked responses are potentially effective features and as supporting differential diagnostic tools

看護学生による「教職員が育成する人材像に向けて大切にしている関わり」に対する評価

「教職員が育成する人材像に向けて大切にしている関わり」に対する学生による評価の現状を明らかにし、学生に対する教職員の関わりのあり方を検討した。学生による評価が高かったのは、「必要な知識・技術・態度が修得できる環境整備」や「必要な知識・技術・態度が修得できる関わり」、「目標達成に向けた行動の尊重」であり、評価が低かったのは、「人間関係の模範を示している」であった。実習等において教職員と関わる時間や密度の濃さが影響していると考えられた。引き続き、学生と関わる時間の確保や質を高めること、教職員自身が人間性を高め、日頃から学生や教職員同士の接し方を考え人間関係の模範が示せるようにすることが必要である

公立看護大学における学生FD活動の展望

A公立大学看護学部の学生FDメンバー11名に「学生に求められるFD活動」をテーマにラベルの自主提出を求めた。そのラベルを基に「学生とともに進めるFD活動とは」をテーマに類似性に従って分類・命名し、図解した。提出されたラベルは57枚で、21のカテゴリに整理できた。カテゴリおよびカテゴリの関連性から導きだされた図解のイメージは波紋で、「楽しく活動することで、大学を好きになり、学びやすく・働きやすい環境を創ること！」が導き出された。また、カテゴリは内容・方法や意図が交錯し、密接に関わり合っていた。今後は、明らかとなったFD活動を教職員が学生とともに取り組み続けることが重要である

臨地実習における看護技術経験状況 : 1999年度及び2000年度3年次生の「看護技術の実習経験リスト」からの検討

本学では、学生に対し看護への学習意識の動機づけ、及び経験状況の把握を目的とし、平成11年度に「看護技術の実習経験リスト」を作成し、平成11年度及び平成12年度に臨地実習で活用した。今回、「看護技術の実習経験リスト」に記載された学生の自己評価を基に、平成11年度及び12年度の3年次生を対象として、本学の卒業時における看護技術経験状況の実態を調査した。その結果、観察・計測、食事、清潔、排泄など主に生活援助に関わる項目は経験状況が高く、処置、検査時の介助などの項目は未経験である学生が多い傾向であった。また、見学のみ、未経験の学生が多い技術項目は、患者の状態、治療内容が関与するものが多かった。今後、本学の基礎教育における看護技術教育の充実に向けての取り組みが必要であることが示唆された