Functional Variety of Toka as a Quotative Marker in Conversational Japanese

　Previous studies of quotation in Japanese have mainly focussed on two types of quotative markers: to and tte. This paper demonstrates the function of another quotative marker toka (a combination of the quotative marker to and the question particle ka), as well as quotation that occurs without any marker at all (zero-marking), in conversational Japanese. Dictionaries define both to and tte as particles demonstrating quotation, while toka is defined as an indication of either uncertain imagination or hearsay. However, these differences in dictionary definition do not necessarily reflect how these markers are actually used. I will suggest that toka in actual conversations has two functions: 1) to show the informality of conversations; and 2) to show an event in a narrative, and contrast the event with the peak of the narrative. My analysis of 270 quotations from 19 conversations in Japanese reveals that toka is used 46.3% of the time, almost as often as tte (48.9%). The complementizer to, which is typical in constructed data, occurs far less often (2.2%). Following Hopper\u27s (1987) claim that grammar comes from and is shaped by discourse, I examine the functions of quotative markers with respect to their use in different types of discourse. Toka is frequently used in informal conversations, whereas to is only used in formal conversations. Use of toka is predominant in narrative type conversations, in which one speaker continues to keep the floor, but it is not used for the peak of such narratives. Instead, either tte or zero-marking is used to mark the peak of a narrative. This paper discusses the functions of toka in contrast with the functions of other quotative markers, based on analyses of spontaneous Japanese conversations

Prevention of hypoglycemia by intermittent-scanning continuous glucose monitoring device combined with structured education in patients with type 1 diabetes mellitus : A randomized, crossover trial

Aims: We conducted a randomized, crossover trial to compare intermittent-scanning continuous glucose monitoring (isCGM) device with structured education (Intervention) to self-monitoring of blood glucose (SMBG) (Control) in the reduction of time below range. Methods: This crossover trial involved 104 adults with type 1 diabetes mellitus (T1DM) using multiple daily injections. Participants were randomly allocated to either sequence Intervention/Control or sequence Control/Intervention. During the Intervention period which lasted 84 days, participants used the first-generation FreeStyle Libre (Abbott Diabetes Care, Alameda, CA, USA) and received structured education on how to prevent hypoglycemia based on the trend arrow and by frequent sensor scanning (≥10 times a day). Confirmatory SMBG was conducted before dosing insulin. The Control period lasted 84 days. The primary endpoint was the decrease in the time below range (TBR; <70 mg/dL). Results: The time below range was significantly reduced in the Intervention arm compared to the Control arm (2.42 ± 1.68 h/day [10.1 %±7.0 %] vs 3.10 ± 2.28 h/day [12.9 %±9.5 %], P = 0.012). The ratio of high-risk participants with low blood glucose index >5 was significantly reduced (8.6 % vs 23.7 %, P < 0.001). Conclusions: The use of isCGM combined with structured education significantly reduced the time below range in patients with T1DM

Plasma protein profiling for potential biomarkers in the early diagnosis of Alzheimer’s disease

<p><b>Objectives</b>: Alzheimer’s disease (AD) is the most common cause of dementia in elderly persons. Since the pathology of AD develops slowly from a preclinical or early phase into a fully expressed clinical syndrome, at the time of diagnosis the disease has been progressing for many years. To facilitate the early diagnosis of AD, we performed protein profiling of blood in patients with mild AD as defined by the Functional Assessment Staging (FAST) scale.</p> <p><b>Methods</b>: Plasma samples from mild AD patients and healthy controls were analyzed using two-dimensional differential gel electrophoresis (2D-DIGE) combined with matrix-assisted laser desorption ionization time-of-flight tandem mass spectrometry (MALDI-TOF/TOF/MS) followed by peptide mass fingerprinting.</p> <p><b>Results</b>: Three downregulated proteins were identified: apolipoprotein A-1, alpha-2-HS-glycoprotein, and afamin. Two proteins, including apolipoprotein A-4 and fibrinogen gamma chain, were upregulated in mild AD patients.</p> <p><b>Discussion</b>: Our results suggest that altered expression levels of these proteins in plasma may yield candidate biomarkers for the early diagnosis of AD.</p> <p><b>Abbreviations</b>: AD, Alzheimer’s disease; FAST, Functional Assessment Staging; 2D-DIGE, two-dimensional differential gel electrophoresis; MALDI-TOF/TOF/MS, matrix-assisted laser desorption ionization time-of-flight tandem mass spectrometry; CSF, cerebrospinal fluid; Aβ, amyloid beta; MMSE, Mini Mental State Examination; MRI, magnetic resonance imaging; NINCDS-ADRDA, National Institute for Neurological Diseases and Stroke/Alzheimer’s Disease and Related Disorders Association; CHAPS, 3-((3-cholamidopropyl) dimethylammonio)-1-propanesulfonate; DTT, dithiothreitol; SDS-PAGE, SDS-polyacrylamide gel electrophoresis; DIA, differential in-gel analysis; BVA, biological variation analysis; CBB, Coomassie brilliant blue; 2DE, two-dimensional gel electrophoresis; TFA, trifluoroacetic acid; ACTH, adrenocorticotropic hormone; Apo A-1, apolipoprotein A-1; AHSG, alpha-2-HS-glycoprotein; Apo A-4, apolipoprotein A-4; MCI, mild cognitive impairment.</p