Plasma angiotensin-converting enzyme 2 (ACE2) is a marker for renal outcome of diabetic kidney disease (DKD) (U-CARE study 3)

Introduction ACE cleaves angiotensin I (Ang I) to angiotensin II (Ang II) inducing vasoconstriction via Ang II type 1 (AT1) receptor, while ACE2 cleaves Ang II to Ang (1-7) causing vasodilatation by acting on the Mas receptor. In diabetic kidney disease (DKD), it is still unclear whether plasma or urine ACE2 levels predict renal outcomes or not. Research design and methods Among 777 participants with diabetes enrolled in the Urinary biomarker for Continuous And Rapid progression of diabetic nEphropathy study, the 296 patients followed up for 9 years were investigated. Plasma and urinary ACE2 levels were measured by the ELISA. The primary end point was a composite of a decrease of estimated glomerular filtration rate (eGFR) by at least 30% from baseline or initiation of hemodialysis or peritoneal dialysis. The secondary end points were a 30% increase or a 30% decrease in albumin-to-creatinine ratio from baseline to 1 year. Results The cumulative incidence of the renal composite outcome was significantly higher in group 1 with lowest tertile of plasma ACE2 (p=0.040). Group 2 with middle and highest tertile was associated with better renal outcomes in the crude Cox regression model adjusted by age and sex (HR 0.56, 95% CI 0.31 to 0.99, p=0.047). Plasma ACE2 levels demonstrated a significant association with 30% decrease in ACR (OR 1.46, 95% CI 1.044 to 2.035, p=0.027) after adjusting for age, sex, systolic blood pressure, hemoglobin A1c, and eGFR. Conclusions Higher baseline plasma ACE2 levels in DKD were protective for development and progression of albuminuria and associated with fewer renal end points, suggesting plasma ACE2 may be used as a prognosis marker of DKD.Trial registration number UMIN000011525

キソカンゴガク ジッシュウ 1 2 ニ オケル カンゴギジュツ ノ ケイケンジョウキョウ ト カダイ

背景 看護をめぐる環境は, 急速な少子高齢化の進展, 医療の高度化等により, 大きく変化している. 看護職は, より患者の視点に立った質の高い看護の提供が要求されている. 看護系大学教育においても, 根拠の伴った安全・安楽, 個別性のある看護実践能力の育成が求められている. しかし, 医療の高度化, 入院患者の高齢化等により臨地実習における実習内容が制限される傾向が生じ, 卒業時の看護実践能力の到達度が課題になっている.目的 基礎看護学実習I, IIについて, 看護技術の経験状況を調査・分析し, 看護技術項目の選定について課題を明らかにする.方法 対象は本研究に同意し, 実施状況表を記載した学生40名とした. 各援助技術項目について, 実習別に 「見学」 「一部援助」 「実施」 の3段階に分けて, 単純集計して得た値をパーセンテージで表し比較した.結果および考察 50%以上の学生が経験した援助技術項目は, 基礎看護学実習Iにおいて11項目, IIにおいて23項目であった. 予測していたよりも学生が経験した援助技術項目の割合が少なかった. 今回の結果を参考にして, 基礎看護学実習I, IIにおける援助技術項目の選定を検討することが必要である. 結論 学生が最も経験できた援助技術項目は, 基礎看護学実習Iでは, 【環境調整技術】のであり, IIでは, 【環境調整技術】のと【症状・生体機能管理】のであった. また, すべての学生が未経験の項目は, 13項目あり到達度の高い項目であった. 学生が援助技術の到達度を確認することができるために, 援助技術項目の選定を検討する必要性が示唆された.Background The nursing practice environment has markedly changed due to a rapid decline in fertility, population aging, and advancements in medicine. Nurses are required to provide high-quality care from patients\u27 perspectives. Nursing schools are also required to nurture nurses who have skills to deliver nursing encompassing evidence-based safety, comfort, and individuality. However, the contents of on-site nursing training are currently being reduced due to advances in medicine and the aging of hospitalized patients, impairing practical nursing abilities achieved at graduation.Purpose To investigate/analyze the experience of learning nursing skills in basic nursing practice I and II, and identify issues in selecting the required nursing skills.Methods ubjects were 40 students who agreed to this study, and submitted a list on the basic nursing implementation status. Items of basic nursing skills were divided into 3 stages: "observational learning", "partial participation in the practice", and "total participation in the practice", according to training classes, and they were compared after converting the obtained values to percentages.Results and Discussion The number of basic nursing skill items that were experienced by more than 50% of the students was 11 and 23 in basic nursing practice I and II, respectively. The number of nursing skill items experienced by the students was lower than we had expected. Based on these results, it is necessary to examine the selection of items of basic nursing skills in basic nursing practice I and I

A ダイガク キソカンゴガク ジッシュウ 1 ノ ジッシュウ カテイ ヒョウカ

背景 基礎看護学実習Iでの学生の実習に対する充実感は, 以後の学生生活や看護への思いに大きな影響を与える. また, 学生が, 教員や実習指導者との相互関係の中で, 既習した知識や技術を主体的に実習へ活かすことは, 実習目的を達成するために必要不可欠となる.目的 学生が, 基礎看護学実習Iを効果的に実施するため, 学生の視点で実習過程を評価した結果から今後の課題を抽出する.方法 研究の趣旨に賛同した看護大学1年の学生を対象に, 授業過程評価スケール (看護学実習用) を用いて調査した.結果・考察 実習過程は, 総合的には高い評価といえた. 各下位尺度の平均値で最も低かったのは, 【学生-患者関係】であり, 受持ち患者を持たない実習過程のため, 患者との関係からの学びに満足できなかったと考える. 次に, 【オリエンテーション】【学習内容・方法】が低かった. これは, 学生が, オリエンテーションや既習の学習を実習過程へ具体的に活かす方法を理解できていないと考える.結論:一人の患者を通して実習過程を学べる配慮を行う. 実習を連想させる講義やオリエンテーションを行う. また, 継続した教員と指導者の実習調整が必要である.Background A sense of fulfillments of the student of Fundamental Nursing Practice I has a major influence on student\u27s future.Objective The goal is to improve Fundamental Nursing Practice I from the student\u27s evaluation.Methods A evaluation surveys with clinical practice evaluation. Results/Discussion The mean of [orientation], [learning contents, method] and [student - patient relations] were low. Students are not able to understand how to make use of specifically to the training process, learned and orientation. Conclusions Perform a lecture and orientation to suggest practice and continue adjusting among teacher and nurse

A custom magnetoencephalography device reveals brain connectivity and high reading/decoding ability in children with autism

A subset of individuals with autism spectrum disorder (ASD) performs more proficiently on certain visual tasks than may be predicted by their general cognitive performances. However, in younger children with ASD (aged 5 to 7), preserved ability in these tasks and the neurophysiological correlates of their ability are not well documented. In the present study, we used a custom child-sized magnetoencephalography system and demonstrated that preserved ability in the visual reasoning task was associated with rightward lateralisation of the neurophysiological connectivity between the parietal and temporal regions in children with ASD. In addition, we demonstrated that higher reading/decoding ability was also associated with the same lateralisation in children with ASD. These neurophysiological correlates of visual tasks are considerably different from those that are observed in typically developing children. These findings indicate that children with ASD have inherently different neural pathways that contribute to their relatively preserved ability in visual tasks

カンゴ ダイガク 1ネンジ ニ オケル 「フィジカルアセスメント」 ノジュギョウ ヒョウカ ト カダイ

背景 医療の高度化に伴い,看護師の高い判断能力と医療チームをまとめていく調整能力が求められており,看護学教育では,「フィジカルアセスメント」を強化することが必要とされている.A大学看護学部(以下本学)は,2011年度に開設し,シラバスの調整上「フィジカルアセスメント」は,1年次前期に開講している.また,学生のレディネスに配慮し,「人体の構造と機能」と「フィジカルアセスメント」を関連付けた授業を試みている. 目的 2011年度前期に行った「フィジカルアセスメント」の授業方法と内容,開講時期について検討し,課題を明らかにする.方法 本学1年71名を対象に,研究の倫理的配慮を説明し,承諾の得られた学生に,授業過程評価スケール尺度(看護学講義用)を基に作成した質問紙調査を行った. 質問紙の内容は,授業の展開に関する7項目と学生主体のプレゼンテーションに関する5項目を5段階で評価した.結果 質問紙調査の結果は,授業の展開を問う7項目の平均は,7項目中6項目は3.9以上であった.最も評価が低かったのは,「専門用語に対してわかりやすい説明であった」が,平均3.5であった.学生が主体となって行ったプレゼンテーションに関する評価5項目の平均は,5項目中3項目は3.9 ～ 4.0であった.最も低かったのは「自分の意見を発言できた」3.5で,次に低かったのは「発表後の達成感があった」3.6であった.考察 質問紙調査で授業の展開に関する7項目中6項目が3.9以上であり,授業に興味をしめしていた.プレゼンテーションでは5項目中3項目に3.9以上の結果から,学生のレディネスを考え,「人体の構造と機能」を学生主体のプレゼンテーションとして授業に導入したことで,積極的に事前学習に取り組んだ結果であると考える.また,「人体の構造と機能」を事前学習することで,「フィジカルアセスメント」の学習目標が明確になり,授業の展開に対して肯定的な評価を得た.一方,授業の展開を問う項目の「専門用語に対してわかりやすい説明であった」が3.5と低かったのは,医療の専門用語について十分に学べていない時期であると考えられる.さらに,プレゼンテーションに関する評価の「自分の意見を発言できた」と「発表後の達成感があった」が3.5,3.6と低かったのは,「人体の構造と機能」が「フィジカルアセスメント」の授業に必要であると考えられない学生がいたためだと考える. 結論 本学での「フィジカルアセスメント」を効果的に実施するには,学生のレディネスを考えた開講時期を考慮し,教科書の選定や授業内容を再検討する必要がある.Background Due to the medical advancement,it is now more important than ever to educate the nurses to have the ability to make good judgment,make adjustments quickly,have solid leadership,and perform stronger "physical assessments" in the nursing science education program.Therefore,in 2011 I have added the material on "physical assessments" in the course for,"Human body function and structure",which is a course taught to the first graders in the first trimester. Purpose The goal is to evaluate the "physical assessments" form students in class of 2011 based on their knowledge and performance. Methods A class evaluation survey with a standard evaluation scale( 5 pts scale) was given to all 71 students. The contents of the survey consisted 7 questions of developments of the class and 5 questions about students\u27 presentation with five stages. Results On the survey,6 out of 7 scored higher than 3.9 pts on average for the 7 questions.The lowest scored question was,"The definitions for technical terminology were easy to understand".However,the average score was 3.5.As for the 5 questions,3 out of 5 scored an average of 3.9-4.0 pts.The lowest scored question was," I was able to state my opinion",which scored 3.5 pts.The second lowest question was,"I felt accomplished after doing the presentation" with the score of 3.6 pts. Discussion In overall,the students showed interest in the class "physical assessments ".Students especially showed interest in using the medical instruments.By experimenting with equipment first hand helps the students to gain experience and feel comfortable the tools.Unfortunately,as much as this class was efficient, it seems that teaching "physical assessments" to the first graders is too early.The material for the course is too advanced for many of the students to understand the terminology and lectures.Thus,teaching the course to upper classmen will have a better result and many of the students will be able to absorb the material faster and easier and more likely be able to utilize the new knowledge in the future. Conclusion In 2012,the course "physical assessments" changed from being taught to the first grader to a later semester and the material has been reviewed and adjusted to a first grade level

Lysophosphatidylinositol causes neurite retraction via GPR55, G13 and RhoA in PC12 cells.

GPR55 was recently identified as a putative receptor for certain cannabinoids, and lysophosphatidylinositol (LPI). Recently, the role of cannabinoids as GPR55 agonists has been disputed by a number of reports, in part, because studies investigating GPR55 often utilized overexpression systems, such as the GPR55-overexpressing HEK293 cells, which make it difficult to deduce the physiological role of endogenous GPR55. In the present study, we found that PC12 cells, a neural model cell line, express endogenous GPR55, and by using these cells, we were able to examine the role of endogenous GPR55. Although GPR55 mRNA and protein were expressed in PC12 cells, neither CB(1) nor CB(2) mRNA was expressed in these cells. GPR55 was predominantly localized on the plasma membrane in undifferentiated PC12 cells. However, GPR55 was also localized in the growth cones or the ruffled border in differentiated PC12 cells, suggesting a potential role for GPR55 in the regulation of neurite elongation. LPI increased intracellular Ca(2+) concentration and RhoA activity, and induced ERK1/2 phosphorylation, whereas endogenous and synthetic cannabinoids did not, thereby suggesting that cannabinoids are not GPR55 agonists. LPI also caused neurite retraction in a time-dependent manner accompanied by the loss of neurofilament light chain and redistribution of actin in PC12 cells differentiated by NGF. This LPI-induced neurite retraction was found to be G(q)-independent and G(13)-dependent. Furthermore, inactivation of RhoA function via C3 toxin and GPR55 siRNA knockdown prevented LPI-induced neurite retraction. These results suggest that LPI, and not cannabinoids, causes neurite retraction in differentiated PC12 cells via a GPR55, G(13) and RhoA signaling pathway