The Development of a Conceptual Understanding of a Sustainable Society in Home Economics Education

To promote a concept-based curriculum in home economics aimed at fostering versatile skills, we clarifi ed the subject-specific perspectives that home economics addresses and the qualities and abilities required in home economics. The research method involved obtaining suggestions on how home economics can be involved in realizing well-being in a sustainable society. Next, we organized the qualities and abilities required in home economics based on a conceptual understanding. Finally, we identified paths for a home economics curriculum to formulate a conceptual understanding. We identified the following four directions to introduce a concept-based curriculum in home economics: (1) Design a curriculum with the pursuit of well-being as the subject axis. (2) Develop a curriculum that takes the family and home as its starting point and expands the idea of transferability to a sustainable society. (3) Consider the learning content and difficulty level of questions according to each student’s developmental stage. (4) Inquiry-based learning that draws out students’ interests and concerns should be actively incorporated. The promotion of a conceptual curriculum allows for the development of curriculum management with competency-based, cross-curricular learning.本研究は，文部科学省科学研究費助成事業（基盤研究(C) 課題番号22K02524，代表者 竹下浩子）の研究助成を受けて行った

The Characteristics of Apathy in University Students and Issues in Education The Effect on Clinical Training of Attitude and Results (GPA) Prior to Clinical Training, and Forecast Training Results

Background: In recent years, the apathetic attitude of students has been a frequent problem in clinical training. Objectives: To consider the effects on students' results for the clinical training element of their course of their attitude and grade point average (GPA) prior to clinical training, and to examine educational issues within the university. Method: The study focused on 43 fourthyear students in this university's Department of Occupational Therapy. In order to survey students' attitudes and results prior to undertaking clinical training, we looked at three criteria: their GPA at the university prior to clinical training, an Apathy scale and a locus of control. Thereafter, using Spearman rank order correlations and multiple logistic regression analysis, we undertook a comparison, at a significance level of 5%, of the relationship between attitude and results prior to the two eight-week periods of clinical training (Clinical Training III) undertaken by the students. Results: With regard to the training results in the field of mental disability, there was a significant correlation between GPA and Apathy. In particular, those with a sense of physical fatigue and those suffering from a disrupted lifestyle tended to have bad results for their training in this field. In the field of geriatric care as well, there was a significant correlation where those with a disrupted lifestyle were concerned. On the other hand, unlike in other fields, results for training in the field of physical disability showed a significant correlation with regard to lack of effort. Looking at the training by period, GPA had an effect on results for the first period of training, but no correlation was seen with regard to results for the second period. On the other hand, the locus of control and Apathy total were related to results for the second period of training. Multiple logistic regression analysis showed us that it was possible to predict the probability that results for training in the field of mental disability would be in the lower two groups from the rise in the total for lifestyle disruption prior to clinical training (odds ratio 2.40; 95% confidence interval, 1.03～5.57, p=0.04). Furthermore, we discovered that it was possibly to predict the probability that results for training in the field of mental disability would be in the top group from the rise in the total for physical fatigue prior to clinical training (odds ratio 0.62; 95% confidence interval, 0.40～0.95, p=0.03). Conclusions: Items where there was a correlation with clinical training results can generally be said to be expressions of attitude or drive. In other words, even if the low expression of attitude or drive can be covered up in the first period of training by academic work completed prior to the training, it is likely that a apathetic attitude will have an effect on results for clinical training during the second period. The point on which we would particularly like to focus is the fact that, based on the results of multiple logistic regression analysis, we were able to calculate that it was possible to predict results for training in the field of mental disability from the totals for lifestyle disruption and physical fatigue prior to clinical training

タンノウ テキシュツジュツ デ チュウイ スベキ タンカン ソウコウ イジョウ Cystohepatic duct ノ 1レイ

　A 74-year-old man presented with epigastralgia and was diagnosed as having cholelithiasis. Endoscopic retrograde cholangiopancreatography (ERCP) initially visualized the cystic duct with the Heister valve from the common bile duct, and then two intra-hepatic biliary ducts of segment 5 (B5) were visualized from the neck of the gallbladder. There was a contrast medium filling defect in B5, which was considered to be due to an incarcerated stone. Magnetic resonance cholangiopancreatography (MRCP) and three-dimensional computed tomography (CT) cholangiography showed similar findings, suggesting that the patient had a biliary anomaly of the cystohepatic duct in which two intrahepatic bile ducts (B5) flowed into the neck of the gallbladder and a stone incarcerated in the neck of the gallbladder.　At surgery, during mobilization of the gallbladder, there was a thick string between the liver and the gallbladder, and this was considered to be the junction of B5 with the gallbladder. Therefore, the neck of the gallbladder was cut, and an incarcerated stone 10 mm in diameter was removed. Intraoperative cholangiography revealed that the cystohepatic ducts were preserved. The postoperative course was uneventful and there was no bile leakage or liver dysfunction.　Although cystohepatic duct is a rare biliary anomaly, the surgeon should be alert for its possible presence during cholecystectomy. When cholecystectomy is scheduled, more than one preoperative examination by three-dimensional CT cholangiography, MRCP or ERCP should be performed, and the surgeon should be careful not to overlook any biliary anomaly.　Keywords: cystohepatic duct, biliary duct anomaly, cholecystectomy, three-dimensional computed tomography, gallston

Tumor necrosis factor-α-induced production of plasminogen activator inhibitor 1 and its regulation by pioglitazone and cerivastatin in a nonmalignant human hepatocyte cell line

金沢大学大学院医学系研究科環境社会医学Plasminogen activator inhibitor 1 (PAI-1) is an important mediator of atherosclerosis and liver fibrosis in insulin resistance. Circulating levels of PAI-1 are elevated in obese individuals, and PAI-1 messenger RNA is significantly higher in the livers of obese type 2 diabetic individuals than in nonobese type 2 diabetic individuals. To address the mechanism underlying the up-regulation of hepatic PAI-1 in obesity, we tested the effects of tumor necrosis factor α (TNF-α), an important link between obesity and insulin resistance, on PAI-1 production in the nonmalignant human hepatocyte cell line, THLE-5b. Incubation of THLE-5b cells with TNF-α stimulated PAI-1 production via protein kinase C-, mitogen-activated protein kinase-, protein tyrosine kinase-, and nuclear factor-κB-dependent pathways. A thiazolidinedione, pioglitazone, reduced TNF-α-induced PAI-1 production by 32%, via protein kinase C- and nuclear factor-κB-dependent pathways. The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor cerivastatin inhibited TNF-α-induced PAI-1 production by 59%, which was reversed by coincubation with mevalonic acid. In conclusion, obesity and TNF-α up-regulation of PAI-1 expression in human hepatocytes may contribute to the impairment of the fibrinolytic system, leading to the development of atherosclerosis and liver fibrosis in insulin-resistant individuals. A thiazolidinedione and a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor may thus be candidate drugs to inhibit obesity-associated hepatic PAI-1 production. © 200

Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy

Introduction: Several studies have shown that statins suppress the progression of diabetic nephropathy. However, few reports have directly compared the renoprotective effects between potent and conventional statins. Materials and Methods: Patients with diabetic nephropathy, selected as those with a serum creatinine level of 0.9-1.5 mg/dL and simultaneously having either microalbuminuria or positive proteinuria, were randomly assigned to one of three groups: a conventional diet therapy group, a group given 10 mg of pravastatin and a group given 10 mg of atorvastatin. Renal function was evaluated before and after a 12-month period of therapy. Results: The atorvastatin group had a significant decrease in low-density lipoprotein cholesterol at 3 months and thereafter compared with the other groups. The urinary albumin-to-creatinine ratio significantly decreased in the atorvastatin group; the degree of this decrease was significantly greater than that in the diet therapy group. The kidney function estimated with cystatin C (CysC) and the estimated glomerular filtration rate calculated from CysC were significantly preserved in the atorvastatin group compared with the pravastatin group. In a multivariate regression analysis, the use of atorvastatin was the only explanatory variable for the changes in CysC; this was independent of changes in low-density lipoprotein cholesterol. Conclusions: Atorvastatin is more effective than pravastatin for the prevention of increase in CysC, and this renoprotective effect was considered to a result of the pleiotropic effect of atorvastatin independent of its lipid-lowering effect. This study was registered with UMIN (no. UMIN 000001774). © 2014 The Authors

Sitagliptin versus mitiglinide switched from mealtime dosing of a rapid-acting insulin analog in patients with type 2 diabetes: a randomized, parallel-group study

Purpose We determined the feasibility of substituting sitagliptin or mitiglinide for bolus insulin injection therapy in patients with type 2 diabetes. Methods 60 patients with type 2 diabetes were enrolled and randomized to switch from mealtime dosing of a rapid-acting insulin analog to either sitagliptin or mitiglinide for 16 weeks. Results Body weight, body mass index, and waist circumference decreased significantly in both groups at the end of the study. Mitiglinide significantly increased fasting plasma glucose (FPG) levels at the end of the study from 146.5±36.3 to 168.0±38.8 mg/dL, whereas sitagliptin did not affect FPG. Glycated hemoglobin (HbA1c) and 1,5-anhydroglucitol increased significantly in both groups. The C peptide immunoreactivity (CPR) responses after arginine were diminished in both groups. γ-GTP and triglycerides increased, and high-density lipoprotein cholesterol and adiponectin decreased, in the sitagliptin group, but not in the mitiglinide group. Mean Diabetes Treatment Satisfaction Questionnaire scores improved significantly in both groups. Patients whose mean total daily doses of rapid-acting insulin analog were 16.6 and 17.8 units were switched to sitagliptin and mitiglinide, respectively, without a change in the HbA1c level. Total insulin doses/body weight predicted changes in HbA1c only in the sitagliptin group, but not in the mitiglinide group. Use of >0.27 IU/kg of a rapid-acting insulin analog predicted an increase in HbA1c after switching to sitagliptin. The CPR index (CPI) was also a predictor for a change in HbA1c in the sitagliptin group, but not in the mitiglinide group; patients with a CPI<1.4 developed a worse HbA1c after switching to sitagliptin. Conclusions Sitagliptin may predominantly act on FPG, whereas mitiglinide may act on postprandial plasma glucose to achieve glycemic control after switching from a bolus insulin regimen. Additional therapy to sitagliptin or mitiglinide is clearly required to obtain equivalent glycemic control in patients using a higher dose of insulin

Pharmacokinetics and pharmacodynamics of insulin aspart in patients with Type 2 diabetes: Assessment using a meal tolerance test under clinical conditions

Few studies have evaluated the pharmacokinetics of rapid-acting insulin analogues in patients with Type 2 diabetes, especially under clinical conditions. The aim of the present study was to assess both the pharmacokinetics and pharmacodynamics of insulin aspart in Type 2 diabetic patients who were being treated with the analogue alone. Meal tolerance tests with and without self-injection of a customary dose of insulin aspart (0.05-0.22 U/kg) were conducted in 20 patients in a randomized cross-over study. The dose of insulin aspart (per bodyweight) was significantly correlated with both the maximum concentration (r 2 = 0.59; P < 0.01) and area under the concentration-time curve for insulin aspart (r 2 = 0.53; P < 0.01). However, the time to maximum concentration (T max), which varied widely from < 60 to ≥ 120 min, was not associated with either dosage (r 2 = 0.02; P = 0.51) or body mass index (r 2 = 0.02; P = 0.57). Injection of insulin aspart exacerbated delayed hyperinsulinaemia after meal loading, mainly in patients with T max ≥ 120 min. With regard to pharmacodynamics, insulin aspart had favourable effects on postprandial hyperglycaemia, hyperglucagonaemia and hyperlipidaemia. The T max for this insulin analogue differed greatly between individuals and delayed hyperinsulinaemia was particularly exacerbated in patients with higher T max values. Identification of the factors contributing to interindividual variation in the absorption lag time is essential for improving the efficacy and safety of insulin aspart. © 2012 The Authors. Clinical and Experimental Pharmacology and Physiology © 2012 Blackwell Publishing Asia Pty Ltd

Ubiquitous occurrence of sulfonamides in tropical Asian waters.

Seven sulfonamides, trimethoprim, five macrolides, lincomycin and three tetracyclines were measured in 150 water samples of sewage, livestock and aquaculture wastewater, and river and coastal waters, in five tropical Asian countries. The sum of the concentrations of the target antibiotics in sewage and heavily sewage-impacted waters were at sub- to low-ppb levels. The most abundant antibiotic was sulfamethoxazole (SMX), followed by lincomycin and sulfathiazole. The average concentration of SMX in sewage or heavily sewage-impacted waters was 1720 ng/L in Vietnam (Hanoi, Ho Chi Minh, Can Tho; n = 15), 802 ng/L in the Philippines (Manila; n = 4), 538 ng/L in India (Kolkata; n = 4), 282 ng/L in Indonesia (Jakarta; n = 10), and 76 ng/L in Malaysia (Kuala Lumpur; n = 6). These concentrations were higher than those in Japan, China, Europe, the US and Canada. A predominance of sulfonamides, especially SMX, is notable in these tropical countries. The higher average concentrations, and the predominance of SMX, can be ascribed to the lower cost of the antibiotics. Both the concentration and composition of antibiotics in livestock and aquaculture wastewater varied widely. In many cases, sulfamethazine (SMT), oxytetracycline (OTC), lincomycin, and SMX were predominant in livestock and aquaculture wastewater. Both human and animal antibiotics were widely distributed in the respective receiving waters (i.e., the Mekong River and Manila Bay). SMT/SMX ratios indicate a significant contribution from livestock wastewater to the Mekong River and nearby canals, with an estimated ~ 10% of river water SMX derived from such wastewater. Mass flow calculations estimate that 12 tons of SMX is discharged annually from the Mekong River into the South China Sea. Riverine inputs of antibiotics may significantly increase the concentration of such antibiotics in the coastal waters

The Catalytic Activity of Solid Acids for the Mutarotation of α-D-Tetramethylglucose in Benzene Solution

Not

A case of scarred uterine rupture at 11 weeks of gestation having a uterine scar places induced by in vitro fertilization-embryo transfer

Having a uterine scar places a woman at increased risk of complications, such as Cesarean scar pregnancy (CSP), uterine rupture, placenta previa, and placenta accreta, in subsequent pregnancies. We report a case of uterine rupture at 11 weeks of gestation in a woman with a previous Cesarean section. A 43-year-old woman with a history of abdominal myomectomy and Cesarean section had her pregnancy induced by in vitro fertilization with donor eggs. The exact location of the gestational sac was identified on her first day of hospitalization, and her pregnancy was suspected to be a CSP. The following day, the patient complained of sudden lower abdominal pain. A uterine scar rupture was diagnosed, and an emergency surgery was required. It may be that first-trimester screening could allow the early recognition of patients at risk for these perinatal complications