A Novel Strategy to Reveal the Latent Abnormalities in Human Embryonic Stages from a Large Embryo Collection

The cause of spontaneous abortion of normal conceptuses remains unknown in most cases. The study was aimed to reveal the latent abnormalities by using a large collection of embryo images from a magnetic resonance imaging (MRI) database and novel phase-contrast radiographic computed tomography (PXCT). MRI from 1, 156 embryos between Carnegie stage (CS) 14 and CS23 from the Kyoto Collection were screened by using the volume of the liver as the target organ. Embryos with liver volumes ≥2 SD above or below the mean for the stage of development were screened and examined precisely on MRI. Embryos with potentially abnormal livers were further analyzed by using PXCT. Liver abnormality was detected in all 7 embryos in the extra-small liver group and in 2 of 8 embryos in the extra-large liver group. The abnormalities in the extra-small liver group consisted of hepatic agenesis (2 embryos), hepatic hypogenesis (4), and liver lobe defect (1). Among the 7 extra-small liver group, 2 had only liver abnormalities and 5 exhibited complications in other organs. Of the 2 embryos in the extra-large liver group, one had only a single liver abnormality and the other had a morphologically abnormal liver with complications in other organs. Most of such liver abnormality cases are not survive, as liver function becomes essential. The prevalence of liver malformations in CS18 and CS21 in the intrauterine population of externally normal embryos is approximately 1.7%. The present study is the first step toward the elucidation of the latent abnormalities resulting in spontaneous abortion in externally normal embryos

The postcard intervention against depression among community-dwelling older adults: study protocol for a randomized controlled trial.

[Background]Depression in older adults deteriorates quality of life and increases morbidity, mortality, and medical expenses. Medicine and social policy should work together to decrease this burden. Existing prevention studies are often based on time-consuming psychotherapies, which therefore are not feasible for a wide application at the community level. Postcard interventions have been shown to be effective for patients after hospitalization for major depression, drug overdose, or self-harm. This paper describes the protocol of a pragmatic, randomized controlled trial designed to examine the efficacy of a postcard intervention for depression among community-dwelling individuals aged 65 years or older. [Methods/Design]This is a pragmatic, non-blinded, parallel comparison, randomized controlled trial using Zelen’s design in a community setting. Participants will include community-dwelling older adults (aged 65 years or older) with limited social support (indicated by eating meals alone) and with symptoms of depression (scoring 4 or higher on the 15-item Geriatric Depression Scale (GDS)). The intervention will consist of sending postcards with handwritten messages and seasonal reports from a historical city to participants once a month for eight consecutive months. Self-addressed, stamped envelopes will be enclosed to facilitate non-obligatory replies. Primary outcomes will be changes in the GDS scores that are administered to all elderly inhabitants of the community every year as part of annual health checks. Secondary outcomes include quality of life as measured by a visual analogue scale, and self-rated basic and advanced activities of daily living. We will also examine the subjective sense of effectiveness of the intervention, recollection of the number of intervention mailings received, and the number of mailed replies as the index of the acceptability of the postcard intervention. The time × group interaction for two consecutive years will be analyzed using a generalized linear mixed model. To detect an effect size of 0.5 at alpha error of 0.05 and statistical power of 0.80, 63 participants per group are required. Based on an estimated consent and dropout rate of 70%, a total of 180 subjects will be recruited

Factor structures of a Japanese version of the Geriatric Depression Scale and its correlation with the quality of life and functional ability.

We investigated the 15-item Geriatric Depression Scale (GDS-15) with regard to its factors and, reproducibility, as well as its relationship to activities of daily living, social factors, medical conditions, and quality of life for community-dwelling elderly people in Japan. The study population consisted of 736 community-dwelling elderly participants aged 65 or older. Exploratory factor analysis of the data and correlation coefficients between factors and activities of daily living, quality of life, social factors, and medical conditions were calculated for two consecutive years. The reproducibility of the results was also evaluated. As the result, GDS-15 had three reproducible factors specified as follows: factor I, "energy loss and pessimistic outlook"; factor II, "positive mental status (reversed)"; and factor III, "empty feeling." Comparing our findings with a review of research in this area, positive items (excluding "feel full of energy") seem to compose an universal factor. Factor I correlated best with quality of life, factor II with activities of daily living, and factor III with subjective cognitive function. These results suggest the GDS-15 can be used to assess the functional ability and quality of life, as well as depressive mood in older adults