Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international5-COOP study.

To measure the use of healthcare services and assistive devices by centenarians in five countries. Cross-sectional study using a survey questionnaire. Community-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark. 1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions. Recent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries. There was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark. Our findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences

The circadian clock is disrupted in mice with adenine-induced tubulointerstitial nephropathy.

Chronic Kidney Disease (CKD) is increasing in incidence and has become a worldwide health problem. Sleep disorders are prevalent in patients with CKD raising the possibility that these patients have a disorganized circadian timing system. Here, we examined the effect of adenine-induced tubulointerstitial nephropathy on the circadian system in mice. Compared to controls, adenine-treated mice showed serum biochemistry evidence of CKD as well as increased kidney expression of inflammation and fibrosis markers. Mice with CKD exhibited fragmented sleep behavior and locomotor activity, with lower degrees of cage activity compared to mice without CKD. On a molecular level, mice with CKD exhibited low amplitude rhythms in their central circadian clock as measured by bioluminescence in slices of the suprachiasmatic nucleus of PERIOD 2::LUCIFERASE mice. Whole animal imaging indicated that adenine treated mice also exhibited dampened oscillations in intact kidney, liver, and submandibular gland. Consistently, dampened circadian oscillations were observed in several circadian clock genes and clock-controlled genes in the kidney of the mice with CKD. Finally, mice with a genetically disrupted circadian clock (Clock mutants) were treated with adenine and compared to wild type control mice. The treatment evoked worse kidney damage as indicated by higher deposition of gelatinases (matrix metalloproteinase-2 and 9) and adenine metabolites in the kidney. Adenine also caused non-dipping hypertension and lower heart rate. Thus, our data indicate that central and peripheral circadian clocks are disrupted in the adenine-treated mice, and suggest that the disruption of the circadian clock accelerates CKD progression

ミトコンドリア DNA ハプロタイプ ブンセキ ニ ヨル グンマケン ツキノワグマ シュウダン ノ イデンテキ タヨウセイ

日本国内でツキノワグマ(Ursus thibetanus)は本州,四国に生息し,現在5地域の個体群が絶滅の恐れのある地域集団とされている。群馬県でもツキノワグマが生息しているが,その捕獲頭数を定めた群馬県ツキノワグマ適正管理計画は,地域集団の構成を考慮しないまま実施されており,このままでは絶滅を招く危険性をはらんでいる。このことから,ツキノワグマの適切な保全を考慮した農林業被害等の防止対策を実施することが,希少野生動物とともに暮らす地域にとって重要な課題といえる。そこで本研究は群馬県ツキノワグマの遺伝的多様性を明らかにするため,群馬県で捕獲されたツキノワグマ30個体のミトコンドリアDNA D-loop領域706bpの配列を決定し,ハプロタイプ分析を行った。その結果,群馬県のツキノワグマから6つのハプロタイプを同定した。これらは先行研究により東日本に生息するツキノワグマで同定された38ハプロタイプのうち,E01, E06, E10, E11, E31, E34に該当した。ハプロタイプの地理的分布および集団構造解析から,群馬県では南西部集団,中之条集団,北東部集団の3集団が存在する可能性が示唆された。群馬県中央部から南東部にかけては平野が広がっており,ツキノワグマの生息は確認されていない。よって群馬県のツキノワグマ3集団は群馬県の西から東へ南西部集団,中之条集団,北東部集団の順に並んで存在していると思われる。つまり,中之条集団の西側で南西部集団と分かれる境界線があり,東側で北東部集団と分かれる境界線が本研究によって想定された。これらは適正管理計画のもとで人為的に設定された地域個体群(越後・三国地域個体群と関東山地個体群)とは異なる境界分布を示しており,今後ツキノワグマの自然集団を繁栄した適切な保全計画を実施するためにも現在の分布境界線を見直していく必要があることを本研究は提唱する。Asiatic black bears living in Gunma Prefecture, Japan, have been divided into two populations (Echigo-Mikuni and Kanto mountain populations) based on the Asiatic Black Bear Population Management Plan. This management plan puts a ceiling on the number of bears captured in each population. However, for convenience, division of the two populations is based on an administrative boundary, and does not represent the natural population structure of this species in Gunma. Accordingly, to clarify the population structure of the species in Gunma, we performed mitochondrial haplotype analysis using 30 individuals captured in the prefecture. We identified six haplotypes, which corresponded to the haplotypes previously discovered in this species in eastern Japan. On the basis of the geographical distribution of the haplotypes and population structure analyses, we suggest that three populations of Asiatic black bear exist in Gunma Prefecture : the Southwestern, Nakanojo, and Northeastern populations. The Nakanojo population appears to be relatively small and genetically unique in Gunma. We identified two borders among these populations. One is situated between the Southwestern and Nakanojo populations, and the second is situated between the Nakanojo and Northeastern populations. These borders clearly differ from the single border drawn between the Echigo-Mikuni and Kanto mountain populations. We conclude that the current management plan does not reflect the natural population structure of these bears and suggest a revision of the plan based on the existence of three discrete populations

Diagnosis of acute myeloid leukemia according to the WHO classification in the Japan Adult Leukemia Study Group AML-97 protocol

We reviewed and categorized 638 of 809 patients who were registered in the Japan Adult Leukemia Study Group acute myeloid leukemia (AML)-97 protocol using morphological means. Patients with the M3 subtype were excluded from the study group. According to the WHO classification, 171 patients (26.8%) had AML with recurrent genetic abnormalities, 133 (20.8%) had AML with multilineage dysplasia (MLD), 331 (51.9%) had AML not otherwise categorized, and 3 (0.5%) had acute leukemia of ambiguous lineage. The platelet count was higher and the rate of myeloperoxidase (MPO)-positive blasts was lower in AML with MLD than in the other WHO categories. The outcome was significantly better in patients with high (≥50%) than with low (<50%) ratios of MPO-positive blasts (P < 0.01). The 5-year survival rates for patients with favorable, intermediate, and adverse karyotypes were 63.4, 39.1, and 0.0%, respectively, and 35.5% for those with 11q23 abnormalities (P < 0.0001). Overall survival (OS) did not significantly differ between nine patients with t(9;11) and 23 with other 11q23 abnormalities (P = 0.22). Our results confirmed that the cytogenetic profile, MLD phenotype, and MPO-positivity of blasts are associated with survival in patients with AML, and showed that each category had the characteristics of the WHO classification such as incidence, clinical features, and OS

Acceptance of care technologies to support activities of daily living by middle-aged and older adults in Japan: A cross-sectional study

10.1016/j.ijnsa.2021.100042International Journal of Nursing Studies Advances310004

Inaccessibility, unresponsiveness, inconsistency, and invisibility of informal caregivers of older persons with cognitive impairment: community-based participatory research

Abstract Background Studies on informal caregivers in Japan have been limited to family caregivers and largely conducted where family caregivers generally gather. Family caregivers who do not visit such places or non-family caregivers are generally overlooked, and data on these informal caregivers remains scant. Consequently, a framework is needed through which healthcare professionals can approach the informal caregivers of community-dwelling older persons. Therefore, this study approaches such informal caregivers and proposes a classification system for them from the starting point of older persons living in the community with cognitive impairment. Methods In 2016, we conducted an epidemiological survey of 7000 + community-dwelling older persons and identified 198 residents with Mini-mental state examination scores less than 23. A team of healthcare professionals contacted them regularly. By 2022, 92 people were still living in the community, and we systematically asked them about their informal caregivers. After approaching the caregivers and obtaining informed consent, we mailed separate questionnaires to older persons and informal caregivers. Results Among the caregivers, 59%, 34%, and 3% were the child, spouse, and sibling of the older person, while the remaining 4% were non-family caregivers. Except for two daughters-in-laws, all children were biological children of the older person. Male caregivers (46%) tended to have full-time jobs, whereas female caregivers (54%) tended to face financial difficulties. Only 3% of the caregivers had joined a family caregivers’ association. Caregivers’ reason for not joining such organizations was a lack of time and knowledge. A 3-tiered classification system was developed for these informal caregivers: (1) the household form, (2) accessibility, and (3) the reciprocal awareness of caregiving. Furthermore, family caregivers who lived with the older person or visited them more than once a week with reciprocal awareness of caring and being cared, or “traditional caregivers,” accounted for 68% of the caregivers in this study. Conclusion Core family caregivers can be easily approached at places where such caregivers generally gather. However, there also exists a group of informal caregivers who are sometimes inaccessible, unresponsive, and invisible to healthcare professionals. Moreover, their awareness of caregiving is sometimes inconsistent