The 90-day oral toxicity of d-psicose in male Wistar rats

d-Psicose is a rare sugar present in small quantities in natural products. In a previous study, we showed that d-psicose suppresses increase in plasma glucose and reduces body fat accumulation in rats. Based on acute toxicity testing in rats, d-psicose is classified as an ordinary substance (LD50 = 16 g/kg). Elucidating the effects of sub-chronic feeding of d-psicose in rats is essential before it can be utilized as a physiologically functional food. In this study, male Wistar rats (3 weeks old) were fed diets containing 3% d-psicose or sucrose for 90 days. The body weight gain and intra-abdominal adipose tissue weight did not differ between the sucrose and the d-psicose groups. The weights of the liver and kidneys were significantly higher in the d-psicose group than in the sucrose group. However, no gross pathological findings were evident at dietary doses of 3% d-psicose or were correlated with hypertrophy of the liver and kidney. In a clinical chemistry analysis, the erythrocyte and leukocyte courts were significantly higher in the d-psicose group, but that was not considered to be toxicologically significant. Therefore, the present study found no adverse effects of d-psicose in rats fed a diet containing 3% d-psicosefor 90 days

O Conteúdo Essencial do Direito ao Trabalho Sadio e os Limites da Livre Iniciativa: o Caso dos Provadores de Cigarros na Indústria do Tabaco

Propósito – O artigo tem por escopo identificar o conteúdo essencial do direito fundamental ao trabalho sadio em face do princípio da livre iniciativa na atividade dos empregados que atuam como provadores de cigarros na indústria do tabaco. Metodologia/abordagem/design – O problema foi examinado à luz de uma teoria objetiva do conteúdo essencial dos direitos fundamentais conectada com a teoria das garantias institucionais dos direitos fundamentais. Resultados – Considerando os sinais das instituições que conformam o direito fundamental ao trabalho sadio – Organização Mundial da Saúde, ciências médicas, políticas públicas de saúde, Conselho Nacional de Saúde, Assembleia Nacional Constituinte e sua consideração em relação à livre iniciativa no bojo da Constituição Federal de 1988, Organização Internacional do Trabalho – a atividade em questão fere o núcleo de significado do direito ao trabalho sadio. Implicações práticas – Concluiu-se que a atividade dos provadores de cigarros na indústria do tabaco afronta o ordenamento jurídico-constitucional delineado a partir do conteúdo essencial do direito fundamental ao trabalho sadio. Portanto, a atividade deve ser proibida

The saw-tooth sign as a clinical clue for intrathoracic central airway obstruction

BACKGROUND: The saw-tooth sign was first described by Sanders et al in patients with obstructive sleep apnea syndrome as one cause of extrathoracic central airway obstruction. The mechanism of the saw-tooth sign has not been conclusively clarified. The sign has also been described in various extrathoracic central airway diseases, such as in burn victims with thermal injury to the upper airways, Parkinson’s disease, tracheobronchomalacia, laryngeal dyskinesia, and pedunculated tumors of the upper airway. CASE PRESENTATION: A 61-year-old man was referred to our hospital with a two-month history of persistent dry cough and dyspnea. He was diagnosed with lung cancer located in an intrathoracic central airway, which was accompanied by the saw-tooth sign on flow-volume loops. This peculiar sign repeatedly improved and deteriorated, in accordance with the waxing and waning of central airway stenosis by anti-cancer treatments. CONCLUSION: This report suggests that the so-called saw-tooth sign may be found even in intrathoracic central airway obstruction due to lung cancer

ガクシュウシャ ノ キョウドウ ト キョウシ ノ カカワリ ヲ ジュウシ シタ ディスカッション レンシュウ ノ カツドウ デザイン

ディスカッション練習が学習者同士の活動であることに注目し、学習者が主体的に関わり目標を共有して協力すること、また教師がそれを支えることを目指した活動デザインを試みた。具体的には、学習者はディスカッションの前に全員でルールを決める、ディスカッション後に振り返りのための内省シートに記入する、教師はディスカッションの内容を板書する、各自の内省シートにコメントすることにした。実践後の検証から1.ルールがディスカッションへの関与の仕方、日本語の学習目標、人間関係保持の意識化を促し、2.内省シートが学習内容の確認、日本語学習の課題の意識化を学習者に促していたことが明らかになった。さらに3.教師の板書や内省シートへのコメントが議論の要点の把握や学習目標の設定等を促し、この活動を支えていたこともわかった。学習者同士の活動を考える際、教師の関わり方も含めたデザインが重要であることが示唆された。We have attempted to design an activity aiming for active learner participation and cooperation in Japanese class through the sharing of their learning objectives with on another and the provision of effective teacher support. Under this design, learners themselves 1. decide the rules for discussion prior to the practice, 2. fill in a reflection sheet following practice. The teacher 3. writes the points of each learner’s opinions on the whiteboard during practice, and 4. provides feedback to each learner’s reflection. The interviews with the learners reveal that 1. the rules help learners to be conscious of participation in discussion, their own learning objectives, and maintain good relations with classmates. 2. the reflection sheet makes learners conscious of what they learn, and their own problems, and 3. Assistance from the teacher encourages learners to understand discussion points, establish their own goals etc. When conducting learner-learner activities, a design considering teacher engagement is important

ダパグリフロジン投与における肥満２型糖尿病患者の治療満足度への影響：a patient reported outcome study (PRO study).

Background: The benefits of sodium glucose cotransporters 2 (SGLT2) inhibitors in patients with type 2 diabetes mellitus include plasma glucose control, reduction in body weight and blood pressure, and low risk of hypoglycemia, although they may also cause genitourinary infections, polyuria, or volume depletion. It is not clear whether dapagliflozin, an SGLT2 inhibitor, improves treatment satisfaction among patients in a comprehensive way despite the negative side effects. This study assessed the effect of dapagliflozin on glycosylated hemoglobin (HbA1c), body weight, and treatment satisfaction in overweight patients with type 2 diabetes mellitus treated with oral hypoglycemic agents. Methods: This multicenter, open-label, single-arm observational study included patients with type 2 diabetes mellitus administering dapagliflozin 5 or 10 mg per day for 14 weeks. Changes in treatment satisfaction were evaluated using a new version of the Oral Hypoglycemic Agent-Questionnaire (OHA-Q ver. 2) consisting of 23 items. Correlation between treatment satisfaction and HbA1c levels and body weight were analyzed using the Spearman's rank-correlation coefficient. Results: Of the 221 patients enrolled, 188 completed the study. Mean HbA1c decreased from 7.8 ± 0.7% (62.1 ± 7.5 mmol/mol) to 7.3 ± 0.8% (55.9 ± 8.7 mmol/mol) (change - 0.6 ± 0.7%, P < 0.001) and body weight decreased from 82.5 ± 14.6 to 80.7 ± 14.8 kg (change - 2.3 ± 2.8 kg, P < 0.001). OHA-Q ver. 2 was validated as well, the mean OHA-Q ver. 2 total score increased from 44.3 ± 9.4 to 46.6 ± 9.8 (best score 69, worst score 0; change 2.3 ± 6.6, P < 0.001). The change in body weight significantly correlated with the OHA-Q ver. 2 total score (Spearman's ρ = - 0.17, P = 0.035). The change in HbA1c levels significantly correlated with the satisfaction subscale score (Spearman's ρ = - 0.19, P = 0.011). Conclusions: Dapagliflozin significantly improved treatment satisfaction among patients with type 2 diabetes mellitus for 14 weeks. Body weight loss significantly correlated with treatment satisfaction.Trial registration UMIN-CTR: UMIN000016304.博士（医学）・甲第694号・平成31年3月15日© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated

Development of a quantitative prediction model for peripheral blood stem cell collection yield in the plerixafor era

BACKGROUND AIMS: Predicting autologous peripheral blood stem cell (PBSC) collection yield before leukapheresis is important for optimizing PBSC mobilization and autologous stem cell transplantation (ASCT) for treating hematological malignancies. Although guidelines for plerixafor usage based on peripheral blood CD34+ (PB-CD34+) cell count are available, their predictive performance in the real world remains unclear. METHODS: This study retrospectively analyzed 55 mobilization procedures for patients with non-Hodgkin lymphoma or multiple myeloma and developed a novel quantitative prediction model for CD34+ cell collection yield that incorporated four clinical parameters available the day before leukapheresis; namely, PB-CD34+ cell count the day before apheresis (day -1 PB-CD34+), number of prior chemotherapy regimens, disease status at apheresis and mobilization protocol. RESULTS: The effects of PB-CD34+ cell counts on CD34+ cell collection yield varied widely per patient characteristics, and plerixafor usage was recommended in patients with poorly controlled disease or those with a history of heavy pre-treatments even with abundant day -1 PB-CD34+ cell count. This model suggested a more proactive use of plerixafor than that recommended by the guidelines for patients with poor pre-collection condition or those with a higher target number of CD34+ cells. Further, the authors analyzed the clinical outcomes of ASCT and found that plerixafor use for stem cell mobilization did not affect short- or long-term outcomes after ASCT. CONCLUSIONS: Although external validations are necessary, the results can be beneficial for establishing more effective and safer mobilization strategies