Background: Diabetes mellitus (DM) is a global health challenge affecting patient well-being and quality of life (QoL). This study aimed to validate the Mongolian version of the Diabetes Quality of Life Brief Clinical Inventory (MVDQOL-BCI) in patients with type II DM in Mongolia.

Methods: Data were collected from 197 participants across three hospitals in Ulaanbaatar. Reliability was assessed using Cronbach’s alpha and the intraclass correlation coefficient (ICC). Pearson’s correlation was used for criterion-related validity and discriminant validity were examined using demographic, disease-specific, and general QoL questionnaires.

Results: The MVDQOL-BCI demonstrated strong internal consistency (α＝0.853) and satisfactory test-retest reliability (ICC＝0.842). Criterion-related validity was confirmed with the Asian DQOL total score, EQ-visual analog scale score, short-form 36 total scores, 8 subscales, and HbA1c percentage (p<0.05). Discriminant validity revealed better QoL was associated with females, higher education, higher income, shorter diabetes duration, and non-insulin therapy use.

Conclusions: The MVDQOL-BCI is a reliable and valid tool for assessing QoL in adult Mongolian patients with DM. Our findings support the extensive utilization of the MVDQOL-BCI and facilitates a deeper understanding of the impact of diabetes and its management on patient well-being.

Background & Aims: In the treatment of people with dementia (PwD), it is necessary to consider behavioral and psychological symptoms of dementia (BPSD). We developed a Dementia Care-assist AI system (DeCaAI) and examined its effectiveness and tasks.

Methods: DeCaAI was introduced in 10 dementia group homes. We enrolled 172 PwD and 206 caregivers. The control group received conventional care, and an intervention group received a 19-week intervention. In the intervention group, we fitted vital sensors to PwD and installed sensors in their rooms. Caregivers recorded cases of BPSD. DeCaAI predicted the occurrence of BPSD from the sensor data and care records and notified caregivers of preventive care measures. We examined severity of BPSD, quality of life, and activities of daily living for PwD in both groups. Moreover, we administered a questionnaire to assess the workload of caregivers.

Results: Four of 10 facilities were excluded because of insufficient care record data and no final evaluation. There were no significant interactions in any of the evaluations of the PwD and caregivers. Moreover, the questionnaire revealed that improvement of the predictive accuracy and usability of DeCaAI is necessary.

Conclusion: We found no significant improvement on BPSD of PwD and workload of caregivers.

Background & Aims: To investigate whether the optimal treatment protocols of cryoablation differ among various cell lines utilizing bioluminescence imaging (BLI).

Methods: Eight luciferase-expressing cancer cell lines originated from various organs were used in this study, including lung, renal, liver, breast, colon, prostate, and skin. These cell lines were uniformly seeded in 96-well plates. The cell lines were then divided into four groups: Group 0 (G0), as a control group, and three treatment groups (G1-G3). G1-G3 were subjected to cryoablation at temperatures of －45℃, －60℃, and －80℃, respectively, with varying treatment cycles (single, double, or triple cycle, respectively). Each freeze‒thaw cycle consisted of ten minutes of freezing followed by five minutes of thawing. Finally, the average radiance of the cells was assessed using BLI.

Results: Cryoablation at “－60℃ and －80℃” showed a significant decrease in average radiance, even after a single cycle of treatment in all cell lines. The average radiance of cells treated with －45℃ was substantially lower than that of untreated cell lines except melanoma.

Conclusion: We found that －45℃ successfully eradicated all cancer cells across multiple cycles except melanoma. The most effective cryoablation protocol for all cell lines was observed at temperatures of －60℃ or lower.

Objectives: This study aimed to elucidate the effect of changes in nursing students’ interpersonal relationships on their mental health during the Coronavirus disease (COVID-19) pandemic.

Methods: The study sample included approximately 320 nursing students from the first to fourth year of various medical universities who completed an anonymous internet questionnaire. The questionnaire comprised the following details: 1) World Health Organization-Five well-being index, 2) five items regarding anxiety during the COVID-19 pandemic, and 3) six items regarding opportunities to converse with others. Responses were obtained at two time points, i.e., during the first (April to September) and second (October to February) semesters of a Japanese university.

Results: Valid responses were obtained from 182 participants (56.9%). In the early (first semester) and late (second semester) periods, 40.1% and 26.9% of individuals experienced poor mental health, respectively; thus, there was a considerably higher incidence of poor mental health in the early period. During the COVID-19 pandemic, anxiety related to the inability to go freely where one wanted to was the highest. Furthermore, there were less opportunities of conversing with others apart from one’s family or part-time job colleagues. Based on binomial logistic analysis, we found that in the early period, during which classes were gtenerally online, the absence of opportunities to converse with others led to poor mental health.

Discussion: The findings of this study indicate that to maintain the mental health of nursing students, it is important to intentionally create opportunities to converse with others.

Objectives: MiR-1253, miR-504-5p, miR-26a-5p, miR-21-3p, and miR495-3p have been identified as driver mutation-specific microRNAs (miRNAs) in human non-small-cell lung cancer. We examined the expression of these miRNAs in human lung adenocarcinoma cell lines and investigated whether the miRNAs truly show specific driver mutations.

Material and Methods: We clarified the status of EGFR and KRAS mutations reported in the literature (2 cell lines) and those identified by DNA sequence analysis (7 cell lines) in human lung adenocarcinoma cell lines, and analyzed the expression of the above driver mutation-specific miRNAs in all 9 cell lines.

Results: MiR-504-5p, miR-26a-5p, miR-21-3p, and miR495-3p did not show any expression patterns related to driver mutations in any of the human lung adenocarcinoma cell lines analyzed. On the basis of cytomorphological characteristics, we could not determine the association between driver mutation and morphological changes.

Discussion: The results of this study indicate that the changes in miR-504-5p, miR-26a-5p, miR-21-3p, and miR495-3p were not directly caused by driver mutations that occurred in cancer cells. However, these changes may indicate driver mutation-led transformations in the tumor tissue environment by driver mutation, suggesting that the miRNAs are products of peritumor noncancer cells rather than tumor cells.

Objectives: We analyzed the accuracy of machine learning (ML) and black box problems utilizing the Cell-in-Cell phenomenon (CIC) observed in culture cell lines.

Methods: An ML program was made using commercially available ML software. CIC-positive and -negative images of mammary carcinoma cell line MCF-7 was input into the program and CIC-positive and -negative data were derived from human lung adenocarcinoma cell line ABC-1 for classification accuracy by confusion matrix. The same trials were performed five times each for two ABC-1-derived data sets. The characteristics of misclassified images were reviewed.

Results: Images misclassified as positive (false positive) showed plenty of white area in fibrin-rich background, which would be misunderstood as CIC. While those misclassified as negative (false negative) showed the following characteristics: the gap between inner and outer cells in CIC was insufficient or inconspicuous due to gaps in the background fibrin. Even though the ABC-1 data set was input with the MCF-7 data for training data, the accuracy was not improved in comparison to the training data set condition with MCF-7 data alone.

Conclusions: In ML, the classification algorithm does not utilize human thought. Thus, there is a “black box problem” in which we could not assume why ML was misclassified. In this analysis, it was difficult to understand why ML causes misclassification, and the reason of misclassification was just assumed, along with morphological features. When using ML in the future, it should be kept in mind that unexplained misclassification can occur necessarily.

Objective: This study aimed to investigate college students’ intentions toward consultation their concerns using peer support, e-mail and LINE, and to examine the possibility of implementing such a system.

Methods: We conducted an anonymous web survey of 4,448 university students. The survey included questions related to following concepts: The ease of use of the consultation service provided by the university, feelings about using the consultation service, whether they can use the consultation service, and methods of consultation when peer support is available.

Results: A total of 617 students completed the survey (response rate 13.9％). Students’ feelings about using the consultation service of the university included the following: “It requires courage to use the consultation service” (70.8％); “Is my problem worth consultation?” (61.2％); and “I struggle to effectively communicate what I want to say” (52.3％). Students’ feelings about using the peer support service were similar to those about the university consultation service. Many students preferred e-mail and LINE app as methods of consultation with peer support. Moreover, 28.0％ of the students reported that they were interested in serving the peer supporter role. Meanwhile, when only responses from the students who could not use the consultation service were analyzed, the data showed that the percentage of students who thought “Is my problem worth consultation?” with peer support was lower than the percentage of students who had the same thought using the university consultation service.

Discussion: Our findings suggest that provision of the student consultation service via peer support facilitates the use of the service by university students who could not use the consultation service otherwise.

Background: The NICU environment, especially the noise and light environment, is considered invasive for low birth weight infants, and there are concerns that it may affect their future development and growth.　Environmental standards have been set to require that they are raised in a quiet environment.

Purpose: To investigate the source of noise and its occurrence time for a better sound environment in the NICU.

Subject and method: Sound pressure and frequency over a 24 hour period were continuously measured and recorded for 7 days in the NICU of facility A. From the recorded data, we listened to sounds with a high sound pressure of 65 to 80 dB. Since alarm sounds occur at all times of the day, we counted the types of alarms, their duration, and the number of times they occurred, and calculated the total energy.

Result Sounds with a high sound pressure of 65 to 80 dB were alarm sounds, medical work sounds, babies crying, and people talking. The most frequent sound was alarm sounds, which occurred throughout the 24 hours, and also occurred for the longest time. It was found that when the alarm sound was turned off, the sound pressure decreased by 1.5 dB to 49.5 dB. It was also found that the alarm sounds were on for about 4 hours per 24 hours, or 17％ of the time.

Conclusion: The alarm sounds occurred approximately once every six minutes over a 24 hour period.

Noise inside the facility is largely influenced by people’s voices, medical work sounds, and alarm sounds.

It was suggested that improvements could be made by increasing the awareness of the staff.

Purpose: This study aimed to report the process in which young patients with breast cancer acquire mastery and adjust their lifestyles while undergoing treatment.

Methods: Eleven young breast cancer patients were interviewed in a semi-structured manner. A modified version of the grounded theory approach was used for analysis.

Results: When breast cancer treatment began, patients experienced“difficulty in living while undergoing breast cancer treatment”such as“frustration of having to prioritize treatment over work and family finances”and“pain from being the cause of sadness in their families.”They also “searched for a way to cope with the difficulties of living”while“wishing to live the ordinary lives they lived before the disease”and received“support for continuing life while undergoing therapy”while alternating between these two experiences. They eventually “(accepted) that what will be will be”to conclude that they would“live with breast cancer while cherishing the present.”

Conclusion: Nursing for young patients with breast cancer should involve deliberate interaction to encourage self-reflection on the process of mastery.

Objective: To report a case of multiple endocrine neoplasia type 2 (MEN2) in which there were difficulties in sharing genetic information within the family.

Case summary: A 50 year- old man was admitted to our hospital because of ureteral stones and right pheochromocytoma. He had several family histories of thyroid and adrenal disease. MEN2 was suspected and thyroid echography was performed, which revealed an irregularly shaped hypoechoic mass in the right thyroid lobe of his thyroid. Needle aspiration biopsy cytology was performed, and the thyroid tumor was diagnosed as medullary thyroid carcinoma. After genetic counseling (GC), genetic testing was performed, which revealed a pathological variant at codon 634 of the RET gene. At the initial GC, he said that there was no MEN2 in his family, but during the subsequent GC, he told us that his blood relative was found to be positive for the RET gene mutation.

Discussion: After the GC, the decision to share genetic information with blood relatives is left to the patient. Sharing genetic information within families is sometimes difficult but rarely reported. We report this case because as genetic testing becomes more common, sharing genetic information becomes a more important issue.