Background & Aims: Community mental health services, particularly home visit services, are essential for facilitating the integration of psychiatric patients into the community. However, the number of home visits by Japanese administrative agencies has not increased past five years. This study investigates the factors influencing number of home visits.

Methods: In June 2022, a survey was conducted among 250 mental healthcare staff working at administrative agencies in the Gunma Prefecture. It sought insights into their work experiences and attitudes related to their roles. Multiple regression analysis was employed to assess the factors impacting number of home visits as the dependent variable.

Results: The study revealed a negative correlation between mental health work experience and both the total number of visits, and the number of visits conducted by respondents within their respective institutions. Positive correlation was observed between the number of home visits and the perception of how much their work contributed to the patient’s recovery.

Conclusions: Work experience and psychological factors among mental healthcare staff play a significant role in determining the frequency of home visits. Enhancing the quality of mental health work may be achieved through the development of work systems, staff education, and the promotion of recovery-orientation approach.

　　In medieval Japan, special operation agents known as “Ninjas” had a profound interest in the management of respiration for successful completion of their mission as well as for their own survival. Examples of their knowledge regarding respiration include being able to estimate the depth of sleep by recognizing the difference between rapid-eye-movement (REM) and non-REM sleep, suppressing their own breathing sounds, adapting special breathing techniques for long distance running, and fostering mental stability through the use of unique breathing patterns. The classic literature notes that ninjas used special breathing apparatuses that allowed them to remain underwater for long durations. For the purposes of the present review, the practicality of these ninja snorkels was investigated in a simple experiment. The findings suggest that the extensive knowledge ninjas held about human respiration was practical and scientifically explainable from the perspective of modern medical science.

Background & Aims: We developed a 98-item semi-quantitative Food Frequency Questionnaire (FFQ) for participants in the Japan Nurses’ Health Study (JNHS) to examine habitual dietary and nutrient intake among working women. The validity of the developed FFQ was examined on the basis of two 7-day diet records (7dDRs; 14 records in total).

Methods: The 7dDRs were provided by 36 female nurses from August to October 2007 and February to April 2008. A semi-quantitative 98-item FFQ (JNHS-FFQ) was administered in October 2007, and the two 7dDRs were used to evaluate its validity.

Results: The validity of the JNHS-FFQ was examined on the basis of the dietary intakes documented in the two 7dDRs. The median Pearson’s correlation coefficient was 0.39 for crude total energy intake and 0.34 for energy-adjusted intake. The energy intake estimated from the JNHS-FFQ was higher than the actual intake according to the DRs, and the correlation coefficients between the DRs and JNHS-FFQ data ranged from -0.04 (iodine) to 0.62 (copper) for crude intakes and -0.12 (zinc) to 0.56 (polyunsaturated fat) for energy-adjusted intakes.

Conclusions: The JNHS-FFQ is useful for epidemiological studies aiming to estimate the nutrient intakes of Japanese working women.

Background & Aims: This study aimed to clarify the background characteristics of visiting nursing stations (STs) providing home care for chronic obstructive pulmonary disease (COPD) patients who had an exacerbation during the past 6 months, as well how they dealt with early detection, responding to exacerbations, and end-of-life treatment.

Methods: A survey was conducted by mailing a questionnaire to 2,000 STs nationwide. The survey items included the organizational background of the STs, exacerbation history, and background of patients with recuperating COPD, the response of STs, and concerns regarding visiting nurses.

Results: The analysis included 301 facilities (24.1％) providing home care for COPD patients during the survey period. Notably, STs (n＝142) with patients who suffered exacerbations provided services for a high number of patients with COPD, noninvasive positive pressure ventilation (NPPV) users, individuals with modified Medical Research Council Dyspnea Scale (mMRC) (Grades 3 and 4), and people living alone. These facilities also created action plans, employed multidisciplinary collaboration, and confirmed whether or not the recuperating COPD patients desired end-of-life treatment (p<0.05).

Conclusions: STs with COPD patients who experienced exacerbations served COPD patients with greater disease severity and employed various response strategies to the onset of exacerbations.

Objective: The transcriptional regulator Spikar/ZMYND8 (Spikar) is a nucleus-associated protein, but in neurons it also binds to drebrin and localizes to dendritic spines. In this study, we identify the signaling region of Spikar that translocates to the cytoplasm from nucleus and clarify the stabilization mechanism of Spikar in the dendritic spine.

Methods: We transfected various GFP-fused Spikar mutant into cultured-cell to investigate their subcellular localization, aiming to identify the specific domain responsible for nuclear export. To examine the dependence of Spikar stabilization in dendritic spines on drebrin, we employed fluorescence recovery after photobleaching (FRAP) analysis in drebrin-knockdown neurons.

Results: The Coiled-Coil domain of Spikar played a pivotal role in mediating the process of nuclear export. FRAP analysis showed that the stable fraction of Spikar was reduced in the dendritic spines of drebrin knockdown neurons.

Conclusion: The coiled-coil region in the C-terminal region is important for the nuclear export of Spikar, and the drebrin-binding region in the N-terminal region is important for its stable localization in the dendritic spine.

Objective: To clarify the efficacy of Prostate Health Index (phi) for clinical use in the office urology.

Methods: For 147 patients with prostate specific antigen (PSA) in the gray zone, phi was measured additionally and the correlation was studied between phi and other conventional biomarkers, including of PSA, free-PSA/total-PSA (F/T PSA) and PSA/volume of the prostate (PSAD). And among 30 patients who were pathologically diagnosed, the accuracy of each biomarker was studied using the findings of digital rectal examination (DRE), ultrasound (US), and MRI.

Results: phi had a weak correlation with PSA, PSAD, and a weak negative correlation with F/T PSA. In 30 biopsied patients (12 patients with cancer and 18 patients with no cancer), sensitivity, specificity, positive predictive value and negative predictive value of phi with a cutoff level of 27.2 were 91.7％, 27.8％, 45.8％ and 83.3％ respectively. Those of PSAD were 66.7％, 27.8％, 38.1％, and 55.6％, while those of F/T PSA were also 66.7％, 27.8, 38.1％, and 55.6 respectively. The diagnostic accuracy was improved by phi. In a group of 15 biopsies-patients with no remarkable finding of DRE, US and MRI, sensitivity and specificity of phi were 100％ and 36.4％ and this group benefit most from the effectiveness of phi.

Conclusion:: The diagnostic accuracy of phi was superior to those of PSAD and F/T PSA in the PSA gray zone cases. In addition, clinical findings, including US and MRI, indicated that phi could be more effective.

Trachea-innominate artery fistula (TIF) is a critical complication of tracheostomy. We performed preventive transection of the innominate artery (IA) in five patients. Their mean age was 16 years, and each patient underwent tracheostomy with endotracheal cannula for a neuromuscular disorder. The preoperative computed tomography showed tracheal compression and stenosis by the IA, and marked thoracic deformity with scoliosis. Communication of the circle of Willis was also recognized. Arterial lines were placed into the right upper extremities and into the left IA to compare their blood pressures. An anterior collar incision was performed, and the IA, the right common carotid artery (RCCA), and the right subclavian artery (RSCA) were exposed without sternotomy. During temporary clamping of the IA, the mean blood pressure of the right upper extremity was 83 mmHg, and the ratio of right upper extremity pressure to systemic pressure was 0.77. Subsequently, the IA was transected after ligation of the proximal side. The distal stump was closed using running sutures to preserve the carotid subclavian junction. None of the patients required bypass grafting to the IA. Their postoperative courses were uneventful. Preventive transection of IA proved useful in the prevention of TIF.

Ms. A is a woman in her 40’s and a nurse. She lives with her mother, husband, and children. 10＋X years have passed since she was diagnosed with cancer shortly after the birth of her second child and has been in remission with surgery and chemotherapy. She supports her fellow patients during lengthy hospital stays as she struggles with post-diagnostic loss. She founded the Patients’ Association because she wanted to leave something behind that would allow patients to talk to each other after discharge, to listen to the experiences of others, and to gain self-reflection. She now lives her life as a cancer survivor, health care provider, participates in policy advocacy and activities while struggling with various issues surrounding cancer patients. She further aims to realize a community-based symbiotic society in which all people can live as they wish, regardless of whether they have cancer. Ms. A’s way of life, in which she overcomes the crisis caused by cancer and expands her way of life into generativity, which turns her attention to others, will provide new awareness to other cancer survivors and medical professionals.