Enhancing quality of care for older adults: The age-friendly health system (4Ms framework) and the role of general medicine physicians as system-based complexologists.

The aging population presents critical challenges to global healthcare systems, with Japan expected to have 35% of its population aged 65 or older by 2040. Older adults often experience multimorbidity, cognitive impairments, and physical frailties, increasing healthcare utilization and costs. Traditional medical approaches that focus on organ-specific diagnoses are insufficient for addressing these multifaceted needs.

In Vitro Analysis of Pressure Resistance in the Paul Glaucoma Implant and Ahmed ClearPath 250 With and Without Polypropylene Thread Inside the Tube.

Purpose: Pressure resistance characteristics of the Paul glaucoma implant (PGI) and Ahmed ClearPath 250 (ACP), with and without the insertion of polypropylene thread in their tubes, were evaluated.

Methods: The in vitro flow pressure was evaluated at varying flow rates, both with and without threads (6-0 for PGI and 4-0 or 3-0 for ACP). Cross-sectional areas of the tube lumen and thread were measured to calculate pressure resistance using the Hagen-Poiseuille equation.

Effects of the Symbiotic on the Host Ciliate Phenotypes.

, a ciliated protist, forms a symbiotic relationship with the green alga . This endosymbiotic association is a model system for studying the establishment of secondary symbiosis and interactions between the symbiont and its host organisms. Symbiotic algae reside in specialized compartments called perialgal vacuoles (PVs) within the host cytoplasm, which protect them from digestion by host lysosomal fusion.

Effectiveness and Components of Health Behavior Interventions on Increasing Physical Activity Among Healthy Young and Middle-Aged Adults: A Systematic Review with Meta-Analyses.

Physical inactivity contributes to various health risks; however, approximately one-third of the global population remains insufficiently active. Many researchers have attempted to increase physical activity levels; however, the effectiveness and the specific components of these interventions remain unclear. This systematic review with meta-analyses utilized a behavior change technique taxonomy to identify and extract effective intervention components, aiming to develop more efficient programs to promote physical activity.

Local Control of Conjunctival Malignant Melanoma by Proton Beam Therapy in a Patient With No Metastasis in Six Years From to Nodular Lesions.

Conjunctival malignant melanoma is extremely rare, with no standard of care established at moment. Here we report a 65-year-old woman, as a hepatitis B virus (HBV) carrier, who presented concurrently a liver mass and lower bulbar conjunctival pigmented lesions in the right eye. Needle liver biopsy and excisional conjunctival biopsy showed hepatocellular carcinoma and conjunctival malignant melanoma , respectively.

Sudden phototactic reversal induced by hypochlorous acid exposure in the bioluminescent ostracod crustacean, .

The reversal of phototaxis has been observed in a wide range of animal species. However, environmental chemicals that can cause a quick reversal of phototaxis have rarely been reported. Here we identified hypochlorous acid (HClO) as an inducer of phototactic reversal in , also known as sea fireflies.

Improvement of image quality for small lesion sizes in F-FDG prone breast silicon photomultiplier-based PET/CT imaging.

Objectives: We investigated image quality and standardized uptake values (SUVs) for different lesion sizes using clinical data generated by F-FDG-prone breast silicon photomultiplier (SiPM)-based positron emission tomography/computed tomography (PET/CT).

Methods: We evaluated the effect of point-spread function (PSF) modeling and Gaussian filtering (Gau) and determined the optimal reconstruction conditions. We compared the signal-to-noise ratio (SNR), contrast, %coefficient of variation (%CV), SUV, and Likert scale score between ordered-subset expectation maximization (OSEM) time-of-flight (TOF) and OSEM+TOF+PSF in phantom and clinical studies.

Complex intervention including pain science education and patient-led goal setting-based self-management strategies for management of aromatase inhibitor-induced musculoskeletal symptoms: a single-arm feasibility and pilot study.

Purpose: Up to 74% of breast cancer survivors (BCS) treated with aromatase inhibitor (AI) experience AI-induced musculoskeletal symptoms (AIMSS). AIMSS is the predominant cause of poor adherence to AI therapy, yet no definitive treatment exists. The primary research objectives of this study were (1) to develop a novel BCS-specific complex intervention to alleviate AIMSS, and to assess its feasibility.

Diagnostic Techniques for Posterior Cutaneous Nerve Entrapment Syndrome.

This case report highlights the diagnostic process for posterior cutaneous nerve entrapment syndrome (POCNES) in an older adult female patient, with an emphasis on using video demonstrations to guide clinicians. POCNES should be diagnosed based on a combination of specific clinical features, including localized back pain accompanied by pinpoint tenderness lateral to the spinous process, cutaneous sensory abnormalities over the area of pain, severe pain response to pressure on the tender point, and normal clinical and imaging findings. This case demonstrates how these criteria were identified via a thorough physical examination captured on video to provide a visual guide for clinicians.

Clinical Pharmacist-Led Collaboration of Multiple Clinical Professions Model Focusing on Continuity of Pharmacotherapy: Japanese Version of the Lund Integrated Medicines Management (LIMM) Model.

(1) Background: In general, it is known that continuity of care can contribute to an increase in patient satisfaction, reduce health care costs, and improve patient outcomes. A guarantee of continuity in pharmacotherapy is a big challenge facing Japanese health care as a system that encourages cooperation/collaboration for pharmacists with other health care professions is currently lacking. (2) Method: This is a narrative review.

Extracranial Vertebral Artery Aneurysm With Neurofibromatosis Type 1: The Effectiveness of Endovascular Intervention.

Neurofibromatosis type 1 (NF-1) is associated with vascular complications, including stenosis or the occlusion of the abdominal aorta and renal arteries. However, reports on the occurrence of extracranial vertebral artery aneurysms are scarce. A man in his 40s had back pain and was feeling unwell.

Aversive social learning with a dead conspecific is achieved by Pavlovian conditioning in crickets.

Social learning, learning from other individuals, has been demonstrated in many animals, including insects, but its detailed neural mechanisms remain virtually unknown. We showed that crickets (Gryllus bimaculatus) exhibit aversive social learning with a dead conspecific. When a learner cricket was trained to observe a dead cricket on a drinking apparatus, the learner avoided the odor of that apparatus thereafter.

Carboxylated Zn-phthalocyanine attenuates brain Aβ in AD model mouse.

The deposition of aggregated amyloid β (Aβ) is considered as a key factor for Alzheimer's Disease (AD). Previously, we demonstrated that a carboxylated Zn-phthalocyanine (ZnPc) inhibits Aβ fibril formation, consequently protects neurons in culture. This study evaluated the effects of ZnPc on pathological changes in an AD mouse model (J20).

Iron redox effect on the structure and viscosity of a sodium silicate glass and melt.

The viscosity of silicate melts is one of the most important physical properties for understanding high-temperature phenomena in magmatic systems and material processing. The effects of composition and temperature on viscosity have long been elucidated. Although iron ions are the main components of magmatic systems, their influence on viscosity remains unclear because the behavior of iron is complicated; iron ions have two redox states, Fe3+ and Fe2+.

Glucocorticoid tapering pace in microscopic polyangiitis and granulomatosis with polyangiitis in Japanese real-world practice: A propensity score-matched retrospective cohort study from the J-CANVAS registry.

Objective: To assess the prevalence and outcomes among regimens of glucocorticoid tapering for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in real-world practice.

Methods: We retrospectively examined the Japan Collaborative Registry of ANCA-associated Vasculitis (J-CANVAS) registry, and evaluated the prevalence of glucocorticoid tapering regimens in the PEXIVAS trial. In patients with newly diagnosed MPA and GPA, we compared outcomes among standard and reduced pace regimens.

Anemia-associated smaller brain volume and sex differences: a cross-sectional study of magnetic resonance imaging in brain health checkups.

Introduction: Anemia is a risk factor for dementia development. However, few studies have examined the relationship between brain volume and anemia. This study aimed to analyze the association between anemia and brain volume using magnetic resonance imaging data from brain health checkups.

Metabolic characteristics involved in the tolerance of bivalves to marine hypoxia: Verification by inter-and intraspecific comparisons of species with different hypoxia tolerance.

Bivalves survive exposure to hypoxic water through anaerobic metabolism. However, the characteristics of anaerobic metabolism that determine the differences in hypoxic tolerance observed between and within species remain unclear. In this study, we examined three species belonging to the superfamily Arcoidea (Anadara kagoshimensis, Tegillarca granosa, and Estellacar olivacea) with differences in hypoxia tolerance as well as one species (A.

NAD deficiency plays essential roles in the hyperuricemia of stroke-prone spontaneously hypertensive rat via xanthine dehydrogenase to xanthine oxidase conversion.

Inhibition of xanthine oxidoreductase (XOR) was shown to ameliorate the stroke susceptibility in the stroke-prone spontaneously hypertensive rat (SHRSP), suggesting hyperuricemia had a pathological role in this rat model. In this study, we thus aimed to explore mechanisms inducing hyperuricemia in SHRSP. XOR is known to have two forms, xanthine dehydrogenase (XDH) as the prototype and xanthine oxidase (XO) as the converted form through cleavage of a peptide bond or through formation of disulfide bonds in the enzyme.

Diffractometer for element-specific analysis on local structures using a combination of X-ray fluorescence holography and anomalous X-ray scattering.

To tackle disorder in crystals and short- and intermediate-range order in amorphous materials, such as glass, we developed a carry-in diffractometer to utilise X-ray fluorescence holography (XFH) and anomalous X-ray scattering (AXS), facilitating element-specific analyses with atomic resolution using the wavelength tunability of a synchrotron X-ray source. Our diffractometer unifies XFH and AXS configurations to determine the crystal orientation via diffractometry. In particular, XFH was realised even for a crystal with blurred emission lines by a standing wave in a hologram, and high-throughput AXS with sufficient count statistics and energy resolution was achieved using three multi-array detectors with crystal analysers.

Persistent Epstein-Barr Virus Infection of Epithelial Cells Leads to APOBEC3C Expression and Induces Mitochondrial DNA Mutations.

Upon infection with the virus, cells increase the expression of cytidine deaminase APOBEC3 family genes. This leads to the accumulation of C-to-T mutations in the replicating viral genome and suppresses viral propagation. In contrast, herpesviruses, including Epstein-Barr virus (EBV), express genes that counteract APOBEC3 during lytic infection.

Preventable diagnostic errors of lower gastrointestinal perforation: a secondary analysis of a large-scale multicenter retrospective study.

Background: Lower gastrointestinal perforation (LGP) is an acute abdominal condition associated with a high mortality rate. Timely and accurate diagnosis is crucial. Nevertheless, a diagnostic delay has been estimated to occur in approximately one-third of the cases, and the factors contributing to this delay are yet to be clearly understood.

Tube Insertion of Ahmed Glaucoma Valve Using a Micro-incision Scleral Tunnel Technique.

We report three cases demonstrating the efficacy and versatility of the micro-incision scleral tunnel (MIST) technique, a novel method for Ahmed glaucoma valve (AGV) tube insertion. MIST is characterized by its small incision, sutureless approach, anterior-to-posterior tunnel creation, and allograft-free design. The technique involves creating a scleral tunnel using a 1-mm crescent knife (Bleb Knife II), allowing for secure tube placement into the anterior chamber, ciliary sulcus, or vitreous cavity.

The Simplest Method for Fishhook Removal: The String-Yank Technique.

Fishing is a popular recreational activity worldwide, but complications arise when fishhooks become embedded in the skin. Barbed hooks, due to their design, are particularly challenging to remove. While many individuals attempt self-extraction, some present to emergency departments for medical intervention.

Comparison of the Effectiveness of Online and Face-to-Face Parent Training for Parents of Children With Developmental Disabilities.

Background: Parent training (PT) is an effective intervention for improving children's behavioral problems and enhancing parental mental health in those caring for children with developmental disabilities (DD). Recent studies report the effectiveness of online PT (ON-PT). ON-PT encompasses both the on-demand type and the real-time type, which involves real-time online group PT delivered through web conferencing systems.