Effectiveness of A School-Based Universal Prevention Program for Enhancing Self-Confiden Considering The Extended Effects Associated With Achievement of The Direct Purposes of The Program

Introduction

We have developed a group of school-based universal prevention programs for children's health and adjustment. The programs are characterized by new theories such as the somatic-marker hypothesis and enjoyable methods that utilize animated stories and games. This study adopted one of the programs for the development of self-confidence.

Objective

The aim was to examine the effectiveness of the program. In addition to the direct purposes of the program, children's adjustments at school and homeroom class were evaluated as extended effects.

Methods

Participants were third grade children in six public elementary schools in Japan. The final sample included 442 children (219 boys and 223 girls). The program was implemented weekly in one regular 45-minute class over 8 weeks. Participants completed a battery of three questionnaires three times, 1 month before the start of the program (T1), 1 week before the start of the program (T2), and during 1 week after the last class of the program (T3).

Results

Results showed that all of the main endpoints of the program significantly improved in the intervention condition (i.e., changes from T2 to T3), compared to the control condition (i.e., changes from T1 to T2). Moreover, children's adjustment at school and homeroom class increased in the intervention condition, compared to the control condition. However, implicit affect was unchanged.

Conclusion

This study suggests that the program is effective for enhancing self-confidence, along with adjustments at school and in class. Future research that examines the sustainability of the effectiveness of the program is planned.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Juxtacortical Lesions in Multiple Sclerosis: Assessment of Gray Matter Involvement Using Phase Difference-enhanced Imaging (PADRE)

Purpose:

In multiple sclerosis (MS), a juxtacortical lesion at the border between the gray matter (GM) and subcortical white matter (WM) may often involve the GM. A recently developed, phase-weighted magnetic resonance imaging (MRI) technique “phase difference enhanced imaging (PADRE)” can delineate the GM and WM clearly due to the difference in myelin concentration. We evaluated whether PADRE is useful for the detection of GM involvement in the juxtacortical MS lesions.

Methods:

One neuroradiologist reviewed the conventional MRI in 13 MS patients and selected 48 juxtacortical lesions. At the first reading session with the conventional MRI alone (T₂-weighted imaging, and two-dimensional and three-dimensional fluid-attenuated inversion recovery), two other neuroradiologists classified the lesions into three patterns according to their anatomical locations: (a) subcortical WM lesions involving the subcortical WM alone; (b) intracortical (IC) lesions involving the GM alone; (c) mixed GM/subcortical WM (mixed) lesions involving the both subcortical WM and GM. We defined the subcortical WM as a WM within a distance of 10 mm from inner edge of the GM. For the analyses, we excluded the white matter lesions further than 10 mm from inner edge of the GM. At the second reading session MRI and PADRE were available and the radiologists re-evaluated their prior classification.

Results:

At the first reading session, 27 lesions were classified as (a), 1 as (b), and 20 as (c). Therefore, a total of 21 lesions (44%) were judged to involve the GM. At the second reading session, the classification of 15 (31%) lesions changed; all 15 lesions were judged to involve the GM on the PADRE. Interobserver agreement (kappa value) was 0.84 for the first- and 0.95 for the second reading session.

Conclusion:

PADRE is useful for detecting GM involvement of the juxtacortical MS lesions.

Enhanced efferocytosis by dendritic cells underlies memory T-cell expansion and susceptibility to autoimmune disease in CD300f-deficient mice

Homeostasis requires the immunologically silent clearance of apoptotic cells before they become pro-inflammatory necrotic cells. CD300f (CLM-1) is a phosphatidylserine receptor known to positively regulate efferocytosis by macrophages, and CD300f gene-deficient mice are predisposed to develop a lupus-like disease. Here we show that, in contrast to CD300f function in macrophages, its expression inhibits efferocytosis by DC, and its deficiency leads to enhanced antigen processing and T-cell priming by these DC. The consequences are the expansion of memory T cells and increased ANA levels in aged CD300f-deficient mice, which predispose CD300f-deficient mice to develop an overt autoimmune disease when exposed to an overload of apoptotic cells, or an exacerbated autoimmunity when combined with FcγRIIB deficiency. Thus, our data demonstrates that CD300f helps to maintain immune homeostasis by promoting macrophage clearance of self-antigens, while conversely inhibiting DC uptake and presentation of self-antigens.

Application of strain to orbital-spin-coupled system MnV2O4 at cryogenic temperatures within a transmission electron microscope

The impact of mechanical stress on the morphology of crystallographic and magnetic domains in shape-controlled specimens of an orbital-spin-coupled system, MnV2O4, was examined by cryogenic Lorentz microscopy. Because of the difference in thermal expansion coefficients of MnV2O4 and the supporting Mo mesh, compression on the order of 0.01% was applied to the thin-foil specimens near the structural/magnetic phase transformation temperatures. The extent of compression was comparable to the lattice striction associated with the cubic-to-tetragonal phase transformation in MnV2O4 The applied strain thus clearly influenced the morphology of crystallographic domains (i.e. twinning configuration in the tetragonal phase) produced during cooling. The magnetic domain structure was entirely dependent on the configuration of twinning in the tetragonal phase. The observations in this study provided useful information for understanding the relationship between the crystallographic domains and the magnetic domains in MnV2O4.

Membrane-bound and soluble Fas ligands have opposite functions in photoreceptor cell death following separation from the retinal pigment epithelium

Fas ligand (FasL) triggers apoptosis of Fas-positive cells, and previous reports described FasL-induced cell death of Fas-positive photoreceptors following a retinal detachment. However, as FasL exists in membrane-bound (mFasL) and soluble (sFasL) forms, and is expressed on resident microglia and infiltrating monocyte/macrophages, the current study examined the relative contribution of mFasL and sFasL to photoreceptor cell death after induction of experimental retinal detachment in wild-type, knockout (FasL-/-), and mFasL-only knock-in (ΔCS) mice. Retinal detachment in FasL-/- mice resulted in a significant reduction of photoreceptor cell death. In contrast, ΔCS mice displayed significantly more apoptotic photoreceptor cell death. Photoreceptor loss in ΔCS mice was inhibited by a subretinal injection of recombinant sFasL. Thus, Fas/FasL-triggered cell death accounts for a significant amount of photoreceptor cell loss following the retinal detachment. The function of FasL was dependent upon the form of FasL expressed: mFasL triggered photoreceptor cell death, whereas sFasL protected the retina, indicating that enzyme-mediated cleavage of FasL determines, in part, the extent of vision loss following the retinal detachment. Moreover, it also indicates that treatment with sFasL could significantly reduce photoreceptor cell loss in patients with retinal detachment.

Macrophage- and RIP3-dependent inflammasome activation exacerbates retinal detachment-induced photoreceptor cell death

Detachment of photoreceptors from the retinal pigment epithelium is seen in various retinal disorders, resulting in photoreceptor death and subsequent vision loss. Cell death results in the release of endogenous molecules that activate molecular platforms containing caspase-1, termed inflammasomes. Inflammasome activation in retinal diseases has been reported in some cases to be protective and in others to be detrimental, causing neuronal cell death. Moreover, the cellular source of inflammasomes in retinal disorders is not clear. Here, we demonstrate that patients with photoreceptor injury by retinal detachment (RD) have increased levels of cleaved IL-1β, an end product of inflammasome activation. In an animal model of RD, photoreceptor cell death led to activation of endogenous inflammasomes, and this activation was diminished by Rip3 deletion. The major source of Il1b expression was found to be infiltrating macrophages in the subretinal space, rather than dying photoreceptors. Inflammasome inhibition attenuated photoreceptor death after RD. Our data implicate the infiltrating macrophages as a source of damaging inflammasomes after photoreceptor detachment in a RIP3-dependent manner and suggest a novel therapeutic target for treatment of retinal diseases.

Portal or superior mesenteric vein resection in pancreatoduodenectomy for pancreatic head carcinoma

BACKGROUND

The aim of this study was to determine the added value of portal or superior mesenteric vein (PV/SMV) resection during pancreatoduodenectomy for pancreatic head carcinoma.

METHODS

A multicentre observational study was conducted in patients with pancreatic head carcinoma who underwent pancreatoduodenectomy in seven Japanese hospitals between 2001 and 2012. Clinicopathological factors were compared between patients who did and did not undergo PV/SMV resection. Those with an impact on survival were identified by univariable and multivariable analysis.

RESULTS

Of the 937 patients who underwent pancreatoduodenectomy, 435 (46·4 per cent) had PV/SMV resection, whereas the remaining 502 (53·6 per cent) did not. Some 71·5 and 63·9 per cent of patients with and without PV/SMV resection respectively had lymph node-positive disease. Patients who underwent PV/SMV resection had more advanced tumours. Perioperative mortality and morbidity rates did not differ between the two groups. Multivariable analysis revealed that PV/SMV resection was not an independent prognostic factor for overall survival (P = 0·268). Among the 435 patients in whom the PV/SMV was resected, borderline resectable tumours with arterial abutment (P = 0·021) and absence of adjuvant chemotherapy (P < 0·001) were independent predictors of poor survival in multivariable analysis. Patients with resectable or borderline resectable tumours with PV/SMV involvement had a median survival time with additional adjuvant chemotherapy of 43·7 and 29·7 months respectively. Median survival time in patients with borderline resectable tumours with arterial abutment was 18·6 months despite adjuvant chemotherapy.

CONCLUSION

Pancreatoduodenectomy with PV/SMV resection and adjuvant chemotherapy in patients with pancreatic head carcinoma may provide good survival without increased mortality and morbidity.

Usefulness of quantitative susceptibility mapping for the diagnosis of Parkinson disease

BACKGROUND AND PURPOSE

Quantitative susceptibility mapping allows overcoming several nonlocal restrictions of susceptibility-weighted and phase imaging and enables quantification of magnetic susceptibility. We compared the diagnostic accuracy of quantitative susceptibility mapping and R2* (1/T2*) mapping to discriminate between patients with Parkinson disease and controls.

MATERIALS AND METHODS

For 21 patients with Parkinson disease and 21 age- and sex-matched controls, 2 radiologists measured the quantitative susceptibility mapping values and R2* values in 6 brain structures (the thalamus, putamen, caudate nucleus, pallidum, substantia nigra, and red nucleus).

RESULTS

The quantitative susceptibility mapping values and R2* values of the substantia nigra were significantly higher in patients with Parkinson disease (P < .01); measurements in other brain regions did not differ significantly between patients and controls. For the discrimination of patients with Parkinson disease from controls, receiver operating characteristic analysis suggested that the optimal cutoff values for the substantia nigra, based on the Youden Index, were >0.210 for quantitative susceptibility mapping and >28.8 for R2*. The sensitivity, specificity, and accuracy of quantitative susceptibility mapping were 90% (19 of 21), 86% (18 of 21), and 88% (37 of 42), respectively; for R2* mapping, they were 81% (17 of 21), 52% (11 of 21), and 67% (28 of 42). Pair-wise comparisons showed that the areas under the receiver operating characteristic curves were significantly larger for quantitative susceptibility mapping than for R2* mapping (0.91 versus 0.69, P < .05).

CONCLUSIONS

Quantitative susceptibility mapping showed higher diagnostic performance than R2* mapping for the discrimination between patients with Parkinson disease and controls.