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Delirium is a common serious complication in dementia that is associated with poor prognosis and a high burden on caregivers and healthcare professionals. Appropriate care is therefore important at an early stage for patients with delirium superimposed on dementiaTo gain insight into the care of six patients with delirium superimposed on dementia, 19 semi-structured interviews were conducted focused on the experiences of caregivers and professionals. The interviews revealed four themes that appeared to play a role 1. experiences with and views on behavioral problems of these patients, 2. recognition and diagnosis of delirium in dementia, 3. views on good care and 4. organizational aspects. Knowledge gaps about delirium in dementia, as well as ethical considerations, play an important role in organizing timely and adequate care for patients with delirium superimposed on dementia.
Integrated disease management with self-management for Chronic Obstructive Pulmonary Disease (COPD) is effective to improve clinical outcomes. eHealth can improve patients' involvement to be able to accept and maintain a healthier lifestyle. Eventhough there is mixed evidence of the impact of eHealth on quality of life (QoL) in different settings.

The primary aim of the e-Vita-COPD-study was to investigate the effect of use of eHealth patient platforms on disease specific QoL of COPD patients.

We evaluated the impact of an eHealth platform on disease specific QoL measured with the clinical COPD questionnaire (CCQ), including subscales of symptoms, functional state and mental state. Interrupted time series (ITS) design was used to collect CCQ data at multiple time points. Multilevel linear regression modelling was used to compare trends in CCQ before and after the eHealth intervention.

Of 742 invited COPD patients, 244 signed informed consent. For the analyses, we only included patients who actually ushat, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.
The e-Vita eHealth platform had a potential beneficial impact on the CCQ-symptoms of COPD patients, but not on functional state. The CCQ-mental state remained stable after the intervention, but this was a deterioration compared to the improving situation before the start of the eHealth platform. In conclusion, this study shows that after the introduction of the COPD platform, patients experienced fewer symptoms, but their mental state deteriorated slightly at the same time. Therefore, health care providers should be aware that, although symptoms improve, there might be a slight increase in anxiety and depression after introducing an eHealth intervention to support self-management.We describe the cypridoidean ostracod Heterocypris spadix sp. nov. from brackish water on Okinawa Island, Japan. The species closely resembles Heterocypris salina (Brady, 1868) but differs in that (1) the marginal infolds on valves are less developed, (2) the tubercles on the anterior margin of the right valve are completely covered by the selvage and invisible in inner view, and (3) the calcified inner lamella on the ventral margin of the left and right valves is scarcely evident in inner view, as the ventral margins of the valves bend inwardly. We determined partial sequences for the cytochrome c oxidase subunit I (COI; cox1) and 18S rRNA genes in H. spadix for future DNA barcoding and phylogenetic analyses. Our sample contained only females. A breeding experiment revealed that H. spadix females reproduce parthenogenetically. Another experiment showed that H. spadix has low tolerance to desiccation, with all individuals at 25°C dying between 1-2 hours after removal from water. We amplified and sequenced a partial 16S rRNA sequence for the endosymbiotic bacterium Cardinium from H. spadix. Infection by Cardinium may be related to the parthenogenetic reproductive mode we observed in H. spadix.In this paper, two new brackish-water species of the macrostomid turbellarian genus Macrostomum, Macrostomum pseudosinense sp. nov. and Macrostomum taurinum sp. nov., collected from coastal water at Shenzhen, Guangdong Province, China, are described based on morphological, histological, and molecular phylogenetic analyses. Macrostomum pseudosinense sp. nov. differs from similar species within the genus in the length of the stylet (152 ± 15.0 µm), diameter of stylet opening (20 ± 4.0 µm proximally; 7 ± 0.5 µm distally), two bends of the stylet, and the non-spiral end of the stylet. Macrostomum taurinum sp. nov. differs from its congeners in the length of the stylet (81 ± 7.4 µm), the stylet bending position and angle (50% and 60°), diameter of stylet proximal opening (15 ± 3.0 µm), sperm with bristles and brush, and the smooth-walled ovaries. Phylogenetic analyses inferred from nuclear 18S and 28S rRNA genes support the establishments of these two new species. In addition, reciprocal mating behavior of M. pseudosinense sp. nov. was observed and documented.We present a complete mitochondrial genomic sequence for the tanaidacean Arctotanais alascensis (Richardson, 1899); this is the first complete mitogenome reported from the order Tanaidacea. The mitogenome is 13,988 bp long and contains 13 protein coding and two ribosomal RNA genes (as is typical for animal mitogenomes), and 21 of 22 transfer RNAs; we did not detect an isoleucine transfer RNA (trnI) gene. The gene order differed markedly from the hypothetical ground pattern for Pancrustacea; only four clusters (trnM + nad2; trnC + trnY + cox1 + trnL2 + cox2; trnD + atp8 + atp6 + cox3; trnH + nad4 + nad4l) ancestrally present were retained. In a malacostracan phylogenetic tree reconstructed from mitogenome data, basal relationships were marginally supported or incongruent with the traditional morphology-based classification and the latest phylogenetic reconstructions from large transcriptomic datasets. Relationships involving more recent divergences were better supported in our tree, suggesting that complete mitogenome sequences are more suitable for phylogenetic analyses within malacostracan orders, presumably including Tanaidacea.The Tsushima salamander, Hynobius tsuensis, is a lotic-breeding species endemic to Tsushima Island, Japan. We investigated genetic variation in this species using samples covering all known localities on the island. Phylogenetic analyses based on mitochondrial cytochrome b gene sequences divided H. tsuensis populations into two genetic groups true H. tsuensis and an unknown species (Hynobius sp.) showing a closer relationship to Hynobius nebulosus than to H. tsuensis. The genetic distance between the two groups was greater than the genetic distances between different species of Hynobius. Both groups were found to breed in mountain streams, sometimes in the same streams syntopically. Population structure analysis based on several nuclear microsatellite loci strongly indicated reproductive isolation between the two groups in the syntopic localities. This is the first report confirming the syntopic occurrence of two lotic salamanders of Hynobius on a small island. We propose that the lotic breeding habits of the two salamanders were independently acquired.Holothuria atra is a black sea cucumber commonly found on the sandy bottom of Okinawan coral reefs. The body surface of H. atra is usually covered with sand; however, sand never covers the body of another black congener, Holothuria leucospilota, which is sympatrically distributed with H. atra. The epidermal structures were examined in these two species by means of transmission electron microscopy to determine how sand adheres to the surface of H. atra. While the epidermis was basically composed of support cells bearing microvilli and vacuolated cells probably corresponding to mucus cells, two types of granular cells, type 1 and 2, were also found at the tip of the tube feet. These granular cells were closely similar in structure to secretory cells that have been supposed to secrete adhesive substances in other holothurians. Type 1 granular cells were also found in the dorsal epidermis of H. atra but not in H. leucospilota. Mizoribine in vitro Therefore, adhesive secretion by type 1 granular cells probably enables the attachment of sand to the H. atra body.Hybridization is one of the negative outcomes for the introduction of non-native species, which can lead to rapid displacement and genetic extinction of native species. Salmonid fishes have been widely introduced outside of their native ranges for food supply and recreational fishing. Here, we investigate the occurrence of introgressive hybridization among native Dolly Varden (Salvelinus curilus (syn. Salvelinus malma)), white-spotted charr (Salvelinus leucomaenis), and introduced brook trout (Salvelinus fontinalis), in streams of the Nishibetsu River, Hokkaido, Japan. Microsatellite DNA analysis detected five hybrids between native Dolly Varden and introduced brook trout. This is the first evidence for hybridization between native Dolly Varden and introduced brook trout, while the latter has been known to hybridize with many other salmonids. Furthermore, incongruence between mitochondrial DNA and microsatellite DNA analyses suggested introgression among the three Salvelinus species. Further studies to estimate the hybrid fitness are necessary to understand how hybridization among the three species affects the native species.Growth-retarded (grt) mice display primary congenital hypothyroidism due to the hyporesponsiveness of their thyroid glands to thyroid-stimulating hormone (TSH). We examined somatic growth, anterior pituitary development, and hormonal profiles in female grt mice and normal ones. Although growth in grt females was suppressed 2 weeks after birth, the measured growth parameters and organ weights gradually increased and finally reached close to the normal levels. Grt mice exhibited delayed eye and vaginal openings and remained in a state of persistent diestrus thereafter, plasma estrogen levels being lower than those in normal mice. Grt mice that received normal-donor thyroids showed accelerated growth and their body weights increased up to the sham-normal levels, indicating the importance of early thyroid hormone supplementation. In the anterior pituitary, there were fewer growth hormone (GH) and prolactin (PRL) cells in grt mice than in normal mice as examined at 12 weeks after birth, but the numbers of these cells did not differ from those in normal mice after 24 weeks. Grt mice had more TSH cells than normal mice until 48 weeks. Plasma GH levels in grt mice were lower than those in normal mice at 2 weeks, but did not differ substantially after 5 weeks. Compared with normal mice, grt mice had significantly lower plasma PRL and thyroxine levels, but notably higher TSH levels until 48 weeks. These findings indicate that thyroid hormone deficiency in grt mice causes delayed development and growth, and inappropriate development of GH, PRL and TSH cells, followed by the abnormal secretion of hormones by these pituitary cells.A Japanese piscivorous chub, "hasu" (Opsariichthys uncirostris), and its main prey, "ayu" (Plecoglossus altivelis), both have laterally asymmetric bodies, similar to other fishes; each population consists of righty morphs and lefty morphs. This antisymmetric dimorphism has a genetic basis. Temporal changes in the ratios of laterality (i.e., frequency of righty morphs in a population) of these predator and prey fish species were investigated for a 20-year period at a pelagic site in the southwestern area of Lake Biwa, Japan. The dimorphism of each species was maintained dynamically throughout the period, and the ratio of laterality was found to change periodically in a semi-synchronized manner. Direct inspection of the relationship between the ratios of laterality of the two species indicated that the ratio of ayu followed that of hasu, suggesting that the predator-prey interaction was responsible for the semi-synchronized change. Stomach contents analysis of each hasu revealed that cross-predation, in which righty predators catch lefty prey and lefty predators catch righty prey, occurred more frequently than the reverse combination (parallel-predation).
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