CURRENT ISSUE

Autism Spectrum Disorder (ASD) is one of several developmental disabilities that can create significant communication and behavioral challenges in affected individuals. Several studies have found that children with ASD have high levels of Folate Receptor Antibody (FRA), which blocks the transport of folate across the Blood-Brain Barrier (BBB) and leads to Cerebral Folate Deficiency (CFD). Supplementation with folate in its reduced form, such as with folinic acid, has been found to improve communication in autistic children with folate receptor antibodies. Here, we provide an overview of the role of folate in nervous system development, effects of FRA on brain folate levels, and clinical trials that have examined the efficacy of folate supplementation in reducing the symptoms of developmental disabilities. Further, we highlight the importance of prenatal folate supplementation in reducing the risk and severity of developmental disorders and the need for additional research to explore optimal dietary interventions to aid in managing them. The results suggest that supplementing with reduced folate may offer a promising treatment approach for individuals with neurodevelopmental disorders, particularly those with FRA.

Anti-aging medicine has been more emphasized in developed countries. For detecting sarcopenia and frailty, bioelectrical impedance analyses (BIA) have recently attracted attention. From BIA by InBody, useful data of water balance, muscle index, and cellular health can be obtained as extracellular water/total body water (ECW/TBW), skeletal muscle mass index (SMI), and phase angle (PhA). PhA shows a close relationship with exercise habits and physical activity. The cut-off values of PhA are approximately 4.05° to 5.05°, which are related to sarcopenia. Average PhA values in males/females showed 7.7°/6.9° in university athletes and 4.1°/3.6° in aged people of 81 years old.

The field of transplantation has provided tremendous progress to diabetic patients. One way to objectify this development is to determine the survival advantage of transplantation in the 4 diabetic recipient categories: simultaneous pancreas and kidney transplantation (SPK), pancreas after kidney transplantation (PAK), pancreas transplantation alone (PTA), and kidney transplantation alone (KTA).
Over a 21-year time period, from January 1, 2000, to May 31, 2021, the IPTR/UNOS collected information about listing and transplant outcome of diabetic patients. A total of 212,049 patient records were reviewed: 89,579 recipients who underwent pancreas and/or kidney transplantation and 122,470 patients who were placed on the waiting list and are still waiting or were removed from the waitlist due to deteriorating health or death. To determine the survival advantage of pancreas transplantation, patient survival on the waiting list versus after transplantation was defined as the primary outcome. Over the 21-year time period, pancreas and/or kidney transplantation in all 4 diabetic recipient categories saved a total of 273,843 life-years. On average, 11.7 life-years per patient were saved in the SPK category, 6.4 life-years in the PTA category, 6.3 life-years in the PAK category, and 6.6 life-years in the KTA category.
The survival advantage of pancreas and/or kidney transplant recipients was highly significant compared to diabetic patients still waiting for transplantation. The survival advantage was higher for patients with type 1 vs. type 2 diabetes mellitus. The significant survival advantage of PTA recipients versus patients on the waiting list justifies the argument for pre-emptive pancreas transplantation, i.e., before the development of end-stage renal disease. Given the survival advantage as evidenced in 273,843 life-years saved, pancreas transplantation should be more widely applied, and pancreas donation encouraged.

Background: Hospitals and healthcare institutions spend a considerable amount of time and capital on constructing an appropriate mission statement for themselves.
Methods: A review of the purpose of mission statements and the statements made by different healthcare organizations was undertaken. For institutions in the USA, their mission statements were examined in the context of their national ratings.
Results: The mission statements of healthcare organizations are often too abstract, using similar phraseology about caring for patients. Concern for the community that the hospital serves is stated by both a hospital listed as one of the best US hospitals and an institution that was considered to be in the lowest tier in the same country. Similarly, the recognition of ‘research’ or ‘innovation and discovery’ was stated by respectively both a top institution in the USA and one in the bottom tier.
Conclusions: Healthcare institutions should replace their mission statements with clear and attainable statements of concrete goals, and indicate how successful the institution is at attaining those goals and improving the experience of its patients and staff.

The latest “Physical Activity and Exercise Guide for Health Promotion 2023” was published in January 2024 by the Ministry of Health, Labor, and Welfare (MHLW) in Japan. Adequate comments were found for some groups, which include age-related differences, various diseases, and working people. The elderly are recommended to have 15 METs of exercise per week, 6,000 walking steps a day, and multi-element exercise >3 days/week such as strength training (ST), balance, and flexibility. Furthermore, this guideline presented key points for safety in three steps: precautions before exercise, understanding symptoms and risk classification, and evaluation of physical activity status.

Background: Patient information in the hospital and any healthcare set up is very important, storing information appropriately ensures that the quality of the patient records is top notch. So, the main objectives were deeply understanding the use of information technology in ensuring that the patient’s confidentiality is in eastern Saudi Arabia is highly elevated.
Methods: The study is a qualitative, descriptive, and cross-sectional to explore various healthcare’s’ perception on the importance of electronic health records in improving patients’ confidentiality in the major hospitals in eastern Saudi Arabia. Qualitative data was obtained from surveying bathe response of the responses of different questions regarding electronic health records. The surveys conducted have been analyzed using Cronbach’s alpha tool that was adopted from the Agency for Healthcare Research and Quality.
Results: 144 healthcare personnel were surveyed through questionnaires. 144 of them took part effectively in the survey. From the survey, 98% of the research participants acknowledged that the use of electronic health records improves confidentiality of the healthcare workers. 70% of the participants agree that they have been issues regarding electronic health records and confidentiality. All the research participants agree that being secretive in keeping patient information.
Conclusion: Electronic health records are very important in the healthcare set up, it is greatly evident that various healthcare workers from various hospitals in eastern Saudi Arabia have weighed in on their perception of the use of electronic health records in the eastern said Arabia. Most of them have shown that the healthcare workers should treat healthcare information with the utmost dignity.

Background: The effectiveness of COVID-19 vaccines in preventing serious infection and death is established, but their protection against infection is less certain. Additionally, their effectiveness diminishes over time. Furthermore, the evolution of the effectiveness of different booster doses of the vaccine against COVID-19, to prevent symptomatic infection in real life during the pandemic and the subsequent endemic, is not clearly documented.
Objective: To compare the effectiveness of the 3^rd and 4^th vaccine boosters against COVID-19 in preventing symptomatic COVID-19 infection during both the pandemic and the subsequent endemic phase.
Methodology: A comparative secondary analysis of the vaccine’s effectiveness against symptomatic COVID-19 infection (calculated as: 1 – (COVID-19 cases with vaccine doses / COVID-19 cases without vaccine dose) × 100) based on a prospective study from December 2021 to October 2023 in a general medicine office was conducted. The first booster dose was administered with monovalent mRNA vaccines, and the second booster with bivalent mRNA vaccines.
Results: From December 2021 to February 2022, the effectiveness of the primer vaccine booster was 60% when administered >= 15 days versus <15 days before infection, and 36% when administered >= 29 days versus < 29 days before infection. From October 2022 to February 2023, the effectiveness of the vaccine’s 4^th dose was 84%. From October 2022 to October 2023, the effectiveness of the 4^th dose of bivalent mRNA vaccine in preventing reinfections was 30%.
Conclusion: In the general practice setting in Toledo, Spain, the effectiveness of the first booster with mRNA vaccines against SARS-CoV-2 primary infection and symptomatic COVID-19 waned over time, but protection remained high with the second bivalent booster. However, the booster vaccine’s effectiveness is more modest in preventing symptomatic reinfections. Overall, completing the booster vaccination is worthwhile.

To maintain health and achieve longevity, an adequate diet is crucial, such as the Mediterranean diet (MD) and the low-carbohydrate diet (LCD). The MD is characterized by whole grains, fruits, vegetables, less red meat, more fish, and four eggs per week. The MD may reduce the risk of heart disease, stroke, dementia, and depression. The LCD shows remarkable weight reduction in a short period, but there may be a probable rebound effect within six months. In Japanese cuisine, the intake of fermented soy foods such as natto and miso can lower the risk of death. As a recommendation, the LCD can be started first, followed by the MD for the long term.

In the context of aging and neuropathology, recent topics in music therapy and related advancements are introduced. The authors have managed the Shikoku division of Integrative Medicine Japan (IMJ). Lifelong engagement in music activities can help maintain cognitive reserve, thus promoting brain health. Musical instrument training has been shown to improve executive function, processing speed, and verbal memory. Playing a musical instrument was associated with a significantly decreased risk of dementia, with a hazard ratio (HR) of 0.64 among the elderly. A comparison between playing an instrument and karaoke showed dementia risk HRs of 0.70 and 0.90, respectively, for elderly males. Musicians were 64% less likely to develop mild cognitive impairment (MCI) or dementia.

The Tokyo University Egogram (TEG) has been recognized as a valuable psychological tool for transactional analysis (TA). TEG has been revised from version 2 to version 3, and the authors have investigated its use in research involving university students. The key findings were as follows: a high prevalence of AC-dominant (dependent) types, a high occurrence of CP-low (gentle) types, dominant child (C) types were more common than parent (P) types, and few cases of A-dominant types were observed, regardless of whether students were in the science and technology departments. The occurrence rate of composite types was low, while that of single ego factors was high. First-year students tended to exhibit low CP and high AC, indicating a need for lifestyle guidance.