Tirzepatide has demonstrated greater efficacy than semaglutide in improving glycemic control and reducing body weight in patients with type 2 diabetes mellitus (T2DM). However, the optimal tirzepatide dose following a switch from 1.0 mg of semaglutide remains unclear. This retrospective study included 15 T2DM patients who switched to tirzepatide due to inadequate weight loss. All patients started tirzepatide at 2.5 mg, with escalation to either 7.5 mg (n=10) or 10 mg (n=5). Changes in glycated hemoglobin (HbA1c) and body weight were assessed over a 3-month period. The 10 mg group experienced a significant reduction in HbA1c (−0.7%±0.3%, P<0.01) and a non-significant trend toward weight loss (−6.6±5.4 kg, P=0.07). In contrast, no significant changes were observed in the 7.5 mg group. There were no statistically significant differences between groups. Since 10 mg of tirzepatide significantly improved glycemic control after switching from 1.0 mg of semaglutide, early escalation to 10 mg may be beneficial for patients who respond inadequately to semaglutide.

BACKGROUND: Since the accident at Fukushima Daiichi Nuclear Power Plant (FDNPP), concerns have arisen in Japan regarding the presence of radionuclides in food. Moreover, exposure levels to ⁹⁰Sr and Pu isotopes in adults and those to ¹³⁴Cs+¹³⁷Cs, ⁹⁰Sr, and Pu (where Cs, Sr, and Pu are cesium, strontium, and plutonium, respectively) in children have not been examined. Therefore, this study employed a duplicate portion approach to examine dietary exposure levels of radionuclides in adults and children following the FDNPP accident. METHODS: The study spanned fiscal years 2012-2014 and was conducted in 10 prefectures: Hokkaido, Iwate, Miyagi, Fukushima, Ibaraki, Saitama, Tokyo, Kanagawa, Osaka, and Kochi. The participants provided portions of their meals for two non-consecutive days and completed questionnaires on the meal items. The activity concentrations of ¹³⁴Cs, ¹³⁷Cs, ⁹⁰Sr, and ^239+240Pu, which are targets of standard limits for radionuclides in foods in Japan, were determined according to the Radioactivity Measurement Series. The daily intake was calculated based on the radionuclide activity concentrations in the duplicate portion samples, and the committed effective doses were estimated using dose coefficients for the ingestion of each radionuclide provided by the International Commission on Radiological Protection. RESULTS: Approximately 80 duplicate samples were obtained in each fiscal year, and 242 samples were collected. The highest summed activity concentration of ¹³⁴Cs and ¹³⁷Cs was 11 Bq/kg, which was recorded in Date City (child) in 2013; this level was approximately one-ninth of the standard limit for general foods (100 Bq/kg). The committed effective dose from annual ingestion of the sample described above was 74 µSv, approximately 14 times lower than the maximum permissible level of 1 mSv/y. Pu was not detected and the ⁹⁰Sr activity concentrations were similar to those before the FDNPP accident. CONCLUSIONS For the samples examined in the present study, the ¹³⁴Cs, ¹³⁷Cs, ⁹⁰Sr, and ^239+240Pu dietary exposure levels were considerably lower than the regulatory levels and may not pose a health risk.
Fukushima Nuclear Accident ; Cesium Radioisotopes/analysis* ; Humans ; Japan ; Dietary Exposure/statistics & numerical data* ; Adult ; Plutonium/analysis* ; Child ; Food Contamination, Radioactive/analysis* ; Strontium Radioisotopes/analysis* ; Male ; Female ; Middle Aged ; Child, Preschool ; Radiation Monitoring ; Young Adult ; Adolescent ; Aged ; Radiation Exposure/analysis*

This study investigated the percentage of patients with acute myocardial infarction (AMI) who engaged in mild exercise at 6 months after discharge based on the stage of behavior change at discharge. Seventeen patients were categorized in the preparation stage and 16 in the contemplation stage at discharge. Overall, 23.5% of AMI patients in the preparation stage engaged in mild exercise at 6 months after discharge compared with 43.8% of patients in the contemplation stage. No significant difference was observed between the patients in the two groups. This suggests that although the stage of behavior change at discharge in AMI patients in this study differed, the percentage of patients who engaged in mild exercise was the same at 6 months after discharge.

1) All students but 1 correctly typed the ABO blood groups, but only 33.2% of students and 63.9% of physicians properly performed cross-matching.
2) Most failures in cross-matching were due to the inability to detect allogeneic antibodies, but 5.2% of students and 2.9% of physicians failed to detect ABO mismatching.
3) Although laboratory practice is suggested to help students to solidify knowledge and comprehend principles, achieving an official goal of residency - gaining competence in performing and interpreting cross-matching independently - appeared difficult.