半島マレーシア熱帯雨林における中大型哺乳類の塩場利用

京都大学新制・論文博士博士(理学)乙第13577号論理博第1579号新制||理||1713(附属図書館)京都大学大学院理学研究科生物科学専攻（霊長類学・野生動物系）(主査)教授 松田 一希, 教授 平田 聡, 准教授 杉浦 秀樹学位規則第4条第2項該当Doctor of ScienceKyoto UniversityDFA

セイシンカ ビョウイン ニオケル タクエツ シタ カンゴ カンリシャ ノ ジンイン ハイチ ニ カンスル シコウ カテイ ノ メイカクカ

Assignment of appropriate staff is a very important role of the as nursing administrator. The purpose of this research was to clarify a staff assignment process based upon the thought process of distinguished nursing administrators in psychiatric hospitals in order to create a computerized system towards improving patient care outcomes. Participants were seven nursing administrators in psychiatric hospitals which have psychiatric acute care unit and dementia care unit etc. in Japan. A semi-structured interview procedure was using to determine the requirements necessary for systematizing process of designing the staff assignment, and survey contents were “method of information gathering required for staff assignment determination”, “what information required for decision-making”, and “how to evaluate from the collected information”. This study used the qualitative analysis of narratives from participants. As a result, the daily record for unit management, interview, personnel information and patient information through the work schedule were collected, and nursing administrator had determined quantitative and qualitative number of staff assignment through the process of three steps of assessment. As a one important issue for staff assignment, it became clear a lot of nursing administrator’s precious time was spent in gathering, organizing and analyzing information for staff assignment determination

Oseltamivir Prescription and Regulatory Actions Vis-à-Vis Abnormal Behavior Risk in Japan: Drug Utilization Study Using a Nationwide Pharmacy Database

BACKGROUND: In March 2007, a regulatory advisory was issued in Japan to restrict oseltamivir use in children aged 10-19 years because of safety concerns over abnormal behavior. The effectiveness and validity of regulatory risk minimization actions remain to be reviewed, despite their significant public health implications. To assess the impact of the regulatory actions on prescribing practices and safety reporting. METHODOLOY/PRINICPAL FINDINGS: In this retrospective review of a nationwide pharmacy database, we analyzed 100,344 dispensation records for oseltamivir and zanamivir for the period from November 2006 to March 2009. The time trend in dispensations for these antiviral agents was presented before and after the regulatory actions, contrasted with intensity of media coverage and the numbers of spontaneous adverse reaction reports with regard to antivirals. The 2007 regulatory actions, together with its intense media coverage, reduced oseltamivir dispensation in targeted patients in fiscal year 2008 to 20.4% of that in fiscal year 2006, although influenza activities were comparable between these fiscal years. In contrast, zanamivir dispensation increased approximately nine-fold across all age groups. The number of abnormal behavior reports associated with oseltamivir in children aged 10-19 years decreased from fiscal year 2006 to 2008 (24 to 9 cases); this decline was offset by the increased number of reports of abnormal behavior in children under age 10 (12 to 28 cases). The number of reports associated with zanamivir increased in proportion to increased dispensation of this drug (11 to 114 cases). CONCLUSIONS/SIGNIFICANCE: The 2007 actions effectively reduced oseltamivir prescriptions and the number of reports of abnormal behavior in the targeted group. The observed increase in abnormal behavior reports in oseltamivir patients under age 10 and in zanamivir patients suggests that these patient groups may also be at risk, calling into question the validity of the current discrimination by age and agent (Abstract translation is available in Japanese: Appendix S1)

High Human T Cell Leukemia Virus Type-1(HTLV-1) Provirus Load in Patients with HTLV-1 Carriers Complicated with HTLV-1-unrelated disorders

<p>Abstract</p> <p>Background</p> <p>To address the clinical and virological significance of a high HTLV-1 proviral load (VL) in practical blood samples from asymptomatic and symptomatic carriers, we simultaneously examined VL and clonal expansion status using polymerase chain reaction (PCR) quantification (infected cell % of peripheral mononuclear cells) and Southern blotting hybridization (SBH) methods.</p> <p>Results</p> <p>The present study disclosed extremely high VL with highly dense smears with or without oligoclonal bands in SBH. A high VL of 10% or more was observed in 16 (43.2%) of a total of 33 samples (one of 13 asymptomatic carriers, 8 of 12 symptomatic carriers, and 7 of 8 patients with lymphoma-type ATL without circulating ATL cells). In particular, an extremely high VL of 50% or more was limited to symptomatic carriers whose band findings always contained at least dense smears derived from polyclonally expanded cells infected with HTLV-1. Sequential samples revealed that the VL value was synchronized with the presence or absence of dense smears, and declined at the same time as disappearing dense smears. Dense smears transiently emerged at the active stage of the underlying disease. After disappearance of the smears, several clonal bands became visible and were persistently retained, explaining the process by which the clonality of HTLV-1-infected cells is established. The cases with only oligoclonal bands tended to maintain a stable VL of around 20% for a long time. Two of such cases developed ATL 4 and 3.5 years later, suggesting that a high VL with oligoclonal bands may be a predisposing risk to ATL.</p> <p>Conclusion</p> <p>The main contributor to extremely high VL seems to be transient emergence of dense smears detected by the sensitivity level of SBH, corresponding to polyclonal expansion of HTLV-1-infected cells including abundant small clones. Major clones retained after disappearance of dense smears stably persist and acquire various malignant characteristics step by step.</p

Factors Predicting the Quality of Life of University Students in Japan Amidst COVID-19: A Cross-Sectional Study

Owing to the COVID-19 pandemic, classes and club activities in Japanese universities have been canceled; this may increase students’ perceived stress and adversely affect their quality of life. This study investigated the factors that influence Japanese university students’ quality of life during the pandemic. An online questionnaire collating data related to demographic characteristics, the perceived stress scale (PSS), sense of coherence (SOC), number of social supports, and quality of life (Short Form Health Survey; SF-8) was distributed to university students. Participants were divided into two groups: those who entered university before (seniors) and after (juniors) the onset of the pandemic. Their scores on the two sub-domains (physical and mental) of the SF-8 were evaluated. Multiple regression analysis was performed to identify factors associated with the composite mental summary of the SF-8. Regression analysis indicated that the predictor model of the composite mental summary differed between juniors and seniors. Among seniors, the composite mental summary was significantly indicated by the composite physical summary (b = 0.549, p < 0.0001) and PSS (b = 0.422, p < 0.0001). Among juniors, it was significantly indicated by the composite physical summary (b = 0.531, p < 0.0001), PSS (b = 0.390, p < 0.0001), and number of social supports (b = −0.148, p = 0.006). The factors associated with quality of life differed between seniors and juniors. Universities must provide opportunities for students to find more friends, especially for juniors who have limited socialization opportunities owing to the pandemic

Efficacy and Safety of Ensitrelvir in Patients With Mild-to-Moderate Coronavirus Disease 2019: The Phase 2b Part of a Randomized, Placebo-Controlled, Phase 2/3 Study

Background: This phase 2b part of a randomized phase 2/3 study assessed the efficacy and safety of ensitrelvir for mild-to-moderate coronavirus disease 2019 (COVID-19) during the Omicron epidemic. Methods: Patients were randomized (1:1:1) to orally receive ensitrelvir fumaric acid 125 mg (375 mg on day 1) or 250 mg (750 mg on day 1) or placebo once daily for 5 days. The co-primary endpoints were the change from baseline in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) titer on day 4 and time-weighted average change from baseline up to 120 hours in the total score of predefined 12 COVID-19 symptoms. Safety was assessed through adverse events. Results: A total of 341 patients (ensitrelvir 125-mg group: 114; ensitrelvir 250-mg group: 116; and placebo group: 111; male: 53.5–64.9%; mean age: 35.3–37.3 years) were included in the efficacy analyses. The change from baseline in SARS-CoV-2 titer on day 4 was significantly greater with both ensitrelvir doses than with placebo (differences from placebo: −0.41 log10 50% tissue-culture infectious dose/mL; P < .0001 for both). The total score of the 12 COVID-19 symptoms did not show a significant difference between the ensitrelvir groups and placebo group. The time-weighted average change from baseline up to 120 hours was significantly greater with ensitrelvir versus placebo in several subtotal scores, including acute symptoms and respiratory symptoms. Most adverse events were mild in severity. Conclusions: Ensitrelvir treatment demonstrated a favorable antiviral efficacy and potential clinical benefit with an acceptable safety profile. Clinical Trials Registration: Japan Registry of Clinical Trials: jRCT2031210350 (https://jrct.niph.go.jp/en-latest-detail/jRCT2031210350)Clinical Infectious Diseases, 76(8), pp.1403-1411, 2022journal articl

Predictive factors of fetal congenital heart block in anti-SS-A antibody-positive pregnant women

Objectives: Identifying predictive factors of fetal congenital heart block (CHB) in pregnant women with positive anti-SS-A antibodies is important for managing cases properly. Methods: We retrospectively reviewed the medical records of 59 anti-SS-A antibody-positive women who underwent perinatal management at our hospital from January 2011 to November 2021. Univariate and multivariate analyses were performed to determine the factors predicting the development of fetal CHB. Results: Of 59 women with positive anti-SS-A antibodies, 9 exhibited fetal CHB. Univariate analysis revealed that fetal CHB was associated with a diagnosis of connective tissue disease (odds ratio (OR)=0.109, p=0.009) and positive anti-SS-A antibodies after conception (OR=31.333, p=0.0002). Multivariate analysis revealed that a connective tissue disease diagnosis was a protective factor (OR=0.049, p=0.025), whereas positive anti-SS-A antibodies after conception was a risk factor (OR=41.738, p=0.004). However, other maternal clinical characteristics did not influence the development of fetal CHB. Preterm birth, cesarean section rate and need for neonatal intensive care were significantly higher in the CHB group (44.4% vs. 10.0%, p=0.0237; 88.9% vs. 42.0%, p=0.0122; and 88.9% vs. 18.0%, p<0.0001, respectively). Conclusions: In pregnant anti-SS-A antibody-positive women, a connective tissue disease diagnosis and positive anti-SS-A antibodies after conception were independent protective and risk factors for fetal CHB, respectively. Thus, obstetricians should promote preconception care for women who already have a diagnosis of connective tissue disease and identify asymptomatic women with anti-SS-A antibodies to provide appropriate action for CHB during prenatal care. Ryukyu Med. J., 42 (1～4) 35～44, 2023http://purl.org/coar/resource_type/c_650

PosMed: ranking genes and bioresources based on Semantic Web Association Study

ABSTRACT Positional MEDLINE (PosMed; http://biolo