Okayama University Medical SchoolActa Medica Okayama0386-300X8022026A Mixed-Methods Study on Changes in Interprofessional Education Attitudes and Fundamental Competencies: A Pre–Post Analysis of Clinical Training in Dietetic Students109117ENMikaSonoiDepartment of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin UniversityNorihiroSonoiCenter for Education in Medicine and Health Sciences, Okayama UniversityYokoKoyamaDepartment of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin UniversityOriginal Article10.18926/AMO/70453This study examined the effects of interprofessional education (IPE) on dietetics students during clinical training, focusing on changes in their attitudes toward IPE and their fundamental competencies. Eighty third-year female students (mean age, 21.0 years) at a Japanese women’s university participated. Self-administered surveys were conducted before and after clinical training to assess attitudes toward IPE using the Readiness for Interprofessional Learning Scale (RIPLS) and the Shakaijin Kisoryoku (SKL; Fundamental Competencies for Working Persons) scale. Quantitative data were analyzed using paired t-tests, chi-squared tests, and cluster analyses. Qualitative data from open-ended responses were analyzed thematically. RIPLS and SKL scores increased significantly, from 65.3 to 68.9, and from 28. 4 to 33. 2, respectively (p<0.001). All 12 SKL items showed significant improvement. In free responses, “initiative” (66 mentions), “communication” (10), and “execution” (8) were the most frequently cited as improved competencies. Cluster analysis identified three groups: increasing scores (n=25), high baseline (n=30), and minimal change (n=25). No significant correlation was found between changes in RIPLS and SKL scores (r=−0.108, p=0.355). IPE integrated into clinical training may enhance dietetics students’ attitudes toward interprofessional collaboration and contribute to the development of professional identity. Individualized, phased IPE implementation is recommended to accommodate differences in learner readiness.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Effects of Nonsurgical Periodontal Treatment on Bacterial and Clinical Parameters in Down Syndrome Patients Based on 16S rRNA Gene Amplicon Sequencing8597ENTakahikoShibaDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoMitsuhitoTakamoriDepartment of Oral Physiology, Graduate School of Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversitySayakaKatagiriDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoRyotaKobayashiDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoAkiKawauchiDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoYujinOhsugiDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoPeiyaLinDepartment of Oral Biology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoDaisukeEkuniDepartment of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasahikoEgusaThe center for Special Needs Dentistry, Medical Development Field, Okayama UniversityTakanoriIwataDepartment of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoShigeruMaedaDepartment of Dental Anesthesiology, Graduate School of Medical and Dental Sciences, Institute of Science TokyoOriginal Article10.18926/AMO/70451Individuals with Down syndrome (DS) are more susceptible to periodontal disease; however, microbial changes following treatment remain insufficiently understood. This study evaluated the effects of nonsurgical periodontal therapy on clinical outcomes and oral microbiome dynamics in 6 patients with DS using 16S rRNA gene amplicon sequencing. Bacterial diversity, composition, network structure, and predicted functional pathways were analyzed using dental plaque samples. Bleeding on probing decreased significantly (p=0.047) after treatment, with a trend toward reduction in periodontal inflamed surface area (p=0.05). The abundance of Fusobacteria at the class level decreased significantly after treatment. The abundance of Mogibacterium timidum was higher in the pretreatment group than in the posttreatment group. M. timidum was positively correlated with Treponema denticola and associated with multiple bacterial taxa in the network during pretreatment. Predicted functional pathways related to aromatic compound degradation were more abundant in posttreatment samples than in pretreatment samples. 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Trends Endocrinol Metab (2020) 31: 818-834.Okayama University Medical SchoolActa Medica Okayama0386-300X8022026Involvement of ADAM12 in TGF-β1-Induced Proliferation of Rheumatoid Arthritis Synovial Fibroblasts7583ENDetingLinDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroHoritaDepartment of Orthopaedic Surgery, Faculty of Medical Development Field, Okayama UniversityMasahitoWatanabeDepartment of Orthopaedic Surgery, Muscat Orthopaedic ClinicJoeHaseiMedical Information and Assistive Technology Development, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiOhtsukiMedical Technology, Graduate School of Health Sciences, Okayama UniversityNoriakiOtsukaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChinatsuIchikawaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiShimizuDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiNaniwaDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroNishidaDivision of Chronic Pain Medicine and Division of Comprehensive Rheumatology, Locomotive Pain Center, Faculty of Medical Development Field, Okayama UniversityOriginal Article10.18926/AMO/70450A disintegrin and metalloproteinase 12 (ADAM12) is known to be involved in chondrocyte proliferation and is upregulated in the synovial tissue of osteoarthritis (OA). However, the underlying mechanisms of ADAM12 on rheumatoid arthritis (RA) synovial cell proliferation remain unknown. Here, we investigated the role of ADAM12 in the proliferation of RA synovial fibroblasts (RASFs). The expression and localization of ADAM12 in RA synovial tissues were examined by immunohistochemistry and compared with OA and healthy control (HC) synovial tissues. The effect of inflammatory cytokines (TNF-α, TGF-β1, and PDGF-BB) on ADAM12 expression in RASFs from RA patients was examined by real-time RT-PCR. The effect of ADAM12 knock-down by ADAM12 siRNA and ADAM12 overexpression on cell proliferation of RASFs were examined by WST-1 assay. ADAM12 was identified predominantly in RA synovial tissue rather than OA and HC synovial tissues. Stimulation with TGF-β1 upregulated the expression of ADAM12 and cell proliferation of RASFs. ADAM12 siRNA suppressed TGF-β1-induced cell proliferation of RASFs, while ADAM12 overexpression promoted the cell proliferation of RASFs. These findings demonstrate that ADAM12 may have a key role in TGF-β1-induced cell proliferation of synovial fibroblasts in patients with RA.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026町づくりを考える実践事例の検討 ―総合的な学習の時間を通じた中学生の意識変化に着目して―191203ENAkemiKAMADAAnan City Anan First Junior High SchoolKazuakiKAJIIFaculty of Education, Okayama University10.18926/CTED/70369 本研究は，中学校総合的な学習の時間における町づくりにおいて，他者との協働や相互作用を通じて町づくりを構想し，実践の結果生じた学習者の変化からその効果を明らかにすることを目的としている。また，対話的な学びで重視される他者との相互作用を，中学校の実践に落とし込み，そのあり方についても検討する。本実践のねらいは，多様な視点から町の将来の姿やあり方を人との関わりについて読み解き，持続可能な町のあり方について自分事に引き寄せて考えることで，町に対する意識の変化を促すことにある。実践の結果，学習者の町に対する見方や考え方の意識変化が引き起こされ，町づくりの持つ地域課題について自分事に引き寄せて思考することができた。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026吹奏楽活動の地域展開における市民吹奏楽団の関わりに関する研究 ―市民吹奏楽団は地域展開の担い手になり得るか―123137ENKunihikoMAKINOCenter for Teacher Education and Development、Okayama University10.18926/CTED/70364 吹奏楽活動の地域展開（以下、地域展開）において、指導者や活動場所の不足は喫緊の課題である。本研究は、地域展開が進む中で、市民吹奏楽団が地域の子ども達の吹奏楽活動を支える担い手となり得るかを調査・検討した。岡山県内の市民吹奏楽団20 団体への聞き取り調査とテキストマイニング分析の結果、地域展開への意識には差がみられ、積極的な団体では子ども達の演奏指導や合同での活動を肯定的に捉える傾向が確認された。一方で、指導技術や時間的制約、責任負担への不安が障壁となっている可能性が示唆された。また、市民吹奏楽団が抱える活動場所や財政的な課題に対して公立学校施設の活用がその解決に寄与し得る可能性が示唆された。一方で、公立学校の施設開放については、実際の制度運用において自治体間の格差が存在することが明らかとなった。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構 教師教育開発センターActa Medica Okayama2186-1323162026地域社会とグローバルをつなぐ和楽器音楽次世代育成の実践研究（３） 小中学生の質問紙調査に見る「異文化間能力」育成の可能性91105ENRinkoHAYAKAWAOkayama UniversityYukoBEPPUKurashiki City CollegeMihoYAMAJIPart-time Lecturer at Okayama UniversityYokoHANAKUSAResearch Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationNorikoTAKESHITABiwako-Gakuin UniversityHiromiTAKASUOkayama UniversityKeikoMIYOSHIResearch Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationNaokoSHIMIZUDoctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationChihiroTOSAYamaha CorporationAiNAKAMURA Doctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationAkiHIGUCHIOkayama Prefectural School for the Deaf10.18926/CTED/70362 本研究は，「おかやま国際和楽器学生フェスティバル」の実践における，異文化間能力育成の可能性について，参加した小中学生の質問紙調査結果から検討した。<br>
その結果，１）体験を通して形成された新たな認識により，和楽器音楽文化と自己との関係性を再認識・再構築し，和楽器音楽文化への積極的な関与を示す価値づけ・意味づけが行われ，内在化が促されたこと，２）越境文化としての和楽器音楽文化に対して，開放的・尊重的態度を示していたが，自己の文化的アイデンティティを意識する契機となったこと，３）和楽器音楽の共有を通して生じた共感の上に，相互理解や協働関係が構築されていたこと，４）「文化の共有の可能性についての認識」が形成されるなど，フェスティバルでの経験が，文化観の形成に影響を与える契機となっていたこと，が明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026わが国のアドバンス・ケア・プランニングにおける地域住民への動機づけと評価についてのナラティブ・レビュー3947ENTakakoHASUIJapanese Red Cross Hokkaido College of NursingNaokoNAKAYAMAKanagawa University of Human Services10.18926/interdisciplinary/70329No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026Shared Decision Making における患者参加の諸相と課題の考察1725ENMihoYOSHIDAGraduate School of Interdisciplinary Science and Engineering in Health Systems Okayama University10.18926/interdisciplinary/70327This paper traces the historical development of decision-making models in healthcare while exploring the meaning and practical significance of “patient participation” within the shared decision-making (SDM) framework. SDM is a recommended approach to clinical decision-making that emphasizes mutual information sharing and deliberation between physicians and patients. Traditional models often assume that patients can clearly articulate their values, preferences, and treatment goals. However, in actual clinical settings, particularly in cases of serious illness or life-threatening situations, patients frequently face emotional distress and psychological burdens, which can hinder their active participation in decision-making and the expression of their preferences. Based on SDM theory and practice reports, this study argues that SDM should not be viewed merely as a process that promotes patient choice. Even when patients choose not to actively participate and ultimately delegate decisions to healthcare providers or family members, such a choice can represent autonomous decision-making if it arises through meaningful communication and mutual understanding. This perspective calls for a more comprehensive and flexible interpretation of patient participation in SDM practice.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322762026The effects of cold compresses on itching in patients with atopic dermatitis: A cross-over controlled pilot trial16ENYukiHIRAMIFormer Department of Nursing, Graduate School of Health Sciences, Okayama UniversityNahokoHARADADepartment of Nursing Science, Faculty of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMihoONODepartment of Nursing, Faculty of Health, Kagawa Prefectural University of Health SciencesMasahideKODACo-learning Community Healthcare Re-innovation Office, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKiyokoFUKAIProfessor Emeritus, Okayama University, Graduate School of Nursing, The Jikei University School of Medicine10.18926/interdisciplinary/70325This cross-over controlled trial aimed to evaluate the effectiveness and safety of two types of cold compresses (towels and ice packs) in alleviating itching among patients with atopic dermatitis. The study recruited 19 participants diagnosed with atopic dermatitis and suffering from chronic itching for over 6 months. Each participant received both types of cold compress interventions. Itching sensations were assessed repeatedly using a visual analogue scale before and after the application of the cold compress. The mean and standard deviation of itching scores for the towel intervention were 16.9 ± 19.1 (baseline) and 11.4 ± 16.1 (post-application). For the ice pack intervention, the scores were 13.6 ± 14.7 (baseline) and 6.2 ± 9.8 (post-application). Although there was a reduction in mean itching scores following the application of cold compresses, the differences were not statistically significant for either intervention. Despite the lack of statistical significance, this study suggests that cold compresses, which are user-friendly and inexpensive, may safely reduce subjective itching in patients with atopic dermatitis without causing pain or discomfort. However, further research with a larger sample size is needed to confirm these findings.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231912026地域と人々を繋ぐ音楽活動 ― 地域活力の回復を目指すコンサートの開催 ―131145ENShinsukeOKAMOTOFaculty of Education, Okayama University10.18926/bgeou/70202 本研究は，人口減少に伴って小中学校の統廃合が進む岡山県玉野市において，地域活力の回復を図る機会を作り，そのような機会を地域住民自ら作り出す機運を高めることを目的としている。本研究では，東児中学校区を対象に，校歌を再構成した作品の発表と，地域住民と協働で企画，運営を行うコンサートの開催という二つの取組を2023～24年度にかけて実践し，住民同士の繋がりを強め，住民らが地域への関心を深めていくことを図った。両取組は，地域住民に好意的に受け入れられた結果となり，今後の取組の展開へ繋がる成果が得られた。2025年現在，両取組を実践した地域において，地域活性化を図る芸術活動団体が新たに結成され，地域活力の回復を目指す動きが住民の中で見られはじめていることから，本地域の今後の動向が注目される。No potential conflict of interest relevant to this article was reported.岡山大学農学部Acta Medica Okayama2186-77551152026北海道東部の森林において林冠木の細根が土壌窒素動態に与える影響912ENMasatakaNakayamaCourse of Environmental Ecology Plants release mixtures of labile organic matter from their fine roots (root exudates) into the surrounding soil (rhizosphere). Partly due to the release of root exudates, microbial community structures and their activities within the rhizosphere differ significantly from those in other soil areas (bulk soil). Consequently, nutrient cycling processes, including nitrogen mineralization, are accelerated in the rhizosphere, facilitating nutrient acquisition by plants. This phenomenon, known as the rhizosphere effect, has been repeatedly reported in studies of herbaceous plants; however, the impact of canopy tree fine roots on soil nitrogen dynamics through the effect in forest ecosystems remains largely unknown. Here, I introduce our research investigating the root exudates and rhizosphere effects of the fine roots of canopy trees, Quercus crispula, and how these fine roots affect soil nitrogen dynamics. The quantity of root exudates varied daily rather than seasonally, with solar radiation having a strong and positive effect on the amounts. However, even after leaf fall, root exudation was observed. In the rhizosphere, specific bacterial communities were present regardless of season, while ectomycorrhizal fungal populations were higher than in the bulk soil only in summer. Extracellular enzymatic activity relating to nitrogen cycling was higher in the rhizosphere than in the bulk soil across seasons. Nitrogen uptake by the tree was likely lower in winter and spring, leading to labile nitrogen accumulation in the rhizosphere during these periods. On an annual basis, however, the impact of fine roots on apparent inorganic nitrogen dynamics was minor. These results suggest that the canopy tree, Q. crispula, accelerates soil nitrogen cycling through root exudation and rhizosphere effects, regardless of season, while the acceleration of the cycle and the utilization of available nitrogen are well-balanced annually, thereby avoiding unnecessary carbon investment.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026Teaching and Learning：Japanese and International Student Collaboration in the Classroom209226ENAlexisPUSINAJunkoOTOSHI10.18926/70122This practical report introduces three intercultural collaborative trial classes designed to integrate Japanese and international students in first-year EFL classes. Using a CLIL-informed approach, the classes promoted intercultural understanding through culturally grounded activities and small-group communication tasks. Reflection surveys from both Japanese and international participants revealed overall positive experiences, with international students expressing strong enjoyment and Japanese students highlighting both linguistic gains and communication challenges. Analysis indicates that interaction across diverse cultural and linguistic backgrounds fostered intercultural awareness while motivating Japanese learners to further develop their speaking skills. The findings support the value of collaborative, content-based activities for enhancing intercultural understanding.No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595232026オンラインによるボランティア日本語教室における参加者間のインターアクションの分析 ―地域型日本語教育の実現に向けて―3140ENMiwaSUESHIGEInstitute for Promotion of Education and Campus Life, Okayama University10.18926/70110 本研究では，地域型日本語教育のモデル構築に向け，地域型の特徴を有する教室内での支援者および参加者の発話や教授行動の傾向を明らかにすべく，外国語相互作用分析システムを用い，オンラインによるボランティア教室におけるインターアクションの分析を行った。分析の結果，（1）支援者の平均発話数が学習者より多いこと，（2）支援者の発話における間接的行動の割合が直接的行動よりもやや高いことが示された。「おしゃべり型の教育」では，学習者が伝えたいことを言語化していくプロセスの中で，間接的行動の下位分類の「質問」「学習者の意図の利用」「学習者の回答の繰り返し」等を支援者が積極的に使用し支援していることが分かった。No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1424-82202642026A Generative AI–Based Technical Data Extraction Tool for IoT Application Systems1081ENDezhengKongDepartment of Information and Communication Systems, Okayama UniversityNobuoFunabikiDepartment of Information and Communication Systems, Okayama UniversityHtoo Htoo SandiKyawDepartment of Information and Communication Systems, Okayama UniversityI Nyoman DarmaKotamaDepartment of Information and Communication Systems, Okayama UniversityZihaoZhuDepartment of Information and Communication Systems, Okayama UniversityAlfiandi AuliaRahmadaniDepartment of Information and Communication Systems, Okayama UniversityNowadays, Internet of Things (IoT) application systems play an essential role in smart cities, industry, healthcare, agriculture, and smart homes. For non-expert users, designing and implementing IoT application systems remains challenging, especially when configuring sensors, edge devices, and server platforms. To support configuration tasks of IoT application systems, we have developed an AI-based setup assistance tool. However, AI models still fail to reliably support newly released or previously unseen devices, sometimes producing incomplete or erroneous outputs that may lead to configuration failures. Incorporating their technical-document information into Retrieval-Augmented Generation (RAG) is an effective way to supplement AI knowledge and improve reliability. In this paper, we propose a generative AI-based technical data extraction tool to address the challenges. It extracts essential technical information using the schema-based extraction from given PDF or HTML datasheets and converts it into a structured format suitable for AI-supported configurations. A local vector database is used to enable semantic similarity retrieval and provide document-grounded evidence for RAG-based answering, ensuring consistent support for previously unseen IoT devices. For evaluations, we applied the proposal to several sensor and device datasheets and compared extracted specifications with ground-truth values to measure accuracy and completeness. Then, we compared end-to-end configuration QA reliability against a commercial baseline (ChatPDF) using the golden benchmark. The results show that the proposed tool reliably acquires key specifications and significantly improves end-to-end configuration QA reliability. Across 960 golden QA pairs, the proposed method improves Recall from 0.636 to 0.926 and Accuracy from 0.595 to 0.807 compared with ChatPDF.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Changes in Prescribing Patterns of Antiviral Drugs before and after Public Coverage Termination among Hospitalized COVID-19 Patients in Regional Hospitals in Japan: A Retrospective, Multicenter Study5562ENHidemasaAkazawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,HideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalShinnosukeFukushimaDepartment of Infectious Diseases, Okayama University HospitalShoheiYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,FumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,Original Article10.18926/AMO/70073In Japan, antiviral agents for COVID-19 were freely available until September 2023 as part of national policy. This study evaluated changes in these agents’ prescribing patterns and the patient outcomes following the policy shift. We conducted a multicenter retrospective study at four hospitals in Japan’s Okayama and Kagawa prefectures from January 2022 to March 2024. The study period was divided into the public-expenditure phase (January 2022 to September 2023) and the post-expenditure phase (October 2023 to March 2024). We extracted the hospitalized patients’ clinical data from the electronic database. The study’s primary outcome was the antiviral prescription rate; the secondary outcome was in-hospital mortality. Among the 302 hospitalized patients (median age 85 years), 52.0% were classified as having a mild condition. Of the patients with mild conditions, 37.7% were diagnosed in outpatient settings prior to hospitalization. During the public-expenditure phase, 47.4% of the patients received antivirals as outpatients, mainly molnupiravir (80.9%). In the post-expenditure period, 80.0% of the patients were prescribed antivirals, mostly molnupiravir (91.7%). The antiviral prescription rate was significantly higher after the policy change. The overall in-hospital mortality was 15.8%, with no significant difference between the two periods (17.0% vs. 10.5%). Despite the termination of government funding, antiviral prescriptions remained frequent at community hospitals located in highly aging regions of western Japan such as Okayama and Kagawa prefectures. Mortality remains high among the elderly, highlighting the need for continued antiviral therapy and booster vaccinations.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X8012026Development of a Stroke Discharge Support Evaluation Scale for Ward Nurses in Acute Care Hospitals1730ENHidekiYanoDepartment of Nursing, Faculty of Human Health Sciences, Niimi UniversityYokoTakahataGraduate School of Health Sciences, Okayama UniversityTakeshiYamaguchiFaculty of Nursing, Shikoku UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/70069This study aimed to develop a scale enabling nurses to objectively evaluate their own stroke discharge support, as a basis for enhancing its overall effectiveness. A draft scale was created based on a literature review, and consisted of a 51-item, 5-point Likert-type questionnaire administered to ward nurses engaged in stroke discharge support at acute care hospitals. Factor analysis was performed to refine the scale. Construct validity was assessed using the known-groups method, and reliability was evaluated through internal consistency analysis. The resulting Stroke Discharge Support Evaluation Scale comprises 29 items across 5 factors, each rated on a 5-point Likert scale. Analysis of the data collected from 237 valid responses demonstrated good internal consistency and supported the scale’s construct validity. The Stroke Discharge Support Evaluation Scale is a reliable and valid tool enabling ward nurses in acute care hospitals to evaluate their own stroke discharge support.No potential conflict of interest relevant to this article was reported.BMJActa Medica Okayama0143-005X8022025Exposure-induced mediator–outcome confounders in causal mediation: implications and visualisation129130ENEtsujiSuzukiDepartment of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomohiroShinozakiInterfaculty Initiative in Information Studies, the University of TokyoEijiYamamotoOkayama University of ScienceNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Blood Pressure and Heart Rate Patterns Identified by Unsupervised Machine Learning and Their Associations with Subclinical Cerebral and Renal Damage in a Japanese Community: The Masuda Study369379ENTakashiHisamatsuDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinakoKinutaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSosukeMunetomoDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMariFukudaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuhideKojimaDepartment of Radiology, Okayama University HospitalKaoriTaniguchiDepartment of Environmental Medicine and Public Health, Izumo, Shimane University Faculty of MedicineNorikoNakahataDepartment of Health and Nutrition, The University of Shimane Faculty of Nursing and NutritionHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/69438We applied unsupervised machine learning to analyze blood pressure (BP) and resting heart rate (HR) patterns measured during a 1-year period to assess their cross-sectional relationships with subclinical cerebral and renal target damage. Dimension reduction via uniform manifold approximation and projection, followed by K-means++ clustering, was used to categorize 362 community-dwelling participants (mean age, 56.2 years; 54.9% women) into three groups: Low BP and Low HR (Lo-BP/Lo-HR), High BP and High HR (Hi-BP/Hi-HR), and Low BP and High HR (Lo-BP/Hi-HR). Cerebral vessel lesions were defined as the presence of at least one of the following magnetic resonance imaging findings: lacunar infarcts, white matter hyperintensities, cerebral microbleeds, or intracranial artery stenosis. A high urinary albumin-to-creatinine ratio (UACR) was defined as the top 10% (≥ 12 mg/g) of the mean value from ≥2 measurements. Poisson regression with robust error variance, adjusted for demographics, lifestyle, and medical history, showed that the Hi-BP/Hi-HR group had relative risks of 3.62 (95% confidence interval, 1.75-7.46) for cerebral vessel lesions and 3.58 (1.33-9.67) for high UACR, and the Lo-BP/Hi-HR group had a relative risk of 3.09 (1.12-8.57) for high UACR, compared with the Lo-BP/Lo-HR group. These findings demonstrate the utility of an unsupervised, data-driven approach for identifying physiological patterns associated with subclinical target organ damage.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7952025Current Status of Extracorporeal Membrane Oxygenation as a Treatment Strategy for Primary Graft Dysfunction after Lung Transplantation329337ENKeiMatsubaraDepartment of Thoracic Surgery, Hiroshima City Hiroshima Citizens HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinichiToyookaDepartment of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/69433Primary graft dysfunction (PGD) is one of the major risk factors affecting patients’ short- and long-term survival after lung transplantation. No particular management strategy has been established for PGD; supportive care is the mainstay of PGD treatment. When a supportive strategy fails, the patient may require the introduction of extracorporeal membrane oxygenation (ECMO) as the last-resort measure for severe PGD. A variety of study of ECMO as a PGD treatment was reported and the management of PGD patients developed so far. Early recognition of a patient’s need for ECMO and its prompt initiation are critical to improved outcomes. The use of venovenous-ECMO became the preferred procedure for PGD rather than venoarterial-ECMO. However, the current ECMO strategy has limitations, and using ECMO to manage patients with PGD is not sufficiently effective. Further studies are required to develop this promising technology.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1999-59031752025An Improved Reference Paper Collection System Using Web Scraping with Three Enhancements195ENTresna MaulanaFahrudinDepartment of Information and Communication Systems, Okayama UniversityNobuoFunabikiDepartment of Information and Communication Systems, Okayama UniversityKomang CandraBrataDepartment of Information and Communication Systems, Okayama UniversityInzaliNaingDepartment of Information and Communication Systems, Okayama UniversitySoe ThandarAungDepartment of Information and Communication Systems, Okayama UniversityAmriMuhaiminDepartment of Data Science, Universitas Pembangunan Nasional Veteran Jawa TimurDwi ArmanPrasetyaDepartment of Data Science, Universitas Pembangunan Nasional Veteran Jawa TimurNowadays, accessibility to academic papers has been significantly improved with electric publications on the internet, where open access has become common. At the same time, it has increased workloads in literature surveys for researchers who usually manually download PDF files and check their contents. To solve this drawback, we have proposed a reference paper collection system using a web scraping technology and natural language models. However, our previous system often finds a limited number of relevant reference papers after taking long time, since it relies on one paper search website and runs on a single thread at a multi-core CPU. In this paper, we present an improved reference paper collection system with three enhancements to solve them: (1) integrating the APIs from multiple paper search web sites, namely, the bulk search endpoint in the Semantic Scholar API, the article search endpoint in the DOAJ API, and the search and fetch endpoint in the PubMed API to retrieve article metadata, (2) running the program on multiple threads for multi-core CPU, and (3) implementing Dynamic URL Redirection, Regex-based URL Parsing, and HTML Scraping with URL Extraction for fast checking of PDF file accessibility, along with sentence embedding to assess relevance based on semantic similarity. For evaluations, we compare the number of obtained reference papers and the response time between the proposal, our previous work, and common literature search tools in five reference paper queries. The results show that the proposal increases the number of relevant reference papers by 64.38% and reduces the time by 59.78% on average compared to our previous work, while outperforming common literature search tools in reference papers. Thus, the effectiveness of the proposed system has been demonstrated in our experiments.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Bloodstream Infections Caused by Gram-Negative Bacteria in Geriatric Patients: Epidemiology, Antimicrobial Resistance and The Factors Affecting Mortality231242ENM Enes KardanDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityIlknurErdemDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityEmreYildizDepartment of Infectious Diseases, Faculty of Medicine, Namik Kemal UniversityNuriKirazDepartment of Medical Microbiology, Faculty of Medicine, Namik Kemal UniversityAliyeÇelikkolDepartment of Biochemistry, Faculty of Medicine, Namik Kemal UniversityOriginal Article10.18926/AMO/69148Bloodstream infections (BSIs) are an important cause of morbidity and mortality in geriatric patients. We retrospectively analyzed the cases of geriatric patients who developed BSIs due to gram-negative bacteria in order to evaluate the epidemiology, antimicrobial resistance, and the factors affecting mortality. The cases of 110 patients aged ≥ 65 years admitted to our hospital between January 1, 2017, and December 31, 2022 were assessed; 70 (63.6%) of the BSIs were healthcare-associated BSIs. The urinary system was the most common detectable source of infection at 43.6%. The most frequently isolated bacteria were Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae, in that order. Carbapenem resistance was detected in 17 patients (15.5%), and extended-spectrum beta-lactamase (ESBL) production from Enterobacterales family members was detected in 37 (51.4%) patients. Multivariate analysis revealed that (i) the probability of mortality in the patients with total bilirubin was increased by approx. sixfold and (ii) the likelihood of mortality for those with a Pitt bacteremia score (PBS) ≥ 4 points was approx. 17 times higher. PBS and simplified qPitt scores can help predict mortality and manage geriatric patients. There is a significant increase in mortality among patients with procalcitonin (PCT) levels at ≥ 2 nm/ml.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7942025Organ Donation after Extracorporeal Cardiopulmonary Resuscitation: Clinical and Ethical Perspectives221229ENTetsuyaYumotoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiromichiNaitoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiHongoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakafumiObaraDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityYoshinoriKosakiDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiAgetaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTsuyoshiNojimaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKoheiTsukaharaDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityAtsunoriNakaoDepartment of Emergency, Critical Care and Disaster Medicine, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/69147Extracorporeal cardiopulmonary resuscitation (ECPR) has evolved into a life-saving therapy for select cardiac arrest patients, yet a growing body of evidence suggests it also holds promise as a bridge to organ donation in non-survivors. This review explores the clinical outcomes, ethical complexities, and evolving policies surrounding organ donation after ECPR. We summarize recent international and Japanese data demonstrating favorable graft function from ECPR donors, with the exception of lung transplantation. The ethical challenges — particularly those involving brain death determination on extracorporeal membrane oxygenation and adherence to the dead donor rule — are discussed in the context of Japan’s recent regulatory reforms. Additionally, we highlight the importance of structured end-of-life communication through multidisciplinary team meetings in facilitating ethically sound transitions from rescue efforts to donation pathways. Moving forward, improvements in donor management, standardized legal frameworks, and public and professional education are essential to optimizing the life-saving and life-giving potential of ECPR.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465712025イノベーションの発生源研究の再検討120ENQiHuangDaijiFujii10.18926/OER/69001 本論文は，イノベーションの発生源に関する先行研究を振り返り，「いつ」「どこで」「誰によって」イノベーションが生み出されるのかを理論的に考察することを目的とする。考察の結果，「B to B」の文脈においては，イノベーションの発生源が企業ユーザーへ移行するメカニズムとして，取引コスト理論，期待利益仮説，情報粘着性の仮説，企業内部の独自能力（吸収能力），および外部の産業構造（製品アーキテクチャ・エコシステム）といった複数の要素からなる経済的合理性の観点から分析されていることが明らかになった。一方，「B to C」の文脈では，エンドユーザーがイノベーションに向かう動機として，「ニッチ市場に対するメーカーの消極的な対応」「創造的活動の楽しさ」「ユーザーコミュニティとの繋がり」「知識・スキルの向上」など多種多様な要素が存在し，中でも創造的活動の楽しさが根源的な動機づけの1つであると確認された。一方で，イノベーターを突き動かす心理的要因をブラックボックス化したまま放置することは，単なる知的好奇心の問題に留まらず，社会科学としての経営学にとっても重要な問題であると考えられる。今後のイノベーションの発生源研究においては，起業家をはじめとするイノベーター個人の心理的側面にいかに目を向け，創造的活動におけるポジティブな感情が働くメカニズムをイノベーションの発生メカニズムにいかに位置づけるか，その研究アプローチの提示が求められる。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama2041-17231512024A high-protein diet-responsive gut hormone regulates behavioral and metabolic optimization in Drosophila melanogaster10819ENYutoYoshinariMetabolic Regulation and Genetics, Institute for Molecular and Cellular Regulation, Gunma UniversityTakashiNishimuraMetabolic Regulation and Genetics, Institute for Molecular and Cellular Regulation, Gunma UniversityTaishiYoshiiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityShuKondoDepartment of Biological Science and Technology, Faculty of Advanced Engineering, Tokyo University of ScienceHiromuTanimotoGraduate School of Life Sciences, Tohoku UniversityTomoeKobayashiDivision of Molecular Genetics, Shigei Medical Research InstituteMakotoMatsuyamaDivision of Molecular Genetics, Shigei Medical Research InstituteRyusukeNiwaLife Science Center for Survival Dynamics, Tsukuba Advanced Research Alliance (TARA), University of TsukubaProtein is essential for all living organisms; however, excessive protein intake can have adverse effects, such as hyperammonemia. Although mechanisms responding to protein deficiency are well-studied, there is a significant gap in our understanding of how organisms adaptively suppress excessive protein intake. In the present study, utilizing the fruit fly, Drosophila melanogaster, we discover that the peptide hormone CCHamide1 (CCHa1), secreted by enteroendocrine cells in response to a high-protein diet (HPD), is vital for suppressing overconsumption of protein. Gut-derived CCHa1 is received by a small subset of enteric neurons that produce short neuropeptide F, thereby modulating protein-specific satiety. Importantly, impairment of the CCHa1-mediated gut-enteric neuronal axis results in ammonia accumulation and a shortened lifespan under HPD conditions. Collectively, our findings unravel the crosstalk of gut hormone and neuronal pathways that orchestrate physiological responses to prevent and adapt to dietary protein overload.No potential conflict of interest relevant to this article was reported.IEEEActa Medica Okayama2833-23502023Non Real-Time Data Transmission Performance Analysis of PROFINET for Assuring Data Transmission Quality236244ENTakashiNorimatsuGraduate School of Natural Science and Technology, Okayama UniversityToshihiroYamauchiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityThe industrial Ethernet PROFINET supports three different data transmission modes: isochronous real-time (IRT), real-time (RT), and non real-time (NRT) transmitting data requiring hard, soft, and no real-time performances, respectively. The data transmission latency in the NRT increased with the amount of data transmission in the IRT, RT, and NRT. Therefore, the quality of data transmission in NRT may degrade as the amount of data transmission in IRT, RT, and NRT increases. In this study, we derived the average data transmission latency in an NRT with data transmission in IRT and RT by applying stochastic processes. This allowed us to maintain the quality of data transmission in the NRT by adjusting the number of devices connected to the network and the number of applications transmitting data in the NRT so that the average latency of data in the NRT does not exceed a certain value.No potential conflict of interest relevant to this article was reported.Springer Nature SwitzerlandActa Medica Okayama2367-45122025Investigation Towards Detecting Landing Websites for Fake Japanese Shopping Websites107119ENDaigoMichishitaGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversitySatoruKobayashiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityToshihiroYamauchiFaculty of Environmental, Life, Natural Science and Technology, Okayama UniversityRecently, the number of victims of fake shopping websites that imitate legitimate ones to defraud people has been increasing. It has been shown that fake shopping websites use legitimate defaced landing websites as their leading paths. Therefore, if the detection of landing websites for fake shopping websites can be achieved, it can assist in addressing these websites and reduce the opportunities for users to be redirected to fake shopping websites. In this study, we collect and investigate existing landing websites that redirect users to fake Japanese shopping websites and identify effective features for detecting them. We identified effective search terms for collecting landing websites for fake Japanese shopping websites and found that using Google searches with queries of top-level domain and product names was effective. We also investigated the conditions for activating analytical evasion functions in the collected landing websites for fake Japanese shopping websites and clarified the differences in search results between crawlers and users.No potential conflict of interest relevant to this article was reported.MDPI AGActa Medica Okayama1424-822025122025Effects of Sampling Frequency on Human Activity Recognition with Machine Learning Aiming at Clinical Applications3780ENTakahiroYamaneDepartment of Biomedical Informatics, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMoekaKimuraFaculty of Health Sciences, Okayama University Medical SchoolMizukiMoritaDepartment of Biomedical Informatics, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHuman activity recognition using wearable accelerometer data can be a useful digital biomarker for severity assessment and the diagnosis of diseases, where the relationship between onset and patient activity is crucial. For long-term monitoring in clinical settings, the volume of data collected over time should be minimized to reduce power consumption, computational load, and communication volume. This study aimed to determine the lowest sampling frequency that maintains recognition accuracy for each activity. Thirty healthy participants wore nine-axis accelerometer sensors at five body locations and performed nine activities. Machine-learning-based activity recognition was conducted using data sampled at 100, 50, 25, 20, 10, and 1 Hz. Data from the non-dominant wrist and chest, which have previously shown high recognition accuracy, were used. Reducing the sampling frequency to 10 Hz did not significantly affect the recognition accuracy for either location. However, lowering the frequency to 1 Hz decreases the accuracy of many activities, particularly brushing teeth. Using data with a 10 Hz sampling frequency can maintain recognition accuracy while decreasing data volume, enabling long-term patient monitoring and device miniaturization for clinical applications.No potential conflict of interest relevant to this article was reported.岡山大学教育学部Acta Medica Okayama0471-4008891992「混住化農村調査」第１次報告書(1)734ENMASAONOBE10.18926/bgeou/68586No potential conflict of interest relevant to this article was reported.岡山大学教育学部Acta Medica Okayama0471-4008901992「混住化農村調査」第１次報告書（Ⅱ）915ENMASAONOBE10.18926/bgeou/68585No potential conflict of interest relevant to this article was reported.岡山大学教育学部Acta Medica Okayama0471-4008951994混住化農村への流入過程の一考察 一倉敷市上東における既婚女性の事例一141152ENMASAONOBE10.18926/bgeou/68580No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025日中の高校生の手紙を使った交流活動を取り入れた国際理解教育の試み ―国際的課題を取り上げた公民科の単元開発―313324ENMoekaBEKKITokyo Metropolitan Ogawa High SchoolXingxingZHOUSchool of Foreign Languages, Shijiazhuang UniversityToshinoriKUWABARAFaculty of Education, Okayama University10.18926/CTED/68501 本研究は，日本と中国の高校生が地球規模の国際的課題について考えを共有するために，手紙を交換する学習活動を通して相互理解を深め，国際社会の一員としての自覚を持つようになることを目指した授業の開発・実践の成果を報告するものである。実践を通して，交流活動は生徒にとって次のような意義があることが明らかになった。第ーは，外国人との初めての一対一の交流であったということである。直接会わない形であったとしても，今回の授業を受けた多くの生徒にとっては他の国の人と関わる初めての経験であった。第二は，他国の文化や学校への関心を持つきっかけとなったことである。第三は，気候変動問題に対してグローバルな視点で考えるきっかけを与えられたということである。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025ASD 児における相互伝達行為の獲得を目指した遊びを中心としたコミュニケーション指導 ポジティブな情動の共有を生み出す遊びの環境設定を通して281295ENKeisukeKAKUHARATobi Special SchoolMarinaBANSpecial School Affiliated with the Faculty of Education at Okayama UniversityTakayukiTANJIInstitute of Human Sciences, University of Tsukuba10.18926/CTED/68497 自閉スペクトラム症児は，相互伝達行為の獲得に遅れがあることが指摘されている。本研究では，自閉スペクトラム症の診断のある知的障害特別支援学校小学部１年生男児を対象に，相互伝達行為の獲得を目指して，遊びを中心とした指導を行った。その結果，対象児の遊びが「感覚運動的遊び」「機能的遊び」から「象徴的遊び」「社会的遊び」へと移行するに伴い，相互伝達行為が見られるようになった。また，教師による働き掛けへの応答も見られるようになり，ポジティブな情動の共有が生み出されやすい遊びの環境設定が，相互伝達行為の獲得において効果的であったことが示唆された。遊び環境については，1）魅力的な玩具，2）魅力的な玩具を介した教師との遊び，3）対象児の遊びの発達段階に応じた介入，4）情動の共有を促す共感的関わりの４点が相互伝達行為の獲得を促した可能性が考えられた。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025地域社会とグローバルをつなぐ和楽器音楽次世代育成の実践研究（１） 「おかやま国際和楽器学生フェスティバル」外的評価の分析235249ENRinkoHAYAKAWAOkayama UniversityMihoYAMAJIKoto PlayerHiromiTAKASUOkayama UniversityYukoBEPPUKurashiki City CollegeAkiHIGUCHIOkayama Prefectural School for the DeafAiNAKAMURADoctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationNaokoSHIMIZUDoctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationYokoHANAKUSAResearch Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationNorikoTAKESHITAResearch Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher EducationKeikoMIYOSHIMaster’s Student at the Graduate School of Education in Okayama UniversityChihiroTOSAMaster’s Student at the Graduate School of Education in Okayama University10.18926/CTED/68494 本稿では，「和楽器音楽及び教育の拠点づくりの実践研究」の一環として開催した「おかやま国際和楽器学生フェスティバル」の取り組みについて，その概要を報告するとともに，外的評価として「おかやま国際和楽器学生フェスティバルコンサート」終演後に実施した一般来場者対象の質問紙調査及びフェスティバルを参観した岡山県内の学校関係者対象の質問紙調査を取り上げ，意義と課題について検討した。<br>
その結果，第一に音楽を通じた世代間や国際交流の喜びを感じ，和楽器の伝承と教育の重要性を強く意識する機会となったこと，第二に，和楽器が様々な国籍・年齢の学生に受容されていることを，来場者が客観視することで，自文化の価値の再認識につながったこと，第三に，フェスティバル全体としては，ワークショップが充実しており，様々な国籍・年齢の学生が同じステージで演奏する姿に対する評価が得られた点が明らかとなった。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025契約概念に注目した小学校社会科法教育の授業構成 ―第３学年の生産や販売に関する単元の開発を通して―207218ENAyuhaMIYAMOTOGraduate School of Humanities and Social Sciences, Okayama UniversityToshinoriKUWABARAFaculty of Education, Okayama University10.18926/CTED/68492 本論文は、小学校社会科における市民性教育としての法教育のあり方を検討し、その授業構成原理を明らかにしたうえで、中学年の教育内容である販売の仕事に関する単元開発を行うものである。これまで小学校法教育では、発達心理学の論を基にしながら研究が進められてきたが、小学校社会科法教育としての体系的な研究は十分ではなかった。小学校第３学年の社会科では、第３学年「地域にみられる生産や販売の仕事について」の内容が設定されている。佐藤はスーパーマーケットを教材として小学校社会科で経済概念を形成する授業を開発し、その有効性を検証した。一方で、販売には売買契約のような法的問題も発生する。本論文では、これまでの社会科教育研究において蓄積されてきた法教育論や価値観形成論の成果を踏まえ、スーパーマーケットを教材とした小学校社会科単元開発を行う。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323152025大学教養教育における創造性を重視した探究型授業の評価 岡山大学教養教育科目「生活の中の創造性」の実践結果の分析Ⅲ107118ENYokoSHINOHARAFaculty of Education, Okayama UniversityYoshihikoINADAFaculty of Education, Okayama University10.18926/CTED/68485 2022年より教養教育科目「現代と社会」において，「色」を主題にして「岡大グッズ」の提案を行う探究型授業「生活の中の創造性」を開講している。授業前後のアンケートによると，学生は「自分にとって創造性は重要」と捉え，「他者とコミュニケーションを取りながら創造的な活動をすることに興味」があり，授業後は「自分のことを創造的である」と肯定的な評価となっていた。この授業は「主体的，対話的に考え，感じ，判断する自分自身の存在を意識すること」を促す効果が大きいことが分かった。この３年間の実践は，主軸となるテーマと探究活動の内容が大学生の探究的な学びに適したものであったと考えている。No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X7522025Discovery of myeloid zinc finger (MZF) 1 nuclear bodies151481ENTakanoriEguchiDepartment of Dental Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesStuart K.CalderwoodDivision of Molecular and Cellular Biology, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolMyeloid zinc finger 1 (MZF1) is a multifaceted transcription factor that can act either as a transcriptional activator or a gene repressor. We examined its production of nuclear bodies (NBs) and subcellular localization. Proteomic and protein–protein interaction analysis were used to identify its cofactors and interactions. These revealed the presence of MZF1-NBs (intranuclear oligomers containing MZF1). MZF-NBs are similar to some other nuclear bodies, notably promyelocytic leukemia (PML) -NBs in terms of size and morphology. However the two structures appear to be different. MZF-NBs and PML-NBs were found to associate in the nucleus. Both MZF1 and PML are SUMO1-SUMOylated in PC-3 cells. Sumoylated MZF1 can interact with proteins containing SUMO-interaction motifs (SIM) through SUMO-SIM interaction. Interactome analysis revealed that its NBs participate in the stress response (TPR and UBAP2L), protein folding (CALR and ANKRD40), transcription, post-translational modification (TRIM33, ACOT7, CAMK2D, and CAMK2G), and RNA binding (ALURBP and CPSF5).
No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595222025成均館・吉林大学交流プログラム【オンライン】実践報告4970ENYukoFUJIWARAInstitute for Promotion of Education and Campus Life, Okayama UniversitySetsukoAKITAInstitute for Promotion of Education and Campus Life, Okayama UniversityTomomiISHIIInstitute for Promotion of Education and Campus Life, Okayama UniversityMihoSATOInstitute for Promotion of Education and Campus Life, Okayama University10.18926/68453岡山大学教育推進機構初修外国語系が毎年２月にオンラインで実施している「成均館・吉
林大学交流プログラム」は、日中韓三ヵ国の大学の学生が、日本語を共通言語として、複
数の文化・言語、学習言語と母語の違いなどを包摂した場で生じるコミュニケーション上
の問題を解決しながら、様々な話題のディスカッションやプレゼンテーションを行なう。
本実践報告は、このプログラムの趣旨と成果、また実践に当たっての様々な課題とそれに
対する取り組みについて報告し、コロナ後の国際交流の一つのモデルとなることを期待す
るものである。No potential conflict of interest relevant to this article was reported.岡山大学教育推進機構Acta Medica Okayama1881-595222025日本への留学を促進する要因に関する研究 －東南アジアからの留学生を事例として－1332ENTakaoINAMORIInstitute of Global Human Resource Development, Okayama University10.18926/68451 本研究では、東南アジアから留学している留学生15人を対象として「なぜ日本に留学したのか？」、半構造化インタビューにより情報を収集した。その結果、(i) 留学生の日本に対するイメージ、(ii) 保護者の日本に対するイメージ、(iii) 奨学金の機会、(iv) 私費留学が可能な学費・生活費レベル、(v) 出身国コミュニティーの有無、が重要であることが分かった。これらの情報やイメージの一部は、(1) 留学先での満足度、(2) 日本人との交流機会、(3) 生活のしやすさ、(4) 留学生の日本語レベル、(5) 日本文化に対する理解等によって形成され、ロコミやインターネットを通じて強化されることが推測された。よって、上記の項目に着目し、留学生の満足度等を向上させるための環境づくりを支援していくことが、日本留学に対するプラスのイメージを作り、東南アジアからの留学生増につながっていくと考えられた。No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231882025地域社会とグローバルをつなぐ和楽器音楽次世代育成の実践研究（２）― 国際文化交流における「異文化間能力」育成の可能性 ―4756ENRinkoHAYAKAWAFaculty of Education, Okayama UniversityHiromiTAKASUFaculty of Education, Okayama UniversityNaokoSHIMIZUDoctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education (Okayama University)MihoYAMAJIKoto PlayerYukoBEPPUDepartment of Early Childhood Education and Care, Kurashiki City CollegeAkiHIGUCHIOkayama Prefectural School for the DeafAiNAKAMURADoctoral Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education (Okayama University)KeikoMIYOSHIMaster’s Student at the Graduate School of Education in Okayama UniversityChihiroTOSAMaster’s Student at the Graduate School of Education in Okayama UniversityYokoHANAKUSAResearch Student at the Joint Graduate School in Science of School Education Hyogo University of Teacher Education (Okayama University)NorikoTAKESHITABiwako-Gakuin University10.18926/bgeou/68413 本研究は，地域社会とグローバルをつなぐ和楽器音楽次世代育成の実践研究の一環として実施した「おかやま国際和楽器学生フェスティバル」について，「異文化間能力」育成の視点からその可能性について検討したものである。<br>
国内の学生については，①和楽器を介した繋がり／音楽的な協働，②演奏の質に関する違いの認識，③ 海外の和楽器演奏者に対する認識の３点が，海外の学生については，①表現スタイルや技術に関する違いの認識，②和楽器音楽の本質の理解，③演奏者としての学びと成長に対する意識の３点が，特徴として示された。「異文化間能力」の視点からは，国内外共に「文化的多様性」と「絶対的正統性の緩和」についての認識が認められ，柔軟で且つ寛容な和楽器との向き合い方が形成されていたことが明らかとなった。また「共感・協働のスキル」については，特に国内の学生に多く認められる結果となった。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025A Rare Case of Compression Neuritis due to Intraorbital Arteriovenous Fistula (IOAVF) Mimicking Retrobulbar Optic Neuritis5964ENShunMinakawaDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalMasayukiHiranoDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalKazuyaTakahashiDepartment of Neurosurgery, Japanese Red Cross Society Himeji HospitalYutaImamuraDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalTakashiWatanabeDepartment of Ophthalmology, Japanese Red Cross Society Himeji HospitalCase Report10.18926/AMO/68363Intraorbital arteriovenous fistulas (IOAVFs) are rare vascular abnormalities. We describe a case of an IOAVF featuring a direct shunt between the accessory meningeal artery and the superior ophthalmic artery. A 55-year-old woman presented with a 1-month history of visual impairment in her right eye, and magnetic resonance imaging (MRI) revealed optic neuritis-like findings. Steroid pulse therapy temporarily resolved visual impairment. However, 1 month later, she experienced decreased visual acuity, ocular conjunctival hyperemia, edema, and a pulsatile murmur. Contrast-enhanced MRI and digital subtraction angiography revealed compression optic neuropathy due to an IOAVF. Following successful treatment with transarterial embolization, her symptoms disappeared.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Prediction of Prostate Cancer Grades Using Radiomic Features2130ENYasuhiroYamamotoDepartment of Radiology, Houshasen Daiichi HospitalTakafumiHaraguchiDepartment of Advanced Biomedical Imaging and Informatics, St. Marianna University School of MedicineKaoriMatsudaDepartment of Radiology, Houshasen Daiichi HospitalYoshioOkazakiDepartment of Radiology, Houshasen Daiichi HospitalShinKimotoDepartment of Radiology, Houshasen Daiichi HospitalNozomuTanjiDepartment of Urology, Houshasen Daiichi HospitalAtsushiMatsumotoDepartment of Urology, Houshasen Daiichi HospitalYasuyukiKobayashiDepartment of Medical Information and Communication Technology Research, St. Marianna University School of MedicineHidefumiMimuraDepartment of Radiology, St. Marianna University School of MedicineTakaoHirakiDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/68355We developed a machine learning model for predicting prostate cancer (PCa) grades using radiomic features of magnetic resonance imaging. 112 patients diagnosed with PCa based on prostate biopsy between January 2014 and December 2021 were evaluated. Logistic regression was used to construct two prediction models, one using radiomic features and prostate-specific antigen (PSA) values (Radiomics model) and the other Prostate Imaging-Reporting and Data System (PI-RADS) scores and PSA values (PI-RADS model), to differentiate high-grade (Gleason score [GS] ≥ 8) from intermediate or low-grade (GS < 8) PCa. Five imaging features were selected for the Radiomics model using the Gini coefficient. Model performance was evaluated using AUC, sensitivity, and specificity. The models were compared by leave-one-out cross-validation with Ridge regularization. Furthermore, the Radiomics model was evaluated using the holdout method and represented by a nomogram. The AUC of the Radiomics and PI-RADS models differed significantly (0.799, 95% CI: 0.712-0.869; and 0.710, 95% CI: 0.617-0.792, respectively). Using holdout method, the Radiomics model yielded AUC of 0.778 (95% CI: 0.552-0.925), sensitivity of 0.769, and specificity of 0.778. It outperformed the PI-RADS model and could be useful in predicting PCa grades, potentially aiding in determining appropriate treatment approaches in PCa patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7912025Endothelial Cell Polarity in Health and Disease17ENMoeThihaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakaoHikitaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasanoriNakayamaDepartment of Pathophysiology and Drug Discovery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/68353Endothelial cell polarity is fundamental to the organization and function of blood vessels, influencing processes such as angiogenesis, vascular stability, and response to shear stress. This review elaborates on the molecular mechanisms that regulate endothelial cell polarity, focusing on key players like the PAR polarity complex and Rho family GTPases. These pathways coordinate the front–rear, apical–basal and planar polarity of endothelial cells, which are essential for the proper formation and maintenance of vascular structures. In health, endothelial polarity ensures not only the orderly development of blood vessels, with tip cells adopting distinct polarities during angiogenesis, but also ensures proper vascular integrity and function. In disease states, however, disruptions in polarity contribute to pathologies such as coronary artery disease, where altered planar polarity exacerbates atherosclerosis, and cancer, where disrupted polarity in tumor vasculature leads to abnormal vessel growth and function. Understanding cell polarity and its disruption is fundamental not only to comprehending how cells interact with their microenvironment and organize themselves into complex, organ-specific tissues but also to developing novel, targeted, and therapeutic strategies for a range of diseases, from cardiovascular disorders to malignancies, ultimately improving patient outcomes.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0378-11199412025Identification of pennaceous barbule cell factor (PBCF), a novel gene with spatiotemporal expression in barbule cells during feather development149244ENMinoriNakaokaGraduate School of Natural Science and Technology, Okayama UniversityHibikiFukuchiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityMahoOgoshiGraduate School of Natural Science and Technology, Okayama UniversitySayakaAizawaGraduate School of Natural Science and Technology, Okayama UniversitySakaeTakeuchiGraduate School of Natural Science and Technology, Okayama UniversityBird contour feathers exhibit a complex hierarchical structure composed of a rachis, barbs, and barbules, with barbules playing a crucial role in maintaining feather structure and function. Understanding the molecular mechanisms underlying barbule formation is essential for advancing our knowledge of avian biology and evolution. In this study, we identified a novel gene, pennaceous barbule cell factor (PBCF), using microarray analysis, RT-PCR, and in situ hybridization. PBCF is expressed in barbule cells adjacent to the ramus during pennaceous barbule formation, where these cells fuse with the ramus to establish the feather’s branching structure. PBCF expression occurs transiently after melanin pigmentation of the barbule plates but before the expression of barbule-specific keratin 1 (BlSK1). Orthologues of PBCF, predicted to be secreted proteins, are conserved across avian species, with potential homologues detected in reptiles, suggesting an evolutionary lineage-specific adaptation. Additionally, PBCF is expressed in non-vacuolated notochord cells and the extra-embryonic ectoderm of the yolk sac, hinting at its broader developmental significance. The PBCF gene produces two mRNA isoforms via alternative splicing, encoding a secreted protein and a glycophosphatidylinositol (GPI)-anchored membrane-bound protein, indicating functional versatility. These findings suggest that PBCF may be involved as an avian-specific extracellular matrix component in cell adhesion and/or communication, potentially contributing to both feather development and embryogenesis. Further investigation of PBCF’s role in feather evolution and its potential functions in other vertebrates could provide new insights into the interplay between development and evolution.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X7412024S-adenosylmethionine and S-adenosyl-L-homocysteine metabolism is involved in the sperm motility and in vitro fertility rate in mouse151006ENTomokoKawaiDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiFujimuraDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIncreased fragmentation of sperm DNA has been implicated in male infertility. Folate deficiency results in impaired methionine synthesis, depletion of S-adenosylmethionine (SAM) levels, an increase in S-adenosyl-l-homocysteine (SAH) levels, and increased DNA fragmentation. Disruption of the dynamic balance between SAM and SAH may also contribute, although the details of this process are not yet fully understood. We investigated the localization of SAM, SAH, and S-adenosylhomocysteine hydrolase (SAHH), and whether SAM/SAH metabolism contributes to sperm motility and fertilization rate. SAM, SAH, and SAHH levels were assessed in the acrosome, midpiece, and tail of spermatozoa. Chemical inhibition of SAM/SAH metabolism and extracellular SAH significantly decreased the straight-line velocity (VSL), curvilinear velocity (VCL), and amplitude lateral head displacement (ALH) of sperm cells, which were thus unable to swim forward and perform oscillatory movements in place. This significantly reduced the fertilization rate. Therefore, the disruption of the SAM/SAH balance may contribute to male infertility.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832642025古代越前国足羽郡の「郡的世界」寸考8090ENAtsunoriWATANABEChigasaki City Museum研究ノート (Research note)10.18926/67957 Often discussed in recent years, the term gun-teki sekai refers to the social conditions of a district. In ancient Japanese local communities, there existed complex webs of historical rule and intertwined relationships between local clans that date back to before the establishment of the Ritsuryō system. Gun-teki sekai is a term that refers to the reality of the control of the provincial and district systems, in which multiple powerful clans served as gunji , district governors under the Ritsuryō system. Each gunji organized smaller clans below them to carry out administrative duties based on such relationships. Recent research is beginning to reveal the multipolar structure of the gun-teki sekai .<br>
In this study, the author examines the gun-teki sekai through an analysis of the Asuwa district in Echizen province, which is rich in historical materials. As a result, the following four points became clear. First, it is highly likely that the powerful clans who served as district governors in the mid-Nara period were traditional clans with roots in the eastern part of the district. Second, the powerful clans who served as district deputy governors may have been an emerging power. Third, from an archaeological perspective, the eastern part of the district is the traditional area, while the dominance of the western part of the district developed after the establishment of the Ritsuryō system. Fourth, in terms of clan distribution, the clans who served as district governors were distributed over the widest area, followed by those who served as district deputy governors.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832642025『理科年表』の「地震年代表」をめぐって－ 10 世紀まで－6479ENHidekiARAIHistorian研究ノート (Research note)10.18926/67956This paper is based on the oral report I gave on July 22, 2023, at the 21st “Disaster Culture and the History of Community Formation” workshop hosted by the Okayama University Research Institute for the Dynamics of Civilizations. I discuss the changes in the “Chronology of Earthquakes” contained within the Rika nenpyō (Chronological Scientific Tables) and some of the problems with them, citing historical earthquake materials. It is necessary to clearly distinguish between real and false earthquakes, such as the Tamba earthquake (701), the Kinai earthquake (734), the Minō earthquake (745), the Ecchū-Echigo earthquake (863), and the Kantō earthquake (878). The author hopes that the “Chronology of Earthquakes” will be published in a better form in the future and calls for efforts in the field of history to verify and introduce historical earthquake materials.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7862024Partial versus Radical Nephrectomy for Small Renal Cancer: Comparative Propensity Score-Matching Analysis of Cardiovascular Event Risk429437ENRisaKubotaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeBekkuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKatayamaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67868Although partial nephrectomy (PN) is preferred over radical nephrectomy (RN) for preserving renal function in patients with cT1 renal cancer, its impact on cardiovascular events (CVe) remains controversial. This study aimed to compare PN and RN in regard to the occurrence of CVe, including cerebrovascular events and exacerbation of hypertension (HT). We retrospectively analyzed 418 consecutive patients who underwent PN or RN for cT1 renal cancer. Propensity score-matching analysis was used to adjust for imbalances between patients who underwent PN and RN, leaving 102 patients in each group. The 5-year probability of cumulative CVe incidence was 6% in the PN group and 12% in the RN group (p=0.03), with a median follow-up of 73.5 months. The statistical significance was retained after propensity score matching for patients without preoperative proteinuria (p=0.03). For all CVe including cerebrovascular events and exacerbation of HT analyzed, PN provided a lower probability of occurrence than RN in patients with small renal cancers.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465622024エージェントベースモデルによる自己組織化的集積の再現：特別区におけるICT 事業所4171ENRyoheiNakamuraTakeshiNagamuneSyuseiHayashi10.18926/OER/67707 As a preliminary step to conducting a self-organizing simulation of the agglomeration and dispersion of the information and communications industry, we quantify the spatial agglomeration of the information and communications industry in Japan’s major cities. Using the town and district data from the Economic Census for Economic Activity, we attempted a spatial analysis of the information and communications industry in the Tokyo Special Wards as well as in Sapporo, Sendai, Hiroshima, and Fukuoka, which have regional central functions. As a result of detecting spatial autocorrelation in small areas within each city, hotspots indicating the agglomeration of information and communications industry offi ces were found in the city center of each city. At the same time, we were able to confi rm the impact of agglomeration economies, which are the premise of the self-organizing model, and confi rmed that the information and communications industry is an industry suitable for simulation of the self-organizing model.
Krugman（1996）was the fi rst to model the self-organizing model in cities and clarifi ed the emergence principle of peripheral cities, but this was limited to numerical simulations. Later, Kumar et al.（2007）used actual data to show that Krugman’s self-organizing model could be applied to predict corporate agglomeration and dispersion. In this paper, we use an agent-based model to examine whether a self-organizing model is also effective in reproducing and predicting the concentration and dispersion of the information and communications industry in Japanese cities.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465622024学生による地方創生活動10年の成果と課題―瀬戸内市裳掛地区での実践活動―1740ENSatoshiMimuraAkaneTokoo10.18926/OER/67706 岡山大学の公認学生サークルのなかで地方創生活動を展開しているサークルに「まちづくり研究会」がある。岡山大学学生サークル「まちづくり研究会」は，2014年に活動を開始，その活動の目的は，過疎化人口減少の問題を抱える瀬戸内市邑久町虫明（おくちょうむしあけ）の裳掛（もかけ）地区をフィールドとした学生と地域住民による地方創生の協働活動であり，通称『瀬戸内市裳掛地区再生プロジェクト』と呼ばれている。
この10年間，学生たちは先輩たちから後輩たちに実践活動をリレーしながら様々な活動を展開してきた。その主眼が，生徒数の減る裳掛小学校の子どもたちの支援活動を続けることで，生徒数の減少に歯止めをかけることである。そのための具体的な方策として，「学生による情報発信」，「耕作放棄地対策への参加」，「空き家の再生支援による拠点づくり」，「移住定住促進支援」，「地域催事への企画・運営支援」，「子どもたちの見守り」などの活動を実践しながら地域を元気にする応援を継続してきた。なお，掲載写真の使用許可は，活動の都度，地域の皆様（保護者を含む）や学生たちに確認・了解を得ている。
本論では，この学生たちの活動の成果を紹介しながら，学生たちの学びと地域への貢献という互恵性の視座に立ち「学生による地域創生活動の実践事例研究」として報告する。No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465622024なぜ中間組織が必要なのか116ENDaijiFujiiTamakoOshima10.18926/OER/67705 This paper challenges a fundamental question, ‘Why is an intermediate organization necessary?’ Due to transaction costs and market failures on the one hand and the limitations of organizational control mechanisms on the other hand, many‘ intermediate organizations’ are observed in the real world. How can we tackle to explain the governance mechanism considered to be‘ intermediate?’
If we are to discuss such socioeconomic orders, this paper assumes that we should not be able to link micro-level explanations and macro-level ones concerning the third mode of governance mechanisms all at once. We need to stick to the meso-level at fi rst. The theoretical elaboration since Ouchi’s（1980） discussion of clan-type governance and cumulative empirical research on industrial agglomerations have allowed us to construct a more sophisticated theory called community capital.
In effective communities, members are ‘embedded as insiders’ who serve the purpose of the community, share experiences of failures and successes, and find and deepen their common identity. This limited membership is bound by‘ mutual trust to rely on each other’ for‘ distribution of short-term risks.’ In contrast to social norms that need to be abstract enough to be widely shared, the communal norms that are concrete enough to allow the members to understand without hesitation how they should behave in localized contexts are cumulatively cultivated along socializing process. Among the norms, sense of mutual obligation to incur intermittent costs for the whole community is a crucial norm for the sustainable development of the community. However, as a practical matter, membership control, mutual trust and short-term risk allocation may serve the communities in the short run, but they do not guarantee long-term accumulation of shared capital. As a result, the limits of community capital may need to be discussed once again, especially today when market liquidity is increasing, and its failures tend to become more apparent in a variety of areas.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1364-548X60932024Machine-learning-assisted prediction of the size of microgels prepared by aqueous precipitation polymerization1367813681ENDaisukeSuzukiGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityHarukaMinatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityYujiSatoGraduate School of Environmental, Life, Natural Science and Technology, Okayama UniversityRyujiNamiokaGraduate School of Textile Science & Technology, Shinshu UniversityYasuhikoIgarashiFaculty of Engineering, Information and Systems, University of TsukubaRisakoShibataDepartment of Applied Chemistry, Faculty of Science and Technology, Keio UniversityYuyaOakiDepartment of Applied Chemistry, Faculty of Science and Technology, Keio UniversityThe size of soft colloids (microgels) is essential; however, control over their size has typically been established empirically. Herein, we report a linear-regression model that can predict microgel size using a machine learning method, sparse modeling for small data, which enables the determination of the synthesis conditions for target-sized microgels.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7852024Phenotypic and Genetic Characteristics of Carbapenemase-Producing Enterobacterales Isolates at Okayama University Hospital371376ENKazuyoshiGotohDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMakotoMiyoshiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityI Putu Bayu MayuraDepartment of Clinical Microbiology, Faculty of Medicine, Udayana UniversityShumaTsujiDepartment of Medical Laboratory Science, Graduate School of Health Sciences, Okayama UniversityKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalShinnosukeFukushimaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalOriginal Article10.18926/AMO/67657Spread of carbapenemase-producing Enterobacterales (CPE) is an ongoing public health issue worldwide, including in Japan. In this study, we investigated the phenotypic and genetic characteristics of CPE isolates at Okayama University Hospital over the 5 years (2013-2018) prior to the outbreak of the 2019 coronavirus pandemic. Of 24 carbapenem-resistant Enterobacterales isolated during the study period, we identified 8 CPE isolates harboring blaIMP-1 (5 isolates) and blaIMP-6 genes (3 isolates). Bacterial species and carbapenem susceptibility patterns exhibited diversity. Minimum inhibitory concentrations (MICs) of meropenem were generally higher than those of imipenem and biapenem. Results of pulsed-field gel electrophoresis demonstrated that neither clonal nor plasmid-mediated outbreaks of blaIMP-harboring CPE isolates have developed at our hospital. One Klebsiella oxytoca isolate showed a high MIC (128 μg/mL) of meropenem, which could be explained by the high plasmid copy number. Subsequent analysis of this isolate may elucidate the intricacies of carbapenem resistance profiles among CPE isolates. Collectively, our findings underscore the necessity for ongoing genetic surveillance of CPE, complemented by tailored approaches for infection prevention and control.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7842024Multicenter Remote-Access Simulation of Vaginal Delivery for High-Flexibility Medical Education during the Coronavirus Pandemic313322ENErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJotaMakiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNoriyukiYamashitaCenter for Education in Medicine and Health Sciences, Okayama UniversityToruHasegawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAyanoSuemoriDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikariNakatoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHikaruObaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohiroMitomaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakurakoMishimaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoeKirinoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoOhiraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67547During the coronavirus pandemic, face-to-face simulation education became impossible. Therefore, we aimed to develop remote-access simulation education with a sense of realism through Information and Communication Technology (ICT) using a perinatal whole-body management and delivery simulator. In September 2021, we administered a multi-center simultaneous remote simulation based on our developed model. Ten universities in the Chugoku–Shikoku region were connected via a web-conferencing system to a live broadcast of a virtual vaginal birth in which a fictional hospitalized pregnant woman experienced accelerated labor and gave birth through vacuum delivery for fetal distress. A Video on Demand (VOD) was made beforehand using a new simulator that allowed for a visual understanding of the process of the inter-vaginal examination. We provided a participatory program that enhanced the sense of realism by combining VOD and real-time lectures on each scenario, with two-way communication between participants and trainee doctors using a chat function. Most participants answered “satisfied” or “very satisfied” with the content, level of difficulty, and level of understanding. From November 2021, we have used the videos of all processes in face-to-face classes. Our construction of a high-flexibility education system using remote simulation in the field of obstetrics and gynecology, especially in the vaginal delivery module, is unique, creative, and sustainable.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-734560522024Switchable synthesis of 3-aminoindolines and 2′-aminoarylacetic acids using Grignard reagents and 3-azido-2-hydroxyindolines66156618ENToshikiYamashiroGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakumiAbeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityThe switchable synthesis of 3-aminoindolines and 2′-aminoaryl acetic acids from the same substrates, 3-azido-2-hydroxyindolines, was developed through denitrogenative electrophilic amination of Grignard reagents. The key to success is the serendipitous discovery that the reaction conditions, including solvents and reaction temperature, can affect the chemoselectivity. It is noteworthy that isotope-labeling experiments revealed the occurrence of the aziridine intermediate in the production of 2′-aminoaryl acetic acids.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Palliative Gamma Knife Radiosurgery for a Small Part of a Large Vestibular Schwannoma in an Elderly Patient301306ENKiyoshiNakazakiDepartment of Neurosurgery, Brain Attack Center Ota Memorial HospitalSatoshiHiraiDepartment of Neurosurgery, Kawasaki Medical SchoolTomohitoHishikawaDepartment of Neurosurgery, Kawasaki Medical SchoolCase Report10.18926/AMO/67207We report a case of a large vestibular schwannoma in an 80-year-old female patient that shrank after palliative Gamma Knife radiosurgery (GKS). Neurological symptoms included hearing deterioration and facial palsy. The tumor volume was 21.9 mL. Craniotomy was considered high-risk, and conventional GKS was risky, owing to the risk of transient enlargement. Therefore, GKS was performed on only a portion of the tumor. The marginal dose (12 Gy) volume was 3.8 mL (17.4%). The tumor began to shrink after transient enlargement. Sixty months later, the tumor volume was only 3.1 mL, and the patient was able to maintain independent activities of daily living without salvage treatment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024The Impact of Reduced Skeletal Muscle Mass on Patients with Knee Osteoarthritis245250ENManabuAkagawaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterHidetomoSaitoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineYasuhiroTakahashiDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterYosukeIwamotoDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterJunpeiIidaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterTakayukiYoshikawaDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterToshikiAbeDepartment of Orthopedic Surgery, Omagari Kousei Medical CenterKimioSaitoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineHiroakiKijimaDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineYujiKasukawaDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineMichioHongoDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineNaohisaMiyakoshiDepartment of Orthopedic Surgery, Akita University Graduate School of MedicineOriginal Article10.18926/AMO/67199Although several studies have suggested a possible association between sarcopenia and knee osteoarthritis (OA) in the elderly, there remains no definitive evidence. Recently, however, the serum creatinine/cystatin C ratio (sarcopenia index: SI) was reported to correlate with skeletal muscle mass. The present retrospective study therefore investigated the impact of reduced skeletal muscle mass on advanced knee OA using SI. In 55 individuals scheduled for knee osteotomy or knee arthroplasty, correlations between SI and patient-reported outcomes such as the Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Oxford Knee Score (OKS) were explored. Significant associations were found between SI and the KSS functional activity score (β=0.37; p=0.022), KOOS subscale for activities of daily living (β=0.42; p=0.0096), and OKS (β=0.42; p=0.0095). This study underscores the role of reduced muscle mass in functional outcomes and introduces SI as a valuable marker for assessing muscle loss in knee OA patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Effect of Lipopolysaccharide on the Duration of Zolpidem-Induced Loss of Righting Reflex in Mice227235ENYudaiWadaDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoichiroUshioDepartment of Pharmacy, Okayama University HospitalYoshihisaKitamuraDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshitoZamamiDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiakiSendoDepartment of Clinical Pharmacy, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/67197Zolpidem, a non-benzodiazepine hypnotic, is primarily used to treat insomnia. In a previous study, pior treatment with non-benzodiazepine receptor agonists was associated with inflammation. The present study aimed to clarify the association between the effects of zolpidem and inflammation in mice treated with lipopolysaccharide (LPS), a known model of inflammation. We assessed the zolpidem-induced loss of righting reflex (LORR) duration 24 h after LPS treatment in mice. Additionally, the expressions of γ-aminobutyric acid (GABA)A receptor subunit and K+-Cl− cotransporter isoform 2 (KCC2) mRNA in the hippocampus and frontal cortex were examined in LPS-treated mice. Pretreatment with LPS was associated with significantly prolonged duration of zolpidem-induced LORR compared to control mice. This effect was significantly attenuated by administering bicuculline, a GABAA receptor antagonist, or flumazenil, a benzodiazepine receptor antagonist, in LPS-treated mice. Compared to controls, LPS-treated mice showed no significant change in the expression of GABAA receptor subunits in the hippocampus or frontal cortex. Bumetanide, an Na+-K+-2Cl− cotransporter isoform 1 blocker, attenuated the extended duration of zolpidem-induced LORR observed in LPS-treated mice. LPS significantly decreased Kcc2 mRNA expression in the hippocampus and the frontal cortex. These findings suggest that inflammation increases zolpidem-induced LORR, possibly through a reduction in KCC2 expression.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7832024Thoughts on and Proposal for the Education, Training, and Recruitment of Infectious Disease Specialists205213ENHideharuHagiyaDepartment of Infectious Diseases, Okayama University HospitalReview10.18926/AMO/67195The global pandemic of COVID-19 has underscored the significance of establishing and sustaining a practical and efficient infection control system for the benefit and welfare of society. Infectious disease (ID) specialists are expected to take on leadership roles in enhancing organizational infrastructures for infection prevention and control (IPC) at the hospital, community, and national levels. However, due to an absolute shortage and an uneven distribution, many core hospitals currently lack the ID specialists. Given the escalating global risk of emerging and re-emerging infectious diseases as well as antimicrobial resistance pathogens, the education and training of ID specialists constitutes an imperative concern. As demonstrated by historical changes in the healthcare reimbursement system, the establishment and enhancement of IPC measures is pivotal to ensuring medical safety. The existing structure of academic society-driven certification and training initiatives for ID specialists, contingent upon the discretionary decisions of individual physicians, possesses both quantitative and qualitative shortcomings. In this article, I first address the present situations and challenges related to ID specialists and then introduce my idea of securing ID specialists based on the new concepts and platforms; (i) ID Specialists as National Credentials, (ii) Establishment of the Department of Infectious Diseases in Medical and Graduate Schools, (iii) Endowed ID Educative Courses Funded by Local Government and Pharmaceutical Companies, and (iv) Recruitment of Young Physicians Engaged in Healthcare Services in Remote Areas. As clarified by the COVID-19 pandemic, ID specialists play a crucial role in safeguarding public health. Hopefully, this article will advance the discussion and organizational reform for the education and training of ID specialists.No potential conflict of interest relevant to this article was reported.IARIAActa Medica Okayama2308-44132024Application of a Deep Reinforcement Learning Algorithm to Virtual Machine Migration Control in Multi-Stage Information Processing Systems1318ENYukinobuFukushimaOkayama UniversityYukiKoujitaniOkayama UniversityKazutoshiNakaneNagoya UniversityYutaTarutaniOkayama UniversityCelimugeWuThe Univ. of Electro-Commun.YushengJiNational Institute of InformaticsTokumiYokohiraOkayama UniversityTutomuMuraseNagoya UniversityThis paper tackles a Virtual Machine (VM) migration control problem to maximize the progress (accuracy) of information processing tasks in multi-stage information processing systems. The conventional methods for this problem (e.g., VM sweeping method and VM number averaging method) are effective only for specific situations, such as when the system load is high. In this paper, in order to achieve high accuracy in various situations, we propose a VM migration method using a Deep Reinforcement Learning (DRL) algorithm. It is difficult to directly apply a DRL algorithm to the VM migration control problem because the size of the solution space of the problem dynamically changes according to the number of VMs staying in the system while the size of the agent’s action space is fixed in DRL algorithms. Therefore, the proposed method divides the VM migration control problem into two problems: the problem of determining only the VM distribution (i.e., the proportion of the number of VMs deployed on each edge server) and the problem of determining the locations of all the VMs so that it follows the determined VM distribution. The former problem is solved by a DRL algorithm, and the latter problem is solved by a heuristic method. The simulation results confirm that our proposed method can select quasi-optimal VM locations in various situations with different link delays.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community171184ENAyaKuramotoGraduate School of Health Sciences, Okayama UniversityShinyaSaitoGraduate School of Health Sciences, Okayama UniversityKumiWatanabeSchool of Nursing, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/66926We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7822024The Roles of Neuropeptide Y in Respiratory Disease Pathogenesis via the Airway Immune Response95106ENJunkoItanoDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKatsuyukiKiuraDepartment of Allergy and Respiratory Medicine, Okayama University HospitalYoshinobuMaedaDepartment of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuakiMiyaharaDepartment of Allergy and Respiratory Medicine, Okayama University HospitalReview10.18926/AMO/66912The lungs are very complex organs, and the respiratory system performs the dual roles of repairing tissue while protecting against infection from various environmental stimuli. Persistent external irritation disrupts the immune responses of tissues and cells in the respiratory system, ultimately leading to respiratory disease. Neuropeptide Y (NPY) is a 36-amino-acid polypeptide and a neurotransmitter that regulates homeostasis. The NPY receptor is a seven-transmembrane-domain G-protein-coupled receptor with six subtypes (Y1, Y2, Y3, Y4, Y5, and Y6). Of these receptors, Y1, Y2, Y4, and Y5 are functional in humans, and Y1 plays important roles in the immune responses of many organs, including the respiratory system. NPY and the Y1 receptor have critical roles in the pathogenesis of asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. The effects of NPY on the airway immune response and pathogenesis differ among respiratory diseases. This review focuses on the involvement of NPY in the airway immune response and pathogenesis of various respiratory diseases.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・学生支援機構Acta Medica Okayama1881-595212024日本人大学生の英語学習に関する実態調査の報告－学習動機、言語使用環境、学習内容、目標とする英語力、海外体験－89105ENMasakoTERANISHIInstitute for Promotion of Education and Campus Life, Okayama UniversityMasaruOGINOInstitute for Promotion of Education and Campus Life, Okayama UniversityJunkoOTOSHIInstitute for Promotion of Education and Campus Life, Okayama University10.18926/66856本稿では、岡山大学の2023年度入学生(約2300名)を対象に実施した２つのアンケート調査の結果報告とその考察を行う。大学英語カリキュラム改革や科目内容のアップデート、学習環境の整備を検討するための基礎資料の提供を目的として、入学時点での、学習動機、言語使用環境、学びたい授業内容、目標とする英語コミュニケーション能力、海外体験等について調査した。結果として、学習動機は「スコア取得志向」と「コミュニケーション志向」が高いことが示された。また約9割の学生は日常的英語使用の機会がほとんどないことがわかった。一方、約6割の学生が「話す」スキルを優先して学びたいと考えており、半数程度の学生はより高い目標を持てるような意識付けが必要であることなどが示された。No potential conflict of interest relevant to this article was reported.岡山大学全学教育・学生支援機構Acta Medica Okayama1881-595212024일본 대학에서 쓰이는 한국어 입문 교재의 문법 항목에 대하여4768ENAnkooLEEInstitute for Promotion of Education and Campus Life, Okayama University10.18926/66854This research is a basic study to develop an integrated Korean language curriculum for universities in Japan, aimed at building social relationships. In order to propose an integrated learning model that combines activities for social relationships and language items as communication tools, I examined the grammar items in introductory Korean textbooks commonly used in Japanese university classes, comparing them with two standards for assessing achievement in Korean language proficiency and introductory Korean textbooks used in universities of Korea, America and China.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・学生支援機構Acta Medica Okayama1881-595212024日本語多読授業における学習者の取り組みと意識－授業の枠組みに着目して－2746ENMasumiNAGANOInstitute for Promotion of Education and Campus Life, Okayama University10.18926/66853本稿では，日本語学習者を対象とする多読授業の実践を詳細に記述するとともに，実践における学習者の記述や語りを分析することにより，授業の枠組みの中で学習者が何を意識し，どのように多読に取り組んだかを明らかにすることを目的とした。分析の結果，学習者が初回授業のオリエンテーションを通じて多読の進め方を知り，自身の日本語での読み方を調整することにより，読む速度の向上の実感や読むことに対する情意面の変化が引き起こされることが示された。また，授業内でともに多読に取り組む他者との交流が読み物の選び方の多様化をもたらし，多読の習慣化の支えとなっていることが示唆された。No potential conflict of interest relevant to this article was reported.岡山大学全学教育・学生支援機構Acta Medica Okayama1881-595212024海外の大学の専門支援部署によるセクシュアルマイノリティ支援－アメリカとカナダの大学への調査－19ENMegumiMATSUIInstitute for Promotion of Education and Campus Life, Okayama University10.18926/66851 アメリカとカナダの大学で，セクシュアルマイノリティ学生への専門支援部署を持つ大学を対象に，支援体制や支援状況について調査を行った。22大学から回答が得られ，半数以上の大学が学生と教職員以外（受験生，卒業生，地域の人等）も支援対象としていた。スタッフの資格については，学位や資格名以外に，当事者であることやサポート経験が挙げられていた。全ての大学で「イベントの開催」「関連する資料の貸し出し」を行っており，当事者への個別の専門的支援よりも，イベント開催やボランティア育成など，サポート資源を充実させるものを行っている大学が多かった。これらの結果は，今後の日本の大学におけるセクシュアルマイノリティ支援の方向性として参考になるものであった。No potential conflict of interest relevant to this article was reported.The Department of Archaeology, Okayama UniversityActa Medica Okayama2024The Isoma-iwakage site: The burial site of a maritime community in 5th- and 6th-century JapanENAkiraSEIKENo potential conflict of interest relevant to this article was reported.岡山大学大学院社会文化科学研究科Acta Medica Okayama1881-1671572024進路選択における自己効力感、ソーシャルスキル、EIの関係に関する考察―コロナ禍における3年間の大学生データを基にして―4158ENHisashiMACHIDA10.18926/66827 進路選択における先行研究では、進路選択能力を高めることにより進路選択行動が活発化し、そこに進路選択自己効力感が媒介するとより進路選択行動が高まるなど多様な研究成果が報告されてきた（富永, 2009）。先行研究を踏まえて筆者らはこれまでMachida, H., & Hirakimoto, H.（2017）、Machida, H.（2021） などにおいて、大学生などの進路選択自己効力感を高める因子としてのソーシャルスキルの存在を明らかにしてきた。しかしながら2020年以降のコロナ禍においては、大学生は学業の場のみならず、課外活動やアルバイトの場においても対人関係を深める活動が制限されると共に、コミュニケーションの機会が失われ、ソーシャルスキルを高める機会は低減した。筆者らはこのような環境下においてもソーシャルスキルを高める因子としてのEI（感情知性）に着目し、2021年度の調査を基礎に町田・開本（2022）においてEI（感情知性）とソーシャルスキル並びに進路選択自己効力感の関係について明らかにしてきた。その後2021年からの3年に渡る、ソーシャルスキルに加えEI（感情知性）が大学生の進路選択自己効力感にどのような影響を及ぼしているかについて明らかにすることを目的に、大学生を対象にサーベイ調査を継続してきた。結果的にEI（感情知性）はソーシャルスキルを媒介して進路選択自己効力感に正の影響を及ぼすことが3年間の継続調査により明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024レッジョ・エミリア教育の研究動向と課題309323ENKeiTAKAHASHIFaculty of Childhood Education, Kurashiki Sakuyo UniversityMariOKAYAMAFaculty of Human Sciences, Chikushi Jogakuen UniversityToshiyukiTAKAHASHIFaculty of Education, Okayama University10.18926/CTED/66789 本論は，レッジョ・エミリア教育に関する研究動向を整理し，実践及び研究上の課題を明らかにするものである。研究の第一段階として日本国内の研究を中心に先行研究を概観した結果，「プロジェクト」「プロジェクト型保育」「創造性と表現活動」にかかわる研究成果が充実していることが判明した。それと同時に，日本の保育理念や保育方法との一致点や相違点も明らかになった。今後は，レッジョ・エミリア教育の根幹と言われる「芸術性」「創造性」「協同性（共同性）」とその理解を学術研究の主題にして，芸術教育や子どもの造形表現を考察した研究成果が待ち望まれる。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024人間関係力を育む保育者養成教育の実践 ―心理教育“サクセスフル・セルフ”保育者養成版の作成，実施と評価2―253264ENYumiKATODepartment of Early Childhood Care and Education, Niimi UniversityMikayoANDOFaculty of Humanities and Social Sciences, Okayama University10.18926/CTED/66785 保育者養成大学の学生が保育現場の実情を知り，職務上の人間関係のあり方について実践的に学ぶことができるようにするため，四年制の保育者養成課程4年生45名対象として心理教育プログラム“サクセスフル・セルフ保育者養成版”の後半5レッスンを実施し，その内容や実施方法，効果について検討した。学生の記述内容から，本プログラムは分かりやすく役立つ内容になっていることが示唆され，学生のコミュニケーション能力や問題解決力等の向上に繋がり，ストレスマネジメントについて考える機会となったことが窺えた。なお，プログラム実施前後の心理社会的要因に関する評価指標には有意な差は見られなかったことから，プログラムの効果については，今後さらに詳細な検討が必要だと考えられる。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024知的障害特別支援学校における被災後も見据えた学校防災のためのチェック項目の作成177189ENNatsumiKAJIMOTOMaster’s degree program student of Graduate School of Education，Okayama UniversityKyogoAKAGIFaculty of Education，Okayama University10.18926/CTED/66780 学校防災の基軸となる学校安全計画は，策定・訓練・見直し等による継続的な改善が十分に行われていない現状がある。またそれを扱う教員，とりわけ特別支援学校教員の，有事の責任の大きさに見合っていない準備体制の不十分さ，そこから教員の不安が派生して存在する。本研究では，今後学校への策定義務化が見込まれる事業継続計画（BCP）の，被災後を見据える観点を，学校安全計画に組み入れることを目的にチェック項目を作成した。その妥当性の検討を行うために，特別支援学校教員２名にインタビュー調査を行った。その結果，本チェック項目に係る，被災後を見通す観点の取得，緊急対応・復旧対応業務のタイミングへの気づき，他の学校の取り組みからの振り返り，の３点の有用性が示唆された。課題としては，妥当性の検証，具体性の検討，学校教育以外の事業体からの水平展開の検討，の３点が挙げられた。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024学校と地域をつなぐ連携支援員の教育観形成に関する研究 ―理想を具体化する過程に注目して―135149ENMasatoshiHATANOGraduate School of Education, Okayama UniversityToshinoriKUWABARAFaculty of Education, Okayama University10.18926/CTED/66777 本研究は，外部人材の教育観に着目し，インタビュー調査を通して連携支援員の教育に関する理想とその具体化の過程を明らかにしようとするものである。対象とするのは，Ｙ県で連携支援員として活動した経験を持つ4名である。近年，「社会に開かれた教育課程」の推進により，地域と連携した授業の開発や学校現場における「地域コーディネーター」をはじめとした連携支援員の配置が進んでいる。全国都道府県教育長協議会第２部会(2019)や地域・教育魅力化プラットフォーム(2019)などにより連携支援員の実態に迫った量的研究が行われるなど，連携支援員に注目が集まっている。本研究では，学校と地域の橋渡し機能を果たしている連携支援員の理想と，その理念の具体化の過程を分析し，連携支援員の教育観が形成される過程を解明したい。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323142024小学校教師の自律的な学びを支える組織的な学び ―組織的な学びのイメージに基づく比較―1731ENRyoMISAWAFaculty of Education, Okayama UniversityMomokaMATSUEAkashi Municipal Futami-Nishi Junior School10.18926/CTED/66769 本研究では，教師の自律的な学びと組織的な学びの連動を検討した。質問紙調査を実施し，公立小学校教師99名から回答を得た。既往知見を参考に，自律的な学習姿勢は4側面（「自己省察」，「同僚の経験の取り入れ」，「児童・保護者の視点の考慮」，「前向きな挑戦姿勢」），組織的な学びについては専門的な学習共同体（PLC）の認識の2要素（「使命と責任の共有」，「同僚との協働的省察」），組織的な学びに対するポジティブおよびネガティブなイメージを測定した。相関分析の結果，PLC 認識の「使命と責任の共有」と「同僚との協働的省察」は学習姿勢の「同僚の経験の取り入れ」と正の関連を示した。また，「同僚との協働的省察」は学習姿勢の「自己省察」とも正の関連を示した。しかし，組織的な学びにネガティブなイメージを抱く場合，自律的な学びと組織的な学びの連動は制限されたり，負の関係になる可能性が示唆された。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Utility of Combined Use of Transabdominal Ultrasonography and Fecal Immunochemical Test Examinations in Ulcerative Colitis7983ENMasahiroTakaharaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSakikoHiraokaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayasuOhmoriDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeikoTakeuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKensukeTakeiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiAoyamaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesErikoYasutomiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShokoIgawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshihiroInokuchiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunkiToyosawaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasushiYamasakiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideakiKinugasaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeitaHaradaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHidekiOnishiDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiOkadaDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShort Communication10.18926/AMO/66674This study examined the utility of the combined use of transabdominal ultrasonography (TUS) and fecal immunochemical testing (FIT) to detect mucosal inflammation, vis-a-vis the Mayo endoscopic subscore (MES), in ulcerative colitis (UC). Sixty-three UC patients who underwent TUS and FIT were retrospectively enrolled. For TUS, the colon was divided into five segments, and the bowel wall thickness was measured and evaluated. The accuracy of FIT (> 100 ng/ml) in detecting mucosal inflammation (MES>0) was 0.93, whereas that of TUS (BWT>2 mm) in each segment was 0.84-0.97. The combined use of TUS and FIT may be helpful in noninvasive treatment strategies.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7812024Role of Macrophages in Liver Fibrosis18ENCuimingSunDepartment of Pathology and Experimental Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihiroMatsukawaDepartment of Pathology and Experimental Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/66664Liver fibrosis, which ultimately leads to liver cirrhosis and hepatocellular carcinoma, is a major health burden worldwide. The progression of liver fibrosis is the result of the wound-healing response of liver to repeated injury. Hepatic macrophages are cells with high heterogeneity and plasticity and include tissue-resident macrophages termed Kupffer cells, and recruited macrophages derived from circulating monocytes, spleen and peritoneal cavity. Studies have shown that hepatic macrophages play roles in the initiation and progression of liver fibrosis by releasing inflammatory cytokines/chemokines and pro-fibrogenic factors. Furthermore, the development of liver fibrosis has been shown to be reversible. Hepatic macrophages have been shown to alternately regulate both the regression and turnover of liver fibrosis by changing their phenotypes during the dynamic progression of liver fibrosis. In this review, we summarize the role of hepatic macrophages in the progression and regression of liver fibrosis.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832632024明治期における水利・洪水と千住中組高尾家―見沼代用水を事例に―7991ENShojiMIMURANational Defense Academy of Japan特集：災害と文明・地域社会 (Special Issue: Disasters, civilization, and local society)10.18926/66194This paper examines the maintenance work of the Minuma Substitute Canal by the Meiji Government and how Noriyoshi Takao who lived at Senjū-nakagumi was involved in it. In the 1880s, when the cost of maintaining the Minuma Substitute Canal was shifted from government expenditures to private ones, the early modern water usage system was on the verge of being converted to a modern one. This meant that the system, which was based on villages or ryō (領), transformed into one based on individuals, especially landowners. The village served as a cost-sharing unit during the Meiji period. Ryō (領) were operated in the downstream water of the Minuma Substitute Canal where there were no critical structures. However, districts (郡) supervised the water usage of ryō, creating a multilayered local community in terms of water usage.No potential conflict of interest relevant to this article was reported.岡山大学文明動態学研究所Acta Medica Okayama2436-832632024How is subjective well-being affected by different factors and groups: Income threshold induces asymmetric effects120ENMasaoTSURIFaculty of Economics, MUSASHI UNIVERSITYKenAOOGraduate School of Humanities and Social Sciences, OKAYAMA UNIVERSITY論文 (Research article)10.18926/66188Holistic well-being has rapidly developed in the 21st century as a policy measurement tool. Nevertheless, there continue to be some gaps in the literature regarding the interrelation between subjective well-being and other factors, and, regarding disaggregation of the well-being status within a country, by age group, gender, and community. This study first illustrates how the concept of well-being developed from a philosophical and psychological conception of “happiness” to being measured by multidimensional tools that measure the impact of policy and the progress of society, such as OECD’s Better Life Index, UK’s National Well-being Measurement, and Japan’s Well-being Survey and Quality of Life. Subsequently, it analyzes the relationships between subjective well-being and objective variables by comparing the country, regional, and individual datasets. It found that some indicators, such as social relationships, have asymmetric effects on life satisfaction depending on the income level or threshold. In other words, if the income is less than a certain level, the effects of some indicators on life satisfaction are complementary to income, while if the income is above that level, the effects are substitutional. Finally, it estimates these effects and confirms them statistically by using the OECD Regional Statistics. Regarding the relationship between social connection and self-evaluation of life satisfaction rated on a 10-point Likert scale, the base score in the estimation is approximately 5.1 points higher in the lowest quartile group of income. However, the substitution is lower than that of the other groups by approximately -0.061. The coefficient of social connection for the other groups was approximately 0.059, and the lowest group had almost zero coefficients for substitution.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Effects of Nutritional Support Combined with Neuromuscular Electrical Stimulation on Muscle Strength and Thickness: A Randomized Controlled Trial in Healthy Young Adult Males635645ENTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama University HospitalKazunoriOkamuraDepartment of Physical Therapy, Faculty of Health and Welfare, Prefectural University of HiroshimaMasakiHasegawaDepartment of Physical Therapy, Faculty of Health and Welfare, Prefectural University of HiroshimaSatoshiTanakaDepartment of Physical Therapy, Faculty of Health and Welfare, Prefectural University of HiroshimaShusakuKanaiDepartment of Physical Therapy, Faculty of Health and Welfare, Prefectural University of HiroshimaOriginal Article10.18926/AMO/66156In the management of post-injury patients with activity limitations, methods to prevent musculoskeletal disorders and hasten recovery are important. This randomized controlled, single-blinded study was a preliminary investigation of the combined effect of nutritional support with neuromuscular electrical stimulation (NMES) on muscle strength and thickness. Healthy young adult males (median age, 21 years) were enrolled; each of their hands was randomly assigned to one of the following four groups: Placebo, Nutrition, NMES, and Nutrition + NMES. All participants received whey protein or placebo (3x/week for 6 weeks) and NMES training (3x/week for 6 weeks) on the abductor digiti minimi (ADM) muscle of either the left or right hand. ADM muscle strength and thickness were analyzed at baseline and at week 7. We analyzed 38 hands (9 Placebo, 10 Nutrition, 9 NMES, 10 Nutrition + NMES). There was significantly greater muscle strengthening in the Nutrition + NMES group compared to the Placebo group or the NMES group, but no significant difference in gain of muscle thickness. The combined intervention may be effective in improving muscle strength. Future clinical trials targeting various muscles after sports-related injuries are warranted.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Survey of Osteoarthritis of the Shoulder in Patients who Underwent Knee Arthroplasty for Knee Osteoarthritis613618ENYoshiakiMiyakeDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolYoshifumiNambaDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolShigeruMitaniDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolNorifumiUmeharaDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolToyohiroKawamotoDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolShuroFuruichiDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolOriginal Article10.18926/AMO/66153The relationship between osteoarthritis (OA) of the lower extremity and shoulder OA has not been established. This study evaluated the prevalence of shoulder OA in patients with knee OA. We collected contrast-enhanced computed tomography (CECT) images of the shoulder joints of 105 patients with knee OA that were taken 1 week after they underwent primary knee arthroplasty to check for venous thromboembolism (VTE). The images were compared with CECT images of 110 control-group patients that were taken for the purpose of differentiating VTE. Shoulder OA was present in a significantly higher percentage of patients with knee arthroplasty than controls (29% versus 15%), and the difference was particularly pronounced in patients in their 70s (33%) compared to age-matched controls (11%). Patients with knee OA often use arm support to stand up or walk due to knee joint pain and muscle weakness, which places the weight-bearing shoulder at risk of developing OA.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Fine Particulate Matter and Diabetes Prevalence in Okayama, Japan607612ENYasunariTaniDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSaoriKashimaEnvironmental Health Sciences Laboratory, Graduate School of Advanced Science and Engineering, Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima UniversityToshiharuMitsuhashiCenter for Innovate Clinical Medicine, Okayama University HospitalEtsujiSuzukiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/66152Many studies have shown an association between long-term exposure to particulate matter having an aerodynamic diameter of 2.5 μm or less (PM2.5) and diabetes mellitus (DM), but few studies have focused on Asian subjects. We thus examined the association between long-term exposure to PM2.5 and DM prevalence in Okayama City, Japan. We included 76,591 participants who had received basic health checkups in 2006 and 2007. We assigned the census-level modeled PM2.5 data from 2006 and 2007 to each participant and defined DM using treatment status and the blood testing. PM2.5 was associated with DM prevalence, and the prevalence ratio (95% confidence interval) was 1.10 (1.00-1.20) following each interquartile range increase (2.1 μg/m3) in PM2.5. This finding is consistent with previous results and suggests that long-term exposure to PM2.5 is associated with an increased prevalence of DM in Okayama City, Japan, where the PM2.5 level is lower than in other cities in Asian countries.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7762023Concomitant Use of Multiple Nephrotoxins including Renal Hypoperfusion Medications Causes Vancomycin-Associated Nephrotoxicity: Combined Retrospective Analyses of Two Real-World Databases595605ENTakashiBandoDepartment of Pharmacy, Tokushima University HospitalMasayukiChumaClinical Research Center for Developmental Therapeutics, Tokushima University HospitalHirofumiHamanoDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesTakahiroNiimuraClinical Research Center for Developmental Therapeutics, Tokushima University HospitalNaotoOkadaDepartment of Pharmacy, Tokushima University HospitalMasateruKondoDepartment of Pharmacy, Tokushima University HospitalYukiIzumiDepartment of Pharmacy, Tokushima University HospitalShunsukeIshidaDepartment of Pharmacy, Tokushima University HospitalToshihikoYoshiokaDepartment of Pharmacy, Tokushima University HospitalMizuhoAsadaDepartment of Medical Molecular Informatics, Meiji Pharmaceutical UniversityYoshitoZamamiDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesKenshiTakechiDepartment of Drug Information Analysis, College of Pharmaceutical Sciences, Matsuyama UniversityMitsuhiroGodaDepartment of Pharmacy, Tokushima University HospitalKojiMiyataDepartment of Clinical Pharmacology and Therapeutics, Tokushima University Graduate School of Biomedical SciencesKentaYagiClinical Research Center for Developmental Therapeutics, Tokushima University HospitalYukiIzawa-IshizawaDepartment of Pharmacology, Tokushima University Graduate School of Biomedical SciencesMomoyoAzumaDepartment of Infection Control and Prevention, Tokushima University HospitalHiroakiYanagawaDepartment of Nursing, Faculty of Health and Welfare, Tokushima Bunri UniversityYoshikazuTasakiDepartment of Hospital Pharmacy and Pharmacology, Asahikawa Medical UniversityKeisukeIshizawaDepartment of Pharmacy, Tokushima University HospitalOriginal Article10.18926/AMO/66151There is a growing concern about the relationship between vancomycin-associated nephrotoxicity (VAN) and concomitant use of nephrotoxins. We examined this relationship by combined retrospective analyses of two real-world databases. Initially, the FDA Adverse Event Reporting System (FAERS) was analyzed for the effects of concomitant use of one or more nephrotoxins on VAN and the types of combinations of nephrotoxins that exacerbate VAN. Next, electronic medical records (EMRs) of patients who received vancomycin (VCM) at Tokushima University Hospital between January 2006 and March 2019 were examined to confirm the FAERS analysis. An elevated reporting odds ratio (ROR) was observed with increases in the number of nephrotoxins administered (VCM + one nephrotoxin, adjusted ROR (95% confidence interval [CI]) 1.67 [1.51-1.85]; VCM + ≥2 nephrotoxins, adjusted ROR [95% CI] 1.54 [1.37-1.73]) in FAERS. EMRs analysis showed that the number of nephrotoxins was associated with higher incidences of VAN [odds ratio: 1.99; 95% CI: 1.42-2.78]. Overall, concomitant use of nephrotoxins was associated with an increased incidence of VAN, especially when at least one of those nephrotoxins was a renal hypoperfusion medication (furosemide, non-steroidal anti-inflammatory drugs, and vasopressors). The concomitant use of multiple nephrotoxins, especially including renal hypoperfusion medication, should be avoided to prevent VAN.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Associations among Preoperative Malnutrition, Muscle Loss, and Postoperative Walking Ability in Intertrochanteric Fractures: A Retrospective Study511516ENKoheiSatoDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHironoriTsujiDepartment of Orthopedic Surgery, Japanese Red Cross Okayama HospitalMasanoriYorimitsuDepartment of Orthopedic Surgery, Okayama University HospitalTakenoriUeharaDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiOkazakiDepartment of Orthopedic Surgery, Tsuyama Chuo HospitalShinichiroTakaoDepartment of Orthopedic Surgery, Okayama Medical CenterToshiakiHataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShiroFukuokaDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomoyukiNodaDepartment of Orthopedic Surgery, Kawasaki Medical School, General Medical CenterHideyukiKandaDepartment of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65973Sarcopenia and malnutrition are increasing in older adults and are reported risk factors for functional impairment after hip fracture surgery. This study aimed to investigate the associations between skeletal muscle mass loss, malnutrition, and postoperative walking ability in patients with hip fracture. We retrospectively reviewed patients who underwent intertrochanteric fracture surgery at our institute. The psoas muscle index, controlling nutritional status score, and functional ambulation category (FAC) were used to evaluate skeletal muscle mass, nutritional status, and walking ability, respectively. Six months after surgery, walking ability was assessed as either “gait disturbance” or “independent gait”. Multivariate binomial logistic regression analysis, with skeletal muscle mass, nutritional status, and other factors, was used to predict the risk of being assigned to the gait disturbance group. This study included 95 patients (mean age, 85.2 years; 70 women). Sixty-six patients had low skeletal muscle mass, 35 suffered from malnutrition, and 28 had both. Malnutrition and low skeletal muscle mass were significantly associated with postoperative gait disturbance (FAC < 3). Preoperative low skeletal muscle mass and malnutrition were risk factors for postoperative poor walking ability. Further preventive interventions focusing on skeletal muscle mass and nutritional status are required.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Participation in the Setouchi Triennale and the Health of Residents in Naoshima: A Cross-Sectional Study491497ENHiroshiHabuDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenAooGraduate School of Humanities and Social Sciences, Okayama UniversityYosukeNishitaGraduate School of Humanities and Social Sciences, Okayama UniversityMasaoTsuriFaculty of Economics, Musashi UniversityTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65971Arts festivals have become increasingly popular in various parts of Japan in recent years. The purpose of this study was to investigate the relationships between arts festival activities participation at the Setouchi Triennale and the health of residents in the town of Naoshima. This was a cross-sectional study. Questionnaires were distributed to all residents of Naoshima who were 20 years old or older (n=2,588). We analyzed responses from 708 people. The associations between arts festival activities participation and health (measured by self-rated health) were analyzed using logistic regression analysis as the primary outcome. Kessler’s psychological distress scale scores were also analyzed in the same manner as the primary outcome. The participating group had an adjusted odds ratio of 1.86 (95% confidence interval: 1.03-3.33) for higher self-rated health compared with those who did not participate. Kessler’s psychological distress scale results showed that the participating group had an adjusted odds ratio of 3.23 (95% confidence interval: 1.19-8.81) for lower psychological distress compared with those who did not participate. In conclusion, arts festival activities participation was associated with higher self-rated health and lower psychological distress. However, caution must be taken in regard to generalizability and causality when interpreting these results.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Childcare and Child Development in Japan479490ENAkikoMurataDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiYorifujiFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/65970For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this “myth of the first three years” in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Relationship between the Hip Abductor Muscles and Abduction Strength in Patients with Hip Osteoarthritis461469ENDaisukeHommaDivision of Orthopaedic Surgery, Niigata University Graduate School of Medical and Dental SciencesIzumiMinatoDivision of Orthopaedic Surgery, Niigata Rinko HospitalNorioImaiDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesDaiMiyasakaDivision of Orthopaedic Surgery, Niigata Bandai HospitalYoshinoriSakaiDivision of Orthopaedic Surgery, Niigata City General HospitalYojiHorigomeDivision of Comprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesHayatoSuzukiDivision of Orthopaedic Surgery, Niigata University Graduate School of Medical and Dental SciencesYoichiroDohmaeDivision of Orthopaedic Surgery, Niigata Bandai HospitalNaotoEndoDivision of Orthopaedic Surgery, Niigata Prefectural Tsubame Rosai HospitalOriginal Article10.18926/AMO/65968This study aimed to determine which muscle the gluteus maximus, gluteus medius, gluteus minimus (Gmin), or tensor fasciae latae (TFL) contributes most to hip abduction strength and to identify effective sites for cross-sectional area (CSA) Gmin and TFL measurement in hip osteoarthritis (OAhip) patients. Twenty-eight patients with OAhip were included. The muscle CSA and volume were determined using magnetic resonance imaging. Peak isometric strength was determined using hand-held dynamometry. Muscle volumes were normalized to the total muscle volume of hip abductors. Multiple regression analysis was performed. The difference between the CSA of Gmin and TFL was calculated, and correlations with volume and muscle strength were determined. Gmin volume was related to abductor muscle strength (p=0.042). The peak CSA of the Gmin correlated with muscle volume and strength. The CSA of the TFL correlated with volume, with no difference between the CSA of the most protruding part of the lesser trochanter and peak CSA. Gmin volume was strongly related to abductor muscle strength. Peak CSA is a useful parameter for assessing the CSA of the Gmin among patients with OAhip. The CSA of the TFL should be measured at the most protruding part of the lesser trochanter.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7752023Does Participation in the Setouchi Triennale Foster Social Capital? : A Cross-Sectional Study443449ENChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHiroshiHabuDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNaomiMatsumotoDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenAooGraduate School of Humanities and Social Sciences, Okayama UniversityYosukeNishitaGraduate School of Humanities and Social Sciences, Okayama UniversityMasaoTsuriFaculty of Economics, Musashi UniversityTakashiYorifujiDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOriginal Article10.18926/AMO/65966This study examined whether participation in an art project was associated with higher social capital (SC). We conducted a questionnaire survey from November 2021 to March 2022 among residents aged 20 years or older of Naoshima, an island in Kagawa Prefecture, Japan. Before the survey, the Setouchi Triennale had been held on Naoshima four times, starting in 2010. We calculated propensity scores for Triennale participation and performed propensity score matching. We then compared cognitive and structural SC by Triennale participation and found significant differences, respectively. We adopted a conditional ordered logistic regression analysis with propensity score matching for cognitive or structural SC, and found adjusted odd ratios of 2.913 (95%CI, 1.846-4.596) for cognitive SC and 4.535 (95%CI, 2.839-7.244) for structural SC. Our findings suggest that Triennale participation enhanced the cognitive aspect of SC while also building structural SC.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1873-96011742023Expression and function of CCN2-derived circRNAs in chondrocytes15011515ENSomaKatoDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumiKawataDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiNishidaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomomiMizukawaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaharuTakigawaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesSeijiIidaDepartment of Oral Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCellular communication network factor 2 (CCN2) molecules promote endochondral ossification and articular cartilage regeneration, and circular RNAs (circRNAs), which arise from various genes and regulate gene expression by adsorbing miRNAs, are known to be synthesized from CCN2 in human vascular endothelial cells and other types of cells. However, in chondrocytes, not only the function but also the presence of CCN2-derived circRNA remains completely unknown. In the present study, we investigated the expression and function of CCN2-derived circRNAs in chondrocytes. Amplicons smaller than those from known CCN2-derived circRNAs were observed using RT-PCR analysis that could specifically amplify CCN2-derived circRNAs in human chondrocytic HCS-2/8 cells. The nucleotide sequences of the PCR products indicated novel circRNAs in the HCS-2/8 cells that were different from known CCN2-derived circRNAs. Moreover, the expression of several Ccn2-derived circRNAs in murine chondroblastic ATDC5 cells was confirmed and observed to change alongside chondrocytic differentiation. Next, one of these circRNAs was knocked down in HCS-2/8 cells to investigate the function of the human CCN2-derived circRNA. As a result, CCN2-derived circRNA knockdown significantly reduced the expression of aggrecan mRNA and proteoglycan synthesis. Our data suggest that CCN2-derived circRNAs are expressed in chondrocytes and play a role in chondrogenic differentiation.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X6772023Demonstration of iodide-dependent UVA-triggered growth inhibition in Saccharomyces cerevisiae cells and identification of its suppressive molecules15ENRyotaOnoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityNozomuSaekiResearch Core for Interdisciplinary Sciences, Okayama UniversityKeiichiKojimaFaculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityHisaoMoriyaResearch Core for Interdisciplinary Sciences, Okayama UniversityYukiSudoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityUpon white light illumination, the growth of the budding yeast Saccharomyces cerevisiae was extremely impaired only in the presence of iodide ions, but not fluoride, chloride and bromide ions. Action spectroscopy revealed that the maximum wavelength of the light is around at 373 nm, corresponding to the UVA region. Using a genetic approach, several genes, including OPY1, HEM1, and PAU11, were identified as suppressors of this growth inhibition. This iodide-dependent UVA-triggered growth inhibition method, along with its suppressive molecules, would be beneficial for understanding cell growth processes in eukaryotes and can be utilized for medium sterilization using UVA light.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Usefulness of Force-Controlled Pelvic Stress Radiograph in the Evaluation and Treatment of Fragility Fractures of the Pelvis in Geriatric Patients: A Pilot Study407414ENKensukeHottaDepartment of Orthopaedic Surgery, Amagi Chuo HospitalTakaomiKobayashiDepartment of Orthopaedic Surgery, Karatsu Red Cross HospitalOriginal Article10.18926/AMO/65751This study aimed to investigate the usefulness of force-controlled pelvic stress radiographs in the evaluation and treatment of fragility fractures of the pelvis (FFP) using a functional treatment strategy. We conducted a retrospective study of 55 geriatric patients with FFP who underwent pelvic stress radiographs on admission. The differences in the sacral width, pelvic ring width, and medial femoral head width between the radiographs with and without the Sam Sling II M size were defined as Δ sacral width, Δ pelvic ring width, and Δ medial femoral head width, respectively. We used Pearson’s correlation test to assess the relationship between the degree of radiographic instability and the Johns Hopkins highest level of mobility scale (JH-HLM) at 10-days postadmission. Conventional receiver-operating-characteristic curve analysis was used to identify cases requiring surgery using the best cutoff value for radiographic instability. The JH-HLM was significantly correlated with Δ sacral width (r=−0.401, p=0.017), but not with Δ pelvic ring width (r=−0.298, p=0.080) nor with Δ medial femoral head width (r= −0.261, p=0.128). The best cutoff value of Δ sacral width in identifying surgical cases was 10.7 mm (sensitivity 75.0%, specificity 98.0%). Force-controlled pelvic stress radiographs could be helpful in assessing the need for surgery on admission.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Changes in TRPV1 Receptor, CGRP, and BDNF Expression in Rat Dorsal Root Ganglion with Resiniferatoxin-Induced Neuropathic Pain: Modulation by Pulsed Radiofrequency Applied to the Sciatic Nerve359364ENTomohiroKoshidaDepartment of Anesthesiology and Pain Clinic, Faculty of Medicine, University of MiyazakiToyoakiMarutaDepartment of Anesthesiology and Pain Clinic, Faculty of Medicine, University of MiyazakiNobuhikoTanakaTanaka homecare clinicKotaroHidakaDepartment of Anesthesiology and Pain Clinic, Faculty of Medicine, University of MiyazakiMioKurogiDepartment of Anesthesiology and Pain Clinic, Faculty of Medicine, University of MiyazakiTakayukiNemotoDepartment of Pharmacology, Faculty of Medicine, Fukuoka UniversityToshihikoYanagitaDepartment of Clinical Pharmacology, School of Nursing, Faculty of Medicine, University of MiyazakiRyuTakeyaDepartment of Pharmacology, Faculty of Medicine, University of MiyazakiIsaoTsuneyoshiDepartment of Anesthesiology and Pain Clinic, Faculty of Medicine, University of MiyazakiOriginal Article10.18926/AMO/65741Pulsed radiofrequency (PRF) is a safe method of treating neuropathic pain by generating intermittent electric fields at the needle tip. Resiniferatoxin (RTX) is an ultrapotent agonist of transient receptor potential vanilloid subtype-1 (TRPV1) receptors. We investigated the mechanism of PRF using a rat model of RTX-induced neuropathic pain. After administering RTX intraperitoneally, PRF was applied to the right sciatic nerve. We observed the changes in TRPV1, calcitonin gene-related peptide (CGRP), and brain-derived neurotrophic factor (BDNF) in the dorsal root ganglia by western blotting. Expressions of TRPV1 and CGRP were significantly lower in the contralateral (RTX-treated, PRF-untreated) tissue than in control rats (p<0.0001 and p<0.0001, respectively) and the ipsilateral tissues (p<0.0001 and p<0.0001, respectively). BDNF levels were significantly higher in the contralateral tissues than in the control rats (p<0.0001) and the ipsilateral tissues (p<0.0001). These results suggest that, while TRPV1 and CGRP are decreased by RTX-induced neuronal damage, increased BDNF levels result in pain development. PRF may promote recovery from neuronal damage with concomitant restoration of TRPV1 and CGRP, and exert its analgesic effect by reversing BDNF increase. Further research is required to understand the role of TRPV1 and CGRP restoration in improving mechanical allodynia.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7742023Biological Roles of Hepatitis B Viral X Protein in the Viral Replication and Hepatocarcinogenesis341345ENMotoyukiOtsukaDepartment of Gastroenterology and Hepatology, Academic Field of Medicine, Density and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/65739Hepatitis B virus is a pathogenic virus that infects 300 million people worldwide and causes chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Hepatitis B virus encodes four proteins. Among them, the HBx protein plays a central role in the HBV pathogenesis. Because the HBx protein is considered to play a central role in the induction of viral replication and hepatocarcinogenesis, the regulation of its function could be a key factor in the development of new interventions against hepatitis B. In this review, HBx protein-related viral replication and hepatocarcinogenesis mechanisms are described, with a focus on the recently reported viral replication mechanisms related to degradation of the Smc5/6 protein complex. We also discuss our recent discovery of a compound that inhibits HBx protein-induced degradation of the Smc5/6 protein complex, and that exerts inhibitory effects on both viral replication and hepatocarcinogenesis. Finally, prospects for future research on the HBx protein are described.No potential conflict of interest relevant to this article was reported.AME Publishing Company Acta Medica Okayama2072-14391592023Long-term management and outcome of lung transplantation in Japan51825194ENSeiichiroSugimotoDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKeiMatsubaraDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinTanakaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalKentarohMiyoshiDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalMegumiIshiharaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalShinichiToyookaDepartment of General Thoracic Surgery and Organ Transplant Center, Okayama University HospitalThe long-term survival after lung transplantation (LT) is favorable in Japan. However, longterm survivors after LT are subject to late complications, including chronic lung allograft dysfunction (CLAD), malignancy, infection, and chronic kidney disease (CKD) because of the need for lifelong immunosuppression. The rates of single cadaveric LT (CLT) and living-donor lobar LT (LDLLT) are higher than that of bilateral CLT in Japan. Here, we will describe the management of late complications and long-term outcome after LT in Japan. Attention should be paid to not only the phenotype of CLAD but also the difference in CLAD after CLT and after LDLLT as well as the timing of lung re-transplantation for advanced CLAD, especially after single CLT. Since post-transplant lymphoproliferative disorder is the most common malignancy after LT, infection monitoring for infection-related malignancies and appropriate screening are keys to the early diagnosis and treatment of malignancy after LT. The long-term management of infection after LT is also important, especially with regard to community-acquired pathogens, Aspergillus, and cytomegalovirus. When providing long-term care after LT, physicians should be aware of CKD and the timing of renal replacement therapy in cases with severe CKD. The widespread use of computed tomography and dialysis in Japan are beneficial for long-term survivors of LT. The similar survival outcomes of single CLT and LDLLT, compared with bilateral CLT, might contribute to improved long-term survival in Japan. Pulmonologists are encouraged to become further involved in long-term management after LT in Japan.No potential conflict of interest relevant to this article was reported.日本薬学会Acta Medica Okayama0031-690314342023保険薬局薬剤師におけるエビデンス創出に対する意識：岡山県薬剤師会会員に対する大規模実態調査393404ENJunMatsumotoDepartment of Personalized Medicine and Preventive Healthcare Sciences, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMadokaItanoOkayama Pharmaceutical AssociationNaohiroIwataOkayama Pharmaceutical AssociationMasafumiOroOkayama Pharmaceutical AssociationChikakoKitakazeOkayama Pharmaceutical AssociationAyukoHirotaOkayama Pharmaceutical AssociationKatsuhikoMakinoOkayama Pharmaceutical AssociationTomoyukiTatenoOkayama Pharmaceutical AssociationRyoheiTeraiOkayama Pharmaceutical AssociationHideoKenmotsuOkayama Pharmaceutical AssociationMotohideDateOkayama Pharmaceutical AssociationCommunity pharmacists in Japan participate in many important clinical cases involving drug therapies. This involvement should be researched and widely publicized to promote evidence-based medicine (EBM). However, the awareness level about the establishment of clinical evidence among community pharmacists remains unknown. Therefore, this large-scale questionnaire survey was conducted among members of the Okayama Pharmaceutical Association to clarify the awareness about the establishment of clinical evidence among community pharmacists to determine the major factors affecting their awareness. Questionnaires requiring open-ended responses were developed in Google Forms. Finally, 366 valid answers were obtained and statistically analyzed based on three aspects: academic conference presentation, research article publication, and research conduct. More than 50% of the participants agreed that they must engage in the establishment of clinical evidence. However, they were unwilling to engage in it by themselves. Additionally, the awareness about the establishment of clinical evidence among participants aged <40 years, who underwent a 6-year course, and with presentation experience was greater than that among participants aged ≥40 years, who underwent a 4-year course and without presentation experience. Thus, age, course duration, and presentation experience are important factors influencing awareness about the establishment of clinical evidence. Further, >70% of the participants did not have enough time to engage in the establishment of clinical evidence, suggesting that reducing workload and ensuring adequate time are necessary for such engagements. Our novel findings may increase the establishment of clinical evidence by community pharmacists, improve community pharmacists’ social standing, and promote EBM in Japan.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8516E106.B22023Multi-Input Physical Layer Network Coding in Two-Dimensional Wireless Multihop Networks193202ENHideakiTSUGITAGraduate School of Natural Science and Technology, Okayama UniversitySatoshiDENNOGraduate School of Natural Science and Technology, Okayama UniversityYafeiHOUGraduate School of Natural Science and Technology, Okayama UniversityThis paper proposes multi-input physical layer network coding (multi-input PLNC) for high speed wireless communication in two-dimensional wireless multihop networks. In the proposed PLNC, all the terminals send their packets simultaneously for the neighboring relays to maximize the network throughput in the first slot, and all the relays also do the same to the neighboring terminals in the second slot. Those simultaneous signal transmissions cause multiple signals to be received at the relays and the terminals. Signal reception in the multi-input PLNC uses multichannel filtering to mitigate the difficulties caused by the multiple signal reception, which enables the two-input PLNC to be applied. In addition, a non-linear precoding is proposed to reduce the computational complexity of the signal detection at the relays and the terminals. The proposed multi-input PLNC makes all the terminals exchange their packets with the neighboring terminals in only two time slots. The performance of the proposed multi-input PLNC is confirmed by computer simulation. The proposed multi-input physical layer network coding achieves much higher network throughput than conventional techniques in a two-dimensional multihop wireless network with 7 terminals. The proposed multi-input physical layer network coding attains superior transmission performance in wireless hexagonal multihop networks, as long as more than 6 antennas are placed on the terminals and the relays.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8516E106.B22023Superposition Signal Input Decoding for Lattice Reduction-Aided MIMO Receivers184192ENSatoshiDENNOGraduate School of Natural Science and Technology, Okayama UniversityKokiKASHIHARAGraduate School of Natural Science and Technology, Okayama UniversityYafeiHOUGraduate School of Natural Science and Technology, Okayama UniversityThis paper proposes a novel approach to low complexity soft input decoding for lattice reduction-aided MIMO receivers. The proposed approach feeds a soft input decoder with soft signals made from hard decision signals generated by using a lattice reduction-aided linear detector. The soft signal is a weighted-sum of some candidate vectors that are near by the hard decision signal coming out from the lattice reduction-aided linear detector. This paper proposes a technique to adjust the weight adapt to the channel for the higher transmission performance. Furthermore, we propose to introduce a coefficient that is used for the weights in order to enhance the transmission performance. The transmission performance is evaluated in a 4×4 MIMO channel. When a linear MMSE filter or a serial interference canceller is used as the linear detector, the proposed technique achieves about 1.0dB better transmission performance at the BER of 10-5 than the decoder fed with the hard decision signals. In addition, the low computational complexity of the proposed technique is quantitatively evaluated.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-734559492023Development of light-induced disruptive liposomes (LiDL) as a photoswitchable carrier for intracellular substance delivery75917594ENTaichiTsuneishiGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeiichiKojimaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityFumikaKubotaFaculty of Pharmaceutical Sciences, Hokkaido UniversityHideyoshiHarashimaFaculty of Pharmaceutical Sciences, Hokkaido UniversityYumaYamadaFaculty of Pharmaceutical Sciences, Hokkaido UniversityYukiSudoGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityLight-driven inward proton pump rhodopsin RmXeR was embedded in pH-sensitive liposomes. Substance release from the proteoliposomes was observed following light illumination both in vitro and in cells, indicating the successful production of light-induced disruptive liposomes (LiDL). Thus, LiDL is a photoswitchable carrier utilized for intracellular substance delivery.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Utility of Comprehensive Genomic Profiling for Precise Diagnosis of Pediatric-Type Diffuse High-Grade Glioma323330ENKeigoMakinoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihiroOtaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentaroFujiiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJojiIshidaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShuichiro HiranoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasukiSurugaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKanaWashioDepartments of Pediatrics, Okayama University HospitalKenjiNishidaDepartments of Pathology, Okayama University HospitalHiroyukiYanaiDepartments of Pathology, Okayama University HospitalShutaTomidaCenter for Comprehensive Genomic Medicine, Okayama University HospitalDaisukeEnnishiCenter for Comprehensive Genomic Medicine, Okayama University HospitalIsaoDateDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/65502In the current World Health Organization classification of central nervous system tumors, comprehensive genetic and epigenetic analyses are considered essential for precise diagnosis. A 14-year-old male patient who presented with a cerebellar tumor was initially diagnosed with glioblastoma and treated with radiation and concomitant temozolomide chemotherapy after resection. During maintenance temozolomide therapy, a new contrast-enhanced lesion developed in the bottom of the cavity formed by the resection. A second surgery was performed, but the histological findings in specimens from the second surgery were different from those of the first surgery. Although genome-wide DNA methylation profiling was conducted using frozen tissue for a precise diagnosis, the proportion of tumor cells was insufficient and only normal cerebellum was observed. We then performed comprehensive genetic analysis using formalin-fixed paraffin-embedded sections, which revealed MYCN amplification without alteration of IDH1, IDH2, or Histone H3. Finally, the patient was diagnosed with pediatric-type diffuse high-grade glioma, H3-wildtype and IDH-wildtype. In conclusion, comprehensive genetic and epigenetic analysis should be considered in pediatric brain tumor cases.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Associations between Comorbidities and Acute Exacerbation of Interstitial Lung Disease after Primary Lung Cancer Surgery301309ENTakahideKatoDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineSeigoMiyoshiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineChizuruHamadaDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineYoshifumiSanoDepartment of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of MedicineNaoyukiNogamiDepartment of Community Medicine, Pulmonology and Cardiology, Ehime University Graduate School of MedicineOsamuYamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineNaohikoHamaguchiDepartment of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of MedicineOriginal Article10.18926/AMO/65495Acute exacerbation (AE) of interstitial lung disease (ILD) is a severe complication of lung resection in lung cancer patients with ILD (LC-ILD). This study aimed to assess the predictive value of comorbidities other than ILD for postoperative AE in patients with LC-ILD. We retrospectively evaluated 68 patients with LC-ILD who had undergone lung resection. We classified them into two groups: those who had developed postoperative AE within 30 days after resection and those who had not. We analyzed patient characteristics, high-resolution computed tomography findings, clinical data, pulmonary function, and intraoperative data. The incidence of postoperative AEs was 11.8%. In univariate analysis, performance status (PS), honeycombing, forced vital capacity (FVC), and high hemoglobin A1c (HbA1c) levels without comorbidities were significantly associated with postoperative AE. Patients were divided into two groups according to cutoff levels of those four variables as determined by receiver operating characteristic curves, revealing that the rates of patients without postoperative AE differed significantly between groups. The present results suggested that preoperative comorbidities other than ILD were not risk factors for postoperative AE in patients with LC-ILD. However, a high preoperative HbA1c level, poor PS, low FVC, and honeycombing may be associated with postoperative AE of LC-ILD.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7732023Current Prevalence of Antimicrobial Resistance in Okayama from a National Database between 2018 and 2021255262ENShinnosukeFukushimaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhiroUdaDepartment of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuyoshiGotohDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/65490Antimicrobial resistance is an emerging global threat that must be addressed using a multidisciplinary approach. This study aimed to raise awareness of high-level antimicrobial-resistant (AMR) pathogens in Japan by comparing their recent prevalences among prefectures, particularly Okayama. Data for the isolation proportions of meropenem-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, cefotaxime-resistant Escherichia coli and Klebsiella pneumoniae, and levofloxacin-resistant E. coli and K. pneumoniae were collected from the Japan Nosocomial Infections Surveillance, a national database sponsored by the Japanese Ministry of Health, Labour, and Welfare, between 2018 and 2021. The average isolated proportions of the seven AMR pathogens were higher in Okayama compared to other prefectures: the worst (19.9%) was meropenem-resistant P. aeruginosa, the sixth worst (57.2%) was methicillin-resistant S. aureus, the eighth worst (3.3%) was vancomycin-resistant E. faecium, the second (37.8%) and fifth worst (17.6%) were cefotaxime-resistant E. coli and K. pneumoniae, respectively, and the fourth (49.9%) and third worst (8.7%) were levofloxacin-resistant E. coli and K. pneumoniae, respectively. Our study highlights the notably high prevalences of representative AMR pathogens in Okayama, suggesting the need for fundamental infection prevention and control by healthcare professionals, promoting antimicrobial stewardship, and educating undergraduates and postgraduates in Okayama.No potential conflict of interest relevant to this article was reported.Department of Otolaryngology, Okayama University HospitalActa Medica Okayama2023Communication Support for People with APD: Schools/WorkplacesENYukoKataokaDepartment of Otolaryngology, Okayama University Hospital10.18926/65474No potential conflict of interest relevant to this article was reported.American Physical Society (APS)Acta Medica Okayama2469-992610742023Measurement of Doppler effects in a cryogenic buffer-gas cell043114ENAyamiHiramotoResearch Institute for Interdisciplinary Science, Okayama UniversityMasaakiBabaDepartment of Chemistry, Graduate School of Science, Kyoto UniversityKatsunariEnomotoDepartment of Physics, University of ToyamaKanaIwakuniInstitute for Laser Science, University of Electro-CommunicationsSusumuKumaAtomic, Molecular and Optical Physics Laboratory, RIKENYuikiTakahashiDivision of Physics, Mathematics, and Astronomy, California Institute of TechnologyReoTobaruResearch Institute for Interdisciplinary Science, Okayama UniversityYukiMiyamotoResearch Institute for Interdisciplinary Science, Okayama UniversityBuffer-gas cooling is a universal cooling technique for molecules and used for various purposes. One of its ap- plications is using molecules inside a buffer-gas cell for low-temperature spectroscopy. Although a high-intensity signal is expected in the cell, complex molecular dynamics is a drawback for precise spectroscopy. In this study, we performed high-resolution absorption spectroscopy of low -J transitions in the òΠ(0, 0, 0)-˜X²Σ<sup>+</sup>(0, 0, 0) band of calcium monohydroxide (CaOH). CaOH molecules were produced by laser ablation in a copper cell and cooled to ∼5 K using helium buffer gas. We probed the Doppler effects in a buffer-gas cell by injecting counterpropagating lasers inside the cell. The time evolutions of the Doppler width and shift were simulated using a dedicated Monte Carlo simulation and compared with data.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813512023新型コロナウイルス感染症院内クラスターの対応経験とそこから見えたクラスター対応アルゴリズム2233ENKojiFujitaDepartment of General Internal Medicine and Infectious Diseases, Tsuyama Chuo HospitalKazukiOchoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokaKadowakiOkayama COVID-19 Cluster Intervention TeamTakashiYorifujiOkayama COVID-19 Cluster Intervention TeamFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences The novel coronavirus disease (COVID-19) pandemic that began in 2019 is yet to end, as of the summer of 2022. During the pandemic, community-acquired infections spread easily to healthcare-associated facilities, resulting in COVID-19 clusters among high-risk individuals that have been difficult to contain. Our regional base hospital also experienced a nosocomial cluster of COVID-19 in October 2020 that took 30 days to contain and affected 9 hospital staff and 14 patients. Six patients died due to COVID-19, and six died due to COVID-19-related complications. Two patients were discharged alive. Patient characteristics included ① advanced age (79.0±8.1 years), ② dementia (64.3%), ③ low Prognostic Nutrition Index (31.1 ±7.9), ④ zinc deficiency (50.2±13.1μg/dL), ⑤ vitamin C deficiency (1.6±1.9μg/mL), ⑥ elevated urea nitrogen-to-creatinine ratio (27.4±23.5), ⑦ anticancer and immunosuppressive drug use (78.6%), and ⑧ malignancy (75.6%). This cluster had a very high mortality rate, but the viral spread was contained in a short period. Algorithmizing the cluster response was crucial to controlling this cluster. We report on our actual cluster response algorithm, as well as our strategy and response procedure during the pandemic.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Validity of the 30-Second Chair-Stand Test to Assess Exercise Tolerance and Clinical Outcomes in Patients with Esophageal Cancer: A Retrospective Study with Reference to 6-Minute Walk Test Results193197ENTomohiroIkedaDepartment of Rehabilitation Medicine, Okayama UniversityKazuhiroNomaDepartment of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiOkuraDivision of Rehabilitation, Akita University Graduate School of MedicineShoKatayamaDepartment of Rehabilitation Medicine, Okayama UniversityYusukeTakahashiDivision of Rehabilitation, Akita University Graduate School of MedicineNaoakiMaedaDepartment of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeTanabeDepartment of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiyukiWakitaDepartment of Esophageal Surgery, Akita University Graduate School of MedicineMasanoriHamadaDepartment of Rehabilitation Medicine, Okayama UniversityToshiyoshiFujiwaraDepartment of Gastroenterological Surgery, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasuoSendaDepartment of Rehabilitation Medicine, Okayama UniversityShort Communication10.18926/AMO/65149This retrospective study aimed to investigate the validity of a 30-sec chair stand test (CS-30) as a simple test to assess exercise tolerance and clinical outcomes in 53 Japanese patients with esophageal cancer. There was a strong correlation between the results of CS-30 and the 6-min walk test (6MWT), the gold standard for assessing exercise tolerance (r=0.759). Furthermore, fewer patients whose CS-30 score was greater than 16 (the cutoff value defined based on 6MWT) experienced pneumonia in their postoperative course. These results suggest that exercise tolerance could be assessed using CS-30, and its cutoff value may be useful in predicting postoperative pneumonia risk.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7722023Prolonged Sedentary Bouts Are Critically Involved in All-Cause Mortality in Patients on Chronic Hemodialysis: A Prospective Cohort Study139145ENKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHiroyukiNishiInnoshima General HospitalAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityKazuhiroUjikeInnoshima General HospitalHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityKiichiKoumotoInnoshima General HospitalOriginal Article10.18926/AMO/65143We investigated the link between prolonged sedentary bouts and all-cause mortality in patients on chronic hemodialysis, using a prospective cohort. A total of 104 outpatients on chronic hemodialysis from 2013 to 2019, aged 71.4±11.4 years, were enrolled. Prolonged sedentary bouts (≥ 30 min and ≥60 min) (min and bouts) and relative prolonged sedentary bouts (≥ 30 min and ≥ 60 min) (%) on the patients’ non-hemodialysis days were measured by a tri-accelerometer, and we also analyzed the patients’ clinical parameters. The relationship between prolonged sedentary bouts and all-cause mortality was evaluated by a survival analysis and the Cox proportional hazard model. Thirty-five patients died during the follow-up period. A Kaplan-Meier analysis detected significant differences in the survival rate between two groups stratified by the median for all prolonged sedentary-bout parameters. After the adjustment for confounding factors, all of the prolonged sedentary-bout parameters were determinant factors for all-cause mortality. These results indicate that prolonged sedentary bouts on non-hemodialysis days were closely related to all-cause mortality in the patients
on hemodialysis.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323132023多文化共生を視点とした外国にルーツをもつ子どもへの支援の試み ―言葉と文化の学習を中心とした取り組みを事例として―275284ENXinyiXieGraduate School of Humanities and Social SciencesToshinoriKuwabaraFaculty of Education, Okayama University10.18926/CTED/65078 本稿では，多文化共生社会の構築を目指して，筆者（謝）が取り組んでいる外国にルーツを持つ子どもに対する多文化交流活動の実践を検討し，その意義を解明しようとするものである。具体的には，筆者（謝）が岡山県内で主催している地域教育支援活動団体「週末エウレカ」の実践の取り組みを取り上げ検討する。本実践は，日本語の学習だけではなく，様々な国の文化を学ぶことによって，多文化共生社会の一員としての資質を育成しようとする点に特質がある。活動の中では，日本で学ぶ外国人留学生によって，外国にルーツを持つ子どもに対する教育活動が行われた。本研究では，そのような支援の特徴と課題を明らかにしたい。そして，今後，このような外国人留学生による活動支援団体を，地域においてコミュニティの協力のもとで運営するための示唆を得たい。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323132023高等学校における地域課題探究ワークショップの意義 ―ファシリテーション能力の育成に焦点をあてて―145159ENNagisaYamadaGraduate School of Humanities and Social SciencesToshinoriKuwabaraFaculty of Education, Okayama University10.18926/CTED/65070本研究は，高等学校の総合的な探究の時間などで取り組まれている地域課題探究学習について，そのねらいを生徒のファシリテーション能力の育成として捉え直そうとするものである。そのために，地域課題探究学習をワークショップの形式で実施している高等学校の実践を調査した。実際には，プログラムの企画・準備段階から実践までのプロセスに支援者として参画するとともに，全体司会やグループ活動のリーダーを務めた生徒に対してアンケートや聞き取り調査を行った。調査の結果，ファシリテーション能力の育成を行うことで，個人の成長や将来を見通した指導の実現に繋がることが明らかになった。また，地域住民や中学生，大学生といった普段の学校生活で関わらない人々とともにワークショップをおこなうことで，大学生から刺激を受けたり，中学生をリードしたりしなければいけないという環境の変化が，ファシリテーション能力の育成をさらに促進させると考える。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323132023幼稚園・保育所・幼保連携型認定こども園における｢専門職の学習共同体｣の醸成 ―教育・保育課程等編成のプロセスに着目して―6982ENYushiFujiiKurashiki Municipal Kurashiki Special Needs SchoolShinnosukeKumagaiFaculty of Education, Okayama University10.18926/CTED/65065 本研究では，幼稚園・保育所・幼保連携型認定こども園においてP L C 醸成をめざした際の，教育・保育課程等編成のプロセスを明らかにすることを目的とした。カリキュラム・マネジメントによる学校文化変革のプロセスとP T L C の関係性を整理した上で，PLC 醸成をめざしたカリキュラム編成のプロセスを示し，それをもとに， P L C 醸成にむけた教育・保育課程等編成のプロセスを示した。そして，『幼稚園教育要領解説』，『保育所保育指針解説』，『幼保連携型認定こども園教育・保育要領解説』で示された教育・保育課程等編成の手順と比較し，プロセスやリーダーシップのあり方に関する違いが確認できた。No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813412022看護師の性別違和への関わりにくさについての尺度作成2227ENMakiMiyakeDepartment of Nursing, Okayama University HospitalYoshitakaOshimaDepartment of Neuropsychiatry, Okayama University HospitalShihokoNambaDepartment of Center for Innovative Clinical Medicine, Okayama University HospitalYosukeMatsumotoDepartment of Gender Center, Okayama University HospitalMakikoHoriuchiDepartment of Medical Support, Clinical Psychology section, Okayama University HospitalNorihitoYamadaDepartment of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences This study aimed to develop a scale to measure the perceived difficulty experienced by nurses in treating and caring for patients diagnosed with gender dysphoria and examine its reliability and validity. We developed a 26-item preliminary scale through discussions with experts in gender dysphoria treatment. We administered a questionnaire including this scale to 1,010 nurses working at Okayama University Hospital and analyzed the data of 346 nurses who had been involved in the treatment of gender dysphoria and had no missing responses.<br>
A total of 20 items consisting of two factors, “relationship building” and “negative emotion for gender dysphoria,” were extracted by exploratory factor analysis, and we used them in the final version of the scale. Cronbach's alpha coefficient for the entire scale was 0.879, indicating a high degree of internal consistency.<br>
However, the correlations with a communication skills scale (ENDCOREs) and the Scale of Gender Conception were limited, and the external validity could not be proven. This scale may be useful for evaluating nursing practice and educational support for nurses; however, there is room for further study on the scale validation.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155813412022令和２年度岡山医学会賞 がん研究奨励賞（林原賞・山田賞）79ENYujiMatsumotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNo potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Increased Glycine-conjugated and Unconjugated Bile Acid Levels Associated with Aggravation of Nonalcoholic Steatohepatitis and Cardiovascular Disease in SHRSP5/Dmcr Rat2936ENShuseiYamamotoAcademic Field of Health Sciences, Okayama UniversityIkumiSatoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityMoeFujiiDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityMaiKakimotoDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityKokiHonmaDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversityNatsumiAkiyamaDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityMikuSakaiDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityNatsukiFukuhamaDepartment of Medical Technology, Faculty of Health Sciences, Okayama UniversityShotaKumazakiDepartment of Medical Technology, Graduate School of Health Sciences, Okayama UniversitySatoshiHirohataAcademic Field of Health Sciences, Okayama UniversityKazuyaKitamoriCollege of Human Life and Environment, Kinjo Gakuin UniversityYukioYamoriInstitute for World Health Development, Mukogawa Women's UniversityShogoWatanabeAcademic Field of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/64358The SHRSP5/Dmcr is a useful animal model for the development of nonalcoholic steatohepatitis (NASH) pathology when fed a high-fat, high-cholesterol diet, and further drug interventions can lead to concomitant cardiovascular disease. While SHRSP5/Dmcr rats have been used for basic research related to NASH, details of their bile acid metabolism in this condition are unknown. In this study, we aimed to clarify the changes in the serum bile acid (BA) fractions associated with NASH and found that glycine-conjugated and unconjugated bile acid increased with worsening NASH and cardiovascular disease while taurine-conjugated BA relatively decreased.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Analysis of Phase Angle and Balance and Gait Functions in Pre-Frail Individuals: A Cross-Sectional Observational Study2127ENDaisukeHommaOrthopaedic Surgery, Niigata University Graduate School of Medical and Dental SciencesIzumiMinatoDivision of Orthopaedic Surgery, Niigata Rinko HospitalNorioImaiComprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesDaiMiyasakaDivision of Orthopaedic Surgery, Niigata Bandai HospitalYoshinoriSakaiDivision of Orthopaedic Surgery, Niigata City General HospitalYojiHorigomeComprehensive Musculoskeletal Medicine, Niigata University Graduate School of Medical and Dental SciencesHayatoSuzukiOrthopaedic Surgery, Niigata University Graduate School of Medical and Dental SciencesYoichiroDohmaeDivision of Orthopaedic Surgery, Niigata Bandai HospitalNaotoEndoDivision of Orthopaedic Surgery, Niigata Prefectural Tsubame Rosai HospitalOriginal Article10.18926/AMO/64357We measured the muscle mass and phase angle of each body part to evaluate the relationship between balance and gait functions in individuals with a pre-frailty status. This cross-sectional observational study determined the skeletal muscle mass-to-body weight ratio and phase angles of 21 control (robust) and 29 pre-frail subjects. Their Brief-Balance Evaluation Systems Test, Timed Up-and-Go (TUG) test, Life-Space Assessment, and Modified Fall Efficacy Scale scores plus the relationship between muscle mass, phase angle, and motor function were evaluated. In the pre-frailty group (three males, 26 females, aged 75.58±7.60 years), significant correlations were noted between the Brief-Balance Evaluation Systems Test score and lower-limb (r=0.614) and wholebody (r=0.557) phase angles, and between the TUG test score and lower-limb muscle mass-to-body weight ratio (r=−0.616), lower-limb phase angle (r=−0.616), and whole-body phase angle (r=−0.527). Evaluating the phase angle of the lower extremities of pre-frail patients and intervening accordingly may help clinicians maintain and improve these patients’ balance and gait functions.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7712023Prevalence of Inducible Macrolide, Lincosamide, and Streptogramin B (inducible MLSB) Resistance in Clindamycin-Susceptible Staphylococcus aureus at Okayama University Hospital19ENLutfunNaharDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakahiroNadaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalKazuyoshiGotohDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOsamuMatsushitaDepartment of Bacteriology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/64355Inducible resistance to the macrolide, lincosamide, and streptogramin B (iMLSB) antibiotic family is a latent mechanism for antimicrobial resistance in Staphylococcus aureus. We here investigated the frequency and genotypic profiles of iMLSB resistance in clindamycin (CLDM)-susceptible S. aureus isolated in Okayama University Hospital from June 2020 to June 2021. We phenotypically screened the iMLSB resistance via D-zone test and performed PCR testing for the erythromycin ribosomal methylase (erm) genes: ermA and ermC. Among 432 CLDM-susceptible S. aureus isolates, 138 (31.9%) exhibited an iMLSB-resistance phenotype, with methicillinresistant S. aureus isolates (MRSA; 61 isolates: 58.6%) exhibiting higher positivity than methicillin-sensitive S. aureus isolates (MSSA; 77 isolates: 23.5%) (p<0.001). Male patients had a higher frequency of iMLSB resistance than females (OR [95%CI]: 1.8 [1.2-2.8]; p=0.007). Genotypically, ermA predominated in both MSSA (70.1%) and MRSA (86.9%) compared to ermC (14.3% in MSSA and 11.5% in MRSA). A single strain of MRSA possessed both ermA and ermC, while 12 (15.6%) MSSA isolates were negative for both ermA and ermC, suggesting the presence of other genetic mechanisms. Collectively, these results show that approximately 33% of CLDM-susceptible S. aureus isolates at our university hospital exhibited iMLSB resistance, predominantly caused by ermA in both MSSA and MRSA.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1873-96011722023Do not overwork: cellular communication network factor 3 for life in cartilage353359ENSatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesHarumiKawakiDepartment of Oral Biochemistry, Asahi University School of DentistryBernardPerbalInternational CCN SocietyMasaharuTakigawaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences/Dental SchoolKazumiKawataDepartment of Biochemistry and Molecular Dentistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakakoHattoriDepartment of Biochemistry and Molecular Dentistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesTakashiNishidaDepartment of Biochemistry and Molecular Dentistry, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical SciencesCellular communication network factor (CCN) 3, which is one of the founding members of the CCN family, displays diverse functions. However, this protein generally represses the proliferation of a variety of cells. Along with skeletal development, CCN3 is produced in cartilaginous anlagen, growth plate cartilage and epiphysial cartilage. Interestingly, CCN3 is drastically induced in the growth plates of mice lacking CCN2, which promotes endochondral ossification. Notably, chondrocytes in these mutant mice with elevated CCN3 production also suffer from impaired glycolysis and energy metabolism, suggesting a critical role of CCN3 in cartilage metabolism. Recently, CCN3 was found to be strongly induced by impaired glycolysis, and in our study, we located an enhancer that mediated CCN3 regulation via starvation. Subsequent investigations specified regulatory factor binding to the X-box 1 (RFX1) as a transcription factor mediating this CCN3 regulation. Impaired glycolysis is a serious problem, resulting in an energy shortage in cartilage without vasculature. CCN3 produced under such starved conditions restricts energy consumption by repressing cell proliferation, leading chondrocytes to quiescence and survival. This CCN3 regulatory system is indicated to play an important role in articular cartilage maintenance, as well as in skeletal development. Furthermore, CCN3 continues to regulate cartilage metabolism even during the aging process, probably utilizing this regulatory system. Altogether, CCN3 seems to prevent "overwork" by chondrocytes to ensure their sustainable life in cartilage by sensing energy metabolism. Similar roles are suspected to exist in relation to systemic metabolism, since CCN3 is found in the bloodstream.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama1444-158622122022Impact of number of functional teeth on independence of Japanese older adults10321039ENKenjiMaekawaOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomokoIkeuchiTokyo Metropolitan Institute of GerontologyShojiShinkaiTokyo Metropolitan Institute of GerontologyHirohikoHiranoTokyo Metropolitan Institute of GerontologyMasahiroRyuResearch Planning and Promotion Committee Japan Prosthodontic SocietyKatsushiTamakiResearch Planning and Promotion Committee Japan Prosthodontic SocietyHirofumiYataniResearch Planning and Promotion Committee Japan Prosthodontic SocietyTakuoKubokiOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAyaKimura‐OnoResearch Planning and Promotion Committee Japan Prosthodontic SocietyTakeshiKikutaniResearch Planning and Promotion Committee Japan Prosthodontic SocietyTakashiSuganumaResearch Planning and Promotion Committee Japan Prosthodontic SocietyYasunoriAyukawaResearch Planning and Promotion Committee Japan Prosthodontic SocietyTomoyaGondaResearch Planning and Promotion Committee Japan Prosthodontic SocietyToruOgawaResearch Planning and Promotion Committee Japan Prosthodontic SocietyMasanoriFujisawaResearch Planning and Promotion Committee Japan Prosthodontic SocietyShoichiIshigakiResearch Planning and Promotion Committee Japan Prosthodontic SocietyYutakaWatanabeTokyo Metropolitan Institute of GerontologyAkihikoKitamuraTokyo Metropolitan Institute of GerontologyYuTaniguchiNational Institute for Environmental StudiesYoshinoriFujiwaraTokyo Metropolitan Institute of GerontologyAyakoEdahiroTokyo Metropolitan Institute of GerontologyYukiOharaTokyo Metropolitan Institute of GerontologyJunichiFuruyaShowa University School of DentistryJunkoNakajimaTokyo Dental CollegeKentoUmekiNihon University School of Dentistry at MatsudoKentaroIgarashiNihon University School of Dentistry at MatsudoYasuhiroHoribeTokyo Dental CollegeYoshihiroKugimiyaTokyo Dental CollegeYasuhikoKawaiNihon University School of Dentistry at MatsudoHideoMatsumuraNihon University School of DentistryTetsuoIchikawaTokushima University Graduate School Institute of Biomedical SciencesShujiOhkawaMeikai University School of DentistryKazuyoshiBabaShowa University School of DentistryKusatsu ISLE Study Working Group CollaboratorsAim<br>
To examine the relationship between the number of present and functional teeth at baseline and future incidence of loss of independence.<br>
<br>
Methods<br>
Participants were community-dwelling older individuals who participated in a comprehensive geriatric health examination conducted in Kusatsu town, Japan, between 2009 and 2015. The primary endpoint was the incidence of loss of independence among participants, defined as the first certification of long-term care insurance in Japan. The numbers of present and functional teeth at baseline were determined via an oral examination. Demographics, clinical variables (e.g., history of chronic diseases and psychosocial factors), blood nutritional markers, physical functions, and perceived masticatory function were assessed.<br>
<br>
Results<br>
This study included 1121 individuals, and 205 individuals suffered from loss of independence during the follow-up period. Kaplan–Meier estimates of loss of independence for participants with smaller numbers of present and functional teeth were significantly greater than for those with larger numbers of teeth. Cox proportional hazard analyses indicated that a smaller number of present teeth was not a significant risk factor after adjusting for demographic characteristics. However, the number of functional teeth was a significant risk factor after the adjustment (hazard ratio: 1.975 [1.168–3.340]). Additionally, higher hazard ratios were observed in other adjusted models, but they were not statistically significant.<br>
<br>
Conclusions<br>
The number of functional teeth may be more closely related to the future incidence of loss of independence than the number of present teeth. This novel finding suggests that prosthodontic rehabilitation for tooth loss possibly prevents the future incidence of this life-event.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8516E105.B102022Adaptive Resource Allocation Based on Factor Graphs in Non-Orthogonal Multiple Access12581267ENTaichiYamagamiGraduate School of Natural Science and Technology, Okayama UniversitySatoshiDennoGraduate School of Natural Science and Technology, Okayama UniversityYafeiHouGraduate School of Natural Science and Technology, Okayama UniversityIn this paper, we propose a non-orthogonal multiple access with adaptive resource allocation. The proposed non-orthogonal multiple access assigns multiple frequency resources for each device to send packets. Even if the number of devices is more than that of the available frequency resources, the proposed non-orthogonal access allows all the devices to transmit their packets simultaneously for high capacity massive machine-type communications (mMTC). Furthermore, this paper proposes adaptive resource allocation algorithms based on factor graphs that adaptively allocate the frequency resources to the devices for improvement of the transmission performances. This paper proposes two allocation algorithms for the proposed non-orthogonal multiple access. This paper shows that the proposed non-orthogonal multiple access achieves superior transmission performance when the number of the devices is 50% greater than the amount of the resource, i.e., the overloading ratio of 1.5, even without the adaptive resource allocation. The adaptive resource allocation enables the proposed non-orthogonal access to attain a gain of about 5dB at the BER of 10<sup>-4</sup>.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X28122022Detection of Enterobacter cloacae complex strain with a blaNDM-1-harboring plasmid from an elderly resident at a long-term care facility in Okayama, Japan16971699ENKazuyoshiGotohDepartment of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalHarutoYamadaDepartment of Clinical Laboratory, Okayama City HospitalOsamuMatsushitaDepartment of Bacteriology, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAmidst the global spread of antimicrobial resistance, New Delhi metallo-beta-lactamase (NDM)-type carbapenemase-producing Enterobacterales (CPE) remain uncommon in Japan, and the detection of such highly drug-resistant organisms is limited to inbound cases. There is little evidence regarding the prevalence of NDM beta-lactamase gene (blaNDM)-harboring CPE in the domestic community, especially in the provincial cities of Japan. Herein, we report the isolation of a blaNDM-1-harboring plasmid in Enterobacter cloacae complex strain isolated from an elderly woman without a history of traveling abroad who had resided in a long-term care facility in Okayama, Japan. The multidrug-resistant blaNDM-harboring CPE isolate was detected in a stool sample of the patient during routine screening at admission. We performed whole-genome sequencing analysis of the isolate using MiSeq (Illumina) and MinION (Oxford Nanopore Technologies) platforms. The isolate was identified as sequence type 171, which has predominantly been reported in the United States and China. The blaNDM-1 gene was encoded on the 46,161 bp IncX3 plasmid, with sequence similarity to plasmids of similar size isolated from individuals in China. Collectively, the genomic data suggest that an imported CPE isolate may have spread among healthy individuals in the regional area of Japan.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022Serum miR-377 Can Be Used as a Diagnostic Marker for Acute Coronary Syndrome and Can Regulate Proinflammatory Factors and Endothelial Injury Markers723730ENQuanZhangDepartment of Cardiovascular Medicine, Affiliated Hospital of Gansu Medical CollegeLixiaYangDepartment of Cardiovascular Medicine, Affiliated Hospital of Gansu Medical CollegeGuozhenWanDepartment of Cardiovascular Medicine, Affiliated Hospital of Gansu Medical CollegeXiaoqiangZhangDepartment of Cardiovascular Medicine, Affiliated Hospital of Gansu Medical CollegeYingWangDepartment of Cardiovascular Medicine, Affiliated Hospital of Gansu Medical CollegeGuannanZhaoDepartment of Dermatological, Pingliang Traditional Chinese Medicine HospitalOriginal Article10.18926/AMO/64123The diagnostic value of microRNA-377 (miR-377) in patients with acute coronary syndrome (ACS) and explored miR-377’s potential mechanisms. We performed an qRT-PCR to assess serum miR-377 levels in ACS patients and coronary artery ligation rat models. The diagnostic value of miR-377 was evaluated by determining the ROC curve. An ELISA assay was conducted to detect the model rat endothelial damage markers von Willebrand factor (vWF) and heart-type fatty acid binding protein (H-FABP), and proinflammatory cytokines TNF-α, IL-6, and IL-1β. The serum miR-377 level was elevated in the ACS patients and significantly increased in the ACS rats. MiR-377 has a high diagnostic value in ACS patients, with a 0.844 ROC, 76.47% specificity, and 87.10% sensitivity. MiR-377 was positively correlated with the expressions of vWF, H-FABP, cTnI, TNF-α, IL-6, and IL-1β. In ACS rats, reducing the expression of miR-377 significantly inhibited the increases in vWF, H-FABP, TNF-α, IL-6, and IL-1β. An elevated miR-377 level can be used as a diagnostic marker in patients with ACS. A reduction of miR-377 may alleviate ACS by improving myocardial damage such as endothelial injury and the inflammatory response.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7662022Knockdown of LncRNA SBF2-AS1 Inhibited Gastric Cancer Tumorigenesis via the Wnt/LRP5 Signaling Pathway625633ENDepartment of General surgery, Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine)QingmeiLiDepartment of General surgery, Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine)YeWangDepartment of General surgery, Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine)YunjieGeDepartment of Healthcare Internal Medicine, Affiliated Qingdao Municipal Hospital of Qingdao UniversityOriginal Article10.18926/AMO/64112This investigation aimed to uncover the impact of a long noncoding RNA, SET-binding factor 2 antisense RNA1 (SBF2-AS1) on the malignant progression of gastric cancer (GC) and to further explore its underlying mechanism. SBF2-AS1 expression was quantified by qRT-PCR in GC cell lines and GC tissues. In vitro loss-of-function studies of SBF2-AS1, accompanied by flow cytometry, CCK-8, and cell invasion tests, were applied to elucidate the impact of SBF2-AS1 on the tumor progression of GC cells. Finally, Western blotting and a luciferase assay were used to detect WNT/LRP5 signaling pathway activation. SBF2-AS1 was aberrantly expressed in GC cell lines (p<0.05) and GC tissues (p<0.05). Cell invasive and proliferative capabilities were inhibited via SBF2-AS1 knockdown, resulting in apoptosis of NCI-N87 and MKN74 cells. Additionally, online database analysis uncovered a positive correlation between SBF2-AS1 and the Wnt/LRP5 signaling pathway (p<0.05). SBF2-AS1 knockdown blocked the Wnt/LRP5 signaling pathway, whereas the effects of SBF2-AS1 knockdown on the malignant genotype of MKN74 as well as NCI-N87 cells were partially restored by triggering the Wnt/ LRP5 signaling pathway. High expression of SBF2-AS1 was found in GC, the malignant progression of which was repressed via SBF2-AS1 knockdown by inhibiting the Wnt/LRP5 signaling pathway.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Hip Function Was Not Associated with the Incidence of Preoperative Deep Vein Thrombosis in Patients Undergoing Primary Total Hip Arthroplasty577584ENYukiOkutaniDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalHiroshiFujitaCenter for Hip and Knee reconstruction, Rakuyo HospitalHidetoHaradaDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalMasanaoKataokaDepartment of Orthopaedic Surgery, Kyoto Katsura HospitalYoshikiMurotaniDepartment of Orthopaedic Surgery, Faculty of Medicine, Kyoto UniversityYuShimizuDepartment of Orthopaedic Surgery, Kyoto City HospitalOriginal Article10.18926/AMO/64039The prevalence of preoperative deep vein thrombosis (DVT) has been reported to be relatively high in patients undergoing total hip arthroplasty. We investigated the prevalence of DVT, the association between hip function and preoperative DVT, and the effect of a history of surgery in patients who underwent primary total hip arthroplasty. We retrospectively analyzed the cases of the patients who underwent primary total hip arthroplasty between April 2013 and February 2020 at our institution. We evaluated the prevalence of preoperative DVT based on the results of the patients’ ultrasound screening. We performed univariate and multivariate analyses to investigate the association between the incidence of DVT and patient factors including age, sex, hip function, medical histories, and American Society of Anesthesiologists Physical Status classification. We analyzed 451 patients (494 hips). The prevalence of DVT was 14.2% (64 patients). The multivariate analysis demonstrated that increased age was an independent significant risk factor for DVT. The prevalence of preoperative DVT was relatively high among patients who underwent primary total hip arthroplasty. Preoperative DVT tended to be more prevalent in older patients. Hip function was not associated with the incidence of DVT.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022First-line Combination Strategy Provides Favorable 5-year Outcomes for Patients with Lupus Nephritis: A Single-center Observational Study547555ENHidetoshiKagawaDepartment of Nephrology and Rheumatology, Japanese Red Cross Society Himeji HospitalRyutaroYamanakaDepartment of Nephrology and Rheumatology, Japanese Red Cross Society Himeji HospitalTsutomuHiromasaDepartment of Nephrology and Rheumatology, Japanese Red Cross Society Himeji HospitalOriginal Article10.18926/AMO/64036This observational study aimed to clarify the long-term results of the combination of mizoribine (MZB), tacrolimus (TAC) and prednisolone as first-line therapy for lupus nephritis (LN). This was our institution’s standard therapy between 2009 and 2015, when we saw 36 patients with LN. When a patient thus treated achieved SLEDAI remission (= 0) and/or the prednisolone dose could be tapered to 5 mg/day, either MZB or TAC was stopped, and the other was continued for maintenance therapy. If treatment failure or relapse occurred, second-line therapy was introduced. At years 1 and 5, overall complete renal response and SLEDAI remission were 94% and 88%, and 50% and 62%, respectively. Excluding 2 cases lost to follow-up, medications after 5 years were as follows: 20 (59%) were stable on 1 drug (MZB or TAC), 11 (32%) required continuation of both drugs (MZB + TAC), and 3 (9%) required second-line therapy. The 5-year retention rate was 91% (non-secondline), with 0% of relapse in this group. Our first-line combination strategy showed high remission rates in the induction phase, and subsequent maintenance therapy demonstrated good outcomes for up to 5 years. Research that fine-tunes the order of therapeutic agents and institutes appropriate treatment goals may further improve long-term outcomes for patients with LN.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Relationship between Wearing a Lead Apron and Work-related Musculoskeletal Disorders: A Questionnaire Survey of Japanese Radiological Technologists541545ENToruAkebiDepartment of Physical Therapy, Faculty of Health Sciences, Okayama Healthcare Professional UniversityRyutaroMatsugakiDepartment of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental HealthToshiroOnoDepartment of Physical Therapy, Faculty of Health Sciences, Okayama Healthcare Professional UniversityOriginal Article10.18926/AMO/64035The purpose of this study was to conduct a self-reported questionnaire survey of work-related musculoskeletal disorders (WMSDs) among Japanese radiological technologists (RTs) and to report on the relationship between wearing a lead apron and WMSDs. Between February and April of 2021, RTs in Okayama Prefecture, Japan, were surveyed by mail and through a website. Information on individual characteristics, physical factors at work, and the presence of WMSDs were collected. All participants were also asked whether they frequently wore lead aprons. A multiple logistic regression analysis was used to assess the relationship between wearing a lead apron and WMSDs. The model was adjusted for age, sex, body mass index (BMI), and working hours. Of the 123 participants, 67 (54.5%) had WMSDs. Multiple logistic regression analysis revealed that WMSDs were significantly associated with wearing a lead apron. Compared to the “Never wear” group, the odds ratios for the “Always/Frequently wear” and “Sometimes/Rarely wear” groups were 7.87 (95% confidence interval [CI]=1.28-48.46; p=0.026) and 7.80 (95% CI=1.43-42.44; p=0.017), respectively. Our analysis suggests that wearing a lead apron is associated with WMSDs, and thus design modifications in lead aprons may improve the occupational health management of RTs.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Viral Sequences Are Repurposed for Controlling Antiviral Responses as Non-Retroviral Endogenous Viral Elements503510ENHirohitoOgawaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomoyukiHondaDepartment of Virology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityReview10.18926/AMO/64025Eukaryotic genomes contain numerous copies of endogenous viral elements (EVEs), most of which are considered endogenous retrovirus (ERV) sequences. Over the past decade, non-retroviral endogenous viral elements (nrEVEs) derived from ancient RNA viruses have been discovered. Several functions have been proposed for these elements, including antiviral defense. This review summarizes the current understanding of nrEVEs derived from RNA viruses, particularly endogenous bornavirus-like elements (EBLs) and endogenous filovirus-like elements (EFLs). EBLs are one of the most extensively studied nrEVEs. The EBL derived from bornavirus nucleoprotein (EBLN) is thought to function as a non-coding RNA or protein that regulates host gene expression or inhibits virus propagation. Ebolavirus and marburgvirus, which are filoviruses, induce severe hemorrhagic fever in humans and nonhuman primates. Although the ecology of filoviruses remains unclear, bats are believed to be potential reservoirs. Based on the knowledge from EBLs, it is postulated that EFLs in the bat genome help to maintain the balance between filovirus infection and the bat’s defense system, which may partially explain why bats act as potential reservoirs. Further research into the functions of nrEVEs could reveal novel antiviral systems and inspire novel antiviral approaches.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7652022Current Insights into Mesenchymal Signatures in Glioblastoma489502ENYujiMatsumotoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTomotsuguIchikawaDepartment of Neurological Surgery, Kagawa Prefectural Central HospitalKazuhikoKurozumiDepartment of Neurosurgery, Hamamatsu University HospitalIsaoDateDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesReview10.18926/AMO/64024Glioblastoma (GBM) is a fatal primary malignant brain tumor in adults. Despite decades of research, the prognosis for GBM patients is still disappointing. One major reason for the intense therapeutic resistance of GBM is inter- and intra-tumor heterogeneity. GBM-intrinsic transcriptional profiling has suggested the presence of at least three subtypes of GBM: the proneural, classic, and mesenchymal subtypes. The mesenchymal subtype is the most aggressive, and patients with the mesenchymal subtype of primary and recurrent tumors tend to have a worse prognosis compared with patients with the other subtypes. Furthermore, GBM can shift from other subtypes to the mesenchymal subtype over the course of disease progression or recurrence. This phenotypic transition is driven by diverse tumor-intrinsic molecular mechanisms or microenvironmental factors. Thus, better understanding of the plastic nature of mesenchymal transition in GBM is pivotal to developing new therapeutic strategies. In this review, we provide a comprehensive overview of the current understanding of the elements involved in the mesenchymal transition of GBM and discuss future perspectives.No potential conflict of interest relevant to this article was reported.Hasanuddin University and Asian Rural Sociology AssociationActa Medica Okayama2548-3269512021Energizing Communities Through Partnerships With E6377ENYasukoHondaGraduate School of Environmental and Life Science, Okayama UniversityThis study aims to specify the contextual conditions that allow for the success of community renewable energy projects, against the background of the expanding use of renewable energy. It analyzes cases where farmers invested in organizations to establish ownership of hydropower plants in the Chugoku region, Japan. Community renewable energy projects derived from local initiatives to provide an alternative energy resource and serve as a catalyst for rural development. However, the costs of small hydropower plant construction and the expert knowledge required for their operation could hinder the diffusion of the technology. Population decline and aging in rural communities also constrain the development of community renewable energy projects. This study presents cases that illuminate the conditions enabling these organizations to succeed in securing the necessary resources for the operation of their renewable energy plants. The survey illustrates how studied organizations have opted to collaborate with external actors to construct or refurbish their plants. The findings indicate that as building partnerships with external actors often becomes essential, it is vital to develop a business-minded framework in which both communities and external actors can financially benefit from introducing small hydropower projects. The cases also reveal that in building collaborative relationships, broad disparities exist between communities and external actors in financial power and expert knowledge, which give the latter substantial advantages in negotiations. An additional important claim derived is that, for an effective partnership that enables a successful community renewable energy project, a third party with expert knowledge and the ability to audit partnership-building processes could play a crucial role in securing community initiatives and independence.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8516E105.B92022Asynchronous Periodic Interference Signals Cancellation in Frequency Domain10871096ENSatoshiDENNOGraduate School of Natural Science and Technology, Okayama UniversityYafeiHOUGraduate School of Natural Science and Technology, Okayama UniversityThis paper proposes a novel interference cancellation technique that prevents radio receivers from degrading due to periodic interference signals caused by electromagnetic waves emitted from high power circuits. The proposed technique cancels periodic interference signals in the frequency domain, even if the periodic interference signals drift in the time domain. We propose a drift estimation based on a super resolution technique such as ESPRIT. Moreover, we propose a sequential drift estimation to enhance the drift estimation performance. The proposed technique employs a linear filter based on the minimum mean square error criterion with assistance of the estimated drifts for the interference cancellation. The performance of the proposed technique is confirmed by computer simulation. The proposed technique achieves a gain of more than 40dB at the higher frequency part in the band. The proposed canceler achieves such superior performance, if the parameter sets are carefully selected. The proposed sequential drift estimation relaxes the parameter constraints, and enables the proposed cancellation to achieve the performance upper bound.No potential conflict of interest relevant to this article was reported.Japanese Society of Veterinary ScienceActa Medica Okayama0916-72508472022Screening of bacterial DNA in bile sampled from healthy dogs and dogs suffering from liver- or gallbladder-associated disease10191022ENSakurakoNEOSchool of Veterinary Medicine, Azabu UniversityIyoTAKEMURA-UCHIYAMADepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityJumpeiUCHIYAMADepartment of Bacteriology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama UniversityHironobuMURAKAMISchool of Veterinary Medicine, Azabu UniversityAyakaSHIMAAnicom Specialty Medical Institute Inc.HidekiKAYANUMASchool of Veterinary Medicine, Azabu UniversityTaikiYOKOYAMASchool of Veterinary Medicine, Azabu UniversitySatoshiTAKAGISchool of Veterinary Medicine, Azabu UniversityEiichiKANAISchool of Veterinary Medicine, Azabu UniversityMasaharuHISASUESchool of Veterinary Medicine, Azabu UniversityAlthough the biliary system is generally aseptic, gallbladder microbiota has been reported in humans and some animals apart from dogs. We screened and analyzed the bacterial deoxyribonucleic acid in canine gallbladders using bile sampled from 7 healthy dogs and 52 dogs with liver- or gallbladder-associated disease. PCR screening detected bacteria in 17.3% of diseased dogs (9/52) and none in healthy dogs. Microbiota analysis of PCR-positive samples showed that the microbial diversity differed between liver- and gallbladder-associated disease groups. Thus, a specific bacterial community appears to occur at a certain frequency in the bile of diseased dogs.No potential conflict of interest relevant to this article was reported.American Astronomical SocietyActa Medica Okayama0004-637X93622022Low-J Transitions in A˜2Π(0,0,0)−X˜2Σ+(0,0,0) Band of Buffer-gas-cooled CaOHENYuikiTakahashiDivision of Physics, Mathematics, and Astronomy, California Institute of TechnologyMasaakiBabaDepartment of Chemistry, Graduate School of Science, Kyoto UniversityKatsunariEnomotoDepartment of Physics, University of ToyamaAyamiHiramotoResearch Institute for Interdisciplinary Science, Okayama UniversityKanaIwakuniInstitute for Laser Science, University of Electro-CommunicationsSusumuKumaAtomic, Molecular and Optical Physics Laboratory, RIKENReoTobaruResearch Institute for Interdisciplinary Science, Okayama UniversityYukiMiyamotoResearch Institute for Interdisciplinary Science, Okayama UniversityCalcium monohydroxide radical (CaOH) is receiving an increasing amount of attention from the astrophysics community as it is expected to be present in the atmospheres of hot rocky super-Earth exoplanets as well as interstellar and circumstellar environments. Here, we report the high-resolution laboratory absorption spectroscopy on low-<jats:italic>J</jats:italic> transitions in <jats:inline-formula><jats:tex-math><?CDATA ${\tilde{A}}^{2}{\rm{\Pi }}(0,0,0)-{\tilde{X}}^{2}{{\rm{\Sigma }}}^{+}(0,0,0)$?></jats:tex-math><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" overflow="scroll"> <mml:msup>
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</jats:inline-formula> band of buffer-gas-cooled CaOH. In total, 40 transitions out of the low-<jats:italic>J</jats:italic> states were assigned, including 27 transitions that have not been reported in previous literature. The determined rotational constants for both ground and excited states are in excellent agreement with previous literature, and the measurement uncertainty for the absolute transition frequencies was improved by more than a factor of 3. This will aid future interstellar, circumstellar, and atmospheric identifications of CaOH. The buffer-gas-cooling method employed here is a particularly powerful method to probe low-<jats:italic>J</jats:italic> transitions and is easily applicable to other astrophysical molecules.</jats:p>No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama2542-6605202022A throughput drop estimation model and its application to joint optimization of transmission power, frequency channel, and channel bonding in IEEE 802.11n WLAN for large-scale IoT environments100583ENKwenga IsmaelMuneneGraduate School of Natural Science and Technology, Okayama UniversityNobuoFunabikiGraduate School of Natural Science and Technology, Okayama UniversityMd. MahbuburRahmanGraduate School of Natural Science and Technology, Okayama UniversityHendyBriantoroGraduate School of Natural Science and Technology, Okayama UniversitySujan ChandraRoyGraduate School of Natural Science and Technology, Okayama UniversityMinoruKuribayashiGraduate School of Natural Science and Technology, Okayama UniversityThe concept of Internet of Things (IoT) has been widely studied in smart home networks, smart city networks, smart grid systems, autonomous driving systems, and smart healthcare systems. In IoT, the IEEE 802.11n wireless local-area network (WLAN) is used as a common communication technology due to its exibility and low cost. Then, the high performance WLAN is required to enhance quality of service (QoS) of large-scale IoT applications connecting a number of devices or sensors allocated in wide areas. WLAN can use the limited number of partially overlapping channels (POCs) at 2.4 GHz band. The WLAN performance can be degraded by interfered signals from other WLANs. Then, to optimize the POC assignment by reducing interferences, we have proposed the throughput drop estimation model for concurrently communicating multiple links under interferences. Unfortunately, the 40 MHz channel bonding (CB) and the 20 MHz non-CB are considered separately, while the transmission power is always fixed to the maximum. In this paper, we study the throughput drop estimation model under coexistence of CB and non-CB while the transmission power is changed. Then, we present its application to the joint optimization of assigning the transmission power, the frequency channel, and the channel bonding to enhance the throughput performance of IEEE 802.11n WLAN. For evaluations, we compare estimated throughputs by the model with measured ones in various network topologies to verify the model accuracy. Then, we apply the model to the joint assignment optimization in them, and confirm the effectiveness through simulations and experiments using the testbed system.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Liquid Biopsy Revealed HBOC Pedigree and Led to Medical Management Among the Relatives479483ENChikakoOgawaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkiraHirasawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReimiSogawaDepartment of Clinical Genetics and Genomic Medicine, Okayama University HospitalKayokoHasuokaDepartment of Nursing, Okayama University HospitalShutaTomidaDepartment of Center for Comprehensive Genomic Medicine, Okayama University Hospital Biobank, Okayama University HospitalMashuFutagawaDepartment of Clinical Genetics and Genomic Medicine, Okayama University HospitalYusakuUrakawaDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMarikoKochiDepartment of Clinical Genetics and Genomic Medicine, Okayama University HospitalHidekiYamamotoDepartment of Clinical Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiichiroNakamuraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/63908A hereditary breast and ovarian cancer (HBOC) pedigree was detected via liquid biopsy, and cancer prevention was initiated for the patient’s daughter, after receiving a definitive result from BRCA genetic testing. A 48-yearold woman with ovarian cancer was administered precision medicine, which used cell-free DNA from plasma. The results revealed a pathogenic variant of BRCA1 as a presumed germline pathogenic mutation. We confirmed the germline pathological variant BRCA1 c.81-1G> A and suggested treatment with a PARP inhibitor. One of her three children had the variant, was diagnosed as an unaffected pathogenic variant carrier, and was advised to initiate surveillance.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Social Capital and Post-traumatic Stress Disorder among Heavy Rainfall and Flood Victims in Japan439446ENChikaraMiyajiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSoshiTakaoDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasayukiNoguchiOkayama Prefectural Mental Health and Welfare CenterTsubasaOkazakiOkayama Prefectural Mental Health and Welfare CenterShunsukeSatoOkayama Prefectural Mental Health and Welfare CenterTakashiYorifujiDepartment of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63903This study examined the relationship between cognitive/structural social capital and post-traumatic stress disorder (PTSD) among victims of heavy rain and flood. Participants were individuals aged≥18 years affected by the July 2018 heavy rainfall in the cities of Kurashiki and Soja, Japan, and living in temporary housing. We distributed five copies of a questionnaire to 1,991 households and received responses from 1,927 individuals (907 men, 1,008 women, 12 respondents of unspecified sex) in 1,029 households (51.7%). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between high (vs. low) social capital and PTSD or other outcomes. After covariate adjustment, the odds of having PTSD were lower in participants with high cognitive social capital than those with low cognitive social capital (OR=0.346, 95%CI: 0.263-0.456). Elderly women with higher structural social capital tended to have lower PTSD odds than those with lower structural social capital (OR=0.671, 95%CI: 0.431-1.046). The opposite pattern was observed for elderly men (OR=1.315, 95%CI: 0.792-2.183). Cognitive social capital is a protective factor that may reduce PTSD or promote
a favorable PTSD prognosis after heavy rainfall and flood events. The associations between structural social capital and PTSD differ by age and sex.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Effects of Exercise Therapy and Nutrition Therapy on Patients with Possible Malnutrition and Sarcopenia in a Recovery Rehabilitation Ward423428ENSatoshiTakahashiDepartment of Rehabilitation Medicine, Saiseikai Imabari Daini HospitalTakuyaKushibeDepartment of Rehabilitation Medicine, Saiseikai Imabari Daini HospitalYoshiteruAkezakiDivision of Physical Therapy, Kochi Professional University of RehabilitationNorioHoriikeDepartment of Internal Medicine, Saiseikai Imabari Daini HospitalOriginal Article10.18926/AMO/63901We compared the effects of an exercise intervention with that of exercise combined with nutrition therapy in patients with possible malnutrition and sarcopenia admitted to a recovery rehabilitation ward, and we examined the differences in the patients’ physical function and activities of daily living (ADLs). There were 16 patients in the Exercise group with exercise therapy and ADL exercises, and 14 patients in the Combined intervention group with exercise therapy, ADL exercises, and nutrition therapy. The survey items were body weight, body mass index, grip strength, lower-leg circumference, gait speed, and ADLs, each of which was measured at the baseline and at 2 weeks, 4 weeks, and at discharge. Significant improvements in grip strength were observed in the Combined intervention group as follows: at 4 weeks>at 2 weeks (p<0.05), and at discharge>baseline and 2 weeks (p<0.05). There were no significant changes in the Exercise group, and an interaction was recognized in both groups. Comprehensive rehabilitation including nutrition therapy is necessary for patients with possible malnutrition and/or sarcopenia, as our results indicate that nutrition therapy in addition to exercise therapy has the effect of promoting improvements of physical function in such patients.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Postoperative Urinary Retention in Japanese Elderly Males with a Femoral Neck or Trochanteric Fracture409414ENToshihiroHigashikawaDepartment of Geriatric Medicine, Kanazawa Medical University Himi Municipal HospitalKenjiShigemotoDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalKenichiGoshimaDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalShintarouIwaiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalManabuMoriyamaDepartment of Urology, Kanazawa Medical University Himi Municipal HospitalDaisukeUsudaDepartment of Emergency and Critical Care Medicine, Juntendo University Nerima HospitalMasahiroHangyouToyama Municipal HospitalHiromiInujimaToyama Municipal HospitalKakeruNozakiToyama Municipal HospitalMiyakoYamaguchiToyama Municipal HospitalKimikoUsudaToyama Municipal HospitalTakeshiNakahashiDepartment of Geriatric Medicine, Kanazawa Medical UniversityTadamiMatsumotoDepartment of Orthopedic Medicine, Kanazawa Medical UniversityShigekiTakashimaKanazawa Medical UniversityTsugiyasuKandaKanazawa Medical UniversityTakeshiHoriiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalMasashiOkuroDepartment of Geriatric Medicine, Kanazawa Medical UniversityTakeshiSawaguchiDepartment of Orthopedics and Joint Reconstructive Surgery, Juntendo University Nerima HospitalOriginal Article10.18926/AMO/63895We assessed risk factors for postoperative urinary retention (UR) in elderly males with femoral bone fractures: 169 Japanese males (mean age 81.95 ± 1.19 years) who had undergone hip surgery at a municipal hospital (Toyama, Japan). A multiple logistic regression analysis was used to test possible risk factors for UR: age, body mass index, serum albumin, cognitive impairment, activities of daily living (ADL), and history of diabetes mellitus (DM). UR occurred in 24 (14.2%) of the 169 patients. A multivariate logistic regression analysis with age adjustment showed that ADL (odds ratio [OR] 3.88; 95% confidence interval [CI]: 1.2-12.5, p=0.023) was significantly associated with the development of UR, and a history of DM showed marginal significance for UR occurrence (OR 0.36, 95%CI: 0.11-10, p=0.064). These results suggests that ADL is a risk factor for UR development in elderly males who have undergone surgery for femoral neck or trochanter fractures.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7642022Therapeutic Approaches Targeting miRNA in Systemic Lupus Erythematosus359371ENSumieHiramatsu-AsanoDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/63887Systemic lupus erythematosus (SLE) is a potentially fatal systemic autoimmune disease, and its etiology involves both genetic and environmental factors such as sex hormone imbalance, genetic predisposition, epigenetic regulation, and immunological factors. Dysregulation of microRNA (miRNA) is suggested to be one of the epigenetic factors in SLE. miRNA is a 22-nucleotide single-stranded noncoding RNA that contributes to post-transcriptional modulation of gene expression. miRNA targeting therapy has been suggested to be useful for the treatment of cancers and other diseases. Gene knockout and miRNA targeting therapy have been demonstrated to improve SLE disease activity in mice. However, these approaches have not yet reached the level of clinical application. miRNA targeting therapy is limited by the fact that each miRNA has multiple targets. In addition, the expression of certain miRNAs may differ among cell tissues within a single SLE patient. This limitation can be overcome by targeted delivery and chemical modifications. In the future, further research into miRNA chemical modifications and delivery systems will help us develop novel therapeutic agents for SLE.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1878-87501592022A New Method of Intracranial Aneurysm Modeling for Stereolithography Apparatus 3D Printer: The “Wall-Carving Technique” Using Digital Imaging and Communications in Medicine Datae113e119ENJunHarumaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKenjiSugiuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMinoriHoshikaDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasafumiHiramatsuDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomohitoHishikawaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiMuraiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazuhikoNishiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYokoYamaokaDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYuSatoDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiEbisudaniDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisanoriEdakiDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyuKimuraDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIsaoDateDepartment of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOBJECTIVE: To assess the ability of the "wall-carving (WC) image technique", which uses vascular images from 3-dimensional digital subtraction angiograms (3DDSAs). Also, to verify the accuracy of the resulting 3D-printed hollow models of intracranial aneurysms.<br>
METHODS: The 3DDSA data from 9 aneurysms were processed to obtain volumetric models suitable for the stereolithography apparatus. The resulting models were filled with iodinated contrast media. 3D rotational angiography of the models was carried out, and the aneurysm geometry was compared with the original patient data. The accuracy of the 3D-printed hollow models' sizes and shapes was evaluated using the nonparametric Wilcoxon signed-rank test and the Dice coefficient index.<br>
RESULTS: The aneurysm volumes ranged from 34.1 to 4609.8 mm 3 (maximum diameters 5.1-30.1 mm), and no statistically significant differences were noted between the patient data and the 3D-printed models (P = 0.4). Shape analysis of the aneurysms and related arteries indicated a high level of accuracy (Dice coefficient index value: 88.1%-97.3%; mean + SD: 93.6% +/- 2.5%). The vessel wall thickness of the 3D-printed hollow models was 0.4 mm for the parent and 0.2 mm for small branches and aneurysms, almost the same as the patient data.<br>
CONCLUSIONS: The WC technique, which involves volume rendering of 3DDSAs, can provide a detailed description of the contrast enhancement of intracranial vessels and aneurysms at arbitrary depths. These models can provide precise anatomic information and be used for simulations of endovascular treatment.No potential conflict of interest relevant to this article was reported.MDPIActa Medica Okayama1660-460119142022Photorefraction with Spot Vision Screener versus Visual Acuity Testing as Community-Based Preschool Vision Screening at the Age of 3.5 Years in Japan8655ENToshihikoMatsuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityChieMatsuoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasamiKayanoOkayama City Government Health OfficeAyaMitsufujiOkayama City Government Health OfficeChiyoriSatouOkayama City Government Health OfficeHiroakiMatsuokaOkayama City Government Health OfficeNationwide in Japan, a community-based vision-screening program in 3.5-year-old children is conducted in three steps: questionnaires and home visual acuity testing as the primary screening; visual acuity testing by nurses and pediatricians’ inspection in community health centers as the secondary screening; and examinations by ophthalmologists as the tertiary screening. In this study, we introduced photorefraction with a Spot vision screener in addition to visual acuity testing to answer the clinical question of whether photorefraction could better detect eye diseases and potentially replace visual acuity testing. Photorefraction was performed on 813 consecutive 3.5-year-old children in a center. The children were sent to tertiary examinations, which were based on the Spot vision screener standard, in addition to the visual acuity testing standard: failure in either eye to pass 0.5 visual acuity in a center. A notice to visit ophthalmologists was issued for 95 children (11%), and documents with the diagnosis were sent back to the Heath Office for 76 children (80%). The rate of children with anisometropic or ametropic amblyopia or accommodative esotropia as treatment-requiring diseases was highest in cases of no pass at both standards (10/15 = 66%), and higher in cases of no pass only at the Spot vision screener standard (13/45 = 28%), compared with cases of no pass only at the visual acuity testing standard (6/33 = 18%, p = 0.0031). Photorefraction, in addition to visual acuity testing and inspection led to additional eye diseases detection at 3.5 years. Visual acuity testing at home would not be omitted in the introduction of photorefraction.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1341-321X2872022Vancomycin MIC creep progresses in methicillin-resistant Staphylococcus aureus despite the national antimicrobial stewardship campaign: Single facility data in Japan918922ENTakumiFujimoriMicrobiology Division, Clinical Laboratory, Okayama University HospitalHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKojiIioMicrobiology Division, Clinical Laboratory, Okayama University HospitalTsukasaHigashionnaDepartment of Pharmacy, Okayama University HospitalAyakaKakehiMicrobiology Division, Clinical Laboratory, Okayama University HospitalMamiOkuraMicrobiology Division, Clinical Laboratory, Okayama University HospitalHiroshiMinabeMicrobiology Division, Clinical Laboratory, Okayama University HospitalYukikaYokoyamaMicrobiology Division, Clinical Laboratory, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkihitoHigashikageMicrobiology Division, Clinical Laboratory, Okayama University HospitalBackground: Methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of nosocomial and community infections, and vancomycin (VCM) is widely recommended as a first-line therapeutic drug. Minimum inhibitory concentrations (MICs) of VCM <2 mu g/mL are defined as susceptible, but increases in these levels, known as "VCM MIC creep" have been reported. The aim of this study was to investigate VCM MIC creep during the promotion of a national antimicrobial stewardship campaign. <br>
Methods: We collected data from 2013 to 2020 on S. aureus isolated at the clinical microbiology laboratory at Okayama University Hospital, Japan. We calculated the annual proportions of MRSA isolation rates by MIC levels for nosocomial and community samples and estimated annual percentage changes in the antimicrobial use density of the VCM. <br>
Results: Of the 1,716 MRSA isolates, no strains showed intermediate or resistant ranges of VCM MIC levels. By 2020, the proportion of MRSA with an MIC of <0.5 mu g/mL decreased to 35.4%, while that with an MIC of 1 mu g/ mL increased to 64.1% over time. The annual percentage changes of the VCM antimicrobial use density significantly increased without any trend change point (average 8.1%, p = 0.035). There was no clear correlation between the VCM AUD and annual proportion of nosocomial MRSA with MIC 1 mu g/mL (correlation coefficient 0.48; p value = 0.24). <br>
Conclusion: We demonstrated a deteriorating situation of VCM MIC creep among MRSA strains isolated at our university hospital during the national antimicrobial stewardship campaign.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7632022Factors Associated with Work Efficiency in Home Health Care by Pharmacists307315ENSatoshiSugiuraDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaKitamuraDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhisaIzushiDepartment of Pharmacotherapy, School of Pharmacy, Shujitsu UniversitySoichiroUshioDepartment of Pharmacy, Okayama University HospitalToshiakiSendoDepartment of Clinical Pharmacy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63740In recent years, medical staff including physicians and nurses have been participating in home health care, reflecting the needs of an aging society in Japan. Pharmacists are also asked to work on home health care teams to ensure the medical safety of patients. It currently remains unclear whether direct communication, i.e. a meeting, between home-visiting physicians and pharmacists contributes to the proper use of medications and continuous medical care. We retrospectively analyzed the medication management guidance records of home-visited patients who received their first home visit between April 2014 and March 2017. We collected data on pharmacist inquiries, the duration of visits, and details from a meeting between home-visiting physicians and pharmacists. Thirty-five patients were included. At the first visit, the inquiry rate by pharmacists was 65.7%. The prescription question rate was significantly lower in patients with a meeting than in those without (p=0.033). The average duration of visits was significantly shorter for home-visited patients whose health care providers had a meeting (p=0.007). These results suggest that pharmacists who held a meeting with the home-visiting physician before the first patient visit were able to resolve drug-related issues earlier, which increased the work efficiency of home-visiting pharmacists.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7632022Intrathecal Administration of the α1 Adrenergic Antagonist Phentolamine Upregulates Spinal GLT-1 and Improves Mirror Image Pain in SNI Model Rats255263ENKosukeNakatsukaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshikazuMatsuokaDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakoKuritaKinoshita Pain ClinicRuilinWangDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChikaTsuboiDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobutakaSueDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyujiKakuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiMorimatsuDepartment of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63719Mirror image pain (MIP) is a type of extraterritorial pain that results in contralateral pain or allodynia. Glutamate transporter-1 (GLT-1) is expressed in astrocytes and plays a role in maintaining low glutamate levels in the synaptic cleft. Previous studies have shown that GLT-1 dysfunction induces neuropathic pain. Our previous study revealed bilateral GLT-1 downregulation in the spinal cord of a spared nerve injury (SNI) rat. We hypothesized that spinal GLT-1 is involved in the mechanism of MIP. We also previously demonstrated noradrenergic GLT-1 regulation. Therefore, this study aimed to investigate the effect of an α1 adrenergic antagonist on the development of MIP. Rats were subjected to SNI. Changes in pain behavior and GLT-1 protein levels in the SNI rat spinal cords were then examined by intrathecal administration of the α1 adrenergic antagonist phentolamine, followed by von Frey test and western blotting. SNI resulted in the development of MIP and bilateral downregulation of GLT-1 protein in the rat spinal cord. Intrathecal phentolamine increased contralateral GLT-1 protein levels and partially ameliorated the 50% paw withdrawal threshold in the contralateral hind paw. Spinal GLT-1 upregulation by intrathecal phentolamine ameliorates MIP. GLT-1 plays a role in the development of MIPs.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465332022Researching Innovation in Language Education: The Case of the English Café89101ENGaroldMurrayCenter for Liberal Arts and Language Education Okayama UniversityNaomiFujishimaCenter for Liberal Arts and Language Education Okayama University10.18926/OER/63489 This paper examines issues pertaining to research methodology that can arise during the planning and execution of studies designed to investigate innovations in language education. In order to address this topic, we draw on the three studies that we carried out in the English Café and the L-café, social spaces for language learning, located on the campus of Okayama University. These studies include an ethnography, a multiple case study, and a narrative inquiry. In this paper we adopt a narrative mode and tell the story of the research process. We begin by describing the research environments − the English Café and the L-café − and outlining the studies. We then examine the evolving theoretical orientation that informed the emergent design of the studies and guided the interpretation of the data. In this section of the paper, we take a close look at how our initial focus on the communities of practice construct led us to adopt an ecological approach that further expanded to encompass aspects of complex dynamic systems theory. In the final section of the paper we reflect on how the expanding theoretical orientation influenced the methodological design of the studies and consider the implications for doing research in innovative language learning environments.No potential conflict of interest relevant to this article was reported.岡山大学経済学会Acta Medica Okayama2433-41465332022Learning Japanese Culture with Shakespeare8188ENSusanMeiki10.18926/OER/63488 This paper is a reflective practice and study of the development of a content-based intermediate English course (over 550 TOEIC score) at a university in Japan. The design of this course utilized scaffolding strategies (Pawan 2008) to provide content and language integrated learning (CLIL) in the classroom. While planning to teach a basic cross-cultural communication (CCC) topics curriculum, a perceived need arose to design a course of study where students can critically engage in analysis from many cultural perspectives. In addition, another requirement of this course was that it must be capable of supporting L1 and L2 students of multiple levels of English ability from native level to intermediate English learners. It was decided to utilize a film studies curriculum allowing students to gain knowledge of this particular skill. With a rich catalogue of films to choose, the scaffolding of learning film analysis techniques leads students on a path of awareness that enables them to compare and contrast differences in film versions of Shakespeare’s Hamlet. The end result was a course that raised student motivation and awareness to explore further outside the classroom thus creating autonomous students learning a language.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama2161-39153392022Minimizing the monetary penalty and energy cost of server migration servicee4511ENYukinobuFukushimaThe Graduate School of Natural Science and Technology, Okayama UniversityTatsuyaSudaUniversity Netgroup Inc.TutomuMuraseInformation Technology Center, Nagoya UniversityYuyaTarutaniThe Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityTokumiYokohiraThe Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityCurrent IaaS (Infrastructure as a Service) cloud service may not satisfy communication QoS (Quality of Service) requirements of delay-sensitive network applications, if there is a significant physical distance between a server of the network application (NetApp server) at a data center and its network application clients (NetApp clients). In order to improve communication QoS of NetApp clients, we propose Server Migration Service (SMS) in this paper. SMS allowsNetApp servers to migrate among different locations in the network (1) to optimally locate themselves in relation to NetApp clients and mitigate the QoS degradation caused by location-related factors (i.e., propagation delays on network links) and (2) to optimally distribute traffic load over routers and processing load over (physical) computers and decrease the energy consumption. We develop a mixed-integer programming model that determines when and to which locations NetApp servers migrate to minimize the total operating cost of SMS, i.e., the sum of the monetary penalty incurred due to QoS violation and energy cost incurred due to energy consumption, while preventing NetApp servers from excessively migrating and adversely impacting QoS of the non-SMS service that share the resource of the substrate network with SMS. Simulation results show that the model developed in this paper achieves up to 42% lower total operating cost of SMS compared to the model that only minimizes the monetary penalty of SMS without considering the energy cost of SMS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7622022Survey of Shoulder Osteoarthritis in Patients who Underwent Total Hip Arthroplasty for Hip Osteoarthritis173177ENYoshiakiMiyakeDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolShigeruMitaniDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolYoshifumiNambaDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolNorifumiUmeharaDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolToyohiroKawamotoDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolShuroFuruichiDepartment of Bone and Joint Surgery, Kawasaki Medical SchoolOriginal Article10.18926/AMO/63411To the best of our knowledge, no previous studies have reported a relationship between osteoarthritis (OA) of the lower limbs and OA of the shoulder joints. We evaluated the correlation between shoulder OA and hip OA. We collected contrast-enhanced computed tomography (CECT) images of the shoulder joints of 159 patients with hip OA who underwent primary total hip arthroplasty (THA). The images, taken 1 week after THA to monitor venous thromboembolism (VTE), were used to examine the prevalence of shoulder OA. They were compared with those of 103 controls who underwent CECT during the same period to monitor VTE. Shoulder OA was observed in 15% of the controls and 24% of the THA patients. Although the rate was somewhat higher in the THA group, the difference was not significant. However, in the THA group, significantly more patients with bilateral hip OA (33%) had shoulder OA than those with unilateral hip OA (17%). In summary, the prevalence of shoulder OA was significantly higher in patients with bilateral hip OA. In these patients, pain and instability in the hip joints require them to use arm support to stand up or walk, putting the weight-bearing shoulder at risk of developing OA.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7622022The Construction of a Community Long-term Care Model for Home-based Elderly Individuals145154ENYiQinGuangxi University of Chinese MedicineLinlinLiuGuangxi University of Chinese MedicineFanghuiZhuGuangxi University of Chinese MedicineHuazhenLuGuangxi University of Chinese MedicineMingliuHuangGuangxi University of Chinese MedicineOriginal Article10.18926/AMO/63408With rapidly aging populations, family care functions can become weakened, and community health services often lack unified standards. A standardized and professional community home-based long-term care model (CHLCM) for the elderly is urgently needed in many regions of China and in other countries. Here, we explored the indicators of the need for a CHLCM among elderly individuals, and we constructed a CHLCM. We created and distributed a questionnaire regarding the requirement of long-term care services, based on a literature review. The two-rounds Delphi method was used, involving 20 experts who were randomly selected from among the medical universities, community health service centers, and nursing homes in Nanning, Guangxi, China. The experts’ enthusiasm rates in the questionnaire’s two rounds were 95% and 100%, respectively. The authentic coefficient of the experts’ consulting was 0.857, and that of the experts’ academic level was 0.835; the judgement coefficient was 0.880 and the familiar coefficient was 0.855. The CHLCM includes service content and an evaluation. The coordination coefficients for the two primary, eight secondary, and 29 tertiary indicators were 0.200, 0.386, and 0.184, respectively (p<0.05). The experts’ enthusiasm and authority were high. The coordination of the experts’ agreement was sufficient, and the analysis results were reliable. The CHLCM includes 29 items that provide a foundation and references for the formulation of concrete indicators and subsequent research.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7622022Relation between Prolonged Sedentary Bouts and Health-Related Quality of Life in Patients on Chronic Hemodialysis113119ENKeiichiNamioDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityNobuyukiMiyatakeDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityShuheiHishiiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityTakashiKondoInnoshima General HospitalHiroyukiNishiInnoshima General HospitalAkihikoKatayamaFaculty of Social Studies, Shikokugakuin UniversityKazuhiroUjikeInnoshima General HospitalKiichiKoumotoInnoshima General HospitalHiromiSuzukiDepartment of Hygiene, Faculty of Medicine, Kagawa UniversityHirooHashimotoInnoshima General HospitalOriginal Article10.18926/AMO/63404This study aimed to investigate the link between prolonged sedentary bouts and health-related quality of life (QOL) in patients on chronic hemodialysis (CHD). A total of 84 outpatients on CHD, aged 71.6±11.8 years, were enrolled in this cross-sectional study. Parameters for prolonged sedentary bouts [i.e., ≧ 30 min (% and bout) and ≧ 60 min (% and bout)] were measured using a triaxial accelerometer. Health-related QOL (HRQOL) was evaluated by the Euro-QOL (EQ-5D). Clinical parameters were obtained from medical records. Relatively prolonged sedentary bouts (%) were 44.0±18.2 (≧ 30 min) and 29.8±16.5 (≧ 60 min) for total days. Prolonged sedentary bouts (bouts) were 6.2±2.7 (≧ 30 min) and 2.7±1.6 (≧ 60 min) for total days. EQ-5D scores were 0.728±0.220. All prolonged sedentary bout parameters were negatively correlated with EQ-5D scores, except for prolonged sedentary bouts (≧ 60 min) (min) and relatively prolonged sedentary bouts (%) on hemodialysis days. Multiple regression analysis showed that prolonged sedentary bout parameters were an important factor in EQ-5D scores even after adjusting for confounding factors for total and non-hemodialysis days. Our results suggested that prolonged sedentary bouts were closely associated with HRQOL in patients on CHD, especially on non-hemodialysis days.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X5992022Vasohibin-1 has α-tubulin detyrosinating activity in glomerular podocytes9399ENTomoyoMifuneDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsuyukiTanabeDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesYuriNakashimaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSatoshiTanimuraDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHitoshiSugiyamaDepartment of Human Resource Development of Dialysis Therapy for Kidney Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences,YasufumiSatoNew Industry Creation Hatchery Center, Tohoku UniversityJunWadaDepartment of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesPodocytes are highly specialized epithelial cells in glomeruli, with a complex morphology composed of a cell body, primary processes, and foot processes, which maintain barrier function in glomerular filtration. The microtubule-based cytoskeleton is necessary for podocyte morphology. Microtubule structure and function can be affected by post-translational modification of tubulin, including detyrosination. Recent studies have shown that vasohibin-1 (VASH1), an antiangiogenic factor, has tubulin carboxypeptidase activity that causes detyrosination of α-tubulin. We aimed to examine the role of VASH1 in regulating α-tubulin detyrosination in podocytes and the potential involvement of VASH1 deficiency in renal morphology. In normal mouse kidneys, detyrosinated α-tubulin was mainly identified in glomeruli, especially in podocytes; meanwhile, in cultured immortalized podocytes, α-tubulin detyrosination was promoted with cell differentiation. Notably, α-tubulin detyrosination in glomeruli was diminished in Vash1 homozygous knockout (Vash1−/−) mice, and knockdown of VASH1 in cultured podocytes prevented α-tubulin detyrosination. Although VASH1 deficiency-induced downregulation of detyrosination caused no remarkable glomerular lesions, urinary albuminuria excretion and glomerular volume were significantly higher in Vash1−/− mice than in wild-type mice. Furthermore, decreased glomerular nephrin expression and narrower slit diaphragms width were observed in Vash1−/− mice. Taken together, we demonstrated that α-tubulin detyrosination in podocytes was mainly regulated by VASH1 and that VASH1 deficiency-mediated decreases in α-tubulin detyrosination led to minor alterations in podocyte morphology and predisposition to albuminuria. VASH1 expression and α-tubulin detyrosination may be novel targets for maintaining glomerular filtration barrier integrity.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966562021International Students Adapting to a New Culture: Key to Global Education Success129135ENMamoruIshida10.18926/63336The Japanese higher education has attempted various internationalization initiatives (e.g., the Top Global University Project), and adopted English-medium instruction (EMI) and English-taught programs (ETPs). Based on several criticisms toward the project and recent investigations of the international students' satisfaction, a lack of formal and structural support for international students has been identified. While a paternalistic approach of student support has been practiced and recognized, this approach relies on informal support of a handful hardworking staff/faculty members and student volunteers/tutors. Furthermore, there are several major issues in integration of EMI/ETPs and administrative infrastructure in internationalization initiatives. In order to make improvements in both activities, international students' adaptation to Japan and its higher education need to be fully considered. In this process of international students' adaptation to a new culture, lack of cultural awareness and intercultural communication, inadequate language skills, educational system differences, and life adjustment and psychological problems are identified as major concerns.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966562021Design Thinking in the PBL Classroom to Address Community Needs120128ENAubraBulin10.18926/63335In a Scholarship in Practice course, Design Thinking and PBL were used as the educational methodology to deliver the learning content in the class called Multilingual Marketing and Community Connection for undergraduate students. Students completed group work, community interactions, and projects all online. Design Thinking and PBL supported student motivation and engagements. This article provides an example of one class that utilized the integration of both Design Thinking and PBL to support innovative problem solving.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966562021The Role of IB students in motivating other students through online Extracurricular activities during the ongoing Covid-19 Pandemic17ENSabinaMahmood10.18926/63326Okayama University is fast becoming a popular choice for International Baccalaureate (1B) students in Japan and abroad. Okayama University was the first Super Global National University (SGU) in Japan, to accept the 1B Diploma and exempt 1B students from taking the university entrance exams. Within a span of 9 years since 1B admissions started in 2012, 87 1B students have enrolled in 10 Faculties and 1 special program including 20 graduates. During their 1B education, 1B students go through an academically rigorous, well-rounded and international minded educational program. Continuous follow-up surveys of 1B students at Okayama University from enrollment to graduation has revealed that, besides academic excellence, 1B students are also well equipped with various other skills as reflected in the 1B learner profile, such as effective communication skills, critical thinking skills, a high level of English fluency and leadership skills. All these added skills prepare 1B students to adapt well to any new or unexpected situation. When the first wave of the Covid-19 pandemic hit University life in Japan, all academic classes switched to online and club activities were postponed indefinitely. As University life adapted and re-adapted to the new norms of the pandemic, extracurricular activities that were mostly face-to-face, were hard hit. This article takes a look at 3 extra-curricular activities led by 1B students in the medical faculty, which went online to keep students motivated and connected during the ongoing pandemic.No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022学齢期の自閉症スペクトラム児における不安定な経験世界 ―自閉症スペクトラムのある子どもの当事者手記の分析から―375386ENYuukaSugawarabambin inc.TakayukiTanjiGraduate School of Education, Okayama University10.18926/CTED/63320学校現場において、教員が発達障害児の言動に対する理解や対応に困難さを感じている現状がある。一方で、その問題の背景には、発達障害児自身が困難に感じている状況もある。特に自閉症スペクトラムに関しては、表面的に現れやすいコミュニケーションの問題やこだわりの強さ等の背景に、外からでは気づかれにくい特有の感じ方や捉え方(不安定な経験世界)があると考えられる。本研究では、学校生活で生じる可能性のある自閉症スペクトラム児が抱える不安定な経験世界とは何かを明らかにするため、学齢期の自閉症スペクトラム当事者手記を分析した。その結果、「外からの刺激を捉える感覚」、「物の見え方」等の特有の感じ方や捉え方が11 のカテゴリーに整理された。本研究の結果から、自閉症スペクトラム児が安心して学校生活を送るためには、教員による不安定な経験世界への理解、その理解に応じた環境調整によって困難さを軽減することが重要であると考察した。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022日本語教育副専攻コースにおけるオンライン実習の試み ―日本語教師に求められる資質・能力の養成を目指して―359373ENMiwaSueshigeInstitute for Education and Student Services, Okayama University10.18926/CTED/63319本稿は，日本語教育副専攻コースにおいて，日本語教師に求められる資質・能力を養うことを目的とし行ったオンラインによる教育実習の実践報告である。オンライン実習において，1）実習生がどのような気づきや学びを得たか，2）問題点や改善すべき課題は何か，の2 点について考察するため，実習生の振り返りレポートをKJ 法を用いて分析した。その結果，①授業・教材作りに関する技術，②状況・相手に応じたやり取りの技術，③学習者の視点・背景の理解，④言語教育者としての態度，⑤精神面のセルフコントロールの5つのカテゴリーに関する気づき・学びならびに実施上の問題が観察されることが分かった。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022テーブルトーク・ロールプレイングゲーム（TRPG）におけるASD およびADHD 児のコミュニケーション行動の変容343357ENGoKinoshitaMaster’ s degree program student of Graduate School of Education, Okayama UniversityTakayukiTanjiGraduate School of Education, Okayama University10.18926/CTED/63318本研究では，自閉スペクトラム症(ASD)または注意欠陥多動性障害(ADHD)のある小学生3名を対象に，テーブルトーク・ロールプレイングゲーム(TRPG)を用いた余暇活動を実施し，児童同士のコミュニケーション行動の変容について検討した。加藤ら(2019)による「いただきダンジョンRPG」において，ゲーム上の場面区分「探索フェイズ」「戦闘フェイズ」が，児童同士の発話量と発話内容にどのような変化をもたらすかについて，実際の活動場面からトランスクリプトを作成して分析した。その結果，児童同士の発話量が「探索フェイズ」「戦闘フェイズ」の両方において増加し，発話内容も多様化した。この結果から，TRPG を用いた余暇活動は，同年代の他者とのコミュニケーションや交流機会の成功体験を蓄積できる活動として，ASD 児にとって有用であることが示唆された。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022教職員の学びの在り方から見た教職員研修の高度化・体系化・組織化 （独）教職員支援機構岡山大学センターにおける取組を通して271285ENKazuakiKajiiShinnosukeKumagaiGraduate School of Education, Okayama UniversityMarikoKokayashiGraduate School of Education, Okayama UniversityAtsushiTakaseGraduate School of Education, Okayama UniversityAkitakaNakayaGraduate School of Education, Okayama UniversityMutsumiMatsuedaGraduate School of Education, Okayama UniversityYukariMimuraGraduate School of Education, Okayama University10.18926/CTED/63313本論文では，これからの教師の学びの在り方を明らかにしたうえで，教師の学びを保障する場やその特質について考察する。具体的には，まず，近年の教員政策のなかで求められる教師像をもとに，教師の学びがどのように意味づけられるかを明らかにする。そのうえで，既存の教師の学びの場である教育委員会等が企画運営する研修，教職大学院，各学校で行われる校内研修等との比較により，（独）教職員支援機構岡山大学センターが構想する研修プログラムの特色を描出し，教職員の学びが深化するためのしくみを構築することの必要性と重要性を指摘したい。と同時に，教職員の学びの成果を可視化していくためには，研修プログラムに対するアウトカム重視の評価の開発が求められる。この点については今後の課題とする。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022市民育成のための地域日本語教育の理論的枠組みの構築―外国人技能実習生のキャリア形成に焦点化して―135149ENHOANG Ngoc Bich TranToshinoriKuwabaraGraduate School of Education, Okayama University10.18926/CTED/63304本稿は、市民育成のための地域社会における日本語教育の原理や方法に関する理論的枠組みを構築しようとするものである。その際、特に外国人技能実習生に対する日本語教育を対象として取り上げ、技能実習生のキャリア形成に焦点をあて、それに対して日本語教育がどのように役立つかを、先行研究の分析を通して理論的に考察していく。外国人技能実習生が直面している問題としては、地域社会に参加する市民を育成するための内容が組み込まれていないことによって、彼ら・彼女らのキャリア形成につながる学習が十分に保障されていないことが挙げられる。本稿では、市民育成と日本語教育の関連について考察した先行研究を分析し、外国人が日本社会の中で個々の生き方を追求するにあたって、日本語教育がどのような役割を担うかを理論的に検討する。そのうえで、そのための学習の場としての地域日本語教育の可能性と意義を探る。No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022小学校体育主任研究会における合意形成パターン ―課題分析場面に着目して87101ENShoShiraishiThe Faculty of Physical Eduction, Kantaiheiyou UniversityYuichiHaraGraduate School of Education, Okayama UniversityShuKajiyamaImari Kindergarten10.18926/CTED/63300本研究の目的は，小学校の体育研究主任研究会において課題分析をする際に，教師がどのような合意形成パターンを取りながらコミュニケーションしていくのかを明らかにすることである．「コンセンサス」と「アコモデーション」という2つの「合意形成」概念を視点に会話分析した結果，6個の合意形成パターンを抽出することができた．「コンセンサス」をめぐる合意形成では，「単語の共有」，「言い換えによる納得」が抽出され，「アコモデーション」をめぐる合意形成では，「実体験への共感」，「概念をめぐる差異の許容」，「つぶやきの強化」，「視点の転換」が抽出された．これらの概念を合意される内容（「コンセンサス」，「アコモデーション」）を縦軸，話題への参加構造（「単線的」，「複線的」）を横軸にとる合意形成パターン構造に整理した．このことにより，教員研修内の発話がどのようになされているのかを認識する枠組みを提示することができた．No potential conflict of interest relevant to this article was reported.岡山大学教師教育開発センターActa Medica Okayama2186-1323122022リアルタイムオンライン講義の受講効率の検証と課題 ―YouTube Live + OBS Studio とGoogle Classroom の活用―3346ENJunjiYamakawaAcademic Field of Natural Science a nd Technology, Okayama UniversityHiroshiTakahataCenter for Teacher Education and Development, Okayama University10.18926/CTED/63296岡山大学でリアルタイムオンライン講義を実施した。使用したオンラインシステムはYouTubeLiveとGoogleClassroomのWebアプリケーションを使用して作成者が新たに構築した。このシステムは，講義ビデオアーカイブを提供することも可能であった。システムの構築費と運用費はかなり低くなる可能性がある。LMSは，講義ビデオの配信に加えて，学生とのコミュニケーションを合理化するために用いた。ビデオ配信システムまたはLMSの障害が原因でオンライン講義が停止することはなかった。このシステムにより講師は講義室の設備や講義の時間割の制約から解放され，マルチメディア教材やバーチャル教材の使用が容易になった。また学生の受講効率は従来の講義形式に対して約2.9倍に向上したと考えられる。授業の構成や内容の質的問題の検証，授業内容に対する生徒の理解の深化，生徒が習得した資質や能力の内容の検証は今後の課題である。No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama0918-944013522022Decades-long phylogeographic issues: complex historical processes and ecological factors on genetic structure of alpine plants in the Japanese ArchipelagoENHajimeIkedaInstitute of Plant Science and Resources, Okayama UniversityMountain regions are important places for biodiversity, where organisms could persist throughout prolonged periods and accumulate genetic divergence as well as promote speciation. Roles of mountains for biodiversity have been exclusively discussed in regions that have specifically diverse species or covered with ice-sheets during the Pleistocene glacial periods, whereas the importance of mountainous regions in East Asia has been less disputed. High mountains in the Japanese Archipelago, located at the eastern edge of the Eurasia continent, have one of southernmost populations of alpine and arctic-alpine plants that are also distributed in the northern Pacific and/or the circumarctic regions. Phylogeographic studies on the Japanese alpine plants have excluded their possible ephemeral occurrence during the current warm period, and rather, suggest persistence of alpine plants throughout several cycles of climate changes in the Pleistocene on high mountains in central Honshu, the main island of the Japanese Archipelago. In this review, I look through decade long phylogeographic studies and show complicated patterns of range dynamics of Japanese alpine plants. In addition, I note recent findings of genetic relationships of Japanese populations of alpine and/or arctic-alpine plants with those in northern regions and their possible ecological divergence in the Japanese Archipelago. Taken together, I provide several issues for understanding historical processes that established distribution of alpine plants following climate changes as well as their diversification and propose importance of Japanese populations of alpine plants on biodiversity in alpine communities across broader range, especially in the northern Pacific region.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231792022小学校社会科における主権者教育の原理と方法に関する研究―地域社会の伝統や文化の保護・継承を扱う単元の開発を通して―5564ENToshinoriKuwabaraDivision of Social Studies and Language Education, Graduate School of Education, Okayama UniversityNagisaYamadaDivision of Social Studies and Language Education, Graduate School of Education, Okayama University10.18926/bgeou/63239本研究は，主権者育成を目指した小学校社会科の原理と方法を解明し，単元開発を通してそれを具体的に提案しようとするものである。18 歳に選挙権年齢が引き下げられて以降，主権者教育が注目されるようになったが，一般的には主権者教育は中等教育段階のものと考えられ，小学校における取組事例は多くはない。しかし，主権者教育は選挙の際の投票行動を促すことを目標とするものではない。主権者として必要な社会認識を形成し，主権者として必要な政治的判断力を養うとともに，主権者としての自覚や態度，さらには主権者として行動するためのスキルを身に着けさせるものである。それらは，初等教育段階から体系的・継続的に育成する必要がある。本研究では，主権者教育の原理に関する先行研究や，小学校主権者教育のために開発された実践等の分析を通して，小学校主権者教育の原理と方法を解明し，社会科の学習として位置づけられる単元の開発を通してそれらを具体的に提案するものである。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7612022Cystic Intracranial Recurrence of Olfactory Neuroblastoma without Accumulation on Fluorine-18-fluorodeoxyglucose Positron Emission Tomography9398ENYukitomoIshiDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityShigeruYamaguchiDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityKanako C.HatanakaDepartment of Surgical Pathology, Hokkaido University HospitalEmiTakakuwaDepartment of Surgical Pathology, Hokkaido University HospitalHiroakiMotegiDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityTaishiHondaDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityHiroyukiKobayashiDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityShunsukeTerasakaDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityAkihiroHommaDepartment of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityMikiFujimuraDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityKiyohiroHoukinDepartment of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido UniversityCase Report10.18926/AMO/63218A 66-year-old man underwent multimodal treatment for olfactory neuroblastoma (ONB). When he was 72 years old, a cystic intracranial lesion without accumulation on fluorine-18-fluorodeoxyglucose positron emission tomography was detected. Surgical resection was performed when the patient was 73 years old. The pathological examination revealed recurrence of ONB, and the patient underwent focal irradiation. At age 81, he presented with a second recurrence in the right occipital lobe with radiological and pathological findings similar to the prior recurrence. This case suggests that pathological confirmation should be considered in cases with atypical radiological findings following the treatment of ONB.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7612022Obesity’s Influence on Insulin Resistance in Pregnant Women with Polycystic Ovary Syndrome5156ENErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazumasaTaniDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesJotaMakiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeiHayataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/63209Polycystic ovary syndrome (PCOS) is a common endocrine metabolic disorder that is associated with high insulin resistance and obesity. However, ~70% of women with PCOS in Japan are non-obese. We retrospectively analyzed the cases of 163 Japanese women with PCOS who visited our Ob/Gyn department in 2006-2018 to determine which has a greater effect on insulin resistance: PCOS or obesity. We reviewed the women’s medical records and calculated their insulin resistance and insulin secretion. The women’s mean age and pre-pregnancy body mass index (BMI) were 30±5.8 years and 24.8±5.6 kg/m2, respectively; their mean ± SD fasting plasma glucose, 94.1±13.7 mg/dL; HOMA-IR, 2.1±2.0; QUICKI, 0.4±0.0; and HOMA-β, 108.9±88.0%. Sixtyeight women were pregnant, and 37% (n=25) were obese (BMI ≥ 25 kg/m2). Obesity had a greater effect on insulin resistance: fasting plasma glucose F(1, 53)=6.134, p<0.05; fasting insulin F(1, 53)=31.606, p<0.01; HOMA-IR F(1, 53)=31.670, p<0.01; QUICKI F(1, 53)=16.156, p<0.01. There was no significant difference in values other than QUICKI and testosterone between the women with and without PCOS. Obesity thus had a greater effect on increased insulin resistance in pregnant women with PCOS. Further studies of the insulin resistance of non-obese women with PCOS is needed, as non-obese women with PCOS are common in Asia.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7612022Mouse Model for Optogenetic Genome Engineering15ENTomokaTakaoDepartment of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDaisukeYamadaDepartment of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakeshiTakaradaDepartment of Regenerative Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/63202Optogenetics, a technology to manipulate biological phenomena thorough light, has attracted much attention in neuroscience. Recently, the Magnet System, a photo-inducible protein dimerization system which can control the intracellular behavior of various biomolecules with high accuracy using light was developed. Furthermore, photoactivation systems for controlling biological phenomena are being developed by combining this technique with genome-editing technology (CRISPR/Cas9 System) or DNA recombination technology (Cre-loxP system). Herein, we review the history of optogenetics and the latest Magnet System technology and introduce our recently developed photoactivatable Cre knock-in mice with temporal-, spatial-, and cell-specific accuracy.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0196-65535022022Impact of the world hand hygiene and global handwashing days on public awareness between 2016 and 2020: Google trends analysis141147ENYoshitoNishimuraDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiKeitokuDepartment of Medicine, John A. Burns School of Medicine, University of HawaiiToshihiroKoyamaDepartment of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesBackground: Scientific evidence suggest that hand hygiene as one of the most effective measures to control infection. To promote good hand hygiene practices, the World Health Organization introduced May 5 as World Hand Hygiene Day (WHHD), and international stakeholders established Global Handwashing Day (GHD) on October 15. However, its contributions to raising public awareness of hand hygiene is unclear. Methods: This study evaluates the impact of the WHHD and GHD on the public awareness of hand hygiene in Japan, the United Kingdom, the United States, and worldwide from 2016 to 2020, using the relative search volume of "Hand hygiene" in Google Trends as a surrogate. To identify a statistically significant timepoint of a trend change, we performed Joinpoint regression analysis. Results: Upticks of the relative search volumes as well as joinpoints were noted worldwide around the WHHD and GHD from 2016 to 2019, but no joinpoints were identified around the WHHD and GHD in 2020. No such changes were observed in Japan, the United Kingdom, and the United States during these periods. Conclusions: While the WHHD was originally established to raise awareness of hand hygiene in healthcare facilities, our result suggests that the WHHD and GHD may not have effectively disseminated the importance of hand hygiene to the general public at a country level. Additional policy measures to advocate hand hygiene to the public are necessary to communicate its benefits. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama1044-579X8612022Cancer extracellular vesicles, tumoroid models, and tumor microenvironment112126ENTakanoriEguchiDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMonaShetaDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasanoriFujiiDepartment of Allergy and Respiratory Medicine, Okayama University HospitalStuart K.CalderwoodDivision of Molecular and Cellular Biology, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolCancer extracellular vesicles (EVs), or exosomes, promote tumor progression through enhancing tumor growth, initiating epithelial-to-mesenchymal transition, remodeling the tumor microenvironment, and preparing metastatic niches. Three-dimensionally (3D) cultured tumoroids / spheroids aim to reproduce some aspects of tumor behavior in vitro and show increased cancer stem cell properties. These properties are transferred to their EVs that promote tumor growth. Moreover, recent tumoroid models can be furnished with aspects of the tumor microenvironment, such as vasculature, hypoxia, and extracellular matrix. This review summarizes tumor tissue culture and engineering platforms compatible with EV research. For example, the combination experiments of 3D-tumoroids and EVs have revealed multifunctional proteins loaded in EVs, such as metalloproteinases and heat shock proteins. EVs or exosomes are able to transfer their cargo molecules to recipient cells, whose fates are often largely altered. In addition, the review summarizes approaches to EV labeling technology using fluorescence and luciferase, useful for studies on EV-mediated intercellular communication, biodistribution, and metastatic niche formation.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-7345572021cis-3-Azido-2-methoxyindolines as safe and stable precursors to overcome the instability of fleeting 3-azidoindoles1338113384ENToshikiYamashiroGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakumiAbeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasaruTaniokaSchool of Pharmaceutical Sciences, Aichi Gakuin UniversityShinichiroKaminoSchool of Pharmaceutical Sciences, Aichi Gakuin UniversityDaisukeSawadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityUse of 3-azidoindoles in organic synthesis remains a difficult task owing to their instabilities. Herein, we report a general and concise approach for tackling this problem by using 3-azidoindole surrogates. The surrogates are bench-stable, presumably due to the observed intramolecular O-N-beta bonding. The resultant fleeting intermediates undergo capturing in situ to afford 3-substitued indoles through formal ipso-substitution of the azide group by nucleophiles. In these investigations, we found that the fleeting 3-azidoindoles show a C3-electrophilic character for the first time.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X5872022Oligomerization of Ca2+/calmodulin-dependent protein kinase kinase160165ENYuseiFukumotoApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityYuheiHaradaApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversitySatomiOhtsukaApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityNaokiKanayamaApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityMasakiMagariApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityNaoyaHatanoApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityHiroyukiSakagamiDepartment of Anatomy, Kitasato University School of MedicineHiroshiTokumitsuApplied Cell Biology, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityCa2+/calmodulin-dependent protein kinase kinases (CaMKKα and β) are regulatory kinases for multiple downstream kinases, including CaMKI, CaMKIV, PKB/Akt, and AMP-activated protein kinase (AMPK) through phosphorylation of each activation-loop Thr residue. In this report, we biochemically characterize the oligomeric structure of CaMKK isoforms through a heterologous expression system using COS-7 cells. Oligomerization of CaMKK isoforms was readily observed by treating CaMKK transfected cells with cell membrane permeable crosslinkers. In addition, His-tagged CaMKKα (His–CaMKKα) pulled down with FLAG-tagged CaMKKα (FLAG–CaMKKα) in transfected cells. The oligomerization of CaMKKα was confirmed by the fact that GST–CaMKKα/His–CaMKKα complex from transiently expressed COS-7 cells extracts was purified to near homogeneity by the sequential chromatography using glutathione-sepharose/Nisepharose and was observed in a Ca2+/CaM-independent manner by reciprocal pulldown assay, suggesting the direct interaction between monomeric CaMKKα. Furthermore, the His-CaMKKα kinase-dead mutant (D293A) complexed with FLAG–CaMKKα exhibited significant CaMKK activity, indicating the active CaMKKα multimeric complex. Collectively, these results suggest that CaMKKα can self-associate in the cells, constituting a catalytically active oligomer that might be important for the efficient activation of CaMKK-mediated intracellular signaling.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7562021Clinical Efficacy and Safety of Sitafloxacin 200 mg Once Daily for Refractory Genitourinary Tract Infections763766ENTakehiroIwataDepartment of Urology, Okayama University HospitalTakuyaSadahiraDepartment of Urology, Okayama University HospitalYukiMaruyamaDepartment of Urology, Okayama University HospitalTakanoriSekitoDepartment of Urology, Okayama University HospitalKasumiYoshinagaDepartment of Urology, Okayama University HospitalShogoWatariDepartment of Urology, Okayama University HospitalKentaroNagaoDepartment of Urology, Okayama University HospitalTatsushiKawadaDepartment of Urology, Okayama University HospitalYusukeTominagaDepartment of Urology, Okayama University HospitalShingoNishimuraDepartment of Urology, Okayama University HospitalAtsushiTakamotoDepartment of Urology, Okayama University HospitalTomokoSakoDepartment of Urology, Okayama University HospitalKoheiEdamuraDepartment of Urology, Okayama University HospitalYasuyukiKobayashiDepartment of Urology, Okayama University HospitalMotooArakiDepartment of Urology, Okayama University HospitalAyanoIshiiDepartment of Urology, Okayama University HospitalMasamiWatanabeDepartment of Urology, Okayama University HospitalToyohikoWatanabeDepartment of Urology, Okayama University HospitalYasutomoNasuDepartment of Urology, Okayama University HospitalKoichiroWadaDepartment of Urology, Okayama University HospitalClinical Study Protocol10.18926/AMO/62820The aim of this ongoing trial is to evaluate the clinical efficacy and safety of sitafloxacin (STFX) 200 mg once daily (QD) for 7 days in patients with refractory genitourinary tract infections, which include recurrent or complicated cystitis, complicated pyelonephritis, bacterial prostatitis, and epididymitis. The primary endpoint is the microbiological efficacy at 5-9 days after the last administration of STFX. Recruitment began in February 2021, and the target total sample size is 92 participants.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7562021Non-Invasive Prenatal Genetic Testing (NIPT) Leading to Prenatal Diagnosis of Trisomy 21 Mosaicism and 18q Deletion Syndrome: Two Cases745750ENKeiHayataDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceSakurakoMishimaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceAkikoOhiraDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceKazumasaTaniDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceJotaMakiDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceErikoEtoDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceChikakoOgawaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical ScienceCase Report10.18926/AMO/62816NIPT is non-definitive testing to estimate the possibility that fetuses have trisomy 21, trisomy 18, or trisomy 13. However, in NIPT-positive and indeterminate cases, rare chromosomal disease may become apparent, requiring advanced genetic considerations and counseling skills. We experienced two such cases, a trisomy 21 mosaicism case triggered by NIPT-positive status and 18q deletion syndrome triggered by NIPT-indeterminate status. These cases have two clinical implications for NIPT. First, it was revealed that trisomy mosaicism might be found in NIPT-positive cases that have lower Z-Scores than those inferred from the fraction of fetal cfDNA in the case of standard trisomy. Second, it is possible that microdeletion syndrome could be the reason for an indeterminate NIPT result. Today’s genetic counseling requires more expertise in ethics and communication as well as genetic science because NIPT can lead to totally unexpected results.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7562021The Significance of Age and Causative Bacterial Morphology in the Choice of an Antimicrobial Agent to Treat Acute Uncomplicated Cystitis719724ENShinyaUeharaDepartment of Urology, Abiko Toho HospitalKeiFujioDepartment of Urology, Abiko Toho HospitalTomoyaYamasakiDepartment of Urology, Abiko Toho HospitalHideoOtsukiDepartment of Urology, Abiko Toho HospitalOriginal Article10.18926/AMO/62812Differentiating patients by age and causative bacterial morphology might aid in making the appropriate choice of antimicrobial agent when treating acute uncomplicated cystitis. In this retrospective analysis, the non-susceptibility rates of the causative bacteria to cefcapene-pivoxil (CFPN-PI) and levofloxacin (LVFX) were determined after dividing patients with acute uncomplicated cystitis by age group (15-54 and 55-74 years old) and by bacterial morphology: gram-positive cocci (GPC) or gram-negative rod (GNR). The overall non-susceptibility rates for CFPN-PI and LVFX were 19.4% and 15.3%, respectively. When the subjects were divided by age, only the non-susceptibility rate for LVFX in the younger group significantly decreased (to 8.7%). When the groups were divided by both age and bacterial morphology, the younger GNR group had non-susceptibility rates of 6.9% to CFPN-PI and 7.8% to LVFX, whereas the younger GPC group showed 10.2% non-susceptibility to LVFX. The older GNR group showed 9.8% non-susceptibility to CFPN-PI, while the older GPC group showed 7.2% non-susceptibility to LVFX. All the non-susceptibility rates were lower than 10.2% in the sub-divided groups. Differentiating patients by age and the morphology of causative bacteria can aid in making the appropriate choice of antimicrobial agent and may improve treatment outcomes in patients with acute uncomplicated cystitis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7562021Multiple Roles of Histidine-Rich Glycoprotein in Vascular Homeostasis and Angiogenesis671675ENShangzeGaoDepartment of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahiroNishiboriDepartment of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/62805Histidine-rich glycoprotein (HRG) is a 75 kDa plasma protein that is synthesized in the liver of many verte-brates and present in their plasma at relatively high concentrations of 100-150 μg/mL. HRG is an abundant and well-characterized protein having a multidomain structure that enable it to interact with many ligands, func-tion as an adaptor molecule, and participate in numerous physiological and pathological processes. As a plasma protein, HRG has been reported to regulate vascular biology, including coagulation, fibrinolysis and angiogenesis, through its binding with several ligands (heparin, FXII, fibrinogen, thrombospondin, and plas-minogen) and interaction with many types of cells (endothelial cells, erythrocytes, neutrophils and platelets). This review aims to summarize the roles of HRG in maintaining vascular homeostasis and regulating angiogen-esis in various pathological conditions.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021Relation Between Identity Disclosure to Family Members and Mental Health in Japanese Transgender People611623ENYuZhouGraduate School of Health Sciences, Okayama UniversityMichiyoFurutaniGraduate School of Health Sciences, Okayama UniversityRukmaliAthurupanaGraduate School of Health Sciences, Okayama UniversityMikiyaNakatsukaGraduate School of Health Sciences, Okayama UniversityOriginal Article10.18926/AMO/62774Family members are critical mediators of the experiences of transgender people. We studied whether transgen-der subjects had disclosed their identity to their families and their families’ reactions after the disclosure. We also evaluated the subjects’ mental state and its association with disclosure status. Transgender people were recruited for this anonymous questionnaire survey in the Okayama University Hospital gender clinic. Subjects disclosed their identity to family members at the following rates: 68.7% to the father, 89.1% to the mother, 59.1% to a brother, 77.8% to a sister, and 47.6% to grandparents. Fathers had the lowest rate (26.7%) of posi-tive reactions, while over 50% of fathers showed an ambiguous response. Approximately 20% of parents showed a negative response. The majority of parents agreed to hormonal treatment and sex-reassignment sur-gery and that the transgender child should live with the gender they wanted to express. However, the rate of subjects with mood and anxiety disorders according to the Kessler 6 scale was significantly higher in those who experienced negative or ambiguous reactions from family members compared to those who experienced posi-tive reactions. Educational and mental health professionals should support the disclosure process of transgen-der people as well as their family members.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021Clinical Manifestations of Patients with Influenza Differ by Age : A Prospective, Multi-centered Study in the Setouchi Marine Area567574ENRyosukeTakaseDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroyukiHondaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuhiroNakanoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokoOgawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMikakoObikaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKeigoUedaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHitomiKataokaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisaHanayamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/62769Influenza potentially has a high mortality rate when it affects the elderly. We aimed to examine the differences in clinical manifestations in patients with influenza according to their age. This multicenter prospective study was performed in six medical institutions in Okayama and Kagawa prefectures (Japan). Between December 1, 2019 and March 31, 2020, we collected data on adult patients diagnosed with influenza type A, who were strat-ified into younger (20-49 years), middle-aged (50-64 years), and older groups (≥ 65 years). We compared the presence or absence of fever, respiratory symptoms, and extrapulmonary symptoms according to age group. In total, 203 patients (113, younger; 51, middle-aged; and 39, older) were eligible for the analysis. The maxi-mum body temperature and temperature at first physician visit in the older group were significantly lower than those in the younger group. The incidence of respiratory symptoms was not different among the three groups. Chills, muscle pain, and arthralgia as systemic symptoms were noted significantly more frequently in the younger (80.9%) and middle-aged (75.5%) groups than in the older group (51.3%) (p = 0.002). Fever and sys-temic symptoms were less likely to appear in older patients, possibly resulting in the delaying of hospital visits among older adults.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021Relationship between Pressure Ulcers in Elderly People and Physiological Indices of the Skin557565ENHirokoTakeshima KoharaDepartment of Nursing, University of KochiMitsunori IkedaDepartment of Nursing, University of KochiMasamiOkawaShiragikuen HospitalOriginal Article10.18926/AMO/62768This study examined the relationship between skin physiological indices and pressure ulcers in elderly people. The subjects were 55 bedridden elderly Japanese patients with a median age of 85 years. The following parame-ters were measured using non-invasive devices: skin surface temperature, moisture content in the stratum corneum, moisture content in the dermis, transepidermal water loss as an index of skin barrier function, skin erythema and skin elasticity. The sacral and 2 heel areas were observed as sites predisposed to pressure ulcers. Within one month after measuring the skin physiological indices, we confirmed pressure ulcers of National Pressure Ulcer Advisory Panel classification Stage II or worse based on medical records. Among the 55 patients, 4 (7.3%) prospectively developed a total of 5 pressure ulcers within 16 days. Only the skin erythema score was significantly higher with than without pressure ulcers (p < 0.001). We performed a binary logistic regression analysis and confirmed a significant relationship between pressure-ulcer development and the level of erythema (odds ratio = 1.026; 95% confidence interval: 1.011-1.042). Skin erythema increased before the development of pressure ulcers. Taken together, our results show that the high skin erythema score can be a predictive indicator of pressure ulcers.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7552021Glial Cells as Possible Targets of Neuroprotection through Neurotrophic and Antioxidative Molecules in the Central and Enteric Nervous Systems in Parkinson’s Disease549556ENNamiIsookaDepartment of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesIkukoMiyazakiDepartment of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasatoAsanumaDepartment of Medical Neurobiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReview10.18926/AMO/62767Parkinson’s disease (PD) is the second most common neurodegenerative disease worldwide. The loss of nigrostriatal dopaminergic neurons produces its characteristic motor symptoms, but PD patients also have non-motor symptoms such as constipation and orthostatic hypotension. The pathological hallmark of PD is the presence of α-synuclein-containing Lewy bodies and neurites in the brain. However, the PD pathology is observed in not only the central nervous system (CNS) but also in parts of the peripheral nervous system such as the enteric nervous system (ENS). Since constipation is a typical prodromal non-motor symptom in PD, often preceding motor symptoms by 10-20 years, it has been hypothesized that PD pathology propagates from the ENS to the CNS via the vagal nerve. Discovery of pharmacological and other methods to halt this progression of neurodegeneration in PD has the potential to improve millions of lives. Astrocytes protect neurons in the CNS by secretion of neurotrophic and antioxidative factors. Similarly, astrocyte-like enteric glial cells (EGCs) are known to secrete neuroprotective factors in the ENS. In this article, we summarize the neuroprotective function of astrocytes and EGCs and discuss therapeutic strategies for the prevention of neurodegeneration in PD targeting neurotrophic and antioxidative molecules in glial cells.No potential conflict of interest relevant to this article was reported.The American Society of Gene and Cell TherapyActa Medica Okayama1525001629102021Local oncolytic adenovirotherapy produces an abscopal effect via tumor-derived extracellular vesicles29202930ENYoshihikoKakiuchi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinjiKuroda Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesNobuhikoKanaya Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKentoKumon Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoTsumura Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasashiHashimoto Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChiakiYagi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyomaSugimoto Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukiHamada Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoruKikuchi Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasahikoNishizaki Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShunsukeKagawa Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHiroshiTazawa Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuoUrataOncolys BioPharma, IncToshiyoshiFujiwara Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesExtracellular vesicles (EVs) play important roles in various intercellular communication processes. The abscopal effect is an interesting phenomenon in cancer treatment, in which immune activation is generally considered a main factor. We previously developed a telomerase-specific oncolytic adenovirus, Telomelysin (OBP-301), and occasionally observed therapeutic effects on distal tumors after local treatment in immunodeficient mice. In this study, we hypothesized that EVs may be involved in the abscopal effect of OBP-301. EVs isolated from the supernatant of HCT116 human colon carcinoma cells treated with OBP-301 were confirmed to contain OBP-301, and they showed cytotoxic activity (apoptosis and autophagy) similar to OBP-301. In bilateral subcutaneous HCT116 and CT26 tumor models, intratumoral administration of OBP-301 produced potent antitumor effects on tumors that were not directly treated with OBP-301, involving direct mediation by tumor-derived EVs containing OBP-301. This indicates that immune activation is not the main factor in this abscopal effect. Moreover, tumor-derived EVs exhibited high tumor tropism in orthotopic HCT116 rectal tumors, in which adenovirus E1A and adenovirus type 5 proteins were observed in metastatic liver tumors after localized rectal tumor treatment. In conclusion, local treatment with OBP-301 has the potential to produce abscopal effects via tumor-derived EVs.No potential conflict of interest relevant to this article was reported.岡山大学大学院教育学研究科Acta Medica Okayama1883-24231772021教員養成カリキュラムへの実践型社会連携科目導入の意義と方法4353ENToshinoriKuwabaraGraduate School of Education, Okayama University10.18926/bgeou/62429本研究は，教員養成カリキュラムに地域社会との連携に基づく実践的な科目を導入することの意義と方法について，岡山大学教育学部での実践をふまえて論じるものである。全国の大学において，講義中心ではなく学生の主体性を重んじる課題解決型の授業や，地域社会と連携した体験型の授業が増えてきている。また，教員養成においても，学校での体験が重視され，インターンシップが導入され始めるなどの動きが見られるようになった。両者の流れは同じように見えて，教員養成においては体験が学校に限定されている点が異なっている。教員養成という目的の下では，実践や体験の場が学校に限定されるのは当然のようにも思われるが，本研究では，教員養成においても学校外の実践や体験が必要であることを論じたうえで，その考え方に基づいて構想，実践した科目の報告を行う。報告を通して，教員の養成にも学校内だけではなく学校外の実践体験が重要であることを論じていきたい。No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7542021Effects of Protective Measures against COVID-19 on Auditory Communication for People with Hearing Loss511516ENYukoKataokaDepartment of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYukihideMaedaDepartment of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAkikoSugayaDepartment of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRyotaroOmichiDepartment of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShinKariyaDepartment of Otolaryngology, Head & Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShort Communication10.18926/AMO/62404WHO has recommended various measures to combat the COVID-19 pandemic, including mask-wearing and physical distancing. However, these changes impair communication for individuals with hearing loss. We investigated the changes in auditory communication associated with COVID-19 measures in 269 patients (male: 45.7%, female: 54.3%, median age: 54 y.o.). Most patients with hearing loss had difficulty engaging in auditory communication with people wearing masks, especially in noisy surroundings or with physical distanc-ing. These difficulties were noticeable in patients with severe hearing loss. Developing communication support strategies for people with hearing loss is an urgent need while COVID-19 measures are in place.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7542021The Cell Cycle Checkpoint Gene, RAD17 rs1045051, Is Associated with Prostate Cancer Risk415421ENJingkaiSunDepartment of Urology, Zhujiang Hospital, Southern Medical UniversityWenfengLinDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesQixuWangDepartment of Urology, Zhujiang Hospital, Southern Medical UniversityAkikoSakaiDepartment of Molecular Genetics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRuizhiXueDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasamiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesChunxiaoLiuDepartment of Urology, Zhujiang Hospital, Southern Medical UniversityTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasutomoNasuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAbaiXuDepartment of Urology, Zhujiang Hospital, Southern Medical UniversityPengHuangDepartment of Urology, Zhujiang Hospital, Southern Medical UniversityOriginal Article10.18926/AMO/62379Human RAD17, as an agonist of checkpoint signaling, plays an essential role in mediating DNA damage. This hospital-based case-control study aimed to explore the association between RAD17 rs1045051, a missense sin-gle nucleotide polymorphism (SNP), and prostate cancer risk. Subjects were 358 prostate cancer patients and 314 cancer-free urology patients undergoing treatment at the Zhujiang Hospital of Southern Medical University in China. RAD17 gene polymorphism rs1045051 was evaluated by the SNaPshot method. Compared with the RAD17 gene polymorphism rs1045051 AA genotype, there was a higher risk of prostate cancer for the CC gen-otype (adjusted odds ratio [AOR] = 1.731, 95% confidence interval [95%CI] = 1.031−2.908, p = 0.038). Compared with the A allele, the C allele was significantly associated with the disease status (AOR = 1.302, 95%CI = 1.037−1.634, p = 0.023). All these findings indicate that in the SNP rs1045051, both the CC genotype and C allele may have a substantial influence on the prostate cancer risk.No potential conflict of interest relevant to this article was reported.IEEEActa Medica Okayama2020Method of Generating a Blacklist for Mobile Devices by Searching Malicious Websites20489448ENTakashiIshiharaGraduate School of Natural Science and Technology, Okayama UniversityMasayaSatoGraduate School of Natural Science and Technology, Okayama UniversityToshihiroYamauchiGraduate School of Natural Science and Technology, Okayama UniversityAs mobile devices have become more popular, malware and attacks directed at them have significantly increased. One of the methods to attack mobile devices is redirecting a user to unwanted websites by unwanted page transition. One of the countermeasures against such attacks is to generate a blacklist of URLs and hostnames, which can prevent access to malicious websites. To generate a blacklist, first, malicious websites are collected in the web space. Then, URLs and hostnames of the malicious websites are added to the blacklist. However, URLs of the malicious websites are typically changed frequently; thus, it is necessary to keep track of the malicious websites and update the blacklist in a timely manner. In this study, we proposed a method to generate blacklists for mobile devices by searching malicious websites. The method collects many HTML files from the web space using a crawler and searches for HTML files that are highly likely to be malicious using keywords extracted from the known malicious websites to discover the new ones. Thus, new malicious websites can be added to the blacklist in a timely manner. Using the proposed method, we discovered malicious websites that were not detected by Google Safe Browsing. Moreover, the blacklist generated using the method had a high detection rate for certain malicious websites. This paper reports the design process and the results of the evaluation of the new method.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8532E100.D102017Kernel Rootkits Detection Method by Monitoring Branches Using Hardware Features23772381ENToshihiroYamauchiGraduate School of Natural Science and Technology, Okayama UniversityYoheiAkaoGraduate School of Natural Science and Technology, Okayama UniversityAn operating system is an essential piece of software that manages hardware and software resources. Thus, attacks on an operating system kernel using kernel rootkits pose a particularly serious threat. Detecting an attack is difficult when the operating system kernel is infected with a kernel rootkit. For this reason, handling an attack will be delayed causing an increase in the amount of damage done to a computer system. In this paper, we propose Kernel Rootkits Guard (KRGuard), which is a new method to detect kernel rootkits that monitors branch records in the kernel space. Since many kernel rootkits make branches that differ from the usual branches in the kernel space, KRGuard can detect these differences by using the hardware features of commodity processors. Our evaluation shows that KRGuard can detect kernel rootkits that involve new branches in the system call handler processing with small overhead.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8532E100.D102017Mitigating Use-After-Free Attacks Using Memory-Reuse-Prohibited Library22952306ENToshihiroYamauchiGraduate School of Natural Science and Technology, Okayama UniversityYutaIkegamiGraduate School of Natural Science and Technology, Okayama UniversityYuyaBanGraduate School of Natural Science and Technology, Okayama UniversityRecently, there has been an increase in use-after-free (UAF) vulnerabilities, which are exploited using a dangling pointer that refers to a freed memory. In particular, large-scale programs such as browsers often include many dangling pointers, and UAF vulnerabilities are frequently exploited by drive-by download attacks. Various methods to prevent UAF attacks have been proposed. However, only a few methods can effectively prevent UAF attacks during runtime with low overhead. In this paper, we propose HeapRevolver, which is a novel UAF attackprevention method that delays and randomizes the timing of release of freed memory area by using a memory-reuse-prohibited library, which prohibits a freed memory area from being reused for a certain period. The first condition for reuse is that the total size of the freed memory area is beyond the designated size. The threshold for the conditions of reuse of the freed memory area can be randomized by HeapRevolver. Furthermore, we add a second condition for reuse in which the freed memory area is merged with an adjacent freed memory area before release. Furthermore, HeapRevolver can be applied without modifying the target programs. In this paper, we describe the design and implementation of HeapRevolver in Linux and Windows, and report its evaluation results. The results show that HeapRevolver can prevent attacks that exploit existing UAF vulnerabilities. In addition, the overhead is small.No potential conflict of interest relevant to this article was reported.Institute of Electronics, Information and Communications Engineers (IEICE)Acta Medica Okayama0916-8532E99.D122016Rule-Based Sensor Data Aggregation System for M2M Gateways29432955ENYuichiNakamuraHitachi, Ltd.AkiraMoriguchiHitachi Solutions, Ltd.MasanoriIrieHitachi Solutions, Ltd.TaizoKinoshitaHitachi, Ltd.ToshihiroYamauchiGraduate School of Natural Science and Technology at Okayama UniversityTo reduce the server load and communication costs of machine-to-machine (M2M) systems, sensor data are aggregated in M2M gateways. Aggregation logic is typically programmed in the C language and embedded into the firmware. However, developing aggregation programs is difficult for M2M service providers because it requires gatewayspecific knowledge and consideration of resource issues, especially RAM usage. In addition, modification of aggregation logic requires the application of firmware updates, which are risky. We propose a rule-based sensor data aggregation system, called the complex sensor data aggregator (CSDA), for M2M gateways. The functions comprising the data aggregation process are subdivided into the categories of filtering, statistical calculation, and concatenation. The proposed CSDA supports this aggregation process in three steps: the input, periodic data processing, and output steps. The behaviors of these steps are configured by an XML-based rule. The rule is stored in the data area of flash ROM and is updatable through the Internet without the need for a firmware update. In addition, in order to keep within the memory limit specified by the M2M gateway’s manufacturer, the number of threads and the size of the working memory are static after startup, and the size of the working memory can be adjusted by configuring the sampling setting of a buffer for sensor data input. The proposed system is evaluated in an M2M gateway experimental environment. Results show that developing CSDA configurations is much easier than using C because the configuration decreases by 10%. In addition, the performance evaluation demonstrates the proposed system’s ability to operate on M2M gateways.No potential conflict of interest relevant to this article was reported.Information Processing Society of JapanActa Medica Okayama1882-66522452016Design of Function for Tracing Diffusion of Classified Information for IPC on KVM781792ENShotaFujiiGraduate School of Natural Science and Technology, Okayama UniversityMasayaSatoGraduate School of Natural Science and Technology, Okayama UniversityToshihiroYamauchiGraduate School of Natural Science and Technology, Okayama UniversityHideoTaniguchiGraduate School of Natural Science and Technology, Okayama UniversityThe leaking of information has increased in recent years. To address this problem, we previously proposed a function for tracing the diffusion of classified information in a guest OS using a virtual machine monitor (VMM). This function makes it possible to grasp the location of classified information and detect information leakage without modifying the source codes of the guest OS. The diffusion of classified information is caused by the file operation, child process creation, and inter-process communication (IPC). In a previous study, we implemented the proposed function for a file operation and child process creation excluding IPC using a kernel-based virtual machine (KVM). In this paper, we describe the design of the proposed function for IPC on a KVM without modifying the guest OS. The proposed function traces the local and remote IPCs inside the guest OS from the outside so as to trace the information diffusion. Because IPC with an outside computer might cause an information leakage, tracing the IPCs enables the detection of such a leakage. We also report the evaluation results including the traceability and performance of the proposed function.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-734557612021Synthesis of α-substituted indolylacetamide using acetonitriles as acetamide enolate equivalents through O-transfer reactions74937496ENTakumiAbeGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKentaNodaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDaisukeSawadaGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityWe introduce readily available ammonium hemiaminals as O-transfer reagents and commercially available acetonitriles as a primary amide enolate precursor. The combination serves as an amide enolate equivalent, thereby providing one-pot access to alpha-substituted indolylacetamides. A broad substrate scope and good functional group tolerance as well as gram-scale synthesis make this protocol highly attractive. Mechanistic experiments suggest that the cyano group is trapped by a hydroxy group of hemiaminals en route to the desired primary amides under metal-free conditions.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X5662021Role of the TRPM4 channel in mitochondrial function, calcium release, and ROS generation in oxidative stress190196ENChenWangDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityJianChenDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMengxueWangDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKeijiNaruseDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKenTakahashiDepartment of Cardiovascular Physiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityIschemic heart disease is one of the most common causes of death worldwide. Mitochondrial
dysfunction, excessive reactive oxygen species (ROS) generation, and calcium (Ca2þ) overload are three key factors leading to myocardial death during ischemia-reperfusion (I/R) injury. Inhibition of TRPM4, a Ca2þ-activated nonselective cation channel, protects the rat heart from I/R injury, but the specific mechanism underlying this effect is unclear. In this study, we investigated the mechanism of cardioprotection against I/R injury via TRPM4 using hydrogen peroxide (H2O2), a major contributor to oxidative stress, as an I/R injury model. We knocked out the TRPM4 gene in the rat cardiomyocyte cell line H9c2 using CRISPR/Cas9. Upon H2O2 treatment, intracellular Ca2þ level and ROS production increased in wild type (WT) cells but not in TRPM4 knockout (TRPM4KO) cells. With this treatment, two indicators of mitochondrial function, mitochondrial membrane potential (DJm) and intracellular ATP levels, decreased inWT but not in TRPM4KO cells. Taken together, these findings suggest that blockade of the TRPM4 channel might protect the myocardium from oxidative stress by maintaining the mitochondrial membrane potential and intracellular ATP levels, possibly through preventing aberrant increases in intracellular Ca2þ and ROS.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7532021A Case of Metastatic Fumarate Hydratase-Deficient–like Renal Cell Carcinoma Successfully Managed by Ipilimumab plus Nivolumab397402ENTakanoriSekitoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAtsushiTakamotoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYasuyukiKobayashiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasaoMitsuiDepartment of Urology, Kurashiki Medical CenterShogoWatariDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesRisaKubotaDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakuyaSadahiraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakehiroIwataDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShingoNishimuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoheiEdamuraDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTomokoSakoDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMotooArakiDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasamiWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToyohikoWatanabeDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesReiShibataDepartment of Pathology, Okayama University HospitalDaisukeEnnishiDepartment of Hematology and Oncology, Okayama University HospitalYasutomoNasuDepartment of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCase Report10.18926/AMO/62237We report a 62-year-old male with metastatic fumarate hydratase-deficient renal cell carcinoma (FH-deficient RCC) without fumarate hydratase (FH) mutation (FH-deficient–like RCC). The International Metastatic RCC Database Consortium risk score was intermediate, and immunotherapy with nivolumab and ipilimumab (Ipi/ Nivo) was initiated. Four cycles of Ipi/Nivo and 5 cycles of nivolumab resulted in a complete response of the metastases. Hypophysitis occurred as an immune-related adverse event after four cycles of Ipi/Nivo. The prognosis of patients with FH-deficient RCC is generally poor. Few reports of FH-deficient RCC successfully treated with Ipi/Nivo have been published. Ipi/Nivo can be effective for treating FH-deficient RCC.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7532021Presence of Microplastics in Four Types of Shellfish Purchased at Fish Markets in Okayama City, Japan381384ENKen-ichiYamamotoDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesToshiyukiOshikiDepartment of Applied Chemistry, Graduate School of Natural Science and Technology, Okayama UniversityHirokoKagawaOkayama University HospitalMasayoshiNambaDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesMasakiyoSakaguchiDepartment of Cell Biology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShort Communication10.18926/AMO/62234The worldwide microplastic pollution in our environment is a matter of great concern. Harmful effects of plastics have been reported in various types of organisms including murine animals. We examined the presence of microplastics in four types of shellfish purchased from fish markets in Okayama, Japan and served to the public: short-neck clam (Ruditapes philippinarum, asari in Japanese), hard-shell clam (Meretrix lusoria, hamaguri), brackishwater clam (Cyrenidae, shijimi), and oyster (Crassostrea gigas, kaki). Our analyses demonstrated that approx. 3 pieces of microplastics were present per single shellfish, based on the division of the total number of pieces of microplastic obtained from all 4 types of shellfish by the total number of shellfish examined. Since health problems in humans due to microplastics have not yet been confirmed, further examinations of the effects of ingested microplastics are needed.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7532021Texture Indices of 18F-FDG PET/CT for Differentiating Squamous Cell Carcinoma and Non-Hodgkin’s Lymphoma of the Oropharynx351356ENKatsuyaMitamuraDepartment of Radiology, Faculty of Medicine, Kagawa UniversityTakashiNorikaneDepartment of Radiology, Faculty of Medicine, Kagawa UniversityYukaYamamotoDepartment of Radiology, Faculty of Medicine, Kagawa UniversityAyumiIhara-NishishitaDepartment of Radiology, Faculty of Medicine, Kagawa UniversityTakuyaKobataDepartment of Radiology, Faculty of Medicine, Kagawa UniversityKengoFujimotoDepartment of Radiology, Faculty of Medicine, Kagawa UniversityYasukageTakamiDepartment of Radiology, Faculty of Medicine, Kagawa UniversityNobuyukiKudomiDepartment of Medical Physics, Faculty of Medicine, Kagawa UniversityHiroshiHoshikawaDepartment of Otolaryngology, Faculty of Medicine, Kagawa UniversityYoshihiroNishiyamaDepartment of Radiology, Faculty of Medicine, Kagawa UniversityOriginal Article10.18926/AMO/62230We assessed the role of 18F-FDG PET/CT texture indices for the differentiation of squamous cell carcinoma (SCC) and non-Hodgkin’s lymphoma (NHL) in the oropharynx. 18F-FDG PET/CT data for 27 patients with SCC and 25 patients with NHL in the oropharynx were investigated. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and six texture indices (homogeneity, entropy, short-run emphasis, long-run emphasis, low gray-level zone emphasis [LGZE], and high graylevel zone emphasis [HGZE]) were derived from PET images. PET/CT parameters of the SCC patients were compared with those of the NHL patients. The diagnostic accuracy of the indices for differentiating SCC from NHL was calculated by a receiver operating characteristic curve analysis. 18F-FDG uptake in the oropharynx was observed in all of the patients. The SUVmax, MTV, and TLG did not differ significantly between the SCC and NHL groups, but two of the six texture indices (LGZE [p=0.004] and HGZE [p=0.03]) showed significant differences between the groups. LGZE was the best discriminative index for the differentiation of SCC and NHL (55.6% sensitivity, 88.0% specificity). The LGZE and HGZE texture indices derived from 18F-FDG PET/CT images may be useful in differentiating SCC and NHL in the oropharynx.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7532021Interrelationships Between Serum Levels of Procalcitonin and Inflammatory Markers in Patients Who Visited a General Medicine Department299306ENJoArakiDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKosukeOkaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiroYamamotoDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesYoshihisa HanayamaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKazukiTokumasuHideharuHagiyaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesHirokoOgawaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesKoichiItoshimaDepartment of Laboratory Medicine, Okayama University HospitalFumioOtsukaDepartment of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOriginal Article10.18926/AMO/62221Various laboratory markers of inflammation are utilized in general practice, but their clinical diagnostic significance is often ambiguous. In the present study, we determined the clinical significance of the examination of serum levels of procalcitonin (PCT) by comparing the PCT levels with the levels of other inflammatory markers,
based on a retrospective review of 332 PCT-positive patients, including cases of bacterial infection (20.5%), non-specific inflammation (20.8%), neoplasm (9.9%), connective tissue diseases (8.4%), and non-bacterial infection (7.2%), were analyzed. The serum PCT level was highest in the bacterial infection group (1.94 ng/ml) followed by the non-specific inflammatory group (0.58 ng/ml) and neoplastic diseases group (0.34 ng/ml). The serum PCT level was positively correlated with serum levels of C-reactive protein (rho=0.62), soluble interleukin-2 receptor (sIL-2R; rho=0.69), and ferritin, the plasma level of D-dimer, and white blood cell count, and negatively correlated with the serum albumin level (rho=−0.52), hemoglobin concentration, and platelet count. The serum PCT level showed a stronger positive correlation with the serum sIL-2R level than the other biomarkers. The results suggest that an increased PCT level may indicate not only an infectious state but also a non-bacterial inflammatory condition in the diagnostic process in general practice.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7532021Dental Treatment for Special Needs Patients Under General Anaesthesia: A 14-year Experience from South Bosnia and Herzegovina261268ENLidija LasicArapovicHealth Care Center Mostar, University of MostarZoranKarlovicSchool of Medicine, University of MostarValentina RajicBrzovicSchool of Medicine, University of MostarAmerBukvicPrimary Health Care Center Novi TravnikAnkaCoricHealth Care Center Mostar, University of MostarKatarinaVukojevicSchool of Medicine, University of MostarZeljkoVerzakSchool of Medicine, University of MostarOriginal Article10.18926/AMO/62217We conducted a retrospective analysis of records of special needs patients (SNPs) who received dental treatment under orotracheal-intubation general anaesthesia (OIGA) at Caritas Centre St. Family in Mostar, Bosnia and Herzegovina during the 14-year period from January 2005 to December 2018. Of the 7,085 SNPs who received dental treatment, 1,220 (17.2%) received dental treatment under OIGA: 829 (67.9%) males and 391 (32.1%) females. The patients’ mean age was 18.3±10.9 years (747 paediatric and 473 adult patients). Mental retardation and psychiatric problems were the most common medical conditions (81.22%). The most common indication for dental treatment under OIGA was behaviour management (87.21%), and 81% of the patients had an urgent need for treatment. Many of the patients had restorative treatment (3,833) and tooth extractions (3,681). From 2011 onwards, the number of tooth extractions decreased significantly. Annual trends revealed a rapid increase of patients every year. The mean dental treatment duration was 95.3±12.1 min; the mean time under OIGA was 98±8.5 min. No serious adverse effects occurred. There was increase of annual trend of SNP in OIGA. The number of extractions decreased while the number of preventive and restorative dental treatments increased.No potential conflict of interest relevant to this article was reported.Elsevier BVActa Medica Okayama0006-291X5572021Adrenergic signaling promotes the expansion of cancer stem-like cells of malignant peripheral nerve sheath tumors199205ENRongshengHuangDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAtsushiFujimuraDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEijiNakataDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShotaTakihiraDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesHirofumiInoueDepartment of Clinical Genetics and Genomic Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesSoichiroYoshikawaDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesTakeshiHiyamaDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesToshifumiOzakiDepartment of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAtsunoriKamiyaDepartment of Cellular Physiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesMalignant peripheral nerve sheath tumor (MPNST), a highly malignant tumor that arises in peripheral nerve tissues, is known to be highly resistant to radiation and chemotherapy. Although there are several reports on genetic mutations and epigenetic changes that define the pathogenesis of MPNST, there is insufficient information regarding the microenvironment that contributes to the malignancy of MPNST. In the present study, we demonstrate that adrenaline increases the cancer stem cell population in MPNST. This effect is mediated by adrenaline stimulation of beta-2 adrenergic receptor (ADRB2), which activates the Hippo transducer, YAP/TAZ. Inhibition and RNAi experiments revealed that inhibition of ADRB2 attenuated the adrenaline-triggered activity of YAP/TAZ and subsequently attenuated MPNST cells stemness. Furthermore, ADRB2-YAP/TAZ axis was confirmed in the MPNST patients’ specimens. The prognosis of patients with high levels of ADRB2 was found to be significantly worse. These data show that adrenaline exacerbates MPNST prognosis and may aid the development of new treatment strategies for MPNST.No potential conflict of interest relevant to this article was reported.Royal Society of Chemistry (RSC)Acta Medica Okayama1359-734557302021Palladium-catalyzed decarbonylative and decarboxylative cross-coupling of acyl chlorides with potassium perfluorobenzoates affording unsymmetrical biaryls36963699ENLiyanFuGraduate School of Natural Science and Technology, Okayama UniversityJingwenYouGraduate School of Natural Science and Technology, Okayama UniversityYasushiNishiharaResearch Institute for Interdisciplinary Science, Okayama UniversityThis paper describes the synthesis of unsymmetrical biaryls by the palladium-catalyzed cross-coupling reaction of acyl chlorides with potassium perfluorobenzoates. This transformation is unique in that it involves simultaneous decarbonylation and decarboxylation under redox-neutral conditions. Compared to conventional cross-coupling protocols for the synthesis of unsymmetrical biaryls, the two reactants in this synthetic strategy can be readily prepared from abundant and inexpensive aromatic carboxylic acids. No potential conflict of interest relevant to this article was reported.老年人文学研究会Acta Medica Okayama2435-574722021独居の認知症高齢者が地域で暮らし続けるということ －福山市鞘町平地区を事例として一120ENYukoIshikawaGraduate School of Humanities and Social Sciences, Okayama UniversityAyamiNakataniGraduate School of Humanities and Social Sciences, Okayama University10.18926/JHG/61931No potential conflict of interest relevant to this article was reported.EmeraldActa Medica Okayama1744-00841722021A proposal of recommendation function for element fill-in-Blank problems in java programming learning assistant system140152ENSu SandyWintDepartment of Electrical and Communication Engineering, Okayama UniversityNobuoFunabikiDepartment of Electrical and Communication Engineering, Okayama UniversityYan WatequlisSyaifudinDepartment of Electrical and Communication Engineering, Okayama UniversityShune LaeAungDepartment of Computer Studies, University of YangonWen-ChunKaoDepartment of Electrical Engineering, National Taiwan Normal UniversityPurpose<br>
To advance Java programming educations, the authors have developed a Web-based Java programming learning assistant system (JPLAS). It offers the element fill-in-blank problem (EFP) for novice students to study Java grammar and basic programming skills by filling in the missing elements in a source code. An EFP instance can be generated by selecting an appropriate code, and applying the blank element selection algorithm. As it is expected to cover broad grammar topics, a number of EFP instances have been generated. This paper aims to propose a recommendation function to guide a student solving the proper EFP instances among them.<br>
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Design/methodology/approach<br>
This function considers the difficulty level of the EFP instance and the grammar topics that have been correctly answered by the student, and is implemented at the offline answering function of JPLAS using JavaScript so that students can use it even without the Internet connections.<br>
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Findings<br>
To evaluate the effectiveness of the proposal, 85 EFP instances are prepared to cover various grammar topics, and are assigned to a total of 92 students in two universities in Myanmar and Indonesia to solve them using the recommendation function. Their solution results confirmed the effectiveness of the proposal.<br>
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Originality/value<br>
The concept of the difficulty level for an EFP instance is newly defined for the proper recommendation, and the accuracy in terms of the average numbers of answer submission times among the students is verified.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7522021Multiacquisition Variable-Resonance Image Combination Selective Can Improve Image Quality and Reproducibility for Metallic Implants in the Lumbar Spine187197ENYutaFujiwaraDivision of Clinical Radiology Service, Okayama Central HospitalTomoakiSasakiDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityYukiMutoDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityMasakiHiranoDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityRyoKamizakiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityKaitoMurakamiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNaoyaMiuraDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityYutakaFujibuchiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNayuOhmukaiDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityNao UedaDepartment of Radiological Technology, Faculty of Health Sciences, Okayama UniversityKouhei SugimotoDepartment of Radiological Technology, Graduate School of Health Sciences, Okayama UniversityKazuhiroOtaDivision of Clinical Radiology Service, Okayama Central HospitalYoshikiKamihoriuchiDivision of Clinical Radiology Service, Okayama Central HospitalTomokoSasakiDivision of Clinical Radiology Service, Okayama Central HospitalSouichirouKaneshigeDepartment of Radiology, Okayama Central HospitalOriginal Article10.18926/AMO/61897The aim of this study is to evaluate how metallic artifacts in the lumbar spine can affect images obtained from magnetic resonance (MR) sequences. We performed a phantom experiment by scanning an agar containing an orthopedic metallic implant using 64-channel multidetector row computed tomography (CT) and a 3-tesla MR unit. We compared the reproducibility in each measurement, enlargement or reduction ratio of the CT and MR measurements, and signal deviation in each voxel from the control. The reproducibility on CT and multiacquisition variable-resonance image combination selective (MAVRIC SL) was good, but that on the other MR sequences showed either fixed bias or proportional bias. The reduction ratios of the distance between the nails were significantly smaller in MAVRIC SL than in the other MR sequences after CT measurements (p<0.001, respectively). MAVRIC SL was able to reduce the metallic artifact, permitting observation of the tissue surrounding the metal with good reproducibility.No potential conflict of interest relevant to this article was reported.岡山大学大学院ヘルスシステム統合科学研究科Acta Medica Okayama2436-322712021遠隔での見守りのための機器・サービスの調査と訪問看護での利用を想定した分類4763ENToshioSakamotoGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama UniversityAkinaHirataYell Co., Ltd.MizukiMoritaGraduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University10.18926/interdisciplinary/61889This study aims to improve the quality of home nursing care for the elderly. The report presents web-based information about devices and services for remote monitoring and health management using information and communication technology and about how they can improve home care nursing station efficiency in Japan. The search terms "elderly people," "watch over," and "service," plus "sensor" were used to narrow the search. After repeating the search using a chained search for materials and links extracted from those search results, services for home care stations particularly addressing the remote monitoring of elderly people were selected and extracted. Early detection of abnormalities for support by home health nurse responsibilities for observing the general condition of the patient was chosen as the main evaluation index of usefulness. The contractor and service cost were secondary evaluation axes. Results show 9 information communication devices and services for real-time monitoring of the elderly persons’ vital signs in real time for 24 hr, 2 of which are highly useful for early detection of abnormalities and subsequent response. Results suggest that other services might be more useful, depending on how they are used, and that general-purpose services with minimum functions and low cost of introduction and maintenance can provide more opportunities for utilization. Providing these services on a BtoBtoC model and responding to patients’ medical needs can supplement home care nursing station work, increase human resource and time efficiencies, and give patients "the feeling that a nurse is always at their bedside,” even when far away.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X7522021Efficacy and Safety of Ramucirumab/nab-paclitaxel for Previously Treated Advanced Gastric Cancer in Community Hospitals133138ENShinsukeHashidaDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalNorimitsuTanakaDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalYutaTakahashiDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalYujiOnodaDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalHugh ShunsukeColvinDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalRyuichiroOhashiDepartment of Gastroenterological Surgery, Kagawa Prefectural Central HospitalKunio OkamotoDepartment of Medical Oncology, Kagawa Prefectural Central HospitalOriginal Article10.18926/AMO/61879As the nanoparticle albumin-bound paclitaxel (nab-PTX) is free of ethanol and premedication, the duration of administration is shorter and patients can drive themselves to and from the hospital. In the 2018 Japanese gastric cancer treatment guidelines, ramucirumab (RAM) plus weekly nab-PTX is conditionally recommended for previously treated patients with advanced gastric cancer. Here, we retrospectively analysed the efficacy and safety of RAM+nab-PTX for such patients in community hospitals. From January 2018 to December 2019, 43 patients with metastatic and recurrent gastric cancer received RAM+nab-PTX treatment. Six patients (13.9%) were older than 80 years and 9 patients (20.9%) showed ECOG-PS 2. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), disease control rate (DCR), and adverse events (AEs) were reviewed retrospectively. Median PFS was 114 days (95% confidence interval [CI]: 84-190) and median OS was 297 days (95% CI: 180-398). ORR and DCR were 32.4% and 72.2%, respectively. The incidence rates of ≥grade 3 neutropenia and febrile neutropenia were 53.5% and 2.3%, respectively. No treatment-related deaths occurred. RAM plus nab-PTX combination therapy demonstrated manageable toxicity even patients who were elderly or had an ECOG-PS 2. This treatment is useful in community hospital settings.No potential conflict of interest relevant to this article was reported.WileyActa Medica Okayama0021-95412021RFX1‐mediated CCN3 induction that may support chondrocyte survival under starved conditionsENTomomiMizukawaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesTakashiNishidaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesShoAkashiDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama JapanKazumiKawataDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama JapanSumireKikuchiDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama JapanHarumiKawakiDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama JapanMasaharuTakigawaAdvanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental SchoolHiroshiKamiokaDepartment of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesSatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCellular communication network factor (CCN) family members are multifunctional matricellular proteins that manipulate and integrate extracellular signals. In our previous studies investigating the role of CCN family members in cellular metabolism, we found three members that might be under the regulation of energy metabolism. In this study, we confirmed that CCN2 and CCN3 are the only members that are tightly regulated by glycolysis in human chondrocytic cells. Interestingly, CCN3 was induced under a variety of impaired glycolytic conditions. This CCN3 induction was also observed in two breast cancer cell lines with a distinct phenotype, suggesting a basic role of CCN3 in cellular metabolism. Reporter gene assays indicated a transcriptional regulation mediated by an enhancer in the proximal promoter region. As a result of analyses in silico, we specified regulatory factor binding to the X‐box 1 (RFX1) as a candidate that mediated the transcriptional activation by impaired glycolysis. Indeed, the inhibition of glycolysis induced the expression of RFX1, and RFX1 silencing nullified the CCN3 induction by impaired glycolysis. Subsequent experiments with an anti‐CCN3 antibody indicated that CCN3 supported the survival of chondrocytes under impaired glycolysis. Consistent with these findings in vitro, abundant CCN3 production by chondrocytes in the deep zones of developing epiphysial cartilage, which are located far away from the synovial fluid, was confirmed in vivo. Our present study uncovered that RFX1 is the mediator that enables CCN3 induction upon cellular starvation, which may eventually assist chondrocytes in retaining their viability, even when there is an energy supply shortage.No potential conflict of interest relevant to this article was reported.Springer Science and Business Media LLCActa Medica Okayama1873-96011512021Bipartite regulation of cellular communication network factor 2 and fibroblast growth factor 1 genes by fibroblast growth factor 1 through histone deacetylase 1 and fork head box protein A18191ENAbdellatifElseoudiDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakashiNishidaDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTomomiMizukawaDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityTakakoHattoriDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKazumiKawataDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityEman A.TahaDepartment of Dental Pharmacology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityMasaharuTakigawaAdvanced Research Center for Oral and Craniofacial Sciences, Dental School, Okayama UniversitySatoshiKubotaDepartment of Biochemistry and Molecular Dentistry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Fibroblast growth factor 1 (FGF-1) is the first FGF family member, and it induces proliferation of fibroblasts and other types of the cells. However, recent studies are uncovering unexpected functions of this molecule. Our previous study redefined this growth factor as a catabolic molecule produced in cartilage upon metabolic insult. Indeed, FGF-1 was found to repress the gene expression of cellular communication network factor 2 (CCN2), which protects and regenerates cartilage, amplifying its own production through positive feedback regulation. In the present study, we investigated the molecular mechanism of this bipartite CCN2 repression and FGF1 activation by FGF-1 in chondrocytes. Repression of CCN2 and induction of FGF1 in human chondrocytic cells were both partly abolished by valproic acid, an inhibitor of histone deacetylase 1 (HDAC1), indicating the involvement of chromatin remodeling by histone acetylation in this system. In contrast, RNA degradation analysis suggested no contribution of post-transcriptional regulation of the mRNA stability to the effects conferred by FGF-1. Suspecting a regulation by a specific transcription factor, we next sought a candidate in silico from a large dataset. As a result, we found fork head box protein A1 (FOXA1) as the transcription factor that bound to both CCN2 and FGF1 loci. Functional analysis demonstrated that FOXA1 silencing significantly attenuated the CCN2 repression and FGF1 induction caused by FGF1. These findings collectively indicate that the bipartite regulation by FGF-1 is enabled by the combination of chromatin remodeling by HDACs and transcriptional modulation by FOXA1 with unknown transcriptional coactivators of opposite functionalities.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama199179021612021A comparison of colorimetric and visual methods for the assessment of masticatory performance with color-changeable chewing gum in older persons380388ENYoshihiroKugimiyaDepartment of Removable Prosthodontics and Gerodontology, Tokyo Dental CollegeYutakaWatanabeGerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido UniversityMakiShirobeThe Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly CareYoshikoMotohashiResearch Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of GerontologyKeikoMotokawaResearch Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of GerontologyAyakoEdahiroResearch Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of GerontologyYukiOharaResearch Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of GerontologyMasahiroRyuDepartment of Removable Prosthodontics and Gerodontology, Tokyo Dental CollegeKentaroIgarashiRemovable Prosthodontics, Nihon University School of Dentistry at MatsudoDaichiHoshinoSpecial Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa UniversityJunkoNakajimaDepartment of Oral Medicine and Hospital Dentistry, Tokyo Dental CollegeTakayukiUedaDepartment of Removable Prosthodontics and Gerodontology, Tokyo Dental CollegeYuTaniguchiCenter for Health and Environmental Risk Research, National Institute for Environmental StudiesToruOgawaDivision of Advanced Prosthetic Dentistry, Tohoku University Graduate School of DentistryKenjiMaekawaDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesKatsushiTamakiDepartment of Critical Care Medicine and Dentistry, Division of Prosthodontic Dentistry for Function of TMJ and Occlusion, Graduate School of Dentistry, Kanagawa Dental UniversityTakuoKubokiDepartment of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesAkihikoKitamuraResearch Team for Social Participation and Health Promotion, Tokyo Metropolitan Institute of GerontologyShojiShinkaiSocial Sciences and Human Care, Tokyo Metropolitan Institute of GerontologyHirohikoHiranoResearch Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of GerontologyBackground/purpose<br/>
Color-changeable chewing gum is used for the evaluation of masticatory performance. However, it is currently unclear whether colorimetric and visual assessment methods yield consistent results. This study aimed to clarify the consistency between colorimetric and visual methods used for the evaluation of color changes in color-changeable chewing gum. <br/>Materials and methods<br/>
The sample comprised 644 older persons (mean age, 75.4 ± 6.4 years). The chewing gum was masticated 60 times at the participant's own chewing rate and then expectorated. The color of the chewing gum was evaluated with the ΔE values and a∗ values, measured using a colorimeter, and the 10 Color Shades (10CSh) and 5 Color Scales (5CSc), using visual evaluation. Spearman's correlation analysis was performed to examine the correlation between the results obtained by the four methods. The significance level was set at α = 0.05. <br/>Results<br/>
The ΔE values, a∗ values, 10CSh scores, and 5CSc scores were all significantly correlated. The highest correlation coefficient (0.979) was between the ΔE values and a∗ values. The lowest correlation coefficient (0.847) was between the a∗ values and 5CSc scores. Decreased masticatory performance was observed with increased age. <br/>
Conclusion<br/>
Significant correlations were found for all four methods used in the assessment of masticatory performance with color-changeable chewing gum. While visually based assessments are valid, colorimetric methods are more sensitive to smaller changes in masticatory performance.No potential conflict of interest relevant to this article was reported.ElsevierActa Medica Okayama26663643212021Japanese Lung Cancer Society Guidelines for Stage IV NSCLC With EGFR Mutations100107ENKiichiroNinomiyaDepartment of Hematology, Oncology, and Respiratory Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesShunsukeTeraokaInternal Medicine III, Wakayama Medical UniversityYoshitakaZenkeDepartment of Thoracic Oncology, National Cancer Center Hospital EastHirotsuguKenmotsuDivision of Thoracic Oncology, Shizuoka Cancer CenterYukikoNakamuraDepartment of Respiratory Medicine, Yokohama Municipal Citizen’s HospitalYusukeOkumaDepartment of Thoracic Oncology, National Cancer Center HospitalAkihiroTamiyaDepartment of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical CenterKanameNosakiDepartment of Thoracic Oncology, National Cancer Center Hospital EastMasahiroMoriseDepartment of Respiratory Medicine, Nagoya University Graduate School of MedicineKeijuAokageDepartment of Thoracic Surgery, National Cancer Center Hospital EastYukoOyaDepartment of Thoracic Oncology, Aichi Cancer Center HospitalToshiyukiKozukiDepartment of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer CenterTomohiroSakamotoDivision of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Tottori UniversityKentaroTanakaResearch Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu UniversityHisashiTanakaDepartment of Respiratory Medicine, Hirosaki University Graduate School of MedicineJunkoTanizakiDepartment of Medical Oncology, Kishiwada City HospitalSatoruMiuraDepartment of Internal Medicine, Niigata Cancer Center HospitalHideakiMizutaniDepartment of Thoracic Oncology, Saitama Cancer CenterEisakuMiyauchiDepartment of Respiratory Medicine, Tohoku University HospitalOuYamaguchiDepartment of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical CenterNoriyukiEbiDepartment of Respiratory Oncology, Iizuka HospitalYasushiGotoDepartment of Thoracic Oncology, National Cancer Center HospitalTakaakiSasakiRespiratory Center, Asahikawa Medical UniversityHarukoDagaDepartment of Medical Oncology, Osaka City General HospitalSatoshiMoritaDepartment of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto UniversityTakeharuYamanakaDepartment of Biostatistics, Yokohama City University School of MedicineShinsukeAmanoJapan Federation of Cancer Patient GroupsKazuoHasegawaJapan Lung Cancer AllianceChiyo K.ImamuraAdvanced Cancer Translational Research Institute, Showa UniversityKenichiSuzukiDivision of Applied Pharmaceutical Education and Research, Hoshi UniversityKazukoNakajimaDepartment of Nursing and The Division of Stem Cell Transplantation, Shizuoka Cancer CenterHitomiNishimotoDepartment of Nursing, Okayama University HospitalSatoshiOizumiDepartment of Respiratory Medicine, National Hospital Organization Hokkaido Cancer CenterToyoakiHidaDepartment of Thoracic Oncology, Aichi Cancer Center HospitalKatsuyukiHottaCenter for Clinical Oncology, Okayama University HospitalYuichiTakiguchiDepartment of Medical Oncology, Chiba University HospitalPatients with NSCLC in East Asia, including Japan, frequently contain EGFR mutations. In 2018, we published the latest full clinical practice guidelines on the basis of those provided by the Japanese Lung Cancer Society Guidelines Committee. The purpose of this study was to update those recommendations, especially for the treatment of metastatic or recurrent EGFR-mutated NSCLC. We conducted a literature search of systematic reviews of randomized controlled and nonrandomized trials published between 2018 and 2019 that multiple physicians had reviewed independently. On the basis of those studies and the advice from the Japanese Society of Lung Cancer Expert Panel, we developed updated guidelines according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We also evaluated the benefits of overall and progression-free survival, end points, toxicities, and patients’ reported outcomes. For patients with NSCLC harboring EGFR-activating mutations, the use of EGFR tyrosine kinase inhibitors (EGFR TKIs), especially osimertinib, had the best recommendation as to first-line treatment. We also recommended the combination of EGFR TKI with other agents (platinum-based chemotherapy or antiangiogenic agents); however, it can lead to toxicity. In the presence of EGFR uncommon mutations, except for an exon 20 insertion, we also recommended the EGFR TKI treatment. However, we could not provide recommendations for the treatment of EGFR mutations with immune checkpoint inhibitors, including monotherapy, and its combination with cytotoxic chemotherapy, because of the limited evidence present in the literature. The 2020 Japanese Lung Cancer Society Guidelines can help community-based physicians to determine the most appropriate treatments and adequately provide medical care to their patients.No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966552020コロナ禍における コミュニケーション力向上のための授業教材開発 —非認知能力間の関係性を切り口にして—296305ENYoshikazuNAKAYAMAKeiHAYASHIDA10.18926/61624コロナ禍によって大学のアクティブラーニング型授業は大きな方向転換を余儀なくされた。学生のコミュニケーション力を目指して開講していた岡山大学の教養科目の授業でも、従来の双方向型コミュニケーション実践を軸とした授業内容を大幅に改める必要に迫られた。そこで、コミュニケーション力を下支えするメタ認知力の育成を目的とした、日々の生活のリフレクションを通した考察を行うための教材を開発した。その後、教材を活用した授業を実践し、授業の前後、学生へのアンケート調査を行った結果、本教材を用いた授業を行ったことにより、学生のメタ認知力が向上したことが明らかになった。No potential conflict of interest relevant to this article was reported.岡山大学全学教育・ 学生支援機構Acta Medica Okayama2432-966552020Relationship between 21st. Century Skills and the IB Learner Profile249256EN10.18926/61620Japanese Universities are becoming a popular choice for International Baccalaureate (IB) students, including National Universities. Okayama University is a Super Global National University (SGU) in Western Japan, which started IB admissions in 2012, and presently hosts 70 IB students including 11 graduates, in 11 faculties and 1 special program. Through continuous follow up of enrolled IB students over a period of almost 9 years, Okayama University has discovered some special characteristics in IB students, which has been embedded in them through their IB education and made them a holistic, global citizen. As a Japanese National University, Okayama University is hopeful that the increasing presence of IB students, who have critical thinking skills, a unique process of learning and an abundance of communication skills, will bring in a new wave of students on campus, in classes and club activities, who can influence international mindedness and help to globalize the university from a local point of view. This report, is an attempt to find similarities between the IB Learner Profile, which lies at the heart of all IB student characteristics and the 21st. Century Skills, which are essential characteristics in developing youth in the age of the internet.No potential conflict of interest relevant to this article was reported.