Search

Soichiro Hozawa,1 Keita Ono,2 Naoyuki Makita,3 Hitomi Uchimura,3 Yoshifumi Arita,3 Takehiro Hirai,2 Naoki Tashiro3 1Hiroshima Allergy and Respiratory Clinic, Hiroshima, Japan; 2AstraZeneca K.K., Tokyo, Japan; 3AstraZeneca K.K., Osaka, JapanCorrespondence: Soichiro Hozawa, Hiroshima Allergy and Respiratory Clinic, 6F, 1-9-28 Hikari-machi, Higashi-ku, Hiroshima, 732-0052, Japan, Tel +81-82-568-1167, Fax +81-82-568-1239, Email hozawa@vesta.ocn.ne.jpPurpose: Japanese guidelines recommend that patients with uncontrolled asthma be referred by non-specialists to specialists (allergists and/or pulmonologists). This study investigated the reality of clinical practice in asthma patients referred to specialists in Japan.Patients and Methods: This was a retrospective, observational cohort study of asthma patients in a health insurance claim database (Cross Fact) referred from facilities with non-specialists to those with specialists from January 2016 to December 2018. The referred asthma patients were defined as patients with ≥ 4 inhaled corticosteroid (ICS)-containing prescriptions during a 1-year baseline period, with an asthma diagnosis, and who had visited a facility with specialists. Asthma exacerbation, maintenance treatment, laboratory tests, and medical procedures before and after referral were analyzed.Results: Data for 2135 patients were extracted, of which 420 with referral codes were analyzed. The proportion of patients with asthma exacerbations was 50.2% (95% confidence interval [CI]: 45.4– 55.1%) before referral and 37.4% (95% CI: 32.7– 42.2%) after, a significant decrease (P< 0.001; McNemar test). The proportions of patients prescribed ICS alone, long-acting beta-agonists (LABA), and ICS/LABA were lower after referral than before, but the proportions of patients prescribed long-acting muscarinic antagonists (LAMA), ICS/LABA/LAMA, and biologics increased after referral. More asthma-related laboratory tests were performed after referral, and spirometry incidence increased from 16.4% before referral to 51.4% after referral.Conclusion: This study shows a decrease in asthma exacerbations, change in asthma treatments, and increase in laboratory tests after referral to a specialist, suggesting that referrals to specialists lead to better management of asthma.Keywords: asthma, database, referral, specialist, symptom exacerbation

Ryuta Kinno,1 Kenjiro Ono2 1Division of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, Yokohama City, Kanagawa, 224-8503, Japan; 2Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, 142-8555, JapanCorrespondence: Ryuta KinnoDivision of Neurology, Department of Internal Medicine, Showa University Northern Yokohama Hospital, 35-1 Chigasakichuo, Tsuzuki-ku, Yokohama City, Kanagawa, 224-8503, JapanTel +81-45-949-7000Fax +81-45-949-7293Email kinno@med.showa-u.ac.jpAbstract: Symptoms of takotsubo syndrome (TTS) include acute and transient regional systolic dysfunction of the left ventricle, as well as a variety of wall-motion abnormalities. The clinical features of TTS, including initial symptoms, cardiac biomarkers, and electrocardiogram (ECG) changes, are similar to those of acute coronary syndrome, with the exception that TTS patients typically have no obstructive coronary artery disease. TTS primarily affects elderly women, and emotional or physical stress is a common cause of the disease. Exaggerated sympathetic stimulation associated with dysfunction of the limbic system has also been reported to be related to TTS occurrence. Cancer also induces emotional and physical stress. Therefore, optimization of TTS care should involve cardiac, neurological, psychiatric, and oncological approaches. The first step in optimizing TTS care is to diagnose it by cardiac means. Multimodality imaging, including ECG, echocardiogram, angiography, ventriculography, and cardiac magnetic resonance imaging, is indispensable for diagnosis, therapy management, and the evaluation of prognosis in the acute and chronic phases of TTS. The current cardiac approach during the acute phase is primarily supportive, with the goal of preventing life-threatening complications. As central nervous system diseases frequently trigger TTS, a neurological approach is also required. Appropriate psychiatric medication may reduce the risk of TTS recurrence, as not only psychiatric disorders themselves but also psychiatric medications can be the trigger for TTS. Several conditions are associated with TTS, including the novel coronavirus disease 2019. We present current knowledge of TTS in this review and describe how to optimize TTS care through a multidisciplinary approach.Keywords: cardiac approach, neurological approach, psychiatric approach, oncological approach, limbic system, exaggerated sympathetic stimulation

Takumi Yamaguchi,1,2 Akio Yamamoto,2,3 Yutaro Oki,2 Hideki Sakai,1 Shogo Misu,1,4 Yusuke Iwata,2 Masahiro Kaneko,5 Kaku Sawada,6 Yukari Oki,2 Yuji Mitani,2 Kumiko Ono,2 Akira Ishikawa2 1Department of Rehabilitation, Kobe City Hospital Organization, Kobe City Medical Center West Hospital, Kobe, Hyogo, 653-0013, Japan; 2Kobe University Graduate School of Health Sciences, Kobe, Hyogo, 654-0142, Japan; 3Department of Faculty of Nursing, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, 569-0095, Japan; 4Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, Kobe, Hyogo, 658-0001, Japan; 5Department of Respiratory Medicine, Kobe City Hospital Organization Kobe City Medical Center West Hospital, Kobe, Hyogo, 653-0013, Japan; 6Department of Internal Medicine, Keiwakai Nishioka hospital, Sapporo, Hokkaido, 062-0034, JapanCorrespondence: Takumi YamaguchiDepartment of Rehabilitation, Kobe City Hospital Organization, Kobe City Medical Center, West Hospital, 2-4, Ichibancho, Nagata-Ku, Kobe, 653-0013, Hyogo, JapanTel +81-78-576-5251Fax +81-78-576-5358Email taato8327@gmail.comPurpose: Japan has only a few respiratory disease-specific activity of daily living scales that are accepted outside of Japan, and they are not widely used. The Barthel Index dyspnea (BI-d), an improved version of the Barthel Index (BI), may be popular in Japan. The purpose of this study was to develop the Japanese version of BI-d (J-BI-d) and investigate its reliability and validity.Patients and Methods: The J-BI-d was developed using the basic guidelines for scale translation. The study included patients with chronic respiratory disease, receiving outpatient care at two centers between January 2019 and February 2020. Scores on the J-BI-d, modified Medical Research Council scale (mMRC scale), BI, respiratory function tests, and 6-minute walk distance (6MWD) test were measured. To verify the test–retest reliability, the J-BI-d was re-administered, and the intraclass correlation coefficient (ICC) was obtained. Internal consistency was verified by Cronbach’s alpha reliability coefficient, and criterion-related validity was verified through a correlation analysis of the J-BI-d with mMRC scale and 6MWD test. Divergent validity was verified through correlation analysis between the J-BI-d and BI.Results: Data for 57 participants (mean age 74.4 ± 8.3 years) were analyzed, and reliability testing was performed with 42 of them. The mean time to retest was 8.1 ± 3.0 days, and the ICC (2, 1) was 0.76 (95% CI: 0.62– 0.85), indicating high reliability. Cronbach’s alpha reliability coefficient was 0.81, indicating high internal consistency. Correlation coefficients of the J-BI-d with 6MWD test (r = − 0.46, p < 0.01) and mMRC scale (ρ = 0.76, p < 0.01) indicated high criterion-related validity. The J-BI-d and BI had a weak negative correlation (r = − 0.29, p < 0.05), indicating high divergent validity.Conclusion: The results of this study demonstrate high reliability and appropriate validity of the J-BI-d in patients with chronic respiratory disease.Keywords: activities of daily living, dyspnea, chronic obstructive pulmonary disease, interstitial lung disease, Japanese, reliability and validity

Toshida H, Funaki T, Ono K, et al. Drug Des Devel Ther. 2017;11:1871– 1879 The authors have advised there are some mistakes in the mean changes and standard errors of the paper: 1. The standard errors of groups Placebo and VApal were all the same value for staining and symptom scores in Figure 1 (on page 1875) and Figure 3 (on page 1876), and Table 3 (on page 1877). 2. There were slight discrepancies in the Mean changes of Placebo group at 1, 2 and 4 weeks in Figure 3D. 3. There was a slight discrepancy in the Mean change of foreign body sensation in Placebo group at 1 week in Table 3. The authors have advised the errors were due to: 1. The standard error listed in a different table on the statistical analysis software was adopted. 2. There were typing errors when transferring numerical values from statistical analysis software to graph creation software. 3. There was a mistake when rounding numerical value. Since the statistical analysis had been performed using the original mean values (correct values), all results do not change. The authors apologize for these errors and advise they do not affect the results of the paper. Read the original article

Taito Hayashida,1,2 Akiyoshi Shimura,2 Motoki Higashiyama,2 Yota Fujimura,1 Kotaro Ono,2 Takeshi Inoue2 1Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Hachioji-shi, Tokyo, 193-0998, Japan; 2Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo,160-0023, JapanCorrespondence: Akiyoshi ShimuraDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, JapanTel +81-3-3342-6111Fax +81-3-3340-4499Email sim@tokyo-med.ac.jpBackground: Presenteeism is the loss of work productivity of workers owing to physical and mental problems, and its socioeconomic effects are greater than those of absenteeism. Presenteeism is caused by psychological and physical dysfunctions. On the other hand, the regularity of mealtimes is an important factor associated with physical and mental health conditions. We hence assessed the association among the irregularity of mealtimes, presenteeism, psychological and physical stress responses, and sleep disturbance in office workers in companies.Methods: From May to December 2017, the data of 2905 participants who had given their consent to use their information for academic purposes, and answered a questionnaire about the survey and their lifestyle were collected. Path analysis was performed to analyze the association between the irregularity of mealtimes, psychosomatic symptoms (Brief Job Stress Questionnaire), sleep disturbance (Pittsburgh Sleep Questionnaire), and presenteeism (Work Limitations Questionnaire).Results: The direct effect of the irregularity of mealtimes on presenteeism was significant but weak. However, the irregularity of mealtimes had a strong effect on presenteeism indirectly through psychological and physical stress responses and sleep disturbance.Conclusion: Psychological and physical stress responses and sleep disturbance were identified as mediating factors of the effects of irregularity of mealtimes on presenteeism.Keywords: presenteeism, Work Limitations Questionnaire, WLQ, mealtimes, sleep disturbance, stress reaction, mediating effect

Tomoteru Seki,1,2 Akiyoshi Shimura,1 Hitoshi Miyama,1 Wataru Furuichi,1 Kotaro Ono,1 Jiro Masuya,1 Yuko Odagiri,3 Shigeru Inoue,3 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Shinjuku-ku, Tokyo 160-0023, Japan; 2Fuji Psychosomatic Rehabilitation Institute Hospital, Fujinomiya, Shizuoka 418-0035, Japan; 3Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjuku-ku, Tokyo 160-8402, JapanCorrespondence: Akiyoshi ShimuraDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel +81-3-3342-6111Fax +81-3-3340-4499Email sim@tokyo-med.ac.jpBackground: The complex interaction between parenting styles, job stressors, and the stress response has not been clarified to date. We hypothesized that neuroticism acts as a mediator in the effects of parenting quality on perceived job stressors and the psychological and physical stress response (PPSR), and tested this hypothesis using covariance structure analysis.Subjects and Methods: We conducted research between April 2017 and April 2018 on 597 adult from the community, and 69 subjects were excluded owing to missing data or nonworkers. Finally, a total of 528 participants were analyzed using the following self-administered questionnaires: the Parental Bonding Instrument, the shortened Eysenck Personality Questionnaire-Revised, and the Brief Job Stress Questionnaire (BJSQ). The data were analyzed by single regression analyses and covariance structure analyses. Job stress was assessed by the BJSQ and 2 subscales, ie, perceived job stressors and the PPSR. This study was approved by the Ethics Committee of Tokyo Medical University.Results: On covariance structure analysis, high parental overprotection was associated with high neuroticism and high PPSR directly, but had no significant effect on perceived job stressors. High parental overprotection was associated with high-perceived job stressors and the high PPSR indirectly through enhanced neuroticism. High parental overprotection was also associated with the high PPSR indirectly through 2 combined paths of neuroticism and perceived job stressors. This model accounted for 40% of the variability of the PPSR. On the other hand, parental care had opposite effects to parental overprotection, and this model of parental care accounted for 39% of the variability of PPSR. The model fits of the 2 models were good.Conclusion: Our results suggest that the quality of parenting in childhood is associated with perceived job stressors and the PPSR indirectly through neuroticism.Keywords: parental care, parental overprotection, neuroticism, job stress, covariance structure analysis, structural equation model

Hitoshi Miyama,1,2 Akiyoshi Shimura,1 Wataru Furuichi,1 Tomoteru Seki,1 Kotaro Ono,1 Jiro Masuya,1 Yuko Odagiri,3 Shigeru Inoue,3 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 2Department of Psychiatry, Maruyamasou Hospital, Ishioka, Ibaraki 315-0116, Japan; 3Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo 160-8402, JapanCorrespondence: Akiyoshi ShimuraDepartment of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-Ku, Tokyo 160-0023, JapanTel +81-3-3342-6111Fax +81-3-3340-4499Email sim@tokyo-med.ac.jpBackground: Chronotype, which is a person’s circadian characteristics throughout a day, greatly influences a person’s lifestyle, health, and sleep pattern; however, the association between job stress and chronotype remains unknown to date. Therefore, in this study, we analyzed the effects of chronotype on the job stress response, and the mediating effects of sleep disturbance using path analysis.Methods: A cross-sectional survey was conducted on 535 adult volunteers (239 men and 296 women; average age, 41.2 ± 11.9 years) from the community. Participants were evaluated using the Diurnal Type Scale for chronotype, Pittsburg Sleep Quality Index for sleep disturbance, Brief Job Stress Questionnaire for job stressors, and the psychological and physical stress response (PPSR). To investigate the association between chronotype, sleep disturbance, perceived job stressors, and PPSR, a covariance structure analysis was performed.Results: The eveningness chronotype had a significant weak direct effect on sleep disturbance, perceived job stressors, and PPSR, and had a significant indirect effect through sleep disturbance. The perceived job stressors indirectly increased PPSR through sleep disturbance. Sleep disturbance mediated the effects of the eveningness chronotype and perceived job stressors on PPSR. This model accounted for 37.3% of the variability in PPSR of adult workers.Conclusion: Chronotype affected PPSR through sleep disturbance. Therefore, improving the sleep disturbance of workers with the eveningness chronotype may reduce their stress response.Keywords: eveningness chronotype, sleep disturbance, job stress, Diurnal Type Scale

Wataru Furuichi,1,2 Akiyoshi Shimura,1 Hitoshi Miyama,1 Terutomo Seki,1 Kotaro Ono,1 Jiro Masuya,1 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan; 2Department of Psychiatry, Seiwakai Nakayama Hospital, Ichikawa, Chiba, 272-0813, JapanCorrespondence: Akiyoshi Shimura Tel +81-3-3342-6111Fax +81-3-3340-4499Email sim@tokyo-med.ac.jpBackground: Occupational mental health, work environment, sleep health, presenteeism, and loss of work productivity caused by health problems are all public health concerns. Although sleep affects mental health and presenteeism, the associations between sleep disturbance, job stressors, stress responses, and presenteeism have remained unclear. We hypothesized that job stressors affect the presenteeism of office workers through sleep disturbance and analyzed the association among these factors.Subjects and Methods: In 2017, a cross-sectional survey of adult office workers was performed. A total of 2899 subjects who provided written consent were included in the analysis. The survey collected demographic information, as well as the Work Limitation Questionnaire (WLQ), Pittsburgh Sleep Quality Index (PSQI), and Brief Job Stress Questionnaire (BJSQ). Associations between each of the variables were analyzed by path analysis (covariance structure analysis). This study was approved by the Ethics Committee of Tokyo Medical University.Results: The path analysis demonstrated that job stressors, psychological and physical stress response (PPSR) in the BJSQ, and sleep disturbance in the PSQI had direct effects on presenteeism in the WLQ. Both job stressors and social support in the BJSQ indirectly affected presenteeism through effects on sleep disturbance and PPSR. Sleep disturbance indirectly affected presenteeism via PPSR. This model accounted for the variation of presenteeism (R2 = 0.322).Conclusion: In the workplace, job stressors and low social support increase presenteeism through psychological and physical stress responses, as well as sleep disturbance. Evaluating and resolving work problems and sleep disturbance would hence be beneficial from the aspects of public health and socioeconomics.Keywords: job stress, occupational stress, sleep disturbance, presenteeism, work limitation questionnaire, WLQ

Azusa Shiromaru-Sugimoto,1 Hidetomo Murakami,1 Akinori Futamura,1 Motoyasu Honma,2 Takeshi Kuroda,1 Mitsuru Kawamura,1,3 Kenjiro Ono1 1Division of Neurology, Department of Internal Medicine, Showa University School of Medicine, Tokyo 142-8666, Japan; 2Department of Physiology, Kyorin University School of Medicine, Tokyo 181-0004, Japan; 3Neurology, Okusawa Hospital and Clinics, Tokyo 158-0083, Japan Background: The relationship between dementia and time perception impairment is unknown. Aim: This study aims to explore subjective perception of the passage of time in patients with Alzheimer’s disease (AD). Methods: We conducted semi-structured interviews with 11 AD patients. Grounded theory, a qualitative research methodology, was used for data analysis. Results: Based on interview transcripts, five categories were designated: {Live according to a private clock}, {The past comes up}, {Move back and forth between the present and the past}, {Cannot imagine the future}, and {Bid farewell to this world as early as tomorrow}. Discussion: Our results suggest that AD patients alternate past and present without complete awareness and cannot imagine a future other than one ending in death. Keywords: dementia, grounded theory, neuropsychology, qualitative study, mind time, interview

Hidetomo Murakami, Tetsuhito Nohara, Hidenobu Shozawa, Yoshiyuki Owan, Takeshi Kuroda, Satoshi Yano, Machiko Kezuka, Mitsuru Kawamura, Kenjiro Ono Department of Neurology, School of Medicine, Showa University, Tokyo, Japan Background: Effects of dopaminergic medication on executive function in patients with Parkinson’s disease (PD) are inconsistent. Objective: We examined the effect of dopaminergic medication on executive function in 24 drug-naïve PD patients (de novo group) and in 21 PD patients on chronic dopaminergic medication (chronic medication group). Methods: PD patients without dementia were included in this study. For the de novo group patients, dopaminergic medication was initiated, and the dose was increased to improve motor symptoms. For the chronic medication group patients, dopaminergic medication was adjusted to relieve clinical problems. All participants were tested prior to and at 4–7 months after the drug initiation/adjustment. Executive function was assessed by using the Behavioral Assessment of the Dysexecutive Syndrome (BADS). Motor function was assessed by using the Unified Parkinson’s Disease Rating Scale (UPDRS; part III). Improvement in executive function was compared with a simultaneous change in levodopa equivalent doses (LED) of dopaminergic medication and with improvement in motor functions. Results: The mean standardized BADS scores showed no significant improvement in both the groups. In the de novo group, percent improvement in the standardized BADS scores showed a significant positive correlation with the LED, but not with percent improvement in UPDRS part III. In the chronic medication group, percent improvement in the standardized BADS scores was negatively correlated with change in the LED, but not with percent improvement in UPDRS part III. Multiple regression analysis using improvement in the standardized BADS score as a dependent variable and patient’s background factors (ie, age, education, disease duration, and motor and executive assessments at baseline) as independent variable showed that improvement in the executive assessment is significantly correlated with the LED only in the de novo group. Conclusion: Effects of dopaminergic drug adjustment on executive function differ according to the patient’s clinical stage and depend on LED in de novo stage. Keywords: motor disorders, dopaminergic drug, levodopa equivalent dose, correlation between executive improvement and levodopa equivalent dose, inverted U-shaped theory

Hiroshi Toshida,1 Toshinari Funaki,2 Koichi Ono,3 Nobuhito Tabuchi,4 Sota Watanabe,4 Tamotsu Seki,5 Hiroshi Otake,6 Takuji Kato,7 Nobuyuki Ebihara,8 Akira Murakami2 1Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka, 2Department of Ophthalmology, Juntendo University Graduate School of Medicine, 3Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, 4Pharmaceutical Research Laboratories, Lion Corporation, Kanagawa, 5Tamagawa Eye Clinic, Tokyo, 6Otake Eye Clinic, Kanagawa, 7Kato Eye Clinic, Tokyo, 8Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Japan Purpose: The purpose of this study was to investigate the efficacy and safety of the administration of retinol palmitate (VApal) ophthalmic solution (500 IU/mL) for the treatment of patients with dry eye. Patients and methods: This study included 66 patients with dry eye. After a 2-week washout period, patients were randomized (1:1) into either a VApal ophthalmic solution or a placebo group, and a single drop of either solution was administered six times daily for 4 weeks. Efficacy measures were 12 subjective symptoms, rose bengal (RB) and fluorescein staining scores, tear film breakup time, and tear secretion. Safety measures included clinical blood and urine analyses and adverse event recordings. Results: In comparisons of the two groups, the mean change in RB staining score from baseline was significantly lower in the VApal group at 2 and 4 weeks (P

Kotaro Ono,1 Yoshikazu Takaesu,1 Yukiei Nakai,2 Akiyoshi Shimura,1 Yasuyuki Ono,1 Akiko Murakoshi,1 Yasunori Matsumoto,1 Hajime Tanabe,3 Ichiro Kusumi,2 Takeshi Inoue1 1Department of Psychiatry, Tokyo Medical University, Tokyo, 2Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, 3Department of Clinical Human Sciences, Graduate school of Humanities and Social Sciences, Shizuoka University, Shizuoka, Japan Background: Recent studies have suggested that the interactions among several factors affect the onset, progression, and prognosis of major depressive disorder. This study investigated how childhood abuse, neuroticism, and adult stressful life events interact with one another and affect depressive symptoms in the general adult population. Subjects and methods: A total of 413 participants from the nonclinical general adult population completed the Patient Health Questionnaire-9, the Child Abuse and Trauma Scale, the neuroticism subscale of the shortened Eysenck Personality Questionnaire – Revised, and the Life Experiences Survey, which are self-report scales. Structural equation modeling (Mplus version 7.3) and single and multiple regressions were used to analyze the data. Results: Childhood abuse, neuroticism, and negative evaluation of life events increased the severity of the depressive symptoms directly. Childhood abuse also indirectly increased the negative appraisal of life events and the severity of the depressive symptoms through enhanced neuroticism in the structural equation modeling. Limitations: There was recall bias in this study. The causal relationship was not clear because this study was conducted using a cross-sectional design. Conclusion: This study suggested that neuroticism is the mediating factor for the two effects of childhood abuse on adulthood depressive symptoms and negative evaluation of life events. Childhood abuse directly and indirectly predicted the severity of depressive symptoms. Keywords: childhood abuse, depression, neuroticism, stressful life events, structural equation modeling

Yukika Takita,1 Yoshikazu Takaesu,1 Kotaro Ono,1 Kunihiro Futenma,1 Akiyoshi Shimura,1 Akiko Murakoshi,1 Yoko Komada,2 Yuichi Inoue,1,2 Takeshi Inoue1 1Department of Psychiatry, 2Department of Somnology, Tokyo Medical University, Tokyo, Japan Background: High-dose use of benzodiazepines (BZPs) reportedly causes adverse effects on cognitive function and quality of life in patients with schizophrenia. However, effects of BZPs on the clinical course of schizophrenia have not been clarified. This study was set out to investigate the association between BZPs and rehospitalization of patients with schizophrenia.Methods: In this retrospective study, patients with schizophrenia who were discharged from Tokyo Medical University Hospital between January 2009 and February 2012 were eligible as subjects. One hundred and eight patients who continued treatment for >2 years after hospital discharge were included in this study. Clinical characteristics, doses of prescribed medication such as BZPs and antipsychotics, and Global Assessment of Functioning scores at discharge were investigated. The primary outcome was rehospitalization of patients for any reason.Results: In a total of 108 subjects with schizophrenia, 44 subjects (40.7%) experienced rehospitalization during the 2-year study period. A multivariate analysis by the Cox proportional hazards model revealed that low educational history (hazard ratio =2.43, P=0.032), younger onset age of schizophrenia (hazard ratio =2.10, P=0.021), and higher diazepam-equivalent dose (hazard ratio =6.53, P=0.011) were significantly associated with the time to rehospitalization after hospital discharge.Conclusion: The results of this study suggest that high-dose use of BZPs at discharge in patients with schizophrenia might be associated with a shorter time to rehospitalization. Keywords: schizophrenia, rehospitalization, risk factor, high-dose benzodiazepine, Cox proportional hazards model

Tadashi Nakano,1 Motoko Kawashima,2 Yoshimune Hiratsuka,3 Hiroshi Tamura,4,5 Koichi Ono,6 Akira Murakami,3 Kazuo Tsubota,2 Masakazu Yamada7,8 1Department of Ophthalmology, Jikei University School of Medicine, 2Department of Ophthalmology, Keio University School of Medicine, 3Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, 4Department of Ophthalmology & Visual Sciences, Kyoto University, 5Division of Medical Information Technology & Administration Planning, Kyoto University Hospital, Kyoto, 6Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center, 7National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 8Department of Ophthalmology, Kyorin University, Tokyo, Japan Background: The purpose of the present study was to assess the vision-related quality of life (QOL) of visually impaired patients using the Japanese 11-item National Eye Institute Visual Function Questionnaire (VFQ-J11). Comparisons with the 25-item version (VFQ-25) and the EuroQoL Index using a large group of patients with various degrees of impairments and various causative diseases were performed.Methods: A total of 232 visually impaired Japanese patients were recruited from six ophthalmology departments in Japan. Information on ophthalmic findings and patient backgrounds was collected, and information on QOL and utility assessments was collected from the patients by means of survey questionnaires.Results: The average age of patients was 69.6±14.3 years. Both the vision-related QOL scores (VFQ-25 composite and VFQ-J11) were significantly associated with better and worse visual acuity (VA) in visually impaired subjects (all P

Red snapper (Lutjanus spp.) is one of the important commodity of demersal fish at the northern waters of Cirebon, Java Sea. The high degree of traditional fishing operations around the coastal area is expected to affect the availability of the fish stock. The Research results showed that there have been over fishing, it is caused by the large number of traditional fishing vessels at the coastal area, especially the persistence of the fishermen who use unfriendly fishing gear such as mini trawl. And then the red snapper which caught generally is young and never spawn or not yet mature. To solve that problem, it must arrange the amount of fishing vessels which can be operated at coastal area and it must law enforcement, and then to utilize the red snapper resources it advised to use the hook size larger than No. 10 and then install the rumpon at the new fishing ground which wider and farther. So the pressure to fishing ground of snapper can be reduced.

Chonlatip Pipattanaboon,1,3,8,* Tadahiro Sasaki,2,8,* Mitsuhiro Nishimura,2,8 Chayanee Setthapramote,1,8 Pannamthip Pitaksajjakul,1,4,8 Pornsawan Leaungwutiwong,1,3,8 Kriengsak Limkittikul,5,8 Orapim Puiprom,6 Mikiko Sasayama,6 Panjaporn Chaichana,6 Tamaki Okabayashi,6 Takeshi Kurosu,2,8 Ken-ichiro Ono,7,8 Pongrama Ramasoota,1,4,8 Kazuyoshi Ikuta2,8 1Center of Excellence for Antibody Research, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; 2Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan; 3Department of Microbiology and Immunology, 4Department of Social and Environmental Medicine, 5Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, 6Mahidol-Osaka Center for Infectious Diseases, Bangkok, Thailand; 7Medical and Biological Laboratories Corporation Ltd, Nagano, Japan; 8JST/JICA, Science and Technology Research Partnership for Sustainable Development, Tokyo, Japan *These authors made an equal contribution to this study Background: Hybridomas that produce human monoclonal antibodies (HuMAbs) against Dengue virus (DV) had been prepared previously using peripheral blood lymphocytes from patients with DV during the acute and convalescent phases of a secondary infection. Anti-DV envelope glycoprotein (E) 99 clones, anti-DV premembrane protein (prM) 8 clones, and anti-DV nonstructural protein 1 (NS1) 4 clones were derived from four acute-phase patients, and anti-DV E 2 clones, anti-DV prM 2 clones, and anti-DV NS1 8 clones were derived from five convalescent-phase patients. Methods and results: In the present study, we examined whether these clones cross-reacted with Japanese encephalitis virus (JEV), which belongs to the same virus family. Forty-six of the above-described 99 (46/99) anti-E, 0/8 anti-prM, and 2/4 anti-NS1 HuMAbs from acute-phase, and 0/2 anti-E, 0/2 anti-prM, and 5/8 anti-NS1 HuMAbs from convalescent-phase showed neutralizing activity against JEV. Thus, most of the anti-E and anti-NS1 (but not the anti-prM) antibodies cross-reacted with JEV and neutralized this virus. Interestingly, 3/46 anti-E HuMAbs derived from acute-phase patients and 3/5 anti-NS1 HuMAbs from convalescent-phase patients showed particularly high neutralizing activity against JEV. Consequently, the HuMAbs showing neutralization against JEV mostly consisted of two populations: one was HuMAbs recognizing DV E and showing neutralization activity against all four DV serotypes (complex-type) and the other was HuMAbs recognizing DV NS1 and showing subcomplex-type cross-reaction with DV. Conclusion: Anti-DV E from acute phase (46/99) and anti-DV NS1 (7/12) indicate neutralizing activity against JEV. In particular, three of 46 anti-DV E clones from acute phase and three of five anti-NS1 clones from convalescent phase showed strong neutralizing activity against JEV. Keywords: Dengue virus, Japanese encephalitis virus, viral neutralization, human monoclonal antibody, envelope, nonstructural protein 1

Methane (CH4) emissions from natural landscapes constitute roughly half of global CH4 contributions to the atmosphere, yet large uncertainties remain in the absolute magnitude and the seasonality of emission quantities and drivers. Eddy covariance (EC) measurements of CH4 flux are ideal for constraining ecosystem-scale CH4 emissions due to quasi-continuous and high-temporal-resolution CH4 flux measurements, coincident carbon dioxide, water, and energy flux measurements, lack of ecosystem disturbance, and increased availability of datasets over the last decade. Here, we (1) describe the newly published dataset, FLUXNET-CH4 Version 1.0, the first open-source global dataset of CH4 EC measurements (available at https://fluxnet.org/data/fluxnet-ch4-community-product/, last access: 7 April 2021). FLUXNET-CH4 includes half-hourly and daily gap-filled and non-gap-filled aggregated CH4 fluxes and meteorological data from 79 sites globally: 42 freshwater wetlands, 6 brackish and saline wetlands, 7 formerly drained ecosystems, 7 rice paddy sites, 2 lakes, and 15 uplands. Then, we (2) evaluate FLUXNET-CH4 representativeness for freshwater wetland coverage globally because the majority of sites in FLUXNET-CH4 Version 1.0 are freshwater wetlands which are a substantial source of total atmospheric CH4 emissions; and (3) we provide the first global estimates of the seasonal variability and seasonality predictors of freshwater wetland CH4 fluxes. Our representativeness analysis suggests that the freshwater wetland sites in the dataset cover global wetland bioclimatic attributes (encompassing energy, moisture, and vegetation-related parameters) in arctic, boreal, and temperate regions but only sparsely cover humid tropical regions. Seasonality metrics of wetland CH4 emissions vary considerably across latitudinal bands. In freshwater wetlands (except those between 20g g€¯S to 20g g€¯N) the spring onset of elevated CH4 emissions starts 3g€¯d earlier, and the CH4 emission season lasts 4g€¯d longer, for each degree Celsius increase in mean annual air temperature. On average, the spring onset of increasing CH4 emissions lags behind soil warming by 1 month, with very few sites experiencing increased CH4 emissions prior to the onset of soil warming. In contrast, roughly half of these sites experience the spring onset of rising CH4 emissions prior to the spring increase in gross primary productivity (GPP). The timing of peak summer CH4 emissions does not correlate with the timing for either peak summer temperature or peak GPP. Our results provide seasonality parameters for CH4 modeling and highlight seasonality metrics that cannot be predicted by temperature or GPP (i.e., seasonality of CH4 peak). FLUXNET-CH4 is a powerful new resource for diagnosing and understanding the role of terrestrial ecosystems and climate drivers in the global CH4 cycle, and future additions of sites in tropical ecosystems and site years of data collection will provide added value to this database. All seasonality parameters are available at 10.5281/zenodo.4672601 (Delwiche et al., 2021). Additionally, raw FLUXNET-CH4 data used to extract seasonality parameters can be downloaded from https://fluxnet.org/data/fluxnet-ch4-community-product/ (last access: 7 April 2021), and a complete list of the 79 individual site data DOIs is provided in Table 2 of this paper.

We study the prospect of determining the decay properties of the gluino in the supersymmetric (SUSY) standard model at a 100 TeV future hadron collider. We consider the case where the neutral Wino is the lightest superparticle. In this case, the long-lived charged Wino can be used to eliminate standard model backgrounds, which enables us to study the details of superparticles. We show that, based on the analysis of the numbers of high pT leptons, boosted W-jets, and b-tagged jets, we may determine the gaugino species and the quark flavors in the gluino decay. With such determinations, we can obtain information about the mass spectrum of squarks even if squarks are out of the kinematical reach.

We report on a new design approach for X-Y symmetric resonator, emphasizing the increase in symmetry by localization of the device anchors. The resonator is mechanized as a z-axis rate gyroscope (RG), and the concept is compatible with the rate-integrating gyroscope mechanization. Our approach is based on strategically placing the critical mechanical elements at the center of the resonator structure, to mitigate the effect of fabrication imperfections across the device. We experimentally demonstrated that the design yields a sub-Hz frequency separation between operational modes, which is attributed to the introduced design approach. The high symmetry of the device led to a temperature stability of 50 mHz over 130 °C temperature range. A ring down test demonstrated the Q-factor greater than 330 K. The thermal stability and preliminary characterization results of the gyro in-run stability are presented.