A STUDY ON FUNCTION OF PROFESSIONAL COORDINATOR FOR REVITALIZATION OF COMMUNITY USING THE METHOD OF PROFILES OF PRACTITIONERS

協働のまちづくりの実践においては，多様なステークホルダーの利害を調整する調整役による調整機能が重要な鍵となっている．しかし，その実態は見えにくく，知見として整理されていない．本研究は，「実践のプロファイリング手法」を用い，立場や専門の異なる5名のプロファイルから，調整役機能を明らかにすることを目的としている．既存研究から調整役機能としての要素を抽出，整理し，立場も異なる5名のプロジェクト実践者のプロファイルから抽出した行動をあてはめ，整理することで，立場を超えた共通の調整役機能や立場による相違を分析した．その結果，すべての対象者が共通の活動目的に対し行動を起こしていたが，その行動の手法が異なることがわかった．すなわち，調整役機能にとって基礎的な要求事項が明らかになったと言える．The collaboration between residents, local government and professionals is said to be an important issue for revitalization of community. Although, it is inevitable for the projects of revitalization of community to adopt a collaborative approach with getting local government and coordination experts' support, confusions in partnership sometimes occur due to the lack of continuous or effective professional coordination. The aim of this study is to clarify rolls of professional coordinator in forming collaborative activity using a method of profile of practitioners proposed by John Forester, by analyzing profiles of five practitioners whose position of collaboration or professional expertise are different. As a result, All practitioners had the some actions for the objectives of collaborative approach listed by the authors, but there action for each is not the same style and depends on their role

Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD

A Wide Symbiotic Channel to Type Ia Supernovae

As a promising channel to Type Ia supernovae (SNe Ia), we have proposed a symbiotic binary system consisting of a white dwarf (WD) and a low mass red-giant (RG), where strong winds from the accreting WD play a key role to increase the WD mass to the Chandrasekhar mass limit. Here we propose two new evolutionary processes which make the symbiotic channel to SNe Ia much wider. (1) We first show that the WD + RG close binary can form from a wide binary even with such a large initial separation as $a_i \lesssim 40000 R_\odot$. Such a binary consists of an AGB star and a low mass main-sequence (MS) star, where the AGB star is undergoing superwind before becoming a WD. If the superwind at the end of AGB evolution is as fast as or slower than the orbital velocity, the wind outflowing from the system takes away the orbital angular momentum effectively. As a result the wide binary shrinks greatly to become a close binary. Therefore, the WD + RG binary can form from much wider binaries than our earlier estimate. (2) When the RG fills its inner critical Roche lobe, the WD undergoes rapid mass accretion and blows a strong optically thick wind. Our earlier analysis has shown that the mass transfer is stabilized by this wind only when the mass ratio of RG/WD is smaller than 1.15. Our new finding is that the WD wind can strip mass from the RG envelope, which could be efficient enough to stabilize the mass transfer even if the RG/WD mass ratio exceeds 1.15. With the above two new effects (1) and (2), the symbiotic channel can account for the inferred rate of SNe Ia in our Galaxy.Comment: 29 pages including 14 firgures, to be published in ApJ, 521, No.

Retraction: NF-κB activation by Helicobacter pylori requires Akt-mediated phosphorylation of p65

Article retracte

Umbilical Cord Blood as an Alternative Source of Reduced-Intensity Hematopoietic Stem Cell Transplantation for Chronic Epstein-Barr Virus–Associated T or Natural Killer Cell Lymphoproliferative Diseases

AbstractChronic Epstein-Barr virus–associated T/natural killer cell lymphoproliferative diseases represented by chronic active Epstein-Barr virus infection are lethal but are curable with several courses of chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Recently, we reported that reduced-intensity conditioning (RIC) provided better outcomes than myeloablative conditioning because RIC was less toxic. However, it was unclear whether cord blood transplantation (CBT) works in the context of RIC. We retrospectively analyzed 17 patients who underwent RIC followed by bone marrow transplantation (RIC-BMT) and 15 patients who underwent RIC followed by CBT (RIC-CBT). The representative regimen was fludarabine and melphalan based. The overall survival rates with RIC-BMT and RIC-CBT were 92.9% ± 6.9% and 93.3% ± 6.4%, respectively (P = .87). One patient died of lung graft-versus-host disease after RIC-BMT, and 1 patient died of multiple viral infections after RIC-CBT. Although cytotoxic chemotherapy was also immunosuppressive and might contribute to better donor cell engraftment after RIC-HSCT, the rate of engraftment failure after RIC-CBT was still higher than that after RIC-BMT (not significant); however, patients who had experienced graft failure were successfully rescued with a second HSCT. Unrelated cord blood can be an alternative source for RIC-HSCT if a patient has no family donor

CLE for visceral pleural invasion

Background: Visceral pleural invasion (VPI) in lung cancer is a significant prognostic factor; however, it is difficult to diagnose preoperatively or intraoperatively. In this study, we examined the possibility of intraoperative diagnosis of VPI using confocal laser endomicroscopy (CLE). Methods: Among patients with primary lung cancer who underwent surgery between April 2018 and August 2019, those in whom the tumor was in contact with the pleura on chest computed tomography and whose pleural changes were intraoperatively confirmed were enrolled in this study. In the 35 patients who underwent lung resection (6 cases with visceral pleural infiltration), the area where pleural change was noted was observed and a short video was recorded using CLE. Based on the video images, three evaluators determined the defect ratio (0%, 25%, 50%, 75%, and 100%) of the autofluorescence-positive structure. The area under the receiver operating characteristic curve was used to evaluate the diagnostic performance for VPI. In 15 cases (3 cases with VPI), a validation study was performed for intraoperative VPI according to the cutoff value of the defect ratio of the autofluorescence-positive structure. Results: The areas under the receiver operating characteristic curve for the defect ratio of the autofluorescence-positive structure were 0.86–0.91 for the three readers. Using defect ratio of autofluorescence-positive structure cutoff of ≥50% as predictor of VPI, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 83.3–100.0%, 57.7–73.1%, 35.3–41.7%, 95.0–100.0%, and 75.0–78.1%, respectively, for the three readers. In the validation study, the sensitivity was 100%, the specificity was 83.3%, and the diagnostic accuracy rate was 86.7%. Conclusions: The diagnosis of VPI through CLE is simple, non-invasive, and has high diagnostic accuracy rates. This method may be applicable for determining surgical procedures

High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study

The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤-6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample

A novel role of serum cytochrome c as a tumor marker in patients with operable cancer.

PURPOSE: This study aimed to evaluate serum cytochrome c (cyto-c) levels as a novel role of tumor marker in patients with operable malignant tumors. METHODS: Serum cyto-c levels and lactate dehydrogenase (LD) activity were measured in a total of 257 cases (232 malignant and 25 benign). To identify the relationship between serum cyto-c and current tumor markers, six variables, such as gender, age, invasion, lymph node metastasis, distant metastasis, and LD, were analyzed by uni- and multivariate regression analysis methods. The test performance of serum cyto-c for the prediction of malignant behavior was evaluated by receiver operating characteristic (ROC) curves. RESULTS: The serum cyto-c level was significantly higher in patients with malignant tumors than patients with benign tumors (20.6 vs. 15.5 ng/mL; P = 0.017, Mann-Whitney U test). No difference in the levels among subtypes of cancer was found, indicating that the change in serum cyto-c levels reflect cancer individually and not specific subtypes of cancer. The survival in patients with serum cyto-c levels over 40 ng/mL was poor (Kaplan-Meier test, P < 0.0001, Hazard ratio 16.76, 95% confidential interval 4.45-63.04). Multiple linear regression analyses disclosed the close association of serum cyto-c levels with invasion (P = 0.0004), metastasis (P = 0.0262) except for regional lymph node metastasis, and activity of serum LD (P < 0.0001), all of which are well known to represent malignant behavior. Conversely, the measurement of serum cyto-c was verified to have excellent diagnostic accuracy of 0.802 and 0.781 for the detection of invasion and metastasis (the area under curves of the constructed ROCs). CONCLUSION: Serum cyto-c is a potent tumor marker as a predictor for malignant potential in cancers

Relationship between nerve fiber layer defect and the presence of epiretinal membrane in a Japanese population: The JPHC-NEXT Eye Study

The study subjects were residents of Chikusei city, Japan, aged 40 years or older who attended annual health check-up programs and participated in the JPHC-NEXT Eye Study which performed non-mydriatic fundus photography of both eyes. The relationship of glaucomatous fundus changes such as optic disc cupping (cup to disc ratio ≥ 0.7) and retinal nerve fiber layer defect (NFLD) with the presence of epiretinal membrane (ERM) were examined cross-sectionally. A total of 1990 persons gave consent to participate in this study in 2013. The overall prevalence of ERM was 12.9%. Of these, 1755 had fundus photographs of sufficient quality and no history of intraocular surgery (mean age: 62.3 ± 10.0 years). After adjusting for age, sex and refractive error, NFLD was positively associated with the presence of ERM (odds ratio [OR]: 2.48; 95% confidence interval [CI]: 1.24, 4.96; P = 0.010), but optic disc cupping was not (OR: 1.33; CI: 0.71, 2.48; P = 0.37). The results did not necessarily suggest an association between glaucoma and ERM, but indicated an association between NFLD and ERM

A Case of Androgen Receptor-positive Triple Negative Breast Cancer with Good Response to Anti-androgen Therapy

Anti-androgen therapy has been proposed to be effective in the treatment of androgen receptor (AR)-positive triple negative breast cancer (TNBC). Herein, we report on the case of a 91-year-old female patient with AR-positive TNBC who underwent anti-androgen therapy and had a good response. Because of dementia, the patient lives in an aged care facility. It was here that a staff member noticed a mass with a rash on the patient\u27s breast. Consequently, the patient was sent for further examination. Ultrasonography revealed an irregularly shaped, indistinct hypoechoic mass measuring 19×18×9mm located in the upper outer quadrant of the left breast. Core needle biopsy (CNB) was performed and the mass was diagnosed as apocrine carcinoma. Further immunohistochemical analysis showed that the mass was AR-positive TNBC. Anti-androgen therapy was determined to be the optimal treatment option for this patient. The Institutional Review Board approval the off-label use of an anti-androgen for the treatment of this patient, who was subsequently treated with the anti-androgen flutamide. After 8 months, the size of the tumor had reduced to 15×9×5mm