カンボジアにおけるLivelihoodプログラムのHIV陽性者の心理社会的側面および生活面に与える影響

学位の種別: 課程博士審査委員会委員 : （主査）東京大学特任教授 井上 真奈美, 東京大学講師 大西 弘高, 東京大学教授 森屋 恭爾, 東京大学准教授 石川 ひろの, 東京大学講師 宮本 有紀University of Tokyo(東京大学

Health and Socio-Economic Impacts of Livelihoods Programs among People Living with HIV in Cambodia: A Case-Control Study

Background: In Cambodia, the circumstances surrounding people living with HIV (PLHIV) remain serious conditions. To ameliorate these situations, KHANA has implemented livelihoods programs since 2010, including village saving and loans (VSL), skill trainings, and cash grants with on-going technical support. This study aims to evaluate the impacts of the programs in improving socio-economic conditions, health, and psychological well-being of PLHIV in Cambodia. Methods: In August 2014, a case-control study was conducted in six selected provinces. The cases were defined as PLHIV who lived in the selected operational districts where KHANA has implemented the livelihoods programs, and have participated in the programs for at least one year. Several indicators in socio-economic situations, food security, health conditions, and psychological well-being of the cases (n= 358) and the controls (n= 329) were compared. Results:The mean of monthly income of the cases who attended the programs for three years or more was 13.6% higher than that of the controls. A significantly higher proportion of the cases reported having three meals per day, while a significantly lower proportion of them received food assistance in the past 12 months. The mean total score for frequency of occurrence also indicated less severity of food insecurity among the cases. Regarding child education, the cases reported a significantly lower rate of out-of-school children. The proportion of the cases who rated their quality of life as good was significantly higher, and they were significantly less likely to report that they felt guilty being HIV-positive persons. Regarding psychological well-being, the mean total score of depressive symptoms for the cases was significantly lower than that for the controls, and the proportion of the cases with a cut-off score smaller than 1.75, which indicated less depressive symptoms, was also significantly higher than that of the controls. Conclusions: Findings from this study portray the positive impacts of KHANA’s livelihoods programs in maintaining and upgrading the livelihoods and quality of life of PLHIV in Cambodia. With these noticeable impacts, the programs should be scaled up to support PLHIV and vulnerable households across the country

CMV infection of trabecular meshwork cells

Purpose: Human cytomegalovirus (HCMV) infections can cause endotheliitis which is associated with an elevation of the intraocular pressure (IOP). However, the mechanism of the IOP elevation has not been determined. The purpose of this study was to determine whether HCMV strains which are capable of infecting corneal endothelial cells can also replicate, induce anti-viral responses, and can reorganize the actin cytoskeleton in trabecular meshwork cells. Study design: Experimental study design Methods: Cultured primary human trabecular meshwork cells (HTMCs) were infected with the Towne or TB40/E strains of HCMV. TB40/E is trophic for vascular endothelial and corneal endothelial cells. Real-time PCR, western blot, and fluorescent immunostaining have been used to determine whether HCMV-infected HTMCs will support the expression of viral mRNA and protein, allow viral replication, and elicit anti-viral host responses. We also determined whether lytic replication was present after an HCMV infection. Results: HCMV infection led to the expression of viral mRNA and proteins of IE1, glycoprotein B(gB), and pp65. TB40/E infection induced interferon-β, a sign of host anti-viral immune response and MCP-1. Together with the induction of the regulators of actin cytoskeleton, myosin phosphatase Rho interacting protein (MPRIP) and monocyte chemotactic protein-1 (MCP-1), TB40/E induced a high level of expression of viral proteins, including IE1, gB, and pp65 as well as actin stress fiber formation, and achieved pathogenically high viral titers. Conclusions: Human trabecular meshwork cells support the replication of endotheliotropic TB40/E strain of HCMV which indicates that this strain may have high virulence for trabecular meshwork

Poly[[{μ3-tris­[2-(4-phenyl-1,2,3-triazol-1-yl)eth­yl]amine}silver(I)] hexa­fluorido­phosphate]

The title compound, {[Ag(L)]PF6)n {L is tris­[2-(4-phenyl-1,2,3-triazol-1-yl)eth­yl]amine, C30H30N10}, consists of alternating two-dimensional cationic layers of [Ag(L)]+ and anionic PF6 − layers. Each AgI atom is three coordinated in a T-shaped geometry by three N atoms from three ligands. Each ligand links three AgI atoms, generating a two-dimensional network structure with two different metallacycles, A and B. In A, eight coordination units from four ligands connect four AgI atoms, forming a 48-membered ring. In B, four coordination units from two ligands link two AgI atoms, forming a 24-membered ring. Each B ring is surrounded by four A rings, and each A ring has four A and four B rings as neighbours. This cationic layer thus generates a 4.82 topology network, with each AgI centre and ligand acting as a three-connected topological node

Anterior and Posterior Corneal Astigmatism after Refractive Lenticule Extraction for Myopic Astigmatism

Purpose. To assess the amount and the axis orientation of anterior and posterior corneal astigmatism after refractive lenticule extraction (ReLEx) for myopic astigmatism. Methods. We retrospectively examined 53 eyes of 53 consecutive patients (mean age ± standard deviation, 33.2 ± 6.5 years) undergoing ReLEx to correct myopic astigmatism (manifest cylinder = 0.5 diopters (D)). Power vector analysis was performed with anterior and posterior corneal astigmatism measured with a rotating Scheimpflug system (Pentacam HR, Oculus) and refractive astigmatism preoperatively and 3 months postoperatively. Results. Anterior corneal astigmatism was significantly decreased, measuring 1.42 ± 0.73 diopters (D) preoperatively and 1.11 ± 0.53 D postoperatively (p<0.001, Wilcoxon signed-rank test). Posterior corneal astigmatism showed no significant change, falling from 0.44 ± 0.12 D preoperatively to 0.42 ± 0.13 D postoperatively (p=0.18). Refractive astigmatism decreased significantly, from 0.92 ± 0.51 D preoperatively to 0.27 ± 0.44 D postoperatively (p<0.001). The anterior surface showed with-the-rule astigmatism in 51 eyes (96%) preoperatively and 48 eyes (91%) postoperatively. By contrast, the posterior surface showed against-the-rule astigmatism in all eyes preoperatively and postoperatively. Conclusions. The surgical effects were largely attributed to the astigmatic correction of the anterior corneal surface. Posterior corneal astigmatism remained unchanged even after ReLEx for myopic astigmatism

Machine learning-based prediction of relapse in rheumatoid arthritis patients using data on ultrasound examination and blood test

Recent effective therapies enable most rheumatoid arthritis (RA) patients to achieve remission; however, some patients experience relapse. We aimed to predict relapse in RA patients through machine learning (ML) using data on ultrasound (US) examination and blood test. Overall, 210 patients with RA in remission at baseline were dichotomized into remission (n = 150) and relapse (n = 60) based on the disease activity at 2-year follow-up. Three ML classifiers [Logistic Regression, Random Forest, and extreme gradient boosting (XGBoost)] and data on 73 features (14 US examination data, 54 blood test data, and five data on patient information) at baseline were used for predicting relapse. The best performance was obtained using the XGBoost classifier (area under the receiver operator characteristic curve (AUC) = 0.747), compared with Random Forest and Logistic Regression (AUC = 0.719 and 0.701, respectively). In the XGBoost classifier prediction, ten important features, including wrist/metatarsophalangeal superb microvascular imaging scores, were selected using the recursive feature elimination method. The performance was superior to that predicted by researcher-selected features, which are conventional prognostic markers. These results suggest that ML can provide an accurate prediction of relapse in RA patients, and the use of predictive algorithms may facilitate personalized treatment options

Isolation and characterization of a virus (CvV-BW1) that infects symbiotic algae of Paramecium bursaria in Lake Biwa, Japan

<p>Abstract</p> <p>Background</p> <p>We performed an environmental study of viruses infecting the symbiotic single-celled algae of <it>Paramecium bursaria </it>(<it>Paramecium bursaria Chlorella </it>virus, PBCV) in Lake Biwa, the largest lake in Japan. The viruses detected were all <it>Chlorella variabilis </it>virus (CvV = NC64A virus). One of them, designated CvV-BW1, was subjected to further characterization.</p> <p>Results</p> <p>CvV-BW1 formed small plaques and had a linear DNA genome of 370 kb, as judged by pulsed-field gel electrophoresis. Restriction analysis indicated that CvV-BW1 DNA belongs to group H, one of the most resistant groups among CvV DNAs. Based on a phylogenetic tree constructed using the <it>dnapol </it>gene, CvV was classified into two clades, A and B. CvV-BW1 belonged to clade B, in contrast to all previously identified virus strains of group H that belonged to clade A.</p> <p>Conclusions</p> <p>We conclude that CvV-BW1 composes a distinct species within <it>C. variabilis </it>virus.</p