医療契約論 -その典型的なるもの-

早大学位記番号:新7230早稲田大

Functional disability trajectories at the end of life among Japanese older adults: findings from the Japan Gerontological Evaluation Study (JAGES)

BACKGROUND: this study aimed to identify distinct subgroups of trajectories of disability over time before 3 years of death and examine the factors associated with trajectory group membership probabilities among community-dwelling Japanese older adults aged 65 years and above. METHODS: participants included 4, 875 decedents from among community-dwelling Japanese older adults, aged ≥ 65 years at baseline (men: 3, 020; women: 1, 855). The certified long-term care levels of the national long-term care insurance (LTCI) system were used as an index of functional disability. We combined data from the 2010 Japan Gerontological Evaluation Study and data from the 2010 to 2016 LTCI system. Group-based mixture models and multinominal logistic regression models were used for data analysis. RESULTS: five distinct trajectories of functional disability in the last 3 years of life were identified: 'persistently severe disability' (10.3%), 'persistently mild disability' (13.0%), 'accelerated disability' (12.6%), 'catastrophic disability' (18.8%) and 'minimum disability' (45.2%). Multinominal logistic regression analysis found several factors associated with trajectory membership; self-rated health was a common predictor regardless of age and gender. The analysis also showed a paradoxical association; higher education was associated with trajectory group membership probabilities of more severe functional decline in men over 85 years at death. CONCLUSIONS: individual perception of health was a strong predictor of trajectories, independent of demographic factors and socio-economic status. Our findings contribute to the development of policies for the long-term care system, particularly for end-of-life care, in Asian countries

「セイカツカ」 ニ ツナガル リョウイキ 「カンキョウ」 ノ アソビ ソノ2 : EEG キョウイク マテリアル オ モチイタ ジッショウテキ ケンキュウ

幼児期の教育と小学校教育の円滑な接続を図っていくという観点から、「生活科」を中心とした合科的な指導のあり方を検討するために、幼児教育における領域「環境」と小学校教育「生活科」の学びの連続性に関する調査を行った。本研究では、EEG教育マテリアルを用い、幼児と小学校低学年の遊び方の特徴と傾向を分析している。その結果、幼児期においても遊び方の工夫が観察されるものの、児童期になるとより遊びを深めたいとする意欲や遊具の持つ可能性など知的な気付きが生まれていた。子どもの気付きは、次の自発的な遊びを誘発することから、子ども自身が幼児教育を通じて培ってきた経験や成果を踏まえながら、小学校教育における指導計画や授業実践を進めていくことが小学校始期の児童にとって極めて重要であることが本研究から明らかとなった

「セイカツカ」 ニ ツナガル リョウイキ 「カンキョウ」 ノ アソビ ソノ1 : キョウイクヨウ マテリアル オ モチイタ キソテキ ケンキュウ

幼児期の教育と小学校教育の円滑な接続を図っていくという観点から、「生活科」を中心とした合科的な指導のあり方を検討するために、幼児教育における領域「環境」と小学校「生活科」の学びの連続性に関する調査を行った。本研究では、保育領域「環境」と小学校「生活科」の内容に焦点を当て、保幼小連携の観点から教育用マテリアル（玩具）活用の可能性を検証することを目的とする。本稿では、基礎研究として、EEGの保育領域と日本の保育５領域の整合性を明らかにした上で、保育園における自由あそびの実践を行い、保育領域「環境」における教育用マテリアルの有用性を考察した。幼児期の子どもの教育用に考えられた教育用マテリアルは、日本の保育５領域と親和性があり、幼児教育の現場で活用可能性が高いことが確かめられた

Crucial role of nitric oxide synthases system in endothelium-dependent hyperpolarization in mice

The endothelium plays an important role in maintaining vascular homeostasis by synthesizing and releasing several relaxing factors, such as prostacyclin, nitric oxide (NO), and endothelium-derived hyperpolarizing factor (EDHF). We have previously demonstrated in animals and humans that endothelium-derived hydrogen peroxide (H2O2) is an EDHF that is produced in part by endothelial NO synthase (eNOS). In this study, we show that genetic disruption of all three NOS isoforms (neuronal [nNOS], inducible [iNOS], and endothelial [eNOS]) abolishes EDHF responses in mice. The contribution of the NOS system to EDHF-mediated responses was examined in eNOS−/−, n/eNOS−/−, and n/i/eNOS−/− mice. EDHF-mediated relaxation and hyperpolarization in response to acetylcholine of mesenteric arteries were progressively reduced as the number of disrupted NOS genes increased, whereas vascular smooth muscle function was preserved. Loss of eNOS expression alone was compensated for by other NOS genes, and endothelial cell production of H2O2 and EDHF-mediated responses were completely absent in n/i/eNOS−/− mice, even after antihypertensive treatment with hydralazine. NOS uncoupling was not involved, as modulation of tetrahydrobiopterin (BH4) synthesis had no effect on EDHF-mediated relaxation, and the BH4/dihydrobiopterin (BH2) ratio was comparable in mesenteric arteries and the aorta. These results provide the first evidence that EDHF-mediated responses are dependent on the NOSs system in mouse mesenteric arteries

First Data Release of the Hyper Suprime-Cam Subaru Strategic Program

The Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP) is a three-layered imaging survey aimed at addressing some of the most outstanding questions in astronomy today, including the nature of dark matter and dark energy. The survey has been awarded 300 nights of observing time at the Subaru Telescope and it started in March 2014. This paper presents the first public data release of HSC-SSP. This release includes data taken in the first 1.7 years of observations (61.5 nights) and each of the Wide, Deep, and UltraDeep layers covers about 108, 26, and 4 square degrees down to depths of i~26.4, ~26.5, and ~27.0 mag, respectively (5sigma for point sources). All the layers are observed in five broad bands (grizy), and the Deep and UltraDeep layers are observed in narrow bands as well. We achieve an impressive image quality of 0.6 arcsec in the i-band in the Wide layer. We show that we achieve 1-2 per cent PSF photometry (rms) both internally and externally (against Pan-STARRS1), and ~10 mas and 40 mas internal and external astrometric accuracy, respectively. Both the calibrated images and catalogs are made available to the community through dedicated user interfaces and database servers. In addition to the pipeline products, we also provide value-added products such as photometric redshifts and a collection of public spectroscopic redshifts. Detailed descriptions of all the data can be found online. The data release website is https://hsc-release.mtk.nao.ac.jp/.Comment: 34 pages, 20 figures, 7 tables, moderate revision, accepted for publication in PAS

The misasandry myth: An inaccurate stereotype about feminists' attitudes toward men

In six studies, we examined the accuracy and underpinnings of the damaging stereotype that feminists harbor negative attitudes toward men. In Study 1 (n = 1,664), feminist and nonfeminist women displayed similarly positive attitudes toward men. Study 2 (n = 3,892) replicated these results in non-WEIRD countries and among male participants. Study 3 (n = 198) extended them to implicit attitudes. Investigating the mechanisms underlying feminists’ actual and perceived attitudes, Studies 4 (n = 2,092) and 5 (nationally representative UK sample, n = 1,953) showed that feminists (vs. nonfeminists) perceived men as more threatening, but also more similar, to women. Participants also underestimated feminists’ warmth toward men, an error associated with hostile sexism and a misperception that feminists see men and women as dissimilar. Random-effects meta-analyses of all data (Study 6, n = 9,799) showed that feminists’ attitudes toward men were positive in absolute terms and did not differ significantly from nonfeminists'. An important comparative benchmark was established in Study 6, which showed that feminist women's attitudes toward men were no more negative than men's attitudes toward men. We term the focal stereotype the misandry myth in light of the evidence that it is false and widespread, and discuss its implications for the movement

DOCK2 is involved in the host genetics and biology of severe COVID-19

「コロナ制圧タスクフォース」COVID-19疾患感受性遺伝子DOCK2の重症化機序を解明 --アジア最大のバイオレポジトリーでCOVID-19の治療標的を発見--. 京都大学プレスリリース. 2022-08-10.Identifying the host genetic factors underlying severe COVID-19 is an emerging challenge. Here we conducted a genome-wide association study (GWAS) involving 2, 393 cases of COVID-19 in a cohort of Japanese individuals collected during the initial waves of the pandemic, with 3, 289 unaffected controls. We identified a variant on chromosome 5 at 5q35 (rs60200309-A), close to the dedicator of cytokinesis 2 gene (DOCK2), which was associated with severe COVID-19 in patients less than 65 years of age. This risk allele was prevalent in East Asian individuals but rare in Europeans, highlighting the value of genome-wide association studies in non-European populations. RNA-sequencing analysis of 473 bulk peripheral blood samples identified decreased expression of DOCK2 associated with the risk allele in these younger patients. DOCK2 expression was suppressed in patients with severe cases of COVID-19. Single-cell RNA-sequencing analysis (n = 61 individuals) identified cell-type-specific downregulation of DOCK2 and a COVID-19-specific decreasing effect of the risk allele on DOCK2 expression in non-classical monocytes. Immunohistochemistry of lung specimens from patients with severe COVID-19 pneumonia showed suppressed DOCK2 expression. Moreover, inhibition of DOCK2 function with CPYPP increased the severity of pneumonia in a Syrian hamster model of SARS-CoV-2 infection, characterized by weight loss, lung oedema, enhanced viral loads, impaired macrophage recruitment and dysregulated type I interferon responses. We conclude that DOCK2 has an important role in the host immune response to SARS-CoV-2 infection and the development of severe COVID-19, and could be further explored as a potential biomarker and/or therapeutic target