自閉スペクトラム症児の偏食に対する応用行動分析的アプローチ : 日常場面で実施可能な先行子操作に基づく介入の検討

この博士論文は内容の要約のみの公開（または一部非公開）になっています筑波大学 (University of Tsukuba)201

自閉スペクトラム症児の偏食に対する応用行動分析的アプローチ: 日常場面で実施可能な先行子操作に基づく介入の検討

筑波大学 (University of Tsukuba)201

〈展望〉選択性緘黙の有病率に関する文献的検討

本研究では、選択性緘黙の有病率に関する先行研究を概観し、有病率の推定値とその根拠資料を把握することを目的とした。対象とする先行研究は英文および和文の学術誌に掲載された選択性緘黙の有病率を調査した論文を選定した。選定基準に適合した16編の論文を分析対象とし、12の項目について分析した。調査研究の対象年齢は3.6～17歳で、有病率は0.02～1.89%であった。また幼稚園および学校で調査を実施した論文が12編、クリニックで実施した諭文は4編であった。選択性緘黙の診断基準としてDSM-III-Rを用いた論文は1編、DSM-IVを用いた論文は8編、DSM-5を用いた論文は1編、記載のない論文は6編であった。和文誌は4論文と少なく、最近の日本の選択性緘黙の有病率に関する大規模の調査は見当たらず、今後、日本における選択性緘黙の現状を把握する必要がある。また、今後の研究では選択性緘黙の発症時期について検討する必要がある。The present study reviewed previous research on the prevalence of selective mutism to provide an overview of evidence-based references and estimate its prevalence rate. Of the previous research published in English or Japanese academic journals, 16 studies were selected on the basis of our inclusion criteria and analyzed in 12 items. The age range of the subjects was from 3.6 to 17, and the range of the prevalence rate was between 0.02 to 1.89%. Twelve studies were conducted at kindergartens or schools, and four were conducted at clinics. Regarding the diagnostic criteria, one study was based on DSM-III-R, eight was on DSM-IV, one was on DSM-5, and six other studies did not state what diagnostic criteria they employed. Very limited studies have been published in Japanese journals, and the total number was only four. There is no extensive research on the prevalence of selective mutism conducted in Japan in recent years. Thus, future research is highly needed to investigate the status of selective mutism in this country as well as examine the age of onset

First confirmed report of Nassarius sinarum (Mollusca, Gastropoda) in Korea

The marine gastropod mollusc Nassarius sinarum has attracted attention due to its status as a potential invasive species and the ecological impact it may have on local environments and the fishing industry. It was observed exclusively within China initially, but its distribution now seems to have expanded into Japan and Korea. Accurate identification of N. sinarum, particularly in its juvenile stage, is vital for understanding its ecological influences and distribution patterns.This study represents the first comprehensive analysis of N. sinarum samples from Korea. It includes morphological examination, scanning electron microscopy images and molecular sequencing. Two live specimens were collected from the Yeongsan River estuary in Korea and their morphological features were analysed and compared to those of samples from China and Japan. The samples’ species were confirmed by molecular identification, based on cytochrome c oxidase subunit I (COI) and histone H3 (H3) genetic markers.It was observed that juvenile N. sinarum shells lack key species-characteristic morphological traits, such as a thick outer lip and diminishing axial ribs. However, COI marker-based molecular identification affirmed that these Korean specimens were N. sinarum. The H3 region was registered with the National Center for Biotechnology Information (NCBI) for the first time. Phylogenetic analysis of the H3 region did not resolve species distinctions within the Nassarius, suggesting that the H3 marker is not suitable for species identification within this genus. In this context, multiple genetic markers, when used appropriately, can also be applied to genus-level searches, enhancing species identification accuracy and reducing misidentification.The sequences provided in this study can serve as a valuable reference for future DNA barcoding research. Additional samples and surveys should be conducted through collaborative efforts amongst national and institutional organisations to further clarify the ecological status of N. sinarum and to investigate its distribution and potential impact around East Asia. Finally, a new Korean name, (No-lan-jul-job-ssal-mu-nui-go-dung; 노란줄좁쌀무늬고둥) has been proposed for N. sinarum

Comparison of First-Line Dual Combination Treatments in Hypertension: Real-World Evidence from Multinational Heterogeneous Cohorts.

Background and objectives: 2018 ESC/ESH Hypertension guideline recommends 2-drug combination as initial anti-hypertensive therapy. However, real-world evidence for effectiveness of recommended regimens remains limited. We aimed to compare the effectiveness of first-line anti-hypertensive treatment combining 2 out of the following classes: angiotensin-converting enzyme (ACE) inhibitors/angiotensin-receptor blocker (A), calcium channel blocker (C), and thiazide-type diuretics (D).Methods: Treatment-naïve hypertensive adults without cardiovascular disease (CVD) who initiated dual anti-hypertensive medications were identified in 5 databases from US and Korea. The patients were matched for each comparison set by large-scale propensity score matching. Primary endpoint was all-cause mortality. Myocardial infarction, heart failure, stroke, and major adverse cardiac and cerebrovascular events as a composite outcome comprised the secondary measure.Results: A total of 987,983 patients met the eligibility criteria. After matching, 222,686, 32,344, and 38,513 patients were allocated to A+C vs. A+D, C+D vs. A+C, and C+D vs. A+D comparison, respectively. There was no significant difference in the mortality during total of 1,806,077 person-years: A+C vs. A+D (hazard ratio [HR], 1.08; 95% confidence interval [CI], 0.97-1.20; p=0.127), C+D vs. A+C (HR, 0.93; 95% CI, 0.87-1.01; p=0.067), and C+D vs. A+D (HR, 1.18; 95% CI, 0.95-1.47; p=0.104). A+C was associated with a slightly higher risk of heart failure (HR, 1.09; 95% CI, 1.01-1.18; p=0.040) and stroke (HR, 1.08; 95% CI, 1.01-1.17; p=0.040) than A+D.Conclusions: There was no significant difference in mortality among A+C, A+D, and C+D combination treatment in patients without previous CVD. This finding was consistent across multi-national heterogeneous cohorts in real-world practice