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Evidence-based intrapartum practice and its associated factors at a tertiary teaching hospital in the Philippines, a descriptive mixed-methods study
Full text linkBackground: Evidenced-based practice is a key component of quality care. However, studies in the Philippines have identified gaps between evidence and actual maternity practices. This study aims to describe the practice of evidence-based intrapartum care and its associated factors, as well as exploring the perceptions of healthcare providers in a tertiary hospital in the Philippines. Methods: A mixed-methods study was conducted, which consisted of direct observation of intrapartum practices during the second and third stages, as well as semi-structured interviews and focus group discussions with care providers to determine their perceptions and reasoning behind decisions to perform episiotomy or fundal pressure. Univariate and multivariate logistic regression were used to analyse the relationship between observed practices and maternal, neonatal, and environmental factors. Qualitative data were parsed and categorised to identify themes related to the decision-making process. Results: A total of 170 deliveries were included. Recommended care, such as prophylactic use of oxytocin and controlled cord traction in the third stage, were applied in almost all the cases. However, harmful practices were also observed, such as intramuscular or intravenous oxytocin use in the second stage (14%) and lack of foetal heart rate monitoring (57%). Of primiparae, 92% received episiotomy and 31% of all deliveries received fundal pressure. Factors associated with the implementation of episiotomy included primipara (adjusted Odds Ratio [aOR] 62.3), duration of the second stage of more than 30 min (aOR 4.6), and assisted vaginal delivery (aOR 15.0). Factors associated with fundal pressure were primipara (aOR 3.0), augmentation with oxytocin (aOR 3.3), and assisted delivery (aOR 4.8). Healthcare providers believe that these practices can prevent laceration. The rate of obstetric anal sphincter injuries (OASIS) was 17%. Associated with OASIS were assisted delivery (aOR 6.0), baby weights of more than 3.5 kg (aOR 7.8), episiotomy (aOR 26.4), and fundal pressure (aOR 6.2). Conclusions: Our study found that potentially harmful practices are still conducted that contribute to the occurrence of OASIS. The perception of these practices is divergent with current evidence, and empirical knowledge has more influence. To improve practices the scientific evidence and its underlying basis should be understood among providers
A Study of Fair Value Concept from the Viewpoint of Value Theory
No full textFair value has become an important measurement model for financial reporting by aggressive promotion of FASB and IASB. However, the terms of "fair" and "value" have not been sufficiently examined in the accounting standards and the accounting researchers. Regardless of the original meaning of fair value, fair value has established the basis for measurement, and fair value accounting has also been spread. Because "fair value" is originally derived from law and economics, it is necessary to examine beyond the scope of accounting. This paper examines the appropriateness of the fair value concept from the viewpoint of value theory of economics.公正価値は，FASB及びIASBによる積極的な推進によって，財務報告の重要な測定モデルになった。しかし，公正価値の「公正」と「価値」が何を意味するのかについては，会計基準や会計研究者によって十分に検討されてこなかった。むしろ，公正価値の本来の意味を問わないまま，公正価値は測定基礎としての地位を確立し，公正価値会計も普及してきたのである。しかし，「公正価値」は，法律学および経済学に由来するので，会計学の範囲を超えて検討する必要がある。このうち，本稿では，主に経済学の価値理論の視点に立って，公正価値概念の適正性を考察し，公正価値会計の将来の発展を探求する。松本睦樹教授定年退職記念号In Honour of Prof. Mutuki Matumot
Virulence assessment of six major pathogenic Candida species in the mouse model of invasive candidiasis caused by fungal translocation
Full text linkGastrointestinal colonization has been considered as the primary source of candidaemia; however, few established mouse models are available that mimic this infection route. We therefore developed a reproducible mouse model of invasive candidiasis initiated by fungal translocation and compared the virulence of six major pathogenic Candida species. The mice were fed a low-protein diet and then inoculated intragastrically with Candida cells. Oral antibiotics and cyclophosphamide were then administered to facilitate colonization and subsequent dissemination of Candida cells. Mice infected with Candida albicans and Candida tropicalis exhibited higher mortality than mice infected with the other four species. Among the less virulent species, stool titres of Candida glabrata and Candida parapsilosis were higher than those of Candida krusei and Candida guilliermondii. The fungal burdens of C. parapsilosis and C. krusei in the livers and kidneys were significantly greater than those of C. guilliermondii. Histopathologically, C. albicans demonstrated the highest pathogenicity to invade into gut mucosa and liver tissues causing marked necrosis. Overall, this model allowed analysis of the virulence traits of Candida strains in individual mice including colonization in the gut, penetration into intestinal mucosa, invasion into blood vessels, and the subsequent dissemination leading to lethal infections
Brain and Neuronal Aging: Aged Brain Controls via Gene Expression Fidelity and Master Regulatory Factors
Full text linkProviding plausible strategies for brain aging protection should be a critical concern for countries with large elderly populations including Japan. Age-related cognitive impairments and movement disorders, such as Alzheimer's and Parkinson's diseases, are caused by neurodegeneration that primarily initiates in the hippocampus and the midbrain substantia nigra, respectively. Neurons are postmitotic, and therefore, the accuracy of cellular metabolism should be crucial for maintaining neural functions throughout their life. Thus accuracy of protein synthesis is a critical concern in discussing mechanisms of aging. The essence of the so-called "error catastrophe theory" of aging was on the fidelity of ribosomal translation and/or aminoacylation of tRNA. There is evidence that reduced protein synthesis accuracy results in neurodegeneration. Similarly, reduced proteostasis via autophagy and proteasomes in aging is crucial for protein quality control and well documented as a risk for aging. In both neurodegeneration and protein quality controls, various proteins are involved in their regulation, but recent evidence suggests that repressor element-1 silencing transcription factor (REST) could be a master regulatory protein that is crucial for orchestrating the neural protecting events in human brain aging. REST is induced in the aged brain, and protects neurons against oxidative stress and protein toxicity. Interestingly, REST is identical with neuron-restrictive silencer factor (NRSF), the master regulator of neural development. Thus NRSF/REST play important roles in both neurogenesis and neurodegeneration. In this review, I summarize the interesting scientific crossover, and discuss the potential use of NRSF/REST as a pharmaceutical target for controlling aging, particularly in relation to brain aging
腎虚血・再灌流誘発急性腎障害モデルラットにおけるミダゾラムの体内動態変動要因の解析
No full textObjectives: This study aimed to investigate the effects of renal ischaemia/reperfusion (I/R)-induced acute kidney injury (AKI) on the distribution of midazolam (MDZ), a probe drug for cytochrome P450 3A (CYP3A) activity.
Methods: We established an AKI model inducing ischaemia of both renal pedicles for 60 min followed by 24-h reperfusion. MDZ was administered intravenously (i.v.) to the rats via the jugular vein, and then, blood samples were collected to determine the plasma concentration of MDZ. Key findings: While the plasma concentration of MDZ after i.v. administration was decreased in the I/R rats, the tissue concentration was not altered. In addition, the tissue-to-plasma (T/P) ratio of MDZ was increased in the I/R rats. The unbound fraction of MDZ and the level of indoxyl sulphate (IS) in plasma were elevated in the I/R rats. Furthermore, the unbound fraction of MDZ was significantly increased by the addition of IS. Conclusions: These results indicated that the displacement of albumin-bound MDZ by IS changed the unbound fraction of MDZ and elevated the T/P ratio of MDZ in I/R rats.長崎大学学位論文 学位記番号:博(医歯薬)甲第1234号 学位授与年月日:令和2年3月19日Author: Ayako Tokunaga, Hirotaka Miyamoto, Shintaro Fumoto, Koyo NishidaCitation: Journal of Pharmacy and Pharmacology, 71(12), pp.1792-1799; 201
福島県富岡町における帰還直後の環境放射能レベルと外部被ばく線量評価
No full textOn 1 April 2017, six years have passed since the Fukushima Daiichi Nuclear Power Station (FDNPS) accident, and the Japanese government declared that some residents who lived in Tomioka Town, Fukushima Prefecture could return to their homes. We evaluated environmental contamination and radiation exposure dose rates due to artificial radionuclides in the livelihood zone of residents (living space such as housing sites), including a restricted area located within a 10-km radius from the FDNPS, immediately after residents had returned home in Tomioka town. In areas where the evacuation orders had been lifted, the median air dose rates were 0.20 μSv/h indoors and 0.26 μSv/h outdoors, and the radiation exposure dose rate was 1.6 mSv/y. By contrast, in the “difficult-to-return zone,” the median air dose rate was 2.3 μSv/h (20 mSv/y) outdoors. Moreover, the dose-forming artificial radionuclides (radiocesium) in the surface soil were 0.018 μSv/h (0.17 mSv/y) in the evacuation order-lifted areas and 0.73 μSv/h (6.4 mSv/y) in the difficult-to-return zone. These findings indicate that current concentrations of artificial radionuclides in soil samples have been decreasing in the evacuation order-lifted areas of Tomioka town; however, a significant external exposure risk still exists in the difficult-to-return zone. The case of Tomioka town is expected to be the first reconstruction model including the difficult-to-return zone.長崎大学学位論文 学位記番号:博(医歯薬)甲第1241号 学位授与年月日:令和2年3月19日Author: Masahiko Matsuo, Yasuyuki Taira, Makiko Orita, Yumiko Yamada, Juichi Ide, Shunichi Yamashita and Noboru TakamuraCitation: International Journal of Environmental Research and Public Health, 16(9), 1481; 201
Towards Incompossibility: The Philosophy of Whitehead in Leibnizian Deleuze
Full text linkGille Deleuze consacrait un chapitre 《Qu’est-ce qu’est un événement ?》 dans
Le Pli : Leibniz et le Baroque, un livre sur la philosophie leibnizienne. Dans le Pli,
Deleuze expliquait la philosophie de Whitehead comme un successeur de la philosophie
leibnizien, mais en même temps il soulignait la confrontation de Whitehead avec le
philophie leibnizien. Mais qu’est-ce que c’est la confrontation ? Pourquoi Deleuze devait
convoquer Whitehead dans son livre sur la philosophie leibnizienne ? En examinant les
interprétations des concepts whiteheadiens par Deleuze, nous avons démontré que la
confrontation entre Whitehead et Leibniz se trouve au concept de 《l’incompossibilité》 ;
l’incompossibilité de monade leibnizien / l’incompossibilité de l’événement whitehedie
Carotid–Carotid Bypass for a Carotid Artery Aneurysm
No full textBackground: Surgical treatment for symptomatic extracranial carotid artery aneurysms should be encouraged because of their high recurrence rates. Case Description: A 55-year-old man presented with progressive right-sided hemiparesis and dysarthria. Computed tomography angiography revealed the cause of his repeated cerebral infarction was due to the distal emboli from an intra-aneurysmal thrombus of a giant thrombosed aneurysm at the origin of left common carotid artery. Right common carotid artery–saphenous vein graft–left common carotid artery bypass followed by left common carotid artery ligation was successfully performed. Conclusions: Carotid–carotid bypass followed by common carotid artery ligation is an optional procedure for symptomatic proximal common carotid artery aneurysm
