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Experimental Study of Structural Behavior with Local Deformations of Connections of Steel Structures and Composite Structures
Get PDF長崎大学学位論文 [学位記番号]博（工）甲第152号 [学位授与年月日]令和7年3月19日(2025-03-19)thesi
音響テレメトリーを用いたイセエビPanulirus japonicus の移動生態に関する研究
Get PDF長崎大学学位論文 [学位記番号]博（水・環）甲第108号 [学位授与年月日]令和7年3月19日(2025-03-19)thesi
Barriers and enablers for group-based manual emptying services for onsite sanitation facilities in Nairobi, Kenya: a qualitative study
Get PDFOnsite sanitation, such as pit latrines, is essential to achieving universal access to safe sanitation, as outlined in Sustainable Development Goal target 6.2. However, manual emptying for pit latrines in low-income areas is often unhygienic, posing health and environmental risks. Enhancing the safety of these services increases costs, yet affordability for customers is essential. Thus, reducing service costs is a key priority. Group-based approach, where emptiers visit multiple toilets consecutively, has potential to improve both service efficiency and affordability. However, few studies have investigated its applicability to manual emptying. This paper aims to identify barriers and enablers for group-based manual emptying services in low-income neighbourhoods of Nairobi. We conducted 12 focus group discussions with landlords, tenants, and manual emptiers in the Korogocho informal settlement in Nairobi and interviewed 20 key informants from relevant sectors in Kenya. We identified five categories of barriers and enablers that affected general and group-based manual emptying: 1) funding, 2) expertise and equipment, 3) social and commercial habits, 4) physical conditions, and 5) regulatory systems. Of these, a norm that pits are not emptied until they get full, operating time constraints, fair and transparent pricing, and an organiser who can arrange group-based emptying from Category 3, and transport capacity from Category 4 specifically affected group-based manual emptying. Given that the barriers have a cascade structure, addressing some primary barriers such as capacity building and recognising manual emptiers’ role in the sanitation policies could be effective ways to ensure safe and affordable emptying services.International Journal of Hygiene and Environmental Health, 267, art. no. 114595; 2025journal articl
Persistence to growth hormone treatment and clinical characteristics of pediatric patients with growth hormone deficiency: A retrospective cohort study of data from the Japan Medical Data Center claims database
Get PDFLimited real-world data are available on persistence to growth hormone replacement therapy (GHRT) in Japan. Therefore, we used the Japan Medical Data Center claims database to retrospectively investigate persistence with GHRT in patients with pediatric growth hormone deficiency (pGHD). We identified 1,020 patients with pGHD treated with GHRT. The mean age at initial diagnosis was 7.5 ± 3.8 years, and we found a bimodal pattern in age, with peaks at 3 and 12 to 13 years of age; the peaks were more pronounced in male patients. After excluding patients with early withdrawal, 1,016 patients were eligible for persistence analysis. The time to initial treatment discontinuation, i.e., the first prescription-free period of 182 days (6 months) or more, for 50% of the patients was 2,526 days, which was similar to that of treatment completion (2,626 days). Most patients persisted with GHRT until they completed treatment, but 24 out of 1,016 (2.4%) had a treatment discontinuation. The mean proportion of days covered was 89.8%. Being female (hazard ratio [95% CI]: 1.85 [1.36–2.51]) and older age at diagnosis (1.50 [1.41–1.60]) were associated with shorter time to discontinuation. This finding suggests that most patients persist with GHRT until puberty. In conclusion, although most Japanese patients with pGHD appear to persist well with GHRT, some complete GHRT before puberty. Additionally, there are patients diagnosed and starting treatment just before puberty. Therefore, continued efforts towards early referral and diagnosis are important.Endocrine Journal, 72(5), pp.475-485; 2025journal articl
Antimicrobial susceptibility and resistance mechanisms to antipseudomonal β-lactams in Pseudomonas aeruginosa isolates from blood
Get PDFBloodstream infection caused by Pseudomonas aeruginosa with antimicrobial resistance can be difficult to treat. Herein, we investigated antimicrobial susceptibility to major antipseudomonal β-lactams and analyzed the relationship between resistance mechanisms and susceptibilities in P. aeruginosa isolates from blood. A total of 97 isolates possessing no carbapenemase gene were included in this study. The susceptibility rates to piperacillin, piperacillin/tazobactam, ceftazidime, and cefepime were in the 80% range, while 74.2% and 80.4% of the isolates showed susceptibility to imipenem and meropenem, respectively. None of the isolates showed resistance to ceftolozane/tazobactam or cefiderocol, and only one isolate each showed intermediate resistance (susceptibility rate, 99.0% each). The susceptibility rate was lowest for aztreonam (71.1%). The most prevalent susceptibility pattern was susceptible to all agents (56 isolates), followed by not susceptible only to aztreonam (nine isolates) or imipenem (seven isolates), and susceptible only to both ceftolozane/tazobactam and cefiderocol (six isolates). Multivariate logistic regression analysis revealed significant correlations between decreased oprD expression and decreased susceptibility to carbapenems; between increased ampC expression and non-susceptibility to piperacillin, piperacillin/tazobactam, and ceftazidime; and between increased mexA expression and decreased susceptibility to piperacillin, piperacillin/tazobactam, cefepime, aztreonam, and meropenem. These findings highlight the correlations between the expression of AmpC β-lactamase, OprD porin, and efflux pumps and non-susceptibility to β-lactams in P. aeruginosa isolates from blood. In contrast to traditional β-lactams, the stability of ceftolozane/tazobactam and cefiderocol against the resistance mechanisms was confirmed.Microbiology Spectrum, 13(5), art. no. e02790-24; 2025journal articl
Impact of Janus kinase inhibitors and methotrexate on interstitial lung disease in rheumatoid arthritis patients
Get PDFNagasaki University (長崎大学)博士(医学)Objectives: Little is known about how various treatments impact the progression of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients. Here, we compared ILD progression in RA patients treated with Janus kinase inhibitors (JAKi) or biological disease-modifying anti-rheumatic drugs (bDMARDs). In vitro experiments were also performed to evaluate the potential effects of the drugs on epithelial–mesenchymal transition (EMT), a key event in pulmonary fibrosis. Methods: This retrospective study included 93 RA-ILD patients who initiated treatment with JAKi, tumour necrosis factor inhibitors (TNFi), or abatacept between 2017 and 2020. Worsening ILD was quantified by changes in chest computed tomography (CT) scans between baseline and follow-up (mean 14 months, range 6–51 months). Response to treatment was evaluated using Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28-ESR). Expression of the EMT marker N-cadherin in A549 lung cells was assessed by western blotting. Results and discussion: Worsening ILD was detected in 19.4% (7/36), 16.7% (5/30), and 22.2% (6/27) of patients treated with JAKi, abatacept, and TNFi, respectively. Multivariate analysis identified female gender (P=0.043) and >10% fibrotic lesions (P=0.015) as significant predictors of worsening ILD. DAS28-ESR-based non-responder status was also significantly associated with worsening ILD (P=0.0085). In vitro, combination treatment with methotrexate and baricitinib significantly impeded EMT progression. Worsening ILD was associated with more extensive fibrotic lesions at baseline and female gender in RA patients treated with JAKi or bDMARDs. JAKi and methotrexate co-treatment may prove beneficial in modifying key events underlying the pathogenesis of RA-ILD.長崎大学学位論文 学位記番号:共博(医歯薬)甲第46号 学位授与年月日:令和7年3月5日Author: Shota Kurushima, Tomohiro Koga, Masataka Umeda, Naoki Iwamoto, Ritsuko Miyashita, Takatomo Tokito, Daisuke Okuno, Hirokazu Yura, Hiroshi Ishimoto, Takashi Kido, Noriho Sakamoto, Yukitaka Ueki, Hiroshi Mukae and Atsushi KawakamiCitation: Frontiers in Immunology, 15, art. no. 1501146; 2024Nagasaki University (長崎大学), 博士(医学) (2025-03-05)doctoral thesi
Influences of advanced age in rheumatoid arthritis: A multicentre ultrasonography cohort study
Get PDFNagasaki University (長崎大学)博士(医学)Objectives: We aimed to evaluate the effects of age on clinical characteristics and outcomes in biologic or targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD)-naïve patients with rheumatoid arthritis (RA). Methods: We analysed the cases of 234 Japanese b/tsDMARD-naïve RA patients who underwent b/tsDMARD treatment in a multicentre ultrasound prospective observational cohort. We compared the clinical characteristics at baseline and outcomes at 12 months between those aged ≥60 years and those <60 years. Results: Compared to the <60-year-old group (n = 78), the ≥60-year-old group (n = 156) had higher inflammatory marker values and ultrasound combined scores, especially wrist joints, at baseline. Age at baseline positively correlated significantly with the ultrasound scores at baseline; however, age was not a significant variable by the multiple regression analysis. The patients treated with different MOAs in the ≥60-year-old group had comparable outcomes and multiple regression analysis revealed that mechanism of action (MOA) was not a significant contributor to the Clinical Disease Activity Index at 12 months. Conclusions: RA patients with advanced age demonstrated distinctive clinical characteristics. The MOAs were not associated with clinical outcomes and ultrasound outcomes in RA patients with advanced age.長崎大学学位論文 学位記番号:共博(医歯薬)甲第47号 学位授与年月日:令和7年3月19日Author: Chieko Kawahara, Shoichi Fukui, Tohru Michitsuji, Ayako Nishino, Yushiro Endo, Toshimasa Shimizu, Masataka Umeda, Remi Sumiyoshi, Tomohiro Koga, Naoki Iwamoto, Tomoki Origuchi, Yukitaka Ueki, Nobutaka Eiraku, Takahisa Suzuki, Akitomo Okada, Naoki Matsuoka, HirokazuTakaoka, Hiroaki Hamada, TomomiTsuru, Yojiro Arinobu, Toshihiko Hidaka, Keita Fujikawa, TamamiYoshitama, YoshifumiTada, Hideo Ohtsubo, Jun Ishizaki, Tomoyuki Asano, Atsushi Kawakami and Shin-ya KawashiriCitation: Modern Rheumatology, 34(6), pp.1142–1148; 2024Nagasaki University (長崎大学), 博士(医学) (2025-03-19)doctoral thesi
長崎県内大学生の起業意思を向上させる効率的なアントレプレナーシップ教育の在り方
Get PDFNagasaki University (長崎大学)博士(経営学)長崎大学学位論文 学位記番号:博(経)甲第36号 学位授与年月日:令和7年3月19日Nagasaki University (長崎大学), 博士(経営学)(2025-03-19)doctoral thesi
Differences Between Medication-Related Osteonecrosis of the Jaw Caused by Bisphosphonates and Denosumab: Histological, Molecular Biological, and Clinical Studies
Get PDFNagasaki University (長崎大学)博士(歯学)Purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of antiresorptive agents such as bisphosphonates (BPs) and denosumab (DMB). We investigated whether a difference exists between BP- and DMB-related osteonecrosis of the jaw (ONJ). Patients and methods: Histological images of 30 patients with BP-related ONJ and 13 patients with DMB-related ONJ were observed using hematoxylin-eosin and cathepsin K staining. Moreover, bone metabolism markers in the blood and bone mineral density were measured in 18 patients with BP-related ONJ and five patients with DMB-related ONJ. Furthermore, we conducted a quantitative analysis of local bone metabolism-related genes using surgical specimens through real-time reverse transcription polymerase chain reaction. Additionally, a retrospective study of 298 patients with MRONJ examined the differences in the characteristics of BP- and DMB-related ONJ and the factors associated with treatment outcomes. Results: Histological examination revealed that patients treated with DMB had more severe osteoclast suppression than those treated with BP. No significant difference was observed in blood-bone metabolism markers between the two drugs; however, the suppression of local bone metabolism-related genes was stronger in patients treated with DMB. Clinical studies indicate that DMB-related ONJ is more frequently observed without osteolysis. Conclusion: BP-associated ONJ and DMB-associated ONJ were shown to differ slightly. Clinical studies indicate that osteolysis is often unclear in DMB-related ONJ, and methods of bone resection during surgery need to be established.長崎大学学位論文 学位記番号:博(医歯薬)甲第1661号 学位授与年月日:令和7年3月19日Author: Taro Miyoshi, Mitsunobu Otsuru, Kota Morishita, Keisuke Omori, Kei-ichiro Miura, Saki Hayashida, Satoshi Rokutanda, Yuki Matsushita, Masahiro Umeda, Tomohiro YamadaCitation: Cureus, 16(6), art. no. e62855; 2024Nagasaki University (長崎大学), 博士(歯学) (2025-03-19)doctoral thesi
Microarchitectural analysis of the metacarpophalangeal joint using HR-pQCT in patients with rheumatoid arthritis: A comparison with healthy controls
Get PDFNagasaki University (長崎大学)博士(医学)Objective: To investigate which joint microarchitectural parameters measured by high-resolution peripheral quantitative computed tomography (HR-pQCT) serve as imaging markers for rheumatoid arthritis (RA). Methods: The second and third metacarpophalangeal (MCP) joints of 50 patients with RA and 50 healthy controls (HCs) (aged 50–79 years, all females) were scanned using a HR-pQCT. Joint space, trabecular bone microarchitecture, and erosion were measured and compared between RA patients and HCs. Results: There were no differences in joint space parameters between RA patients and HCs. For bone microarchitecture, RA patients had lower trabecular bone mineral density (127 vs. 167 mg/cm3), thinner trabecular thickness (0.20 vs. 0.21 mm), fewer trabecular number (1.49 vs. 1.55 /mm), more rod-like structure (1.68 vs. 1.23), and poorer trabecular connectivity (4.51 vs. 5.72 /mm3) than HCs. Regarding erosion, RA patients had a higher number of erosions per joint (36/100 vs. 18/100), larger volume (4.62 vs. 1.89 mm3), and longer width (2.40 vs. 1.82 mm) and longer length (2.34 vs. 1.64 mm) than HCs. Most of the erosions in HCs were 5 mm3 in the MCP joints are sensitive imaging markers of RA. Erosions <5 mm3 in RA patients may include not only early pathological erosion but also physiological erosion because even HCs can have erosions <5 mm3.長崎大学学位論文 学位記番号:博(医歯薬)甲第1666号 学位授与年月日:令和7年3月5日Author: Kounosuke Watanabe, Ko Chiba, Kazuteru Shiraishi, Takeshi Iida, Naoki Iwamoto, Akihiko Yonekura, Atsushi Kawakami, Makoto OsakiCitation: Bone, 189, art. no. 117250; 2024Nagasaki University (長崎大学), 博士(医学) (2025-03-05)doctoral thesi