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  • 1
    Online Resource
    Online Resource
    Surveillance of Antimicrobial Prescriptions in Community Pharmacies Located in Tokyo, Japan
    MDPI AG ; 2023
    In:  Antibiotics Vol. 12, No. 8 ( 2023-08-17), p. 1325-
    Details
    In: Antibiotics, MDPI AG, Vol. 12, No. 8 ( 2023-08-17), p. 1325-
    Abstract: An antimicrobial resistance (AMR) Action Plan was launched in 2016 to prevent the spread of antimicrobial-resistant bacteria in Japan. Additional support for the appropriate use of pediatric antimicrobial agents was initiated in 2018 to promote the appropriate use of antimicrobial agents in the community. To evaluate the effectiveness of the AMR Action Plan in the community, we investigated antimicrobial prescriptions in community pharmacies. Data on prescriptions for antimicrobial agents dispensed in 42 community pharmacies located in the Tama district, Tokyo, Japan, were collected between April 2013 and December 2019. In this study, we employed the DPY, which was calculated as defined daily doses (DDDs)/1000 prescriptions/year. The DPY is the number of antimicrobial agents used (potency) per 1000 antimicrobial prescriptions dispensed in pharmacies per year. The number of prescriptions for third-generation cephalosporins, fluoroquinolones, and macrolides decreased after the initiation of the AMR Action Plan; the DPYs of these antimicrobial agents decreased significantly by 31.4%, increased by 15.8%, and decreased by 23.6%, respectively (p 〈 0.05). The number of antimicrobial prescriptions for pediatric patients has been decreasing since 2018. Declines in the DPYs of third-generation cephalosporins, fluoroquinolones, and macrolides were higher in pediatric pharmacies than in other pharmacies. Our data suggest that the AMR Action Plan and additional support for the appropriate use of antimicrobial agents in children influenced the number of antimicrobial prescriptions in community pharmacies in Japan.
    Type of Medium: Online Resource
    ISSN: 2079-6382
    URL: Article
    DOI: 10.3390/antibiotics12081325
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2681345-2
    SSG: 15,3
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  • 2
    Online Resource
    Online Resource
    Clinical Characteristics, Differential Diagnosis and Genetic Analysis of Concentric Retinitis Pigmentosa
    MDPI AG ; 2021
    In:  Life Vol. 11, No. 3 ( 2021-03-22), p. 260-
    Details
    In: Life, MDPI AG, Vol. 11, No. 3 ( 2021-03-22), p. 260-
    Abstract: Concentric retinitis pigmentosa (RP), in which retinal degeneration is limited in the periphery, is rare and little information exists to date on the subject. Herein, we describe the clinical and genetic characteristics of this atypical form of RP. We retrospectively reviewed our database and identified 14 patients with concentric RP. Additionally, 14 patients with age-matched typical RP were also included. Patients with concentric RP had better visual acuity (logarithm of minimum angle of resolution −0.04 vs. 0.32, p = 0.047) and preserved ellipsoid zones (7630 µm vs. 2646 µm, p 〈 0.001) compared to typical RP. The electroretinogram showed subnormal but recordable responses in patients with concentric RP. Genetic testing was done in nine patients with concentric RP and revealed causative mutations in the EYS gene in one patient and the RP9 gene in one patient. Two patients had myotonic dystrophy and the diagnosis was revised as myotonic dystrophy-associated retinopathy. Concentric RP is a rare, atypical form of RP with better visual function. There is some overlap in the causative genes in concentric and typical RP. Myotonic dystrophy-associated retinopathy is an important differential diagnosis.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life11030260
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662250-6
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  • 3
    Online Resource
    Online Resource
    Long-Term Survival after Linac-Based Stereotactic Radiosurgery and Radiotherapy with a Micro-Multileaf Collimator for Brain Metastasis
    MDPI AG ; 2022
    In:  Current Oncology Vol. 29, No. 9 ( 2022-08-24), p. 6068-6076
    Details
    In: Current Oncology, MDPI AG, Vol. 29, No. 9 ( 2022-08-24), p. 6068-6076
    Abstract: Background: this study aimed to evaluate the prognostic factors associated with long-term survival after linear accelerator (linac)-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) with a micro-multileaf collimator for brain metastasis (BM). Methods: This single-center retrospective study included 226 consecutive patients with BM who were treated with linac-based SRS or fSRT with a micro-multileaf collimator between January 2011 and December 2018. Long-term survival (LTS) was defined as survival for more than 2 years after SRS/fSRT. Results: The tumors originated from the lung (n = 189, 83.6%), breast (n = 11, 4.9%), colon (n = 9, 4.0%), stomach (n = 4, 1.8%), kidney (n = 3, 1.3%), esophagus (n = 3, 1.3%), and other regions (n = 7, 3.1%). The median pretreatment Karnofsky performance scale (KPS) score was 90 (range: 40–100). The median follow-up time was 13 (range: 0–120) months. Out of the 226 patients, 72 (31.8%) were categorized in the LTS group. The median survival time was 43 months and 13 months in the LTS group and in the entire cohort, respectively. The 3-year, 4-year, and 5-year survival rate in the LTS group was 59.1%, 49.6%, and 40.7%, respectively. Multivariate regression logistic analysis showed that female sex, a pre-treatment KPS score ≥ 80, and the absence of extracranial metastasis were associated with long-term survival. Conclusions: female sex, a favorable pre-treatment KPS score, and the absence of extracranial metastasis were associated with long-term survival in the current cohort of patients with BM.
    Type of Medium: Online Resource
    ISSN: 1718-7729
    URL: Article
    DOI: 10.3390/curroncol29090477
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2270777-3
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  • 4
    Online Resource
    Online Resource
    Selective Neck Dissection and Survival in Pathologically Node-Positive Oral Squamous Cell Carcinoma
    MDPI AG ; 2019
    In:  Cancers Vol. 11, No. 2 ( 2019-02-25), p. 269-
    Details
    In: Cancers, MDPI AG, Vol. 11, No. 2 ( 2019-02-25), p. 269-
    Abstract: The most important prognostic factor in oral squamous cell carcinoma (OSCC) is neck metastasis, which is treated by neck dissection. Although selective neck dissection (SND) is a useful tool for clinically node-negative OSCC, its efficacy for neck node-positive OSCC has not been established. Sixty-eight OSCC patients with pN1–3 disease who were treated with curative surgery using SND and/or modified-radical/radical neck dissection (MRND/RND) were retrospectively reviewed. The neck control rate was 94% for pN1–3 patients who underwent SND. The five-year overall survival (OS) and disease-specific survival (DSS) in pN1-3 OSCC patients were 62% and 71%, respectively. The multivariate analysis of clinical and pathological variables identified the number of positive nodes as an independent predictor of SND outcome (OS, hazard ratio (HR) = 4.98, 95% confidence interval (CI): 1.48–16.72, p 〈 0.01; DSS, HR = 6.44, 95% CI: 1.76–23.50, p 〈 0.01). The results of this retrospective study showed that only SND for neck node-positive OSCC was appropriate for those with up to 2 lymph nodes that had a largest diameter ≤3 cm without extranodal extension (ENE) of the neck and adjuvant radiotherapy. However, the availability of postoperative therapeutic options for high-risk OSCC, including ENE and/or multiple positive lymph nodes, needs to be further investigated.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers11020269
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2527080-1
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  • 5
    Online Resource
    Online Resource
    Land-Based Mitigation Strategies under the Mid-Term Carbon Reduction Targets in Indonesia
    MDPI AG ; 2016
    In:  Sustainability Vol. 8, No. 12 ( 2016-12-08), p. 1283-
    Details
    In: Sustainability, MDPI AG, Vol. 8, No. 12 ( 2016-12-08), p. 1283-
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su8121283
    Language: English
    Publisher: MDPI AG
    Publication Date: 2016
    detail.hit.zdb_id: 2518383-7
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  • 6
    Online Resource
    Online Resource
    Study on Winter Comfort Temperature in Mixed Mode and HVAC Office Buildings in Japan
    MDPI AG ; 2022
    In:  Energies Vol. 15, No. 19 ( 2022-10-06), p. 7331-
    Details
    In: Energies, MDPI AG, Vol. 15, No. 19 ( 2022-10-06), p. 7331-
    Abstract: Comfort temperature is important to investigate because the chosen office indoor temperatures affect the energy used in a building, and a thermally comfortable environment makes the occupants be more productive. The effects of temperature on comfort are broadly recognized for thermal comfort. Japanese office buildings are well equipped with air-conditioning systems to improve the thermal comfort of the occupants. The main objectives of this research were to compare the winter comfort temperature in mixed mode (MM) and heating, ventilation and air-conditioning (HVAC) office buildings and to investigate the relationship between the comfort temperature and the indoor air temperature. This study measured the thermal environmental conditions of the office buildings and surveyed the thermal comfort of the occupants. The field survey was conducted during winter in seven office buildings located in the Aichi prefecture of Japan. In total, 4466 subjective votes were collected from 46 occupants. The result suggested that the occupants were found to be more satisfied with the thermal environment of MM buildings than that of HVAC office buildings. Overall, 95% of comfort temperatures were in the range 22~28 °C in MM and HVAC buildings, which were higher than the indoor temperature of 20 °C recommended by the Japanese government. The comfort temperature was highly correlated to the indoor air temperature of the MM buildings than to that of HVAC buildings. This indicated that the occupants were more adapted towards the given thermal environment of MM buildings.
    Type of Medium: Online Resource
    ISSN: 1996-1073
    URL: Article
    DOI: 10.3390/en15197331
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2437446-5
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  • 7
    Online Resource
    Online Resource
    Development of Adaptive Model and Occupant Behavior Model in Four Office Buildings in Nagasaki, Japan
    MDPI AG ; 2023
    In:  Energies Vol. 16, No. 16 ( 2023-08-18), p. 6060-
    Details
    In: Energies, MDPI AG, Vol. 16, No. 16 ( 2023-08-18), p. 6060-
    Abstract: A field survey of indoor environmental measurements and questionnaires on thermal sensation, overall comfort, and behaviors was conducted in four office buildings in Japan by visiting each office every month over a duration of more than a year during the coronavirus disease 2019 (COVID-19) pandemic. The indoor environment was measured concurrently. We obtained 1047 votes from office workers in their 20s to 60s. The regression and Griffiths’ methods were used to calculate the indoor comfort temperature. A logistic regression analysis was used to develop the occupant behavior model. Over 70% of the occupants found the indoor environment comfortable at a mean comfort temperature of 23.2 to 25.9 °C. Gender differences were observed in thermal sensation and overall comfort, but a gender difference was observed only in the cooling mode for the indoor comfort temperature. An adaptive model was developed for the office buildings in Nagasaki city to predict the indoor comfort temperature from the outdoor air temperature. The proportions of heating, cooling, and fan usage can be predicted from the outdoor air temperature using a logistic regression analysis. The adaptive model and occupant behavior model are useful for the indoor temperature control of the existing buildings and thermal simulation of the new building design.
    Type of Medium: Online Resource
    ISSN: 1996-1073
    URL: Article
    DOI: 10.3390/en16166060
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2437446-5
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  • 8
    Online Resource
    Online Resource
    Microbial Antigen-Presenting Extracellular Vesicles Derived from Genetically Modified Tumor Cells Promote Antitumor Activity of Dendritic Cells
    MDPI AG ; 2021
    In:  Pharmaceutics Vol. 13, No. 1 ( 2021-01-04), p. 57-
    Details
    In: Pharmaceutics, MDPI AG, Vol. 13, No. 1 ( 2021-01-04), p. 57-
    Abstract: Tumor-derived extracellular vesicles (EVs), as tumor vaccines, carry tumor-associated antigens (TAAs), and were expected to transfer TAAs to antigen-presenting cells. However, treatment with tumor-derived EVs exhibited no obvious antitumor effect on the established tumors, likely due to their immuno-suppressive functions, and also to the poor immunogenicity of TAAs. In order to improve the immune stimulating properties, EVs expressing a highly immunogenic bacterial antigen, 6 kDa early secretory antigenic target (ESAT-6), from Mycobacterium tuberculosis were prepared by genetically modifying the parent tumor cells with a plasmid coding for ESAT-6. Cultured B16 tumor cells were transfected with a ternary complex system consisting of pDNA, polyethylenimine (PEI), and chondroitin sulfate. The cells that were transfected with the ternary complex secreted EVs with a higher number of ESAT-6 epitopes than those transfected by a conventional DNA/PEI binary complex, due to the low cytotoxicity, and durable high expression efficiency of the ternary complex systems. The EVs presenting the ESAT-6 epitope (ESAT-EV) were collected and explored as immune modulatory agents. Dendritic cells (DCs) were differentiated from mouse bone marrow cells and incubated with ESAT-EV. After incubating with the EVs for one day, the DCs expressed a significantly higher level of DC maturation marker, CD86. The DCs treated with ESAT-EV showed a significantly improved antitumor activity in tumor-bearing mice.
    Type of Medium: Online Resource
    ISSN: 1999-4923
    URL: Article
    DOI: 10.3390/pharmaceutics13010057
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2527217-2
    SSG: 15,3
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  • 9
    Online Resource
    Online Resource
    Salvage Surgical Resection after Linac-Based Stereotactic Radiosurgery for Newly Diagnosed Brain Metastasis
    MDPI AG ; 2021
    In:  Current Oncology Vol. 28, No. 6 ( 2021-12-09), p. 5255-5265
    Details
    In: Current Oncology, MDPI AG, Vol. 28, No. 6 ( 2021-12-09), p. 5255-5265
    Abstract: Background: This study aimed to assess the clinical outcomes of salvage surgical resection (SSR) after stereotactic radiosurgery and fractionated stereotactic radiotherapy (SRS/fSRT) for newly diagnosed brain metastasis. Methods: Between November 2009 and May 2020, 318 consecutive patients with 1114 brain metastases were treated with SRS/fSRT for newly diagnosed brain metastasis at our hospital. During this study period, 21 of 318 patients (6.6%) and 21 of 1114 brain metastases (1.9%) went on to receive SSR after SRS/fSRT. Three patients underwent multiple surgical resections. Twenty-one consecutive patients underwent twenty-four SSRs. Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 17 months (range: 2–78 months). The range of tumor volume at initial SRS/fSRT was 0.12–21.46 cm3 (median: 1.02 cm3). Histopathological diagnosis after SSR was recurrence in 15 cases, and radiation necrosis (RN) or cyst formation in 6 cases. The time from SRS/fSRT to SSR was shorter in the recurrence than in the RNs and cyst formation, but these differences did not reach statistical significance (p = 0.067). The median survival time from SSR and from initial SRS/fSRT was 17 and 74 months, respectively. The cases with recurrence had a shorter survival time from initial SRS/fSRT than those without recurrence (p = 0.061). Conclusions: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.
    Type of Medium: Online Resource
    ISSN: 1718-7729
    URL: Article
    DOI: 10.3390/curroncol28060439
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2270777-3
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  • 10
    Online Resource
    Online Resource
    Macroeconomic Impacts of Climate Change Driven by Changes in Crop Yields
    MDPI AG ; 2018
    In:  Sustainability Vol. 10, No. 10 ( 2018-10-14), p. 3673-
    Details
    In: Sustainability, MDPI AG, Vol. 10, No. 10 ( 2018-10-14), p. 3673-
    Abstract: Changes in agricultural yields due to climate change will affect land use, agricultural production volume, and food prices as well as macroeconomic indicators, such as GDP, which is important as it enables one to compare climate change impacts across multiple sectors. This study considered five key uncertainty factors and estimated macroeconomic impacts due to crop yield changes using a novel integrated assessment framework. The five factors are (1) land-use change (or yield aggregation method based on spatially explicit information), (2) the amplitude of the CO2 fertilization effect, (3) the use of different climate models, (4) socioeconomic assumptions and (5) the level of mitigation stringency. We found that their global impacts on the macroeconomic indicator value were 0.02–0.06% of GDP in 2100. However, the impacts on the agricultural sector varied greatly by socioeconomic assumption. The relative contributions of these factors to the total uncertainty in the projected macroeconomic indicator value were greater in a pessimistic world scenario characterized by a large population size, low income, and low yield development than in an optimistic scenario characterized by a small population size, high income, and high yield development (0.00%).
    Type of Medium: Online Resource
    ISSN: 2071-1050
    URL: Article
    DOI: 10.3390/su10103673
    Language: English
    Publisher: MDPI AG
    Publication Date: 2018
    detail.hit.zdb_id: 2518383-7
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