京都大学 / 0048 / 新制・課程博士 / 博士(農学) / 甲第22848号 / 農博第2431号 / 新制||農||1082(附属図書館) / 学位論文||R2||N5308(農学部図書室) / 京都大学大学院農学研究科応用生物科学専攻 / (主査)教授 松浦 健二, 教授 大門 高明, 教授 吉村 剛 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

Objective: Although patients with avoidant/restrictive food intake disorder (ARFID) often consult general pediatric services initially, existing literature mostly concentrated on ntensive eating disorder treatment settings. This cross-sectional study sought to describe symptoms of ARFID and their associations with eating disorder psychopathology, quality of life, anthropometry, and physical comorbidities in a general pediatric sample. Methods: In N = 111 patients (8-18 years) seeking treatment for physical diseases, prevalence of ARFID-related restrictive eating behaviors was estimated by self-report and compared to population-based data (N = 799). Using self-report and medical record data, further ARFID diagnostic criteria were evaluated. Patients with versus without symptoms of ARFID based on self-report and medical records were compared in diverse clinical variables. Results: The prevalence of self-reported symptoms of ARFID was not higher in the inpatient than population-based sample. Only picky eating and shape concern were more common in the inpatient than population-based sample. Although 69% of the inpatient sample reported any restrictive eating behaviors, only 7.2% of patients showed symptoms of ARFID based on medical records in addition to self-report, particularly those with underweight, without significant effects for age, sex, and medical diagnoses. Discussion: The study revealed the importance of considering ARFID within the treatment of children and adolescents with physical diseases, especially for those with underweight. Further research is needed to replicate the findings with interview-based measures and to investigate the direction of effects in ARFID and its physical correlates.

This diploma thesis deals with methods of determining and treatment of coeliac disease. In the theoretical part of the work sums up informations about coeliac disease - history, prevalence, etiopathogenesis, immunopathogenesis, possibilities of diagnosis, discusses about gluten-free diet, mentions legislation of the Czech Republic and the European Union and compares expensiveness of gluten-free diet and normal diet. The experimental part of this thesis compares PCR, ELISA and indirect immunofluorescence methods for assesment of determination of genetic predisposition and antibodies in coeliac disease (greatest emphasis was placed on the comparison of antibodies against gliadin and deamidated gliadin antibodies in IgA and IgG).

Orientador: Carlos Magno Castelo Branco Fortaleza / Resumo: Embora o Programa Nacional de Imunização (PNI) do Brasil seja reconhecidamente bem-sucedido, pouco se conhece a cobertura vacinal em adultos no país. Essa lacuna do conhecimento é especialmente extensa no caso dos adultos não idosos. Com o objetivo de contribuir para o conhecimento de prevalência e preditores de adesão a vacinas estratégicas para adultos, realizamos um inquérito domiciliar em área urbana de Botucatu, Estado de São Paulo, Brasil. Ao todo, 758 indivíduos adultos foram incluídos. Aplicou-se questionário abordando uso de vacinas, bem como fatores demográficos, comorbidades e opiniões/atitudes relacionadas à imunização. Dados do questionário foram complementados e/ou corrigidos conforme informações coletadas pela Secretaria Municipal de Saúde de Botucatu. Escolhemos como desfechos de interesse a vacinação em dia contra difteria e tétano, hepatite B, influenza e sarampo/caxumba/rubéola (vacina tríplice viral). Foi realizado georreferenciamentoin loco dos domicílios. Análise de preditores envolveu modelos uni e multivariados de regressão logística. Em nossos achados, a adesão/atualização para imunização foi baixa para tétano (37%). Essa adesão esteve associada a sexo feminino e idade mais baixa. Quanto à vacina contra hepatite B, esta foi de 77% nos grupos para os quais está indicada, tendo o sexo feminino como único preditor independente. A vacinação contra influenza foi mais baixa em idosos (58%) que em outros grupos. Já para a tríplice viral, an... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Even though Brazilian governmental program for immunization is considered a particular example of success in public health, little is known about vaccine coverage among adults. This is especially true for those at younger age. Our study aimed at contributing to the knowledge of the prevalence and predictors of adherence to vaccination among adults. We conducted a population-based suvey in the city of Botucatu, São Paulo State, Brazil. A total of 758 subjects were enrolled. A questionnaire addressed issues concerning immunization, demographics, comorbidities and opinions/attitudes regarding vaccines. Georreferencing of households was performed. Results of the questionnaire were complemented and/or corrected according to information obtained in the Botucatu Municipal Health Department. We chose as outcomes of interest vaccination against tetanus/diphtheria, hepatitis B, influenza and mumps/measles/rubella (MMR). We found low prevalence of updated tetanus vaccination (37%), and it was independently associated with female gender and younger age. As for hepatitis B. coverage was 77% in the target group (adults under 50). Influenza coverage was lower among elderly (58%) as compared to other groups to whom this vaccine is recommended. MMR coverage was 61% among women at reproductive ave. with no identifiable predictors. Maps presenting Kernel estimates of outcome density showed varied patterns of hot spots for different vaccines, as well as between vaccinated and non-vaccinated subjects. However, we found no association of living close to Healthcare Basic Units to adherence to immunization. Our data suggest that males and elderly people should be focused by policies aiming at increasing adherence to immunization among adults. / Mestre

La néophobie alimentaire est une réticence à goûter et/ou le rejet des aliments inconnus. Elle a une incidence négative sur la variété du répertoire alimentaire de l’enfant et sur le climat familial lors des repas. L’objectif de notre étude, qui se situe dans une perspective développementale, est de répondre à trois questions concernant cette conduite qui demeurent insuffisamment traitées dans la littérature scientifique : 1/ la néophobie alimentaire émerge-t-elle brusquement à 2 ans ; 2/ si oui, quels sont les processus développementaux à l’origine de cette évolution ? ; 3/ quels liens la néophobie alimentaire entretient-elle avec la sélectivité alimentaire (réticence à goûter des aliments familiers) et l’alimentation difficile (rejet d’aliments inconnus et familiers, assorti de fortes préférences alimentaires) ?Via l’utilisation de questionnaires, nous avons évalué : 1/ la néophobie alimentaire en termes de prévalence et d’intensité ; 2/ les compétences développementales susceptibles d’expliquer son évolution dans les sphères motrice, praxique, linguistique et psycho-affective ; ces compétences ont été sélectionnées sur la base d’arguments temporel (évolution synchrone) et fonctionnel (liens théorique et psychologique) ; 3/ les conduites avec lesquelles elle est fréquemment confondue, à savoir la sélectivité alimentaire et l’alimentation difficile. Notre échantillon principal s’est trouvé composé de 432 sujets âgés de 3 à 60 mois. Nos résultats ont indiqué que la néophobie alimentaire constituait une période normale du développement de l’enfant. La prévalence de la néophobie alimentaire était de 57 % et associée à une intensitée modérée entre 3 et 6 mois ; elle augmentait de manière importante en termes de prévalence et d’intensité entre 19 et 36 mois, concernant 90 % des enfants à cet âge, puis elle se stabilisait jusqu’à 60 mois. Suivant cette évolution, nous avons proposé un modèle développemental de la néophobie alimentaire comprenant deux phases : 1/ une néophobie primaire commune aux nourrissons et aux animaux, liée à la perception de la nouveauté d’une texture ou d’une flaveur et sous-tendue par des processus de pensée intuitifs ; 2/ une néophobie secondaire, liée aux acquisitions réalisées par les enfants aux alentours de 2 ans, reposant largement sur l’aspect visuel des aliments et impliquant des traitements cognitifs plus élaborés. Nous n’avons pas identifié les processus développementaux à l’origine de son évolution entre 19 et 36 mois. Plusieurs explications méthodologiques et théoriques ont été envisagées pour expliquer cette absence de résultat telles que l’existence d’une phase intermédiaire dans l’acquisition des compétences ou l’implication d’autres mécanismes psychologiques ou neurobiologiques non mesurés dans cette recherche. De plus, nous avons constaté une intrication des processus développementaux mesurés aux alentours de 2 ans. Tous les progrès réalisés par l’enfant sur une courte période semblent converger dans une même direction, celle de l’autonomie : une autonomie à la fois motrice, avec l’acquisition de la marche et de la capacité à se nourrir seul, et une autonomie psychique, avec l’acquisition de la conscience de soi et l’entrée en phase d’opposition. Dans ce cadre, le développement du langage permettrait à l’enfant d’exprimer son individualité à travers l’affirmation de ses goûts et de ses besoins. La capacité à exprimer des demandes verbales et l’acquisition de la conscience de soi ont d’ailleurs été les compétences approchant le plus des critères de validation d’hypothèse. De ce fait, nous pouvons nous demander si l’augmentation de la néophobie alimentaire aux alentours de 2 ans vise à protéger l’enfant d’un éventuel empoisonnement à un moment où il devient de plus en plus autonome et/ou si elle reflète simplement des tentatives d’individuation. / Food neophobia is a reluctance to taste and/or the rejection of unknown foods. It has a negative impact on the diversity of the child's food repertoire and on the family dynamic during meals. The objective of our study, within a developmental perspective, is to answer three questions that remain insufficiently addressed in the scientific literature concerning this behavior: 1/ does food neophobia suddenly emerge at 2 years old; 2/ if so, what are the developmental processes involved in this evolution? ; 3/ how is food neophobia linked with pickiness (the reluctance to taste unfamiliar ingredients) and picky eating (the rejection of both unfamiliar and familiar foods, assorted with strong food preferences)?Through the use of questionnaires, we assessed: 1/ Food neophobia in terms of prevalence and intensity; 2/ Some developmental skills that are likely to explain its evolution in the motor, praxic, linguistic and psycho-affective spheres; these skills have been determined on the basis of temporal (synchronous evolution) and functional (theoretical and psychological links) arguments; 3/ The different behaviors it is frequently confused with: pickiness and picky eating. Our research sample was composed of 432 subjects aged between 3 and 60 months old.Our results showed that food neophobia was a normal period during childhood. The prevalence of food neophobia was 57% and was moderate intense between 3 and 6 months; it increased significantly in terms of prevalence and intensity between 19 and 36 months, with 90% of children affected by this condition at this age, then it stabilized until 60 months old. Based on this evolution, we have proposed a developmental model of food neophobia that can be divided in two phases: 1/ A primary neophobia common to infants and animals, that is mostly related to the perception of a new textures or flavors which relies on intuitive thinking processes; 2/ Secondary neophobia, that is based on children development around 2 years old, and that largely relies on food’s visual aspect and involves more elaborate cognitive processes.We did not identify the developmental processes that are responsible for its evolution between 19 and 36 months. Several methodological and theoretical explanations have been considered to justify this lack of results such as the existence of an intermediate phase during the skills acquisition period or the involvement of other psychological or neurobiological mechanisms that have not been measured for this study. In addition, we found an entanglement of developmental processes measured around 2 years. All the progress made by the child over a short period seem to converge in the same direction, that of autonomy: a motor autonomy, with the ability to walk and eat alone, and a psychic autonomy, with self-awareness and the opposition phase. In this context, language development would allow the child to express his/her individuality through the assertion of his preferences and needs. Furthermore, the ability to express verbal demands and the acquisition of self-awareness have been the closest things to our hypothesis validation criteria. As a result, we can ask whether the increase in food neophobia around 2 years is aimed at protecting the child from possible poisoning at a time when he is becoming more and more autonomous and/or if he simply reflects individuation attempts.

Bakgrund:Ländryggssmärta är en vanlig orsak till nedsatt funktionsförmåga och 60–80% av alla vuxna har upplevt smärta i ländryggen någon gång i livet. Fysisk aktivitet (FA) har god evidens att förhindra att ländryggssmärtan utvecklas till kronisk samt för att minska smärta och öka/bibehålla funktion. Fysioterapeutstudenter inhämtar under utbildningen kunskap om betydelsen av FA i både prevention och behandling, men lever vi som vi lär? Syfte:Att undersöka förekomst av ländryggssmärta, genomsnittlig mängd FA samt skillnader gällande mängd och intensitet av FA hos fysioterapeutstudenter i Sverige med respektive utan ländryggssmärta. Studien har även undersökt könsskillnader avseende prevalens av ländryggssmärta.  Metod:En tvärsnittsstudie av kvantitativ, komperativ och icke-experimentell design. En webbenkät skickades till samtliga fysioterapeutprogram i Sverige. Totalt deltog 252 personer av uppskattningsvis 1700 studerande. De svarande fick fylla i bakgrundsdata samt för de senaste sju dagarna skatta sin upplevda ländryggssmärta enligt 1–10 på Numeric Rating Scale (NRS) och sin mängd FA på olika intensiteter enligt International Physical Activity Questionnaire Short Form (IPAQ-SF). Resultat: Prevalensen av ländryggssmärta var 60% och förekomsten var lika mellan könen (män: 58%, kvinnor: 60%). Majoriteten av deltagarnas aktivitetsmängd klassificeras som hög. Resultaten påvisade ingen skillnad i FA mellan grupperna gällande total, mycket ansträngande samt måttligt ansträngande FA.  Konklusion:Inga statistiska skillnader gällande prevalens av ländryggssmärta kunde ses mellan könen. Studien påvisade ingen signifikant skillnad mellan grupperna med respektive utan ländryggsmärta gällande mängd eller intensitet av FA. Vidare forskning behövs på ämnet. / Background:Low back pain (LBP) is a common cause of disability and 60-80% of adults have experienced LBP at some point in their lives. Physical activity (PA) has good evidence to prevent LBP from becoming chronic, reduce pain and increase function. Physical therapy students learn of the importance of PA in both prevention and treatment. But do we live as we learn? Objective:To investigate the prevalence of LBP, average amount of PA and differences regarding the amount and intensity of PA amongst physical therapy students with and without LBP in Sweden. The study has also examined gender differences in the prevalence of LBP. Method:A cross-sectional study with quantitative, comparative and non-experimental design. A web survey was distributed to all physiotherapy programs in Sweden. Out of an estimated 1,700 students, 252 responded. Respondents submitted background information and estimated for the last seven days their LBP from 1-10 according to Numeric Rating Scale (NRS) and their amount of PA at different intensities according to International Physical Activity Questionnaire Short Form (IPAQ-SF). Results:The prevalence of LBP was 60%. 58% of men and 60% of women estimated LBP in the last seven days. The majority of the participants’ PA was classified as high. The results showed no significant difference in PA between the groups. Conclusion:No statistic differences regarding prevalence of LBP could be seen between the sexes. No significant difference regarding amount or intensity of PA was found between the groups with and without LBP. Further research is needed.

Avian contact zones were suggested to act as barriers to parasite expansions. I studied haemosporidian parasites (genera Plasmodium, Haemoproteus, and Leucocytozoon) of two Nightingale species which meet in a contact zone in Europe. In total 20 lineages of parasites were detected. Surprisingly, all common lineages were shared by the two host species. The parasite prevalence vary between species (Trush Nightingales were more often parasitized than Common Nightingales.) but did not vary to a large extent within zones inside species Parasitemia of the most frequent Haemoproteus LULU1 lineage assessed by Real-Time PCR method did not differ significantly between the two host species. Six out of nine hybrids of the nightingale species were parasitized. Haemosporidian lineages found in hybrids were also frequent in the parental species. In conclusion, the nightingale contact zone seems to have only little (if any) effect on the distribution of haemosporidian parasites.

The genera Haemoproteus and Plasmodium are widespread genera of blood parasites from phylum Apicomplexa. Both genera have dixenous life cycle and their definitive hosts belong to the order Diptera. Both parasites can be found in birds where asexual division takes place. The infection with genera Haemoproteus and Plasmodium is usually asymptomatic; during long lasting chronic phase relapses of the infection can occur. We gained 1 092 blood samples from 29 trapped species of passerines in Milovice forest during seasons 2017-2019. Haemosporidians were detected in 48 % of samples. The prevalence of genus Plasmodium was 16 %, the prevalence of genus Haemoproteus was 22 % and 10 % we could not specify the parasite. We have found six new lineages of genus Haemoproteus, provisionally named Haemoproteus lineages coccoc_1, coccoc_2, coccoc_3, coccoc_4, embcit, fricoe which total prevalence was 14 %. Lineage Haemoproteus sp. coccoc_1 was the most noticed one and its prevalence was 12 %. Plasmodium relictum clone Peng14-121Br2AF and isolate Cc_P1 was the second most prevalent (13 %). Infection dynamics was studied in samples gained in years 2014-2019. Forty individuals were examined between years and twenty-seven individuals were examined intraseasonally. Three individuals were trapped both intra- and...

The location of mental nerve has been extensively studied anatomically and radiographically. This systematic review aims to summarize the common location of mental foramen (MF) as well as its anatomical variation, the accessory mental foramen (AMF). The PubMed and Google Scholar databases were both searched for the available study until Jan 2020. The database search yield 2766 study of which 47 were included in this study according to the inclusion criteria. The study concludes that in general the position of the mental foramen is between area distal to the first premolar root apex and the long axis of the apex of second premolar in 82% to 90% according to panoramic and CBCT studies reported until 2020 respectively. Importantly, AMF incident has been found in 8.3% of the population, according the all of the CBCT studies included in this systematic review.

Background: In the treatment of hypertension, physicians’ attitudes and practice patterns are receiving increased attention as contributors to poor blood pressure (BP) control. Thus, current use of antihypertensive drugs in primary care was analyzed and the association with selected physician and patient characteristics was assessed. Methods: The Hypertension and Diabetes Risk Screening and Awareness (HYDRA) study is a cross-sectional point prevalence study of 45,125 primary care attendees recruited from a representative nationwide sample of 1912 primary care practices in Germany. Prescription frequencies of the various antihypertensive drugs in the individual patients were recorded by the physicians using standardized questionnaires. We assessed the association of patient variables [age, gender; co-morbidities such as diabetes, nephropathy or coronary heart disease (CHD)] and physician variables (general practitioner vs internist, guideline adherence, etc.) with drug treatment intensity and prescription patterns. Results: Of all 43,549 patients for whom a physician diagnosis on hypertension or diabetes was available, 17,485 (40.1%) had hypertension. Of these hypertensive patients, 1647 (9.4%) received no treatment at all, 1191 (6.8%) received non-pharmacological measures only, and 14,647 (83.8%) were given one or more antihypertensive drugs. Drug treatment rates were lower in young patients (16–40 years: 57.4%). BP control was poor: 70.6% of all patients were not normalized, i.e., had BP ≥140/90 mmHg. Antihypertensive treatment was generally intensified with increasing age, or if complications or comorbidities were present. The use of the different drug classes was rather uniform across the various patient subgroups (e.g., by age and gender). Individualized treatment with regard to co-morbidities as recommended in guidelines was not the rule. Adherence to guidelines as self-reported by physicians as well as other physician characteristics (region, training etc.) did not result in more differentiated prescription pattern. Conclusions: Despite the broad armamentarium of drug treatment options, physicians in primary care did not treat hypertension aggressively enough. Treatment was only intensified at a late stage, after complications had occurred. Treatment should be more differentiated in terms of coexisting morbidities such as diabetes, nephropathy, or CHD.