The coronavirus disease (COVID-19) pandemic has greatly altered peoples’ daily lives, and it continues spreading as a crucial concern globally. Knowledge, attitudes, and practices (KAP) toward COVID-19 are related to individuals’ adherence to government measures. This study evaluated KAP toward COVID-19 among university students in Japan between May 22 and July 16, 2020, via an online questionnaire, and it further investigated the associated determining KAP factors. Among the eligible respondents (n = 362), 52.8% were female, 79.0% were undergraduate students, 32.9% were students whose major university subjects were biology-related, 35.4% were from the capital region, and 83.7% were Japanese. The overall KAP of university students in Japan was high. All respondents (100%) showed they possessed knowledge on avoiding enclosed spaces, crowded areas, and close situations. Most respondents showed a moderate or higher frequency of washing their hands or wearing masks (both at 96.4%). In addition, 68.5% of respondents showed a positive attitude toward early drug administration. In the logistic regressions, gender, major subjects, education level, nationality, residence, and psychological factors (private self-consciousness and extroversion) were associated with knowledge or attitudes toward COVD-19 (p < 0.05). In the logistic and multiple linear regressions, capital regions, high basic knowledge, high information acquisition, correct information explanations contributed positively to preventative action (p < 0.05). Non-capital regions, male gender, non-bio-backgrounds, high public self-consciousness, high advanced knowledge, incorrect information explanations, and high extroversion contributed negatively to self-restraint (p < 0.05). Moreover, self-restraint was decreasing over time. These findings clarify the Japanese university students’ KAP and the related factors in the early period of the COVID-19 pandemic, and they may help university managers, experts, and policymakers control the future spread of COVID-19 and other emerging infections.

While the community-based integrated care systems are in the process of being structured currently, more and more community pharmacists want to learn physical assessment skills. However, no large-scale survey focusing on present implementation status and problems of physical assessment by community pharmacists has been conducted yet. Osaka has the 2nd highest number of community pharmacies in Japan now, and the population aged 65 years will be expected to become the 3rd highest in 2025. Thus, Osaka can become a national leading model case for community pharmacists' activity in future home medical care. Therefore, this study aimed to reveal the present implementation status and problems of physical assessment by community pharmacists in Osaka, especially focusing on vital-signs. The questionnaires were sent to all the 3571 insurance pharmacies belonging to the Osaka Pharmaceutical Association and 871 pharmacies responded. Many pharmacists recognized the necessity for vital-signs measurement by pharmacists in home medical care (81.5％ of pharmacies that oŠered home medical care and 75.4％ of pharmacies that did not oŠer one). However, the proportion of pharmacies that conduct vital-signs measurement in home medical care was 18.7％, therefore, it was suggested that the present problem is``many pharmacists cannot conduct vital-signs measurement, although they think it should be conducted''. Moreover, the most common reason for not measuring vital-signs was the lack of instruments, such as stethoscopes and sphygmomanometer (43.2％). This is the latest report with a large-scale sample, thus, it can serve as valuable knowledge in considering what pharmacists do for the future.

Many of the neurodegenerative diseases associated with a decrease in regional cerebral blood flow (rCBF) are untreatable, and the appropriate therapeutic strategy is to slow the progression of the disease. Therefore, it is important that a definitive diagnosis is made as soon as possible when such diseases are suspected. Diagnostic imaging methods, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT), play an important role in such a definitive diagnosis. Since several problems arise when evaluating these images visually, a procedure to evaluate them objectively is necessary, and studies of image analyses using statistical evaluations have been suggested. However, the assumed data distribution in a statistical procedure may occasionally be inappropriate. Therefore, to evaluate the decrease of rCBF, it is important to use a statistical procedure without assumptions about the data distribution. In this study, we propose a new procedure that uses nonparametric or smoothed bootstrap methods to calculate a standardized distribution of the Z-score without assumptions about the data distribution. To test whether the judgment of the proposed procedure is equivalent to that of an evaluation based on the Z-score with a fixed threshold, the procedure was applied to a sample data set whose size was large enough to be appropriate for the assumption of the Z-score. As a result, the evaluations of the proposed procedure were equivalent to that of an evaluation based on the Z-score.Key words single-photon emission computed tomography; diagnostic imaging; bootstrap method Diagnostic imaging methods, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging, are well established for assessing decreases in regional cerebral blood flow (rCBF). Many of the neurodegenerative diseases associated with a decrease of rCBF are untreatable, and the appropriate therapeutic strategy is to slow the progression of the disease. Therefore, when such diseases are suspected, it is important that a definitive diagnosis is made as soon as possible. Diagnostic imaging methods such as PET and SPECT play an important role in the definitive diagnosis of neurodegenerative diseases. Since several problems arise when evaluating these images visually, a procedure to evaluate them objectively is necessary, and studies of image analyses using statistical evaluations, such as statistical parametric mapping (SPM), three-dimensional stereotactic surface projection (3D-SSP), and the easy Z-score imaging system (eZIS), have been suggested. 1-9) For example, the Z-score is calculated for each pixel of an image and is then used as an index of the decrease of rCBF in each pixel. The Z-score is based on statistical significance, and the formula iswhere x is the pixel value in the patient data, and x̄0 and σ 0 are the average and the standard deviation of the pixel values in the control data set, respectively.If a Z-score exceeds a threshold, T 0 , which is based on the signifi...

Alzheimer's disease (AD) and Parkinson's disease (PD) are both prominent central nervous system diseases that are frequently diagnosed and studied using brain single-photon emission computed tomography (SPECT). Owing to divergent clinical features, AD and PD are often considered distinct diseases; however, it is difficult to distinguish AD from PD on SPECT. Tools for objectively analyzing differences between AD and PD on SPECT images are not currently available. To construct a model for discriminating AD from PD in Japanese patients, we used a support vector machine (SVM) and SPECT images acquired at two different time points after radiotracer injection to extract the determinant regions for classification. We assessed SPECT images from 68 Japanese patients with AD or PD. After pre-processing noise voxels, a non-linear SVM classification with Gaussian kernels was adopted to construct the predictive model. The best SVM model was highly accurate for distinguishing AD from PD. The accuracy of this model was 98.1% for leave-one-out cross-validation and 78.6% for the test set. Our data showed that the temporal, sub-lobar, parietal, limbic, and frontal areas exhibited decreased regional cerebral blood flow in AD; whereas the frontal, anterior, parietal, and occipital areas exhibited decreased regional cerebral blood flow in PD. Here, we present a useful SVM model for classifying AD versus PD using SPECT images and show the utility of two-time-point SPECT imaging for AD/PD discrimination.

Few studies have addressed the effects and adverse events associated with daily teriparatide use, as well as the adherence and causes for non-adherence, among Japanese patients with osteoporosis, particularly those older than 80 years. In this study, we aimed to clarify various parameters associated with daily teriparatide use in Japanese patients with osteoporosis in a real-world clinical setting. This retrospective study compared the persistence of daily teriparatide use and the associated effects and adverse events in older (≥80 years, n=52) and younger patients (<80 years, n=106) treated with teriparatide between May 2013 and May 2018 at a single orthopedic clinic. We observed a significantly higher treatment completion rate among younger patients compared to their older counterparts (59.6% vs. 40.6%, p=0.036). Of the 74 patients (both patient groups) who completed a 24-month treatment course, only one (1.35%) developed new vertebral fractures. Our findings suggest that older patients would benefit from consistent osteoporosis treatment, particularly with a generally safe and effective agent, such as teriparatide. However, Log-rank test also shows the older patients exhibits a greater tendency to drop out than the younger patients (p=0.0238). The older patients tended to continue to drop out from the beginning. Accordingly, our results emphasize the importance of interventions, especially continuous encouraging from the first self-injection of teriparatide.