Oita University Hospital

This study investigated whether wakeful targeted memory reactivation (TMR) during short rest intervals improves motor learning. Participants were randomly assigned to three groups and performed a sequential key-press task under each condition: (1) TMRregular group: auditory cues played at the same speed as the previous task, (2) TMRfast group: auditory cues played 1.3 times faster, and (3) TMRrandom group: auditory cues randomized in pitch. To examine the motor learning effect of cue structure, we compared motor learning across three groups (TMRregular, TMRfast, and TMRrandom). The TMRfast group enhanced early learning gains compared with the TMRregular group. Electroencephalogram data revealed stronger functional connectivity centered on the lateral orbitofrontal cortex (lOFC) in the TMRfast group than in the TMRregular group. Together, these findings suggest that wakeful TMR can enhance early motor learning depending on cue timing and structure, highlighting the importance of optimizing sensory parameters for learning improvement.

During the COVID-19 pandemic, Mycoplasma pneumoniae infections were rarely observed in Japan, but a significant outbreak occurred in 2024. At Oita Children's Hospital, a rapid quenching probe polymerase chain reaction (QP-PCR) method was employed to detect the pathogen and to determine the prevalence of macrolide resistance. Between April 1 and September 30, 2024, we tested 679 patients - 462 (68.0%) were positive and 399 (86.4%) were macrolide resistant. The resistance rate was among the highest reported in Japan and comparable to those in neighboring Asian countries. Inpatients were younger than outpatients, and their diagnoses required longer periods of time; corticosteroids were used in 86% of hospitalized cases. QP-PCR detects common A2063G and A2064G mutations and provides results within 40 minutes, which could promote timely therapy, and this is true particularly in the case of younger children whose options could be limited. Early administration of effective antimicrobial agents is crucial for the control of macrolide-resistant M. pneumoniae. These findings indicate that QP-PCR-based diagnostics could significantly contribute to the management and control of M. pneumoniae outbreaks.

ObjectiveGentamicin (GM), a renally eliminated drug, is widely used to treat infections in neonates. Neonatal dosing is typically based on body weight and postmenstrual age (PMA). Although serum creatinine (Cr) is the gold standard for evaluating renal function, Cr at birth may reflect both neonatal and maternal levels. This study aimed to identify determinants of trough GM concentrations, focusing on renal function parameters.MethodsThis retrospective, single-center, observational study included 78 neonates who started intravenous GM on postnatal days 0–1. Dosing regimen was stratified by birth weight: < 1200 g (n = 22), 5 mg/kg every 48 h; 1200–1999 g (n = 10), 4 mg/kg every 36 h; ≥ 2000 g (n = 46), 4 mg/kg every 24 h. Dose-normalized trough concentration (C/D) was calculated by dividing trough GM concentration by 24-h equivalent GM dose. Cr level measured at birth (Crbirth) and the first Cr level measured after GM initiation (CrGM) were analyzed.ResultsIn neonates < 1200 g and 1200–1999 g, CrGM was significantly higher than Crbirth. C/D correlated significantly with PMA, CrGM, and urine output, but not with Crbirth. Multiple regression analysis incorporating variables measured at birth (Crbirth and PMA) as covariates identified PMA as the only significant predictor of C/D. When variables available following GM initiation (Crbirth, PMA, CrGM, urine output, and ibuprofen co-administration) were included as covariates, Crbirth emerged as the sole independent factor predicting C/D.ConclusionPMA-based dosing appears to be preferable for determining initial GM dosing on postnatal day 0, whereas Cr-based renal function parameters may be more effective for guiding maintenance dosing.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11095-026-04045-z.

Oz virus (OZV) was first isolated from ticks in Japan in 2018, and human infections with OZV were reported in 2023. However, serosurveillance for OZV infections, compared with that for severe fever with thrombocytopenia syndrome (SFTS), is rarely performed among wild animals. We conducted a retrospective study on the epidemiology of SFTS virus and OZV infections in wild animals. Serum samples were collected from 289 deer, 158 raccoons, and 381 wild boars in this study. The positivity rates for the anti-OZV IgG antibody in deer (10.3%), raccoons (12%), and wild boars (12.1%) showed no difference. Both OZV and SFTS virus IgG antibodies were detected in wild animals. Wild animals in Oita Prefecture had anti-OZV antibodies, suggesting that human cases will occur in the future. We recommend educating the public about the tick-borne pathogen risks in this area and implementing tick bite prevention strategies.

In the field of drug development, pharmacokinetic studies primarily focus on adult and pediatric populations, resulting in limited pharmacokinetic data for specific populations such as neonates, pregnant women, and critically ill patients. Optimizing drug therapy for these populations requires dosing strategies that are personalized for individual patients, and are based on pharmacokinetic/pharmacodynamic analyses and therapeutic drug monitoring. In our study of patients admitted to intensive care unit (ICU), the pharmacokinetic parameters of doripenem differed from those in non-ICU patients, with higher pharmacokinetic/pharmacodynamic breakpoints in ICU patients. Population pharmacokinetic modeling of doripenem revealed that prolonged infusion for 4 h was necessary for critically ill patients undergoing continuous renal replacement therapy. In patients with hematological malignancies, inflammatory markers such as C-reactive protein (CRP) significantly affected the intra-individual pharmacokinetic variability of voriconazole, highlighting the need for dose titration according to CRP levels. Furthermore, febrile neutropenia (FN) significantly increased vancomycin clearance in children, requiring higher daily doses than in children without FN. In contrast, augmented renal clearance, but not FN, significantly affected teicoplanin clearance in adults. Physiologically based pharmacokinetic modeling of sublingual buprenorphine facilitated prediction of drug exposure in pregnant women and their fetuses. Post hoc optimization of sublingual absorption using concentrations observed in the mothers markedly improved prediction of fetal exposure. These findings underscore the importance of personalized pharmacokinetic assessments to improve individualized therapeutic strategies in specific populations, and to aim for optimizing efficacy while minimizing adverse effects. Future research integrating mathematical modeling and simulation techniques is expected to improve dosing precision.

Fragility hip fracture (FHF) has been frequently seen in trauma of older people, resulted in decreased mobility and a loss of independence. This study retrospectively assessed the long-term health-related quality of life (HRQOL) and living arrangement in older patients following FHF, and evaluated the factors associating with long-term EuroQol 5D (EQ5D) for 5years or more. This study included 203 Japanese patients (male 26, female 177) with FHF over the age of 60years. We examined the long-term EQ5D and life style at final follow-up, and identified the factors affecting with EQ5D. The mean age at baseline of 79years, the mean observation duration was 6years, and the average value of EQ5D at final follow-up was 0.65. Multivariate analysis presented that EQ5D at final follow-up was significantly predicted by serum albumin, trochanteric fracture, comorbidity stroke, higher BI at post-admission, less length of stay hospital, and living at home at final follow-up. The people living at home at final follow-up (148/203 [72.9%]) was less than the people at baseline (190/203 [93.6%]). In multivariate analysis, the people living at home at final follow-up were younger age at baseline, and higher BI at post-admission. In conclusion the long-term EQ5D after FHF was decreased in patients with lower serum albumin at baseline, with trochanteric fracture, with stroke comorbidity, and with lower BI at post-admission. The people living at home after FHF were young age at baseline and high BI at post-admission.

BackgroundWeather is recognized as an environmental risk factor for acute myocardial infarction (AMI). This study explores the meteorological factors linked to a higher incidence of AMI.Methods and resultsThe study involved 403 patients from the Oita AMI Registry who were admitted to 20 medical facilities with an AMI diagnosis between April 2012 and September 2013. We defined “frequent onset days” (F-days) as days when three or more patients were admitted for AMI, in contrast to "non-frequent onset days” (non-F-days), which were days with fewer than three admissions. This period was categorized into four seasons: spring, summer, autumn, and winter. The meteorological data used in this study came from the Japan Meteorological Agency. During autumn, F-days were associated with a significantly older patient population (77.4 ± 11.7 years vs. 68.3 ± 13.8 years, p = 0.02) and a higher population of female patients (57.1% vs. 17.4%, p = 0.003) compared to non-F-days. Additionally, the body mass index was significantly lower on F-days compared to non-F days (21.5 ± 3.5 kg/m² vs. 23.6 ± 3.2 kg/m², p = 0.03). In summer, the average atmospheric pressure was significantly higher on F-days than on non-F-days for day-1 (1009.8 ± 2.8 hPa vs. 1007.1 ± 3.7 hPa, p = 0.03) and day-2 (1010.1 ± 2.7 hPa, compared to 1007.2 ± 3.7 hPa, p = 0.02). In autumn, among the variables that showed significant differences, only female patients remained independently associated with the risk of F-days in the multivariate analysis (p = 0.007).ConclusionsOur research indicated that elevated atmospheric pressure during summer was associated with a higher occurrence of AMI on days with frequent onset of cardiac events. In autumn, women were independently associated with a higher occurrence of AMI on such days.