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Hokkaido faces challenges to the effective implementation of its healthcare infrastructure because of demographic factors such as negative population growth and an aging population, and economic factors, including financial difficulties faced by local governments. Regional healthcare networks have been built to overcome these problems and streamline healthcare delivery. However, the number of registered patients is only 1% of the total population. This study investigated the factors that cause the stagnation of the number of registered patients in the regional healthcare networks in Hokkaido. Our survey identified 46 networks in 21 medical regions. The average ratio of registered patients in Hokkaido was 4.1%, regional healthcare networks in the Sapporo area were dysfunctional. We estimated the factors influencing the ratio. The ratio of networked medical institutions in the region and the dummy variable for their business size were statistically significant for Hokkaido and for the secondary medical areas, excluding the Sapporo medical area. It follows that the number of registered patients in a network could be determined by the ratio of connected medical institutions and the size of their business. The problems could be overcome by exploiting the economy of scale in the networks. Establishing a prefecture-wide network would increase the number of registered patients and lower the overall cost of the networks.

Summary We encountered a case of double inferior vena cava (DIVC) in a 76 year old male cadaver during anatomy practice at Matsumoto Dental University in 2015. The left and right internal iliac veins drained into the interiliac vein ran horizontal in front of the cape angle and joined the left and right external iliac veins. Then the inferior vena cava on each side originated.The width of the origin of the inferior vena cava were 13.7 mm and 11.6 mm on the right and left side, respectively. Based on the previous DIVCʼs classifications, we attempted to classify the DIVC and iliac venous system by combining the direction of the internal iliac veins (lateral (l), vertical (s), and medial (m)), the inclination of the interiliac veins (lower left to upper right (L to R), horizontal (H), and lower right to upper left (R to L)),and the width of the right and left IVC (RIVC>LIVC, RIVC=LIVC, and RIVCLIVC, H, l-l. In this case, hemi-azygos vein was not found, and the height of the left kidney was lower than the right one. We therefore investigated the co-existence of the venous system and the height of the kidney to the 53 cases and referred to the embryological relationship between them. The present classification provides basic knowledge for the clinical anatomy and surgery of the pelvic region.

The new coronavirus (COVID-19), which has spread all over the world, has a great impact on today's social structure and economy. Training and Research Ship “SEISUI MARU” was also affected by this, and it was necessary to take new measures to prevent the spread of coronavirus infection, such as reviewing plans and changing work systems. This paper describes the changes in the operational status of the ship from the beginning of the global epidemic of the new coronavirus to the present, and the changes in various infection prevention measures for the new coronavirus, actually implemented by Mie University and the ship, are listed in chronological order, showing the history of the fight against the new coronavirus.The main prevention of infection measure taken on “SEISUIMARU” was to require the crew and passengers to take care of and record their health condition on a daily basis. The number of passengers on board was limited to seven in order to ensure that crew and passengers were accommodated in private rooms on the voyage. As a result of these prevention of infection measure, we were able to conduct all of the voyage training in 2020. In 2021, we began inoculation of the new coronavirus vaccine, and we will continue to take all necessary prevention of infection measures to ensure the safe operation of the ship.

執筆：奥村松平, 解題：菅野智博、甲賀真広、今井就稔, 編集：奥村武彦、上田裕子、甲賀真広

令和4年度宇宙科学に関する室内実験シンポジウム（2023年3月6日-7日. オンライン開催), 2023 Symposium on Laboratory Experiment for Space Science (March 6-7, 2023. Online Meeting), 著者人数: 15名, 資料番号:SA6000187041, レポート番号: 41

本研究は，マイクロフォン地上センサとドローンリモートセンシングによるニホンジカ個体数推定手法の開発をおこない，それらの精度を比較検討し，最終的に人のアプローチによる調査が難しい湿原域におけるシカ個体数推定手法の提案をおこなった． 最終的な研究成果として，マイクロフォンによるシカ個体数推定では，尾瀬ヶ原西部地域のシカの個体数は，およそ539.9～667.4頭と推定され，ドローンによる個体数は，およそ470～696頭と推定された．マイクロフォンとドローンによるシカの個体数の推定原理は全く違うにも関わらずほぼ同じ推定結果が得られ，それぞれの手法の有効性が示された．今後，尾瀬においてこれらの手法の活用が期待される．, In the present study, we developed a method for evaluating the deer population in western Ozegahara using microphone ground sensors and an unmanned aerial vehicle (UAV). Specifically, we first developed a deer population estimation method using a microphone, followed by a deer population estimation method using the UAV. We then carried out a comparative examination of the accuracy of these deer population estimation methods. We propose these new methods for estimating deer populations in wetlands, which are difficult for humans to enter. Our research results showed that the deer population estimated by the microphone was 539.9 to 667.4 in the western Oze area, and the drone estimated it to be 470 to 696. Although the two methods for estimating the deer population are completely different, almost the same results were obtained, indicating that these methods are effective. It is expected that these methods will be utilized in Oze in the future.

尾瀬地域はニホンジカの影響を受けずに成立した生態系と考えられているが，1990年代からシカによる湿原植物の採食被害や掘り返しなどの攪乱被害が報告されており，湿原や森林生態系への不可逆的な影響が懸念されている．環境省では，尾瀬内でのモニタリング調査として，GPS首輪によるシカの行動調査，ライトセンサス調査，採食痕跡調査および裸地の空撮を実施している．また，モニタリング結果を踏まえた対策として，国立公園内でのシカ捕獲および植生保護柵の設置を行っている．対策を講じている一方，近年の調査結果によれば，個体数は増加傾向であり，採食被害の拡大が報告されていることから，より効果的な対策が求められている．, Ecosystem in Oze had been established without sika deer's effect. Since sika deer inhabitation was reported even in Oze in the mid-1990s, disturbance of vegetation including marsh has become prominent, and it is concerned that they might have the irreparable impact on the original ecosystem. Ministry of the Environment have conducted the survey of sika deer in Oze such as tracking deer with GPS collar, spotlight count, investigating vegetation damage further measuring the area of the bare ground. Considering the result of survey, we have attempted culling deer around marsh and constructing fence for protecting endangered plants. However, according to recent survey, the number of sika deer trends upward and the damage of vegetation expanding while we've tried some countermeasures. Because of that, effective strategies to suppress the impact are required.

The purpose of this paper is to examine the characteristics of moral education and moral philosophy of educators who have managed “workers’ education”, namely, Ministry of Education, Ministry of Home Affairs, and the leftist intellectual group connected with labor union during the prewar period. As a result of comparison among representatives of each institutions or organization, that is to say, Obi Hanji, Tazawa Yoshiharu, Morito Tatsuo, the following three major points of their thought was found in common among the characters. First, they tended to bury “the individual character” so that people would only be treated as a “whole” (integrating them as a whole). Second, they tried to make people believe that there were enemies and tended to educate their people by conquering their common enemies. Third, their educational value was to build a fixed relationship between the educator and the learner (hierarchical relationship), so that they could inculcate existing values and answers toward learners when they were teaching.

執筆：奥村松平, 整理・編集：奥村武彦、上田裕子、甲賀真広、今井就稔

金沢大学理工研究域機械工学系, The brown macroalga, Sargassum horneri, is now attracting attention not only as a food source but also with regard to coast environmental preservation, coastal ecosystems, CO2 fixation, and as a marine indicator for environmental impact assessment. The present study was conducted to identify the effects of decreased seawater pH on S. horneri growth at three early developmental stages: embryo, germling, and young plant. After being exposed to acidic seawater of pH 6.0–7.5 for approximately 1–5 days, S. horneri embryos could germinate and grow when cultured in seawater with pH 8.0. At the germling stage, S. horneri growth was significantly inhibited when cultured in seawater with pH 6.0–6.6 compared to its growth in seawater with pH 8.0 (control). Moreover, at the young plant stage, S. horneri growth was significantly inhibited when cultured in seawater with pH 7.0 compared to when cultured in seawater with pH 7.5–8.0. These results demonstrate that the effects of decreased pH differ depending on the early growth stage of S. horneri, and as the growth of S. horneri progresses, the adverse effects of low pH increase. The results of this study can be used as preliminary data to promote S. horneri aquaculture in coastal areas and to assess the environmental impacts on its growth.

75 year-old man followed up regularly for the treatment of lung cancer came to our hospital with a chief complaint of general malaise. Blood test results showed deterioration in the renal function, and computed tomography (CT) confirmed left hydronephrosis. He was admitted to the hospital with the diagnosis of obstructive pyelonephritis. Despite antibiotic therapy after the left ureteral stent placement, CT on day 19 of hospitalization showed an enlarged soft tissue shadow along the renal pelvis and ureter, which was suspected to be peripelvic urinary extravasation caused by stent occlusion. We decided that conservative treatment would not improve his condition and conducted surgical therapy considering the possibility of malignancy. Intraoperatively, viscous and fragile tumor affected the renal pelvis and ureter. The operation resulted in left nephrectomy because radical resection was impossible. The pathological diagnosis was sarcomatoid urothelial carcinoma of the renal pelvis with ureter origin. He died due to multipleorgan failureon day 20 after theope ration. Were port a caseof sarcomatoid urothelial carcinoma in the upper urinary tract that was difficult to diagnose preoperatively based on imaging studies.

京都府立医科大学附属北部医療センター 総合診療科, Department of General internal medicine , North Medical Center , Kyoto Prefectural University of Medicine, 好酸球性多発血管炎性肉芽腫症(EGPA)は1951年にChurgとStraussによって報告された疾患で、以前はChurg-Strauss症候群やアレルギー性肉芽腫性血管炎と呼ばれていた。EGPAは、好酸球の組織浸潤、小型から中型血管の壊死性血管炎によって特徴付けられる稀な全身性疾患である。EGPAの臨床症状としては、気管支喘息、アレルギー性鼻炎、好酸球の組織浸潤(心臓、消化管、皮膚、腎臓)、末梢神経障害などの血管炎症状である。EGPAの予後を改善させる上で、早期診断と早期治療は極めて重要であり、末梢神経障害による運動麻痺が出現すればQOLは著しく低下する可能性がある。しかし、その一方でEGPAの診断には難渋することが多く、その理由としては慢性好酸球性肺炎、好酸球増多症候群、他の一次性全身性血管炎などと臨床的特徴が類似または重複するためと考えられる。今回、我々は顔面浮腫と関節痛を初発症状とし、末梢血好酸球増多の鑑別をしている際に末梢神経障害を発症し、EGPAの診断に至った症例を経験した。Prednisolone(PSL)による寛解導入後も末梢神経障害は残存していたため、早期に免疫グロブリン大量療法(IVIg)を施行したところ、末梢神経障害の著明な改善を得た。EGPAの早期診断と末梢神経障害に対するIVIgの有効性に関して、文献を踏まえた考察を行い、報告する。(著者抄録)

The aim of this study is to design the peace education unit, which support the students to achieve the two goals: (1) to reconstruct their own notions of peace, and (2) to acquire interdisciplinary concepts and apply them to find and describe the (non-)peaceful situations in our usual life. Therefore, we developed and implemented a concept based inquiry unit (18 class hours) at Hiroshima Global Academy (HiGA) middle school by contextualize the previous unit plan into the integrated learning program on “Global Justice.” As a result, we could choose the six concepts explaining a nonviolent but threatening the peaceful governance, human relation, and agency, demonstrate the social examples to apply them, and set a controversy defining the criteria of peace. The first outcome of this study is that we show the curricular-instructional gatekeeping adjusting to the school context of HiGA. The second is to find the relations between the students' learning of peace concepts and the reconstruction of peace notion.

量子科学技術研究開発機構（QST）高崎量子応用研究所のイオン照射施設（TIARA）には4台の加速器が設置されており、主にバイオ技術や材料開発の研究分野へ様々なイオン種のビームを幅広いエネルギー範囲で提供している。AVFサイクロトロン（K110）、3MVタンデム加速器、3MVシングルエンド加速器、400kVイオン注入装置の2020年度運転時間は，それぞれ1879.8h，1629.0h，1637．8h，1555．1hであり，コロナ禍による施設の利用停止措置のため例年よりも短い運転となった。年間を通じて大きな故障はなく，コロナ禍による実験キャンセルを除けば，計画した照射実験はすべて実施した。主な保守・整備としては，サイクロトロンの共振器へ電力を供給するRFアンプの前段増幅部分について，800W真空管アンプから1ｋWトランジスタアンプへの変更を行った。これまで30年近く使用してきた真空管が製造中止になり，入手不能となっためである。主な技術開発として，タンデム加速器においてC60フラーレン専用イオン源の整備やフラーレン・マイクロビーム形成実験を実施した。本発表では，上記に加え，その他加速器の保守・整備及び技術開発，施設の利用状況について報告する。

We have been working on a number of collaborative projects with companies and local governments as a practical educational program for Gifu City Women's College Department of Design for Contemporary Life. One of our representative projects is the mural painting at Gifu Municipal Hospital. Through our efforts in this project, we have acquired know-how regarding the visual presentation of space. And this time, we challenged a new project, mural painting for the nursing room of new City Hall in Gifu. Therefore, we introduce the background and contents of the project in this paper. Then, we analyze the educational effects of this project on students.

Currently, there is a growing policy interest in learning about controversial issue as part of voting learning against a backdrop of social change. However, the study of controversial issues in social studies education began already in the 1970s, and a certain amount of research has been accumulated up to the present. This paper examines the previous studies related to ‘learning about controversial issues’ from the perspective of “educational borrowing” in order to the characteristics of Japanese educational research. A literature search of CiNii and Google scholar database was conducted, using the following key words: Ronsomondai (Controversial Issues), Gakushu (Learning), Syakaika (social studies), Jugyo (Lesson). The findings reveal that these studies have been reflected by Japanese context around academic, policy and practical context. Learning about controversial issues could support existing social studies theories, but it also gives questions existing social studies practice.

(主査) 教授 龔 剣萍, 教授 黒川 孝幸, 准教授 佐藤 勝彦, 助教 Daniel R. King, 生命科学院（ソフトマター専攻）