Infants with trisomy 18 (T18) previously had a poor prognosis; however, the intensive care of these patients has markedly diversified the prognosis. We investigated the current situation of patients with T18, clarified factors for survival discharge, and surveyed actual home healthcare. A total of 117 patients with T18 admitted to nine institutions between 2000 and 2015 were retrospectively investigated. After excluding four patients whose outcomes were unclear, we divided 113 patients into two groups—the survival discharge group (n = 52) and the death discharge group (n = 61)—and compared maternal factors, perinatal factors, neonatal factors, and therapeutic factors between the groups. In addition, home healthcare, readmission, utilization of respite care and home nursing, and cause of death among the survival group were surveyed. Fifty‐two (44%) patients with T18 survived at discharge and their 1‐year survival rate was 29%. The survival group had a longer gestation period, larger physique, and longer survival time, compared to the death group. Independent factors associated with survival discharge were the absence of an extremely low birthweight infant (ELBWI), the absence of esophageal atresia and patent ductus arteriosus, and cardiovascular surgery. All surviving patients required some home healthcare. The most frequent cause of death was a respiratory disorder. We recommend discussing the treatment strategy with families in the presence of neonatologists or pediatric surgeons, who can explain differences in prognosis, based on the gestation period, birthweight, severity of cardiovascular disease, and cardiovascular surgery.

The acquisition and transmission of new feeding behaviours in Japanese macaques (Macaca fuscata) such as sweet potato washing [1, 2], wheat washing [2] and caramel eating [3, 4] have been well documented. These behaviours are all related to provisioned food. Here we report carrying and washing of grass roots by Japanese macaques in a free-ranging group. This would appear to be the first report of washing of dirt from natural food, such as grass roots, among macaques. Furthermore, some monkeys in the present study rubbed dirt from roots by rolling them along the surface of a flat rock at the edge of a river. This may be considered a tool-using behaviour.

To visualize long-term social relationships among 12 gorillas in a captive breeding group at the San Diego Wild Animal Park, San Diego, CA, the multidimensional scaling (MDS) procedure was applied to proximity (within 5 m) values collected in five different periods over 2.5 years. The resulting two-dimensional representations clearly show that in samples taken during this 2.5-year period, the silverback male was surrounded by five adult females, while three infant or young juvenile females, gathered in a body, remained between the silverback male and adult females. Some adult females maintained proximity to the silverback male more frequently than other adult females throughout the five periods. Unlike mountain gorillas in the wild, females with dependent offspring did not tend to stay near the silverback male more frequently than other females, and related females did not tend to spend more time near each other than non-related females. Three older juvenile or young adult males were plotted the furthest from the silverback male, with gradual changes with increasing age. The usefulness of the MDS procedure, which can be used to visualize easily and clearly the social relationships among individuals, is discussed from the viewpoint of the management of breeding groups of captive gorillas.

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We report on nine cases who were diagnosed with tonic accommodation and needed a long period for relief, and discuss the diagnosis, background and treatment. We followed up these patients for 2 to 29 (average 12.0) months. They were in two age groups; 9 to 11 years-old schoolchildren and 22 to 27 years-old young adults. In these patients, women were in the majority. Schoolchildren complained mostly of visual disturbance and adults complained mostly of photophobia. At first visit , their naked eye visions were mostly below 0.3 and these were corrected with concave lenses.Corection was not particulary effective. Under cycloplegia, we detected +1D hyperopia and +1D

We analyzed results of visual screening program for three-year-old children and close examination in Higashimatuyama City, and discussed problems of visual screening. Orthoptists joined that program, and we considered that effective screening was performed. Among 72 children, who were required close examinations, 58 children (80%) visited medical facilities actually. On close ophthalmic examinations, five (9%) were amblyopia, four (7%) were strabismus, three (5%) were poor vision or impossible of visual acuity test and one (2%) was nystagmus. They were about one percent among total examinees. Among 26 children required close examinations, whom we could conduct a follow-up study, 17 (65%) were found to be normal on second visual acuity test. We considered that 2/3 were pseudo-positive was problem of visual screening. And if child has considerably strong refractive error, but whose visual acuity without correction is good, such child may not be detected. Therefore, we considered that an introduction of objective refractomerty equipment should make screening more precisely.

We made a questionnaire survey of feelings and problems of reading loupes to20 patients with low vision, who were prescribed at our hospital. Their needs ofreading were considerably high. Although patient, who had used loupes reviously, were 12 (60%), no patients had any advice or orientation from medical facilities.Patients, who used new loupes usefully, were 15 (75%). We considered that givingloupes a trial was important for selection of loupe. Furthermore, orthoptists should practice low vision care under close connections with ophthalmologists and other medical and social personnel.