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More than a decade ago, Joao Masuko seized an opportunity. With the burgeoning Latin American migrant population in Hamamatsu hungering for a taste of home, he opened a small grocery.
In recent years, Japan has experienced a series of earthquakes and torrential rain disasters in various regions, and in Gifu City, there is concern about the possibility ofNankai Trough earthquakes in the near future. However, pharmacists’ awareness of disaster preparedness and status of drug stockpiles in pharmacies are not clearly outlined.
Methods
A survey on disaster prevention and stockpiling was conducted in 286 pharmacies in Gifu City. Data were collected from August to the end of October 2022. A simple aggregate was used in the study.
Results
The response rate was 66.8% (191 pharmacies). Among them, 9.9% (19 pharmacies) had stockpiles of medicines for disasters, in which 33.3% of the medicines needed in the early stages of a disaster were above the average overall stockpiling rate. In addition, 2.1% (4 pharmacies) selected medicines according to national or prefectural manuals, and 96.3% (184 pharmacies) preferred to have the “national or local government” bear the cost of stockpiling.
Conclusions
This study allowed us to understand the stockpiling situation of pharmacies in Gifu City in event of a disaster such as the Nankai Trough earthquake, which is likely to occur in the future. Based on these results, it is necessary to consider measures for disaster stockpiling.
Species in the genus Engraulis show extensive intraspecific as well as interspecific morphological and genetic diversity. Since morphological differences do not necessarily correspond to genetic differences, it is necessary to clarify the relationship between morphological differences and genetic differences for a better understanding of the population structure. Fish morphology at a given standard length differs between cohorts of Japanese anchovy Engraulis japonicus during the early life stages in the Kii Channel, but it is unknown whether the differences are caused by genetic differences or not. The Kii Channel includes the boundary between the Pacific (southern side of the Kii Channel) and the Seto Inland Sea stocks (northern side), but stock separation is based primarily on demographic characteristics. In the present study, genetic analyses were conducted to examine the genetic differences among samples (month and area) based on mitochondrial DNA cytochrome b region (Cyt b), control region (CR) and microsatellite markers. AMOVA revealed that the percentage of genetic variation among samples was low at 0.11% for Cyt b, 0.30% for CR and 0.00% for microsatellite, and no significant genetic variation was observed among samples. Although two clades were identified in the unrooted neighbour-joining tree for Cyt b and CR, both Cyt b and CR sequences were similar between months and between areas. Accordingly, the morphological differences among cohorts can be attributed to phenotypic plasticity. Additionally, there were no genetic differences between samples from the southern side and the northern side of the Kii Channel, suggesting strong genetic connectivity in these areas.
In this study, the asymptotic solutions of the pressure variations induced by two trains passing each other in a tunnel are theoretically investigated. The one-dimensional inviscid compressible airflow is analysed, and two methods to obtain numerically exact solutions and $M_{H}$ expansion formulas for approximate equations are presented, where $M_{H}$ is the Mach number of the high-speed train. The pressure coefficient, corresponding to the maximum value of the magnitude of the pressure, is expressed as $|c_{p}|_{max}=|c_{p,min}|=[({R}/({1-R}))$$(1+\alpha )^{2}+({R(1-R)}/{(1-2R)^{2}})(1-\alpha )^{2}]+O[M_{H}]$, where $c_{p,min}<0$, $\alpha =U_{L}/U_{H}$ and $U_{L}$ and $U_{H}$ denote the speeds of the low- and high-speed trains, respectively, and $R$ is the cross-sectional area ratio of the train to the tunnel. The theoretical results indicate the dependence of the speeds of the two trains on the pressure distribution and that the maximum magnitude of the asymptotic pressure for a fixed value of $M_{H}$ is obtained for $\alpha =1$ and $\alpha =0$ when $R< R_{c}$ and $R>R_{c}$, respectively, where $R_{c}$ denotes the critical blockage ratio. Because the airflow along the side of the low-speed train, induced by the low-speed train, is along the running direction of the high-speed train and reduces the relative velocity of the high-speed train as the two trains pass each other, $|c_{p}|_{max}$ for $\alpha =0$ is larger than $|c_{p}|_{max}$ for $\alpha =1$ when $R>R_{c}$. It is theoretically demonstrated that, as conventional high-speed railway systems satisfy $R< R_{c}$, a conservative pressure estimation can be established assuming $\alpha =1$.
In recent years, new concepts have been proposed to discriminate between healthy (adaptive) and unhealthy (nonadaptive) self-esteem. Among them, Yamasaki et al. (2017) proposed the concepts of “autonomous” and “heteronomous” self-esteem. As they underscored that autonomous self-esteem needs to be nonconsciously assessed, several nonconscious assessment methods have been developed using implicit association tests (IATs). However, any IAT has not been developed for younger children, even though it is necessary to measure autonomous self-esteem in early childhood because it is largely formed in early developmental stages.
Objectives
The aim was to develop an IAT to measure autonomous and heteronomous self-esteem for 1st-grade elementary school children. In order to standardize it, the validity and reliability were examined.
Methods
Participants were 1st-grade children in a public elementary school in Japan. The final sample included 55 children (35 boys and 20 girls). Their two home-room teachers participated to evaluate the children. The IAT was administered twice, around four weeks apart. The original paper-and-pencil version of the IAT was developed based on the IAT by Yokoshima et al. (2021). In this test, the implicit association between two kinds of stimuli, category (e.g., “myself”) and attribute (face pictograms expressing high and low self-esteem), is measured in terms of accuracy and speed. The evaluation by teachers was conducted using 7-point Likert scales (“not true at all” to “very true”). The evaluation items were “this child proactively does what he or she wants to do alone or with friends for autonomous self-esteem and “this child is competitive and concerned with the consequences of other children” for heteronomous self-esteem.
Results
The test-retest reliability was calculated using correlational analyses of the two measurements. The correlation was significantly positive, r = .70, p < .01. To examine the validity, the children were divided into high and low groups based on the cut-off scores (over 1 SD above the mean and under 1 SD below the mean). Statistical analyses showed that the evaluated scores were significantly higher in Group High than in Group Low regarding the characteristic of autonomous self-esteem, t (19) = 3.87, p < .01, d = 1.62, and that they were significantly higher in Group High than in Group Low for the characteristic of heteronomous self-esteem, t (19) = 3.14, p < .01, d = 1.32.
Conclusions
This study showed that the newly developed IAT for lower-grade children includes high reliability and validity. Hereafter, this test can be utilized at schools to assess autonomous and heteronomous self-esteem. As schools are interested in enhancing healthy and adaptive self-esteem, this tool will be an effective assessment method to ascertain how autonomous self-esteem is cultivated.
In this study, the effects of the degree of thermal denaturation of whey protein (WP) added to milk on the dissociation of κ-casein from casein micelles were investigated, since they are related to the strength of acid milk gel and its factors. Acid milk gels were prepared by heating thermally denatured WP isolate (WPI) and undenatured milk mixtures and treating them with glucono-δ-lactone as a coagulant. The strength of these gels was negatively correlated with the WPI denaturation degree and strongly positively correlated with the extent of κ-casein dissociation from casein micelles. This behavior was ascribed to the fact that α-lactalbumin (α-La) and β-lactoglobulin (β-Lg) contained in WPI denatured after heating and engaged in disulfide bond formation with each other. With an increase in the degree of denaturation and disulfide bond formation, the bonding between β-lactoglobulin and κ-casein was suppressed to decrease the amount of κ-casein–WPI complexes. When β-Lg forms SS bonds with α-La, the number of highly reactive, free SH groups decreases, which complicates the formation of SS bridges between β-Lg and κ-casein. Thus, the denaturation degree of WPI largely determined the degree of κ-casein dissociation from casein micelles and, consequently, the strength of acid milk gels. Adding WP to milk increases the strength of acid milk gel, and it can be controlled by changing the degree of thermal denaturation of the WP. Furthermore, it was clarified for the first time that the dissociation of κ-casein from casein micelles influences this effect. Further studies are needed to elucidate the structural features of κ-casein-dissociated micelles.
The early landmark trials which showed that multi-factorial interventions were effective in preventing falls included assessments of medical risk factors for falls which were then used to guide interventions. As discussed in Chapter 20, the identification of medical risk factors can inform which of a suite of possible multi-factorial interventions a patient should receive. The maintenance of the postural stability is a complex task involving many physiological systems (Chapters 2–5). Sensory input from visual and vestibular pathways, muscle spindles, and joint proprioceptors is channelled centrally to the brain where it is rapidly processed to produce appropriate and co-ordinated motor responses [1]. The key components of this process are represented in Figure 10.1, whilst Table 10.1 lists some of the diseases which can impact on these systems to increase an individual’s risk of falling.
This study was conducted to examine whether the nuclear to cytoplasmic (N/C) ratio had any influence on the timing of embryo compaction and blastocoel formation, as well as formation rate and quality of blastocyst. First, we produced embryos with increased N/C ratio by removal of approximately one-third of the cytoplasm and with decreased N/C ratio by doubling the oocyte cytoplasm with an enucleated oocyte. The initiation of compaction and cavitation in reduced cytoplasm group was significantly earlier (P < 0.05) compared with the control and doubled cytoplasm groups. The rate of blastocysts in the reduced cytoplasm and doubled cytoplasm groups was significantly lower (P < 0.05) compared with the control group. Blastocyst quality in terms of total cell number in the reduced cytoplasm group was significantly lower (P < 0.05) compared with the doubled cytoplasm group, but not different from the control group. Next, we produced embryos with various N/C ratios by oocyte fusion combined with cytochalasin D treatment. The onset of compaction and cavitation in the 2N/2C group (decreased N/C ratio) was significantly delayed (P < 0.05) or had the tendency to be delayed (P = 0.064), respectively, compared with the control group (2N/1C). A significantly higher rate of blastocyst was observed in the 4N/2C group compared with the 1N/1C group (P < 0.05) but not different from the remaining groups. These results demonstrated that an increase in N/C ratio caused an earlier occurrence of morula compaction and blastocyst formation in both in vitro fertilization (IVF) and parthenogenetically activated pig embryos.
Positive psychiatry is the science and practice of psychiatry seeking to promote overall well-being and understand the “positive” aspects of the patient’s life, such as resilience, social connections, and meaning and values in life. While positive psychiatry research has recently blossomed, the field lacks practical ways to integrate these overarching principles into clinical practice. Life review interventions are commonly used in palliative care, spiritual care, and geriatrics, and involve a healthcare team member interviewing a patient about their life.
Objectives
Our objective is to describe the implementation of a positive psychiatry-informed life story review initiative into medical education, with the goal of creating a structure for medical trainees to see the larger context of patients’ health, understand how past experiences influence current values, and improve patients’ overall well-being.
Methods
First- and third-year students at Alpert Medical School of Brown University are required to participate in at least one strengths-based life review with a patient in the community or inpatient setting, transcribe the story, and integrate the story into the electronic health record.
Results
Preliminary results demonstrate high acceptability and perceived development of patient-centered competencies, such as understanding patients as more complete human beings. While this is a low cost and sustainable intervention, barriers include buy-in from medical educators, hospital administrators, and trainees.
Conclusions
To our knowledge, this is one of the first positive psychiatry-informed interventions to be implemented into the required medical curricula. Life story reviews may allow providers to understand the “positive” aspects of patients’ lives and understand their patients better as people.
Existence of the cold-mode gas accretion along with the hot-mode accretion can explain the diversity in the galactic star formation history across galaxy mass. We examine the role of various physical processes in producing the observed diversity.
Existence of cold-mode gas accretion along with the hot-mode accretion of the shock-heated gas can explain the bimodality in the elemental abundance of the Milky Way disk stars as well as the mass-dependence of galaxy morphology represented by mass ratios of thin disks, thick disks, and bulges.
Thirteen boys and one girl, 5–30 years (median 13 years), underwent percutaneous transluminal coronary rotational atherectomy. The interval from the onset of Kawasaki disease to PTCRA ranged from 5 to 29 years (median 12 years). The follow-up period was 1–22 years (median 13 years). The target vessels were the right coronary artery (7), left anterior descending artery (3), left circumflex (2), and left main trunk (2). The maximum burr size used was 1.75 mm in four, 2.00 mm in four, and 2.15 mm in six. The immediate results of rotational atherectomy were successful in all patients, and the mean stenosis degree improved from 86 ± 15% (mean ± standard deviation) to 37 ± 14% (p < 0.001). Cardiac events in the late period were found in four patients (29%). Acute myocardial infarction occurred in two, and syncope and ventricular fibrillation in one each. The cardiac event-free rate at 10 and 20 years was 79% (95% confidence interval 50–92) and 39% (6–87), respectively, (n = 14). The overall 20-year patency rate was 54% (95% CI 28–78). That in patients more than 10 years old was 77% (95% CI 42–94, n = 10). PTCRA alone is suitable for severe localised stenosis with calcification caused by KD in young adults except for small children. Re-stenosis within the first year after PTCRA often develops because of reactive intimal thickening after the procedure. If a target vessel is a patent 1 year after the procedure, long-term patency may be expected in patients more than 10 years old.
Intakes of excess Na and insufficient K are two major contributors of heart diseases and stroke development. However, no precise study has previously been carried out on Na and K intakes among Indonesian adults. The present study aimed to estimate the Na and K intakes using two consecutive 24-h urine collections. Participants were community-dwelling adults aged between 20 and 96 years, randomly selected from a pool of resident registration numbers. Of the 506 participants, 479 (240 men and 239 women) completed urine collections. The mean Na excretion was 102·8 and 100·6 mmol/d, while the mean K excretion was 25·0 and 23·4 mmol/d for men and women, respectively. Na and K excretions were higher in participants with a higher BMI. A higher K excretion was associated only with younger age. More than 80 % of the participants consumed more than 5 g/d of salt (the upper limit recommended by the Indonesian government), whereas none of them consumed more than 3510 mg/d of K (the lower limit). The high Na and low K intakes, especially high Na among participants with high BMI, should be considered when future intervention programmes are planned in this country.
We report two females with coronary artery occlusion caused by presumed Kawasaki disease that delivered children without any special treatment. After a 58-year-old female had ventricular tachycardia, a giant coronary artery aneurysm with calcification at the bifurcation of the left coronary artery and segmental stenosis of the right coronary artery were pointed out by CT angiography. She had an episode of sepsis when 3 years old. Further, she remembered chest pain during sleep after that episode. She had delivered twice without any complication during her 20s. Her diagnosis was undiagnosed coronary artery lesions caused by presumed Kawasaki disease and a previous myocardial infarction, and she underwent radiofrequency catheter ablation and implantable cardioverter defibrillator implantation. The other 48-year-old female was accidentally discovered to have coronary artery calcification on CT, while experiencing pneumonia. Her CT angiograms revealed a right coronary artery occlusion and coronary artery calcification at segments 1, 6, and 11. She had a history of “scarlet fever” before 12 months. Premature ventricular contractions were detected, while delivering her first child when 31 years old. However, she was not diagnosed as ischaemic heart disease and delivered twice by a vaginal delivery without any complication. Current guidelines recommend systemic anti-coagulation and anti-platelet therapy for all patients with giant aneurysms resulting from Kawasaki disease in childhood. The two women reported here were fortunate not to have had complications during pregnancy and delivery despite their severe coronary artery aneurysms, which were unrecognised clinically until later in life. They were lucky cases.
In the present study, a compressible low-Reynolds-number flow over a circular cylinder was investigated using a low-density wind tunnel with time-resolved schlieren visualizations and pressure and force measurements. The Reynolds number ($Re$) based on freestream quantities and the diameter of a circular cylinder was set to be between 1000 and 5000, and the freestream Mach number ($M$) between 0.1 and 0.5. As a result, we have clarified the effect of $M$ on the aerodynamic characteristics of flow over a circular cylinder at $Re=O(10^{3})$. The results of the schlieren visualization showed that the trend of $M$ effect on the flow field, that are the release location of the Kármán vortices, the Strouhal number of vortex shedding and the maximum width of the recirculation, is changed at approximately $Re=3000$. In addition, the spanwise phase difference of the surface pressure fluctuation was captured by the measurement using pressure-sensitive paint at approximately $Re=3000$ of higher-$M$ cases. The observed spanwise phase difference is considered to relate to the spanwise phase difference of the vortex shedding due to the oblique instability wave on the separated shear layer caused by the compressibility effects. The Strouhal number of the vortex shedding is influenced by $M$ and $Re$, and those effects are nonlinear. However, the effects of $M$ and $Re$ can approximately be characterized by the maximum width of the recirculation. In addition, the $M$ effect on the drag coefficient can be characterized by the maximum width of the recirculation region and the Prandtl–Glauert transformation.
The Act on medical care and treatment for insane or quasi-insane person who have caused serious incidents in Japan went into effect in July, 2005. It is critical to understand the current situation and the issue concerning medical care in this legal system for revision of the Act five years later. Therefore, this research aims to evaluate and analyze the information comprehensively collected from designated inpatient medical institutions and outpatient medical institutions from a technical standpoint.
Method:
The subjects of this research are 50 cases from designated inpatient medical institutions and 4 cases from designated outpatient medical institutions who have been registered as the subject of treatment under the Act. Static information at the time of the treatment starts and dynamic information, such as treatment evaluation usually created periodically in routine work, were the specific documentation for this research. From the information, variables required for analysis of improvement of medical care and operational situation of the Act were collected through the use of a database system.
Results and Conclusion
Since the Act was enacted last year, this one year research remains as a short term monitoring targeting a few cases. In this report, evaluation and progress of treatment of the subject will be presented with the information relevant to the mental illness and the judicial system exposed by collected various kinds of data. From this information, we outline the current situation and issues in this legal system and shows the usability of the result from this monitoring research.
Several cross-sectional studies, but no prospective studies, have reported an association between an abnormal lipid profile and posttraumatic stress disorder (PTSD). We hypothesized that an abnormal lipid profile might predict risk for developing PTSD. In this prospective study, we analyzed data from 237 antidepressant-naïve severely injured patients who participated in the Tachikawa Cohort of Motor Vehicle Accident Study. High-density lipoprotein cholesterol (HDL-C) levels at baseline were significantly lower in patients with PTSD than those without PTSD at 6 months after motor vehicle accident (MVA) and were inversely associated with risk for PTSD. In contrast, triglycerides (TG) at baseline were significantly higher in patients with PTSD than in those without PTSD at 6 months post-MVA and were positively associated with risk for PTSD. There was no clear association between low-density lipoprotein cholesterol or total cholesterol and risk for PTSD. In conclusion, low HDL-C and high TG may be risk factors for PTSD. Determining lipid profiles might help identify those at risk for PTSD after experiencing trauma.
This study aimed to propose appropriate management for odontogenic chronic rhinosinusitis.
Method
Thirty-one adult patients with odontogenic chronic rhinosinusitis undergoing maxillary extraction were retrospectively analysed. Patients with (n = 21) and without (n = 10) oroantral fistula on computed tomography were classified. Functional endoscopic sinus surgery was performed when sinusitis did not improve after extraction. The critical indicators for surgical requirement in the management of odontogenic chronic rhinosinusitis were analysed.
Results
Sinusitis significantly improved after extraction in both groups. Patients without oroantral fistula had significantly more severe remnant sinusitis than those with oroantral fistula after extraction on computed tomography (p = 0.0037). The requirement for functional endoscopic sinus surgery was statistically significant for patients without orofacial fistula over those with orofacial fistula (p < 0.0001). The surgical improvement ratio was 93 per cent.
Conclusion
The absence of oroantral fistula and severe sinusitis can be critical indicators for the requirement of functional endoscopic sinus surgery after extraction in the management of odontogenic chronic rhinosinusitis.
We aimed to examine missing data in FFQ and to assess the effects on estimating dietary intake by comparing between multiple imputation and zero imputation.
Design
We used data from the Okazaki Japan Multi-Institutional Collaborative Cohort (J-MICC) study. A self-administered questionnaire including an FFQ was implemented at baseline (FFQ1) and 5-year follow-up (FFQ2). Missing values in FFQ2 were replaced by corresponding FFQ1 values, multiple imputation and zero imputation.
Setting
A methodological sub-study of the Okazaki J-MICC study.
Participants
Of a total of 7585 men and women aged 35–79 years at baseline, we analysed data for 5120 participants who answered all items in FFQ1 and at least 50% of items in FFQ2.
Results
Among 5120 participants, the proportion of missing data was 3·7%. The increasing number of missing food items in FFQ2 varied with personal characteristics. Missing food items not eaten often in FFQ2 were likely to represent zero intake in FFQ1. Most food items showed that the observed proportion of zero intake was likely to be similar to the probability that the missing value is zero intake. Compared with FFQ1 values, multiple imputation had smaller differences of total energy and nutrient estimates, except for alcohol, than zero imputation.
Conclusions
Our results indicate that missing values due to zero intake, namely missing not at random, in FFQ can be predicted reasonably well from observed data. Multiple imputation performed better than zero imputation for most nutrients and may be applied to FFQ data when missing is low.