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The 2011 Great East Japan Earthquake caused major disruptions in the provision of health care, including that for patients with sleep-disordered breathing (SDB) using a nasal continuous positive airway pressure (nCPAP) device. This study investigated the ability of SDB patients to continue using the nCPAP device in the weeks immediately following the earthquake, whether inability to use the nCPAP device led to symptom relapse, and measures that should be taken to prevent disruptions in nCPAP therapy during future disasters.
Hypothesis
If nCPAP devices cannot be used during disasters, SDB patients’ health will be affected negatively.
Methods
Within 14 days of the disaster, 1,047 SDB patients completed a questionnaire that collected data regarding ability to use, duration of inability to use, and reasons for inability to use the nCPAP device; symptom relapse while unable to use the nCPAP device; ability to use the nCPAP device use at evacuation sites; and recommendations for improvement of the nCPAP device.
Results
Of the 1,047 patients, 966 (92.3%) had been unable to use the nCPAP device in the days immediately following the earthquake. The most common reason for inability to use the nCPAP device was power failure, followed by anxiety about sleeping at night due to fear of aftershocks, involvement in disaster-relief activities, loss of the nasal CPAP device, and fear of being unable to wake up in case of an emergency. Among the 966 patients, 242 (25.1%) had experienced relapse of symptoms, the most common of which was excessive daytime sleepiness (EDS), followed by insomnia, headache, irritability, and chest pain.
Conclusion
Developing strategies for the continuation of nCPAP therapy during disasters is important for providing healthy sleeping environments for SDB patients in emergency situations.
MitoF, NishijimaT, SakuraiS, KizawaT, HosokawaK, TakahashiS, SuwabeA, AkasakaH, KobayashiS. Effects of CPAP Treatment Interruption Due to Disasters: Patients with Sleep-disordered Breathing in the Great East Japan Earthquake and Tsunami Area. Prehosp Disaster Med. 2013;28(6):547-555.
The microstructural evolution of Fe–Mn–C austenitic steels, which exhibit outstanding high-ductile deformation in their plastic regions, was characterized by line-profile and texture analyses. The convolutional multiple whole profile fitting procedure was used for a line-profile analysis of 2θ−θ diffraction data to evaluate variations of crystallite size, dislocation density, and dislocation arrangement. A substantial refinement of the crystallite size proceeded at an early deformation stage. In addition, the dislocation density increased with an increase in the tensile strain. Texture evolution was characterized by the analysis of orientation distribution functions. Three texture components grew with an increase in the tensile strain. According to the pole figure describing the full width at half maximum (FWHM) distribution of the 220 reflection, the nontextured grains had more microstructural defects than the textured grains. To evaluate the microstructural defects in detail, the 220 reflection observed at each texture orientation was analyzed by the single-line-profile method. The crystallite size and dislocation density were almost comparable, irrespective of the kind of texture component. The crystallite size of the nontextured grains was also comparable to that of the textured grains, whereas the nontextured grains had a dislocation density several times that of the textured grains.
The growth of precipitates in a deformed Cu–Ni–Si alloy with an aging treatment and the rearrangement of dislocations were investigated using small-angle X-ray scattering method and XRD line-profile analysis. The small-angle X-ray scattering method was used for characterizing the growth behavior of the precipitates. The results showed that the precipitates grew gradually to a few nanometers in radius when aged under the condition that the alloy exhibited a maximum of the hardness due to precipitation hardening. The growth rate rose from the onset of the overaging, where the hardness started to decrease. The line-profile analysis of copper-based alloy diffraction peaks using modified Williamson–Hall and modified Warren–Averbach procedures yielded a variation in the dislocation densities of the alloy as a function of the aging time. The dislocation density of the alloy before the aging treatment was estimated to be 1.7×1015 m−2 and its high value was held up to the peak-aging time. With the onset of the overaging, however, the dislocation density distinctly decreased by about 1 order of magnitude indicating that a large amount of the dislocations rearranged to release the alloy from the high dislocation-density state. The results suggest that the massive rearrangement of dislocations was accompanied with coarsening of the precipitates.
To examine the validity and reproducibility of a self-administered food-frequency questionnaire (FFQ) used for two cohort studies in Japan.
Design:
Cross-sectional study.
Setting:
Two rural towns in the Miyagi Prefecture, in north-eastern Japan.
Subjects:
Fifty-five men and 58 women.
Results:
A 40-item FFQ was administered twice, 1 year apart. In the mean time, four 3-day diet records (DRs) were collected in four seasons within the year. We calculated daily consumption of total energy and 15 nutrients, 40 food items and nine food groups from the FFQs and the DRs. We computed Spearman correlation coefficients between the FFQs and the DRs. With adjustment for age, total energy and deattenuation for measurement error with the DRs, the correlation coefficients for nutrient intakes ranged from 0.25 to 0.58 in men and from 0.30 to 0.69 in women, with median of 0.43 and 0.43, respectively. Median (range) of the correlation coefficients was 0.35 (−0.30 to 0.72) in men and 0.34 (−0.06 to 0.75) in women for food items and 0.60 (−0.10 to 0.76) and 0.51 (0.28–0.70) for food groups, respectively. Median (range) of the correlation coefficients for the two FFQs administered 1 year apart was 0.49 (0.31–0.71) in men and 0.50 (0.40–0.64) in women for nutrients, 0.43 (0.14–0.76) and 0.45 (0.06–0.74) respectively for food items, and 0.50 (0.30–0.70) and 0.57 (0.39–0.66) respectively for food groups. Relatively higher agreement percentages for intakes of nutrients and food groups with high validity were obtained together with lower complete disagreement percentages.
Conclusions:
The FFQ has a high reproducibility and a reasonably good validity, and is useful in assessing the usual intakes of nutrients, foods and food groups among a rural Japanese population.
The integrability of a control function of the almost sure convergence $$ \displaystyle\lim_{n \to \infty}\frac{X_1(\omega)+X_2(\omega)+\ldots+X_n(\omega)}{T_n}, $$ where $T_n \,{\uparrow}\, \infty $ as $n \to \infty$ and $X_1,X_2,\cdots,X_n,\cdots $ are independent identically distributed random variables, is studied.
Two experiments were conducted to determine the effects of essential amino acid deficiencies on several immunological variables in male broiler chickens. Essential amino acids were classified into five groups as follows: S-containing amino acids (SAA; methionine + cysteine), aromatic amino acids (AAA; phenylalanine + tyrosine), branched-chain amino acids (BCAA; isoleucine + leucine + valine), arginine plus lysine (Arg + Lys), and other essential amino acids (OEAA; glycine + serine + histidine + threonine + tryptophan). Chickens were fed ad libitum from 10 to 24 d of age on a control diet or amino-acid-deficient diets formulated to contain each amino acid group at 50 % and 16 % (Expt 1) at 50 % (Expt 2) of the recommended requirements (). Effects of feed consumption on immune responses were also considered by setting pair-feeding (Expt 1) or restricted-feeding (Expt 2) groups fed on the control diet. In Expt 1, changes in lymphoid organ weights varied with the type and degree of deficiency of amino acid groups, with BCAA deficiency markedly decreasing weights. The haemagglutinin titres against sheep erythrocytes did not change in any amino-acid-deficient chickens except that the titres were lower in chickens fed on the 50 %- and 16 %-BCAA diets as compared with their pair-fed counterparts. In Expt 2, the splenocyte proliferative response to concanavalin A was higher in the chickens fed on the BCAA- and Arg + Lys-deficient diets and lower in chickens fed on the SAA- and AAA-deficient diets than the control chickens, independent of feed consumption. These results suggest that the effects of specific amino acid deficiencies on immune responses cannot be generalized, and that BCAA have the greatest potential to modulate immune responses among the amino acids in chickens.
We have carried out an angle-resolved photoemission study of double Ag nanofilm structures, composed of an outer Ag nanofilm / Cu barrier layer / inner Ag nanofilm / Cu(111) substrate. From these results, we discuss the electronic coupling between the quantized electronic states in the double Ag nanofilm structures with various configurations.
To confirm the presence of apneusis in patients with hypoxic–ischemic encephalopathy and to clarify which factors influence their respiratory patterns, polygraphic studies were performed on two patients. Apneusis was clinically suspected in both patients who had severe brainstem damage. In one subject, inputs of vagal afferents from the gastrointestinal tract and the urinary bladder often resulted in extreme tachypnea instead of apneusis. Lung inflation facilitated expiration during inspiratory arrest. Expiration preceded a periodic inhibition of rigospastic discharge in the right biceps muscle. In the other subject, prolonged inspiratory pauses with cyanosis occurred with or without preceding epileptic seizure. Both phenytoin dose reduction and treatment with tandospirone, a serotonin-1A agonist, were effective in improving the respiratory distress in this subject.
A layered perovskite type oxide, K2La2Ti3O10, was prepared by a gel technique using the polymerized complex (PC) method. A single phase K2La2Ti3O10 was obtained by adding twice the potassium required for stoichiometry. The Ni–K2La2Ti3O10 catalyst prepared by the PC method exhibited a higher photocatalytic activity for decomposition of H2O into H2 and O2 than that prepared by a conventional solid state reaction.