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Foreign body airway obstruction (FBAO) is a life-threatening emergency, and the prognosis of patients with FBAO is greatly affected by the prehospital process. There are only a few large-scale studies analyzing prehospital process databases of the fire department.
Study Objective:
The aim of this study was to investigate whether characteristics of patients with FBAO were associated with prehospital factors and outcomes.
Methods:
In this retrospective observational study, patients transferred to the hospital by the Tokyo, Japan Fire Department for FBAO from 2017 through 2019 were included. The association between neurologically favorable survival among the characteristics of patients with FBAO and prehospital factors affecting the outcomes was evaluated.
Results:
Of the 2,429,175 patients, 3,807 (0.2%) patients had FBAO. The highest number of FBAO cases was 99 (2.6%), which occurred on January 1 (New Year’s Day), followed by 40 cases (1.1%) on January 2, and 28 cases (0.7%) on January 3. The number of patients who experienced out-of-hospital cardiac arrest (OHCA) caused by FBAO was 1,644 (43.2%). Comparing the OHCA and non-OHCA groups, there were significant differences in age, sex, time spent at the site, and distance between the site and hospital. Cardiac arrest was significantly lower in infants after FBAO (P < .001). In total, 98.2% of patients who did not have return of spontaneous circulation (ROSC) before hospital arrival died within 30 days, a significantly higher mortality rate than that in patients who had ROSC (98.2% versus 65.8%; P < .001).
Conclusions:
Among patients who did not have ROSC following FBAO upon arrival at the hospital, 98.2% died within 30 days. Thus, it is important to remove foreign bodies promptly and provide sufficient ventilation to the patient at the scene to increase the potential for ROSC. Further, more precautions should be exercised to prevent FBAO at the beginning of the year.
Canga, or ironstone, ecosystems are hotspots of old-growth plant diversity and highly specialized cave invertebrates. These ancient metalliferous habitats are amongst the most threatened ecosystems because of the destruction caused by large-scale iron ore mining. International debate on biodiversity offsets is increasing because these mechanisms are seen as tools for potentially balancing economic development with conservation biodiversity. Leading mining companies worldwide, including some of the largest iron ore producers in Brazil, are signatories to offset principles and best practices that aim to achieve no net loss of habitats, species or ecosystem functions. We aimed to analyse whether Brazilian legal requirements for biodiversity offsets result in the achievement of conservation outcomes or in elevated threat of extinction in canga ecosystems. We evaluated technical reports that support decision-making related to environmental licensing for iron ore mining and specific offset proposals linked to the Atlantic Forest Act. We found a relevant net loss in canga ecosystems and observed shortcomings related to the equivalency and transparency of offset principles. These deficiencies are mainly related to lax norms and regulations and the absence of an integrated database for accessing information on environmental licensing processes. We argue that both policy flaws and low engagement by the Brazilian mining industry in implementing offset principles have increased the threat of extinction in canga ecosystems.
First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders.
Objectives
We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE)— a historically large earthquake that resulted in a tsunami and a nuclear disaster.
Methods
56 388 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this seven-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised (IES-R). Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analyzed using multinomial logistic regression.
Results
Five symptom severity trajectories were identified: “resilient” (54.7%), “recovery” (24.5%), “incomplete recovery” (10.7%), “late-onset” (5.7%), and “chronic” (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences, and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave, and longer post-deployment overtime.
Conclusions
The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection, and intervention in individuals at risk of developing symptomatic trajectories.
Cadets training to become licensed mariners based on the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers (STCW) Code have been under pressure to keep up with the countermeasures against COVID-19 from the Spring of 2020. For several reasons, sea training voyages were restricted or cancelled, and the schooling style was drastically changed from face-to-face to remote. Since the research vessel owned by Tokai University is not a training vessel exclusively for cadets, the decision was inevitably made to make more effective use of the shiphandling simulator. Because training in the simulator also had to be done remotely, new ideas were put into practice to explore the possibility of building new educational methods. Numerous open-ended evaluation comments were submitted by the cadets who received remote training on the simulator. The results suggested that the remote use of the simulator is likely to be an effective method for training in bridge resource management (BRM).
First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders.
Aims
We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE) – a historically large earthquake that resulted in a tsunami and a nuclear disaster.
Method
A total of 55 632 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this 7-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised. Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analysed using multinomial logistic regression.
Results
Five symptom severity trajectories were identified: ‘resilient’ (54.8%), ‘recovery’ (24.6%), ‘incomplete recovery’ (10.7%), ‘late-onset’ (5.7%), and ‘chronic’ (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave and longer post-deployment overtime.
Conclusions
The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection and intervention in individuals at risk of developing symptomatic trajectories.
Despite acceptable survival for Fontan operation, there are concerns about late complications affecting the major organs. We herein present two cases of adults after Fontan operation who developed focal segmental glomerulosclerosis. These cases suggest that focal segmental glomerulosclerosis is owing to haemodynamic incompetence associated with Fontan operation, including congestion, hypoxia, and hyperviscosity, which may be called Fontan-associated renal disease.
This paper examines how population aging affects the output effect of a government spending shock by using a panel data of OECD countries. The government spending shock is identified as a forecast error of government spending, and its output effect is estimated by using the local projection method. We find that population aging affects the output effect of the government spending shock. While in non-aging economies, government spending shock increases output significantly in both short- and medium-terms, in aging economies, output responses are not statistically significant.
To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey—large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.
To compile the findings of studies assessing emotional and behavioral changes in the survivors of the 2011 Fukushima nuclear disaster, we performed a systematic review in August 2019 using four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI). Peer-reviewed manuscripts, either in English or Japanese, were included in the searches. Sixty-one studies were retrieved for the review. Of these, 41 studies (67.2%) assessed emotional consequences, 28 studies (45.9%) evaluated behavioral consequences, and 8 studies (13.1%) evaluated both emotional and behavioral outcomes. The main research topic in emotional change was radiation exposure-associated risk perception, as reported in 15 studies. This risk perception included immediate health effects (eg, acute radiation syndrome) as well as future health effects (eg, future cancer and genetic effects). Lowered subjective well-being was reported in eight studies. Six studies reported perceived discrimination/stigmatization in the disaster survivors. The most critical behavioral change was an increase in suicides compared with residents in the whole of Japan or affected by the earthquake and tsunami, but not by the nuclear disaster. Increased rate of alcohol and tobacco use was reported, although the effect on one’s health was inconsistent. As a conclusion, the Fukushima nuclear disaster survivors suffered issues in risk perception, well-being, stigmatization, and alcohol/tobacco use in the first 8 years after the disaster. The present study is important in order to better understand the emotional and behavioral responses to future nuclear/radiological disasters as well as other “invisible” disasters, such as chemical and biological public health crises.
Fungi are one of the most diverse carbon source-assimilating organisms, living as saprobes, parasites and symbionts; they play an important role in carbon cycling in the ecosystem. A lichen thallus provides habitats for many non-lichenized fungi and usually contains large quantities of polyols. However, research has not been undertaken to identify carbon sources of lichen-inhabiting fungi. In this study, we isolated various lichen-inhabiting fungi from surface-sterilized Ramalina spp., Flavoparmelia caperata and Peltigera degenii, and demonstrated their ability to assimilate carbon sources, namely glucose, ribitol and mannitol. Several isolates efficiently assimilated mannitol and ribitol; however, most isolates could assimilate only mannitol or both ribitol and mannitol at low levels. It is suggested that there are different preferences and niche segregation of carbon sources among lichen-inhabiting fungi, and that this assemblage includes fungi with different lifestyles such as saprobes, endophytes and transient visitors.
The wings of butterflies are relatively heavier than those of other insects, and the inertial force and torque due to the wing mass are likely to have a significant effect on agility and manoeuvrability in the flapping flight of butterflies. In the present study, the effect of wing mass on the free flight of butterflies is investigated by numerical simulations based on an immersed boundary–lattice Boltzmann method. We use a butterfly-like model consisting of two square wings with mass connected by a rod-shaped body. We simulate the free flights of the model by changing the ratio of the wing mass to the total mass of the model and also changing the mass distributions of the wings. As a result, we find that the aerodynamic vertical and horizontal forces decrease as the wing-mass ratio increases, since for a large wing-mass ratio the body has large vertical and horizontal oscillations in each stroke and consequently the speeds of the wing tip and the leading edge relatively decrease. In addition, we find that the wing-mass ratio has a dominant effect on the rotational motion of the model, and a large wing-mass ratio reduces aerodynamic force and intensifies the time variation of the pitching angle. From the results of our free flight simulations, we clarify the critical wing-mass ratio between upward flight and downward flight and find that the critical wing-mass ratio is a function of the non-dimensional total mass and almost independent of the wing length. Then, we evaluate the effect of the wing-mass distribution on the critical wing-mass ratio. Finally, we discuss the limitations of the model.
Behavioural activation is an efficient treatment for depression and can improve intrinsic motivation. Previous studies have revealed that the frontostriatal circuit is involved in intrinsic motivation; however, there are no data on how behavioural activation affects the frontostriatal circuit.
Aims
We aimed to investigate behavioural activation-related changes in the frontostriatal circuit.
Method
Fifty-nine individuals with subthreshold depression were randomly assigned to either the intervention or non-intervention group. The intervention group received five weekly behavioural activation sessions. The participants underwent functional magnetic resonance imaging scanning on two separate occasions while performing a stopwatch task based on intrinsic motivation. We investigated changes in neural activity and functional connectivity after behavioural activation.
Results
After behavioural activation, the intervention group had increased activation and connectivity in the frontostriatal region compared with the non-intervention group. The increased activation in the right middle frontal gyrus was correlated with an improvement of subjective sensitivity to environmental rewards.
Conclusions
Behavioural activation-related changes to the frontostriatal circuit advance our understanding of psychotherapy-induced improvements in the neural basis of intrinsic motivation.
United Nations peacekeeping personnel face numerous stressors due to their challenging deployments. Past studies have had inconsistent results regarding whether or not their deployment experience affects their mental health outcomes. Further studies are required to ascertain the associations between their outcomes and factors before, during and after their peacekeeping missions.
The 2011 Fukushima Daiichi nuclear accident was the worst nuclear disaster since Chernobyl. The Daiichi workers faced multiple stressors (workplace trauma, victim experiences, and public criticism deriving from their company’s post-disaster management). Literatures suggest the importance of workplace interpersonal support (WIS) in enhancing psychological health among disaster workers. We sought to elucidate the role of their demographics, disaster-related experiences, and post-traumatic stress symptoms on perceived WIS.
Methods
We analyzed self-report questionnaires of 885 workers 2-3 months post-disaster. We used sociodemographic and disaster exposure-related variables and post-traumatic stress symptoms (measured by the Impact of Event Scale-Revised) as independent variables. We asked whether WIS from colleagues, supervisors, or subordinates was perceived as helpful, and used yes or no responses as a dependent variable. Logistic regression analyses were performed to assess correlates of WIS.
Results
Of the participants, one-third (34.7%) reported WIS. WIS was associated with younger age (20-28 years [vs 49-], adjusted odds ratio [aOR]: 3.25, 95% CI: 1.99-5.32), supervisory work status (aOR: 2.30, 95% CI: 1.35-3.92), and discrimination or slur experience (aOR: 1.65, 95% CI: 1.08-2.53).
Conclusions
Educational programs focusing on WIS might be beneficial to promote psychological well-being among nuclear disaster workers, especially younger workers, supervisors, and workers with discrimination experiences. (Disaster Med Public Health Preparedness. 2018;12:460–463)
Cognitive–behavioral therapy (CBT) is thought to be useful for chronic pain, with the pathology of the latter being closely associated with cognitive–emotional components. However, there are few resting-state functional magnetic resonance imaging (R-fMRI) studies. We used the independent component analysis method to examine neural changes after CBT and to assess whether brain regions predict treatment response.
Methods
We performed R-fMRI on a group of 29 chronic pain (somatoform pain disorder) patients and 30 age-matched healthy controls (T1). Patients were enrolled in a weekly 12-session group CBT (T2). We assessed selected regions of interest that exhibited differences in intrinsic connectivity network (ICN) connectivity strength between the patients and controls at T1, and compared T1 and T2. We also examined the correlations between treatment effects and rs-fMRI data.
Results
Abnormal ICN connectivity of the orbitofrontal cortex (OFC) and inferior parietal lobule within the dorsal attention network (DAN) and of the paracentral lobule within the sensorimotor network in patients with chronic pain normalized after CBT. Higher ICN connectivity strength in the OFC indicated greater improvements in pain intensity. Furthermore, ICN connectivity strength in the dorsal posterior cingulate cortex (PCC) within the DAN at T1 was negatively correlated with CBT-related clinical improvements.
Conclusions
We conclude that the OFC is crucial for CBT-related improvement of pain intensity, and that the dorsal PCC activation at pretreatment also plays an important role in improvement of clinical symptoms via CBT.
During the Pleistocene a fauna composed of large (biomass > 44 kg) and giant mammals (biomass > 1000 kg) that are usually associated with open environments lived in the Brazilian Intertropical Region. We present here new information concerning the paleoecology and chronology of some species of this megafauna. Carbon isotope analyses were performed for a better understanding of the paleoecology of the species Eremotherium laurillardi (Lund, 1842), Notiomastodon platensis (Ameghino, 1888) and Toxodon platensis (Owen, 1849). The δ13C data allow attributing a generalist diet to these species, which varied according to the kind of habitat in which they lived. In more open habitats all species were grazers; in mixed habitats E. laurillardi and T. platensis were mixed feeders, and N. platensis was grazer; and in more closed habitats all species were mixed feeders.
Late watergrass is a serious weed of California rice that has evolved resistance to molinate, thiobencarb, fenoxaprop-ethyl, and bispyribac-sodium. To obtain an insight into the origin and spread of resistant (R) late watergrass in California rice fields, we evaluated similarities in morphological traits and amplified fragment length polymorphism (AFLP) fingerprints among 15 R strains compared with susceptible (S) strains. All strains were derived by inbreeding from accessions collected in rice fields of the Sacramento Valley, CA. In the field, R plants were shorter than S plants; they also had narrower and shorter flag leaves and thinner culms. Spikelets also appeared smaller and more slender in R plants. There was greater morphological similarity among the 15 R strains than among the eight S strains. The mean coefficients of variation for morphological traits were much smaller among R strains, which in a cluster analysis (Ward's method) were grouped morphologically apart at early clustering stages from the more variable S strains. AFLP electropherograms also showed greater similarity between R strains. R strains were grouped separately from the S strains in a cluster analysis based on calculated Nei and Li coefficients used in an unweighted pair group method using arithmetic means. However, small genetic differences also existed because the R strains were grouped into six clusters, suggesting that R strains were not samples from an identical strain. It was concluded that R strains originated from a preexisting and preadapted mutant late watergrass population in the Sacramento Valley. This study establishes that resistance moved by spikelet dispersal, not independent mutation events, most likely defined the geographical distribution of R late watergrass in California. Prevention and control of this dispersal combined with elimination of seed-producing survivors after herbicide treatment should be relevant components of the integrated management of herbicide-resistant late watergrass in California rice.
Laboratory and field experiments were conducted to determine the effects of several environmental factors on seed germination and seedling emergence of the invasive weed, apple of Peru. The anatomy of the seed was also investigated in this study. The anatomy of the seed is similar to that of an eggplant (Solanum melongena L.) seed. The seed is albuminous, and consists of a seed coat, endosperm, and an embryo. The seed coat, which consists of both outer and inner integuments, is relatively thick. Fresh and dry stored seeds exhibited strong dormancy. Hot water treatment did not affect the seed germination in the light, but significantly (P < 0.05) reduced the germination rate in the dark. Dry-heat treatment had no significant effect on seed germination in the dark, but it significantly (P < 0.05) increased the germination rate in the light. Cold stratification alone did not influence seed germination under constant temperature (25 C) but affected it under alternating temperature (25–15 C). However, a combination of warm and cold stratification produced significant (P < 0.05) germination in the dark as well as in the light. In addition, the effect of warm stratification followed by cold stratification was more pronounced in the dark than in the light. Gibberellin A3 (GA3) (10–3 and 10–4 M) treatments significantly (P < 0.05) increased the seed germination rate compared with that of the control. Emergence rate was maximum for seeds placed on the soil surfaces; no seedling emergence occurred when seeds were placed at a depth of 5 cm.
The Fukushima Daiichi and Daini Nuclear Power Plant workers experienced multiple stressors as both victims and onsite workers after the 2011 Great East Japan Earthquake and subsequent nuclear accidents. Previous studies found that disaster-related exposures, including discrimination/slurs, were associated with their mental health. Their long-term impact has yet to be investigated.
Method
A total of 968 plant workers (Daiichi, n = 571; Daini, n = 397) completed self-written questionnaires 2–3 months (time 1) and 14–15 months (time 2) after the disaster (response rate 55.0%). Sociodemographics, disaster-related experiences, and peritraumatic distress were assessed at time 1. At time 1 and time 2, general psychological distress (GPD) and post-traumatic stress response (PTSR) were measured, respectively, using the K6 scale and Impact of Event Scale Revised. We examined multivariate covariates of time 2 GPD and PTSR, adjusting for autocorrelations in the hierarchical multiple regression analyses.
Results
Higher GPD at time 2 was predicted by higher GPD at time 1 (β = 0.491, p < 0.001) and discrimination/slurs experiences at time 1 (β = 0.065, p = 0.025, adjusted R2 = 0.24). Higher PTSR at time 2 was predicted with higher PTSR at time 1 (β = 0.548, p < 0.001), higher age (β = 0.085, p = 0.005), and discrimination/slurs experiences at time 1 (β = 0.079, p = 0.003, adjusted R2 = 0.36).
Conclusions
Higher GPD at time 2 was predicted by higher GPD and discrimination/slurs experience at time 1. Higher PTSR at time 2 was predicted by higher PTSR, higher age, and discrimination/slurs experience at time 1.