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Integration of head-mounted virtual reality (VR) devices has been revolutionary in health professions education. In disaster preparedness training, VR simulation-based learning exposes health care professionals to the unique challenges of diverse scenarios, enhancing their adaptability. The aim of the study was to evaluate the effectiveness of a head-mounted VR tool for teaching basic radiation emergency medicine skills to medical students.
Methods
The participants were 64 medical students (5th-year) who underwent a 3-hour training session in radiation emergency medicine that was conducted via head-mounted VR devices. Students scored their perceived emotion, performance, and self-efficacy at various time points in a self-reported online questionnaire.
Results
Comparison of survey responses before and after the session showed significant differences in terms of neutral emotion (P = 0.011), negative activating emotions (P < 0.001), and negative deactivating emotions (P = 0.004). The post-hoc test revealed statistically significant differences in negative activating emotions between before and during (P < 0.05), and between before and after (P < 0.05) the VR simulation. In addition, negative deactivation and neutral emotions changed significantly after the simulation.
Conclusions
The use of head-mounted VR devices was effective in modulating medical students’ emotions and contributed to improving their perceived performance in radiation emergency medicine.
Healthcare-associated infections (HAIs) pose significant challenges to healthcare systems worldwide. Epidemiological data are essential for effective HAI control; however, comprehensive information on HAIs in Japanese hospitals is limited. This study aimed to provide an overview of HAIs in Japanese hospitals.
Methods:
A multicenter point-prevalence survey (PPS) was conducted in 27 hospitals across the Aichi Prefecture between February and July 2020. This study encompassed diverse hospital types, including community, university, and specialized hospitals. Information on the demographic data of the patients, underlying conditions, devices, HAIs, and causative organisms was collected.
Results:
A total of 10,199 patients (male: 5,460) were included in this study. The median age of the patients was 73 (interquartile range [IQR]: 56–82) years, and the median length of hospital stay was 10 (IQR: 4–22) days. HAIs were present in 6.6% of patients, with pneumonia (1.83%), urinary tract infection (1.09%), and surgical site infection (SSI) (0.87%) being the most common. The prevalence of device-associated HAIs was 0.91%. Staphylococcus aureus (17.3%), Escherichia coli (17.1%), and Klebsiella pneumoniae (7.2%) were the primary pathogens in 433 organisms; 29.6% of the Enterobacterales identified showed resistance to third-generation cephalosporins. Pneumonia was the most prevalent HAI in small-to-large hospitals (1.69%–2.34%) and SSI, in extra-large hospitals (over 800 beds, 1.37%).
Conclusions:
This study offers vital insights into the epidemiology of HAIs in hospitals in Japan. These findings underscore the need for national-level PPSs to capture broader epidemiological trends, particularly regarding healthcare challenges post-COVID-19.
Knowledge management on Disaster Health Management (DHM) is one of the priority areas in the Plan of Action to implement the ASEAN Leaders’ Declaration on DHM (POA/ ALD DHM) (2019-2025). The Japan International Cooperation Agency (JICA) has been implementing the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) since 2016 to assist the ASEAN region in strengthening coordination capacity on DHM. A regional training course on DHM for ASEAN member states (AMS) in Japan was proposed to be implemented in 2022 as a JICA’s Knowledge Co-creation Program (KCCP).
Method:
The training curriculum of the KCCP included emergency and disaster medicine in Japan, international trends on DHM, and underwent reviews by AMS representatives of the ARCH Project. Prior to the training, participants were required to prepare country reports (CRs) outlining information on legislation, system and structure related to emergency and disaster medicine, as well as systems to receive international emergency medical teams (I-EMTs).
Results:
The four-week KCCP course contained a trial implementation of a four-day training program for receiving I-EMTs and coordination among stakeholders in ASEAN disaster response, based on the regional standard curriculum developed by the ARCH Project, and invited experts in DHM not only from Japan but also from AMS as instructors. Participants analyzed and identified challenges on DHM in their countries, and developed draft action plans (APs) to improve the situation through the knowledge obtained from the program.
Conclusion:
The draft APs, the training deliverables, will be shared with the ARCH Project, and used to build a support mechanism to achieve national level targets of the POA/ ALD DHM, and the progress will be reflected in the CR in the subsequent year. The KCCP on DHM is expected to facilitate knowledge sharing in AMS and Japan, and contribute to fostering the culture of mutual learning.
To understand the physical properties of the interstellar medium (ISM) in various scales, we should investigate it with pc-scale resolution over kpc scale coverage. Here, we report the sub-kpc scale Gas Density Histogram (GDH) of the Milky Way. GDH is a histogram of averaged density and corresponds to the probability density distribution (PDF) of gas volume density. We use galactic plain survey data (l =10∘− 50∘) at 12CO and 13CO (J = 1 − 0) obtained as a part of the FOREST Unbiased Galactic plane Imaging survey with the Nobeyama 45m telescope (FUGIN). With this method and data, we are free from spatial structure and molecular cloud identification. GDH can be well fitted with single or double log-normal distribution; which we call as the low-density log-normal (L-LN) and high-density log-normal (H-LN) components. We found both the H-LN fraction (fH) and L-LN width (σL) along the gas density axis show a coherent structure on the longitude-velocity diagram. It suggests that there is a relationship between the ISM property and kpc scale structure in the Milky Way.
The present study aims were (1) to identify the proportion of terminally ill cancer patients with desire for hastened death (DHD) receiving specialized palliative care, (2) to identify the reasons for DHD, and (3) to classify patients with DHD into some interpretable subgroups.
Methods
Advanced cancer patients admitted to 23 inpatients hospices/palliative care units in 2017 were enrolled. Data were prospectively obtained by the primarily responsible physicians. The presence/absence of DHD and reasons for DHD were recorded. A cluster analysis was performed to identify patterns of subgroups in patients with DHD.
Results
Data from 971 patients, whose Richmond Agitation–Sedation Scale score at admission was zero and who died in palliative care units, were analyzed. The average age was 72 years, common primary cancer sites were the gastrointestinal tract (31%) and the liver/biliary ducts/pancreas (19%). A total of 174 patients (18%: 95% confidence interval, 16–20) expressed DHD. Common reasons for DHD were dependency (45%), burden to others (28%), meaninglessness (24%), and inability to engage in pleasant activities (24%). We identified five clusters of patients with DHD: cluster 1 (35%, 61/173): “physical distress,” cluster 2 (21%, 37/173): “dependent and burdensome,” cluster 3 (19%, 33/173): “hopelessness,” cluster 4 (17%, 30/173): “profound fatigue,” and cluster 5 (7%, 12/173): “extensive existential suffering.”
Conclusions
A considerable number of patients expressed DHD and could be categorized into five subgroups. These findings may contribute to the development of therapeutic strategies.
Lithium thio-phosphorus oxynitride glasses, LiPOSN, have been prepared by mechanical milling process from the mixture of Li2S and LiPON glass. The anionic substitution of oxygen by sulphur and nitrogen in the phosphate glass structure has been confirmed by 1D 31P solid state nuclear magnetic resonance and x-ray photoelectron spectroscopy. The study of thermal and electrical properties reveals a decrease in the glass transition temperature, likely due to the depolymerization of glass network by the decrease of bridging oxygens and sulphurs, along with a sharp increase in the ionic conductivity when lithium sulphide is incorporated into the oxynitride glasses. The improvement of chemical durability by the introduction of nitrogen, together with the increase in ionic conductivity up to values closed to the value of commercial LiPON thin film electrolyte, suggests that these LiPOSN glasses could be good candidates as solid electrolytes for lithium microbatteries.
To assess the genetic diversity of spinach germplasm, 250 individuals of 50 accessions collected from geographically diverse regions (West Asia, East Asia, Japan, Europe and the USA) were analysed using simple sequence repeat (SSR) markers. A total of 39 polymorphic alleles were identified, with an average of 6.5 alleles per locus for six loci. The overall gene diversity (0.62) in the entire set of individuals suggests that the germplasm has high genetic variability. The West Asian accessions showed the highest gene diversity, with a value of 0.57, followed by the East Asian accessions. These results help confirm the notion that spinach originated from West Asia. Hierarchical analysis of molecular variance revealed significant genetic differentiation among the geographical regions, which accounts for 26% of the total variation detected. Furthermore, pairwise Φst values indicate low genetic differentiation between the East Asian and Japanese germplasm accessions, both of which showed high genetic differentiation from the European accessions. The differentiation between the East Asian and European gene pools may be attributed to the founder effect associated with crop dissemination, as well as to the selection and genetic drift that occurred during the breeding process.
A 60 GHz tandem coupler using offset broadside coupled lines is proposed in a WLP (Wafer Level Packaging) technology. The fabricated coupler has a core chip area of 750 μm × 385 μm (0.288 mm2). The measured results show an insertion loss of 0.44 dB, an amplitude imbalance of 0.03 dB and a phase difference of 87.6° at 60 GHz. Also the measurement shows an insertion loss of less than 0.67 dB, an amplitude imbalance of less than 0.31 dB, a phase error of less than 3.7°, an isolation of more than 29.7 dB and a return loss of more than 27.9 dB at the input ant coupled ports and more than 14.3 dB at the direct and isolated ports over the frequency band of 57-66 GHz, covering 60 GHz band both in Japan and US. To the best of our knowledge the proposed coupler achieves the lowest ever reported insertion loss and amplitude imbalance for a 3-dB coupler on a silicon substrate. With its superior performance and lower cost compared to the CMOS counterparts, the proposed coupler is a suitable candidate for low-cost high-performance millimeter-wave systems.
In order to enhance the photosensitivity of photoreactive materials utilizing base-catalyzed reactions, we developed base amplifiers that decompose autocatalytically to generate newborn amine molecules. Actually, we reported that the addition of base amplifiers to the photoreactive materials such as photoresists and UV-curing materials resulted in the marked improvement photosensitivity. However, conventional base amplifiers have aromatic rings such as fluorenyl groups and phenyl groups. Consequently, these base amplifiers have strong absorption of UV light which is a trigger of photolysis of a photobase generator. This leads to the hindrance of the photolysis. We report here novel base amplifiers with 3-nitropentan-2-yl group which has no aromatic rings.
The base amplifiers decomposed autocatalytically to generate newborn amine molecules at an elevated temperature in solution and a polystyrene film in the presence of a catalytic amount of amines. Moreover, combining the base amplifiers with UV-curing materials consisting of a photobase generator and liquid epoxy resins resulted in the improvement of curing efficiency. To apply the base amplifier to photopatterning materials, we synthesized novel silicone resins with 3-nitropentan-2-yl groups as base-amplifying polymers. A film of the resin decomposed autocatalytically to generate amino groups in its side chains at an elevated temperature in the presence of a catalytic amount of amines. Furthermore, we demonstrated that the resins sensitized with a photobase generator provided negative- and positive-working photopolymers in the following ways. A thin film of the resin containing 10 wt% of a photobase generator became soluble in an acidic aqueous solution after 254 nm light irradiation of an exposure dose of 1 mJ/cm2 and subsequent baking at 50 oC for 20 min. This is because of formation of amino groups in its side chains. On the other hand, the film became insoluble in organic solvents after 254 nm light irradiation of an exposure dose of 1 mJ/cm2 and subsequent heat treatment at 50 oC for 40 min, this arises from that the photobase-catalyzed hydrolytic condensation of residual ethoxysilyl units of the resin proceeded to form crosslinked networks.
Effects of prostaglandin E2 (PGE2) on exocytosis of mucin were studied in mucous cells isolated from guinea-pig antrum using video-microscopy. Stimulation with PGE2 elicited a sustained increase in the frequency of exocytotic events in a dose-dependent manner, which was under regulation by both Ca2+ and cAMP. Stimulation with a selective prostanoid EP4 receptor agonist (ONO-AEI-329, 10 µM), which activates cAMP signals, elicited a sustained increase in the frequency of exocytotic events (30 % of that evoked by 1 µM PGE2). Stimulation with an EP1 agonist (17-P-T-PGE2, 1 µM), which activates Ca2+ signals, increased the frequency of exocytotic events to a lesser extent (5 % of that evoked by 1 µM PGE2), while addition of an EP1 antagonist (ONO-8713, 10 µM) decreased the frequency of exocytotic events (approximately 40 % of that evoked by 1 µM PGE2). However, addition of the EP1 agonist potentiated the frequency of exocytotic events evoked by the EP4 agonist or forskolin (which elevates cAMP levels) and increased the sensitivity of the exocytotic events to forskolin. These results suggest that the Ca2+ signal activated via the EP1 receptor potentiates the cAMP-regulated exocytotic events activated via the EP4 receptor during PGE2 stimulation, by increasing the sensitivity of the exocytotic response to cAMP. In conclusion, exocytotic events in PGE2-stimulated antral mucous cells were regulated by interactions between EP1 and EP4 receptors. Experimental Physiology (2001) 86.4, 451-460.
The effects of cAMP accumulation evoked by
acetylcholine (ACh) stimulation were studied in rat
submandibular acinar cells by observing the exocytotic
events, swelling of intercellular canaliculi (IC) and
intracellular Ca2+ concentration ([Ca2+]i), which were monitored using
an optical microscope. ACh stimulation evoked transient increases
followed by sustained increases in the frequency of exocytotic events
and IC swelling, while isoproterenol (isoprenaline; IPR) stimulation
evoked sustained increases in these parameters. BAPTA treatment
reduced the frequency of exocytotic events evoked by 5 µM ACh in the
absence of extracellular Ca2+, and further addition of Rp-cAMPS or
H-89 (protein kinase A (PKA) inhibitors) eliminated the remaining
ACh-evoked responses (50 %). Addition of PKA inhibitors in the
presence of extracellular Ca2+ reduced the frequency of exocytotic
events evoked by 500 µM ACh in non-BAPTA-loaded cells. However,
IC swelling evoked by 5 µM ACh was not affected by addition of PKA
inhibitors, and was eliminated in BAPTA-loaded cells perfused with
Ca2+-free solution. These results indicate that the IC swelling is
regulated by [Ca2+]i and the frequency of exocytotic events is regulated
by both [Ca2+]i and [cAMP]i during ACh stimulation. Addition of H-89
inhibited the capacitative Ca2+ entry into ACh-stimulated acinar cells.
Biochemical analysis revealed that ACh stimulation increased the
cAMP content in perfused submandibular glands. These results indicate
that ACh stimulates the accumulation of cAMP in submandibular
acinar cells and that this accumulation of cAMP modulates
Ca2+-regulated exocytosis.
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