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Parotid gland carcinoma is a rare and complicated histopathological classification. Therefore, assembling a sufficient number of cases with long-term outcomes in a single institute can present a challenge.
The medical records of 108 parotid gland carcinoma patients who were treated at Kyushu University Hospital, Fukuoka, Japan, between 1983 and 2014 were reviewed. The survival outcomes were analysed according to clinicopathological findings.
Forty-six patients had low clinical stage tumours (I–II), and 62 patients had high clinical stage tumours (III–IV). Fifty-two, 10 and 46 patients had low-, intermediate- and high-grade tumours, respectively. Twenty-seven of 65 cases had positive surgical margins. In high clinical stage and intermediate- to high-grade tumours, adjuvant radiation therapy was correlated with local recurrence-free survival (p = 0.0244). Intermediate- to high-grade tumours and positive surgical margins were significantly associated with disease-specific survival in multivariate analysis (p = 0.0002 and p = 0.0058).
The results of this study show that adjuvant radiation therapy is useful for improved local control in patients with high clinical stage and intermediate- to high-grade tumours.
The torrential rain triggering massive flooding and hundreds of landslides was the worst weather disaster in Western Japan. A temporary pharmacy was established in the Kurashiki health center, which provided medicine to victims.
To evaluate the supply status of prescription under the health insurance system during a disaster.
When the enormous disaster occurred, victims get a prescription in the hospital or community pharmacy under the Disaster Relief Act or Health Insurance Act. Under the Disaster Relief Act, prescriptions that are given at a first aid station are able to be filled at the mobile pharmacies at no cost to the patient from the local government. Prescriptions that are issued by a medical institution, and are in accordance with the Health Insurance Act or National Health Insurance Act, can be dispensed at hospitals or community pharmacies. Patients may be exempt from the co-payment by being covered by their health insurance. Here, we investigated the supply status of prescription to affected people.
The good points of the supply status were as following: 1) dispensing out of disaster area was a good system to relieve a pharmacist2. ) J-SPEED was also a good reporting system to provide appropriative medicine inventory management, and 3) sending prescription using a mobile phone was very useful for pharmaceutical activities. On the other hand, the points for improvement were as following: 1) more time to learn the medical insurance system during the disaster was needed, and 2) the mobile pharmacy is better to make the rounds of shelters including health care consultation.
In case of a disaster, two different medicine supply systems cause confusion to medical relief teams. It is considered that collaboration relief activities with relief teams that included a pharmacist was very important.
Hydrolytically polymerized poly(methyl-co-vinyl)siloxane is cross-linked by radically and dehydrolytically at elevated temperature. Peroxide-type thermal radical generator is found to cross-link the polymer at the vinyl and methyl pendant groups. In parallel, free silanol (Si-OH) end groups in the polymer also contribute to cross-linking by dehydrolytic polycondensation. By use of these two-fold cross-linking mechanisms, we were able to deposit highly cross-linked siloxane polymer film which provides excellent optical and electrical properties. Cured film of 500 nm thickness exhibited the pencil hardness of 9H on glass with > 95% visible light transmittance. These excellent features are applied to optical hard coating for flexible displays and touch panels. The cured film also exhibited excellent electric properties. The leakage current of the film is as low as that of CVD dielectric film, and the break down field is exceeded 3 MV/cm, which enabled the film to be applied to insulator in thin film transistor. We carried out analyses of the polymer in film and powder form with 13C- and 29Si-NMR MAS, FT-RAMAN and FTIR-ATR methods to investigate curing mechanism. The analysis results clearly indicated that the cured film contains unique Si-(CH)n-Si bonds generated by radical crosslinking, and all the Si-OH bonds are consumed by hydrolytic polycondensation as well. The Si-(CH)n-Si bonds are more rigid and less polar than Si-O-Si bond, which should be the major reasons that radical condensation remarkably reinforced the film. This radically and thermally cured poly(methyl-co-vinyl)siloxane film was applied to Mo-gate thin film transistor fabricated on glass as the gate insulator. The I-V characteristics from the transistor were equivalent to those made using CVD-SiN insulator.
Dynamic fracture of a two-dimensional MoWSe2 membrane is studied with molecular dynamics (MD) simulation. The system consists of a random distribution of WSe2 patches in a pre-cracked matrix of MoSe2. Under strain, the system shows toughening due to crack branching, crack closure and strain-induced structural phase transformation from 2H to 1T crystal structures. Different structures generated during MD simulation are analyzed using a three-layer, feed-forward neural network (NN) model. A training data set of 36,000 atoms is created where each atom is represented by a 50-dimension feature vector consisting of radial and angular symmetry functions. Hyper parameters of the symmetry functions and network architecture are tuned to minimize model complexity with high predictive power using feature learning, which shows an increase in model accuracy from 67% to 95%. The NN model classifies each atom in one of the six phases which are either as transition metal or chalcogen atoms in 2H phase, 1T phase and defects. Further t-SNE analyses of learned representation of these phases in the hidden layers of the NN model show that separation of all phases become clearer in the third layer than in layers 1 and 2.
To understand the geological origins of minerals in cryoconite and the nutrients sources for microbes on glaciers, we analyzed the Sr–Nd isotopic ratios of the four mineral fractions in cryoconites including saline, carbonate, phosphate, silicate and the organic fraction obtained from Gulkana Glacier in Alaska. The isotopes in the silicate mineral fraction exhibited spatial variation within the glacier (87Sr/86Sr: 0.704533–0.709563, εNd (0): −16.0 to 0.5), which can be explained by the different mixing ratios of the two distinct sources: one of the sources is lateral and terminal moraines or soil, and the other is the medial moraine of the glacier. The minerals in the cryoconite at the lower sites in the glacier are likely derived from the former source, whereas those at the upper sites are from latter sources. The mineralogical and elemental compositions also support mixing of the silicate minerals from the two local sources. The Sr isotopic ratios of the organic fraction also showed spatial variation on the glacier in the middle sites – a trend similar to those of the phosphate fraction. The results suggest that the organic matter is mostly the byproducts of microbes using the phosphate minerals as a nutrient source.
Let R be a semi-ordered linear space, that is, a vector lattice in Birkhoff's terminology . An element a ∈ R is said to be discrete, if for every element x ∈ R such that there exists a real number a for which x = aa. For every pair of discrete elements a, b ∈ R we have or there exists a real number a for which b = aa or a = ab.
Albeit with little reference to Woodrow Wilson, Yanaihara Tadao, the Chair of Colonial Policy at Tokyo Imperial University in the 1920s and 1930s, and a pious Christian, adapted the core ideas of Wilsonian liberalism such as national self-determination, multilateralism, and democracy to the political and legal framework of imperial Japan. Yanaihara advocated the principle of autonomy for the Japanese empire to transform itself into the core of a liberal international order. He articulated that the combination of colonialism and unfettered capitalism had detrimental effects on the colonized and advocated for a Japanese empire that reflected the voice of its colonized people. However, having seen little improvement in the status of the colonized, Yanaihara increasingly regarded Japanese pan-Asianist ideas in the 1930s as a cover-up of Japanese expansionism. Almost abandoning his earlier ideas about empire as a multiethnic society, he criticized Japan's military venture as economically unprofitable, and policies toward Manchuria as stoking the rise of Chinese nationalism. He advocated for the normative framework advanced by the Mandate System of the League of Nations as a way toward the universalization of sovereignty, and protection of stateless populations. The failure of the Wilsonian moment in Japan forced Yanaihara out of Tokyo Imperial University but also strengthened his inclination towards liberal internationalism.
Sexual differences in behaviours are often affected by the difference in individual interests between the sexes: growth in males and egg production in females. Some hermit crabs show sexual differences in shell use patterns during the reproductive season. In the non-reproductive season, however, when both sexes are focused on increasing growth, this sexual difference is expected to be reduced. In this study, we compared the pattern of shell use in the hermit crab Pagurus minutus between seasons, while focusing on the effects of shell shape on growth or egg production. As we predicted, sexual differences in shell use in P. minutus showed seasonal change. In the non-reproductive season, both sexes appeared to use shells well suited for growth. In the reproductive season, sexual differences became more evident, especially in larger solitary crabs and guarding pairs; males monopolized round-type shells such as those of Umbonium moniliferum, whereas more than 80% of females relied on high-spired Batillaria-type shells such as those of Batillaria zonalis. A lack of advantage for egg number in females using Batillaria-type shells suggests that female shell use is explained by factors other than maximizing clutch size. Both sexes can moult during the reproductive season, and larger body size is advantageous for reproduction. Given that Batillaria-type shells resulted in a lower growth increment and males have an advantage in shell fights in congeneric crabs, our findings suggest the importance of intersexual competition for shells and female compromise in determining the seasonal change of shell use patterns in P. minutus.
A male neonate with d-transposition of the great arteries was diagnosed with the concomitant anomaly of left circumflex aortic arch and right-sided ductus arteriosus, which formed a vascular ring. Initial postnatal echocardiography had demonstrated an obscured aortic isthmus mimicking coarctation of the aorta, which could be a diagnostic clue to circumflex aortic arch.
The aim of this study was to assess the impact of age at bidirectional cavopulmonary anastomosis on haemodynamics after total cavopulmonary connection.
We conducted a retrospective analysis of 100 consecutive patients who underwent total cavopulmonary connection from 2010 to 2014. All patients had previously undergone bidirectional cavopulmonary anastomosis. These patients were classified into two groups according to age at bidirectional cavopulmonary anastomosis: younger group, <6 months (n=33), and older group, >6 months (n=67).
The proportion of hypoplastic left heart syndrome was higher in the younger group (48 versus 4%). After total cavopulmonary connection, the chest tube period was longer in the younger group (10.1±6.6 versus 6.7±4.5 days; p=0.009). Catheterisation 6 months after total cavopulmonary connection revealed that pulmonary artery pressure was higher (11.5±1.9 versus 10.4±2.1 mmHg; p=0.017) and Nakata index was lower (219±79 versus 256±70 mm2/m2; p=0.024) in the younger group. In patients with a non-hypoplastic left heart syndrome, there was no difference in post-operative haemodynamics between two groups, but the total amount of chest drainage after total cavopulmonary connection was larger in the younger group (109±95 versus 55±40 ml/kg; p=0.044).
Early bidirectional cavopulmonary anastomosis did not affect the outcome of total cavopulmonary connection. Longer chest tube period, smaller pulmonary artery, and higher pulmonary artery pressure after total cavopulmonary connection were recognised in early bidirectional cavopulmonary anastomosis patients, especially in hypoplastic left heart syndrome.
The mechanical and thermal properties of single crystals of the type-I clathrate compounds Ba8Ga16Ge30 and Sr8Ga16Ge30 have been investigated by measuring the elastic constants, coefficients of thermal expansion (CTE) and plastic deformation behavior in compression. The feasibility of these two clathrate compounds as a thermoelectric material in terms of mechanical stability under possible thermal stresses is evaluated by calculating thermal stresses that are expected to develop within these compounds when used as thermoelectric devises.
Catheter interventions for residual lesions in the early postoperative period after CHD operations are still not established as a reliable treatment option.
We retrospectively reviewed our institutional experience of cardiac catheterisations and catheter interventions performed in the early postoperative period. We classified our patients into two groups. The “hyper” acute phase group – operation to cardiac catheterisation of ⩽7 days – and acute phase group – operation to cardiac catheterisation from 7 to 30 days.
Of the 47 patients, catheter interventions were performed in 38 patients (81%). The success rate of the intervention was 96% in the acute phase group and 90% in the “hyper” acute phase group. The overall success rate was 95%. There were two self-limited complications in the acute phase group, but not in the “hyper” acute phase group. There were four cases of catheter interventions performed for a newly reconstructed aortic arch, and those procedures were also safe and effective.
Cardiac catheterisations and catheter interventions were safe and effective not only in the early postoperative period but also in the very early postoperative period. Catheter interventions for the left-sided heart in the early postoperative period were also safe and effective.
To identify the predictive and prognostic factors associated with ampicillin-resistant enterococcal bacteraemia, we retrospectively reviewed demographic, microbiological and clinical data of patients attending the Kyoto University Hospital, Japan, between 2009 and 2015. Logistic regression and Cox regression analyses were performed to determine the predictive and prognostic factors, respectively. In total, 235 episodes of enterococcal bacteraemia were identified. As ampicillin susceptibility was uniform for Enterococcus faecalis isolates and almost all ampicillin-resistant isolates were E. faecium, bacteraemia due to these species was investigated separately. E. faecalis and E. faecium accounted for 41.7% (98/235) and 48.1% (113/235) of the isolates, respectively and 91.2% of all E. faecium were ampicillin resistant. Nosocomial E. faecium bacteraemia acquisition (odds ratio (OR), 13.6; 95% confidence intervals, 3.16–58.3) was associated with ampicillin-resistant isolates. Bacteraemia from an unknown source (hazard ratio (HR), 2.91; 95% CI 1.36–6.21) and an increased Pitt bacteraemia score (PBS) (HR, 1.36; 95% CI 1.21–1.52) were associated with 30-day mortality in E. faecium infections. Likewise, bacteraemia from an unknown source (HR, 4.17; 95% CI 1.25–13.9) and increased PBS (HR, 1.27; 95% CI 1.09–1.48) were associated with 30-day mortality in patients with E. faecalis bacteraemia. The empirical therapeutic administration of glycopeptides is recommended for patients with bacteraemia from an unknown source in whom severe E. faecium bacteraemia is suspected.