To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
A 14-year-old girl suddenly developed ventricular tachycardia and severe chest pain during hospitalisation for trauma surgery. CT revealed a needle in the pericardium. Careful interview elicited that she had inserted the needle by herself, and Munchausen syndrome was diagnosed. This is the first report of ventricular tachycardia caused by a foreign body in a patient with Munchausen syndrome.
Does media choice cause polarization, or merely reflect it? We investigate a critical aspect of this puzzle: How partisan media contribute to attitude polarization among different groups of media consumers. We implement a new experimental design, called the Preference-Incorporating Choice and Assignment (PICA) design, that incorporates both free choice and forced exposure. We estimate jointly the degree of polarization caused by selective exposure and the persuasive effect of partisan media. Our design also enables us to conduct sensitivity analyses accounting for discrepancies between stated preferences and actual choice, a potential source of bias ignored in previous studies using similar designs. We find that partisan media can polarize both its regular consumers and inadvertent audiences who would otherwise not consume it, but ideologically opposing media potentially also can ameliorate the existing polarization between consumers. Taken together, these results deepen our understanding of when and how media polarize individuals.
To investigate the association between suicide death and serum cholesterol levels as measured at times close to suicide death.
We conducted a nested case-control study of 41 cases of suicide deaths and 205 matched controls with serum total cholesterol (TC) levels till 3 years before suicide death in a large cohort of Japanese workers.
Individuals in the lowest versus highest tertile/predefined category of TC in a Japanese working population had a three- to four-fold greater risk of suicide death. Each 10 mg/dl decrement of average TC was associated with an 18% increased chance of suicide death (95% confidence interval, 2–35%). Similar results were found for TC levels at each year.
These results suggest that a low serum TC level in recent past is associated with an increased risk of suicide death.
The integration of external staff into a hospital’s disaster response can present technical challenges. Although hospitals will always prefer to use their own staff in disaster response, there have been many historical examples where external staffing is required. During the 2016 Kumamoto Earthquakes, the Oita Prefectural Hospital required medical professionals to expand disaster response staff. They were able to identify 2 appropriate emergency physicians belonging to a remote hospital who had previously worked at the Oita Prefectural hospital. The physicians were effectively able to supplement the hospital staff, providing care for additional patients, and giving the existing on-duty staff some respite. Based on our experience, we suggest that hospital coalitions and disaster response authorities explore mechanisms of cross-credentialing and cross-training staff to make it easier to share staff in a disaster.
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.
Recent years have seen a renaissance of conjoint survey designs within social science. To date, however, researchers have lacked guidance on how many attributes they can include within conjoint profiles before survey satisficing leads to unacceptable declines in response quality. This paper addresses that question using pre-registered, two-stage experiments examining choices among hypothetical candidates for US Senate or hotel rooms. In each experiment, we use the first stage to identify attributes which are perceived to be uncorrelated with the attribute of interest, so that their effects are not masked by those of the core attributes. In the second stage, we randomly assign respondents to conjoint designs with varying numbers of those filler attributes. We report the results of these experiments implemented via Amazon's Mechanical Turk and Survey Sampling International. They demonstrate that our core quantities of interest are generally stable, with relatively modest increases in survey satisficing when respondents face large numbers of attributes.
HMIMMS (Major Incident Medical Management and Support: The Practical Approach in the Hospital) has been introduced by ALSG (Advanced Life Support Group, Manchester, UK) and developed for many countries for preparing to accept huge numbers of casualties at a hospital during major incidents. The original HMIMMS course has been held in Japan since 2007, produced over 1,200 providers. Japan has a crucial history of natural disasters, earthquakes, tsunamis, and typhoons often resulting in extensive damages to infrastructure and communications.
The MIMMS-JAPAN and the Japanese Association for Disaster Medicine have joined to plan to revise the original HMIMMS course from the point of view of the difference of the type of disaster.
By the permission of ALSG, two subjects were added “Hospital Evacuation” and “Business Continuity Plan” as lectures, workshops, and tabletops to the original HMIMMS course. Before attending the course, students were required to watch e-learning for deeper understanding and time-saving. Total program was organized into two days.
Main points of modification are to:
1.Replace a system peculiar to the UK with a Japanese system.
2.Add unique contents of a Japanese disaster.
3.Add the important subjects especially in Japan.
4.Modify the presentation slides to understand easily for Japanese students. But the fundamental concept that hospital functions upon ‘CSCATTT’ is strictly preserved.
Newly revised HMIMMS course will start in 2019 for Japanese learners. Many reflections must be accumulated and further revisions will continue.
There is an increasing need for integrating high dielectric constant ceramic thin film components in organic and 3D IC packages to lower the power-supply impedance at high frequencies and supply noise-free power to the ICs. Sol-gel approach is very attractive for high density capacitors because of its ability to precisely control the composition of the films and the ease of introducing dopants to engineer the dielectric properties such as breakdown voltages and DC leakage characteristics. Thin films on copper foils lend themselves to organic package integration with standard foil lamination techniques used in package build-up processes. However, fabrication of thin film barium titanate on copper foils is generally affected by process incompatibility during crystallization in reducing atmospheres, leading to poor crystallization, oxygen vacancies and copper diffusion through the film that degrades the electrical properties.
This paper focuses on the dielectric properties and electrical reliability of thin films on copper foils. Thin film (300-400 nm) embedded capacitors with capacitance density of 2 μF/cm2, low leakage current and high breakdown voltage were fabricated via sol-gel technology and foil lamination. To lower the leakage current, the chemical composition was altered by incorporating – 1.) Excess barium 2.) Acceptor dopants such as Mn. Both approaches lowered the leakage current compared to that of pure barium titanate. SEM analysis showed enhanced densification and refined grain structure with chemistry modification. The films showed good stability in leakage currents at 150 C with an applied field strength of 100 kV/cm, demonstrating the electrical reliability of these films.
An electron probe Auger emission microanalyzer has been constructed. The instrument is composed of an electromagnetic focussing primary probe column and a cylindrical mirror electron energy analyzer. By using this instrument, Auger electron spectroscopy studies have been carried out in the modes of both emission microanalysis and emission micrograph. The feasibility o£ this method is investigated through its application to the study of iron surface.
A fluorescent and diffracted X-ray spectrometer with an X-ray sub-micron beam was developed for the analysis of stress, crystal structure, and contamination in micro-regions of ULSIs. A fine glass capillary with a parabolic cross-sectional inner wall surface was made to form a micro X-ray beam. A micro-focus X-ray generator with a membrane-type target was also developed for use with the capillary. The equipment was used to analyze the crystal phases of Ti silicide fine lines and the strains in Al interconnections.
The resistance of Ti-silicide lines increases the line width narrows under about 0.5 μrn. This is because of the growth of crystal phases of TiSi2(C49) and TiSi(B27) with high resistivity ﹛60 to 100 μΩ-cm).
Hillocks of Al grow at line edges when Al layers are compressed by Si substrates and surrounding insulating layers. On the other hand, when the Al is extended by these layers, voids form in the AI lines.
The clinical characteristics of male patients with pulmonary Mycobacterium avium complex disease have not been clearly defined. We aimed to clarify the clinical characteristics of male patients with pulmonary Mycobacterium avium complex disease compared with female patients.
We retrospectively reviewed the medical records of patients with pulmonary Mycobacterium avium complex disease who visited the outpatient clinic of the Shinshu University Hospital between 2003 and 2016 and compared the clinical characteristics of male and female patients.
A total of 234 patients with pulmonary Mycobacterium avium complex disease were identified (68 men and 166 women). Male patients were significantly older than female patients. Blood examination results showed that the lymphocyte count, total protein level and albumin level were significantly lower in men than in women. Chest imaging findings were broadly categorised into the fibrocavitary and nodular bronchiectasis types. There were no significant differences in chest imaging findings and the time from diagnosis to disease exacerbation between men and women.
During the study period, the incidence of the nodular bronchiectasis type of pulmonary Mycobacterium avium complex disease in male patients increased compared with previous reports. Men had no difference in time to exacerbation compared with women.