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Psychological distress is a common symptom after natural disasters. Although musculoskeletal pain also increases after natural disasters, its relation to psychological distress is not known. This study aimed to examine the association of musculoskeletal pain with new-onset psychological distress among survivors of the Great East Japan Earthquake.
A panel study was conducted with survivors at 2 and 3 years after the Great East Japan Earthquake. New-onset psychological distress was defined as psychological distress absent at 2 years and present at 3 years after the disaster. The number of musculoskeletal pain sites at 2 years after the disaster was divided into 3 categories (0, 1, and ≥2). Multivariate logistic regression models were used to calculate the odds ratio and 95% confidence interval for new-onset psychological distress according to the number of musculoskeletal pain sites.
The rate of new-onset psychological distress was 6.7%. Musculoskeletal pain was associated with new-onset psychological distress. Using “0” as a reference, the adjusted odds ratios (95% confidence interval) were 1.65 (0.92-2.95) in “1” and 2.12 (1.24-3.64) in “≥2” (P for trend=.02).
Musculoskeletal pain is associated with new-onset psychological distress among survivors of the Great East Japan Earthquake. (Disaster Med Public Health Preparedness. 2019;13:295–300)
the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important.
The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.
The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.
In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows:
More frequently documented symptoms from the face, legs/arms, and speech;
More frequently assessments of neurology, face, arms/legs, speech, and eyes;
More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation;
Less frequently documented symptoms of headache, vertigo, and nausea; and
More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled.
In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.
Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations.
AnderssonE, BohlinL, HerlitzJ, SundlerAJ, FeketeZ, Andersson HagiwaraM. Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke. Prehosp Disaster Med. 2018;33(1):63–70.
The use of Emergency Medical Services (EMS) is increasing. A number of patients call repeatedly for EMS. Early studies of frequent callers show that they form a heterogenous group.
There is a lack of research on frequent EMS callers. There is furthermore a lack of knowledge about characteristics and the prehospital assessment of the patients who call for EMS on several occasions. Finally, there is a general lack of knowledge with regard to the association between the prehospital assessment by health care providers and the final diagnosis.
Patients in Skaraborg in Western Sweden, who used the EMS at least four times in 2014, were included, excluding transport between hospitals. Information on the prehospital assessment on-scene and the final diagnosis was collected from the EMS and hospital case records.
In all, 339 individual patients who used the EMS on 1,855 occasions were included, accounting for five percent of all missions. Fifty percent were women. The age range was 10-98 years, but more than 50.0% were in the age range of 70-89 years.
The most common emergency signs and symptoms (ESS) codes on the scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease (eight percent).
Thirteen percent of all cases had a final diagnosis defined as a potentially life-threatening condition. Among these, 22.0% of prehospital assessments were retrospectively judged as potentially inappropriate.
Forty-nine percent had a defined final diagnosis not fulfilling the criteria for a potentially life-threatening condition. Among these cases, 30.0% of prehospital assessments were retrospectively judged as potentially inappropriate.
Among patients who used EMS on multiple occasions, the most common symptoms on-scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease. In 13.0%, the final diagnosis of a potentially life-threatening condition was indicated. In a minority of these cases, the assessment on-scene was judged as potentially inappropriate.
TärnqvistJ, DahlénE, NorbergG, MagnussonC, HerlitzJ, StrömsöeA, AxelssonC, Andersson HagiwaraM. On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions. Prehosp Disaster Med. 2017;32(5):528–535.
We present recent observation results of Sgr A* at millimeter obtained with VLBI arrays in Korea and Japan.
7 mm monitoring of Sgr A* is part of our AGN large project. The results at 7 epochs during 2013-2014, including high resolution maps, flux density and two-dimensional size measurements are presented. The source shows no significant variation in flux and structure related to the G2 encounter in 2014. According to recent MHD simulations by kawashima et al., flux and magnetic field energy can be expected to increase several years after the encounter; We will keep our monitoring in order to test this prediction.
Astrometric observations of Sgr A* were performed in 2015 at 7 and 3.5 millimeter simultaneously. Source-frequency phase referencing was applied and a combined ”core-shift” of Sgr A* and a nearby calibrator was measured. Future observations and analysis are necessary to determine the core-shift in each source.
To determine the characteristics of acute phase nystagmus in patients with cerebellar lesions, and to identify a useful indicator for differentiating central lesions from peripheral lesions.
Acute phase nystagmus and the appearance of neurological symptoms were retrospectively investigated in 11 patients with cerebellar stroke.
At the initial visit, there were no patients with vertical nystagmus, direction-changing gaze evoked nystagmus or pure rotatory nystagmus. There were four cases with no nystagmus and seven cases with horizontal nystagmus at the initial visit. There were no neurological symptoms, except for vertigo and hearing loss, in any cases at the initial visit. The direction and type of nystagmus changed with time, and neurological symptoms other than vertigo appeared subsequently to admission.
It is important to observe the changes in nystagmus and other neurological findings for the differential diagnosis of central lesions.
We present high resolution molecular line observations of dusty AGN and starburst in nearby luminous infrared galaxies (LIRGs), VV 114 (band 3/4/7) and NGC 1614 (band 3/6/7/9), with ALMA. Multi-frequency imaging from 4.8 GHz to 691 GHz of NGC 1614 allows us to study spatial properties of the radio-to-FIR continuum and multiple CO transitions, and we find the CO excitation up to Jupp = 6 can be explained by a single ISM model powered by nuclear starbursts. Our processing line imaging survey for VV 114 detected at least 30 molecular lines which show different chemical composition from region to region. Multi-molecule imaging helps us to diagnose the chemical differences of dusty ISM, while multi-transition imaging allows us to investigate gas physical conditions affected by nuclear activities directly.
To evaluate the effectiveness of tympanostomy tube placement in controlling symptoms of intractable Ménière's disease.
Fifteen patients with intractable Ménière's disease underwent tympanostomy tube placement in the affected ear. Post-operative changes in vertigo attacks and hearing level were recorded, and were evaluated according to American Academy of Otolaryngology–Head and Neck Surgery criteria.
At 12 months after treatment, 3 patients (20 per cent) showed complete control of vertigo, 7 (47 per cent) showed substantial control and 2 (13 per cent) showed limited control; 3 patients (20 per cent) required other treatment. At 24 months after treatment, 7 patients (47 per cent) showed complete control of vertigo, 3 (20 per cent) showed substantial control and 1 (7 per cent) showed limited control; 1 patient required other treatment 15 months after tympanostomy tube placement.
There is no definite pathophysiological explanation for the effect of tympanostomy tube placement in reducing vertigo attacks. This treatment is not effective for all patients with intractable Ménière's disease. However, tympanostomy tube placement might be an additional surgical therapeutic option to consider prior to contemplating other, more invasive treatments.
We present ALMA cycle 0 observations of the luminous merger VV 114. One of the main goals is to investigate mechanisms of molecular line ratio enhancement. Regions with the high 12CO (1–0)/13CO (1–0) and 12CO (3–2)/12CO (1–0) is located at a central filamentary structure (∼6 kpc) in VV 114. The filament consists of the eastern nucleus and the overlap region, where the galaxy disks are colliding. We also investigate these molecular line ratios on the Kennicutt-Schmidt law. VV 114 fills a gap between the “starburst” sequence and the “normal disk” sequence, and regions with the high ratios show the high ΣSFR and ΣH2. We suggest that the high ratios in VV 114 are due to star-forming activities in the both progenitor's nuclei and the merger-induced overlap region.
The representation of social groups in advertising has been a major concern in academia. However, research focusing on older people has been scant and mainly conducted in Western countries. In Japan, the country that has been most affected by demographic change, this research area has received little attention. Through a content analysis of a systematic sample of 2,972 television advertisements broadcast on the five major commercial television stations in Japan in 1997 and 2007, this paper tries to fill this research gap, examining changes in the representation of older people in Japanese television advertising. When comparing 2007 to 1997, we found that older people appeared more often, were increasingly alone and in major roles, and were portrayed in more favourable ways, which suggests that their status changed. These changes appear to be related to the fact that older people have become more important within Japanese society. However, some aspects have remained unchanged; older people continue to be under-represented, which does not reflect demographic reality, and are used in advertisements for foods and beverages, confirming findings from previous studies. Our findings indicate that the representation of older people in Japanese television advertising has changed but remains unrealistic.
In the autumn of 2012, the Japan Atomic Energy Agency (JAEA) launched a new research project named F-TRACE (Long-Term Assessment of Transport of Radioactive Contaminant in the Environment of Fukushima). The aims of this project are to develop a system for prediction of radiation exposure, taking into consideration the transport, deposition, and remobilization behavior of radiocaesium (RCs) from the highest contaminated mountain forests, down through the biosphere, before deposition in a number of different aquatic systems. Especially, it is important to understand balances of suspended and deposited particles and RCs inventory in inflow water, discharge water and bottom sediments of an upland reservoir. In this paper, we describe current research activities performed by JAEA at the Ogi Reservoir, Fukushima prefecture, Japan.
According to our analyses the specific sediment yield and the average rate of storage capacity loss at the Ogi Reservoir are 210 m3 km-2 year-1 and 0.15 % year-1, respectively. The vertical distribution of RCs exhibits clear peaks at several sites in the reservoir formed by deposition of eroded soil particles from the catchment that were contaminated by accident fallout. Above the depth of each of the RCs peaks, the distribution of RCs was found to be variable with depth, with concentrations ranging over five orders of magnitude for a single core. The peaks in the sedimentation profiles are probably formed from eroded soil particles entering the reservoir from the surrounding contaminated watershed (most probably during storm events). Results from grain size analyses suggest that contaminated fine sediment tends to be deposited thickly within deeper parts of the reservoir. In addition, above the depth of RCs peaks at these deeper sites, the concentration of RCs approximately increased or decreased as the proportion of fine sediments increased or decreased. However, some fine particles are possibly discharged downstream during operational releases from the dam.
In a mass decontamination during a nuclear, biological, or chemical (NBC) response, the capability to command, control, and communicate is crucial for the proper flow of casualties at the scene and their subsequent evacuation to definitive medical facilities. Information Technology (IT) tools can be used to strengthen medical control, command, and communication during such a response. Novel IT tools comprise a vehicle-based, remote video camera and communication network systems.
During an on-site verification event, an image from a remote video camera system attached to the personal protective garment of a medical responder working in the warm zone was transmitted to the on-site Medical Commander for aid in decision making. Similarly, a communication network system was used for personnel at the following points: (1) the on-site Medical Headquarters; (2) the decontamination hot zone; (3) an on-site coordination office; and (4) a remote medical headquarters of a local government office. A specially equipped, dedicated vehicle was used for the on-site medical headquarters, and facilitated the coordination with other agencies.
The use of these IT tools proved effective in assisting with the medical command and control of medical resources and patient transport decisions during a mass-decontamination exercise, but improvements are required to overcome transmission delays and camera direction settings, as well as network limitations in certain areas.
FuseA, OkumuraT, HagiwaraJ, TanabeT, FukudaR, MasunoT, MimuraS, YamamotoK, YokotaH. New Information Technology Tools for a Medical Command System for Mass Decontamination. Prehosp Disaster Med.2013;28(3):1-3.
Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient.
Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials.
Results: Use of the DST in prehospital care may have the possibility to decrease “time to definitive care” and improve diagnostic accuracy among prehospital personnel, but more studies are needed.
Conclusions: The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care.
Subclinical mastitis (SM) is a major concern in the dairy industry because it causes economic losses and can lead to clinical mastitis. The mechanisms of the onset and progression of SM are not fully understood, and a new procedure for the detection and appropriate prediction of SM leading to clinical mastitis is necessary for dairy cow management. Inflammatory cytokines such as interleukin (IL)-6 are known to be present in inflamed mammary glands at the onset of mastitis, and IL-6 concentrations correlate with the levels of inflammation. In this study, the detection of IL-6 was examined for the evaluation for the future prediction of SM in 77 quarter milk samples from 20 cows. IL-6 concentrations in quarter milk were measured by sandwich ELISA, and the data were compared with milk somatic cell count (SCC) levels to diagnose SM. Average IL-6 concentration was significantly higher in SM quarter milk (207·0±441·6 pg/ml) than in healthy control quarter milk (12·6±33·4 pg/ml, P<0·01). Results of the cross-tabulation table show that SM prediction accuracy based on IL-6 concentration was almost equal or superior to SM prediction accuracy based on SCC. The detection of IL-6 in milk indicated SM earlier than did the detection of elevated SCC. Thus, the detection of IL-6 in milk could be a future prediction marker for SM.
Many inbred and isofemale lines derived from wild populations of Drosophila melanogaster were tested for gonadal dysgenic sterility, male recombination and snw secondary mutation. Among them, we have found strains whose dysgenic offspring show negligible sterility, and undetectable male recombination and snw mutation. They can be considered to be neutral strains in the strict sense. Such neutral strains appear to carry only defective P elements in their genomes. Taking the observations of Karess & Rubin (1984) into account, it is suggested that some defective P elements retain the function necessary for P cytotype. Cytotype determination mechanisms are discussed.
Production of biodiesel fuel (fatty acid methyl ester) by use of conventional method (alkaline catalyst method) requires deacidification process prior to the reaction and refining process to remove the catalyst after the reaction. These processes increase total cost required for production of biodiesel fuel. In order to solve the problem, authors recently proposed a method called superheated methanol vapor method. In a process with this method, superheated methanol vapor is continuously bubbled into the oil in the reactor vessel and reacted with triglycerides to form fatty acid methyl ester and glycerol. The fatty acid methyl ester and glycerol formed flows out of the reactor together with unreacted methanol vapor and is collected using a condenser. Reaction using the superheated methanol vapor method can be conducted at atmospheric pressure. Production of fatty acid methyl ester by use of the superheated methanol vapor method does not require refining process after the reaction because no catalyst is used in this method and fatty acid methyl ester can be separated from glycerol simply by sedimentation. The method does not require deacidification process prior to the reaction because not only triglyceride but also free fatty acid can be converted into fatty acid methyl ester by use of the method. Therefore, both initial and running costs required for biodiesel production are thought to be reduced by applying the method. In order to estimate the cost required by a process based on the superheated methanol vapor method, a demonstration plant (design productivity: 400 L/d) was constructed and its efficiency was evaluated. The plant could produce 425 L of fatty acid methyl ester in a day from used frying oil. Energy consumed in each unit of the demonstration plant was measured (electrical energy and thermal energy). Based on the energy consumption data obtained with the demonstration plant, production cost required with a practical scale plant (designed productivity: 6000 kL/y) was calculated. The cost required by the practical scale plant with the superheated methanol vapor method was estimated to be 40.2 yen/L (about 40 cent/L) while the cost required by a plant with the alkaline catalyst method was 62.5 yen/L (about 62 cent/L). The estimated cost includes depreciation cost, cost of repairing, labor cost, methanol cost and energy cost (heat and electricity). Most of the energy consumed by the plant was thermal energy and the plant could be automatically controlled. Therefore, required cost will be further decreased by installing the plant next to an incineration facility because thermal energy can be supplied from the facility and the labor cost can also be supported by the facility.
This study aimed to investigate the validity of adjusting computed tomography thresholds in order to replicate a temporal bone model suitable for dissection training and education.
Materials and methods:
A simulated three-dimensional model of a human temporal bone was prototyped using selective laser sintering. The powder layers were laser-fused, based on detailed computed tomography data, and accumulated to create a three-dimensional structure. The computed tomography threshold value of the stapes was modified on standard triangular language file in order to replicate the stapes. The intensity value was determined to select the fluid lumen of the inner ear and the bone surface, in order to replicate the inner ear.
The model could be shaved, using surgical instruments, in the same manner as during real surgery. The stapes could be reproduced, making this model even more realistic than a previous version. The inner ear was recreated, along with the surrounding bony wall and the ossicles.
This model facilitates dissection training and easy understanding of the relation between the labyrinth and the surrounding structures.
General properties of the Canadian English vowel space are derived from an experimental-acoustic study of vowel production underway in Winnipeg, Manitoba. Comparing the preliminary Winnipeg results with similar data from General American English confirms previously described generalizations for Canadian English: the merger of low-back vowels, the relative retraction of /æ/, and the relative advancement of /u/ and /Ʊ/. However, a similar comparison of the Winnipeg sample with comparable Southern California data disputes the accuracy of the claim that Canadian Shift (Clarke et al. 1995) is a feature of ‘general’ Canadian and Californian English. An acoustic analysis uncovers subtle phonetic distinctions that make possible a more precise characterization of Canadian Raising: rather than only adjusting the height of the nucleus, Winnipeg speakers produce a directional shift in both the nucleus and offglide of the diphthongs /aɪ, aƱ/; this process applies to all three diphthongs (including /oɪ/).
Linguistics, as one of general cognitive theories, has been clarifying the unconscious knowledge of how the syntactic structure of sentences is represented. Psycholinguistics has been concerned with the algorithms that implement this knowledge when we speak and understand. Neurolinguistics, or the study of the brain–language relations, has been seeking to find the neural mechanisms that instantiate these algorithms and their cerebral localization in the human brain. It is by now a commonly shared view that the brain is a computational device that combines and transforms information. Among various research domains that investigate the brain, one approach that linguistics can take at the moment is to hypothesize that each mental operation posited by linguistic theory corresponds to a computation carried out by the brain. By corroborating the neural reality of abstract mental representation and operations, we hope eventually to construct a biologically feasible brain theory of human language processing.
Minimalist model of the language faculty
Much of the current model of linguistic knowledge, known as the “Minimalist Program” of generative grammar (Chomsky, l995), consists of a computational system, called “Syntax,” as its core, and a lexicon, as shown in figure 40.1.
The Syntax first selects elements from the lexicon and then uses them to create hierarchical syntactic structures by means of the combinatorial operation, called “Merge.” This operation takes place recursively until all the lexical items, each of which consists of bundles of abstract features and is selected from the lexicon, are used up.