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To clarify the characteristic of impaired and unimpaired Instrumental Activities of daily living (IADL) processes with the severity of cognitive impairment in community-dwelling older adults with Alzheimer’s disease (AD) using the Process Analysis of Daily Activity for Dementia (PADA-D).
13 medical and care centers in Japan.
115 community-dwelling older adults with AD.
The severity of cognitive impairment was classified by Mini-Mental State Examination (20 ≥ mild group, 20 < moderate group ≥ 10, 10 < severe group), and IADL scores and eight IADL items in PADA-D were compared among three groups after adjusting for covariates. Rate of five feasible processes included in each IADL of PADA-D was compared.
IADL score showed a decrease in independence with the severity of AD except for Use modes of transportation and Managing finances, which was especially pronounced in Shopping (F = 25.58), Ability to use the telephone (F = 16.75), and Managing medication (F = 13.1). However, when the PADA-D was examined by process, some processes that were impaired and unimpaired with the severity of cognitive impairment were clear. For example, Plan a meal was impaired (ES = 0.29) with the severity, but Prepare the food was not in Cooking performance.
We suggested that detailed process analysis in IADLs can clarify the characteristic of processes that are impaired and unimpaired with the severity of cognitive impairment in older adults with AD living in the community. Our findings may be useful for rehabilitation and care in IADL to continue living at home.
The spread of COVID-19 has made it difficult to provide training in medical treatment in a radiation disaster. In this study, we will examine the effects and challenges of using a hybrid approach that combines online and face-to-face components.
A total of 5 face-to face and 25 online medical staff participated in the training program. This program was conducted by using multiple cameras for live coverage, while protective clothing and decontamination kits had been sent in advance to the participants so that they could experience face-to-face and online learning at the same time.
Participants reported a high level of satisfaction and achievement with the style of delivery. They also experienced problems such as fatigue due to long hours, and dissatisfaction with the debriefing.
In designing new online training, it is necessary to consider the quantity and content of the program, and to take participant fatigue into consideration.
Based on experiences following the Great East Japan Earthquake and nuclear power plant accident in 2011, Nuclear Emergency Core Hospitals (NECHs) were designated as centers for radiation disaster management in Japan. This study aimed to investigate their current status and identify areas for improvement.
This cross-sectional study was conducted in October 2018. Demographic data were collected by a questionnaire with free text responses about attitudes toward NECHs. Considerations regarding risk communications during a radiation disaster were analyzed using qualitative text mining analysis.
A total of 36 hospitals participated in this study. Only 31% of NECHs anticipated a radiation disaster. The importance of business continuity plans and risk communications was shown. Text analysis identified 7 important categories for health care workers during a radiation disaster, including media response, communications to hospital staff, risk communications, radiation effects on children, planning for a radiation disaster in the region, rumors, and the role in the region.
The radiation disaster medical system and NECHs in Japan were surveyed. The importance of risk communications, planning for a radiation disaster in each region, and the role in the region are identified as issues that need to be addressed.
We conducted a systematic review to determine the prevalence and characteristics of earthquake-associated head injuries for better disaster preparedness and management.
We searched for all publications related to head injuries and earthquakes from 1985 to 2018 in MEDLINE and other major databases. A search was conducted using “earthquakes,” “wounds and injuries,” and “cranio-cerebral trauma” as a medical subject headings.
Included in the analysis were 34 articles. With regard to the commonly occurring injuries, earthquake-related head injury ranks third among patients with earthquake-related injuries. The most common trauma is lower extremity (36.2%) followed by upper extremity (19.9%), head (16.6%), spine (13.1%), chest (11.3%), and abdomen (3.8%). The most common earthquake-related head injury was laceration or contusion (59.1%), while epidural hematoma was the most common among inpatients with intracranial hemorrhage (9.5%) followed by intracerebral hematoma (7.0%), and subdural hematoma (6.8%). Mortality rate was 5.6%.
Head injuries were found to be a commonly occurring trauma along with extremity injuries. This knowledge is important for determining the demands for neurosurgery and for adequately managing patients, especially in resource-limited conditions.
The present status of R&D for various types of solar cells is presented by overviewing research and development projects for solar cells in Japan as the PV R&D Project Leader of the New Energy and Industrial Technology Development Organization (NEDO) and the Japan Science and Technology Agency (JST). Developments of high-efficiency solar cells such as 44.4% (under concentration) and 37.9% (under 1-sun) InGaP/GaAs/InGaAs 3-junction solar cells by Sharp, 26.6% crystalline Si heterojunction back-contact (HBC) solar cells by Kaneka, 22.3% CIGS solar cells by Solar Frontier have been demonstrated under the NEDO PV R&D Project. 15.0% efficiency has also been attained with 1 cm2 perovskite solar cell by NIMS under the JST Project. This article also presents analytical results for efficiency potential of high-efficiency solar cells based on external radiative efficiency (ERE), open-circuit voltage loss and fill factor loss. Crystalline Si solar cells, GaAs, III–V compound 3-junction and 5-junction, CIGSe, and CdTe solar cells have efficiency potential of 28.5%, 29.7%, 42%, 43%, 26.5%, and 26.5% under 1-sun condition, respectively, by improvements in ERE.
Malignancy-related thromboembolism, also referred to as Trousseau's syndrome, can present as acute cerebral infarction, nonbacterial thrombotic endocarditis (NBTE), and migratory thrombophlebitis. Therefore, many physical, neurological, and psychological symptoms associated with Trousseau's syndrome may occur in the clinical course.
To illustrate this, we report a case of a male patient in his 50s with carcinomatous peritonitis caused by gastric cancer, with multiple cerebral infractions that developed during disease progression. The patient was admitted to our hospital for the treatment of side effects of chemotherapy, although he strongly hoped to go home as soon as possible. In addition to making social supports plans, we were required to perform intensive total palliative care, because of his physical pain, general fatigue, anorexia, abdominal and neck pain, and psychological issues (insomnia, delirium, depression, suicidal thoughts, self-mutilation, panic attacks, agoraphobia, fear of death, and feelings of hopelessness).
To the best of our knowledge, based on the literature search, this is the first reported case of Trousseau's syndrome described in the context of total palliative care, especially psychological care.
Significance of results:
We propose that neurological symptoms of Trousseau's syndrome cause these extensive mental disorders. Furthermore, because of the prognosis of Trousseau's syndrome, we should utilize our expertise fulfill the patient's wishes.
Face centered cubic (FCC) single crystal silver nanoparticles(NPs) of nearly monodispersed particle size of 12nm were prepared by simple ripening multi-twined particles (MTP). The product yield was nearly 100% and growth mechanism was considered to be similar to Ostwald ripening but utilize chemical potential difference between MTP and FCC NPs. Controlling the ratio between defectless and defective particles before ripening by controlling kinetics of particle generation stage, it was possible to control the final defectless particle size from 7-18 nm maintaining almost 100% product yield.
We report on the growth of self-aligned InN nano-dots on nano-patterned GaN templates by electron cyclotron resonance plasma-excited molecular beam epitaxy (ECR-MBE). In the fabrication of the nano-dots, InN was grown on GaN templates with reticular patterns of holes, which were prepared by the focused ion beam (FIB) technique. The InN nano-dots were formed selectively at the holes, resulting in the reticular array of InN nano-dos. The size of InN dots was controlled by varying the hole-pitch and the growth temperature. Furthermore, the shape of InN dots improved by thermal annealing after the growth. We have succeeded in controlling the position and size of InN nano-dots on nano-patterned substrates. Typically, InN nano-dots with a diameter of 50 nm and a height of 10 nm were fabricated in 410°C growth.
This paper describes studies on high-quality InN growth on sapphire by RF-MBE. Critical procedures to obtain high-quality InN films were investigated and (1) nitridation process of sapphire substrates prior to growth, (2) precise control of V/III ratio and (3) selection of optimum growth temperature were found to be essential. Detailed structural characterizations by XRD, TEM, Raman scattering and EXAFS indicate that InN films obtained in this study have ideal hexagonal wurtzite structure. FWHMs of ω-2Θ mode XRD and E2(high)-phonon-mode of Raman scattering are as small as 28.9 arcsec and 3.2 cm-1, respectively. True band gap energy of InN is also discussed based on optical characterization results obtained from well-characterized hexagonal InN grown in this study. PbS, instead of InGaAs, was used as a detector for PL study in order to solve the problem coming from the cut-off wavelength of InGaAs detector. Based on these systematic studies on structural and optical property characterizations using high-quality InN, true band-gap energy of InN is suggested to be less than 0.67 eV and approximately 0.65 eV at room temperature. Single-crystalline InN films are also successfully grown on Si substrates by a brief nitridation of the Si substrates. Significant improvement of InN crystal quality on Si substrates by the insertion of an AlN buffer layer is also demonstrated.
A newly reported narrow bandgap for indium nitride means that the indium gallium nitride system of alloys can be a candidate for new high efficiency solar cells covering most of the solar spectrum. In this paper, n-InN films were grown on p-Si (100) substrates. We characterize, for the first time, photovoltaic properties using n-InN/p-Si hetero-junction grown by RF-MBE.
Many properties of LPCVD SiC film as X-ray mask membrane have been investigated in detail. The film has an atomic ratio of 1.0 and negligible impurities, and was found to be damage-free to SR X-rays up to 500 KJ/cm2. An integrated transparency of 1.05 μm thick SiC membrane for SR X-rays was measured to be 76%. The interference peak at 633 nm of optical spectrum has given the membrane of around 1.0 μm in thickness the transmittance peak of 70% and increased to more than 80% after an AR coating or planarizations by polishing and etching-back. The attainable transmittance was found to be limited to about 84%, theoretically and experimentally, due to the absorption of the membrane. The peak transmittance of 87% is obtainable by the AR coating on the polished SiC membrane. The internal stress was found to be independent of thicknesses above 0.6 μm and the measured Young's modulus is 4.5×1011 Pa irrespective of the thickness and stress. Some extremely polished (0.1 nm Ra) and all the etched-back membranes studied withstood breakage at the pressure as high as the as-deposited ones. The stress uniformity in 30 mm square of the membrane was found to be ± 10 % by measuring five local stresses with a bulge method.
The β-SiC formation process through post-implantation annealing of Si-C mixtures fabricated on Si by C-ion implantation at room temperature is studied by means of infrared absorption spectroscopy. It is shown that the formation of B-SiC from the Si-C mixtures is greatly enhanced by the subsequent irradiation of other energetic ions prior to the thermal annealing. The continuous amorphization of the Si-C mixed layers is considered to be the dominant cause for the enhancement of the B-SiC formation. The activation energy of the β-SiC formation process which is 5.3 eV without irradiation is reduced to 4.0 eV by the irradiation of 150 keV, 1 × 1017/cm2 Ar ions.
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