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Nationwide registry data of patients with single-ventricle physiology have been rarely reported. The Medical Aid Program for Chronic Pediatric Diseases of Specified Categories (Japan) has contributed to the financial support of medical expense for patients younger than 20 years with chronic paediatric disease, and almost all children in Japan who require disease-specific treatment voluntarily apply to this programme. The epidemiology and medium- to long-term outcome of patients following a Fontan procedure were investigated using the database. The usefulness of this epidemiologic investigation in identifying real-world objectives and clinical applications was also examined. A total of 2862 patients who underwent a Fontan operation were identified from 18,589 patients with chronic heart disease registered to the medical aid programme. The details of symptoms, treatment, and somatic growth were evaluated, from which we were able to clarify the nationwide data regarding the current status of post-Fontan patients younger than 20 years. This study elucidated the current status of post-Fontan patients under 20 years of age in Japan. Data analysis of the Medical Aid Program for Chronic Pediatric Diseases of Specified Categories cohort provided useful information towards understanding the comprehensive status of patients with chronic heart disease and contributed to improved disease management.
A 14-year-old boy was receiving subcutaneous infusions of treprostinil for pulmonary artery hypertension. Because he had severe infusion site pain in the lower abdomen, we changed his infusion site to the upper buttocks, adding some analgesics. His pain improved gradually. This change may be an effective method for reducing infusion site pain in subcutaneous treprostinil therapy, particularly in children.
We aimed to elucidate the relationship between severity of secondary mitral regurgitation and mitral valve geometry in children with dilated cardiomyopathy. The medical records of 16 children with dilated cardiomyopathy (median age, 1.2 years; range, 0.4–12.3 years) were reviewed. Mitral valve geometry was evaluated by measuring coaptation depth using echocardiographic apical four-chamber views at the initial presentation. Patients were dichotomised according to the mitral regurgitation severity: patients with moderate or severe secondary mitral regurgitation (n=6) and those with mild secondary mitral regurgitation (n=10). A total of 58 healthy children were considered as normal controls, and a regression equation to predict coaptation depth by body surface area was derived: coaptation depth [mm]=4.37+1.34×ln (body surface area [m2]) (residual standard error, 0.49; adjusted R2, 0.68; p<0.0001). Compared with patients with mild secondary mitral regurgitation, those with moderate or severe secondary mitral regurgitation had significantly larger coaptation depth z-scores (6.4±2.3 versus 1.9±1.4, p<0.005), larger mitral annulus diameter z-scores (3.6±2.6 versus 0.9±1.8, p<0.05), higher left ventricular sphericity index (0.89±0.07 versus 0.79±0.06, p<0.005), and greater left ventricular fraction shortening (0.15±0.05 versus 0.09±0.05, p<0.05). In conclusion, geometric alteration in the mitral valve and the left ventricle is associated with the severity of secondary mitral regurgitation in paediatric dilated cardiomyopathy, which would provide a theoretical background to surgical intervention for secondary mitral regurgitation in paediatric populations.
Over 30 funerary bundles were excavated in 2005 from a large chamber tomb at the prehispanic religious center of Pachacamac on the central coast of Peru. The largest and most elaborate bundle was found in the innermost part of the tomb, tightly surrounded by other bundles. We hypothesized that this bundle contained the deceased leader of a social group whose members collectively cared for their ancestor's bundle (for example, by rewrapping it) and continued to use the tomb to inter deceased individuals from subsequent generations. We tested this hypothesis by dating samples from different layers of the wrapping materials and soft tissue from the bodies and conducting a Bayesian analysis of the resultant dates. We determined carbon and nitrogen isotope ratios in the diet of the interred individuals to correct for marine reservoir effects. Our findings suggest that (1) rewrapping did not occur; (2) the tomb was used for over 500 years starting at cal A.D. 1000; and (3) existing bundles were reshuffled each time new bundles were introduced. Overall, diverse lines of evidence indicate that the tomb had a complex use history and contained individuals with diverse geographical and social origins. This challenges conventional thinking about the social and chronological significance of coexisting bundles in large tombs.
We performed first-principles calculations to obtain the phonon deformation potential (PDP) constants of wurtzite ZnO. The results are in good agreement with available experimental data except for a few PDP constants. We also found that the phonon frequencies of the A1 and B2 modes have relatively stronger nonlinear characteristics than the other modes.
The Main Occluding Area (MOcA) defined by Kato (1996) has been found to almost always be located between the upper and lower first molars in Japanese. However, there have not been any reports of this feature in other human populations. In this study, the location of the MOcA was assessed in a sample of 80 Australian dental students as part of an exercise relating to dental occlusion. A piece of stopping material was used to locate the MOcA and to determine the preferred chewing side. There was no significant difference between published findings for Japanese and those for Australians in relation to the location of the MOcA, nor were there any significant differences between the ethnicities represented within the Australian sample. However, there was a difference between ethnicities within the Australian sample in the preferred chewing side, with Asians displaying a preference for the left side. We propose that the location of the MOcA is relatively stable across human populations, having been derived from the tribosphenic biting system of the earliest mammals. The difference observed in preferred chewing side between Europeans and Asians may relate to differences in the use of food utensils between these groups.
During human chewing behaviour, only limited contact occurs between opposing surfaces of the dental crowns. Kato et al. (1996) examined the nature of this contact in Japanese and defined the region where maximum contact occurred as the Main Occluding Area (MOcA). He found that the MOcA was usually located between the functional cusps, ie supporting cusps, of the upper and lower first molars. The importance of this feature when chewing food, is that one tends to clench and begin to chew on the MOcA. An understanding of the position of the MOcA is important for dental treatment and also for placing the pattern of modern human masticatory activity into a broader evolutionary perspective.
Iodine filters expended after nuclear fuel reprocessing contain radioactive iodine (I-129), almost all of which exists as silver iodide (AgI). The synthetic rock technique is a solidification treatment technique using hot isostatic press (HIP), in which the alumina adsorbent base material is synthesized to form a dense solidified material (synthetic rock), and I-129 is physically confined in the form of AgI in the alumina matrix. Thus, it is necessary to understand the matrix dissolution behavior to evaluate the iodine release behavior.
Experiments involving the dissolution of the matrix were carried out under various temperatures (35–70 °C) and pH values (10–12.5) that reflect the disposal conditions. The results of the experiments showed that the dissolution rate of Al visibly increases with temperature and pH. The dissolution rate constant was calculated from the initial data assuming the dissolution of the matrix as a primary reaction. The logarithmic rate constant showed a good linear correlation with the pH and the reciprocal of temperature. The 27Al-NMR analysis of the solutions of the dissolved matrix showed that the major chemical species present in the solutions was Al(OH)4-. This indicated that the dissolution of the matrix can be described by the following equation: Al2O3 + 2OH- + 3H2O → 2Al(OH)4-. Subsequently, the empirical equation of the rate of dissolution of the matrix as a function of the temperature and pH was derived. It will be used to evaluate the iodine release behavior from the synthetic rock.
Semiconductor epitaxial CVD single crystal diamond is considered a potential material for power devices because of its unique characteristics. In the discussion on the relationship between crystal quality and device performance, the atomic purity and defect concentration have been considered; however, the information on the local stress-strain distribution in a single crystal is not sufficient. In this paper, the local stress-strain distribution of the epitaxial CVD single crystal diamond is quantitatively examined using the birefringence and cathodoluminescence images and the Raman peak-shift map. From the Raman peak-shift map, the local stress-strain is estimated and the stress is found to range from -67 MPa to +160 MPa in the observed area.
Semiconductor epitaxial CVD single crystal diamond is considered a potential material for power devices because of its unique characteristics. In the discussion on the relationship between crystal quality and device performance, the atomic purity and defect concentration have been considered; however, the information on the local stress-strain distribution in a single crystal is not sufficient. In this paper, the dislocation analysis is shown for the suggestion of the established standard dislocation analysis method. The aggregation of mixed dislocations is observed by the analysis by using the birefringence image, cathodoluminescence image and x-ray topography.
The H12 performance assessment (PA) provided a test for the robustness of a HLW repository system concept based on structured siting and design, taking account of a wide range of potentially suitable Japanese geological environments. The generic nature of the host rock in the H12 assessment means, however, that emphasis is placed verymuch on strong EBS performance. The assessment included a comprehensive evaluation of uncertainty and potentially detrimental factors, including perturbations due to external events and processes. Despite the considerable uncertainty at the current stage of the Japanese program, a safety case that is adequate for the aims of the assessment can be made by a strategy of employing conservatism where there is uncertainty and stressing the reliability and effectiveness of the performance of the near-field. The aim of this paper is to present the H12 PA in a way which makes the PA process clearer and the implications of the results more meaningful, both to workers within the PA field and to a wider technical audience.
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