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The use of mechanical restraint is a challenging area for psychiatry. Although mechanical restraint remains accepted as standard practice in some regions, there are ethical, legal and medical reasons to minimise or abolish its use. These concerns have intensified following the Convention on the Rights of Persons with Disabilities. Despite national policies to reduce use, the reporting of mechanical restraint has been poor, hampering a reasonable understanding of the epidemiology of restraint. This paper aims to develop a consistent measure of mechanical restraint and compare the measure within and across countries in the Pacific Rim.
Methods
We used the publicly available data from four Pacific Rim countries (Australia, New Zealand, Japan and the United States) to compare and contrast the reported rates of mechanical restraint. Summary measures were computed so as to enable international comparisons. Variation within each jurisdiction was also analysed.
Results
International rates of mechanical restraint in 2017 varied from 0.03 (New Zealand) to 98.8 (Japan) restraint events per million population per day, a variation greater than 3000-fold. Restraint in Australia (0.17 events per million) and the United States (0.37 events per million) fell between these two extremes. Variation as measured by restraint events per 1000 bed-days was less extreme but still substantial. Within all four countries there was also significant variation in restraint across districts. Variation across time did not show a steady reduction in restraint in any country during the period for which data were available (starting from 2003 at the earliest).
Conclusions
Policies to reduce or abolish mechanical restraint do not appear to be effecting change. It is improbable that the variation in restraint within the four examined Pacific Rim countries is accountable for by psychopathology. Greater efforts at reporting, monitoring and carrying out interventions to achieve the stated aim of reducing restraint are urgently needed.
A Vaisman manifold is a special kind of locally conformally Kähler manifold, which is closely related to a Sasaki manifold. In this paper, we show a basic structure theorem of simply connected homogeneous Sasaki and Vaisman manifolds of unimodular Lie groups, up to holomorphic isometry. For the case of unimodular Lie groups, we obtain a complete classification of simply connected Sasaki and Vaisman unimodular Lie groups, up to modification.
We report fourteen and twenty-eight protocluster candidates at z = 5.7 and 6.6 over 14 and 19 deg2 areas, respectively, selected from 2,230 Lyα emitters (LAEs) photometrically identified with Subaru/Hyper Suprime-Cam (HSC) deep images. Six out of the 42 protocluster candidates include at least 1 spectroscopically confirmed LAEs at redshifts up to z = 6.574. By the comparisons with the cosmological Lyα radiative transfer (RT) model reproducing LAEs with the reionization effects, we find that more than a half of these protocluster candidates might be progenitors of the present-day clusters with a mass of ≳ 1014M⊙. We also investigate the correlation between LAE overdensity and Lya rest-frame equivalent width (EW), because the cosmological Lyα RT model suggests that a slope of EW-overdensity relation is steepened towards the epoch of cosmic reionization (EoR), due to the existence of the ionized bubbles around galaxy overdensities easing the escape of Lyα emission from the partly neutral intergalactic medium. The available HSC data suggest that the slope of the EW-overdensity correlation does not evolve from the post-reionization epoch z = 5.7 to the EoR z = 6.6 beyond the moderately large statistical errors.
We apply two methods to estimate the 21-cm bispectrum from data taken within the Epoch of Reionisation (EoR) project of the Murchison Widefield Array (MWA). Using data acquired with the Phase II compact array allows a direct bispectrum estimate to be undertaken on the multiple redundantly spaced triangles of antenna tiles, as well as an estimate based on data gridded to the uv-plane. The direct and gridded bispectrum estimators are applied to 21 h of high-band (167–197 MHz; z = 6.2–7.5) data from the 2016 and 2017 observing seasons. Analytic predictions for the bispectrum bias and variance for point-source foregrounds are derived. We compare the output of these approaches, the foreground contribution to the signal, and future prospects for measuring the bispectra with redundant and non-redundant arrays. We find that some triangle configurations yield bispectrum estimates that are consistent with the expected noise level after 10 h, while equilateral configurations are strongly foreground-dominated. Careful choice of triangle configurations may be made to reduce foreground bias that hinders power spectrum estimators, and the 21-cm bispectrum may be accessible in less time than the 21-cm power spectrum for some wave modes, with detections in hundreds of hours.
Recently, an epoch-making printing technology called “SuPR-NaP (Surface Photo-Reactive Nanometal Printing)” that allows easy, high-speed, and large-area manufacturing of ultrafine silver wiring patterns has been developed. Here we demonstrate low-voltage operation of organic thin-film transistors (OTFTs) composed of printed source/drain electrodes that are produced by the SuPR-NaP technique. We utilize an ultrathin layer of perfluoropolymer, Cytop, that functions not only as a base layer for producing patterned reactive surface in the SuPR-NaP technique but also as an ultrathin gate dielectric layer of OTFTs. By the use of 22 nm-thick Cytop gate dielectric layer, we successfully operate polycrystalline pentacene OTFTs below 2 V with negligible hysteresis. We also observe the improvement of carrier injection by the surface modification of printed silver electrodes. We discuss that the SuPR-NaP technique allows the production of high-capacitance gate dielectric layers as well as high-resolution printed silver electrodes, which provides promising bases for producing practical active-matrix OTFT backplanes.
The mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.
Methods
This study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.
Results
We identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.
Conclusions
The present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.
Although outbreaks of acute respiratory infection (ARI) at shelters are hypothesized to be associated with shelter crowding, no studies have examined this relationship. We conducted a retrospective study by reviewing medical records of evacuees presenting to one of the 37 clinics at the shelters in Ishinomaki city, Japan, during the 3-week period after the Great Eastern Japan Earthquake and tsunami in 2011. On the basis of a locally weighted scatter-plot smoothing technique, we categorized 37 shelters into crowded (mean space <5·5 m2/per person) and non-crowded (⩾5·5 m2) shelters. Outcomes of interest were the cumulative and daily incidence rate of ARI/10 000 evacuees at each shelter. We found that the crowded shelters had a higher median cumulative incidence rate of ARI [5·4/10 000 person-days, interquartile range (IQR) 0–24·6, P = 0·04] compared to the non-crowded shelters (3·5/10 000 person-days, IQR 0–8·7) using Mann–Whitney U test. Similarly, the crowded shelters had an increased daily incidence rate of ARI of 19·1/10 000 person-days (95% confidence interval 5·9–32·4, P < 0·01) compared to the non-crowded shelters using quasi-least squares method. In sum, shelter crowding was associated with an increased incidence rate of ARI after the natural disaster.
The purpose of this report is to advocate speedy approval and less stringent regulations for the use of experimental drugs such as favipiravir in emergencies. Favipiravir is a new antiviral medication that can be used in emerging viral pandemics such as Ebola virus, 2009 pandemic influenza H1N1 virus, Lassa fever, and Argentine hemorrhagic fever. Although favipiravir is one of the choices for the treatment of patients with Ebola virus, several concerns exist. First, a clinical trial of favipiravir in patients infected with the Ebola virus has not yet been conducted, and further studies are required. Second, favipiravir has a risk for teratogenicity and embryotoxicity. Therefore, the Ministry of Health, Welfare and Labor of Japan has approved this medication with strict regulations for its production and clinical use. However, owing to the emerging Ebola virus epidemic in West Africa, on August 15, 2014, the Minister of Health, Welfare and Labor of Japan approved the use of favipiravir, if needed. (Disaster Med Public Health Preparedness. 2014;0:1-3)
As a method to evaluate high-temperature equation of state (EOS) data of fissile materials precisely and safely, we numerically examined an experimental setup based on a sub-range fissile target and a high-intensity short-pulsed heavy-ion beam. As an example, we calculated one-dimensional hydrodynamic motion of a uranium target with ρ = 0.03ρsolid (ρsolid ≡ solid density = 19.05 g/cm3) induced by a pulsed 23Na+ beam with a duration of 2 ns and a peak power of 5 GW/mm2. The projectile stopping power was calculated using a density- and temperature-dependent dielectric response function. To heat the target uniformly, we optimized the experimental condition so that the energy deposition could occur almost at the top of the Bragg peak. The energy deposition inhomogeneity could be reduced to ±5% by adjusting the incident energy and the target thickness to be 2.02 MeV/u and 180 μm, respectively. The target could be heated homogeneously up to kT =7 eV well before the arrival of the rarefaction waves at the center of the target. In principle, the EOS data can be evaluated by iteratively adjusting the data embedded in the hydro code until the measured hydrodynamic motion is reproduced by the calculation. This method is consistent with the conditions of nuclear nonproliferation, because a very small amount of fissile material is enough to perform the experiment, and no shock compression occurs in the target.
We confirmed a specific detection of immunoglobulin E(IgE) by using an aptamer immobilized reduced graphene oxide(rGo) field effect transistor(FET). A detection limit and dynamic range were estimated 8.1 ng/ml and 10000 respectively. These characteristics are comparable with current fluorescent markers. Although a mobility of rGo FET was around 5 cm2/V.sec, and this is two to three orders lower than mechanically exfoliated pristine graphene FET, a sensitivity of it was only one order lower than using pristine graphene.
Delirium and dementia are highly interrelated. However, few comprehensive epidemiological studies have examined this altered state of consciousness superimposed on dementia. We investigated the frequency of delirium in patients with dementia, its prevalence in patients with each dementia type, and its association with cerebrovascular disease (CVD) in patients with neurodegenerative dementias.
Methods:
We studied 261 consecutive outpatients in the memory clinic of a psychiatric hospital between April 2010 and September 2011. All patients underwent routine laboratory tests and computed tomography (CT), and their Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Physical Self-Maintenance Scale (PSMS), and Delirium Rating Scale – Revised 98 scores were recorded. The diagnosis of delirium was based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. CVD was detected by CT.
Results:
Among the 206 patients with dementia, delirium was present in 40 (19.4%). The proportion of patients who experienced episodes of delirium was 14.7% in the Alzheimer's disease, 34.4% in the vascular dementia, 31.8% in the dementia with Lewy bodies, and none in frontotemporal lobar degeneration. Delirium was frequently observed in patients with dementia and CVD. The NPI total and agitation subscale scores were significantly higher in dementia patients with delirium than in those without delirium. PSMS scores were significantly lower for patients with delirium than for patients without delirium.
Conclusions:
The frequency of delirium varies with each dementia type. In addition, delirium decreases activities of daily living, exaggerates behavioral and psychological symptoms dementia, and is associated with CVD in patients with neurodegenerative dementias.
The plastic deformation behaviour of single crystals of Pt3Al with a chemical composition of Pt-27 at.%Al was investigated in compression from 77K to 1,273K. The L12 structure is not stable below around 220 K, transforming into either D0c, D0c’ or Pt3Ga structures. {001} slip system was operative for most loading axis orientations while {111} slip system was operative for a narrow orientation region close to [001]. The CRSS for {111} slip gradually decreases in the temperature range where the L12 structure is stable, followed by a sharp decrease above 1,073 K, without showing positive temperature dependence. On the other hand, the CRSS for {001} slip gradually decreases below 673 K and moderately increases above 673 K. Dislocations on {111} tend to align along their screw orientation, suggesting high Peierls stress for their motion, while those on {001} are edge-oriented and fairly curved on a local scale, suggesting relatively low Peierls stress. Dislocations on both {111} and {001} with a Burgers vector b = [$\bar 1$01] dissociate into two collinear superpartials with b = 1/2[$\bar 1$01] separated by an anti-phase boundary.
Two new species of Syphacia (Nematoda: Oxyuridae) are described from endemic murids of Sulawesi, Indonesia: Syphacia(Syphacia)taeromyos sp. n. and S.(S.)paruromyos sp. n. parasitic in the caecum of Taeromys celebensis and Paruromys dominator, respectively. They are readily distinguished from all of the congeners recorded from Indonesia–Australian regions by having a round cephalic plate, vesicular lateral alae in the male, posteriorly positioned excretory pore in the male, and/or lacking cervical alae. Syphacia (S.) paruromyos differs from S. (S.) taeromyos by having a whip-like tail appendage in the male, longer relative distance between excretory pore and vulva, and larger eggs. The round cephalic plate in both sexes and developed vesicular lateral alae in the male are morphological traits common in endemic Syphacia species hitherto known from Sulawesi murids, suggesting that they have derived from a common ancestor and evolved with their hosts in the isolated insular environment.
The gullet worm (Gongylonema pulchrum) has been recorded from a variety of mammals worldwide, including monkeys and humans. Due to its wide host range, it has been suggested that the worm may be transmitted locally to any mammalian host by chance. To investigate this notion, the ribosomal RNA gene (rDNA), mainly regions of the internal transcribed spacers (ITS) 1 and 2, and a cytochrome c oxidase subunit I (COI) region of mitochondrial DNA of G. pulchrum were characterized using parasites from the following hosts located in Japan: cattle, sika deer, wild boars, Japanese macaques, a feral Reeves's muntjac and captive squirrel monkeys. The rDNA nucleotide sequences of G. pulchrum were generally well conserved regardless of their host origin. However, a few insertions/deletions of nucleotides along with a few base substitutions in the ITS1 and ITS2 regions were observed in G. pulchrum from sika deer, wild boars and Japanese macaques, and those differed from G. pulchrum in cattle, the feral Reeves's muntjac and captive squirrel monkeys. The COI sequences of G. pulchrum were further divided into multiple haplotypes and two groups of haplotypes, i.e. those from a majority of sika deer, wild boars and Japanese macaques and those from cattle and zoo animals, were clearly differentiated. Our findings indicate that domestic and sylvatic transmission cycles of the gullet worm are currently present, at least in Japan.
This study examined the link between sibling relationships and children's social adjustment by comparing twin siblings and siblings with different ages (singleton siblings), and clarified the role of reciprocity in sibling relationships on children's social development. Mothers of 58 monozygotic twin pairs, 48 dizygotic twin pairs, and 86 singleton sibling pairs reported their children's sibling relationships and social adjustment. This study showed that the effects of sibling relationships on the prosocial behaviors and conduct problems of each child are stronger for twins than for singleton siblings. Moreover, positivity toward one's sibling increased peer problems only among monozygotic twins. The opposite tendency was present among dizygotic twins and singleton siblings. This study suggests the importance for children's social development of having many interactions with siblings and establishing reciprocity in sibling relationships. Moreover, our results suggest that the quality of sibling relationships among monozygotic twins may be different from those among dizygotic twins and singleton siblings.
Recent epidemiological data suggest a link between the consumption of bovine offal products and Shiga toxin-producing Escherichia coli (STEC) infection in Japan. This study thus examined the prevalence of STEC in various types of these foods. PCR screened 229 bovine offal products for the presence of Shiga toxin (stx) gene. Thirty-eight (16·6%) samples were stx positive, of which eight were positive for rfbEO157 and three were positive for wzyO26. Four O157 and one O26 STEC isolates were finally obtained from small-intestine and omasum products. Notably, homogenates of bovine intestinal products significantly reduced the extent of growth of O157 in the enrichment process compared to homogenates of beef carcass. As co-incubation of O157 with background microbiota complex from bovine intestinal products in buffered peptone water, in the absence of meat samples, tended to reduce the extent of growth of O157, we reasoned that certain microbiota present in offal products played a role. In support of this, inoculation of generic E. coli from bovine intestinal products into the homogenates significantly reduced the extent of growth of O157 in the homogenates of bovine intestinal and loin-beef products, and this effect was markedly increased when these homogenates were heat-treated prior to inoculation. Together, this report provides first evidence of the prevalence of STEC in a variety of bovine offal products in Japan. The prevalence data herein may be useful for risk assessment of those products as a potential source of human STEC infection beyond the epidemiological background. The growth characteristic of STEC O157 in offal products also indicates the importance of being aware when to test these food products.
Transition metal (Cr) and rare-earth (Dd, Dy) doped III-nitride semiconductor bulk layers and superlattice (SL) structures are grown on sapphire (0001) substrates and GaN (0001) templates by plasma-assisted molecular-beam epitaxy. For the GaGdN/GaN and InGaGdN/GaN SL and Si co-doped samples, enhancement of magnetization and magnetic moment are observed, suggesting the carrier-mediated ferromagnetism. Low temperature growth of GaGdN can increase the Gd concentration and magnetization. Results for the Dy-doped GaN as well as the GaCrN/AlN/GaCrN tunnel magneto-resistance (TMR) diodes are also described.
To examine the usefulness of a three-dimensional model for surgical navigation of cholesteatoma.
Materials and method:
A three-dimensional model was prototyped using selective laser sintering. Based on detailed computed tomography data, powder layers were laser-fused and accumulated to create a three-dimensional structure. The computed tomography threshold was adjusted to simultaneously replicate bony structures and soft tissues.
Results:
The cholesteatoma, major vessels and bony structures were well replicated. This laser-sintered model was used to aid surgery for recurrent cholesteatoma. The cholesteatoma, which extended from the hypotympanum through the styloid process sheath and the internal carotid artery sheath, was removed safely via a minimal skin incision.
Conclusion:
The laser-sintered model was useful for surgical planning and navigation in a cholesteatoma case involving complex bony structures and soft tissue.