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We report two cases of successful emergency pacing via the umbilical vein in neonates with congenital complete atrioventricular block. The first patient, a neonate with normal cardiac anatomy, underwent emergency temporary pacing via the umbilical vein under echocardiographic guidance. The patient underwent permanent pacemaker implantation on postnatal day 4. The second patient, a neonate with heterotaxy syndrome, underwent emergency temporary pacing through the umbilical vein under fluoroscopic guidance. The patient underwent permanent pacemaker implantation on postnatal day 17.
The purpose of this feasibility study was to examine the impacts of a peer discussion group intervention called “the pancreatobiliary cancer salon” on psychological distress among patients with pancreatobiliary cancer and their caregivers.
We recruited patients with pancreatic or biliary tract cancer and their caregivers. We conducted a within-group pre–post comparison study. Participants were grouped by the type of cancer and treatment. Each group consisted of four to five patients or caregivers. Hospital staff members facilitated group discussions where participants freely talked for 1 h. We evaluated participants’ psychological condition using the Profile of Mood States (POMS) and their impressions of the pancreatobiliary cancer salon.
We analyzed data from 42 patients and 27 caregivers who joined the salon for the first time. Thirty-five patients (83.3%) had pancreatic cancer. Thirty-one patients (71.4%) had unresectable pancreatobiliary cancer and 14 patients (33.3%) were being treated with second-line or third-line chemotherapy at the time of the survey. Twenty-two patients (52.4%) participated in the salon within 6 months after diagnosis. Most participating caregivers were the patient's spouse/partner (51.9%) or child (34.6%). Both patients and caregivers experienced high levels of satisfaction with the pancreatobiliary cancer salon. Both patients and caregivers had significantly lower psychological distress as assessed by POMS after the salon.
Significance of results
A peer discussion group intervention might be well-received and has potential to benefit for patients with pancreatobiliary cancer and their caregivers.
Exercise stress echocardiography and layer-specific strains are emerging as important tools for cardiac assessment. This study was aimed to evaluate layer-specific strains and torsion parameters during exercise in order to investigate the characteristics of cardiac dysfunction in patients with repaired tetralogy of Fallot and to detect subclinical left ventricular dysfunction.
Materials and Methods:
Thirteen patients with repaired tetralogy of Fallot (median age, 17.3 [interquartile range, 14.5–22.9] years; 6 males) and 13 controls (median age, 28.5 [interquartile range, 27.6–31.6] years; 13 males) underwent echocardiography at rest and during supine exercise. Layer-specific longitudinal strain and circumferential strain of three myocardial layers (endocardium, midmyocardium, and epicardium), torsion, and untwisting rate were measured using two-dimensional speckle-tracking echocardiography.
Peak endocardial papillary circumferential strain (−21.1 ± 2.6% vs. −25.8 ± 3.8%, p = 0.007), midmyocardial apical circumferential strain (−11.1 ± 4.0% vs. −15.6 ± 3.2%, p = 0.001), epicardial apical circumferential strain (−11.1 ± 4.0% vs. −15.6 ± 3.2%, p = 0.021), and torsion (8.9 ± 6.0 vs. 14.9 ± 4.8 degree, p = 0.021) were significantly lower in the repaired tetralogy of Fallot group than in the control group during exercise, though no significant difference was found between patients and controls at rest.
Analysis of layer-specific strains and torsion parameters during exercise could detect subclinical left ventricular dysfunction in patients with repaired tetralogy of Fallot, which might reflect potential myocardial damage, at a stage where these parameters have normal values at rest. This finding provides new insight into the mechanisms of cardiac dysfunction in patients with repaired tetralogy of Fallot.
Recently, spectroscopic detections of O[III] 88 μm and Ly-α emission lines from the z ≍ 9.1 galaxy MACS1149-JD1 have been presented, and with these, some interesting properties of this galaxy were uncovered. One such property is that MACS1149-JD1 exhibits a significant Balmer break at around rest-frame 4000 Å, which may indicate that the galaxy has experienced large variations in star formation rate prior to z ∼ 9, with a rather long period of low star formation activity. While some simulations predict large variations in star formation activity in high-redshift galaxies, it is unclear whether the simulations can reproduce the kind of variations seen in MACS1149-JD1. Here, we utilize synthetic spectra of simulated galaxies from two simulation suites in order to study to what extent these can accurately reproduce the spectral features (specifically the Balmer break) observed in MACS1149-JD1. We show that while the simulations used in this study produce galaxies with varying star formation histories, galaxies such as MACS1149-JD1 would be very rare in the simulations. In principle, future observations with the James Webb Space Telescope may tell us if MACS1149-JD1 represents something rare, or if such galaxies are more common than predicted by current simulations.
Little is known about physical constitution outcomes for very preterm infants. Here, we compare z-scores of anthropometric parameters up to 6 years of age in children born with very low birth weight (VLBW) at less than 30 weeks of gestation, with or without intrauterine growth restriction (IUGR).
Participants were divided into four subgroups: male (M), small for gestational age (SGA) (n = 30); M, appropriate for gestational age (AGA) (n = 59); female (F), SGA (n = 24); and F, AGA (n = 61). z-Scores of body weight (BW), body length (BL), and body mass index (BMI) were assessed at birth, 1 year corrected age, 3 years of age, and 6 years of age.
For boys, BW and BMI were significantly lower among SGA children than among AGA children at all assessments, but there was no difference in BL at 3 or 6 years. For girls, BW and BL were significantly lower among SGA children than among AGA children at all assessments, but no difference was detected in BMI after 1.5 years. No significant variation in the z-score of BW or BMI in either SGA group was observed after 1 year. BL z-score in all groups gradually increased until 6 years of age.
IUGR affects BW and BMI in boys and BW and BL in girls during the first 6 years in VLBW children born at less than 30 weeks of gestation. SGA children did not catch up in BW or BMI from 1 to 6 years of age.
The purpose of this study is to identify psychiatric disorders and stress factors experienced by staff members in cancer hospitals who were referred to psychiatric consultation service, and to investigate the association between psychiatric disorders and stress factors.
A retrospective descriptive study using clinical practice data on staff members referred to psychiatric consultation service, obtained for 8 years, was conducted at two National Cancer Center Hospitals in Japan. Psychiatric disorders were identified according to DSM-IV. Stress factors were extracted from a chief complaint at the initial visit in medical charts, using a coding approach, and grouped as job stress or personal stress. The frequencies of the stress factors were determined by two coders who were unaware of the categorized procedure. Fisher's exact test was used to determine the association between psychiatric disorders and stress factors.
Of 8077 psychiatric consultations, 65 (1%) staff members were referred. The most common psychiatric disorder was adjustment disorder (n = 26, 40%), followed by major depression (n = 17, 26%). Eight stress factors were identified from 76 meaning units and were grouped into five job stresses and three personal stresses. Of the five job stresses, four were most frequently experienced in adjustment disorders, and “failure to adapt to job environmental change” was significantly associated (p = 0.014). Two of the three personal stresses were most frequently experienced in psychiatric disorders other than major depressive disorder and adjustment disorders, and “suffering from mental disease” was significantly associated (p = 0.001).
Significance of results:
We found that very few staff members were provided with psychiatric consultation service. A comprehensive support system for job stress might be needed to prevent adjustment disorders, as those are suggested to be the most common psychiatric disorders among staff members in cancer hospitals.
Psychological distress of cancer patients' family members is treated by psychiatric consultation service for outpatients at National Cancer Center Hospitals in Japan. The purpose of this study was to identify psychiatric disorders and explore background characteristics of cancer patients' family members referred to psychiatric consultation service, so that we could better understand current utilization of this psychiatric consultation service for cancer patients' family members.
A retrospective descriptive study using clinical practice data obtained for 5 years (from January 2000 to December 2004) was conducted at two National Cancer Center Hospitals. We reviewed the psychiatric consultation database, computerized patient database of the National Cancer Center Hospitals, and medical charts of cancer patients' family members who were referred to psychiatry and their cancer patients.
Out of a total of 4992 psychiatric consultations, 118 (2%) were for cancer patients' family members. The most common psychiatric disorders among cancer patients' family members were adjustment disorders (n = 69, 58%), followed by major depression (n = 30, 25%). Female (n = 101, 86%), spouse (n = 87, 74%), married (n = 92, 78%), and housewife (n = 63, 53%) were the most common background characteristics of the family members. Sixty-four percent of cancer patients (n = 75) were hospitalized at the time of their family members' referral and 34% of cancer patients (n = 40) had already received psychiatric consultation service and 55% of cancer patients (n = 65) had delivered bad news prior to their family members' referral.
Significance of the research:
We found that very few family members were provided with psychiatric consultation service at two National Cancer Center Hospitals. Adjustment disorders are suggested to be the most common psychiatric disorders among cancer patients' family members.
We previously reported that the nurse-assisted screening and psychiatric referral program (NASPRP) facilitated the psychiatric treatment of depressive patients, but the high refusal rate was a problem even though referral was recommended by the nurse to all positively screened patients. We modified the program so that the nurses could judge the final eligibility of referral using the result of the screening. This study assessed if the modified NASPRP led to more psychiatric referral of depressive patients.
We retrospectively evaluated the annual change of the psychiatric referral proportion and compared the findings among the usual care term, the NASPRP term, and the modified NASPRP terms.
The referral proportions of the modified NASPRP terms were 4.4% and 3.9%. These were not significantly higher than the usual care term (2.5%), and significantly lower than the NASPRP term (11.5%).
Significant of results:
The modified NASPRP did not facilitate psychiatric treatment of depressive patients and another approach is needed.
Objective: Although depression is a prevalent and burdensome
psychiatric problem in end-of-life cancer patients, little is known about
its susceptibility to treatment, especially when patients reach very close
to the end of life. This study was conducted to evaluate response rate of
that end-of-life depression to psychiatric intervention and to assess the
feasibility of conventional evidence-based pharmacological therapy for
Methods: The medical records of 20 patients who were referred
to the psychiatry division for major depressive disorder and died within 3
months after the referral were reviewed. The Clinical Global
Impression–Improvement (CGI-I) Scale was used for each case, and
responders were defined as patients whose scores were much or very much
improved. All pharmacological treatments were extracted, and the doses of
the antidepressant prescribed were compared to their
evidence-based-defined therapeutic doses.
Results: Of the 20 patients, seven were responders, but no
response was achieved when the survival time was less than 3 weeks. Most
patients were treated with antidepressants, but the doses prescribed were
far less than the defined doses, especially the doses of the tricyclic
Significance of results: These results suggested that
patients' survival time largely determines susceptibility to
psychiatric treatment, and it is hard to achieve response in patients
whose survival time was less than about 1 month. Implementation of
conventional evidence-based pharmacological treatment is difficult,
especially with TCAs, and various antidepressants, which can be
administrated by other routes, are needed when oral intake is
An amorphous p-type conductive oxide semiconductor was created based on a mother crystalline material, a p-type conductive ZnRh2O4 spinel. The amorphous film of ZnRh2O4 was deposited by an rf sputtering method. Seebeck coefficient was positive, +78 μVK-1, indicating that major carrier is a positive hole. A moderate electrical conductivity (2 S cm-1 at room temperature) for a p-type semiconductor was observed. Optical band gap was estimated to be 2.1 eV. P-n junction diodes with a structure of Au / a-ZnRh2O4 / a-InGaZnO4 / ITO fabricated on glass substrates, operated with a good rectifying characteristics, a rectification current ratio at ± 5V of ∼103. The threshold voltage was 2.1 eV, which corresponds to the band gap energy of the amorphous ZnRh2O4. This is the first discovery of a p-type amorphous oxide and the demonstration of p-n junction all composed of amorphous oxide semiconductors.
New methods are presented for characterizing MIPs. These methods address the problems of quantitatively comparing the binding properties of different MIPs. Heterogeneous binding models were applied to MIPs based on an exponentially decaying distribution known as the Freundlich isotherm. The Freundlich isotherm was found to accurately model the binding isotherm of the majority of non-covalently imprinted MIPs. Using this model the experimental binding isotherm can be fit in log-log form to a linear equation from which the fitting parameters can be used to plot a quantitative affinity distribution which is a plot of the number of sites with respect to the binding constant of those sites. Comparison of MIPs using this methodology allowed for simpler and more accurate assessment of the binding properties than by previous methods such as the limiting slopes analysese of curved Scatchard plots.
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