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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.
To determine whether carbapenem consumption and Pseudomonas aeruginosa resistance rates can be used as benchmarks to compare and improve antimicrobial stewardship programs across multiple pediatric hospitals.
A prospective study.
Setting and participants:
Healthcare institutions in Japan with >100 pediatric beds.
An annual survey of the total days of therapy (DOT) per 1,000 patient days for carbapenem antibiotics (meropenem, imipenem-cilastatin, panipenem-betamipron, doripenem) and susceptibility rates of Pseudomonas aeruginosa to meropenem and imipenem-cilastatin from each institution was conducted over a 7-year period. Data were reported to the administration, as well as to the infection control team, of each institution annually.
Data were obtained from 32 facilities. The median total carbapenem DOT per 1,000 patient days was 16.6 and varied widely, with a range of 2.7 to 59.0. The median susceptibility to meropenem was 86.6%, ranging from 78.6% to 96.6%. We detected an inverse correlation between total carbapenem DOT versus susceptibility (r = – 0.36; P < .01). Over the 7-year period, the DOT per 1,000 patient days of carbapenem decreased by 27% from a median of 16.0 to 11.7 (P < .01). We also observed an improvement in susceptibility to meropenem from a median of 87% to 89.7% (P = .01) and to imipenem-cilastatin from 79% to 85% (P < .01). The decreases in the use of carbapenem were greater in institutions with antimicrobial stewardship programs led by pediatric infectious disease specialists.
Antimicrobial use and resistance, targeting carbapenems and P. aeruginosa, respectively, can serve as benchmarks that can be utilized to promote antimicrobial stewardship across pediatric healthcare institutions.
The occurrence of anorectal malformations (ARM) is thought to be reduced with sufficient folate intake. However, there is no apparent evidence. We focused on enzyme cofactors for one-carbon metabolism, including folate (vitamin B9), vitamin B6 and vitamin B12, and explored the association between maternal combined intake of these B vitamins and the risk of ARM. Using baseline data from a Japanese nationwide birth cohort study between 2011 and 2014, we analysed data of 89 235 women (mean age at delivery = 31·2 years) who delivered singleton live births without chromosomal anomalies. Information on dietary intake was obtained via a FFQ focused on early pregnancy and used to estimate B vitamin intake. We also collected information on the frequency of folic acid supplement use. ARM occurrence was ascertained from medical records. We identified forty-three cases of ARM diagnosed up to the first month after birth (4·8 per 10 000 live births). In terms of individual intake of the respective B vitamins, high vitamin B6 intake was non-significantly associated with reduced odds of ARM. Compared with women in the low combined B vitamin intake group, the OR of having an infant with ARM was 0·4 (95 % CI 0·2, 1·0) in the high intake group (folate ≥400 μg/d, and upper half of vitamin B6 and/or vitamin B12). In conclusion, our cohort analysis suggested an inverse association between the combined intake of one-carbon metabolism-related B vitamins in early pregnancy and ARM occurrence.
Microglia express the TSPO (TranSlocalor PrOtein) receptor formerly known as the PBR (peripheral benzodiazepine receptor). The densitiy of the TSPO is dependent on the inflammatory state of microglia. The radiopharmaceutical [11C]PK11195 binds in excess to the TSPO in activated microglia. We showed that the hippocampus of psychotic patients experienced significantly more [11C]PK11195 binding than the hippocampus of healthy controls. To elucidate the effect of antipsychotic medication on brain inflammation the herpes encephalitis rat model was chosen, because of pathophysiological similarity: Herpes simplex virus preferentially infects hippocampus. In adult rats 10E5 pfu of HSV-1 (clinical strain) was administered intranasally. After 3–5 days sickness behavior developed. At the 6th day and at the 13th day after inoculation a [11C]PK11195 PET scan was performed. Drugs were delivered by osmotic minipumps (haloperidol, clozapine, saline). Only clozapine treatment delayed sickness behavior. Clozapine treatment reduced the inflammation in the mesecephalon and immediate surrounding regions after 6 days and reduced dissemination of inflammation to brain cortex at 13 days after inoculation.
In a herpes infection model clozapine exerts potent antiinflammatory effects on microglia. The hippocampus might be the link between infectious pathology and inflammation in schizophrenia patients.
A variety of hereditary spinocerebellar ataxia (SCA) develops a broad spectrum of both ataxia and non-ataxia symptoms. Cognitive and affective changes are one such non-ataxia symptoms, but have been described only in hereditary SCAs with exonic CAG gene expansion.
We newly found intronic hexanucleotide GGCCTG gene expansion in NOP56 gene as the causative mutation (=SCA36) in nine unrelated Japanese familial SCA originating from Asida river area in the western part of Japan, thus nicknamed Asidan for this mutation. These patients show unique clinical balance of cerebellar ataxia and motor neuron disease (MND), locating on the crossroad of these two diseases. We examined cognitive and affective analyses on 12 Asidan patients who agreed to join the examination.
The 12 Asidan patients demonstrated a significant decrease in their frontal executive functions measured by frontal assessment battery (FAB) and Montreal cognitive assessment (MoCA) compared with age- and gender-matched controls, whilst mini-mental state examination (MMSE) and Hasegawa dementia score-revised (HDS-R) were within normal range. the decline of frontal executive function was related to their disease duration and scale for the assessment and rating of ataxias (SARA). They also demonstrated mild depression and apathy. Single-photon emission tomography (SPECT) analysis showed that these Asidan patients showed decline of regional cerebral blood flow (rCBF) in a particular areas of cerebral cortices such as Brodmann areas 24 and 44-46.
These data suggest the patients with Asidan mutation show unique cognitive and affective characteristics different from other hereditary SCAs with exonal CAG expansion or MND.
This experimental study explores the physical mechanisms by which a transverse jet’s upstream shear layer can transition from being a convective instability to an absolute/global instability as the jet-to-cross-flow momentum flux ratio
is reduced. As first proposed in computational studies by Iyer & Mahesh (J. Fluid Mech., vol. 790, 2016, pp. 275–307), the upstream shear layer just beyond the jet injection may be analogous to a local counter-current shear layer, which is known for a planar geometry to become absolutely unstable at a large enough counter-current shear layer velocity ratio,
. The present study explores this analogy for a range of transverse jet momentum flux ratios and jet-to-cross-flow density ratios
, for jets containing differing species concentrations (nitrogen, helium and acetone vapour) at several different jet Reynolds numbers. These studies make use of experimental data extracted from stereo particle image velocimetry as well as simultaneous stereo particle image velocimetry and acetone planar laser-induced fluorescence imaging. They provide experimental evidence for the relevance of the counter-current shear layer analogy to upstream shear layer instability transition in a nozzle-generated transverse jet.
The pathogenesis of congenital diaphragmatic hernia (CDH) is largely unknown; however, vitamin A seems to play a role in diaphragmatic development. Previous case–control studies reported that maternal dietary vitamin A intake was inversely associated with the risk of CDH. To our knowledge, however, there is no prospective evidence regarding this association. Our aim was to examine whether maternal intake of vitamin A was associated with CDH occurrence. Baseline data, from the Japan nationwide birth cohort study (2011–2014) of 89 658 mothers (mean age at delivery = 31·2 years) who delivered singleton live births, were analysed. We assessed dietary habits using an FFQ focused on the first trimester and estimated the daily intake of total vitamin A (retinol activity equivalents), retinol, provitamin A carotenoids and vegetables. The occurrence of CDH was ascertained from medical records. A total of forty cases of CDH were documented. The adjusted OR of CDH occurrence for the high total vitamin A intake category (median = 468 μg/d) was 0·6 (95 % CI 0·3, 1·2) with reference to the low intake category (230 μg/d). When we restricted to mothers with a prepregnancy BMI of 18·5–24·9 kg/m2, vitamin A intake was inversely associated with the risk of their children being born with CDH (OR 0·5, 95 % CI 0·2, 1·0). Even given the limited number of cases in the study, our findings provide additional evidence to link vitamin A with CDH.
To investigate the response of the fish community structure to a natural disturbance in their habitat, fish abundance, biomass and species composition were analysed in relation to temporal variability of environmental conditions in a seagrass Zostera marina bed. A total of 3024 fishes belonging to 46 taxa (22 families) were collected by quantitative sampling for 10 years from 2007 to 2016 in the Seto Inland Sea, south-western Japan. Seagrass shoot density decreased to less than 1/20 of its original density after disappearance of vegetation caused by heavy rain in the autumn of 2011 and the area did not recover for the next five years. In order to analyse temporal changes of fish community, the fishes were divided into three groups depending on their habitats or lifestyles: pelagic or migratory species (PM), sand or mud bottom-associated species (SM) and seagrass (Z. marina) – or substrate (rocky bottom including macrophytes) – associated species (ZS). Multiple regression analysis showed seagrass shoot density had the most significant effect on biomass of ZS among the three groups, with higher fish biomass under higher seagrass shoot density. Fish community composition changed after the disappearance of the seagrass vegetation coverage with an increase in abundance of SM during the five years of the post-disturbance period. Seagrass vegetation was concluded to affect temporal change of fish community structure through a stronger influence on fish species that are more dependent on seagrass beds as habitat.
This chapter reviews pertinent issues facing Japanese smallholders and explores the role of small-scale farming households in contemporary Japan. Here, the influences of agricultural policy and technological innovations on smallholders are considered alongside reviews of key regional differences in Japanese agriculture, based on geographical terrain, management scale and labour force organization. Research reveals that the small-scale nature of household farms, ageing, and a lack of successors are some of the major factors – among others – threatening the persistence of smallholder agriculture in Japan.
According to the Ministry of Agriculture, Forestry, and Fisheries, Japan’s self-sufficiency in grains stands at only 29% because of wheat and feed grain imports. Despite this deficiency, the self-sufficiency rate of rice maintains at 95%. Part-time family farms continue to play a large role in rice production. The 2010 World Census of Agriculture and Forestry in Japan reports that the average paddy-holding size of Japanese farming households which produce rice was only 1.43 ha. Thus, the farm size of most Japanese farming households is small-scale. In this chapter we highlight the particular issues faced by Japanese smallholders and clarify their socio-economic and cultural position in Japan. The position of smallholder family farms has been strongly shaped by government policies over more than fifty years, since the postwar period.
During the war, the Staple Food Control Law of 1942 was enacted to solve serious food shortages and increase farmers’ motivation to produce more rice. Essentially, the government would purchase rice at the highest price from the producers (the producers’ rice price) and sell it at the cheapest price to the consumers (consumers’ rice price). As a result of the law, rice production was greatly increased as intended and Japan was able to successfully solve its food shortage.
In the postwar period, the government passed the Agricultural Basic Law of 1961, “Jiritsu Keiei no Ikusei ” (Nurturing Viable Farms) with its primary objective of accomplishing the modernization of agriculture. At the time the Agricultural Basic Law was enacted, income disparities between urban and rural areas as well as the agricultural and industrial sectors had been exacerbated by the advancement of urbanization and industrialization during the postwar period of high economic growth (Tashiro 1999).
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.
Although introduced pasture grasses are essential for forage production in current livestock farming, some species cause serious impacts on native biodiversity when naturalized. Information on the seed dispersal of invasive forage grasses from cultivated settings to surrounding environments can inform management efforts to prevent their naturalization. In this case study, we quantified the wind-mediated seed dispersal distance and amount of dispersed seed of invasive forage grasses from agricultural grasslands in Hokkaido, northern Japan. In total, 200 funnel seed traps were installed around three regularly mown grasslands and one unmown grassland where various forage grass species were grown in mixture. Seeds of each species dispersed outside the grasslands were captured from May to October 2017. Based on the trapped distances of seeds, the 99th percentile dispersal distance from the grasslands was estimated for six species, including timothy (Phleum pratense L.), orchardgrass (Dactylis glomerata L.), and Kentucky bluegrass (Poa pratensis L.). For two dominant species, P. pratense and D. glomerata, the numbers of seeds dispersed outside the field under mown and unmown conditions were determined under various plant cover situations. The estimated dispersal distances ranged from 2.3 m (P. pratense) to 31.5 m (P. pratensis), suggesting that areas within approximately 32 m of the grasslands are exposed to the invasion risk of some forage grass species. For both P. pratense and D. glomerata, the number of seeds dispersed outside the unmown grassland exceeded 100 seeds m−2 under high plant cover situations, while the number of seeds dispersed from the mown grasslands at the same plant cover level was less than one-third of that number. The results suggest that local land managers focus their efforts on frequent mowing of grasslands and monitoring of the areas within approximately 32 m of the grasslands to substantially reduce the naturalization of invasive forage grasses.
Earthquakes have killed around 800,000 people globally in the past 20 years, with head injury being the main cause of mortality and morbidity.
To conduct a systematic review to determine the characteristics of head injuries after earthquakes for better disaster preparedness and management.
All publications related to head injuries and earthquakes were searched using Pubmed, Web of Science, the Cochrane Library, and Ichushi.
Thirty-six articles were included in the analysis. Head injury was the third most common cause of injury among survivors of earthquakes. The most common injury after an earthquake occurred was in the lower extremities (36.2%), followed by the upper extremities (19.9%), head (16.6%), spine (13.3%), chest (11.3%), and abdomen (3.8%). Earthquake-related head injuries were predominantly caused by a blunt strike (79%), and were more frequently associated with soft tissue injury compared to non-earthquake-related head injuries and less frequently with intracranial hemorrhage. The mean age of patients with earthquake-related head injuries was 32.6 years, and 55.1% of sufferers were male. The most common earthquake-related head injury was laceration or contusion (59.2%) while epidural hematoma was most common among inpatients with intracranial hemorrhage after an earthquake (9.5%). Early wound irrigation and debridement and antibiotics administration are needed to decrease the risk of infection. Mortality due to earthquake-related head injuries was 5.6%.
Head injury was the main cause of mortality and morbidity after an earthquake. The characteristics of earthquake-related head injuries differed from those of non-earthquake-related head injuries, including the frequency of multiple injuries, and occurrence of contaminated soft tissue injury and epidural hematoma. This knowledge is important for determining demands for neurosurgery and for adequate management of patients, especially in resource-limited conditions.
Nickel thin films were prepared by electroless plating in a foam of electrolyte generated by bubbling nitrogen into a hypophosphite-based electroless plating solution added with surfactants of sulfuric acid monododecyl ester sodium salt and ammonium pentadecafluorooctanoate (APFO). Ferroxyl test revealed that the films deposited in foam had substantially higher corrosion resistance than those deposited in liquid. Even with a film thickness of only 1.5 µm, the fraction of corroded area was as small as 0.002% when the film was deposited in the foam. The notable improvement in the corrosion resistance was made possible by adding APFO as the surfactant.
Current evidence suggests that the aetiology of congenital gastrointestinal (GI) tract atresia is multifactorial, and not based solely on genetic factors. However, there are no established modifiable risk factors for congenital GI tract atresia. We used data from a Japanese nationwide birth cohort study launched in 2011, and examined whether fish consumption in early pregnancy was associated with congenital GI tract atresia. We analysed data of 89 495 women (mean age at delivery=31·2 years) who delivered singleton live births without chromosomal anomalies. Based on the results of the FFQ, we estimated the daily intake of fish and n-3 PUFA consumption in early pregnancy. We defined a composite outcome (oesophageal atresia, duodenal atresia, jejunoileal atresia and/or anorectal malformation) as congenital GI tract atresia. In this population, median fish intake was 31·9 g/d, and seventy-four cases of congenital GI tract atresia were identified. Fish consumption in early pregnancy was inversely associated with the composite outcome (multivariable-adjusted OR for the high v. low consumption category=0·5, 95 % CI 0·3, 1·0). For all the specific types of atresia, decreased OR were observed in the high consumption category, although not statistically significant. Reduced atresia occurrence was observed even beyond the US Food and Drug Administration’s recommended consumption of no more than 340 g/week. Also, n-3 PUFA-rich fish and n-3 PUFA consumptions tended to be inversely associated with atresia. Fish consumption in early pregnancy may be a preventive factor for congenital GI tract atresia.
Diel vertical migration of the cutlassfish Trichiurus japonicus larvae were investigated by consecutive 24-h collections at 3-h intervals at a station in the central Seto Inland Sea, Japan in June and September. Only one larva was collected in June 2017, while 224 and 40 larvae were collected in September 2016 and 2017, respectively. Larvae were present only at depths of ≥ 11 m during the day, whereas they were present at depths of 1, 6, 11 and 16 m during the night. Migration was observed in larvae in which swim bladder formation was completed. A similar pattern, namely nocturnal occurrence at shallow depths only of the developed larvae, was observed in another 24-h survey, suggesting that the swim bladder regulates the upward movement of larvae at night.
The present experiments explored the dynamical character of the gaseous jet injected flush into cross-flow for variable jet-to-cross-flow momentum flux ratios
(5, 12 and 41) and density ratios
(0.35 and 1.0). Contoured nozzle and straight pipe injectors were studied here, with the jet Reynolds number fixed at 1900 as other flow parameters were varied. Simultaneous acetone planar laser-induced fluorescence (PLIF) imaging and stereo particle image velocimetry (PIV) were used to study the relationships between scalar and velocity/vorticity fields, with a special focus on comparing PLIF-based extraction of scalar dissipation rates and local strain rates with PIV-based local strain rates in the upstream and downstream shear layers of the jet. There was remarkable similarity between the scalar and vorticity fields for the jet in cross-flow, spanning conditions for absolutely unstable upstream jet shear layers at low
values to conditions for convectively unstable shear layers for larger
, equidensity conditions (Megerian et al., J. Fluid Mech., vol. 593, 2007, pp. 93–129; Getsinger et al., Exp. Fluids, vol. 53, 2012, pp. 783–801). Proper orthogonal decomposition applied to both scalar and velocity fields revealed strengthening instabilities in both the upstream shear layer and in the jet’s wake as
was reduced. The simultaneous measurements allowed PLIF-extracted scalar dissipation rates and strain rates to be determined via a flamelet-like model and compared with PIV-extracted strain rates, each in the diffusion layer-normal direction. There was generally very good qualitative and quantitative agreement for these metrics in both the jet upstream and downstream shear layers for most flow conditions, with excellent correspondence to locations of shear layer vorticity roll up, although downstream shear layer strain rates in some cases showed lesser correspondence between PLIF- and PIV-based data. Such differences are shown to potentially result from diffusion and resolution effects as well as the influence of three-dimensional and transient effects which can be more significant in the lee side of the jet. Nevertheless, the present results reveal interesting dynamics and demonstrate the importance of strain fields in enhanced diffusion and transport phenomena.
Nickel thin films were prepared by electroless plating in a foam of electrolyte that was generated by bubbling nitrogen gas into a hypophosphite-based electroless plating solution to which was added a surfactant of sulfuric acid monododecyl ester sodium salt. Although the film growth rate in the foam was considerably lower than that in the conventional liquid, film growth was enhanced by inducing a flow in the foam. Compared with films deposited in liquid, the films deposited in foam had a smaller number of pinholes, smaller crystallite size, and superior corrosion resistance. The ferroxyl indicator test showed that the area of corrosion can be reduced to less than 1/20 by depositing the film in foam instead of liquid.
Microstructure and pitting corrosion behavior of base metal (BM), heat-affected zone (HAZ), and weld zone (WZ) in the 316L stainless steel weld joint was investigated. The results indicated that WZ, including ferrite and austenite phases, was mainly composed of columnar dendrites, while BM and HAZ exhibited a full-austenite structure with low Σ coincidence site lattice boundaries especially twin boundary primarily. No obvious pitting occurred in WZ, while the millimeter-scale pits were observed in HAZ and BM after immersion test in 6% FeCl3 solution. HAZ had a lower pitting potential than WZ and BM, while not much difference in pitting potential was observed between WZ and BM. Dendrite-selected corrosion occurred in WZ, while grain boundary was the preferable site for pitting corrosion in HAZ and BM. Gain refinement and a decrease in twin boundary volume fraction promoted the pitting corrosion susceptible of HAZ.