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This study aimed to examine the prevalence of deep vein thrombosis (DVT) among evacuees in Minamiaso, a village which was temporarily isolated after the earthquakes, from the acute to recovery phase after the 2016 Kumamoto Earthquakes (GLIDE no: EQ-2016-000033-JPN).
This prospective study, which was approved by Fukui University Medical Research Ethics Committee (approval no. 20160024 and 20160089), enrolled 181 evacuees (73.9 ± 11.6 y) who participated in a series of 3 DVT screenings using portable ultrasound machines conducted over 19 mo. All participants completed a questionnaire before the screenings, and none of the participants attended all 3 screenings. Data analysis was performed using EZR version 1.41.
The DVT prevalence was 14.3% (79.4 ± 8.2 y) at first screening of evacuees staying in shelters and 18.5% (71.5 ± 13.1 y) and 12.2% (72.8 ± 10.9 y) in second and third screenings of evacuees staying in temporary housing, respectively. Multivariate analysis revealed age ≥75 y and alcohol consumption as independent risk factors in the entire cohort and in patients aged ≤74 y, respectively.
A high DVT prevalence over a long time period of 19 mo was observed where survivors were temporarily isolated after the disaster.
In Japan, with the revision of the Nuclear Emergency Response Guidelines in 2015, nuclear emergency medical assistance teams responsible for the medical treatment in the acute phase of nuclear disaster have been developed nationwide. The purpose of this research is to develop active learning materials for the education of medical staff, to confirm the educational effect of the materials, and to identify the gaps in nuclear disaster risk reduction in Japan.
We established a working group and created active learning materials. We trained members of the nuclear emergency medical assistance team using the developed active learning materials and then conducted a questionnaire survey for trainees who participated in the training.
Regarding the developed teaching materials, out of 33 trainees, 33 (100%) answered “easy to understand” or “a little understandable” to the item dealing with how to use the radiation detectors and attaching/detaching personal protective equipment. Regarding the simulation about practicing hospital support and medical provision, 3 (8%) answered “a little confusing.”
The study demonstrated that the developed materials have an educational effect. Additionally, the results of the trainee questionnaire showed the necessity for improvement in the triage system and new protocols to help both the patients and responders.
Ductal patency is mandatory to manage patients with ductal-dependent pulmonary circulation. The aim of this study is to elucidate the morphological and haemodynamic features of ductus arteriosus with right ventricular outflow tract obstruction, and investigate the appropriate perinatal management.
Patients and methods
Patients with prenatal diagnosis of right ventricular outflow tract obstruction at our institution between 2010 and 2015 were included in the study. Reverse orientation of the ductus arteriosus is defined as an inferior angle of <90° at the aortic junction, and normal orientation of the ductus arteriosus as an angle of >90°. We retrospectively reviewed the shape and flow pattern of ductus arteriosus and the clinical characteristics of the cases.
A total of 39 patients were enrolled. The shape was divided into normal orientation (n=15) and reverse orientation (n=24) of the ductus arteriosus. There was no significant difference in the type of oxygen saturation at birth and age at shunt operation between both the groups. However, the median narrowest diameter of ductus arteriosus in the normal orientation group was significantly smaller than that in the reverse orientation group (2.0 [1.0–5.4] versus 3.0 [1.3–4.4] mm, p<0.05). In two patients of the normal orientation group, ductus arteriosus had closed at birth, and one of whom died because of severe cyanosis.
Normal orientation pattern might have high incidence of an early narrowing or closure of ductus arteriosus at birth. The critical patients need careful evaluation by repeated foetal echocardiography and further maternal interventions.
Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity.
SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope, cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions.
SPICA instruments offer spectral resolving power ranging from R ~50 through 11 000 in the 17–230 μm domain and R ~28.000 spectroscopy between 12 and 18 μm. SPICA will provide efficient 30–37 μm broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 μm. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of ~5 × 10−20 W m−2 (5σ/1 h)—over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
Behavioural activation is an efficient treatment for depression and can improve intrinsic motivation. Previous studies have revealed that the frontostriatal circuit is involved in intrinsic motivation; however, there are no data on how behavioural activation affects the frontostriatal circuit.
We aimed to investigate behavioural activation-related changes in the frontostriatal circuit.
Fifty-nine individuals with subthreshold depression were randomly assigned to either the intervention or non-intervention group. The intervention group received five weekly behavioural activation sessions. The participants underwent functional magnetic resonance imaging scanning on two separate occasions while performing a stopwatch task based on intrinsic motivation. We investigated changes in neural activity and functional connectivity after behavioural activation.
After behavioural activation, the intervention group had increased activation and connectivity in the frontostriatal region compared with the non-intervention group. The increased activation in the right middle frontal gyrus was correlated with an improvement of subjective sensitivity to environmental rewards.
Behavioural activation-related changes to the frontostriatal circuit advance our understanding of psychotherapy-induced improvements in the neural basis of intrinsic motivation.
We performed a far-IR imaging survey of the circumstellar dust shells of 144 evolved stars as a mission program of the AKARI infrared astronomical satellite. Our objectives were to characterize the far-IR surface brightness distributions of the cold dust component in the circumstellar dust shells. We found that (1) far-IR emission was detected from all but one object, (2) roughly 60–70 % of the target sources showed some extension, (3) 29 sources were newly resolved in the far-IR in the vicinity of the target sources, (4) the results of photometry measurements were reasonable with respect to the entries in the AKARI/FIS Bright Source Catalogue, and (5) an IR two-color diagram would place the target sources in a roughly linear distribution that may correlate with the age of the circumstellar dust shell.
We observed two proto-planetary nebulae, HD 56126 representing a source with an elliptical circumstellar shell, and IRAS 16594−4656 representing a source with a bipolar circumstellar shell, with ALMA in the 12CO and 13CO J=3−2 lines and neighboring continuum to see how the morpho-kinematics of CO gas and dust emission properties in their circumstellar environments differ.
The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008–2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0–27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49–1.66, 0.90 (0.19) and 0–6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.
We propose a new dynamic flow imaging using 320-detector row CT, and investigate the assessment of coronary flow in aneurysms of Kawasaki disease in adulthood.
Six patients with Kawasaki disease and coronary aneurysms associated (26.7 years old) and six controls were enrolled. Dynamic coronary CT angiography with 320-row CT was continuously performed at mid-diastole throughout 15–25 cardiac cycles with prospective Electrocardiogram gating after injection of contrast media. Dynamic data sets of 15–25 cycles were computed into 90–100 data sets by motion coherence image processing. Next, time–density curves for coronary arteries were calculated for all the phases. On the basis of the maximum slope method, coronary flow index was defined as the ratio of the maximum upslope of the attenuation of coronary arteries to the upslope of the attenuation of ascending aorta on the time–density curves. Coronary flow indexes for the proximal and distal sites of coronary arteries and intra-aneurysm were measured.
OBJECTIVES/SPECIFIC AIMS: Childhood obesity has become an issue of some concern worldwide. Some reviews and a recent study in adults have indicated that obesity-related inflammatory responses produce brain damage. However, studies exploring associations between inflammation and executive functions in children are overlooked. Therefore, the objective of this cross-sectional study is to determine whether difficulties in executive functions and emotional processing are associated with obesity and inflammation. METHODS/STUDY POPULATION: We have recruited 12 of a total of 60 children aged 6–8 years old. They have completed the NIH Toolbox Cognition Battery and the NEPSY II Affect Recognition tests. Samples of plasma and saliva were collected to quantify inflammatory biomarkers cytokines (IL-6 and TNF-α) assay by Luminex procedure. We performed descriptive analysis and Mann-Whitney U test to compare obese Versus nonobese groups. RESULTS/ANTICIPATED RESULTS: Obese children have lower scores in measures of affect recognition than healthy weight children. They also showed higher median scores in both salivary and plasma IL-6 and TNF-α. DISCUSSION/SIGNIFICANCE OF IMPACT: Although no statistical differences were found among groups in either measurement, these preliminary data based on the initial recruitment suggest that children with higher body mass index may have difficulties in emotional processing. More data will be available after completing recruitment to determine if the association between obesity and affect recognition is significant and if it is mediated by inflammation.
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.
After the 2011 Great East Japan Earthquake, the resource utilization of and the problems encountered with communication devices were examined.
A questionnaire survey was submitted to disaster medical assistance teams (DMATs) that were at the primary sites of destruction after the earthquake.
We collected data from 196 teams. During the first 4 days after the earthquake, the use of mobile phones, laptop computers, and landline phones was rated as poor to moderate, and satisfaction was very low, while satisfaction with satellite phones was rated as good to moderate (50%). The degree of satisfaction continued to increase gradually over time. Satellite phones, however, had several problems: poor reception, line instability, voice call use only, and inability to send large amounts of data.
To ensure effective communication during the acute phase in the aftermath of large disasters, a new satellite communication device is needed that not only is portable, battery powered, and able to send large volumes of data, but also offers stable communication. (Disaster Med Public Health Preparedness. 2014:0:1–4)
After the Great Eastern Japan Earthquake and tsunami, the World Health Organization cautioned that evacuees at shelters would be at increased risk of infectious disease transmission; however, the frequency that occurred in this population was not known.
We reviewed medical charts of evacuees who visited medical clinics at 6 shelters from March 19, to April 8, 2011. Excluded were patients who did not reside within the shelters or whose medical records lacked a name or date. We investigated the frequency of and cumulative incidences of acute respiratory infection [ARI], acute gastroenteritis, acute jaundice syndrome, scabies, measles, pertussis, and tetanus.
Of 1364 patients who visited 6 shelter clinics, 1167 patients (86.1%) were eligible for the study. The median total number of evacuees was 2545 (interquartile range [IQR], 2277-3009). ARI was the most common infectious disease; the median number of patients with ARI was 168.8 per week per 1000 evacuees (IQR, 64.5-186.1). Acute gastroenteritis was the second most common; the median number of patients was 23.7 per week per 1000 evacuees (IQR, 5.1-24.3). No other infectious diseases were observed. The median cumulative incidence of ARI per 1000 evacuees in each shelter was 13.1 person-days (IQR, 8.5–18.8). The median cumulative incidence of gastroenteritis was 1.6 person-days (IQR, 0.3–3.4).
After the Great Eastern Japan Earthquake and tsunami, outbreaks of ARI and acute gastroenteritis occurred in evacuation shelters. (Disaster Med Public Health Preparedness. 2014;0:1-7)
Milk is an effective post-exercise rehydration drink that maintains the net positive fluid balance. However, it is unclear which components are responsible for this effect. We assessed the effect of milk protein solution (MPS) obtained by dialysis on body fluid retention. Milk, MPS, milk electrolyte solution (MES), sports drink and water were administered to male Wistar rats at a dose of 6 ml/rat after treadmill exercise. Total body fluid retention was assessed by urine volume 4 h after administration of hydrating liquids. The rate of gastric emptying was evaluated by a tracer method using 13C-labelled acetate. Plasma osmolality, Na and K levels, and urinary Na and K were measured by HPLC and osmometry, respectively. The gastric emptying rate was not delayed by MPS. During 4 h of rehydration, cumulative urine volumes differed significantly between treatment groups (P < 0·05) with 4·9, 2·2 and 3·4 ml from water-, milk- and MPS-fed rats, respectively. Thus, MPS elicited 50 % of the total body fluid retention of milk. Plasma aldosterone levels were significantly higher in MPS- and milk-fed rats compared with water-fed rats. Plasma osmolality was maintained at higher levels in MPS-fed rats than in water- and MES-fed rats (P < 0·05). Cumulative urine Na excretion was also suppressed in the milk- and MPS-fed groups compared with the MES-fed group. Our results demonstrate that MPS obtained by dialysis clearly affects net body water balance without affecting gastric emptying after exercise. This effect was attributed to retention of Na and water, and maintenance of plasma osmolality.
The Great East Japan Earthquake of March 11, 2011 was a catastrophe of unprecedented proportions even for a country that is one of the most earthquake-prone in the world. The saveMLAK project, which came into being in response to this earthquake and its related disasters, comprises an online network of museums, libraries and archives, as well as kōminkan, or community centres (hence the acronym MLAK), and is the first organisation of its kind in Japan. What was the genesis of saveMLAK, and what kind of activities does it engage in? Who are saveMLAK’s participants? What needs to be done to help the saveMLAK network develop further and become even more effective in coping with future natural disasters?
Food habits of threadfin hakeling Laemonema longipes, the dominant demersal fish in the upper continental slope of the western sub-Arctic North Pacific, were described based upon >1400 specimens collected off north-eastern Honshu Island and south-eastern Hokkaido Island, Japan. Threadfin hakeling depended exclusively on pelagic organisms including copepods Neocalanus cristatus, Euphausia pacifica, shrimps Sergestes similis, firefly squid Watasenia scintillans and myctophids Diaphus theta. Threadfin hakeling showed a clear size-dependent dietary variation, with mesozooplankton and shrimps being important for small- and medium-sized fish (≤400 mm standard length (SL)), and myctophids being important for large-sized fish (>400 mm SL). Since all of these prey undertake diurnal vertical migration, it was concluded that threadfin hakeling take an important role in capturing energy and materials transported from the epipelagic zone to the bathypelagic layer over the upper continental slope. Dietary variation among different areas, seasons and depths were also examined. Of these, areal difference was rather obscure reflecting common prey field in the Tohoku and Doto areas under the prevalence of the North Pacific Intermediate Water, whereas clear seasonal difference was found in the Doto area; the 0-group of walleye pollock Theragra chalcogramma was ingested only in the late summer and early autumn in this area.
We investigate the infrared emission bands from Polycyclic Aromatic Hydrocarbons (PAHs) in Galactic planetary nebulae (PNe). PAHs in PNe are assumed to be in transition from circumstellar to interstellar PAHs. We select 15 evolved PNe taking account of effective stellar temperatures and obtain infrared spectra of PNe from AKARI (2.5–5 μm) and Spitzer (5–14 μm) observations. Their evolutionary phase is estimated using [SIV]10.51/[NeII]12.81. We find that the near-infrared PAH bands are significantly enhanced along with stellar evolution sequence. We also find that the ratio of 3.4 to 3.3 μm bands is enhanced. The enhancement might indicate some chemical processing, such as hydrogenation, on small PAHs.