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The aim of this study is to reveal the characteristics and outcomes of patients injured in a major earthquake and who were transported to a hospital by ambulance.
Methods:
This study was a retrospective descriptive epidemiological study including all patients who were injured after a major earthquake struck Osaka Prefecture on June 18, 2018, and were transported to a hospital by ambulance. The main outcome was the prognosis at each hospital’s emergency department.
Results:
In total, 214 patients were included in the analysis. Their median age was 74 years (IQR, 54-82); 53 (24.8%) were men and 161 (75.2%) were women. The median time from ambulance call to arrival at the scene was 10 min (IQR, 7-15), and the median time from ambulance call to the hospital arrival was 37 min (IQR, 30-51). Ninety-seven patients (45.3%) were admitted to a hospital, 114 patients (53.3%) were discharged home to and from the emergency department, and 3 patients (1.4%) died. Among the patients discharged to home from the emergency department, the most common pathological condition was head bruising in 16 patients.
Conclusions:
This study revealed the profile of injured patients transported by ambulances after an earthquake that struck an aging society.
Imagery rescripting (IR) for early aversive memories in patients with social anxiety disorder (SAD) has shown promising results, but no study has investigated the reactions and perspectives of patients who received IR.
Aims:
This study aimed to gain understanding of patients’ experiences/perspectives on IR as an adjunct to cognitive behavioural therapy (CBT) for SAD.
Method:
Twenty-five individuals with SAD received one or two sessions of IR over 16 CBT sessions. Contents of recurrent images and linked memories were identified during IR. Outcome measures included social anxiety, image and memory distress and vividness, and encapsulated belief. Patients completed a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyse the qualitative data.
Results:
IR resulted in significant within-session improvement in most outcome measures. Linked memories to negative recurrent images in social situations were categorized into nine groups. Common memories were ‘Being criticized by others’, ‘Being made fun of’, ‘Failing or not doing something well’ and ‘Being left out in a group’. Most patients (82%) experienced IR as impressive, and more than half of patients (59%) found IR effective. Themes of reasons of impressiveness and effectiveness were categorized as ‘Results of IR session’ and ‘Processes of IR session’. The theme ‘Results of IR session’ included six subthemes, and the theme ‘Processes of the IR session’ included five subthemes.
Conclusions:
Regarding patients’ perspectives, although they may experience negative emotions in the process of an IR session, our results suggest that many patients with SAD found IR sessions effective.
There is an extensive literature discussing how individuals’ marriage behavior changes as a country develops. However, no existing data set allows an explicit investigation of the relationship between marriage and economic development. In this paper, we construct new cross-country panel data on marital statistics for 16 OECD countries from 1900 to 2000, in order to analyze such a relationship. We use this data set, together with cross-country data on real GDP per capita and the value added share of agriculture, manufacturing, and services sectors, to document two novel stylized facts. First, the fraction of a country’s population that is married displays a hump-shaped relationship with the level of real GDP per capita. Second, the fraction of the married correlates positively with the share of manufacturing in GDP. We conclude that the stage of economic development of a country is a key factor that affects individuals’ family formation decisions.
Physicians are key disaster responders in foreign medical teams (FMTs) that provide medical relief to affected people. However, few studies have examined the skills required for physicians in real, international, disaster-response situations.
Problem
The objectives of this study were to survey the primary skills required for physicians from a Japanese FMT and to examine whether there were differences in the frequencies of performed skills according to demographic characteristics, previous experience, and dispatch situations to guide future training and certification programs.
Methods
This cross-sectional survey used a self-administered questionnaire given to 64 physicians with international disaster-response site experience. The questionnaire assessed demographic characteristics (sex, age, years of experience as a physician, affiliation, and specialty), previous experience (domestic disaster-relief experience, international disaster-relief experience, or disaster medicine training experience), and dispatch situation (length of dispatch, post-disaster phase, disaster type, and place of dispatch). In addition, the frequencies of 42 performed skills were assessed via a five-point Likert scale. Descriptive statistics were used to assess the participants’ characteristics and total scores as the frequencies of performed skills. Mean scores for surgical skills, health care-related skills, public health skills, and management and coordination skills were compared according to the demographic characteristics, previous experience, and dispatch situations.
Results
Fifty-two valid questionnaires (81.3% response rate) were collected. There was a trend toward higher skill scores among those who had more previous international disaster-relief experience (P=.03). The more disaster medicine training experience the participants had, the higher their skill score was (P<.001). Physicians reported involvement in 23 disaster-relief response skills, nine of which were performed frequently. There was a trend toward higher scores for surgical skills, health care-related skills, and management and coordination skills related to more disaster medicine training experience.
Conclusion
This study’s findings can be used as evidence to boost the frequency of physicians’ performed skills by promoting previous experience with international disaster relief and disaster medicine training. Additionally, these results may contribute to enhancing the quality of medical practice in the international disaster relief and disaster training curricula.
NoguchiN,
InoueS,
ShimanoeC,
ShibayamaK,
MatsunagaH,
TanakaS,
IshibashiA,
ShinchiK. What Kinds of Skills Are Necessary for Physicians Involved in International Disaster Response?Prehosp Disaster Med. 2016;31(4):397–406.
A growing body of evidence from Western countries shows that infant feeding practices are associated with later childhood dietary habits, but little is known about these relationships in non-Western countries with different food cultures. We examined the association of breast-feeding duration and age at introduction of solid foods with later intake of fruit and vegetables among Japanese toddlers.
Design
Information on breast-feeding duration, age at introduction of solid foods and child’s intake frequency of fruit and vegetables were collected with a self-administered questionnaire at 16–24 months postpartum. Logistic regression analysis was used to calculate odds ratios of low intake (<1 time/d) of fruit or vegetables for each infant feeding practice.
Setting
Japan.
Subjects
Japanese mother–child pairs (n 763) from a prospective birth cohort study.
Results
Neither breast-feeding duration nor age at introduction of solid foods was associated with fruit intake at 16–24 months of age. Breast-feeding duration, but not age at introduction of solid foods, was associated with later intake of vegetables. When breast-feeding duration was categorized into two groups with the cut-off at 6 months, children who were breast-fed for ≥6 months had a significantly decreased risk of low intake of vegetables (OR=0·53; 95 % CI 0·34, 0·84) than those breast-fed for <6 months. This association was independent of potential confounders including maternal education and maternal vegetable intake (OR=0·59; 95 % CI 0·36, 0·97).
Conclusions
This finding suggests that ≥6 months of breast-feeding may prevent low intake of vegetables in early childhood among Japanese toddlers.
Employing the Kolodner–Coffman method, we show the exact multiplicity of positive solutions for the one-dimensional p-Laplacian that is subject to a Dirichlet boundary condition with a positive convex nonlinearity and an indefinite weight function.
We recently showed that social encounter stimulation induces hyperactivity in mice reared in social isolation from early life and this is associated with the transient activation of prefrontal dopaminergic and serotonergic systems. In the present study, we examined the effect of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) receptor antagonist 2, 3-dioxo-6-nitro-1, 2, 3, 4-tetrahydrobenzo[f]quinoxaline-7-sulfonamide (NBQX) on encounter-induced behavioural and neurochemical changes to study the role of the receptor in abnormal behaviours in isolation-reared mice. The encounter to an intruder mouse induced hyperactivity with transient increases in prefrontal dopamine and serotonin levels in isolation-reared mice. NBQX attenuated the encounter-induced hyperactivity and the associated neurochemical changes in isolation-reared mice. In addition, NBQX reduced aggressive behaviour and cognitive impairment in isolation-reared mice, but did not affect depressive-like behaviour or spontaneous hyper-locomotion in these animals. The AMPA receptor agonist (S)-AMPA increased prefrontal dopamine and serotonin release, and this effect was higher in isolation-reared mice than in the group-reared mice, suggesting higher prefrontal AMPA receptor activity in isolation-reared mice. Furthermore, isolation rearing increased the expression of AMPA receptor subunits (GluR1, GluR2 and GluR3) and GluR1 Ser845 phosphorylation in the prefrontal cortex, but not in the hippocampus or nucleus accumbens. Taken together, these results suggest that an increase in AMPA receptor activity in the prefrontal cortex contributes to some, but not all, abnormal behaviours in isolation-reared mice.
CrB2 possess the hexagonal AlB2 structure which belongs to the spacegroup of P6/mmm. The compound exhibits para- to antiferro-magnetic transition at about 88 K. By using a macroscopic measurement technique, that is, a conventional resonant ultrasound spectroscopy (RUS) with a millimeter size mono-crystal, significant elastic anomalies have been observed just above the magnetic transition temperature. On the other hand, elastic constants determined by a microscopic measurement technique, that is, an inelastic X-ray scattering method (BL35XU of SPring-8, Japan) do not show any elastic anomalies at around the transition temperature. In order to explain the discrepancy, we have introduced a kind of so called ΔE effect resulting from a multidomain structure. If crystal lattice is slightly deformed by a spontaneous magnetostriction in the antiferromagnetic state, the symmetry of crystal lattice is lowered from hexagonal to monoclinic when the symmetry of magnetic structure is taken into account. By the lowering of the symmetry, the crystal consists of six magnetic domains in the antiferro magnetic state. If magnetic domain boundaries move in response to externally applied stresses, the mechanical deformation is absorbed by nonelastic deformations induced by the movement of magnetic domain boundaries. This multidomain model well explains the experimental results obtained by both microscopic (X-ray) and macroscopic (ultrasound) measurements. The microscopic measurement technique is useful to obtain the true elastic properties of crystal lattice without effects coming from a multidomain structure.
Collagen fibril membranes (CFMs) with a high mechanical property were
fabricated with a lateral face evaporation method, in which type I
atelocollagen extracted from tilapia scales was used. The density and
thickness of the CFM obtained were 0.51 ± 0.04 mg/cm3 and 50 ± 5
μm. The collagen fibrils in the CFM had a similar periodic stripped pattern
of 67 nm with native collagen fibrils. The CFM was crosslinked in gaseous
glutaraldehyde for different duration in order to increase the mechanical
property. The crosslinking degrees of the CFMs analyzed by free amino groups
gradually increased to 70.3 % against the exposure duration until 6 hours,
and reached a plateau. The denaturation temperatures of the CFMs with the
crosslinking degrees at 20.4 % to 43% were linearly increased from 49°C to
75°C. The tensile strength of the CFMs was slightly improved until the
crosslinking degree at 33.3 % and then the tensile strength rapidly
increased to be 68 MPa. It was suggested that a percolation phenomenon took
place in the CFMs by crosslinking of collagen fibrils with polymerized GA
molecules.
This paper considers the magnitude of the gripping power, i.e., the internal force that depends on the grasping posture or object orientation in a two-dimensional grasp by two contact points with friction. Expressing the effect of variations in the object posture as the direction of an external force, we propose an “internal force diagram.” The internal force necessary to create a statically stable grasp is depicted in the object coordinate frame. Then, a polar coordinate system is introduced in which the orientation represents the direction of the external force, while the distance from the origin represents the minimum necessary internal force. We demonstrate a method based on friction cone configurations to manually draw the internal force diagram, using only a ruler and a compass. The validity of this drawing method is confirmed by a comparison with computer-generated plots. Finally, the characteristics of the internal force diagram are discussed.
Maternal nutritional status during pregnancy is an important determinant of fetal growth. Although the effects of several nutrients and foods have been well examined, little is known about the relationship of overall maternal diet in pregnancy to fetal growth, particularly in non-Western populations. We prospectively examined the relationship of maternal dietary patterns in pregnancy to neonatal anthropometric measurements at birth and risk of small-for-gestational-age (SGA) birth among 803 Japanese women with live-born, singleton, term deliveries. Maternal diet in pregnancy was assessed using a validated, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups (g/4184 kJ) were extracted by cluster analysis. The following three dietary patterns were identified: the ‘meat and eggs’ (n 326), ‘wheat products’, with a relatively high intake of bread, confectioneries and soft drinks (n 303), and ‘rice, fish and vegetables’ (n 174) patterns. After adjustment for potential confounders, women in the ‘wheat products’ pattern had infants with the significantly lowest birth weight (P = 0·045) and head circumference (P = 0·036) among those in the three dietary patterns. Compared with women in the ‘rice, fish and vegetables’ pattern, women in the ‘wheat products’ pattern had higher odds of having a SGA infant for weight (multivariate OR 5·2, 95 % CI 1·1, 24·4), but this was not the case for birth length or head circumference. These results suggest that a diet high in bread, confectioneries, and soft drinks and low in fish and vegetables during pregnancy might be associated with a small birth weight and an increased risk of having a SGA infant.
The effects of water vapor and oxygen on the cyclic fatigue behavior of oxygen-excess La0.8Sr0.2MnO3+δ (LSM) were investigated under three-point bending at 1273 K. Because the fatigue life did not obviously depend on the number of cycles, which also represented the effective time of the applied stress, the fracture was presumed to not be significantly controlled by stress-corrosion cracking. Under a low oxygen partial pressure (), however, wet exposure inhibited both fatigue fracture and permanent deformation, in which the LSM crystal lattice was distorted and the unit cell free volume was reduced. Under a high , on the contrary, the crystal symmetry was increased by the wet exposure. The inhibition of fatigue fracture and deformation at both high and low was probably caused by retardation of lanthanum diffusion through its vacancies.
Although several nutrients and foods are suggested to be preventive against postpartum depression, all previous studies have primarily focused on single nutrients or foods. In contrast, studies on dietary patterns, namely the measurement of overall diet by considering the cumulative effects of nutrient, may provide new insights into the influence of diet on postpartum depression. We prospectively examined the association between dietary patterns during pregnancy and the risk of postpartum depression among 865 Japanese women. Diet was assessed with a validated, self-administered diet history questionnaire. Dietary patterns from thirty-three predefined food groups (energy-adjusted food (g/d)) were extracted by factor analysis. Postpartum depression was defined as present when the subjects had an Edinburgh Postnatal Depression Scale score of ≥ 9 at 2–9 months postpartum. A total of 121 women (14·0 %) were classified as having postpartum depression. Three dietary patterns were identified: ‘Healthy’, ‘Western’ and ‘Japanese’ patterns. After adjustment for potential confounders, neither the ‘Healthy’ nor the ‘Japanese’ pattern was related to the risk of postpartum depression. Compared with the first quartile of the ‘Western’ pattern, only the second quartile was independently related to a decreased risk of postpartum depression (multivariate OR 0·52, 95 % CI 0·30, 0·93), although no evident exposure–response associations were observed (P for trend = 0·36). The present study failed to substantiate clear associations between dietary patterns and the risk of postpartum depression. Further studies with more accurate measurements are warranted to confirm the relationship between dietary patterns and the risk of postpartum depression.
To examine the adequacy and inadequacy of dietary patterns in pregnant women for which information is absolutely lacking.
Design
Diet was assessed by a validated, self-administered diet history questionnaire (DHQ). Dietary patterns were extracted from the intake of thirty-three food groups (g/4184 kJ (1000 kcal)), which were summarized from 147 foods assessed with the DHQ, by cluster analysis. Nutritional inadequacy for selected twenty nutrients in each dietary pattern was examined using the reference values given in the Dietary Reference Intakes (DRI) for Japanese as the temporal gold standard.
Setting
Japan.
Subjects
Nine hundred and ninety-seven pregnant Japanese women aged 18–43 years.
Results
The three dietary patterns identified were labelled as ‘meat and eggs’ (n 423), ‘wheat products’ (n 371) and ‘rice, fish and vegetables’ (n 203). The ‘rice, fish and vegetables’ pattern characterized by high intake of rice, vegetables, potatoes, pulses, fruits, seaweed, fish and miso soup showed significantly the lowest prevalence of inadequate intake for fifteen nutrients and significantly the highest prevalence of inadequate sodium intake. In contrast, the ‘wheat products’ pattern characterized by high intake of bread, noodles, confectioneries and soft drinks showed the highest prevalence of inadequate intake for fourteen nutrients. The median number of nutrients not meeting the DRI as a marker of overall nutritional inadequacy was eight in the ‘rice, fish and vegetables’ pattern. It was significantly lower at ten in the ‘meat and eggs’ and eleven in the ‘wheat products’ patterns (P < 0·001).
Conclusions
In pregnant Japanese women, the dietary pattern high in rice, fish, vegetables, fruit and some others showed a better profile of nutritional adequacy except for sodium.
Increased homocysteine levels might accelerate dopaminergic cell death in Parkinson's disease (PD) through neurotoxic effects; thus, increasing intake of B vitamins involved in the regulation of homocysteine metabolism might decrease the risk of PD through decreasing plasma homocysteine. However, epidemiological evidence for the association of dietary B vitamins with PD is sparse, particularly in non-Western populations. We conducted a hospital-based case–control study in Japan to examine associations between dietary intake of folate, vitamin B6, vitamin B12 and riboflavin and the risk of PD. Patients with PD diagnosed using the UK PD Society Brain Bank criteria (n 249) and controls without neurodegenerative diseases (n 368) were recruited. Dietary intake during the preceding month was assessed at the time of study recruitment using a validated, self-administered, semi-quantitative, comprehensive diet history questionnaire. After adjustment for potential dietary and non-dietary confounding factors, intake of folate, vitamin B12 and riboflavin was not associated with the risk of PD (P for trend = 0·87, 0·70 and 0·11, respectively). However, low intake of vitamin B6 was associated with an increased risk of PD, independent of potential dietary and non-dietary confounders. Multivariate OR (95 % CI) for PD in the first, second, third and fourth quartiles of vitamin B6 were 1 (reference), 0·56 (0·33, 0·94), 0·69 (0·38, 1·25) and 0·48 (0·23, 0·99), respectively (P for trend = 0·10). In conclusion, in the present case–control study in Japan, low intake of vitamin B6, but not of folate, vitamin B12 or riboflavin, was independently associated with an increased risk of PD.
is considered, where B = {x ∈ ℝN : |x| < 1}, N ≥ 3, p > 1, K ∈ C2[0, 1] and K(r) > 0 for 0 ≤ r ≤ 1. A sufficient condition is derived for the uniqueness of radial solutions of (*) possessing exactly k − 1 nodes, where k ∈ ℕ. It is also shown that there exists K ∈ C∞[0, 1] such that (*) has at least three radial solutions possessing exactly k − 1 nodes, in the case 1 < p < (N + 2)/(N − 2).
Buckling of arc discharge made multi-walled carbon nanotubes with various lengths was studied by alternating the length of a multi-walled nanotube by intermittent cutting. Buckling stresses were determined by measuring force-distance curves employing an atomic force microscope and the values were compared with those expected from the Euler's theoretical model. As the length of a nanotube was shortened, its buckling mode changed from elastic compressive bending with Young's modulus of 1.2TPa, to inelastic compressive fracture. The inelastic behavior observed for short nanotubes can be attributed to the buckling mechanism, in which ripple-like distortions develop along the nanotube sidewalls.
We report the preparation and thermoelectric properties of oriented higher manganese silicide (HMS) with a composition of MnSi1.73 bulk. The grain alignment and densification were achieved by rotating high magnetic field and spark plasma sintering (SPS) techniques, respectively. The easy magnetization axis of MnSi1.73 was found to be c-axis, and the applied magnetic field of 2 T was strong enough to rotate the powder with a mean grain size of 1 μm. The c-axis of grains was oriented when applying the magnetic field, and the degree of orientation was further increased after heat treatment. However, a secondary phase that was mono manganese silicide (MnSi) was observed as a result of oxidation on the surface of synthesized powder. The electrical conductivity of the c-axis oriented specimen along the ab-plane was about 40% larger than that for sample processed only by SPS, while the Seebeck coefficient of oriented and nonoriented specimens showed similar values regardless of existence of the second phase. Consequently, the power factor of the c-axis oriented specimen along the ab-plane was enhanced by about 35% compared to the nonoriented one. The proposed approach is found to be very effective not only in obtaining the oriented materials with nonductility but also in enhancing the thermoelectricity.