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Social withdrawal, or hikikomori, is one of Japan’s most serious psychosocial issues. The concept gained international attention around 2010 and widespread psychiatric epidemiological studies have since been conducted.
With an understanding of the extensive range of hikikomori circumstances as a spectrum, we aimed to quantitatively measure the severity of hikikomori in adolescent subjects, an age group considered particularly susceptible to the condition, and to identify factors associated with its severity.
We selected population demographics, socioeconomic data, and psycho-behavioral characteristics as factors related to hikikomori and explored their associations with hikikomori severity using cross-sectional analysis. Subjects were a patient group of middle school students examined as outpatients at a psychiatric clinic during adolescence for a chief complaint of hikikomori and a control group of middle school students matched for sex and age. Subjects’ parents completed a questionnaire pertaining to their child’s hikikomori symptoms and living environment along with the Child Behavior Checklist (CBCL). The data collected was then statistically analyzed.
T-test results demonstrated that scores for all CBCL syndrome scales were significantly higher in the patient group, but no scores fell within the clinical range. Multiple regression analysis revealed that being anxious/depressed, somatic complaints, lack of communication between parents, and overuse of the Internet were statistical predictors of hikikomori severity.
It may be possible to prevent hikikomori from becoming severe if the above predictors are used to identify high-risk individuals requiring active intervention while hikikomori is at an early stage.
Children in a prodromal state manifesting as truancy or social isolation (hikikomori) often complain of problems that are physical in nature and are subject to significant changes. We developed the Child Psychosis-Risk Screening System (CPSS) that incorporates childhood psycho-behavioral characteristics revealed through a retrospective survey of schizophrenia patients into its algorithm.
Our research aimed to test the risk identification of pediatric and psychiatric clinic outpatients using the CPSS.
We conducted an epidemiological study involving 204 outpatients between the ages of 6 and 14 years who had been examined at a pediatric or psychiatric clinic using the CBCL and clinical data from medical charts. Logistic regression analysis and T-tests were performed using each clinical data variable to clarify the risk of the CPSS calculated from the CBCL data and contributing factors.
The results of the logistic regression analysis demonstrated that the diagnostic category (physical illness or DSM-5 diagnosis) and chief complaint did not contribute to differentiate between the high-risk and low-risk groups. Meanwhile, the environmental factors of “abuse” and “social isolation” did contribute to the discrimination of the two groups.
The fact that the diagnostic category during childhood does not contribute to the discrimination of the high- risk group warrants attention. It is possible that the high-risk group only had a latent endophenotype that had not yet manifested during this period. The factors suggested to have an association with the high-risk group may be reflecting activators and the dynamic state of the critical period for psychosis.
An ultra-small tactile sensor with functions of signal processing and digital communication has been prototyped based on MEMS-CMOS integration technology. The designed analog-digital mixed signal ASIC allows many tactile sensors to connect each other on a common bus line, which drastically reduces the number of wire. The ASIC capacitively detects the deformation of a force sensor and sends digital data to the common bus line when the force exceeds a threshold. The digital data contain a physical ID of each sensor, 32-bit sensing data and 16-bit cyclic redundancy check (CRC) code. In this study, a novel wafer-level integration and packaging technology were developed, and a chip-size-packaged tactile sensor with a small footprint (2.5mm×2.5mm) and a low profile (0.27mm) was prototyped and tested. The sensor autonomously sends digital data like a tactile receptor of human.
Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving procedure used to treat laryngeal cancer. However, the post-operative neoglottis tends to be variable in form and difficult to predict.
We retrospectively analysed three-dimensional images reconstructed from multidetector-row computed tomography data for 21 patients, assessing arytenoid motion and minimum neoglottic gap cross-sectional area.
While mean transverse and coronal motion was similar for bilateral and unilateral arytenoids, movement along the sagittal axis was greater for unilateral than bilateral arytenoids. The neoglottic gap during respiration was wider in patients with bilateral arytenoids, but both groups had a similar neoglottic gap during phonation.
Anterior shifting of the unilateral arytenoid plays an important role in compensating for the inability to achieve neoglottic closure. These two results demonstrate that the unilateral arytenoid alone is capable of achieving sufficient neoglottic narrowing to compensate for the resected arytenoid. Three-dimensional analysis was useful to evaluate the physiological status of the neoglottis after supracricoid laryngectomy with cricohyoidoepiglottopexy.
Supracricoid partial laryngectomy is a reliable laryngeal preservation procedure for tumour stage 2 and selected stage 3 to 4 laryngeal cancers. Of 70 patients thus treated, two (3 per cent) had ‘flaccid neoglottis’, i.e. redundant mucosa at the inner arytenoid edge which intermittently obstructed the neoglottis. We discuss the mechanism and management of this complication.
The two cases are presented. A navigation system was used to assist surgery. Neoglottal spatial alteration (specifically cross-sectional area) was assessed pre- and post-operatively using three-dimensional computed tomography. Voice was also evaluated.
Inspiratory stridor and delayed stomal closure were the main symptoms. Minimum neoglottal cross-sectional area was smaller in case one than in non-affected patients. Both patients had relatively rougher and breathier voices, but had adapted well to this.
Flaccid neoglottis is mainly due to excessive anterior retraction of residual laryngeal mucosa and to excessive mucosal pliability with age. A navigation system was useful for confirmation, but the potential for incorrect image recognition should be kept in mind. Flaccid neoglottis was treatable, with improved laryngeal function.
After the Great Hanshin-Awaji Earthquake, the disaster countermeasures concerning medical care in Japan changed drastically. In 2005, the Japanese government began to develop a domestic, rapid, medical response system called Disaster Medical Assistance Team (DMAT) for the purpose of rapid medical correspondence in the acute phase. As of 12 July 2010, 393 institutions and 734 teams (3,700 persons) were trained. A DMAT is important not only to the response to large disasters such as earthquakes, but also the response to local disasters. It is important to establish the DMAT system of each prefecture and district.
The DMAT system at the local level was described at the 15th World Congress on Disaster and Emergency Medicine. During the present Congress, the development and activities of the DMAT system over the past three years will be reported.
Results and Conclusion
Eight local districts in the DMAT system have been developed, and progress has been made in the fields of policy, operative plans, and agreement among each province. The system of inter-prefecture mutual aid must be built upon in the near future.
Supracricoid laryngectomy with cricohyoidoepiglottopexy is an organ-preserving surgical technique used to treat laryngeal cancer. This procedure resects the vocal folds; however, it is unclear how the sound source and airway morphology are involved in phonation through the post-operative neoglottis.
Multidetector helical computed tomography scanning was performed on two patients who had undergone supracricoid laryngectomy with cricohyoidoepiglottopexy. The cricoid and arytenoid cartilages and the airway were visualised using three-dimensional images.
The mobility of the arytenoid cartilages was well preserved in the one patient with bilateral arytenoids, and in the other patient with only one arytenoid remaining. Two types of airway configuration were observed during phonation: one patient had a single stream airway, while the other had a combination of several streams.
In the patient with only one arytenoid remaining, the preserved arytenoid tended to be rotated excessively inward. Therefore, phonation may have also occurred in various airways followed by mucosal vibration, which may be a sound source.
This study aimed to analyse vocal performance and to investigate the nature of the neoglottal sound source in patients who had undergone supracricoid laryngectomy with cricohyoidoepiglottopexy, using a high-speed digital imaging system.
High-speed digital imaging analysis of neoglottal kinetics was performed in two patients who had undergone supracricoid laryngectomy with cricohyoidoepiglottopexy; laryngotopography, inverse filtering analysis and multiline kymography were also undertaken.
In case one, laryngotopography demonstrated two vibrating areas: one matched with the primary (i.e. fundamental) frequency (75 Hz) and the other with the secondary frequency (150 Hz) at the neoglottis. In case two, laryngotopography showed two vibrating areas matched with the fundamental frequency (172 Hz) at the neoglottis. The interaction between the two areas was considered to be the sound source in both patients. The waveform of the estimated volume flow at the neoglottis, obtained by inverse filtering analysis, corresponded well to the neoglottal vibration patterns derived by multiline kymography. These findings indicated that the specific sites identified at the neoglottis by the present method were likely to be the sound source in each patient.
High-speed digital imaging analysis is effective in locating the sites responsible for voice production in patients who have undergone supracricoid laryngectomy with cricohyoidoepiglottopexy. This is the first study to clearly identify the neoglottal sound source in such patients, using a high-speed digital imaging system.
We succeeded in fabricating ultra-thin (<3 nm-thick) layer on top of the surface of porous low-k. The roughness of the surface of porous low-k remains homogeneous even after covering by the thin layer. Furthermore, we found that such ultra-thin layer suppresses the diffusion of metal into porous low-k film. Concerning adhesion property, the abrasion between the thin layer and copper was not detected after annealing at 350 deg C in forming gas. TVS measurement suggested that pH control of solution is the key to reduce damages of porous low-k and mobile ions. We believe that such ultra-thin layer, which we propose here, has a potential as a pore seal layer for porous low-k films.
We have performed supracricoid laryngectomy with cricohyoidoepiglottopexy or with cricohyoidopexy for tumour (T) stage T2 and T3 laryngeal cancer cases and some T4 cases. We report the clinical symptoms and management, using this technique to avoid complications.
Among patients undergoing the procedure, two cases manifested laryngeal chondritis following laryngectomy with cricohyoidoepiglottopexy. This complication was caused by C3–4 cervical osteophytes physically contacting the cricoid cartilage. Laryngeal microlaryngoscopy was performed, which revealed white, necrotic tissue in the posterior wall of the pharynx and persistent oedema of the neoglottis.
When encountering a patient with an excessive osteophyte formation at the level of C3–4, one needs to take extra precautions when undertaking laryngectomy with cricohyoidoepiglottopexy or with cricohyoidopexy.
We demonstrate that Franz-Keldysh oscillations (FKOs) observed by photoreflectance (PR) spectroscopy are highly sensitive to the surface morphology of AlxGa1−xN layers in AlxGa1−x N heterostructures. Three Al0.2Ga0.8N/GaN heterostructures with different surface-morphology profiles, which are confirmed with atomic force microscopy, have been investigated. The X-ray-diffraction patterns are hardly affected by the Al0.2Ga0.8N/GaN-layer morphology. In contrast, it is revealed that cracks and pits dominating the morphology remarkably reduce the amplitude of the FKOs from the Al0.2Ga0.8N/GaN layer, which is attributed to the following two mechanisms related to the cracks and pits. One is lifetime broadening due to carrier scattering, and the other is the suppression of the modulation magnitude for the built-in electric field, which is caused by the trapping and recombination of photogenerated carriers at the surface.
Two patients who received supracricoid laryngectomy with cricohyoidoepiglottopexy to treat laryngeal cancers, underwent intra-operative electromyography analysis. After the lesion was removed and the electrodes were inserted into the remaining intrinsic laryngeal muscles, the depth of anaesthesia was carefully reduced. Gentle tactile stimulations were applied to the pharynx to trigger the reflex movement of the remaining arytenoids. Recordings were made when reflex movement was achieved.
Case one: Electromyography (EMG) of the remaining arytenoid demonstrated clear phase differences indicating reciprocal activities between the adductor group (lateral cricoarytenoid muscle, interarytenoid muscle) and the abductor muscle (posterior cricoarytenoid muscle). Case two: EMG of the remaining arytenoid demonstrated reciprocal activities between the interarytenoid muscle and the posterior cricoarytenoid muscle. Activity of the lateral cricoarytenoid muscle was not evident because the muscle was excised during removal of the paraglottic space. Mobility of the arytenoid was attributed to interaction between the interarytenoid muscle and posterior cricoarytenoid muscle. Reciprocal interaction between the interarytenoid muscle and posterior cricoarytenoid muscle alone is also capable of maintaining post-operative laryngeal functions after supracricoid laryngectomy with cricohyoidoepiglottopexy.
It is shown for the first time that the gradient diffusion hypothesis often adopted for thermal dispersion heat flux in heat transfer within porous media can be derived from a transport equation for the thermal dispersion heat flux based on the Navier–Stokes and energy equations. The transport equation valid for both thermal equilibrium and non-equilibrium cases is mathematically modelled so that all unknown spatial correlation terms, associated with redistribution and dissipation of the dispersion heat flux, are expressed in terms of determinable variables. The unknown coefficients are determined analytically by considering of macroscopically unidirectional flow through a tube as treated by Taylor. Taylor's expression for the dispersion has been generated from the transport equation. Both laminar and turbulent flow cases are investigated to obtain two distinct limiting expressions for low- and high-Péclet-number regimes. The results obtained for the Taylor diffusion problem are translated to the case of heat and fluid flow in a packed bed, to obtain the corresponding expressions for the axial dispersion coefficient in a packed bed. The resulting expression for the high-Péclet-number case agrees well with the empirical formula, validating of the present transport analysis.
The on/off ratio of the vertical-type metal-base organic transistors was drastically improved by heat treatment in air. The heat treatment after deposition of the collector layer and base electrode reduced the leakage current between the base and collector, resulting in remarkable suppression of the off current. As a result, in addition to the advantage of low voltage and high current operation based on the vertical structure, very high on/off ratio exceeding 105 was achieved.
A process for the fabrication of textured Ba2CuO3 material with a microstructure similar to that of melt-processed YBa2Cu3Oy (Y123) superconductor is discussed. The Ba2CuO3 samples were melt processed with the intent to use them as textured precursors for processing of HgBa2CuOy superconductor. The microstructure formation of the Ba2CuO3 phase was studied by observing the samples being quenched from intermediate stages of a melt growth schedule. The microstructure of melt-processed Ba2CuO3 reveals randomly oriented large-sized grains, similar to that of melt textured Y123. Other important microstructural features observed were finely distributed properitectic BaO particles, the absence of the platelet gaps within the domains, and the presence of a different kind of twin structure. The conversion of melt textured Ba2CuO3 into superconducting HgBa2CuOy phase by a two-step process is discussed.
We have developed a well-controlled method for manipulating carbon nanotubes. The first crucial process involved is to prepare a nanotube array, named nanotube cartridge. We have found the ac electrophoresis of nanotubes by which nanotubes are aligned at the knife-edge. The nanotubes used were multiwalled and prepared by an arc discharge with a relatively high gas temperature. The second important process is to transfer a nanotube from the nanotube cartridge onto a substrate in a scanning electron microscope. Using this method, we have developed nanotube tips and nanotube tweezers that operate in a scanning probe microscope. The nanotube probes have been applied for observation of biological samples and industrial samples to clarify their advantages. The nanotube tweezers have demonstrated their motion in scanning-electron-microscope and operated to carry nanomaterials in a scanning probe microscope.
A single crystalline Bi2Sr2CaCu2O8+8 which has columnar defects in its inside are observed by Lorentz microscopy using the newly developed 1-MV field emission electron microscope at the first time. The superconducting vortices are observed with higher contrast than ever. Simultaneous observation of vortices and columnar defect is succeeded in real time.