The “Community-based Integrated Care System” and Discourse Ethics – From the Viewpoint of Autonomy and Solidarity –

Since the establishment of the Long-term Care Insurance System in 2000, the promotion of the Community-based Integrated Care System has been promoted. The policy of the Long-term Care Insurance System sets in-home care services before reducing the economic burden in this country. However, this idea is not used in the latest report. The policy that individuals requiring care and terminal stage patients be sent into a large-scale accommodation in a depopulated area and live there until they die, is not adopted because of the belief or philosophy of the foundation of respect for dignity. In this study, I discuss the problems of the core concepts of the community-based integrated care system; we reconsider these problems from the standpoint of discourse ethics, which considers autonomy and solidarity as equal fundamental principles

The Community-based Integrated Care System in the Context of the Novel Coronavirus disease (COVID-19) Pandemic

Abstract Since the establishment of the Long-term Care Insurance System in 2000, the promotion of the Community-based Integrated Care System has been advocated in COVID-19 Pandemic. But H30 Research Report on Community-based Integrated Care expects mutual aid based on self-help, while accepting economic and health disparities on the ground of inevitable disparities . We will discuss the Community-based Integrated Care System in the era of emerging viruses with a view to infectious disease pandemics such as the novel coronavirus pandemic in relation to the significance and prospects of ACP (Advance Care Planning)

NMR Analysis of Poly(Lactic Acid) via Statistical Models

The physical properties of poly(lactic acid) (PLA) are influenced by its stereoregularity and stereosequence distribution, and its polymer stereochemistry can be effectively studied by NMR spectroscopy. In previously published NMR studies of PLA tacticity, the NMR data were fitted to pair-addition Bernoullian models. In this work, we prepared several PLA samples with a tin catalyst at different L,L-lactide and D,D-lactide ratios. Upon analysis of the tetrad intensities with the pair-addition Bernoullian model, we found substantial deviations between observed and calculated intensities due to the presence of transesterification and racemization during the polymerization processes. We formulated a two-state (pair-addition Bernoullian and single-addition Bernoullian) model, and it gave a better fit to the observed data. The use of the two-state model provides a quantitative measure of the extent of transesterification and racemization, and potentially yields useful information on the polymerization mechanism

Microstructure-resolved degradation simulation of lithium-ion batteries in space applications

In-orbit satellite REIMEI, developed by the Japan Aerospace Exploration Agency, has been relying on off-the-shelf Li-ion batteries since its launch in 2005. The performance and durability of Li-ion batteries is impacted by various degradation mechanisms, one of which is the growth of the solid-electrolyte interphase (SEI). In this article, we analyse the REIMEI battery and parameterize a full-cell model with electrochemical cycling data, computer tomography images, and capacity fading experiments using image processing and surrogate optimization. We integrate a recent model for SEI growth into a full-cell model and simulate the degradation of batteries during cycling. To validate our model, we use experimental and in-flight data of the satellite batteries. Our combination of SEI growth model and microstructure-resolved 3D simulation shows, for the first time, experimentally observed inhomogeneities in the SEI thickness throughout the negative electrode for the degraded cell

Metastatic skull tumors: MRI features and a new conventional classification

Skull metastases are malignant bone tumors which are increasing in incidence. The objectives of this study were to characterize the MR imaging features, locations, and extent of metastatic skull tumors to determine the frequency of the symptomatic disease, and to assess patient outcomes. Between September 2002 and March 2008, 175 patients undergoing routine head MR imaging were found to have metastatic skull tumors. Contrast-enhanced study with fat suppression was used in some cases when required. Classification of metastases was simplified to three yes/no questions: first, with regard to location (either in the calvarium or in the cranial base); second, with regard to distribution within the plane of the cranial bone (either “circumscribed” meaning clearly demarcated and confined to one bone, or “diffuse” and likely to spread across a suture to another bone); and third, with regard to invasion (“intraosseous” in cranial bones only, or “invasive” spreading from the skull, either out into the scalp or inward to the dura and perhaps further in). Primary sites were breast cancer (55%), lung cancer (14%), prostate cancer (6%), malignant lymphoma (5%), and others (20%). The mean time from primary diagnosis to skull metastasis diagnosis was 71 months for cases of breast cancer, 26 months for prostate cancer, 9 months for lung cancer, and 4 months for malignant lymphoma. Calvarial circumscribed intraosseous metastases were found most frequently (27%). The patients were mainly asymptomatic. However, some patients suffered from local pain or cranial nerve palsies that harmed their quality of life. Treatment, mainly for symptomatic cases, was by local or whole-skull irradiation. Metastatic skull tumors are not rare, and most are calvarial circumscribed intraosseous tumors. MR images contribute to understanding their type, location, and multiplicity, and their relationship to the brain, cranial nerves, and dural sinuses. Radiation therapy improved the QOL of patients with neurological symptoms