A Study on the Base of Educational Management in Community to Support Home Education

The purpose of this study is to demonstrate what kind of function OKATO pursued in the Kominkan as the base of Educational Management in Community. The following 2 results were obtained through this study. Firstly, in addition to the conventional functions of “gathering”, “learning”, and “connecting”, OKATO (1997) found 5 functions in the Kominkan: ① Communication adjustment between facilities which offer education and learning in the area, ② Function to propel networking of education-related businesses, ③ Function as a learning information center, ④ Function to provide learning consultation, and ⑤ Function as the base of "Community Educational Management" where residents can manage autonomous learning for their lives. Secondly, the following five conditions should be included in the base of Educational Management in Community according to OKATO’s theory :　A) It should be a place residents are familiar with, centrally-located and with good traffic connections in the everyday life sphere, B) It should have sufficient facilities and equipment to offer education and learning, C) There is staff to encourage the learning of residents, D) It has been provided educational content to attract people, and E) It has a function that communicates with residents and reflects their will in management

Experimental Investigation of Static Channel Bonding Performance in Competitive Environment －Impact of Different MAC Procedures in 802.11ac－

Channel bonding technology, which bundles multiple adjacent channels for frame transmission, is one of the promising way for improving throughput performance in IEEE802.11ac wireless LANs. However, channel bonding technology leads to co-channel interference with other access points (APs) within the bonded channels. In our previous study, we investigated transmission performance of several commercially-available 802.11ac APs. As a result, we clarified three communication procedures from difference in method of implementation of Request To Send (RTS) / Clear To Send (CTS) or not. Furthermore, we investigated the impact of RTS/CTS on transmission performance by conducting experiments where two APs using RTS/CTS are competing in a bonded channels. However, we have not investigated transmission performance in the case that APs with different transmission procedures compete with each other in a bonded channels. Therefore, in this study, we conducted experiments using real WLAN products. Then, we compared and evaluated the communication performance in the case that two APs with different transmission procedures compete in the same channel. As a result, we showed that the AP employing CTS-to-self doesn’t set duration time in CTS frames, thereby the communication performance of the AP using RTS/CTS in channel bonding degrades due to frequent collisions in conflict channel. On the other hand, since AP not using RTS/CTS dynamically adjusts the number of data frames for each transmission opportunity to avoid frame collisions, we confirmed that the communication performance can be relatively maintained even under the competitive environment. / IEEE802.11ac規格の通信高速化技術の一つに、隣接する複数のチャネルをまとめて利用するチャネルボンディング機能がある。しかし、通信帯域が拡大するため他の無線LAN機器と競合しやすくなってしまう。先行研究では、競合しない環境の単一のAPの通信性能を調査し、オプション機能のRequest To Send (RTS) / Clear To Send (CTS)の実装方法の違いから3パターンの通信手順があることを明らかにしたうえで、RTS/CTS利用の有無が競合時に性能に与える影響を調査した。しかし、CTS-to-Selfによる競合時の影響は未だ明らかになっていない。そこで本研究では、実機を用いた実験を行い、CTS-to-Selfによる競合時の通信性能を調査するとともに、3パターンの通信手順の競合時における各通信性能の比較および評価を行った。その結果、CTS-to-selfによる通信手順ではNAV期間が確保できていないためフレーム衝突が起こりやすく、RTS/CTSを利用しチャネルボンディングさせていたAPに悪影響を与えていた。それに対して、RTS/CTSを利用しないAPは、送信機会毎のデータフレーム数を調節しながら通信していたためフレーム衝突が起こりにくく、お互いの通信性能への影響が低減されていることがわかった。電子情報通信学会 スマート無線研究会（SR）, 2018年10月30日-31日, Bangkok, Thailan

A Study of Leadership Required for Young Researcher

The objective of this paper is to investigate the leadership of young researchers. In recent years, career formation support for young researchers is being developed. In this research, to support young researchers' various career options, interview was conducted to 15 active leaders across different fields and ages. We asked questions about 1) attitudes and behaviors necessary for leaders, 2) abilities that helped to take on the current leading position, and 3) ability required for young researchers. The responses from the interview can be summarized as "the necessary attitude and behavior", "the useful skill", and "the required condition." Among all these responses, common ideas such as "the mission and vision", "the humility", and "the foundation of inter-personal relationship" can be pointed out in this research

Trends and Issues of Child-rearing Support Measures in Japan

本研究は，平成30年度サタケ基金助成金の助成を受けて，共同研究「ネウボラを拠点とした継続的な家庭教育支援に関する研究－広島県東広島市の事例を中心に－」（代表者 : 藤井瞳）の一環として行いました

A Comparison of the Efficacy of Plastic Stent Placement Above and Across the Sphincter of Oddi for Benign Biliary Hilar Stricture

We investigated the efficacy and safety of endoscopic plastic stent (PS) placement for hilar benign biliary strictures (BBSs) and compared cases with PS placement above (inside stent, IS) and across (usual stent, US) the sphincter of Oddi. Patients who underwent initial endoscopic PS placement for hilar BBSs between August 2012 and December 2021 were retrospectively analyzed. Hilar BBSs in 88 patients were investigated. Clinical success was achieved in 81 of these cases (92.0%), including 38 patients in the IS group and 43 patients in the US group. Unexpected stent exchange (uSE) before the first scheduled PS exchange occurred in 18 cases (22.2%). The median time from first stent placement to uSE was 35 days. There was no significant difference in the rate and median time to uSE between the two groups. The rates of adverse events such as pancreatitis or cholangitis in the two groups did not significantly differ. However, the rate of difficult stent removal in the IS group (15.8%) was significantly higher than that in the US group (0%) (p=0.0019). US placement is preferable to IS placement for scheduled stent exchange, as it offers the same effectiveness and risk of adverse events with easier stent removal

HbA1c and telemedicine during COVID-19

Aims/Introduction: To investigate whether the COVID-19 pandemic affected behavioral changes and glycemic control in patients with diabetes and to conduct a survey of telemedicine during the pandemic. Materials and Methods: In this retrospective study, a total of 2,348 patients were included from 15 medical facilities. Patients were surveyed about their lifestyle changes and attitudes toward telemedicine. Hemoglobin A1c (HbA1c) levels were compared among before (from June 1 to August 31, 2019) and in the first (from June 1 to August 31, 2020) and in the second (from June 1 to August 31, 2021) year of the pandemic. A survey of physician attitudes toward telemedicine was also conducted. Results: The HbA1c levels were comparable between 2019 (7.27 ± 0.97%), 2020 (7.28 ± 0.92%), and 2021 (7.25 ± 0.94%) without statistical difference between each of those 3 years. Prescriptions for diabetes medications increased during the period. The frequency of eating out was drastically reduced (51.7% in 2019; 30.1% in 2020), and physical activity decreased during the pandemic (48.1% in 2019; 41.4% in 2020; 43.3% in 2021). Both patients and physicians cited increased convenience and reduced risk of infection as their expectations for telemedicine, while the lack of physician–patient interaction and the impossibility of consultation and examination were cited as sources of concern. Conclusions: Our data suggest that glycemic control did not deteriorate during the COVID-19 pandemic with appropriate intensification of diabetes treatment in patients with diabetes who continued to attend specialized diabetes care facilities, and that patients and physicians shared the same expectations and concerns about telemedicine

Cognitive behavioral therapy with interoceptive exposure and complementary video materials for irritable bowel syndrome (IBS): protocol for a multicenter randomized controlled trial in Japan

BackgroundThere is growing evidence of the treatment efficacy of cognitive behavioral therapy (CBT) for irritable bowel syndrome (IBS). CBT is recommended by several practice guidelines for patients with IBS if lifestyle advice or pharmacotherapy has been ineffective. Manual-based CBT using interoceptive exposure (IE), which focuses on the anxiety response to abdominal symptoms, has been reported to be more effective than other types of CBT. One flaw of CBT use in general practice is that it is time and effort consuming for therapists. Therefore, we developed a set of complementary video materials that include psycho-education and homework instructions for CBT patients, reducing time spent in face-to-face sessions while maintaining treatment effects. The purpose of this study is to examine the effects of CBT-IE with complementary video materials (CBT-IE-w/vid) in a multicenter randomized controlled trial (RCT).MethodsThis study will be a multicenter, parallel-design RCT. Participants diagnosed with IBS according to the Rome IV diagnostic criteria will be randomized to either the treatment as usual (TAU) group or the CBT-IE-w/vid + TAU group. CBT-IE-w/vid consists of 10 sessions (approximately 30 min face-to-face therapy + viewing a video prior to each session). Patients in the CBT-IE-w/vid group will be instructed to pre- view 3- to 13-min videos at home prior to each face-to-face therapy visit at a hospital. The primary outcome is the severity of IBS symptoms. All participants will be assessed at baseline, mid-treatment, post-treatment, and follow-up (3 months after post assessment). The sample will include 60 participants in each group.DiscussionTo our knowledge, this study will be the first RCT of manual-based CBT for IBS in Japan. By using psycho-educational video materials, the time and cost of therapy will be reduced. Manual based CBTs for IBS have not been widely adopted in Japan to date. If our CBT-IE-w/vid program is confirmed to be more effective than TAU, it will facilitate dissemination of cost-effective manual-based CBT in clinical settings

Increased tissue levels of omega-3 polyunsaturated fatty acids prevents pathological preterm birth

Omega-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have anti-inflammatory effects. Preterm birth is an important problem in modern obstetrics and one of the main causes is an inflammation. We here showed that abundance of omega-3 fatty acids reduced the incidence of preterm birth induced by LPS with fat-1 mice, capable of converting omega-6 to omega-3 fatty acids. We also indicated that the gene expression of IL-6 and IL-1β in uteruses and the number of cervical infiltrating macrophages were reduced in fat-1 mice. The analyses of lipid metabolomics showed the high level of 18-hydroxyeicosapentaenoate in fat-1 mice, which was derived from EPA and was metabolized to anti-inflammatory product named resolvin E3 (RvE3). We finally showed that the administration of RvE3 to LPS-exposed pregnant wild type mice lowered the incidence of preterm birth. Our data suggest that RvE3 could be a potential new therapeutic for the prevention of preterm birth

高齢者の認知機能向上とITヘルスケアシステム

IT（Information Technology）ヘルスケアシステムが高齢者の認知機能の向上に影響をもたらすか，その効果を測定するため，デイサービス事業所５か所において調査を行った．効果測定は，認知機能評価スケールMini Mental State Examination（MMSE）を用い，介入前後に測定できた４９人（介入群４０人，対照群９人）のデータを分析し比較検討した．結果，ITヘルスケアシステム（ITHCS）介入前後のMMSE得点，および認知機能の変化（前後差）において，介入群の方が有意に高い得点を示す項目はなかった．しかし，介護度別にみると介入後の方が有意に高い認知機能の変化を示した項目（即時想起，物品呼称，自発書字）もあった．そのためITヘルスケアシステムの効率性を高めるには，利用者への個別的対応を組み合わせるなどのアプローチが必要であると結論付けられた．This article examines how effective IT（Information Technology）health care system is in improving cognitive functioning for the elderly people. We have organized a small project for health promotion among elderly people at five day-care centers and evaluated its effectiveness in the cognitive abilities of the service users. Mini Mental State Examination （MMSE） is used to assess the project’s efficacy, including the impact of the IT health care system. Eleven types of cognitive abilities are tested on ４９ people （４０ within intervention group and ９ within contrast group） prior the intervention and after. The result doesn’t show significant improvement on the score, however, some improvement on cognitive abilities such as short-term memory, calculation, identifying objects, and following simple directions, was seen in some group according to their care requirement level. Therefore, we concluded that the program with IT health care system combined with some individualized approach is necessary in order to improve its effectiveness

Use of Nafamostat Mesilate as an Anticoagulant during Extracorporeal Membrane Oxygenation

Although the incidence of bleeding complications during extracorporeal membrane oxygenator (ECMO) support has decreased in various trials, bleeding is still the most fatal complication. We investigated the ideal dosage and efficacy of nafamostat mesilate for use with ECMO in patients with acute cardiac or respiratory failure. We assessed 73 consecutive patients who received ECMO due to acute cardiac or respiratory failure between January 2006 and December 2009. To evaluate the efficacy of nafamostat mesilate, we divided the patients into 2 groups according to the anticoagulants used during ECMO support. All patients of nafamostat mesilate group were male with a mean age of 49.2 yr. Six, 3, 5, and 3 patients were diagnosed with acute myocardial infarction, cardiac arrest, septic shock, and acute respiratory distress syndrome, respectively. The mean dosage of nafamostat mesilate was 0.64 mg/kg/hr, and the mean duration of ECMO was 270.7 hr. The daily volume of transfused packed red blood cells, fresh frozen plasma, and cryoprecipitate and the number of complications related to hemorrhage and thrombosis was lower in the nafamostat mesilate group than in the heparin group. Nafamostat mesilate should be considered as an alternative anticoagulant to heparin to reduce bleeding complications during ECMO