反復的な督励が口頭指導下の心肺蘇生法に与える効果に関する無作為化シミュレーション研究

Background: Current guidelines emphasize the assistance of the emergency dispatcher in bystander cardiopulmonary resusitation (CPR). Its quality, however, has varied across cases. Objective: To determine the effect of repetitive coaching by dispatchers using verbal encouragement on the quality of lay-rescuer CPR. Methods: We conducted a dispatch-assisted CPR (DACPR) simulation study. Participants with no CPR training within the previous year were assigned randomly to 1 of 2 DACPR simulations. One was the No Coaching Group: callers were told to perform CPR and the dispatcher periodically confirmed that the caller was performing CPR. The second group was the Coaching Group: the dispatcher repetitively coached, encouraged, and counted aloud using a metronome. Participants performed CPR for 2 min under instruction from the study dispatcher. Parameters including chest compression depth, rate, and chest compression fraction were recorded by video camera and CPR manikin. Results: Forty-nine participants 20 to 50 years of age were recruited, and 48 completed the simulation (Coaching Group, n = 27; No Coaching Group, n = 21). The chest compression fraction was higher in the Coaching Group (99.4% vs. 93.0%, p = 0.005) and no participants interrupted chest compression more than 10 s in this group. When comparing the average depth of each 30-s period in each group, the depth increased over time in the Coaching Group (40.9 mm, 43.9 mm, 44.1 mm, and 42.8 mm), while it slightly decreased in the No Coaching Group (40.6 mm, 40.1 mm, 39.4 mm, and 39.8 mm). Conclusions: Repetitive verbal encouragements augmented chest compression depth with less-hands off time. Continuous coaching by dispatchers can optimize lay-rescuer CPR.博士（医学）・甲第852号・令和4年9月28日© 2022 Elsevier Inc.© 2022 The Author(s). Published by Elsevier Inc.This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Pressure Study of BiS2-Based Superconductors Bi4O4S3 and La(O,F)BiS2

We report the electrical resistivity measurements under pressure for the recently discovered BiS2-based layered superconductors Bi4O4S3 and La(O,F)BiS2. In Bi4O4S3, the transition temperature Tc decreases monotonically without a distinct change in the metallic behavior in the normal state. In La(O,F)BiS2, on the other hand, Tc initially increases with increasing pressure and then decreases above ? 1 GPa. The semiconducting behavior in the normal state is suppressed markedly and monotonically, whereas the evolution of Tc is nonlinear. The strong suppression of the semiconducting behavior without doping in La(O,F)BiS2 suggests that the Fermi surface is located in the vicinity of some instability. In the present study, we elucidate that the superconductivity in the BiS2 layer favors the Fermi surface at the boundary between the semiconducting and metallic behaviors.Comment: 4 pages, 6 figures, Accepted for publication in J. Phys. Soc. Jp

Examination of High-Torque Sandwich-Type Spherical Ultrasonic Motor Using with High-Power Multimode Annular Vibrating Stator

Spherical ultrasonic motors (SUSMs) that can operate with multiple degrees of freedom (MDOF) using only a single stator have high holding torque and high torque at low speed, which makes reduction gearing unnecessary. The simple structure of MDOF-SUSMs makes them useful as compact actuators, but their development is still insufficient for applications such as joints of humanoid robots and other systems that require MDOF and high torque. To increase the torque of a sandwich-type MDOF-SUSM, we have not only made the vibrating stator and spherical rotor larger but also improved the structure using three design concepts: (1) increasing the strength of all three vibration modes using multilayered piezoelectric actuators (MPAs) embedded in the stator, (2) enhancing the rigidity of the friction driving portion of the stator for transmitting more vibration force to the friction-driven rotor surface, and (3) making the support mechanism more stable. An MDOF-SUSM prototype was tested, and the maximum torques of rotation around the X(Y)-axis and Z-axis were measured as 1.48 N?m and 2.05 N?m, respectively. Moreover, the values for torque per unit weight of the stator were obtained as 0.87 N?m/kg for the X(Y)-axis and 1.20 N?m/kg for the Z-axis. These are larger than values reported for any other sandwich-type MDOF-SUSM of which we are aware. Hence, the new design concepts were shown to be effective for increasing torque. In addition, we measured the transient response and calculated the load characteristics of rotation around the rotor’s three orthogonal axes

Sacral Stress Fracture following the Bone Union of Lumbar Spondylolysis

While 22 articles have reported on sacral stress fractures, it is a rare injury and its etiology is not well known. We present the case of a 16-year-old male who presented with low back pain in 2015. He was a high school soccer player with a previous history of a bilateral L5 lumbar spondylolysis in 2014. The patient refrained from soccer and wore a brace for six months. Two months after restarting soccer, he again complained of low back pain. After 1 year, a lumbar spine computed tomography revealed the bone union of the spondylolysis. At his first visit to our hospital, his general and neurological conditions were normal and laboratory data were within the normal range. Sacral coronal magnetic resonance imaging (MRI) of the left sacral ala revealed an oblique lineal signal void surrounding bone marrow edema. Based on his symptoms, sports history, and MRI, he was diagnosed with a sacral stress fracture. He again refrained from soccer; his low back pain soon improved, and, after 1 year, the abnormal signal change had disappeared on sacral MRI. Recurrent low back pain case caused by a sacral stress fracture occurring after the bone union of lumbar spondylolysis is uncommon

Development of electromagnetic and piezoelectric hybrid actuator system

An ordinal force-feedback device typically uses an electromagnetic motor (EMM), which provides an excellent expression of elasticity. However, it is not easy to express the sense of hardness and roughness because the response of the current is delayed due to the inductance of the armature winding. On the contrary, a piezoelectric actuator, which has a rapid response, is good at expressing the sense of hardness and roughness. Thus, if different types of actuators are used in the same actuator system (AS), the weaknesses of each type can be compensated for. In this study, as an ideal force-feedback device, a hybrid actuator system combining an EMM with an ultrasonic motor (USM) and a piezoelectric clutch/brake (piezo-clutch/brake) is proposed and examined. This AS can expand the range of representable feelings. This paper describes the construction of a hybrid AS and some experimental results of a force-feedback display. In this experiment, the feelings of roughness, friction, and elasticity were represented. The feeling of roughness was represented by the on-off control of the piezo-brake at defined positions. The feeling of friction was represented by the PID control of braking using the piezo-clutch. The feeling of elasticity was represented by two methods: the use of the EMM and brake and the use of a combination of the USM, clutch, and brake. As a result, the hardness feeling was realistically represented by the piezo-brake, and the elastic feeling was represented by either the EMM or the USM

Perehdyttämisopas Yläristin Pysäkille

Opinnäytetyöni tarkoituksena oli suunnitella ja toteuttaa sähköisessä muodossa oleva perehdyttämisopas Yläristin pysäkin henkilökunnan ja opiskelijoiden käyttöön. Yläristin pysäkki on Pieksämäen kaupungin ylläpitämä 8-paikkainen päihdekuntoutus- ja asumispalveluyksikkö, jonka toiminta kuuluu mielenterveys- ja päihdepalveluiden piiriin. Toiminta perustuu tiimi- ja verkostoyhteistyöhön sekä yksilöhoitoon yhteisöhoidollisin menetelmin, ja sen tavoitteena on tukea asiakkaan päihteettömyyttä ja olla mukana muutosprosessin eri vaiheissa. Henkilökuntaan kuuluu yksi sairaanhoitaja ja kolme lähihoitajaa. Lisäksi Yläristin pysäkillä on vuosittain useita sairaanhoitaja-, sosionomi- ja lähihoitajaopiskelijoita suorittamassa opintoihin kuuluvia harjoittelujaksoja. Tavoitteena opinnäytetyölläni oli tukea työyhteisön hyvinvointia ja yhtenäisten toimintamallien toteutumista perehdyttämisoppaan avulla. Opinnäytetyön teoreettinen viitekehys käsittelee perehdyttämistä ja siihen liittyviä tekijöitä – perehdyttämisen sisältöä, perehdyttäjiä ja perehdyttämisprosessia kokonaisuutena. Aiempaa tutkimustietoa hoitoalan perehdyttämisestä ja sen hyödyistä löytyi suomen kielellä melko niukasti. Tutkimusten mukaan hyvällä perehdyttämisellä on merkittäviä vaikutuksia muun muassa työhön sitoutumiseen ja työssä viihtymiseen. Opinnäytetyöprosessi käynnistyi keväällä 2015 työharjoitteluni aikana ja eteni pääosin ennalta suunnitel-lun aikataulun mukaisesti. Toimeksiantajan edustajat olivat aktiivisesti mukana tuotteen kehittämisessä sekä koko opinnäytetyöprosessissa. Tuotteen kehitysvaiheessa toimeksiantajan edustajia haastateltiin tarpeista ja toiveista perehdyttämisoppaaseen liittyen, näin kokoon saatiin mahdollisimman kattava ja sisällöltään toimeksiantajan tarpeita vastaava tuote. Viimeistelyvaiheessa toteutettiin toinen haastattelu, jossa toimeksiantajan edustajat arvioivat tuotteen ja pohtivat sen jatkokehitysmahdollisuuksia. Valmis tuote, eli perehdyttämisopas on yhteisymmärryksessä toimeksiantajan ja koulun edustajien kanssa salattu sen sisältämien yksityiskohtaisten ja arkaluontoisten tietojen vuoksi.The purpose of this thesis was to design and create a digital orientation guide for the employees and students working at Yläristin Pysäkki. Yläristin Pysäkki is a rehabilitation and accommodation unit, which is maintained by the City of Pieksämäki. It has 8 places and operates under Pieksämäki mental and sub-stance abuse services. The operations are based on co-operation in teams and networks. Collaborative methods are used for supporting individual care. The aim in the unit is to support the clients’ abstinence and take part in the different stages of their change process. There a registered nurse and three practical nurses working in the unit. In addition, every year there are several registered and practical nurse students as well as students from social services programmes performing their practical training. The goal of the digital guide was to support the wellbeing of the personnell and harmonise and enable coherent procedures. The theoretical framework of the study discusses orientation and the factors related to it – the content of orientation, mentors and the orientation process as a whole. There were only a few previous studies avail-able on orientation in the Finnish language. According to the studies proper orientation has significant impact on employee commitment and satisfaction. The process of the thesis started in spring 2015 during my practical training and it progressed according to plan. The representatives of Yläristin Pysäkki took active part in the development phase as well as sup-ported me during the whole process. During the design phase the representatives of Yläristin Pysäkki were interviewed about their needs and hopes regarding the orientation guide. With this information it was possible to create a comprehensive product, which would fulfil their needs. During the finishing phase a second set of interviews was conducted for evaluation by the unit representatives. Further development possibilities were also considered. The final product itself, the digital orientation guide for Yläristin Pysäkki has been classified as Company Confidential due to its detailed and sensitive content.Opinnäytetyö sisältää perehdyttämisoppaan (30 sivua), josta julkaistu vain sisällysluettel

Effect of Cytokines on Osteoclast Formation and Bone Resorption during Mechanical Force Loading of the Periodontal Membrane

Mechanical force loading exerts important effects on the skeleton by controlling bone mass and strength. Several in vivo experimental models evaluating the effects of mechanical loading on bone metabolism have been reported. Orthodontic tooth movement is a useful model for understanding the mechanism of bone remodeling induced by mechanical loading. In a mouse model of orthodontic tooth movement, TNF-α was expressed and osteoclasts appeared on the compressed side of the periodontal ligament. In TNF-receptor-deficient mice, there was less tooth movement and osteoclast numbers were lower than in wild-type mice. These results suggest that osteoclast formation and bone resorption caused by loading forces on the periodontal ligament depend on TNF-α. Several cytokines are expressed in the periodontal ligament during orthodontic tooth movement. Studies have found that inflammatory cytokines such as IL-12 and IFN-γ strongly inhibit osteoclast formation and tooth movement. Blocking macrophage colony-stimulating factor by using anti-c-Fms antibody also inhibited osteoclast formation and tooth movement. In this review we describe and discuss the effect of cytokines in the periodontal ligament on osteoclast formation and bone resorption during mechanical force loading

Osteocrin ameliorates adriamycin nephropathy via p38 mitogen-activated protein kinase inhibition

Natriuretic peptides exert multiple effects by binding to natriuretic peptide receptors (NPRs). Osteocrin (OSTN) binds with high affinity to NPR-C, a clearance receptor for natriuretic peptides, and inhibits degradation of natriuretic peptides and consequently enhances guanylyl cyclase-A (GC-A/NPR1) signaling. However, the roles of OSTN in the kidney have not been well clarified. Adriamycin (ADR) nephropathy in wild-type mice showed albuminuria, glomerular basement membrane changes, increased podocyte injuries, infiltration of macrophages, and p38 mitogen-activated protein kinase (MAPK) activation. All these phenotypes were improved in OSTN- transgenic (Tg) mice and NPR3 knockout (KO) mice, with no further improvement in OSTN-Tg/NPR3 KO double mutant mice, indicating that OSTN works through NPR3. On the contrary, OSTN KO mice increased urinary albumin levels, and pharmacological blockade of p38 MAPK in OSTN KO mice ameliorated ADR nephropathy. In vitro, combination treatment with ANP and OSTN, or FR167653, p38 MAPK inhibitor, reduced Ccl2 and Des mRNA expression in murine podocytes (MPC5). OSTN increased intracellular cyclic guanosine monophosphate (cGMP) in MPC5 through GC-A. We have elucidated that circulating OSTN improves ADR nephropathy by enhancing GC-A signaling and consequently suppressing p38 MAPK activation. These results suggest that OSTN could be a promising therapeutic agent for podocyte injury

ALMA Observations of the Submillimeter Dense Molecular Gas Tracers in the Luminous Type-1 Active Nucleus of NGC 7469

We present ALMA Cycle 1 observations of the central kpc region of the luminous type-1 Seyfert galaxy NGC 7469 with unprecedented high resolution (0.5$"$ $\times$ 0.4$"$ = 165 pc $\times$ 132 pc) at submillimeter wavelengths. Utilizing the wide-bandwidth of ALMA, we simultaneously obtained HCN(4-3), HCO$^+$(4-3), CS(7-6), and partially CO(3-2) line maps, as well as the 860 $\mu$m continuum. The region consists of the central $\sim$ 1$"$ component and the surrounding starburst ring with a radius of $\sim$ 1.5$"$-2.5$"$. Several structures connect these components. Except for CO(3-2), these dense gas tracers are significantly concentrated towards the central $\sim$ 1$"$, suggesting their suitability to probe the nuclear regions of galaxies. Their spatial distribution resembles well those of centimeter and mid-infrared continuum emissions, but it is anti-correlated with the optical one, indicating the existence of dust obscured star formation. The integrated intensity ratios of HCN(4-3)/HCO$^+$(4-3) and HCN(4-3)/CS(7-6) are higher at the AGN position than at the starburst ring, which is consistent to our previous findings (submm-HCN enhancement). However, the HCN(4-3)/HCO$^+$(4-3) ratio at the AGN position of NGC 7469 (1.11$\pm$0.06) is almost half of the corresponding value of the low-luminosity type-1 Seyfert galaxy NGC 1097 (2.0$\pm$0.2), despite the more than two orders of magnitude higher X-ray luminosity of NGC 7469. But the ratio is comparable to that of the close vicinity of the AGN of NGC 1068 ($\sim$ 1.5). Based on these results, we speculate that some other heating mechanisms than X-ray (e.g., mechanical heating due to AGN jet) can contribute significantly for shaping the chemical composition in NGC 1097.Comment: Fixed typos in the title. 15 pages, 8 figures, 4 tables: accepted for publication in ApJ. Comments welcom

Expression and Subcellular Localization of Mammalian Formin Fhod3 in the Embryonic and Adult Heart

The formin family proteins play pivotal roles in actin filament assembly via the FH2 domain. The mammalian formin Fhod3 is highly expressed in the heart, and its mRNA in the adult heart contains exons 11, 12, and 25, which are absent from non-muscle Fhod3 isoforms. In cultured neonatal cardiomyocytes, Fhod3 localizes to the middle of the sarcomere and appears to function in its organization, although it is suggested that Fhod3 localizes differently in the adult heart. Here we show, using immunohistochemical analysis with three different antibodies, each recognizing distinct regions of Fhod3, that Fhod3 localizes as two closely spaced bands in middle of the sarcomere in both embryonic and adult hearts. The bands are adjacent to the M-line that crosslinks thick myosin filaments at the center of a sarcomere but distant from the Z-line that forms the boundary of the sarcomere, which localization is the same as that observed in cultured cardiomyocytes. Detailed immunohistochemical and immuno-electron microscopic analyses reveal that Fhod3 localizes not at the pointed ends of thin actin filaments but to a more peripheral zone, where thin filaments overlap with thick myosin filaments. We also demonstrate that the embryonic heart of mice specifically expresses the Fhod3 mRNA isoform harboring the three alternative exons, and that the characteristic localization of Fhod3 in the sarcomere does not require a region encoded by exon 25, in contrast to an essential role of exons 11 and 12. Furthermore, the exon 25-encoded region appears to be dispensable for actin-organizing activities both in vivo and in vitro, albeit it is inserted in the catalytic FH2 domain