せん妄の遷延化に関連する因子についての後方視研究

Background: It has been reported that delirium causes various problems. Many researchers have reported the risk factors associated with the onset of delirium; however, there are few reports focused on persistent delirium. This study aimed to identify the risk factors associated with persistent delirium. Methods: A total of 573 patients hospitalised in Nara Prefecture General Medical Centre from October 2014 through September 2017 who were referred to the psychiatry consultation service were included in this study. Persistent delirium was defined as delirium lasting for 14 days or more. A retrospective study was carried out based on the patients' records. The relationship between various background factors and persistent delirium was statistically analysed. Results: Of the 573 hospitalised patients, 295 were diagnosed as having delirium. Forty-six patients with persistent delirium and 181 patients with nonpersistent delirium were included in this study. Multivariable logistic regression analyses revealed that male gender, opioid analgesics use, non-opioid analgesics use, and low serum sodium were significantly and independently associated with persistent delirium. Ramelteon or trazodone was used significantly more in persistent delirium, although each use was not significant. Conclusion: This is the first study to reveal that male gender and use of analgesics were associated with persistent delirium in general hospital. However, as this is a case-control study and may contain bias, future cohort studies and intervention studies are needed. It is also necessary to investigate the relevance of the 'degree of pain' behind the use of analgesics.博士（医学）・乙第1516号・令和3年12月21日© 2021 Japanese Psychogeriatric Society.This is the peer reviewed version of the following article: [https://onlinelibrary.wiley.com/doi/10.1111/psyg.12655], which has been published in final form at [https://doi.org/10.1111/psyg.12655]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited

Basic Reseach on the Simulation of "Sensibility Information Processing"

We have studied the information processing of human sensibility from various approaches. In an approach from information retrieval theory, we constructed a "sensibility information retrieval system" which extracts words expressing human feelings from a novel and analyzes the chronological structure of the novel. Novels are thus classified into those with increasing-sadness, those with happy-endings, etc. In an approach from psychology, we constructed a model which simulates the process of evoking emotion. Words expressing feelings are classified, and the influence of past experiences and the effects on future actions are investigated by experiments. In an approach from business management, we point out that the study of sensibility information has a good applicability in the decision making system of an organization because the feelings of its members are crucial in making decisions. In particular, we emphasize that a "good morale" among organizational members is essential in avoiding serious accidents. From a device approach, we study the signal processing of electrical data trains using a modulated laser diode, and propose a potential application to the microwave phase shifter with small variations in amplitude

Development of 1 MJ Conduction-Cooled LTS Pulse Coil for UPS-SMES

A 1 MW, 1 s UPS-SMES is being developed for a protection from a momentary voltage drop and an instant power failure. As a key technology of the UPS-SMES, we developed a prototype LTS pulse coil with a stored energy of 100 kJ and conducted cooling and excitation tests in 2005. The operation test of the prototype UPS-SMES using this 100 kJ coil with power converters have been performed in 2006. A 1 MJ coil was designed before the fabrication of the 100 kJ prototype coil. The superconductor, the electric insulation technique, the winding method, and the cooling structure used for the 100 kJ coil were based upon the 1 MJ coil design. The successful performance test results of the prototype 100 kJ coil validated the design concept and fabrication technique of the 1 MJ coil. According to the achievement of the prototype 100 kJ UPS-SMES, the 1 MJ conduction-cooled LTS pulse coil has been fabricated successfully. The successful experimental results of the 100 kJ prototype coil with power converters and the fabrication procedure of the 1 MJ full size coil are described

Suzaku Observations of HESS J1616-508: Evidence for a Dark Particle Accelerator

We observed the bright unidentified TeV gamma-ray source HESS J1616-508 with the X-ray Imaging Spectrometers onboard the Suzaku satellite. No X-ray counterpart was found to a limiting flux of 3.1e-13 erg/s/cm^2 in the 2--10 keV band, which is some 60 times below the gamma-ray flux in the 1--10 TeV band. This object is bright in TeV gamma-rays but very dim in the X-ray band, and thus is one of the best examples in the Galaxy of a "dark particle accelerator." We also detected soft thermal emission with kT=0.3--0.6 keV near the location of HESSJ1616. This may be due to the dust grain scattering halo from the nearby bright supernova remnant RCW103.Comment: 10 pages, 9 figures. Accepted for publication in PASJ Suzaku Special Issue (vol. 59 sp. 1

Percutaneous Cryoablation for the Treatment of Medically Inoperable Stage I Non-Small Cell Lung Cancer

BACKGROUND: To evaluate the midterm results of percutaneous cryoablation for medically inoperable stage I non-small cell lung cancer. METHODOLOGY/PRINCIPAL FINDINGS: Between January 2004 and June 2010, 160 patients underwent computer tomography guided percutaneous cryoablation for lung tumors at our institution. Of these patients, histologically proven stage I lung cancer patients with more than one year of follow-up, were retrospectively reviewed. All of these patients were considered to be medically inoperable with Charlson comorbidity index of 3 or greater. Follow-up was based primarily on computed tomography. There were 22 patients with 34 tumors who underwent 25 sessions of cryoablation treatment. Complications were pneumothoraces in 7 treatments (28%, chest tube required in one treatment), and pleural effusions in 8 treatments (31%). The observation period ranged from 12-68 months, average 29±19 months, median 23 months. Local tumor progression was observed in one tumor (3%). Mean local tumor progression-free interval was 69±2 months. One patient died of lung cancer progression at 68 months. Two patients died of acute exacerbations of idiopathic pulmonary fibrosis which were not considered to be directly associated with cryoablation, at 12 and 18 months, respectively. The overall 2- and 3-year survivals were 88% and 88%, respectively. Mean overall survival was 62±4 months. Median overall survival was 68 months. The disease-free 2- and 3-year survivals were 78% and 67%, respectively. Mean disease-free survival was 46±6 months. Pulmonary function tests were done in 16 patients (18 treatments) before and after cryoablation. Percentage of predicted vital capacity, and percentage of predicted forced expiratory volume in 1 second, did not differ significantly before and after cryoablation (93±23 versus 90±21, and 70±11 versus 70±12, respectively). CONCLUSIONS/SIGNIFICANCE: Although further accumulation of data is necessary regarding efficacy, cryoablation may be a feasible option in medically inoperable stage I lung cancer patients