Factors predicting mortality in emergency abdominal surgery in the elderly

OBJECTIVE: This study aimed to investigate clinical features of abdominal emergency surgery in elderly patients, and to determine factors predicting mortality in these patients. METHODS: The study population included 94 patients aged 80 years or older who underwent emergency surgery for acute abdominal diseases between 2000 and 2010. Thirty-six patients (38.3%) were male and fifty-eight patients (61.7%) were female (mean age, 85.6 years). Main outcome measures included background of the patient’s physical condition (concomitant medical disease, and performance status), cause of disease, morbidity and mortality, and disease scoring system (APACHE II, and POSSUM). Prognostic factors affecting mortality of the patient were also evaluated by univariate analysis using Fisher’s exact test and Mann–Whitney U–test, and by multivariate analysis using multiple logistic regression analysis. RESULTS: Of the 94 patients, 71 (75.5%) had a co-existing medical disease; most patients had hypertension (46.8%). The most frequent surgical indications were acute cholecystitis in 23 patients (24.5%), followed by intestinal obstruction in 18 patients (19.1%). Forty-one patients (43.6%) had complications during hospital stay; the most frequent were surgical site infection (SSI) in 21 patients (22.3%) and pneumonia in 12 patients (12.8%). Fifteen patients died (overall mortality, 16%) within 1 month after operation. The most common causes of death were sepsis related to pan-peritonitis in 5 patients (5.3%), and pneumonia in 4 patients (4.3%). Multiple logistic regression analysis showed that time from onset of symptoms to hospital admission and the POSSUM scoring system could be prognostic factors for mortality. CONCLUSIONS: Mortality in elderly patients who underwent emergency surgery for acute abdominal disease can be predicted using the disease scoring system (POSSUM) and on the basis of delay in hospital admission

Evolution of the Parents Support through enhanced Social Ties in Kindergarten Education

　本論は，幼稚園教育における親支援の方向性を探ることを目的とする。幼稚園１年間（全５回）の「親の会」 を分析したところ，両極的感情と２つの不安を抱える親達は，「安心」「感覚」「ゆとり」を共有する人的つなが りを基盤とし，子育てを肯定的に捉えられることが明らかになった。親の興味や欲求に基づく環境を構成し，主 体性に働きかける援助をする親支援は，幼稚園教育における子育て支援として有効であることが示唆される。課 題は，親の主体性に働きかける環境を構成し，援助する支援者の専門性の確立である

Effect of Including Sand Component in a Debris Flow on Concentration of Coarser Particles at the Flow Front

We conducted flume experiments for a debris flow consisting of coarser particles, finer particles and sand, focusing on the concentration of coarser particles at the flow front. Our experimental results revealed that the concentration of coarser particles at the flow front using sediment mixture with sand was less than that without sand. This may be because including of sand component in the material contributed to be a smaller averaged interstice between particles in the flow layer and a smaller averaged particle size. These may lead to reduce the falling volume of sand or finer particles and dispersion pressure for the rise of coarser particles, respectively, resulting in the inhibition of inverse grading formation. Our experimental results also suggested that the changing trend in the proportion of finer particles depended on the relationship between their particle size and the average particle size of the flow. These are consistent with our previous experimental results using material without sand. This consistency suggested that for the concentration of coarser particles at the flow front, the behavior of the sand component can be considered in the same manner as other coarser-sized components

Deciphering Elapsed Time and Predicting Action Timing from Neuronal Population Signals

The proper timing of actions is necessary for the survival of animals, whether in hunting prey or escaping predators. Researchers in the field of neuroscience have begun to explore neuronal signals correlated to behavioral interval timing. Here, we attempt to decode the lapse of time from neuronal population signals recorded from the frontal cortex of monkeys performing a multiple-interval timing task. We designed a Bayesian algorithm that deciphers temporal information hidden in noisy signals dispersed within the activity of individual neurons recorded from monkeys trained to determine the passage of time before initiating an action. With this decoder, we succeeded in estimating the elapsed time with a precision of approximately 1 s throughout the relevant behavioral period from firing rates of 25 neurons in the pre-supplementary motor area. Further, an extended algorithm makes it possible to determine the total length of the time-interval required to wait in each trial. This enables observers to predict the moment at which the subject will take action from the neuronal activity in the brain. A separate population analysis reveals that the neuronal ensemble represents the lapse of time in a manner scaled relative to the scheduled interval, rather than representing it as the real physical time

Understanding and evaluation of preschool "children of concern"

The expression "children of concern" is often used among kindergarten teachers and nursery school staffs, however, there is no unified view or consensus regarding the meaning of this word and the area covered by this term. This study reviewed articles dealing with nursery school teacher\u27s awareness of "children of concern". Nursery school teachers tended to focus on an adaptive behavior which allow children to participate in group activities in the classroom, and also focused on social relationships such as eye contact and friend relationships. Clumsiness was also taken up as an important sign of the needs for special support. Furthermore, present study outlined various assessments for preschoolers. New assessment tool for nursery school teachers was developed with the aim of providing the basis of optimal support to meet the needs of each child. It is important to provide ongoing and transitional supports with a long-term prospect, and to prevent psychiatric comorbidities by sharing information among supporters based on objective evaluation from early development at nursery school

Tissue distribution of striped jack nervous necrosis virus (SJNNV) in adult striped jack.

Fluorescent antibody technique (FAT) and polymerase chain reaction (PCR) method were used to localize striped jack nervous necrosis virus (SJNNV, a nodavirus) in adult striped jack Pseudocaranx dentex. One group of brood stocks (N = 4) consisted of 13-yr-old spawners whose reproductive fluids were SJNNV-positive by the PCR test. The other group (N = 4) consisted of 4-yr-old fish which had not previously spawned whose reproductive fluids were negative by the PCR test. Positive FAT reactions using an anti-SJNNV rabbit serum were observed in the gonad, intestine, stomach, kidney, and liver of the 13-yr-old fish but not in the corresponding organs of the 4-yr-old fish. In neither group were the viral antigens detected in the spinal cord, brain, or retina tissues, the target organs of the virus in striped jack larvae. The FAT results were consistent with PCR results for the detection of the SJNNV coat protein gene. The present results suggest that SJNNV originates in various organs of striped jack spawners and is shed from the intestine and gonad, which results in contamination of eggs

Enhancement of gene transduction efficiency in cancer cells using cationic liposome with hyperthermia.

We evaluated the effects of hyperthermia on the efficiency of gene transduction by using a cationic liposome to develop an efficient method for lipofection. We used Lewis lung carcinoma (LLC), NIH3T3, and A549 cell lines, with Lipofectamine reagent as the cationic liposome and the LacZ gene as the reporter gene. In LLC, co-incubation of the cationic liposome and plasmid DNA complex (lipoplex) with the cells for 2 h at 41 degrees C enhanced the efficiency of gene transduction approximately 1.4-fold compared to incubation for 2 h at 37 degrees C, as measured by X-gal staining and beta-galactosidase activity. In cell lines NIH3T3 and A549, the efficiency of gene transduction showed a tendency toward enhancement after 2 h co-incubation with lipoplex at 41 degrees C compared to that at 37 degrees C, as measured by X-gal staining. This is the first study to demonstrate the enhancement of gene transduction efficiency achieved by using a cationic liposome under conditions of hyperthermia. This method should prove useful for lipofection in other cancer cells.</p