From QFT to DCC

A quantum field theoretical model for the dynamics of the disoriented chiral condensate is presented. A unified approach to relate the quantum field theory directly to the formation, decay and signals of the DCC and its evolution is taken. We use a background field analysis of the O(4) sigma model keeping one-loop quantum corrections (quadratic order in the fluctuations). An evolution of the quantum fluctuations in an external, expanding metric which simulates the expansion of the plasma, is carried out. We examine, in detail, the amplification of the low momentum pion modes with two competing effects, the expansion rate of the plasma and the transition rate of the vacuum configuration from a metastable state into a stable state.We show the effect of DCC formation on the multiplicity distributions and the Bose-Einstein correlations.Comment: 34 pages, 10 figure

A proposed core curriculum for dental English education in Japan

Background: Globalization of the professions has become a necessity among schools and universities across the world. It has affected the medical and dental professions in terms of curriculum design and student and patient needs. In Japan, where medicine and dentistry are taught mainly in the Japanese language, profession-based courses in English, known as Medical English and Dental English, have been integrated into the existing curriculum among its 83 medical and 29 dental schools. Unfortunately, there is neither a core curriculum nor a model syllabus for these courses. Methods: This report is based on a survey, two discussion forums, a workshop, and finally, the drafting of a proposed core curriculum for dental English approved by consensus of the participants from each university. Results: The core curriculum covers the theoretical aspects, including dental English terms and oral pathologies; and practical aspects, including blended learning and dentist-patient communication. It is divided into modules and is recommended to be offered for at least two semesters. Conclusions: The core curriculum is expected to guide curriculum developers in schools where dental English courses are yet to be offered or are still in their early development. It may also serve as a model curriculum to medical and dental schools in countries in Asia, Europe, Africa, and Central and South America, where English is not the medium of instruction

Moral hazard in the Japanese universal health insurance system: KONBINI doctor visits

This paper describes and analyzes a unique phenomenon in the Japanese healthcare system: “KONBINI doctor visits,” in which patients visit holiday/night emergency medical services even when they are not in urgent need, and demand the same convenience and hospitality provided by Japanese convenience stores, which are popularly known as “KONBINI” in Japan. KONBINI doctor visits are inefficient, a significant burden on the system, and result in an inequitable consumption of finite medical resources; and furthermore, they may lead to physician shortages and the consequent closures of emergency medical services in rural areas. KONBINI doctor visits are here analyzed as a kind of moral hazard, in which patients consume medical services inefficiently due to low cost-sharing. Although this kind of moral hazard is a concern in any health insurance systems, KONBINI doctor visits are unique to Japan, as features of Japanese society and traditional morality may contribute to their occurrence. The virtues, values, and policies in current Japanese society may cause or accelerate patient behaviors regarding the use of emergency medical services. Traditional conceptions of physician virtues require physicians to prioritize the well-being of patients over their own well-being, even to the extent that personal sacrifice is required. As a result, virtuous physicians are expected to provide medical care whenever patients want. The traditional value of “Omotenashi” or selfless hospitality encourages people to provide services that exceed the expectations of service consumers, which may lead to unreasonable demands from patients. In addition, laws regulating medical professionals assign physicians a legal obligation to provide medical care at the patient’s request with rare exceptions. Several possible methods for discouraging KONBINI doctor visits are proposed: reducing the anxiety of patients; creating financial incentives; and appealing to patients’ ethical values to encourage them to reduce their overuse of medical care. In particular, the cooperation of patients may be elicited by emphasizing the virtues distinctive of prospective patients: as members of society, they can demonstrate loyalty to the society, by avoiding behaviors that could possibly undermine the healthcare system and disadvantage other members of the society

Colonic volvulus detected by CT scan in a case with mental retardation and prune belly syndrome

Colonic volvulus is a rare disease in children. Delayed diagnosis of the condition can often be fatal, especially in pediatric patients with mental retardation. We herein present the case of a female pediatric patient with colonic volvulus, prune belly syndrome, and mental retardation. Preoperative CT scans showed the characteristic signs of this disease. The volvulus occurred in the proximal colon of the colostomy. The release of the colonic volvulus and reconstruction of the colostomy were performed without the resection of the ischemic colon. The postoperative clinical course was uneventful

Colonic volvulus detected by CT scan in a case with mental retardation and prune belly syndrome

Colonic volvulus is a rare disease in children. Delayed diagnosis of the condition can often be fatal, especially in pediatric patients with mental retardation. We herein present the case of a female pediatric patient with colonic volvulus, prune belly syndrome, and mental retardation. Preoperative CT scans showed the characteristic signs of this disease. The volvulus occurred in the proximal colon of the colostomy. The release of the colonic volvulus and reconstruction of the colostomy were performed without the resection of the ischemic colon. The postoperative clinical course was uneventful

Serum Hyaluronic Acid Concentration in Fontan Circulation: Correlation With Hepatic Function and Portal Vein Hemodynamics

Abstract Although liver fibrosis causes significant morbidity in the late postoperative period of the Fontan procedure, the diagnostic value of hyaluronic acid (HA), a serum marker of liver fibrosis, has not been established in Fontan patients. The purpose of this study was to determine whether increased serum HA concentration in Fontan patients is associated with an increase in inspiratory-to-expiratory flow rate ratio (Qin/ Qex) of the portal vein (PV), which is indicative of liver fibrosis. We retrospectively studied 28 consecutive patients with Fontan circulation who underwent cardiac catheterisation for various indications. The median age at examination was 5.5 years (range 2.2-5.6). The median HA concentration was 17.7 ng mL -1 (range 10.0-82.1), which was used to divide our 28 patients into two groups. Patients in the high-HA group had significantly greater Qin/Qex of the PV than those in the low-HA group (1.25 ± 0.12 vs. 1.12 ± 0.11, p \ 0.05). Platelet counts were significantly lower in the high-HA group (216 ± 74 vs. 294 ± 104 9 10 9 L -