The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

Rate Constant and Anti-oxidative Activity toward Hydroxyl Radicals; UV Irradiation

The anti-oxidative activity toward hydroxyl radicals was expressed by the reaction rate constant. Rate constants were presented for basic organic substances and reducing reagents. Hydroxyl radicals were generated by UV-irradiation of hydrogen peroxide. The pH was controlled through the reaction in the range 6.5-7.0. The dependence on the concentration of anti-oxidative substances was so small that the validity of the theoretical analysis was guaranteed

Nano Quasicrystal Formation and Local Atomic Structure in Zr––Pd and Zr––Pt Binary Metallic Glasses

Formation of the nanoscale icosahedral quasicrystalline phase (I-phase) in the melt-spun Zr70Pd30 and Zr80Pt20 binary metallic glasses were reported. Local atomic structure in the glassy and quasicrystal (QC)-formed states were also analyzed by XRD and EXAFS measurements in order to investigate the formation mechanism of QC phase. The distorted icosahedral-like local structure can be identified around Zr atom in the Zr70Pd30 metallic glass. In the QC formation process, a change of local environment around Zr is detected, in which the approximately one Zr atom substitutes for one Pd atom. In contrast, since the local environment around Pt atom is remaining during the QC precipitation, it is suggested that the stable icosahedral local structure is mainly formed around a center Pt atom in the glassy state in Zr80Pt20. We also found that the local environment around Zr atom significantly changes during the quasicrystallization in the alloy. These results differ from those in the Zr70Pd30 metallic glass