Descriptive Analysis of Patients’ EMS Use Related to Severity in Tokyo: A Population-Based Observational Study

IntroductionFew studies are available on the clinical characteristics of patients using emergency medical transports in Japan. In this study, we aimed to investigate reasons for emergency medical transports and their relation to clinical severity.MethodsWe conducted a 3-year population-based observational study of patients transported by ambulance to emergency departments (ED) in the capital of Japan, Tokyo, which has a population of about 13 million. Demographic data, reasons for transport, and the severity of initial assessment at ED were recorded. Logistic regression was used to determine the odds of the clinical severity of each reason for transport.ResultsThe number of emergency medical transports in the three-year study period was 1,832,637. Mean age was 53±26. Males were 976,142 (53%). Overall, 92% of all transported patients were in a mild or moderate medical state and patients with the 17 most frequent reasons for transport occupied 82% (1,506,017) of all transports. Pain was the most frequent reason for transport, followed by traffic accident. Considering all the patients and their reasons for transport, patients whose reason was pain or a traffic accident (29% of all patients) were in a relatively mild state compared with patients with other reasons for transport. Patients in an altered mental state in the prehospital setting (6.8% of all patients) were in a more severe medical state than other patients.ConclusionsIn Tokyo, Japan, 92% of transported patients were in a mild or moderate medical state. In particular, most patients from traffic accidents were in a mild state, even though traffic accidents were the second most frequent reason for transport. Patients in an altered mental state were most likely to be in a severe medical state

A case report of posttraumatic growth from a psychosomatic disorder due to traumatic stress in a 50s woman

【目的】本研究では，トラウマ性ストレスによる心身障害を抱えた50代女性に対する，トラウマ体験を物語ることに焦点を当てた介入の症例から心的外傷後成長（Posttraumatic growth: PTG）の生起過程を考察する。【現病歴】a 市における自然災害死目撃を機に不安，恐怖が持続。薬物治療で回復に向かうも，a 市に帰郷すると体調が増悪するというサイクルを繰り返した。【事例の経過】トラウマ体験を物語ることを目的に，ナラティブ・エクスポージャー・セラピー（Narrative Exposure Therapy: NET）を実施した結果，不安と恐怖が軽減した。その過程の中で夫との親密さが増し，ともにトラウマに立ち向かった結果，症状なくa 市に帰郷できるようになった。【考察】トラウマ体験を物語ることで，PTG に必要な「意図的反芻」，「語りの発展」，「スキーマの変化」を促進し「人間としての強さ」，「他者との関係」の領域においてPTG が生起したと考えられる。【Purpose】 This clinical study is to report the effectiveness of narrative approach for PTG to open up traumatic experiences in a 50s women with psychosomatic disorder due to traumatic stress.【History of present illness】 I anxiety and fear continued after witnessing the death of a natural disaster in a city. The patient recovered with medication. However, she repeated the cycle that his physical condition got worse when he returned to a city.【Progress】 As she described her traumatic experience, her anxiety and fear lessened. In the process, the intimacy with the husband increased, and they faced the trauma together. Two years after intervention, She was back to a city without symptoms.【Disccusion】 It is considered that “intentional rumination”, “development of the narrative”, and “change of the schema”necessary for PTG were promoted by telling the traumatic experience, and PTG arose in the region of “strength as a human” and “relation with others

The Japanese space gravitational wave antenna; DECIGO

DECi-hertz Interferometer Gravitational wave Observatory (DECIGO) is the future Japanese space gravitational wave antenna. DECIGO is expected to open a new window of observation for gravitational wave astronomy especially between 0.1 Hz and 10 Hz, revealing various mysteries of the universe such as dark energy, formation mechanism of supermassive black holes, and inflation of the universe. The pre-conceptual design of DECIGO consists of three drag-free spacecraft, whose relative displacements are measured by a differential Fabry– Perot Michelson interferometer. We plan to launch two missions, DECIGO pathfinder and pre- DECIGO first and finally DECIGO in 2024

Comparison of the Effects of Phenylhydrazine Hydrochloride and Dicyandiamide on Ammonia-Oxidizing Bacteria and Archaea in Andosols

Dicyandiamide, a routinely used commercial nitrification inhibitor (NI), inhibits ammonia oxidation catalyzed by ammonia monooxygenase (AMO). Phenylhydrazine hydrochloride has shown considerable potential for the development of next-generation NIs targeting hydroxylamine dehydrogenase (HAO). The effects of the AMO inhibitor and the HAO inhibitor on ammonia-oxidizing bacteria (AOB) and ammonia-oxidizing archaea (AOA) present in agricultural soils have not been compared thus far. In the present study, the effects of the two inhibitors on soil nitrification and the abundance of AOA and AOB as well as their community structure were investigated in a soil microcosm using quantitative polymerase chain reaction and pyrosequencing. The net nitrification rates and the growth of AOA and AOB in this soil microcosm were inhibited by both NIs. Both NIs had limited effect on the community structure of AOB and no effect on that of AOA in this soil microcosm. The effects of phenylhydrazine hydrochloride were similar to those of dicyandiamide. These results indicated that organohydrazine-based NIs have potential for the development of next-generation NIs targeting HAO in the future

Severity of patients in ambulance transports in Tokyo.

<p>Severity of patients in ambulance transports in Tokyo.</p

Subgroup analysis of internal causes using logistic regression for severity.

<p>Subgroup analysis of internal causes using logistic regression for severity.</p

Characteristics of emergency medical transports in Tokyo.

<p>Characteristics of emergency medical transports in Tokyo.</p