Characteristics of patients hospitalised in an emergency department observation unit in Japan

In Japan, transporting elderly patients to emergency departments has recently posed serious problems, including a longer average time from patients’ initial emergency calls to their arrival at hospitals. To manage emergency departments more efficiently, many hospitals in the United States and some other developed countries, including Japan, introduced emergency department observation units (EDOU). However, because the usefulness of EDOUs in managing elderly patients remains uncertain, we analysed data of patients admitted to a Japanese university hospital’s EDOU to gauge its efficacy. We followed 1,426 patients admitted to the hospital’s EDOU from 1 January 2011 to 31 December 2014. The average age of patients who stayed in the EDOU increased, whereas the average length of time that they spent there decreased. Although the percentage of patients older than 65 years increased slightly, from 36.42% (2011–2012) to 37.73% (2013–2014), the proportion of those patients between the two periods did not significantly change (P = .61). Moreover, their average length of stay was 2.16 ± 0.91 days, whereas patients younger than 65 years stayed for significantly less time (1.92 ± 0.82 days). By condition, approximately 36% of patients older than 65 years presented with non-neurosurgical trauma, approximately 59% presented with other forms of trauma, but proportions of both categories of trauma were significantly smaller in patients younger than 65 years (nonneurosurgical trauma, 23%; all trauma, 47%). Most elderly patients with limb trauma prepped for surgery were transferred to other hospitals after a few days. Results suggest that the EDOU at the university hospital has served to as a buffer for regional emergency medical systems in Japan, especially given the continued ageing of the Japanese population

Novel, Objective, Multivariate Biomarkers Composed of Plasma Amino Acid Profiles for the Diagnosis and Assessment of Inflammatory Bowel Disease

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic intestinal disorder that is associated with a limited number of clinical biomarkers. In order to facilitate the diagnosis of IBD and assess its disease activity, we investigated the potential of novel multivariate indexes using statistical modeling of plasma amino acid concentrations (aminogram). METHODOLOGY AND PRINCIPAL FINDINGS: We measured fasting plasma aminograms in 387 IBD patients (Crohn's disease (CD), n = 165; ulcerative colitis (UC), n = 222) and 210 healthy controls. Based on Fisher linear classifiers, multivariate indexes were developed from the aminogram in discovery samples (CD, n = 102; UC, n = 102; age and sex-matched healthy controls, n = 102) and internally validated. The indexes were used to discriminate between CD or UC patients and healthy controls, as well as between patients with active disease and those in remission. We assessed index performances using the area under the curve of the receiver operating characteristic (ROC AUC). We observed significant alterations to the plasma aminogram, including histidine and tryptophan. The multivariate indexes established from plasma aminograms were able to distinguish CD or UC patients from healthy controls with ROC AUCs of 0.940 (95% confidence interval (CI): 0.898-0.983) and 0.894 (95%CI: 0.853-0.935), respectively in validation samples (CD, n = 63; UC, n = 120; healthy controls, n = 108). In addition, other indexes appeared to be a measure of disease activity. These indexes distinguished active CD or UC patients from each remission patients with ROC AUCs of 0.894 (95%CI: 0.853-0.935) and 0.849 (95%CI: 0.770-0.928), and correlated with clinical disease activity indexes for CD (r(s) = 0.592, 95%CI: 0.385-0.742, p<0.001) or UC (r(s) = 0.598, 95%CI: 0.452-0.713, p<0.001), respectively. CONCLUSIONS AND SIGNIFICANCE: In this study, we demonstrated that established multivariate indexes composed of plasma amino acid profiles can serve as novel, non-invasive, objective biomarkers for the diagnosis and monitoring of IBD, providing us with new insights into the pathophysiology of the disease

Fabrication of CeCl₃/LiCl/CaCl₂ Ternary Eutectic Scintillator for Thermal Neutron Detection

To date, 3He gas has been commonly used to detect thermal neutrons because of their high chemical stability and low sensitivity to γ-rays, owing to their low density and large neutron capture cross-section. However, the depletion of 3He gas prompts the development of a new solid scintillator for thermal neutron detection to replace 3He gas detectors. Solid scintillators containing 6Li are commonly used to detect thermal neutrons. However, they are currently used in single crystals only, and their 6Li concentration is defined by their chemical composition. In this study, 6Li-containing eutectic scintillators were developed. CeCl3 was selected as the scintillator phase because of its low density (3.9 g/cm3); high light yield (30,000 photons/MeV); and fast decay time with four components of 4.4 ns (6.6%), 23.2 ns (69.6%), 70 ns (7.5%) and >10 μs (16.3%), owing to the Ce3+ 5d-4f emission peak at approximately 360 nm. Crystals of the CeCl3, LiCl and CaCl2 ternary eutectic were fabricated by the vertical Bridgman technique. The grown eutectic crystals exhibited Ce3+ 5d-4f emission with a peak at 360 nm. The light yield was 18,000 photons/neutron, and the decay time was 10.5 ns (27.7%) and 40.1 ns (72.3%). Therefore, this work demonstrates optimization by combining a scintillator phase and Li-rich matrix phase for high Li content, fast timing, high light yield and low density

Fabrication of CeCl3/LiCl/CaCl2 Ternary Eutectic Scintillator for Thermal Neutron Detection

To date, 3He gas has been commonly used to detect thermal neutrons because of their high chemical stability and low sensitivity to &gamma;-rays, owing to their low density and large neutron capture cross-section. However, the depletion of 3He gas prompts the development of a new solid scintillator for thermal neutron detection to replace 3He gas detectors. Solid scintillators containing 6Li are commonly used to detect thermal neutrons. However, they are currently used in single crystals only, and their 6Li concentration is defined by their chemical composition. In this study, 6Li-containing eutectic scintillators were developed. CeCl3 was selected as the scintillator phase because of its low density (3.9 g/cm3); high light yield (30,000 photons/MeV); and fast decay time with four components of 4.4 ns (6.6%), 23.2 ns (69.6%), 70 ns (7.5%) and &gt;10 &mu;s (16.3%), owing to the Ce3+ 5d-4f emission peak at approximately 360 nm. Crystals of the CeCl3, LiCl and CaCl2 ternary eutectic were fabricated by the vertical Bridgman technique. The grown eutectic crystals exhibited Ce3+ 5d-4f emission with a peak at 360 nm. The light yield was 18,000 photons/neutron, and the decay time was 10.5 ns (27.7%) and 40.1 ns (72.3%). Therefore, this work demonstrates optimization by combining a scintillator phase and Li-rich matrix phase for high Li content, fast timing, high light yield and low density

High Tangent Radiation Therapy With Field-in-Field Technique for Breast Cancer

Purpose: We evaluated whether the field-in-field (FIF) technique improves the homogeneity of the target in high tangent radiation therapy (HTRT). Materials and Methods: This study included 30 patients. In total, 3 HTRT plans were created: 1 with conventional opposed fields (Conv-p), 1 with the FIF technique (FIF-p), and 1 with FIF technique using lung-blocked subfields (FIF-LB-p). Results: The maximum dose of the breast and planning target volume (PTV) was significantly lower for FIF-p and FIF-LB-p than Conv-p. Homogeneity index of PTV was also significantly lower for FIF-p and FIF-LB-p than Conv-p. Homogeneity index of the breast or PTV was significantly better for FIF-p than FIF-LB-p. The volumes of the breast or the PTV receiving 95% and 90% of the prescribed dose were also significantly better for FIF-p, indicating the advantages of FIF-p. Conclusions: The FIF technique was useful in HTRT and improved homogeneity in the target

Fabrication and Characterization of K₂CeCl₅/⁶LiCl and CeCl₃/SrCl₂/⁶LiCl Eutectics for Thermal Neutron Detection

In recent years, thermal neutron detection using scintillators has been used in a wide range of fields. Thus, the development of scintillators with a higher light yield, faster decay, and higher sensitivity for thermal neutrons is required. In this study, K2CeCl5/6LiCl and CeCl3/SrCl2/6LiCl were developed as novel eutectic scintillators for thermal neutron detection. LiCl was selected as the neutron capture phase and K2CeCl5 and CeCl3 were used as the scintillator phases. The eutectics of K2CeCl5/6LiCl and CeCl3/SrCl2/6LiCl were prepared using the Vertical Bridgman method and the phases were identified by scanning electron microscopy and powder X-ray diffraction measurements. The results of radioluminescence measurements under Ag source X-ray tube irradiation confirmed that the 5d-4f emission derived from Ce3+. The cathodoluminescence spectra and thermal neutron responses of the prepared eutectics were measured to evaluate their optical properties

Fabrication and Characterization of K2CeCl5/6LiCl and CeCl3/SrCl2/6LiCl Eutectics for Thermal Neutron Detection

In recent years, thermal neutron detection using scintillators has been used in a wide range of fields. Thus, the development of scintillators with a higher light yield, faster decay, and higher sensitivity for thermal neutrons is required. In this study, K2CeCl5/6LiCl and CeCl3/SrCl2/6LiCl were developed as novel eutectic scintillators for thermal neutron detection. LiCl was selected as the neutron capture phase and K2CeCl5 and CeCl3 were used as the scintillator phases. The eutectics of K2CeCl5/6LiCl and CeCl3/SrCl2/6LiCl were prepared using the Vertical Bridgman method and the phases were identified by scanning electron microscopy and powder X-ray diffraction measurements. The results of radioluminescence measurements under Ag source X-ray tube irradiation confirmed that the 5d-4f emission derived from Ce3+. The cathodoluminescence spectra and thermal neutron responses of the prepared eutectics were measured to evaluate their optical properties

MIAI for monitoring IBD patients.

<p>Monitoring of some individual patients was performed prospectively. Upper panel shows the alterations in Index (CDa/CDr) in ten patients with active CD (CDAI≥150; closed circles). Remission was defined as CDAI<150 (open circles). Lower panel shows the alterations in Index (UCa/UCr) in 12 patients with active UC (CAI≥5; closed circles). Remission was defined as CAI<5 (open circles).</p