Patient experience (PX) among individuals with disabilities in Japan: a mixed-methods study

[Background] People with disabilities (PWDs) tend to be disadvantaged in terms of receiving preventive medicine and medical checkups. About 7.6% of the Japanese population is estimated to have a disability. Although patient experience (PX) is an effective measure of patient-centeredness, little is known about the PX of PWDs. The present study aimed to compare the PX of PWDs with those of the non-disabled both quantitatively and qualitatively. [Methods] The present study involved a questionnaire survey and a free-response question on the survey form. The quantitative part of the study involved a comparison of JPCAT scores between PWDs and non-disabled participants. JPCAT is composed of five primary care principles: First contact, Longitudinality, Coordination, Comprehensiveness (service provided and service available), and Community orientation. Descriptive statistics were used to assess age, sex, years of education, self-rated health status, and type of disability (for PWDs). Multivariable analysis was performed using a linear regression model to detect differences between PWDs and non-disabled participants in total and domain-specific JPCAT scores. The model included the following confounding variables: age, sex, years of education, and self-rated health status. The qualitative part of the study involved a thematic analysis of answers to the free-response question. [Results] Data from 338 participants (169 PWDs and 169 non-disabled participants) were analyzed (response rate of 36% for PWDs). After adjusting for age, sex, years of education, and self-rated health status, PWD scores were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains of the JPCAT. Qualitative analysis yielded six themes, each of which was further divided to have Disability-Specific and General themes. [Conclusions] JPCAT scores in PWDs were significantly lower than those of non-disabled participants for the Longitudinality, Community Orientation, and Comprehensiveness (services available) domains. Qualitative analysis revealed that PWDs shared several themes with non-disabled participants, but also to face unique challenges due to disabilities, such as the lack of a health care provider familiar with disabilities and the insurance transition at age 65, a unique feature of the Japanese health care system. [Trial registration] The study was a non-interventional, observational research trial, and thus registration was not required

Q(√5)の円分的Z₂-拡大の類数問題について

早大学位記番号:新8412早稲田大

Designing a banking scale of human induced pluripotent stem cells based on suspension time-dependent quality variations in filling and cryopreservation processes

To establish a robust commercial production system for a cell product, it is necessary to investigate a lot of variable factors inside and outside of the system and discuss the cell manufacturability. In case of trying a scale-up of banking system for human induced pluripotent stem cells (hiPSCs), the process time to fill the cell suspension into vials before cryopreservation is prolonged. And that will cause the decay of the cell quality, because cryoprotective agent (CPA) including dimethyl sulfoxide has toxicity to cells. Based on such fluctuation of cell product quality derived from time-dependency in down-stream process, novel strategy to design a process time and a banking scale is required. In this study, four performance indexes, survival ratio of cells during suspension in CPA before cryopreservation (γ), survival ratio, attachment efficiency and specific growth rate of cells after cryopreservation (β, α and μ, respectively) are proposed to evaluate the cellular state and potential of the product. And, the quality variations of suspended cells in CPA are elucidated by changing the process time of suspension at room temperature and 4 °C. At room temperature, γ decreased with process time (ts) exponentially, being γ = 0.72 at ts = 6 h. With respect to α, 4 hours suspension at room temperature had an insignificant effect, however, it dropped after the lag-time, being α = 0.73 at ts = 6 h. In contrast, β and μ were kept high level of 0.80 and 5.3 × 10-2 h-1, respectively, similarly to those without the process. In addition, the suspension at 4°C made the enhancement of γ and α at ts = 6 h (γ = 0.88 and α = 1.08, respectively), suggesting that the suppression in cell activity during suspension is important to preserve the cell quality. In conclusion, the proposed performance indexes are useful to estimate the state and potential of cell product in filling and cryopreservation processes, and the temperature control in filling process is one of the promising factors to maintain the cell product quality. Please click Additional Files below to see the full abstract

Primary care patient experience and cancer screening uptake among women: an exploratory cross-sectional study in a Japanese population

Background: Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population. Methods: We conducted a cross-sectional mail survey. The questionnaire was sent to 1000 adult female residents randomly selected from a basic resident register in Yugawara town, Kanagawa, Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT) and uptake of breast and cervical cancer screening. Results: The overall response rate was 46.5%. Data were analyzed for 190 female participants aged 21–74 years who had a usual source of primary care. Multivariate logistic regression analyses revealed that the JPCAT total score was significantly associated with uptake of breast cancer screening [odds ratio (OR) per 1 standard deviation increase = 1.63; 95% CI 1.11–2.41], but not with uptake of cervical cancer screening (OR per 1 standard deviation increase = 1.47; 95% CI 0.97–2.24). Conclusions: Patient experience of primary care was associated with uptake of breast cancer screening among Japanese women. The results of our study might support the argument that patient experience of primary care and the clinical process of preventive care, such as breast cancer screening, are linked. Electronic supplementary material The online version of this article (doi:10.1186/s12930-017-0033-7) contains supplementary material, which is available to authorized users

FORMATION OF CARBON INTERPHASE ON POLYCRYSTALLINE AND AMORPHOUS SiC FIBERS IN SiC/SiC COMPOSITES BY ELECTROPHORETIC DEPOSITION

Continuous silicon carbide fiber-reinforced silicon carbide matrix (SiC/SiC) composites have been recognized as key materials for aerospace industries, high-temperature gas turbines and future nuclear and fusion applications because they show a pseudo-ductile fracture behavior and excellent fracture tolerance. Fiber/matrix interfaces act as an important role for toughening and strengthening SiC/SiC composites. Currently, carbon or hexagonal-boron nitride has been formed on SiC fibers as the interphases, and these interphases have been generally formed by chemical vapor infiltration (CVI), chemical vapor deposition (CVD) or solution-coating/pyrolysis process. However, these processes generally require long manufactuiring time and complicated apparatuses, and they use toxic, flammable or combustible reactant gases, resulting in much higher production cost and an increase in environmental load. Present authors paid attention to EPD process to form interphases on SiC fibers in SiC/SiC composites and demonstrated that EPD process was effective to form homogeneous C-interphase on SiC fibers [1-5]. In this study, EPD was applied for carbon interphase formation on polycrystalline (electric conductive) and amorphous (low electric conductive) SiC fibers in SiC/SiC composites, and microstructure and mechanical properties of the SiC/SiC composites were evaluated. From TEM micrograph of carbon interphase on the polycrystalline SiC fiber in the SiC/SiC composite formed by EPD, it was observed that flaky carbon particles were deposited parallel to the SiC fiber. Carbon has a layered structure and the layers bonded by weak van der Waals forces enable a low friction coefficient. As a result, the SiC/SiC composites with carbon interphases showed excellent mechanical properties with a pseudo-ductile fracture behavior. For amorphous SiC fibers, thin electric conductive polymer was coated on the amorphous SiC fibers, and carbon interphase formation was successfully achieved by EPD. The SiC/SiC composites reinforced with the carbon-coated amorphous SiC fibers also showed pseudo-ductile fracture behavior. References [1] K. Yoshida et al., Key Eng. Mater., 352 (2007) 133. [2] K. Yoshida et al., J. Nucl. Mater., 386-388 (2009) 643. [3] K. Yoshida et al., Mater. Sci. Eng. B, 161 (2009) 188. [4] K. Yoshida, J. Ceram. Soc. Japan, 118 (2010) 82. [5] K. Yoshida et al., Compos. Sci. Technol., 72 (2012) 1665. [6] K. Yoshida et al., Key Eng. Mater., 617 (2014) 213. [7] K. Yoshida, Chapter 18, in “MAX Phases and Ultra-High Temperature Ceramics for Extreme Environments” (2013)

Development of 3-Cylinder Rotary Compressor for Large Capacity

The authors have developed a large capacity rotary compressor with compact size and low vibration. Recently, we have strong requirements for larger capacity without changing the compressor shell diameter. Considering for larger capacity in conventional 2-cylinder rotary compressor inverter type, there are issues such as high vibration, big sound. As the solution for these problems, we have developed 3-cylinder rotary compressor inverter type which have different compression process of 120 ° phase per revolution for each cylinder. The developed compressor achieves a capacity target, proves one-quarter vibration level comparing with 2-cylinder rotary compressor and ensure the improvement of reliability result. We have been manufacturing the world largest capacity of new rotary compressor and have been launching into the market since September 2020. This new model has successfully attained more large capacity with same shell diameter as our previous large capacity of 2-cylinder rotary compressor inverter type. This new model adopt some new technologies such as the 3-cylinder design for balancing rotation torque, the multi discharge valve structure, the integrated bearing with partition plate and the new wide-range motor. By these technologies, the outdoor units of multiple air conditioner for buildings (Variable Refrigerant Flow-VRF) can achieve a large capacity 20 HP (56kW) with applying one compressor unit only

The effect of our local motion on the Sandage-Loeb test of the cosmic expansion

Redshifts of an astronomical body measured at multiple epochs (e.g., separated by 10 years) are different due to the cosmic expansion. This so-called Sandage-Loeb test offers a direct measurement of the expansion rate of the Universe. However, acceleration in the motion of Solar System with respect to the cosmic microwave background also changes redshifts measured at multiple epochs. If not accounted for, it yields a biased cosmological inference. To address this, we calculate the acceleration of Solar System with respect to the Local Group of galaxies to quantify the change in the measured redshift due to local motion. Our study is motivated by the recent determination of the mass of Large Magellanic Cloud (LMC), which indicates a significant fraction of the Milky Way mass. We find that the acceleration towards the Galactic Center dominates, which gives a redshift change of 7 cm/s in 10 years, while the accelerations due to LMC and M31 cannot be ignored depending on lines of sight. We create all-sky maps of the expected change in redshift and the corresponding uncertainty, which can be used to correct for this effect.Comment: 6 pages, 3 figures. Accepted for publication in PAS