Influence of Years of Experience on Clinical Competence of Novice Physical and Occupational Therapists in Japan

Purpose: To increase the clinical competence of novice physical and occupational therapists, an accurate assessment of their clinical competence is necessary. However, no previous study has objectively analyzed the changes in novice therapists’ clinical competence in Japan. Hence, this study investigated and evaluated the changes in the clinical competence of such therapists using an objective analysis. Method: The study included 34 novice therapists with 1–3 years of experience in clinical practice. Participants were divided into groups according to their years of experience. The clinical competence of the novice therapists was evaluated twice using a clinical competency evaluation scale. For comparison among the 3 groups, the scores of the first evaluation were used. For comparison within each experience-year, the scores from both evaluations were used. Results: A comparison of the 3 groups showed that therapists with 3 years of clinical experience had significantly higher clinical competence than therapists with 1 year of clinical experience. Between the first and second evaluations, all therapists with 1 year of clinical experience demonstrated increased scores, whereas scores decreased by approximately 50% for therapists with 2–3 years of clinical experience. Conclusion: These findings suggest that it is necessary to increase educational opportunities for therapists with 2−3 years of clinical experience and re-examine the content of their education and training

Evaluation of the relationship between joint torque and angular velocity using a modified leg extension machine

OBJECTIVE: When performing knee extension using a leg extension machine, the lower limb is pushed back in the direction in which knee flexion occurs in response to the freefall of the weight after maximal knee extension. Therefore, eccentric contractions of the knee extensors are needed, which may lead to cumulative fatigue of the extensors, consequently reducing the reliability of the knee extensor torque values. This study aimed to determine the relationship between joint torque and angular velocity in one repetition maximum (1RM) measurement for knee extension using a leg extension machine with and without a modification to prevent counter-rotation. METHODS: Twenty-one healthy adult men (mean age: 27.7±5.4 years) participated in the study. A leg extension machine was modified to prevent counter-rotation due to the freefall of weights. The subjects performed knee extension using the modified leg extension machine, and the joint torque and angular velocity were calculated using two-dimensional analysis. A regression equation between these two factors was created to estimate the maximal isometric torque. RESULTS: Both the joint torque and angular velocity tended to increase after modification of the leg extension machine, although these differences were not significant. Similarly, there were no significant post-modification changes in the estimated maximal isometric torque. CONCLUSIONS: Our results showed that the joint torque, angular velocity, and estimated maximal isometric torque remained unchanged after machine modification; thus, the modified leg extension machine may make it possible to produce the knee extensor torque more safely in 1RM measurement

Population density, call-response interval, and survival of out-of-hospital cardiac arrest

<p>Abstract</p> <p>Background</p> <p>Little is known about the effects of geographic variation on outcomes of out-of-hospital cardiac arrest (OHCA). The present study investigated the relationship between population density, time between emergency call and ambulance arrival, and survival of OHCA, using the All-Japan Utstein-style registry database, coupled with geographic information system (GIS) data.</p> <p>Methods</p> <p>We examined data from 101,287 bystander-witnessed OHCA patients who received emergency medical services (EMS) through 4,729 ambulatory centers in Japan between 2005 and 2007. Latitudes and longitudes of each center were determined with address-match geocoding, and linked with the Population Census data using GIS. The endpoints were 1-month survival and neurologically favorable 1-month survival defined as Glasgow-Pittsburgh cerebral performance categories 1 or 2.</p> <p>Results</p> <p>Overall 1-month survival was 7.8%. Neurologically favorable 1-month survival was 3.6%. In very low-density (<250/km²) and very high-density (≥10,000/km²) areas, the mean call-response intervals were 9.3 and 6.2 minutes, 1-month survival rates were 5.4% and 9.1%, and neurologically favorable 1-month survival rates were 2.7% and 4.3%, respectively. After adjustment for age, sex, cause of arrest, first aid by bystander and the proportion of neighborhood elderly people ≥65 yrs, patients in very high-density areas had a significantly higher survival rate (odds ratio (OR), 1.64; 95% confidence interval (CI), 1.44 - 1.87; p < 0.001) and neurologically favorable 1-month survival rate (OR, 1.47; 95%CI, 1.22 - 1.77; p < 0.001) compared with those in very low-density areas.</p> <p>Conclusion</p> <p>Living in a low-density area was associated with an independent risk of delay in ambulance response, and a low survival rate in cases of OHCA. Distribution of EMS centers according to population size may lead to inequality in health outcomes between urban and rural areas.</p

Development of AI-driven prediction models to realize real-time tumor tracking during radiotherapy

[Background] In infrared reflective (IR) marker-based hybrid real-time tumor tracking (RTTT), the internal target position is predicted with the positions of IR markers attached on the patient’s body surface using a prediction model. In this work, we developed two artificial intelligence (AI)-driven prediction models to improve RTTT radiotherapy, namely, a convolutional neural network (CNN) and an adaptive neuro-fuzzy inference system (ANFIS) model. The models aim to improve the accuracy in predicting three-dimensional tumor motion. [Methods] From patients whose respiration-induced motion of the tumor, indicated by the fiducial markers, exceeded 8 mm, 1079 logfiles of IR marker-based hybrid RTTT (IR Tracking) with the gimbal-head radiotherapy system were acquired and randomly divided into two datasets. All the included patients were breathing freely with more than four external IR markers. The historical dataset for the CNN model contained 1003 logfiles, while the remaining 76 logfiles complemented the evaluation dataset. The logfiles recorded the external IR marker positions at a frequency of 60 Hz and fiducial markers as surrogates for the detected target positions every 80-640 ms for 20-40 s. For each logfile in the evaluation dataset, the prediction models were trained based on the data in the first three quarters of the recording period. In the last quarter, the performance of the patient-specific prediction models was tested and evaluated. The overall performance of the AI-driven prediction models was ranked by the percentage of predicted target position within 2 mm of the detected target position. Moreover, the performance of the AI-driven models was compared to a regression prediction model currently implemented in gimbal-head radiotherapy systems. [Results] The percentage of the predicted target position within 2 mm of the detected target position was 95.1%, 92.6% and 85.6% for the CNN, ANFIS, and regression model, respectively. In the evaluation dataset, the CNN, ANFIS, and regression model performed best in 43, 28 and 5 logfiles, respectively. [Conclusions] The proposed AI-driven prediction models outperformed the regression prediction model, and the overall performance of the CNN model was slightly better than that of the ANFIS model on the evaluation dataset

Preparation of Au-Pd Core-shell Nanoparticles Supported TiO2 and Influence of Photocatalytic Activity on the Shell Thickness

ナノダイナミクス国際シンポジウム 平成22年1月21日(木) 於長崎大学Nagasaki Symposium on Nano-Dynamics 2010 (NSND2010), January 21, 2010, Nagasaki University, Nagasaki, Japan, Invited Lectur

Dependence of the Pickup-Like Ion Effective Heating on the Poloidal and Toroidal Magnetic Fields during Magnetic Reconnection

The dependence of the ion effective heating on the poloidal (reconnection) and toroidal (guide) magnetic fields during magnetic reconnection in the presence of a guide magnetic field is investigated by means of particle simulations, which mimic merging plasmas in a spherical tokamak. In previous works, our simulations demonstrated that the ion temperature perpendicular to the magnetic field grows mainly in the downstream, in which ring-shaped velocity distributions are formed. This means that ions are effectively heated. The basic theory explains that the ring-shaped distribution is formed by the ions which rotate around the guide magnetic field while E × B drifting. In this work, the basic theory is extended to a more general theory including not only a ring-shaped distribution, but also a circular-arc-shaped distribution. The generalized theory explains that the effective temperature changes by the radius and the central angle of the arc-shaped velocity distribution and conjectures the dependence of the ion effective heating on the poloidal and toroidal magnetic fields. The simulations show that the ion heating energy is proportional to the square of the poloidal magnetic field, whereas the ion temperature decreases as the toroidal field is larger, but the toroidal field dependence becomes small for the regime of high toroidal field. These tendencies are consistent with those observed in experiments

Sarcomatoid Variant of Bladder Carcinoma: A Case Report

A 59-year-old man was referred to our hospital complaining of asymptomatic gross hematuria. Cystoscopy revealed a papillary tumor 8 cm in diameter filling the bladder. The patient underwent transurethral resection of the bladder tumor. The pathological findings revealed the sarcomatoid variant of urothelial carcinoma with a heterologous osteosarcomatous element. He had no metastasis according to our imaging analyses; thus, we planned radical cystectomy after two courses of neoadjuvant chemotherapy (gemcitabine and cisplatin). Following chemotherapy, enlarged pelvic lymph nodes were noted, and extremely aggressive local progression of the bladder tumor was confirmed. The patient ultimately died 6 months after his initial visit to our hospital