Development of Space Truss Structure Using Glass Fiber Reinforced Plastics

This paper describes the development of a space truss structure using Glass Fiber Reinforced Plastic (GFRP) pipe that decreases life cycle cost and enhances construction efficiency. Material tests, structural experiments and FEM analysis verify the practicality of this structural system

Environmental Consciouness in Japan on Materials and Products -Analysis of Eco-MCPS, a Web-database for Ecomaterials

Eco-MCPS database is a web-based database system that contains data of environment-conscious materials,components, products, and services. The text data compiled in the Eco-MCPS and the access log data of Eco-MCPS were subjected to data mining. Word-frequency analysis and dependency parsing analysis were applied tothe data to obtain the frequently used terms and their situations of use. By analyzing the access log, the interestof the visitors accessed to the web-site can be understood. The results showed that eco-products\u27 environmental performances are realized by the use of environment-friendly components or materials. The page views, which represent the visitors\u27 interest, were related with the frequently used term in the comments of Eco-MCPS to showthe social consciousness on environment-friendly products. By further analyzing the access log, it was found thatthe word search rank followed the Zipf\u27s Law

ガラスノブンソウナラビニケッショウカトキカイテキキョウドニカンスルケンキュウ

京都大学0048新制・課程博士工学博士甲第1241号工博第301号新制||工||225(附属図書館)3306UT51-47-K15京都大学大学院工学研究科工業化学専攻(主査)教授 田代 仁, 教授 功刀 雅長, 教授 神野 博学位規則第5条第1項該当Kyoto UniversityDA

Shared decision-making interventions for people with mental health conditions

Background One person in every four will suffer from a diagnosable mental health condition during their life. Such conditions can have a devastating impact on the lives of the individual and their family, as well as society. International healthcare policy makers have increasingly advocated and enshrined partnership models of mental health care. Shared decision‐making (SDM) is one such partnership approach. Shared decision‐making is a form of service user‐provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This review assesses whether SDM interventions improve a range of outcomes. This is the first update of this Cochrane Review, first published in 2010. Objectives To assess the effects of SDM interventions for people of all ages with mental health conditions, directed at people with mental health conditions, carers, or healthcare professionals, on a range of outcomes including: clinical outcomes, participation/involvement in decision‐making process (observations on the process of SDM; user‐reported, SDM‐specific outcomes of encounters), recovery, satisfaction, knowledge, treatment/medication continuation, health service outcomes, and adverse outcomes. Search methods We ran searches in January 2020 in CENTRAL, MEDLINE, Embase, and PsycINFO (2009 to January 2020). We also searched trial registers and the bibliographies of relevant papers, and contacted authors of included studies. We updated the searches in February 2022. When we identified studies as potentially relevant, we labelled these as studies awaiting classification. Selection criteria Randomised controlled trials (RCTs), including cluster‐randomised controlled trials, of SDM interventions in people with mental health conditions (by Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) criteria). Data collection and analysis We used standard methodological procedures expected by Cochrane. Two review authors independently screened citations for inclusion, extracted data, and assessed risk of bias. We used GRADE to assess the certainty of the evidence. Main results This updated review included 13 new studies, for a total of 15 RCTs. Most participants were adults with severe mental illnesses such as schizophrenia, depression, and bipolar disorder, in higher‐income countries. None of the studies included children or adolescents. Primary outcomes We are uncertain whether SDM interventions improve clinical outcomes, such as psychiatric symptoms, depression, anxiety, and readmission, compared with control due to very low‐certainty evidence. For readmission, we conducted subgroup analysis between studies that used usual care and those that used cognitive training in the control group. There were no subgroup differences. Regarding participation (by the person with the mental health condition) or level of involvement in the decision‐making process, we are uncertain if SDM interventions improve observations on the process of SDM compared with no intervention due to very low‐certainty evidence. On the other hand, SDM interventions may improve SDM‐specific user‐reported outcomes from encounters immediately after intervention compared with no intervention (standardised mean difference (SMD) 0.63, 95% confidence interval (CI) 0.26 to 1.01; 3 studies, 534 participants; low‐certainty evidence). However, there was insufficient evidence for sustained participation or involvement in the decision‐making processes. Secondary outcomes We are uncertain whether SDM interventions improve recovery compared with no intervention due to very low‐certainty evidence. We are uncertain if SDM interventions improve users' overall satisfaction. However, one study (241 participants) showed that SDM interventions probably improve some aspects of users' satisfaction with received information compared with no intervention: information given was rated as helpful (risk ratio (RR) 1.33, 95% CI 1.08 to 1.65); participants expressed a strong desire to receive information this way for other treatment decisions (RR 1.35, 95% CI 1.08 to 1.68); and strongly recommended the information be shared with others in this way (RR 1.32, 95% CI 1.11 to 1.58). The evidence was of moderate certainty for these outcomes. However, this same study reported there may be little or no effect on amount or clarity of information, while another small study reported there may be little or no change in carer satisfaction with the SDM intervention. The effects of healthcare professional satisfaction were mixed: SDM interventions may have little or no effect on healthcare professional satisfaction when measured continuously, but probably improve healthcare professional satisfaction when assessed categorically. We are uncertain whether SDM interventions improve knowledge, treatment continuation assessed through clinic visits, medication continuation, carer participation, and the relationship between users and healthcare professionals because of very low‐certainty evidence. Regarding length of consultation, SDM interventions probably have little or no effect compared with no intervention (SDM 0.09, 95% CI ‐0.24 to 0.41; 2 studies, 282 participants; moderate‐certainty evidence). On the other hand, we are uncertain whether SDM interventions improve length of hospital stay due to very low‐certainty evidence. There were no adverse effects on health outcomes and no other adverse events reported. Authors' conclusions This review update suggests that people exposed to SDM interventions may perceive greater levels of involvement immediately after an encounter compared with those in control groups. Moreover, SDM interventions probably have little or no effect on the length of consultations. Overall we found that most evidence was of low or very low certainty, meaning there is a generally low level of certainty about the effects of SDM interventions based on the studies assembled thus far. There is a need for further research in this area

Treatment strategy for insomnia disorder: Japanese expert consensus

PurposeThere is a lack of evidence regarding answers for clinical questions about treating insomnia disorder. This study aimed to answer the following clinical questions: (1) how to use each hypnotic and non-pharmacological treatment differently depending on clinical situations and (2) how to reduce or stop benzodiazepine hypnotics using alternative pharmacological and non-pharmacological treatments.MethodsExperts were asked to evaluate treatment choices based on 10 clinical questions about insomnia disorder using a nine-point Likert scale (1 = “disagree” to 9 = “agree”). The responses of 196 experts were collected, and the answers were categorized into first-, second-, and third-line recommendations.ResultsThe primary pharmacological treatment, lemborexant (7.3 ± 2.0), was categorized as a first-line recommendation for sleep initiation insomnia, and lemborexant (7.3 ± 1.8) and suvorexant (6.8 ± 1.8) were categorized as the first-line recommendations for sleep maintenance insomnia. Regarding non-pharmacological treatments for primary treatment, sleep hygiene education was categorized as the first-line recommendation for both sleep initiation (8.4 ± 1.1) and maintenance insomnia (8.1 ± 1.5), while multicomponent cognitive behavioral therapy for insomnia was categorized as the second-line treatment for both sleep initiation (5.6 ± 2.3) and maintenance insomnia (5.7 ± 2.4). When reducing or discontinuing benzodiazepine hypnotics by switching to other medications, lemborexant (7.5 ± 1.8) and suvorexant (6.9 ± 1.9) were categorized as first-line recommendations.ConclusionExpert consensus indicates that orexin receptor antagonists and sleep hygiene education are recommended as first-line treatments in most clinical situations to treat insomnia disorder