ビョウインマエ シンパイ テイシ ニオケル キュウキュウ キュウメイシ ノ キカン ソウカン ニツイテ : ホンケン ノ ゲンジョウ ト コンゴ ノ カダイ

Activities of Japanese Paramedics have increased and advanced year by year. Especially, intubation for OHCPA（out of hospital cardiopulmonary arrest） is approved since July 2004, but it is necessary to finish the training in Fire-fighter’s school and intubation practice in hospitals. In Fire-fighter’s school, Paramedics attend lectures and simulation, and in hospital, intubation practice for patients. Medical-control is the system for keeping the qualities and verification of details in the scene of pre-hospital medical care. This report discusses the states and problems of paramedic intubation, practice in hospital, airway management, from the questionnaire survey

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016)

Background and purposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J-SSCG 2016), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 and published in the Journal of JSICM, [2017; Volume 24 (supplement 2)] https://doi.org/10.3918/jsicm.24S0001 and Journal of Japanese Association for Acute Medicine [2017; Volume 28, (supplement 1)] http://onlinelibrary.wiley.com/doi/10.1002/jja2.2017.28.issue-S1/issuetoc.This abridged English edition of the J-SSCG 2016 was produced with permission from the Japanese Association of Acute Medicine and the Japanese Society for Intensive Care Medicine.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ) and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two-thirds (> 66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J-SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation, and its supporting evidence were also added to each recommendation statement. We conducted meta-analyses for 29 CQs. Thirty-seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for five CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese-specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non-specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals

Eliminate crosstalk using symmetry in MIMO arrays of inductive antennas: an introduction to Pie-Chart antennas

We present a topology of MIMO arrays of inductive antennas exhibiting inherent high crosstalk cancellation capabilities. A single layer PCB is etched into a 3-channels array of emitting/receiving antennas. Once coupled with another similar 3-channels emitter/receiver, we measured an Adjacent Channel Rejection Ratio (ACRR) as high as 70 dB from 150 Hz to 150 kHz. Another primitive device made out of copper wires wound around PVC tubes to form a 2-channels “non-contact slip-ring” exhibited 22 dB to 47 dB of ACRR up to 15MHz. In this paper we introduce the underlying theoretical model behind the crosstalk suppression capabilities of those so-called “Pie-Chart antennas”: an extension of the mutual inductance compensation method to higher number of channels using symmetries. We detail the simple iterative building process of those antennas, illustrate it with numerical analysis and evaluate there effectiveness via real experiments on the 3-channels PCB array and the 2-channels rotary array up to the limit of our test setup. The Pie Chart design is primarily intended as an alternative solution to costly electronic filters or cumbersome EM shields in wireless AND wired applications, but not exclusively

Preparation of board-like moldings from composites of isolated lignins and waste paper II : effect of inorganic salt addition on board performance and evaluation of practical use of MDF

Board-shaped composites with medium density (MDF) were prepared from isolated lignins and waste newspaper, in addition to preparation of the composites with high density (HB). The board properties of both composites concerning bending strength and water resistance were improved by the addition of hardwood acetic acid lignin (HAL). The internal bond strength and water resistance of MDF, in particular the degree of thickness swelling (TS), were also improved by prolonged molding time. Adding inorganic salts contributed to the improvement of TS. The effect depended on the charge of the cation. Considering practical utilization of lignin-based MDF as a structural material, its performance was evaluated by combination of the single-shear test of nailed joints and the modulus of rigidity. As a result, this MDF had sufficient strength to be utilized as an internal shear wall material. Therefore, lignin can be considered as an alternative to conventional adhesives for the production of boards such as HB and MDF