Evaluation for interventions against influenza of H5N1 in Sapporo-city by using an Individual Based Model

The spread of the highly pathogenic avian influenza (H5N1) among domestic poultry and wild birds has caused global concern over the outbreak of an influenza pandemic of H5N1. The "Pandemic Influenza Preparedness Action Plan" determines the strategy against an influenza pandemic in Japan. Simulations were carried out using an individual based model (IBM). The IBM targeted a virtual area with a population of 100,000 using the demographic data of Sapporo-city, Hokkaido. The effectiveness of targeted antiviral prophylaxis (TAP), geographical targeted antiviral prophylaxis (GTAP), school closure, and pre-pandemic vaccination were explored. Moreover, this study focused on infections among children, who have a high attack rate, and analyzed the effectiveness of interventions for school-age targeted antiviral prophylaxis (STAP). Consequently, TAP, which is recommended by the "Pandemic Influenza Preparedness Action Plan", was found to have high effectiveness in the suppression of the outbreak. Moreover, this study showed the importance of intervention among children, such as STAP and school closure, to prevent the spread of H5N1 influenza

Analysis of the effectiveness of control strategies against bioterrorist smallpox attacks by using Individual Based Model

We carried out simulations of various scenarios for bioterrorist attacks using smallpox occurring in a virtual area set up on the basis of the census of Okayama-city, Japan, which predict the effect of control strategies against bioterrorism and the loss scale. On simulating a smallpox epidemic, we followed the method of the Individual Based Model stochastically, which can treat the population in the virtual area as individuals. Individuals have personal information, behavior patterns, and interactions among social groups. We took into consideration the influence of residual immunity due to past vaccination. We considered Traced Vaccination (TV) and Mass Vaccination (MV) strategies against bioterrorism. We investigated the effect of TV and MV strategies on the suppression of smallpox epidemics. Consequently, the TV strategy was found to have higher effectiveness than the MV strategy

Support for Decision-making Regarding Continuing or Suspending Terminal-Stage Dialysis

【Purpose】The aim of this study was to clarify the state of discussion regarding terminal-stage dialysis,advance directive preparation, and opinions of patients and their family members regarding terminal-stagedialysis to facilitate support for decision-making regarding terminal-stage dialysis by nurses.【Methods】Study design was a Mixed-method research. Study subjects comprised 948 dialysis patients whowere members of the Kidney Disease Patient Association of Prefecture A, Japan. The response rate was 41.0%(n = 389), and the valid response rate was 38.8% .(n = 368) We distributed questionnaires to dialysis patients,that included questions about Patient characteristics, Status of discussion regarding terminal-stage dialysis andadvance directive preparation, and Free response comments regarding terminal-stage dialysis and advancedirective preparation. Results were then analyzed using Pearson’s chi-square test (for small-size samples,Fisher’s exact test was used). K-J method was used to analyze free comments regarding terminal-stage dialysis.This study was approved by the institutional review board of Naragakuen University. (approval no: 27-004)【Result/Consideration】Fewer than 40% of the subjects had discussed terminal-stage dialysis with their familymembers, whereas <10% had discussed the issue with a healthcare provider. Moreover, only 3% of the subjectshad prepared an advance directive. When offering support for decision-making regarding terminal-stage dialysis,nurses should provide necessary information while confirming the health state and current status of patients,particularly those who have received dialysis for a certain period of time and are interested in terminal-stagedialysis, as well as informing their family members. In addition, nurses should make adjustments such thatpatients can thoroughly discuss terminal-stage dialysis

Impaired response of hypoxic sensor protein HIF-1 alpha and its downstream proteins in the spinal motor neurons of ALS model mice

We have recently reported spinal blood flow-metabolism uncoupling in an amyotrophic lateral sclerosis (ALS) animal model using Cu/Zn-superoxide dismutase 1 (SOD1)-transgenic (Tg) mice, suggesting a relative hypoxia in the spinal cord. However, the hypoxic stress sensor pathway has not been well studied in ALS. Here, we examined temporal and spatial changes of the hypoxic stress sensor proteins HIF-1 alpha and its downstream proteins (VEGF, HO-1, and EPO) during the normcodccourse of motor neuron (MN) degeneration in the spinal cord of these ALS model mice. We found that HIP-1 alpha protein expression progressively increased both in the anterior large MNs and the surrounding glial cells in Tg mice from early symptomatic 14 week (W) and end stage 18W. Double immunofluorescence analysis revealed that HIP-1 alpha, plus GFAP and Iba-1 double-positive surrounding glial cells, progressively increased from 14 W to 18 W, although the immunohistochemistiy in large MNs did not change. Expression levels of VEGF and HO-1 also showed a progressive increase but were significant only in the surrounding glial cells at 18W. In contrast, EPO protein expression was decreased in the surrounding glial cells of Tg mice at 18W. Because HIF1-alpha serves as an important mediator of the hypoxic response, these findings indicate that MNs lack the neuroprotective response to hypoxic stress through the HIF-1 alpha system, which could be an important mechanism of neurodegeneration in ALS

PreFlap: From Photoacoustic Tomography Images to Vascular Mapping Sheets for Improved Preoperative Flap Evaluation

Objective: Advancements in technology have improved image acquisition and processing in the field of medical imaging, giving medical doctors the tools to implement effective medical care. In plastic surgery, despite advances in anatomical knowledge and technology, problems in preoperative planning for flap surgery remain. Methods: In this study, we propose a new protocol to analyze three-dimensional (3D) photoacoustic tomography images and generate two-dimensional (2D) mapping sheets that can help surgeons identify perforators and the perfusion territory during preoperative planning. The core of this protocol is PreFlap, a new algorithm that converts 3D photoacoustic tomography images into 2D vascular mapping images. Conclusion: Experimental results demonstrate that PreFlap can improve preoperative flap evaluation, thus can greatly saving surgeons' time and improving surgical outcomes

PESI-MS for Diagnostic Cytology

Objectives: Cytology and histology are 2 indispensable diagnostic tools for cancer diagnosis, which are rapidly increasing in importance with aging populations. We applied mass spectrometry (MS) as a rapid approach for swiftly acquiring nonmorphological information of interested cells. Conventional MS, which primarily rely on promoting ionization by pre-applying a matrix to cells, has the drawback of time-consuming both on data acquisition and analysis. As an emerging method, probe electrospray ionization-MS (PESI-MS) with a dedicated probe is capable to pierce sample and measure specimen in small amounts, either liquid or solid, without the requirement for sample pretreatment. Furthermore, PESI-MS is timesaving compared to the conventional MS. Herein, we investigated the capability of PESI-MS to characterize the cell types derived from the respiratory tract of human tissues. Study Design: PESI-MS analyses with DPiMS-2020 were performed on various type of cultured cells including 5 lung squamous cell carcinomas, 5 lung adenocarcinomas, 5 small-cell carcinomas, 4 malignant mesotheliomas, and 2 normal controls. Results: Several characteristic peaks were detected at around m/z 200 and 800 that were common in all samples. As expected, partial least squares-discriminant analysis of PESI-MS data distinguished the cancer cell types from normal control cells. Moreover, distinct clusters divided squamous cell carcinoma from adenocarcinoma. Conclusion: PESI-MS presented a promising potential as a novel diagnostic modality for swiftly acquiring specific cytological information

Proposal and Evaluation of Toilet Timing Suggestion Methods for the Elderly

Elderly people need to urinate frequently, and when they go on outings they often have a difficult time finding restrooms. Because of this, researching a body water management system is needed. Our proposed system calculates timing trips to the toilet in consideration with both their schedules and the amount of body water needing to be expelled, and recommends using the restroom with sufficient time before needing to urinate. In this paper, we describe the suggested methods of this system and show the experimental results for the toilet timing suggestion methods

治療を中止したがん患者の回復への希望に対する看護師のジレンマ

In this study, the authors clarified experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment. An interview survey was performed for 14 nurses who had ever care cancer patients who discontinued their treatment. Experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment consisted of the following categories ;［ I am not able to respond to the patient’s wish though I want to］,［There is difference how to spend the time remained between the patient and me］,［I do not have a sufficient power to support the end of the patient’s life］,［I feel disconsolate being unable to realize the patient’s wish for recover］and［I’m a nurse. I never run from my patients］. The nurses with dilemma had experience in facing nursing cares driven by the sense of responsibility as a nurse while holding pain in their heart. Ethical problems may be underlying in this experience, and the need of team work, not individual responses, has been suggested. Therefore, support to reveal experience of nurses in daily nursing care is needed