Search results for: Mika Nashimoto

Authors: Naomi Sakamoto, Eisuke Fukuma, Mika Nashimoto, Yoshitomo Koshida

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Background: Selective localization of the metastatic lymph node with clip and removal of clipped nodes with sentinel lymph node (SLN), known as targeted axillary dissection (TAD), reduced false-negative rates (FNR) of SLN biopsy (SLNB) after neoadjuvant chemotherapy (NAC). For the patients who achieved nodal pathologic complete response (pCR), accurate staging of axilla by TAD lead to omit axillary lymph node dissection (ALND), decreasing postoperative arm morbidity without a negative effect on overall survival. This study aimed to investigate the ultrasound (US) identification rate and success removal rate of two kinds of ultrasound-visible clips placed in metastatic lymph nodes during TAD procedure. Methods: This prospective study was conducted using patients with clinically T1-3, N1, 2, M0 breast cancer undergoing NAC followed by surgery. A US-visible clip was placed in the suspicious lymph node under US guidance before neoadjuvant chemotherapy. Before surgery, US examination was performed to evaluate the detection rate of clipped node. During the surgery, the clipped node was removed using several localization techniques, including hook-wire localization, dye-injection, or fluorescence technique, followed by a dual-technique SLNB and resection of palpable nodes if present. For the fluorescence technique, after injection of 0.1-0.2 mL of indocyanine green dye (ICG) into the clipped node, ICG fluorescent imaging was performed using the Photodynamic Eye infrared camera (Hamamatsu Photonics k. k., Shizuoka, Japan). For the dye injection method, 0.1-0.2 mL of pyoktanin blue dye was injected into the clipped node. Results: A total of 29 patients were enrolled. Hydromark™ breast biopsy site markers (Hydromark, T3 shape; Devicor Medical Japan, Tokyo, Japan) was used in 15patients, whereas a UltraCor™ Twirl™ breast marker (Twirl; C.R. Bard, Inc, NJ, USA) was placed in 14 patients. US identified the clipped node marked with the UltraCore Twirl in 100% (14/14) and with the Hydromark in 93.3% (14/15, p = ns). Success removal of clipped node marked with the UltraCore Twirl was achieved in 100% (14/14), whereas the node marked with the Hydromark was removed in 80% (12/15) (p = ns). Conclusions: The ultrasound identification rate differed between the two types of ultrasound-visible clips, which also affected the success removal rate of clipped nodes. Labelling the positive node with a US-highly-visible clip allowed successful TAD.

Keywords: breast cancer, neoadjuvant chemotherapy, targeted axillary dissection, breast tissue marker, clip

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Authors: Michaela Vašková, Jiří Barta, Otakar J. Mika, Jan Hrdlička, Josef Kellner

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The paper is focused on the method to solutions the crisis situation in the Czech Republic associated with the mass methanol poisoning. The emphasis is put on tasks of individual state bodies and of Integrated Rescue System during the handling of the crisis. The theoretical part describes poisonings, ways of intoxication, types of intoxicants and cases of mass poisoning by dangerous substances in the world. The practical part describes the development, causes and solutions of extraordinary event, mass methanol poisoning in the Czech Republic. The main emphasis was put on the crisis management of the Czech Republic in solving this situation.

Keywords: crisis management, poisoning, methanol, hazardous substances, extraordinary event

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Authors: Mika Kaufman

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Behavioral health in school-age children is a great concern. Negative behaviors can affect mental and physical health and, if ignored, can lead to further problems later in life. Rural communities often lack resources for counselors, social workers, and mental health care in the hopes of intervening with children who exhibit negative behaviors. Because of this, schools in rural communities are more likely to have children with behavioral issues. Prevention programs to recognize and address these behavioral concerns can educate teachers about mental health, different negative behaviors that students might exhibit, and how to manage those behaviors and engage with students in a positive way.

Keywords: prevention programs, behavioral health, resources for teachers, rural schools

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Authors: Tommi Mahlamaki, Mika Ojala

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Digitalization is changing our lives in many ways. As consumers, we are accustomed using different online interactive sales systems. However, while many online selling sites offer systems that have evolved from simple selling functions, the change has not been as rapid in business-to-business (B2B) markets. This is because many B2B companies rely on personal sales and personal communication. The main objective of this research is to clarify perceptions towards digital interactive sales systems and, more specifically, sales configurators. It also aims to identify trends towards the use of sales configurators. To reach these objectives, an online questionnaire was created that targets Finnish B2B distributors who are, by definition, part of B2B markets. The questionnaire was sent to 340 distributors, and it was returned by 150 respondents. The results showed that 82% of respondents had heard about sales configurators, and 64% had used them. The results also showed that 48% of respondents felt that the use of sales configurators would increase in the future, while only 2% felt they would be used less. The future use of sales configurators was not seen as affecting the level of personal sales. In light of the results, we recommend that B2B companies create marketing strategies that integrate and complement traditional sales processes with digital interactive systems.

Keywords: digitalization, interactive systems, marketing, sales process

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Authors: Sabahattin Comertpay, Sandra Pastorino, Rosanna Mezzapelle, Mika Tanji, Oriana Strianese, Andrea Napolitano, Tracey Weigel, Joseph Friedberg, Paul Sugarbaker, Thomas Krausz, Ena Wang, Amy Powers, Giovanni Gaudino, Harvey I. Pass, Fatmagul Ozcelik, Barbara L. Parsons, Haining Yang, Michele Carbone

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Tumors are thought to be monoclonal in origin. This paradigm arose decades ago, primarily from the study of hematopoietic malignancies and sarcomas. The clonal origin of malignant mesothelioma (MM), a deadly cancer resistant to the current therapies, has not been investigated. Examination of the pleura from patients with MM shows often the presence of multiple pleural nodules, raising the question of whether they represent independent or metastatic growth processes. To investigate the clonality patterns of MM, we used the HUMARA (Human Androgen Receptor) assay to examine 14 sporadic and 2 familial Malignant Mesotheliomas (MM). Of 16 specimens studied, 15 were informative and 14/15 revealed two electrophoretically distinct methylated HUMARA alleles, indicating a polyclonal origin for these tumors. This discovery has important clinical implications, because an accurate assessment of tumor clonality is key to the design of novel molecular strategies for the treatment of MM.

Keywords: malignant mesothelioma, clonal origin, HUMARA, sarcomas

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Authors: Catherine Cheetam, Alan Harper, Melody Elliott, Mika Ito

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This paper describes a pilot study conducted with English as a foreign language (EFL) students at a private university in Japan who used graded readers and the MReader website in class or independently to enhance their English reading skills. Each semester students who read 100,000 words with MReader quizzes passed enter into the ‘MReader Challenge,’ a reading contest that recognizes students for their achievement. The study focused specifically on the attitudes of thirty-six EFL students who successfully completed the Challenge in the 2015 spring semester using graded readers and MReader, and their motivation to continue using English in the future. The attitudes of these students were measured using their responses to statements on a Likert scaled survey. Follow-up semi-structured interviews were conducted with eleven students to gain additional insight into their opinions. The results from this study suggest that reading graded readers in general promoted intrinsic motivation among a majority of the participants. This study is preliminary and needs to be expanded and continued to assess the lasting impact of the extensive reading program. Limitations and future directions of the study are also summarized and discussed.

Keywords: attitudes, extensive, intrinsic, methodolgies, motivation, reading

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Authors: Mária Hudáková, Vladimír Míka, Katarína Hollá

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Making decisions is the core of management and a result of conscious activities which is under way in a particular environment and concrete conditions. The managers decide about the goals, procedures and about the methods how to respond to the changes and to the problems which developed. Their decisions affect the effectiveness, quality, economy and the overall successfulness in every organisation. In spite of this fact, they do not pay sufficient attention to the individual steps of the decision-making process. They emphasise more how to cope with the individual methods and techniques of making decisions and forget about the way how to cope with analysing the problem or assessing the individual solution variants. In many cases, the underestimating of the analytical phase can lead to an incorrect assessment of the problem and this can then negatively influence its further solution. Based on our analysis of the theoretical solutions by individual authors who are dealing with this area and the realised research in Slovakia and also abroad we can recognise an insufficient interest of the managers to assess the risks in the decision-making process. The goal of this paper is to assess the risks in the managers´ decision-making process relating to the conditions of the environment, to the subject’s activity (the manager’s personality), to the insufficient assessment of individual variants for solving the problems but also to situations when the arisen problem is not solved. The benefit of this paper is the effort to increase the need of the managers to deal with the risks during the decision-making process. It is important for every manager to assess the risks in his/her decision-making process and to make efforts to take such decisions which reflect the basic conditions, states and development of the environment in the best way and especially for the managers´ decisions to contribute to achieving the determined goals of the organisation as effectively as possible.

Keywords: risk, decision-making, manager, process, analysis, source of risk

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Authors: Shuji Fujimoto, Fumiko Kojima, Mika Shigematsu

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Biorisk management (Biosafety/Biosecurity) is required for anyone working in a clinical laboratory (including medical/clinical research laboratories) where infectious agents and potentially hazardous biological materials are examined/stored. Proper education and training based on international standards of biorisk management should be provided not only as a part of laboratory safety program in work place but also as a part of introductory training at educational institutions for continuity and to elevate overall baseline of the biorisk management. We reported results of the pilot study of biorisk management education for graduate students majored in laboratory diagnostics previously. However, postgraduate education is still late in their profession and the participants’ interview also revealed importance and demands of earlier biorisk management education for undergraduates. The aim of this study is to identify the need for biosafety/biosecurity education and training program which is designed for undergraduate students who are entering the profession in clinical microbiology. We modified the previous program to include more basic topics and explanations (risk management, principles of safe clinical lab practices, personal protective equipment, disinfection, disposal of biological substances) and provided incorporating in the routine educational system for faculty of medical sciences in Kyushu University. The results of the pre and post examinations showed that the knowledge of the students on biorisk control had developed effectively as a proof of effectiveness of the program even in the undergraduate students. Our study indicates that administrating the basic biorisk management program in the earlier stage of learning will add positive impact to the understanding of biosafety to the health professional education.

Keywords: biorisk management, biosafety, biosecurity, clinical microbiology, education for undergraduates

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Authors: Sigal Barkai

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'Ironic Historiography' is a hybrid notion combining criticism of historical narratives concerning the Israeli state with ironic artistic expression. The paper will deal with questions of identities of native Israeli visual artists who chose to live out of the country, or to move back and forth to and from it. It will examine the ways these wanderings are reflected in their work. The paper discusses the work of 4 contemporary artists who produce artworks in diverse techniques and media, such as video, performance and installation art. Yael Bartana, Erez Israeli and Tamir Zadok are artists who constantly deal with Israeli nationality and history in their artwork, using ironic components. In comparison, the paper will review the works of Mika Rottenberg, who is now a New York based artist. She is concerned with global social issues and neglected specific national identity altogether. All of them use visual irony as a means of reflecting and criticizing society. The analysis was done in awareness of the life stories of the artists, in an attempt to trace the ways they establish their identities through their art. It was pre-supposed that these identities will be shaped in the in-between space of being an Israeli citizen and a citizen of the world. The study asks how ironic expression appears in their work, what kind of irony do they use and in what ways does it serves them. The methodology combined visual analysis, interviews with the artists, and analyzation of secondary discourses in the media. As theoretical background various fields of knowledge were used, such as literature and language studies, Sociology, and Visual Culture studies. The findings point out that visual and artistic irony has many different goals in the use of historiographic fiction. It can bind an artist to his homeland and native society, or it can help her to detach. It helps healing breaches in the in-between space, or it can be used as a means to completely detach from any identification with a native origin.

Keywords: visual art, irony, identities, Israel

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Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

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Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

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Authors: Joanna Cydejko, Paulina Mika

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Hypersensitivity reactions are side effects of medications that resemble an allergic reaction. Anaphylaxis is a generalized, severe allergic reaction of the body caused by exposure to a specific agent at a dose tolerated by a healthy body. The most common causes of anaphylaxis are food (about 70%), Hymenoptera venoms (22%), and medications (7%), despite detailed diagnostics in 1% of people, the cause of the anaphylactic reaction was not indicated. Contrast media are anaphylactic agents of unknown mechanism. Hypersensitivity reactions can occur with both immunological and non-immunological mechanisms. Symptoms of anaphylaxis occur within a few seconds to several minutes after exposure to the allergen. Contrast agents are chemical compounds that make it possible to visualize or improve the visibility of anatomical structures. In the diagnosis of computed tomography, the preparations currently used are derivatives of the triiodide benzene ring. Pharmacokinetic and pharmacodynamic properties, i.e., their osmolality, viscosity, low chemotoxicity and high hydrophilicity, have an impact on better tolerance of the substance by the patient's body. In MRI diagnostics, macrocyclic gadolinium contrast agents are administered during examinations. The aim of this study is to present the results of the number and severity of anaphylactic reactions that occurred in patients in all age groups undergoing diagnostic imaging with intravenous administration of contrast agents. In non-ionic iodine CT and in macrocyclic gadolinium MRI. A retrospective assessment of the number of adverse reactions after contrast administration was carried out on the basis of data from the Department of Radiology of the University Clinical Center in Gdańsk, and it was assessed whether their different physicochemical properties had an impact on the incidence of acute complications. Adverse reactions are divided according to the severity of the patient's condition and the diagnostic method used in a given patient. Complications following the administration of a contrast medium in the form of acute anaphylaxis accounted for less than 0.5% of all diagnostic procedures performed with the use of a contrast agent. In the analysis period from January to December 2022, 34,053 CT scans and 15,279 MRI examinations with the use of contrast medium were performed. The total number of acute complications was 21, of which 17 were complications of iodine-based contrast agents and 5 of gadolinium preparations. The introduction of state-of-the-art contrast formulations was an important step toward improving the safety and tolerability of contrast agents used in imaging. Currently, contrast agents administered to patients are considered to be one of the best-tolerated preparations used in medicine. However, like any drug, they can be responsible for the occurrence of adverse reactions resulting from their toxic effects. The increase in the number of imaging tests performed with the use of contrast agents has a direct impact on the number of adverse events associated with their administration. However, despite the low risk of anaphylaxis, this risk should not be marginalized. The growing threat associated with the mass performance of radiological procedures with the use of contrast agents forces the knowledge of the rules of conduct in the event of symptoms of hypersensitivity to these preparations.

Keywords: anaphylactic, contrast medium, diagnostic, medical imagine

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Authors: Hideaki Endo, Mika Goto

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The global outbreak of the COVID-19 pandemic has seriously affected railway businesses. The number of railway passengers decreased due to the decline in the number of commuters and business travelers to avoid crowded trains and a sharp drop in inbound tourists visiting Japan. This has affected not only railway businesses but also related businesses, including hotels, leisure businesses, and retail businesses at station buildings. In 2021, the companies were divided into profitable and loss-making companies. This division suggests that railway companies, particularly loss-making companies, needed to decrease operational inefficiency. To measure the impact of COVID-19 and discuss the sustainable management strategies of railway companies, we examine the cost inefficiency of Japanese listed railway companies by applying stochastic frontier analysis (SFA) to their operational and financial data. First, we employ the stochastic frontier cost function approach to measure inefficiency. The cost frontier function is formulated as a Cobb–Douglas type, and we estimated parameters and variables for inefficiency. This study uses panel data comprising 26 Japanese-listed railway companies from 2005 to 2020. This period includes several events deteriorating the business environment, such as the financial crisis from 2007 to 2008 and the Great East Japan Earthquake of 2011, and we compare those impacts with those of the COVID-19 pandemic after 2020. Second, we identify the characteristics of the best-practice railway companies and examine the drivers of cost inefficiencies. Third, we analyze the factors influencing cost inefficiency by comparing the profiles of the top 10 railway companies and others before and during the pandemic. Finally, we examine the relationship between cost inefficiency and the implementation of efficiency measures for each railway company. We obtained the following four findings. First, most Japanese railway companies showed the lowest cost inefficiency (most efficient) in 2014 and the highest in 2020 (least efficient) during the COVID-19 pandemic. The second worst occurred in 2009 when it was affected by the financial crisis. However, we did not observe a significant impact of the 2011 Great East Japan Earthquake. This is because no railway company was influenced by the earthquake in this operating area, except for JR-EAST. Second, the best-practice railway companies are KEIO and TOKYU. The main reason for their good performance is that both operate in and near the Tokyo metropolitan area, which is densely populated. Third, we found that non-best-practice companies had a larger decrease in passenger kilometers than best-practice companies. This indicates that passengers made fewer long-distance trips because they refrained from inter-prefectural travel during the pandemic. Finally, we found that companies that implement more efficiency improvement measures had higher cost efficiency and they effectively used their customer databases through proactive DX investments in marketing and asset management.

Keywords: COVID-19 pandemic, stochastic frontier analysis, railway sector, cost efficiency

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Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

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In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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