Meiji University of Integrative Medicine

Summary: The 2018 Western Japan floods resulted in numerous fatalities among elderly residents, with many cases of “drowning at home” reported. This study analyzes victim characteristics to explore mitigation strategies for a society experiencing increasing climate-related disasters. We collected cases of home drowning fatalities during the floods in Ehime and Okayama Prefectures through media reports (newspapers and television) and analyzed survival patterns. In Ehime Prefecture, 9 (29.1%) of 32 victims drowned, with 3 (9.7%) drowning at home. All three were over 70 and found on the first floor. In Okayama’s Mabi town, 43 (84.3%) of 51 drowning victims died at home, with 36 (70.6%) being elderly (65+). 42 died on the first floor, one on the second floor. Both prefectures reported cases where surviving elderly residents reached the second floor but failed to convince their spouses to follow, resulting in spouse fatalities. In one case, an elderly couple survived by floating on their bed, which rose with the water level near the ceiling. In Ehime, a family successfully rescued a one-year-old girl and her great-grandmother using a two-seater sofa as flotation. Swimming while clothed is challenging, particularly for elderly individuals with reduced physical strength. Given that most elderly victims drowned on the first floor, the survival probability could increase through flotation strategies. When external evacuation risks are high during indoor flooding, back float and improvised flotation devices (life jackets, coolers, sealed backpacks with clothing) may contribute to survival. This survival technique, internationally known as “Uitemate” (Float and Wait), effectively prevents drowning in various flood disasters and represents a household-level disaster risk reduction strategy.

This paper proposes a new method for unit commitment (UC) in power systems. The approach utilizes quantum evolutionary computation within the framework of quantum artificial intelligence and machine learning. The mathematical formulation can be expressed as a mixed-integer nonlinear programming (MINLP) problem. Recently, nonlinear factors have become increasingly significant in UC, highlighting the need for an efficient method to tackle the MINLP challenges faced by power system planners. The paper introduces an innovative solution to the UC problem through a technique called Parallel Quantum Predator-Prey Brain Storm of Quantum Evolutionary Computation. This method enhances Brain Storm Optimization (BSO) by incorporating a predator-prey strategy, quantum superposition, and a parallel processing scheme. The effectiveness of the proposed method has been validated through successful testing on the New England 39-node system.

ObjectiveThis study aimed to investigate the background information of suicide cases with a history of psychiatric consultations using postmortem data from the Osaka Prefectural Medical Examiner’s Office. The goal was to explore the relationship between psychiatric consultations and the timing of suicide. Methods: A retrospective analysis was conducted on 191 suicide cases recorded in 2017. Background data such as gender, age, occupation, method of suicide, and the time interval between the last psychiatric consultation and suicide were analyzed. Descriptive statistics and correlation analysis were used to examine trends. Results: Females accounted for 55.0% of the cases, with most individuals being middle-aged (56.0%) and unemployed (70.7%). Hanging (44%) was the most common suicide method, while Mondays (24.1%) had the highest suicide frequency. The median time between the last psychiatric consultation and suicide was 9 days, and a strong negative correlation (r = -0.79) was observed between this interval and the number of suicides. Conclusion: The findings suggest that suicides often occur shortly after psychiatric consultations, emphasizing the need for timely intervention. Postmortem data can offer critical insights into suicide risks. However, further research is needed to better understand psychiatric consultation details and their link to suicide prevention.

Abstract Background Seacoasts are generally considered dangerous, and the situation of patients being transported from the coast to hospitals for emergency care has not been fully examined. To clarify the acute health risk associated with the seacoast, we investigated the survival status of patients who arrived at the hospital following transportation from the seacoast by ambulance compared with patients from other locations, and analyzed related factors. Methods All patients who were transported by ambulance to hospitals between 2020 and 2021 in Japan were enrolled in this study. Patients transported from the seacoast were compared with the patients from other locations with respect to the cardiac arrest rate as a survival state. The variables of sex, age, response time, and cause of injury or illness were also compared between the two groups. To adjust for the influence of these variables, we conducted propensity score matching between the two groups and compared the cardiac arrest rates again. Results Of the enrolled patients, 7,003 were from coastal areas, and 9,780,140 were from other locations. Among seacoast patients, 9.1% experienced cardiac arrest upon hospital arrival, whereas 1.6% of patients from other locations experienced cardiac arrest (P < 0.001). In addition, patients from the seacoastal region were more likely to be male, younger, have a longer response time, and have a higher percentage of drowning. Even after adjusting for these factors via using propensity score matching, the cardiac arrest rate still remained higher in the patients from the seacoast (7.3% vs 4.8%, P < 0.001). Conclusions Even if the characteristic factors of patients from the seacoast, including longer response time and a high percentage of drowning were adjusted by propensity matching, the rate of cardiac arrest remained higher in these patients.

Abstract Rodents acquire environmental information through their whiskers by employing active whisking and touch. Each whisker extends from a highly complex follicle containing hundreds of mechanoreceptors (MRs) of various types, positioned in different locations and surrounded by diverse tissue structures. Previous studies have shown that individual primary sensory afferents from these follicles respond selectively either to whisking (W) or touch (T), or non-selectively to both (WT). Given that MRs are sensitive to tiny, sub-micron deformations, the mechanisms enabling such selectivity were enigmatic. In this study, using artificial whisking, intra-axonal recordings and single-cell morphological analysis, we identify one class of MRs, the club-like endings, as T cells - all responding selectively to active touch and not to active whisking. The other MR types examined here, Merkel and lanceolate endings, exhibited various selectivity patterns. Club-like endings are arranged as a one-layer circular array around the whisker shaft near its center of mass, within the neck of a specialized structure called ringwulst (Rw). Using scanning electron microscopy (SEM), we found that individual club-like endings were directly attached to the glassy membrane covering the epithelial sheath attached to the whisker shaft, while being anchored to a specialized network of collagen fibers. This morphology minimizes deformations during whisking in air while allowing high sensitivity to whisker deformations induced by touch. We hypothesize that these specific morphological adaptations evolved to enable the detection of light touch, which is crucial for precise object localization during active whisking and show that cats, which do not use active whisking, lack several of these adaptations.

【目的】本研究の目的は、 学生の生成AIに対する認識および活用経験の実態を明らかにすることである。 そして、 今後の生成AIの教育現場における導入および活用に関する議論を推し進める一助になることを目指す。 【方法】調査対象は全国のあはき教員養成機関に在籍する学生103名である。 調査はGoogle Formを用いて令和5年10月から11月で実施した。 【結果】回答者は57名 （回答率：55.3％） であった。 主な結果を次に示す。 1． 生成AIに対する感想 （印象）：生成AIに対して 「期待感」 を持つ学生が比較的多く （38.6％）、 逆に 「抵抗感」 を感じる学生は少数派であった （24.6％）。 2． 生成AIの信頼性、 安全性、 効率化に対する意識：信頼性に関しては 「少し高いと思う」 が42.1％、 「少し低いと思う」 が26.3％と意見が分かれた。 安全性に関しては 「少し低いと思う」 が43.9％と評価が低かった。 3． 教育現場での生成AI活用に対する意見：生成AIの活用に対しては、 「まあ賛成する」 が47.4％で最多であり、 積極的に賛成する学生も21.1％いた。 4． 生成AIの教材としての有用性：生成AIの教材としての有用性については、 「まあ有用と思う」 が45.6％である一方、 「わからない」 が24.6％という結果であった。 5． 学習スキルへの影響：生成AIが 「書く力」 や 「思考力」 に対してネガティブな影響を与えると懸念する学生が多かった一方、 「読む力」 や 「質問力」 にはポジティブな影響を期待する意見が多い。 【考察・結語】本調査から、 学生は生成AIに対して期待感を持ちながらも、 不安や抵抗感を抱いていることが明らかになった。 また、 作業効率化を期待する一方で、 その信頼性や安全に対する懸念を抱いている学生が多いことが示された。 さらに、 教育現場での活用に対する意見は前向きであるが、 学習スキルへの影響については慎重な検討が求められる。

【目的】鍼の切皮に関しては痛みが起きにくい方法や用具を検討した研究があるが、 新人と熟練者で技術の差が大きいとされる刺入手技に関する研究はみられない。 そこで本研究では、 患者の呼吸に合わせて刺入する方法を取り上げ、 呼吸運動が鍼刺入時の機械的抵抗に及ぼす影響について調べた。 【方法】7名の被験者を対象に、 鼻孔付近の温度変化によって被験者の呼吸状態をモニターしながら腰部の刺入抵抗を測定した。 刺入抵抗の測定には特製の鍼刺入抵抗測定器を用いた。 本器は鍼を一定の速度で刺入し、 そのとき鍼にかかる力をヒズミゲージで検出し電圧として出力するものであり、 その値を刺入抵抗とした。 次に腰部の刺入抵抗測定中に被験者に呼吸を止めてもらい、 呼吸停止前・停止中・呼吸再開後の刺入抵抗の変化を観察した。 さらに通常呼吸時の大腿部の刺入抵抗を測定した。 【結果】呼気と吸気が切り替わるのに同期して腰部の刺入抵抗が変化する現象が見られた。 その変化は呼吸停止と同時に消失し、 呼吸再開とともに再現した。 大腿部では呼吸に同期して刺入抵抗が変化する現象は見られなかった。 【考察】腰部では、 呼吸の変化と鍼刺入抵抗の変化には極めて高い相関 （r=0.81， p＜0.05） があった。 また刺入抵抗の変化が呼吸停止と同時に消失し、 呼吸再開とともに再現したことから、 呼吸による刺入抵抗の変化が観察されたと考えられる。 このような刺入抵抗の変化は、 筋の収縮・弛緩に伴う硬さの変化が要因と考えられ、 呼吸と同期する機序として自律神経系の関与あるいは呼吸時に特異的に活動する筋の影響が示唆された。 しかし今回、 大腿部では刺入抵抗性の変化や呼吸に同期した腰部の筋活動が観察されなかったことからさらなる検討が必要である。

【目的】熱感や温感を感じるときに燃焼中の艾を取り除く知熱灸では、 燃焼した艾の割合を取り除く際の目安にしてきたが、 7分から9分と範囲が広く、 温度は異なると考えられる。 本研究では、 目標の温度で艾を取り除くために、 形状や硬さが異なる艾を用いて、 温度と燃焼部の高さの関係を明らかにする。 【方法】艾は、 底面径が20mmと10mmの円錐形状として、 艾高さと艾密度を変化させた。 檜板上に設置したK型熱電対を用いて艾底面中央部の温度を測定した。 温感が得られる上昇温度ΔTの目標値を15℃として、 燃焼時間は点火から15℃、 加熱時間は1℃から15℃の時間とした。 艾底面から燃焼部の距離を燃焼部高さとした。 【結果】艾が高くなると、 燃焼速度、 燃焼時間、 加熱時間のいずれも増加した。 艾密度が高くなると、 燃焼速度は低下し、 燃焼時間と加熱時間は増加した。 艾高さや艾密度を変えても、 ΔT=15℃となる燃焼部高さは殆ど変わらず、 底面径の半分になった。 燃焼部高さと艾形状の関係を詳細に検討するために、 上昇温度を定式化した。 艾が高く艾密度が低い場合は、 ΔT=15℃となる燃焼部高さは底面径の半分より高くなった。 艾が高く艾密度が高い場合は、 輻射光の1秒あたりの熱量は低下した。 【結論】温感が得られる目標値としてΔT=15℃で艾を取り除く場合、 艾高さや艾密度を変えても燃焼部高さは殆ど変わらず、 底面径の半分が目安になる。 艾が高く艾密度が低い場合は、 若干早目に艾を取り除くとよい。 艾が小さく軟らかいほど1秒あたりの熱量が大きく、 加熱特性が向上すると考えられる。

Aim: To translate the Rushton Moral Resilience Scale (RMRS) into Japanese and validate its applicability among Japanese healthcare professionals. Background: To overcome daily challenges in the field of healthcare, in which moral difficulties are routinely encountered, the development of intervention methods to address moral suffering and moral distress is crucial. Methods: We conducted a cross-sectional survey using a web-based questionnaire. The RMRS-16 was translated into Japanese and confirmed through back-translation. Reliability analyses (Cronbach's alpha and intraclass correlation coefficient [ICC]), confirmatory factor analyses (CFAs), correlation analyses, t-tests, and analysis of variance (ANOVA) were used to assess the validity of the scale. Results: Participants comprised 1295 healthcare professionals, including 498 nurses. All subscales and the total scale had acceptable reliability values (α ≥ 0.70). CFA supported the original four-factor structure (response to moral adversity, personal integrity, relational integrity, and moral efficacy), with acceptable fit indices. The ANOVA results suggested that, among Japanese healthcare professionals, nurses and individuals from other professions showed lower average moral resilience scores compared to physicians, consistent with previous research on mental health and moral distress. In addition, women scored lower for moral resilience than men. However, the ICC values for the subscales of the RMRS were below acceptable levels, and the results of the standardized residual covariances also suggested a model misfit. Conclusion and Implications: The reliability, validity, and utility of the Japanese version of the RMRS were generally supported. However, there were areas at the item level that required structural examination. The current findings suggest that there are cultural differences in the concept of moral resilience. Therefore, for future cultural comparisons, the original four-factor structure was maintained in the Japanese version without modifications. Further conceptual development of moral resilience is needed in Japanese healthcare.