Violation of Eigenstate Thermalization Hypothesis in Quantum Field Theories with Higher-Form Symmetry.

We elucidate how the presence of higher-form symmetries affects the dynamics of thermalization in isolated quantum systems. Under reasonable assumptions, we analytically show that a p-form symmetry in a (d+1)-dimensional quantum field theory leads to the breakdown of the eigenstate thermalization hypothesis for many nontrivial (d-p)-dimensional observables. For discrete higher-form (i.e., p≥1) symmetry, this indicates the absence of thermalization for observables that are nonlocal but much smaller than the whole system size without any local conserved quantities. We numerically demonstrate this argument for the (2+1)-dimensional Z_{2} lattice gauge theory. While local observables such as the plaquette operator thermalize even for mixed symmetry sectors, the nonlocal observable exciting a magnetic dipole instead relaxes to the generalized Gibbs ensemble that takes account of the Z_{2} one-form symmetry.

Comparison between cancer specialists and general physicians regarding the education of nurse practitioners in Japan: a postal survey of the Japanese Society of Clinical Oncology.

BACKGROUND: Japanese physicians' attitudes regarding the education of nurse practitioners (NPs) are not well described. PARTICIPANTS AND METHODS: A survey was mailed to 1,094 board members of the Japanese Society of Clinical Oncology (JSCO) and the Japanese Primary Care Association (JPCA), and the directors of the clinical training program for physicians. The physicians of JSCO were classified as the cancer specialist group, and both the board members of JPCA and the directors of the clinical training program for physicians constituted the general physician group. We compared the responses of cancer specialists and general physicians. RESULTS: The survey response rate was 25.9% (69 of 266) in the cancer specialist group and 19.4% (161 of 828) in the general physician group. The median age of respondents was 53 and 55 years, respectively, of which 84 and 79%, respectively, were men. We found that the percentages of respondents who considered NP education necessary were almost identical in the 2 groups (r = 0.898, p < 0.0001). Education items considered necessary for NPs by >80% respondents in both groups included many symptoms, emergency management, basic procedures, general screening, palliative care including management against adverse effects, health education, and communication. More cancer specialists than general physicians (p < 0.01) expected NPs to be educated in multidisciplinary practice and palliative care, including management against adverse effects. CONCLUSIONS: Our study suggests that cancer specialists expect NPs to provide symptom management and psychosocial support, clarify information, provide education, and work as a member of a multidisciplinary team.

[Home medical support at Jikei Medical University].

A clinical clerkship of home care has been introduced to third-year medical students since 1998 at our university. Visiting nurses from the regional visiting nursing stations would give actual trainings at patient's home to a lot of medical students every year. For the improvement of medical education, it is not sufficient to give actual trainings to the students from visiting nurses. Then what we can do for visiting nurses about the role of the medical University was to offer and introduce the programs of cardiac and respiratory assessment as lifelong learning for the visiting nurses. After these programs were finished, two kinds of questionnaires were given to all participants to examine the necessity and scheduling of these program: 1 ) The first questionnaires after the programs was of cardiac and respiratory assessment, 2 ) The second questionnaires was for the participants with the experience of these programs, 3 ) Last questionnaires was for all visiting nurses about our 41 regional visiting nursing stations to promote the new programs(eight programs: home hospice care and opioids, PEG for the nutrition, ICLS, management of respirator at home, management of IVH port, ECG, foreign body of the airway, and the anatomy of organs)for lifelong learning. 1 ) A total of 7 2 visiting nurses participated in our programs for about one year recently, and 100% of these attendants returned questionnaires. After the programs, almost all of visiting nurses agreed that these programs were meaningful for them and it should be continued. 2 ) A total of 2 10 visiting nurses participated in our programs for the past 5 years. Fifty seven percent(57. 1%)of visiting nurses returned questionnaires. After the programs, a lot of visiting nurses agreed that these programs were meaningful for them and it should be continued. 3 ) Nearly 50 percent (47. 8% or 213/446)of visiting nurses from 41 visiting nursing stations returned questionnaires. A lot of visiting nurses expressed that they would like to participate in the subject of hospice care and opioids, PEG for the nutrition, ICLS and management of respirator at home as new programs. For the role of the medical University to promote a home care, it is necessary to support a community-based home care with educational issues at the university and to offer the new program mentioned previously as lifelong learning with practical and essential issues for medical staffs at patients' homes.

Experiences of alcohol-related harassment among medical students.

OBJECTIVES: Although fatal accidents caused by alcohol-related harassment occur frequently among college students, this issue has not been adequately examined. This study set out to investigate the prevalence of alcohol-related harassment among medical students in Japan. METHODS: A multi-institutional, cross-sectional survey was carried out across seven medical schools in Japan. A self-report anonymous questionnaire was distributed to 1152 medical students; 951 respondents (82.6%) satisfactorily completed it. From the responses, we determined the reported prevalences of the following types of alcohol-related harassment among medical students by senior medical students or doctors: (i) being coerced into drinking alcohol; (ii) being compelled to drink an alcoholic beverage all at once (the ikki drinking game); (iii) being deliberately forced to drink until unconscious, and (iv) being subjected to verbal abuse, physical abuse or sexual harassment in relation to alcohol. The prevalence of becoming a harasser among medical students was also measured. Multivariate regressions were used to assess the associations between experiences of alcohol-related harassment and student characteristics. RESULTS: A total of 821 respondents (86.3%) had experienced alcohol-related harassment and 686 (72.1%) had harassed others. Experiences of the ikki drinking game were frequently reported by both victims (n=686, 72.1% of all respondents) and harassers (n=595, 62.6% of all respondents). In multivariate regression, having an experience of alcohol-related harassment correlated with both being harassed (odds ratio [OR] 14.22, 95% confidence interval [CI] 8.73-23.98) and being a harasser (OR 13.19, 95% CI 8.05-22.34). The presence of senior members of medical college clubs who were regular drinkers also correlated with both being harassed (OR 2.96, 95% CI 1.88-4.67) and being a harasser (OR 2.97, 95% CI 2.06-4.27). CONCLUSIONS: Alcohol-related harassment among medical students is common and tends to occur at drinking parties with senior college club members. Hence, one of the most important strategies for preventing alcohol-related harassment may be to disrupt this vicious cycle.

Phosphorylation of ERK in the spinal dorsal horn following pancreatic pronociceptive stimuli with proteinase-activated receptor-2 agonists and hydrogen sulfide in rats: evidence for involvement of distinct mechanisms.

Noxious stimuli cause prompt phosphorylation of extracellular signal-regulated kinase (ERK) in the spinal dorsal horn that contributes to facilitation of pain sensation and is often used as an immediate marker for excitation of spinal neurons following somatic and colonic nociception. Here we asked whether two distinct pronociceptive stimuli with proteinase-activated receptor-2 (PAR2) agonists and hydrogen sulfide (H(2)S) in the pancreas cause phosphorylation of ERK in the spinal dorsal horn and also examined involvement of their possible downstream signaling molecules, transient receptor potential vanilloid-1 (TRPV1) and T-type Ca(2+) channels, respectively. Capsaicin (a TRPV1 agonist), trypsin (an endogenous PAR2 agonist), SLIGRL-NH(2) (a PAR2-activating peptide), and NaHS (an H(2)S donor) were infused into the pancreatic duct in anesthetized rats, and phosphorylated ERK in the spinal cord was detected by immunohistochemistry. Intraductal administration of capsaicin and trypsin caused prompt phosphorylation of ERK in the superficial layers of T9, but not T5 or T12, spinal dorsal horn. SLIGRL-NH(2) and NaHS, administered in the same manner, also produced ERK phosphorylation in the corresponding spinal regions. Mibefradil, a T-type Ca(2+) channel blocker, abolished the phosphorylation of ERK caused by intraductal NaHS but not SLIGRL-NH(2). In contrast, capsazepine, an inhibitor of TRPV1, suppressed the phosphorylation of ERK caused by intraductal SLIGRL-NH(2) but not NaHS. Our data thus demonstrate that pancreatic pronociceptive stimuli with PAR2 agonists and H(2)S cause ERK phosphorylation in the spinal dorsal horn, through activation of TRPV1 and T-type Ca(2+) channels, respectively, and that those two pronociceptive pathways are independent of each other.

[eLearning service for home palliative care].

In order to support the home palliative care learning, we made the eLearning service for home palliative care (beta version) and tried to teach the palliative care to the medical staffs in the community. The various learners (such as nurses, pharmacists and the like) accessed to the online learning and used this eLearning service. After the learners finished eLearning for home palliative care, some questionnaires were distributed to the learners and analyzed by us. The analysis of questionnaires revealed that almost all were satisfied with our eLearning services. Especially the learners were not only interested in using the skills of opioids and the management of pain control, but they had a good cognition for the usage of opioids.

Corrosion resistance and surface characterization of electrolyzed Ti-Ni alloy.

Ti-Ni alloy has been increasingly applied to medical and dental devices, such as coronary stents and orthodontic wires. This alloy contains nickel, which is known to give rise to cytotoxicity, metal allergy, and carcinogenicity. Therefore, the purpose of this study was to improve the corrosion resistance of Ti-Ni alloy by electrolytic treatment, whereby investigation was carried out using different acidic electrolyte compositions. As a result, specimens electrolyzed with lactic acid, water, and glycerol were found to show higher corrosion potential and release lower amount of titanium and nickel ions than mechanical-polished specimens (p<0.05). With the electrolytic treatment, nickel concentration in the surface oxide layer of Ti-Ni alloy decreased, and the thickness of the surface oxide layer increased. Based on the results of this study, it was shown that electrolytic treatment with suitable electrolyte could improve the corrosion resistance of Ti-Ni alloy, which is effective to produce medical and dental devices that utilize shape memory effect or superelasticity with better biocompatibility.

Suppression of pancreatitis-related allodynia/hyperalgesia by proteinase-activated receptor-2 in mice.

1 Proteinase-activated receptor-2 (PAR2), a receptor activated by trypsin and tryptase, is abundantly expressed in the gastrointestinal tract including the C-fiber terminal, and might play a role in processing of visceral pain. In the present study, we examined and characterized the roles of PAR2 in pancreatitis-related abdominal hyperalgesia/allodynia in mice. 2 Caerulein, administered i.p. once, caused a small increase in abdominal sensitivity to stimulation with von Frey hairs, without causing pancreatitis, in PAR2-knockout (KO) mice, but not wild-type (WT) mice. 3 Caerulein, given hourly six times in total, caused more profound abdominal hyperalgesia/allodynia in PAR2-KO mice, as compared with WT mice, although no significant differences were detected in the severity of pancreatitis between the KO and WT animals. 4 The PAR2-activating peptide, 2-furoyl-LIGRL-NH(2), coadministered repeatedly with caerulein six times in total, abolished the caerulein-evoked abdominal hyperalgesia/allodynia in WT, but not PAR2-KO, mice. Repeated doses of 2-furoyl-LIGRL-NH(2) moderately attenuated the severity of caerulein-induced pancreatitis in WT animals. 5 Our data from experiments using PAR2-KO mice provide evidence that PAR2 functions to attenuate pancreatitis-related abdominal hyperalgesia/allodynia without affecting pancreatitis itself, although the PAR2AP applied exogenously is not only antinociceptive but also anti-inflammatory.

Medical student abuse during clinical clerkships in Japan.

OBJECTIVE: To assess the prevalence of medical student abuse during clinical clerkships in Japan. DESIGN: A cross-sectional questionnaire survey. SETTING: Six medical schools in Japan. PARTICIPANTS: Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it. MEASUREMENTS: Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences. RESULTS: Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases). CONCLUSIONS: Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of "medical student abuse" is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue.

[Clinical clerkship of home care for medical students].

UNLABELLED: A clinical clerkship of home care has been introduced in our program for third-year medical students since 1998 at this university. In our clinical clerkship of home care, medical students are not only dispatched to visiting nursing stations, but they also participate in home care service activities with visiting nursing people at patients' homes. Through these experiences the students have an opportunity to study the policy of community medicine and home care, and to gain the knowledge of teamwork. OBJECTIVE AND METHOD: The clerkship of home care (1 week program) was introduced to all of the third-year medical students. The students were dispatched to visiting nursing stations and they had to take part in home care service activities at patients' homes with community care visiting nurses. After this program was finished, questionnaires were given to all the students and visiting nurses to examine the necessity and scheduling of this program and to evaluate the students by the visiting nurses, etc. RESULT: A total of 621 students participated in our program for the past 6 years since 1998, and 90 visiting nurses from 30 visiting nursing stations gave actual trainings to our students every year at patients' homes. 98% of the students as well as 97% of the home care nurses returned questionnaires. After the program, 95.1% of the students and 97.8% of the visiting nurses agreed that this program was meaningful for both sides and it should be continued. Furthermore, regarding a question of the suitability of the third-year medical students to be in the program, 70% of the students and 48% of the visiting nurses agreed. As to a question of the training duration, 80% of the students and 87% of the visiting nurses also agreed. Both students and visiting nurses were in agreement that this home care clerkship was important. Meanwhile, both students and visiting nurses also expressed a degree of some difficulty for this clinical clerkship training. These results suggested that there were some factors to be resolved in order to carry out the clinical clerkship as a success. The clinical trainings for community-based home care are not carried out sufficiently under present medical education because clinical clerkships are always performed at a bedside of a university hospital. It is hard for the students to learn community-based home care and the time related progression of a patient's disease. Therefore, clinical clerkship of home care is a good and effective method to educate the students in those areas.