The Evaluation of Fetal Cardiac Remote Screening in the Second Trimester of Pregnancy Using the Spatio-Temporal Image Correlation Method.

We prospectively performed remote fetal cardiac screening using the spatio-temporal image correlation (STIC), and examined the usefulness and problems of remote screening. We performed heart screening for all pregnant women at four obstetrics clinics over the three years from 2009 to 2014. The STIC data from 15,404 examinations in normal pregnancies (16-27 weeks, median 25 weeks) were analyzed. Obstetricians and sonographer collected STIC data from four-chamber view images. Eight pediatric cardiologists analyzed the images offline. A normal heart was diagnosed in 14,002 cases (90.9%), an abnormal heart was diagnosed in 457 cases (3.0%), and poor images were obtained in 945 cases (6.1%). 138 cases had congenital heart disease (CHD) after birth, and severe CHD necessitating hospitalization occurred in 36 cases. We were not able to detect CHD by screening in 12 cases. The sensitivity and specificity of STIC in CHD screening was 50% and 99.5%, respectively. The sensitivity and specificity of STIC in screening for severe CHD was 82% and 99.9%, respectively. The STIC method was useful in fetal remote screening for CHD. However, the fact that > 10% of images that could not be analyzed by this method was a problem.

Concerns of Disaster Medical Assistance Team (DMAT) members about troubles at the nuclear power plant: experience from the Niigata Chuetsu-Oki earthquake, 16 July 2007, in Japan.

An earthquake measuring 6.8 on the Richter scale struck the Niigata-Chuetsu region of Japan at 10:13 on 16 July 2007. The earthquake was followed by the sustained occurrence of numerous aftershocks, delaying the reconstruction of community lifelines. The earthquake affected the Kashiwazaki-Kariwa nuclear power plants (NPPs), the biggest NPP site in the world. The earthquake caused damage to NPPs, resulting in a small amount of radioactive materials being released into the air and the sea. However, no significant effects were detected in the public and the environment. As medical response to this earthquake, 42 Disaster Medical Assistance Teams (DMATs) were sent to hospitals and first-aid care centers at the NPP site. In order to evaluate the perceptions of the deployed DMAT personnel regarding concerns about the health effects of radiation and information about the damage to NPPs, questionnaires were sent to 40 facilities that dispatched DMATs to the earthquake area. Most of them were concerned with the effects of radiation, and adequate information about the problems at the NPPs was not communicated to them. This preliminary study suggests that communication of information is extremely important for DMAT members in the case of disasters, in particular if there exists a possibility of radiation exposure, since radiation cannot be detected by our senses. DMAT members are critical to any mass casualty incident, whether caused by humans or nature. We have learned from this earthquake that there is urgent need for an all-hazards approach, including a "combined disaster" strategy, which should be emphasized for current disaster planning and response. This is the first report on DMATs deployed to an earthquake site with damage to NPPs.