Incorporating Tacit Knowledge of Experts in the Assessment of Shelters Under Disaster.

During disasters, prompt assessment of evacuation centres and appropriate measures taken based on the assessment are important for protecting local residents' lives and health. To clarify experts' tacit knowledge for improving the management of shelters under disaster, we conducted a questionnaire survey of specialists in disaster management to examine the assessment items to which they accorded top priority. Our results suggest that specialists give highest priority to the number of evacuees, followed by infrastructure and need for medical intervention. Identifying their common views on priorities can be the first step towards taking standard appropriate measures in evacuation centres.

Development and Verification of a Mobile Shelter Assessment System "Rapid Assessment System of Evacuation Center Condition Featuring Gonryo and Miyagi (RASECC-GM)" for Major Disasters.

UNLABELLED: Introduction There were 5,385 deceased and 710 missing in the Ishinomaki medical zone following the Great East Japan Earthquake that occurred in Japan on March 11, 2011. The Ishinomaki Zone Joint Relief Team (IZJRT) was formed to unify the relief teams of all organizations joining in support of the Ishinomaki area. The IZJRT expanded relief activity as they continued to manually collect and analyze assessments of essential information for maintaining health in all 328 shelters using a paper-type survey. However, the IZJRT spent an enormous amount of time and effort entering and analyzing these data because the work was vastly complex. Therefore, an assessment system must be developed that can tabulate shelter assessment data correctly and efficiently. The objective of this report was to describe the development and verification of a system to rapidly assess evacuation centers in preparation for the next major disaster. Report Based on experiences with the complex work during the disaster, software called the "Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi" (RASECC-GM) was developed to enter, tabulate, and manage the shelter assessment data. Further, a verification test was conducted during a large-scale Self-Defense Force (SDF) training exercise to confirm its feasibility, usability, and accuracy. The RASECC-GM comprises three screens: (1) the "Data Entry screen," allowing for quick entry on tablet devices of 19 assessment items, including shelter administrator, living and sanitary conditions, and a tally of the injured and sick; (2) the "Relief Team/Shelter Management screen," for registering information on relief teams and shelters; and (3) the "Data Tabulation screen," which allows tabulation of the data entered for each shelter, as well as viewing and sorting from a disaster headquarters' computer. During the verification test, data of mock shelters entered online were tabulated quickly and accurately on a mock disaster headquarters' computer. Likewise, data entered offline also were tabulated quickly on the mock disaster headquarters' computer when the tablet device was moved into an online environment. CONCLUSIONS: The RASECC-GM, a system for rapidly assessing the condition of evacuation centers, was developed. Tests verify that users of the system would be able to easily, quickly, and accurately assess vast quantities of data from multiple shelters in a major disaster and immediately manage the inputted data at the disaster headquarters. Ishii T , Nakayama M , Abe M , Takayama S , Kamei T , Abe Y , Yamadera J , Amito K , Morino K . Development and verification of a mobile shelter assessment system "Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi (RASECC-GM)" for major disasters. Prehosp Disaster Med. 2016;31(5):539-546.

Access Control for Mobile Assessment Systems Using ID.

The assessment of shelters during disaster is critical to ensure the health of evacuees and prevent pandemic. In the Ishinomaki area, one of the areas most damaged by the Great East Japan Earthquake, the highly organized assessment helped to successfully manage a total of 328 shelters with a total of 46,480 evacuees. The input and analysis of vast amounts of data was tedious work for staff members. However, a web-based assessment system that utilized mobile devices was thought to decrease workload and standardize the evaluation form. The necessary access of information should be controlled in order to maintain individuals' privacy. We successfully developed an access control system using IDs. By utilizing a unique numerical ID, users can access the input form or assessment table. This avoids unnecessary queries to the server, resulting in a quick response and easy availability, even with poor internet connection.

Enhanced Rho-kinase activity in circulating neutrophils of patients with vasospastic angina: a possible biomarker for diagnosis and disease activity assessment.

OBJECTIVES: The aim of this study was to examine whether Rho-kinase activity is systemically enhanced in patients with vasospastic angina (VSA) and, if so, whether a noninvasive diagnostic method could be developed to improve practice. BACKGROUND: The activated Rho-kinase pathway plays a central role in the molecular mechanism of coronary vasospasm in animal models and patients with VSA. Recently, it has been reported that Rho-kinase activity in circulating leukocytes is associated with various diseases. METHODS: Fifty-three consecutive patients with chest pain who underwent acetylcholine provocation testing for coronary spasm were examined. Patients were divided into 2 groups depending on their response to the test: VSA (n = 33) and non-VSA (n = 20) groups. Venous blood samples were collected to measure Rho-kinase activity in circulating neutrophils, determined by the extent of phosphorylation of myosin-binding subunit (MBS), a substrate of Rho-kinase. RESULTS: Rho-kinase activity was significantly higher in the VSA group than in the non-VSA group (phosphorylated MBS/total MBS ratio 1.33 ± 0.37 vs. 0.95 ± 0.22, p < 0.001). In the VSA group, no correlation was noted between Rho-kinase activity and high-sensitivity C-reactive protein, smoking, or accumulated number of coronary risk factors. After the 3-month medical treatment, Rho-kinase activity in the VSA group was significantly decreased to 1.08 ± 0.31 (p < 0.001). On receiver-operating characteristic curve analysis, a phosphorylated MBS ratio of 1.18 was identified as the best cutoff level to predict the diagnosis of VSA. CONCLUSIONS: These results indicate that Rho-kinase activity in circulating neutrophils is enhanced in patients with VSA and may be a useful biomarker for diagnosis and disease activity assessment of the vasospastic disorder.