Changes in fears and worries related to COVID-19 during the pandemic among current employees in Japan: a 5-month longitudinal study.

OBJECTIVES: This study investigates and describes the time course of fears and worries about COVID-19 among current employees during this outbreak. STUDY DESIGN: This was a longitudinal study. METHODS: This study was a part of the Employee Cohort Study in Japan. The study comprised 4120 individuals from February 2019. A baseline survey in March 2020, a 2-month follow-up survey in May 2020, and a 5-month follow-up survey in August 2020 were conducted. Questions surveyed respondents' global fear and worry and six items related to COVID-19. A mixed model for repeated measures of an analysis of variance was used. RESULTS: A total of 1421 respondents completed the baseline survey. At 2- and 5-month follow-ups, 1032 and 1181 respondents completed surveys, respectively. Of those, 64 and 33 individuals who were temporarily laid off or on leave were recorded as missing values. Global fear and worry about COVID-19 significantly increased from March to August 2020. Fears of personal or family infection, limiting one's activities and national and local government policies also significantly increased with time. In contrast, fears of lack of knowledge and difficulty of obtaining hygiene products significantly decreased. CONCLUSION: To conduct efficient risk communication during a pandemic, knowing the concerns of the populace, providing correct information and a sufficient supply of products, and setting clear guidelines are essential.

Novel multipole Wien filter as three-dimensional spin manipulator.

Spin polarized electron beam is often used in material characterizations which relates to magnetism as well as in the high energy particle physics. The manipulation of the spin polarization toward the arbitrary direction is indispensable in such studies. In the present work, a novel multipole Wien filter is proposed as the three-dimensional spin manipulator, and a prototype 8-pole Wien filter is developed. It is applied to spin polarized low energy electron microscopy, and the variation of the magnetic contrast with managing the spin polarization is evaluated. It is confirmed that the novel multipole Wien filter can manipulate the spin polarization three-dimensionally.

Omega filter installed in the 1MV microscope of Kyushu University.

A 1.25MV high-voltage electron microscope with a B-type omega filter has been successfully installed at Kyushu University. An image detection chamber has been set inside a concrete block below the ground level without changing the frame structure for anti-vibration. Nearly the same design as that for the 200kV microscope has been kept for the present omega filter except for its size. A new pre- and post-filter lens system with rotation-free imaging has been designed. Energy resolution, beam shape and stability of the filter have been measured. Some application data have been obtained to demonstrate the performance of the filter.

Differential diagnosis of the infundibular dilation and aneurysm of internal carotid artery: assessment with fusion imaging of 3D MR cisternography/angiography.

Fusion imaging of 3D MR cisternography/angiography was used for the assessment of the vascular bulging finding detected by MR angiography from the viewpoint of the outer wall configuration of the corresponding internal carotid artery depicted by MR cisternography. With a fusion image, useful information was obtained to distinguish an infundibular dilation and enlarged origin of the normal posterior communicating artery from an aneurysm. This imaging technique can be a feasible addition to a noninvasive screening of cerebrovascular lesions with MR angiography alone.

Third-order aberration theory of Wien filters for monochromators and aberration correctors.

Third-order aberrations at the first and the second focus planes of double focus Wien filters are derived in terms of the following electric and magnetic field components--dipole: E1, B1; quadrupole: E2, B2; hexapole: E3, B3 and octupole: E4, B4. The aberration coefficients are expressed under the second-order geometrical aberration free conditions of E2 = -(m + 2)E1/8R, B2 = -mB1/8R and E3R2/E1 - B3R2/B1 = m/16, where m is an arbitrary value common to all equations. Aberration figures under the conditions of zero x- and y-axes values show very small probe size and similar patterns to those obtained using a previous numerical simulation [G. Martinez & K. Tsuno (2004) Ultramicroscopy, 100, 105-114]. Round beam conditions are obtained when B3 = 5m2B1/144R2 and (E4/E1 - B4/B1)R3 = -29m2/1152. In this special case, aberration figures contain only chromatic and aperture aberrations at the second focus. The chromatic aberrations become zero when m = 2 and aperture aberrations become zero when m = 1.101 and 10.899 at the second focus. Negative chromatic aberrations are obtained when m < 2 and negative aperture aberrations for m < 1.101. The Wien filter functions not only as a monochromator but also as a corrector of both chromatic and aperture aberrations. There are two advantages in using a Wien filter aberration corrector. First, there is the simplicity that derives from it being a single component aberration correction system. Secondly, the aberration in the off-axis region varies very little from the on-axis figures. These characteristics make the corrector very easy to operate.

Design of Wien filters with high resolution.

The design of a compact high-energy resolution device based on a symmetrical double Wien filter is presented. An accurate version of the boundary element method (BEM) is employed to model the shape and behaviour of the filters very precisely. Using a direct ray tracing technique, we investigate the geometrical aberrations in the basic filter, in which dipole and quadrupole electric fields and a dipole magnetic field are present. The additions of a quadrupole magnetic component along with some slight modifications in the geometry produce a drastic reduction in the aberrations.

BEM simulation of Wien filters.

The boundary element method can provide accurate solutions to the electromagnetic problem in numerical simulations of electron optics devices. In this paper, we describe our approach, which applies a subsectional-bases method to generate a boundary division, representing the shape and behaviour of the Wien filter precisely. We investigate by direct ray tracing the origin of the second-order geometrical aberrations of this filter and propose new designs to reduce them.

[Extraaxial primary malignant lymphoma associated with calcified chronic subdural hematoma: a case report].

The authors report the case of a 54-year-old male with extraaxial primary malignant lymphoma associated with calcified chronic subdural hematoma. He slowly developed progressive headache accompanied by a bulge in the left forehead. Skull radiogram showed a large biconvex calcification in the left frontoparietal region, with concave change in the overlying bone. Computed tomograms and magnetic resonance images revealed a left frontoparietal chronic subdural hematoma surrounded by a calcified rim, with marginal enhancement in the frontal portion extending upward to the subcutaneous tissue through the underlying bone. The lesion was suspected to be an infectious calcified hematoma. The patient underwent a craniotomy for the removal of the hematoma. It was observed that the tumor was located mainly in the epidural and subdural space. The extent of the tumor corresponded with the enhanced area of the lesion in the preoperative neuroimages. The histological diagnosis was malignant lymphoma of B cell origin. General examination, which included bone marrow study and Ga scintigraphy, failed to prove systemic lymphoma. Extraaxial primary malignant lymphoma is extremely rare, and this is the first report of a lymphoma associated with calcified chronic subdural hematoma. The authors review the literature and discuss the clinical features and the pathogenesis of the lesion.

[Congenital arteriovenous malformation of the scalp with a drainage to the transverse sinus: a case report].

Arteriovenous malformation (AVM) of the scalp is uncommon, and a subtype which has connection with the intracranial dural sinus is extremely rare. Only 3 cases have been reported. We present a case of congenital AVM of the scalp which was connected with the intracranial venous sinus. A 27-year-old woman had been noted as having a pulsatile soft mass in the midline of the occipital region since her birth. She visited our hospital because of pain and enlargement of the mass. The patient had had no history of trauma. Physical examination revealed a pulsatile scalp mass in the midline of the occipital region, measuring 3.5 x 3.5 x 1 cm. A loud bruit was ausculated. Tenderness was noted. The skin over the mass was slightly reddish. No focal neurological deficits were noted. Plain skull films demonstrated a round defect in the midline of the occipital bone. Magnetic resonance imaging (MRI) demonstrated a subcutaneous mass with low signal intensity and an infratentorial mass with flow void. 3D CT angiograms demonstrated a subcutaneous vascular mass with a single large vein draining into the right transverse sinus. External carotid angiograms revealed a vascular lesion within the scalp with supply from the branches of the bilateral occipital arteries and the meningeal arteries. The nidus penetrated the skull and connected to a dilated varix, which had a draining vein shunting into the right transverse sinus. After embolization of the right meningeal feeding arteries, surgery was performed. The vascular lesion penetrated the skull and the dura. The infratentorial mass was in the epiarachnoid space and was fed by a small pial artery. The mass was excised completely after interruption of the pial artery and the draining vein. Postoperative course was uneventful. Histologically, the subcutaneous mass and infratentorial vascular mass were shown to be AVM and varix, respectively.

Relationship between serum biochemical values and marbling scores in Japanese Black steers.

In order to obtain available biochemical parameters related to the marbling score (MS), by which the meat was graded from 1 to 12 in Japan, serum biochemical values were examined in 13 Japanese Black steers during the fattening stages. The steers were divided into high MS (8-11) and low MS (4-5) groups and the fattening stage was also divided into 4 stages according to their feed contents; Stage I (11-13 month-old; 0-4 months after the fattening (af)), II (5-9 months af), III (10-14 months af), and IV (15-20 months af). High MS group showed significantly higher levels in glucose and urea nitrogen (at Stage I), albumin/globulin ratio (at Stage II), and magnesium (at Stage I and III), and lower level in vitamin A (at Stage III) than low MS group. These biochemical parameters, indicating conditions of steers during the fattening stages, are considered to have a possibility related to MS in fattening steers.

Development of a high energy resolution electron energy-loss spectroscopy microscope.

We have developed a high energy resolution electron energy-loss spectroscopy (EELS) microscope, which can take spectra from specified small specimen areas and specified small reciprocal space areas to investigate detailed electronic structures. The EELS microscope is equipped with retarding Wien filters as the monochromator and the analyser. The filters are designed to achieve a stigmatic focus. The energy resolutions are 12 meV and 25 meV for cases without and with a specimen, respectively. Spatial and momentum resolutions are 30-110 nm in diameter and 1.1 nm-1 in angular diameter, respectively. EELS spectra are presented to show the performance of this instrument.

A new 200 kV Omega-filter electron microscope.

A new 200 kV Omega-filter electron microscope was developed under a project supported by a Grant-in-Aid for Specially Promoted Research of the Ministry of Education, Science, Sports and Culture of Japan. The performance of the microscope is described.

Intratracheal pulmonary ventilation at low airway pressures in a ventilator-induced model of acute respiratory failure improves lung function and survival.

STUDY OBJECTIVE: The pulmonary parenchyma in patients with acute respiratory failure (ARF) is commonly not involved in a homogenous disease process. Conventional mechanical ventilation (MV) at elevated positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP) aims at recruiting collapsed or nonventilated lung units. Invariably, those pressures are also transmitted to the healthiest regions, with possible extension of the disease process (barotrauma). During intratracheal pulmonary ventilation (ITPV), a continuous flow of fresh gas is delivered directly at the carina, bypassing the dead space proximal to the catheter tip. In healthy sheep, it allows lowering tidal volume (VT) to as low as 1.0 mL/kg, at respiratory rates (RR) up to 120 breaths/min, while maintaining normocapnia. In a model of ventilator-induced lung injury, we wished to explore whether ITPV, applied at low VT and low PEEP and tailored to ventilate the healthiest regions of the lungs, could provide adequate oxygenation and alveolar ventilation, without any attempt to recruit lungs. DESIGN: Randomized study in sheep. SETTING: Animal research laboratory. PARTICIPANTS: We induced ARF in 12 sheep following 1 to 2 days of MV at a PIP of 50 cm H2O, except that 5 to 8% of lungs were kept on apneic oxygenation of 5 cm H2O, sparing those regions from the injury process. INTERVENTIONS: Sheep were randomized to volume-controlled MV (control group) (n = 6) with VT of 8 to 12 mL/kg, PEEP of 5 to 10 cm H2O, or to ITPV (n = 6) at PEEP of 3 to 5 cm H2O, VT of 2.5 to 4 mL/kg, PIP of <20 cm H2O, at RRs sufficient to sustain normocapnia. MEASUREMENTS AND RESULTS: Hemodynamic status in the ITPV group progressively improved, and all six sheep were weaned to room air within 83+/-54 h. Sheep in the control group had progressively deteriorating conditions and all animals died after a mean of 50+/-39 h. Barotrauma and postmortem histopathologic changes were more pronounced in the control group. CONCLUSION: In this model of ventilator-induced lung injury, low PEEP-low VT ventilation with ITPV sustained normocapnia and prevented further lung injury, allowing weaning to room air ventilation.

Pharmacologic inhibition of collagen in an experimental model of subglottic stenosis.

Subglottic stenosis occurs as a complication of prolonged endotracheal intubation secondary to inflammation with development of scar tissue and subsequent fibrosis. Collagen I and III levels increase during the healing process. Steroids alter the inflammatory response, decreasing recruitment of macrophages and fibroblasts. Beta-aminopropionitrile (betaAPN) inhibits the development of collagen cross-linking. A mechanism that would minimize hypertrophic scarring was sought. Eighteen dogs were anesthetized, had tracheostomies performed, and later had cautery of the mucosa and inner layer of the cricoid cartilage. Of 18 survivors, 6 animals were used as controls, 6 animals received oral Decadron, 2 mg/d, and 6 animals received oral betaAPN, 40 mg/d. There were 9 early deaths--5 in the steroid group. Animals were painlessly sacrificed, and the specimens were sectioned at the cricoid cartilage level and were stained immunohistochemically for antibodies to collagen types I to VI. Analysis of the area of scar and the intensity of stain was performed with Mocha image analysis software. Collagen III increased in control animals to 14.38 +/- 1.85 (intensity stain index), but this reaction was reduced by betaAPN (5.77 +/- 1.78, p < .01). Steroids had no significant effect on formation of any type of collagen. Lathyrogens (betaAPN) may offer a pharmacologic tool to reduce scar tissue.

[Cervical myelopathy caused by bilateral vertebral artery compression].

We report a rare case of myelopathy caused by compression of the upper cervical cord by the bilateral anomalous vertebral arteries. A 49-year-old man had dragged his right foot for 4 years. He also complained of a tingling sensation in his right arm and occipitalgia. Neurological examination disclosed right hemiparesis, hypalgesia in the right half of the body and hypertonicity of the lower extremities. MRIs showed a flow void area which compressed and distorted the spinal cord bilaterally at the level of the atlas. A vertebral angiogram showed that the bilateral vertebral arteries had pierced the dura matter under the posterior arch of the atlas, turned upward and laterally in the vertebral canal, making vascular loops at the level of the atlas. 3D CT angiography showed the loops convex medially in the anterior part of the vertebral canal. With these findings, we diagnosed the patient as suffering compression of the cervical cord by the bilateral anomalous vertebral arteries. Suboccipital craniectomy and C1 laminectomy were performed. When the dura mater was opened, the dorsolateral aspect of the spinal cord was found to be compressed and indented markedly by the vertebral arteries. To decompress the spinal cord, the vertebral arteries were retracted dorsolaterally by means of Gore-tex tape and anchored to the spinous process of the axis. Postoperatively, his neurological symptoms improved. Postoperative MRIs showed that the spinal cord was decompressed and had recovered its contour. A review of the literature revealed that only 3 such cases as this one have been reported. The clinical features of these rare cases are nonspecific myelopathy and concomitant occipitalgia or neck pain. The main cause of this rare entity seemed to be the compression of the vertebral artery through its course when it enters the vertebral canal between the atlas and the axis.

[Placement of self-expanding metallic stents in the stenotic trachea and bronchus under the support of gas exchange by extracorporeal lung assist (ECLA)].

Three self-expanding metallic stents (MS) were placed in a patient with severe dyspnea due to tracheo-bronchial stenosis caused by a large metastatic malignant tumor. To ensure adequate gas exchange, we used ECLA during surgery. After ECLA was started with V-V bypass (blood flow 1.3 l.min-1, 100% O2 flow 10 l.min-1), the patient was administered droperidol and fentanyl, and orotracheally intubated with an endotracheal tube (7.0 mm ID) using a bronchofiberscope. Anesthesia was maintained with midazolam, but no neuromuscular blocking agent was used. The pulmonary ventilation was withheld 3 times during each period of 5-10 min for MS placement through the endotracheal tube. The patient was ventilated for a few min between each procedure. Values of arterial blood gas were maintained within physiological ranges throughout the surgery. ECLA was a useful means of ensuring adequate gas exchange in perioperative patients with difficult airway.

Values of the serum components in Japanese black beef steers at farms with high productivity and low frequencies of disease and death in Miyazaki Prefecture.

Few reference values for use in metabolic profile tests for the maintenance of high productivity and the prevention of production diseases have been reported in Japanese Black beef cattle. To obtain basic data, 101 healthy steers at farms with high productivity and low frequencies of disease and death in Miyazaki Prefecture, Japan, were examined for the values of their serum components in this preliminary study. At the later fattening stage (5 to 20 months after introduction), statistically significant increases were observed in the mean serum activities of lactic dehydrogenase, glutamic-oxalacetic transaminase, gamma-glutamyl transpeptidase, and creatine phosphokinase, the mean serum contents of triglyceride, total cholesterol, albumin (Alb), total protein, blood urea nitrogen, magnesium, and vitamin E, and the mean serum calcium (Ca)/inorganic phosphorus (IP) ratio, and statistically significant decreases were seen in the mean serum alkaline phosphatase activity and the mean serum contents of glucose, IP, and vitamin A. The mean serum Alb/globulin ratio and the mean serum Ca and nonesterified fatty acids contents demonstrated no statistically significant changes.

Design and development of ultrathin-walled, nonkinking endotracheal tubes of a new "no-pressure" laryngeal seal design. A preliminary report.

BACKGROUND: Endotracheal tubes (ETTs) of conventional design and manufacture greatly increase the air-flow resistance of the upper airways. This increase in upper-airway resistance can lead to a significant increase in the work of breathing and may necessitate the use of assisted mechanical ventilation. Current ETTs are relatively stiff and contribute greatly to patient discomfort. The inflatable cuffs now mounted onto the ETTs function well in short-term use but impart significant morbidity when used over longer periods. These issues were addressed by the designing of a low-resistance ETT. METHODS: Using new techniques, we developed ultrathin-walled, wire reinforced ETTs of conventional configuration and ETTs the oropharyngeal-section diameter of which was a few millimeters larger than the diameter of the tracheal section. The wall thickness was a constant 0.20 mm. The wire reinforcement was stainless steel flat wire or superelastic nickel-titanium alloy. The superelastic nickel-titanium alloy reinforcement made those ETTs crush-proof; after forceful manual compression, recovery was complete. To obtain a seal with the upper airways, we first shaped a short section of the oropharyngeal section of the ETT from round to oval (or egg-shaped) to conform better to the larynx. We then attached to this segment numerous soft, pliable, 0.025-0.075-mm-thick rings of polyurethane to occlude voids for potential air leaks from within the larynx. RESULTS: In vitro pressure-flow studies showed a decrease by as much as four- or fivefold in air-flow resistance in the adult ETT range, effectively increasing the internal diameter by 2.3-3.7 mm, compared with conventional ETTs of the same outside diameter. In vivo studies for 24 h in sheep showed no air leaks at airway pressures to 30 cmH2O and minimal leak at greater pressures. The gross appearance of the trachea was normal. CONCLUSIONS: Although the new tubes appear to offer advantages to those currently used, testing in humans is required to assess the clinical utility of the tube-cuff design.

[Patterns of recurrence in malignant gliomas after brachytherapy].

More than 80% of malignant gliomas have been reported to recur locally after conventional chemoradiation therapy. This regional pattern of recurrence has encouraged the introduction of new treatments for local tumors. Since 1987 interstitial brachytherapy using Iridium-192 seeds has been carried out in our department for malignant brain tumors. The present study was designed to evaluate the patterns of recurrence following interstitial brachytherapy and to assess how this recurrence differs from that observed in patients treated by conventional means. Ten patients who satisfied the following criteria were selected among 41 patients treated with brachytherapy. The criteria were; 1) histologically diagnosed to be malignant glioma (astrocytoma grade III or glioblastoma), 2) followed up with MRI every month after the brachytherapy, 3) follow-up period was more than 6 months, and 4) the time of recurrence was confirmed. The patients were classified into 3 groups according to the patterns of tumor recurrence as follows; 1. Local recurrence group: The tumor recurred near the pretreatment tumor site. 2. Necrotomy group: Reoperation was performed because of neurological deterioration and radiographic evidence of increasing mass effect with surrounding edema. Neurological symptoms were unchanged or improving during the 6 months after the reoperation. 3. CSF seeding group: Primary tumor was well controlled, but seeding via cerebrospinal fluid was recognized on MRI. Local recurrence occurred in three patients, necrotomy was carried out in three patients, and CSF metastases were defined by both MRI and clinical symptoms in four patients. Median radiation does was 33 Gy in the local recurrence group, 57.6 Gy in the necrotomy group, and 43.2Gy in the CSF seeding group.(ABSTRACT TRUNCATED AT 250 WORDS)

Intratracheal pulmonary ventilation (ITPV): control of positive end-expiratory pressure at the level of the carina through the use of a novel ITPV catheter design.

A new mode of pulmonary ventilation called intratracheal pulmonary ventilation (ITPV) was studied. Briefly, a continuous flow of air/oxygen is introduced through a small catheter, the tip of which is positioned at the carina, with a diffuser mounted at its distal end. A timed expiration valve, when closed, provides for inspiration; when open, it provides for expiration. The system as first described had a potential for significant back pressure at the level of the carina, which was more at rapid gas flows and with smaller endotracheal tubes. We have now mounted a venturi on the tip of the catheter (reverse thrust catheter [RTC]) that avoids back pressure, and which facilitates expiration. At respiratory rates from 10 to 120/min, the ITPV system with the RTC maintained end-expiratory pressure at the level of the carina at, or near 0 cm H2O. Compared to conventional mechanical ventilation, at identical respiratory rates, this system reduced tidal volume by one half at the lowest respiratory rates, and by as much as two thirds at the highest respiratory rates, with a proportional decrease in peak inspiratory pressure. ITPV has the smallest minute volume ventilation of any conventional or nonconventional mode of pulmonary ventilation.