Effectiveness of the educational training program for Japanese chief residents: A one-year pilot study.

Background: Multi-institutional faculty development programs for chief residents were lacking in Japan. This study evaluated the effectiveness of the program for enhancing the knowledge and behaviors of chief residents at the national level.

Methods: Six participants completed self-assessment questionnaires at three points: before, immediately after, and 6 months post-program.

FRAMED: a framework facilitating insight problem solving.

Insight has been studied as an element of problem solving in the field of cognitive psychology and may play an important role in clinical reasoning. We propose a new strategy based on theories that promote insight that may help generate further diagnostic hypotheses by reviewing the interpretation of a case and an individual's list of differential diagnoses from multiple perspectives: formation (F), re-encoding (R), analogy (A), modification (M), elaboration (E), and deliberation (D) (FRAMED). The FRAMED strategy may help clinicians overcome misinterpretations and cognitive bias by systematically reflecting on previous clinical reasoning processes from multiple perspectives.

Rapid anticalcification treatment for glutaraldehyde-fixed autologous tissue in cardiovascular surgery.

Background: Glutaraldehyde (GA)-fixed autologous tissues, including the pericardium, are widely used as patches and valve substitutes in cardiovascular surgery. However, GA treatment causes tissue calcification. No rapid anticalcification method has been established for use during surgery.

Identification of the Core Activate Position for a Seated Subject: Proposal of a new Exercise Method for Maintenance Rehabilitation.

Objectives: This study aimed to identify a position for core muscle activation (core activate position) for a seated subject and to design an exercise method using this position for rehabilitation during the daily maintenance or maintenance stages.

Methods: Thirteen young men participated as subjects in this study. We manufactured a chair in which the seat had an adjustable forward tilt angle.

Low hematocrit levels: a risk factor for long-term outcomes in patients requiring prolonged mechanical ventilation after cardiovascular surgery. A retrospective study.

While low-risk patients who undergo elective surgery can tolerate low hematocrit levels, the benefits of higher hematocrit levels might outweigh the risk of transfusion in high-risk patients. Therefore, this study aimed to evaluate the effects of perioperative hematocrit levels on mortality in patients requiring prolonged mechanical ventilation (PMV) after a cardiovascular surgery. This single-center retrospective cohort study was conducted on 172 patients who underwent cardiovascular surgery with cardiopulmonary bypass or off-pump coronary artery bypass grafting and required PMV for ≥72 hours in the intensive care unit (ICU) from 2008 to 2012 at the Yokohama City University Medical Center in Yokohama, Japan.

Priming and replenishment in cardiopulmonary bypass with hydroxyethyl starch 130/0.4 decreases fluid overbalance without renal dysfunction or bleeding in adult valve surgery.

The best priming and replenishment solution in cardiopulmonary bypass remains unknown, and the efficacy and drawbacks of artificial colloid are controversial. We retrospectively compared consecutive patients undergoing elective adult valve surgery in cases wherein cardiopulmonary bypass was primed and replenished with hydroxyethyl starch 130/0.4 (n = 12) or crystalloid solution (n = 11).

De-airing an open stent graft to potentially reduce spinal cord injury.

We have occasionally observed a bubble leaving the suture line of an open stent graft; hence, we hypothesized that de-airing an open stent graft could potentially reduce spinal cord injury. Postoperative computed tomography often showed residual air in thoracic aortic aneurysms, confirmed by the presence of a certain amount of air in an open stent graft in a dry lab. We filled CO in the sterilized package of an open stent graft and subsequently filled it with saline, which absorbed the CO and entered into the gap of the graft.

Efficacy of Glutaraldehyde-Treated Leaflets for Mitral Valve Repair to Treat Active Infective Endocarditis: A Case Report.

We report the use of glutaraldehyde (GA) in a case of valve repair for mitral valve prolapse associated with active infective endocarditis. GA scrubbed at the site of infection decontaminates and reinforces infected fragile tissue, avoids excessive debridement, and strengthens the edges of valve leaflets to facilitate suturing.

A Wireless Sensor Network for Growth Environment Measurement and Multi-Band Optical Sensing to Diagnose Tree Vigor.

We have tried to develop the guidance system for farmers to cultivate using various phenological indices. As the sensing part of this system, we deployed a new Wireless Sensor Network (WSN). This system uses the 920 MHz radio wave based on the Wireless Smart Utility Network that enables long-range wireless communication.

Heparin-Induced-Thrombocytopenia Causing Massive Aortic Thrombosis after Ascending Aortic Replacement for Type A Acute Aortic Dissection.

A 77-year-old woman underwent emergency ascending aortic replacement for type A acute aortic dissection. Fifteen days after the operation, she had motor and sensory disturbances in the lower limbs. Computed tomography revealed multiple aortic thrombi and disrupted blood flow in the right external iliac and left common iliac arteries.

Pitfalls for the "Sandwich technique" via a right ventricular incision to repair post-infarction ventricular septal defects.

Background: We have reported "sandwich technique," via a right ventricular incision, to treat a post-infarction ventricular septal defect (VSD). This technique involves the placement of patches on both the left and right sides of the septum, pinching the VSD sealed with surgical adhesive between the two patches. In this study, we analyzed factors influencing 1-year mortality to determine the pitfalls in our procedure.

Pathophysiology and Surgical Treatment of Type A Acute Aortic Dissection.

Unlabelled: We report the pathophysiology and treatment results of type A acute aortic dissection from our 20-year experience.

Methods: We studied 673 patients with type A acute aortic dissection who underwent initial treatment from 1994 through July 2014. We divided these patients into two groups.

Classification of patients with non-alcoholic fatty liver disease using rapid immunoassay of serum type IV collagen compared with liver histology and other fibrosis markers.

Aim: Non-alcoholic fatty liver disease (NAFLD) can progress to non-alcoholic fatty liver (NAFL) or non-alcoholic steatohepatitis (NASH). We investigated the association among serum type IV collagen level, liver histology, and other fibrosis markers in NAFLD progression.

Methods: We evaluated 184 patients diagnosed with NAFLD following biopsy, including 89 males and 95 females with an average age of 52.

Effects of Immersion Solvent on Photovoltaic and Photophysical Properties of Porphyrin-Sensitized Solar Cells.

Memory effects in self-assembled monolayers (SAMs) of zinc porphyrin carboxylic acid on TiO2 electrodes have been demonstrated for the first time by evaluating the photovoltaic and electron transfer properties of porphyrin-sensitized solar cells prepared by using different immersion solvents sequentially. The structure of the SAM of the porphyrin on the TiO2 was maintained even after treating the porphyrin monolayer with different neat immersion solvents (memory effect), whereas it was altered by treatment with solutions containing different porphyrins (inverse memory effect). Infrared spectroscopy shows that the porphyrins in the SAM on the TiO2 could be exchanged with the same or analogous porphyrin, leading to a change in the structure of the porphyrin SAM.

"Pouch Technique" Makes Proximal Anastomosis of Free Internal Thoracic Artery Graft to Ascending Aorta Easy and Safe in Coronary Artery Bypass Surgery.

Purpose: The proximal anastomosis of free right internal thoracic artery to ascending aorta is technically difficult when the caliber is not enough.

Methods: We incise the proximal stump of the graft longitudinally for 10 mm. One side of start point of longitudinal incision is sewn to the end point of incision by 7-0 polypropylene.

"Sandwich Technique" via a Right Ventricle Incision to Repair Postinfarction Ventricular Septal Defects.

Background: Residual shunting and mortality are problems associated with the current surgical repair techniques for postinfarction ventricular septal defects (VSD). We developed the "sandwich technique" via a right ventricle incision and assessed the surgical outcome of 13 years of experience with this technique.

Methods: Between June 2001 and March 2013, 25 consecutive patients with postinfarction VSD underwent surgical repair using this technique.

Modeling the current-voltage characteristics of thin-film silicon solar cells based on photo-induced electron transfer processes.

Power conversion efficiency of p-i-n type macrocrystalline silicon (µc-Si:H) solar cells has been analyzed in terms of sequential processes of photo-induced electron transfer. The effect of the excitonic state on the charged carrier generation has been studied compared to a conventional scheme in which only charged carriers are taken into account for the operation of the solar cells. A numerical model has been developed to calculate current-voltage characteristics of solar cells on the basis of two types of charged carrier generation processes (exciton process and charged carrier process).

Quantitative analysis of microbial biomass yield in aerobic bioreactor.

We have studied the integrated model of reaction rate equations with thermal energy balance in aerobic bioreactor for food waste decomposition and showed that the integrated model has the capability both of monitoring microbial activity in real time and of analyzing biodegradation kinetics and thermal-hydrodynamic properties. On the other hand, concerning microbial metabolism, it was known that balancing catabolic reactions with anabolic reactions in terms of energy and electron flow provides stoichiometric metabolic reactions and enables the estimation of microbial biomass yield (stoichiometric reaction model). We have studied a method for estimating real-time microbial biomass yield in the bioreactor during food waste decomposition by combining the integrated model with the stoichiometric reaction model.

Stability of α''-Fe16N2 in hydrogenous atmospheres.

We revealed the inherent instability of α''-Fe16N2 in hydrogenous atmospheres due to the denitrification toward α-Fe by forming NH3 at the particle surface. Coating the particle surface with SiO2 to suppress the formation of NH3 has proven to be a simple yet powerful method to enhance the stability of α''-Fe16N2 in hydrogenous atmospheres.