Differences in code status practice patterns among emergency clinicians working in Japan and the United States.

Objective: This study aimed to examine self-reported code-status practice patterns among emergency clinicians from Japan and the U.S.

Methods: A cross-sectional questionnaire was distributed to emergency clinicians from one academic medical center and four general hospitals in Japan and two academic medical centers in the U.

A Case Study of Non-specialist Disease Management Using Teladoc Health Support: A Case Report.

In Japan, there is a shortage of emergency medicine specialists, often leading non-specialists (physicians who treat conditions outside their area of specialty) to handle cases outside their expertise, which can cause challenges and necessitate specialist support. Starting from December 2023, the St. Marianna University Hospital, which has emergency medicine specialists, began offering overnight emergency outpatient support to Kawasaki Municipal Tama Hospital using the Teladoc HEALTH Mini Cart telemedicine device (Teladoc Health, Inc.

Onlinization of a simulation course that includes minor emergency procedures.

Aim: We attempted to convert a simulation course held on-site for primary care physicians to learn about the initial treatment of minor emergencies, including some common surgical procedures, to an online format.

Methods: We reviewed the subjects covered in the course and evaluated whether it was "decision-making" or "technical skills" that had been primarily taught as simulation-based training for each subject, and then supplemented the contents accordingly.

Results: As a result, satisfaction levels with the online course were comparable to those with the on-site course as measured by a postcourse questionnaire (97.

Nail Gun Injury of the Trachea and Spinal Cord.

Introduction: A 26-year-old man was impaled by a nail after a nail gun accident. He was fully conscious with weakness and loss of sensation in the extremities. Cervical computed tomography showed a 9-centimeter long nail penetrating the spinal cord.

Effects of short-term upper limb immobilization on sensory information processing and corticospinal excitability.

Several studies have reported the effects of short-term immobilization of the upper limb on the excitability of the primary motor cortex. In a report examining the effects of upper limb immobilization on somatosensory information processing using somatosensory-evoked potentials (SEPs), short-term upper limb immobilization reduced the amplitude and increased the latency of the P45 component recorded over the contralateral sensorimotor cortex of SEPs. However, the effects of upper limb immobilization on other regions involved in somatosensory information processing are unknown.

Intensive care burden of COVID-19 in tertiary care hospitals during the first year of outbreak in Kawasaki City, Japan: A retrospective cohort study.

Introduction: This study aimed to describe the changes in the intensive care burden of coronavirus disease 2019 (COVID-19) during the first year of outbreak in Japan.

Methods: This retrospective cohort study included COVID-19 patients who received mechanical ventilation (MV) support in two designated hospitals for critical patients in Kawasaki City. We compared the lengths of MV and stay in the intensive care unit (ICU) or high care unit (HCU) according to the three epidemic waves.

Efficacy of awake prone positioning for severe illness coronavirus disease 2019 patients: a propensity score-adjusted cohort study.

Aim: Awake prone positioning (PP) in patients with coronavirus disease 2019 (COVID-19) can improve oxygenation. However, evidence showing that it can prevent intubation is lacking. This study investigated the efficacy of awake PP in patients with COVID-19 who received remdesivir, dexamethasone, and anticoagulant therapy.

Orbiting and Lidars for Earth and Planetary Applications.

At NASA Goddard Space Flight Center, we have been developing spaceborne lidar instruments for space sciences. We have successfully flown several missions in the past based on mature diode pumped solid-state laser transmitters. In recent years, we have been developing advanced laser technologies for applications such as laser spectroscopy, laser communications, and interferometry.

Development of Clinical Skills and Confidence Questionnaire for Triage and Action Minor Emergency Course: Test-Retest Exam.

Aim: The Triage and Action (T&A) minor emergency course was developed to improve the clinical skills of Japanese non-specialist physicians for minor emergent problems. Currently, the course quality is evaluated only by a self-reported satisfaction questionnaire. This study described a new clinical skills and confidence questionnaire to evaluate its validity and reliability.

Relationship Between Motor Function, DTI, and Neurophysiological Parameters in Patients with Stroke in the Recovery Rehabilitation unit.

Objectives: We investigated the relationship between pyramidal tract evaluation indexes (i.e., diffusion tensor imaging, transcranial magnetic stimulation (TMS)-induced motor-evoked potential (MEP), and central motor conduction time (CMCT) on admission to the recovery rehabilitation unit) and motor functions at discharge in patients with ischemic or hemorrhagic stroke.

Euglycemic diabetic ketoacidosis due to a strict low-carbohydrate diet during treatment with sodium-glucose cotransporter 2 inhibitors.

Background: Euglycemic diabetic ketoacidosis is a critical clinical presentation that can occur during treatment with sodium-glucose cotransporter 2 inhibitors. However, little is known regarding how a low-carbohydrate diet in combination with this treatment can increase the risk for this condition. Here, we report a case of euglycemic diabetic ketoacidosis in a patient treated with sodium-glucose cotransporter 2 inhibitors after initiation of a low-carbohydrate diet.

Error analysis for lidar retrievals of atmospheric species from absorption spectra.

We generalize a model for retrieving atmospheric constituents from lidar absorption spectra measured at any laser frequency channels. Random and systematic retrieval errors from measurement noise and model bias, respectively, are analyzed parametrically and numerically to provide deeper insight. By placing four or more channels symmetrically around the absorption peak, retrieval errors from a common laser frequency shift and spectral baseline tilt can be eliminated.

Comparison of acute vertigo diagnosis and treatment practices between otolaryngologists and non-otolaryngologists: A multicenter scenario-based survey.

Acute vertigo is a common problem in emergency departments. However, clinical strategies of acute vertigo care vary among care providers. The aim of the study was to investigate differences in diagnosis [Dix-Hallpike test, the head impulse, nystagmus, and the test of skew (HINTS) procedure, and imaging modalities] and treatment (pharmacological treatments and the Epley maneuver) by otolaryngologists and non-otolaryngologists in emergency medicine settings.

IV crystalloid fluid for acute alcoholic intoxication prolongs ED length of stay.

Objectives: Acute alcohol intoxication is often treated in emergency departments by intravenous crystalloid fluid (IVF), but it is not clear that this shortens the time to achieving sobriety. The study aim was to investigate the association of IVF infusion and length of stay in the ED.

Methods: This single-center retrospective cohort study was conducted in Japan and included patients aged ≥20years of age and treated for acute alcohol intoxication without or with IVF.

Methane optical density measurements with an integrated path differential absorption lidar from an airborne platform.

We report on an airborne demonstration of atmospheric methane (CH) measurements with an Integrated Path Differential Absorption (IPDA) lidar using an optical parametric amplifier (OPA) and optical parametric oscillator (OPO) laser transmitter and sensitive avalanche photodiode detector. The lidar measures the atmospheric CH absorption at multiple, discrete wavelengths near 1650.96 nm.

The Development of Cerebral Venous Thrombosis after Tadalafil Ingestion in a Patient with Antiphospholipid Syndrome.

We report a case of cerebral venous thrombosis related to the ingestion of tadalafil. A 45-year-old man presented with posterior headache and was diagnosed with tension headache. Five days later, he was transported to our hospital via ambulance due to a tonic-clonic seizure.

Impact of broadened laser line-shape on retrievals of atmospheric species from lidar sounding absorption spectra.

We examine the impact of broadened laser line-shape on retrievals of atmospheric species from lidar-sounding absorption spectra. The laser is assumed to be deterministically modulated into a stable, nearly top-hat frequency comb to suppress the stimulated Brillouin scattering, allowing over 10-fold pulse energy increase without adding measurement noise. Our model remains accurate by incorporating the laser line-shape factor into the effective optical depth.

Error reduction in retrievals of atmospheric species from symmetrically measured lidar sounding absorption spectra.

We report new methods for retrieving atmospheric constituents from symmetrically-measured lidar-sounding absorption spectra. The forward model accounts for laser line-center frequency noise and broadened line-shape, and is essentially linearized by linking estimated optical-depths to the mixing ratios. Errors from the spectral distortion and laser frequency drift are substantially reduced by averaging optical-depths at each pair of symmetric wavelength channels.

Characteristics of the single-longitudinal-mode planar-waveguide external cavity diode laser at 1064 nm.

We describe the characteristics of the planar-waveguide external cavity diode laser (PW-ECL). To the best of our knowledge, it is the first butterfly-packaged 1064 nm semiconductor laser that is stable enough to be locked to an external frequency reference. We evaluated its performance from the viewpoint of precision experiments.