Boosting integration of physical and mental health: The impact of increasing psychiatrists in general hospitals without psychiatric Ward.

Objective: It remains unclear whether general hospitals without psychiatric wards can provide sufficient services for both physical and mental health needs, as they often lack adequate psychiatrists, primarily due to cost constraints. This article explores the relationship between the number of full-time psychiatrists and functionality for integrating physical and mental health services in these settings.

Methods: The Medical Policy Committee of the Japanese Society of General Hospital Psychiatry conducted a nationwide survey in 2022 to evaluate the detailed scope and volume of service of psychiatric departments in general hospitals without a psychiatric ward.

Scaling narrowband THz generation to large apertures in LiNbO and KTP.

Millijoule-scale pulses of multicycle terahertz radiation (MC-THz) are increasingly being pursued as drivers for applications requiring high-fields and high spectral brightness. An attractive approach for generating high peak-power MC-THz pulses is nonlinear optical down-conversion of laser pulses in periodically-poled crystals. A principal limitation to the yield, however, is the small (sub-centimeter) apertures of commercially-available crystals which restrict the amount of laser energy that can be used.

Focused Ultrasound Pallidothalamic Tractotomy in Cervical Dystonia: A Pilot Study.

Background: No clinical trials have been reported on the use of focused ultrasound (FUS) for treating cervical dystonia.

Objective: We aimed to confirm the efficacy and safety of FUS pallidothalamic tractotomy for cervical dystonia.

Methods: This was a prospective, open-label, non-controlled pilot study.

Plant Density and Location: Optimization of Growth and Quality of Cut Sunflower in Tropical and Subtropical Environments.

The cultivation of sunflower ( L.) as a cut flower stands out in floriculture due to its aesthetic beauty and commercial value. Understanding how cut sunflower genotypes adapt to different edaphoclimatic regions and management practices is essential to optimize flower quality and productivity.

Machine learning for the localization of Subthalamic Nucleus during deep brain stimulation surgery: a systematic review and Meta-analysis.

Introduction: Delineating subthalamic nucleus (STN) boundaries using microelectrode recordings (MER) and trajectory history is a valuable resource for neurosurgeons, aiding in the accurate and efficient positioning of deep brain stimulation (DBS) electrodes within the STN. Here, we aimed to assess the application of artificial intelligence, specifically Hidden Markov Models (HMM), in the context of STN localization.

Methods: A comprehensive search strategy was employed, encompassing electronic databases, including PubMed, EuroPMC, and MEDLINE.

Successful Radiofrequency Lesioning of the Pallidothalamic Tract in Paretic Form Focal Hand Dystonia With Paradoxical Unexpected Response to Intraoperative Test Electrical Stimulation: A Case Report.

We report a case with paretic focal hand dystonia, which at first glance was diagnosed as writer's cramp, with poor performance only when playing the guitar and writing but with increased muscle tension around the elbow rather than in the fingers and hands. The muscle tension was around the elbow and the pallidothalamic tract (PTT) was selected as the proximal muscle target with less permanent complications. During the operation, the PTT test electrical stimulation was impaired only for guitar playing, but not for other hand movements.

Unilateral Stereotactic Radiofrequency Lesioning as a Surgical Treatment Option for Meige Syndrome.

Background Meige syndrome is a segmental dystonia affecting the head and neck, with bilateral blepharospasm as the primary symptom. First-line treatment typically involves Botox injections. For cases resistant to this treatment, bilateral deep brain stimulation of the globus pallidus internus (GPi) is considered.

Suvorexant for Reduction of Delirium in Older Adults After Hospitalization: A Randomized Clinical Trial.

Importance: Delirium is common among older hospitalized adults. In addition to presenting immediate management issues, delirium can increase the long-term risk of dementia, institutionalization, and mortality. Delirium is associated with disrupted sleep, and prior studies suggest that some specific sleep-promoting agents may reduce delirium.

Practical approach to thrombocytopenia in patients with sepsis: a narrative review.

Thrombocytopenia frequently occurs in patients with sepsis. Disseminated intravascular coagulation (DIC) may be a possible cause of thrombocytopenia owing to its high prevalence and association with poor outcomes; however, it is important to keep the presence of other diseases in mind in sepsis practice. Thrombotic microangiopathy (TMA), which is characterized by thrombotic thrombocytopenic purpura, Shiga toxin-producing Escherichia coli hemolytic uremic syndrome (HUS), and complement-mediated HUS, is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and organ damage.

Subacute Thyroiditis Following COVID-19: A Case of Diagnostic Challenge in the Absence of Neck Pain.

This case report presents a 77-year-old woman who developed subacute thyroiditis following COVID-19. The patient exhibited atypical symptoms, including fever, fatigue, anorexia, significant weight loss, headaches, and palpitations, without the typical neck pain or tenderness associated with thyroiditis. One week later, a follow-up examination showed mild enlargement and tenderness of the thyroid.

Efficacy and Safety of Zolpidem for Musician's Dystonia.

Objective: The efficacy and safety of zolpidem for treating musician's dystonia are not well understood. We aimed to retrospectively investigate the efficacy and safety of zolpidem for treating musician's dystonia.

Methods: We retrospectively reviewed medical records between January 2021 and December 2023 to identify patients with musician's dystonia who had been prescribed zolpidem.

Joule-class sub-nanosecond pulses produced by end-pumped direct bonded YAG/sapphire modular amplifier.

A Joule-class room-temperature diode-pumped solid-state laser was developed. The energy scaling of the 100 mJ 1064 nm seed pulse was realized by a series of two diode-pumped amplifiers. The gain medium consists in free combinations of Nd:YAG ceramics bonded to sapphire transparent heat sinks, to relax the thermal load induced by the 34 kW pump power.

Pharmacological inhibition of HPK1 synergizes with PD-L1 blockade to provoke antitumor immunity against tumors with low antigenicity.

Immune checkpoint inhibitors have significantly transformed the landscape of cancer therapy. Nevertheless, while these inhibitors are highly effective for certain patient groups, many do not benefit due to primary or acquired resistance. Specifically, these treatments often lack sufficient therapeutic efficacy against cancers with low antigenicity.

Fluid balance during acute phase extracorporeal cardiopulmonary resuscitation and outcomes in OHCA patients: a retrospective multicenter cohort study.

Objective: The association between fluid balance and outcomes in patients who underwent out-of-hospital cardiac arrest (OHCA) and received extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. We aimed to examine the above relationship during the first 24 h following intensive care unit (ICU) admission.

Methods: We performed a secondary analysis of the SAVE-J II study, a retrospective multicenter study involving OHCA patients aged ≥ 18 years treated with ECPR between 2013 and 2018 and who received fluid therapy following ICU admission.

A case of fatal fulminant fat embolism syndrome saved by VA-ECMO in the acute phase of multiple trauma.

Fat embolism syndrome (FES) is a rare complication of long bone fractures, with fulminant FES developing within 12 h of injury and often proving fatal (Shaikh, 2009 [1]). Here, we present a case of fulminant FES in a patient who developed sudden right heart failure after undergoing external fixation of a lower leg fracture and required veno-arterial extracorporeal membrane oxygenation (VA-ECMO). A 79-year-old woman injured in a traffic accident was transferred to our emergency department.

Design of Protease-Responsive Antifungal Liposomal Formulation Decorated with a Lipid-Modified Chitin-Binding Domain.

is a prevalent fungal pathogen that displays antibiotic resistance. The polyene antifungal amphotericin B (AmB) has been the gold standard because of its broad antifungal spectra, and its liposomal formulation, AmBisome, has been used widely and clinically in treating fungal infections. Herein, we explored enhancing the antifungal activity of AmBisome by integrating a small chitin-binding domain (LysM) of chitinase A derived from .

Covered self-expandable metallic stent placement for tumor bleeding from duodenal invasion in patients with unresectable pancreatic cancer.

Patients with unresectable pancreatic cancer often present with duodenal bleeding, a potentially life-threatening complication. In our case series of six unresectable pancreatic cancer patients with tumor bleeding, we explored the efficacy and safety of placement of a covered self-expandable metallic stent in the duodenum as a treatment option; we achieved a hemostasis rate of 67% (4/6), with a rebleeding rate of 50% (2/4). No complications occurred with stent placement, except for food impaction in one patient.

Treatment outcomes of gemcitabine plus nab-paclitaxel in pancreatic cancer patients with malignant ascites.

Background: Gemcitabine plus nab-paclitaxel (GnP) therapy has been shown to improve the prognosis in patients with metastatic pancreatic cancer (PC); however, the efficacy and safety of GnP in PC patients with malignant ascites (MA) remains unknown.

Methods: We retrospectively investigated PC patients with peritoneal dissemination who had received GnP as first-line chemotherapy at our institution between March 2015 and August 2021. The following patient data were reviewed: patient characteristics, overall survival (OS), progression-free survival (PFS), objective response rate (ORR), adverse events (AEs), and relative dose intensity (RDI).