journal article

A 88-year-old man who underwent abdominoperineal resection for rectal cancer 40 years earlier. The patient visited our hospital because of abdominal pain and vomiting. An abdominal CT scan showed an abdominal incisional hernia with a 23×15mm orifice in the midline of lower abdomen. The patient diagnosed with severe aortic valve stenosis on echocardiography. We performed elective surgery under intravenous anesthesia using ketamine and local anesthesia. The patient was discharged on postoperative day 8, and the postoperative course was uneventful. No recurrence has occurred 16 months after the operation. In conclusion, our strategy for patient with severe aortic valve stenosis is safe and effective.

Anaplastic large cell lymphoma(ALCL)is a rare peripheral T-cell lymphoma. According to anaplastic lymphoma kinase(ALK)expression, the World Health Organization classifies ALCL into two subtypes:ALK-positive or ALK-negative. Anthracycline-based combination chemotherapy is a standard frontline treatment for ALK-positive ALCL, with a long-term event- free survival rate of 60%-70%. For the salvage treatments of relapsed or refractory cases, the efficacies of brentuximab vedotin or ALK inhibitor have been established. We undertook a phase II clinical trial to investigate the efficacy and safety of alectinib, which is a second-generation ALK inhibitor, for relapsed or refractory ALK-positive ALCL. Ten patients were enrolled, and objective responses were documented in eight patients(80%),with six complete responses. Allogeneic hematopoietic stem cell transplantation(allo-HSCT)has also been reported to be one of curative treatments for relapsed or refractory ALCL. However, a high rate of treatment-related mortality was observed in allo-HSCT because of the myeloabrative conditioning regimen. We have reported the efficacy of the reduced-intensity conditioning(RIC)regimen for relapsed or refractory ALCL including the patients who did not obtain complete remission at allo-HSCT. The RIC regimen might be able to improve the outcomes of allo-HSCT by reducing treatment-related mortality.

A 69-year-old deaf-mute man received 6 cycles of R-CHOP therapy for diffuse large B-cell lymphoma(DLBCL)of the stomach. Although he showed a complete response to this therapeutic regimen, the patient developed intractable diarrhea upon completion of chemotherapy. He was diagnosed with cytomegalovirus(CMV)enteritis and was administered ganciclovir and foscarnet;however, CMV infection persisted. We suspected immunodeficiency other than that associated with chemotherapy-induced immunosuppression. Further examinations revealed a decrease in the CD4^+ T lymphocyte count and positive results on anti-human immunodeficiency virus(HIV)antibody testing, which confirmed HIV infection, and he was diagnosed with acquired immunodeficiency syndrome(AIDS).Antiviral therapy was initiated, and the HIV-RNA viral load became undetectable;however, the CD4^+ T lymphocyte count recovery was insufficient. Despite the clinical presentation of an AIDS-indicator disease, diagnosis of HIV infection was delayed, which may be attributable to deaf-mutism and the patient’s advanced age that may have led to bias among the medical staff and prevented prompt diagnosis of HIV infection.

Forensic pathologists perform autopsies and external examinations of deceased bodies to judge the cause of death. Forensic autopsies are only carried out in a small percentage of all deaths, and are performed for cases in which the cause of death is unknown and because many of these cases have background social problems. Therefore, both the cause and circumstances of death are important to those in related fields, and it is particularly significant to share information from forensic autopsies and to discuss prevention of recurrence in similar cases with persons involved in these fields. This report provides an overview of the forensic autopsies performed at our department in 2021. In the near future, we intend to share these cases through participation in workshops and conferences with related clinical departments, health and welfare workers, and medical scientists, so that this forensic autopsy information can be used effectively.

The number of children requiring medical care is on the rise, reducing childcare burdens and establishing support systems' urgent undertakings. Public health nurses at public health centers are in a position to shoulder these responsibilities. This study aimed to clarify the activities performed by public health nurses at public health centers for children requiring medical care based on the content of support in individual cases. Interview surveys covering a summary of support and community resources were conducted for four individual cases. Analysis was performed using the practical competencies framework required of public health nurses at public health centers.As a result, 260 activities of public health nurses were organized into 79 codes and 39 categories and categorized according to the framework of practical competencies required of public health nurses at public health centers. Public health nurses at public health centers were found to provide direct support, categorized into“interpersonal support competency,”based on the prerequisite that patients require 24-hour medical care, and characterized by connecting medicine and welfare to manage the family unit. Public health nurses also provide indirect support, categorized into“community support competency,”“policy competency,”and“management competency,”in which they were understood to be attempting to build a care system through individual support.

This study aimed to evaluate the effects of care incorporating passive motion exercise of the ankle plantar dorsiflexion on lower extremity hemodynamics and comfort using physical methods for deep vein thrombosis(DVT)prevention. We recruited 16 healthy women, aged 20-40 years old, using a simple random allocation crossover design. We categorized them into three groups:intermittent pneumatic compression was performed continuously(IPC group);the patients underwent passive exercise of ankle dorsiflexion and plantar flexion(ankle exercise group),and IPC was removed(IPC removal group).We evaluated lower extremity hemodynamics, coagulation and fibrinolysis, autonomic nervous functions, and subjective sensation during each intervention.The ankle exercise group showed a decrease in the maximum blood flow velocity in the femoral vein and deoxygenated hemoglobin. Three coagulation and fibrinolysis complexes, namely, fibrin monomer complex, thrombin-antithrombin complex, and plasmin-alpha2-plasmininhibitor-complex, showed no change among the three groups. One autonomic nervous function, the high-frequency component, remained lower in the IPC group than in the other two groups after 15 minutes. Subjective sensation was highest in the IPC group.The ankle exercise group did not show exacerbation of lower limb venous stasis and coagulability, suggesting that a nursing intervention reduces discomfort that occurs with continuous use of IPC.

Understanding of central nervous system mechanisms underlying age-related infertility remains limited. Fibril α-synuclein, distinct from its monomeric form, is implicated in age-related diseases. Notably, fibril α-synuclein spreads among neurons, similar to prions, from damaged old neurons in cortex and hippocampus to healthy neurons. However, less is known whether α-synuclein propagates into oxytocin neurons, which play crucial roles in reproduction. We compared α-synuclein expression in the oxytocin neurons in suprachiasmatic nucleus (SCN), supraoptic nucleus (SON), paraventricular hypothalamic nucleus (PVN), and posterior pituitary (PP) gland of healthy heifers and aged cows to determine its role in age-related infertility. We analyzed mRNA and protein expression, along with Congo red histochemistry and fluorescent immunohistochemistry for oxytocin and α-synuclein, followed by confocal microscopy with Congo red staining. Both mRNA and protein expressions of α-synuclein were confirmed in the bovine cortex, hippocampus, SCN, SON, PVN, and PP tissues. Significant differences in α-synuclein mRNA expressions were observed in the cortex and hippocampus between young heifers and old cows. Western blots showed five bands of α-synuclein, probably reflecting monomers, dimers, and oligomers, in the cortex, hippocampus, SCN, SON, PVN, and PP tissues, and there were significant differences in some bands between the young heifers and old cows. Bright-field and polarized light microscopy did not detect obvious amyloid deposition in the aged hypothalami; however, higher-sensitive confocal microscopy unveiled strong positive signals for Congo red and α-synuclein in oxytocin neurons in the aged hypothalami. α-synuclein was expressed in oxytocin neurons, and some differences were observed between young and old hypothalami.

本稿では、まず人工知能の根幹に係る一般パターン認識の問題を明らかにするとともに、その解決に有用な統計的パターン認識とそれを発展させた離散Bayes識別則を概説する。次に離散Bayes識別則の個別化医療への応用としての診断・予測問題と創薬における治験問題に言及する。

Context: Ethanolamine plasmalogens (EPls) and choline plasmalogens (CPls) are classes of ethanolamine ether phospholipids (ePE) or choline ether phospholipids (ePC), respectively. EPls play crucial roles in maternal and breastfed infant bodies and stimulate gonadotropin secretion by gonadotrophs. Aims: To estimate changes in and importance of plasma concentrations of EPls and CPls, utilizing newly developed enzymatic fluorometric assays for ePE and ePC in postpartum Holstein cows. Methods: Plasma samples were collected 3 weeks before expected parturition until approximately 8 weeks after parturition (16 primiparous and 38 multiparous cows) for analysis. Key results: Plasma concentrations of ePE and ePC, most of which are plasmalogens, declined before and increased after parturition and stabilised near the day of the first postpartum ovulation (1stOV). From weeks 2 to 3 after parturition, third-parity cows exhibited ePE concentrations that were higher than those of other parity cows. The days from parturition to 1stOV correlated with days from parturition to conception. On the day of 1stOV, milk yield correlated with plasma concentration of both ePE and ePC, while ePC concentration correlated negatively with milk fat percentage. At the early luteal phase after 1stOV, plasma ePE concentration correlated with plasma anti-Müllerian hormone concentration (r = 0.39, P < 0.01), and plasma ePC concentration correlated with plasma follicle-stimulating hormone concentration (r = 0.43, P < 0.01). Conclusion: The concentrations of ePE and ePC changed dramatically around parturition and 1stOV, and then the concentrations correlated with the important parameters. Implications: The blood plasmalogen may play important roles in postpartum dairy cows.

McTaggart’s paradox and his A-theory and B-theory are basic notions in the contemporary philosophy of time. It is well known that the paradox was introduced by McTaggart’s paper called “The Unreality of Time” published in 1908, so that it has a one-hundred-year history. As for A-theory and B-theory, in contrast, McTaggart himself didn’t consider both of them at all. The notions of A-theory and B-theory came much later, 60 years after the paradox. Moreover, they had not been as popularized as they are today until quite recently, at least after the 1990s. This paper aims to trace the origin of the notions of A-theory and B-theory and show how the debates behind them, especially objections to “spatialising time,” form the notions.

Since its inception, analytic philosophy has failed to attain dominance in Japan. However, the 21st century has seen analytic philosophy gain traction among Japanese philosophers. This paper, which examines the status quo of analytic philosophy in Japan since 2000, consists of two parts. The first part deals primarily with organizations—specifically, relevant associations, journals, conferences, universities, and publishers are illustrated. The second part explores key works in each area—namely, philosophy of science, philosophy of language, philosophy of logic and mathematics, philosophy of mind, and metaphysics. Key works in other areas are also briefly addressed.

China has been struggling with waste classification for decades, even after the mandatory implementation of relevant policy in 2017. However, the causes of the failing performance of waste classification in developing countries attract little scholarly attention. A recent literature review also identified a failure to classify waste in developing countries, noting that its causes have attracted little scholarly interest. In this paper, we would like to examine the current situation and issues of policies for classifying household waste in China's urban sector. In this paper, we conducted a questionnaire survey of residents in Changsha City, Hunan Province, examined their awareness of waste classification, classifying behavior, and their awareness of paying for waste reduction, elucidated the factors that affect them, and estimated the amount of willing to pay (WTP) for waste reduction. In this paper, endogenous factors are more significant influencing behaviors than exogenous factors.

Imitation is simple behavior which uses successful actions of others in order to deal with one’s own problems. Because success of imitation generally depends on whether profit of an imitating agent coincides with those of other agents or not, game theory is suitable for specifying situations where imitation can be successful. One of the concepts describing successfulness of imitation in repeated two-player symmetric games is unbeatability. For infinitely repeated two-player symmetric games, a necessary and sufficient condition for some imitation strategy to be unbeatable was specified. However, situations where imitation can be unbeatable in multi-player games are still not clear. In order to analyze successfulness of imitation in multi-player situations, here we introduce a class of totally symmetric games called unexploitable games, which is a natural extension of two-player symmetric games without exploitation cycles. We then prove that, for infinitely repeated unexploitable games, there exist unbeatable imitation strategies. Furthermore, we also prove that, for infinitely repeated non-trivial unexploitable games, there exist unbeatable zero-determinant strategies, which unilaterally enforce some relationships on payoffs of players. These claims are demonstrated in the public goods game, which is the simplest unexploitable game. These results show that there are situations where imitation is unbeatable even in multi-player games.

We investigate symmetric equilibria of mutual reinforcement learning when both players alternately learn the optimal memory-two strategies against the oppo-nent in the repeated prisoners' dilemma game. We provide a necessary condi-tion for memory-two deterministic strategies to form symmetric equilibria. We then provide three examples of memory-two deterministic strategies which form symmetric mutual reinforcement learning equilibria. We also prove that mu-tual reinforcement learning equilibria formed by memory-two strategies are also mutual reinforcement learning equilibria when both players use reinforcement learning of memory-n strategies with n > 2.

Zero-determinant strategies are memory-one strategies in repeated　games which unilaterally enforce linear relations between expected payoffs of　players. Recently, the concept of zero-determinant strategies was extended　to　the class of memory-n strategies with n _ 1, which enables more compli-cated control of payoffs by one player. However, what we can do by　memory-n　zero-determinant strategies is still not clear. Here, we show that memory-n　zero-determinant strategies in repeated games can be used to control condi-tional expectations of payoffs. Equivalently, they can be used to control ex-pected payoffs in biased ensembles, where a history of action pro_les with large　value of bias function is more weighted. Controlling conditional expectations　of payoffs is useful for strengthening zero-determinant strategies, because play-ers can choose conditions in such a way that only unfavorable action pro_les　to one player are contained in the conditions. We provide several examples　of memory-n zero-determinant strategies in the repeated prisoner's dilemma　game. We also explain that a deformed version of zero-determinant strategies　is easily extended to the memory-n case.

Zero-determinant strategies are a class of memory-one strategies in repeated games which unilaterally enforce linear relationships between payoffs. It has long been unclear for what stage games zero-determinant strategies exist. We provide a necessary and sufficient condition for the existence of zero-determinant strategies. This condition can be interpreted as the existence of two different actions which unilaterally adjust the total value of a linear combination of payoffs. A relation between the class of stage games where zero-determinant strategies exist and other class of stage games is also provided.

The quadratic unconstrained binary optimization (QUBO) problem is categorized as an NP-hard combinatorial optimization problem. The variable neighborhood search (VNS) algorithm is one of the leading algorithms used to solve QUBO problems. As neighborhood structure change is the central concept in the VNS algorithm, the design of the neighborhood structure is crucial. This paper presents a modified VNS algorithm called "B-VNS", which can be used to solve QUBO problems. A binomial trial was used to construct the neighborhood structure, and this was used with the aim of reducing computation time. The B-VNS and VNS algorithms were tested on standard QUBO problems from Glover and Beasley, on standard max-cut problems from Helmberg-Rendl, and on those proposed by Burer, Monteiro, and Zhang. Finally, Mann-Whitney tests were conducted using α = 0.05, to statistically compare the performance of the two algorithms. It was shown that the B-VNS and VNS algorithms are able to provide good solutions, but the B-VNS algorithm runs substantially faster. Furthermore, the B-VNS algorithm performed the best in all of the max-cut problems, regardless of problem size, and it performed the best in QUBO problems, with sizes less than 500. The results suggest that the use of binomial distribution, to construct the neighborhood structure, has the potential for further development.

Wireless power transfer (WPT) systems have attracted considerable attention in relation to providing a reliable and convenient power supply. Among the challenges in this area are maintaining the performance of the WPT system with the presence of a human body and minimizing the induced physical quantities in the human body. This study proposes a magnetic resonant coupling WPT (MRC-WPT) system that utilizes a resonator with a grounded loop to mitigate its interaction with a human body and achieve a high-efficiency power transfer at a short range. Our proposed system is based on a grounded loop to reduce the leakage of the electric field, resulting in less interaction with the human body. As a result, a transmission efficiency higher than 70% is achieved at a transmission distance of approximately 25 cm. Under the maximum-efficiency conditions of the WPT system, the use of a resonator with a grounded loop reduces the induced electric field, the peak spatial-average specific absorption rate (psSAR), and the whole-body averaged SAR by 43.6%, 69.7%, and 65.6%, respectively. The maximum permissible input power values for the proposed WPT systems are 40 and 33.5 kW, as prescribed in the International Commission of Non-Ionizing Radiation Protection (ICNIRP) guidelines to comply with the limits for local and whole-body average SAR.

The power transmission effi ciency of a resonatorcoupled wireless power transfer (RC-WPT) system with some angular misalignments is examined in this paper. In addition to conventional single-spiral resonators, the dual-spiral resonators which we have proposed are used in the RC-WPT system. It was confi rmed that the power transmission effi ciency of the RC-WPT system decreased with the increment of angular misalignments. However, it was shown that the decayed power transmission efficiency due to the angular misalignments could be recovered by adding the appropriate axial displac ements between transmitting (Tx) and receiving (Rx) units.

In presented work dye assemblies with J-type intermolecular coupling, which are well recognized not only for their exciton transport but also for hole and electron transport properties were investigated. The use of materials consisting of J-type dye assemblies can be significantly enhanced if their photonic properties can be controlled by some external stimuli. For these reasons the switching abilities between J-type aggregated and non-aggregated states of a cationic cyanine dye, 1,1′-diethyl-2,2′-cyanine (pseudoisocyanine, PIC) intercalated in the interlayer space of synthetic saponite (Sap) were compared. The switching was performed by adding and removing of dimethyl sulfoxide (DMSO) from the interlayer space. The PIC/Sap hybrid film prepared at 70% CEC loading level has shown excellent stability within 20 cycles of photophysical response after adding and removing of DMSO from the interlayer space, indicating that presented experimental approach can be useful in the future development of artificial light harvesting or semiconductor systems with controllable properties.

The interlayer space of clays is an interesting microenvironment to control the properties of included organic materials. In this study, chromic hybrid films consisting of synthetic saponite (SSA) and fluorescent organic molecules with planar p-conjugated systems were fabricated. The hybrid films exhibited reversible fluorescence color switching induced by swelling and drying, which caused the gallery height of SSA to change. Ultraviolet–visible absorption, steady-state and time-resolved fluorescence measurements of the hybrid films strongly suggested that the organic molecules formed an excimer in the swollen interlayer space of SSA, while they were a monomer in the dried interlayer space. The different emission wavelengths of the excimer and monomer resulted in the fluorescence color switching of the hybrid films. The reversibility of the color switching was maintained for at least 50 cycles with no change of fluorescence maxima. These chromic hybrid films represent a novel approach to obtain color switching.

Ferroelectrics have found a wide range of applications including memory elements, capacitors, and sensors. Molecular f erroelectric crystals have recently attracted growing interest as viable alternatives for conventional ceramic ferroelectrics, especially due to their non toxicity and solution processability. Herein, we show that a class of molecular compounds known as plastic crystals can exhibit ferroelectricity, provided that the constituent molecules are judiciously chosen from polar ionic molecules. The intrinsic features of plastic crystals, e.g. the rotational mot ion of molecules and phase transitions with lattice symmetry changes, provide the crystals with unique ferroelectric properties relative to conventional molecular crystals , i.e. the possibility to flexibly alter the direction of the polarization axis of a grown crystal by applying an electric field. Owing to t he tunability of the crystal orientation together with mechanical deformability, this novel type of molecular crystals represents an attractive functional material, which will undoubtedly find diverse applications.

Near-infrared two-photon absorption of the phosphorescent Ir(III) complex (2,4-pentanedionato-κO2,κO4)bis[2-(6-phenanthridinyl-κN)benzo[b]thien-3-yl-κC]iridium (BTPHSA) was characterized. It exhibited a 800–1200 nm two-photon absorption band, and thus could be electronically excited by 1030-nm femtosecond Ti:sapphire and Yb-doped fiber lasers. By using BTPHSA, oxygen concentrations in human embryonic kidney 293 (HEK293) cells were imaged. These results demonstrate two-photon oxygen sensing of live tissues via easily operable excitation sources.

We measured the three-photon absorption spectra of two europium acetylacetonate-type complexes. The three-photon absorption peak wavelengths of tris(hexafluoroacetylacetonato)europium(III) (Eu(hfa)) and tris(2-naphthoyltrifluoroacetonato)europium(III) (Eu(ntfa)) were 925 and 1025 nm, respectively. The peak values of the 3PA cross-sections of Eu(hfa) and Eu(ntfa) were 1.9 and 13.9 GM (1 GM = 10−82 cm6 s2), respectively. Using Eu(ntfa) as a probe, a three-photon microscope image of a living cell was obtained using a 1030 nm operating femto-second fiber laser as the light-source. Thus, Eu(ntfa) is a fiber laser excitable luminescent probe useful for three-photon microscopy.

We have found that X-ray diffraction peaks of clay-organic hybrid films were narrowed after swelling followed by removing of solvent. We fabricated hybrid films consisting of natural montmorillonite (Mont), synthetic saponite (SSA) or synthetic stevensite (SST) and a cationic organic molecule. Full width at half maximum (FWHM) of 001 reflection of as-prepared Mont hybrid was 1.58 2θ degree whereas that after swelling and solvent removing procedure was 0.84 2θ degree. This decreasing of FWHM indicated that the improvement of packing order of clay particles in clay-organic hybrid was occurred during swelling and solvent removing procedure. Similar decreasing of FWHM was also found in hybrids consisting of SSA or SST. Improvement of packing order of hybrid was found to accompany suppression of light scattering of hybrid at the same time.

A 38-year-old woman was referred to our hospital with a complaint of left buttock pain. Contrast-enhanced computed tomography and magnetic resonance imaging showed a 7cm smooth mass on the anterior sacrum adjacent to the small intestine and mesentery. The mass was suspected to be a gastrointestinal stromal tumor of the small intestine;however, a definitive diagnosis from radiological and clinical findings was impossible. Laparoscopic visualization revealed that there was no lesion in the small intestine;the mass situated in the retroperitoneally, in contact with the anterior sacrum around the aortic bifurcation. With a diagnosis of retroperitoneal tumor, laparoscopic resection was performed simultaneously. An incision was made in sigmoid mesentery, and the tumor was detached and resected preserving the anterior fascia of the hypogastric nerve. Intraoperatively the surface of the tumor was confirmed to be smooth, and there was no infiltration around the tumor, which facilitated handling and manipulation of the tumor for resection. The patient was discharged without any complications and the pathological diagnosis was benign schwannoma. Anterior sacral retroperitoneal schwannomas are rare and difficult to diagnose preoperatively. In this case, successfully management was achieved via simultaneous laparoscopic observation and resection.

A 52-year-old-man visited hospital with right lower abdominal pain. We diagnosed acute appendicitis and intraperitoneal abscess. We decided to perform interval appendectomy and started antibacterial treatment. Antibacterial treatment was successful and the patient was discharged. Laparoscopic appendectomy was performed six month later. Only thickening of appendix mucosa was found in the specimen, but postoperative pathological diagnosis revealed goblet cell adenocarcinoma(GCA)of appendix. There was a risk factor associated with invasion depth T4, we performed ileocecal resection(D3)one month after the first surgery. The postoperative pathological examination result was pT4aN0M0 pStageⅡ.Recurrence has not been observed 18 months later. This case was an appendiceal GCA which was accidentally found in a specimen after interval appendectomy and treated by additional surgery. Infrequently, there are some reports of acute appendicitis associated with appendiceal tumor. In clinical practice, it is difficult to perform interval appendectomy for all appendicitis cases after conservative treatment, but it is suggested that for complicated appendicitis, we should perform interval appendectomy in consideration of age, ADL, and social background.

Abdominal incisional hernia is a frequent complication of open abdominal surgery. We herein report a rare case in which the left lateral segment of the liver prolapsed as the contents of an abdominal incisional hernia.The patient was a woman in her 80s whose chief complaint was abdominal protrusions. She had undergone abdominal surgery for gallstones 30 years ago. Computed tomography revealed abdominal incisional hernias in the upper abdomen, from which the left lateral segment of the liver and the transverse colon had prolapsed. Laparoscopic hernia repair surgery was performed under general anesthesia. The intraoperative findings showed the adhesion of the round ligament of the liver to the abdominal wall and transverse mesocolon. The prolapsed left lateral segment of the liver appeared as if being pulled upward by the round ligament of the liver and the poor formation of the triangle ligament. Two hernia orifices were repaired using two meshes. Recently, laparoscopic hernia repair surgery is increasing. Laparoscopic hernia repair surgery is useful to observe the abdominal cavity, details of hernia orifice and content, and the check of repair’s completion.

We have developed ACTce‑CCM̶ Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine. The preparation process was carried out in four stages:construct setting and prototype creation, application of prototype version to fictitious cases, clarification of the construct based on focus group interviews, and a fact-finding survey on ethical issues and ethical adjustment. The completed version of ACTce-CCM consists of information organization and assessment frameworks, problem analysis and integration, problem lists, goals, care practices, and ethical adjustment. There are six frameworks for information organization and assessment:pathology and treatment, QOL and QOD, patient intention, family psychosocial situation, medical team situation, and the surrounding situation. The problem lists include those related to the patient, the family, and the medical staff. Goals include those of the medical team and the expected outcomes for the patient/family. Care practices and ethical adjustment consist of three aspects: direct patient care, direct family care, and medical team adjustment.

This study aimed to clarify outcome of the public health nursing practice conducted under the influence of COVID-19. A self-administered anonymous questionnaire survey was performed for 4th grader students at University from 2018 through 2020. The investigation items consisted of basic attributes, impression of public health nurse activity, learning motivation and learning target items. We compared shortened clinical practice and online practice enforced in 2020 and before. For 217 effective answers,＂A public health nurse was involved in practice sufficiently＂ was significantly low. In top learning achievement scores of 2020 included many of the items from the the learning target＂Process of public health nursing activity＂ and ＂Role and function of public health center and municipalities. In 2018 and 2019, learning achievement degrees were over 80% in 94.3% of 53 items while on the other hand it was only 32.1% in 2020. Learning achievement degrees were less than 60% in no items in 2018 and 2019 while it was 15.1% in 2020. For the techniques of health service and health practice for which the learning achievement degree were low in 2020, it is necessary to support students so that they can acquire them as a public health nursing practice ability.

To realize a stable and efficient wireless power transfer (WPT) system that can be used in any environment, it is necessary to inspect the influence of environmental interference along the power transmission path of the WPT system. In this paper, attempts have been made to reduce the influence of the medium with a dielectric and conductive loss on the WPT system using spiral resonators for resonator-coupled type wireless power transfer (RC-WPT) system. An important element of the RC-WPT system is the resonators because they improve resonant characteristics by changing the shape or combination of spiral resonators to confine the electric field that mainly causes electrical loss in the system as much as possible inside the resonator. We proposed a novel dual-spiral resonator as a candidate and compared the basic characteristics of the RC-WPT system with conventional single-spiral and dual-spiral resonators. The parametric values of the spiral resonators, such as the quality factors and the coupling coefficients between resonators with and without a lossy medium in the power transmission path, were examined. For the lossy mediums, pure water or tap water filled with acryl bases was used. The maximum transmission efficiency of the RC-WPT system was then observed by tuning the matching condition of the system. Following that, the transmission efficiency of the system with and without lossy medium was investigated. These inspections revealed that the performance of the RC-WPT system with the lossy medium using the modified shape spiral resonator, which is the dual-spiral resonator proposed in our laboratory, outperformed the system using the conventional single-spiral resonator.

We report the case of a 48-year-old woman with relapsed B-lineage acute lymphoblastic leukemia(B-ALL)following cord blood transplantation, in which leukemic cell CD22 antigens became negative after a single administration of inotuzumab ozogamicin(InO).At relapse, a major part of leukemic cells expressed CD19 and CD22 antigens, however some leukemic cells were negative for CD22. As treatment with blinatumomab proved ineffective, InO therapy was subsequently initiated