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.

This paper examines : (1) the medical governance of infectious diseases in Taiwan based on the experience of infectious diseases and the background of medical governance reform, (2) the role of big data and digital technology in infectious disease control, (3) medical strategy and non-pharmaceutical intervention, and (4) socio-political viewpoints regarding the COVID-19 pandemic in Taiwan. It will be possible to confirm that Taiwan's non-pharmaceutical intervention strategies, including mask wearing, AHH practices, quarantine / quarantine, travel restrictions and the implementation of social distancing, are increasing the effectiveness of preventive measures during the COVID-19 pandemic. In addition, the combination of extensive risk communication highlighting the importance of early border control, government leadership and preventive action has prevented Taiwan from locking down. These comprehensive preventive measures against COVID-19 in 2020 are more efficient and effective than those implemented during SARS in 2003, as well as immunoassay responses. In addition, democracy provided institutional support for vibrant civil society and synergies between state and civil society, strengthened the legitimacy of Taiwan's crisis governance, and enhanced voluntary compliance among citizens.