Effect of practice on similar and dissimilar skills in patient transfer through training with a robot patient

With the number of hospital stays increasing, nurses require more training to handle a variety of patients. However, time for training in nursing schools is limited, and students lack the opportunity to practice on a diverse variety of patients. Using a robot to simulate actual patients, this study observes the learning transfer effect of practice on practice-similar and practice-dissimilar skills from one patient to another, and investigates which types of practice suit which kinds of training. An experiment was conducted by administering a pre-test, practice, a post-test, and a transfer test to two groups (N?=?8), each with different practice-related skills. The evaluation used a checklist covering required skills that were either similar or dissimilar across groups, depending on their practice. The effect of practice can be observed through a comparison of skills similar to one group but dissimilar to the other. The results show that practice facilitates learning transfer on similar skills but not, or to a lesser degree, on dissimilar skills. Furthermore, if skills needed to handle given symptoms are unfamiliar or inaccessible to students, practice related to those symptoms should be emphasized through simulated training with robots.     

Research and Development of the Coprecipitation Process for Lanthanum Germanate Oxyapatite

Although lanthanum germanate oxyapatite (La–Ge–O) has shown good potential for use as a solid electrolyte in energy storage applications, its synthesis has been challenging by either solid‐ or solution‐state methods. In this study, a new synthesis of La–Ge–O was developed through a coprecipitation technique, in which a highly concentrated homogeneous aqueous solution of La and Ge was prepared from aqueous ammonium germanate and lanthanum nitrate solutions with the addition of dilute nitric acid. Several precipitates were formed by pH manipulation, including an amorphous material obtained at pH > 3. Compared to the individual precipitation behaviors of the parent compounds, the amorphous precipitate was formed only from the aqueous two‐component mixture, and appeared to contain both metals. This material was transformed into crystalline mixtures upon heating at 1273 K. The crystalline phases were La₂Ge₃O₉ and hexagonal‐type GeO₂ when the precipitate was formed below pH 8, and the La–Ge–O and La₂Ge₂O₇ phases when the precipitate was formed around pH 8. Product formation from the coprecipitate was discussed based on X‐ray diffraction and thermal analyses. The improved availability of La–Ge–O will allow more extensive investigations of its useful properties.     

Densification of rare-earth (Lu, Gd, Nd)-doped alumina nanopowders obtained by a sol-gel route under seeding

Rare-earth (RE: Lu, Gd, Nd, 0.10 mol%)-doped alumina nanopowders were prepared by a new sol-gel route using polyhydroxoaluminum (PHA) and RECl₃ solutions under α-alumina (∼ 75 nm) seeding. Among the rare-earth dopants studied, Lu yields the most suitable nanopowders for low-temperature densification. The 0.10 mol% Lu-doped nanopowders, which were obtained at a calcination temperature of 900 °C under 5 mass% α-alumina seeding, consisted of ∼ 80-nm α-alumina particles and γ-alumina nanoparticles. Using these Lu-doped alumina nanopowders, fully densified alumina ceramics with a uniform microstructure composed of fine grains with an average size of 0.61 μm could be obtained at 1400 °C by pressureless sintering. Clearly, the Lu-doped nanopowders obtained here represent a viable option for fabricating dense, finer-grained alumina ceramics because an undoped sample with 5 mass% seeds gave a microstructure with an average grain size of 1.78 μm at 1400 °C.     

Surgical strategy for abdominal aortic aneurysm with concurrent symptomatic malignancy

In an attempt to improve the guidelines for concurrent management of concomitant abdominal aortic aneurysm (AAA) and symptomatic malignancy, a retrospective study was undertaken. A total of 186 AAA repairs were performed electively, and 25 patients (13.4%) had concurrent symptomatic malignancy from April 1986 to March 1997. Fourteen patients underwent a one-stage operation, including five abdominoperineal rectal resections, four subtotal gastrectomies, three total gastrectomies, and two right hemicolectomies. Eleven others underwent a two-stage operation, including four with total gastrectomy and left hemicolectomy followed by AAA repair, as well as two with right hemicolectomy and one with left hemicolectomy prior to AAA repair. There were no operative deaths or severe postoperative complications. Of the 25 patients, 22 (88.0%) are still alive during follow-up ranging from 8 months to 11 years. Our surgical approach to both lesions is as follows: (1) Using the transperitoneal approach alone, subtotal gastrectomy and abdominoperineal rectal resection can be safely done simultaneously. (2) Although total gastrectomy can also be performed concurrently, the approach used for each lesion is separate. (3) Colorectal resection is generally done separately. However, a one-stage operation can be performed using the thromboexclusion procedure for AAA repair in patients with right-sided colonic cancer or a temporary transverse colostomy for left-sided colorectal cancer.     

Curative laparoscopic surgery for early gastric cancer: five years experience

Sixty-one patients who were diagnosed with mucosal gastric cancer have been successfully treated with two laparoscopic techniques at our institute from March 1992 to March 1997. One is laparoscopic wedge resection of the stomach using a lesion-lifting method for lesions of the anterior wall, the lesser curvature, and the greater curvature of the stomach. The other is laparoscopic intragastric mucosal resection for lesions of the posterior wall of the stomach and near the cardia or the pylorus. Indications are as follows: (1) preoperatively diagnosed mucosal cancer; (2) <25 mm diameter elevated lesions; and (3) <15 mm diameter depressed lesions without ulcer formation. Patients were discharged in 4 to 8 days uneventfully. There was no major complication or mortality. The resected specimens had sufficient surgical margins horizontally (16 +/- 5 and 8 +/- 4 mm, respectively) and vertically. In one patient histologic examination revealed slight tumor infiltration into the submucosal layer with lymphatic invasion. He underwent gastrectomy with lymph node dissection 1 month after surgery. Otherwise, histologic examination revealed curative surgery. All patients in the series have survived during the 4- to 65-month follow-up period. There have been two recurrences in the series, both of which were found near the staple line 2 years after the initial surgery and were still mucosal lesions. They were successfully treated by open gastrectomy and laser irradiation. A separate early gastric cancer was found 2 years after the initial surgery in one patient, who then underwent curative open gastrectomy. In conclusion, if the patients are selected properly, these laparoscopic procedures are curative, minimally invasive treatment for early gastric cancer.     

Constitutive Effects of Lead on Aryl Hydrocarbon Receptor Gene Battery and Protection by β‐carotene and Ascorbic Acid in Human HepG2 Cells

Lead (Pb) is an environmental pollutant that can get entry into human body through contaminated foods, drinks, and inhaled air leading to severe biological consequences, and has been responsible for many deaths worldwide. The objectives of this study were 1st to investigate the modulatory effects of environmentally relevant concentrations of Pb on AhR gene battery, which is controlling xenobiotics metabolism. 2nd, trials to reduce Pb‐induced adverse effects were done using some phytochemicals like β‐carotene or ascorbic acid. Human hepatoma (HepG2) cell lines were exposed to a wide range of Pb concentrations varying from physiological to toxic levels (0 to 10 mg/L) for 24 h. High Pb concentrations (1 to 10 mg/L) significantly reduced phase I (CYP1A1 and 1A2) and phase II (UGT1A6 and NQO1) xenobiotic metabolizing enzyme mRNA expression in a mechanistic manner through the AhR regulation pathway. Additionally, these Pb concentrations induced oxidative stress in HepG2 cells in terms of production of reactive oxygen species (ROS) and induced heme oxygenase‐1 mRNA expression in a concentration‐dependent phenomenon. Coexposure of HepG2 cells to physiological concentrations of some micronutrients, like β‐carotene (10 μM) or ascorbic acid (0.1 mM), along with Pb (1 mg/L) for 24 h significantly reduced the levels of ROS production and recovered AhR mRNA expression into the normal levels. Thus, consumption of foods rich in these micronutrients may help to reduce the adverse effects of lead in areas with high levels of pollution.     

Adsorption and Plasma Decomposition of Gaseous Acetaldehyde on Fibrous Activated Carbon

In this paper, adsorption and nonthermal plasma decomposition of gaseous acetaldehyde were studied using barrier-discharge plasma reactor, in which fibrous activated-carbon textile (ACT) was used as both an electrode and adsorbent. The acetaldehyde molecule was adsorbed on ACT depending on the concentration of gaseous acetaldehyde. When acetaldehyde concentration was 500 ppm or lower, the amount of adsorbed acetaldehyde was estimated by Henry's equation. The adsorbed acetaldehyde on ACT sheet was decomposed by the barrier-discharge plasma generated by applying high-voltage ac regulated by a neon transformer. When 200 ppm of acetaldehyde was fed continuously to the plasma reactor, 30, 45, and 120 ppm of acetaldehyde remained, with applied voltage of 13, 10, and 5 kVp, respectively. We also checked electric energy efficiency on the decomposition of acetaldehyde. Although 10 or 13 kVp of plasma has the same energy efficiency, 5 kVp of plasma was less effective for the decomposition because of unstableness of plasma generation. These results suggested that 10 kVp or more high-voltage ac is suitable for the decomposition of acetaldehyde by using ACT as the high-voltage electrode.      

Fabrication of submicron alumina ceramics by pulse electric current sintering using M2+ (M = Mg,Ca, Ni)-doped alumina nanopowders

Dense submicron-grained alumina ceramics were fabricated by pulse electric current sintering (PECS) using M²⁺(M: Mg, Ca, Ni)-doped alumina nanopowders at 1250 °C under a uniaxial pressure of 80 MPa. The M²⁺-doped alumina nanopowders (0–0.10 mass%) were prepared through a new sol–gel route using high-purity polyhydroxoaluminum (PHA) and MCl₂ solutions as starting materials. The composite gels obtained were calcined at 900 °C and ground by planetary ball milling. The powders were re-calcined at 900 °C to increase the content of α-alumina particles, which act as seeding for low-temperature densification. Densification and microstructural development depend on the M²⁺ dopant species. Dense alumina ceramics (relative density ≥99.0%) thus obtained had a uniform microstructure composed of fine grains, where the average grain size developed for non-doped, Ni-doped, Mg-doped and Ca-doped samples was 0.67, 0.67, 0.47 and 0.30 μm, respectively, showing that Ca-doping is the most promising method for tailoring of nanocrystalline alumina ceramics.     

Preparation of novel porous solids from alumina-pillared fluorine micas by acid-treatment

New porous solids from alumina-pillared fluorine micas (APMs), which were obtained from synthetic Na-tetrasilicic fluorine mica [NaMg_2.5Si₄O₁₀F₂], were prepared by sulfuric acid-treatment under mild conditions at 25 °C. The products were investigated by XRD, ICP, SEM, TEM and N₂ adsorption–desorption isotherm at 77 K. XRD measurements indicated that the interlayer pillared structure having a large basal spacing collapsed during the early stages of the acid-treatment. ICP analyses indicated that Al³⁺ and Mg²⁺ ions were leached out from the pillared micas during the acid-treatment. The pore properties of the leached products were found to differ from those of the mother pillared micas: the acid leaching of the pillared micas leads to the formation of mesopores around 3.2 nm in diameter. The correlation between the change in pore properties and cation elution behavior suggests that the mesopore formation results from the leaching of Mg²⁺ ions from the octahedral sheet of the pillared micas. The leached products thus obtained retained the flaky morphology of the mother pillared micas. These results show that the mild acid-treatment using APMs provides a novel route for obtaining unique mesopore solids having the large particle sizes of the mother micas.     

Hemispherical grained Si formation on in-situ phosphorus dopedamorphous-Si electrode for 256 Mb DRAM's capacitor

The cylindrical capacitor structure with hemispherical grained-Si (HSG-Si) described here reliably achieves a cell capacitance of 30 fF in a 0.4 μm-high storage electrode with a cell area of a 0.72 μm² for 256 Mbit dynamic random access memory. An HSG-Si formation technology using Si₂H₆-molecule irradiation and annealing enables control of the grain density and grain size of HSG-Si fabricated selectively on the whole surface of phosphorus-doped amorphous Si cylindrical electrodes