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Nishimura H, Kaptchuk RP, Mbabali I, Mulamba J, Nakyanjo N, Anok A, Wawer MJ, Kennedy CE, Nakigozi G, Chang LW, Amico KR, Hutton H. Motivational interviewing experiences from a community health worker-led HIV prevention and care intervention in rural Uganda: a qualitative study. AIDS Care 2024; 36:491-499. [PMID: 37713732 DOI: 10.1080/09540121.2023.2253504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 08/25/2023] [Indexed: 09/17/2023]
Abstract
Motivational Interviewing (MI) and Community Health Workers (CHWs) are increasingly utilized in global settings to improve HIV outcomes, yet research exploring implementation strategies using MI and CHWs is lacking. We examined the experiences of CHWs and their clients in a counseling intervention which used MI-informed counseling to increase engagement in HIV prevention and treatment. This study was nested within the mLAKE cluster-randomized trial in a high HIV prevalence fishing community in rural Rakai District, Uganda. We conducted in-depth interviews with purposively-sampled CHWs (n = 8) and clients (n = 51). Transcripts were analyzed thematically to characterize CHWs' implementation of the intervention. Main themes identified included use of specific MI strategies (including evocation, guidance towards positive behavior change, active listening, and open-ended questions), and MI spirit (including collaboration, power-sharing, trust, and non-judgmental relationship building). Through these specific MI mechanisms, CHWs supported client behavior change to facilitate engagement with HIV services. This study provides evidence from a low-resource setting that CHWs with no previous experience in MI can successfully implement MI-informed counseling that is well-received by clients. CHW-led MI-informed counseling appears to be a feasible and effective approach to increase uptake of HIV prevention and care services in low-resource, HIV endemic regions.
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Affiliation(s)
- Holly Nishimura
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rose Pollard Kaptchuk
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ismail Mbabali
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
| | - Jeremiah Mulamba
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
| | - Neema Nakyanjo
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
| | - Aggrey Anok
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
| | - Maria J Wawer
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gertrude Nakigozi
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
| | - Larry W Chang
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Social and Behavioral Sciences Department, Rakai Health Sciences Program, Kalisizo, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K Rivet Amico
- Department of Health Behavior Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Heidi Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Muralidhar K, Nishimura H, Coursey K, Krupp K, Jaykrishna P, Srinivas V, Madhivanan P. Knowledge and practice of family planning among pregnant tribal women in Southern India: an observational study. Contracept Reprod Med 2024; 9:2. [PMID: 38217011 PMCID: PMC10785510 DOI: 10.1186/s40834-023-00259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 11/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND There are over 700 Scheduled Tribes (ST) living in 30 Indian states. As with other indigenous groups across the world, Indian ST have some of the poorest infant and child health outcomes of any communities in India. A child born to an ST family is 19% more likely to die in the first month of life and has a 45 percent risk of dying in their first year compared with other Indian populations. Research suggests that early conception, high fertility, and low use of family planning methods are large contributors to these disparities. METHODS A cross sectional survey in Kannada was conducted among 303 pregnant tribal women in Mysore, India after obtaining informed consent. Univariate and multivariable analyses were carried out to determine the demographic and psychosocial factors associated with knowledge of contraceptive methods using Stata 14.0. RESULTS There was widespread knowledge about female sterilization, while only 39.3% of women reported hearing about one or more forms of temporary contraception, and 36.3% knew where to get them. The largest proportion of women had heard about copper-T (33.0%), followed by oral contraceptive pills (23.8%), condoms (11.9%), and injectables (4.6%). Only 2.7% of women reported ever using any form of temporary contraception. Results from the multivariable logistic regression indicated that knowledge of at least one form of temporary contraception was linked to higher age (adjusted odds ratio[AOR]: 1.09; 95% CI: 1.02, 1.17), greater number of years of marriage (AOR: 0.90; 95% CI: 0.85, 0.96), and last birth in a government facility (AOR: 3.67; 95% CI: 1.99, 6.82). CONCLUSIONS The study revealed poor knowledge and utilization of temporary contraceptive methods among a tribal population in rural Mysore, India. Interventions aiming to increase knowledge of contraceptive options are important for birth spacing in this population and should target younger women and those without contact with government health facilities.
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Affiliation(s)
- Kiranmayee Muralidhar
- Public Health Research Institute of India, Mysore, Karnataka, India.
- JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
| | - Holly Nishimura
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kate Coursey
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
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Perkins S, Nishimura H, Olatunde PF, Kalbarczyk A. Educational approaches to teach students to address colonialism in global health: a scoping review. BMJ Glob Health 2023; 8:bmjgh-2022-011610. [PMID: 37055173 PMCID: PMC10106004 DOI: 10.1136/bmjgh-2022-011610] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/18/2023] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION The enduring legacy of colonisation on global health education, research and practice is receiving increased attention and has led to calls for the 'decolonisation of global health'. There is little evidence on effective educational approaches to teach students to critically examine and dismantle structures that perpetuate colonial legacies and neocolonialist control that influence in global health. METHODS We conducted a scoping review of the published literature to provide a synthesis of guidelines for, and evaluations of educational approaches focused on anticolonial education in global health. We searched five databases using terms generated to capture three concepts, 'global health', 'education' and 'colonialism'. Pairs of study team members conducted each step of the review, following Preferred Reporting Items for Systematic reviews and Meta-Analyse guidelines; any conflicts were resolved by a third reviewer. RESULTS This search retrieved 1153 unique references; 28 articles were included in the final analysis. The articles centred North American students; their training, their evaluations of educational experiences, their individual awareness and their experiential learning. Few references discussed pedagogical approaches or education theory in guidelines and descriptions of educational approaches. There was limited emphasis on alternative ways of knowing, prioritisation of partners' experiences, and affecting systemic change. CONCLUSION Explicit incorporation of anticolonial curricula in global health education, informed by antioppressive pedagogy and meaningful collaboration with Indigenous and low-income and middle-income country partners, is needed in both classroom and global health learning experiences.
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Affiliation(s)
- Sylvie Perkins
- Center for Indigenous Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Holly Nishimura
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Praise F Olatunde
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anna Kalbarczyk
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Yamaura K, Nelson AL, Nishimura H, Rutledge JC, Ravuri SK, Bahney C, Philippon MJ, Huard J. The effects of losartan or angiotensin II receptor antagonists on cartilage: a systematic review. Osteoarthritis Cartilage 2023; 31:435-446. [PMID: 36586717 DOI: 10.1016/j.joca.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/06/2022] [Accepted: 11/28/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study is to analyze the latest evidence on the effects of losartan or Ang II receptor antagonists on cartilage repair, with a focus on their clinical relevance. DESIGN The PubMed, Embase, and Cochrane Library databases were searched up to November 12th 2021 to evaluate the effects of losartan or Ang II receptor antagonists on cartilage repair in in vitro studies and in vivo animal studies. Study design, sample characteristics, treatment type, duration, and outcomes were analyzed. The risk of bias and the quality of the eligible studies were assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias assessment tool and Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies (CAMARADES). RESULTS A total of 12 studies were included in this systematic review. Of the 12 eligible studies, two studies were in vitro human studies, three studies were in vitro animal studies, one study was an in vitro human and animal study, and six studies were in vivo animal studies. The risk bias and quality assessments were predominantly classified as moderate. Since meta-analysis was difficult due to differences in treatment type, dosage, route of administration, and method of outcome assessment among the eligible studies, qualitative evaluation was conducted for each study. CONCLUSIONS Both in vitro and in vivo studies provide evidence to demonstrate beneficial effects of Ang II receptor antagonists on osteoarthritis and cartilage defect models across animal species.
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Affiliation(s)
- K Yamaura
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - A L Nelson
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA.
| | - H Nishimura
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA; Department of Orthopaedic Surgery, University Hospital of Occupational and Environmental Health, Fukuoka, Japan.
| | - J C Rutledge
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA.
| | - S K Ravuri
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA.
| | - C Bahney
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA; The Orthopaedic Trauma Institute, University of California, San Francisco (UCSF), San Francisco, CA, USA.
| | - M J Philippon
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA.
| | - J Huard
- Center for Regenerative and Personalized Medicine, Steadman Philippon Research Institute, Vail, CO, USA.
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Edwards AJ, Pollard R, Kennedy CE, Mulamba J, Mbabali I, Anok A, Kong X, Nakyanjo N, Ddaaki W, Nishimura H, Wawer M, Rivet Amico K, Hutton HE, Nakigozi G, Larry W Chang. Impact of community health worker intervention on PrEP knowledge and use in Rakai, Uganda: A mixed methods, implementation science evaluation. Int J STD AIDS 2022; 33:995-1004. [PMID: 36006865 PMCID: PMC9910624 DOI: 10.1177/09564624221121208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Effective models of support for HIV pre-exposure prophylaxis (PrEP) are needed for populations at elevated risk. In a hyperendemic Ugandan fishing community, PrEP counseling was provided through a situated Information, Motivation, and Behavioral Skills (sIMB)-based community health worker (CHW) intervention. We evaluated the intervention using a mixed-methods, implementation science design. METHODS We surveyed all community members aged 15-49 through the Rakai Community Cohort Study. We used multivariable logistic regressions with generalized estimating equations to estimate the intervention's effect on PrEP knowledge and utilization. To understand intervention experiences and mechanisms, we conducted 74 qualitative interviews with 5 informant types (clients, CHWs, program staff, community leaders, health clinic staff) and analyzed data using an iterative, deductive approach. A mobile phone application provided intervention process implementation data. RESULTS Individuals self-reporting receipt of the CHW intervention showed significantly higher PrEP knowledge (N = 1848, PRR: 1.10, 95% CI: 1.06-1.14, p = <.0001), PrEP ever use (N = 1176, PRR: 1.77, 95% CI: 1.33-2.36, p = <.0001), and PrEP current use (N = 1176, PRR: 1.86, 95% CI: 1.22-2.82, p = 0.0039) compared to those who did not. Qualitative findings attributed positive PrEP outcomes to CHW counseling and effective use of motivational interviewing skills by CHWs. Salient themes across the RE-AIM framework included support for the CHW intervention and PrEP across clients, community, and implementers. Mobile application data demonstrated consistent delivery of the PrEP module throughout implementation. CONCLUSIONS CHWs improved PrEP knowledge and use among clients in an HIV hyperendemic fishing community. Mixed-methods, implementation science evaluations can inform adaptation of similar PrEP implementation strategies.
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Affiliation(s)
- Abagail J Edwards
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rose Pollard
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Rakai Health Sciences Program, Rakai, Uganda
| | | | | | - Aggrey Anok
- Rakai Health Sciences Program, Rakai, Uganda
| | - Xiangrong Kong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Holly Nishimura
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Maria Wawer
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Rakai Health Sciences Program, Rakai, Uganda,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - K Rivet Amico
- Department of Health Behavior Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Heidi E Hutton
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Larry W Chang
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Rakai Health Sciences Program, Rakai, Uganda,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Adewumi K, Nishimura H, Oketch SY, Adsul P, Huchko M. Barriers and Facilitators to Cervical Cancer Screening in Western Kenya: a Qualitative Study. J Cancer Educ 2022; 37:1122-1128. [PMID: 33411253 PMCID: PMC9257902 DOI: 10.1007/s13187-020-01928-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/22/2020] [Indexed: 06/12/2023]
Abstract
About nine out of 10 cervical cancer deaths occur in low-resource countries, with a particularly high burden in sub-Saharan Africa. The objectives of this study were to assess barriers and facilitators to cervical cancer screening in western Kenya from the perspectives of community members and healthcare providers. We conducted two focus groups with female community members (n = 24) and one with providers (n = 12) in Migori County, Kenya. Discussion guides queried about knowledge and awareness of cervical cancer prevention; structural, social, and personal barriers; and facilitators towards cervical cancer screening uptake. Group discussions were recorded, transcribed, and analyzed for emerging themes. Participants in both groups reported low awareness of HPV and cervical cancer screening in the community, and identified that as a main barrier to screening. Community members reported fear of pain and embarrassment as significant barriers to a screening pelvic exam. They also reported that providers' lack of knowledge and discomfort with a sensitive subject were significant barriers. A personal connection to cervical cancer and/or screening was associated with willingness to screen and awareness. Providers reported workload and lack of supplies and trained staff as significant barriers to offering services. Based on these findings, we identified three intervention components to address these facilitators and barriers to screening. They include utilizing existing social networks to expand awareness of cervical cancer risk and screening, training non-physician health workers to meet the demand for screening, and employing female-driven screening techniques such as self-collection of specimens for HPV testing. Cervical cancer prevention programs must take into account the local realities in which they occur. In low-resource areas in particular, identifying low-cost, effective, and culturally appropriate strategies for addressing poor screening uptake is important given limited funding. This study took a formative approach to identify facilitators and barriers to cervical cancer screening based on focus groups and interviews with community members and healthcare providers.
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Affiliation(s)
- Konyin Adewumi
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.
| | - Holly Nishimura
- School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Sandra Y Oketch
- Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Prajakta Adsul
- National Cancer Institute/National Institutes of Health, Bethesda, MD, USA
| | - Megan Huchko
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
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Ryan-Ibarra S, Nishimura H, Gallington K, Grinnell S, Bekemeier B. Time to Modernize: Local Public Health Transitions to Population-Level Interventions. J Public Health Manag Pract 2021; 27:464-472. [PMID: 31834010 DOI: 10.1097/phh.0000000000001100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To identify facilitating factors that guide local health departments (LHDs) in their transition from direct clinical service provision to population-level interventions addressing the social determinants of health. DESIGN Key informant interviews with LHD leaders and their staff were conducted using a semistructured interview guide. Thematic qualitative analysis was used to identify common characteristics and strategies among the LHD leaders and staff. PARTICIPANTS LHDs represented both rural and urban communities with population sizes from 9746 to 919 628 and agencies in Illinois, Montana, North Carolina, Oregon, Tennessee, Washington, and West Virginia. OUTCOME MEASURE The impetus and facilitators for transitioning health department services from clinical to population health. RESULTS Leaders from 7 LHDs emphasized that an impetus for their transition from direct clinical services to population-level interventions was that it was "time to modernize." Among LHDs interviewed, most included the 10 Essential Public Health Services or Public Health 3.0 in their strategic plan. Adding this focus to their strategic plan facilitated buy-in from local government and the ability to maintain the LHDs' focus on population-level interventions. We found that strong relationships and open communication with community members and partner organizations (eg, federally qualified health centers) were critical facilitators of transition. Themes from interviews were used to identify an initial set of 8 key elements of an effective transition: partnership/leadership, vision/goals, communication, community engagement, interventions, data/evaluation, workforce issues, and sustainability. CONCLUSIONS Prevention systems suffer from a lack of adequate health promotion and access to quality care for their community's residents. There is a need for LHDs to access technical support to strategically address complexity and ensure core population-focused prevention. The results shared provide replicable solutions, practices, and methods that enable successful transitions of LHDs toward maximizing their role in population health.
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Affiliation(s)
- Suzanne Ryan-Ibarra
- Survey Research Group (Dr Ryan-Ibarra and Mss Nishimura and Gallington) and Population Health Innovation Lab (Ms Grinnell), Public Health Institute, Oakland, California; and Northwest Center for Public Health Practice, Seattle, Washington (Dr Bekemeier)
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Nishimura H, Yeh PT, Oguntade H, Kennedy CE, Narasimhan M. HPV self-sampling for cervical cancer screening: a systematic review of values and preferences. BMJ Glob Health 2021; 6:e003743. [PMID: 34011537 PMCID: PMC8137189 DOI: 10.1136/bmjgh-2020-003743] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/31/2021] [Accepted: 04/26/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The WHO recommends human papillomavirus (HPV) cervical self-sampling as an additional screening method and HPV DNA testing as an effective approach for the early detection of cervical cancer for women aged ≥30 years. This systematic review assesses end user's values and preferences related to HPV self-sampling. METHODS We searched four electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature and Embase) using search terms for HPV and self-sampling to identify articles meeting inclusion criteria. A standardised data extraction form was used to capture study setting, population, sample size and results related to values and preferences. RESULTS Of 1858 records retrieved, 72 studies among 52 114 participants published between 2002 and 2018 were included in this review. Almost all studies were cross-sectional surveys. Study populations included end users who were mainly adolescent girls and adult women. Ages ranged from 14 to 80 years. Most studies (57%) were conducted in high-income countries. Women generally found HPV self-sampling highly acceptable regardless of age, income or country of residence. Lack of self-confidence with collecting a reliable sample was the most commonly cited reason for preferring clinician-collected samples. Most women preferred home-based self-sampling to self-sampling at a clinic. The cervical swab was the most common and most accepted HPV DNA sampling device. CONCLUSIONS HPV self-sampling is generally a highly accepted method of cervical cancer screening for end users globally. End user preferences for self-sampling device, method and setting can inform the development of new and expanded interventions to increase HPV screening.
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Affiliation(s)
- Holly Nishimura
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ping Teresa Yeh
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Habibat Oguntade
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caitlin E Kennedy
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Geneva, Switzerland
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Srinivas V, Herbst De Cortina S, Nishimura H, Krupp K, Jayakrishna P, Ravi K, Khan A, Madhunapantula SV, Madhivanan P. Community-based Mobile Cervical Cancer Screening Program in Rural India: Successes and Challenges for Implementation. Asian Pac J Cancer Prev 2021; 22:1393-1400. [PMID: 34048166 PMCID: PMC8408397 DOI: 10.31557/apjcp.2021.22.5.1393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background: The aim of this study is to demonstrate the feasibility; mention the challenges encountered and highlight the success of implementing a community-based mobile cervical cancer-screening program in rural India. Methods: Communities were mobilized through extensive peer education and by screening in existing community spaces using a mobile clinic model. An initial “screen and treat” protocol was transitioned to “screen, test, and treat” using Pap smears for confirmatory testing, and cryotherapy or Loop Electrosurgical Excision Procedure (LEEP) for treatment. We trained 50 Peer Educators and conducted 190 screening camps in 58 locations. Results: Of 3,821 registered women, 3,544 (92.8%) accepted screening. Overall, 440/3544 (12.4%, 95% CI 11.3-13.5%) women had VIA-positive lesions. Under “screen and treat”, 56/156 (35.9%) women accepted same-day treatment. Under “screen, test, and treat”, 555/762 (72.8%) women received a Pap smear. Overall, 83 women underwent cryotherapy (n=56) and LEEP (n=27). Of those, 49 (59.0%) participants were followed up, with normal VIA results up to two years after treatment. In summary, the peer educators promoted awareness of cervical cancer and helped in gaining buy-in from communities. Acceptance of same-day treatment was low and accompanied by loss to follow-up, limiting the utility of VIA in these studies. Conclusions: Mobile infrastructure utilized in community spaces brought screening directly to rural women. Culturally appropriate methods to increase linkage to treatment and additional screening options such as HPV DNA testing should be explored.
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Affiliation(s)
| | - Sasha Herbst De Cortina
- Public Health Research Institute of India, Mysore, India.,School of Medicine, University of California Irvine, Irvine, USA.,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, USA
| | - Holly Nishimura
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, India.,Department of Biochemistry, JSS Medical College, Leader, Special Interest Group (SIG) in Cancer Biology and Cancer Stem Cells JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | | | - Kavitha Ravi
- Public Health Research Institute of India, Mysore, India
| | - Anisa Khan
- Public Health Research Institute of India, Mysore, India
| | | | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, India.,Department of Biochemistry, JSS Medical College, Leader, Special Interest Group (SIG) in Cancer Biology and Cancer Stem Cells JSS Academy of Higher Education & Research, Mysore, Karnataka, India.,Department of Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
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Madhivanan P, Nishimura H, Ravi K, Pope B, Coudray M, Arun A, Krupp K, Jayakrishna P, Srinivas V. Acceptability and Concordance of Self- Versus Clinician- Sampling for HPV Testing among Rural South Indian Women. Asian Pac J Cancer Prev 2021; 22:971-976. [PMID: 33773563 PMCID: PMC8286674 DOI: 10.31557/apjcp.2021.22.3.971] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Despite being largely preventable, HPV-related cervical cancers continues to be the second highest cause of cancer deaths among Indian women. HPV testing using self-sampled samples may offer an opportunity to expand cervical cancer screening in India where there is currently a shortage of providers and facilities for cervical cancer screening. The study examines acceptability and concordance of self vs. clinician collected samples for HPV-relted cervical cancer screening among rural South Indian women. Methods: Between May and August 2017, eight mobile screening clinics were conducted among 120 eligible women in rural villages in Mysore District, India. Women over the age of 30 underwent informed consent process and then self-sampled a sample for cervicovaginal HPV DNA testing. Next, the women underwent clinical exam where the clinician collected a cervicovaginal HPV DNA sample. Following the clinical exam, all participants answered an interviewer-administered questionnaire to assess their history of cervical cancer screening and acceptability of self- and clinician-sampling methods. To assess diagnostic accuracy, concordance of self- and clinician-sampled HPV DNA specimens was calculated in addition to five measures of acceptability (feeling of caring, privacy, embarrassment, genital discomfort, and genital pain). Results: Study participants had a median age 39 years, about four-in-ten (41.7%) had a secondary education or above, the vast majority (87.5%) were married and only 3.4% reported having screened for cervical cancer. For all measures of participant acceptability, self-sampling was rated significantly higher than clinician-sampling. Cohen’s kappa was 0.73 (95% CI: 0.34, 1.00), indicating substantial agreement between self- and clinician-sampling. Conclusion: This study demonstrates that HPV self-sampling for cervical cancer screening is feasible and acceptable in a community setting among South Indian rural women. Concordance between self-sampling and clinician-sampling was adequate for screening in community settings.
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Affiliation(s)
- Purnima Madhivanan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.,Public Health Research Institute of India, Mysore, India.,Departments of Medicine, Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| | - Holly Nishimura
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Kavitha Ravi
- Public Health Research Institute of India, Mysore, India
| | - Benjamin Pope
- Department of Epidemiology & Biostatistics, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Makella Coudray
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, USA
| | - Anjali Arun
- Public Health Research Institute of India, Mysore, India
| | - Karl Krupp
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.,Public Health Research Institute of India, Mysore, India
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11
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Ohtake H, Ishii J, Nishimura H, Kawai H, Muramatsu T, Harada M, Motoyama S, Watanabe E, Ozaki Y, Iwata M. Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.
Purpose
We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.
Method
We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset >3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.
Results
Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.
Conclusion
The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ohtake
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | | | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - M Harada
- Fujita Health University, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - M Iwata
- Fujita Health University, Toyoake, Japan
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12
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Senoo K, Nakata M, Teramukai S, Yamamoto T, Nishimura H, Matoba S. Gender differences in patterns of relationship between body mass index and AF incidence. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Obesity is reportedly associated with the new incidence of atrial fibrillation (AF). However, gender differences in patterns of relationship between body mass index (BMI) and the risk of AF are unknown.
Methods
We analyzed 21,382 middle-aged Japanese subjects (10923 men, 10459 women) without AF from a cohort of employees undergoing annual health examinations, with a follow-up period of 4.8±3.7 years. We examined the relationship between BMI at baseline to AF incidence in unadjusted and adjusted analyses. This relationship was also studied using linear and quadratic models.
Results
AF had developed in 137 subjects (119 men; mean age, 54.4±8.2 years; incidence, 2.19 and 0.38 per 1000 person-years in men and women, respectively). In multivariable Cox proportional-hazard models, increasing age (hazard ratio [HR], 2.72 per year; 95% CI, 2.22 to 3.33; P<0.001), male gender (HR, 3.28; 95% CI, 1.86 to 5.76; P<0.001) and BMI (HR, 1.08; 95% CI, 1.02 to 1.15; P=0.007) were associated with the new incidence of AF in all cohorts. The shape of the BMI-incident AF relationship showed a linear association in women and a J-shaped association in men. (Figure) In particular, a U-shaped relationship was observed in young men aged 40–49, with increased risk among those with higher BMI and with very low BMI. In analyses adjusted for comorbidities and risk factors for CV disease, the U-shaped AF incidence versus BMI curves were not attenuated, suggesting that other genetic or congenital factors may mediate this relationship.
Conclusion
Our results indicate that the shape of the BMI-incident AF relation differs by sex and in particular a U-shaped relationship was observed in young men.
Patterns of relation among BMI and AF
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Senoo
- Kyoto Prefectural University of Medicine, Department of Cardiac Arrhythmia Research and Innovation, Kyoto, Japan
| | - M Nakata
- Kyoto Prefectural University of Medicine, Department of Biostatistics, Kyoto, Japan
| | - S Teramukai
- Kyoto Prefectural University of Medicine, Department of Biostatistics, Kyoto, Japan
| | - T Yamamoto
- Medical Corporation Soukenkai, Nishimura Clinic, Kyoto, Japan
| | - H Nishimura
- Medical Corporation Soukenkai, Nishimura Clinic, Kyoto, Japan
| | - S Matoba
- Kyoto Prefectural University of Medicine, Department of Cardiovascular medicine, Kyoto, Japan
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13
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - W Fujiwara
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - M Ohta
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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14
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Leemann SC, Liu S, Hexemer A, Marcus MA, Melton CN, Nishimura H, Sun C. Demonstration of Machine Learning-Based Model-Independent Stabilization of Source Properties in Synchrotron Light Sources. Phys Rev Lett 2019; 123:194801. [PMID: 31765214 DOI: 10.1103/physrevlett.123.194801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/23/2019] [Indexed: 06/10/2023]
Abstract
Synchrotron light sources, arguably among the most powerful tools of modern scientific discovery, are presently undergoing a major transformation to provide orders of magnitude higher brightness and transverse coherence enabling the most demanding experiments. In these experiments, overall source stability will soon be limited by achievable levels of electron beam size stability, presently on the order of several microns, which is still 1-2 orders of magnitude larger than already demonstrated stability of source position and current. Until now source size stabilization has been achieved through corrections based on a combination of static predetermined physics models and lengthy calibration measurements, periodically repeated to counteract drift in the accelerator and instrumentation. We now demonstrate for the first time how the application of machine learning allows for a physics- and model-independent stabilization of source size relying only on previously existing instrumentation. Such feed-forward correction based on a neural network that can be continuously online retrained achieves source size stability as low as 0.2 μm (0.4%) rms, which results in overall source stability approaching the subpercent noise floor of the most sensitive experiments.
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Affiliation(s)
- S C Leemann
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Liu
- Department of Chemistry, University of California, Berkeley, California 94720, USA
| | - A Hexemer
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M A Marcus
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C N Melton
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - H Nishimura
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Sun
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
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15
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Morace A, Iwata N, Sentoku Y, Mima K, Arikawa Y, Yogo A, Andreev A, Tosaki S, Vaisseau X, Abe Y, Kojima S, Sakata S, Hata M, Lee S, Matsuo K, Kamitsukasa N, Norimatsu T, Kawanaka J, Tokita S, Miyanaga N, Shiraga H, Sakawa Y, Nakai M, Nishimura H, Azechi H, Fujioka S, Kodama R. Enhancing laser beam performance by interfering intense laser beamlets. Nat Commun 2019; 10:2995. [PMID: 31278266 PMCID: PMC6611939 DOI: 10.1038/s41467-019-10997-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 05/21/2019] [Indexed: 11/12/2022] Open
Abstract
Increasing the laser energy absorption into energetic particle beams represents a longstanding quest in intense laser-plasma physics. During the interaction with matter, part of the laser energy is converted into relativistic electron beams, which are the origin of secondary sources of energetic ions, γ-rays and neutrons. Here we experimentally demonstrate that using multiple coherent laser beamlets spatially and temporally overlapped, thus producing an interference pattern in the laser focus, significantly improves the laser energy conversion efficiency into hot electrons, compared to one beam with the same energy and nominal intensity as the four beamlets combined. Two-dimensional particle-in-cell simulations support the experimental results, suggesting that beamlet interference pattern induces a periodical shaping of the critical density, ultimately playing a key-role in enhancing the laser-to-electron energy conversion efficiency. This method is rather insensitive to laser pulse contrast and duration, making this approach robust and suitable to many existing facilities. Enhanced coupling of laser energy to the target particles is a fundamental issue in laser-plasma interactions. Here the authors demonstrate increased photon absorption leading into higher laser to electron and proton energy transfer through the interference of multiple coherent beamlets.
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Affiliation(s)
- A Morace
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan.
| | - N Iwata
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - Y Sentoku
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - K Mima
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - Y Arikawa
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - A Yogo
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - A Andreev
- Max Born Institute for non-linear optics and short pulse spectroscopy, Berlin, 12489, Germany.,St. Petersburg State University, Sankt-Petersburg, 199034, Russia
| | - S Tosaki
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - X Vaisseau
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - Y Abe
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - S Kojima
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - S Sakata
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - M Hata
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - S Lee
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - K Matsuo
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - N Kamitsukasa
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - T Norimatsu
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - J Kawanaka
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - S Tokita
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - N Miyanaga
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - H Shiraga
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - Y Sakawa
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - M Nakai
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - H Nishimura
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - H Azechi
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
| | - R Kodama
- Institute of Laser Engineering, Osaka University, Suita, 565-0871, Japan
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16
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Placek CD, Nishimura H, Hudanick N, Stephens D, Madhivanan P. Reframing HIV Stigma and Fear : Considerations from Social-ecological and Evolutionary Theories of Reproduction. Hum Nat 2019; 30:1-22. [PMID: 30661161 DOI: 10.1007/s12110-018-09335-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
HIV stigma and fears surrounding the disease pose a challenge for public health interventions, particularly those that target pregnant women. In order to reduce stigma and improve the lives of vulnerable populations, researchers have recognized a need to integrate different types of support at various levels. To better inform HIV interventions, the current study draws on social-ecological and evolutionary theories of reproduction to predict stigma and fear of contracting HIV among pregnant women in South India. The aims of this study were twofold: compare the social-ecological model to a modified maternal-fetal protection model and test a combined model that included strong predictors from each model. The study took place in 2008-2011 in Mysore District, Karnataka, India. Using data from a cross-sectional survey and biological indicators of health, we statistically modeled social-ecological variables representing individual, interpersonal, and community/institutional levels. Participants were 645 pregnant women. The social-ecological and combined models were the best-fitting models for HIV-related stigma, and the combined model was the best fit for HIV-related fear. Our findings suggest that combining reproductive life history factors along with individual, interpersonal, and community/institutional factors are significant indicators of HIV-related stigma and fear. Results of this study support a multifaceted approach to intervention development for HIV-related stigma and fear. The combined model in this study can be used as a predictive model for future research focused on HIV stigma and fear, with the intent that dual consideration of social-ecological and evolutionary theories will improve public health communication efforts.
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Affiliation(s)
- Caitlyn D Placek
- Department of Anthropology, Ball State University, Muncie, IN, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.,Public Health Research Institute of India, Mysore, Karnataka, India
| | - Holly Nishimura
- School of Public Health, University of California at Berkeley, Berkeley, CA, USA
| | - Natalie Hudanick
- Department of Anthropology, Ball State University, Muncie, IN, USA
| | - Dionne Stephens
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA. .,Public Health Research Institute of India, Mysore, Karnataka, India.
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Brondfield S, Boscardin C, Strewler G, Hyland K, Oakes SA, Nishimura H, Crawford J, Hauer KE. A Medical Student Inquiry Behavior Assessment Tool: Development and Validity Evidence. Acad Med 2019; 94:586-594. [PMID: 30431452 DOI: 10.1097/acm.0000000000002520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE The University of California, San Francisco (UCSF) School of Medicine's Bridges curriculum is designed to teach inquiry: the process of approaching problems with curiosity, challenging current concepts, and creating new knowledge. The authors aimed to develop and gather validity evidence for a tool to guide development of medical student inquiry behaviors in small groups. METHOD The authors reviewed the literature to identify inquiry behaviors, verified findings with an expert focus group, and synthesized the results into 40 behaviors. In a modified two-round Delphi survey in 2016, faculty and students rated the behaviors for inclusion in the tool. Feedback from cognitive interviews and a pilot helped refine the tool. In 2016-2017, the authors implemented the final tool for 152 first-year UCSF medical students in inquiry small groups as a faculty assessment and a student self-assessment each quarter. RESULTS The two-round response rate was 77% (36/47). Five behaviors were selected for inclusion in the tool: select relevant questions to pursue; justify explanations with evidence; critically evaluate his/her explanation in light of alternative possibilities; allow for the possibility that his/her own knowledge may not be completely correct; and collaborate well with peers. During implementation, faculty and student scores increased on most items, indicating skills development over time. Content, response process, internal structure, and consequential validity evidence is presented. CONCLUSIONS The tool's five items are observable, measurable core inquiry behaviors. The tool is ready for use by small-group facilitators within inquiry-based curricula to promote student self-assessment and guide feedback to students.
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Affiliation(s)
- Sam Brondfield
- S. Brondfield was internal medicine chief resident at the time of the study and is currently chief hematology/oncology fellow, Department of Medicine, University of California, San Francisco, San Francisco, California. C. Boscardin is associate professor, Department of Medicine, University of California, San Francisco, San Francisco, California. G. Strewler is professor, Department of Medicine, University of California, San Francisco, San Francisco, California. K. Hyland is professor, Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, California. S.A. Oakes is professor, Department of Pathology, University of California, San Francisco, San Francisco, California. H. Nishimura was research analyst, Office of Research and Development in Medical Education, University of California, San Francisco, San Francisco, California, at the time of the study. J. Crawford was curriculum manager, Office of the Dean, University of California, San Francisco, San Francisco, California, at the time of the study. K.E. Hauer is professor, Department of Medicine, University of California, San Francisco, San Francisco, California
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18
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Jauregui J, O'Sullivan P, Kalishman S, Nishimura H, Robins L. Remooring: A Qualitative Focus Group Exploration of How Educators Maintain Identity in a Sea of Competing Demands. Acad Med 2019; 94:122-128. [PMID: 30095452 DOI: 10.1097/acm.0000000000002394] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Longitudinal faculty development programs (LFDPs) are communities of practice (CoPs) that support development of participants' educator identity (EID). This study explored how program graduates negotiated their newly formed EIDs among competing identities and demands in academic medicine. METHOD In this multicenter, cross-sectional, qualitative study, graduates of two LFDP cohorts (one and five years post graduation) were invited in 2015 to participate in a one-hour, cohort-specific focus group. The focus group included questions about views of themselves as educators, experiences of transition out of the LFDP, and sustainability of their EID following program participation. Researchers analyzed transcripts using Wenger's CoP and Tajfel's social identity theories to guide interpretation of findings. RESULTS Thirty-seven graduates, 17 from one year and 20 from five years post graduation, participated in eight focus groups. They described developing a new EID in their LFDP CoPs. Three major themes emerged: context, agency, and identity. A push-pull relationship among these themes influenced faculty members' EID trajectory over time. Graduates described feeling unmoored from their LFDP community after graduation and relied on individual agency to remoor their new identities to supports in the larger institutional context. CONCLUSIONS LFDP graduation represented a transition point. Graduates found it challenging to lose supports from their time-limited CoP and remoor their EIDs to workplace supports. Remooring required individual agency and external support and affirmation. Faculty development programs must be designed with transition periods and sustainability in mind to ensure that participants and institutions can benefit from their transformative effects over time.
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Affiliation(s)
- Joshua Jauregui
- J. Jauregui is assistant professor, Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington. P. O'Sullivan is professor, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California. S. Kalishman is professor, Department of Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico. H. Nishimura is research analyst, Center for Faculty Educators, University of California, San Francisco School of Medicine, San Francisco, California. L. Robins is professor, Department of Biomedical Informatics and Medical Education, University of Washington School of Medicine, Seattle, Washington
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19
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Senoo S, Yoshida K, Miyawaki D, Ishihara T, Nishikawa R, Inoue Y, Nishimura H, Okamoto Y, Nishimura Y, Sasaki R. Treatment Outcomes of Radiation Therapy or Chemoradiotherapy for Postoperative Locoregional Recurrence of Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tatarano S, Enokida H, Yamada Y, Nishimura H, Nakagawa M. Living Kidney Donor With Small Lymphocytic Lymphoma at the Time of Donation: A Case Report. Transplant Proc 2018; 50:2581-2582. [PMID: 30316403 DOI: 10.1016/j.transproceed.2018.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/19/2018] [Accepted: 04/06/2018] [Indexed: 12/01/2022]
Abstract
Living kidney donor guidelines recommend that donors in whom a malignancy is diagnosed should be excluded. Although preoperative screening for malignancies was performed, we experienced a case of living donor with small lymphocytic lymphoma (SLL) at the time of donation. A 53-year-old woman was referred to our hospital for a kidney donation to her son. She had no past medical history of malignancy. We screened the patient using medical examinations, but there was no obvious presence of malignancy. Although preoperative computed tomography showed a small lymph node swelling at the left renal hilum, we diagnosed it as an insignificant lymph node. When a laparoscopic donor nephrectomy was performed, however, we recognized the small lymph node during the surgery and performed a lymphadenectomy. Postoperatively, pathologic examination showed that the small node was lymphocytic lymphoma, known as a low malignant potential disease. Currently, there is no presence of malignancy transmission with the recipient. To the best of our knowledge, this is the first case report of living kidney donor with SLL. Although SLL is considered a low-grade malignancy, it is crucial to follow it carefully in both the donor and the recipient.
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Affiliation(s)
- S Tatarano
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - H Enokida
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Y Yamada
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - H Nishimura
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - M Nakagawa
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Sakai K, Inoue M, Nishimura H, Mikami S, Kuwabara Y, Kojima A, Toda M, Kobayashi Y, Kikuchi S, Hirata Y, Kyoyama H, Moriyama G, Gemma A, Uematsu K. P2.06-31 Inhibition of Heat Shock Protein 70 Function Suppresses Proliferation in Mesothelioma Cells. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abe Y, Nakajima N, Sakaguchi Y, Arikawa Y, Mirfayzi SR, Fujioka S, Taguchi T, Mima K, Yogo A, Nishimura H, Shiraga H, Nakai M. A multichannel gated neutron detector with reduced afterpulse for low-yield neutron measurements in intense hard X-ray backgrounds. Rev Sci Instrum 2018; 89:10I114. [PMID: 30399813 DOI: 10.1063/1.5039436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 07/11/2018] [Indexed: 06/08/2023]
Abstract
A design of multichannel gated photomultiplier tube (PMT) is presented for the 960-channel neutron time-of-flight detector at the Institute of Laser Engineering of Osaka University. This is important for the fusion science and the nuclear photonics where intense hard X-rays are generated from the interaction of ultra-short laser pulse of petawatt power density with matter. The hard X-rays often overload PMTs and cause signal-induced background noises called afterpulses, making the detection of subsequent neutrons impossible. For this reason, the PMTs are coupled with an electrical time-gating (ETG) system to avoid overloading. The ETG system disables the PMT by modulating the dynode potential during the primary X-ray flash. An after-pulsing suppression technique is demonstrated by applying a reverse bias voltage between the photocathode and the first dynode. The presented multichannel scheme provides a gate response time of 80 ns, a signal cutoff ratio of 2.5 × 102, and requires reasonably low power consumption.
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Affiliation(s)
- Y Abe
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - N Nakajima
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | | | - Y Arikawa
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - S R Mirfayzi
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - T Taguchi
- Setsunan University, Osaka 572-8508, Japan
| | - K Mima
- Graduate School for the Creation of New Photonics Industries, Shizuoka 431-1202, Japan
| | - A Yogo
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - H Nishimura
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - H Shiraga
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
| | - M Nakai
- Institute of Laser Engineering, Osaka University, Osaka 565-0871, Japan
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Arikawa Y, Matsubara S, Kishimoto H, Abe Y, Sakata S, Morace A, Mizutani R, Nishibata J, Yogo A, Nakai M, Shiraga H, Nishimura H, Fujioka S, Kodama R. A large-aperture high-sensitivity avalanche image intensifier panel. Rev Sci Instrum 2018; 89:10I128. [PMID: 30399964 DOI: 10.1063/1.5037623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
A large-aperture high-sensitivity image intensifier panel that consists of an avalanche photodiode array and a light-emitting diode array is presented. The device has 40% quantum efficiency, over 104 optical gain, and 80-ns time resolution. The aperture size of the device is 20 cm, and with the current manufacturing process, it can be scaled to arbitrarily larger sizes. The device can intensify the light from a single particle scintillation emission to an eye-visible bright flash. The image resolution of the device is currently limited by the size of the avalanche photodiode that is 2 mm, although it can be scaled to smaller sizes in the near future. The image intensifier is operated at a small voltage, typically +57 V. The device can be applied to various applications, such as scintillation imaging, night vision cameras, and an image converter from non-visible light (such as infrared or ultraviolet) to visible light.
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Affiliation(s)
- Y Arikawa
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - S Matsubara
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - H Kishimoto
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - Y Abe
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - S Sakata
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - A Morace
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - R Mizutani
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - J Nishibata
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - A Yogo
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - M Nakai
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - H Shiraga
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - H Nishimura
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
| | - R Kodama
- Institute of Laser Engineering, Osaka University, 2-6 Yamadaoka, Suita, Osaka, Japan
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Nishimura H, Krupp K, Gowda S, Srinivas V, Arun A, Madhivanan P. Determinants of exclusive breastfeeding in rural South India. Int Breastfeed J 2018; 13:40. [PMID: 30181763 PMCID: PMC6114539 DOI: 10.1186/s13006-018-0178-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 07/23/2018] [Indexed: 11/12/2022] Open
Abstract
Background While breastfeeding rates have improved globally, disparities in breastfeeding practices persist particularly in rural and low resource settings. In India, only 56% of Indian mothers practice exclusive breastfeeding (EBF) for the recommended six months. As India leads the world in the number of preterm births, under 5 years of age malnutrition and neonatal mortality, understanding the factors associated with EBF can help improve the nutritional status for millions of infants. We assessed the factors associated with EBF in rural Mysore, India. Methods This cross-sectional analysis was nested within a cohort study assessing the feasibility and uptake of mobile prenatal care and HIV counseling and testing intervention in Mysore District. Multivariable logistic regression was used to identify the factors associated with EBF for infants between birth and six months. Exclusive breastfeeding was defined as breastfeeding with no other liquids or breastfeeding substitutes given to infants exceptfor medicine or oral rehydration solution, between birth and 6 months and was assessed at six months postpartum. Results We surveyed mothers who delivered in rural Mysore taluk between 2008 and March 2011. A total of 1292 mothers participated in the study. The overall breastfeeding rate at six months postpartum was 74.9% and the EBF rate was 48.5%. Factors associated with EBF included higher maternal age (Adjusted Odds Ratio[aOR] 1.04; 95% Confidence Interval [CI] 1.00, 1.09), lower maternal education (aOR1.56, 95% CI 1.10, 2.21), and 7–10 antenatal visits (aOR 1.57; 95% CI 1.09, 2.27). The most common reason for non-exclusive breastfeeding was the mother’s feeling that she did not have enough milk (23.7%). Infants that were not exclusively breastfed were most commonly fed formula/animal milk (42.6%) or castor oil/ghee (18.4%). Conclusions Less than half of the mothers in our sample reported exclusive breastfeeding in a rural region of Karnataka, India in the first six months, a rate lower than national and state level rates. Future interventions should evaluate whether antenatal education can improve breastfeeding outcomes. The only modifiable factor was number of antenatal visits. Breastfeeding education should be emphasized at every antenatal visit so that even mothers with fewer than 7–10 antenatal visits can learn the best techniques and benefits of breastfeeding.
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Affiliation(s)
- Holly Nishimura
- 1School of Public Health, University of California at Berkeley, 50 University Hall Berkeley, Berkeley, CA 94720-7360 USA
| | - Karl Krupp
- 2Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, HLS 390W2, Miami, FL 33199 USA.,Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, 570020 India
| | - Savitha Gowda
- Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, 570020 India
| | - Vijaya Srinivas
- Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, 570020 India
| | - Anjali Arun
- Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, 570020 India
| | - Purnima Madhivanan
- 2Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, HLS 390W2, Miami, FL 33199 USA.,Public Health Research Institute of India, 89/B, Ambika, 2nd Main, 2nd Cross, Yadavagiri, Mysore, 570020 India
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Kondo H, Ogawa S, Nishimura H, Ono A. Massage therapy for home care patients using the health insurance system in Japan. Complement Ther Med 2018; 36:142-146. [PMID: 29458922 DOI: 10.1016/j.ctim.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 01/04/2018] [Accepted: 01/04/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To clarify the status of home care massage services provided to patients. This will help in understanding how many patients utilize this service and the circumstances under which treatment is provided. DESIGN A retrospective study. SETTING Fifty-four acupuncture, moxibustion, and massage clinics. Participants were patients who had received home care massage for six months or more. We collected a total of 1587 responses from these 54 massage clinics; of these, 1415 responses (mean age = 79.1 ± 11.5 years) were valid (valid response rate 89.2%). MAIN OUTCOME MEASURES Actual patients and actual care services. RESULTS The most common disorder observed among patients who utilized home care massage services was cerebrovascular disease (at approximately 36%), while the second most common were arthropathy-related disorders (16.3%). Although most patients received massage, approximately 30% received manual therapy (e.g. manual correction) and hot fomentation as part of thermotherapy. Notably, only around 10% of patients received massage alone; the majority received treatment in combination with range of motion and muscle-strengthening exercises. CONCLUSIONS This study helped to clarify the actual state of patients receiving home care massage and the details of the massage services provided. This study clearly showed the treatment effectiveness of massage, which can be used by home medical care stakeholders to develop more effective interventions.
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Affiliation(s)
- H Kondo
- Course of Acupuncture and Moxibustion, Department of Health, Faculty of Health Sciences, Tsukuba University of Technology, Japan; Japan Acupuncture, Moxibustion and Massage Association, Japan.
| | - S Ogawa
- Japan Acupuncture, Moxibustion and Massage Association, Japan
| | - H Nishimura
- Japan Acupuncture, Moxibustion and Massage Association, Japan
| | - A Ono
- Japan Acupuncture, Moxibustion and Massage Association, Japan
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26
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Nakai S, Nakatsuka M, Fujita H, Miyanaga N, Jitsuno T, Kanabe T, Izawa Y, Norimatsu T, Takagi M, Yamanaka T, Kato Y, Azechi H, Nishimura H, Shiraga H, Nakai M, Tanaka K, Kodama R, Takabe H, Nishihara K, Mima K, Kitagawa Y, Sakabe S, Yamanaka M, Kosaki Y, Yamanaka C, Sasaki T, Mori Y, Miyazaki K, Nishikawa M, Kan H, Hiruma T, Soman Y, Ito H, Perlado J, Alonso E, Munoz E, Sanz J. Laser Fusion Research at Ile Osaka University. ACTA ACUST UNITED AC 2018. [DOI: 10.13182/fst96-a11963008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Nakai
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nakatsuka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Fujita
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - N. Miyanaga
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Jitsuno
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Kanabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Izawa
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Norimatsu
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Takagi
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kato
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Azechi
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Nishimura
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Shiraga
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nakai
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K.A. Tanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - R. Kodama
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Takabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Nishihara
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Mima
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kitagawa
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - S. Sakabe
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Kosaki
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - C. Yamanaka
- Institute of Laser Engineering, Osaka University 2-6 Yamada-oka, Suita, Osaka 565 Japan
| | - T. Sasaki
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - Y. Mori
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - K. Miyazaki
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - M. Nishikawa
- Faculy of Engineering, Osaka University 2-1 Yamada-oka, Suita, Osaka 565 Japan
| | - H. Kan
- Hamamatsu Photonics K.K. 5000 Hirakuchi, Hamakita, Shizuoka 434 Japan
| | - T. Hiruma
- Hamamatsu Photonics K.K. 5000 Hirakuchi, Hamakita, Shizuoka 434 Japan
| | - Y. Soman
- Mitsubishi Heavy Industries. Ltd. 1-1-1 Wadasaki-cho, Hyogo-ku, Kobe 562 Japan
| | - H. Ito
- Kawasaki Heavy Industries. Ltd. 2-4-25 Minamisuna, Koto-ku, Tokyo 136 Japan
- Members of Laser Fusion Reactor Committee of Laser Society of Japan
| | - J.M. Perlado
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - E. Alonso
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - E. Munoz
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
| | - J. Sanz
- Instituto de Fusion Nuclear, Universidad Politecnica de Madrid 28006 Madrid Spain
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Sekiya K, Nishimura M, Suehiro F, Nishimura H, Hamada T, Kato Y. Enhancement of Osteogenesis by Concanavalin a in Human Bone Marrow Mesenchymal Stem Cell Cultures. Int J Artif Organs 2018; 31:708-15. [DOI: 10.1177/039139880803100804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigates concanavalin A (ConA) as a novel factor that may enhance osteogenesis of mesenchymal stem cells (MSCs) in vitro. Various factors, such as cytokine bone morphogenetic protein-2 (BMP-2), have been studied for their possible promotion of MSC osteogenesis in vivo and in vitro. However, the factor that might be safer, more effective, and less expensive than these has not been determined. We therefore cultured human MSCs in osteogenic medium in the presence or absence of ConA, and used calcium assays to compare the effects of ConA and BMP-2 on MSC calcification. We also used enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction (PCR) to evaluate the expression levels of bone-specific markers. ConA and BMP-2 enhanced calcification with comparable effectiveness. The combination of ConA and BMP-2 further enhanced calcification slightly but significantly. ConA also increased osteocalcin and BMP-2 protein levels in MSC culture medium. Furthermore, ConA increased osteocalcin, RUNX2, BMP-2, BMP-4, and BMP-6 mRNA expression levels. However, the gene expression pattern of ConA-stimulated MSCs was different from that of MSCs stimulated by BMP-2. Together, these results suggest that ConA and BMP-2 enhance MSC osteogenesis via different pathways. ConA-induced bone formation in MSC cultures may be useful in regenerative medicine or tissue engineering in clinical studies, as well as in basic research on bone formation.
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Affiliation(s)
- K. Sekiya
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
| | - M. Nishimura
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
| | - F. Suehiro
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
| | - H. Nishimura
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
| | - T. Hamada
- Department of Prosthetic Dentistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima
| | - Y. Kato
- Department of Dental and Medical Biochemistry, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima - Japan
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Veeranki SP, Nishimura H, Krupp K, Gowda S, Arun A, Madhivanan P. Suboptimal Breastfeeding Practices among Women in Rural and Low-Resource Settings: a Study of Women in Rural Mysore, India. Ann Glob Health 2017; 83:577-583. [PMID: 29221531 DOI: 10.1016/j.aogh.2017.10.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/21/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Breastfeeding rates are progressively increasing worldwide while optimal breastfeeding practices are lagging behind, especially in rural and low resource settings like India. OBJECTIVES This study estimated the prevalence of and factors associated with suboptimal breastfeeding practices among mother-infant dyads in rural southern India. METHODS This is a cross-sectional analysis of data collected in Mysore District from 2008-2011 from 1294 mother-infant dyads. All women answered an interviewer-administered survey, which included maternal, infant, and sociodemographic information and breastfeeding-related characteristics. Logistic regressions were conducted to determine factors associated with suboptimal breastfeeding practice. FINDINGS About 20% (n = 281) of mothers reported delayed initiation of breastfeeding. Mothers who were unsatisfied with the infant's gender had higher odds of delayed breastfeeding (adjusted odds ratio [AOR]: 1.42, 95% confidence interval [CI]: 1.00, 2.00). Odds of delayed initiation were significantly lower among mothers who received 7-10 antenatal checkups (AOR: 0.59, 95% CI: 0.41, 0.87) and assistance during breastfeeding (AOR: 0.73, 95% CI: 0.57, 0.95). About half (51.4%) the sample did not breastfeed exclusively for the first 6 months. Older age was associated with lower odds of nonexclusive breastfeeding (AOR: 0.95, 95% CI: 0.92, 1.00). Compared with mothers with no education, mothers with primary education (AOR: 1.94, 95% CI: 1.35, 2.79) or more than primary education (AOR: 1.58, 95% CI: 1.10, 2.26) had higher odds of nonexclusive breastfeeding. CONCLUSIONS Optimal breastfeeding practices were influenced by a multitude of factors, including maternal age, education, number of antenatal checkups, receiving assistance with breastfeeding, and satisfaction with the infant's gender. Health promotion efforts should focus on encouraging mothers to attend antenatal care visits. Early antenatal education and counseling should include breastfeeding education in early antenatal visits. Further research should examine how to mitigate the effect of gender preference on initiation of breastfeeding.
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Affiliation(s)
- Sreenivas P Veeranki
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX
| | - Holly Nishimura
- School of Public Health, University of California Berkeley, Berkeley, CA
| | - Karl Krupp
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL; Public Health Research Institute of India, Mysore, India
| | - Savitha Gowda
- Public Health Research Institute of India, Mysore, India
| | - Anjali Arun
- Public Health Research Institute of India, Mysore, India
| | - Purnima Madhivanan
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL; Public Health Research Institute of India, Mysore, India.
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Abstract
BACKGROUND In-training evaluation reports are a commonly used assessment method for clinical learners that can characterise the development of competence in essential domains of practice. Strategies to increase the usefulness and specificity of written narrative comments about learner performance in these reports are needed to guide their learning. Soliciting narrative comments by competency domain from supervising doctors on in-training evaluation reports could improve the quality of written feedback to students. METHODS This is a pre-post study examining narrative comments derived from assessments of core clerkship students by faculty members and resident supervisors in seven clerkships using two assessment forms in academic years 2013/14 (pre; two comments fields - summative, constructive) and 2014/15 (post; seven comments fields - six competency domains, constructive comments). Using a purposive sample of 60 students based on overall clerkship performance, we conducted content analysis of written comments to compare comment quality based on word count, competencies addressed and reinforcing or constructive content. Differences between the two forms across these three components of quality were compared using Student's t-tests. RESULTS The revised form elicited more narrative comments in all seven clerkships, with more competencies addressed. The revised form led to a decrease in the proportion of constructive comments about the students' performances. In-training evaluation reports are a commonly used assessment method for clinical learners DISCUSSION: Structural changes to a medical student assessment form to elicit narrative comments by competency improved some measures of the quality of narrative comments provided by faculty members and residents. Additional study is needed to determine how learners use this information to improve their clinical practice.
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Affiliation(s)
- Karen E Hauer
- University of California at San Francisco, San Francisco, California, USA
| | - Holly Nishimura
- University of California at San Francisco, San Francisco, California, USA
| | - Diego Dubon
- University of California at Berkeley, Berkeley, California, USA
| | - Arianne Teherani
- University of California at San Francisco, San Francisco, California, USA
| | - Christy Boscardin
- University of California at San Francisco, San Francisco, California, USA
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Naganuma R, Sato S, Kudo A, Sato C, Uwatoko H, Shirai S, Nishimura H, Takahashi I, Matsushima M, Kano T, Yabe I, Houzen H, Sasaki H. Long term observation of Lambert-Eaton myasthenic syndrome patients treated with 3,4-diaminopyridine. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Nakamura M, Nishikawa R, Hashimoto N, Ishihara T, Uezono H, Harada A, Mayahara H, Ejima Y, Nishimura H. Dosimetric Parameters Predicting Local Failure after Stereotactic Body Radiation Therapy Using the Robotic Radiosurgery System for Oligometastatic Lesions in the Lung and Liver. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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32
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Fukada S, Anderl RA, Pawelko RJ, Smolik GR, Schuetz ST, O’Brien JE, Nishimura H, Hatano Y, Terai T, Petti DA, Sze DK, Tanaka S. Flibe-D2Permeation Experiment and Analysis. Fusion Science and Technology 2017. [DOI: 10.13182/fst03-a369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Fukada
- Kyushu University, Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan
| | - R. A. Anderl
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
| | - R. J. Pawelko
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
| | - G. R. Smolik
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
| | - S. T. Schuetz
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
| | - J. E. O’Brien
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
| | - H. Nishimura
- University of California, Center for Energy Research, San Diego, CA 92093-0417, USA
| | - Y. Hatano
- Toyama University, Gofuku, Toyama 930-8555, Japan
| | - T. Terai
- University of California, Center for Energy Research, San Diego, CA 92093-0417, USA
| | - D. A. Petti
- Idaho National Engineering and Environmental Laboratory (INEEL), Idaho Falls, ID 83415, USA
- The University of Tokyo, Hongo, Bunkyo-ku, Tokyo 113-8656, Japan
| | - D.-K. Sze
- University of California, Center for Energy Research, San Diego, CA 92093-0417, USA
| | - S. Tanaka
- University of California, Center for Energy Research, San Diego, CA 92093-0417, USA
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33
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Mima K, Azechi H, Johzaki Y, Kitagawa Y, Kodama R, Kozaki Y, Miyanaga N, Nagai K, Nagatomo H, Nakai M, Nishimura H, Norimatsu T, Shiraga H, Tanaka KA, Izawa Y, Nakao Y, Sakagami H. Present Status of Fast Ignition Research and Prospects of FIREX Project. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a762] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. Mima
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - H. Azechi
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Y. Johzaki
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Y. Kitagawa
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - R. Kodama
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Y. Kozaki
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - N. Miyanaga
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - K. Nagai
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - H. Nagatomo
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - M. Nakai
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - H. Nishimura
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - T. Norimatsu
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - H. Shiraga
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - K. A. Tanaka
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Y. Izawa
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - Y. Nakao
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
| | - H. Sakagami
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan
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34
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Motojima O, Yamada H, Komori A, Watanabe KY, Mutoh T, Takeiri Y, Ida K, Akiyama T, Asakura N, Ashikawa N, Chikaraishi H, Cooper WA, Emoto M, Fujita T, Fujiwara M, Funaba H, Goncharov P, Goto M, Hamada Y, Higashijima S, Hino T, Hoshino M, Ichimura M, Idei H, Ido T, Ikeda K, Imagawa S, Inagaki S, Isayama A, Isobe M, Itoh T, Itoh K, Kado S, Kalinina D, Kaneba T, Kaneko O, Kato D, Kato T, Kawahata K, Kawashima H, Kawazome H, Kobuchi T, Kondo K, Kubo S, Kumazawa R, Lyon JF, Maekawa R, Mase A, Masuzaki S, Mito T, Matsuoka K, Miura Y, Miyazawa J, More R, Morisaki T, Morita S, Murakami I, Murakami S, Mutoh S, Nagaoka K, Nagasaki K, Nagayama Y, Nakamura Y, Nakanishi H, Narihara K, Narushima Y, Nishimura H, Nishimura K, Nishiura M, Nishizawa A, Noda N, Notake T, Nozato H, Ohdachi S, Ohkubo K, Ohyabu N, Oyama N, Oka Y, Okada H, Osakabe M, Ozaki T, Peterson BJ, Sagara A, Saida T, Saito K, Sakakibara S, Sakamoto M, Sakamoto R, Sasao M, Sato K, Seki T, Shimozuma T, Shoji M, Sudo S, Takagi S, Takahashi Y, Takase Y, Takenaga H, Takeuchi N, Tamura N, Tanaka K, Tanaka M, Toi K, Takahata K, Tokuzawa T, Torii Y, Tsumori K, Watanabe F, Watanabe M, Watanabe T, Watari T, Yamada I, Yamada S, Yamaguchi T, Yamamoto S, Yamazaki K, Yanagi N, Yokoyama M, Yoshida N, Yoshimura S, Yoshimura Y, Yoshinuma M. Review on the Progress of the LHD Experiment. Fusion Science and Technology 2017. [DOI: 10.13182/fst04-a535] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- O. Motojima
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Yamada
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Komori
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Y. Watanabe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Mutoh
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Takeiri
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Ida
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Akiyama
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Asakura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Ashikawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Chikaraishi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - W. A. Cooper
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Emoto
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Fujita
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Fujiwara
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Funaba
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - P. Goncharov
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Goto
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Hamada
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Higashijima
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Hino
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Hoshino
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Ichimura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Idei
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Ido
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Ikeda
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Imagawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Inagaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Isayama
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Isobe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Itoh
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Itoh
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Kado
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - D. Kalinina
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Kaneba
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - O. Kaneko
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - D. Kato
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Kato
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Kawahata
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Kawashima
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Kawazome
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Kobuchi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Kondo
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Kubo
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - R. Kumazawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - J. F. Lyon
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - R. Maekawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Mase
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Masuzaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Mito
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Matsuoka
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Miura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - J. Miyazawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - R. More
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Morisaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Morita
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - I. Murakami
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Murakami
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Mutoh
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Nagaoka
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Nagasaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Nagayama
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Nakamura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Nakanishi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Narihara
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Narushima
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Nishimura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Nishimura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Nishiura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Nishizawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Noda
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Notake
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Nozato
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Ohdachi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Ohkubo
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Ohyabu
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Oyama
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Oka
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Okada
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Osakabe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Ozaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - B. J. Peterson
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - A. Sagara
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Saida
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Saito
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Sakakibara
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Sakamoto
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - R. Sakamoto
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Sasao
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Sato
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Seki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Shimozuma
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Shoji
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Sudo
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Takagi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Takahashi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Takase
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - H. Takenaga
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Takeuchi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Tamura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Tanaka
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Tanaka
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Toi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Takahata
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Tokuzawa
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Torii
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Tsumori
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - F. Watanabe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Watanabe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Watanabe
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Watari
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - I. Yamada
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Yamada
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - T. Yamaguchi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Yamamoto
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - K. Yamazaki
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Yanagi
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Yokoyama
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - N. Yoshida
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - S. Yoshimura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - Y. Yoshimura
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
| | - M. Yoshinuma
- National Institute for Fusion Science, 322-6 Oroshi-cho, Toki-shi, Gifu-ken 509-5292, Japan
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35
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Yogo A, Mima K, Iwata N, Tosaki S, Morace A, Arikawa Y, Fujioka S, Johzaki T, Sentoku Y, Nishimura H, Sagisaka A, Matsuo K, Kamitsukasa N, Kojima S, Nagatomo H, Nakai M, Shiraga H, Murakami M, Tokita S, Kawanaka J, Miyanaga N, Yamanoi K, Norimatsu T, Sakagami H, Bulanov SV, Kondo K, Azechi H. Boosting laser-ion acceleration with multi-picosecond pulses. Sci Rep 2017; 7:42451. [PMID: 28211913 PMCID: PMC5304168 DOI: 10.1038/srep42451] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/09/2017] [Indexed: 11/28/2022] Open
Abstract
Using one of the world most powerful laser facility, we demonstrate for the first time that high-contrast multi-picosecond pulses are advantageous for proton acceleration. By extending the pulse duration from 1.5 to 6 ps with fixed laser intensity of 1018 W cm-2, the maximum proton energy is improved more than twice (from 13 to 33 MeV). At the same time, laser-energy conversion efficiency into the MeV protons is enhanced with an order of magnitude, achieving 5% for protons above 6 MeV with the 6 ps pulse duration. The proton energies observed are discussed using a plasma expansion model newly developed that takes the electron temperature evolution beyond the ponderomotive energy in the over picoseconds interaction into account. The present results are quite encouraging for realizing ion-driven fast ignition and novel ion beamlines.
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Affiliation(s)
- A. Yogo
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
- PRESTO, Japan Science and Technology Agency, Kawaguchi, Saitama 332-0012, Japan
| | - K. Mima
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
- The Graduate School for the Creation of New Photon Industries, Hamamatsu, Shizuoka 431-1202, Japan
| | - N. Iwata
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - S. Tosaki
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - A. Morace
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - Y. Arikawa
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - S. Fujioka
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - T. Johzaki
- Graduate School of Engineering, Hiroshima University, Higashi-Hiroshima 739-8511, Japan
| | - Y. Sentoku
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - H. Nishimura
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - A. Sagisaka
- Kansai Photon Science Institute, National Institutes for Quantum and Radiological Science and Technology, Kizugawa 619-0215, Kyoto, Japan
| | - K. Matsuo
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - N. Kamitsukasa
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - S. Kojima
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - H. Nagatomo
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - M. Nakai
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - H. Shiraga
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - M. Murakami
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - S. Tokita
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - J. Kawanaka
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - N. Miyanaga
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - K. Yamanoi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - T. Norimatsu
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
| | - H. Sakagami
- National Institute for Fusion Science, Gifu 509-5292, Japan
| | - S. V. Bulanov
- Kansai Photon Science Institute, National Institutes for Quantum and Radiological Science and Technology, Kizugawa 619-0215, Kyoto, Japan
| | - K. Kondo
- Kansai Photon Science Institute, National Institutes for Quantum and Radiological Science and Technology, Kizugawa 619-0215, Kyoto, Japan
| | - H. Azechi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Osaka, Japan
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Abstract
BACKGROUND Physicians will be called upon to care for patients who bear the burden of disease from the impact of climate change and ecologically irresponsible practices which harm ecosystems and contribute to climate change. However, physicians must recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity in changing the status quo. Sustainable healthcare education (SHE), defined as education about the impact of climate change and ecosystem alterations on health and the impact of the healthcare industry on the aforementioned, is vital to prevention of adverse health outcomes due to the changing climate and environment. OBJECTIVE To systematically determine which and when a set of SHE objectives should be included in the medical education continuum. DESIGN Fifty-two SHE experts participated in a two-part modified-Delphi study. A survey was developed based on 21 SHE objectives. Respondents rated the importance of each objective and when each objective should be taught. Descriptive statistics and an item-level content validity index (CVI) were used to analyze data. RESULTS Fifteen of the objectives achieved a content validity index of 78% or greater. The remaining objectives had content validity indices between 58% and 77%. The preclinical years of medical school were rated as the optimal time for introducing 13 and the clinical years for introducing six of the objectives. Respondents noted the definition of environmental sustainability should be learned prior to medical school and identifying ways to improve the environmental sustainability of health systems in post-graduate training. CONCLUSIONS This study proposes SHE objectives for the continuum of medical education. These objectives ensure the identity of the physician includes the requisite awareness and competence to care for patients who experience the impact of climate and environment on health and advocate for sustainability of the health systems in which they work. ABBREVIATIONS CVI: Content validity index; SHE: Sustainable healthcare education.
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Affiliation(s)
- Arianne Teherani
- Department of Medicine and Center for Faculty Educators, School of Medicine, University of California, San Francisco, CA, USA
- CONTACT Arianne Teherani Department of Medicine and Center for Faculty Educators, School of Medicine, University of California, San Francisco 94143, CA, USA
| | - Holly Nishimura
- Center for Faculty Educators, School of Medicine, University of California, San Francisco, CA, USA
| | - Latifat Apatira
- Occupational Health Services, The Permanente Medical Group, South San Francisco, CA, USA
| | - Thomas Newman
- Departments of Epidemiology and Biostatistics and Pediatrics, School of Medicine, University of California, San Francisco, CA, USA
| | - Susan Ryan
- Department of Anesthesia, School of Medicine, University of California, San Francisco, CA, USA
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Nishimura H, Okuda I, Kunizawa N, Inoue T, Nakajima Y, Amano S. Analysis of morphological changes after facial massage by a novel approach using three-dimensional computed tomography. Skin Res Technol 2016; 23:369-375. [DOI: 10.1111/srt.12345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- H. Nishimura
- Division of Radiology; Ishikawajima Memorial Hospital; Tokyo Japan
| | - I. Okuda
- Department of Diagnostic Radiology; International University of Health and Welfare; Mita Hospital; Tokyo Japan
- Department of Radiology; St. Marianna University School of Medicine; Kanagawa Japan
| | - N. Kunizawa
- Shiseido Global Innovation Center; Kanagawa Japan
| | - T. Inoue
- Shiseido Global Innovation Center; Kanagawa Japan
| | - Y. Nakajima
- Department of Radiology; St. Marianna University School of Medicine; Kanagawa Japan
| | - S. Amano
- Shiseido Global Innovation Center; Kanagawa Japan
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Tanaka H, Furuya T, Kumazaki Y, Nakayama M, Nishimura H, Ruschin M, Pinnaduwage D, Phua J, Thibault I, St-Hilaire J, Ma L, Sahgal A, Shikama N, Karasawa K. An International Multi-Institutional Planning Study Reducing Interinstitutional Variations for Spine Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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39
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Sakai F, Sone S, Kawai T, Maruyama A, Kiyono K, Morimoto M, Haniuda M, Honda T, Ishii K, Ikeda SI, Kobayashi O, Nishimura H. Ultrasonography of Thymoma with Pathologic Correlation. Acta Radiol 2016. [DOI: 10.1177/028418519403500106] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Preoperative ultrasonograms of 11 surgically proved thymomas and ex vivo ultrasonograms of 3 resected specimens were compared with pathologic findings of resected specimens. Among 11 thymomas 7 appeared solid, 3 were solid with several cystic regions, and the remaining one was unilocular cystic in appearance. Cystic regions on ultrasonograms corresponded to cystic changes on pathologic specimens. Six malignant thymomas showed a typical lacy appearance on ultrasonograms, which corresponded to the lobulated configuration separated by fibrous septa shown on the pathologic specimens.
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Nakayama M, Munetomo Y, Ogata T, Uehara K, Tsudou S, Nishimura H, Mayahara H, Sasaki R. SU-F-T-293: Experimental Comparisons of Ionization Chambers with Different Volumes for CyberKnife Delivery Quality Assurance. Med Phys 2016. [DOI: 10.1118/1.4956478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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41
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Nishimura H, Yatich N, Huchko M. Facilitators and Barriers to Cervical Cancer Screening in Migori County, Kenya. J Glob Oncol 2016. [DOI: 10.1200/jgo.2016.003970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 77 Background: Cervical cancer, a disease that is largely preventable through organized screening programs, still impacts over 500,000 women every year. Sub-Saharan Africa has the highest global incidence and mortality, largely due to lack of screening coverage. Low-cost and simple-to-implement screening technologies can potentially impact the rates of cervical cancer, if they are acceptable and scalable. As part of a trial to evaluate implementation strategies for cervical cancer prevention in western Kenya, we sought to identify the barriers and facilitators of screening, as well as opinions on a strategy employing self-collection of specimens for human papillomavirus (HPV) testing. Methods: Providers and female community members were recruited for focus groups using purposive sampling. Two focus group discussions (FGDs) with community members (n=24) and one FGD with providers (n=12) and key stakeholders were held in Migori County, Kenya, using structured guides to assess and current cervical cancer knowledge, screening practices, barriers to screening and potential strategies to facilitate screening access and uptake, including self-collected HPV testing. Results: Participants in both groups assessed the education around HPV, cervical cancer, and screening as very low in the community, and identified this lack of education as the main barrier to screening. Community members reported fear of pain and embarrassment as significant barriers to a screening pelvic exam. They also reported that lack of knowledge and discomfort among providers were significant barriers. Having undergone screening themselves or talking to someone with experience increased willingness to screen. Providers reported workload and lack of supplies and trained staff as significant barriers. Most participants in both FGDs felt that self-collection would help address barriers. Women expressed willingness to self-collect if given adequate instructions and if knowledgeable counselors were present to discuss results. Conclusion: Cervical cancer prevention strategies employing effective educational components and self-collected HPV testing could address many of the identified barriers to screening. Key findings from analysis of the focus group transcripts will be used to inform the implementation of community health campaigns. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.
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Affiliation(s)
- Holly Nishimura
- Holly Nishimura, Nelly Yatich, and Megan Huchko, University of California, San Francisco
| | - Nelly Yatich
- Holly Nishimura, Nelly Yatich, and Megan Huchko, University of California, San Francisco
| | - Megan Huchko
- Holly Nishimura, Nelly Yatich, and Megan Huchko, University of California, San Francisco
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Sawada H, Fujioka S, Hosoda T, Zhang Z, Arikawa Y, Nagatomo H, Nishimura H, Sunahara A, Theobald W, Patel PK, Beg FN. Development of 4.5 keV monochromatic X-ray radiography using the high-energy, picosecond LFEX laser. ACTA ACUST UNITED AC 2016. [DOI: 10.1088/1742-6596/717/1/012112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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43
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Endo K, Suzuki H, Sawaji Y, Nishimura H, Yorifuji M, Murata K, Tanaka H, Shishido T, Yamamoto K. Relationship among cervical, thoracic, and lumbopelvic sagittal alignment in healthy adults. J Orthop Surg (Hong Kong) 2016; 24:92-6. [PMID: 27122521 DOI: 10.1177/230949901602400121] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate the association between cervical sagittal alignment and thoracic/lumbopelvic sagittal alignment in healthy Japanese adults. METHODS 30 male and 22 female healthy adults aged 22 to 50 years were recruited. Spinal parameters were measured on radiographs, including the cervical sagittal vertical axis, sagittal vertical axis, C7 tilt angle, Ishihara index for cervical lordosis, thoracic kyphosis, lumbar lordosis, sacral slope, pelvic tilt, and pelvic incidence. RESULTS The C7 tilt angle positively correlated with the Ishihara index (r=0.52, p<0.0001) and thoracic kyphosis (r=0.53, p<0.0001). The Ishihara index positively correlated with thoracic kyphosis (r=0.34, p=0.01) and C7 tilt angle (r=0.52, p<0.0001). Pelvic incidence positively correlated with sacral slope (r=0.45, p=0.001), lumbar lordosis (r=0.26, p=0.07), and pelvic tilt (r=0.29, p=0.03). Compared with men, women had a smaller Ishihara index (0.07 vs. 0.001, p=0.03), thoracic kyphosis (30.5º vs 24.1º, p=0.02), and C7 tilt angle (23.1º vs. 16.8º, p=0.02). Women had less cervical lordosis and thoracic kyphosis, that is, a straighter cervico-thoracic sagittal alignment. CONCLUSION In healthy Japanese adults, cervical sagittal alignment is associated with thoracic sagittal alignment but not with lumbopelvic alignment.
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Affiliation(s)
- K Endo
- Tokyo Medical University, Japan
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Nakamura R, Komatsu N, Murao T, Okamoto Y, Nakamura S, Fujita K, Nishimura H, Katsuki Y. The validity of the classification for lateral hinge fractures in open wedge high tibial osteotomy. Bone Joint J 2015; 97-B:1226-31. [PMID: 26330589 DOI: 10.1302/0301-620x.97b9.34949] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this study was to validate the efficacy of Takeuchi classification for lateral hinge fractures (LHFs) in open wedge high tibial osteotomy (OWHTO). In all 74 osteoarthritic knees (58 females, 16 males; mean age 62.9 years, standard deviation 7.5, 42 to 77) were treated with OWHTO using a TomoFix plate. The knees were divided into non-fracture (59 knees) and LHF (15 knees) groups, and the LHF group was further divided into Takeuchi types I, II, and III (seven, two, and six knees, respectively). The outcomes were assessed pre-operatively and one year after OWHTO. Pre-operative characteristics (age, gender and body mass index) showed no significant difference between the two groups. The mean Japanese Orthopaedic Association score was significantly improved one year after operation regardless of the presence or absence of LHF (p = 0.0015, p < 0.001, respectively). However, six of seven type I cases had no LHF-related complications; both type II cases had delayed union; and of six type III cases, two had delayed union with correction loss and one had overcorrection. These results suggest that Takeuchi type II and III LHFs are structurally unstable compared with type I. Cite this article: Bone Joint J 2015;97-B:1226-31.
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Affiliation(s)
- R Nakamura
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - N Komatsu
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - T Murao
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - Y Okamoto
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - S Nakamura
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - K Fujita
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - H Nishimura
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
| | - Y Katsuki
- Yawata Medical Center, 12-7, Komatsu, 923-8551, Japan
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Uruha A, Noguchi S, Sato W, Nishimura H, Mitsuhashi S, Yamamura T, Nishino I. Plasma IP-10 level distinguishes inflammatory myopathy. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Muromachi K, Kamio N, Matsuki-Fukushima M, Nishimura H, Tani-Ishii N, Sugiya H, Matsushima K. CCN2/CTGF expression via cellular uptake of BMP-1 is associated with reparative dentinogenesis. Oral Dis 2015; 21:778-84. [PMID: 25944709 DOI: 10.1111/odi.12347] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 04/08/2015] [Accepted: 04/27/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE CCN family member 2/connective tissue growth factor (CCN2/CTGF) is known as an osteogenesis-related molecule and is thought to be implicated in tooth growth. Bone morphogenetic protein-1 (BMP-1) contributes to tooth development by the degradation of dentin-specific substrates as a metalloprotease. In this study, we demonstrated the correlations between CCN2/CTGF and BMP-1 in human carious teeth and the subcellular dynamics of BMP-1 in human dental pulp cells. MATERIALS AND METHODS Expression of CCN2/CTGF and BMP-1 in human carious teeth was analyzed by immunohistochemistry. BMP-1-induced CCN2/CTGF protein expression in primary cultures of human dental pulp cells was observed by immunoblotting. Intracellular dynamics of exogenously administered fluorescence-labeled BMP-1 were observed using confocal microscope. RESULTS Immunoreactivities for CCN2/CTGF and BMP-1 were increased in odontoblast-like cells and reparative dentin-subjacent dental caries. BMP-1 induced the expression of CCN2/CTGF independently of protease activity in the cells but not that of dentin sialophosphoprotein (DSPP) or dentin matrix protein-1 (DMP-1). Exogenously added BMP-1 was internalized into the cytoplasm, and the potent dynamin inhibitor dynasore clearly suppressed the BMP-1-induced CCN2/CTGF expression in the cells. CONCLUSION CCN2/CTGF and BMP-1 coexist beneath caries lesion and CCN2/CTGF expression is regulated by dynamin-related cellular uptake of BMP-1, which suggests a novel property of metalloprotease in reparative dentinogenesis.
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Affiliation(s)
- K Muromachi
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, Yokosuka, Kanagawa, Japan.,Department of Endodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - N Kamio
- Department of Endodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - M Matsuki-Fukushima
- Division of Pathology, Department of Oral Diagnostic Sciences, School of Dentistry, Showa University, Shinagawa-ku, Tokyo, Japan
| | - H Nishimura
- Department of Oral Surgery, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
| | - N Tani-Ishii
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, Yokosuka, Kanagawa, Japan
| | - H Sugiya
- Laboratory of Veterinary Biochemistry, Nihon University College of Bioresource Sciences, Fujisawa, Kanagawa, Japan
| | - K Matsushima
- Department of Endodontics, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan.,Research Institute of Oral Science, Nihon University School of Dentistry at Matsudo, Matsudo, Chiba, Japan
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Uehara K, Ogata T, Nakayama M, Shinji T, Nishimura H, Masutani T, Ishihara T, Ejima Y, Sasaki R. SU-E-T-145: Beam Characteristics of Flattening Filter Free Beams Including Low Dose Rate Setting. Med Phys 2015. [DOI: 10.1118/1.4924507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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48
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Harada A, Sasaki R, Miyawaki D, Yoshida K, Nishimura H, Ejima Y, Kitajima K, Saito M, Otsuki N, Nibu KI. Treatment outcomes of the patients with early glottic cancer treated with initial radiotherapy and salvaged by conservative surgery. Jpn J Clin Oncol 2014; 45:248-55. [DOI: 10.1093/jjco/hyu203] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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49
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Sakata S, Arikawa Y, Kojima S, Ikenouchi T, Nagai T, Abe Y, Inoue H, Morace A, Utsugi M, Kato R, Nishimura H, Nakai M, Shiraga H, Fujioka S, Azechi H. Photonuclear reaction based high-energy x-ray spectrometer to cover from 2 MeV to 20 MeV. Rev Sci Instrum 2014; 85:11D629. [PMID: 25430205 DOI: 10.1063/1.4893943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A photonuclear-reaction-based hard x-ray spectrometer is developed to measure the number and energy spectrum of fast electrons generated by interactions between plasma and intense laser light. In this spectrometer, x-rays are converted to neutrons through photonuclear reactions, and the neutrons are counted with a bubble detector that is insensitive to x-rays. The spectrometer consists of a bundle of hard x-ray detectors that respond to different photon-energy ranges. Proof-of-principle experiment was performed on a linear accelerator facility. A quasi-monoenergetic electron bunch (Ne = 1.0 × 10(-6) C, Ee = 16 ± 0.32 MeV) was injected into a 5-mm-thick lead plate. Bremsstrahlung x-rays, which emanate from the lead plate, were measured with the spectrometer. The measured spectral shape and intensity agree fairly well with those computed with a Monte Carlo simulation code. The result shows that high-energy x-rays can be measured absolutely with a photon-counting accuracy of 50%-70% in the energy range from 2 MeV to 20 MeV with a spectral resolution (Δhν/hν) of about 15%. Quantum efficiency of this spectrometer was designed to be 10(-7), 10(-4), 10(-5), respectively, for 2-10, 11-15, and 15-25 MeV of photon energy ranges.
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Affiliation(s)
- S Sakata
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - Y Arikawa
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - S Kojima
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - T Ikenouchi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - T Nagai
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - Y Abe
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - H Inoue
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - A Morace
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - M Utsugi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - R Kato
- Institute of Scientific and Industrial Research, Osaka University, Ibaraki 565-0047, Japan
| | - H Nishimura
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - M Nakai
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - H Shiraga
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - S Fujioka
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
| | - H Azechi
- Institute of Laser Engineering, Osaka University, Suita 565-0871, Japan
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Miyawaki D, Ejima Y, Uezono H, Yoshida K, Nishimura H, Otsuki N, Nibu K, Sasaki R. Result of Multimodal Treatment Including Radiation Therapy for Squamous Cell Carcinomas of Maxillary Sinus: A Retrospective Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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