The Minimal Important Difference of Acoustic Voice Quality Index in the Treatment of Voice Disorders

OBJECTIVES

The acoustic voice quality index (AVQI) is a reliable tool that objectively assesses dysphonia levels using six acoustic parameters. Despite its high criterion-related concurrent validity, diagnostic accuracy, and minimal detectable change derived from test-retest reliability, the minimal important difference (MID) of the AVQI has not been tested before. This study aimed to estimate the MIDs of AVQI for improvement audibly perceived by clinicians and self-reported improvement by patients.

METHODS

A retrospective study was conducted on 110 patients who received treatment for voice disorders. Patients completed AVQI and Voice Handicap Index-10 (VHI-10) questionnaires before and after the therapy. The MIDs of the AVQI were estimated using the anchor of either auditory-perceptual judgment of total dysphonia levels by clinicians or the VHI-10 questionnaire by patients. A distribution-based approach was also used to complement the results.

RESULTS

First, using the auditory-perceptual anchor, a decrease of 0.95 in the AVQI was estimated as the MID for clinicians' perception, as a result of the receiver operating curve. Then, using the patient-reported anchor, an improvement of 1.36 in the AVQI was estimated as the MID for patients' voice-related disability. The distribution-based approach also ensured the anchor-based results of both the MIDs.

CONCLUSIONS

The AVQI is a reliable and valid tool for evaluating voice quality, and a 0.95 decrease in the AVQI represents a meaningful improvement for clinicians' perception, whereas a 1.36 decrease in the AVQI influences patients' self-reported disability. This study contributes to understanding the minimal change necessary for clinicians to make informed decisions and ensure patient satisfaction.

LEVEL OF EVIDENCE

3 Laryngoscope, 134:2805-2811, 2024.

Hybridization of layered double hydroxides with functional particles

Layered double hydroxides (LDHs) are a class of materials with useful properties associated with their anion exchange abilities as well as redox and adsorptive properties for a wide range of applications including adsorbents, catalysts and their supports, electrodes, pigments, ceramic precursors, and drug carriers. In order to satisfy the requirements for each application as well as to find alternative applications, the preparation of LDHs with the desired composition and particle morphology and post-synthetic modification by the host-guest interactions have been examined. In addition, the hybridization of LDHs with various functional particles has been reported to design materials of modified, improved, and multiple functions. In the present article, the preparation, the heterostructure and the application of hybrids containing LDHs as the main component are overviewed.

Nanoarchitectonics of a Smectite with 4,4'-Diammonium-α-truxillic Acid and Its Methyl Ester for the Removal of o-Phenylphenol and Biphenyl from Water

Adsorbents with hydrophilic and hydrophobic natures were designed by intercalating a bioderived molecule; 4,4'-diammonium-α-truxillic acid (4ATA) and 4,4'-diammonium-α-truxillic acid dimethyl ester (E4ATA), which both are bioderived molecules, into a smectite (purified bentonite) to concentrate o-phenylphenol and biphenyl, respectively, from water. The adsorption isotherm showed high affinity between the 4ATA-smectite hybrid and o-phenylphenol with a high Langmuir constant (0.98 L mg-1). Meanwhile, the E4ATA-smectite hybrid adsorbed biphenyl with a high Langmuir constant (3.61 L mg-1). The adsorption properties of 4ATA- and E4ATA-smectite hybrid were contributed by the chemical characteristics of 4ATA and E4ATA in the interlayer space of the smectite.

NiFe Layered Double Hydroxides with Controlled Composition and Morphology for the Efficient Removal of Cr(VI) from Water

A layered double hydroxide (LDH) composed of Ni2+ and Fe3+ with a Fe3+/(Ni2+ + Fe3+) ratio of 0.05, which is not commonly available, was successfully prepared by coprecipitation from an aqueous solution of glycerol containing nickel nitrate and iron nitrate. Precipitation using NaOH as a precipitating agent at room temperature or 120 °C under hydrothermal conditions gave products with micrometer-sized aggregates of nanometer-sized unshaped particles, while that using urea yielded LDHs with a foam-like porous architecture composed of platy particles with a size of 100-300 nm. The products were examined to remove Cr(VI) from an acidic (pH = 3) aqueous solution of K2Cr2O7 by adsorption and photocatalytic reduction. The foam-like porous NiFe-LDH exhibited the highest adsorbed amount (122 mg g-1) and rate (0.017 g mg-1 min-1) in the dark and the highest rate (0.012 min-1) of photocatalytic Cr(VI) reduction among the NiFe-LDHs prepared in the present study, which can be explained as a positive effect of the foam-like porous architecture. These performances were superior to those of other reported LDHs, showing the importance of the composition and the particle morphology to boost the removal of Cr(VI).

Absence of Anaphylactic Reactions to Injection of Hemoglobin Vesicles (Artificial Red Cells) to Rodents

The safety and efficacy of hemoglobin vesicles (HbVs) as artificial oxygen carriers encapsulating a purified and concentrated Hb solution in liposomes have been studied extensively. The HbV surface, modified with PEG by incorporating a PEG-conjugated phospholipid, is beneficial for storage and biocompatibility. However, it might be possible that interaction of PEG and the pre-existing anti-PEG antibody in the bloodstream causes acute adverse reaction. This study used two sets of experiments with rats and guinea pigs to ascertain whether the anti-PEG antibody generated by the PEG-modified HbV injection can induce anaphylactic reactions. SD rats received repeated intravenous injection of HbV at a dose rate of 16 or 32 mL/kg three times. Not anti-PEG IgG but anti-PEG IgM was detected. Nevertheless, no anaphylactic reaction occurred. Guinea pigs were used to study the presence of active systemic anaphylaxis further after injections of the PEG-modified liposomes used for HbV. The animals were sensitized by three repeated subcutaneous injections of PEG-modified liposomes (PEG-liposome) along with adjuvant at 1 week intervals. For comparison, unmodified liposomes (liposome) and 10 times excessively PEG-modified liposomes with ionizable lipid (10PEG-DODAP-liposome) were used. Inclusion of PEG modification induced not only anti-PEG IgM but also anti-PEG IgG. Three weeks after the final injection, intravenous injection of both PEG-liposome and liposome (1 mL/kg) induced no anaphylactic reaction. However, the injection of 10PEG-DODAP-liposome showed one lethal anaphylaxis case and one mild anaphylaxis case. Antisera obtained from the animal sensitized as described above were inoculated (0.05 mL) intradermally into fresh guinea pigs. The presence of passive cutaneous anaphylaxis was evaluated after intravenous injections (1 mL/kg) of three liposomes with Evans blue. No dye leakage was detected at any inoculated skin point for PEG-liposome or liposome, but a slight leakage was detected in one inoculated skin point for 10PEG-DODAP-liposome. These results indicate the absence of acute allergic reactions at repeated injections of HbVs despite the anti-PEG antibody induction. Not all the PEG-modified liposomes show anaphylaxis, and it may depend on the amount of PEGylated phospholipid and lipid composition of PEG-modified liposomes.

Swelling-Induced Chromotropism of Bionanocomposite Hydrogel Beads

Monodispersed gelatin hydrogel beads containing smectite with adsorbed cyanine dye exhibit chromotropic responses to compression and swelling/deswelling by solvent. Photoluminescence color of the beads changes by swelling in water (blue) and deswelling in ethanol (purple) reversibly. The forces generated by swelling/deswelling are thought to induce the transition between the J-aggregate and the monomer of cyanine dye adsorbed on smectite, giving the photoluminescent color changes.

Validation of Subharmonics Quantification Using Two-Stage Cepstral Analysis

OBJECTIVES

Hoarseness is primarily perceived as breathiness or roughness. Despite the various tools that quantitatively assess hoarseness, roughness has been difficult to quantify because of its complex acoustic structure, such as subharmonics. The parameter obtained from the two-stage cepstral analysis is promising for evaluating roughness. Thus, this study aimed to improve the accuracy of the parameter using a customized pitch setting and investigate the relationship between roughness and subharmonics.

STUDY DESIGN

The design is a retrospective study.

METHODS

Two-stage cepstral analysis was used to analyze the voice recordings of 455 participants, speech impaired and normal controls, using the Analysis of Dysphonia in Speech and Voice and Praat software. For validation, the ground truth of subharmonics was visually quantified using a narrowband spectrogram. The reliability and validity of the two-stage cepstral analysis and subharmonics measures on spectrograms were evaluated.

RESULTS

The two-stage cepstral analysis showed a very strong correlation (r = 0.963) between the two software programs. Intra- and inter-rater reliability of the subharmonics measures on spectrograms were also good. Two-stage cepstral analysis showed that even with customized pitch settings, the diagnostic systems and correlations for perceptual roughness and subharmonics were weak to moderate. The subharmonics measures on spectrograms showed a strong correlation with roughness and moderate diagnostic accuracy of subharmonics.

CONCLUSIONS

The two-stage cepstral analysis showed some improvement in diagnostic accuracy and correlation with customized pitch settings, but it did not sufficiently detect subharmonics or roughness. The analysis using subharmonics measures on spectrograms proved the high correlation between subharmonics and roughness, indicating that developing acoustic analysis parameters that sufficiently detect subharmonics is necessary.

Rehospitalisation rates after long-term follow-up of patients with severe mental illness admitted for more than one year: a systematic review

AIMS

This study aimed to conduct a systematic review of studies on the outcomes of long-term hospitalisation of individuals with severe mental illness, considering readmission rates as the primary outcome.

METHODS

Studies considered were those in which participants were aged between 18 and 64 years with severe mental illness; exposure to psychiatric hospitals or wards was long-term (more than one year); primary outcomes were readmission rates; secondary outcomes were duration of readmission, employment, schooling, and social participation; and the study design was either observational or interventional with a randomised controlled trial (RCT) design. Relevant studies were searched using MEDLINE, PsycINFO, Web of Science, CINAHL, and the Japan Medical Abstract Society. The final search was conducted on 1 February 2022. The risk of bias in non-randomised studies of interventions was used to assess the methodological quality. A descriptive literature review is also conducted.

RESULTS

Of the 11,999 studies initially searched, three cohort studies (2,293 participants) met the eligibility criteria. The risk of bias in these studies was rated as critical or serious. The 1-10 years readmission rate for patients with schizophrenia who had been hospitalised for more than one year ranged from 33 to 55%. The average of readmission durations described in the two studies was 70.5 ± 95.6 days per year (in the case of a 7.5-year follow-up) and 306 ± 399 days (in the case of a 3-8-year follow-up). None of the studies reported other outcomes defined in this study.

CONCLUSIONS

The readmission rates in the included studies varied. Differences in the follow-up period or the intensity of community services may have contributed to this variability. In countries preparing to implement de-institutionalisation, highly individualised community support should be designed to avoid relocation to residential services under supervision. The length of stay for readmissions was shorter than that for index admissions. The results also imply that discharge to the community contributes to improved clinical outcomes such as improved social functioning. The validity of retaining patients admitted because of the risk of rehospitalisation was considered low. Future research directions have also been discussed.

Association between glomerular filtration rate and plasma N-terminal pro-atrial natriuretic peptide concentration in dogs

OBJECTIVES

To investigate the association between plasma N-terminal pro-atrial natriuretic peptide concentration and glomerular filtration rate in dogs.

MATERIALS AND METHODS

Dogs were classified into four categories by bodyweight. Dogs were divided into four groups (Groups 1 to 4) based on glomerular filtration rate estimates using plasma iohexol clearance per bodyweight category. Generalised linear models were built to explore the relationship between plasma N-terminal pro-atrial natriuretic peptide concentration and glomerular filtration rate and the effect of confounders on plasma N-terminal pro-atrial natriuretic peptide concentration.

RESULTS

Fifty-three dogs were included (Group 1, 25; Group 2, seven; Group 3, five; and Group 4, 16). The medians (interquartile range) N-terminal pro-atrial natriuretic peptide concentrations for Groups 1 to 4 were 7224 pg/mL (4766 to 10,254 mg/dL), 8958 pg/mL (4935 to 11,271 mg/dL), 9280 pg/mL (9195 to 10,384 mg/dL) and 12,683 pg/mL (9133 to 19,217 mg/dL), respectively. Group 4, estimated to have the highest reduction in glomerular filtration rate, had a higher plasma N-terminal pro-atrial natriuretic peptide concentration than Groups 1 to 3. Based on the final generalised linear model, influencing factors for plasma N-terminal pro-atrial natriuretic peptide concentration were plasma iohexol clearance (-0.136; 95% confidence interval, -0.227 to -0.046) and bodyweight (-0.058; 95% confidence interval, -0.098 to -0.018).

CLINICAL SIGNIFICANCE

N-terminal pro-atrial natriuretic peptide concentration is associated with the glomerular filtration rate.

Novel Floating Adsorbent for Water Treatment: Organically Modified Layered Alkali Silicate by Facile Mechanochemical Reaction

Adsorption serves as an effective way to collect (remove) contaminants from aqueous solution. In the present study, a novel floating adsorbent was designed through surface modification of a layered alkali silicate (octosilicate) using a silane coupling reagent (chlorodimethyl[3-(2,3,4,5,6-pentafluorophenyl)propyl]silane) to collect metal ions from water. By conducting the grafting by solvent-free mechanochemical reaction at room temperature, the external surface of octosilicate was modified to be hydrophobic while preserving the ion exchange capability in the interlayer space. Characterizations of XRD, IR, SEM, TGA, 29Si MAS NMR, and 19F MAS NMR confirmed the successful grafting at the external surface of octosilicate particles. The modified silicate demonstrated buoyancy at the air-water interface, facilitating the concentration of methylene blue, Ni2+, and Pb2+ from aqueous solutions. The adsorbed amounts of metal ions on the floating adsorbent were greater than those reported for the common nonfloating adsorbents (zeolites, clays, and clay minerals).

Electrochemical and electrical characteristics of ball milled Cs2Ti6O13 modified by the surface-to-bulk migration of hydroxyl groups

Ball milling of solids under benign conditions leads to surface functionalization without altering the crystal structure and morphology. However, these additional surface functional groups are rarely fixed but instead mobilized across such ball milled solids. This phenomenon, including its effects on electrochemical and electrical properties, has received limited attention. We report herein that dry vibratory ball milling of lepidocrocite-type Cs2Ti6O13 generated hydroxyl groups which subsequently migrated from surfaces to bulk. The increased number of bulk hydroxyl groups is deduced from Raman, IR, and solid state 1H nuclear magnetic resonance spectroscopy, and thermogravimetric analysis. In contrast, the decrease in the relative proportion of surface hydroxyl groups/water and carbon-oxygen species was deduced from X-ray photoelectron spectroscopy. The inaccessible hydroxyl groups in ball milled Cs2Ti6O13 lead to a smaller amount of stored charge and increased charge transfer resistance, according to galvanostatic charge-discharge experiments and electrochemical impedance spectroscopy studies in 1 M Na2SO4. The alternating current electrical properties were also measured, revealing fundamental insights such as the one-dimensional conduction pathway and the relaxation time in microseconds. A model has been proposed for this surface-to-bulk migration of the hydroxyl groups, which competes with surface dangling bonds leading to particle agglomeration.

Controlled Phase Transformation and Crystal Growth of Titanium Dioxide from Anatase/Silica Core/Shell Particles

Anatase/silica core/shell particles were prepared by the hydrolysis and condensation of tetraethyl orthosilicate on anatase particles with the sizes of 9, 22, and 111 nm, respectively. The thickness of the silica layer was designed from ca. 3 to 14 nm by repeating the coating procedure on anatase with a particle size of 22 nm. By the heat treatment at 1000 °C, though the pristine anatase particles transformed to rutile, anatase remained for the silica-coated particles. Anatase particles (111 nm) transformed to rutile upon heating at 1100 °C, while the transformation was not observed for the smaller particles (9 and 22 nm). With the increase of the silica thickness to 14 nm, anatase did not transform to rutile even after heating at 1150 °C, while resulting in varied compositions of anatase and rutile after heating at 1200 °C. The crystal growth of anatase and rutile was also suppressed for the silica-coated particles compared with that seen for pristine anatase. Thus, the thermal transformation and crystal growth of titania were controlled by the coating with silica, and the effects were shown to affect the coating.

The Significant Influence of Hoarseness Levels in Connected Speech on the Voice-Related Disability Evaluated Using Voice Handicap Index-10

OBJECTIVES

This retrospective study examines the influence of voice quality in connected speech (CS) and sustained vowels (SV) on the voice-related disability in patients' daily living documented by Voice Handicap Index-10 (VHI-10).

METHODS

A total of 500 voice recordings of CS and SV samples from 338 patients with voice disturbances were included, along with the patients' age, diagnoses, maximum phonation time, and VHI-10. Dataset-1 comprised of 338 untreated patients, whereas Dataset-2 included 162 patients before and after phonosurgeries. As a preliminary study, the concurrent and diagnostic validities based on auditory-perceptual judgments were examined for cepstral peak prominence (CPP) and CPP smoothed (CPPS) for CS and SV tasks. Next, simple correlations and multivariate regression analyses (MRA) were performed to identify which of the acoustic measures for the CS or SV tasks significantly influenced the total score or improvement of VHI-10.

RESULTS

The preliminary study confirmed high correlations with hoarseness levels as well as the excellent diagnostic accuracy of CPP and CPPS for both CS and SV tasks. In Dataset-1, the simple correlations and MRA results showed that cepstral measures in both tasks demonstrated moderate correlations with, and significant contribution to the total score of VHI-10, respectively. However, in Dataset-2, the changes of cepstral measures, as well as the median pitch after phonosurgeries in the CS tasks only, showed significant contributions to the improvement of VHI-10.

CONCLUSION

The study demonstrated that the hoarseness levels in both the CS and SV tasks equivalently influenced the VHI-10 scores, and that the post-surgical change of voice quality only in the CS tasks influenced the improvement of voice-related disability in daily living.

Soap-Free Emulsion Composed of Polymer Solutions and an Aqueous Clay Suspension

Novel emulsification was found in the system of aqueous suspension of a clay mineral (a synthetic hectorite) and a solution of polyvinyl butyral in 1-butanol without using surface-active agents. Droplets of the oil phase exhibited different sizes depending on the concentration of polyvinyl butyral solution and aqueous clay suspension. Shearing force produced from the high viscosity of the clay suspension was a factor to lead oil droplets to size smaller. The clay mineral was confirmed to be in the water phase, not at the oil and water interface. The emulsion showed useful thermal stability up to 80 °C. The present emulsion was successfully applied as a platform of the photochromic reaction of spiropyran.

Synthesis of NiFe layered double hydroxides with varied layer charge densities: templating effect of dioctyl sulfosuccinate

NiFe layered double hydroxides (LDHs) intercalated with dioctyl sulfosuccinate with varied Fe3+/(Ni2+ + Fe3+) ratios (0.04–0.25) were prepared by constant-pH co-precipitation from an aqueous solution of Ni and Fe perchlorates...

A Case of Pharyngeal Stenosis Caused by Behçet's Disease Treated With Transoral Videolaryngoscopic Surgery

Behçet's disease is a refractory inflammatory disease characterized by recurrent oral aphthous ulcers. Ulcers are commonly seen in the oral cavity and the pharyngeal region. In patients with recurrent pharyngeal ulcers, pharyngeal stenosis may occur and leads to dysphagia. Herein, we report a case of pharyngeal stenosis caused by recurrent ulcers due to incomplete Behçet's disease. Prednisolone, colchicine, and infliximab were administered and resolved the pharyngeal ulcers, however, dysphagia persisted. To improve the swallowing function, a pharyngeal dilation surgery and transoral videolaryngoscopic surgery were performed, which resulted in an enlarged pharyngeal cavity. Oral intake of water was initiated the day after surgery, and after six days, the patient was able to take a normal diet. The pharyngeal stenosis had not recurred for one year after the surgery, and a normal diet continued without any dietary restrictions. Therefore, in a case of a severe oropharyngeal lesion, periodic follow-up and surgical interventions by an otolaryngologist are necessary.

Development of infectious mononucleosis as an unusual manifestation of COVID-19

It has generally been reported that patients with COVID-19 show a fever, cough, and/or respiratory failure as the most common clinical symptoms but some have unusual symptoms, such as anosmia, diarrhea, and throat pain. We herein report a 26-year-old woman with chief complaints of lymphadenopathy and a fever. First, she underwent a laboratory examination, which showed a high proportion of atypical lymphocytes (19%) and an increase in hepatic enzyme activities, and was then hospitalized with a diagnosis of infectious mononucleosis (IM). However, the blood examination did not show any increase in anti-Epstein-Barr virus VCM-IgM. Subsequently, she developed tonsillar hypertrophy with purulent plugs. An additional examination for infection of other pathogens revealed positivity only for SARS-CoV-2 in a loop-mediated isothermal amplification (LAMP) test. The patient was transferred to the COVID-19-specific isolation ward, and none of the ward staff, patients, or either of the two otolaryngologists who had directly examined this patient showed positive signs for SARS-CoV-2 in a LAMP test. Consequently, this case suggests that even if patients show clinical symptoms and signs of common diseases for otolaryngologists, such as IM, we should keep in mind the possibility of COVID-19 without arbitrarily assuming that IM is caused by Epstein-Barr virus.

Photoinduced movement: how photoirradiation induced the movements of matter

Pioneered by the success on active transport of ions across membranes in 1980 using the regulation of the binding properties of crown ethers with covalently linked photoisomerizable units, extensive studies on the movements by using varied interactions between moving objects and environments have been reported. Photoinduced movements of various objects ranging from molecules, polymers to microscopic particles were discussed from the aspects of the driving for the movements, materials design to achieve the movements and systems design to see and to utilize the movements are summarized in this review.

What outcomes in community mental health research are important to caregivers of people with schizophrenia? An exploratory qualitative analysis of an online survey

AIMS

This study investigated outcomes in community mental health research that were important to caregivers of people with schizophrenia.

METHODS

Using an online survey conducted from August 1 to 31, 2020, data were collected from caregivers belonging to the LINE Schizophrenia Family Association. Caregivers identified outcomes important in community mental health research. Two researchers categorized caregivers' statements into research outcomes.

RESULTS

A total of 132 caregivers completed the online selfreported questionnaire, and 296 caregiver statements were identified. Qualitative analysis identified 17 outcome categories. The caregivers tended to value having more free time, maintaining an appropriate relationship with people with schizophrenia, and being able to cope with their symptoms.

CONCLUSIONS

This exploratory study newly demonstrates the outcomes that caregivers of people with schizophrenia consider important in community mental health research. The findings may be useful in selecting outcomes for future studies of caregivers.

Multicenter survey clarifying phrases in emergency radiology reports

PURPOSE

Interactions between radiologists and emergency physicians are often diminished as imaging volume increases and more radiologists read off site. We explore how several commonly used phrasings are perceived by radiologists and emergency physicians to decrease ambiguity in reporting.

METHODS

An anonymous survey was distributed to attendings and residents at seven academic radiology and emergency departments across the USA via a digital platform as well as to an email group consisting of radiologists across the country with an interest in quality assurance. Physicians were asked to assign a percent score to probabilistic phrases such as, "suspicious of," or "concerned for." Additional questions including, "how often the report findings are reviewed," "what makes a good radiology report," and "when is it useful to use the phrase 'clinical correlation are recommended.'" Median scores and confidence intervals were compared using an independent Student's T-test.

RESULTS

Generally, there was agreement between radiologists and emergency room physicians in how they interpret probabilistic phrases except for the phrases, "compatible with," and "subcentimeter liver lesions too small to characterize." Radiologists consider a useful report to answer the clinical question, be concise, and well organized. Emergency physicians consider a useful report to be concise, definitive or include a differential diagnosis, answer the clinical question, and recommend a next step. Radiologists and emergency physicians did not agree on the usefulness of the phrase, "clinical correlation recommended," in which radiologists found the phrase more helpful under particular circumstances.

CONCLUSION

The survey demonstrated a wide range of answers for probabilistic phrases for both radiologists and emergency physicians. While the medians and means of the two groups were often different by statistical significance, the actual percent difference was minor. These wide range of answers suggest that use of probabilistic phrases may sometimes lead to misinterpretation between radiologist and emergency room physician and should be avoided or defined if possible.

Multiple stakeholders' perspectives on patient and public involvement in community mental health services research: A qualitative analysis

Background

Patient and public involvement (PPI) has become essential in health research. However, little is known about multiple stakeholders' perspectives on the implementation of PPI in community mental health research settings. The present study aimed to qualitatively analyse multiple stakeholders' views on PPI, including potential concerns, barriers and approaches.

Methods

This study involved conducting focus group interviews and collecting qualitative data from 37 participants in multiple stakeholder groups (patients = 6, caregivers = 5, service providers = 7, government staff = 5 and researchers = 14) in the community mental health field. The data were qualitatively analysed using a data‐driven approach that derived domains, themes and subthemes related to perspectives on PPI and to specific challenges and approaches for implementing PPI.

Results

The qualitative analysis identified four domains. The ‘Positive views and expectations regarding PPI’ domain consisted of themes related to supportive views of PPI in a mental health service research setting and improvements in the quality of research and service. The ‘General concerns about PPI’ domain included themes concerning the need for non‐PPI research and tokenism, excessive expectations concerning social changes and use of evidence from PPI research, and heavy burdens resulting from PPI. The ‘Specific issues regarding the implementation of PPI’ domain consisted of four themes, including academic systems, selection methods (e.g., representativeness and conflict of interest issues), relationship building, and ambiguous PPI criteria. In particular, all stakeholder groups expressed concerns about relational equality during PPI implementation in Japan. The ‘Approaches to PPI implementation’ domain included themes such as facilitating mutual understanding, creating a tolerant atmosphere, establishing PPI support systems (e.g., training, ethics and human resource matching) and empowering patient organizations.

Conclusion

The study replicated most of the barriers and approaches to PPI reported by qualitative research in Western counties. However, utilization of evidence produced by PPI research and partnership in the PPI process may be particularly serious issues in Japan. Future PPI studies should carefully address solutions that fit each culture.

Patient or Public Contribution

A patient‐researcher was involved in all stages of this project, from development of the research topic and the protocol to manuscript preparation.

A six-fold difference in structure results in a six-order difference in conductivity: silica shell nanoarchitectonics on carbon black particles

Carbon black (Ketchen Black with a particle size of several tens of nm) was coated with silica with a varied thickness of 2 and 12 nm. Carbon/silica core-shell particles were grafted with the γ-methacryloxypropylsilyl group to be homogeneously dispersed into a poly(methyl methacrylate) film. The electrical conductivity of the poly(methyl methacrylate) films containing carbon/silica particles was successfully controlled by the thickness of the silica layer; silica coating with 2 nm thickness gave a conducting film, while that with 12 nm thickness gave a less conducting film with a remarkable difference on the order of 10⁶ (in volume conductivity).

Handlebody decompositions of three-manifolds and polycontinuous patterns

We introduce the concept of a handlebody decomposition of a three-manifold, a generalization of a Heegaard splitting, or a trisection. We show that two handlebody decompositions of a closed orientable three-manifold are stably equivalent. As an application to materials science, we consider a mathematical model of polycontinuous patterns and discuss a topological study of microphase separation of a block copolymer melt.

Organophilic Clay with Useful Whiteness

An organophilic clay was obtained by the intercalation of dioctadecyldimethylammonium ions into the interlayer space of a purified bentonite. The organophilic clay was characterized by its excellent whiteness, which originated from the used purified bentonite with a low content of colored impurities, suitable for its practical application in paints, cosmetics, polymer additives, etc. The dioctadecyldimethylammonium-bentonite clay was applied as a support to accommodate polyaromatic molecules to afford luminescent hybrids with high luminescence efficiency, showing its usefulness as a component of photofunctional hybrid materials.

Depression prevention in healthcare workers during the COVID-19 pandemic

BACKGROUND

Few studies have assessed depression in healthcare workers (HCWs) in Japan owing to the coronavirus disease 2019 (COVID-19) pandemic, and no studies have proposed effective interventions to help support their mental health.

AIMS

To test the hypothesis that enhancing access to mental healthcare professionals helps to improve HCWs' mental health.

METHODS

This cross-sectional study assessed depressive symptoms in HCWs at three hospitals in Osaka prefecture between May and July, 2020. The survey obtained information on HCWs' mental state and related situations/perceptions. Multivariable logistic regression analysis was performed to identify factors associated with depressive symptoms.

RESULTS

Of the 3291 eligible HCWs, 1269 (39%) completed the survey. Of all HCWs, 87 (7%) were physicians, and 700 (55%) were nurses. A total of 181 (14%) HCWs had moderate-to-severe symptoms of depression. Being a frontline worker was not significantly associated with depressive symptoms (odds ratio: 0.86 [95% confidence intervals: 0.54-1.37], P = 0.50). The unwillingness to consult with anyone was significantly associated with more severe depressive symptoms (1.70 [1.10-2.63], P < 0.01). HCWs who had no opportunity to confide in family/friends (1.66 [1.10-2.52], P < 0.01) or colleagues/supervisors (3.19 [2.22-4.58], P < 0.001) were significantly more likely to have depressive symptoms.

CONCLUSIONS

Being a frontline HCW in a Japanese hospital treating patients with COVID-19 was not significantly associated with having depressive symptoms. The study highlights that encouraging daily communication with close persons (family, friends, colleagues and supervisors), rather than improving access to mental health professionals, might help to prevent depression in HCWs during the COVID-19 pandemic.

Mechanochromic Luminescence of Bionanocomposite Hydrogel

Bionanocomposite hydrogels were prepared from gelatin hydrogel and subsequent ionic crosslinking in the presence of the smectite with adsorbed cyanine dye (pseudoisocyanine). In addition to the improved mechanical properties achieved...

A novel geo-photocatalyst, an iron-containing layered clay mineral, for photocatalytic H2 evolution from water

An iron-containing layered clay mineral was discovered as a novel geo-photocatalyst found in nature for hydrogen evolution from water.

Facile solvothermal synthesis of plate-like submicron NaNbO3 particles

Platy particles of NaNbO3 were successfully prepared by a solvothermal reaction using a methanol/ethanol mixed solvent, in contrast to the formation of cubic NaNbO3 particles from methanol alone.

Composition-Dependent Thermal Stability and Water-Induced Self-Healing Behavior of Smectite/Waterborne Polymer Hybrid Film

By casting an aqueous suspension containing a water-soluble polymer, polyvinylpyrrolidone, and a layered silicate, synthetic hectorite, on the solid substrate, films with varied interlayer expansion were obtained depending on the composition. The thermal stability, water resistance, water-induced self-healing behavior, and adhesion were examined to find their composition dependence, which is thought to be originated from the nanostructure variation. Polyvinylpyrrolidone was thermally stable up to 300 °C for the hybrid with the polymer/clay weight ratio of 0.36 and 260 °C for the weight ratios of 1.08 and 1.80 as shown by the changes in the appearance and structure after heat treatment. The hybrid film with the polymer/clay ratio of 0.36 maintained the film shape when it was soaked in water for 24 h. The hybrids with the polymer/clay ratios of 1.08 and 1.80 were re-dispersed/dissolved into water after the immersion, while the water resistance of the films was enhanced by the thermal treatment at 200 °C for 2 h and showed very fast water-induced self-healing.

Outcomes frequently specified in Cochrane reviews of community-based psychosocial interventions for adults with severe mental illness: A systematic search and narrative synthesis

Background

Outcome selection in intervention studies is a critical issue for synthesizing evidence. This study is aimed to investigate outcomes used in Cochrane reviews assessing community‐based psychosocial interventions for adults with severe mental illness.

Methods

Cochrane reviews that evaluated a community‐based psychosocial intervention for adults with severe mental illness were searched electronically and manually. We extracted all outcomes specified in the Methods section in each Cochrane review. Outcomes that represent the same concept and context were synthesized into an outcome term. Outcome terms were categorized according to the existing taxonomy.

Results

We included 33 Cochrane reviews. Of the 216 outcome terms identified, 13 were used in more than half of the reviews: quality of life, mental state, admission to hospital, economic outcome, leaving the study early, social functioning, satisfaction, global state, relapse, adverse events/effects, carer satisfaction, employment, and duration of admission. Most outcome terms were categorized into the life impact core area (55%), followed by the resource use area (21%).

Conclusions

Our study provides a candidate outcome list for developing a core outcome set for severe mental illness and offers a basis for comparison for future outcome investigation on mental health research.

Two hundred and sixteen outcome terms were found by investigating all the outcomes used in 33 Cochrane reviews assessing community‐based psychosocial interventions for adults with severe mental illness. Thirteen outcome terms were used in more than half of the reviews: quality of life, mental state, admission to hospital, economic outcome, leaving the study early, social functioning, satisfaction, global state, relapse, adverse events/effects, carer satisfaction, employment, and duration of admission.

Consensus development of priority outcome domains for community mental health cares by multiple stakeholders: Protocol for an online Delphi study in Japan

Background

Treatment goals for mental illness have expanded from hospital discharge and improved functioning to employment, living alone, and personal realization. These changes in treatment goals have also influenced mental health research. Recent studies have addressed the development of core outcome sets focusing on clinical aspects of mental illness such as depression and anxiety. However, a well‐developed framework of essential outcomes for people with mental illness (service users) who live in the community is lacking. In addition, recent worldwide trends suggest more patient and public involvement and the importance of considering multiple stakeholders’ views in the area of mental health research. Purpose of this study is to explore consensus on high‐priority outcome domains among multiple stakeholders in community mental healthcare fields in Japan.

Methods

A three‐step approach to developing an outcome list will be used. First, we developed a long list of outcomes for community mental health through a literature review, focus group interviews with key stakeholders, and online questionnaire surveys of service users and caregivers. Second, the long list was checked and revised in a pilot study. Third, the long list will be shortened to the outcome list through the Delphi methodology with participation from multiple stakeholders.

Discussion

Identifying important common outcome domains through collaboration with multiple stakeholders appears to contribute to the development of evidence for community mental health research in Japan. In addition, the study process itself may help promote patient and public involvement in education, practice, and research in the field of community mental health.

Mechanochemical syntheses of all-inorganic iodide perovskites from layered cesium titanate and bismuth (and antimony) iodide

All-inorganic iodide perovskites were prepared by a mechanochemical reaction between a layered cesium titanate and bismuth (or antimony) triiodide under ambient conditions. The layered cesium titanate was a sacrificial template and also acted as a milling media for the formation of the perovskite nanoparticles with the size of a few nanometres.

Important Roles of Water Clusters Confined in a Nanospace as Revealed by a Synchrotron X-ray Diffraction Study

States of water molecules confined in a nanospace designed by montmorillonite (negatively charged silicate layer) and charge compensating benzylammonium were investigated. Caffeine was used as a probe because of its compatibility for the fine structure of the interlayer water. Powder synchrotron radiation X-ray diffraction (SXRD) and adsorption isotherms of the water vapor revealed a metastable structure of bimolecular water layers (2WLs) in the interlayer space. Water molecules readily penetrated to expand the interlayer space to 0.56 nm. The interlayer space did not increase further even in the presence of excess water. According to the isosteric heat of water, the expansion was limited because of moderate hydration as forming 2WLs. Caffeine molecules replaced a part of the water molecules in the 2WLs to expand the interlayer space to 0.65 nm. Time-resolved SXRD with an accumulation time of 500 ms revealed that the interlayer expansion reached a steady state within a few minutes. The caffeine intercalation proceeded, involving a change in the molecular orientation that increased the contact area of the caffeine molecules. The interlayer expansion was limited in all the solvents examined (mixtures of water with methanol, ethanol, acetone, and tetrahydrofuran), while the packing density of the incorporated caffeine was maximized in the absence of an organic solvent. The water molecules confined in the interlayer space acted as an actuator to accommodate a large quantity of amphiphilic molecules by adapting the nanostructure, which was achieved by releasing the confined water molecules.

Hydrophobic composite foams based on nanocellulose-sepiolite for oil sorption applications

TEMPO (2,2,6,6-tetramethylpiperidin-1-oxyl)-oxidized cellulose nanofibers (CNF) were assembled to fibrous clay sepiolite (SEP) by means of a high shear homogenizer and an ultrasound treatment followed by lyophilization using three different methods: normal freezing, directional freezing, and a sequential combination of both methods. Methyltrimethoxysilane (MTMS) was grafted to the foam surface by the vapor deposition method to introduce hydrophobicity to the resulting materials. Both the SEP addition (for the normal and directional freezing methods) and the refreezing preparation procedure enhanced the compressive strength of the foams, showing compressive moduli in the range from 28 to 103 kPa for foams loaded with 20% w/w sepiolite. Mercury intrusion porosimetry shows that the average pore diameters were in the range of 30-45 µm depending on the freezing method. This large porosity leads to materials with very low apparent density, around 6 mg/cm³, and very high porosity >99.5%. In addition, water contact angle measurement and Fourier-transform infrared spectroscopy (FTIR) were applied to confirm the foam hydrophobicity, which is suitable for use as an oil sorbent. The sorption ability of these composite foams has been tested using olive and motor oils as models of organophilic liquid adsorbates, observing a maximum sorption capacity of 138 and 90 g/g, respectively.

Clarification of the aspects of tongue-palate contacts during mastication with/without stage II transport

BACKGROUND

During mastication, the tongue presses the bolus into the pharynx by a "squeeze-back" motion, known as stage II transport (St2Tr). However, the pressure of St2Tr tongue-palate contact has not been examined.

OBJECTIVES

We aimed to clarify aspects of St2Tr occurrence and tongue-palate contact during mastication by measuring tongue pressure.

METHODS

Ten healthy adults (eight men, two women, aged 26.8 ± 2.2 years) were enrolled. Tongue pressure was measured (Swallow Scan) during mastication. Sensors were placed on the palate near the incisive papilla (Ch.1), in the middle (Ch.2), at the posterior (Ch.3), and near the first molars on the habitual (Ch.H) and non-habitual (Ch.Nh) masticatory sides. Nasopharyngeal endoscopy confirmed St2Tr and swallowing. Tongue pressures were measured repeatedly, from mastication onset through the first swallow, until eight sets of data were obtained. Tongue-palate contact frequencies, integrated values of tongue pressure, and mastication times were recorded for St2Tr(+) and St2Tr(-) mastication conditions.

RESULTS

St2Tr occurred in 43 of 80 trials (53.8%). St2Tr(+) exhibited the highest tongue-palate contact frequency at Ch.H; it exhibited higher contact frequencies at Ch.2, Ch.3 and Ch.H than St2Tr(-). St2Tr(+) exhibited higher tongue pressures at Ch.1, Ch.2 and Ch.H than at Ch.3; it exhibited higher tongue pressures at Ch.1 and Ch.2 than St2Tr(-).

CONCLUSION

The study suggested that during St2Tr, the tongue frequently touched the palate at the central and posterior regions, as well as at its habitual masticatory side. It applies the strongest pressure at the anterior and central palate to transport the bolus to the pharynx.

Formation of BiOX (X = Cl and Br) in a mesoporous silica by the infiltration of Bi salts and the subsequent reaction with HX vapor

The formation of BiOX (X = Br and Cl) nanoparticles in a mesoporous silica (SBA-15) was found by the reaction of the infiltrated bismuth oxo species with HX vapor at room temperature. The cylindrical pores of SBA-15 led to the directional growth of BiOX nanorods and control of the particle diameter.

Highly Luminescent Inorganic-Organic Hybrids with Molecularly Dispersed Perylene

A highly photoluminescent material was obtained by the incorporation of perylene into an inorganic-organic hybrid film. Octosilicate, a layered alkali silicate, was modified with a cationic surfactant, dioleyldimethylammonium ion, to accommodate perylene molecularly and uniformly. The perylene-doped dioleyldimethylammonium octosilicate films were fabricated by simply casting the toluene solution of perylene with dispersed dioleyldimethylammonium octosilicate on substrates. Near-unity photoluminescence quantum efficiency was achieved for hybrids containing a high concentration of perylene.

Skin Acceleration Levels Estimated by a Neck-surface Accelerometer during Phonation Are Affected by The Mechanical Properties of The Anterior Cervical Skin

OBJECTIVES

The aim of the present study was to assess whether skin acceleration levels (SAL) estimated by a neck-surface accelerometer (ACC) are affected by the anterior neck skin condition.

METHODS

Each of six healthy non-dysphonic participants wore a headset microphone (MIC), had an ACC sensor fitted on the skin over the cervical trachea, and were subsequently asked to gradually increase the vocal loudness during sustained phonation of the vowel /e:/ (crescendo task), while the sound pressure levels on a sound level meter (SPL_SLM) and MIC/ACC signals were simultaneously recorded. Root mean squared values were calculated from the MIC and ACC signals as the sound pressure level (SPL_MIC) and SAL, respectively, and the relationships between SPL_SLM and SAL were compared between neck anteflexion and retroflexion or between outward and inward skin retraction on both sides of the sensor.

RESULTS

In the total samples for the successful crescendo performance in a natural head position, the SPL_MIC and SPL_SLM showed a strong linear correlation (r=0.980), whereas the correlation between the SAL and SPL_SLM showed a distorted regression line (r=0.765) with individual differences. In all participants, the anteflexion and inward skin retraction decreased the SAL value at the same SPL_SLM value, whereas the retroflexion increased the SAL value at the same SPL_SLM value.

CONCLUSION

These results demonstrate that the signal intensity of a neck-surface ACC is affected by the condition of the anterior cervical skin, perhaps leading to inter-individual variability in SAL measurements.

Suppressing the Photocatalytic Activity of Titania by Precisely Controlled Silica Coating

A homogeneous thin silica layer with the thickness of a few nanometers was successfully deposited on an anatase particle by the hydrolysis and condensation of tetraethyl orthosilicate. The heat treatment of the titania/silica hybrid at 1000 °C led to the densification of the silica layer on the anatase particles. The anatase particle after the silica coating did not transform to rutile, and no change in the crystallite size was seen by the heat treatment at 1000 °C. The coating and subsequent heating were repeated to vary the thickness of the silica layer to obtain each coating with similar thickness by each coating procedure (ca. 3 and 2 nm, before and after the heat treatment). The samples were evaluated for the photocatalytic decomposition of methylene blue by the UV irradiation to find that the decomposition became slower after the coating and subsequent heat treatment, and the repeated procedures led to further suppression of the photocatalytic decomposition of methylene blue. The quite small decomposition rate constant (0.01 h^-1) was successfully achieved by the coating and subsequent heating for three times (the thickness of the dense silica layer was ca. 7 nm).

Preparation of MgGa Layered Double Hydroxides and Possible Compositional Variation

Layered double hydroxides (LDHs), shown as the general formula of [M2+1-xM3+x(OH)2]x+(An-)x/n∙yH2O, are useful for various applications such as anion exchangers/adsorbents, catalysts and catalysts' supports, and drug/gene carriers due to their structural, compositional and morphological characteristics and their variation. The x value (M3+/(M2+ + M3+) ratio) in layered double hydroxides (LDHs), corresponding to the layer charge density, is one of the important parameters for controlling the properties of LDHs. The x values in commonly available LDHs are limited (0.2 < x < 0.3). In order to obtain LDHs with x < 0.2, Mg2+ Ga3+-LDHs with interlayer iodide were examined. The linear correlation between lattice parameter a and x value in the products with x of 0.06-0.24 was seen, suggesting the successful substitution of Mg2+ in the brucite-like sheet with Ga3+. Carbonate and dodecyl sulfate types MgGa-LDH were prepared by ion exchange with carbonate anion and reconstruction in aqueous solution of sodium dodecyl sulfate. The products with x of 0.06 were dispersed in water and hexanol better than those with x of 0.24 for MgGa-LDHs containing carbonate and dodecyl sulfate, respectively, suggesting effects of the lower layer charge density on the dispersion.

Efficient Negative Photochromism by the Photoinduced Migration of Photochromic Merocyanine/Spiropyran in the Solid State

Efficient negative photochromism was achieved by the photoinduced migration of merocyanine in mesoporous silica to an organophilic clay as spiropyran. Depending on the nature of the organophilic clays (dioctadecyldimethylammonium and dioleyldimethylammonium clays), important differences in the negative photochromisms and the thermal coloration were observed; the dioleyldimethylammonium clay gave a higher yield (98%) and faster reaction (half-life t_1/2 = 2.8 h) than the dioctadecyldimethylammonium clay (94% and t_1/2 = 3.2 h) of the negative photochromism, indicating the important role of the surfactant assembly to control the molecular diffusion.