The Development of an Active Learning Program for the Medical Responders in a Nuclear Disaster.

OBJECTIVE: In Japan, with the revision of the Nuclear Emergency Response Guidelines in 2015, nuclear emergency medical assistance teams responsible for the medical treatment in the acute phase of nuclear disaster have been developed nationwide. The purpose of this research is to develop active learning materials for the education of medical staff, to confirm the educational effect of the materials, and to identify the gaps in nuclear disaster risk reduction in Japan. METHODS: We established a working group and created active learning materials. We trained members of the nuclear emergency medical assistance team using the developed active learning materials and then conducted a questionnaire survey for trainees who participated in the training. RESULTS: Regarding the developed teaching materials, out of 33 trainees, 33 (100%) answered "easy to understand" or "a little understandable" to the item dealing with how to use the radiation detectors and attaching/detaching personal protective equipment. Regarding the simulation about practicing hospital support and medical provision, 3 (8%) answered "a little confusing." CONCLUSION: The study demonstrated that the developed materials have an educational effect. Additionally, the results of the trainee questionnaire showed the necessity for improvement in the triage system and new protocols to help both the patients and responders.

Hemodynamic changes in the breast and frontal cortex of mothers during breastfeeding.

The objective of this study was to confirm physiological reactions in the breast and brain in mothers during breastfeeding and collect basic objective data, aiming at effective support for breastfeeding. Ten healthy women who were exclusively breastfeeding their babies participated in this study. Changes in the concentration of oxygenated Hb (oxyHb) and deoxygenated Hb in the breasts and frontal cortex of these women during breastfeeding lactation were measured using double-channel near-infrared spectroscopy (NIRS). Changes were measured in three conditions: (1) in both breasts; (2) the ipsilateral breast and frontal cortex; and (3) the contralateral breast and frontal cortex. OxyHb and total Hb (totalHb) levels in the bilateral breasts decreased significantly after the onset of breastfeeding in comparison with prebreastfeeding levels. These two values repeatedly increased and decreased thereafter. In the frontal cortex, regardless of which breast was involved, oxyHb and totalHb levels increased significantly in comparison with prebreastfeeding levels. Similar hemodynamic changes occurred simultaneously in the bilateral breasts during breastfeeding regardless of the feeding or nonfeeding side. Hemodynamic changes were also noted in the frontal cortex, but the reactions in the breast and prefrontal cortex were different and not synchronous, confirming that the physiological circulatory dynamics during breastfeeding vary among organs.

HEPC-based liposomes trigger cytokine release from peripheral blood cells: effects of liposomal size, dose and lipid composition.

The immune response caused by liposome stimulation was studied by assessing the level of several cytokines released from human peripheral blood cells. Liposome stimulation resulted in the release of IL-6, IL-10, IL-1beta, TNF-alpha and IFN-gamma. The size of the liposomes affected the degree of the cytokine releases with larger sized liposomes causing higher levels of cytokine induction. In addition, it appears that the lipid composition of liposomes had no effect on the degree of cytokine release. The release of cytokines occurred even in the absence of serum, suggesting that serum proteins did not contribute to liposome stimulation in peripheral blood cells. The release of cytokines induced by liposome stimulation was inhibited by the presence of either protein kinase-C (PKC) or protein tyrosine kinase (PTK) inhibitor, but not by the presence of an endocytosis inhibitor. This indicates that signal transduction via PKC or PTK is necessary, in order for human peripheral blood cells to release cytokines (IL-6, IL-10, IL-1beta, TNF-alpha and IFN-gamma) as the result of liposome stimulation. These quantitative data on the release of cytokines by liposomal stimulation provide useful information for the development of rational drug delivery systems and the safety of cytokine induction via the use of liposomes.