Efficacy and safety of intravenous ketamine treatment in Japanese patients with treatment-resistant depression: A double-blind, randomized, placebo-controlled trial.

AIM: Although the antidepressant effect of ketamine on treatment-resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD. METHODS: In this double-blind randomized placebo-controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post-treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score. RESULTS: Intention-to-treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (-8.1 ± 10.0 vs -2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per-protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (-9.1 ± 10.2 vs -2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score. CONCLUSION: Intravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations.

Model-based analysis to identify the impact of factors affecting electricity gaps during COVID-19: A case study in Germany.

The recent COVID-19 pandemic has precipitated drastic changes in economic and lifestyle conditions, significantly altering residual electricity demand behavior. This alteration has expanded the demand gap between actual and forecasted electricity usage based on pre-pandemic data, highlighting a critical global issue. Many studies in the pandemic have explored the features of this widening gap, which is impacted by major social events like fast virus spread and lockdowns. However, the influence of factors like economic shifts and lifestyle changes on this demand remains largely unexplored, primarily due to the pandemic's significant effects in these areas. Understanding the essential factors affecting the demand gap is crucial for stakeholders in the electricity sector to develop effective strategies. This study examines the hourly electricity consumption and related factors during the specified period. We present a method combining time-series forecasting and sparse modeling. This helps identify critical factors affecting the electricity demand gap during the pandemic, highlighting the most crucial variables. Utilizing this method, we identify the variables that have undergone significant changes during the pandemic and evaluate their effects on the electricity demand gap. The effectiveness is proven by applying it to the dataset collected in German.

Development and Validation of an E-Learning Educational Program for Acquiring Basic Knowledge in Inflammatory Bowel Disease Nursing.

Introduction: This study focuses on developing and validating an e-learning educational program for nurturing inflammatory bowel disease (IBD) nursing specialists. Methods: The program was developed using the attention, relevance, confidence, and satisfaction models within the instructional design framework. The program validation encompassed four steps: (1) nurses took a basic IBD knowledge test (pretest), (2) participants scoring <80% were encouraged to undergo web-based training, (3) a follow-up test (posttest) gauged post-training improvement, and (4) participant satisfaction with e-learning was assessed. Results: The analysis included 63 participants. The average score in the pretest was 81.3%, 40 participants exceeded the pretest passing score, which is 80% (average: 88.3%), and 23 participants failed (average: 69.1%). Of those who failed, 19 participants showed improvement after undergoing web-based training, with their posttest scores exceeding the passing threshold (average: 97.4%). The comparison results between the passing and failing groups revealed no correlation between the baseline characteristics of the participants. The participants were highly satisfied with the e-learning program. Conclusion: The program was effective as an educational program for acquiring basic knowledge to foster IBD nursing professionals. The learning design was adapted to the participants' lifestyles and tailored to the readiness of the nurse, ensuring a satisfactory e-learning user experience for the nurses.

Factors of Self-Care Agency in Patients with Inflammatory Bowel Disease in Japan.

Introduction: Currently, no self-care measurement tool specific to inflammatory bowel disease (IBD) exists in Japan. The Instrument for Diabetes Self-care Agency (IDSCA) is a reliable and valid self-care measurement tool for patients with diabetes. Factors affecting self-care ability assessed by IDSCA appear to meet the requirements for patients with IBD. Therefore, we created a self-care ability measurement tool adapted from IDSCA as an original draft for the Instrument for IBD Self-care Agency and extracted factors and items required to measure the self-care ability of patients with IBD. Methods: An anonymous questionnaire survey was distributed among 226 patients. Exploratory factor analysis examined the relationship of factors from multiple perspectives, identified factors based on their content, and confirmed their internal consistency. Statistical analyses were performed using JMP® 14.0.0. Results: Five factors with 23 items were extracted from the IDSCA, including ability to build a human support system, ability to acquire knowledge, ability to maintain self-care, ability to self-manage, and ability to self-assess. Cronbach's alpha was 0.765-0.861 for each factor and 0.904 for the entire scale. Conclusion: We could identify the self-care agencies of patients with IBD, including 5 factors and 23 items. Focusing on these self-care factors may provide critical information to guide nurses' self-care interventions.

Culturally Congruent Health Activities for the Prevention of Functional Disabilities Among Older Adults in Japan's Forest Communities.

INTRODUCTION: In Japan's forest areas, cultural capital and older adults play key roles in helping to sustain the community. The purpose was to explore cultural values/beliefs related to culturally congruent health activities among older adults in forest communities. METHOD: The qualitative ethnonursing research method was used. Data were collected through fieldwork and key informants' interviews (n = 14) over 1 year. The setting was a traditional village with 80% forest cover. RESULTS: Findings included two universal cultural values/beliefs, which were "community identity as a community member" and "our cohesion and connection as community members." Additionally, two diverse cultural values/beliefs were found: "gender-based differences" and "differences between those having experience working outside the forest community and those without this experience." These were related to community-based health activities. DISCUSSION: These values/beliefs were suggested to develop a multilayered network around health activities in order to prevent functional disabilities among older adults.

Simple but long-lasting: A specimen imaging method applicable for small- and medium-sized herbaria.

Major international herbaria, natural history museums and universities have recently begun to digitise their collections to facilitate studies and improve access to collections. In Japan, more than 10 million herbarium specimens are housed in various universities/museums; however, only 1% of these have been digitised. In this paper, we describe a new method for imaging herbarium specimens that is applicable to local/small herbaria. It is safe, fast, simple and inexpensive, but also satisfies usage guidelines for minimum image quality and can produce digital files suitable for long-term storage and future post production. During an eight-month trial at the Museum of Nature and Human Activities, Hyogo, with three part-time workers using a custom-made copy stand and a mirrorless interchangeable lens camera with a large LED light bank system, we were able to image 73,180 herbarium specimens (571 per day on average), obtaining two RAW and two JPEG files for each specimen.

Urgent Catheter Ablation in Octogenarians with Serious Tachyarrhythmias.

BACKGROUND: Urgent catheter ablation is often required for various tachyarrhythmias; however, its efficacy and safety in elderly patients have not been fully elucidated. METHODS: This study included consecutive octogenarians who underwent urgent radiofrequency catheter ablation (RFCA) for various serious tachyarrhythmias (urgent group, n=28) that were life-threatening, hemodynamically deleterious, or provoking ischemia, and consecutive octogenarians who underwent elective RFCA (control group, n=36). The rate of a successful RFCA, complications, later arrhythmia recurrences, and mortality were compared between the groups. RESULTS: There was no significant difference in the breakdown of the targeted arrhythmias between the groups, and common-type atrial flutter was most often targeted in both the urgent group (57%) and the elective group (56%). Compared with the control group patients, the patients of the urgent group were older (84±3 vs. 82±2 years P=0.001), with a higher frequency of baseline heart disease (68% vs. 17%, P<0.001) and lower left ventricular ejection fraction (45%±15% vs. 68%±10%, P<0.001). The rates of acute success (100% vs. 100%, P=1.00) and later arrhythmia recurrences (4% vs. 14%, P=0.22) were comparable between the groups. Two patients in the urgent group and 2 in the elective group had procedure-related nonlethal complications (7% vs. 6%, P=1.00): groin hematoma in 2, pressure ulcer in 1, and CO2 narcosis in 1. There were no in-hospital deaths, and mortality during follow-up did not differ between the urgent and elective groups (6.0% vs. 3.9% per year, log-rank P=0.38). CONCLUSION: Even in octogenarian patients, urgent catheter ablation for serious tachyarrhythmias can be safely performed with a high success rate and acceptable prognosis.

An estimation of generalized bradley-terry models based on the em algorithm.

The Bradley-Terry model is a statistical representation for one's preference or ranking data by using pairwise comparison results of items. For estimation of the model, several methods based on the sum of weighted Kullback-Leibler divergences have been proposed from various contexts. The purpose of this letter is to interpret an estimation mechanism of the Bradley-Terry model from the viewpoint of flatness, a fundamental notion used in information geometry. Based on this point of view, a new estimation method is proposed on a framework of the em algorithm. The proposed method is different in its objective function from that of conventional methods, especially in treating unobserved comparisons, and it is consistently interpreted in a probability simplex. An estimation method with weight adaptation is also proposed from a viewpoint of the sensitivity. Experimental results show that the proposed method works appropriately, and weight adaptation improves accuracy of the estimate.

A grouped ranking model for item preference parameter.

Given a set of rating data for a set of items, determining preference levels of items is a matter of importance. Various probability models have been proposed to solve this task. One such model is the Plackett-Luce model, which parameterizes the preference level of each item by a real value. In this letter, the Plackett-Luce model is generalized to cope with grouped ranking observations such as movie or restaurant ratings. Since it is difficult to maximize the likelihood of the proposed model directly, a feasible approximation is derived, and the em algorithm is adopted to find the model parameter by maximizing the approximate likelihood which is easily evaluated. The proposed model is extended to a mixture model, and two applications are proposed. To show the effectiveness of the proposed model, numerical experiments with real-world data are carried out.