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Objective: We aimed to evaluate a proposed conceptual framework for quality assessment of medical interpretation using actual data from clinical settings., Methods: A mixed methods approach was used. Routine outpatient encounters involving Portuguese-speaking Brazilian patients, Japanese physicians, and hospital-provided and ad hoc interpreters were digitally recorded and transcribed. A questionnaire survey examining participants' satisfaction was conducted; 111 and 13 encounters by hospital-provided and ad hoc interpreters, respectively, were recorded. Segments of consecutively interpreted utterances were coded as "altered," whereby the interpreter changed the meaning of the source utterance, or "unaltered (accurate)." Frequency and type of alteration were analyzed. The effect of positive interpretation alterations on physician-patient interactions was qualitatively described., Results: Interpretation accuracy was significantly higher for hospital-provided interpreters, but was not associated with overall patient satisfaction. Overall physician satisfaction was associated with accurate interpretation, clinically negative altered interpretations, and positive voluntary interventions (p < 0.05). Positive alterations promoted patient, physician, and interpreter interactions, which helped to achieve clinical outcomes., Conclusion: A new conceptual framework for quality assessment of medical interpretation was developed for clinical settings. Healthcare provider satisfaction can provide a measure of interpretation alterations., Practice Implications: Healthcare providers can effectively use the conceptual framework to improve medical interpretation and collaboration with healthcare interpreters., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Pteris cretica is a native fern in temperate regions known for its ability to hyperaccumulate arsenic (As). However, the uptake and translocation of As in hydroponic conditions have remained poorly understood. In this study, we modified a hydroponic cultivation system, combining 24 plants into one unit, to suppress individual differences among plants and evaluate As uptake and translocation in P. cretica. The 7-day short-term As removal experiment results revealed that the As uptake rate by P. cretica appears to be dependent on the initial As concentration in the hydroponic medium. Furthermore, the rhizomes play a role in regulating As translocation from roots to fronds in P. cretica was observed. In the 27-day long-term continuous flow experiment, approximately 1 mg/d of As was removed by P. cretica with 200 μg/L As applied. Moreover, the long-term translocation factor (TF) between rhizomes and roots and between fronds and rhizomes from the 27-day long-term continuous flow experiment demonstrated the same pattern as the short-term TF from the 7-day short-term As removal experiment, further indicating the role of rhizomes in regulating As translocation from roots to fronds in P. cretica., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

A passive treatment process using sulfate-reducing bacteria (SRB) is known to be effective in removing heavy metals from acid mine drainage (AMD), though there has been little discussion of the mechanism involved to date. In this work, a sulfate-reducing column test was carried out using supplementary ethanol as an electron donor for microorganisms, and the reaction mechanism was examined using geochemical modeling and X-ray absorption fine structure (XAFS) analysis. The results showed that Cu was readily removed from the AMD on the top surface of the column (0-0.2 m), while Zn and Cd depletion was initiated in the middle of the column (0.2-0.4 m), where sulfide formation by SRB became noticeable. Calculations by a developed geochemical model suggested that ethanol decomposition by aerobic microbes contributed to the reduction of Cu, while sulfide produced by SRB was the major cause of Zn and Cd removal. XAFS analysis of column residue detected ZnS, ZnSO 4 (ZnS oxidized by atmospheric exposure during the drying process), and CuCO 3 , thus confirming the validity of the developed geochemical model. Based on these results, the application of the constructed geochemical model to AMD treatment with SRB could be a useful approach in predicting the behavior of heavy metal removal.

Typically, sulfate-reducing bioreactors used to treat acid mine drainage (AMD) undergo an initial incubation period of a few weeks to acclimatize sulfate-reducing bacteria (SRB), although necessity of this preincubation has rarely been evaluated. To reduce time and economic cost, we developed an SRB acclimatization method using the continuous flow of AMD into bioreactors fed with rice bran, and compared with the conventional acclimatization method. We found that the SRB sufficiently acclimatized without the preincubation phase. Furthermore, we examined the performance and SRB communities in bioreactors operated for >200 days under seven different conditions, in which the amount of rice bran added and hydraulic retention times (HRTs) were varied. A comparison of the various bioreactor conditions revealed that the lowest rice bran amount (50 g) and the shortest HRT (6 h) caused a deterioration in reactor performance after day 144 and 229, respectively. In both cases, relatively aerobic environments developed due to the lack of organic matter seemed to inhibit sulfate reduction. Of the conditions tested, operation of the bioreactors with 200 g of rice bran and an HRT of 12.5 h was the most effective in treating AMD, showing a sulfate reduction rate of 20.7-77.9% during days 54-242. DATA AND MATERIALS AVAILABILITY: All data needed to evaluate the conclusions of this study are presented in the paper and/or the appendix., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Sulfate-reducing bioreactors, also called biochemical reactors, represent a promising option for passive treatment of mining-influenced water (MIW) based on similar technology to aerobic/anaerobic-constructed wetlands and vertical-flow wetlands. MIW from each mine site has a variety of site-specific properties related to its treatment; therefore, design factors, including the organic substrates and inorganic materials packed into the bioreactor, must be tested and evaluated before installation of full-scale sulfate-reducing bioreactors. Several full-scale sulfate-reducing bioreactors operating at mine sites provide examples, but holistic understanding of the complex treatment processes occurring inside the bioreactors is lacking. With the recent introduction of high-throughput DNA sequencing technologies, microbial processes within bioreactors may be clarified based on the relationships between operational parameters and key microorganisms identified using high-resolution microbiome data. In this review, the test design procedures and precedents of full-scale bioreactor application for MIW treatment are briefly summarized, and recent knowledge on the sulfate-reducing microbial communities of field-based bioreactors from fine-scale monitoring is presented.Key points• Sulfate-reducing bioreactors are promising for treatment of mining-influenced water.• Various design factors should be tested for application of full-scale bioreactors.• Introduction of several full-scale passive bioreactor systems at mine sites.• Desulfosporosinus spp. can be one of the key bacteria within field-based bioreactors.

Five types of sulfate-reducing passive bioreactors with rice bran as substrate were operated at three different mine sites under various operating conditions to investigate and compare the dominant sulfate-reducing bacteria (SRBs) involved in acid mine drainage (AMD) treatment. In all bioreactors, AMD was properly treated under the national effluent standard of Japan when 16 samples in total were taken from different depths of the bioreactors at different sampling times. Analysis of the microbiomes in the five bioreactors by Illumina sequencing showed that Desulfosporosinus spp. were dominant SRBs in all bioreactors (the relative abundances were ~ 26.0% of the total population) regardless of reactor configurations, sizes, and operating conditions. This genus is known to comprise spore-forming, acid-tolerant, and oxygen-resistant SRBs with versatile metabolic capabilities. Microbial populations of AMD water and soil samples (as inocula) from the respective mine sites were also analyzed to investigate the origin of the genus Desulfosporosinus. Desulfosporosinus spp. were detectable in most AMD water samples, even at low relative abundances (0.0025 to 0.0069% of total AMD population), suggesting that the genus Desulfosporosinus is present within the AMD water that flows into the bioreactor. These data strongly imply that the passive treatment system is a versatile and widely applicable process for AMD treatment.

A unique solution-based technology to manufacture self-assembled ultrathin organic-semiconductor layers with ultrauniform single-molecular-bilayer thickness over an area as large as wafer scale is developed. A novel concept is adopted in this technique, based upon the idea of geometrical frustration, which can effectively suppress the interlayer stacking (or multilayer crystallization) while maintaining the assembly of the intralayer, which originates from the strong intermolecular interactions between π-conjugated molecules. For this purpose, a mixed solution of extended π-conjugated frameworks substituted asymmetrically by alkyl chains of variable lengths (i.e., (πCore)-C n 's) is utilized for the solution process. A simple blade-coating with a solution containing two (πCore)-C n 's with different alkyl chain lengths is effective to provide single molecular bilayers (SMBs) composed of a pair of polar monomolecular layers, which is analogical to the cell membranes of living organisms. It is demonstrated that the chain-length disorder does not perturb the in-plane crystalline order, but acts effectively as a geometrical frustration to inhibit multilayer crystallization. The uniformity, stability, and size scale are unprecedented, as produced by other conventional self-assembly processes. The obtained SMBs also exhibit efficient 2D carrier transport as organic thin-film transistors. This finding should open a new route to SMB-based ultrathin superflexible electronics., (© 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

For acceleration of removing toxic metals from acid mine drainage (AMD), the effects of hydraulic retention time (HRT) and pH on the reactor performance and microbial community structure in the depth direction of a laboratory-scale packed-bed bioreactor containing rice bran as waste organic material were investigated. The HRT was shortened stepwise from 25 to 12 h, 8 h, and 6 to 5 h under the neutral condition using AMD neutralized with limestone (pH 6.3), and from 25 to 20 h, 12 h, and 8 to 7 h under the acid condition using AMD (pH 3.0). Under the neutral condition, the bioreactor stably operated up to 6 h HRT, which was shorter than under the acid condition (up to 20 h HRT). During stable sulfate reduction, both the organic matter-remaining condition and the low oxidation-reduction potential condition in lower parts of the reactor were observed. Principal coordinate analysis of Illumina sequencing data of 16S rRNA genes revealed a dynamic transition of the microbial communities at the boundary between stable and unstable operation in response to reductions in HRT. During stable operation under both the neutral and acid conditions, several fermentative operational taxonomic units (OTUs) from the phyla Firmicutes and Bacteroidetes dominated in lower parts of the bioreactor, suggesting that co-existence of these OTUs might lead to metabolic activation of sulfate-reducing bacteria. In contrast, during unstable operation at shorter HRTs, an OTU from the candidate phylum OP11 were found under both conditions. This study demonstrated that these microorganisms can be used to monitor the treatment of AMD, which suggests stable or deteriorated performance of the system.

Objectives　This study aimed to investigate the need for medical interpreters, in relation to hospital size, the number of foreign patients accepting, and risk management in municipal hospitals in Japan.Methods　In 2016, we conducted a questionnaire survey at 894 municipal hospitals in Japan. The questionnaire included hospital characteristics, the number of foreign patients, the need for medical interpreters, and the respondents' background. We used the incident classification of the Safety Management Council of National University Hospitals (0-5 levels and others). We applied pairwise analysis to hospital size: small hospitals (20-99 beds), medium hospitals (100-399 beds), and large hospitals (400 or more beds).Results　The response rates of the small, medium, and large hospital were 30.1%, 32.5%, and 32.8%, respectively. The percentage of hospitals that had accepted foreign patients over the previous year ranged from 84.9% to 97.6%, a higher with larger hospitals. Larger hospitals attended to emergencies, hospitalization, and surgical patients more frequently than the smaller hospitals. Hospital staff who communicated with non-Japanese-speaking foreign patients via ad-hoc interpreters accompanying the patients ranged from 84.3% to 86.7% in larger hospitals. Of the staff at small, medium, and large hospitals, 66.7%, 58.5%, and 44.7%, respectively, considered the interpretations of the ad-hoc interpreters accompanying the patient to be accurate. Of the small, medium, and large hospitals, 31.6%, 76.5% and 92.3% claimed that they would use interpreting services if the interpretation costs were covered by the National Health Insurance System (P<0.001). When foreign patients are accepted, 75.7%, 84.7% and 94.6% of small, medium and large hospitals require trained medical interpreters, respectively (P=0.014). Hospital staff reporting that the most common reason for using an interpreter was to reduce medical risks ranged from 81.1% to 94.3%. Of the 274 hospital staff surveyed, 4.7% had experiences of incidents due to the language barriers when dealing with foreign patients. The incident classification was as follows: 3 cases with Impact Level 0, including MRI withdrawal; 9 cases with Level 1, including unauthorized discharge and self-extraction of an in-travenous drip; 1 case of precipitate labor; 1 case of Level 5 death; and 3 other cases. Small hospitals have not been reporting incidents, but larger hospitals, despite the small number of foreign patients, have been reporting incidents.Conclusion　Large or medium-sized hospitals need medical interpreters more than smaller hospitals because of the greater number of foreign patients being attended to, and diversity and complexity of reasons for seeking hospital services. Our results suggest that language barriers when dealing with foreign patients are a threat to patient safety. The majority of the responding Japanese municipal hospitals believe that they require trained language interpreters to improve risk management.