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The impact of the location where accidental hypothermia (AH) occurs has not been fully investigated thus far. This was a multicenter retrospective study of patients with a body temperature ≤35°C obtained at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into two groups according to the location where AH occurred (indoor group versus outdoor group). The association between each location of the occurrence of AH and in-hospital mortality was evaluated via a multivariable logistic regression analysis. The primary outcome of this study was in-hospital death. The secondary outcomes were the lengths of ICU and hospital stay. A total of 572 patients were enrolled in the hypothermia database, and 537 patients were included in the analyses. A total of 119 and 418 patients experienced hypothermia with outdoor and indoor occurrence, respectively. The indoor group was older and had worse activities of daily living compared with the outdoor group. With regard to the outcome, the proportion of in-hospital death was higher in the indoor group than in the outdoor group (28.2% [118/418] vs. 10.9% [13/119]

Respiratory infections pose a serious threat worldwide, and many new antiviral agents and coatings have been developed to reduce the overall risk of viral infection. Here, we evaluate the methodology used to test these antiviral coatings and developed a novel system that is more similar to “real-world” conditions. Contact infection is largely mediated via contact with saliva containing the active virus released as droplets by coughing or sneezing, with these droplets adhering to objects and surfaces and subsequently entering the human body via indirect contact with the mucous membranes. Here, we evaluated the antiviral effect of a known antiviral coating agent using an artificial saliva based system, where artificial saliva containing phages were sprayed onto the antiviral coating under various conditions associated with viral replication and infectious spread. We used a commercially available antiviral coating in this evaluation, and M13 bacteriophages as model viruses. This method enables simple biomimetic evaluations of any product’s antiviral effects.

Respiratory infectious diseases pose a serious threat worldwide, and novel antiviral materials are highly demanded. Photocatalytic nanoparticles have been developed to inhibit indirect transmission of pathogens by acting as surface coating materials. During development of such antiviral materials, researchers use bacteriophages as model viruses due to their safety and experimental efficiency. Screening methods are used to identify potential antiviral materials, and better screening technologies will accelerate the discovery of antiviral treatments. In this study, we constructed a novel platform to evaluate antiviral activity of surface coating materials using the M13 bacteriophage and phagemid system derived from phage display technology. The evaluation results generated by this system for the two tested antiviral materials were comparable to those for the materials tested on the Qβ bacteriophage and influenza virus using traditional screening methods. The experimental system developed in this study provides rapid and effective screening and can be applied to the development of novel antiviral materials.

Nobunaga Okada, Tasuku Matsuyama, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Kunio Hamanaka, Tetsuhisa Kitamura, Kei Nishiyama, Bon Ohta, Osborn Wave Is Related to Ventricular Fibrillation and Tachycardia in Hypothermic Patients, Circulation Journal, 2020, Volume 84, Issue 3, Pages 445-455, Released February 25, 2020, [Advance publication] Released January 30, 2020, Online ISSN 1347-4820, Print ISSN 1346-9843, https://doi.org/10.1253/circj.CJ-19-0856, https://www.jstage.jst.go.jp/article/circj/84/3/84_CJ-19-0856/_article/-char/en, BACKGROUND: The Osborn wave (OW) is often observed in hypothermic patients; however, whether OW in hypothermic patients is related to the development of fatal ventricular arrhythmia, including ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), remains undetermined. This study aimed to estimate the association between OW and the incidence of fatal ventricular arrhythmias.Methods and Results: This retrospective study used the Japanese Accidental Hypothermia Network registry database and included 572 hypothermic patients. Patients were divided into the OW group (those with OW) and non-OW group (those without OW). The relationship between the development of fatal arrhythmias and presence of OW was assessed using the chi-squared test. All patients who developed VF/VT (n=10) had OW on electrocardiogram upon hospital arrival. The presence of OW had a sensitivity of 100%, specificity of 47.8%, positive predictive value of 4.0%, and negative predictive value of 100% for VF/VT development. The in-hospital mortality rate was 22.3% in the OW group and 21.2% in the non-OW group (P=0.781). CONCLUSIONS: OW was observed in all hypothermic patients with VF/VT. The occurrence of ventricular arrhythmias is highly unlikely in the absence of OW on the electrocardiogram. Although the presence of OW might be used to predict these fatal arrhythmias in hypothermic patients, there was no association between the presence of OW and in-hospital mortality.

In order to reduce infection risk of novel coronavirus (SARS-CoV-2), we developed photocatalysts with nanoscale rutile TiO2 (4–8 nm) and CuxO (1–2 nm or less). Their extraordinarily small size leads to high dispersity and good optical transparency, besides large active surface area. Those photocatalysts can be applied to white and translucent latex paints and a transparent varnish. Although Cu2O clusters involved in the paint coating undergo gradual aerobic oxidation in the dark, the oxidized clusters are re-reduced under >380 nm light. The paint coating inactivated novel coronavirus and its alpha (B.1.1.7) variant under irradiation with fluorescent light for 3 h. The coating also exhibited antivirus effects on influenza A virus, feline calicivirus and bacteriophage Qβ. The photocatalysts would be applied to practical coatings and lower the risk of coronavirus infection via solid surfaces.

Care at a critical care medical center is associated with improved outcomes in patients with accidental hypothermia. In subgroup analyses, shock was associated with poor outcomes of accidental hypothermia. Optimizing the transport of patients with accidental hypothermia to a specialized center is likely to be beneficial., Aim The recommendation that patients with accidental hypothermia should be transported to specialized centers that can provide extracorporeal life support has not been validated, and the efficacy remains unclear. Methods This was a multicenter retrospective cohort study of patients with a body temperature of ≤35°C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into two groups based on the point of care delivery: critical care medical center (CCMC) or non‐CCMC. The primary outcome of this study was in‐hospital death. In‐hospital death was compared using a multivariable logistic regression analysis. Subgroup analyses were carried out according to patients with severe hypothermia (

AIM We aimed to evaluate the prevalence and outcomes of accidental hypothermia (AH) among elderly patients in Japan. METHODS This was a multicenter chart review study of patients with AH (Japanese accidental hypothermia network registry; J-Point registry) that included patients with a body temperature ≤35 °C and those aged ≥18 years who visited the emergency department of 12 institutions in Japan from 1 April 2011 to 31 March 2016. The patients were classified into three groups: adult (aged 18-64 years), young-old (aged 65-79 years) and old-old (aged ≥80 years). The association between each age category and in-hospital mortality from AH was examined through a multivariable logistic regression analysis. RESULTS In total, 572 patients were registered in the J-Point registry database, of which 537 were included. The proportion of individuals who developed AH in an indoor setting was higher in the old-old group than in the adult group (86.9% [226/260] vs 61.1% [87/113]). The in-hospital mortality rates of the adult, young-old and old-old groups were 15.0% (17/113), 21.3% (35/164) and 30.4% (79/260), respectively. In the multivariable analysis, the in-hospital mortality rate was higher in the young-old and old-old groups than in the adult group (young-old vs adult, adjusted odds ratio: 2.31 and 95% confidence interval 1.16-4.64; old-old vs adult, adjusted odds ratio: 2.91 and 95% confidence interval 1.41-6.02). CONCLUSIONS Approximately 80% of patients with AH were aged ≥65 years. The in-hospital mortality rate of patients aged ≥65 years was significantly higher than that of those aged

Background: The recommendation that patients with accidental hypothermia (AH) should be transported to specialized centers which can provide extracorporeal life support has not been validated, and the efficacy still remains unclear.Methods: This was a multicenter retrospective cohort study of patients with a body temperature of ≤35°C presenting at the emergency department of 12 hospitals in Japan between April 2011 and March 2016. We divided the patients into the two groups based on the point of care delivery: Critical Care Medical Center (CCMC) or non-CCMC. The primary outcome of this study was in-hospital death. In-hospital death was compared between AH patients at the CCMC and non-CCMC via a multivariable logistic regression analysis. Subgroup analyses were conducted according to patients with severe hypothermia (Results: A total of 537 patients were included; 413 patients (76.9%) in the CCMC and 124 patients (23.1%) in the non-CCMC group. The in-hospital death rate was lower in the CCMC group than in the non-CCMC group (22.3% versus 31.5%, pConclusions: Our multicenter study indicated that Care at CCMC was associated with improved outcomes in patients with AH. Optimizing the transport of patients with AH to specialized centers is likely to be beneficial.

Background: Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system which uses core body temperature and clinical findings; however, research has shown that core body temperature is not associated with in-hospital mortality in urban settings. Therefore, we developed and validated a severity scale for predicting in-hospital mortality among urban Japanese patients with accidental hypothermia. Methods: Data for this multi-center retrospective cohort study were obtained from the J-point registry. We included patients with accidental hypothermia who were admitted to an emergency department. The total cohort was divided into a development cohort and validation cohort, based on the location of each institution. We developed a logistic regression model for predicting in-hospital mortality using the development cohort and assessed its internal validity using bootstrapping. The model was then subjected to external validation using the validation cohorts. Conclusion: Our “5A” severity scoring system could accurately predict the risk of in-hospital mortality among patients with accidental hypothermia., The Correction to this article has been published in Journal of Intensive Care 2019 7:34, The Publisher Correction to this article has been published in Journal of Intensive Care 2019 7:43

Introduction In cases of severe accidental hypothermia (AH) in urban areas, the prognostic factors are unknown. We identified factors associated with in-hospital mortality in patients with moderate-to-severe AH in urban areas of Japan. Method The J-Point registry database is a multi-institutional retrospective cohort study for AH in 12 Japanese emergency departments. From this registry, we enrolled patients whose core body temperature was 32 °C or less on admission. In-hospital death was the primary outcome of this study. We investigated the association between each candidate prognostic factor and in-hospital death by applying the multivariate logistic regression analyses with adjusted odds ratios (AORs) and their 95% confidence interval [CI] as the effect variables. Results Of 572 patients registered in the J-point registry, 358 hypothermic patients were eligible for analyses. Median body temperature was 29.2 °C (interquartile range, 27.0 °C–30.8 °C). In-hospital deaths comprised 26.3% (94/358) of all study patients. Factors associated with in-hospital death were age ≥ 75 years (AOR, 3.09; 95% CI, 1.31–7.27), need for assistance with activities of daily living (ADL; AOR, 3.06; 95% CI, 1.68–5.59), hemodynamic instability (AOR, 2.49; 95% CI, 1.32–4.68), and hyperkalemia (≥5.6 mEq/L; AOR, 2.65; 95% CI, 1.13–6.21). Conclusion The independent prognostic factors associated with in-hospital mortality of patients with moderate-to-severe AH in urban areas of Japan were age ≥ 75 years, need for assistance with ADL, hemodynamic instability, and hyperkalemia.

We aimed to evaluate the prevalence and outcomes of accidental hypothermia (AH) among elderly patients in Japan.This was a multicenter chart review study of patients with AH (Japanese accidental hypothermia network registry; J-Point registry) that included patients with a body temperature ≤35 °C and those aged ≥18 years who visited the emergency department of 12 institutions in Japan from 1 April 2011 to 31 March 2016. The patients were classified into three groups: adult (aged 18-64 years), young-old (aged 65-79 years) and old-old (aged ≥80 years). The association between each age category and in-hospital mortality from AH was examined through a multivariable logistic regression analysis.In total, 572 patients were registered in the J-Point registry database, of which 537 were included. The proportion of individuals who developed AH in an indoor setting was higher in the old-old group than in the adult group (86.9% [226/260] vs 61.1% [87/113]). The in-hospital mortality rates of the adult, young-old and old-old groups were 15.0% (17/113), 21.3% (35/164) and 30.4% (79/260), respectively. In the multivariable analysis, the in-hospital mortality rate was higher in the young-old and old-old groups than in the adult group (young-old vs adult, adjusted odds ratio: 2.31 and 95% confidence interval 1.16-4.64; old-old vs adult, adjusted odds ratio: 2.91 and 95% confidence interval 1.41-6.02).Approximately 80% of patients with AH were aged ≥65 years. The in-hospital mortality rate of patients aged ≥65 years was significantly higher than that of those aged65 years. Geriatr Gerontol Int 2018; 18: 1427-1432.

Icosahedral Au@Ag core−shell nanocrystals have been prepared using a two-step reduction method. In the first step, icosahedral Au core seeds were prepared by reducing HAuCl4·4H2O in tetraethylene glycol (TEG) under microwave (MW) heating in the presence of polyvinylpyrrolidone (PVP) as a polymer surfactant. In the second step, Ag shells were overgrown on icosahedral Au seeds in N,N-dimethylformamide (DMF) in the presence of PVP under oil-bath heating for 3 h or MW heating for 10 min. Crystal structures of products were characterized using TEM, TEM-EDS, and SEM. Under oil-bath heating, Au@Ag icosahedral nanocrystals nearly fully covered by Ag shells were prepared, whereas those partially covered by tetrahedral units of Ag shells were formed under MW heating. On the basis of these findings, it was concluded that icosahedral Au@Ag core−shell particles are formed through stepwise growth of tetrahedral units, as observed in the crystal growth of monometallic icosahedral Ag crystals in DMF. There were minor Au/...

Accidental hypothermia (AH) has higher incidence and mortality in geriatric populations. Japan has a rapidly ageing population, and little is known about the epidemiology of hypothermia in this country.We created an AH registry based on retrospective review of patients visiting the ED of 12 institutions with temperature ≤35°C between April 2011 and March 2016. The severity of AH was classified as mild (≤35, ≥32°C), moderate (32, ≥28°C) or severe (28°C). The relationship between in-hospital mortality and severity of AH was assessed using a multivariable logistic regression analysis.A total of 572 patients were registered in this registry and 537 patients were eligible for our analysis. The median age was 79 (IQR 66-87) years and the proportion of men was 51.2% (273/537). AH was more likely to occur in elderly patients aged ≥65 years (424/537, 80.0%) and in indoor settings (418/537, 77.8%). The condition most frequently associated with AH, irrespective of severity, was acute medical illness. A lower mean outside temperature was associated with a higher prevalence of AH, and particularly severe AH (p for trend0.001). The overall proportion of cases resulting in in-hospital death was 24.4% (131/537), with no significant difference between severity levels observed in a multivariable logistic regression analysis (severe group (37/118, 31.4%) vs mild group (42/192, 21.9%), adjusted OR (AOR) 1.01, 95% CI 0.61 to 1.68; and moderate group (52/227, 22.9%) vs mild group, AOR 1.11, 95% CI 0.58 to 2.14).Active prevention and intervention should occur for this important public health issue.

Shape-dependent Au@Ag core−shell nanocrystals have been successfully synthesized by using a two-step method. First, Au nanocrystal seeds with various shapes including single-crystal octahedron, single-twinned triangle or hexagon plate, and multiple-twinned decahedron were prepared by reducing HAuCl4 in ethylene glycol (EG) in the presence of polyvinylpyrrolidone (PVP) as a polymer surfactant under the condition of microwave heating. Subsequently, thus-obtained Au seeds were added into N,N-dimethylformamide (DMF) solution containing Ag+ ions for overgrowth of Ag shells by an oil-bath heating. Transmission electron microscope (TEM) observation demonstrates that shapes of formed Ag shells strongly depend on shapes of initiated Au seeds. These newly produced triangular or hexagonal platelike, octahedral, and multiple-twinned decahedral Au@Ag nanocrystals are mainly dominated by the Ag shells having {111} facets. This case is completely different from that previously investigated by us in EG system where forme...

Roles of chloride ion in the formation of Au@Ag core–shell nanocrystal structures through a separated two-step process have been studied using a microwave (MW)-polyol method. The first step is to reduce HAuCl4 precursor to form Au cores and the second is to grow Ag shells epitaxially around the pre-existing Au nuclei by reducing AgNO3 at various Cl− concentrations. Without Cl− ions in the second step, dominant product is spherical Ag particles and few Au@Ag particles can be produced. While, higher Cl− ion concentrations lead to the formation of a significant amount of AgCl due to the reaction between Cl− from HAuCl4 or NaCl and Ag+ from AgNO3, which will remarkably interfere with the formation of Au@Ag nanocrystals. A small amount of Cl− anions (∼0.3 mM) has been found to be a key factor for the preferential formation of Au@Ag nanocrystals with well-defined shapes. The role of Cl− anions has been discussed in terms of shape selective oxidative etching of spherical Ag nanoparticles and the formation of AgCl leading to slow face-selective crystal growth by decreasing the concentration of free Ag+ ions. Under our MW heating condition, spherical Ag particles or shells are preferentially etched, while single crystal cubic, twinned bi-pyramidal, and five-twinned nano-rod/-wire structures can survive and further grow into larger particles or Au@Ag core–shell nanostructures with clear facets and shape edges. This finding provides new information in stability of twinned Au@Ag core–shell and Ag nanoparticles against oxidative etching by Cl−/O2 (dissolved in solvent).

Shape- and size-controlled synthesis of gold nanocrystals was studied by using a microwave–polyol method in the presence of Au seeds and poly(vinylpyrrolidone) (PVP) as a polymer surfactant. Mixtur...

Shape and size controlled synthesis of gold nanocrystals have been studied by using a microwave (MW)-polyol method. When Au3+ in HAuCl4·4H2O was reduced in ethylene glycol (EG) in the presence of poly(vinylpyrrolidone) (PVP) at a low HAuCl4 concentration, mixtures of spherical, triangular, octahedral, and decahedral particles were prepared in a few minutes. It was found that the shape selective oxidative etching by AuCl4− + Cl− anions and crystal growth occurred simultaneously at high HAuCl4 concentrations. The addition of MCl (M = Na, K, H) was very effective to enhance the shape selective oxidative etching by AuCl4− + Cl− anions. With increasing the AuCl4− and Cl− concentrations, yields of large plate-type and ribbon-type single twin particles increased, while those of spherical and octahedral particles decreased in most cases. Possible etching and growth mechanisms are discussed from dramatic color and absorption spectral changes of Au seeds in the HAuCl4·4H2O/PVP/EG solution with increasing the solution temperature and from TEM images before and after oxidative etching. The present results provide a new simple technique for the rapid shape and size controlled synthesis of Au nanocrystals under MW heating.

Pentagonal bipyramid-shaped gold-rich Au/Ag alloy nanoparticles are synthesized in ethylene glycol (EG) in the presence of small amounts of AgNO3 and PVP without using Au seeds. The contents of Au and Ag in pentagonal nanobipyramids are determined by energy-dispersive X-ray spectroscopy (EDS). The EDS data demonstrates that this kind of nanoparticles is composed of Au/Ag alloys, not silver monolayers simply covering the surface of Au nanoparticles. Insights into the growth mechanism of pentagonal bipyramid-shaped gold-rich Au/Ag alloy nanoparticles are discussed.

Silver nanostructures have been synthesized by a microwave (MW)-polyol method. When AgNO3 was reduced by ethylene glycol (EG) in the presence of Pt seeds and polyvinylpyrrolidone (PVP), mixtures of one-dimensional (1-D) nanorods and nanowires, 2-D nanosheets and nanoplates, and 3-D spherical and cubic nanoparticles were prepared within a few minutes. It was found that morphologies and sizes of silver nanostructures depended strongly on such experimental parameters as concentrations of Pt, PVP, and AgNO3, and heating time. Possible growth mechanism of each silver nanostructure was discussed. The growth mechanism of nanorods was especially discussed on the basis of crystal structure of rod type of Au core-Ag shell nanoparticle.

Silver nanorods and nanowires have been synthesized by using a microwave (MW)-polyol method. When AgNO3 was reduced by ethylene glycol (EG) in the presence of Pt seeds and a long chain length of poly(vinylpyrrolidone) (PVP: Mw = 360 k), mixtures of one-dimensional (1-D) silver nanorods and nanowires and three-dimensional (3-D) spherical, triangular-bipyramidal, and cubic nanoparticles were synthesized within a few minutes. The average diameters, lengths, and yields of these products were measured as a function of concentration of Pt, PVP, or AgNO3, heating time, or MW power to determine optimum conditions for the synthesis of 1-D products. 1-D products could be easily separated from other 3-D nanoparticles by repeating centrifugal separation in water. Longer and thicker 1-D products could be prepared by using 1-D products as seeds and repeating the reduction of AgNO3 in EG under MW irradiation. In this two-step preparation, some bent 1-D wires due to the combination of {111} facets of two rods and wires ...

PtRu alloy nanoparticles (24 +/- 1 wt %, Ru/Pt atomic ratios = 0.91-0.97) supported on carbon nanofibers (CNFs) were prepared within a few minutes by using a microwave-polyol method. Three types of CNFs with very different surface structures, such as platelet, herringbone, and tubular ones, were used as new carbon supports. The dependence of particles sizes and electrochemical properties on the structures of CNFs was examined. It was found that the methanol fuel cell activities of PtRu/CNF catalysts were in the order of platelettubularherringbone. The methanol fuel cell activities of PtRu/CNFs measured at 60 degrees C were 1.7-3.0 times higher than that of a standard PtRu (29 wt %, Ru/Pt atomic ratio = 0.92) catalyst loaded on carbon black (Vulcan XC72R) support. The best electrocatalytic activity was obtained for the platelet CNF, which is characterized by its edge surface and high graphitization degree.

Au@Ag core−shell nanocrystals have been synthesized by using a microwave−polyol method, and their growth mechanisms have been studied. When HAuCl4·4H2O was reduced in ethylene glycol in the presence of poly(vinylpyrrolidone) (PVP) as a polymer surfactant, a mixture of triangular twin platelike, octahedral, and multiple-twinned decahedral Au nanocrystals, having only {111} facets, was prepared. When Ag+ was reduced by using these Au nanocrystals as seeds, triangular-bipyramidal, cubic, and rod/wire Ag shells, having {100} facets, were overgrown, respectively. It was concluded that morphology changes between Au cores and Ag shells arise from changes in the adsorption selectivity of PVPs from {111} facets of Au to {100} facets of Ag. Total space volumes of Ag shells overgrown on Au cores were on the order of cubes > triangular-bipyramidal crystals > rods and wires. These findings provide general information on the growth mechanism of face-centered cubic (FCC) types of single crystals in the presence of a pol...

When silver nanostructures were prepared by a microwave(MW)-polyol method in the presence of polyvinylpyrrolidone (PVP) as a capping reagent, besides spherical nanoparticles, nanosheets, polygonal nanoplates, nanorods, and nanowires were synthesized within 8 min. Effects of chain length of PVP were examined by using three different molecular weights of PVPs (10, 40, and 360 k). When a short chain PVP (10 k) was used, nanosheets and nanoplates were dominantly prepared, while nanorods and nanowires were preferentially synthesized by using longer chain PVPs (40, 360 k). The maximum aspect ratios of nanorods and nanowires were ∼ 7, ∼ 130, and ∼ 200 for PVP (10, 40, 360 k), respectively. These results indicated that shape and size of Ag nanostructures can be controlled by changing chain length of PVP. On the basis of UV and visible absorption spectra of product solutions, the number density of Ag nanostructures including spherical nanoparticles increased rapidly with increasing chain length of PVP.

Au core-Ag shell bimetallic nanoparticles, denoted as Au@Ag, have been prepared by a microwave(MW)-polyol method through the two-step reduction of AuCl 4 - and Ag + ions in the presence of poly(vinylpyrrolidone) (PVP) as a capping reagent. When single crystal polygonal Au nanoplates and nanorods were used as seeds, a mixture of various Au@Ag core-shell nanostructures was prepared after MW heating for only 2 min. Among them, small amounts of novel polygonal and rod types of Au@Ag nanostructures, in which morphologies of Au core were conserved, were produced.