Objective: To develop a remote, live ultrasound education program using video conferencing and an on-demand ultrasound program utilizing virtual reality (VR) as nonface-to-face modes of education to obtain learning outcomes comparable to those of face-to-face education for beginners. Methods: Undergraduate nursing students, the participants, were divided into face-to-face, remote live, and VR-on-demand groups; each group was enrolled in a 30-min program. The volume of the participants’ bladder urine was measured using ultrasonography. Then, the difference between the measured volume (ml ) and the true value was calculated for each group and compared among the three groups. Furthermore, subjectivity was assessed after the completion of the program. Results: There was no significant difference between the groups in terms of the value of the difference between the bladder urine volume (ml) and the true value. The face-to-face/remote live group demonstrated considerably higher satisfaction than the other two groups, whereas the remote live group showed considerably higher comprehension than the VR on-demand group. Conclusions: A new educational program enabling beginners to learn how to measure the amount of urine in the bladder using ultrasonography in 30 min is as effective in nonface-to-face education as in face-to-face education.

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　To improve the work environment, nursing managers need to understand the actual conditions and analyze objective data on nurses’ workloads and movement lines obtained from long-term surveys. In this paper, we aim to validate an accuracy of a method for estimating nurses’ movement lines in an unattended time study using beacons and mobile devices and discuss the practicality of the visualization software framework using the estimation method. To do so, a pilot experiment was conducted in a surgical ward of a large acute care hospital. To evaluate the impact of parameter settings on estimation accuracy, we proposed a new approach for determining optimal thresholds based on the F-measure. By comparing the proposed optimization-based and conventional heuristic approaches, we demonstrate the effectiveness of the heuristic approach in achieving the high accuracy of position estimation. After that, we validated the high accuracy of movement lines estimated by the heuristic approach. Error evaluation for entering/leaving timing and staying periods showed that the method has a time resolution of a few seconds. Results suggest that the framework enables nursing managers to easily capture nurses’ movement lines throughout the ward and analyze them qualitatively to improve nursing workflows.

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　In aging societies, the number of wheelchair users continues to rise, which in turn has increased the need for caregivers to provide assistance. However, research on the effects of cross slopes on wheelchair running trajectories has been lacking. We carried out experiments to measure the effects of cross slopes on the upper-limb muscle activity of caregivers, strength when gripping the wheelchair, and the wheelchair trajectory. To act as caregivers, 10 healthy participants were asked to drive wheelchairs carrying passengers along a 5-m-long experimental track. Three cross slopes were tested: 0%, 2%, and 5%. Increasing the cross slope significantly increased the activities of the forearm flexor muscles on the downslope side and extensor muscles on the upslope side, as well as the strength when gripping the wheelchair. In addition, the coefficients of variation for the wheelchair trajectory were significantly higher on the 5% cross slope than on the other cross slopes. These results suggest that wheelchair caregivers mainly use their forearms to handle cross slopes, especially as the cross slope increases. This study can help with training wheelchair caregivers to effectively handle cross slopes.

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　The Lyapunov dimension allows for observation of the complexity and temporal dynamics of chaotic systems. Here, we examined the changes in the Lyapunov dimensions of the heart sounds of human mother-fetus pairs from early pregnancy to after birth. Time-series data of the heart sounds of four pregnant women and their fetuses were obtained at four phases (early, mid, and late pregnancy, and the early postnatal period) under five different vocal stimulation conditions (no stimulation, during and after stimulation with a recording of the mother′s voice, and during and after stimulation with a recording of a stranger′s voice), and the medium Lyapunov dimension for each mother and fetus at each phase and under each stimulation condition was determined. The Lyapunov dimension of the mother did not significantly change from early pregnancy to the postnatal period. In contrast, that of the fetus increased dramatically at each gestation phase (p<0.001) until it matched that of the mother during the postnatal period. These findings imply that mothers maintain a mature chaotic state throughout pregnancy whereas fetuses harbor a changing, more complex chaotic state.

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　This study aimed to examine the usefulness of a surgical recording system utilizing a speech recognition system. The subjects were 15 nurses and ten students in the operating department. Cataract surgery records were converted to text by the speech recognition system or typed, and the following items were measured: input time, number and content of wrong entries, noise level, and problems and feelings related to the burden of recording and operation. Recording time for nursing students was significantly shorter with the speech recognition system, reducing recording time by approximately 53%. The average number of mis recordings was 3 for nurses and 2.5 for nursing students. In a comparison of questionnaires regarding voice input, nursing students were significantly lower in “increased workload,” with students thinking less impact on workload. In summary, it is clear that nurses expect the speech recognition system to reduce their workload and be utilized in the future; however, improvement of the recognition rate and handling personal information from an ethical standpoint are future issues to be addressed.

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　To identify risk factors for developing febrile neutropenia (FN), a retrospective study was conducted at an advanced treatment hospital in Japan. Data from 193 patients with lung, breast, and colorectal cancers undergoing outpatient chemotherapy were analyzed. Patient background information, blood test results, and vital signs were extracted from the electronic health records. Using multivariate logistic regression analysis, factors associated with FN or infection-related fever were determined. The results showed that the therapeutic use of granulocyte-colony stimulating factor (G-CSF) agents, use of antibiotics, and a history of sepsis were significant risk factors for FN. Additionally, body mass index, cancer type, therapeutic use of G-CSF agents and steroids, also contributed to the risk of developing neutropenia. At the beginning of the chemotherapy cycle, our models predicted the onset of infection or neutropenia during the cycle. For the safe continuation of outpatient chemotherapy, the above risk factors should be considered in the treatment plan and management.

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Aim: Dysbiotic wound microbiota, which is dissimilar to those of the peri-wound skin, is likely to cause delayed wound healing. However, no point-of-care microbiota test is available. This study aimed to investigate the relationship between wound pH and microbial dissimilarity in wound and peri-wound skin. Methods: This cross-sectional study investigated hard-to-heal wounds extending into the subcutaneous tissue without macroscopic signs of infection. Wound pH was measured using a pH meter and microbiota were characterized by 16S rRNA gene analyses. Spearman′s rank correlation coefficient between the weighted UniFrac dissimilarity index measured microbial dissimilarity, and wound pH was calculated. Results: Thirteen wounds were investigated. The median dissimilarity index and pH value were 0.36 (IQR: 0.30-0.38) and 7.71 (IQR:7.61-7.83), respectively. There was a significant positive correlation between the dissimilarity index and wound pH (p=0.75, p<0.01). Conclusions: Microbial dissimilarity was associated with increased wound pH. This finding is compatible with the fact that alkaline tissue environments impair wound healing and that wound healing is delayed with dysbiosis. Further studies are needed to compare these relationships based on the healing status, which is necessary for the clinical use of wound pH as an indicator of dysbiosis.

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Purpose: One of the factors contributing to complications during surgeries is pressure on the body surface. We investigated whether back pressure was affected by the surgical site in the lithotomy position, and whether the maximum pressure site was changed. Methods: Lower gastrointestinal and gynecological surgery cases with a lithotomy position were included in the study. The surgeries were divided into four groups: lower gastrointestinal surgery open (SO) and laparoscopic (SL) and gynecological surgery open (GO) and laparoscopic (GL). The pressure applied to the back during those surgeries were measured over time. Results: Seventy-two patients were enrolled in the study: 17 SO, 20 SL, 11 GO, and 24 GL. The back pressure in the SO was significantly lower than that in the other groups initially and over time. Based on the comparison by surgical site, the GO had higher scores than the SO, and the GL had lower scores than the SL. The relationship between initial pressure and body weight or body mass index were examined, but no significant correlation was found in either case. By monitoring pressure over time, it was shown that the maximum pressure site could be moved. Conclusion: During laparotomy of the lower gastrointestinal tract, the back pressure was lower than that in other surgeries. During the surgeries in lithotomy position, the back pressure was different depending on the surgical site and technique. The maximum pressure site were moved during the surgery.

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Objective: A finite element model of the lower back was created to evaluate the mechanical properties of two types of pressure-distributing mattresses in the lateral position for pressure injury prevention（include deep tissue injury）mattress. Methods: A finite element model of the human lower back and two types of pressure-distributing mattresses was created, and a simulation evaluation was performed in the lateral position considering the pressure redistribution functions. The validity of the model was evaluated by comparing it with actual measurements. The contact pressure and deformation between the body and the air mattress obtained from the analysis were generally consistent with the actual measurements, and the analytical model and its analytical method were effective for evaluating mattresses. These results suggest that the shape and deformability of the mattress have little effect on the risk of pressure ulcers occurring inside the body. The analysis taking into account the pressure redistribution functions confirmed that pressure redistribution is also effective in reducing stress inside the body.

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　This study conducted a comprehensive literature review on the effects of voluntary vocalization and active listening on muscle activity. A total of 20 target articles were selected from national and international sources, and the vocalized and listened-to words, postures, and task-related movements were systematically analyzed. The findings suggest that voluntary vocalization effectively promotes muscle activity, whereas active listening lacked sufficient comparative studies with control groups. Additionally, a notable limitation was identified in the demographic characteristics of the subjects, as most studies predominantly focused on young males, with limited attention to task-related movements reflective of daily life activities. Future research is expected to address these gaps by incorporating comparisons between control and experimental groups, as well as including a more diverse range of subjects and tasks relevant to everyday scenarios.

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　This study aimed to explore the challenges faced by persons with intellectual and developmental disabilities in operating a harvester equipped with a driving direction correction system, which by using a global navigation satellite system instruct the driver to the correct driving route if the driver deviates from the preset driving route, and to examine the difficulty of operation and its impact on safety, with the aim of finding clues for improving the machine and its operation method. The results suggested that the installation of the system makes the disabled person’s gaze point appear while operating the mower, thereby improving safety. In addition, since there was no difference in the number of gaze points between disabled and able-bodied people with the system installed, it was suggested that disabled people may operate the mower with the same level of attention as able-bodied people. In addition, the group with a high attention score moved their eyes less while operating the mower, which may allow them to operate it more safely. Since the results of this study are based on a small amount of data, it is necessary to continue accumulating data and proceed with improving the system and developing appropriate operation methods.

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　Assessment of nipple flexibility in nursing mothers can help provide breastfeeding support and advance the research and development of artificial nipples. In this study, we proposed and evaluated a new manual compression nipple reaction force measurement system called the Nipple Flexibility Assessment System that enables easier and safer assessment than conventional systems. To this end, measurement data were collected from lactating women who were 1-2 months into their postpartum period. The reaction force was measured by compressing the nipple with an indenter fitted with a force sensor using the nipple diameter as the reference value. None of the participants reported any pain or discomfort. The temporal variation in reaction force revealed the viscoelastic characteristics of the biological tissue. Based on the viscoelasticity-aware analysis, reaction force values measured at 0 and 2 s under 50% compression were identified as useful assessment indices of nipple flexibility. Based on the continued accumulation of data on nipple flexibility in nursing mothers, we expect to clarify the relationship between nipple flexibility and the mother’s childbirth history, age, number of days into the postpartum period, nursing status, and frequency of nipple problems, as well as utilize these data to develop artificial nipples.

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　Monitoring sleep status in psychiatric settings is crucial. However, psychiatric symptoms and cognitive impairments complicate traditional sleep assessments, such as polysomnography (PSG). To address this, we employed Nemuri SCAN (NSCAN, Paramount Bed Co. Ltd.), a contact-free patient sensor, and compared its performance with PSG in patients with psychiatric disorders. This cross-sectional study included 29 cases (median age: 61 years; 55.2% male) from August 2021 to January 2023. NSCAN showed lower specificity than PSG, often misclassifying still wakefulness as sleep. To improve this, we developed a logistic regression model named the Patient-Adjusted Cole Model (PAC Model), which incorporates 10 patient characteristics into the NSCAN decision algorithm based on the Cole–Kripke equation (Cole model). The agreement with PSG, sensitivity, and specificity were 77.8%, 97.3%, and 28.2% for the Cole model and 78.8%, 94.5%, and 38.9% for the PAC Model, respectively, where agreement represented the percentage of sleep/wake determinations by NSCAN that matched those by PSG. While sensitivity was slightly lower in the PAC Model, specificity improved notably, addressing a critical limitation of non-contact sensors. These findings highlight the importance of integrating patient characteristics into sleep monitoring algorithms to enhance the practicality and utility of NSCAN in psychiatric care.

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　This study examines high school students’ thoughts about being parents after participating in a parenthood education program. A total of 1,295 students from six high schools in Japan answered an open-ended questionnaire about “being a parent yourself”. The students’ grade, gender, family structure, experience of interaction with infants, and feelings of being loved were recorded. Text mining analysis was conducted: overview analysis was performed using co-occurrence network and feature word analysis. The co-occurrence network analysis yielded 11 topics, with topic 1, “It must be hard and I feel anxious but it seems fun and joyful,” emerging as a positive aspect of becoming a parent. The results of the feature word analysis indicated that boys, students who had little interaction with infants and toddlers, and students with less “sense of being loved,” wrote Topic 3 “We shouldn’t think it’s simple and easy to raise children because we need to be responsible and prepared to cherish and nurture them”, and that they focused more strongly on the need for a sense of responsibility as a parent than on positive feelings about becoming a parent. Child abuse prevention support for pre-parental youth should include opportunities to interact with parents of infants and toddlers.

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　Bathing is a routine childcare activity often performed in bathroom washing areas. However, it can cause significant strain on the body. This study aimed to identify bathing postures that are less burdensome on the lower back by using an anterior tilt of the trunk angle, kyphosis posture of the spine, and subjective burden as indicators. Twenty-five subjects were divided into two groups: those adopting squatting postures and those using bathchairs. We employed a motion capture system and a questionnaire to assess the anterior trunk-tilt angle, kyphosis posture of the spine, and burden experienced in each posture. The anterior trunk-tilt angle and kyphosis posture of the spine are remarkably greater in the bathchair posture group. In the squatting group, the stronger the kyphosis posture of the spine, the more significant is the back burden. In the bathchair posture group, the more anterior the trunk-tilt angle, the more significant is the back burden. The findings of this study suggest that the posture with the least burden is one without an anterior tilt of the trunk angle or kyphosis posture of the spine.

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　Many sexually mature females suffer from premenstrual syndrome (PMS); however, effective coping methods for PMS are limited owing to the heterogeneity of symptoms and unclear pathogenesis. Our research goal was to establish a convenient and simple method to make an individual aware of their own psychological and autonomic conditions. In a previous study, we demonstrated that participants could be classified into the non-PMS and PMS groups based on mood scores obtained during the follicular phase. This study aimed to classify participants based on their response scores to a mood questionnaire during the follicular phase and evaluate their autonomic nervous system (ANS) activity using a simple device that measures pulse waves from the earlobe. Participants were grouped into Clusters I (highly positive mood) and II (low mood). Cluster II participants decreased parasympathetic nervous system activity, although not significantly (p = 0. 11), from the follicular to the menstrual phase. This may indicate that participants in Cluster II exhibited PMS symptoms. This study demonstrates the feasibility of using mood scores to classify individuals into PMS and non-PMS groups and to monitor ANS changes across menstrual phases. Despite limitations, such as sample size and device variability, the findings highlight a promising avenue for convenient PMS self-monitoring.

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Aim: This study aimed to verify the reliability of inferior vena cava (IVC) diameter visualization by recruiting nursing and graduate students with no experience in echocardiographic scanning or education on self-monitoring echocardiography (SMEC) before watching the video material. Methods and Results: Participants visualized their IVC diameters after watching video material on SMEC. A skilled researcher, experienced in conducting the procedure, visualized the participants. IVCs under identical conditions. After blinding the visualized IVC images to the participants and researcher, the researcher measured the maximum and minimum IVC diameters and viewed and compared the IVC images to evaluate their IVC visualization and measurement success rate. Intraclass correlation coefficients (ICCs) were calculated, and Bland.Altman analysis was used to determine the presence or absence of addition and proportional errors. The IVC was recognized in the echocardiography images visualized by the participants and met the measurement requirements. The ICC (2,1) values were 0.984 and 0.981 for the maximum and minimum IVC diameters, respectively. Additive and proportional errors were not observed for either maximum or minimum IVC diameter. Conclusion: Our results suggest that nursing and graduate students can visualize the IVC with high reliability after watching video materials related to SMEC created in this study.

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Purpose: This study examined the usefulness of a telepresence robot (TR) without a display as a practical training tool in public health nursing practicum by comparing students’ experiences when guided by instructors through the TR versus face-to-face instruction. Methods: A questionnaire survey was conducted after practical training sessions at three points in time. Results: Students instructed via TR reported significantly lower levels of tension and resistance in communication with instructors compared to those receiving face-to-face instruction. There was no significant difference between the two groups in terms of ease of discussion and participation, suggesting that TR is not inferior to face-to-face instruction in practical training settings. Free-text responses indicated that students felt TR’s cute appearance helped create a relaxed atmosphere, suggesting that【TR is a alternative for a capable instructor.】However, for challenges they noted【communication difficulties due to the device】and 【the irreplaceable value of face-to-face instruction.】

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　Skin blotting is a method to non-invasively evaluate local cytokines and other substances in the skin. Still, its clinical application is difficult due to the need for advanced immunostaining techniques. The liquid-phase method, which collects skin blot samples in liquid form, has the potential for simple testing, but the validity of liquid-phase method needs to be clarified. This study evaluated the validity of the liquid-phase method by assessing (1) the recovery rate of liquid-phase protein and (2) the correlation between the amount of applied protein and that of protein recovered by the liquid-phase method, using five types of proteins. The results showed that (1) while the recovery rate of urease was significantly lower (P = 0.046), (2) there was a significant, high correlation (0.90 ≤ r ≤ 0.98; P < 0.05) between the amount of applied and liquidphased proteins for all proteins. Therefore, the validity of the liquid-phase skin blot sample method was demonstrated quantitatively.

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Purpose: To examine the effectiveness of local alpha-blocker injection for prevention of alpha-1 receptor activation in development of skin lesions induced by extravasation of administered dobutamine using a rat model. Methods: Skin lesions were induced in rats by subcutaneous injection of dobutamine into the back skin, and the rats were divided into two groups - a group given topical injection of alpha-blocker and an untreated group - and observed for 3 days. Results: In the group given topical injection of alpha-blocker, six out of ten injection sites turned black on the first day, and this gradually became ulcerated by the third day. On the other hand, in the untreated group, six out of ten injection sites also turned black on the first day, and this gradually became ulcerated by the third day in all of them. Conclusion: When extravasation of dobutamine occurs, prevention of alpha-1 receptor activation has been recommended. However, the present findings suggest that rats develop ulcers irrespective of whether or not they have received topical injection of alpha-blocker.

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　This study examined regional disparities in secondary medical areas for hemodialysis (HD) and endovascular surgery (EVS) for vascular access occlusion (VAO) among patients with end-stage renal disease in Japan using two types of open data: the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data and the geographic information system. Analysis of secondary medical areas revealed a weak positive correlation for thrombectomy, while no spatial autocorrelation was observed for other procedures. Principal component and K-means clustering analyses categorized the regions into four distinct groups. The implementation of HD was consistent across clusters, whereas regional differences were observed in advanced treatments, including nocturnal dialysis and EVS-VAO. Notably, the cluster with the highest aging rate showed the lowest EVS-VAO implementation rate. These findings indicate regional disparities in the provision of advanced dialysis treatments and EVS-VAO, despite the consistency of basic HD services. The results suggest potential variations in the provision of comprehensive care for dialysis patients across different regions.

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　In recent years, Japan has been facing a serious aging population issue. Efforts are being made to utilize various sensors to enhance care quality in the field of caregiving to address this challenge. However, the use of sensors directly observing the caregiver′s state can be burdensome. In this study, we implemented a method to estimate the caregiver′s behavioral state using machine learning and environmental sensor data, which can be obtained without imposing a significant burden on the caregiver. Specifically, we utilized LSTM (long short-term memory), a machine learning technique capable of capturing the long-term time dependency of time-series data, to classify the caregiverbs state into three categories at each time point: sleeping, waking up, and going out. The proposed method was compared with an existing method that does not employ machine learning in terms of accuracy. It was confirmed that the proposed method outperforms the existing method. Finally, potential applications of the proposed method in the field of nursing care were discussed.

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Aim: To investigate and verify the possibility of using umbilical artery blood cortisol concentration as a candidate of childbirth stress in newborns, and to use this information for assist midwives in providing support to newborns. Method: Immediately after birth, umbilical artery blood was collected, and cortisol concentration was measured. The analysis was conducted using umbilical artery blood cortisol concentration as an independent variable and using the Apgar score at 1 minute after birth as the dependent variable. Results: Although no significant correlation was observed, five newborns with an Apgar 10 points had significantly higher umbilical artery blood cortisol concentrations than with an Apgar score of 9 or less. Discussion: It was the newborn cortisol plays a role in producing surfactants in the fetal lungs. Newborns with an Apgar 10 points may have had high level cortisol concentrations and have good respiratory conditions. Conclusion: Cortisol measurements may be useful for midwives to provide safe and secure support to newborns and may make it possible to detect and predict abnormalities in full-term newborns. In the future, it’s measuring a newborn’s saliva may lead to information on the condition of babies following a precipitate delivery and various forms of developing nursing care.

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　This study clarifies the actual utilization of communication robots (C. robots) by staff in medical and care facilities and the factors related to their continued use. Accordingly, a questionnaire survey was conducted among 44 staff members working in medical and care facilities that own C. robots, and the results were analyzed using methods such as Fisher′s exact test and correspondence analysis. Approximately 60% of the facilities were not adequately utilizing C. robots after their introduction. Factors related to the continued use of C. robots include “high professional self-esteem among staff”, “difficulty in matching the characteristics of patients or residents with those of C. robots”, “voice and appearance”, “the need for staff to mediate interactions between patients or residents and C. robotsz, andyexpectations for C. robots to reduce workload”. These results suggest that when it is difficult to match the characteristics of patients or residents with those of C. robots, or when staff mediation is required for interactions, the resulting burden on staff becomes a factor leading to the underutilization of C. robots.

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　A liquid-phase method has been proposed for clinical application of skin blotting, a non-invasive skin evaluation method. However, this method is time-consuming (1 h) and requires high detergent concentrations (1%), limiting its application. The present study aimed to optimize the time and detergent concentration of the liquid-phase method. The amount of protein recovered was compared under different conditions: detachment time set at 1 h or 5 s and detergent concentration set at 1%, 0.3%, 0.2%, and 0.1%. The results showed no significant difference in the amount of protein recovered between 1 h and 5 s of detachment. Although no significant difference was observed in the amount of protein recovered with 0.3% and 0.2% detergent concentrations compared with that recovered with 1% detergent concentration, a change in the modification of ovalbumin was observed. Conversely, the recovered amounts of urease and ovalbumin were significantly reduced (P＜ 0.01 and P = 0.024, respectively) at 0.1% detergent concentration; however, the modification of ovalbumin was minimal. Taken together, 5 s of detachment was sufficient for the liquid-phase method, 0.1% detergent concentration was optimal for preventing protein modification, and 0.2% detergent concentration was optimal for protein recovery.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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