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Comparison of Anticancer Drug Preparation Techniques between Chemotherapy Specialist Pharmacists and Non-Chemotherapy Pharmacists Using Eye-Tracking Techniques

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Pharmacology & Pharmacy 2023年第8期14卷 229-238页

作者： Yuka Miyachi Yukina Miyagi Saori Gocho Chika Nakayama Masayuki Ejiri Masayuki Takeuchi masafumi ohnishi Taeyuki Oshima College of Pharmacy Kinjo Gakuin University Nagoya Japan Graduate School of Medicine Aichi Medical University Nagakute Japan Department of Pharmacy Nagoya Ekisaikai Hospital Nagoya Japan Faculty of Pharmacy Gifu University of Medical Science Kani Japan Department of Pharmacy Aichi Medical University Hospital Nagakute Japan

Anticancer drug preparation by pharmacists is a critical task directly related to medical incidents. This study examined the factors influencing medical errors in chemotherapy, that is, errors by specialist pharmacists (CPh) and pharmacists in other departments (NCPh), by measuring their gaze during the preparation of anticancer drugs. The eye-tracking results showed that the gazing time of NCPh was significantly longer than that of CPh for items such as “preparation of a closed-system device” and “preparation of the syringe” and all preparation times (P < 0.05). The NCPh were not assigned to prepare drugs on a regular basis, indicating their lack of familiarity with the process. There was no significant difference in gaze ratio between CPh and NCPh. This outcome was suggested to be a result of the use of an anticancer drug preparation support system. The results for the pupil diameter variation rate showed that NCPh were significantly more mydriatic in the “mixing injections” category than CPh. However, CPh tended to be more mydriatic in the “checking” category. CPh exhibited a smooth workflow and focused on the important items to be checked. This study showed that the differences in procedure flow and concentration points may lead to errors. Furthermore, the results are of interest from the perspective of medical incident prevention. They will be useful in identifying potential human factors, such as where the pharmacist focuses their attention by measuring eye movements.

关键词： Eye Tracking Medicine Inspection Anticancer Drug Pharmacists

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Study of Factors Affecting Medical Incident: 2 Powdered Medication Dispensing

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Pharmacology & Pharmacy 2019年第6期10卷 309-317页

作者： Yuka Miyachi Chika Nakayama Satomi Funahashi Hiroyuki Shimada Masayuki Takeuchi masafumi ohnishi Hiroko Saito Taeyuki Oshima College of Pharmacy Kinjo Gakuin University Nagoya Japan

Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the quantity of the active ingredient in the medication that has been dispensed and the quantities that have been mixed together. Therefore, special prevention measures are considered essential. In this study, we examined the work content of pharmacists’ powdered medication dispensing, using an eye-tracking technology of measuring a human eye movement, and studied on factors that affect medical incident. Participants were five pharmacists with 8 to 26 years of working experience (expert), and five pharmacists with less than one year of working experience (newcomer). Gaze measurement experiments were implemented for powdered medication dispensing during regular work activity. The gaze measurement equipment used was Tobii Pro Glasses 2. Based on the results of the eye tracking, newcomer had a longer dispensing time than expert for all powdered medication dispensing. In particular, it was suggested that there is a close relationship to “years of experience” and “weighing and mixing skills.” Experts did unwasted and efficient movements, when preparing the dispensing apparatus, taking medications from the shelves, and scanning the barcode in the powders dispensing checking system. These movements led to shorter working time in experts. In contrast, newcomer had individual differences at the dispensing. Even with the same pharmacist, the work progression differed depending upon the prescription. Therefore, it is thought that the factor of common error was inadequate check and overlooked. The state that it’s messy on the workplace is also considered highly likely to cause dispensing mistakes. At the weighing, expert started weighing after the inspection of the prescription and checking weighed amount. However, certain newcomer dispensed to depend on the powders di

关键词： Dispensing Error Eye Tracking Pharmacist Powdered Medication

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Study of Factors Affecting Medical Incident: 1. Dispensing

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Pharmacology & Pharmacy 2018年第12期9卷 527-535页

作者： Yuka Miyachi Chika Nakayama Kazuyo Nagashiba Kou Kinoshita Masayuki Takeuchi masafumi ohnishi Hiroko Saito Taeyuki Oshima College of Pharmacy Kinjo Gakuin University Moriyama-ku Nagoya Japan

In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine dispensing. However, automating the dispensing, or having it replaced by artificial intelligence (AI) will not, eradicate human error. Thus, measures against human error will continue to serve as an important topic. Therefore, hospitals are required to improve the efficiency of the pharmacy department. For these purposes, attention has now shifted to Supply Processing and Distribution (SPD). In this study, we measured for the gaze of the pharmacist and SPD, and examined the factors affecting dispensing error;moreover, we examined prevention of the human error. In the results of the eye tracking, SPD members tended to spend a greater number of gaze time and gaze counts, for each medicine, on “medicines” and “picking lists,” than pharmacists. On the other hand, when pharmacists picking medicines, they performed various work operations in parallel, such as checking the prescription and looking the next shelf location. It was conjectured that SPD members had more clearly defined items to check when picking, compared to pharmacists. This may have possibly led to a lower chance of dispensing errors being introduced by SPD members. These results suggest that the process of selection is not a mandatory requirement of pharmacists during the action of dispensing. Instead, SPD members, pharmacy assistants, or automatic dispensing devices could serve as substitutes for picking. It is suggested that pharmacists should spend more time and effort on prescription inspection, medicines checking and dosing operations.

关键词： Dispensing Error Eye Tracking Pharmacist Supply Processing and Distribution

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Study of Factors Affecting Medical Incident: 3. Medicine Inspection

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Pharmacology & Pharmacy 2020年第1期11卷 9-16页

作者： Yuka Miyachi Chika Nakayama Takashi Horiba Tomoaki Hino Kazuyo Nagashiba Miki Kato masafumi ohnishi Hiroko Saito Masato Isogai Nami Sugiura Keiko Matsuura Taeyuki Oshima College of Pharmacy Kinjo Gakuin University Nagoya Japan

It is the responsibility of pharmacists to ensure the safety of patients as pharmacist’s professional duties expand into diverse directions. In recent years, the use of automated dispensing systems has increased;however, the inspection by pharmacists is the most important step in the prevention of medical errors. Comparing the inspection of hospital and community pharmacists may lead to an increased awareness of incident countermeasures. Therefore, eye tracking was performed for hospital and community pharmacists who conduct inspection, and the results revealed the factors that affect dispensing errors. One of the factors was the size of the dispensing space, especially if the space was small and the items needed were not easily accessible. In addition, differences in the inspection procedures among pharmacists were presumed to lead to possible dispensing errors due to oversights. Moreover, it was suggested that any subsequent work would flow more smoothly if a pharmacist checked the prescription and medication history management records at the beginning. Furthermore, it was thought that keeping a history of checks, such as recording any prescription checks in writing, would speed up finding the cause in the unlikely event that a dispensing error occurred. Accordingly, creating an environment in which one can concentrate without distractions during the inspections can lead to the prevention of dispensing error.

关键词： Medicine Inspection Dispensing Error Eye Tracking Pharmacist

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Fulminant phlegmonitis of the esophagus, stomach,and duodenum due to Bacillus thuringiensis

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World Journal of Gastroenterology 2015年第12期21卷 3741-3745页

作者： Hisatake Matsumoto Hiroshi Ogura masafumi Seki Mitsuo ohnishi Takeshi Shimazu Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Division of Infection Control and Prevention Osaka University Graduate School of Medicine

We report a case of phlegmonitis of the esophagus, stomach, and duodenum in patient in an immunocompromised state. Culture of gastric juice and blood yielded Bacillus thuringiensis. This case showed that even low-viru... 详细信息

关键词： Phlegmonous gastritis Esophagus Duodenum Bacillus

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Factors associated with the overall survival of elderly patients with hepatocellular carcinoma

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World Journal of Gastroenterology 2012年第16期18卷 1926-1932页

作者： Hideki Fujii Yoshito Itoh Naoki ohnishi masafumi Sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida Yasuo Ohkawara Kanji Yamaguchi Masahito Minami Takeshi Okanoue Department of Internal Medicine Aiseikai Yamashina HospitalKyoto 602-8566Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan Hepatology Center Saiseikai Suita HospitalOsaka 564-0013Japan

AIM:To identify the factors associated with overall survival of elderly patients with hepatocellular carcinoma(HCC).METHODS:A total of 286 patients with HCC(male/female:178/108,age:46-100 years),who were diagnosed and treated by appropriate therapeutic procedures between January 2000 and December 2010,were enrolled in this *** were stratified into two groups on the basis of age:Elderly(≥ 75 years old) and non-elderly(< 75 years old).Baseline clinical characteristics as well as cumulative survival rates were then compared between the two *** and multivariate analyses were used to identify the factors associated with prolonged overall survival of patients in each *** survival rates in the two groups were calculated separately for each modified Japan Integrated Stage score(mJIS score) category by the Kaplan-Meier *** addition,we compared the cumulative survival rates of elderly and non-elderly patients with good hepatic reserve capacity(≤ 2 points as per mJIS).RESULTS:In the elderly group,the proportion of female patients,patients with absence of hepatitis B or hepatitis C viral infection,and patients with coexisting extrahepatic comorbid illness was higher(56.8% vs 31.1%,P < 0.001;27.0% vs 16.0%,P = 0.038;33.8% vs 22.2%,P = 0.047;respectively) than that in the nonelderly *** the non-elderly group,the proportion of hepatitis B virus(HBV)-infected patients was higher than that in the elderly group(9.4% vs 0%,P = 0.006).The cumulative survival rates in the elderly group were 53.7% at 3 years and 32.9% at 5 years,which were equivalent to those in the non-elderly group(55.9% and 39.4%,respectively),as shown by a log-rank test(P = 0.601).In multivariate analysis,prolonged survival was significantly associated with the extent of liver damage and stage(P < 0.001 and P < 0.001,respectively),but was not associated with patient ***,on individual evaluation of factors in both groups,stage was significantly(P < 0.001) associ

关键词： Age Hepatocellular carcinoma Liver damage Stage Survival

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Effects of uniaxial compressive strain on the electronic- transport properties of zigzag carbon nanotubes

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Nano Research 2016年第5期9卷 1267-1275页

作者： Masato ohnishi Ken Suzuki Hideo Miura Fracture and Reliability Research Institute Graduate School of Engineering Tohoku University Sendai 980-8579 Japan

Recently, substantial attention has been paid to the strain sensitivity of the carbon nanotubes＇（CNTs＇） electronic properties. In this study, the relationships between the geometric structures and electronic states of zigzag CNTs under uniaxial compressive strain were investigated. We found that different factors dominate the electronic states of zigzag CNTs depending on the strain regions： the initial stage of the strain loading, which lasts until column-buckling deformation begins, and the strain regions corresponding to column- and shell-buckling deformations. Because shell-buckling deformation significantly increases the re-orbital angle, the angle between the π orbital axis vectors of adjacent atoms, strong localization of the density of states （LDOS） occurs in the buckled area. We also analyzed the current able to pass through deformed CNTs using a tight-binding-based Green＇s function approach and determined that the current can be significantly suppressed by applying uniaxial compressive strain. Our method of predicting the electronic state of a deformed CNT based on the π-orbital angle is expected to be useful for predicting the electronic properties of CNT-based electronic devices and sensors.

关键词： carbon nanotube strain buckling deformation Green's function method electronic-transport property

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Case of autoimmune hepatitis with markedly enlarged hepatoduodenal ligament lymph nodes

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World Journal of Gastroenterology 2013年第11期19卷 1834-1840页

作者： Hideki Fujii Naoki ohnishi Kazuho Shimura masafumi Sakamoto Tohru Ohkawara Yoshihiko Sawa Koichi Nishida Yasuo Ohkawara Tatsuro Kobata Kanji Yamaguchi Yoshito Itoh Department of Internal Medicine Aiseikai Yamashina HospitalShichouno-choTakehanaYamashinakuKyoto 602-8086Japan Department of Gastroenterology and Hepatology Uji Tokushukai HospitalKyoto 611-0042Japan Molecular Gastroenterology and Hepatology Kyoto Prefectural University of MedicineGraduate School of Medical ScienceKyoto 602-8566Japan

Autoimmune hepatitis(AIH) is a necroinflammatory liver disease of unknown *** disease is characterized histologically by interface hepatitis,biochemically by increased aspartate aminotransferase and alanine aminotransferase levels,and serologically by increased autoantibodies and immunoglobulin G *** we discuss AIH in a previously healthy 37-year-old male with highly elevated serum levels of soluble interleukin-2 receptor and markedly enlarged hepatoduodenal ligament lymph nodes(HLLNs,diameter,50 mm).Based on these observations,the differential diagnoses were AIH,lymphoma,or Castleman's *** biopsy revealed the features of interface hepatitis without bridging fibrosis along with plasma cell infiltration which is the typical characteristics of acute *** node biopsy revealed lymphoid follicles with inflammatory lymphocytic infiltration;immunohistochemical examination excluded the presence of lymphoma ***,he was administered corticosteroid therapy:after 2 mo,the enlarged liver reached an almost normal size and the enlarged HLLNs reduced in *** could not find AIH cases with such enlarged lymph nodes(diameter,50 mm) in our literature ***,we speculate that markedly enlarged lymph nodes observed in our patient may be caused by a highly activated,humoral immune response in AIH.

关键词： Autoimmune hepatitis Humoral immune response Hepatoduodenal ligament lymph nodes Corticosteroid Hepatomegaly

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Role of gut microbiota and Toll-like receptors in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第23期20卷 7381-7391页

作者： Kouichi Miura Hirohide ohnishi Department of Gastroenterology Akita University Graduate School of MedicineAkita 010-8543Japan

Emerging data have shown a close association between compositional changes in gut microbiota and the development of nonalcoholic fatty liver disease(NAFLD).The change in gut microbiota may alter nutritional absorption and *** addition,gut microbiota are a source of Toll-like receptor(TLR)ligands,and their compositional change can also increase the amount of TLR ligands delivered to the *** ligands can stimulate liver cells to produce proinflammatory ***,the gut-liver axis has attracted much interest,particularly regarding the pathogenesis of *** abundance of the major gut microbiota,including Firmicutes and Bacteroidetes,has been considered a potential underlying mechanism of obesity and NAFLD,but the role of these microbiota in NAFLD remains *** reports have demonstrated that certain gut microbiota are associated with the development of obesity and *** instance,a decrease in Akkermansia muciniphila causes a thinner intestinal mucus layer and promotes gut permeability,which allows the leakage of bacterial *** to increase Akkermansia muciniphila improve the metabolic parameters in obesity and *** children,the levels of Escherichia were significantly increased in nonalcoholic steatohepatitis(NASH)compared with those in obese *** can produce ethanol,which promotes gut ***,normalization of gut microbiota using probiotics or prebiotics is a promising treatment option for *** addition,TLR signaling in the liver is activated,and its downstream molecules,such as proinflammatory cytokines,are increased in *** data,TLR2,TLR4,TLR5,and TLR9 have been shown to be associated with the pathogenesis of ***,gut microbiota and TLRs are targets for NAFLD treatment.

关键词： Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Gut microbiota Toll-like receptor Probiotics Prebiotics

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Special focus on advances in disturbance/uncertainty estimation and attenuation techniques with applications

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Science China(Information Sciences) 2018年第7期61卷 180-181页

作者： Shihua LI Lei GUO Kouhei ohnishi Southeast University Beihang University Keio University

Disturbances and uncertainties exist in most engineering systems and always result in adverse effects on the control performances of closed-loop *** design and analysis of nonlinear control systems under disturbances is an active research topic in control systems *** advanced disturbance/uncertainty estimation and attenuation(DUEA)techniques have been developed to deal with systems in the presence of various disturbances and parametric uncertainties,e.g.,stochastic control,

关键词： Special focus on advances in disturbance/uncertainty estimation and attenuation techniques with applications

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