Search

The diagnosis of Kawasaki disease (KD) is challenging as it requires the identification of specific signs and symptoms through physicians’ subjective evaluations. Thus, we aimed to evaluate the influence of cognitive bias on pediatricians’ identification of KD signs. Seventy-five pediatricians were randomly divided into two groups and asked to examine photographs of healthy children’s eye, tongues, and fingertips with different case histories suggesting either Kawasaki disease (KD) or the common cold. Of the 75 pediatricians, 28 responded to the questionnaire. The 14 pediatricians were given KD-suggestive histories; the others were given common cold-suggestive histories. The group that was given KD-suggestive histories was more likely to misdiagnose healthy children’s eye (85.7% vs 50.0%, p = 0.043), tongues (35.7% vs 7.1%, p = 0.065), and fingertips (85.7% vs 35.7%, p = 0.007) as positive KD signs in the photographs than that were given common cold-suggestive histories. We found that medical histories suggestive of KD can cause cognitive bias in physicians when identifying KD signs in photographs.

Background The initial symptoms of Guillain-Barre Syndrome (GBS) can be similar to a case of spontaneous spinal epidural hematoma (SSEH) located at the cervicothoracic junction. Therefore, SSEH may be misdiagnosed as GBS. Case Report: A previously healthy 6-year-old girl presented with a 2-day history of progressive pain in the lower extremities and an inability to walk. On initial evaluation, she was completely paraparetic in the lower extremities. Deep tendon reflexes were absent in the lower extremities, and Babinski reflexes were positive on both sides. She exhibited reduced response to light touch and pinprick with a sensory level below T10, and experienced difficulty during urination. However, the strength, sensation and flexion of upper extremities were normal. Because her presentation and examinations were consistent with GBS, we initiated intravenous immunoglobulin therapy. The next day, she also developed pain and muscle weakness of the right upper extremity. Three days after admission, respiratory depression progressed rapidly. Spinal MRI showed a mass extending from the level of C7-T3, with spinal cord compression. The patient underwent an emergency laminectomy with evacuation of hematoma, and was diagnosed with SSEH. Sixty days after admission, she was transferred to the rehabilitation hospital with severe neurologic sequelae of paralysis in both legs. Conclusion: SSEH might have severe consequences, including neurologic deficits and risk of death. This case report serves to raise the awareness of SSEH that mimics the initial presentation of GBS.

To improve severe ketoacidosis with COVID‐19, insulin treatment, invasive mechanical ventilation therapy, and continuous hemodiafiltration with sodium bicarbonate infusion were effective.

We revisit supersymmetric nonlinear sigma models on the target manifold $CP^{N-1}$ and $SO(N)/SO(N-2)\times U(1)$ in four dimensions. These models are formulated as gauged linear models, but it is indicated that the Wess-Zumino term should be added to the linear model since the hidden local symmetry is anomalous. Applying a procedure used for quantization of anomalous gauge theories to the nonlinear models, we determine the form of the Wess-Zumino term, by which a global symmetry in the linear model becomes smaller in the action than the conventional one. Moreover, we analyze the resulting linear model in the $1/N$ leading order. Consequently, we find that the model has a critical coupling constant similar to bosonic models. In the weak coupling regime, the $U(1)$ local symmetry is broken but supersymmetry is never broken. In contrast to the bosonic case, it is impossible to find stable vacua in the strong coupling regime as far as in the $1/N$ leading order. These results are straightforwardly generalized to the case of the hermitian symmetric space., Comment: 1+22 pages, 2 figures; v2: a subsection, footnotes and a reference added; v3: references and comments added for section 1, published version

本研究では，提示形態が音声か映像かの区別に関する幼児期の外部情報のソースモニタリングの正確さを発達的に検討した．学習場面では，音声と映像(音声を含む)を用いて参加児に単語を提示した．すなわち，音声か映像の一方で男性が単語を言い，もう一方で女性が単語を言う場面を提示した．また，単語は音声のみ，映像のみの提示に加えて，音声と映像で1度ずつ提示する二つの情報源に由来する重複情報も含めた．学習後，単語ごとに再認テストとソースモニタリングテストを行った．ソースモニタリングテストでは，四つの情報源(音声，映像，両方，ない)について選択形式で尋ねた．その結果，4歳児と5歳児と比較して6歳児はソースモニタリングが正確であった．また，年齢により音声と映像の判断に違いが示された．そして，幼児は重複情報(両方)の判断が最も困難であった．以上の結果から，幼児期のソースモニタリング能力の発達的変化と重複情報の特性が明らかになった．

成人100名を調査対象者として、音声情報の発話者（男性もしくは女性）を特定するソースモニタリングテストを、情報量と情報内容の発話者への帰属レベルを操作した4条件で行った。情報量は、情報が単語か文かで操作され、情報内容の発話者への帰属レベルでは、単語もしくは文が発話者の自己紹介すなわち情報は発話者に関するものであるという文脈で発話されるか（情報源帰属）、何の文脈もなしに発話されるか（ニュートラル）で操作された。調査対象者には、記銘時に、男性のみが発話する11項目の単語または文、女性のみが発話する11項目、男性と女性の両方が発話する11項目の計33項目を聴かせ、テスト時には、ディストラクタ11項目を追加した44項目に対して、それぞれ、男性が言った項目か、女性が言った項目か、両方が言った項目か、記銘時にはなかった項目かを4択で判断させた。その結果‘文－情報源帰属’条件が、最もソースモニタリングが正確であり‘単語－ニュートラル’条件が最も不正確であった。また、‘情報源帰属’条件では、両方が言った項目についてのソースモニタリングが不正確になった。これらの結果から、発話者の情報量と、情報の帰属レベルの両方がソースモニタリングの正確さに影響すること、情報の帰属レベルの影響は、判断項目の種類によって異なること等が明らかになった。

The retinas of macaque monkeys usually contain three types of photopigment, providing them with trichromatic color vision homologous to that of humans. However, we recently used molecular genetic analysis to identify several macaques with a dichromatic genotype. The affected X chromosome of these animals contains a hybrid gene of long-wavelength-sensitive (L) and middle-wavelength-sensitive (M) photopigments instead of separate genes encoding L and M photopigments. The product of the hybrid gene exhibits a spectral sensitivity close to that of M photopigment; consequently, male monkeys carrying the hybrid gene are genetic protanopes, effectively lacking L photopigment. In the present study, we assessed retinal expression of L photopigment in monkeys carrying the hybrid gene. The relative sensitivities to middle-wavelength (green) and long-wavelength (red) light were measured by electroretinogram flicker photometry. We found the sensitivity to red light to be extremely low in protanopic male monkeys compared with monkeys with the normal genotype. In female heterozygotes, sensitivity to red light was intermediate between the genetic protanopes and normal monkeys. Decreased sensitivity to long wavelengths was thus consistent with genetic loss of L photopigment.