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Objective: This retrospective observational study aimed to look into the social demographic change of the occupants of a long-term care (LTC) facility that was constructed in 2015 as a restoration support after the Fukushima Daiichi nuclear power plant accident. Methods: The social demographic information during 2015–2021 of occupants in the Kawauchi Special Nursing Home was analyzed. Results: A total of 172 participants were included in the analysis. The number (proportion) of evacuees was 37 (69.8%) in 2015, then gradually decreased to 7 (31.8%) in 2018, yet increased to 21 (58.3%) in 2019. There were 121 occupants (70.4%) who were from Kawauchi Village and other municipalities of the former evacuation area. Conclusion: The Kawauchi Special Nursing Home initially received people who hoped to return to the former evacuation zone; however, its role changed to receive people who became in need of LTC after returning to Kawauchi Village. The construction of LTC facilities in the former evacuation area may help enhance the local LTC service where returnees are rapidly aging.

Objective:Typhoon Hagibis struck Japan on October 12, 2019. This study documents and characterizes deaths caused by Hagibis and helps identify strategies to reduce mortality in future disasters.Methods:Japanese residents, who were killed by Typhoon Hagibis, as reported by Japan’s Fire and Disaster Management Agency, were considered for the study. Details were collected from mainstream Japanese media, and flooding data from hazard maps published by local municipalities.Results:Out of the 99 total fatalities, 65 (73.0%) were aged 65 years or above. Among those who drowned indoors (20), 18 (90.0%) lived in high-risk areas of flooding, and their bodies were found on the first floor of their residences. A total of 10 (55.6%) out of the 18 fatalities lived in homes with 2 or more floors, indicating that they could have moved upstairs to avoid the floodwater. However, 6 (33.3%) could not do so due to existing health issues.Conclusions:Relatively elderly people, particularly those in areas at high risk of flooding, were most affected. Seeking higher ground is a standard safety measure in times of flooding, but this may not be possible for everyone depending on their health status, structure of their residence, and the depth of floodwaters.

Background: The problem of the uneven distribution of medical services is drawing much attention worldwide. To reveal how the changes in the specialty training system affected the distribution of doctors in Japan can help us understand this problem. In 2018, a new and standardized specialty training system was implemented by the Japanese Medical Specialty Board, which is recognized by the Ministry of Health, Labor and Welfare. The purpose of this study was to investigate how this has affected the geographical distribution of doctors commencing specialty training (trainees) and choice of specialty in Japan. Methods: Change in the number of trainees between the control period (2012 to 2014) and 2018 was investigated, taking into account prefecture and specialty selected. Population, aging rate, and total number of overall doctors in each prefecture were considered as the background characteristics of each prefecture. The Gini coefficient was used to determine evenness of trainees' distribution. Findings: In 2018, the number of trainees per 100,000 population showed an increase to 6.6 nationwide compared with 5.5 during the control period. The number of trainees per 100,000 population in 2018 showed an increase in prefectures with a large population of ≧ 2,000,000, a low aging rate (< 27%), and a high doctor density (≧ 250 doctors per 100000 population). The Gini coefficient showed an increase to 0.226 in 2018 compared with only 0.160 during the control period. The total number of trainees and that per 100,000 population showed an increase in all specialties. Interpretation: After the implementation of the new training system, the number of doctors enrolling in specialty programs showed an increase. Inequality of distribution urban and rural prefectures worsened, however, indicating the need to explore ways of balancing unevenness of distribution while maintaining optimal opportunities for specialist training. Funding Statement: The authors state: "This research isn’t receiving any funding." Declaration of Interests: Dr. Saito reports honorarium from TAIHO Pharmaceutical Co., Ltd., outside the submitted work. Ethics Approval Statement: The authors state: "Not applicable."

Background To minimize the interval from symptom onset to treatment commencement is essential for a favorable outcome among breast cancer patients. This study examined whether provider interval (time elapsed from first consultation to treatment onset) lengthened among breast cancer patients following Japan’s 2011 earthquake, tsunami, and nuclear disaster in Fukushima. Factors associated with the length of post-disaster interval and whether interval was associated with breast cancer stage, were also investigated. Materials and Methods So-so District (study site), was an area damaged by the 2011 disasters. Data of all breast cancer patients who made their first medical consultation and received initial treatment at the core medical institutions in the area five years pre- or post-disaster, were extracted from the patients’ medical records. We employed several regression approaches to fulfill our study objectives. Results We included 263 patients (140 pre-disaster and 123 post-disaster). After adjustment for covariates, the interval did not significantly change post-disaster compared with pre-disaster. Those with 4 or 5 cohabiting family members experienced shorter interval post-disaster than those with 0 or 1 cohabiting family members (relative length 0.47, 95% confidence interval 0.28–0.78). Those with >60 days interval had lower odds of stages III or IV cancer than those with Conclusion Overall, the total interval did not lengthen post-disaster. However, those with restricted cohabiting family members might have experienced a longer total interval. Cancer stage may not necessarily reflect the influence of provider interval on the patients’ outcome. Micro Abstract This study assessed provider interval among breast cancer patients in a post-disaster setting. The participants were patients diagnosed in Fukushima, Japan, either five years before or after the 2011 disasters. Although statistically significant change in the provider interval post-disaster was not observed after adjusting for covariates, the number of cohabiting family members might be associated with longer intervals.

Protecting the health of farmworkers is a crucial issue. Previous studies report that safety training and educational interventions might increase farmworkers’ protective behaviors. The present study aimed to investigate the effectiveness of distributing a checklist as an interventional measure for pesticide protection in rural Asia, where pesticide poisoning is a major problem. This study was a community-based interventional study, using the distribution of a checklist with pesticide protective habits in Narail district, Bangladesh, with a total of 100 eligible males. Two questionnaire surveys were conducted before distributing the checklist and 25 days after. Change between the baseline and follow-up surveys was measured by frequency scores of protective behavior. The average pesticide-protective behavioral score increased from 4.58 in the baseline survey to 8.11 in the follow-up. Additionally, the checklist was more effective in the group with higher education, the younger group, and the group with lower pesticide-protective behavioral scores in the baseline survey. The paper checklist on protective behaviors against pesticide poisoning was effective because of the increase in the frequency of such positive behavior among farmworkers. Thus, intervention measures should be implemented to increase the knowledge and awareness regarding pesticide protection habits to protect the health of farmworkers.

Objective:It is crucial to determine the health status of returnees to former evacuation areas. We aimed to examine the long-term care (LTC) utilization rate among elderly returnees as the indicator of care needs.Methods:This study used a resident registration database to collect information on LTC utilization rate among elderly returnees to former evacuation areas in Fukushima, Japan, following the 2011 Fukushima Daiichi Nuclear Power Plant accident. LTC utilization rates were descriptively analyzed.Results:For all age groups, the LTC utilization rates were lower among returnees than evacuees. The LTC utilization rate among returnees in each age group (chi-square test results compared to evacuees) were as follows: 0.78% (P = 0.194) for those aged 65–69, 0.69% (P = 0.003) for those aged 70–74, 3.23% (P = 0.007) for those aged 75–79, 6.79% (P < 0.001) for those aged 80–84, 22.84% (P = 0.011) for those aged 85–89, and 44.09% (P = 0.089) for those aged 90 and over.Conclusion:Elderly returnees had fewer LTC needs than elderly evacuees. Nevertheless, the proportion of aging people is high in evacuation area, meaning the number of elderly returnees would increase at an enormous rate. Therefore, LTC utilization rate would increase in the future.

The construction of apartment buildings after the disaster and the way of living there fostered the social capital of the original area. Community formation made it possible for elderly people living alone to respond to emergencies and prevent lonely death. It can be proposed to the future super-aging society.

We have investigated the electronic structure of protect annealed Pr1.3−xLa0.7CexCuO4 (x = 0.05) with small superconducting volume fraction by means of angle-resolved photoemission spectroscopy (AR...

Following the lifting of the evacuation order due to the Fukushima Daiichi Nuclear Power Plant accident, the medical demand and emergency medical system (EMS) in the area where the evacuation orders were lifted have not been well-investigated. This study aimed to evaluate the emergency transportation in such areas and compare the differences with areas that had minimal impact. Using the local EMS transport records, the characteristics of patients who were transferred by an EMS vehicle in Minamisoma City were collected between July 12, 2016 and July 31, 2018, and were compared between former evacuation zones and outside the evacuation zones in the city. The number of emergency transports in the study period in Minamisoma City were 325 cases in the area where the evacuation orders were lifted and 4307 cases in the other areas. The total EMS time was significantly longer in the area where the evacuation order was lifted (48 ± 16 minutes) than in the other areas (40 ± 15 minutes) (P

Introduction Japan is considered to have an overabundance of dentists; however, there are scarce data on regional inequalities in the ratio of dentists to patients. We examined these inequalities in Japan's Greater Tokyo Area - otherwise known as the Kanto region, and the world's most populous metropolitan area - by subdividing it into small- and medium-sized medical care zones. Methods We calculated the number of dentists per 100,000 population using the 2012 Survey of Physicians, Dentists, and Pharmacists for the three medical district tiers [primary medical care zones: municipalities (cities, towns, villages and special wards); secondary medical care zones: multiple adjacent municipalities; and tertiary care zones: prefectures]. We also estimated the influence of having a dental school in the district or an adjacent district on the number of dentists. Results The number of dentists per 100,000 population was 79.2 across the whole Kanto region; the range for each type of medical care zone was as follows: 65.3-126.4 at the tertiary level; 38.0-929.6 at the secondary level; and 0-3,087.6 at the primary level. The median Gini coefficient among tertiary medical care zones was 0.16 (range 0.11-0.36). The median number of dentists per 100,000 population was 273.8 in primary medical care zones that had a dental school, 79.9 in adjacent zones, and 59.6 in other zones. Conclusions We identified significant inequalities in the number of dentists among the medical care zones, and the presence of a dental school had a major influence on this number.

Key Clinical Message Caregiving in a long‐term facility played a key role in improvements of this patient's behavioral and psychological symptoms of dementia, which also led to a reduced caregiver burden on her family members. Considering the global population aging trend, the lesson from this case may apply to other settings beyond disasters.

Contrary to the assumption that older adults are only cared for by their families in rural Japan, this case illustrates that community formation can effectively provide older adult care after an emergency as well. We look at the life of a woman who lived in a housing facility for older adults, Idobata-Nagaya in Soma, Japan, exploring how social housing—which addresses the needs of older adults regarding community, familiarity and socialising—can provide a viable, effective and comfortable environment for older adults to live. In the case of Idobata-Nagaya, not only could older adults take care of one another but they could also share experiences of the Fukushima disaster with each other. This is a qualitative case study which provides a stable foundation for policymakers, healthcare workers and government officials to better understand the effectiveness of housing projects for communities and older adults in Japan and globally.

Objectives A previous report indicated that evacuation owing to the government order after the Fukushima disaster impacted the health status of older people; however, the association between living in evacuation areas and independence in their daily lives was unclear. This study examined the hypothesis that people who were forced to evacuate their homes were more likely to need long-term care (LTC). Design Historical cohort study. Setting and Participants Older individuals (n = 13,934) in Minamisoma, Fukushima Prefecture, Japan, part of which was designated as an evacuation area. Methods Background and certification data from April 2012 to December 2016 were extracted. Logistic regression analysis with sex stratification was performed to examine the association between certification of care levels 1-5 and living in evacuation areas. Results In total, 18,178 Minamisoma residents aged ≥65 years who had not received LTC certification as of March 11, 2011, were eligible for follow-up. Of these, 4244 residents without a certificate of residence by June 1, 2016, were excluded. Of 13,934 residents followed up, 1553 (11.1%) were newly certified as care levels 1-5. Certification of care levels 1-5 was associated with living in evacuation areas [odds ratio (OR) 1.61, 95% confidence interval (CI) 1.20-2.18] and living alone at the time of the disaster (OR 2.58, 95% CI 1.92-3.47) in men and living alone at the time of the disaster (OR 1.35, 95% CI 1.15-1.59) in women. Conclusions and Implications Living in evacuation areas and living alone were associated with LTC certification. In evacuation areas, individuals with family members were more likely to be certified compared with those in nonevacuation areas. Among residents in evacuation areas, several individuals with family members experiencing family structure changes might need LTC. Preventive measures (including group relocation) may be beneficial for those being evacuated following a disaster.

A silver nanoparticle/silver titanium phosphate–nanocomposite nanobelt thin film was synthesized on a titanium plate by Ag+ ion exchange treatment of a titanium phosphate (Ti2O3(H2PO4)2·2H2O) nanobelt thin film. Silver nanoparticles with sizes ranging from several nanometers to a few dozen nanometers were regioselectively deposited along the edges of the nanobelts to form the nanocomposite. The coexisting anions in the solution played a crucial role in the Ag+ ion exchange reaction. In the presence of CH3COO− anions, Ag+ ions were intercalated into the titanium phosphate nanobelts through ion exchange between Ag+ and the H+ in the H2PO4 group of Ti2O3(H2PO4)2·2H2O, along with an accompanying change in the crystal structure of titanium phosphate. The silver nanoparticle/silver titanium phosphate–nanocomposite nanobelt thin film showed excellent antibacterial activity against methicillin-resistant Staphylococcus aureus, although the titanium phosphate nanobelt thin film possessed no antibacterial activity.

The rhodium(III)-catalyzed ortho-alkenylation of N-Boc-anilines with alkenes such as acrylate ester and styrene proceeds smoothly through C-H bond cleavage. Obtained o-alkenylanilines can be readily transformed to nitrogen-containing fused heteroaromatic compounds including indoles and quinolines.

Objectives Limited information exists concerning occupational risks in decontamination work after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Workers involved tend to be migrant workers, face various health risks, and are usually from a low socioeconomic background and generally have difficulty in finding employment. We report a specific case to illustrate the way these workers tend to get injured during working hours and draw attention to the problems arising. Case presentation A 59‐year‐old Japanese male decontamination worker was referred to our emergency department after a fall while he was working in an Exclusion Zone surrounding the FDNPP. He was blind in his right eye. He was diagnosed with traumatic multiple rib fractures and a tube thoracostomy was performed. He was discharged from hospital after 7 days. Payment has been changed from “occupational accident,” which is required to be reported to the Local Labor Standards Office, to “general medical treatment” which is no obligation. Conclusion Trauma or physical injury of any kind is an occupational hazard for workers, especially those operating in the chaotic and unpredictable environments following any disasters. Companies employing such workers and owners of any facilities or locations in which they may be working are responsible for the safety of their workers. They should provide appropriate training and should comply with all prevailing Employment Laws and follow mandatory safety regulations. If companies and authorities are in breach of any laws, ignore their responsibilities, or jeopardize the health of their workers, they should be held accountable.

BackgroundThough mass evacuation may increase the need for long-term care (LTC) services, how the need for LTC services increases and how the public LTC system affects it is not well understood. We evaluated changes in public LTC benefits for the people living in the mandatory evacuation areas established after the 2011 Fukushima nuclear disaster and examined the roles of the universal LTC insurance system in Japan.MethodsIn order to evaluate the effect of the mandatory evacuation on LTC benefits, we examined the trends of LTC benefits in the Fukushima evacuation group and the nationwide non-evacuation group. We first decomposed per-elderly-individual benefits at the municipality level into the LTC certification rate and per-certified-individual benefits, and then implemented difference-in-differences analysis using these variables as outcomes.ResultsPer-elderly-individual benefits significantly increased from 2012 onward in the evacuation group, and this was explained by an increase in the certification rate rather than in per-certified-individual benefits. Increases in per-elderly-individual benefits and the certification rate in the post-disaster period were observed in all but the highest care level, and the corresponding outcomes for the highest care level decreased immediately after the disaster. We also found that the increase in the certification rate had been mostly realized by an increase in the number of certified individuals.ConclusionsThe increase in LTC benefits can be associated with the impact of the increase in the number of people newly certified to receive LTC benefits after the mandatory evacuation. In order to cope with the increase in utilization of long-term care and associated costs after disasters in aging societies, both formal long-term care services and social support for informal care for evacuees should be considered important.

Although psychiatric patients are likely to be adversely impacted by disasters, information regarding the processes involved in adverse impacts is limited. In March 2011, Japan experienced an earthquake, tsunami, and the Fukushima Daiichi Nuclear Power Plant accident. In its aftermath, Takano Hospital, 22 km south of the power plant, underwent forced patient evacuation. A 54-year-old Japanese male with schizophrenia, who had been hospitalized in the psychiatric ward for over 20 years, was transferred and experienced a series of hospital relocations. Although his physical status was intact when he left Takano Hospital, his condition gradually worsened, presumably due to incomplete exchange of patient information between institutions and changes in the treatment environment. Having developed ileus a few days prior, he was bedridden when he returned to Takano Hospital in May 2011. Over the course of treatment, he developed aspiration pneumonia and died in August 2011. A review of medical records revealed that all his purgative medicines had been stopped after his evacuation, possibly contributing to the development of ileus. This case highlights the necessity of establishing systems enabling patient information sharing between institutions in disaster settings and the importance of recognizing that long-term evacuation may have fatal impacts for psychiatric patients.

Chiikiwaku is a measure to improve the maldistribution and shortage of physicians in rural areas in Japan. Although Chiikiwaku quota seats have been on the rise, a considerable number of young physicians and medical students return their loans and do not fulfill their duty periods for several important reasons, including an obligation term lasting for 9 years. The number of medical students who do not apply for admission to the Chiikiwaku quota has increased, and vacancies have developed in some medical schools. Urgent modification of this program is therefore required to make it suitable for actual situations of both rural medical care and the education of young physicians.

This article evaluates research activities after wide-scale disaster damage. Wide-scale disasters rarely occur, and thus there are insufficient research and data on recovery and reconstruction from such disasters. The large earthquake and tsunami in Japan’s Tohoku region in 2011 caused serious damage in Iwate, Miyagi, and Fukushima Prefectures. Significantly, many research facilities were destroyed at Tohoku University, located in Miyagi Prefecture, and caused serious damage to research activities. There were 3 medical facilities located in the disaster-affected area: Fukushima Medical University, Iwate Medical University, and Tohoku University. Tohoku University is a comprehensive university and is the largest in the Tohoku District. To evaluate the damage to medical research activity caused by the earthquake and tsunami, we investigated the research activities at the aforementioned 3 universities. Using PubMed Advanced Search Builder, published articles between 2008 and 2011 were extracted. Articles were categorized into basic medicine, clinical medicine, and public health by the researchers. The number of articles published from those 3 universities increased from 1411 to 1711, roughly 21%. In the same period, article publication across all of Japan increased by roughly 13%. There were 1327 articles published from Tohoku University in 2013, a 21% increase from 2008; Iwate Medical University had 210 more articles published, a 70% increase; and Fukushima Medical University, had 176 more articles published, a 30% increase (Figure 1). Distribution across the 3 categories was generally the same during this period. Among the 1327 articles, 45 were disaster-related articles; Tohoku University, Iwate Medical University, and Fukushima Medical University published 25, 5, and 15 articles, respectively. Of these, 3 articles were related to the disaster at the Fukushima Daiichi Nuclear Power Plant caused by the tsunami. The data demonstrate that medical research activities continued even after the wide-scale disaster, indicating that damage was limited at these 3 universities in the disaster-affected area. This can be explained by the following reasons. First, the tsunami did not directly damage the universities. Most of the casualties were caused by the tsunami, and thus human casualties at the universities were greatly limited. Moreover, the universities are a long distance from the Fukushima Daiichi Nuclear Power Plant, and thus the schools’ research activities, which require intensive human resources, were not severely damaged. Second, large postquake reconstruction projects may have ameliorated any damage to research activities; an example is the genomic cohort project, which cost approximately US$13 billion, took place from 2011 to 2012, and was begun at Tohoku University and Iwate Medical University. Approximately 100 researchers and other staff were newly employed for this project. Those researchers may have supported a wide range of research activities and offset any damages, although only 2 articles were published from the project between 2011 and 2012.

In 2011, an earthquake and tsunami struck Japan, and these were followed by the Fukushima Daiichi nuclear power plant accident. The long-term impact on hemodialysis care access in rural areas after the disaster is unknown. Here we report on a 66-year-old male hemodialysis patient who was forced to evacuate and relocate multiple times to receive hemodialysis after the accident. While he returned to his hometown in 2012, all the available hemodialysis facilities had been placed in different districts. Therefore, the patient needed to cross a mountain to visit the hemodialysis facility. On a snowy day, the patient was unable to reach hemodialysis care in a timely manner. With community cooperation, a public ambulance successfully transferred the patient via a detour, taking 4 h to reach the hemodialysis facility. This case demonstrates that access to hemodialysis care in rural areas remains vulnerable even in the long term after a nuclear disaster.

Cognitive-behavioural therapy is a first-line treatment for post-traumatic stress disorder (PTSD), but it is difficult to implement in disaster settings. We report the case of an 80-year-old Japanese woman, who was diagnosed with PTSD after the 2011 triple disaster (earthquake, tsunami and nuclear plant accident) in Fukushima. Her recovery was greatly enhanced by the social support she received while living in Idobata-Nagaya community housing, established by Soma city in Fukushima, where residents could naturally discuss their traumatic experiences. Habituation to traumatic memories and processing of cognitive aspects of the psychological trauma, which are therapeutic mechanisms of trauma-focused psychotherapies, spontaneously occurred in this setting. The details of this case support the effectiveness of Idobata Nagaya as a provider of psychological first aid, an evidence-informed approach to assist children, adolescents, adults and families in the aftermath of a disaster.

Objective As status of rheumatoid arthritis (RA) is highly affected by environmental factors, a catastrophic disaster may also affect RA activity. Herein we conducted a retrospective cohort study in the disaster area of the 2011 triple disaster in Fukushima, Japan: an earthquake, tsunamis and a nuclear accident. Methods Clinical records of RA patients who attended a hospital near the Fukushima Daiichi Nuclear Power Plant were collected. For those who underwent whole-body counter testing, internal radiation exposure levels were also collected. As clinical parameters may fluctuate in the absence of a disaster, changes in values before and after the disaster were also compared. Logistic regression was conducted to identify factors affecting RA status. Results Fifty-three patients (average age, 64.2 years; females, 83%; average disease duration, 15.7 years) were included in the study. Five patients lived within the no-entry zone, 37 evacuated immediately after the disaster, and four temporarily stopped RA treatment. The proportions of patients who showed worsened tender joint counts, swollen joint counts and rheumatoid factor values were significantly higher after the disaster compared to those before. Among the 16 patients who underwent whole-body counter testing, only one showed a detectable, but negligible, radioactive cesium level. Use of methotrexate was identified as a possible preventive factor for RA exacerbation in this setting. Conclusion This is the first study to analyze detailed profiles of RA patients after a disaster. As methotrexate may prevent disease exacerbation, continuity of care for this common chronic disease should be considered in disaster settings.

Introduction In breast cancer, delay in first presentation and self-interruption of continuous treatment are associated with lower survival. It has been suggested that risk factors for such behavioral patterns include poor social support. Minamisoma City, located within a 30 kilometers radius from Fukushima Daiichi nuclear power plant, has experienced rapid change in social structures following the Great East Japan Earthquake and the subsequent power plant accident. There has been a mass evacuation among young and middle-aged generations for fear of potential irradiation, and this has resulted in the separation of families and friends. These changes may have resulted in a deterioration of social support for residents, which could consequently lead to changed patterns of behavior in diseases such as breast cancer. Objectives This study compared the behavioral patterns before and after the disasters in patients with breast cancer in Minamisoma City. Methods We retrospectively analyzed data from patients with breast cancer who were diagnosed from January 2008 through March 2015 in the two main cancer centers in Minamisoma City. Demographic and clinical information was extracted from medical records, including age, stage, pathological findings, treatment, and the reason for the first hospital visit. The main outcome was a change of interval from the appearance of initial symptoms to the first hospital visit before and after the disasters. We also assessed whether continuous follow-up was maintained after the disasters. We used an unpaired t-test for numerical variables and a chi-squared test for categorical variables. Results A total of 102 and 97 patients were diagnosed with breast cancer before and after the disasters, respectively. There were no statistically significant differences between the 2 groups concerning average age (61 years old vs. 61 years old, p=1), stage 3 or 4 cancer (18% vs. 17%, p=0.81), invasive cancer (92% vs. 93%, p=0.87) and symptomatic patients (75% vs. 74%, p=0.74), respectively. However, after the disasters, there were significant increases in the ratio of patients with more than a one-year delay from the appearance of the initial symptom to the first hospital visit (5.4% vs. 15%, p Discussion The characteristics of patients were not significantly different before and after the disasters, while the ratio of patients with more than a one-year delay of the first hospital visit significantly increased after the disasters. Although information on social capital and other sociodemographic factors was not available, we speculate that poor social support due to changed social structures after the disasters might contribute to delay in first presentation in symptomatic breast cancer patients. Further study is warranted to clarify the factors associated with delayed hospital visits, in order to establish effective health interventions in the aftermath of mass disasters. Citation Format: Ozaki A, Tsubokura M, Nomura S, Morita T, Ochi S, Kato S, Saji S, Yokota T, Leppold C, Tanimoto T, Kami M, Tsukada M, Ohira H. Delayed hospital visits in patients with breast cancer after the great East Japan earthquake and the subsequent Fukushima Daiichi nuclear power plant accident: A retrospective comparative analysis. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-12-04.

The palladium-catalyzed direct alkenylation of thieno[3,2-b]thiophene takes place regioselectively at C2. Symmetrically and unsymmetrically 2,5-dialkenylated thienothiophene derivatives can be prepared by the catalytic procedure. Related fused thienyl and carbazole derivatives also undergo regioselective direct alkenylation.