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Purpose: Psychological distress and related factors in suicide prevention supporters during the COVID-19 pandemic were clarified. Methods: A web-based survey for supporters from helplines or psychiatric institutions was conducted from May to July 2021. It included items about profession, stress and anxiety, and the Kessler Psychological Distress Scale. Results: 818 participants were analyzed. Psychological distress was significantly higher among healthcare workers in psychiatric institutions than among helpline volunteers. The factor most related to psychological distress in both professions was insufficient rest with overwork. Distress in helpline volunteers was related to their lack of ability to support people with suicidal thoughts and suicide attempts, excessive media coverage related to COVID-19, and trouble dealing with complainers. Distress in healthcare workers was related to their lack of ability to provide sufficient support to their clients due to infection prevention measures. Conclusion: Psychological distress among suicide prevention supporters during the pandemic has been affected by overwork, the fact that helpline volunteers cannot be trained in suicide prevention, and the fact that healthcare workers can only provide insufficient support to their clients due to infection prevention measures. To maintain suicide prevention during pandemics, it is necessary to implement measures that are tailored to the factors of psychological distress in supporters.

ObjectivesMajor depressive disorder (MDD) is often comorbid with other chronic and/or serious diseases. However, little is known about the prevalence of various diseases that are present before MDD onset. We examined the prevalence of all pre-existing diseases in the 12 months before an MDD diagnosis.DesignExploratory nested case–control study.SettingData, including diagnoses based on International Statistical Classification of Diseases and Related Health Problems, 10th revision codes, were from a Japanese health insurance database (JMDC).ParticipantsAdults newly diagnosed with MDD during 2015, 2016 or 2017 (but not the preceding year) (cases) were matched (exact) 1:10 to controls by age, sex, index date and working status.Primary and secondary outcome measuresThe primary outcome was the proportion of patients in each group with each pre-existing disease during the 12 months before the index date (ie, before MDD diagnosis in cases). Odds ratios (ORs) for onset of MDD were calculated for each pre-existing disease. A post hoc multivariate analysis examined interactions of metabolic risk factors (diabetes, hypertension, dyslipidaemia), psychiatric disorders (sleep disorders, psychiatric disorders other than depression) and MDD-related symptoms (headache, pain, autonomic nerve imbalance) on MDD diagnosis.ResultsThere were 13 420 cases and 134 200 controls (mean age 41.9 years; 66.5% male). The prevalence of almost all pre-existing diseases was higher in cases than in controls. The highest ORs (5.8–21.0) were for psychiatric diseases and sleep disorders. Insomnia (21.1% of patients; OR 8.7) and neurosis (9.7%; OR 10.6) were particularly prevalent in the case group. The odds of MDD increased in the presence of metabolic risk factors, psychiatric disorders and/or MDD-related symptoms.ConclusionsThere is a high prevalence of pre-existing diseases in Japanese patients who develop MDD compared with matched controls without MDD. These results suggest that patients with chronic and/or serious diseases should be actively monitored for depression.

Suicide is one of the common severe accidents occurring in hospitals. This study aimed to investigate inpatient suicides simultaneously in medical and psychiatric settings in a large number of hospitals and to examine the prevalence of common suicide risk factors, related symptoms in inpatients who had died by suicide and the differences in inpatient suicides between both settings. We conducted a survey of hospitals in Japan that belonged to the nationwide standard-setting and accrediting body. The questionnaire covered the: 1) presence or absence of inpatient suicides in each hospital from 2012 to 2015; 2) number of inpatient suicides; 3) method, location, and timing of inpatient suicides; and 4) characteristics of inpatients who died by suicide. In total, 529 hospitals reported 262 inpatient suicides during the 3-year period: 131 were in medical settings and 131 were in psychiatric settings. The prevalence of common suicide risk factors was frequent in inpatient suicides. Inpatients had characteristics and suicide risk factors specific to those settings such as worsening of physical health in medical settings. Therefore, recognizing common suicide risk factors and understanding differences in inpatient suicides between both settings are important to prevent inpatient suicides.

Suicide is a major cause of death among inpatients with schizophrenia. However, there are only a limited number of surveys of suicide among such patients, especially in Asia. Therefore, we conducted a multi-institutional survey on suicide death among inpatients with schizophrenia in Japan. We investigated the characteristics of patients with schizophrenia who died by suicide during hospitalization in psychiatric wards, and simultaneously, those of patients with depression. Forty-five suicides of patients with schizophrenia occurred in 27 hospitals, and 46 suicides of patients with depression occurred in 33 hospitals. Hanging was the most common suicide method in both diagnostic groups. More than half of the patients with schizophrenia had histories of suicide attempts, although there was no significant difference in previous suicide attempts or self-harm between both diagnostic groups. Medical staff should confirm whether inpatients with schizophrenia have such histories. In this study, there was no significant difference in characteristics between inpatients with schizophrenia or depression. In order to prevent suicides of patients with schizophrenia during hospitalization, nonspecific suicide attempt prevention needs to be undertaken, such as ensuring comprehension of the general risk factors of suicide among medical staff.

The dielectric constant, elastic modulus and reliability of the pure silica-zeolite composite film which was formed by self-assembly of porous silica having hydrothermally crystallized zeolite nanoparticles. Fourier-transform-infrared spectroscopy indicated that Si-OH and O-H bonds decreased by zeolite formation, resulting in the decrease of the dielectric constant. Silylation hardening by 1,3,5,7-tetramethylcyclotetrasiloxane (TMCTS) vapor treatment could decrease the dielectric constant due to the decrease of Si-OH and O-H bonds. The elastic modulus of 7.03 GPa and the dielectric constant of 1.94 were achieved for the meso-porous silica-zeolite film by silylation hardening. Furthermore, mean-time-to-failure (MTF) lifetime of time-dependent dielectric breakdown (TDDB) is longer than ten years at 125°C under the electric field of 3.4 MV/cm.

Pure silica zeolite films were prepared by a vapor-phase transport method using ethylenediamine (EDA), triethylamine (Et3N), and water as vapor sources. The optimum mixture ratio of EDA:Et3N:H2O was 1:2:1 for forming randomly oriented ZSM-48 zeolite crystals. Compared with samples formed by the sol–gel technique and spin-coating method, the vapor-phase transport method can suppress isolated Si–OH bonds and film shrinkage. Dielectric constant decreased with increasing vapor-phase transport time, and leakage current decreased to an order of 10-8 A/cm2.

The dependence of the electrical characteristics of hydrothermally crystallized pure-silica–zeolite films on the water concentration in the precursor was investigated. Zeolite was crystallized in a silica–zeolite composite film after spin-coating the precursor, which was composed of tetraethylorthosilicate, tetrabutylammonium hydroxide, ethylalcohol, and deionized (DI) water, followed by calcinations at 400 °C. The results of Fourier-transform infrared (FT-IR) spectroscopy indicated that the number of Si–OH and O–H bonds decreased with an increase in the water concentration in the precursor. The dielectric constant of the film decreased with an increase in water concentration, while the leakage current increased.

We calculate the effective potential for the vacuum gauge field from the one-loop matter effect in M3×S3×S1 spacetime. This background geometry is motivated from the recent studies on gauged supergravities with a positive-definite potential, which admits a generalized Kaluza–Klein reduction. We investigate how symmetry breaking patterns through the Hosotani mechanism are affected by the ratio of the radii of S1 and S3.

In view of the fact that the suicide rate in Japan has remained high since 1998, the Basic Act on Suicide Prevention was implemented in 2006 with the objective of comprehensively promoting suicide prevention measures on a national scale. Based on this Basic Act, in 2007, the Japanese government formulated the General Principles of Suicide Prevention Policy as a guideline for recommended suicide prevention measures. These General Principles were revised in 2012 in accordance with the initial plan of holding a review after five years. The Basic Act places an emphasis on the various social factors that underlie suicides and takes the perspective that suicide prevention measures are also social measures. The slogan of the revised General Principles is "Toward Realization of a Society in which Nobody is Driven to Commit Suicide". The General Principles list various measures that are able to be used universally. These contents would be sufficient if the objective of the General Principles were "realization of a society that is easy to live in"; however, the absence of information on the effectiveness and order of priority for each measure may limit the specific effectiveness of the measures in relation to the actual prevention of suicide. In addition, considering that nearly 90% of suicide victims are in a state at the time of committing suicide in which a psychiatric disorder would be diagnosed, it would appear from a psychiatric standpoint that measures related to mental health, including expansion of psychiatric services, should be the top priority in suicide prevention measures. However, this is not the case in the General Principles, in either its original or revised form. Revisions to the General Principles related to clinical psychiatry provide more detailed descriptions of measures for individuals who unsuccessfully attempt suicide and identify newly targeted mental disorders other than depression; however, the overall proportion of contents relating to psychiatric care remains small. In particular, it must be noted that almost no measures are provided for individuals with chronic psychiatric disorders. We believe that the role of academic societies involved in suicide prevention, including our own, is to organize the contents of the General Principles based on evidence, to advance research in areas lacking in evidence, and to promote support for implementation of activities in areas with clear evidence.

Suicide in the elderly is one of the major issues in the field of psychiatry. In Japan, the suicide rate among aged persons is very high, and the proportion of suicides among those aged 65 years and older to all suicides (27.6 % in 2010) is higher than that of those aged 65 years and older to the total population (23.1% in 2010). It is revealed that the vast majority of the elderly suicides suffered from depression at the time of suicide. Elderly people tend to have many loss experiences and also to have their executive function declined. Such tendencies might contribute, psychologically and biologically, to high lethality of their suicidal behavior. Attention should be paid to dementia, in particular its early stage. It is important for clinicians to ask depressed patients about death wishes and help suicidal patients seek for social support as well as psychiatric treatment.

It is assumed that discontinuation of treatment for depression may increase the risk of suicide. A population-based register study in Denmark did not find a lower risk among people over age 50 who followed treatment in comparison with those who discontinued treatment with antidepressants at an early stage. This result, however, does not allow us to think superficially that early discontinuation of treatment does not increase the risk of suicide. It is because the study has limitations without information of such as psychiatric diagnoses, severity of the depressed state, and reasons of discontinuation. It is safe for clinicians to aim at preventing discontinuation of treatment. Particularly, in Japan and South Korea where there is a sociocultural climate of tolerability for suicide, suicide can occur in milder depressed state and discontinuation of treatment should be taken more seriously than in Western countries.

People do not commit suicide all of a sudden. There is a suicidal process where negative life events are there in the beginning, and social support and help-seeking behavior play an important role in impeding the progress of the process. Mental disturbance would be deeply associated with the suicidal process around the final stage, thinking of the fact that approximately 90% of the suicides suffered from mental disorders at the time of suicide. In considering the strategies for suicide prevention, there are two perspectives: a community model and a medical model. A community model is thought to be related mainly to the first half of the suicidal process and a medical model to the latter half. It is an ideal that both community and medical approaches are put into practice simultaneously. However, if resources available for suicide prevention are limited, a medical-model approach would be more efficient and should be given priority. Starting from a medical model and considering treatment and social resources necessary for suicidal people, the range of suicide prevention activities would be expand more efficiently than starting from a community-model approach. Clinical psychiatry plays a greatly important role in preventing suicide. It is found that approximately 20% of seriously injured suicide attempters were diagnosed as adjustment disorder in Japan, which means that even the mildly depressed can commit suicide. Therefore, no one can take a hands-off approach to suicidality as long as he/she works in the field of clinical psychiatry. It is earnestly desired to detect and treat properly the suicidal patients, but there is no perfect method. It would be helpful to pay attention to patients' personality development, stress-coping style and present suicidal ideation. Besides, as suicide prevention is not completed only in a consulting room, it is important for psychiatrists to look for teamwork.

Mycotic celiac artery aneurysm following infective endocarditis is extremely rare and, to our knowledge, only four cases have been reported in the literature to date. We describe the case of a 60 year-old man who developed a mycotic aneurysm of the celiac artery, which was detected by computed tomography (CT) following an episode of infective endocarditis. He successfully underwent endovascular isolation and packing of the aneurysm using N-butyl cyanoacrylate (NBCA) with embolization coils.

We examine charged static perfect fluid distributions with a dilaton field in the frame-work of general relativity. We consider the case that the Einstein equations reduce to a non-linear version of Poisson equation. We show that Maxwell equation and an equation for a dilaton imply the relation among the charge, mass and dilatonic charge densities., Comment: 8 pages, 14 esp files, LaTex2e with the standard packages graphicx

We fabricated a biosensor based on a silicon nanowire field-effect transistor (SiNW FET) with a Si3N4 gate insulator for highly sensitive detection of target biomolecules. The fabricated SiNW FET acted as an ion-sensitive FET that could detect the charge density in solutions flowing along the gate surface by responding to the pH of the solutions. The SiNW FET also detected charged protein molecules in solution, suggesting that our device can be used in highly sensitive, label-free biosensing.

In relation to clinical and histological findings of gingiva, local microcirculatory system of hamster gingiva was studied on its morphology and the blood flow according to the 133Xe clearance method under the four different thermal irritations.The results were as follows:1) No change on the morphology of blood vessels and the amount of blood flow was observed in the control group, 37°C (preliminary experiment) group, which exhibited no abnormal clinical and histological findings of gingiva.2) 45°C group exhibited similar findings to the control group, i. e. no changes were observed in its clinical and histological findings of gingiva and the morphology of blood vessels as well as the amount of blood flow.3) 55°C group showed normal gingival findings clinically, however, a slight disturbance was observed histologically, and morphological changes of blood vessels together with the persistent decrease of blood flow were recognized.4) 65°C group and 75°C group showed considerable disorders on clinical and histological findings of gingiva and, in accordance to those, morphological changes of blood vessels and the decrease of the amount of blood flow were observed.From these results, it may be concluded that the amount of blood flow decreases when gingiva is suffered from some pathologic conditions such as inflammation. Even in the clinically normal gingiva, the changes in blood flow were found when pathologic conditions were observed histologically.