The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J‐SSCG 2020), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created as revised from J‐SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high‐quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J‐SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU‐acquired weakness [ICU‐AW], post‐intensive care syndrome [PICS], and body temperature management). The J‐SSCG 2020 covered a total of 22 areas with four additional new areas (patient‐ and family‐centered care, sepsis treatment system, neuro‐intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large‐scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members. As a result, 79 GRADE‐based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J‐SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to improve the prognosis of patients undergoing treatment for sepsis and septic shock. We aimed to provide high-quality guidelines that are easy to use and understand for specialists, general clinicians, and multidisciplinary medical professionals. J-SSCG 2016 took up new subjects that were not present in SSCG 2016 (e.g., ICU-acquired weakness [ICU-AW], post-intensive care syndrome [PICS], and body temperature management). The J-SSCG 2020 covered a total of 22 areas with four additional new areas (patient- and family-centered care, sepsis treatment system, neuro-intensive treatment, and stress ulcers). A total of 118 important clinical issues (clinical questions, CQs) were extracted regardless of the presence or absence of evidence. These CQs also include those that have been given particular focus within Japan. This is a large-scale guideline covering multiple fields; thus, in addition to the 25 committee members, we had the participation and support of a total of 226 members who are professionals (physicians, nurses, physiotherapists, clinical engineers, and pharmacists) and medical workers with a history of sepsis or critical illness. The GRADE method was adopted for making recommendations, and the modified Delphi method was used to determine recommendations by voting from all committee members.As a result, 79 GRADE-based recommendations, 5 Good Practice Statements (GPS), 18 expert consensuses, 27 answers to background questions (BQs), and summaries of definitions and diagnosis of sepsis were created as responses to 118 CQs. We also incorporated visual information for each CQ according to the time course of treatment, and we will also distribute this as an app. The J-SSCG 2020 is expected to be widely used as a useful bedside guideline in the field of sepsis treatment both in Japan and overseas involving multiple disciplines.

We demonstrate a full-range complex and transmissive spatial light modulator (SLM) for simultaneous and independent amplitude and phase modulation of an input wave field. Arbitrary scalar complex optical fields are generated by stacking a pixelated liquid crystal display operating in phase-only (2π) modulation with passive polarization-sensitive components. The principle is based on optical combining the light fields of two neighboring phase-only modulating pixels, which were made orthogonally polarized by a structured half-wave plate, then passing through a birefringent plate to laterally shift one of the beams collinear to the other, and finally bringing to interference by a linear polarizer. Complex modulation by the proposed SLM is experimentally verified in monochrome green operation.

The desire for smaller, lower-cost portable multimedia devices, along with recent advances in TFT technology, is driving the integration of advanced functionality onto LCD display substrates [1][2][3]. Historically, active matrix LCD (AMLCD) devices have utilized thin-film amorphous silicon transistors as pixel switches to enable larger, higher resolution displays than would otherwise be possible. More recently, the development of low-temperature polysilicon (LTPS) thin-film transistors (TFTs) has permitted the integration of display driver circuits onto the display glass substrate. Now, with the advent of advanced TFT processes, such as Sharp's continuous grain (CG) silicon technology, it is possible to integrate other functions onto the display glass substrate thereby adding value to the display and facilitating a significant evolution in the design of mobile devices.In this paper we present a 2.6 inch VGA (640×480) AMLCD with an integrated optical input function that provides a 300dpi sensor output image at a 30Hz frame rate. A 1-transistor (1T) activepixel sensor (APS) circuit is integrated within each display pixel to achieve a total aperture ratio of 40%. With this technology, functions such as touch/pen input and fingerprint scanning may be achieved within one ultra-thin low-cost display module.The key enabling technology for this device is the CG-silicon TFT process. This proprietary process allows TFTs with higher performances than those of standard LTPS processes to be fabricated on the display glass substrate (see Fig 7.2.2). The image sensor's photosensor elements are thin-film lateral PIN-type photodiodes, formed on the glass substrate alongside the TFTs in the same CG-silicon process.The lack of a substrate connection and low parasitic capacitance of the lateral photodiode structure provides additional degrees of freedom in circuit design not open to the conventional CMOS image sensor. For example, as will now be described, by using a combination of (1) reset through the photodiode and (2) row select via the integration capacitor, the need for the reset and row-select transistors of the standard 3T-APS pixel circuit is obviated. As shown in Fig. 7.2.3, the resulting 1T-APS pixel circuit comprises only the lateral PIN photodiode (PD), an integration capacitor (C INT ) and a source follower TFT (M1).The operation of this 1T pixel circuit is described with reference to the circuit diagram of Fig. 7.2.3 and the waveforms shown in Fig. 7.2.4. At the start of the integration period, the voltage of the integration capacitor is reset to an initial value by temporarily pulsing the reset signal RST. When RST is brought high, the voltage of integrating node V INT is reset to an initial reset potential of V DDR -V F via the forward biased photodiode (where V F is the diode forward voltage drop). Since the RST high potential is less than the threshold voltage of the source follower transistor M1, it remains off during the reset and subsequent integration periods. At the end of the reset period RST is brought low...

Background: There is lack of evidence regarding nutritional management among intensive care unit (ICU) patients in a population with relatively low body mass index. Therefore, we conducted an observational study to assess the nutritional management in Japanese ICUs. Also, we investigated the impact of nutritional management and rehabilitation on physical outcome. Methods: The study population comprised 389 consecutive patients who received mechanical ventilation for at least 24 h and those admitted to the ICU for > 72 h in 13 hospitals. The primary outcomes were caloric and protein intake in ICU on days 3 and 7, and at ICU discharge. The secondary outcome was the impact of nutritional management and rehabilitation on physical status at ICU discharge. We defined good physical status as more than end sitting and poor physical status as bed rest and sitting. We divided the participants into 2 groups, namely, the good physical status group (Good group) and poor physical status group (Poor group) for analysis of the secondary outcome. Data were expressed as median (interquartile range). Results: The median amount of caloric intake on days 3 and 7, and at ICU discharge via enteral and parenteral routes were 8.4 (3.1–15.6), 14.9 (7.5–22.0), and 11.2 (2.5–19.1) kcal/kg/day, respectively. The median amount of protein intake on days 3 and 7, and at ICU discharge were 0.2 (0–0.5), 0.4 (0.1–0.8), and 0.3 (0–0.7) g/kg/day, respectively. The amount of caloric intake on day 3 in the Poor group was significantly higher than that of the Good group (10.1 [5.8, 16.2] vs. 5.2 [1.9, 12.4] kcal/kg/day, p < 0.001). The proportion of patients who were received rehabilitation in ICU in the Good group was significantly higher than that of the Poor group (92 vs. 63%, p < 0.001). The multivariate analysis revealed that caloric intake on day 3 and rehabilitation in ICU were considered independent factors that affect physical status (OR 1.19; 95% CI 1.05–1.34; p = 0.005 and OR 0.07; 95% CI 0.01–0.34; p = 0.001). Conclusions: The caloric and protein intakes in Japanese ICUs were 15 kcal/kg/day and 0.4 g/kg/day, respectively. In addition, critically ill patients might benefit from low caloric intake (less than 10 kcal/kg/day) until day 3 and rehabilitation during ICU stay.