Effect of COVID-19 Infection on Presenteeism: Cohort Study Using Large Health Insurance-Based Data in Japan.

OBJECTIVE: Presenteeism occurs when employees attend work despite experiencing problems and ill-health that require sick leave. This study examined whether presenteeism worsened following COVID-19 infection. METHODS: We used the DeSC, a large health insurance claims database. Participants were 9,241 individuals who responded to questionnaires at baseline (June 2020) and 6 months later, had been continuously insured for at least 6 months prior to baseline, and reported being employed. Propensity score matching was performed. Adjusted multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of worsening presenteeism from baseline according to COVID-19 infection compared with non-infection. RESULTS: Conditional logistic regression analysis showed that the adjusted OR for presenteeism in the COVID-19 infected group was 1.555 (95% CI, 1.086-2.225). CONCLUSION: The findings suggest that COVID-19 infection affected worsening of presenteeism.

Characteristics and Methodological Quality of the Top 50 Most Influential Articles on Stroke Rehabilitation: A Bibliometric Analysis.

ABSTRACT: This study aimed to conduct a comprehensive review of the top 50 most influential articles on stroke rehabilitation to investigate characteristics, such as the number of citations, year of publication, study design, and research topic, as well as to assess the evidence level and methodological quality. Moreover, we performed a supplementary assessment of the top 10 articles published within the past 5 yrs in the same domain, aiming to discern potential shifts in trends and methodological quality. Web of Science was used to search for articles on stroke rehabilitation. The data extracted from the articles included title, journal impact factor, year of publication, total number of citations, article topic, study design, and others. The level of evidence and methodological quality were assessed by two reviewers. Noninvasive brain stimulation and robotic rehabilitation were frequently discussed in the top 50 articles. We found that there was no difference in methodology quality between the top 50 articles in all years and the top ten articles in the past 5 yrs. Furthermore, the number of citations and citation density were not associated with the methodological quality. The findings suggest that the number of citations alone may not be a reliable indicator of research quality.

Impact of changes in skeletal muscle mass and quality during the waiting time on outcomes of lung transplantation.

INTRODUCTION: The association of changes in skeletal muscle mass and quality during the waiting time with outcomes of lung transplantation (LT) remains unclear. We aimed to examine the association of changes in skeletal muscle mass and quality during the waiting time, as well as preoperative skeletal muscle mass and quality, with outcomes of LT. METHODS: This study included individuals who underwent LT from brain-dead donors. Skeletal muscle mass (cm2 /m2 ) and quality (mean Hounsfield units [HU]) of the erector spinae muscle at the 12th thoracic level were evaluated using computed tomography. Preoperative skeletal muscle mass and quality, and their changes during the waiting time were calculated. We evaluated the associations among mechanical ventilation (MV) duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, 6-minute walk distance at discharge, and 5-year survival after LT. RESULTS: This study included 98 patients. The median waiting time was 594.5 days (interquartile range [IQR], 355.0-913.0). The median changes in skeletal muscle mass and quality were -4.4% (IQR, -13.3-3.1) and -2.9% (IQR, -16.0-4.1), respectively. Severe low skeletal muscle mass at LT was associated with prolonged ICU LOS (B = 8.46, 95% confidence interval [CI]: .51-16.42) and hospital LOS (B = 36.00, 95% CI: 3.23-68.78). Pronounced decrease in skeletal muscle mass during the waiting time was associated with prolonged MV duration (B = 7.85, 95% CI: .89-14.81) and ICU LOS (B = 7.97, 95% CI: .83-15.10). CONCLUSION: Maintaining or increasing skeletal muscle mass during the waiting time would be beneficial to improve the short-term outcomes of LT.

Differential Associations of Frailty with the Incidence of Mild and Severe Disabilities in Older Adults: A 3-Year Cohort Study.

BACKGROUND: Frailty is associated with the incidence of disability in older adults; however, few studies have investigated differences in the association of frailty with mild and severe disabilities according to Japanese long-term care insurance certification. This study separately investigated the associations between frailty and the incidence of mild and severe disabilities. METHODS: This 3-year retrospective cohort study included community-dwelling adults in Okayama City aged ≥65 years. We assessed frailty status using the Kihon Checklist and defined the outcomes as mild and severe disabilities according to long-term care insurance certifications. We applied multinomial logistic regression analysis to investigate the association between frailty and the incidence of mild and severe disabilities. RESULTS: The analysis included a total of 36,043 participants. For mild disability, the odds ratios (ORs) comparing frail to robust and prefrail to robust were 3.85 (95% confidence interval [CI], 3.36-4.42) and 1.82 (95% CI, 1.58-2.10), respectively. Similarly, the corresponding ORs for severe disability were 4.35 (95% CI, 3.55-5.34) and 1.78 (95% CI, 1.43-2.21), respectively. In the age-stratified analysis of mild disability, the pre-old group (aged 65-74 years) with frail showed a higher association than the old-age group (aged ≥75 years) with frail. Regarding severe disability, the older group with frailty showed a higher association than the pre-old group with frailty. CONCLUSION: The results showed that both prefrail and frail were associated with the incidence of mild and severe disabilities, with different patterns of association between the pre-old and old age groups.

Letter to the editor: Calcar fracture gapping: a reliable predictor of anteromedial cortical support failure after cephalomedullary nailing for pertrochanteric femur fractures.

A recently published article by Song H et al. investigated the risk factors for anteromedial cortical support loss in pertrochanteric fractures treated with cephalomedullary nails. In this Correspondence, we would like to raise some concerns. Specifically, calcar fracture gap and anteromedial cortical support are different concepts in evaluating reduction quality. In addition, calcar fracture gap using immediate postoperative radiographic images has measurement bias. Lastly, explanatory variables selected for multivariable analysis are inappropriate. We would like to discuss and suggest solutions for these problems.