Influence of patients' walking ability at one-week post-proximal femur fracture surgery on the choice of discharge destination in Japan.

[Purpose] With the innovation of healthcare delivery systems, a need for early determination of patients' discharge outcomes arises after proximal femur fracture surgery, to reduce the burden on healthcare infrastructure. Several studies have examined the extent of walking ability early in the postoperative period to predict the outcome destination. In this study, as an additional validation of these studies, we examined the effect of walking ability on the hospital discharge prognosis of patients in the first week after proximal femur fracture surgery in Japan. [Participants and Methods] Medical records of 228 patients with proximal femur fractures, aged ≥75 years old, admitted between April 2015 and March 2019, were retrospectively analyzed. The objective variable was discharge destination. The main evaluation factor was walking ability one-week post-surgery. [Results] Good walking ability and the company of a relative living together one week post-surgery were significant determining factors of discharge destination. [Conclusion] The ability to walk and the presence of a co-resident one week after surgery increased the likelihood of proximal femur fracture patients to be discharged directly to home. Our findings may help rehabilitation professionals make better decisions regarding discharge destination.

Correlative microscopy and block-face imaging (CoMBI): a 3D imaging method with wide applicability in the field of biological science.

Correlative microscopy and block-face imaging (CoMBI) is an imaging method, which is characterized by the ability to obtain both serial block-face images as a 3-dimentional (3D) dataset and sections for 2-dimentional (2D) light microscopic analysis. These 3D and 2D morphological data can be correlated with each other to facilitate data interpretation. CoMBI is an easy-to-install and low-cost 3D imaging method since its system can be assembled by the researcher using a regular microtome, consumer digital camera, and some self-made devices, and its installation and instruction manuals are open-source. After the first release of CoMBI method from our laboratory, CoMBI systems have been installed in more than a dozen laboratories and are used for 3D analysis of various biological specimens. Typical application of CoMBI is 3D anatomical analysis using the natural color and contrast of the specimen. We have been using CoMBI for analyzing human brain to obtain the fine 3D anatomy as a reference to determine the causes of neurological diseases and to improve the effectiveness of surgery. Recently, we have been using CoMBI for detecting the colors of chromogens, which are used for labeling specific molecules. Mouse embryos colored with X-gal, a conventional chromogen for detecting LacZ products, were imaged using CoMBI, and the 3D distribution of X-gal was successfully visualized. Thus, CoMBI can now be used for many purposes, including 3D anatomical analysis, 2D microscopy using sections, and 3D distribution of specific molecules. These suggest that CoMBI should be more widely used in the field of biological research.

Early Ambulation Shortened the Length of Hospital Stay in ICU Patients after Abdominal Surgery.

The optimal time to ambulation remains unclear for intensive care unit (ICU) patients following abdominal surgery. While previous studies have explored various mobilization techniques, a direct comparison between ambulation and other early mobilization methods is lacking. Additionally, the impact of time to ambulation on complications and disuse syndrome prevention requires further investigation. This study aimed to identify the optimal time to ambulation for ICU patients after abdominal surgery and considered its potential influence on complications and disuse syndrome. We examined the relationship between time to ambulation and hospital length of stay (LOS). Patients were categorized into the nondelayed (discharge within the protocol time) and delayed (discharge later than expected) groups. Data regarding preoperative functioning, postoperative complications, and time to discharge were retrospectively collected and analyzed. Of the 274 postsurgical patients managed in the ICU at our hospital between 2018 and 2020, 188 were included. Time to ambulation was a significant prognostic factor for both groups, even after adjusting for operative time and complications. The area under the curve was 0.72, and the cutoff value for time to ambulation was 22 h (sensitivity, 68%; specificity, 77%). A correlation between time to ambulation and complications was observed, with both impacting the hospital LOS (model 1: p < 0.01, r = 0.22; model 2: p < 0.01, r = 0.29). Specific cutoff values for time to ambulation will contribute to better surgical protocols.

Factors Affecting the Length of Hospital Days After Laparoscopic Gastrectomy for Elderly Patients with Gastric Cancer.

PURPOSE: To clarify the factors affecting the length of hospitalization after laparoscopic gastrectomy based on the physical function, body composition, and postoperative course of the patients. METHODS: Of the patients with gastric cancer who underwent laparoscopic resection at the Ageo Central General Hospital, Japan, during 2018-2019, 51 underwent physical therapy. Data regarding the objective variables, such as length of postoperative hospital stay, and baseline attributes, such as age, body weight, body mass index (BMI), and corrected limb muscle mass, postoperative course (operation time, the estimated blood loss, the day before walking independently), preoperative physical function (grip strength, 6-min walking distance), and preoperative respiratory function (vital capacity [VC]%, one-second rate) were collected retrospectively from the medical records and analyzed using multiple regression plots. RESULTS: The most suitable hospital day model after surgery is one that incorporates the total postoperative course, respiratory function, physical function (R2 = 0.45, p < 0001), and operation time (ß = 0.12, p < 0.06). The information of the day before independent walking (ß = 0.68, p < 0.001) and % VC (ß = -0.19, p < 0.04) was extracted as factors. CONCLUSION: We concluded that the operation time, walking independence days, and % VC influence the postoperative length of hospital days.

Effect of HEMA adsorption on the stability of native and denatured type I tendon collagen.

Adsorption behavior and stabilization/destabilization effects of 2-hydroxyethyl methacrylate (HEMA) on a bovine tendon collagen (BTC) (type I), either native (N) or thermally denatured (D), were studied by IR spectroscopy and differential scanning calorimetry (DSC). The amount of HEMA adsorbed was larger on BTC(D) than on BTC(N), because BTC(D) had a larger specific surface area (SSA) as revealed from SSA measurement. Denaturation temperature (Td) of BTC(N), measured by DSC in aqueous HEMA solution, decreased from 63 degrees C to 40 degrees C with increasing HEMA concentration (CHEMA) up to 20 wt%. This destabilization might be caused by the loss of hydrophobic stabilization of the helix structure as CHEMA was increased. At CHEMA > 20 wt%, the structure of collagen was restabilized presumably due to the dehydration effect conferred by HEMA at higher concentration. BTC(D) with little helix content, however, showed only a weak endothermic peak in the DSC measurement and the Td at 40 degrees C was independent of CHEMA.

Cognition, blinks, eye-movements, and pupillary movements during performance of a running memory task.

INTRODUCTION: Blinks, saccades, and pupil diameter changes are studied for their application as tools to unobtrusively monitor aspects of performance. METHODS: Subjects performed a running memory task for a 60-min period. To evaluate changes in the relationship of blinks to saccades as a function of time on task, the ratio of blinks occurring with and without saccade was calculated for the second following stimulus termination plus the last 0.2 s of stimulus presentation, and also the second preceding stimulus onset plus the initial 0.2 s of stimulus presentation. Changes in pupil diameter following blinks with and without saccades were measured at the beginning, middle, and late in the experiment. RESULTS: Blink frequency increased during both periods as a function of time on task (p < 0.0001). The ratio of blinks concurrent with saccades during the post-stimulus period increased as a function of time on task (p < 0.0001). Pupil diameter increased following blink termination (p < 0.05), regardless of time on task, blink duration, or the presence of a saccade during the blink. CONCLUSION: Our results suggest that the increase in blinking associated with saccades as a function of time on task, and the pupillary dilation following a blink are associated with aspects of information processing. These results provide a framework for future studies assessing higher-order cognitive function in operational environments based on measurements of blink, pupil, and saccades.