The range of atlanto-occipital joint motion in cetaceans reflects their feeding behavior.

The cetaceans display a wide variety of lifestyles, especially with regard to their feeding behavior. However, the evolutionary process of the feeding behavior in cetaceans is still poorly understood, in part because reconstructing the feeding behavior of extinct taxa remains difficult. In cetaceans, cranium mobility relative to the trunk largely depends on the range of motion permitted by the atlanto-occipital joint, given the lack of flexibility of the cervical series. In this study, we examined 56 extant cetacean skeletal specimens from 30 species in 25 genera and nine families in order to investigate the relationships between anatomical traits and feeding behavior. Our results suggest that the range of dorso-ventral motion allowed by the atlanto-occipital joint (ROM) depends on prey habitat and the feeding technique of cetaceans. Cetaceans feeding on benthic/demersal prey had a relatively large ROM compared with those feeding on pelagic prey. In addition, ROM was largest in raptorial feeders, intermediate in suction feeders, and smallest in ram-filter feeders. Among raptorial feeders, ROM tended to be larger in taxa that facultatively tear off the prey's flesh compared with taxa that swallow their prey whole. Therefore, we conclude that ROM is a powerful tool to reliably reconstruct the feeding behavior of extinct cetacean taxa.

Anatomic characterization of the humeral nutrient artery: Application to fracture and surgery of the humerus.

Anatomic characterization of the humeral nutrient artery varies among the several textbooks on human anatomy. To clarify the anatomic characteristics of the humeral nutrient artery, we reexamined its origin and course by cadaveric dissection. In typical cases, one prominent nutrient foramen was situated on the anteromedial surface of the humeral shaft, and the nutrient canal distally penetrated the cortical bone layer. The humeral nutrient artery originated from the brachial artery below the level of the nutrient foramen as a short ascending branch. On reaching near the nutrient foramen, the humeral nutrient artery formed a hairpin loop on the periosteum to enter into the nutrient foramen. In some cases, an accessory nutrient foramen was also found near the groove for the radial nerve on the posterior surface of the humerus. This accessory nutrient foramen received an accessory humeral nutrient artery that originated from the radial collateral artery. The present findings corresponded well with the descriptions in the anatomy textbooks published in English-speaking countries. However, textbooks published in German-speaking countries describe only one type of humeral nutrient artery, the branch of the profunda brachii artery. Terminologia Anatomica, the international standard in human anatomic terminology, most likely adopted the description in the German anatomy textbooks, and thus, it is necessary to correct the position of the humeral nutrient artery in the hierarchy of Terminologia Anatomica for accurate morphological description. Clin. Anat. 30:978-987, 2017. © 2017 Wiley Periodicals, Inc.

Physiotherapy program through home visits for community-dwelling elderly Japanese women with mild knee pain.

Knee pain is extremely common among the elderly, particularly women. Hence, there is an urgent need for applicable community-based intervention models for halting the progression of knee pain and related disabilities in elderly women. We aimed to assess the efficacy of home-visit physiotherapy as a new intervention model. This non-randomized 5-month-long controlled trial enrolled elderly community-dwelling women (aged 60-83 years) with mild knee pain. The intervention consisted of two home visits by a physiotherapist, with instructions on routinely performing muscle-strengthening exercises at home and implementing simple environmental modifications when necessary. Outcome measures were assessed at baseline and 5 months later. The primary outcomes were measured as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and a newly devised seiza-style sitting score. People in Japan, especially elderly women, are accustomed to seiza-style sitting that involves kneeling on one's lower legs while resting the buttocks on the heels. The secondary outcomes included quadriceps isometric strength, knee alignment in the frontal and sagittal planes, and passive knee extension range. Forty-two subjects (20 in the intervention group and 22 in the control group) completed the study. At baseline, characteristics and the primary outcomes did not significantly differ between the 2 groups. At 5 months, the primary outcomes improved significantly in the intervention group. Estimated differences in the change from baseline for each outcome between the 2 groups were computed, adjusting for outcome variables imbalanced at baseline. Even after the adjustment, the home-visit physiotherapy regimen provides favorable improvement in the seiza-style sitting score.

Anatomic characterization of the radial and ulnar nutrient arteries in humans.

BACKGROUND: The localization of nutrient foramens has been extensively studied in humans and other vertebrate animals. However, accurate information on the origin and extraosseous course of the nutrient arteries in some types of long tubular bones is lacking. Terminologia Anatomica, the international standard on human anatomic terminology, lists the radial nutrient artery (RNA) and the ulnar nutrient artery (UNA) as branches of the radial and ulnar arteries, respectively. Anatomy textbooks published in both German- and English-speaking countries regard both the RNA and UNA as branches of the anterior interosseous artery. METHODS: To clarify the anatomic characteristics of the RNA and UNA in humans, we reexamined the origin and course of these arteries by cadaveric dissection. RESULTS: Almost all RNAs and UNAs branched from the ulnar artery or its tributaries. In typical cases, the RNA branched from the anterior interosseous artery and the UNA branched from the proximal part of the ulnar artery or the anterior interosseous artery. These findings are reasonable from the perspective of regional anatomy, since the ulnar artery passes more deeply than the radial artery in the proximal forearm and thus the proximal part of the ulnar artery and its major branches are situated more closely to the radial and ulnar nutrient foramens. CONCLUSIONS: Based on our findings, it is necessary to correct the position of the RNA and UNA in the arterial hierarchy of T. Anatomica for accurate morphological description.

FALL-RELATED ACTIVITIES OF DAILY LIVING AND BEHAVIOUR DISTURBANCES IN DEMENTIA.

The purpose of this study is to clarify the activities of daily living and behaviour disturbances related to inpatients and outpatients with dementia experiencing falls. Patients diagnosed with dementia belonging to 18 facilities which consented to the study were subjected. The study involved "whether or not the patient has fallen in the past 12 months", "Barthel Index (B.I)", and "Dementia Behaviour Disturbance Scale (DBD)" and other data from 325 people in 18 facilities who had been diagnosed with dementia. The ratio of subjects who had fallen to those who had not was 113:212. The results of multiple logistic regression analysis showed that the study items related to falls including the DBD item of "making unwarranted accusations" had an OR = 1.445, 95% CI (1.133-1.843), the DBD item of "refusing to eat" had an OR = 0.699, 95% CI (0.521- 0.938), the B.I item of "feeding" had OR = 1.115, 95% CI (1.032-1.204) and the B.I item of "bathing" had OR = 0.782, 95% CI (0.671-0.912). Integral characteristics of dementia patients who have fallen are assumed to be making unwarranted accusations, having a low rate of refusing to eat, being able to eat alone and requiring attention when bathing.

The usefulness of a questionnaire to evaluate daily living performance in psychiatric inpatients: results of cross-sectional and follow-up studies.

The purpose of this research was to study the usefulness of daily living performance scores (DLPS) in order to indicate the capabilities of inpatients at psychiatric hospitals in performing activities of daily living (ADL). A cross-sectional study was conducted on 44 subjects who were inpatients at psychiatric hospitals in Japan and who responded to a questionnaire about daily living performance. A follow-up survey was conducted 9 months later on 43 patients. These patients were targeted for a study on the relationship between items relating to adverse ambulatory events and DLPS. The results showed a strong correlation between DLPS. From the follow-up survey, the odds ratio (OR) and 95% confidence intervals (CI) for each event experience that produced a 1-point increase in the DLPS were obtained by gender and age-adjusted multiple logistic analysis. The results were as follows: "falling" OR = 0.89, CI (0.805 - 0.977), "stumbling" OR = 0.84, CI (0.733 - 0.977), "indoor ambulatory anxiety" OR = 0.87, CI (0.795 - 0.996), "outdoor ambulatory anxiety" (OR = 0.88, CI (0.795 - 0.996), "injury due to falling" OR = 0.89, CI (0.798 - 0.984) (p < 0.05). The results confirm that DLPS are useful in predicting adverse ambulatory events experienced by patients in psychiatric hospitals.

Evaluation of performance status of daily living activities and of the future risk of falls in the non-handicapped, community-dwelling elderly.

OBJECTIVES: There is a growing need to evaluate the performance status of the activities of daily living (ADL) of the elderly in the rapidly aging Japanese society. The purpose of this study was to verify the usefulness of our new scoring sheet for assessing present ADL status and to clarify whether or not the assessed ADL status can predict the future risk of adverse conditions related to falls. METHODS: The validation study was performed using 116 non-handicapped community-dwelling Japanese elderly at least 60 years of age. Of those subjects, 44 were also analyzed for the relationship between baseline ADL status and subsequent risk of adverse conditions related to falls. RESULTS: The daily living performance score sheet had good internal consistency, with a Cronbach's alpha of 0.82 and a sequential hierarchical structure that reflected the difficulty of the activities. The total score was significantly and positively associated with six of eight subscale scores on the Short-Form 36-Item Health Survey (P < 0.01). In the follow-up study, every one-point decrease in total score was significantly associated with a 39% elevated risk of a stumble or fall (P = 0.022) and also borderline significantly associated with higher risks of a fall, anxiety while walking indoors, and anxiety while walking outdoors (P < 0.10). CONCLUSION: Our new scoring sheet can reliably and comprehensively assess present ADL status. The assessed ADL could predict the future risk of adverse conditions related to falls.