Development of new measurement system of thoracic excursion with biofeedback: reliability and validity.

BACKGROUND: Respiratory rehabilitation reduces breathlessness from patient with respiratory dysfunction. Chest expansion score, which represents the circumference magnitude of the thoracic cage, is used for a target when treating patients with respiratory disease. However, it is often difficult for patients to understand the changes in the respiratory status and be motivated for therapy continuously. We developed a new measurement system with biofeedback named BREATH which shows chest expansion scores in real time. The purpose of this study was to determine the reliability and validity of the novel system in advance of clinical application. METHODS: Three evaluators measured chest expansion in 33 healthy individuals using tape measure, which is used for the measurement traditionally, and BREATH. The wire for BREATH system was threaded over the thoracic continuously and the data was recorded automatically; whereas the tape was winded and measured each maximal expiration and inspiration timing by evaluator. All participants were performed both measurement simultaneously for three times during deep breath. In this study, we studied chest expansion score without using biofeedback data of BREATH to check the validity of the result. To confirm intra- and inter-evaluator reliability, we computed intra-class correlations (ICCs). We used Pearson's correlation coefficient to evaluate the validity of measurement result by BREATH with reference to the tape measure results. RESULTS: The average (standard deviation) chest expansion scores for all, men and women by the tape measure were 5.53 (1.88), 6.40 (1.69) and 5.22 (1.39) cm, respectively, and those by BREATH were 3.89 (2.04), 4.36 (1.83) and 2.89 (1.66) cm, respectively. ICC within and among the three evaluators for BREATH and the tape measure were 0.90-0.94 and 0.85-0.94 and 0.85 and 0.82, respectively. The correlation coefficient between the two methods was 0.76-0.87. CONCLUSION: The novel measurement system, BREATH, has high intra- and inter-evaluator reliabilities and validity; therefore it can lead us more effective respiratory exercise. Using its biofeedback data, this system may help patients with respiratory disease to do exercises more efficiently and clinicians to assess the respiratory exercise more accurately.

Cancer Screening Abstinence Rates and Rationales Among Regular Outpatients at a Rural Hospital in Japan: A Cross-Sectional Study.

Purpose: This study aimed to investigate cancer screening rates and the reasons for not undergoing screening among patients who regularly visited the Sanmu Medical Center. Patients and Methods: This prospective observational study recruited patients aged ≥40 years with regular clinic visits to Sanmu Medical Center during October 2019. We conducted a self-administered survey to determine the patient's sex and whether they underwent cancer screening in 2019, and if not, the reason for the same. The primary outcome measure was the percentage of people who did not undergo cancer screening. Results: A total of 198 responses (108 male respondents) were obtained. Among them, 189 were valid responses (valid response rate 94.5%). One hundred and twenty-nine patients (68.2%, 76 male) had not undergone screening. The most common reasons provided were "I have regular regular clinic visits and do not think they are necessary" (N = 65, 50.3%), "I underwent a gastroscopy within 2 years, a colorectal camera examination within a few years, and a chest radiography within a year" (42.5%), and "I have a separate complete medical checkup" (N = 15, 11.6%). Of the 65 patients who responded that their cancer screenings were unnecessary, 42 patients (64.6%) had not undergone a gastroscopy within 2 years, a colorectal camera examination within a few years, or a chest radiography or examination within a year. Conclusion: Roughly half of the respondents who did not undergo cancer screening elected to abstain because they believed that regular hospital visits were sufficient. Encouraging patients who regularly visit medical institutions to receive cancer screening is therefore necessary.

Development of a toileting performance assessment test for patients in the early stroke phase.

Purpose: The study aimed to develop a toileting performance assessment test to measure the toileting performance ability of patients in the early phase after stroke.Methods: In this study, 214 stroke patients were enrolled. Cronbach's α, Spearman's rank correlations (ρ values) with the toileting-related items of the functional independence measure and Barthel Index, interrater reliability (weighted κ), and responsiveness (standardized response mean) were evaluated. Receiver operating characteristic and the area under the curves were utilized to determine the cutoff scores for the significance of the independence of toilet ability with the functional independence measure and Barthel Index.Results: Cronbach's α was ≥0.90. The p values between toileting performance assessment test and Barthel Index and between toileting performance assessment test and functional independence measure were 0.88 and 0.86, respectively. The weighted κ for each item was ≥0.61. The standardized response means were 0.81 for the functional independence measure, 0.70 for the Barthel Index, and 0.93 for the toileting performance assessment test. Cutoff scores of the toileting performance assessment test were 18 points.Conclusions: The toileting performance assessment test has acceptable psychometric properties and proved useful in assessing toileting performance ability of patients in the early phase after stroke.Implications for rehabilitationToileting performance assessment test demonstrated acceptable psychometric properties, and it can be useful for assessing the toileting ability of patients in the early phase after stroke.Toileting performance assessment test should provide information that leads to lowered risk of falls while toileting, and the information gathered can assist patients in achieving early toileting independence after stroke.As the development of toileting performance assessment test excluded patients with cognitive disabilities, the item for cognitive function should be developed as well.

Multi-Probe-Fluorescence in situ Hybridization for the Rapid Enumeration of Viable Vibrio parahaemolyticus.

A one-step multi-probe FISH method of detecting viable Vibrio parahaemolyticus was developed. Three candidate regions, corresponding to Helix 440+441, Helix 588, and Helix 1241 in 16S rRNA, were selected for detection, the thermodynamic parameters (ΔG(overall)) of the probes were optimized, and VP437, VP612 and VP1253, whose fluorescence were 1.7 to 11.3 times that of ΔG(overall)-unadjusted sequences, were designed. The addition of competitive oligonucleotides to reactions with VP612 and VP1253 strengthened the specificity of the probes. The three probes were labeled with FITC, TAMRA, and Cy5, respectively, and using a mixture of the probes and six competitive oligonucleotides, one-step FISH was applied to the species-specific detection of V. parahaemolyticus including epidemic strains of O3:K6 and O4:K68 serotypes. V. alginolyticus, V. rotiferianus, and V. campbellii were not detected in the reaction. Microcolonies (30-80 µm in diameter) of V. parahaemolyticus were observed within 6 hours at 37°C on seawater agar plates in both fresh and heat-damaged V. parahaemolyticus. Viable bacterial counts based on the proposed method were significantly different from those measured with typical vibrio selective media (CHROMagar Vibrio and TCBS).