Prolonged Sedentary Bouts Are Critically Involved in All-Cause Mortality in Patients on Chronic Hemodialysis: A Prospective Cohort Study.

We investigated the link between prolonged sedentary bouts and all-cause mortality in patients on chronic hemodialysis, using a prospective cohort. A total of 104 outpatients on chronic hemodialysis from 2013 to 2019, aged 71.4±11.4 years, were enrolled. Prolonged sedentary bouts (≥ 30 min and ≥60 min) (min and bouts) and relative prolonged sedentary bouts (≥ 30 min and ≥ 60 min) (%) on the patients' non-hemodialysis days were measured by a tri-accelerometer, and we also analyzed the patients' clinical parameters. The relationship between prolonged sedentary bouts and all-cause mortality was evaluated by a survival analysis and the Cox proportional hazard model. Thirty-five patients died during the follow-up period. A Kaplan-Meier analysis detected significant differences in the survival rate between two groups stratified by the median for all prolonged sedentary-bout parameters. After the adjustment for confounding factors, all of the prolonged sedentary-bout parameters were determinant factors for all-cause mortality. These results indicate that prolonged sedentary bouts on non-hemodialysis days were closely related to all-cause mortality in the patients on hemodialysis.

The influence of interradicular anatomy on the predictability of periodontal regenerative therapy of furcation defects: a retrospective, multicenter clinical study.

BACKGROUND: The relationship between the anatomy of the interradicular space and success in regenerative therapy of furcation defects is discussed in this paper. The goal of this retrospective, multicenter clinical study is to clinically evaluate the relationship between the interradicular conformation and regenerative therapy success with the use of a novel measurement method. METHODS: One hundred thirty-eight radiographs of mandibular molars with furcation defects that had been treated with regenerative therapy were collected from six clinical centers. Data on the type of therapy and clinical parameters before and after treatment (follow-up of at least 12 months) were collected. The radiographs (before surgery and at least 12 months postoperatively) were measured with a visual evaluation method by a blind operator using graphics software. RESULTS: Success, defined as a reduction in horizontal and vertical furcation involvement, decrease in probing depths, and increase in clinical attachment level, was statistically assessed on 138 regenerated molars sites and were related to clinical variables such as age, sex, center, and treatment. No correlation was found between success in regenerative therapy and the conformation of the interradicular space, measured with a visual ratio method and a standard linear measurement. At the univariate analysis, the parameters that had a correlation with success were center, extent of furcation involvement, treatment, and sex. The use of enamel matrix derivative (EMD) seemed to be the most favorable therapy, with increase in CAL gain and reduction of vertical or horizontal furcation involvement. CONCLUSIONS: The regenerative outcome was not significantly influenced by the anatomy of furcation. The center, the degree of furcation involvement, sex, and treatment (EMD) were significantly associated with higher success of periodontal regeneration.

Relation between Prolonged Sedentary Bouts and Health-Related Quality of Life in Patients on Chronic Hemodialysis.

This study aimed to investigate the link between prolonged sedentary bouts and health-related quality of life (QOL) in patients on chronic hemodialysis (CHD). A total of 84 outpatients on CHD, aged 71.6±11.8 years, were enrolled in this cross-sectional study. Parameters for prolonged sedentary bouts [i.e., ≧ 30 min (% and bout) and ≧ 60 min (% and bout)] were measured using a triaxial accelerometer. Health-related QOL (HRQOL) was evaluated by the Euro-QOL (EQ-5D). Clinical parameters were obtained from medical records. Relatively prolonged sedentary bouts (%) were 44.0±18.2 (≧ 30 min) and 29.8±16.5 (≧ 60 min) for total days. Prolonged sedentary bouts (bouts) were 6.2±2.7 (≧ 30 min) and 2.7±1.6 (≧ 60 min) for total days. EQ-5D scores were 0.728±0.220. All prolonged sedentary bout parameters were negatively correlated with EQ-5D scores, except for prolonged sedentary bouts (≧ 60 min) (min) and relatively prolonged sedentary bouts (%) on hemodialysis days. Multiple regression analysis showed that prolonged sedentary bout parameters were an important factor in EQ-5D scores even after adjusting for confounding factors for total and non-hemodialysis days. Our results suggested that prolonged sedentary bouts were closely associated with HRQOL in patients on CHD, especially on non-hemodialysis days.

Disaster Prevention Education along with Weekly Exercise Improves Self-Efficacy in Community-Dwelling Japanese People-A Randomized Control Trial.

Background and Objectives: Both disaster prevention and health promotion have become public health challenges in Japan. Maintaining physical fitness from the perspective of disaster prevention and maintaining physical fitness from the perspective of health are basically covering similar issues, they are seen as different from one another because of differences in administrative jurisdiction in Japan. In the case of disaster prevention education, physical fitness is not mentioned. In and outside Japan, partial integration of disaster prevention education and health education is required. This study compares and examines the effects of disaster prevention education and traditional exercise education, as well as exercise practice. A randomized controlled trial alongside an evacuation behavior model during the event of a disaster were used in this research. Materials and Methods: A total of 97 community-dwelling participants were randomly allocated to two groups, a disaster prevention education group (Group D) and a traditional exercise education group (Group E). Group D received disaster prevention education with weekly exercise. Group E received traditional exercise education with weekly exercise. After ten weeks of intervention, the total evacuation time of the disaster evacuation model course, physical fitness, self-efficacy (General Self-Efficacy Scale: GSES), and health-related quality of life (QOL) were compared between the two groups. Results: No differences were observed between the two groups regarding the changes in the parameters of total evacuation time, physical fitness, and health-related QOL. However, the changes in GSES scores were significantly higher in Group D (1.4 ± 3.9) than in Group E (-1.1 ± 7.5). Conclusions: Disaster prevention education with weekly exercise significantly increased participants' self-efficacy compared to traditional exercise education. The combination of disaster prevention education and exercise practice may have a positive effect not only on disaster prevention behavior but also on self-efficacy in health promotion. Disaster prevention education does not directly influence health promotion, but it may be a very effective method for indirectly promoting health.

Face-to-Face Exercises Performed by Instructors to Improve the Mental Health of Japanese in the Community-A Randomized Control Trial.

Background and objectives: The purpose of this study is to clarify the effects on the mental health of face-to-face exercise performed by an instructor (lesson-style Group: Group L) and exercise using machines (program-style Group: Group P) by randomized control trial. Materials and Methods: Among 120 subjects, 117 subjects were allocated to two groups with stratified randomization by sex (Group P: 58 subjects; Group L: 59 subjects). A 60-min health exercise class was held once per week for 12 consecutive weeks. The measurement items were mental health as a primary evaluation item and self-efficacy as a secondary evaluation item. Physical fitness was also measured using a new physical fitness test used in Japan. The 12-item general health questionnaire (GHQ-12) was used to measure mental health and the general self-efficacy scale (GSES) was used to measure self-efficacy. Results: After the intervention, 102 subjects were analyzed. The changes in mental health evaluated by GHQ-12 scores were significantly lower in Group L -0.7 (95% CI, -1.2 to -0.3) than Group P -0.1 (95% CI, -0.4 to 0.2) (p = 0.03). The changes in self-efficacy evaluated by GSES scores were significantly higher in Group P 5.3 (95% CI, 3.1 to 7.5) than Group L 1.3 (95% CI, -0.4 to 3.1) (p < 0.01). Conclusions: Compared with program exercises mainly using machines, face-to-face exercises performed by instructors improved mental health.

Relationship between Sedentary Behavior and All-cause Mortality in Japanese Chronic Hemodialysis Patients: A Prospective Cohort Study.

We investigated the relationship between sedentary behavior and all-cause mortality in patients undergoing hemodialysis. A total of 71 patients (39 men, 32 women, aged 72.1±11.7 years) were enrolled in this longitudinal study. Their sedentary behavior was measured using a tri-accelerometer that provides relative values per daily wearing time. We classified the sedentary behavior time into 2 groups (under the median: short-sedentary behavior (SB) group; over the median: long-SB group) and compared the groups' clinical parameters. We compared the groups' survival rates by using Kaplan-Meier curves and the log-rank test, and we performed multivariate analyses by a Cox-proportional hazard model to evaluate the relationship between the sedentary behavior and the survival rate. Twenty patients (28.2%) died during the observation period. The survival rate of the short-SB group was significantly higher than that of the long-SB group. Sedentary behavior was thus an important factor for all-cause mortality even after adjusting for confounding factors by a Cox-proportional hazard model. Sedentary behavior is closely linked to all-cause mortality, especially total days and non-hemodialysis days, and reducing sedentary behavior may be beneficial to reduce the all-cause mortality of patients on chronic hemodialysis.

A Pilot Study of the Relationship between Diet and Mental Health in Community Dwelling Japanese Women.

Background and Objectives: Diet is closely linked to mental health. The aim of this study was to explore the link between diet and mental health in community dwelling Japanese women. Materials and Methods: A total of 89 community dwelling Japanese women, aged 66.8 ± 7.6 years, were enrolled in this cross-sectional study. Diet surveys were evaluated using the brief-type self-administered diet history questionnaire (BDHQ) and mental health was evaluated using the general health questionnaire-12 (GHQ) and clinical parameters. Results: The mean energy intake was 1806 ± 570 kcal and the GHQ score was 1.0 ± 1.4. Among nutrients, the n-6/n-3 fatty acid ratio was significantly correlated with the GHQ score (r = 0.269, p = 0.011), and some micronutrients and vitamins were weakly or negatively correlated with the GHQ score. Among the food groups, fish and shellfish were negatively correlated with the GHQ scores. Multiple regression analysis demonstrated that the n-6/n-3 fatty acid ratio was the determinant factor for the GHQ score, even after adjusting for confounding factors. Conclusions: These results suggest that a proper diet to reduce the n-6/n-3 fatty acid ratio may improve mental health in community dwelling Japanese women.

Relationship between Sedentary Behavior and Health-Related Quality of Life in Patients on Chronic Hemodialysis.

We explored the relationship between sedentary behavior and the health-related quality of life (HRQOL) in patients on chronic hemodialysis. A total of 60 outpatients, aged 71.1±12.0 years, were enrolled in this cross-sectional study. Sedentary behavior was measured using a tri-accelerometer and HRQOL was evaluated by the Euro-QOL questionnaire (EQ-5D). The relationship between the patients' sedentary behavior and HRQOL was evaluated by simple and multiple correlation analyses. The relative sedentary behavior (%) for total days was 73.7±12.9% and the EQ-5D scores were 0.688±0.233. Relative sedentary behavior (%) was negatively correlated with EQ-5D scores for total days, hemodialysis days and non-hemodialysis days. The relative light-intensity physical activity (LPA) (%) and relative moderately vigorous-intensity physical activity (MVPA) (%) were correlated with EQ-5D scores. Multiple regression showed that the relative sedentary behavior (%) had a clinical impact on EQ-5D scores after adjusting for confounding factors for total, hemodialysis and non-hemodialysis days. Sedentary behavior is closely linked to HRQOL, and reducing sedentary behavior may be beneficial to improve the HRQOL of patients on chronic hemodialysis.

Relationship between Changes in Physical Activity and Changes in Health-related Quality of Life in Patients on Chronic Hemodialysis with 1-Year Follow-up.

In a longitudinal study, we examined the link between changes in physical activity and changes in health-related quality of life (HRQOL) in patients on chronic hemodialysis. Seventy-one patients (43 males, 28 females; aged 70.9±10.6 years) on chronic hemodialysis in September 2013 were enrolled. The data of the 43 patients whose complete measurements were taken again in September 2014 were used for the longitudinal analysis. Clinical parameters including age, height, dry weight, duration of hemodialysis, blood pressure (BP), blood triglyceride and HDL cholesterol levels, physical activity, and HRQOL were evaluated. Physical activity was measured by a tri-accelerometer, and HRQOL was evaluated by the EuroQol questionnaire (EQ-5D). In the first cross-sectional analysis, EQ-5D scores were significantly correlated with daily step counts (steps per day) on all days and non-hemodialysis days. In the second longitudinal analysis, in the women, changes in EQ-5D scores were positively correlated with changes in daily step counts on all days. In all patients, changes in EQ-5D were weakly and negatively correlated with changes in physical activity (1-3 METs: min per day) on hemodialysis days. Promoting daily physical activity may improve the HRQOL in patients on chronic hemodialysis, especially in women.

Psychological distress between chronic hemodialysis patients with and without low back pain.

OBJECTIVE: The aim of this study was to compare psychological distress between patients on chronic hemodialysis with and without chronic low back pain (CLBP). SUBJECTS AND METHODS: A total of 72 patients on chronic hemodialysis, aged 72.9 ± 10.8 years, were enrolled in this cross-sectional study. Psychological distress using the K6, questionnaire for CLBP, and physical activity using the tri-accelerometer were evaluated. RESULTS: Twenty-nine patients (40.3 %) were having CLBP. The K6 scores were 4.0 ± 4.6 and physical activity (n = 55) was 1.0 ± 1.0 METs h/day. K6 scores in patients on chronic hemodialysis with CLBP were significantly higher than those in patients on chronic hemodialysis without CLBP even after adjusting for sex, age, duration of hemodialysis and physical activity. CONCLUSION: These results suggest that higher psychological distress was a fundamental feature in patients on chronic hemodialysis with CLBP.

Evaluation of psychological distress using the K6 in patients on chronic hemodialysis.

OBJECTIVE: The aim of this study was to evaluate psychological distress in patients on chronic hemodialysis. SUBJECTS AND METHODS: A total of 72 patients on chronic hemodialysis were enrolled in this study. We evaluated psychological distress by using the K6 questionnaire, health-related quality of life (HRQOL) by using the EQ-5D questionnaire, and clinical parameters. Among the 72 patients, we also evaluated changes in K6 scores in 58 patients at 1-year follow-up. RESULTS: The mean K6 score was 3.7 ± 3.7 and 2 subjects (2.8%) were defined as having psychological distress. K6 scores were significantly correlated with body fat percentage, albumin level, and EQ-5D scores in total subjects. K6 scores were also significantly and negatively correlated with EQ-5D scores in men and women. In the 1-year follow-up group, changes in K6 scores were weakly and negatively correlated with changes in EQ-5D scores. CONCLUSION: Psychological distress was closely associated with HRQOL in patients on chronic hemodialysis. Coping strategies for psychological distress might be useful in improving HRQOL in patients on hemodialysis.

The linkage among ambulance transports, death and climate parameters in Asahikawa City, Japan.

OBJECTIVE: The aim of this study was to investigate the linkage among climate parameters, total ambulance transports and the number of deaths in Asahikawa City in northern Japan. METHODS: Monthly data on total ambulance transports and the number of deaths from January 2004 to December 2011 were obtained from Asahikawa City Fire Department and the Asahikawa City official website. Climate parameters for the required period were also obtained from the Japan Meteorological Agency, Japan. To adjust for the population, we also used monthly population data on Asahikawa City. The linkage among climate parameters, total ambulance transports and the number of deaths was evaluated by ecological analysis. RESULTS: The mean air temperature in the Asahikawa area was 7.3 ± 10.1 °C. Total ambulance transports (/a hundred thousand people/day) and the number of deaths (/a hundred thousand people/day) were 10.0 ± 0.6 and 2.6 ± 0.3, respectively. Using quadratic curves, total ambulance transports and the number of deaths were weakly correlated with some climate parameters. The number of deaths was weakly and positively correlated with total ambulance transports. CONCLUSION: A weak linkage among climate parameters, total ambulance transports and the number of deaths was noted in Asahikawa City, Japan. However, these associations were not as high as expected.

Evaluation of physical activity and its relationship to health-related quality of life in patients on chronic hemodialysis.

OBJECTIVE: The aim of this study was to investigate the relationship between physical activity and health-related quality of life (HRQOL) in patients on chronic hemodialysis. METHODS: A total of 31 men (69.0 ± 11.1 years) and 17 women (66.9 ± 10.0 years) among 61 male and 30 female patients on chronic hemodialysis at Innoshima General Hospital, Onomichi, Japan, were enrolled in this cross-sectional study. Physical activity was evaluated using tri-axial accelerometers. HRQOL and psychological distress were also evaluated using the EuroQol questionnaire (EQ-5D) and the K6 questionnaire, respectively. RESULTS: Physical activity evaluated by Σ[metabolic equivalents × h per week (METs·h/w)] was 8.1 ± 6.0 METs·h/w, and EQ-5D score was 0.754 ± 0.177. Among all patients, EQ-5D scores were significantly correlated with physical activity over 4 METs on non-hemodialysis treatment days (r = 0.426, p = 0.003). In women, EQ-5D scores were also correlated with physical activity over 4 METs on hemodialysis treatment days and non-hemodialysis treatment days. By stepwise multiple regression analysis, physical activity over 4 METs on non-hemodialysis treatment days was a determinant factor of EQ-5D even after adjusting for age and K6 scores. CONCLUSION: Physical activity over 4 METs on non-hemodialysis treatment days might be associated with EQ-5D in patients on chronic hemodialysis, especially in women.

Novel Synthetic Carbonate Apatite as a Bone Substitute in Implant Treatments: Case Reports.

Bone graft materials are often used in implant treatment to optimize functional and esthetic outcomes. The requirements for bone grafting materials are the ability to maintain space for bone regeneration to occur and the capability of being resorbed by osteoclasts and replaced with new bone tissue occurring in passive chemolysis and bone remodeling. Carbonate apatite (CO3Ap) granules (Cytrans Granules, GC) are a chemically synthetic bone graft material similar to autogenous bone minerals and more biocompatible than allografts and xenografts. The aim of this report is to evaluate the efficacy of CO3Ap granules in implant treatments when used alone or in combination with autogenous bone. The clinical findings and the radiographic and histologic assessments in three cases of immediate implant placement and lateral and vertical guided bone regeneration are reported. Despite the short-term follow-ups, histologic findings showed that CO3Ap granules were efficiently resorbed and replaced bone in clinical use. Furthermore, the clinical findings showed that CO3Ap granules maintained their morphology around the implant. This limited short-term case report suggests that this bone substitute is effective. However, further clinical studies and long-term reports of this new biomaterial are needed.

Relationship between Driving Ability and Physical Fitness Factors in Older Adults: A Multiple Linear Regression Analysis.

The number of older drivers is increasing with the aging population; this has led to concerns about traffic accidents involving older drivers. For older adults, the automobile is not just a means of transportation, but a life necessity that promotes social activities and maintains and improves health-related quality of life. In this study, we aimed to clarify the relationship between driving ability and physical fitness factors among 70 older adult drivers using a single regression analysis and multiple regression models adjusted for age, sex, and other factors. Driving ability was evaluated by driving an actual car on an ordinary road without a simulator. The single regression analysis revealed no relationship between driving ability and any physical fitness factor. In the multiple regression model analysis, only grip strength was an important explanatory factor; however, the driving ability scores decreased as grip strength scores increased. By clarifying the physical fitness factors that influence the maintenance and improvement of driving ability, it is possible to propose more efficient intervention programs to maintain and improve driving ability. We could not identify the relevant physical fitness factors in this study; therefore, further research is required to improve safe driving among older adults.

Novel Synthetic Carbonate Apatite as Bone Substitute in Implant Treatments: Case Reports.

Bone graft materials are often used in implant treatment for optimizing functional and esthetic outcomes. The requirements for bone grafting materials should be that they must be able to maintain space for bone regeneration to occur and must be resorbed by osteoclasts and replaced with new bone tissue occurring in passive chemolysis and bone remodeling. Carbonate apatite (CO3Ap) granules (Cytrans Granules, GC) are chemically synthetic bone graft material that are similar to autologous bone mineral and more biocompatible than allografts and xenografts. The aim of this report is to evaluate the efficacy of CO3Ap granules in implant treatments using CO3Ap granules in combination with autogenous bone or CO3Ap granules separately. This report will show the clinical findings as well as radiographic and histological assessments in three cases of immediate implant placement, lateral GBR and vertical GBR. These results demonstrated, although it was a short-term report, that in histological findings CO3Ap granules were efficiently resorbed and replaced bone in clinical use. Furthermore, the clinical findings showed that CO3Ap granules contributed to maintaining their morphology tissue around the implant. In this limited short-term case report, it was suggested that this bone substitute was effective. However, further clinical studies and long-term reports of this new biomaterial are needed.

Enhancing Driving Ability in Older Adults through Health Exercises and Physical Activity: A Randomized Controlled Trial.

The global rise in the aging driving population has heightened concerns about traffic incidents involving this demographic. Beyond transportation, automobiles represent a vital lifeline for older adults, fostering social activities and influencing their health-related quality of life. This study explores improving and sustaining driving ability among older adults with anticipated declines through health-conscious exercises. Sixty-eight participants were randomly allocated into two groups. The exercise-oriented group (E-group) engaged in twelve 90 min health and exercise sessions over twelve weeks, while the control group (C-group) maintained their regular daily routines and did not receive any specific interventions during this period. The focal point of assessment was driving ability, as evaluated by a person using a real car on public roads without using a simulator. Driving ability and physical fitness were assessed before the intervention in both groups. Post-intervention measurements occurred twelve weeks after the initial gauging, encompassing both cohorts. Comparative analysis of pre- and post-intervention changes was executed between the two groups. The E-group demonstrated improved overall driving ability compared to the C-group. The results suggest that healthy exercise and physical activity may maintain and enhance driving ability for older adults.

Treatment of Mandibular Class III/IV Furcation Defects with a Combination Plastic Regenerative Technique: A Case Series.

The aim of this present case series investigated the effect of a combination therapy utilizing connective tissue graft (CTG) in the treatment of periodontal regeneration of mandibular Class Ⅲ furcation involvement (FI). Six patients diagnosed with periodontitis stage Ⅲ or Ⅳ (grade A to C), presenting with Class Ⅲ or Ⅳ FI, were treated with fibroblast growth factor 2 and carbonate apatite in combination with CTG. The following clinical parameters were evaluated at baseline and after 6, 12 and 18 months: periodontal probing depth, clinical attachment level, furcation invasion, the radiographic vertical defect depth, and gingival phenotype. Significant improvements in clinical parameters were observed in all treated FI sites. Four Class Ⅲ Fls and one Class Ⅳ Fl obtained complete closure, and one Class Ⅳ furcation was improved to Class Ⅰ. This case series showed the potential of administering combination regenerative therapy for changing the prognosis of hopeless teeth with severe furcation defects.

Seasonal Changes in Continuous Sedentary Behavior in Community-Dwelling Japanese Adults: A Pilot Study.

Background: Sedentary behavior (SB) is associated with adverse health outcomes. The aim of this study was to clarify seasonal changes in SB including continuous SB (CSB) in community-dwelling Japanese adults. Methods: In this secondary analysis, a total of 65 community-dwelling Japanese adults (7 men and 58 women, 69 (50-78) years) were enrolled. SB (%), including CSB (≥30 min) as well as physical activity, were evaluated using a tri-accelerometer. The differences in these parameters between baseline (summer) and follow-up (winter) were examined. Results: %CSB and %SB at baseline were 20.5 (4.0-60.9) and 54.0 ± 11.5, respectively. CSB was significantly increased (6.6%), and SB was also increased (5.1%) at follow-up compared with baseline. In addition, there were positive relationships between changes in CSB and SB, and body weight and body mass index. Conclusions: These results suggest that there were significant seasonal changes in CSB and SB in community-dwelling Japanese adults.