Achieving complete electrooxidation of ethanol by single atomic Rh decoration of Pt nanocubes.

SignificanceDirect ethanol fuel cells are attracting growing attention as portable power sources due to their advantages such as higher mass-energy density than hydrogen and less toxicity than methanol. However, it is challenging to achieve the complete electrooxidation to generate 12 electrons per ethanol, resulting in a low fuel utilization efficiency. This manuscript reports the complete ethanol electrooxidation by engineering efficient catalysts via single-atom modification. The combined electrochemical measurements, in situ characterization, and density functional theory calculations unravel synergistic effects of single Rh atoms and Pt nanocubes and identify reaction pathways leading to the selective C-C bond cleavage to oxidize ethanol to CO2. This study provides a unique single-atom approach to tune the activity and selectivity toward complicated electrocatalytic reactions.

Automatic Plaque Removal Using Dual-Energy Computed Tomography Angiography: Diagnostic Accuracy and Utility in Patients with Peripheral Artery Disease.

Background and Objectives: This study aimed to evaluate the utility and accuracy of dual-energy automatic plaque removal (DE-APR) in patients with symptomatic peripheral arterial disease (PAD) using digital subtraction angiography (DSA) as the reference standard. Materials and Methods: We retrospectively analyzed 100 patients with PAD who underwent DE computed tomography angiography (DE-CTA) and DSA of the lower extremities. DE-CTA was used to generate APR subtracted images. In the three main arterial segments (aorto-iliac segment, femoro-popliteal segment, and below-the-knee segment), the presence or absence of hemodynamically significant stenosis (>50%) and calcification was assessed using the images. CTA data were analyzed using different imaging approaches (DE-standard reconstruction image (DE-SR), DE-APR maximum intensity projection image (APR), and DE-SR with APR). Results: For all segments evaluated, the sensitivity, specificity, and accuracy for detecting significant stenosis were 98.16%, 81.01%, and 89.58%, respectively, with DE-SR; 97.79%, 83.33%, and 90.56%, respectively, with APR; and 98.16%, 92.25%, and 95.20%, respectively, with DE-SR with APR. DE-SR with APR had greater accuracy than DE-SR or APR alone (p < 0.001 and p < 0.001, respectively). When analyzed based on vascular wall calcification, the accuracy of DE-SR with APR remained greater than 90% regardless of calcification severity, whereas DE-SR showed a considerable reduction in accuracy in moderate to severe calcification. In the case of APR, the degree of vascular wall calcification did not significantly influence the accuracy in the aorto-iliac and femoro-popliteal segments. DE-SR with APR achieved significantly higher diagnostic accuracy for all lower extremity segments in evaluating hemodynamically significant stenosis in patients with symptomatic PAD and transcended the impact of vascular wall calcification compared with DE-SR. Conclusions: APR demonstrated favorable diagnostic performance in the aorto-iliac and femoro-popliteal segments, exhibiting good agreement with DSA even in cases of moderate to severe vascular wall calcification.

Translation and validation of the Korean version of the Sarcopenia Quality of Life (SarQoL-K®) questionnaire and applicability with the SARC-F screening tool.

PURPOSE: The purpose of this paper was to translate and validate into the Korea language and setting the Sarcopenia Quality of Life (SarQoL®) questionnaire. METHODS: The participants consisted of 450 individuals in Namgaram-2 cohort who were followed up in 2019-2020. The study participants were divided into four groups: (1) SARC-F < 4, (2) SARC-F ≥ 4 and robust grip strength, (3) SARC-F ≥ 4, low grip strength, robust muscle mass, (4) SARC-F ≥ 4, low grip strength, and low muscle mass. To assess construct validity, population with sarcopenia-associated symptoms (SARC-F ≥ 4) apart from the Korean SarQoL (SarQoL-K®) completed the Korean versions of two generic questionnaires, the Short Form-36 and the EuroQoL 5-dimension. To validate the Korean SarQoL®, we assessed its validity (discriminative power, construct validity), reliability (internal consistency, test-retest reliability), and floor/ceiling effects. RESULTS: The SarQoL-K® questionnaire was translated without major difficulties. The mean SarQoL-K scores were 72.9 (95%, CI; 71.2-74.6) in SARC-F < 4, 54.6 (95%, CI; 50.7-58.3) in SARC-F ≥ 4 and robust grip strength, 47.0 (95%, CI; 43.8-50.1) in SARC-F ≥ 4, low grip strength, robust muscle mass, 46.6 (95%, CI; 43.0-50.1) in SARC-F ≥ 4, low grip strength, and low muscle mass. The results indicated good discriminative power across each four groups (p < 0.001), high internal consistency (Cronbach's alpha of 0.866), and excellent test-retest reliability (ICC = 0.977, 95% CI 0.975-0.979). No floor- or ceiling-effects were observed. CONCLUSIONS: This is the first study to confirm the reliability and validity of the Korean version of the SarQoL®. We demonstrated that the population with sarcopenia-associated symptoms (determined using the SARC-F questionnaire) has a lower quality of life.

Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: a cross-sectional study.

BACKGROUND: The healthy adherer effect is a phenomenon in which patients who adhere to medical therapies tend to pursue health-seeking behaviors. Although the healthy adherer effect is supposed to affect health outcomes in patients with coronary artery disease, evaluation of its presence and extent is not easy. This study aimed to assess the relationship between medication adherence and lifestyle modifications and health-related quality of life among post-acute myocardial infarction (AMI) patients. METHODS: A cross-sectional study was conducted in 417 post-AMI patients who underwent percutaneous coronary intervention (PCI). Patients were recruited from 11 university hospitals from December 2015 to March 2016 in South Korea. Details regarding socio-demographic factors, six health behaviors (low-salt intake, low-fat diet and/or weight-loss diet, regular exercise, stress reduction in daily life, drinking in moderation, and smoking cessation), medication adherence using the Modified Morisky Scale (MMS), and HRQoL using the Coronary Revascularization Outcome Questionnaire (CROQ) were surveyed in a one-on-one interview. RESULTS: In the univariate logistic analysis, sex (female), age (≥70 years), MMS score (≥5), and CROQ score were associated with adherence to lifestyle modification. In the multiple logistic analysis, a high MMS score (≥5) was associated with adherence to lifestyle modification after adjusting for sex, age, marital status, education, and family income (adjusted odds ratio [OR] = 11.7, 95% confidence interval [CI] = 1.5-91.3). After further adjusting for the CROQ score, the association between high MMS score and adherence to lifestyle modification was significant (adjusted OR = 11.5, 95% CI = 1.4-93.3). CONCLUSIONS: Adherence to medication was associated with adherence to lifestyle modification, suggesting the possible presence of the healthy adherer effect in post-AMI patients. After further adjusting for HRQoL, the association remained. To improve health outcome in post-AMI patients, early detection of patients with poor adherence to medication and lifestyle modification and motivational education programs to improve adherence are important. In addition, the healthy adherer effect should be considered in clinical research, in particular, in studies evaluating the effects of therapies on health outcomes.

WHO disability assessment schedule 2.0 is related to upper and lower extremity disease-specific quality of life.

PURPOSE: We evaluated whether two disease-specific quality of life instruments (Disabilities of the Arm, Shoulder and Hand, DASH and Western Ontario & McMaster Universities Osteoarthritis Index, WOMAC) reflect a patient's perception of general disability using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and determined whether disability components are explained by upper and lower extremity HRQOL. METHODS: We recruited 421 participants, 50 years or older without stroke, cancer, or history of surgery for musculoskeletal disease, who participated in the NAMGARAM Cohort. Upper extremity HRQOL was determined with the DASH score and lower extremity HRQOL with the WOMAC; as a measure of disability, we obtained WHODAS 2.0 component. Multiple regression modeling was used to assess the relative contributions made by upper and lower extremity HRQOL to disability. RESULTS: When adjusted for covariates, the DASH total score was correlated with getting around (ß = 0.217, p < 0.001) and social participation (ß = 0.226, p < 0.001), and the WOMAC total score was correlated with getting around (ß = 0.363, p < 0.001), life activation (ß = 0.363, p < 0.001), and social participation (ß = 0.301, p < 0.001). QOL significantly correlated with upper extremity disorders (ß = 0.081, p = 0.018) or lower extremity disorders (ß = 0.095 p = 0.004). CONCLUSION: We found that in a community-based population, perceived activity limitation and social participation were associated with upper and lower extremity HRQOL. Since the WHODAS 2.0 does not target a specific disease (as opposed to DASH and WOMAC), it can be used to compare disabilities caused by different diseases.

Effects of exercise training intensity on cardiac autonomic regulation in habitual smokers.

BACKGROUND: The sympathoexcitatory effects of cigarette smoking cause an autonomic imbalance that may lead to cardiovascular disease. Aerobic training improves autonomic function by developing cardiorespiratory fitness; however, it is still uncertain whether aerobic training ameliorates the compromised autonomic modulation in smokers. This study aimed to investigate the effects of 8 weeks' aerobic training at different exercise intensities on autonomic regulation in habitual smokers. METHODS: Healthy males (n = 34) were randomly assigned to a moderate-intensity aerobic training (MAT, 60% of heart rate reserve [HRR]), a high-intensity training group (HAT, 75% HRR), or a control group (CG). Training groups performed 8 weeks' aerobic training on a treadmill (3 times/week), but all subjects continued to smoke cigarettes as usual. Heart rate variability was monitored to evaluate the effect of aerobic training on autonomic regulation. RESULTS: Aerobic training improved autonomic balance despite the continued smoking. In the time domain, rMSSD and pNN50 were significantly increased in HAT than in CG. On spectral analysis, the absolute and normalized units of high frequency (HF) were significantly increased in HAT, whereas the LF/HF ratio and the normalized unit of LF were significantly decreased compared to that in CG. SD1 and the SD1/SD2 ratio of the Poincaré plot analysis were significantly increased compared to CG. Although MAT showed a similar tendency to HAT in nonlinear indexes, there were no significant differences compared to CG. CONCLUSION: Aerobic training, particularly high-intensity training, increases the parasympathetic contribution to the sympathovagal system, leading to an improvement in autonomic balance despite continued cigarette smoking.

[Effects of an intervention program for community-dwelling elderly to improve frailty and dietary habits].

OBJECTIVES: The effects of a comprehensive intervention program for community-dwelling elderly on frailty and dietary habits were examined. METHODS: We conducted randomized control trials to examine the efficacy of the intervention. To examine lasting changes, we made paired comparisons between pre- and post- intervention and at a three-month follow-up. The subjects were recruited in Hatoyama town, Saitama prefecture. The program was composed of exercise, nutritional education, and social participation and was held from October to December 2011. The exercise program aimed at fall prevention and took place twice per week for 60 min. The nutritional education aimed at prevention of malnutrition, and the social participation program aimed at prevention of "homeboundness"; both were held once per week for 30 min. Questionnaires inquired about frailty and dietary variety. A blood test was conducted to ascertain nutritional state, and a brief self-administered diet history questionnaire was used to estimate food and nutrient intake. To examine the efficacy of the intervention, 22 control subjects (CR) and 21 subjects in the intervention group (IV) were analyzed with intention to treat. To examine lasting changes, 16 subjects in IV who correctly completed surveys at each of the three time points were analyzed, using repeated ANOVA and a multiple comparison procedure. RESULTS: 1. Men comprised 70-80% of subjects, and the average age was 75.7±5.4 and 74.7±5.4 years in IV and CR, respectively. 2. There was no significant difference in pre- and post-intervention changes between IV and CR in frailty, which was the main outcome of the study. 3. A significant difference in pre- and post-intervention values was noted in ① "homeboundness", one of the components of frailty (median [25-75%tile]): IV 0 [0-0] and CR 0 [0-1] (P=0.023); ② nutrient intake (mean±standard deviation [SD], energy ratio [%E]): protein, IV 2.3±0.7 and CR -0.3±2.0 (P=0.002); animal protein, IV 2.4±1.5 and CR -0.5±1.5 (P=0.002); and ③ food intake (mean±SD, g/1000 kcal): fish, IV 18.1±25.1 and CR -4.1±21.9 (P=0.004); egg, IV 5.0±11.2 and CR -2.1±11.3 (P=0.046). All variables improved in IV. 4. Lasting improvement was observed in "homeboundness" and protein intake [%E]. CONCLUSION: Although the intervention did not improve frailty, it may improve frailty and dietary habits by improving homeboundness and increasing protein intake.

Effects of a comprehensive intervention program, including hot bathing, on physical function in community-dwelling healthy older adults: a pilot randomized controlled trial.

BACKGROUND AND AIMS: To study the effects of a comprehensive intervention program comprising exercise, diet, and hot bathing in community-dwelling older adults by using a randomized controlled trial. METHODS: The program included 61 community-dwelling healthy older adults (mean [SD] age, 69.9 [5.3] years) who were using a hot bath facility. The participants were randomly assigned to four groups as follows: an exercise, diet, and hot bath intervention group (A); an exercise and diet intervention group (B); a hot bath intervention group (C); and a control group (D). Individuals in groups A and B participated in a comprehensive intervention program (including exercise and diet classes) twice a week for 3 months, and those in groups A and C took hot baths. RESULTS: After 3 months, the participants in groups A and B showed a significantly greater improvement in their timed up and go test and stepping test scores than the participants in groups C and D. However, the participants in groups A and C did not show any dependent or independent effects of hot bathing. Three months after the intervention, a follow-up assessment indicated that the group A participants maintained the effect of the intervention and showed improved lower extremity function and health-related quality of life. CONCLUSIONS: The present study suggests that a comprehensive intervention program involving hot bathing may improve lower extremity function and that its effects can be maintained even in healthy older adults. However, the dependent or independent effects of hot bathing may not be expected for healthy older adults.

[Validity of the "Kaigo-Yobo Check-List" as a frailty index].

OBJECTIVES: A frailty index for Japanese older people is not yet available. This study examined the validity of "Kaigo-Yobo Check-List" (CL) as a frailty index. METHODS: The study site was Kusatsu town, Gunma prefecture. Out of 612 older persons aged 65 years and over who undertook a comprehensive geriatric assessment in 2007, results from 526 who had no missing data were used to examine the cross-sectional relationship between frailty as defined by Fried's criteria (= external criteria) and CL scores in order to evaluate concurrent and construct validity. Further, 916 older individuals aged 70 years and over who responded to the baseline survey in 2001 were followed for the subsequent 4 years and 4 months regarding the onset of ADL disability, service use under the Long Term Care Insurance program, and mortality. We examined the predictive validity of the CL for such adverse outcomes after adjustment for gender, age, and comorbidity. RESULTS: The CL (cut-off point = 3/4) discriminated frailty from non-frailty at the sensitivity of 70.0% and specificity of 89.3%. The higher the CL score, the higher the prevalence of frailty; the trend was highly significant (P < 0.001). The Multitrail Multimethod Model showed that there were significant associations among three components of CL (homeboundness, falling, and lower nutrition) and four out of five components of Fried's frailty criteria (shrinking, exhaustion, low activity, and slowness), whereas those components of the CL did not have an association with the weakness component of Fried's frailty criteria. As compared with older persons who had CL scores of 3 points or below, those who had CL scores of 4 or more points had a significantly higher risk for developing adverse outcomes. Multivariate-adjusted odds ratios for ADL disability at 2 and 4 years after baseline were 5.25 (95% confidence interval, 2.79-9.89) and 3.42 (1.79-6.54), respectively. Likewise, multivariate-adjusted hazard ratios for the onset of service use under the Long Term Care Insurance program and mortality during the follow-up period of 4 years and 4 months were 3.50 (2.41-5.07) and 2.43 (1.70-3.47), respectively. Although the construct validity remained inconclusive, the "Kaigo-Yobo Check-List" showed CONCLUSION: good concurrent and predictive validity as a frailty index. Since it comprises 15 easy-to-answer questions, it could be widely used for research on frailty and its preventive intervention.

Change of Femoral Anteversion Angle in Children With Intoeing Gait Measured by Three-Dimensional Computed Tomography Reconstruction: 3-Year Follow-Up Study.

OBJECTIVE: To investigate long-term changes in femoral anteversion angle (FAA) in children with intoeing gait and to identify factors that affect FAA changes. METHODS: We retrospectively analyzed three-dimensional computed tomography data from 2006 to 2022 of children with intoeing gait with ≥3 years of follow-up without active treatment. The study examined the mean changes in FAA, the effects of sex, age, and initial FAA on FAA change, and mean FAAs by age. Changes in FAA severity up to eight years of age were also observed and analyzed by sex. RESULTS: A total of 126 lower limbs of 63 children (30 males, 33 females) with intoeing gait were included, with a mean age of 5.11±1.05 years and a mean follow-up period of 43.59±7.74 months. The initial FAA was 41.42°±8.29° and the follow-up FAA was 33.25°±9.19°, indicating a significant decrease (p<0.001). Significant correlations were observed between age and changes in FAA, as well as between initial FAA and changes in FAA (r=0.248, p=0.005; r=-0.333, p<0.001). At age 8 years, only 22 limbs were classified as having mild FAA severity. CONCLUSION: During the follow-up period, children with intoeing gait had a significant decreased in FAA. No significant difference in FAA change was found between sex, but younger children and those with greater initial FAA were more likely to have decreased FAA. However, most children retained moderate to severe severity of increased FAA. Further studies are required to validate these findings.

Associations of cold exposure with hospital admission and mortality due to acute kidney injury: A nationwide time-series study in Korea.

BACKGROUND: Emerging evidence supports an association between heat exposure and acute kidney injury (AKI). However, there is a paucity of studies on the association between cold exposure and AKI. OBJECTIVE: We aimed to investigate the associations of cold exposure with hospital admission and mortality due to AKI and to explore whether these associations were influenced by age and sex. METHODS: Information on daily counts of hospital admission and mortality due to AKI in 16 regions of Korea during the cold seasons (2010-2019) was obtained from the National Health Insurance Service (a single national insurer providing universal health coverage) and Statistics Korea. Daily mean temperature and relative humidity were calculated from hourly data obtained from 94 monitoring systems operated by the Korean Meteorological Administration. Associations of low temperatures (<10th percentile of daily mean temperature) and cold spells (≥2 consecutive days with <5th percentile of daily mean temperature) up to 21 days with AKI were estimated using quasi-Poisson regression models adjusted for potential confounders (e.g., relative humidity and air pollutants) with distributed lag models and univariate meta-regression models. RESULTS: Low temperatures were associated with hospital admission due to AKI [relative risk (RR) = 1.12, 95 % confidence interval (CI): 1.09, 1.16]. Cold spells were associated with hospital admission (RR = 1.87, 95 % CI: 1.46, 2.39) and mortality due to AKI (RR = 4.84, 95 % CI: 1.30, 17.98). These associations were stronger among individuals aged ≥65 years than among those aged <65 years. CONCLUSION: Our results underscore the need for the general population, particularly the elderly, physicians, and other healthcare providers to be more vigilant to cold exposure, given the risk of AKI. Government agencies need to develop specific strategies for the prevention and early detection of cold exposure-related AKI.

Heavy metal exposure linked to metabolic syndrome in Korean male firefighters: FRESH cohort cross-sectional analysis.

This study aimed to identify the relationship between blood lead and Cadmium (Cd) concentrations and metabolic syndromes (MetS), including its components (central obesity, hypertriglyceridemia, low high-density lioioritein, hypertension, and hyperglycemia) among Korean firefighters. A total of 965 firefighters of the Enhancement of Safety and Health cohort were analyzed in this study. MetS was defined according to the 2005 revised National Cholesterol Education Program-Adult Treatment Panel III criteria and the Korean Society for the Study of Obesity criteria for waist circumference. The collected data were analyzed using a logistic regression model. Of the 965 participants, 190 (19.7%) had MetS. After adjusting for age, body mass index, smoking, drinking, exercise, shift duty, and main duty position, the Cd level was significantly associated with an increased risk of MetS in the Korean firefighter population (odds ratio [OR] = 1.62, 95% confidence interval [CI] 1.07, 2.46). This association was significant among non-smokers and ex-smokers (OR = 1.58, 95% CI 1.03, 2.43), non-drinkers and ex-drinkers (OR = 1.77, 95% CI 1.06, 2.94), firefighters aged 40 year or older (OR = 1.77, 95% CI 1.10, 2.86), and office administrators (OR = 3.85, 95% CI 1.42, 10.39). This outcome suggests that exposure to Cd is likely to increase risk of MetS among firefighters.

The Hatoyama Cohort Study: design and profile of participants at baseline.

BACKGROUND: Investigation of frailty among elderly adults and development of prevention strategies to address this are critical in delaying progression of functional decline and thus extending healthy life expectancy. However, there has been no Japanese epidemiologic cohort study of frailty. The Hatoyama Cohort Study was launched in 2010 to identify factors that predict functional decline and to establish strategies to prevent frailty among community-dwelling elderly Japanese. This report describes the study design and the profile of the participants at baseline. METHODS: The Hatoyama Cohort Study is a prospective study of community-dwelling individuals aged 65 years or older living in the town of Hatoyama in Saitama Prefecture, Japan. Comprehensive information, including socioeconomic status, physiological indicators, physical, psychological, and cognitive function, social capital, neighborhood environment, and frailty, was collected in a baseline survey using face-to-face interviews in September 2010. Survival time, long-term care insurance certification, and medical and long-term care costs after the baseline survey will be followed. In addition, a follow-up survey will be conducted in the same manner as the baseline survey every 2 years. RESULTS: A total of 742 people participated in the baseline survey (mean age: 71.9 ± 5.2 years, men: 57.7%, living alone: 7.7%). Almost all participants were independent in their daily lives, and approximately 10% were categorized as frail on the kaigo-yobo (care prevention) checklist. CONCLUSIONS: The Hatoyama Cohort Study is expected to contribute to the development of strategies that prevent frailty in later life and extend healthy life expectancy in Japan's rapidly aging society.

Investigation of the copper binding site on the human islet amyloid polypeptide hormone.

The metal ion binding sites of human islet amyloid polypeptide (hIAPP) have been investigated to explain the biological activity difference in the fibril formation process. The structures of [hIAPP...Cu (or Al)](n+) and [hIAPP17-30...Cu]2+ complex were investigated by electrospray ionization-mass spectrometry (ESI-MS). The fragmentation patterns of [hIAPP...Cu [or Al)](n+) and [hIAPP17-30...Cu]2+ complex were analyzed by tandem mass spectrometry (MS/MS) and multi-stage mass spectrometry (MS3) spectra. The [hIAPP+Cu+H]3+, [hIAPP+Al+H]4+ and [hIAPP17-30+Cu]2+ complexes were observed in MS spectra. The Cu binding site of hIAPP is suggested to be the N22-F-G-A-I26 part for the [hIAPP+Cu+H]3+ gas-phase complex. The original hIAPP conformation was supposed to be changed by the interaction between the Cu ion and the N22-F-G-A-I26 part in the [hIAPP+Cu+H]3+ gas-phase complex.

[The influences of exercise fulfillment on mental and physical functions of targeted older adults and the effect of a physical exercise intervention].

OBJECTIVES: To investigate the influence of the differences in exercise fulfillment on mental and physical functions and the effects of exercise intervention on community-dwelling older adults. METHODS: Participants in this study included 260 community-dwelling older adults (mean age +/- SD, 70.4 +/- 6.0 years) who participated in the exercise intervention study (intervention and control groups). Exercise fulfillment levels (low or high), physical activity levels (low or high), mental health (WHO-5 scores), health-related QOL (SF-8 score), and physical abilities of these adults were measured during a baseline health checkup. Based on the status of the 3 exercise fulfillment groups, multivariate analysis of variance (MANOVA), which was adjusted for age, sex, and physical activity levels, was performed to compare the results of the outcome measures among the 3 groups. The intervention group (n = 88, aged 70.3 +/- 6.2 years) was divided into 2 subgroups: the deterioration subgroup (participants with low-exercise fulfillment after the intervention) and the improvement subgroup (participants with high-exercise fulfillment after the intervention). Subsequently, the intervention effects were assessed by repeated measurements of the analysis of variance (ANOVA) between the 2 subgroups. RESULTS: MANOVA analysis revealed that body mass index, grip strength, maximum walking speed, the WHO-5 score, and the SF-8 subscale (8 items) score differed significantly amongst the groups. The high-exercise fulfillment group demonstrated better results for these variables than the low-exercise fulfillment group. Similar results were obtained for each group with respect to the physical activity levels. The repeated-measures ANOVA revealed that time had an important effect on lower physical functions and the SF-8 subscale (1 item) score; it also revealed the important effects of body mass index, the WHO-5 score, the SF-8 subscale (6 items) score, and psychological independence on the group. CONCLUSION: Older adults with higher exercise fulfillment demonstrated better mental and psychological health, regardless of their physical activity levels. Older adults with low-exercise fulfillment could potentially improve their physical abilities; however, their mental and psychological health significantly differed from that of older adults with medium- or high-exercise fulfillment after exercise intervention. These findings provide preliminary evidence, which indicates that exercise can provide sufficient fulfillment and contribute to the promotion and improvement of health in older adults. Moreover, performing adequate tests on exercise fulfillment may aid in assessing the effects of intervention programs in regional healthcare systems.

[Prevalence and characteristics of frailty among community-dwelling older people in Japan].

OBJECTIVE: To examine the prevalence and characteristics of frailty in community-dwelling people over 70 years of age. METHODS: Data collected from in-home interviews conducted in 2001 were used to determine the prevalence of frailty. A total of 916 out of 1,039 older adults responded, and the data of 914 were eligible. Secondly, data collected from a comprehensive health examination undertaken in two areas in 2005 were used to identify the characteristics of frailty. 1,005 older adults participated and the data of 974 were eligible. We used a frailty index (Kaigo-Yobo Checklist) developed by Shinkai et al. (2010) to divide data into Frail and Non-frail groups. RESULTS: The prevalence of frailty was 24.3% for men and 32.4% for women. The prevalence showed a tendency to rapidly increase after age 80 in men and 75 in women. Even after controlling for age, study area, ADL disability and comorbidity, a number of variables showed significant associations with frailty. The results showed poor functional status in physical, mental and social areas in the Frail group. The Frail group was more likely to have comorbid geriatric syndromes than the Non-frail group, such as lower MMSE scores, higher prevalence of depression, higher prevalence of hearing impairment in men, and urinary incontinence and walking impairment in women. In contrast, almost no associations with frailty were detected on routine clinical tests such as blood pressure or blood examination. CONCLUSIONS: Overall, frailty was identified as a multifactorial syndrome which was strongly related to other geriatric syndromes. The symptoms of frailty manifested as poor functioning in multiple areas. Routine clinical tests may not be useful for detecting frailty.

[Predictors of frailty development in a general population of older adults in Japan using the Frailty Index for Japanese elderly patients].

AIM: To identify predictors for the onset of frailty in Japanese older adults using the Frailty Index for Japanese elderly people, we focused on subjects who participated in a routine health check. METHODS: Of 357 older people (age, ≥70 years) who participated in a routine health check-up in Kusatsu, Japan in 2005, 334 individuals were identified as non-frail and were followed up 2 years later. A logistic regression model using the stepwise method was used to identify predictors for the onset of frailty, after controlling for age and gender. RESULTS: A total of 45 subjects (13.5%) had developed symptoms of frailty at follow-up. Even after multiple adjustment for controlling factors, a history of hypertension, hand grip strength, and albumin were significantly associated with frailty 2 years later (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.24-5.25; OR per 1 kg decrease, 1.08; 95% CI, 1.00-1.16; OR per 0.1 g/dl decrease, 1.22; 95% CI, 1.03-1.46, respectively). CONCLUSION: These results supported a definition of frailty which includes geriatric symptoms such as vascular disease and sarcopenia in Japanese older adults. Undernutrition was strongly associated with the onset of frailty and is an important target for prevention.

Effect of High Temperature on Walking among Residents of Rural and Urban Communities.

PURPOSE: This study aimed to establish the association between high temperature and walking among residents of rural and urban areas. MATERIALS AND METHODS: This cross-sectional study used data from the Korea Meteorological Administration and the 2018 Community Health Survey to confirm the association between temperature and walking practice. The dependent variable was walking practice. Walking practice was considered if the participants walked for more than 30 minutes a day or more than 5 days a week. The independent variable was the daily maximum temperature (℃) for the preceding 7 days, calculated from the survey date of each participant. A multilevel analysis was conducted to simultaneously consider the individual- and neighborhood-level variables that could affect determining the association between daily maximum temperatures and walking practice. RESULTS: When the daily maximum temperature increased by 1℃, the odds ratio of walking practice decreased to 0.95 (95% confidence interval 0.94-0.97) in rural areas. In contrast, it decreased to 0.98 (95% confidence interval 0.97-1.00) in urban areas, considering both individual- and neighborhood-level factors. Individual- and neighborhood-level determinants of walking practice in rural areas, including educational attainment, marital status, driving a car, subjective health, depression, and meeting neighbors and friends, were confirmed. CONCLUSION: This study confirmed that increased temperature led to more decrease in physical activity levels in rural areas than in urban areas. Physical and environmental approaches to avoid heat are needed to maintain and promote physical activity, since temperatures can reduce physical activity during the hot summer months.

Clinical and histopathological analyses of kidney biopsies in a single center for 7 years.

Kidney biopsy is the most important tool for diagnosing kidney disease and can be helpful in determining treatment and prognosis. Pathological spectra vary by country, region, race, sex, and age. We are the first to investigate the pathological spectrum of biopsy-proven kidney disease in Gyeongnam province of South Korea. We retrospectively analyzed 631 patients who underwent a kidney biopsy between 2013 and 2019 at Gyeongsang National University Hospital. The mean age of the 631 patients was 51.5 ± 18.1 years, and 361 patients (57.2%) were male. The mean estimated glomerular filtration rate by serum creatinine (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) was 68.0 ± 45.7 mL/min/1.73 m2. The mean systolic blood pressure was higher in 2017, 2018, and 2019 than in 2013 (P = .002). Hypertension (47.4%) was the most common comorbid disease, followed by diabetes (18.2%) and dyslipidemia (10.9%). Common clinical syndromes at the time of biopsy were renal insufficiency (42.0%) and nephrotic syndrome (33.9%). The prevalence of primary and secondary glomerular disease and tubulointerstitial disease were 71.4%, 16.9%, and 5.4%, respectively. Immunoglobulin A nephropathy was the most common primary glomerular disease (34.9%). Diabetic nephropathy was the most common secondary glomerular disease, followed by lupus nephritis. Tubulointerstitial disease was underestimated, as in other reports. Our data can be a useful reference for diagnosing kidney disease and understanding the patients in our province.

Population attributable fraction of indicators for musculoskeletal diseases: a cross-sectional study of fishers in Korea.

Background: The musculoskeletal disease (MSD) burden is an important health problem among Korean fishers. We aimed to investigate the indicators of the prevalence of MSD and contributions of significant indicators to MSD in Korean fishers. Methods: This cross-section study included 927 fishers (male, 371; female, 556) aged 40 to 79 years who were enrolled from 3 fishery safety and health centers. The outcome variable was one-year prevalence of MSD in 5 body parts (the neck, shoulder, hand, back, and knee). Independent variables were sex, age, educational attainment, household income, job classification, employment xlink:type, hazardous working environment (cold, heat, and noise), ergonomic risk by the 5 body parts, anxiety disorder, depression, hypertension, diabetes, and hyperlipidemia. The adjusted odds ratio of MSDs by the 5 body parts were calculated using multiple logistic regression analysis. We computed the population attributable fraction (PAF) for each indicators of MSDs using binary regression models. Results: The one-year prevalence of MSD in the neck, shoulder, hand, back, and knee was 7.8%, 17.8%, 7.8%, 27.2%, and 16.2% in males vs. 16.4%, 28.1%, 23.0%, 38.7%, and 30.0% in females, respectively. The ergonomic risk PAF according to the body parts ranged from 22.8%-59.6% in males and 22.8%-50.3% in female. Mental diseases showed a significant PAF for all body parts only among female (PAF 9.1%-21.4%). Cold exposure showed a significant PAF for the neck, shoulder, and hand MSD only among female (25.6%-26.8%). Age was not a significant indicator except for the knee MSD among female. Conclusions: Ergonomic risk contributed majorly as indicators of MSDs in both sexes of fishers. Mental disease and cold exposure were indicators of MSDs only among female fishers. This information may be important for determining priority risk groups for the prevention of work-related MSD among Korean fishers.