Alterations in the hub structure of whole-brain functional networks in patients with drug-naïve schizophrenia: Insights from electroencephalography-based research.

Aim: This study aimed to identify atypical hubs in the whole-brain networks of patients with schizophrenia (SZ) and examine the effects of antipsychotic medications, using electroencephalography (EEG) data. Methods: We estimated the functional connectivity across all electrodes by applying the phase lag index to the EEG signals of 21 drug-naïve patients with SZ and 31 age-matched healthy controls. Betweenness centrality (BC), a measure of hub status, was calculated for each electrode and frequency band. Data from 14 patients were re-evaluated after initiating treatment with antipsychotic medications. Results: BC values decreased significantly at the Fz site in the beta band, decreased significantly at Pz in the gamma band, and increased significantly at O1 in the gamma band among patients with SZ. These changes persisted after antipsychotic treatment and were unrelated to clinical symptoms. Conclusion: The abnormal hub topology we observed, especially in the high-frequency band, may reflect the pathophysiology of SZ, and this study highlights the utility of BC analysis of EEG data for detecting alterations in the whole-brain networks of patients with SZ.

Continuous laxative use and its relationship to defecation among residents of nursing homes: A longitudinal observational study using the interRAI.

AIM: To clarify the association between constipation, diarrhea, and long-term laxative use in Japanese nursing home residents. METHODS: Data from 306 residents with chronic constipation aged over 75 years for basic characteristics, medication use, activities of daily living, and concurrent illness were collected via two consecutive 6-monthly surveys conducted using the Japanese interRAI assessment tool. We used bivariate and multivariate analyses to examine the associations between chronic constipation, diarrhea, and continuous laxative use. RESULTS: Chronic constipation persisted in 74.5% of residents despite their continuous use of laxatives. Additionally, 14.4% experienced chronic diarrhea while on laxatives. Residents using salt laxatives had significantly lower chronic constipation than those not using salt laxatives (adjusted odds ratio [AOR] 0.52), while residents using novel laxatives had significantly higher chronic diarrhea than those not using novel laxatives (AOR 4.28). CONCLUSIONS: Our findings reveal that bowel movement-related problems remain a concern and highlight the need for further research on the use of novel laxatives in nursing home residents. Geriatr Gerontol Int 2024; 24: 133-139.

Impact of family involvement and an advance directive to not hospitalize on hospital transfers of residents in long-term care facilities.

OBJECTIVE: With the rapidly aging population, the number of residents transferred to hospitals from long-term care facilities (LTCFs) is increasing globally. The objective of this study was to investigate the association between family involvement and an advance directive (AD) for not hospitalizing and hospital transfers among LTCF residents with dementia. METHOD: Using the InterRAI assessment database from September 2014 to June 2019, we included 874 residents from 16 LTCFs in Japan. RESULTS: Of the 874 participants, 19.0% had an AD for not hospitalizing, and 20.5% were transferred to hospitals. An AD for not hospitalizing decreased the likelihood of hospital transfers (p = 0.005). Multilevel logistic regression analysis showed that family involvement was not associated with hospital transfers (odds ratio [OR]: 1.18; 95% confidence interval [CI]: 0.77-1.80), while an AD for not hospitalizing was significantly associated with decreased hospital transfers (OR: 0.50; 95% CI: 0.28-0.89) among the LTCF residents. CONCLUSIONS: Although ADs are not legally defined in Japan, we found that an AD for not hospitalizing decreased hospital transfers. Given that many older people tend to hesitate to express their wishes in clinical decision-making situations in Japan, regular discussions are necessary to help them express their care preferences while also documenting the discussions to ensure the residents receive high-quality care.