Changes in physical activity level during hospitalization in patients with stroke and those with fracture: a prospective longitudinal study.

[Purpose] To examine changes in physical activity levels between admission and discharge in patients hospitalized after stroke and fracture. [Participants and Methods] Patients with stroke (n=36) or fracture (n=41) wore an accelerometer during the daytime for three days after admission and before discharge. Physical activity was divided into sedentary behavior (SB), light-intensity (LIPA), and moderate-to-vigorous (MVPA), and then compared between hospital admission and discharge using the Wilcoxon signed-rank test. The characteristics of patients with or without changes in SB during hospitalization were compared using the Mann-Whitney U test. [Results] The median LIPA time in patients after stroke and fracture increased from 107.5 and 106.7 minutes on admission to 122.0 and 127.3 minutes at discharge, and the median MVPA time increased from 2.7 and 0.7 minutes on admission to 4.2 and 2.7 minutes at discharge, respectively. In particular, LIPA in non-therapy time increased for patients both after stroke and fracture. No differences in characteristics were observed between with or without changes in SB regardless of differences in diagnoses. [Conclusion] These findings indicate that while physical activity levels increased during hospitalization, they remained below World Health Organization recommendations for MVPA, and patient characteristics alone may not account for increased activity levels.

First nationwide survey of the seroprevalence of Toxoplasma gondii in wild boars in Japan.

The increase in some wildlife species is of global concern. The utilization of wildlife meat as food and feed represents a potential source of food-borne pathogens; this is particularly a potential concern for the use of wild board as a food source in Japan. Regarding food safety and an animal infectious disease control, however, little is known about the infection level of zoonotic pathogens including Toxoplasma gondii (T. gondii) in wild boar populations in their natural habitats in Japan. A total of 1279 blood samples from 41 prefectures were collected from apparently healthy wild boars during the three hunting periods (September to February) of 2014-2015, 2015-2016, and 2017-2018. Out of these sera, 461 samples tested positive by a commercial indirect ELISA for T. gondii, and the total apparent and adjusted true seroprevalence were estimated to 36.0% (95% confidence interval [CI], 33.4-38.7) and 31.3% (95% CI, 33.1-38.9), respectively. The seroprevalence was significantly higher in yearlings and adults than in piglets (P < 0.05); however, no significant difference according to gender was noted. These results indicate the importance of adequate heating of wild boar meat before consumption to prevent transmission of T. gondii to humans. Furthermore, freezing meat for several days before cooking is recommended to reduce the risk of infection. In addition, although the incidence of toxoplasmosis in pig farms is relatively low in Japan, biosecurity measures against the felids and the varied intermediate hosts should be strengthened, especially, at the farms located in the wild boar habitats to prevent livestock infection.

Development of a microchip electrophoresis-based, high-throughput PCR-RFLP method to type Tax 233 variants of bovine leukemia virus in Japan.

Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis (EBL). We used microchip electrophoresis in combination with automatic image analysis to develop a novel high-throughput PCR-RFLP to type the gene sequences that encode BLV Tax 233. This method revealed that 233L-Tax is more prevalent than 233P-Tax in cattle in Japan. The proportion infected with BLV carrying the gene encoding 233L-Tax was significantly higher in Holstein cattle than in Japanese Black cattle. Holsteins infected with BLV encoding 233L-Tax had higher proviral loads than did Holsteins infected with BLV encoding 233P-Tax and Japanese Blacks infected with BLV encoding 233L-Tax or 233P-Tax. The novel method developed in this study will be a useful tool for identifying cattle harboring BLV with a higher risk of EBL and viral transmission.

Simultaneous evaluation of diagnostic marker utility for enzootic bovine leukosis.

BACKGROUND: Enzootic bovine leukosis (EBL) is a disease of cattle caused by bovine leukemia virus (BLV). More than 60% of BLV-infected cattle remain subclinical and are thus referred to as aleukemic (AL) cattle. Approximately 30% of infected cattle show a relatively stable increase in the number of B lymphocytes; these cattle are termed persistent lymphocytosis (PL) cattle. A small percentage of infected cattle develop BLV-induced B cell lymphoma (EBL) and are called EBL cattle. Due to the increase in the number of BLV-infected cattle, the number of EBL cattle has featured a corresponding increase over recent years in Japan. Several diagnostic criteria for EBL (e.g., enlarged superficial lymph nodes, protrusion of the eye, increased peripheral blood lymphocyte, etc.) are used for on-farm diagnosis and antemortem tests at slaughterhouses. Since the slaughter of EBL cattle for human consumption is not allowed, on-farm detection of EBL cattle is important for reducing the economic loss incurred by farms. Therefore, establishing new diagnostic markers to improve the efficiency and accuracy of the antemortem detection of EBL cattle is a critical, unmet need. To simultaneously evaluate the utility of candidate markers, this study measured the values of each marker using the blood samples of 687 cattle with various clinical statuses of BLV infection (EBL, PL, AL and non-infected cattle). RESULTS: Sensitivity (Se) and specificity (Sp) were highest for the serum thymidine kinase (TK) followed by the serum lactate dehydrogenase (LDH) isozyme 2. The number of peripheral blood lymphocytes and proviral load in peripheral blood had the lowest Se and Sp. The values of all markers other than TK were influenced by the sex of the tested cattle. CONCLUSIONS: Although tLDH and its isozymes (LDHs) may be influenced by the sex of the tested cattle, the high accuracy of TK and LDH2 as well as accessibility and simplicity of the protocol used to measure these enzymes recommend the utility of TK and LDHs for EBL cattle detection. Using these markers for screening followed by the application of existing diagnostic criteria may improve the efficiency and accuracy of EBL cattle detection on farms, thereby contributing to the reduction of economic losses in farms.

Meteorological factors affecting seroconversion of Akabane disease in sentinel calves in the subtropical Okinawa Islands of Japan.

Akabane virus, the pathogen-causing Akabane disease, is an arthropod-borne virus (arbovirus) transmitted by the Culicoides biting midge. A nationwide serological surveillance program for bovine arboviral diseases, including Akabane disease, has been established in Japan to monitor the circulation of arboviruses by targeting sentinel calves. Okinawa, which is located in the southwestern-most region of Japan, is a high-risk area for incursion of arboviruses. The aim of the present study was to identify the meteorological factors related to farm-level seroconversion of Akabane virus by analyzing the serological surveillance data for sentinel calves collected in Okinawa between 2007 and 2015. Rainfall in winter, spring, and autumn was positively associated with seroconversion. Adequate rainfall seems to keep the soil in a suitably moist state for growth and survival of biting midges. Maximum temperature in winter was also positively associated with seroconversion in sentinel calves. The warmer temperatures in winter may provide conditions suitable for shortening the larval development cycle and increase production of adult midges. Our findings indicate that meteorological factors such as temperature and rainfall may be important factors that produce circumstances conducive to effective transmission of the virus between vectors and the host. The results of this study provide a better understanding of the circulation of arboviruses and offer suggestions for developing better surveillance and measures to prevent arboviral disease.

Epidemiological analysis of bovine ephemeral fever in 2012-2013 in the subtropical islands of Japan.

BACKGROUND: Bovine ephemeral fever (BEF) is a febrile disease of cattle that is transmitted by arthropod vectors such as mosquitoes and Culicoides biting midges. An outbreak of BEF recently occurred in Ishigaki Island and surrounding islands that are located southwest of Japan. In this study, an epidemiological analysis was conducted to understand the temporal and spatial characteristics of the outbreak. Factors associated with the disease spread within Ishigaki Island were investigated by hierarchical Bayesian models. The possibility of between-island transmission by windborne vectors and transmission by long-distance migration of infected vectors were examined using atmospheric dispersion models. RESULTS: In September 2012, the first case of the disease was detected in the western part of Ishigaki Island. In 1 month, it had rapidly spread to the southern part of the island and to surrounding islands, and led to 225 suspected cases of BEF during the outbreak. The dispersion model demonstrated the high possibility of between-island transmission by wind. Spatial analysis showed that paddy fields, farmlands, and slope gradients had a significant impact on the 1-km cell-level incidence risk. These factors may have influenced the habitats and movements of the vectors with regard to the spread of BEF. A plausible incursion event of infected vectors from Southeast Asia to Ishigaki Island was estimated to have occurred at the end of August. CONCLUSION: This study revealed that the condition of a terrain and land use significantly influenced disease transmission. These factors are important in assessing favorable environments for related vectors. The results of the dispersion model indicated the likely transmission of the infected vectors by wind on the local scale and on the long-distance scale. These findings would be helpful for developing a surveillance program and developing preventive measures against BEF.

Spatial epidemiological analysis of bovine encephalomyelitis outbreaks caused by Akabane virus infection in western Japan in 2011.

Akabane disease, which is distributed in temperate and tropical regions in the world, is a vector-borne disease of ruminants caused by the Akabane virus, transmitted by Culicoides biting midges. In 2011, outbreaks of Akabane viral encephalomyelitis occurred in the Shimane Prefecture in western Japan. In this study, a spatial epidemiological analysis was conducted to understand environmental factors associated with the spread of Akabane disease. By applying a conditional autoregressive model, the relationship between infection and environmental variables was explored. The results showed that the dominance of farmlands and the presence of infected farms within a 3-km radius had a significant effect on infection. This result implies that land use, which would relate with the vector habitat, and the presence of neighboring infected farms as a source of infection may have influenced the spread of the disease in this region. These findings provide basic insights into the spread of Akabane disease and useful suggestions for developing a surveillance program and preventive measures against the disease.

Pooled Minimal Clinically Important Differences of the Mini-Balance Evaluation Systems Test in Patients With Early Subacute Stroke: A Multicenter Prospective Observational Study.

OBJECTIVE: Balance problems are common in patients with stroke, and the Mini-Balance Evaluation Systems Test (Mini-BESTest) is a reliable and valid assessment tool for measuring balance function. Determining the minimal clinically important difference (MCID) is crucial for assessing treatment effectiveness. This study aimed to determine the MCID of the Mini-BESTest in patients with early subacute stroke. METHODS: In this prospective multicenter study, 53 patients with early subacute stroke undergoing rehabilitation in inpatient units were included. The mean age of the patients was 72.6 (SD = 12.2) years. The Mini-BESTest, which consists of 14 items assessing various aspects of balance function, including anticipatory postural adjustments, postural responses, sensory orientation, and dynamic gait, was used as the assessment tool. The global rating of change (GRC) scales completed by the participants and physical therapists were used as external anchors to calculate the MCID. The GRC scale measured subjective improvement in balance function, ranging from -3 (very significantly worse) to +3 (very significantly better), with a GRC score of ≥+2 considered as meaningful improvement. Four methods were used to calculate the MCID: mean of participants with GRC of 2, receiver operating characteristic-based method, predictive modeling method, and adjustment of the predictive modeling method based on the rate of improvement. From the MCID values obtained using these methods, a single pooled MCID value was calculated. RESULTS: The MCID values for the Mini-BESTest obtained through the 4 methods ranged from 3.2 to 4.5 points when using the physical therapist's GRC score as the anchor but could not be calculated using the participant's GRC score. The pooled MCID value for the Mini-BESTest was 3.8 (95% CI = 2.9-5.0). CONCLUSIONS: The Mini-BESTest MCID obtained in this study is valuable for identifying improvements in balance function among patients with early subacute stroke. IMPACT: Determination of the MCID is valuable for evaluating treatment effectiveness. The study findings provide clinicians with practical values that can assist in interpreting Mini-BESTest results and assessing treatment effectiveness.

Clinical prediction rules for multi surfaces walking independence using the Berg Balance Scale or Mini-Balance Evaluation Systems Test in persons with stroke.

BACKGROUND: A Clinical prediction rule (CPR) for determining multi surfaces walking independence in persons with stroke has not been established. OBJECTIVES: To develop a CPR for determining multi surfaces walking independence in persons with stroke. METHODS: This was a multicenter retrospective analysis of 419 persons with stroke. We developed a Berg Balance Scale (BBS)-model CPR combining the BBS, comfortable walking speed (CWS) and cognitive impairment, and a Mini-Balance Evaluation Systems Test (Mini-BESTest)-model CPR combining the Mini-BESTest, CWS, and cognitive impairment. A logistic regression analysis was conducted with multi surfaces walking independence as the dependent variable and each factor as an independent variable. The identified factors were scored (0, 1) based on reported cutoff values. The CPR's accuracy was verified by the area under the curve (AUC). We used a bootstrap method internal validation and calculated the CPR's posttest probability. RESULTS: The logistic regression analysis showed that the BBS, CWS, and cognitive impairment were factors in the BBS model, and the Mini-BESTest was a factor in the Mini-BESTest model. The CPRs were 0-3 points for the BBS model and 0-1 points for the Mini-BESTest model. The AUCs (bootstrap mean AUC) of the CPR score were 0.89 (0.90) for the BBS model and 0.72 (0.72) for the Mini-BESTest model. The negative predictive value (negative likelihood ratio) was 97% (0.054) for CPR scores < 2 for the BBS model and 94% (0.060) for CPR scores < 1 for the Mini-BESTest model. CONCLUSIONS: The CPR developed herein is useful for determining multi surfaces walking independence.

Serum bta-miRNA-375 as a potential biomarker for the early diagnosis of enzootic bovine leukosis.

To identify a biomarker for the early diagnosis of enzootic bovine leukosis (EBL) caused by bovine leukemia virus (BLV), we investigated the expression of a microRNA, bta-miR-375, in cattle serum. Using quantitative reverse-transcriptase PCR analysis, we measured bta-miR-375 levels in 27 samples from cattle with EBL (EBL cattle), 45 samples from animals infected with BLV but showing no clinical signs (NS cattle), and 30 samples from cattle uninfected with BLV (BLV negative cattle). In this study, we also compared the kinetics of bta-miR-375 with those of the conventional biomarkers of proviral load (PVL), lactate dehydrogenase (LDH), and thymidine kinase (TK) from the no-clinical-sign phase until EBL onset in three BLV-infected Japanese black (JB) cattle. Bta-miR-375 expression was higher in NS cattle than in BLV negative cattle (P < 0.05) and greater in EBL cattle than in BLV negative and NS cattle (P < 0.0001 for both comparisons). Receiver operating characteristic curves demonstrated that bta-miR-375 levels distinguished EBL cattle from NS cattle with high sensitivity and specificity. In NS cattle, bta-miR-375 expression was increased as early as at 2 months before EBL onset-earlier than the expression of PVL, TK, or LDH isoenzymes 2 and 3. These results suggest that serum miR-375 is a promising biomarker for the early diagnosis of EBL.

Risk factors for the transmission of foot-and-mouth disease during the 2010 outbreak in Japan: a case-control study.

BACKGROUND: In 2010, foot-and-mouth disease (FMD) occurred for the first time in a decade in Japan. Movement or shipment of people and animals around infected farms was restricted; however these contingency measures proved insufficient to prevent FMD spread. Consequently, a total of 292 farms were confirmed as infected during this outbreak. We conducted a case-control study to identify the risk factors associated with FMD transmission between farms during these restrictions. As there was discordance in the control measures taken, risk factors were examined separately for two areas. Analyses were also performed separately for cattle and pig farms given their different infectivity and susceptibility. RESULTS: For cattle farms in the movement restriction area, the odds of having the factor 'farm equipment was shared with other farms' was significantly higher for case farms than for control farms. For cattle farms in the shipment restriction area, the odds of having the factors 'feed transport vehicles visited the farm' and 'staff of livestock-related companies visited the farm' were significantly higher on case farms than control farms. In pig farms in the movement restriction area, the odds of having factor 'farm staff commuted from outside' was 20 times higher for case farms than control farms. In addition, case farms were less likely to have the factors 'fattening farm' and 'barn has physical barriers' compared with control farms. CONCLUSIONS: In the movement restriction area, the disease was likely to spread regardless of the movement of people and vehicles, and physical barriers were found to be a protective factor. Therefore, physical barriers from the surrounding environments seemed to prevent farms from being infected. Conversely, in the shipment restriction area, movement of people and vehicles was strongly associated with disease spread. These results allow a better understanding of the risk factors associated with FMD transmission and are useful to enhance future preventive measures against transmission during FMD outbreaks.

Cut-off values and sub-items of the Berg Balance Scale for walking-aid use in hospitalized older adults with a hip fracture: a retrospective analysis.

OBJECTIVE: To identify the Berg Balance Scale (BBS) values that can be used to discriminate the use of a walking aid and the BBS sub-items that reveal the differences in the use of walking aids among hospitalized older adults with a hip fracture. METHODS: The cases of 77 older adults (age 80.8 ± 7.5 years) with a hip fracture who were able to walk independently in the hospital were retrospectively analyzed. A receiver operating characteristic curve (AUC) analysis was used to identify BBS scores that optimized the identification of subjects with different levels of aids. The BBS sub-items identifying differing among the walking aids were identified by a classification and regression tree analysis. RESULTS: The BBS scores were highest for no aid, a cane, and a walker, in that order. The ability to walk without an aid and the ability to walk without a walker showed moderate AUCs (0.824 and 0.865) with cutoff values of 51.5 and 45.5 points, respectively. The sub-items identified were Turning 360° (4 vs. < 4 points) as the best discriminator for using/not using a cane and Stool Stepping (≥ 2 vs. < 2 points) for using a cane or walker. CONCLUSION: The BBS is useful for determining whether to discontinue the use of a walker in individuals with a hip fracture.

The association between farm-level antimicrobial usage and resistance of Staphylococcus spp., as the major genus isolated from aerosol samples, in Japanese piggeries.

Bacteria are the dominant particulate matter in livestock houses and can threaten animal and public health. Antimicrobial resistance (AMR) is a crucial concern worldwide, and nationwide measures established based on the One Health approach are being implemented in many countries. This requires multidisciplinary perspectives and collaboration among the human, animal, and environmental sectors. However, information on the AMR risk in livestock house aerosol is limited, especially its association with antimicrobial usage (AMU). Therefore, this study was conducted to reveal the AMR profile of Staphylococcus, the major bacterial genus in the aerosol of the piggeries of Japanese farms, and the association between farm-level AMU and AMR. The investigation at 10 farrow-to-finish pig farms revealed that regardless of the sampling season and the piggery group, the resistance rate of isolated staphylococci for oxacillin, erythromycin, and lincomycin was more than 40% of the median and tended to be higher than that for other antimicrobials. The AMU adjusted by the defined daily dose (DDD-adjusted AMU) in the fattening piggery group was significantly higher than that in the sow piggery group (p < 0.05). Finally, for the fattening piggery group, the generalized linear mixed model revealed that the AMR rate for oxacillin, erythromycin, tetracycline, and chloramphenicol was positively associated with the corresponding class-based DDD-adjusted AMU of penicillins (odds ratio (OR) = 2.63, p = 0.03), macrolides (OR = 6.89, p = 0.0001), tetracyclines (OR = 2.48, p = 0.04), and amphenicols (OR = 3.22, p = 0.03), respectively. These significant positive associations observed in this study imply that the resistance rate for these antimicrobials may decrease by reducing the corresponding antimicrobials' use. In addition, the resistance rates for erythromycin and chloramphenicol also displayed a positive association with the AMU of antimicrobial classes other than macrolides and amphenicols, respectively. The mechanism underlying these phenomena is unclear; therefore, further evaluation will be needed. As limited studies have reported staphylococci in piggery aerosol and its AMR with quantitative AMU, these results based on on-farm investigations are expected to aid in establishing countermeasures for AMR of aerosol bacteria in pig farms.

Minimal important change in the Berg Balance Scale in older women with vertebral compression fractures: A retrospective multicenter study.

BACKGROUND: Vertebral compression fractures, which are commonly associated with older age and osteoporotic fractures, have an increased risk of re-fracture. Therefore, improving balance is important to prevent falls. The minimal important change (MIC) has been recommended for interpreting clinically meaningful changes in rating scales. The MIC of the Berg Balance Scale (BBS) for use in older women with vertebral compression fractures has not been established. OBJECTIVE: To identify the MIC of the BBS that can be used in older women with vertebral compression fractures using predictive modeling methods and the receiver-operating characteristic (ROC)-based method. DESIGN: A retrospective longitudinal multicenter study. PATIENTS: Sixty older women (mean age ± standard deviation: 84.1 ± 7.0 years) with vertebral compression fractures who were unable to ambulate independently on a level surface. METHODS: A change of one point in the Functional Ambulation Category (FAC) was used as an anchor to calculate the MIC of the BBS based on the change between admission and discharge. We calculated the MIC for the women whose FAC score improved by ≥1 point. We used three anchor-based methods to examine the MIC: the ROC-based method (MICROC ), the predictive modeling method (MICpred ), and the MICpred -based method adjusted by the rate of improvement and reliability of transition (MICadj ). RESULTS: Thirty-nine women comprised the "important change" group based on their FAC score improvement. In this group, the MICROC (95% confidence interval [CI]) value of the BBS was 10.0 points (5.5-15.5), with an area under the curve of 0.71. The MICpred (95% CI) value was 9.7 (8.1-11.0), and the MICadj (95% CI) was 7.0 (5.5-8.5) points. CONCLUSION: For women with vertebral compression fractures who are unable to ambulate independently, a 7.0-point improvement in the BBS score may be a useful indicator for reducing the amount of assistance required for walking.

Occurrence and the potential ecological risk of veterinary antimicrobials in swine farm wastewaters in Japan: Seasonal changes, relation to purchased quantity and after termination of oxytetracycline usage.

This study provides the first comprehensive investigation of the residual concentrations of eight classes of antimicrobial agents (AMs, 20 compounds) in 13 swine wastewater treatment facilities in Japan. These facilities implemented the aerobic activated sludge (AS) or its alternative methods. The maximum concentrations before treatment were found at the level of 7100, 6900, 6000, 3600, 3400, and 1400 µg/L for tilmicosin, oxytetracycline (OTC), chlortetracycline, lincomycin , sulfamethoxazole, and trimethoprim, respectively. The highest detection rate (96.3%) in influents was noted for the morantel, which was a feed additive. The seasonal difference in residual concentration was much greater for tetracyclines (TCs) and macrolides (MLs) when their residual concentrations were high, especially in the cold season. There was a positive correlation between the purchased quantity of TCs and fluoroquinolones (FQs) and their residue levels detected in the effluents (p < 0.01). The estimated removal rate of AMs was greater than 80%. In contrast, on a few occasions, it was diminished due to failing operating conditions, such as water temperature and AS rate in the aeration tank. The estimated ecological risks of AMs in effluents based on risk quotients (RQs) considered to enhance the selection pressure for drug resistance (RQs-AMR) were high for TCs and FQs, whereas ecotoxicological effects (RQs-ENV) to aquatic organisms were higher for sulfonamides and MLs. When OTC usage ceased, its concentration in wastewater decreased rapidly; however, it remained longer period in the effluents, probably due to OTC desorption from the AS. The concentrations (and respective RQs) of TCs were decreased by >99.8% and >92% in the influents and effluents, respectively. This data suggested that it is essential to reduce the amount used and introduce more efficient methods and operating conditions to constantly remove AMs during the treatment to reduce the risk of AM discharge from swine farms.

Characteristics of antimicrobial residues in manure composts from swine farms: Residual patterns, removal efficiencies, and relation to purchased quantities and composting methods in Japan.

Present study provides first comprehensive results on the residual levels of 19 antimicrobial (AM) residues in 12 Japanese swine manure composting facilities that use open or enclosed types of treatment methods. Tilmicosin (14000 µg/kg d.w.) and tiamulin (15000 µg/kg d.w.) were present in the highest concentrations in manure composts. Morantel (MRT) had the highest detection frequency (100%) in compost, suggesting its ubiquitous usage and resistance to degradation during composting. Sulfamethoxazole had low detection frequencies and concentrations, likely due to limited partitioning to the solid phase. A positive correlation (p < 0.05) between purchasing quantities and residue levels in manure composts was detected for fluoroquinolones (FQs). The removal efficiencies of AMs in enclosed-type facilities were lower and more inconsistent than those in open-type facilities. Tetracyclines (TCs), lincomycin, and trimethoprim were easily removed from open-type facilities, whereas FQs and MRT persisted in both facilities. After discontinuing the usage of oxytetracycline (OTC), TCs concentrations reduced drastically in input materials, remained pseudo-persistent in composts for up to 4 months, suggesting a time lag for composting and were not detected (<10 µg/kg) after 4 months of OTC withdrawal. This study emphasizes on the effectiveness of manure composting methods in reducing AM residues in swine waste.

Isolation, molecular characterization, and disinfectants susceptibility of swine-carried mammalian orthoreoviruses in Japan in 2020-2022.

Biosecurity enhancement contributes to the reduction of various microbial pathogens. Mammalian orthoreoviruses (MRVs) which are increasingly recognized as potentially serious problems on swine industry were used as indicators of biosecurity enhancement on two pig farms. Twelve MRVs were detected and isolated from fecal specimens of healthy pigs collected from one of the two farms in Japan. By sequencing based on the partial S1 gene, MRV isolates were classified as MRV1 and MRV2. Additionally, the virucidal activities of disinfectants toward the isolated MRV1 were evaluated using quaternary ammonium compound (QAC) diluted 500 times with water (QAC-500), 0.17% food additive glade calcium hydroxide (FdCa(OH)2) solution, QAC diluted with 0.17% FdCa(OH)2 solution (Mix-500), sodium hypochlorite at 100 or 1,000 parts per million (ppm) of total chlorine (NaClO-100 or NaClO-1000, respectively). To efficiently inactivate MRV1 (≥3 log10 reductions), 0.17% FdCa(OH)2, Mix-500 and NaClO-1000 required 5 min, whereas it took 30 min for QAC-500. The number of MRV detections has decreased over time, after using Mix-500 for disinfection on the positive farm. These results suggest that different serotypes of MRVs are circulating among pigs, and that the occurrence of MRVs in the farms decreased consequent to more effective disinfection.

Berg Balance Scale is a Valid Measure for Plan Interventions and for Assessing Changes in Postural Balance in Patients with Stroke.

OBJECTIVES: After confirming the measurement properties of the Berg Balance Scale (BBS) in patients with stroke by conducting a Rasch analysis, this study sought: (i) to generate a keyform as a tool for goal-setting and intervention-planning; and (ii) to determine the appropriate strata for separating patients' postural balance ability. DESIGN: Methodological analyses of cross-sectional study data. PATIENTS: A pooled sample of 156 patients with stroke: mean (standard deviation) age 74.4 (12.9) years. METHODS: This study evaluated the BBS's rating scale structure, unidimensionality, and measurement accuracy (0: unable to perform or requiring help, to 4: normal performance) and then generated a keyform and strata. RESULTS: The BBS rating scale fulfilled the category functioning criteria. Principal component analysis of standardized residuals confirmed the unidimensionality of the test. All items fit the Rasch analysis. Person ability-item difficulty matching was good. Person reliability was 0.96, and the patients were divided into 9 strata. The keyform for the BBS will enable clinicians and investigators to estimate patients' postural balance ability and monitor their progress. CONCLUSION: The BBS has strong measurement properties. This study generated both a keyform that can contribute to clinicians' decision-making in goalsetting and intervention-planning and strata that can facilitate understanding of patients' abilities.

Disinfectant resistance of Salmonella in in vitro contaminated poultry house models and investigation of efficient disinfection methods using these models.

Salmonellaenterica subsp. enterica (Salmonella) shows disinfectant resistance by forming biofilms on solid surfaces. However, efficient disinfection methods to eliminate Salmonella biofilms from farms have not yet been examined in detail. In this study, more than 80% of Salmonella strains from farms in Yamagata prefecture, Japan, were biofilm producers. Regardless of the extent of their biofilm formation ability, their biofilms were highly resistant to hypochlorous acid on plastic surfaces. To establish efficient disinfection methods in farms, we developed in vitro Salmonella-contaminated poultry house models by depositing dust on ceramic and stainless-steel carriers in poultry houses for one month and culturing a representative Salmonella strain on the carriers. Biofilm-like structures, including Salmonella-like cells, were observed on the models by scanning electron microscopy. Salmonella was not efficiently removed from the models even by cleaning with a surfactant at 25/65°C and disinfection with quaternary ammonium compound or hypochlorous acid at 25°C; on the contrary, viable Salmonella cells increased in some tests under these conditions, suggesting that these models successfully simulate the highly persistent characteristics of Salmonella in farms. However, the persistent bacterial cells were markedly decreased by soaking in 65°C surfactant followed by rinsing with 80°C water, additional cleaning using chlorine dioxide or disinfection with dolomitic lime, suggesting the effectiveness of these methods against Salmonella in farms. Since many different disinfection conditions may be easily tested in laboratories, our models will be useful tools for establishing effective and practical disinfection methods in farms.

Minimal clinically important difference of the Berg Balance Scale score in older adults with hip fractures.

PURPOSE: The minimal clinically important difference (MCID) is the smallest clinically significant difference in treatment identified as crucial to the patient. There is no known MCID for the Berg Balance Scale (BBS), which measures balance function in patients with hip fractures. We aimed to calculate the MCID of the BBS in older adults with hip fractures. MATERIALS AND METHODS: This is a retrospective multicenter clinical study that included 187 older adults with hip fractures. MCID was calculated using functional ambulation categories (FACs), which were used as anchors for the change in BBS scores between admission and discharge. MCID was calculated as an improvement for more than one point and as a substantial change for improvement for more than two points in the FAC. RESULTS: MCID of the BBS was 11.5 points and that of the substantial change was 18.5 points, with an area under the curve of 0.76 and 0.81, respectively. CONCLUSIONS: MCID for the BBS was 11.5 points in older adults with hip fractures. In addition, an improvement of more than 18.5 points in BBS can be considered a substantial change. These values may be useful in determining meaningful balance function improvement.Implications for rehabilitationHip fractures are a common injury for the older adults, and improvement in gait function has a bearing on prognosis.The effectiveness of meaningful rehabilitation is possible to determine by clarifying the minimal clinically important difference in balance function, which is important for the acquisition of gait.An improvement of 11.5 points or more on the Berg Balance Scale in an older adult with a hip fracture is considered a meaningful effect.