In-Hospital Fall Risk Prediction by Objective Measurement of Lower Extremity Function in a High-Risk Population.

OBJECTIVES: Limited data exist regarding association between physical performance and in-hospital falls. This study was performed to investigate the association between physical performance and in-hospital falls in a high-risk population. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: The study population consisted of 1200 consecutive patients with a median age of 74 years (50.8% men) admitted to a ward with high incidence rates of falls, primarily in the departments of geriatrics and neurology, in a university hospital between January 2019 and December 2021. METHODS: Short Physical Performance Battery (SPPB) was measured after treatment in the acute phase. As the primary end point of the study, the incidence of in-hospital falls was examined prospectively based on data from mandatory standardized incident report forms and electronic patient records. RESULTS: SPPB assessment was performed at a median of 3 days after admission, and the study population had a median SPPB score of 3 points. Falls occurred in 101 patients (8.4%) over a median hospital stay of 15 days. SPPB score showed a significant inverse association with the incidence of in-hospital falls after adjusting for possible confounders (adjusted odds ratio for each 1-point decrease in SPPB: 1.19, 95% CI 1.10-1.28; P < .001), and an SPPB score ≤6 was significantly associated with increased risk of in-hospital falls. Inclusion of SPPB with previously identified risk factors significantly increased the area under the curve for in-hospital falls (0.683 vs. 0.740, P = .003). CONCLUSION AND IMPLICATIONS: This study demonstrated an inverse association of SPPB score with risk of in-hospital falls in a high-risk population and showed that SPPB assessment is useful for accurate risk stratification in a hospital setting.

Effects of dance video game training on cognitive functions of community-dwelling older adults with mild cognitive impairment.

BACKGROUND: Some patients with minor cognitive impairment can revert to normal cognition if intervention is implemented early. Dance video games as multi-task training have shown beneficial effects on cognitive and physical functions in older adults. AIMS: This study aimed to elucidate the effects of dance video game training on cognitive functions and prefrontal cortex activity in older adults with and without mild cognitive impairment. METHODS: A single-arm trial was used for this study. The participants were divided based on the Japanese version of Montreal Cognitive Assessment scores into the mild cognitive impairment (n = 10) and normal cognitive function (n = 11) groups. Dance video game training was performed 60 min/day, 1 day/week, for a total of 12 weeks. Neuropsychological assessments, prefrontal cortex activity using functional near-infrared spectroscopy, and step performance of dance video game were recorded at pre- and post-intervention. RESULTS: Dance video game training significantly improved the Japanese version of Montreal Cognitive Assessment score (p < 0.05), and tendency toward improvement was observed in the trail making test in the mild cognitive impairment group. The dorsolateral prefrontal cortex activity in the Stroop color word test was significantly increased in the mild cognitive impairment group (p < 0.05) after dance video game training. CONCLUSIONS: Dance video game training improved cognitive function and increased prefrontal cortex activity in the mild cognitive impairment group.

[A Case of Dedifferentiated Liposarcoma with Reducing Surgery Followed by Chemotherapy and Additional Reducing Surgery].

Dedifferentiated liposarcoma shows poor prognosis because of poor resectability due to aggressive invasion of adjacent organs with multicentric growth and its low sensitivity to chemotherapy. We report herein a case of a giant dedifferentiated liposarcoma, successfully treated by pancreaticoduodenectomy(PD)for tumor reduction and chemotherapy for 1 year after surgery, followed by additional surgery for tumor reduction. The patient is a woman in 50s. CT showed an 18.5×9 cm main mass surrounding the superior mesenteric artery(SMA and SMV)with multiple tumors in the pelvis. Needle biopsy revealed dedifferentiated liposarcoma. Although complete resection or chemotherapy was not feasible, surgery was performed for local control and introduction of chemotherapy. The main tumor was resected by PD with SMV resection and right colectomy. Chemotherapy with doxorubicin followed by eribulin was administered after surgery. The residual lesions were controlled for 1 year. Partial resection of the tumors in the mesentery was performed. Eribulin were administered starting postoperatively. One year and 10 months after the initial surgery, there was no progress in residual disease. Although R2 resection for dedifferentiated liposarcoma shows extremely poor prognosis. Even when complete resection would be difficult, multidisciplinary treatment including debulking surgery might be effective for disease control.

Illusion of Wetness by Dynamic Touch.

Humans perceive wetness on contact with a dry-cold material; however, the magnitude of wetness that can be perceived using dynamic touch remains unclear. This study assessed how the type of touch, namely hand movement (either statically or dynamically) and pressing force (either low or high pressure), affect the perception of wetness. The participants judged the magnitude of perceived wetness after four types of touch of four stimuli comprising four fabrics of varying water content and surface temperatures. Overall, the perceived wetness was differed between static and dynamic touch independent of pressure and the participants scored the dry-cold stimulus as relatively dry for dynamic touch. Furthermore, cluster analysis revealed individual differences in the recognition of wetness in dynamic touch conditions. These results revealed the variability in the mechanisms used by humans to perceive wetness. Additionally, we discussed the optimal methods to reproduce the wetness perception using this illusion.

Physical-Perceptual Correspondence for Dynamic Thermal Stimulation.

Thermal displays have been applied in various haptic applications, from material simulation to interpersonal communication; however, there is insufficient knowledge about the temporal processing in human thermal sense to provide a　knowledge basis for thermal display design. In this study, we investigated the physical-perceptual correspondence for dynamic thermal stimulation to shed a light on the temporal processing of human thermal sense. In the experiments, participants reported subjective timings of the temperature onset and temperature peak of continuous temperature changes applied to the thenar eminence. We found that the physical-perceptual correspondence was not consistent for warm and cold stimulations. For warm stimulation, the subjective experience always came after the corresponding physical event. On the other hand, for cold stimulation, while the subjective onset always lagged the physical onset, the subjective temperature peak preceded the physical temperature peak. We analyzed these results in the framework of linear systems theory. The results suggest that the senses of warmth and cold have distinct temporal filtering properties, with the sense of cold being more transient than the sense of warmth. These findings advance our knowledge regarding temporal processing in human thermal sense and serve as a basis for thermal display design.