Impact of cataract surgery on cognitive impairment in older people.

OBJECTIVES: To examine the impact of cataract surgery on mild cognitive impairment (MCI) and dementia in older people. METHODS: This prospective observational study included patients aged 75 years and older who underwent cataract surgery between 2019 and 2021. Mini-mental state examination (MMSE) and MMSE for the visually impaired (MMSE-blind) were measured to evaluate cognitive function before and 3 months after cataract surgery. MMSE score at baseline was used to categorize patients into dementia (MMSE ≤ 23) and MCI groups (23 < MMSE ≤ 27). Logistic regression models were used to estimate associations between improvement in cognitive function and other factors. RESULTS: Of 132 patients screened for inclusion in the study, 88 met the inclusion criteria; 39 patients were assigned to the dementia group (mean age, 85.7 ± 4.2 years) and 49 to the MCI group (mean age, 84.2 ± 3.4 years). The MCI group showed significant improvement from before to after surgery in the MMSE score (25.65 ± 1.03 vs. 27.08 ± 1.99, respectively, p < 0.001) and MMSE-blind score (18.04 ± 1.14 vs. 19.41 ± 2.01, respectively, p < 0.001). Cognitive function improved significantly in the MCI group compared with the dementia group (odds ratio, 2.85; 95% confidence interval, 1.02-7.97; and p = 0.046). CONCLUSIONS: Cataract surgery significantly increases cognitive test scores in older patients with MCI. After cataract surgery, the likelihood of improvement in cognitive function may be highly dependent on a patient's preoperative cognitive state.

High Fever, Wide Distribution of Viral Pneumonia, and Pleural Effusion are More Critical Findings at the First Visit in Predicting the Prognosis of COVID-19: A Single Center, retrospective, Propensity Score-Matched Case-Control Study.

Introduction: Currently, infection control measures for SARS-COV2 are being relaxed, and it is important in daily clinical practice to decide which findings to focus on when managing patients with similar background factors. Methods: We retrospectively evaluated 66 patients who underwent blood tests (complete blood count, blood chemistry tests, and coagulation tests) and thin slice CT between January 1 and May 31, 2020, and performed a propensity score-matched case-control study. Cases and controls were a severe respiratory failure group (non-rebreather mask, nasal high-flow, and positive-pressure ventilation) and a non-severe respiratory failure group, matched at a ratio of 1:3 by propensity scores constructed by age, sex, and medical history. We compared groups for maximum body temperature up to diagnosis, blood test findings, and CT findings in the matched cohort. Two-tailed P-values <0.05 were considered statistically significant. Results: Nine cases and 27 controls were included in the matched cohort. Significant differences were seen in maximum body temperature up to diagnosis (p=0.0043), the number of shaded lobes (p=0.0434), amount of ground-glass opacity (GGO) in the total lung field (p=0.0071), amounts of GGO (p=0.0001), and consolidation (p=0.0036) in the upper lung field, and pleural effusion (p=0.0117). Conclusion: High fever, the wide distribution of viral pneumonia, and pleural effusion may be prognostic indicators that can be easily measured at diagnosis in COVID-19 patients with similar backgrounds.

Waterproofing Spray-Associated Lung Injury Review: Differences between Cases of Early and Delayed Improvement of Waterproofing Spray-Associated Lung Injury.

Waterproofing spray-associated lung injury (WALI) is an acute respiratory disorder characterized by bilateral diffuse lung injury on chest computed tomography (CT). In most cases, the symptoms and abnormal radiographic findings of WALI patients improve spontaneously over several days; however, some cases have persistent symptoms and abnormal shadows for >1 week. The distinctive features of each WALI are unknown. Herein, we present two new cases of WALI that we encountered in our hospital, and we previously reported two other cases of WALI. We examined the characteristics of WALI in our cases and 39 other cases of WALI definitively diagnosed and reported in PubMed and the Japan medical board with verifiable data during a 15-year period. We compared the clinical characteristics of the 22 cases in which the patients' symptoms were resolved within 1 week (early improvement) to those of the 21 cases in which the symptoms were resolved after >1 week (delayed improvement). The WALI cases with delayed improvement had significantly more shadowing that extended over the entire lung field and was not biased in intensity toward the upper or lower lung field. In addition, the serum white blood cell (WBC) counts and serum Krebs von den Lungen-6 (KL-6) levels differed significantly between the cases of early and delayed improvement of WALI.

A case of reinfection with a different variant of SARS-CoV-2: case report.

Background: Coronavirus disease 2019 (COVID-19) was previously thought to have a low reinfection rate, but there are concerns that the reinfection rate will increase with the emergence and spread of mutant variants. This report describes the case of a 36-year-old, non-immunosuppressed man who was infected twice by two different variants of COVID-19 within a relatively short period. Case presentation: A 36-year-old Japanese man with no comorbidities was infected with the E484K variant (R.1 lineage) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptoms were mild and improved with symptomatic treatment alone. About four months later he presented to another outpatient department with high fever and headache. We diagnosed him as infected with the Alpha variant (B.1.1.7) of SARS-CoV-2 based on SARS-CoV-2 real-time reverse transcription polymerase chain reaction testing (RT-PCR). The patient was hospitalized with high fever. The patient received treatment in the form of anti-inflammatory therapy with corticosteroid and antibacterial chemotherapy. The patient improved without developing severe disease. Conclusion: Concerns have been raised that the reinfection rate of COVID-19 will increase with the emergence of mutant variants. Particularly in mild cases, adequate amounts of neutralizing antibodies may not be produced, and reinfection may thus occur. Continued attention to sufficient infection control is thus essential.

Super Mg2+ Conductivity around 10-3 S cm-1 Observed in a Porous Metal-Organic Framework.

We first report a solid-state crystalline "Mg2+ conductor" showing a superionic conductivity of around 10-3 S cm-1 at ambient temperature, which was obtained using the pores of a metal-organic framework (MOF), MIL-101, as ion-conducting pathways. The MOF, MIL-101⊃{Mg(TFSI)2}1.6 (TFSI- = bis(trifluoromethanesulfonyl)imide), containing Mg2+ inside its pores, showed a superionic conductivity of 1.9 × 10-3 S cm-1 at room temperature (RT) (25 °C) under the optimal guest vapor (MeCN), which is the highest value among all Mg2+-containing crystalline compounds. The Mg2+ conductivity in the MOF was estimated to be 0.8 × 10-3 S cm-1 at RT, by determining the transport number of Mg2+ (tMg2+ = 0.41), which is the level as high as practical use for secondary battery. Measurements of adsorption isotherms, pressure dependence of ionic conductivity, and in situ Fourier transform infrared measurements revealed that the "super Mg2+ conductivity" is caused by the efficient migration of the Mg2+ carrier with the help of adsorbed guest molecules.

Corneal Eccentricity in a Rural Japanese Population: The Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS).

PURPOSE: To determine normal corneal eccentricity in a rural Japanese population and to examine factors associated with eccentricity value. METHODS: This used data from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS) project between 2009 and 2012. Residents of Minamiaizu and Tadami in Fukushima, Japan, who were aged 40 years or over, were invited for a comprehensive eye examination. For 1371 patients with no history of internal eye surgery, corneal eccentricity was measured using a Pentacam. RESULTS: Of 1371 people recruited to the study, 1215 (1215 eyes) met the inclusion criteria. The overall mean eccentricity was 0.46 (SD = 0.18; range, -0.85 to 0.88). Corneal eccentricity was significantly associated with age, spherical equivalent, pupil diameter, anterior chamber angle, anterior chamber volume, and central corneal thickness, but not with gender or body mass index. CONCLUSIONS: In this study, the normal cornea in this Japanese population was prolate. Corneal eccentricity was likely to decrease with increasing age. Also, spherical equivalent and other anterior segment parameters had an influence on corneal eccentricity. Corneal eccentricity measurements might be helpful in the diagnosis of corneal diseases and in calculations for intraocular lens implantation and corneal refractive surgery.

Impact of retinal vein occlusion on cardiovascular events in elderly Japanese patients.

ABSTRACT: To assess the relationship between retinal vein occlusion (RVO) and the incidence of cardiovascular (CV) events.This was a single-institution, retrospective cohort study. We enrolled 57 patients diagnosed with RVO between January 2012 and December 2019, and 125 non-RVO patients who had undergone cataract surgery by a single surgeon between January and April 2012. We compared the relative risk and incidence rate ratio of CV events between the 2 groups. In addition, survival analysis was performed to calculate the hazard ratio (HR) using the Cox proportional hazards model. RVO, age, sex, blood pressure, body mass index, presence of diabetes, blood sample data, and smoking were considered confounders.The mean observation period (± standard deviation) for the RVO and non-RVO groups was 2.68 ±â€Š2.04 and 2.81 ±â€Š2.70 years, respectively. Seven CV events were observed in the RVO group and 2 in the non-RVO group. Relative risk and incidence rate ratio were 7.68 (95% confidence interval [CI]: 1.65-35.8) and 8.07 (95% CI: 1.54-79.6), respectively. Multivariate analysis revealed that the RVO group had a high HR for CV events (HR: 16.13 [95% CI: 2.29-113.74]) and older age (HR: 1.26 [95% CI: 1.06-1.49]).RVO can predict future CV events, especially in the elderly population. Fundus observations should be shared between ophthalmologists and internists to prevent future CV events.

Bulk-sensitive spin-resolved resonant electron energy-loss spectroscopy (SR-rEELS): Observation of element- and spin-selective bulk plasmons.

We have developed spin-resolved resonant electron energy-loss spectroscopy with the primary energy of 0.3-1.5 keV, which corresponds to the core excitations of 2p-3d absorption of transition metals and 3d-4f absorption of rare-earths, with the energy resolution of about 100 meV using a spin-polarized electron source as a GaAs/GaAsP strained superlattice photocathode. Element- and spin-selective carrier and valence plasmons can be observed using the resonance enhancement of core absorptions and electron spin polarization. Furthermore, bulk-sensitive electron energy-loss spectroscopy spectra can be obtained because the primary energy corresponds to the mean free path of 1-10 nm. The methodology is expected to provide us with novel information about elementary excitations by resonant inelastic x-ray scattering and resonant photoelectron spectroscopy.

Two Cases of Severe COVID-19 Pneumonia Effectively Treated with Extracorporeal Membrane Oxygenation in Addition to Favipiravir and Corticosteroid.

Case 1: A 65-year-old man with novel coronavirus infection (COVID-19) complicated with acute respiratory failure. On admission, the patient was started on favipiravir and corticosteroid. However, due to a lack of significant improvement, he was introduced to mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Although iliopsoas hematoma occurred as a complication, the patient recovered. Case 2: A 49-year-old man with COVID-19 had been started on favipiravir and corticosteroid. Due to progressive respiratory failure, the patient underwent mechanical ventilation and ECMO. The patient recovered without complications. We successfully treated these severe cases with a multimodal combination of pharmacological and non-pharmacological supportive therapy.

A case of COVID-19 pneumonia successfully treated with favipiravir (Avigan) in which serum SARS-CoV-2 RNA detected by LAMP method was clinically useful.

A 49-year-old Japanese male was managed by mechanical ventilation due to coronavirus disease 2019 (COVID-19) pneumonia. Favipiravir as an antiviral therapy, and anti-inflammatory treatment were administered. SARS-CoV-2 RNA was detected in serum by the loop-mediated isothermal amplification (LAMP) method on Day 9; favipiravir treatment was continued. On Day 13, negative serum RNA was confirmed, followed by mechanical ventilation was removed. On Day 23, LAMP negative was confirmed in nasopharynx, after that the patient discharged on Day 27. We could treat successfully for severe COVID-19 pneumonia based on the LAMP method. We consider this method will be useful in COVID-19 treatment.

Clinical Features of 154 COVID-19 Patients and the Parameters for the Effective Detection of Pneumonia at the Time of the Initial Diagnosis in Japan.

Objective We aimed to clarify clinical and laboratory characteristics of coronavirus disease 2019 (COVID-19) patients, and further explore the features to detect COVID-19 pneumonia at the first visit to community-based hospitals. Methods Diagnoses of COVID-19 were based on positive results from real-time reverse-transcription polymerase chain reaction testing of nasopharyngeal-swab specimens. We retrospectively reviewed the medical records of patients showing positive results. The clinical characteristics and results of blood tests were compared between the patients with and without pneumonia. The risk factors associated with pneumonia were then evaluated by a multivariable analysis. Results The study cohort comprised 154 patients, including 117 patients (76.0%) with pneumonia at first visit. Significant differences were seen in age, the frequency of fever, tachycardia, desaturation (peripheral oxygen saturation ≤95%), any comorbidity, neutrocyte count and fraction, lymphocyte count and fraction, platelet count, lactate dehydrogenase (LDH), C-reactive protein (CRP), and fibrinogen between the patients with and without pneumonia. Using a multivariable analysis, CRP ≥0.3 mg/dL and fibrinogen >400 mg/dL were found to be associated with the presence of pneumonia. Conclusion Community-based settings for screening COVID-19 patients should perform chest X-ray and blood tests for white blood cell fractions, fibrinogen, LDH, and CRP. Of these, elevations in the CRP and fibrinogen levels could be critically associated with the presence of COVID-19 pneumonia.

Association between visual status and social participation in older Japanese: The JAGES cross-sectional study.

RATIONALE: Population aging in Japan has been accompanied by increases in those with visual impairment. No previous study has examined whether visual impairment is associated with reduced social participation in older people in Japan. METHODS: In this cross-sectional study, questionnaires were mailed to older people living in 39 Japanese communities in 2016. Data from 24,313 respondents (70.3%, 74.0 ± 6.2 years) included information on visual status, social participation, socioeconomic status, and health. Visual status was measured by self-report (excellent, very good, good, or fair/poor). RESULTS: The prevalence of visual impairment (fair/poor) was 9.3%. After adjusting for individual covariates in multinominal logistic regression analysis with multiple imputations, visual status was significantly associated with reduced participation (once a week or more) in volunteer groups, sports groups, hobby groups, neighborhood associations, study/cultural groups, health promotion groups, and involvement in teaching skills/passing on experiences to others (p for trend <0.01). On the other hand, participation in senior citizen clubs was not associated with visual status (p for trend = 0.07). While excellent/very good vision was associated with increased volunteerism (e.g., involvement in teaching skills/passing on experiences to others: Odds ratios (OR) 1.78/1.21), poor vision disrupted participation in activities that require physical activity (e.g., sports groups: OR 0.64). CONCLUSION: These results suggest that vision status is an important determinant of social participation among older adults in Japan.

Electron-Catalyzed Cross-Coupling of Arylboron Compounds with Aryl Iodides.

Arylboroxines in combination with zinc chloride and potassium tert-butoxide were found to undergo the electron-catalyzed cross-coupling with aryl iodides to give the corresponding biaryls without the aid of transition-metal catalysis.

Resting-state functional connectivity analysis of the mouse brain using intrinsic optical signal imaging of cerebral blood volume dynamics.

OBJECTIVE: Resting-state functional connectivity (rsFC) of the human brain is closely related with neurological and psychiatric disorders. Mice are widely used to investigate the physiological mechanisms of such disorders, because of the applicability of invasive experimental techniques. Thus, studies on rsFC of the mouse brain are essential to link physiological mechanisms with these disorders in humans. In this study, we investigated the applicability of intrinsic optical signal imaging of cerebral blood volume (IOSI-CBV) for rsFC analysis of the mouse brain. APPROACH: Transcranial IOSI-CBV images were collected from the brains of un-anesthetized wild-type mice with a cooled-CCD camera. The time traces of all pixels were averaged to create a global signal (GS). Marginal and partial correlation analyses were performed to estimate the rsFC based on CBV signals both with and without GS removal. The consistency of the results were confirmed by comparing them with to the rsFCs data reported in the previous studies. MAIN RESULTS: We confirmed that GS correlated with heart rate fluctuation in the FC frequency band. The marginal correlation coefficient of CBV with GS removal was consistent with measurements using conventional optical imaging methods relying on oxygenated hemoglobin concentration and cerebral blood flow. SIGNIFICANCE: These results suggest the applicability and usefulness of the transcranial IOSI-CBV method to estimate rsFC of the mouse brain.

Palladium-Catalyzed Amination of Aryl Sulfoxides.

Amination of diaryl sulfoxides with anilines and alkylamines has been accomplished under palladium/N-heterocyclic carbene (NHC) catalysis. Owing to its electron deficiency, the leaving arenesulfenate anion would be smoothly released from the palladium center to result in uneventful catalyst turnover under milder reaction conditions in comparison with previous C-S bond amination reactions. This amination accommodated a wider range of functional groups such as silyl, boryl, methylsulfanyl, and halogen moieties. Regioselective amination of unsymmetrical diaryl sulfoxides was also executed by means of steric bias.

Reduction of light source noise from optical intrinsic signals of mouse neocortex by using independent component analysis.

Because the optical intrinsic signal (OIS) of the brain is very weak, noise reduction is essential. Independent component analysis (ICA) is widely used for noise reduction. However, the applicability of ICA to the reduction of light source (LS) noise has not been discussed in detail. In addition, determining the proper number of independent components (ICs) for decomposition is very important to a reasonable classification of the ICs. In this study, we considered the applicability of ICA to LS noise reduction by modeling the impact of LS noise on OIS data. We propose a method for determining the number of ICs that uses the power spectral density of LS noise. To evaluate its usefulness, the method was applied to real OIS data of a mouse's cerebral cortex.

Development of a practicable non-contact bedside autonomic activation monitoring system using microwave radars and its clinical application in elderly people.

We developed a practicable, non-contact, autonomic activation monitoring system using microwave radars without imposing any stress on monitored individuals. Recently, the rapid increase in the aging population has raised concerns in developed countries. Thus, hospitals and care facilities will need to perform long-term health monitoring of elderly patients. The system allows monitoring of geriatric autonomic dysfunctions caused by chronic diseases, such as diabetes or myocardial infarction (MI), while measuring vital signs in non-contact way. The system measures heart rate variability (HRV) of elderly people in bed using dual, 24-GHz, compact microwave radars attached beneath the bed mattress. HRV parameters (LF, HF, and LF/HF) were determined from the cardiac peak-to-peak intervals, which were detected by radars using the maximum entropy method. We tested the system on 15 elderly people with and without diabetes or MI (72-99 years old) from 7:00 p.m. to 6:00 a.m. at a special nursing home in Tokyo. LF/HF obtained by the system correlated significantly (R = 0.89; p < 0.01) with those obtained by Holter electrocardiography (ECG). Diabetic subjects showed significantly lower LF (radar) than non-diabetic (119.8 ± 57.8 for diabetic, 405.9 ± 112.6 for non-diabetic, p < 0.01). HF (radar) of post-MI subjects was significantly lower than that of non-MI (219.7 ± 131.7 for post-MI and 580.0 ± 654.6 for non-MI, p < 0.05). Previous studies using conventional ECG reveal that diabetic neuropathy decreases LF, and also MI causes parasympathetic attenuation which leads to HF reduction. Our study showed that average SDNN of post-MI patients is smaller than 50 ms which is known to have high mortality. The non-contact autonomic activation monitoring system allows a long-term health management especially during sleeping hours for elderly people at healthcare facilities.