Calf circumference and stroke are independent predictors for an improvement in the food intake level scale in the Japanese sarcopenic dysphagia database.

PURPOSE: The purpose of this study was to use the food intake level scale (FILS) to clarify whether calf circumference (CC) and stroke contribute to an improvement of inpatient dysphagia. METHODS: We used the Japanese sarcopenic dysphagia database (n = 467) to analyze FILS data recorded at admission and after follow-up in 322 cases. A multivariate analysis was performed to determine whether CC and stroke improved the FILS by two points or more. RESULTS: The patient characteristics were as follows: 177 (55%) men; median age, 81 years; median body mass index, 20.3 kg/m2; median CC, 28.2 cm; presence of sarcopenic dysphagia, 183 (56.8%); history of stroke, 103 (32%); median FILS on admission (interquartile range (IQR)), 6 (2-7); and median FILS at the end of the observation (IQR), 7 (7-8). Comparison of FILS at admission and discharge showed that 137 patients had an improvement in the scale of two points or more, whereas 185 patients had no improvement. Multivariate logistic regression analysis showed the factors that were associated independently with an improvement in dysphagia were: age < 80 years (odds ratio (OR) 2.20, 95% confidence interval (CI) 1.36-3.54, p = 0.001); CC ≥ 29.4 cm (OR 2.19, 95% CI 1.33-3.61, p = 0.002); sex (OR 1.67, 95% CI 1.03-2.71, p = 0.037); and stroke (OR 1.85, 95% CI 1.09-3.16, p = 0.023). CONCLUSIONS: Our results suggest that a CC ≥ 29.4 cm and history of stroke contributed to an improvement of inpatient dysphagia at discharge. The contribution of the easy-to-measure CC to predict an improvement in swallowing function may be very useful in daily clinical practice.

Sorry, Not Sorry: Effects of Different Types of Apologies and Self-Monitoring on Non-verbal Behaviors.

This study examines the effects of different types of apologies and individual differences in self-monitoring on non-verbal apology behaviors involving a server apologizing to a customer. Apologies divide into sincere apologies that reflect genuine recognition of fault, and instrumental apologies, made for achieving a personal goal such as avoiding punishment or rejection by others. Self-monitoring (public-performing and other-directedness) were also examined. Fifty-three female undergraduate students participated in the experiment. Participants were assigned randomly to either a sincere apology condition or an instrumental apology condition. They watched the film clip of the communication between a customer and server and then role-played how they would apologize if they were the server. Participants' non-verbal behavior during the role-play was videotaped. The results showed an interaction between the apology condition and self-monitoring on non-verbal behaviors. When public-performing was low, gaze avoidance was more likely to occur with a sincere apology than an instrumental apology. There was no difference when the public-performing was high. Facial displays of apology were apparent in the instrumental apology compared to the sincere apology. This tendency became more conspicuous with increased public-performing. Our results indicated that the higher the public-performing, the more participants tried to convey the feeling of apology by combining a direct gaze and facial displays in an instrumental apology. On the other hand, results suggest that lower levels of public-performing elicited less immediacy in offering a sincere apology. Further studies are needed to determine whether these results apply to other conflict resolution situations.

Nutritional intervention after an early assessment by a flexible endoscopic evaluation of swallowing is associated with a shorter hospital stay for patients with acute cerebral infarction: A retrospective study.

BACKGROUND AND OBJECTIVES: It is important to evaluate the swallowing function of patients with acute cerebral infarction. The effects of nutritional intervention after an early assessment by a flexible endoscopic evaluation of swallowing (FEES) were evaluated. METHODS AND STUDY DESIGN: This retrospective study included 274 patients who were hospitalized for acute cerebral infarction and underwent a FEES between 2016 and 2018. The effects of early nutritional intervention after an assessment by a FEES within 48 h from admission were evaluated. The patients were divided into a shorter hospital stay group (<30 days) and a longer group (≥30 days). A multivariate analysis was performed to identify the predictive factors for a shorter hospital stay. RESULTS: The overall patient characteristics were as follows: 166 men; median age, 81 years old; and median body mass index (BMI), 21.1 kg/m2. No significant differences in the age, sex, or BMI were found between the shorter and longer hospital stay groups. A FEES within 48 h of admission (odds ratio [OR], 2.040; 95% confidence interval [CI], 1.120-3.700; p=0.019), FILS level ≥6 at admission (OR, 2.300; 95% CI, 1.190-4.440; p=0.013), and an administered energy dose of ≥18.5 kcal/kg on hospital day 3 (OR, 2.360; 95% CI, 1.180-4.690; p=0.015) were independently associated with a hospital stay <30 days. CONCLUSIONS: Patients with acute cerebral infarction are more likely to have a shorter hospital stay (<30 days) if they undergo a FEES early after admission and receive optimal nutritional intervention.

Prediction of oral intake recovery for inpatients with aspiration pneumonia by videoendoscopic evaluation using the Hyodo-Komagane score in Japan.

OBJECTIVE: To verify the validity of the prediction of oral intake recovery for inpatients with aspiration pneumonia using the Hyodo-Komagane score. BACKGROUND: Patients admitted for treatment of aspiration pneumonia sometimes have difficulty in resuming oral intake due to decreased swallowing function. Predicting whether the swallowing function will recover enough to achieve oral ingestion at discharge is an important factor in developing a treatment strategy. No studies have investigated the prediction of oral intake recovery using videoendoscopic examination. METHODS: Subjects were 65 patients who were admitted to an acute care hospital for the treatment of aspiration pneumonia. The patients were divided into two groups, the oral feeding group and the tube feeding group, according to their oral intake status at discharge or transfer. Logistic regression analysis was performed using the condition that tube feeding was not required as an objective variable and the items with significant differences between the two groups as explanatory variables. Additionally, the receiver operating characteristic curve was used to identify patients who could take food orally at discharge. RESULTS: The odds ratios for the Hyodo-Komagane score and the pharyngeal clearance score were 1.485 and 3.379, respectively. When the cut-off values of the Hyodo-Komagane score and the pharyngeal clearance score were 6 and 1, the sensitivity was 0.88 and 0.91, and the specificity was 0.64 and 0.70, respectively. CONCLUSION: The Hyodo-Komagane score and especially the pharyngeal clearance score are useful indices to predict oral intake recovery for inpatients with aspiration pneumonia.

Relationship between oral intake level and oral health assessment tool scores in the convalescent ward.

PURPOSE: To examine the relationship between oral intake function and oral health status in convalescent inpatients. METHODS: Subjects were 222 patients admitted to a convalescent hospital between 1 January and 30 June 2018. Investigation items were age, sex, causative disease, body mass index, functional oral intake scale (FOIS), functional independence measure, occlusal contact, assistance with oral cleaning, and oral health assessment tool (OHAT) scores. Multiple regression analysis was performed with FOIS as the dependent variable, and investigation items were related to FOIS as independent variables. RESULTS: Results of multiple regression analysis for all patients suggested that saliva and denture scores were significantly associated with FOIS. However, analysis excluding non-oral feeding patients did not show a significant association between FOIS and OHAT scores. CONCLUSION: The results of this study suggest that oral health status is associated with oral intake function. In addition, the oral health status of inpatients may be strongly related to whether or not they are eating orally. Therefore, it is necessary to take good care of oral health in non-oral feeding patients in the convalescent ward.

Time Course and Recovery of the Movements of Hyoid Bone and Thyroid Cartilage During Swallowing in a Patient With Sarcopenic Dysphagia.

Sarcopenia is known to adversely affect swallowing function. In this report, we describe the treatment progress of an older patient with dysphagia caused by sarcopenia and the analysis results from videofluorographic examination images. An 89-yr-old man who had been hospitalized for lumbar fracture experienced lower back pain and thus had his oral intake reduced. After transfer to a rehabilitation hospital, he developed aspiration pneumonia and then sarcopenia with low nutrition and low activity. At the beginning of intervention, he aspirated food paste, but he recovered sufficiently to be able to ingest a normal meal via a nutritional approach combined with rehabilitation at the time of discharge. During this process, the maximum amounts of displacements and maximum moving velocities of his hyoid bone and thyroid cartilage during swallowing of moderately thick water were improved. Adequate nutrition intake and training for hyoid muscles are considered effective for the patient with sarcopenic dysphagia. It was concluded that measuring the maximum displacements and moving velocities of the hyoid bone and thyroid cartilage during swallowing in patients with sarcopenic dysphagia was an effective way to monitor their improvement.

[Inferential evaluation of intimacy based on observation of interpersonal communication].

How do people inferentially evaluate others' levels of intimacy with friends? We examined the inferential evaluation of intimacy based on the observation of interpersonal communication. In Experiment 1, participants (N = 41) responded to questions after observing conversations between friends. Results indicated that participants inferentially evaluated not only goodness of communication, but also intimacy between friends, using an expressivity heuristic approach. In Experiment 2, we investigated how inferential evaluation of intimacy was affected by prior information about relationships and by individual differences in face-to-face interactional ability. Participants (N = 64) were divided into prior- and no-prior-information groups and all performed the same task as in Experiment 1. Additionally, their interactional ability was assessed. In the prior-information group, individual differences had no effect on inferential evaluation of intimacy. On the other hand, in the no-prior-information group, face-to-face interactional ability partially influenced evaluations of intimacy. Finally, we discuss the fact that to understand one's social environment, it is important to observe others' interpersonal communications.

Expression analysis of MIF4GD in the rat testis.

The difference between transcriptional and translational activities of genes is one of the remarkable features in spermatogenesis. In this study, we characterized MIF4GD (MIF4G domain containing), a possible translational regulator, to uncover the function during rat spermatogenesis. Western blot analysis revealed the presence of two forms of MIF4GD with molecular sizes of 25 and 16 kDa in various tissues including the testis. An additional 20-kDa form of MIF4GD was also found exclusively in the testis. These three proteins were abundantly present in pachytene spermatocytes and haploid spermatids. Importantly, the 16-kDa MIF4GD was distinguished from the 25- and 20-kDa proteins by presence in fractions of 40S subunits and ribosomes of spermatogenic cells according to analysis of subcellular localizations. These results suggest that the 16-kDa MIF4GD may function as a translational regulator in spermiogenesis.

Functional roles of mouse sperm hyaluronidases, HYAL5 and SPAM1, in fertilization.

Although sperm entry into the oocyte-cumulus complex and subsequent sperm penetration through the cumulus matrix to reach the oocyte zona pellucida are essential for mammalian fertilization, the molecular mechanism remains controversial. Previously, we have shown that mouse sperm lacking SPAM1 are capable of penetrating the cumulus matrix despite a delayed dispersal of cumulus cells. We also have identified another sperm hyaluronidase, HYAL5, as a candidate enzyme involved in sperm penetration through the cumulus. In the present study, we produced HYAL5-deficient mice to uncover the functional roles of HYAL5 and SPAM1 in fertilization. The HYAL5-deficient mice were fully fertile and yielded normal litter sizes. In vitro fertilization assays demonstrated that HYAL5-deficient epididymal sperm is functionally normal. We thus conclude that HYAL5 may be dispensable for fertilization. Comparative analysis among wild-type, HYAL5-deficient, and SPAM1-deficient epididymal sperm revealed that only SPAM1 is probably involved in sperm penetration through the cumulus matrix. Notably, the loss of SPAM1 resulted in a remarkably increased accumulation of sperm on the surface or outer edge of the cumulus. These data suggest that SPAM1 may function in sperm entry into the cumulus and sperm penetration through the cumulus matrix.

Characterization of two cytoplasmic poly(A)-binding proteins, PABPC1 and PABPC2, in mouse spermatogenic cells.

Mouse spermatogenic cells are known to contain at least two isoforms of cytoplasmic poly(A)-binding proteins, PABPC1 and PABPC2 (previously known as PABPT). In this study, we have characterized PABPC1 and PABPC2. PABPC2 was present in pachytene spermatocytes and round spermatids, whereas elongating spermatids still included PABPC1. These two proteins are capable of binding mRNA poly(A) tails nonspecifically and of directly associating with each other and with several translational regulators, including EIF4G1, PAIP1, PAIP2, and PIWIL1 (previously known as MIWI). Moreover, both PABPC1 and PABPC2 exhibited the ability to enhance translation of a reporter mRNA in vitro. Despite these similarities, PABPC2 was distinguished from PABPC1 by the absence of PABPC2 in actively translating polyribosomes of testicular cells. PABPC1 was distributed in polyribosomes and in translationally inactive messenger ribonucleoprotein particles. Most importantly, PABPC2 and PIWIL1 were noticeably enriched in the chromatoid body of round spermatids. These results suggest that PABPC2 may function in translational repression during spermatogenesis.

Sperm penetration through cumulus mass and zona pellucida.

Mammalian fertilization requires sperm to penetrate the cumulus mass and egg zona pellucida prior to fusion with the egg. Although sperm penetration through these physical barriers is essential, the molecular mechanism has not yet been completely elucidated. In addition to sperm motility, hyaluronan-hydrolyzing and proteolytic enzymes of sperm have been suggested to participate in the penetration events. Here we focus on the functional roles of hyaluronidase and protease in sperm passage through the cumulus mass and zona pellucida.

Non-canonical poly(A) polymerase in mammalian gametogenesis.

Polyadenylation of mRNA precursors initially occurs in the nucleus of eukaryotic cells, and the polyadenylated mRNAs are then transported into the cytoplasm. Because the length of the poly(A) tail is implicated in various aspects of mRNA metabolism, including the transport into the cytoplasm, stability, and translational control, processing of mRNA precursors at the 3'-end is important for post-transcriptional gene regulation. In particular, the lengthening, maintenance, and shortening of poly(A) tails in the cytoplasm are all essential for modulation of gametogenesis. Here we focus on the functional roles of mouse Tpap and Gld-2 in spermatogenesis and oocyte maturation, respectively.

Disruption of mouse poly(A) polymerase mGLD-2 does not alter polyadenylation status in oocytes and somatic cells.

The elongation of poly(A) tails in cytoplasm is essential for oogenesis and early embryogenesis in Xenopus laevis. mGLD-2 is a mouse homologue of Xenopus cytoplasmic poly(A) polymerase xGLD-2. We found an association of mGLD-2 with cytoplasmic polyadenylation components, CPEB and CPSF described in Xenopus oocytes. To clarify the role of mGLD-2 in mouse, we produced an mGLD-2 disrupted mouse line by homologous recombination. In spite of the ubiquitous expression of mGLD-2, the disrupted mice were apparently normal and healthy. Moreover, it was demonstrated that mGLD-2 disruption did not affect the poly(A) tail elongation in oocytes using reporter RNAs. Coincide with these observations, the maturation of the oocytes was normal and the mice were fertile. Thus mGLD-2 is dispensable for full-term development and oogenesis. Our results also indicate that there is another source of cytoplasmic poly(A) polymerase in mouse.

Mouse sperm lacking ADAM1b/ADAM2 fertilin can fuse with the egg plasma membrane and effect fertilization.

Fertilin, a heterodimeric protein complex composed of alpha (ADAM1) and beta (ADAM2) subunits on the sperm surface, is believed to mediate adhesion and fusion between the sperm and egg plasma membranes. Here we have shown that mutant male mice lacking ADAM1b are fertile and that the loss of ADAM1b results in no significant defect in sperm functions such as migration from the uterus into oviduct, binding to egg zona pellucida, and fusion with zona pellucida-free eggs. ADAM1b-deficient epididymal sperm showed a severe reduction of ADAM2 on the cell surface, despite the normal presence of ADAM2 in testicular germ cells. The appearance of ADAM1b and ADAM2 on the sperm surface depended on formation and abundance of ADAM1b/ADAM2 fertilin in testicular germ cells. These results suggest that mouse ADAM1b/ADAM2 fertilin may play a crucial role not in the sperm/egg fusion but in the appearance of these two ADAMs on the sperm surface.

Identification of a hyaluronidase, Hyal5, involved in penetration of mouse sperm through cumulus mass.

A glycosylphosphatidylinositol (GPI)-anchored hyaluronidase, PH-20, on the sperm surface has long been believed to assist sperm penetration through the cumulus mass surrounding the eggs. However, mouse sperm lacking PH-20 were still capable of penetrating the cumulus mass despite a delayed dispersal of cumulus cells. Intriguingly, a 55-kDa hyaluronan-hydrolyzing protein was abundantly present in wild-type and PH-20-deficient mouse sperm. In this study, we purified the 55-kDa mouse protein from soluble protein extracts released from epididymal sperm by acrosome reaction and identified as a hyaluronidase, Hyal5. Hyal5 was exclusively expressed in the testis and formed a 160-kbp gene cluster together with Hyalp1, Hyal4, and Ph-20 on mouse chromosome 6. Hyal5 was a single-chain hyaluronidase present on the plasma and acrosomal membranes of sperm presumably as a GPI-anchored protein. Moreover, hyaluronan zymography revealed that Hyal5 is enzymatically active in the pH range 5-7 and inactive at pH 3 and 4. Both Hyal5-enriched PH-20-free soluble protein extracts and PH-20-deficient mouse sperm were capable of dispersing cumulus cells from the cumulus mass. Cumulus cell dispersal was strongly inhibited by the presence of a hyaluronidase inhibitor, apigenin. These results suggest that in the mouse, Hyal5 may function principally as a "cumulus matrix depolymerase" in the sperm penetration through the cumulus mass and in the local hyaluronan hydrolysis near or on the surface of the egg zona pellucida to enable the proximal region of sperm tail to move freely. PH-20 may compensate in part for the functional roles of Hyal5.

Dynamic evolution of the spectrum of long-period fiber Bragg gratings fabricated from hydrogen-loaded optical fiber by ultraviolet laser irradiation.

Long-period fiber Bragg gratings fabricated by exposure of hydrogen-loaded fiber to UV laser light exhibit large-scale dynamic evolution for approximately two weeks at room temperature. During this time two distinct features show up in their spectrum: a large upswing in wavelength and a substantial deepening of the transmission minimum. The dynamic evolution of the transmission spectrum is explained quantitatively by use of Malo's theory of UV-induced quenching [Electron. Lett. 30, 442 (1994)] followed by refilling of hydrogen in the fiber core and the theory of hydrogen diffusion in the fiber material. The amount of hydrogen quenched by the UV irradiation is 6% of the loaded hydrogen.

Thermal tuning of mechanically induced long-period fiber grating.

We have developed a wideband tunable optical filter that uses a long-period fiber grating (LPFG) in which both resonance wavelength and its signal attenuation can be adjusted. We create the grating mechanically by pressing a spring coil to an optical fiber. We achieve continuous fine tuning of wavelength and attenuation by varying the temperature of the LPFG. The adjustable ranges of the LPFG are more than 200 nm in resonance wavelength and more than 10 dB in signal attenuation.