Efficacy and Safety of 6-Month High Dietary Protein Intake in Hospitalized Adults Aged 75 or Older at Nutritional Risk: An Exploratory, Randomized, Controlled Study.

The aim of this study was to investigate the effects of increased dietary protein in daily-life settings in Japan for 6 months on the activities of daily living (ADL) in adults aged 75 or older at nutritional risk. The study was an open-label, exploratory, randomized controlled trial conducted at seven hospitals in Japan. The study participants were adults aged 75 or older who were hospitalized for treatable cancer, pneumonia, fractures, and/or urinary-tract infection at nutritional risk. The primary outcome was change in grip strength, skeletal muscle, and ADL indices (Barthel index, Lawton score). One hundred sixty-nine patients were randomly assigned to the intensive care (IC) or standard care (SC) group; the protein intake goals (g/kgw/day) were 1.5 for IC and 1.0 for SC. There was a significant improvement in grip strength only in the IC group (1.1 kg: 95% CI 0.1 to 2.1) (p = 0.02). While the skeletal muscle index and ADL indices were not significantly improved in either group, the improvement ratio tended to be greater in the IC group. There was no decrease in renal function in either group. Thus, intervention of increased dietary protein in daily-life settings for 6 months in adults aged 75 or older with treatable cancer, pneumonia, fractures, and/or urinary-tract infection and at nutritional risk may be effective in ameliorating loss of muscle strength.

DUV coherent light emission from ultracompact microcavity wavelength conversion device.

A unique design of our ultracompact microcavity wavelength conversion device exploits the simple principle that the wavelength conversion efficiency is proportional to the square of the electric field amplitude of enhanced pump light in the microcavity, and expands the range of suitable device materials to include crystals that do not exhibit birefringence or ferroelectricity. Here, as a first step toward practical applications of all-solid-state ultracompact deep-ultraviolet coherent light sources, we adopted a low-birefringence paraelectric SrB4O7 crystal with great potential for wavelength conversion and high transparency down to 130 nm as our device material, and demonstrated 234 nm deep-ultraviolet coherent light generation, whose wavelength band is expected to be used for on-demand disinfection tools that can irradiate the human body.

Exercise-related fatigue affects joint-driven resistance: comparison of flexor and extensor.

[Purpose] Muscle fatigue can affect the inherent properties of muscles. It is important to know how muscle stiffness changes with muscle fatigue and the different effects of the initial and terminal stages of exercise. Therefore, we aimed to examine the effects of bicep and tricep contraction tasks that lead to fatigue on joint-driven resistance of the elbow joint. [Participants and Methods] Twenty-five healthy men were included. Joint-driven resistance of the elbow joint was measured before and after the muscle contraction task. The slope of the regression line of the angle torque at the time of passive movement was calculated as an elastic coefficient and the entire movable range, proximal range, and distal range were compared. [Results] Owing to the muscular contraction of the biceps and triceps, the elastic coefficient increased in the elbow joint during both flexion and extension. The rate of change in the elastic coefficient was lower during the tricep contraction task than during the bicep contraction task. For both tasks, the change in the elastic coefficient varied depending on the range of exercise. [Conclusion] Resistance exercise increased the driven resistance of the joint during passive movement, and this effect was greater during terminal exercises.

Seasonal variations on endothelium-dependent flow-mediated vasodilation in adults with type 2 diabetes and nondiabetic adults with hypertension and/or dyslipidaemia who perform regular exercise.

Introduction: Endothelium-dependent flow-mediated dilation (FMD) of the brachial artery often changes seasonally. We aimed to examine the association between the seasonal variation on FMD and regular exercise in adults with type 2 diabetes (T2D) and nondiabetic adults with hypertension and/or dyslipidaemia (non-T2D). Methods: This retrospective study included 14 T2D and 17 non-T2D adults, who started to perform moderate-intensity aerobic exercise for 30-40 min/d at a hospital gym in 2006-2010 and maintained exercise performance at least 2 d/wk until the end of the observation period. We observed and analysed the data for 5 years (from March 2011 to February 2016). FMD, cardio-ankle vascular index (CAVI) and metabolic outcomes were compared among seasons in the T2D and non-T2D groups. Results: The FMD values were lower in winter than in other seasons in both groups (all P < .01). The annual range of FMD was larger by 31% in the T2D group than in the non-T2D group (P < .05). The systolic blood pressure (BP) values were higher in winter than in other seasons in both groups (all P < .01), and the diastolic BP values were higher in winter than in summer in both groups (T2D: P < .05; non-T2D: P < .01). CAVI and other outcomes did not change seasonally. Conclusions: Flow-mediated vasodilation showed seasonal variation in T2D adults, even if they performed exercise regularly for a long period of time. Additionally, we found that the annual range of FMD might increase with the presence of T2D.

Effect of moderate-intensity seated exercise on the management of metabolic outcomes in hypertensive individuals with or without exercise habits.

BACKGROUND: We aimed to evaluate the effect of moderate-intensity seated exercise on metabolic outcomes in hypertensive individuals with or without exercise habits. METHODS: Forty-two hypertensive individuals volunteered for this study and were classified into 3 groups by their habits and place for moderate-intensity exercise prior to this study: NONE (<2 days/week or no exercise; n = 13), HOME (≥30 min/day and ≥2 days/week at home; n = 15), and GYM (≥30 min/day and ≥2 days/week at a hospital gym; n = 14). They performed their daily activities as usual and seated exercise (stepping and stepping with trunk rotation; a range of 11-13 on the Borg rating of perceived exertion scale) for at least 15 min/day and at least 3 days/week for 12 weeks. RESULTS: Thirty-five participants (age: 67.7 ± 5.9 years) completed the study, and there was no difference among the 3 groups regarding weekly exercise. The homeostasis model assessment of insulin resistance (HOMA-IR) value in the NONE group was significantly higher than that in the GYM group at baseline (p < 0.05), but it decreased significantly after 12 weeks (from 2.2 ± 0.8 to 1.7 ± 0.7, p < 0.05). Changes in HOMA-IR in the NONE group after 12 weeks was greater than that in the HOME and GYM groups (both p < 0.01). The HOME and GYM groups showed no significant changes in any of the variables. CONCLUSION: Moderate-intensity seated exercise may be an effective strategy to improve insulin resistance in hypertensive individuals without exercise habits.

Effect of maintaining supervised gym- and home-based exercises on the seasonal variations of metabolic outcomes in overweight and obese Japanese adults.

OBJECTIVES: This study aimed to examine whether maintaining supervised gym- and home-based exercises for an extended time of period could decrease seasonal variations of metabolic outcomes in overweight and obese Japanese adults. METHODS: This retrospective study recruited 54 overweight and obese outpatients who started exercising in 2006-2010 and analysed their metabolic outcomes for 5 years from March 2011 to February 2016. In this group, 26 participants performed moderate-intensity aerobic exercise (MIAE) for 30-40 min/day for at least 2 days/week, supervised by physical therapists at a hospital gym (GYM) during the observation period. Conversely, 28 participants were asked to perform MIAE by themselves at or around their homes (HOME) for the same duration. RESULTS: The body mass index (BMI), waist circumference and homoeostasis model assessment of insulin resistance (HOMA-IR) values in winter were higher than those in other seasons in the HOME group but not in the GYM group. The annual ranges of BMI, waist circumference, fasting plasma glucose and HOMA-IR in the GYM group were smaller than those in the HOME group. CONCLUSION: Maintaining supervised gym-based exercise, as opposed to home-based exercise, may decrease seasonal variations of some metabolic outcomes in overweight and obese Japanese adults.

Association among social-networking service usage via smartphone, internet addiction, and psychological stress in Japanese physical therapy university students: a single-university cross-sectional study.

[Purpose] This study aimed to examine the influence of social-networking service usage via smartphone on internet addiction and psychological stress in Japanese university students studying physical therapy. [Participants and Methods] This single-university cross-sectional study involved 247 physical therapy students in the second to fourth years (ages 19 to 22). By use of self-administered questionnaires, we collected information on daily time of smartphone usage, social-networking service usage via smartphone, and daily self-learning time outside of class hours. We assessed internet addiction and psychological stress using the Internet Addiction Test and Stress Response Scale-18, respectively. After excluding twelve participants, we analyzed the data collected for the other 235. [Results] Multiple regression analysis showed an association of the Internet Addiction Test score with gender and daily time of smartphone usage. "Surfing without any purpose", which is one of the purposes of social-networking service usage, and the Internet Addiction Test score were associated with the Stress Response Scale-18 score. Other variables were not associated with the Internet Addiction Test or Stress Response Scale-18 scores. [Conclusion] Our results suggest that gender (males), longer time of smartphones usage, or using social-networking service usage passively cause internet addiction or psychological stress in Japanese physical therapy university students.

Impact of Self-Reported Sitting Time and Transtheoretical Model Based on Exercise Behavior Change on Glycemic and Weight Control in Japanese Adults with Type 1 Diabetes: A Cross-Sectional Study.

This cross-sectional study aimed to examine the associations among self-reported sitting time (ST), transtheoretical model (TTM) based on exercise behavior change, and glycemic and weight control in Japanese adults with type 1 diabetes (T1D). Forty-two adults (age, 44.0 (33.3-56.8) years) with uncomplicated T1D answered questions regarding their lifestyles, including ST per day, and TTM using self-administered questionnaires. The glycated hemoglobin (HbA1c) level correlated with age and ST (p < 0.05, p < 0.01, respectively), whereas body mass index correlated with duration of T1D and TTM (p < 0.05, p < 0.01, respectively). Logistic regression analysis showed that poor glycemic control (HbA1c, >7%) was associated with ST (odds ratio, 3.53 (95% confidence interval, 1.54-8.11), p < 0.01). In addition, the cut-off points for quartiles of ST were 4.6, 6.0, and 8.0 h/day, and the HbA1c level in the lowest quartile was 15% lower than that in the highest quartile (p < 0.01). Although further studies with larger samples are needed, these results implied that expanded self-reported ST might be related to poor glycemic control in Japanese T1D adults, most of whom were lean, young and middle-aged, regardless of TTM based on exercise behavior change.

Comparison of respiratory muscle strength in individuals performing continuous and noncontinuous walking exercises in water after the 6-week program.

This study aimed to compare respiratory muscle strength in individuals performing continuous and noncontinuous walking exercises in water after the 6-week program. Twenty-nine healthy men were randomly divided into a continuous group (CG, n=14) and a noncontinuous group (NG, n=15). Firstly, both groups executed the 6-week program which set them to walk for 30 min, 4 times per week, over 6 weeks in a pool with the adjusted intensity that their walking speed increased the heart rate to 60% of the predicted maximum. After the 6-week program, participants in the CG continued the water-walking program for 4 weeks while those in the NG discontinued the water-walking program. In both groups, respiratory muscle strength evaluated by maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax) increased significantly after the 6-week program compared with pre-exercise value. Compared to the value after the 6-week program, PEmax increased significantly in the CG after 10 weeks (P<0.05), but the PImax showed no significant change. Compared to the value after the 6-week program, after 10 weeks, in the NG, PEmax decreased significantly, with a considerable decrease after 9 and 10 weeks compared to the CG (P<0.05). The PImax in the NG significantly decreased after 10 weeks from the value observed after the 6-week program. We demonstrated that 6 weeks of walking in water at 60% of the predicted maximum heart rate enhances PImax and PEmax, and that PImax and PEmax decrease in 4 weeks without a water-walking program.

Repeated 3-minute stair climbing-descending exercise after a meal over 2 weeks increases serum 1,5-anhydroglucitol levels in people with type 2 diabetes.

[Purpose] The purpose of this study was to examine the hypoglycemic effect of a postprandial exercise program using brief stair climbing-descending exercise in people with type 2 diabetes. [Subjects and Methods] Seven males with uncomplicated type 2 diabetes (age 68.0 ± 3.7 years) performed two sets of stair climbing-descending exercise 60 and 120 min after each meal for the first 2 weeks but not for the following 2 weeks. Each set of exercise comprised 3-min of continuous repetition of climbing briskly to the second floor followed by slow waking down to the first floor in their home. A rest period of 1-2 min was allowed between each set. [Results] Serum 1,5-anhydroglucitol level was significantly higher by 11.5% at the end of the 2-week exercise period than at the baseline. By contrast, the 1,5-anhydroglucitol level at the end of the following 2-week period did not differ from the baseline value. Fasting blood glucose level and insulin resistance index at the end of the exercise period did not differ from the baseline value. [Conclusion] Repeated 3-min bouts of stair climbing-descending exercise after a meal may be a promising method for improving postprandial glycemic control in people with type 2 diabetes.

Stair climbing/descending exercise for a short time decreases blood glucose levels after a meal in people with type 2 diabetes.

OBJECTIVE: We examined whether stair climbing-descending exercise (ST-EX), a convenient method to increase physical activity in daily life, for a short period would acutely improve the postprandial blood glucose (BG) response in people with type 2 diabetes (T2D). METHODS: 16 people with T2D (age 65.4±1.1 years) participated in 2 separate sessions. After an overnight fast, each participant consumed a test meal and then kept resting for 180 min, except when performing each 3 min bout of ST-EX at 60 and 120 min after the meal (ST-EX session), or kept resting for 180 min (REST session). ST-EX comprised 6 continuous repetitions of climbing to the second floor (21 steps) at a rate of 80-110 steps/min followed by walking down slowly to the first floor at a free step rate. RESULTS: The BG at 60 min after the meal during the ST-EX session (immediately before the first ST-EX) did not differ from that during the REST session, but analysis of variance revealed a significant interaction between time and treatment (p<0.01). The BG at 150 min after the meal (30 min after the second ST-EX) was significantly lower than that during the REST session (p<0.01). The area under the curve was also 18% lower during the ST-EX session than during the REST session (p<0.05). The heart rate and blood lactate levels indicated that the actual intensity of ST-EX was 'hard'. In contrast, the rating of perceived exertion (RPE) indicated that the overall intensity of ST-EX was 'moderate' because of decreased RPE scores during descent. CONCLUSIONS: The present findings suggest that performing 3 min ST-EX 60 and 120 min after a meal may be a useful strategy to accelerate the decrease in postprandial BG levels in people with T2D.