Impact of Number of Drug Types on Clinical Outcome in Patients with Acute Hip Fracture.

OBJECTIVES: This study aims to investigate the impact of the number of drug types on clinical outcomes for patients with acute hip fracture. DESIGNS: This is a retrospective cross-sectional study. SETTING: A hospital-based database constructed by the Japan Medical Data Center. PARTICIPANTS: Consecutive patients exhibiting acute hip fractures on admission between April 2014 and November 2017 were included. MEASUREMENTS: Relationships among the numbers of varying drug types of ≥6 and ≤5 as well as clinical outcomes were analyzed in 11,073 patients aged ≥65 years. The primary outcome was defined as the Barthel Index efficiency, with the secondary outcome being the length of hospital stay. RESULTS: Median Barthel Index scores at admission and discharge were 5 (interquartile range: 5-20) and 50 (interquartile range: 20-85). The Barthel Index efficiency was significantly higher in the group having received 5 or fewer drug variations taken (1.45 ± 1.77) than in the group receiving 6 or more drug types taken (0.94 ± 1.18) during hospital stays (p < 0.001). The length of hospital stay was significantly shorter in the group receiving 5 or fewer drug types taken (29.9 ± 23.8) than in the group having 6 or more drug types taken (44.3 ± 30.3) during hospital stays (p < 0.001), with the latter number being independently associated with the Barthel Index efficiency and length of hospital stay. CONCLUSIONS: Number of drug types of 6 or more were associated with lower Barthel Index efficiency and longer lengths of hospital stays.

Influence of Antipsychotics on Functional Prognosis after Geriatric Hip Fracture.

OBJECTIVE: To investigated the effects of antipsychotics on rehabilitation outcomes for geriatric hip fracture inpatients. DESIGN: Retrospective cohort study. SETTING: The registry data from the Japan Rehabilitation Nutrition Database for analysis. PARTICIPANTS: Of the 234 patients in the Japan Rehabilitation Nutrition Database admitted between November 2015 and March 2018, 214 met the eligibility criteria. MEASUREMENTS: The antipsychotics were phenothiazine, butyrophenone, benzamide, and atypical antipsychotics. For hip fracture patients, the following information was registered: (a) admission data: age, sex, Charlson Comorbidity Index, Functional Independence Measure (FIM) at admission, medications, height, body weight, and Mini Nutritional Assessment-Short Form score (MNA-SF) and (b) discharge data: discharge destination, FIM at discharge, MNA-SF, and total units of provided rehabilitation therapy (one unit = 20 minutes based on the national healthcare insurance policy). RESULTS: Thirteen patients (6.1%) were prescribed antipsychotics. According to the multiple linear regression analysis, antipsychotics negatively affected FIM efficiency (ß=-0.190, 95% confidence interval, -0.652 to -0.104, p=0.007). Furthermore, on logistic regression analysis, fall during hospitalization was correlated with the use of antipsychotics (odds ratio=4.376, 95% confidence interval: 1.153 to 16.612, p=0.030). CONCLUSION: The use of antipsychotics impaired the improvement of the activities of daily living (ADL) and increased the incidence of fall during hospitalization. Reviewing medication therapies at admission may further improve ADL.

Long-term grooming partnerships between unrelated adult females in a free-ranging group of Japanese monkeys (Macaca fuscata).

In order to examine the presence of long-term grooming relationships among unrelated females, grooming interactions of 18 adult females (range: 16-32 years) in a free-ranging group of Japanese monkeys (Macaca fuscata) were recorded in 2003 and compared with those recorded 10 years earlier, i.e., in 1993. In 2003, on average, each female who had survived the 10 years had grooming interactions with 2.2 surviving old partners with whom she was recorded to have grooming interactions in 1993, 3.5 females related to the surviving old partners, and 4.5 unrelated females who were other than the surviving old partners or their related females. By calculating the ratio of actual grooming partners to available females in 2003, we concluded that females had a greater possibility of selecting surviving old partners as their grooming partners than other unrelated partners, and that they also had a greater possibility of selecting females related to surviving old partners than females other than surviving old partners and their related females. These findings indicate that with regard to grooming relationships, female Japanese monkeys are basically conservative, showing a tendency to concentrate their grooming interactions on closely related females and certain familiar unrelated females such as surviving old partners and some females closely related to these partners. At the same time, however, female Japanese monkeys also showed a progressive trait for grooming since they formed grooming relationships with new partners. The necessity of long-term psychological bonding for long-term grooming relationships between unrelated females is discussed in this work.

Playback experiment to test maternal responses of Japanese macaques (Macaca fuscata) to their own infant's call when the infants were four to six months old.

Calls emitted by infants when the infant loses sight of its parents are useful to estimate the infant's requirement for parental care. When an Old World monkey infant loses sight of its mother it emits whistles. Therefore, it would be interesting to determine whether mothers could distinguish their own infant's whistles from the whistles of other infants. The response of each of seven Japanese macaque (Macaca fuscata) mothers to her own infant's whistle was compared with their responses to another infant's whistle. Matched control playback experiments were performed when the infants were four to six months old. The results showed that each mother could distinguish her own infant's whistle from that of another infant when the infants were four to six months old. Although a stricter experimental plan is required to further examine the issue, we found that the dominance rank of the infant's mother was another important factor in the female response to the infant's call. The finding suggests that females can associate a call emitted by an infant with its mother's rank, even before the infant begins to wander far from its mother.

Synthesis of branched cyclomaltooligosaccharide carboxylic acids (cyclodextrin carboxylic acids) by microbial oxidation.

Novel branched cyclomaltooligosaccharide carboxylic acid (cyclodextrin carboxylic acid) derivatives were synthesized by microbial oxidation using Pseudogluconobacter saccharoketogenes to oxidize five types of branched cyclodextrins, including maltosyl beta-cyclodextrin (maltosyl-beta-CyD). For each novel cyclodextrin carboxylic acid derivative synthesized, the hydroxymethyl group of the terminal glucose residue in the branched part of the molecule was regiospecifically oxidized to a carboxyl group to give the corresponding uronic acid. In addition, the physicochemical properties of cyclomaltoheptaosyl-(6-->1)-alpha-D-glucopyranosyl-(4-->1)-alpha-D-glucopyranosiduronic acid (GUG-beta-CyD) (1) and its sodium salt were studied more extensively, as these compounds are most likely to have a practical application.

[Animal models of drug dependence using the drug self-administration method].

This paper will review 1) experimental models of drug-seeking behavior and 2) mechanisms underlying the behavior, focusing on cocaine self-administration. After the acquisition of self-administration, vigorous lever-pressing is generally observable after the drug was replaced by saline. This lever-pressing behavior under saline infusion can be considered "drug-seeking behavior". Drug-seeking behavior is reinstated by non-contingent injection of the drug, stress exposure and presentation of drug-associated stimuli even after extinction. This is called a relapse/reinstatement model. Electrophysiological studies showed that the majority of accumbal neurons is tonically inhibited during cocaine self-administration and exhibited phasic increases in firing time-locked to cocaine self-infusion, which might represent the craving state or drive animals to drug-seeking behavior. Voltammetry and microdialysis studies indicated that the timing of drug-seeking responses can be predicted from fluctuations in accumbal extracellular dopamine concentration. Whereas dopamine D2-like agonists reinstated extinguished cocaine-seeking behavior, D1-like agonists prevented the relapse in cocaine-seeking behavior induced by cocaine itself. Given that an AMPA receptor antagonist, but not dopamine antagonist, prevented cocaine-seeking behavior induced by cocaine, glutamate transmission in the nucleus accumbens is thought to be important for expression of craving or drug-seeking behavior.

Intra-troop affiliative relationships of females with newborn infants in wild ring-tailed lemurs (Lemur catta).

To determine how the birth and development of infants influence their mothers' social relationships with other adult troop members, we observed two free-ranging troops of ring-tailed lemurs (Lemur catta) at the Berenty Reserve, Madagascar. The number of acts of affiliative contact that the mothers received from other adult troop members during the first and second months of infant life were significantly higher than those before they gave birth, and the values during the third month were as low as that before giving birth. Two mothers received acts of affiliative contact less frequently after their infants died, compared with the values while the infants were alive. On the other hand, more than 95% of all acts of licking of infants by adult troop members other than their mothers occurred when the infants were in contact with their mothers. These findings suggest that infants per se and mothers per se were not attractive, but rather the mother-infant pair was attractive to other troop members. Acts of infant-licking were observed in almost all mother-mother pairs and mother-non-mother adult female pairs, and in two thirds of mother-adult male pairs. Moreover, the frequency of infant-licking was not affected by female parity, female and male dominance rank, or infant sex. Therefore, acts of infant-licking, which are widespread among troop members, may function to make or maintain stable social relationships.

Behavioral effects of perches on group-housed adult female Japanese monkeys.

The use of perches to enrich the environment of group-housed Japanese monkeys (Macaca fuscata) was assessed. When monkeys were housed in a cage which contained eight wooden perches to increase the usable space, the rate of agonistic interactions as well as the rates of spatial proximity and social grooming decreased in comparison with those evident when they were housed in a cage without such perches. These results suggest that agonistic interactions were reduced which are likely to occur more frequently in crowded conditions and the monkeys displayed affiliative behavior such as social grooming more frequently in a cage without perches, i.e., more crowded conditions, than in a cage with perches. Attempts to enrich the environment of group-housed monkeys may lead to a better understanding of their behavioral flexibility and social adjustment.

Birth rate and mortality rate of infants with congenital malformations of the limbs in the Awajishima free-ranging group of Japanese monkeys (Macaca fuscata).

The birth rate and mortality rate of infants with congenital malformations of the limbs were examined in the Awajishima free-ranging group of Japanese macaques (Macaca fuscata). Of the 606 infants born between 1978 and 1995, 86 (14.2%) were malformed. The male-female ratio did not differ between malformed and normal infants. Most kin-groups included females who gave birth to malformed infants at least once. The mortality rate within the first year after birth for malformed infants (28.2%) was significantly higher than that for normal infants (10.0%). However, this indicates that more than 70% of malformed infants were able to survive for the first year of life, even though they were unable to cling to their mother's ventrum due to their limb deformities. This finding indicates that maternal care-taking is sufficient to enable malformed infants to survive during the early stages of development and that clinging by the infant is not necessary for the display of maternal care.

A child-holding thought experiment: students prefer to imaging holding an infant on the left side of the body.

The tendency of women to prefer to hold infants on the left side of the body has been confirmed by several methods: surveys of works of art and of photographs, field observations, and experimental methods. The present study developed a new method to examine the patterns of child-holding, that is, the child-holding thought experiment. 2287 female and 1268 male undergraduates were instructed to imaging nursing or feeding a baby. Then, they were asked on which side of the body they imagined holding the baby. Seventy-two percent of the women and 65% of the men reported imaging holding a baby on the left side of the body. This preference for the left side was noted, irrespective of handedness. These results indicate that both women and men who have never fed their own babies prefer to imaging holding a baby on the left side of the body. Moreover, that the magnitude of this preference was significantly stronger for the women adds to the evidence of a gender-dependent expression for lateral preferences in holding a baby.

Dominance relations among adult females in a free-ranging group of Japanese monkeys at Katsuyama.

Dominance relations among adult females in the Katsuyama group of Japanese monkeys (Macaca fuscata) were analyzed. Dominance relations among female relatives of 6 or more years of age corresponded almost exactly to those predicted by Kawamura's principles [Primates, 1:149-156, 1958] in the four highest-ranking kin-groups. According to these principles, 1) a mother is dominant to her daughter and 2) among sisters, the younger is dominant to the older. However, 9 of the remaining 11 middle-and low-ranking kin-groups included dyads in which dominance relations did not correspond to those expected from Kawamura's principles. Within the dominance rank order, of all 74 adult females of 6 or more years of age, individuals of the high-ranking kin-groups always ranked adjacent to members of their own kin-group, while individuals in middle- and low-ranking kin-groups tended to be ranked independently of members of their own kin-groups. These results indicate that, since females of a high-ranking kin-group form a cohesive matrilineal unit, it may be very difficult for females of other kin-groups to break into the dominance rank order that exists among females of the high-ranking kin-groups. © 1995 Wiley-Liss, Inc.

Fibre digestion and digesta retention from different physical forms of the feed in the rabbit.

1. Digestibility of fibre was higher in guinea-pigs than in rabbits, however, the digestibility of hemicellulose fraction containing agar was similar in both animals. 2. The digestibility of fibre of a fine particle diet was higher than that of a large particle diet in the rabbit permitted coprophagy, whereas it was lower in the rabbit prevented from coprophagy. 3. The fine particle diet tended to cause shorter retention time of digesta in the rabbit prevented from coprophagy. 4. These suggest that the digestibility of fine components relates to their physical properties which affect the retention time of digesta in the rabbit.

Behavior of infant Japanese monkeys (Macaca fuscata) with congenital limb malformations during their first three months.

Locomotion and mother-infant interactions of a severely malformed, a slightly malformed, and a normal infant were observed in a free-ranging group of Japanese monkeys (Macaca fuscata). The severely malformed infant had no feet and had hands consisting of 2 digits. The slightly malformed infant had normal feet and hands consisting of 2 digits. The severely malformed infant was more retarded in development of posture and locomotion than the other infants; however, it developed locomotor patterns appropriate to its defects. All infants spent approximately the same amount of time in contact with their mothers. High mother-infant contact of malformed infants was maintained because their mothers were very attentive and carried and held them. Mothers reared their handicapped infants even though the infants lacked the movement necessary for clinging.