Serum bta-miRNA-375 as a potential biomarker for the early diagnosis of enzootic bovine leukosis.

To identify a biomarker for the early diagnosis of enzootic bovine leukosis (EBL) caused by bovine leukemia virus (BLV), we investigated the expression of a microRNA, bta-miR-375, in cattle serum. Using quantitative reverse-transcriptase PCR analysis, we measured bta-miR-375 levels in 27 samples from cattle with EBL (EBL cattle), 45 samples from animals infected with BLV but showing no clinical signs (NS cattle), and 30 samples from cattle uninfected with BLV (BLV negative cattle). In this study, we also compared the kinetics of bta-miR-375 with those of the conventional biomarkers of proviral load (PVL), lactate dehydrogenase (LDH), and thymidine kinase (TK) from the no-clinical-sign phase until EBL onset in three BLV-infected Japanese black (JB) cattle. Bta-miR-375 expression was higher in NS cattle than in BLV negative cattle (P < 0.05) and greater in EBL cattle than in BLV negative and NS cattle (P < 0.0001 for both comparisons). Receiver operating characteristic curves demonstrated that bta-miR-375 levels distinguished EBL cattle from NS cattle with high sensitivity and specificity. In NS cattle, bta-miR-375 expression was increased as early as at 2 months before EBL onset-earlier than the expression of PVL, TK, or LDH isoenzymes 2 and 3. These results suggest that serum miR-375 is a promising biomarker for the early diagnosis of EBL.

Pooled Minimal Clinically Important Differences of the Mini-Balance Evaluation Systems Test in Patients With Early Subacute Stroke: A Multicenter Prospective Observational Study.

OBJECTIVE: Balance problems are common in patients with stroke, and the Mini-Balance Evaluation Systems Test (Mini-BESTest) is a reliable and valid assessment tool for measuring balance function. Determining the minimal clinically important difference (MCID) is crucial for assessing treatment effectiveness. This study aimed to determine the MCID of the Mini-BESTest in patients with early subacute stroke. METHODS: In this prospective multicenter study, 53 patients with early subacute stroke undergoing rehabilitation in inpatient units were included. The mean age of the patients was 72.6 (SD = 12.2) years. The Mini-BESTest, which consists of 14 items assessing various aspects of balance function, including anticipatory postural adjustments, postural responses, sensory orientation, and dynamic gait, was used as the assessment tool. The global rating of change (GRC) scales completed by the participants and physical therapists were used as external anchors to calculate the MCID. The GRC scale measured subjective improvement in balance function, ranging from -3 (very significantly worse) to +3 (very significantly better), with a GRC score of ≥+2 considered as meaningful improvement. Four methods were used to calculate the MCID: mean of participants with GRC of 2, receiver operating characteristic-based method, predictive modeling method, and adjustment of the predictive modeling method based on the rate of improvement. From the MCID values obtained using these methods, a single pooled MCID value was calculated. RESULTS: The MCID values for the Mini-BESTest obtained through the 4 methods ranged from 3.2 to 4.5 points when using the physical therapist's GRC score as the anchor but could not be calculated using the participant's GRC score. The pooled MCID value for the Mini-BESTest was 3.8 (95% CI = 2.9-5.0). CONCLUSIONS: The Mini-BESTest MCID obtained in this study is valuable for identifying improvements in balance function among patients with early subacute stroke. IMPACT: Determination of the MCID is valuable for evaluating treatment effectiveness. The study findings provide clinicians with practical values that can assist in interpreting Mini-BESTest results and assessing treatment effectiveness.

Changes in physical activity level during hospitalization in patients with stroke and those with fracture: a prospective longitudinal study.

[Purpose] To examine changes in physical activity levels between admission and discharge in patients hospitalized after stroke and fracture. [Participants and Methods] Patients with stroke (n=36) or fracture (n=41) wore an accelerometer during the daytime for three days after admission and before discharge. Physical activity was divided into sedentary behavior (SB), light-intensity (LIPA), and moderate-to-vigorous (MVPA), and then compared between hospital admission and discharge using the Wilcoxon signed-rank test. The characteristics of patients with or without changes in SB during hospitalization were compared using the Mann-Whitney U test. [Results] The median LIPA time in patients after stroke and fracture increased from 107.5 and 106.7 minutes on admission to 122.0 and 127.3 minutes at discharge, and the median MVPA time increased from 2.7 and 0.7 minutes on admission to 4.2 and 2.7 minutes at discharge, respectively. In particular, LIPA in non-therapy time increased for patients both after stroke and fracture. No differences in characteristics were observed between with or without changes in SB regardless of differences in diagnoses. [Conclusion] These findings indicate that while physical activity levels increased during hospitalization, they remained below World Health Organization recommendations for MVPA, and patient characteristics alone may not account for increased activity levels.

Clinical prediction rules for multi surfaces walking independence using the Berg Balance Scale or Mini-Balance Evaluation Systems Test in persons with stroke.

BACKGROUND: A Clinical prediction rule (CPR) for determining multi surfaces walking independence in persons with stroke has not been established. OBJECTIVES: To develop a CPR for determining multi surfaces walking independence in persons with stroke. METHODS: This was a multicenter retrospective analysis of 419 persons with stroke. We developed a Berg Balance Scale (BBS)-model CPR combining the BBS, comfortable walking speed (CWS) and cognitive impairment, and a Mini-Balance Evaluation Systems Test (Mini-BESTest)-model CPR combining the Mini-BESTest, CWS, and cognitive impairment. A logistic regression analysis was conducted with multi surfaces walking independence as the dependent variable and each factor as an independent variable. The identified factors were scored (0, 1) based on reported cutoff values. The CPR's accuracy was verified by the area under the curve (AUC). We used a bootstrap method internal validation and calculated the CPR's posttest probability. RESULTS: The logistic regression analysis showed that the BBS, CWS, and cognitive impairment were factors in the BBS model, and the Mini-BESTest was a factor in the Mini-BESTest model. The CPRs were 0-3 points for the BBS model and 0-1 points for the Mini-BESTest model. The AUCs (bootstrap mean AUC) of the CPR score were 0.89 (0.90) for the BBS model and 0.72 (0.72) for the Mini-BESTest model. The negative predictive value (negative likelihood ratio) was 97% (0.054) for CPR scores < 2 for the BBS model and 94% (0.060) for CPR scores < 1 for the Mini-BESTest model. CONCLUSIONS: The CPR developed herein is useful for determining multi surfaces walking independence.

Minimal important change in the Berg Balance Scale in older women with vertebral compression fractures: A retrospective multicenter study.

BACKGROUND: Vertebral compression fractures, which are commonly associated with older age and osteoporotic fractures, have an increased risk of re-fracture. Therefore, improving balance is important to prevent falls. The minimal important change (MIC) has been recommended for interpreting clinically meaningful changes in rating scales. The MIC of the Berg Balance Scale (BBS) for use in older women with vertebral compression fractures has not been established. OBJECTIVE: To identify the MIC of the BBS that can be used in older women with vertebral compression fractures using predictive modeling methods and the receiver-operating characteristic (ROC)-based method. DESIGN: A retrospective longitudinal multicenter study. PATIENTS: Sixty older women (mean age ± standard deviation: 84.1 ± 7.0 years) with vertebral compression fractures who were unable to ambulate independently on a level surface. METHODS: A change of one point in the Functional Ambulation Category (FAC) was used as an anchor to calculate the MIC of the BBS based on the change between admission and discharge. We calculated the MIC for the women whose FAC score improved by ≥1 point. We used three anchor-based methods to examine the MIC: the ROC-based method (MICROC ), the predictive modeling method (MICpred ), and the MICpred -based method adjusted by the rate of improvement and reliability of transition (MICadj ). RESULTS: Thirty-nine women comprised the "important change" group based on their FAC score improvement. In this group, the MICROC (95% confidence interval [CI]) value of the BBS was 10.0 points (5.5-15.5), with an area under the curve of 0.71. The MICpred (95% CI) value was 9.7 (8.1-11.0), and the MICadj (95% CI) was 7.0 (5.5-8.5) points. CONCLUSION: For women with vertebral compression fractures who are unable to ambulate independently, a 7.0-point improvement in the BBS score may be a useful indicator for reducing the amount of assistance required for walking.

Characteristics of antimicrobial residues in manure composts from swine farms: Residual patterns, removal efficiencies, and relation to purchased quantities and composting methods in Japan.

Present study provides first comprehensive results on the residual levels of 19 antimicrobial (AM) residues in 12 Japanese swine manure composting facilities that use open or enclosed types of treatment methods. Tilmicosin (14000 µg/kg d.w.) and tiamulin (15000 µg/kg d.w.) were present in the highest concentrations in manure composts. Morantel (MRT) had the highest detection frequency (100%) in compost, suggesting its ubiquitous usage and resistance to degradation during composting. Sulfamethoxazole had low detection frequencies and concentrations, likely due to limited partitioning to the solid phase. A positive correlation (p < 0.05) between purchasing quantities and residue levels in manure composts was detected for fluoroquinolones (FQs). The removal efficiencies of AMs in enclosed-type facilities were lower and more inconsistent than those in open-type facilities. Tetracyclines (TCs), lincomycin, and trimethoprim were easily removed from open-type facilities, whereas FQs and MRT persisted in both facilities. After discontinuing the usage of oxytetracycline (OTC), TCs concentrations reduced drastically in input materials, remained pseudo-persistent in composts for up to 4 months, suggesting a time lag for composting and were not detected (<10 µg/kg) after 4 months of OTC withdrawal. This study emphasizes on the effectiveness of manure composting methods in reducing AM residues in swine waste.

The association between farm-level antimicrobial usage and resistance of Staphylococcus spp., as the major genus isolated from aerosol samples, in Japanese piggeries.

Bacteria are the dominant particulate matter in livestock houses and can threaten animal and public health. Antimicrobial resistance (AMR) is a crucial concern worldwide, and nationwide measures established based on the One Health approach are being implemented in many countries. This requires multidisciplinary perspectives and collaboration among the human, animal, and environmental sectors. However, information on the AMR risk in livestock house aerosol is limited, especially its association with antimicrobial usage (AMU). Therefore, this study was conducted to reveal the AMR profile of Staphylococcus, the major bacterial genus in the aerosol of the piggeries of Japanese farms, and the association between farm-level AMU and AMR. The investigation at 10 farrow-to-finish pig farms revealed that regardless of the sampling season and the piggery group, the resistance rate of isolated staphylococci for oxacillin, erythromycin, and lincomycin was more than 40% of the median and tended to be higher than that for other antimicrobials. The AMU adjusted by the defined daily dose (DDD-adjusted AMU) in the fattening piggery group was significantly higher than that in the sow piggery group (p < 0.05). Finally, for the fattening piggery group, the generalized linear mixed model revealed that the AMR rate for oxacillin, erythromycin, tetracycline, and chloramphenicol was positively associated with the corresponding class-based DDD-adjusted AMU of penicillins (odds ratio (OR) = 2.63, p = 0.03), macrolides (OR = 6.89, p = 0.0001), tetracyclines (OR = 2.48, p = 0.04), and amphenicols (OR = 3.22, p = 0.03), respectively. These significant positive associations observed in this study imply that the resistance rate for these antimicrobials may decrease by reducing the corresponding antimicrobials' use. In addition, the resistance rates for erythromycin and chloramphenicol also displayed a positive association with the AMU of antimicrobial classes other than macrolides and amphenicols, respectively. The mechanism underlying these phenomena is unclear; therefore, further evaluation will be needed. As limited studies have reported staphylococci in piggery aerosol and its AMR with quantitative AMU, these results based on on-farm investigations are expected to aid in establishing countermeasures for AMR of aerosol bacteria in pig farms.

Occurrence and the potential ecological risk of veterinary antimicrobials in swine farm wastewaters in Japan: Seasonal changes, relation to purchased quantity and after termination of oxytetracycline usage.

This study provides the first comprehensive investigation of the residual concentrations of eight classes of antimicrobial agents (AMs, 20 compounds) in 13 swine wastewater treatment facilities in Japan. These facilities implemented the aerobic activated sludge (AS) or its alternative methods. The maximum concentrations before treatment were found at the level of 7100, 6900, 6000, 3600, 3400, and 1400 µg/L for tilmicosin, oxytetracycline (OTC), chlortetracycline, lincomycin , sulfamethoxazole, and trimethoprim, respectively. The highest detection rate (96.3%) in influents was noted for the morantel, which was a feed additive. The seasonal difference in residual concentration was much greater for tetracyclines (TCs) and macrolides (MLs) when their residual concentrations were high, especially in the cold season. There was a positive correlation between the purchased quantity of TCs and fluoroquinolones (FQs) and their residue levels detected in the effluents (p < 0.01). The estimated removal rate of AMs was greater than 80%. In contrast, on a few occasions, it was diminished due to failing operating conditions, such as water temperature and AS rate in the aeration tank. The estimated ecological risks of AMs in effluents based on risk quotients (RQs) considered to enhance the selection pressure for drug resistance (RQs-AMR) were high for TCs and FQs, whereas ecotoxicological effects (RQs-ENV) to aquatic organisms were higher for sulfonamides and MLs. When OTC usage ceased, its concentration in wastewater decreased rapidly; however, it remained longer period in the effluents, probably due to OTC desorption from the AS. The concentrations (and respective RQs) of TCs were decreased by >99.8% and >92% in the influents and effluents, respectively. This data suggested that it is essential to reduce the amount used and introduce more efficient methods and operating conditions to constantly remove AMs during the treatment to reduce the risk of AM discharge from swine farms.

Cut-off values and sub-items of the Berg Balance Scale for walking-aid use in hospitalized older adults with a hip fracture: a retrospective analysis.

OBJECTIVE: To identify the Berg Balance Scale (BBS) values that can be used to discriminate the use of a walking aid and the BBS sub-items that reveal the differences in the use of walking aids among hospitalized older adults with a hip fracture. METHODS: The cases of 77 older adults (age 80.8 ± 7.5 years) with a hip fracture who were able to walk independently in the hospital were retrospectively analyzed. A receiver operating characteristic curve (AUC) analysis was used to identify BBS scores that optimized the identification of subjects with different levels of aids. The BBS sub-items identifying differing among the walking aids were identified by a classification and regression tree analysis. RESULTS: The BBS scores were highest for no aid, a cane, and a walker, in that order. The ability to walk without an aid and the ability to walk without a walker showed moderate AUCs (0.824 and 0.865) with cutoff values of 51.5 and 45.5 points, respectively. The sub-items identified were Turning 360° (4 vs. < 4 points) as the best discriminator for using/not using a cane and Stool Stepping (≥ 2 vs. < 2 points) for using a cane or walker. CONCLUSION: The BBS is useful for determining whether to discontinue the use of a walker in individuals with a hip fracture.

Isolation, molecular characterization, and disinfectants susceptibility of swine-carried mammalian orthoreoviruses in Japan in 2020-2022.

Biosecurity enhancement contributes to the reduction of various microbial pathogens. Mammalian orthoreoviruses (MRVs) which are increasingly recognized as potentially serious problems on swine industry were used as indicators of biosecurity enhancement on two pig farms. Twelve MRVs were detected and isolated from fecal specimens of healthy pigs collected from one of the two farms in Japan. By sequencing based on the partial S1 gene, MRV isolates were classified as MRV1 and MRV2. Additionally, the virucidal activities of disinfectants toward the isolated MRV1 were evaluated using quaternary ammonium compound (QAC) diluted 500 times with water (QAC-500), 0.17% food additive glade calcium hydroxide (FdCa(OH)2) solution, QAC diluted with 0.17% FdCa(OH)2 solution (Mix-500), sodium hypochlorite at 100 or 1,000 parts per million (ppm) of total chlorine (NaClO-100 or NaClO-1000, respectively). To efficiently inactivate MRV1 (≥3 log10 reductions), 0.17% FdCa(OH)2, Mix-500 and NaClO-1000 required 5 min, whereas it took 30 min for QAC-500. The number of MRV detections has decreased over time, after using Mix-500 for disinfection on the positive farm. These results suggest that different serotypes of MRVs are circulating among pigs, and that the occurrence of MRVs in the farms decreased consequent to more effective disinfection.

Berg Balance Scale is a Valid Measure for Plan Interventions and for Assessing Changes in Postural Balance in Patients with Stroke.

OBJECTIVES: After confirming the measurement properties of the Berg Balance Scale (BBS) in patients with stroke by conducting a Rasch analysis, this study sought: (i) to generate a keyform as a tool for goal-setting and intervention-planning; and (ii) to determine the appropriate strata for separating patients' postural balance ability. DESIGN: Methodological analyses of cross-sectional study data. PATIENTS: A pooled sample of 156 patients with stroke: mean (standard deviation) age 74.4 (12.9) years. METHODS: This study evaluated the BBS's rating scale structure, unidimensionality, and measurement accuracy (0: unable to perform or requiring help, to 4: normal performance) and then generated a keyform and strata. RESULTS: The BBS rating scale fulfilled the category functioning criteria. Principal component analysis of standardized residuals confirmed the unidimensionality of the test. All items fit the Rasch analysis. Person ability-item difficulty matching was good. Person reliability was 0.96, and the patients were divided into 9 strata. The keyform for the BBS will enable clinicians and investigators to estimate patients' postural balance ability and monitor their progress. CONCLUSION: The BBS has strong measurement properties. This study generated both a keyform that can contribute to clinicians' decision-making in goalsetting and intervention-planning and strata that can facilitate understanding of patients' abilities.

Disinfectant resistance of Salmonella in in vitro contaminated poultry house models and investigation of efficient disinfection methods using these models.

Salmonellaenterica subsp. enterica (Salmonella) shows disinfectant resistance by forming biofilms on solid surfaces. However, efficient disinfection methods to eliminate Salmonella biofilms from farms have not yet been examined in detail. In this study, more than 80% of Salmonella strains from farms in Yamagata prefecture, Japan, were biofilm producers. Regardless of the extent of their biofilm formation ability, their biofilms were highly resistant to hypochlorous acid on plastic surfaces. To establish efficient disinfection methods in farms, we developed in vitro Salmonella-contaminated poultry house models by depositing dust on ceramic and stainless-steel carriers in poultry houses for one month and culturing a representative Salmonella strain on the carriers. Biofilm-like structures, including Salmonella-like cells, were observed on the models by scanning electron microscopy. Salmonella was not efficiently removed from the models even by cleaning with a surfactant at 25/65°C and disinfection with quaternary ammonium compound or hypochlorous acid at 25°C; on the contrary, viable Salmonella cells increased in some tests under these conditions, suggesting that these models successfully simulate the highly persistent characteristics of Salmonella in farms. However, the persistent bacterial cells were markedly decreased by soaking in 65°C surfactant followed by rinsing with 80°C water, additional cleaning using chlorine dioxide or disinfection with dolomitic lime, suggesting the effectiveness of these methods against Salmonella in farms. Since many different disinfection conditions may be easily tested in laboratories, our models will be useful tools for establishing effective and practical disinfection methods in farms.

Development of Cut-off Values on the Berg Balance Scale for Predicting Walking Independence in Older Adults with Hip Fracture.

Objectives: The aim of the current study was to identify a cut-off value for predicting walking independence at discharge in older adults with hip fracture based on their Berg Balance Scale (BBS) score at admission to a convalescent rehabilitation ward. Methods: This was a retrospective, multicenter, observational study of 187 older adults with hip fractures (mean age 83.7, range 66-97 years). Data was collected on the patients' age, sex, treatment, and physical function evaluation. An ordinal logistic regression analysis was used to identify predictors associated with the degree of independence in walking at discharge. Receiver operating characteristic curves were used to estimate cut-off values to predict independent and supervised walking at discharge based on the BBS score at admission. The accuracy of the classification was assessed using the area under the curve (AUC). Results: The BBS score at admission was a significant factor predicting the degree of walking independence at discharge (odds ratio = 1.09, 95%CI: 1.06-1.11). The cut-off values of the BBS score at admission for predicting independent walking and supervised walking at discharge were 28 points (AUC = 0.76, 95%CI: 0.69-0.83) and 21 points (AUC = 0.84, 95%CI: 0.77-0.91), respectively. Conclusions: The BBS scores of older adults with hip fracture on admission to a rehabilitation ward are useful for predicting the degree of independence in walking at discharge and can help to structure therapy according to the predicted degree of independence.

Item distribution of the Berg Balance Scale in older adults with Hip fracture: a Rasch analysis.

INTRODUCTION: Balance impairment occurs after a hip fracture, but the characteristics of the impairment are not clear. OBJECTIVE: To investigate the uni-dimensionality, fit statistics, and item difficulty of the Berg Balance Scale (BBS) in older adults with hip fracture by conducting a Rasch analysis. METHODS: This was an observational cross-sectional study. The 254 participants were all ≥ 65 years old and had been hospitalized for rehabilitation after a unilateral hip fracture incurred during a fall. We collected their BBS scores at the time of hospital discharge and conducted a Rasch analysis to examine the uni-dimensionality, fit statistics, and item difficulty. RESULTS: The principal component analysis (PCA) of the Rasch model demonstrated that the BBS is uni-dimensional. The information-weighted mean square (MnSq) fit statistic was within the range of fit criteria for all items. The underfit item of the outlier-sensitive MnSq fit statistics was "Standing unsupported eyes closed" with the MnSq of 2.06. The difficult items were in order of logits: "Standing on one leg" (logits = 4.01); "Step tool" (logits = 2.74); and "Turn 360°" (logits = 2.61). CONCLUSION: The BBS is uni-dimensional and conforms with the Rasch model. The BBS most difficult items for older adults with a hip fracture required one-legged support and dynamic balance.

Comparative susceptibility of mallard (Anas platyrhynchos) to infection with high pathogenicity avian influenza virus strains (Gs/Gd lineage) isolated in Japan in 2004-2017.

The Goose/Guangdong-lineage (Gs/Gd) H5 high pathogenicity avian influenza viruses (HPAIVs) spread among poultry and wild birds worldwide; an association has been identified between the migration of wild birds and spread of HPAIVs. Every autumn-spring season, the mallard (Anas platyrhynchos) migrates to Japan in substantial numbers for overwintering; however, to the best of our knowledge, no virological studies have focused on mallards' susceptibility to the HPAIVs in Japan. To evaluate the susceptibility of mallards to infection with Gs/Gd H5 HPAIVs isolated during previous outbreaks in Japan, we experimentally infected the birds with various virus strains: A/chicken/Yamaguchi/7/2004 (H5N1) (clade 2.5), A/chicken/Miyazaki/K11/2007 (H5N1) (clade 2.2), A/whooper swan/Akita/1/2008 (H5N1) (clade 2.3.2), A/mandarin duck/Miyazaki/22M-765/2011 (H5N1) (clade 2.3.2.1c), A/duck/Chiba/26-372-48/2014 (H5N8) (clade 2.3.4.4c), A/duck/Hyogo/1/2016 (H5N6) (clade 2.3.4.4e) and A/mute swan/Shimane/3211A002/2017 (H5N6) (clade 2.3.4.4b). The birds exhibited high tracheal shedding for a prolonged period, particularly those infected with A/duck/Hyogo/1/2016 (H5N6). Various clinical manifestations ranging from asymptomatic to mild (corneal opacity) infections to neurological disorders accompanied by mortality were noted depending on the virus strain. Furthermore, virus-infected mallards contaminated both cohoused mallards and water in their surroundings. Thus, mallards may disseminate viruses in the environment, thereby influencing HPAI outbreaks in Japan. Therefore, mallards represent an important migratory bird species that spread HPAIVs in Japan.

Comparative Evaluation of Three Commercial Quantitative Real-Time PCRs Used in Japan for Bovine Leukemia Virus.

Bovine leukemia virus (BLV) is an oncogenic virus belonging to the genus Deltaretrovirus and is the causative agent of enzootic bovine leukosis. Proviral load (PVL) determined by real-time quantitative PCR (qPCR) is now widely used as an indicator of not only BLV infection, but also BLV disease progression. To interpret PVLs determined by different qPCRs used in Japan, we compared a chimeric cycling probe-based qPCR, CY415, targeting the BLV tax region; a TaqMan probe-based qPCR, RC202, targeting the BLV pol region; and a TaqMan probe-based qPCR, CoCoMo, targeting the BLV long terminal repeat (LTR) region. Whole-blood samples collected from 317 naturally BLV-infected cattle (165 Holstein-Friesian and 152 Japanese Black) and tumor tissue samples collected from 32 cattle at a meat inspection center were used. The PVLs determined by each qPCR were strongly correlated. However, the PVL and the proportion of BLV-infected cells determined by RC202 or CoCoMo were significantly higher than those determined by CY415. Genetic analysis of three tumor tissue samples revealed that LTR region mutations or a deletion affected the PVL determined by CoCoMo. These results suggest that the TaqMan-based RC202 or CoCoMo qPCR is better than CY415 for BLV PVL analysis. However, qPCR target region mutations were not rare in tumors and could hamper PVL analysis by using qPCR.

Minimal clinically important difference of the Berg Balance Scale score in older adults with hip fractures.

PURPOSE: The minimal clinically important difference (MCID) is the smallest clinically significant difference in treatment identified as crucial to the patient. There is no known MCID for the Berg Balance Scale (BBS), which measures balance function in patients with hip fractures. We aimed to calculate the MCID of the BBS in older adults with hip fractures. MATERIALS AND METHODS: This is a retrospective multicenter clinical study that included 187 older adults with hip fractures. MCID was calculated using functional ambulation categories (FACs), which were used as anchors for the change in BBS scores between admission and discharge. MCID was calculated as an improvement for more than one point and as a substantial change for improvement for more than two points in the FAC. RESULTS: MCID of the BBS was 11.5 points and that of the substantial change was 18.5 points, with an area under the curve of 0.76 and 0.81, respectively. CONCLUSIONS: MCID for the BBS was 11.5 points in older adults with hip fractures. In addition, an improvement of more than 18.5 points in BBS can be considered a substantial change. These values may be useful in determining meaningful balance function improvement.Implications for rehabilitationHip fractures are a common injury for the older adults, and improvement in gait function has a bearing on prognosis.The effectiveness of meaningful rehabilitation is possible to determine by clarifying the minimal clinically important difference in balance function, which is important for the acquisition of gait.An improvement of 11.5 points or more on the Berg Balance Scale in an older adult with a hip fracture is considered a meaningful effect.

The minimal clinically important difference in Berg Balance Scale scores among patients with early subacute stroke: a multicenter, retrospective, observational study.

BACKGROUND: Balance dysfunction is common in stroke patients. The Berg Balance Scale (BBS) is useful for evaluating the balance function of stroke patients, and it can estimate the minimal clinically important difference (MCID) in balance. BBS scores differ among stroke patients depending on whether they require walking assistance. The MCID should thus be estimated separately for patients who require assistance and those who do not. OBJECTIVES: To estimate the MCID of individuals who have had an early subacute stroke and require a walking aid and those who do not, to assist the clinical determination of the effectiveness of therapy. METHODS: This was a retrospective clinical analysis of 80 early subacute stroke patients. We estimated the MCID by using the Functional Ambulation Categories (FAC) as anchors for changes in BBS scores during a 1-month period. The MCID was estimated based on a cutoff score for separating the patients who achieved a FAC change ≥1 point on receiver operator characteristic curves. The area under the curve (AUC) was used to measure the discrimination accuracy. The MCID was estimated for the patients who needed walking assistance and those who did not. RESULTS: The estimated MCID of BBS scores in the assisted-walking group was 5 points and the AUC was 0.84 (p < .01); the corresponding values in the unassisted-walking group were 4 points and 0.62 (p = .26). CONCLUSIONS: For early subacute stroke patients who require assistance to walk, a 5-point improvement in the BBS score is a useful indicator for reducing the amount of assistance.

Comparative susceptibility of the common teal (Anas crecca) to infection with high pathogenic avian influenza virus strains isolated in Japan in 2004-2017.

High pathogenic avian influenza viruses (HPAIVs) of the H5 subtype have spread in poultry and wild birds worldwide. Current studies have highlighted the association between the migration of wild birds and the spread of HPAIVs. However, virological studies examining responsible species of migratory birds to spread HPAIVs are limited. In Japan, the common teal (Anas crecca) arrives in great numbers for overwintering every autumn-spring season; therefore, we performed experimental infection using six H5 HPAIVs isolated in past outbreaks in Japan (A/chicken/Yamaguchi/7/2004 (H5N1), A/whooper swan/Akita/1/2008 (H5N1), A/mandarin duck/Miyazaki/22M-765/2011 (H5N1), A/duck/Chiba/26-372-48/2014 (H5N8), A/duck/Hyogo/1/2016 (H5N6) and A/mute swan/Shimane/3211A002/2017 (H5N6)) to evaluate the susceptibility of the species to HPAIV infection. The results illustrated that most birds in all experimental groups were infected by the strains, and they shed viruses for a prolonged period, in trachea than cloaca, without displaying distinctive clinical signs. In addition, comparative analysis using calculation value of total viral shedding during the experiment revealed that the birds shed viruses at above a certain level regardless of the differences of strains. These results suggested that the common teal could be a migratory bird species that disseminates viruses in the environment, thereby influencing HPAI outbreaks in wild birds in Japan.

Characterization of microRNA expression in B cells derived from Japanese black cattle naturally infected with bovine leukemia virus by deep sequencing.

Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis (EBL), a malignant B cell lymphoma. However, the mechanisms of BLV-associated lymphomagenesis remain poorly understood. Here, after deep sequencing, we performed comparative analyses of B cell microRNAs (miRNAs) in cattle infected with BLV and those without BLV. In BLV-infected cattle, BLV-derived miRNAs (blv-miRNAs) accounted for 38% of all miRNAs in B cells. Four of these blv-miRNAs (blv-miR-B1-5p, blv-miR-B2-5p, blv-miR-B4-3p, and blv-miR-B5-5p) had highly significant positive correlations with BLV proviral load (PVL). The read counts of 90 host-derived miRNAs (bta-miRNAs) were significantly down-regulated in BLV-infected cattle compared to those in uninfected cattle. Only bta-miR-375 had a positive correlation with PVL in BLV-infected cattle and was highly expressed in the B cell lymphoma tissue of EBL cattle. There were a few bta-miRNAs that correlated with BLV tax/rex gene expression; however, BLV AS1 expression had a significant negative correlation with many of the down-regulated bta-miRNAs that are important for tumor development and/or tumor suppression. These results suggest that BLV promotes lymphomagenesis via AS1 and blv-miRNAs, rather than tax/rex, by down-regulating the expression of bta-miRNAs that have a tumor-suppressing function, and this downregulation is linked to increased PVL.