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[Purpose] To classify and compare the physical characteristics and functions of community-dwelling elderly individuals of various age groups participating in the Kayoi-no-ba program. [Participants and Methods] A total of 176 community-dwelling elderly individuals living in six cities and towns in the Niigata Prefecture who participated in the Kayoi-no-ba program between 2018 and 2020 were recruited in this study. Physical characteristics, such as strength, balance, and mobility, were assessed. [Results] Among elderly females and males who participated in the Kayoi-no-ba program, those >80â years of age showed shorter height, lighter weight, and lower body muscle mass than the other age groups. Strength, balance, and mobility functions, including grip strength, sit-to-stand test, single-leg-stand test, and timed up-and-go test, were significantly decreased, especially in patients aged >80â years. [Conclusion] Among community-dwelling elderly individuals participating in the Kayoi-no-ba program, physical characteristics and functions were affected by aging, with significant decline particularly in those aged >80â years old. These findings suggest that early intervention is necessary to maintain muscle mass, strength, balance, and mobility in the elderly.
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BACKGROUND AND PURPOSE: Uncomfortable care and histamine H2 antagonist (H2A) are implicated in precipitating delirium. In acute stroke, however, the need for them depends on stroke severity, an established risk factor for delirium. So, it is unclear whether care or H2A itself is responsible for delirium. We aimed to evaluate their causal effects on delirium in acute stroke patients. METHODS: This is a prospective cohort study on acute stroke patients admitted to a stroke care unit. Patients without stupor, coma, sedation, or delirium upon admission were enrolled. The treatment was H2A and five care modalities given during the first 24 h: restraint use, prohibited self-transfer, no oral feeding, indwelling catheters, and frequent nighttime care. The outcome was delirium within 5 days defined as Intensive Care Delirium Screening Checklist ≥4 points. We estimated the relative risk (RR) for delirium with regression models weighted by overlap weights using propensity scores estimated through logistic models incorporating known and potential confounders, including stroke severity. RESULTS: Of the 387 participants, 188 were given at least one care modality and 130 were given H2A. A total of 42 developed delirium. Delirium was significantly associated with prohibited self-transfer (RR 1.7, 95% CI 1.0-3.0), frequent nighttime care (RR 2.1, 95% CI 1.2-3.7), and multiple care modalities (RR 2.4, 95% CI 1.3-4.4), while other care modalities and H2A were not. CONCLUSIONS: This study showed possible causal effects of uncomfortable care on delirium and suggests that minimizing it could prevent delirium in acute stroke.
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Delírio , Acidente Vascular Cerebral , Delírio/epidemiologia , Delírio/etiologia , Histamina , Antagonistas dos Receptores H2 da Histamina , Humanos , Unidades de Terapia Intensiva , Pontuação de Propensão , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
BACKGROUND AND PURPOSE: Delirium frequently complicates acute stroke and worsens outcomes. Because delirium is potentially preventable, predicting its occurrence is essential. Although several prediction scores have been proposed, nurses need to quickly predict delirium in stroke care units (SCUs). We aimed to develop a simple tool for this purpose by examining a comprehensive set of potential predictors. METHODS: This is a prospective cohort study on acute stroke patients admitted to an SCU. Patients without stupor, coma, or delirium upon admission were eligible. Participants were followed for 5 days from admission. Delirium was defined as Intensive Care Delirium Screening Checklist ≥4 points. We examined 27 potential predictors, of which 13 predictors were used to developed a least absolute shrinkage and selection operator-penalized logistic regression model. Five variables with the largest coefficients were assigned one point each in the prediction score. The internal validation was performed by bootstrapping. RESULTS: Delirium occurred in 42 of the 387 participants. The score consisted of prior delirium, alcohol, NIHSS ≥5, dementia, and auditory/visual impairment (PANDA). The apparent AUC was 0.84 (95% confidence interval [CI], 0.78-0.89), and the optimism-corrected AUC was 0.81 (95% CI, 0.73-0.88). With a cutoff of ≥2 points, sensitivity was 0.78 (95% CI, 0.65-0.90), and specificity was 0.74 (95% CI, 0.70-0.79). CONCLUSIONS: PANDA score is simple and predicts delirium in an SCU satisfactorily.
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Delírio , Acidente Vascular Cerebral , Cuidados Críticos , Delírio/diagnóstico , Delírio/epidemiologia , Delírio/etiologia , Humanos , Unidades de Terapia Intensiva , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnósticoRESUMO
Macrophage foam cells play critical roles in the initiation and development of atherosclerosis by synthesizing and accumulating cholesteryl ester (CE) in lipid droplets. However, in analyzing lipid metabolism in foam cell formation, studies have focused on the sterol group, and little research has been done on the acyl chains. Therefore, we adapted a model system using liposomes containing particular acyl chains and examined the effect of various acyl chains on foam cell formation. Of the phosphatidylserine (PS) liposomes tested containing PS, phosphatidylcholine, and cholesterol, we found that unsaturated (C18:1), but not saturated (C16:0 and C18:0), PS liposomes induced lipid droplet formation, indicating that foam cell formation depends on the nature of the acyl chain of the PS liposomes. Experiments on the uptake and accumulation of cholesterol from liposomes by adding [14C]cholesterol suggested that foam cell formation could be induced only when cholesterol was converted to CE in the case of C18:1 PS liposomes. Both microscopic observations and metabolic analysis suggest that cholesterol incorporated into either C16:0 or C18:0 PS liposomes may stay intact after being taken in by endosomes. The [14C]C18:1 fatty acyl chain in the C18:1 PS liposome was used to synthesize CE and triacylglycerol (TG). Interestingly, the [14C]C16:0 in the C18:1 PS liposome was metabolized to sphingomyelin rather than being incorporated into either CE or TG, which could be because of enzymatic acyl chain selectivity. In conclusion, our results indicate that the acyl chain preference of macrophages could have some impact on their progression to foam cells.
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Ésteres do Colesterol/biossíntese , Colesterol/metabolismo , Células Espumosas/metabolismo , Macrófagos Peritoneais/metabolismo , Fosfolipídeos/metabolismo , Animais , Células Cultivadas , Feminino , Lipossomos , Camundongos Endogâmicos ICRRESUMO
The ratio of C 26:0/C 22:0 fatty acids in patient lipids is widely accepted as a critical clinical criterion of peroxisomal diseases, such as Zellweger syndrome and X-linked adrenoleukodystrophy (X-ALD). However, phospholipid molecular species with very long chain fatty acids (VLCFA) have not been precisely characterized. In the present study, the structures of such molecules in fibroblasts of Zellweger syndrome and X-ALD were examined using LC-ESI-MS/MS analysis. In fibroblasts from Zellweger patients, a large number of VLCFA-containing molecular species were detected in several phospholipid classes as well as neutral lipids, including triacylglycerol and cholesteryl esters. Among these lipids, phosphatidylcholine showed the most diversity in the structures of VLCFA-containing molecular species. Some VLCFA possessed longer carbon chains and/or larger number of double bonds than C 26:0-fatty acid (FA). Similar VLCFA were also found in other phospholipid classes, such as phosphatidylethanolamine and phosphatidylserine. In addition, VLCFA-containing phospholipid species showed some differences among fibroblasts from Zellweger patients. It appears that phospholipids with VLCFA, with or without double bonds, as well as C 26:0-FA might affect cellular functions, thus leading to the pathogenesis of peroxisomal diseases, such as Zellweger syndrome and X-ALD.
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Ácidos Graxos/química , Fosfolipídeos/química , Síndrome de Zellweger/metabolismo , Adrenoleucodistrofia/metabolismo , Adrenoleucodistrofia/fisiopatologia , Ácidos Graxos/análise , Fibroblastos/metabolismo , Humanos , Fosfatidilcolinas/análise , Fosfatidilcolinas/metabolismo , Fosfolipídeos/análise , Espectrometria de Massas por Ionização por Electrospray/métodos , Espectrometria de Massas em Tandem/métodos , Síndrome de Zellweger/fisiopatologiaRESUMO
We report our observation of the photorefractive effect in undoped aluminum nitride. We measured the coupling constant and the formation rate as a function of pump intensity at a wavelength of 405 nm in a two-wave mixing experiment. The photorefractive gain coefficient was 0.47 cm(-1) at I = 6.9 W/cm(2), and the actual saturated value was probably larger than this. The time constant was 59 ms at I = 1.0 W/cm(2). In addition to a refractive index grating, an absorption grating was also formed, which is attributed mainly to an ionized trap density modulation process.
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OBJECTIVE: To compare the effectiveness of zanamivir with oseltamivir for influenza A and B. METHODS: 1113 patients with influenza A or B were enrolled in the 2006-2007 influenza season. The duration of fever (temperature, >or=37.5 degrees C) and the percentage of patients afebrile at 24 and 48 h after the first dose of zanamivir or oseltamivir were calculated. Virus persistence after zanamivir therapy was also evaluated. RESULTS: There were marginally significant differences between the duration of fever after the first dose of zanamivir (31.8+/-18.4h) and oseltamivir (35.5+/-23.9h) for influenza A (p<0.05). The duration of fever after starting zanamivir therapy (35.8+/-22.4h) was significantly shorter than that of oseltamivir (52.7+/-31.3h) for influenza B (p<0.001). There were no significant differences between influenza A and B in the percentage of patients afebrile at 24 or 48 h after the first inhalation of zanamivir. The reisolation rate after zanamivir therapy showed marginally significant differences between influenza A and B (<0.05). By multiple regression analysis, therapy (zanamivir or oseltamivir) was the major determinant affecting the duration of fever for influenza B. CONCLUSION: Zanamivir therapy is more effective than oseltamivir for the treatment of influenza B infection.
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Vírus da Influenza A , Vírus da Influenza B , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêutico , Zanamivir/uso terapêutico , Administração por Inalação , Administração Oral , Adolescente , Adulto , Feminino , Febre/patologia , Humanos , Influenza Humana/patologia , Influenza Humana/virologia , Japão , Masculino , Oseltamivir/administração & dosagem , Resultado do Tratamento , Zanamivir/administração & dosagemRESUMO
We report a high-average-power laser-diode-pumped Nd:YAG master oscillator power amplifier system that has a minimum number of elements in the single multipass zigzag-slab amplifier stage and is used to pump a high-peak-power and high-average-power Ti:sapphire laser system. This phase-conjugated system produces an average power of 362 W at 1 kHz in a 30-ns pulse with an optical-to-optical conversion efficiency of 14%. With an external KTP doubler this system generates 132 W of green average output power at 1 kHz with a conversion efficiency of 60% when pumped at a power level of 222 W. To the best of our knowledge these results represent the highest average output power at both infrared and green wavelengths achieved in a single amplifier stage.