The impact of a new exercise facility on physical activity at the community level: A non-randomized panel study in Japan

Background Considering that building a sports facility is a major investment to promote population health, it is important to understand whether it is effective in increasing the level of physical activity (PA) in the community. This study examined the impact of building a new multipurpose exercise facility on community-level PA in Japan. Methods This non-randomised panel study compared two sites: an intervention site where a new exercise facility was built (opened after baseline data collection) and a control site where there was no such additional exercise facility. From each site, 3200 adult residents (aged 30–74 years) were randomly selected at baseline (2013) and at follow-up (2015). The number of participants retained for analysis was 845 at baseline and 924 at follow-up for the intervention site, and 821 at baseline and 1018 at follow-up for the control site. The outcomes were participants’ self-reported PA, perceived availability of PA facilities, awareness of others being active, and willingness to engage in PA. We examined the interaction terms between the sites and time of measurement in regression analyses to examine whether the magnitude of change from baseline to follow-up differed between the two sites. Results The changes in the proportion of participants meeting the PA guideline and those engaging in moderate-to-vigorous intensity PA were not significantly different between the intervention and control sites. The intervention site had a greater increase in the proportion of participants who were aware of PA facilities from baseline to follow-up than in the control site. The odds ratio for awareness of others being active approached significance, suggesting that there was a tendency at the intervention site towards a greater increase in the proportion of participants who noticed physically active people. Conclusions This study did not find community-level increases in PA after the construction of the exercise facility. However, a significant improvement in the awareness of PA facilities was observed in the intervention site. A sustained community-level effort to promote PA, possibly including social components, and a further tracking of residents’ PA are needed to take a full advantage of the new exercise facility and to assess its long-term impact. Trial registration UMIN-CTR UMIN000034116 (retrospectively registered: 13 September 2018)

Autonomous Decentralized Control of Traffic Signals that can Adapt to Changes in Traffic

A major challenge for traffic signal control is adapting to unpredictable changes in traffic. To address this issue, we propose an autonomous decentralized control scheme for traffic signals that is based on physics. More specifically, “virtual impulses” given by red signals or preceding cars, which are defined in a similar manner as the impulses generally used in physics, are calculated at each traffic signal by using an optimal velocity model, and traffic signals are switched to reduce these virtual impulses. We performed simulations under various traffic conditions, and the results showed that the proposed control scheme works adaptively and resiliently in response to each set of circumstances. Thus, the virtual impulse can be a key physical quantity for designing adaptive traffic systems

Exploring common control principles underlying versatile body−limb coordination in many-legged locomotion

The 11th International Symposium on Adaptive Motion of Animals and Machines. Kobe University, Japan. 2023-06-06/09. Adaptive Motion of Animals and Machines Organizing Committee.Poster Session P

Ultrasonographic evaluation of geniohyoid muscle mass in perioperative patients

Surgical invasion and postoperative disuse are known to promote systemic skeletal muscle atrophy; however, similar effects on the mass of the muscles of deglutition have yet to be confirmed. Our method of using ultrasonography to measure the area of the geniohyoid muscle (GM), to evaluate the mass of the muscles of deglutition, has been shown to have high reliability. In the present study, we measured the GM area before and after surgery in patients to investigate changes in their muscle mass. Parameters including GM area, quadriceps femoris muscle (QF) thickness, hand grip strength (HGS), and arm muscle circumference were measured preoperatively and at 7 and 14 days postoperatively in patients who underwent thoracotomy and laparotomy. Patient height, weight, and serum albumin (Alb) level were also obtained from medical charts. Comparison of each evaluation parameter between measurement time points demonstrated significant decreases in GM area, QF thickness, HGS, and Alb between preoperatively and both postoperative day (POD) 7 and POD 14. The patients were divided into good (n = 19) and poor (n = 12) postoperative oral intake groups for comparison of GM area. The percentage decrease in GM area was significantly greater in patients with poor oral intake. To our knowledge, this is the first study to demonstrate that muscle atrophy due to surgical invasion or disuse may occur in the muscles of deglutition, as in the limb muscles. The findings showed that muscle atrophy occurs in the early postoperative period and persists even at 2 weeks postoperatively. Furthermore, insufficient oral intake may promote disuse muscle atrophy

<原著>副腎腫瘤の臨床的検討

We reviewed the records of 13 patients with adrenal masses operated on over a ten-year period to clarify clinical characteristics of adrenal tumors. Tumors were found incidentally in seven of nine patients with primary adrenal tumors (78%); however, three of these seven patients (43%) proved to have shown symptoms related to adrenal hyperfunction when re-e、raluated. Other adrenal tumors (metastatic in three patients and inflammatory in one) were found without any symptoms referable to the tumors. In nine of 13 patients (69%), tumors were discovered by computerized tomography (CT). All patients with primary tumors have been gotten free of disease postoperatively. In contrast, although all three patients with metastatic adrenal tumors underwent resection of all known disease tissue, they died of the recurrence of malignancies within 10 months. This study suggests that a number of functional adrenal tumors are possibly left undiagnosed until found incidentally, and that CT is the most powerful tool to detect adrenal tumors. Our data did not support surgical intervention in cases of metastatic adrenal tumors.副腎腫瘤の臨床的特徴を明らかにするために過去10年間に当科で手術された13例を検討した. 原発性腫瘍9例中2例は臨床症状より原発性アルドステロン症を疑われ副腎腫瘍を発見されているが, 残りの7例(78%)は偶然腫瘍が発見された, いわゆる incidentaloma であった. しかしながら, retrospective にみるとこの7例中3例(43%)で副腎機能亢進によると考えられる症状を呈していた. 転移性腫瘍3例, histoplasma による肉芽腫1例は全て無症状であった. 13例中9例(69%)はCTにより, 2例は超音波, 1例は血管造影, 1例は scintigraphy によりそれぞれ病変を発見され, CT で副腎腫瘤を指摘できなかったのは1例のみであった. 13例中11例は経腹的に, 2例 は開胸開腹で手術されたが, 術後合併症は1例に創感染を認めたのみであった. 原発性腫瘍例は全例術後再発を認めていないが, 転移性腫瘍の3例は全例, 術後10ヶ月以内に再発死した. 以上の結果は機能性副腎腫瘍でも偶然発見されるまで診断されない場合が多いことを示唆しており, 臨床症状を注意深く検討し常に副腎腫瘍の可能性を考慮にいれることが肝要であると考えられる. また, 今回の結果より CT が副腎腫瘤の診断において重要な位置を占めるものと考えられた. なお, 転移性副腎腫瘍に対する手術療法は今回の検討ではそれを積極的に支持する結果は得られず, 今後さらに検討を要する問題と思われる

Assessment of chest movements in tetraplegic patients using a three-dimensional motion analysis system

We used optoelectronic plethysmography (OEP) to evaluate the effects of posture on chest and abdominal movements during respiration in patients with chronic-stage complete spinal cord injuries. The subjects were five cervical injury patients (male, C4-C8 injury, American Spinal Injury Association Impairment Scale grade A) and five healthy people matched to each of the cervical injury patients for age, height, and weight. The chest wall movement each of the subjects was recorded using OEP during six quiet breathing and three deep breathing periods in each of the following positions: supine, with the trunk elevated to 30°, and with the trunk elevated to 60°. Data on the chest wall volume and compartment volumes (upper thorax, lower thorax, abdomen) were then compared among the postures. During quiet breathing in the tetraplegic patients, the change in upper thorax volume was smaller at the end of inhalation than at the end of exhalation, presenting as a paradoxical breathing pattern. During deep breathing in the tetraplegic patients, abdominal volume accounted for a large portion of the change in total chest wall volume. Posture affected the recorded abdominal volume; volume was greatest in the supine position and decreased as the posture became more upright

<症例>胃癌手術 (脾摘術合併胃全摘術) 後の門脈血栓症の1例

A 48-year-old woman underwent total gastrectomy, splenectomy, and distal pancreatectomy with en bloc regional lymph node dissection for gastric carcinoma. Dull pain in the right upper quadrant and the back developed postoperatively. Contrast-enhanced computed tomography and ultrasonography disclosed portal vein thrombosis (PVT). Heparin and urokinase were given in conjunction with antbiotics. This treatment resulted in clinical improvement, but failed to achieve complete thrombolysis. Cavernous transformation of the portal system was confirmed. Although PVT after splenectomy has been reported mainly in patients with hematological disorders, our case suggests that splenectomy for en bloc node dissection in gastric carcinoma is a possible cause of PVT.門脈血栓症は肝硬変や肝癌の患者で時に認められる病態であるが, 術後の門脈血栓症は稀であり, そのほとんどが脾腫に対する脾摘術後に発生している. 我々は胃癌根治術に伴う脾摘術後に門脈血栓をきたした症例を経験したので報告する. 症例は48才の女性で, 胃体上部後壁を中心とする5型胃癌に対し, 胃全摘術, 脾摘術, 膵尾側切除術を行なった. 病変は組織学的には低分化腺癌, 深達度ss, No, Po, Ho の stage I b で, 摘出した脾重量は 150g であった. なお, 術前の出血凝固系検査には異常を認めなかった. 術後18日目より右上腹部から背部の鈍痛が出現し, 白血球数, CRP, 血清アルカリフォスファターゼ値も上昇してきた. 術後19日目の造影CTで, 門脈, 上腸間膜静脈がほとんど造影されず, 門脈から上腸間膜静脈におよぶ血栓形成が考えられた. 抗生剤の投与とともにただちにへパリンの持続静注とウロキナーゼ投与を併用したところ, 臨床症状や検査所見は軽快した. ただし, 血栓は完全に消失せず, その後の腹部血管造影では側副血行路としての肝十二指腸間膜内の静脈拡張, いわゆるcavernous transformation が認められた. へパリン, ウロキナーゼの投与からワーファリン内服に切り替え, 患者は術後66日目に退院した. 現在, 術後2年経過したが, 食道静脈瘤の出現や消化管出血などの門脈血栓, 門脈圧充亢進に起因すると思われる症状は認めていない. 我々の症例は, 進行胃癌根治術の際にしばしは合わせ行われる脾摘術後にも門脈血栓症の出現する可能性があることを示唆しており, そのような手術を受けた患者が術後原因不明の腹部症状や白血球増加を来たした時には門脈血栓症も疑い精査を進める必要があると考えられる

Investigation into the safety of driving by individuals with higher brain dysfunction

Dangerous driving by drivers with diseases or disabilities such as dementia, epilepsy, or higher brain dysfunction is viewed as a problem In Worldwide. Given that the majority of such cases of dangerous driving are caused by impairments to cognitive function resulting from these conditions, there is an urgent need to create systems to detect drivers with cognitive functional disability and develop criteria for safe resumption of driving. Because driving would understandably be extremely dangerous for people with higher brain dysfunction, particularly in cases of attention dysfunction, we first examined the correlation between the Clinical Assessment of Attention (CAT), a theoretical task offering an index of attention function, and the cathode ray tube (CRT) driving aptitude test. We then examined correlations between CRT total score and CRT sub-scores. Only the time required for the position Stroop test had a moderate correlation (r=-0.43, p<0.01) with CRT total score. Correlations between CRT total score and sub-scores relating to reaction speed showed a strong correlation. Other than reaction speed, items with significant moderate to strong correlations were also seen in the maintenance of moderate mental tension, attention distribution and situation processing skill. The present results show a correlation between CAT score and CRT total score, indicating that CRT total score places relative weights on speed of information processing and suppression of stereotypes, representing a very meaningful result