Long-term Multidisciplinary Rehabilitation Efficacy in Older Patients After Traumatic Brain Injury: Assessed by the Functional Independence Measure

Instances of traumatic brain injury (TBI) in the elderly have been increasing along with the aging of popula-tions. In the present study, we examined the effect of aging on long-term multidisciplinary in-patient rehabili-tation efficacy after TBI. Sixty-three patients with physical and cognitive impairments after TBI were enrolled in this study. Patients were divided into 4 age groups (≤ 24, 25-44, 45-64, ≥ 65 years) and the clinical charac-teristics and rehabilitation efficacy of each age group were determined. Functional disability was evaluated using motor and cognitive Functional Independence Measure (FIM) scores. Rehabilitation efficacy was assessed by FIM gains during rehabilitation and compared among the groups. There were no statistically significant dif-ferences in motor and cognitive FIM gains among the age groups. However, cognitive FIM gain was limited in a subset of ≥ 65 patients, and initial cognitive measures could not predict cognitive FIM improvement. These results indicate that chronological age is insufficient to accurately predict rehabilitation efficacy in older TBI patients, and that such patients should be considered candidates for intensive rehabilitation programs based on these results. Accurate prognostication of rehabilitation efficacy with continuing data collection is important when using rehabilitation resources for older TBI patients

The incidence of diabetes among the non-diabetic residents in Kawauchi village, Fukushima, who experienced evacuation after the 2011 Fukushima Daiichi nuclear power plant disaster

OBJECTIVES: After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village. METHODS: Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: "Diabetes (DM)" (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5% or hospital visit for DM or usage of diabetic medication), "Borderline DM" (126 mg/dL > FBG ≥ 110 mg/dL or 6.5% > HbA1c ≥ 6.0%, and without hospital visit, and without diabetic medication), and "Normoglycemic" (FBG < 110 mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9 years in Kawauchi village and 3.6 years in Ono town. RESULTS: Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village. CONCLUSIONS: The current results confirmed that diabetes incidence was increased 6 years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority

Free Amino Acids and Related Compounds in the Fluid from Surgical Ciliated Cysts of the Maxilla

Fluids from 6 surgical ciliated cysts of the maxilla and autologous sera were analyzed for total free amino acids and related compounds concentrations. All of the amino acids present in the serum were observed in the cyst fluids, but the concentrations and profile of their constituents were markedly different from that of the serum. The concentrations of non-essential amino acids such as Ala, Glx, and Gly were extremely low in the cyst fluids. The composition and concentration of the amino acids and related compounds in the fluids of these cysts may reflect the balance between proteolytic and catabolic metabolism and also in the permeability effect of the lining cells of the cyst wall

Naked Singularity and Thunderbolt

We consider quantum theoretical effects of the sudden change of the boundary conditions which mimics the occurrence of naked singularities. For a simple demonstration, we study a massless scalar field in $(1 + 1)$-dimensional Minkowski spacetime with finite spatial interval. We calculate the vacuum expectation value of the energy-momentum tensor and explicitly show that singular wave or {\em thunderbolt} appears along the Cauchy horizon. The thunderbolt possibly destroys the Cauchy horizon if its backreaction on the geometry is taken into account, leading to quantum restoration of the global hyperbolicity. The result of the present work may also apply to the situation that a closed string freely oscillating is traveling to a brane and changes itself to an open string pinned-down by the ends satisfying the Dirichlet boundary conditions on the brane.Comment: 12 pages, 1 figure, references added, to appear in Phys. Rev.

カスケード型超並列シミュレーションによるタンパク質構造遷移のパスウェイ探索

要旨あり生体高分子の揺らぎとダイナミクス－シミュレーションと実験の統計解析－研究詳