Determination of the reference value and systematic bias of the functional reach test in Japanese elderly people by meta-analysis

AbstractBackground/PurposeThe functional reach test (FRT), which was developed as a clinical balance assessment tool, has been widely used as a fall risk assessment tool in elderly people. The aim of the present study was to investigate the reference value and the presence of systematic bias in the FRT using the methodology of meta-analysis in community-dwelling elderly people.MethodsRelevant research articles were sought from electronic databases: MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Igakucyuouzasshi. The search was conducted from January 1990 to August 2011, and the terms “functional reach” and “elderly” were used in combination in the search. The searches were limited to peer-reviewed research articles involving Japanese elderly people with good functioning, aged 60 years and older. Weighted means were calculated for the reference value of FRT by a fixed effect model and a random effect model. Furthermore, weighted least squares regression was performed to determine the presence of systematic bias in the reference value of FRT.ResultsA total of 19 articles fulfilled the inclusion criteria, including 4274 participants whose mean age ranged from 69.0 to 81.4 years. The reference value of FRT was 29.44 cm (95% confidence interval: 27.60–31.27 cm) using the random-effect model, since the reference value using the fixed-effect model was found to have significant heterogeneity. Furthermore, multivariate weighted least squares regression was performed, and sex, age, height, and measurement method (one-arm or two-arm reach) were all independently associated with the FRT value (multiple R2 = 0.295, χ2 = 76.6, p < 0.001).ConclusionsSince participants' characteristics (sex, age, and height) and measurement method are probably related to systematic error in the FRT, judgment of physical function in elderly people using only the reference value determined in this study may have limitations

Quality and safety issues related to traditional animal medicine: role of taurine

<p>Abstract</p> <p>Background</p> <p><it>Calculus Bovis</it> (:<it>C.Bovis</it>) is one of the most precious and commonly-used medicinal materials in Japan and China. As the natural occurrence is very rare, a source of supply for <it>C. Bovis</it> is far behind the actual need and great efforts have been taken for some substitutes of natural <it>C. Bovis</it>. Unfortunately, very little information is available on the quality and/or clinical efficacy of medication based on <it>C. Bovis</it>. To ensure sustainable use of traditional therapeutic agents derived from <it>C. Bovis</it>, we felt that several issues needed to be addressed: 1) the source of the <it>C. Bovis</it> materials and quality control; 2) the role of taurine in the efficacy of <it>C. Bovis</it>.</p> <p>Methods</p> <p>Nine samples of natural <it>C. Bovis</it> and its substitutes were collected. ICP-MS was used for elemental analysis and the characterization was performed by principal component analysis (PCA) and soft independent modeling of class analogy (SIMCA) as multivariate approaches. The efficacy of <it>C. Bovis</it> was evaluated for morphology, viability and beating pattern on cultured cardiac myocytes and/or fibroblasts.</p> <p>Results</p> <p>PCA and multi-elemental focus was effective in discriminating <it>C. Bovis</it> samples derived from different habitats. A satisfactory classification using SIMCA was obtained among Australia <it>C. Bovis</it>, other habitats and the substitutes. Australian samples had better batch uniformity than other habitats and were composed of fewer elements. We have used Australian<it> C. Bovis</it> for assessment on its bioactive compounds. Rat cardiac cells incubated with <it>C. Bovis</it> extract (0.01-0.1mg/ml) maintained normal morphology, viability and beating pattern. Cardiac myocytes and fibroblasts treated for 48 h with CA (0.5mM) or DCA (0.1mM) caused cell injury, as reflected by changes in appearance and a reduction of viability detected by the MTS assay. In cardiomyocytes, 0.5 h exposure of CA (0.5mM) markedly decreased the velocity ratio of beating, whereas the simultaneous addition of 1 mM taurine largely prevented the decrease.</p> <p>Conclusions</p> <p>The multi-elemental focus provided some references for the quality control and the efficacy of <it>C. Bovis</it>. Taurine partly attenuated the harmful actions of bile acids. It is plausible that the relationship between taurine and the bile acids contributes to therapeutic effect of <it>C. Bovis</it>.</p

QOL and self-efficacy of patients with chronic hepatitis C for three months after interferon therapy began

本研究は,Interferon 治療過程におけるC型慢性肝炎患者のQOL 及びSelf-efficacy の変化と相互の関連性を,治療開始後3ヶ月までの期間において探求することを目的に行った.C型慢性肝炎患者45人を対象に,自記式質問紙調査法により,入院時と治療開始後1ヶ月,3ヶ月の3回にわたる縦断的調査を実施した.その結果,以下のことが明らかになった.1.QOL は,治療開始後1ヶ月以内に低下し,3ヶ月まで低値のまま推移し,副作用の影響を受けていた.2.Self-efficacy は,治療中の変化は見られず,副作用の影響を受けていなかった.3.QOL 下位尺度である心の健康,活力,社会生活機能と,Self-efficacy の間に,正の相関を認めた.今後は支援検討に向けて,疾患特異的なSelf-efficacy やQOL 尺度を開発し,それらを用いてQOL とSelf-efficacyの関連性を確認する必要があろう.The purpose of this study was to investigate changes in the quality of life (QOL) and the self-efficacyof patients with chronic hepatitis C during the interferon treatment process, and mutual relevance,forthree months after the medical treatment began. The subjects were 45 patients with chronic hepatitis C,who answered a total of 3 surveys conducted at the time of hospitalization, one month after medicaltreatment began, and three months after using a questionnaire. As a result, the following conclusions weremade:1. QOL declined for one month after medical treatment began, and maintained a low value for threemonths. QOL was influenced by side effects.2. Self-efficacy did not change during the medical treatment. Self-efficacy was not influenced by sideeffects.3. In the relation of QOL and self-efficacy, a positive correlation between scales of QOL (such as mentalhealth, vitality, and social functioning) and self-efficacy was observed.For the support examination in the future,it is necessary to develop a self-efficacy and QOL standardrelation to hepatitis C disease,and the relationship between QOL and self-efficacy that uses a properoutcome measure is likely to be confirmed

Reduction of total E2F/DP activity induces senescence-like cell cycle arrest in cancer cells lacking functional pRB and p53

E2F/DP complexes were originally identified as potent transcriptional activators required for cell proliferation. However, recent studies revised this notion by showing that inactivation of total E2F/DP activity by dominant-negative forms of E2F or DP does not prevent cellular proliferation, but rather abolishes tumor suppression pathways, such as cellular senescence. These observations suggest that blockage of total E2F/DP activity may increase the risk of cancer. Here, we provide evidence that depletion of DP by RNA interference, but not overexpression of dominant-negative form of E2F, efficiently reduces endogenous E2F/DP activity in human primary cells. Reduction of total E2F/DP activity results in a dramatic decrease in expression of many E2F target genes and causes a senescence-like cell cycle arrest. Importantly, similar results were observed in human cancer cells lacking functional p53 and pRB family proteins. These findings reveal that E2F/DP activity is indeed essential for cell proliferation and its reduction immediately provokes a senescence-like cell cycle arrest

高齢者における発酵L 型乳酸カルシウム（CV カルシューム）摂取の効果についての研究

This study added fermentation calcium L-lactate（ CV calcium） in an everyday meal for resident of nursing home for the elderly in the long term and evaluated calcaneus by osteo-sono assessment index and we examined the effectiveness of the ingestion fermentation calcium L-lactate（ CV calcium）. We were not able to obtain a result indicating the effectiveness of the ingestion of fermentation calcium L-lactate（ CV calcium）, because a change was not seen in a result of the bone density measurement. However, it may be suggested that fermentation calcium L-lactate（ CV calcium） is effective to easily take in calcium. The because it is easy to cook to have high water solubility and the taste of the meal does not change

Assessment of the Efficacy of ReoGo-J Robotic Training Against Other Rehabilitation Therapies for Upper-Limb Hemiplegia After Stroke: Protocol for a Randomized Controlled Trial

Background: Stroke patients experience chronic hemiparesis in their upper extremities leaving negative effects on quality of life. Robotic therapy is one method to recover arm function, but its research is still in its infancy. Research questions of this study is to investigate how to maximize the benefit of robotic therapy using ReoGo-J for arm hemiplegia in chronic stroke patients.Methods: Design of this study is a multi-center parallel group trial following the prospective, randomized, open-label, blinded endpoint (PROBE) study model. Participants and setting will be 120 chronic stroke patients (over 6 months post-stroke) will be randomly allocated to three different rehabilitation protocols. In this study, the control group will receive 20 min of standard rehabilitation (conventional occupational therapy) and 40 min of self-training (i.e., sanding, placing and stretching). The robotic therapy group will receive 20 min of standard rehabilitation and 40 min of robotic therapy using ReoGo®-J device. The combined therapy group will receive 40 min of robotic therapy and 20 min of constraint-induced movement therapy (protocol to improve upper-limb use in ADL suggests). This study employs the Fugl-Meyer Assessment upper-limb score (primary outcome), other arm function measures and the Stroke Impact Scale score will be measured at baseline, 5 and 10 weeks of the treatment phase. In analysis of this study, we use the mixed effects model for repeated measures to compare changes in outcomes between groups at 5 and 10 Weeks. The registration number of this study is UMIN000022509.Conclusions: This study is a feasible, multi-site randomized controlled trial to examine our hypothesis that combined training protocol could maximize the benefit of robotic therapy and best effective therapeutic strategy for patients with upper-limb hemiparesis

Prediction Model of Amyotrophic Lateral Sclerosis by Deep Learning with Patient Induced Pluripotent Stem Cells

Deep LearningとALS iPS細胞を用いた疾患予測テクノロジー --人工知能のALS検知・診断への応用--. 京都大学プレスリリース. 2021-02-24.Deep learning amyotrophic lateral sclerosis by taking pictures. 京都大学プレスリリース. 2021-02-24.In amyotrophic lateral sclerosis (ALS), early diagnosis is essential for both current and potential treatments. To find a supportive approach for the diagnosis, we constructed an artificial intelligence‐based prediction model of ALS using induced pluripotent stem cells (iPSCs). Images of spinal motor neurons derived from healthy control subject and ALS patient iPSCs were analyzed by a convolutional neural network, and the algorithm achieved an area under the curve of 0.97 for classifying healthy control and ALS. This prediction model by deep learning algorithm with iPSC technology could support the diagnosis and may provide proactive treatment of ALS through future prospective research. ANN NEUROL 202

Deep Learning and ALS

In amyotrophic lateral sclerosis (ALS), early diagnosis is essential for both current and potential treatments. To find a supportive approach for the diagnosis, we constructed an artificial intelligence-based prediction model of ALS using induced pluripotent stem cells (iPSCs). Images of spinal motor neurons derived from healthy control subject and ALS patient iPSCs were analyzed by a convolutional neural network, and the algorithm achieved an area under the curve of 0.97 for classifying healthy control and ALS. This prediction model by deep learning algorithm with iPSC technology could support the diagnosis and may provide proactive treatment of ALS through future prospective research

An experiential observational study of graduates from the Japanese six year programme

OBJECTIVE: To provide an initial experiential competency assessment of the first wave of graduates from the reformed Japanese six-year pharmacy initial education programme. METHODS: The authors evaluated observed competencies of recently qualified pharmacists who graduated from the pharmacy six-year programme (6-YP pharmacists) from the perspective of experienced pharmacists from the previous national four-year initial education and training programme. A web-based survey of working pharmacists who had graduated from the previous pharmacy four-year programme (4-YP) was conducted, targeting 200 pharmacists (100 hospital pharmacists and 100 community pharmacists). Inclusion criteria specified working with, and having experience of, qualified 6-YP pharmacists. These recruits provided an observational evaluation of itemised competencies for the first wave of 6-YP pharmacists in workplace environments. This methodology was designed to overcome the logistical challenges of objective structured performance-related evaluation of practice competency. RESULTS: The 4-YP community pharmacists gave a significantly higher overall perceived competency assessment of the 6-YP pharmacists than did hospital pharmacists (p<0.05 U-test). In the competency assessment analysis, the improvements of competencies considered to be a priority for 6-YP community-based pharmacists were “medication therapy management” and “education and training competencies”, while the priority improvement competencies of 6- YP hospital-based pharmacists were considered to be “professionalism”, “inter-professional collaboration”, “medication therapy management”, “community health and medical care”, and “lifelong learning”. CONCLUSION: This research suggests that curriculum improvement should continue to be reviewed together with efforts to better foster these competencies in initial education and training. Methods to continuously evaluate and improve the lower assessed competencies need to be introduced together with post-registration continued training, preferably using validated competency development frameworks in the near future