Balance of Autonomic Nervous Activity, Exercise, and Sleep Status in Older Adults : A Review of the Literature

While older people are frequently known to experience sleep disturbances, there are also many older people who have a good quality of sleep. However, little is known about the balance of autonomic nervous activity, exercise habits, and sleep status in healthy older adults. This study reviews the literature regarding balance of the autonomic nervous activity, exercise, and sleep in healthy older adults. Relevant articles were searched from electronic databases using the combination of the following keywords: “Autonomic nervous activity”, “sleep status”, “sleep”, “healthy older adults”, “aging”, “heart rate variability (HRV)” and “exercise”. Articles were included if they met inclusion criteria: (1) Published in English, (2) Article types: research and review articles, (3) Main outcome was related to the autonomic nervous activity, lifestyle, sleep, and/or healthy aging, and (4) Fully accessed. From 877 articles that were identified, 16 articles were included for review. Results showed that the autonomic nervous activity changes with increasing age, particularly a constant decline in cardiac vagal modulation due to the significant decrease in the nocturnal parasympathetic activity. In addition, the autonomic nervous activity was also related to sleep status and lifestyle, particularly the capability to exercise. In preparing older people toward a healthy aging, maintaining good sleep quality and exercise is suggested

Healthy Lifestyle, Autonomic Nervous System Activity, and Sleep Status for Healthy Aging

With the super-aging society, it is important to pay attention to the quality of life of older people so that they can face healthy aging. Lifestyle, particularly exercise, autonomic nervous system activities, and sleep status are factors that affect the quality of aging. This chapter explores how those three variables are related and what strategies can be employed to maintain and enhance these variables to prepare. (1) The combination of healthy lifestyles, adequate physical activity, healthy dietary patterns, moderate alcohol consumption, and nonsmoking were related to the risk of cardiovascular diseases. (2) For older people, being physically active is important to the improvement of their physical and mental functions and keeping them independent and mobile. The increasing HRV after exercise might be caused by increasing vagal tone and decreasing sympathetic activity. (3) To reach healthy aging, people should maintain the proper function of autonomic balance activities. This is important because slowing down the decline in sympathetic status might delay many geriatric complaints. (4) To achieve healthy aging, maintaining a healthy sleep is essential. Thus, the key to a lifestyle that facilitates healthy aging is a balance of regular physical exercise and adequate sleep, which mediates and is mediated by autonomic nervous system activity

Encounter of Pepper-CPGE

In Japan, humanoid robots has been introduced in the medical and elderly care environment. The application program of Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) made by Xing Company, Japan is a body-brain gymnastics recreation program for 40 minutes tailored to the elderly's functional level. It consists of moving, watching/healing, and playing. “Move the body” exercise and other active range of motion activities are done according to the music. Pepper-CPGE was introduced as a clinical trial at the Mifune hospital, beginning in May 2018. At the units where clinical trials are done, 80% of the patients are with mental illness diagnosis with decreased physical functions often moving by wheelchair only. When Pepper-CPGE was introduced, the following changes were observed : (1) communication between patients and nurses during rehabilitation care using Pepper-CPGE was increased ; (2) patients were interactive, engaged, and actively participated in the Care Prevention Gymnastic Exercises using Pepper-CPGE ; (3) patients had fun and enjoyed talking to Pepper-CPGE. Interventions using Pepper-CPGE appear to be an effective rehabilitation strategy to increase engagement and participation of elderly patients who require long-term care and rehabilitation

多職種連携による作業療法活動への積極的動機付け

Patients with mental health problems in long-term hospitalization have severe impairments and disabilities in their daily social life, thereby needing constant assistance. The purpose of this study was to clarify the relationships between the status of the improved duration of participation in occupational therapy activities through active motivation and interdisciplinary collaboration in enhancing mental health and severe physical functional level as evaluated by the Global Assessment of Function（GAF）score. Subjects were１７５hospitalized patients in psychiatric units at a Psychiatric hospital in Kagawa Prefecture. The duration of participation in the occupational therapy group activities was divided into Groups A-０‐５, B-６‐１０, C-１１‐１５, and D-１６‐２０times per month. The number of the occupational therapy group activities per month was ２０ times in August ２０１７ and ２１ times in March２０１８, respectively. The number of classified four group participants before and after were calculated by the chi-square test with adjusted residuals. Comparing the number of participants in the four groups before and after ７ months by the active motivation, the number of participants was significantly decreased in group C but was increased in group D（χ２ = ６．８２, p <.０５）. Findings show the number of participants was increased because of the active motivation by interdisciplinary collaboration and enhanced relations. However, the degree of GAF was not related to the duration of participation times. Moreover, it was clearly found that respect for individuality and patient’s will were critical motivational factors in effective patient participation

先天性血友病患者の移行期の実態

【Introduction】Congenital hemophilia is a category of hemorrhagic disease caused by a genetic defect in the production of coagulation factors. It is treated by administering regular coagulation factor injections on an ongoing basis. Hemophilia is a hereditary illness, often causing social and psychological problems as a result of the disease. To analyze the objective effects of hemophilia, we conducted a retrospective analysis in Tokushima University Hospital. 【Result】All ２３ cases were men between the ages of２０and７２. Hemophilia A was present in１７cases, and hemophilia B was present in six. Nineteen out of ２３ cases were severe, and the others were intermediate. Medical assessments were conducted at pediatrics in seven cases and hematology in １６ cases. Adoption of the self-injection technique was not realized in five cases. Seventeen cases were complicated by hemophilic arthropathy, seven with human immunodeficiency virus（HIV）, and １２ with hepatitis C virus. Eight participants were unemployed, and１７were unmarried. 【Discussion】 Many adult hemophilia patients still visit pediatrics in our hospital. Hemophilia in the period of growth between adolescence and young adulthood is often accompanied by life-altering events such as entering higher education, marriage, and work experience. Therefore, collaboration among professionals of multiple occupations, such as doctors, nurses, pharmacists, medical social workers, and clinical psychologists, is essential. Furthermore, there are many cases of HIV and hepatitis C virus infections complicating hemophilia study due to the stigma surrounding HIV-tainted blood. 【Conclusion】It is imperative that we establish a long-term, sustainable, and multi-disciplinary transitional care and medical support system for patients and their families

HIF2α-Sp1 interaction mediates a deacetylation-dependent FVII-gene activation under hypoxic conditions in ovarian cancer cells

Hypoxia-inducible factors (HIF)-1α and HIF2α are major transcription factors required for adaptive responses to hypoxia. HIFs form a complex with aryl hydrocarbon receptor nuclear translocator (ARNT) to bind to the regulatory regions of target genes. The acetylation of histones by histone acetyltransferases (HATs) is one of the epigenetic marks associated with active chromatin. Indeed, HIFs recruit p300 HAT to hypoxia response elements (HREs) within gene regulatory regions. Here, we report an unusual HIF-mediated transcriptional activation in ovarian clear cell carcinoma (CCC). While characterizing coagulation factor VII (FVII) gene induction during hypoxic conditions, we observed that the interaction of HIF2α with Sp1, but not with ARNT, could induce transcription of FVII in a HRE-independent manner. Unexpectedly, this gene activation is associated with histone deacetylation. We found that a class II HDAC, HDAC4, is recruited with HIF2α to the FVII promoter as a co-activator, while p300 HAT negatively regulated this process. Furthermore, this mechanism can be synergistically enhanced via a deacetylation-dependent pathway when cells are simultaneously exposed to hypoxic and serum-free conditions. These results suggest the presence of a stress-responsive transcription mediated by the HIF2α/Sp1/HDAC4 network and explain how CCC shed their procoagulant activity under hypoxia

HIV感染症およびAIDS患者の臨床的特徴

【Introduction】The survival rate in patients with HIV infection and acquired immunodeficiency syndrome （AIDS） has been improved dramatically due to the advances in anti-HIV drug therapy, while aging-associated complications become a critical issue. The incidence of sudden occurrence of AIDS without prior detection of HIV infection, so called “Ikinari AIDS”, still remains high. 【Objective】We retrospectively analyzed the incidence and clinical characteristics of HIV/AIDS patients in both Tokushima University Hospital and Tokushima Prefectural Central Hospital. 【Results】Eighty four patients （74 males and 10 females） with a median age of 39 years old （range 16 - 85） were enrolled. Thirty-four patients （40.5％） were diagnosed with “Ikinari AIDS” from 2001 to 2020. All 4 patients were diagnosed with “Ikinari AIDS” after 2020. AIDS-defining illnesses were diagnosed as follows ; pneumocystis pneumonia in 21 cases, CMV infection in 8 cases and candidiasis in 6 cases. All patients over 60 years old were suffered from AIDS. Other complications included syphilis in 17 cases, hepatitis B infection in 12 and herpes zoster in 7. 【Discussion/Conclusion】In Tokushima, the incidence rate of “Ikinari AIDS” appeared to be higher than that of national average. COVID - 19 pandemic hampered the public health care services of awareness-raising activity for HIV infection and telephone consultations about HIV, which may become more lease asymptomatic HIV patients without diagnosis. For early diagnosis of HIV/AIDS, it is becoming more important to share information to make early screening of HIV infection among medical staffs, such as medical doctors, dentists, nurses, pharmacists and MSWs

利き耳・非利き耳側への聴覚刺激が重心動揺に与える効果 足圧中心(COP)総軌跡長・矩形面積・外周面積に着目して

本研究は，利き耳・非利き耳側からの聴覚刺激が重心動揺に与える効果について検討した．被験者は健常若年者30名である．本研究は横断研究である．重心動揺の測定には重心動揺計を使用し，足圧中心（COP）総軌跡長・矩形面積・外周面積を抽出して比較検討した．研究条件は条件①：聴覚刺激無，条件②：利き耳側からの聴覚刺激，条件③：非利き耳側からの聴覚刺激である．結果，聴覚刺激無（条件①）と，利き耳側から聴覚刺激（条件②）では両群で有意な差を示さなかった．非利き耳側からの聴覚刺激（条件③）は，聴覚刺激無（条件①）と利き耳側から聴覚刺激（条件②）を比較したところ重心動揺が有意に減少していた．これにより，非利き耳側から入力された聴覚刺激は脳の側性化により対側半球の空間認知機能局在に情報が伝搬され，姿勢の調整に影響を与えていることが推察された．The purpose of this study was to examine the effect of auditory stimulation from dominant ear/nondominant ear on body sway. The subject were 30 healthy young people. This study was a Cross-Sectional study. The assessment of body sway was taken as the total length of Center of pressure（COP） displacements, Rectangular area, and Environmental area of COP using the stabilometer. Research Condition ①：Conditions that do not give auditory stimulation. Research Condition ②：Conditions of giving an auditory stimulus from the dominant ear side. Research Condition ③：Conditions for giving an auditory stimulus from the non-dominant ear side. As a result, Condition ① and Condition ② showed no significant difference in both groups. Condition ③ decreased significantly than Condition ① . Condition ③ also decreased significantly than condition ② . These results, auditory stimulation input from the non-dominant ear is sent to the cerebral hemisphere on the opposite side by laterality. From this, it is considered that the effect was given the body sway

電流計測原子間力顕微鏡による共役高分子薄膜のナノ電子物性の解明

京都大学0048新制・課程博士博士(工学)甲第20406号工博第4343号新制||工||1673(附属図書館)京都大学大学院工学研究科高分子化学専攻(主査)教授 大北 英生, 教授 辻井 敬亘, 教授 竹中 幹人学位規則第4条第1項該当Doctor of Philosophy (Engineering)Kyoto UniversityDGA