Changes in the physical functions of pre-frail elderly women after participation in a 1-year preventative exercise program

Aim: The present study clarifies the effects of participation in a preventative health classroom program (exercise program) for 1 year on the physical functions of pre-frail elderly individuals in comparison with healthy elderly individuals. Methods: Participants in the study included 28 elderly pre-frail female participants and 28 elderly healthy female participants. Participants engaged in the exercise program for 1 year. There was no significant age or physical differences between both groups. Before and after the exercise program, the following physical function tests were carried out: grip strength, one-legged balance with eyes open, 5-m walking time and a timed up & go (TUG). Results: The pre-frail elderly group tested significantly lower in the one-legged balance with eyes open test and the TUG test compared with the healthy elderly group. The 5-m walking time test improved significantly in both groups, but the TUG improved only in the pre-frail elderly group. Conversely, the grip strength and one-legged balance with eyes open tests remained unchanged. Conclusion: Improvements in the TUG and 5-m walking time tests were found in the pre-frail elderly group after the 1-year exercise program. Their results in the TUG test might be greater than those among the healthy elderly individuals. © 2013 Japan Geriatrics Society

Progressing subglottic and tracheobronchial stenosis in a patient with CHARGE syndrome diagnosed in adulthood

AbstractA 33-year-old woman was admitted for a pseudocroup-like cough and wheezing after general anesthesia. Several months ago, she had undergone cardiac re-operation and turbinectomy, both of which had involved difficult intubations. Bronchoscopy indicated a pin-hall-like subglottic stenosis; therefore, emergency tracheotomy was performed. Six years later, a computed tomography scan demonstrated progressive stenosis of the entire circumference of the trachea and main bronchi. She died at 40 years. Her autopsy revealed marked tracheobronchial stenosis. She had many medical histories that had gone undiagnosed and had been clinically ill with only heart defects. She did not have coloboma but had microphthalmos, atresia choanae, retarded growth development, and deafness; thus, we diagnosed CHARGE syndrome that refers to multiple congenital anomalies, including airway abnormalities, which can lead to secondary complications such as traumatic stenosis after intubation. Physicians should have knowledge of this rare disease and should pay special attention to potential airway problems

International Journal of Smart Grid and Clean Energy Generator output and static capacitor control considering voltage stability for large penetration of photovoltaic power

Abstract In Japan, the introduction of large capacity of clean energy such as PV (photovoltaic power generation) is planned to reduce environmental burdens. The Japanese government has set the target of 53 GW of PV by 2030. However, large penetration of PV will cause several problems in power systems. One of these problems is that voltage values increase with the amount of PV penetration. Thus, we focus our attention on the upper voltage limit for a large penetration of PV in terms of voltage stability. In this paper, we consider a smart generator output and static capacitor control for the large penetration of PV. For the generator output control we propose to use the optimal power flow in terms of minimizing bus voltage deviations from the prescribed values. Simulations are run using the IEEJ WEST 10-machine O/V system model to confirm the validity of the proposed method

International Journal of Smart Grid and Clean Energy Generator output and static capacitor control considering voltage stability for large penetration of photovoltaic power

Abstract Keywords: Voltage stability, VMPI, generator output control, static capacitor control, photovoltaic powe

Translation, reliability, and validity of Japanese version of the Respiratory Distress Observation Scale

Dyspnea is a common, distressing symptom of cardiopulmonary and neuromuscular diseases and is defined as “a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity.” However, Japanese intensive care units (ICUs) do not routinely screen for dyspnea, as no validated Japanese version of the Respiratory Distress Observation Scale (RDOS) is available. Therefore, we aimed to translate the English version of this questionnaire into Japanese and assess its validity and reliability. To translate the RDOS, we conducted a prospective observational study in a 12-bed ICU of a universal hospital that included 42 healthcare professionals, 10 expert panels, and 128 ventilated patients. The English version was translated into Japanese, and several cross-sectional web-based questionnaires were administered to the healthcare professionals. After completing the translation process, a validity and reliability evaluation was performed in the ventilated patients. Inter-rater reliability was evaluated using Cohen’s weighted kappa coefficient. Criterion validity was ascertained based on the correlation between RDOS and the dyspnea visual analog scale. The area under the receiver operating characteristic curve analysis was used to evaluate the ability of the RDOS to identify patients with self-reported dyspnea. The average content validity index at the scale level was 0.95. Data from the 128 patients were collected and analyzed. Cohen’s weighted kappa coefficient and the correlation coefficient between the two scales were 0.76 and 0.443 (95% confidence intervals 0.70–0.82 and 0.23–0.62), respectively. For predicting self-reported dyspnea, the area under the receiver operating characteristic curve was 0.81 (95% confidence interval 0.67–0.97). The optimal cutoff used was 1, with a sensitivity and specificity of 0.89 and 0.61, respectively. Our findings indicated that the Japanese version of the RDOS is acceptable for face validity, understandability, criterion validity, and inter-rater reliability in lightly sedated mechanically ventilated patients, indicating its clinical utility