Preventive maintenance is a critical element of maintenance policies in a wide range of industries, including the power sector. To achieve reasonable and effective maintenance of nuclear power plants ...(NPPs), proper aging management is critical and should be optimized from both safety and economic perspectives. Thus, in this paper, we propose a maintenance-scheduling model based on an adaptive parallel particle swarm optimization (PSO) to minimize the total number of maintenance activities over the lifetime of an NPP while ensuring the reliability of safety-critical functions. The proposed model recognizes that effective maintenance activities differ depending on the cause of the latent failure. In addition, the applied PSO algorithm, which is based on the dynamic exchange of hyperparameters between adjacent swarms, allows us to optimize inertia factor and learning factors adaptively during the solution search process. The proposed model is verified by applying it to a representative case in which the best maintenance schedules for the components constituting a water injection function are produced.
Abstract
Sarcoidosis is a complex, polygenic, inflammatory granulomatous multi-organ disease of unknown cause. The granulomatous inflammation in sarcoidosis is driven by the interplay between T cells ...and macrophages. Extracellular vesicles (EVs) play important roles in intercellular communication. We subjected serum EVs, isolated by size exclusion chromatography, from seven patients with sarcoidosis and five control subjects to non-targeted proteomics analysis. Non-targeted, label-free proteomics analysis detected 2292 proteins in serum EVs; 42 proteins were up-regulated in patients with sarcoidosis relative to control subjects; and 324 proteins were down-regulated. The protein signature of EVs from patients with sarcoidosis reflected disease characteristics such as antigen presentation and immunological disease. Candidate biomarkers were further verified by targeted proteomics analysis (selected reaction monitoring) in 46 patients and 10 control subjects. Notably, CD14 and lipopolysaccharide-binding protein (LBP) were validated by targeted proteomics analysis. Up-regulation of these proteins was further confirmed by immunoblotting, and their expression was strongly increased in macrophages of lung granulomatous lesions. Consistent with these findings, CD14 levels were increased in lipopolysaccharide-stimulated macrophages during multinucleation, concomitant with increased levels of CD14 and LBP in EVs. The area under the curve values of CD14 and LBP were 0.81 and 0.84, respectively, and further increased to 0.98 in combination with angiotensin-converting enzyme and soluble interleukin-2 receptor. These findings suggest that CD14 and LBP in serum EVs, which are associated with granulomatous pathogenesis, can improve the diagnostic accuracy in patients with sarcoidosis.
Proteomics of extracellular vesicles reveals new sarcoidosis biomarkers
Graphical Abstract
Graphical Abstract
Maintenance and improvement of neuromuscular functions is crucial for everyone regardless of age. An easy way to assess neuromuscular properties without muscle contraction is useful especially for ...those who cannot perform strenuous muscular force production, such as older adults and patients with orthopedic or cognitive disorders. Bioelectrical impedance analysis (BIA) can assess body electrical properties e.g., phase angle (PhA) which is regarded as muscle quantity/quality index. The purpose of this study was to investigate associations of PhA with neuromuscular properties of the knee extensors in 55 young (
n
= 23) and older (
n
= 32) adults. The values of PhA of the right thigh and whole-body were determined with BIA at 50 kHz. The participants performed 4-s maximal voluntary isometric contraction (MVIC) to measure peak torque (PT
MVIC
), and 1-s brief MVIC to assess rate of torque development (RTD) over the time interval of 0–200 ms. As markers of physiological mechanisms of muscle force production, twitch contractile properties (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque) of the knee extensors obtained by femoral nerve electrical stimulation, and muscle activity assessed as root mean square values of electromyographic activity (EMG-RMS) during PT
MVIC
and RTD measurements were measured. Thigh and whole-body PhA significantly correlated with PT
MVIC
(
r
≥ 0.555,
p
< 0.001) and electrically evoked twitch parameters (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque; |
r
| ≥ 0.420,
p
≤ 0.001), but not RTD (
r
≤ 0.237,
p
≥ 0.081) or EMG-RMSs (|
r
| ≤ 0.214,
p
≥ 0.117). Stepwise multiple linear regression analysis revealed that thigh PhA was selected as a significant variable to predict PT
MVIC
but not RTD. Whole-body PhA was not selected as a significant variable to predict PT
MVIC
or RTD. In conclusion, both thigh and whole-body PhA can associate with maximal voluntary muscle strength of the knee extensors, and this association may be due to intrinsic contractile properties but not neural aspects. Regarding prediction of the knee extensor strength, thigh PhA is preferable as the predictor rather than whole-body PhA which is used as a widely acknowledged indicator of sarcopenia.
Abstract
Pachyvessels are pathologically dilated large choroidal vessels and are associated with the pathogenesis of several pachychoroid-related disorders, including central serous ...chorioretinopathy. We aimed to investigate the prevalence of and risk factors for pachyvessels in the Japanese population. We included 316 participants (aged ≥ 40 years) with normal right eyes. The presence of pachyvessels (vertical diameter > 300 µm, distance to the retinal pigment epithelium < 50 µm) was determined using 6 × 6 mm macular swept-source optical coherence tomography images, and associated risk factors were investigated. Subfoveal choroidal thickness was measured, and its associated risk factors investigated. The overall prevalence of pachychoroids was 9.5%. Regression analysis showed that a younger age, shorter axial length, male sex, and smoking were significantly associated with the presence of pachyvessels (
p
= 0.047; odds ratio OR 0.96 per year,
p
= 0.021; OR 0.61 per 1 mm,
p
= 0.012; OR 3.08 vs. female, and
p
= 0.011; OR 3.15 vs. non-smoker, respectively) and greater choroidal thickness (
p
< 0.001,
p
< 0.001,
p
< 0.003, and
p
< 0.017, respectively). The results were consistent with other research findings which showed that pachychoroid-related disorders such as central serous chorioretinopathy were associated with younger age, male sex, shorter axial length, and smoking. Smoking may be associated with choroidal circulatory disturbance in the Japanese population.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
We investigated the effect of an unsupervised, body mass- home-based resistance training program in older adults performed at either a fast or slow contractile speed on changes to muscle-power, ...-volume, -architecture, and fatigue resistance of the knee extensors.
Thirty-two male older adults (age 65–88 years) were separated into 1) fast-speed exercise (Fast-group), 2) slow-speed exercise (Slow-group), and 3) no exercise (Control-group) groups. Participants in the exercise groups performed 30–45 repetitions of knee-extension and sit-to-stand exercises 3 times a week for 8 weeks with different exercise speed between the groups. Before and after the intervention period, the following variables were measured: Isotonic power, isometric strength, twitch contractile properties, muscle-activity, -architecture, and -quality, neuromuscular fatigue resistance of the knee extensors, and thigh muscle volume.
Peak power was increased in both the Fast-group (+24 %, P < 0.01, d = 0.65) and Slow-group (+12 %, P < 0.05, d = 0.33) but not in the Control-group. Training increased pennation angle of the vastus lateralis in both the Fast-group (+8 %, P < 0.01, d = 0.42) and Slow-group (+8 %, P < 0.01, d = 0.42), while only the Fast-group showed increase in pennation angle of the rectus femoris (+12 %, P < 0.01, d = 0.64) and thigh muscle volume (+16 %, P < 0.01, d = 0.52). There was no time × group interaction effect for the other neuromuscular measures.
Unsupervised, body mass- and home-based resistance training performed at either fast or slow speeds can improve muscle power in older adults, while fast-speed exercise may be preferable over slow-speed owing to the relatively greater improvement of muscle-power, −volume, −architecture, and better time efficiency.
•Home- and body mass-based resistance training increased muscle power of older adults.•Home-based resistance training improved muscle power irrespective of exercise speed.•Home-based resistance training increased dynamic torque and pennation angle.•Home-based resistance training performed at fast speed increased muscle volume.•Fast-speed exercise may induce preferable changes in skeletal muscle of older adults.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This study investigated associations of fatigue resistance determined by an exercise-induced decrease in neuromuscular power with prefatigue neuromuscular strength and power of the knee extensors in ...31 older men (65-88 years). A fatigue task consisted of 50 consecutive maximal effort isotonic knee extensions (resistance: 20% of prefatigue isometric maximal voluntary contraction torque) over a 70° range of motion. The average of the peak power values calculated from the 46th to 50th contractions during the fatigue task was normalized to the prefatigue peak power value, which was defined as neuromuscular fatigue resistance. Neuromuscular fatigue resistance was negatively associated with prefatigue maximal power output (r = -.530) but not with prefatigue maximal voluntary contraction torque (r = -.252). This result highlights a trade-off between prefatigue maximal power output and neuromuscular fatigue resistance, implying that an improvement in maximal power output might have a negative impact on neuromuscular fatigue resistance.
Surgical management has a direct impact on the quality treatment of patients and the economic efficiency of hospitals. Surgeries are managed in hospitals according to the duration of surgery reported ...by the surgeons. Surgical management efficiency would improve if the duration could be predicted accurately. This study focuses on predicting the individual duration in surgical management. The data on 9567 surgical cases from the National Cancer Center Hospital Japan East illustrates hospital characteristics and forecasts the duration requirements using a machine learning algorithm. We obtain an adjusted coefficient of determination exceeding 0.7 and show the relationship between the hospital characteristics and duration in a case-mix classification framework. We also discuss the relationship between data characteristics and the prediction accuracy of machine learning. This study supports operating room managers when they predict surgical duration by machine learning in ascertaining data characteristics, understanding the prediction accuracy of machine learning, and predicting surgical duration more accurately.
•Relationship between data characteristics and duration prediction illustrates.•Surgical duration predicts using machine learning with case-mix classification.•Data from 9567 surgical cases performed at a Japanese hospital are used.•Model supports operating room managers in predicting surgical duration.•Managers can ascertain data characteristics and predict duration more accurately.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background. The biopsychosocial mechanism by which exercise leads to improvement in chronic low back pain (CLBP) remains unstudied. This prospective cohort study was performed to examine the ...effectiveness of exercise on pain, disability, and psychological status for CLBP. We also tested path analytic models in which changes in these variables were included. Methods. CLBP patients who visited the Interdisciplinary Pain Center of Keio University Hospital from July 2018 to April 2020 were included. The propensity score matching was performed between patients who underwent exercise (the exercise group) and those who did not (the control group). At the first visit and at the 3-month follow-up, pain (Numerical Rating Scale (NRS)), disability (Pain Disability Assessment Scale (PDAS)), and psychological status (Pain Self-Efficacy Questionnaire (PSEQ), and Pain Catastrophizing Scale (PCS)) were assessed. Changes in pain and disability at the follow-up were compared between the groups. The relationships between changes in pain, disability, and psychological variables were examined using Pearson’s correlation and mediation analysis. Results. A significantly larger decrease in the PDAS was observed in the exercise group (N = 49) than in the control (N = 49) (p<0.05). Increased PSEQ scores were significantly correlated with decreased NRS scores in both groups. In the exercise group, decreased PDAS fully mediated the relationship between increased PSEQ and decreased NRS (P<0.05). Conclusion. Exercise improved disability, and the improved disability by exercise mediated the effect of increased self-efficacy on pain relief in CLBP patients.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Chronic obstructive pulmonary disease (COPD) has been recently characterized as a disease of accelerated lung aging, but the mechanism remains unclear. Tetraspanins have emerged as key players in ...malignancy and inflammatory diseases. Here, we found that CD9/CD81 double knockout (DKO) mice with a COPD-like phenotype progressively developed a syndrome resembling human aging, including cataracts, hair loss, and atrophy of various organs, including thymus, muscle, and testis, resulting in shorter survival than wild-type (WT) mice. Consistent with this, DNA microarray analysis of DKO mouse lungs revealed differential expression of genes involved in cell death, inflammation, and the sirtuin-1 (SIRT1) pathway. Accordingly, expression of SIRT1 was reduced in DKO mouse lungs. Importantly, siRNA knockdown of CD9 and CD81 in lung epithelial cells additively decreased SIRT1 and Foxo3a expression, but reciprocally upregulated the expression of p21 and p53, leading to reduced cell proliferation and elevated apoptosis. Furthermore, deletion of these tetraspanins increased the expression of pro-inflammatory genes and IL-8. Hence, CD9 and CD81 might coordinately prevent senescence and inflammation, partly by maintaining SIRT1 expression. Altogether, CD9/CD81 DKO mice represent a novel model for both COPD and accelerated senescence.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Aim
Pneumonia is a common disease that is often fatal, particularly in older persons. Dysphagia is known to be closely associated with aspiration pneumonia, and hospitalized patients with aspiration ...pneumonia often have difficulty with oral intake. However, the relationship between acquisition of oral intake and detailed swallowing data has not been explored. The purpose of the present study was to examine the predictors, including videofluoroscopic swallowing evaluation, for achieving oral intake in older patients with aspiration pneumonia.
Methods
This study included older patients, aged ≥65 years, who were admitted to Kawasaki Municipal Hospital (Kawasaki, Japan) from April 2012 through March 2014 as a result of aspiration pneumonia. Factors likely related to oral intake, including swallowing, nutritional, metabolic, and functional status, pneumonia severity and comorbidities were extracted from the medical records. Multiple logistic regression analysis was carried out to identify independent predictors for acquisition of oral intake.
Results
A total of 160 patients were assigned to either the “oral intake” group (n = 104) or the “non‐oral intake” group (n = 56). Multiple regression analysis showed that a low penetration aspiration scale on videofluoroscopy using 3 mL of moderately thick liquid water with tilting 30–60°, high albumin values, short duration of non‐oral intake and a high Food Intake Level Scale score before admission were significantly associated with achievement of oral intake.
Conclusions
Aspiration on videofluoroscopy, swallowing status before admission, nutritional status and duration of non‐oral intake are important factors for acquiring oral intake. These results might be helpful for the management of older patients with aspiration pneumonia. Geriatr Gerontol Int 2018; 18: 1469–1473.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
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