The semiquantitative Clinical Frailty Scale (CFS) is a simple tool to assess patients' frailty and has been shown to correlate with mortality in elderly patients even when evaluated by ...nongeriatricians. The aim of the current study was to determine the prognostic value of CFS in patients who underwent transcatheter aortic valve replacement.
We utilized the OCEAN (Optimized Catheter Valvular Intervention) Japanese multicenter registry to review data of 1215 patients who underwent transcatheter aortic valve replacement. Patients were categorized into 5 groups based on the CFS stages: CFS 1-3, CFS 4, CFS 5, CFS 6, and CFS ≥7. We subsequently evaluated the relationship between CFS grading and other indicators of frailty, including body mass index, serum albumin, gait speed, and mean hand grip. We also assessed differences in baseline characteristics, procedural outcomes, and early and midterm mortality among the 5 groups.
Patient distribution into the 5 CFS groups was as follows: 38.0% (CFS 1-3), 32.9% (CFS4), 15.1% (CFS 5), 10.0% (CFS 6), and 4.0% (CFS ≥7). The CFS grade showed significant correlation with body mass index (Spearman's ρ=-0.077,
=0.007), albumin (ρ=-0.22,
<0.001), gait speed (ρ=-0.28,
<0.001), and grip strength (ρ=-0.26,
<0.001). Cumulative 1-year mortality increased with increasing CFS stage (7.2%, 8.6%. 15.7%, 16.9%, 44.1%,
<0.001). In a Cox regression multivariate analysis, the CFS (per 1 category increase) was an independent predictive factor of increased late cumulative mortality risk (hazard ratio, 1.28; 95% confidence interval, 1.10-1.49;
<0.001).
In addition to reflecting the degree of frailty, the CFS was a useful marker for predicting late mortality in an elderly transcatheter aortic valve replacement cohort.
We investigate the electronic states of organic semiconductors with herringbone structures using the multi-orbital tight-binding model for highest and second highest occupied molecular orbitals ...(HOMOs and SHOMOs) to elucidate the effect of SHOMOs on the valence-band state. We diagonalize the Hamiltonian analytically and derive the valence band width considering hybridization of HOMO and SHOMO. It is shown that the SHOMO effect is enhanced in the condition where the sum of the intermolecular transfer integrals of HOMO-SHOMO in the sublattice and the sum between the sublattices is respectively so large that their product is not negligible compared to the energy difference between HOMO and SHOMO. We also investigate acene, phenacene and thienoacene using density functional theory. It is shown that 1benzothieno3,2-b1benzothiophene(BTBT) based materials satisfy this condition, and SHOMO contributes significantly. It implies that the origins of the high-mobility of BTBT based materials can be ascribed to the light effective mass due to the contribution of SHOMO.
This paper presents details of a third-order accurate and unconditionally stable time-discontinuous Galerkin Space-Time Finite Element Method (ST/FEM) for solving solid-dynamics and earthquake ...engineering problems. This method is derived by employing the newly developed concept of displacement functions for satisfying the displacement-velocity relationships. The proposed method, which is designated as LC v-ST/FEM, is derived from the linear combination of displacement functions of single-field and two-field ST/FEMs. Consequently, LC v-ST/FEM has a user-defined parameter 0 ≤ α ≤1, which is introduced for controlling the high-frequency dissipation characteristics. From numerical analysis and solutions of benchmark problems, it is demonstrated that the proposed method is the third-order accurate in time, unconditionally stable, and contains negligible numerical dispersion error for all 0 ≤ α≤1. Moreover, for α ≠ 0, the method can attenuate the spurious high-frequency components from the velocity and displacement fields.
The rheological properties and processability at injection molding were studied for bisphenol-A polycarbonate (PC) that was modified by low-density polyethylene (LDPE) having a low shear viscosity. ...The LDPE addition significantly decreased the steady-state shear viscosity, especially in the high shear rate region. The decrease did not originate from slippage on the die wall but due to interfacial slippage between the PC and dispersed LDPE droplets that deformed to the flow direction to a great extent. As a result of the viscosity decrease, injection pressure largely decreased from 150 to 110 MPa with the addition only 5 wt.% of LDPE. The enhanced flowability also reduced the warpage of the molded product significantly, demonstrating that the processability at injection molding was improved by the addition of LDPE.
This study describes the development of a body-powered upper-limb prosthesis for children with congenital digit defects that realizes pinching motions using their own residual digits and joints. ...Existing digit prostheses assume that the thumb remains intact. If there is no thumb, a conventional upper-limb prosthesis cannot sufficiently restore grasping function. The developed body-powered upper-limb prosthesis was designed to mechanically convert the flexion and rotation power of the residual digits into the power of the opposing prosthetic digit. This conversion enabled the reconstruction of opposing pinching motions at the fingertip. Consequently, this design enhanced the function of the residual digit in the absence of the thumb. In this study, we developed a body-powered upper-limb prosthesis applicable to a single residual digit or two parallel digits. The digit prosthesis, which includes the thumb, was designed to synchronize its movement with the motion of the metacarpophalangeal (MP) joint of the residual digit. The prosthesis joints enable two degree-of-freedom (DOF) motions: flexion/extension and adduction/abduction. The digit opposing the thumb can be selected through this joint by the adduction and abduction rotation movements of the residual digit. The mechanism performance was evaluated using tensile tests, which confirmed that the force applied to the residual digit was linearly transmitted and exerted as a pinch force on the prosthesis. This feature allows for a more intuitive use by the user. The evaluation of its application in children with congenital digit defects revealed that expanding the palm allows the user to throw and catch a ball and use scissors in daily life.
In addition to traditional clinical research, advances in information communication technologies facilitates new medical research using internet of things devices and other cutting-edge technologies. ...Such medical research also simplifies the collection of data on research subjects in their daily lives internationally. In this context, medical research is increasingly required to comply with rules protecting patients' personal data. This study proposes a model to enable researchers and other stakeholders including ethics committees in such international medical research to easily verify whether the planned processing of patient data complies with relevant legal and ethical rules. The model proposed in this study consists of (1) how patient information is processed, (2) the rules that are relevant to the processing, and (3) the analysis of whether the processing complies with the rules. This study suggests that the model should describe the aspects of data processing that are subject to many rules, such as the location of the processing, categories of data, purposes of the processing, and the storage period. Thus, using the information described in the model as a guide, stakeholders can determine which national and international legal/ethical rules apply to the planned processing. Then, they can use the model to verify and document whether the processing complies with the specific regulatory rules. The use of the model in this study enables stakeholders in medical research to comply with the rules related to patient data more effectively than without using the model.
Tangeretin and nobiletin are polymethoxylated flavonoids in citrus peel. Both tangeretin and nobiletin are bitter; however, their bitterness has not been evaluated using human bitter taste receptors ...(hTAS2Rs). We screened 25 kinds of hTAS2Rs and found that hTAS2R14 and hTAS2R46 received both compounds.
The usability of a prosthetic hand differs significantly from that of a real hand. Moreover, the complexity of manipulation increases as the number of degrees of freedom to be controlled increases, ...making manipulation with biological signals extremely difficult. To overcome this problem, users need to select a grasping posture that is adaptive to the object and a stable grasping method that prevents the object from falling. In previous studies, these have been left to the operating skills of the user, which is extremely difficult to achieve. In this study, we demonstrate how stable and adaptive grasping can be achieved according to the object regardless of the user’s operation technique. The required grasping technique is achieved by determining the correlation between the motor output and each sensor through the interaction between the prosthetic hand and the surrounding stimuli, such as myoelectricity, sense of touch, and grasping objects. The agents of the 16-DOF robot hand were trained with the myoelectric signals of six participants, including one child with a congenital forearm deficiency. Consequently, each agent could open and close the hand in response to the myoelectric stimuli and could accomplish the object pickup task. For the tasks, the agents successfully identified grasping patterns suitable for practical and stable positioning of the objects. In addition, the agents were able to pick up the object in a similar posture regardless of the participant, suggesting that the hand was optimized by evolutionary computation to a posture that prevents the object from being dropped.
Recent studies have suggested that the clinical features of elderly-onset adult-onset Still's disease (AOSD) differ from those of young and middle-aged-onset patients, whereas the details remain ...unclear, and cytokine profiles of elderly-onset AOSD have not been reported. To clarify the clinical features and cytokine profiles of elderly-onset AOSD, we examined patients with AOSD who developed the disease between January 2006 and September 2021. We divided the patients into the young and middle-aged-onset group (aged < 65 years) and the elderly-onset group (aged ≥ 65 years) and compared the groups in terms of patient characteristics, clinical symptoms, laboratory findings including serum interleukin (IL)-6 and IL-18, treatment, and prognosis. A total of 48 patients were examined (10 in the elderly-onset group). In the elderly-onset group, atypical rash was significantly more frequent, typical rash and splenomegaly were significantly less frequent, white blood cell count and neutrophil ratio were significantly higher and serum IL-6 levels were significantly lower. Serum IL-6 showed a significantly negative correlation with age at onset. Treatment and relapse were comparable between the 2 groups, whereas infections were significantly more frequent in the elderly-onset group. The clinical features and cytokine profiles of elderly-onset AOSD might differ from those of young and middle-aged-onset AOSD.
The optimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism.
A 47-year-old male presented with weakness in his ...left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery.
When a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.
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