Purpose The purpose of this study is to clarify the relationship between work performance and health‐related quality of life of the elderly living in the community.Subjects and Methods The subjects ...were 101(12 males and 89 females) who participated in the primary prevention project.The survey items were age， gender， OSA‐SF， MoCA‐J， and SF‐8 (body area / mental area). Results Physical health‐related QOL was associated with "exercising one's abilities well"， and mental health‐related QOL was associated with "jumping toward a goal". Conclusion For care prevention， it is important to provide support that encourages people to demonstrate their abilities and goals.
Objective
To validate whether the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria of macrophage activation syndrome (MAS) complicating systemic ...juvenile idiopathic arthritis (JIA) is practical in the real world.
Methods
A combination of expert consensus and analysis of real patient data was conducted by a panel of 15 pediatric rheumatologists. A total of 65 profiles comprised 18 patients with systemic JIA–associated MAS and 47 patients with active systemic JIA without evidence of MAS. From these profiles, 10 patient data points for full‐blown MAS, 11 patient data points for MAS onset, and 47 patient data points for acute systemic JIA without MAS were evaluated.
Results
Evaluation of the classification criteria to discriminate full‐blown MAS from acute systemic JIA without MAS showed a sensitivity of 1.000 and specificity of 1.000 at the time of full‐blown MAS. Sensitivity was 0.636 and specificity was 1.000 at the time of MAS onset. The number of measurement items that fulfilled the criteria increased in full‐blown MAS compared to that at MAS onset. At MAS onset, the positive rates of patients who met the criteria for platelet counts and triglycerides were low, whereas those for aspartate aminotransferase were relatively high. At full‐blown MAS, the number of patients who met the criteria for each measurement item increased.
Conclusion
The classification criteria for MAS complicating systemic JIA had a very high diagnostic performance. However, the diagnostic sensitivity for MAS onset was relatively low. For the early diagnosis of MAS in systemic JIA, the dynamics of laboratory values during the course of MAS should be further investigated.
Generally, urban green infrastructure aids in the mitigation of air pollution. However, little is known about the role of densely packed vegetation canopies, such as Pueraria lobata (Willd.) Ohwi ...(kudzu) in air pollution mitigation. Here, we conducted field measurements of tropospheric ozone (O3) and nitrogen oxides (NOx) concentrations on a highway embankment slope with and without kudzu canopies in Japan. We measured O3 and NOx concentrations above and within the kudzu canopies by using a passive sampler several times during the growing season in 2019. The results demonstrated that both O3 and NOx concentrations reduced within the kudzu canopy throughout the growing season, suggesting that kudzu generally acts as “vegetation barrier” for both gas pollutants along the highway roadside. Depending on meteorological and vegetative surface conditions, the reduction rate within the canopy ranged from 11% to 64% and from −2% to 33% for O3 and NOx concentrations, respectively. Considering lower canopy height but higher leaf area density of kudzu than those for urban tree plantations or forest patches along the roadside, kudzu can be useful as green infrastructure depending on situations. We also found that the higher the leaf area index of kudzu canopies, the higher the reduction rates of O3 and NOx. Depending on the maintenance cost for roadside tree planting, the minimal management without targeting the eradication of kudzu over a certain area can be an option for realizing green infrastructure at least for maintaining local air quality during the growing season.
•Field observations were conducted over a Japanese highway embankment slope.•O3 and NOx concentrations were measured by passive and active sampling.•All above concentrations reduced within the kudzu canopies.•Densely packed kudzu canopies act as “vegetation barriers” for O3 and NOx.•Minimal management of kudzu is an option for green infrastructure as tree planting.
Background: Regular assessment of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is essential for detecting glucocorticoid-induced osteoporosis in juvenile-onset autoimmune ...diseases. Z-score is used in children for standardization of osteoporosis assessment. Z-score in children can be evaluated with only one of the three models in Japan. The purpose of this study was to investigate how many domestic medical facilities for pediatric rheumatic diseases could not evaluate osteoporosis using Z-score exist.Methods: Electronic questionnaires were distributed between 2017 and 2019 to hospitals belonging to the Pediatric Rheumatology Association of Japan and to university hospitals and public children' s hospitals that provide medical care for pediatric rheumatic diseases. The questionnaire included the location of DXA measurement, manufacturer (Hologic, GE healthcare, Hitachi), and measurement site, and the answers were collected using Google Forms. Statcel 4 was used for analysis.Results: Overall,120 facilities responded to the survey, of which 117 had DXA. In the remaining three facilities, DXA was not installed in two and was out of order in one. Bone loss in childhood was evaluated using a Z-score calculated from age-based reference values. It was revealed that 30% of hospitals without HOLOGIC DXA could not evaluate osteoporosis by Z-score in Japanese childhood. The characteristics of the hospitals enrolled in this study did not bias the selection of Hologic DXA.Conclusions: Neighboring institutions should consider sharing access to Hologic DXA equipment to ensure the use of uniform reference values. GE BMD reference values for Japanese children should be established.
Objectives
To clarify how pediatric rheumatologists treat systemic juvenile idiopathic arthritis (s‐JIA) associated macrophage activation syndrome (MAS) in the real world and to assess the efficacy ...and safety of dexamethasone palmitate (DEX‐P) in the treatment of s‐JIA‐associated MAS.
Methods
This multicenter, retrospective study was conducted at 13 pediatric rheumatology institutes in Japan. This study included 28 patients with s‐JIA‐associated MAS. Clinical findings, such as treatment details and adverse events, were evaluated.
Results
Methylprednisolone (mPSL) pulse therapy was selected as the first‐line treatment in more than half of the patients with MAS. Cyclosporine A (CsA) was used as first‐line therapy in combination with corticosteroids in half of the patients with MAS. DEX‐P and/or CsA were selected as the second‐line therapy in 63% of patients with corticosteroid‐resistant MAS. Plasma exchange was selected as the third‐line therapy for DEX‐P and CsA‐resistant MAS. All patients improved and there were no characteristically severe adverse events associated with DEX‐P.
Conclusions
The first‐line treatment for MAS in Japan is mPSL pulse therapy and/or CyA. DEX‐P could be an effective and safe therapeutic option for patients with corticosteroid‐resistant MAS.
The dry deposition of atmospheric ammonia (NH3) volatilized from feedlots, one of major loads of nitrogen into the basin, has been rarely observed at the tree canopies close to the feedlot in ...Ibaraki, Japan. We made multi-point annual observations of the NH3 concentration using passive samplers within and surrounding the cattle feedlot in Ibaraki. The throughfall and wet deposition of ammonium-nitrogen (NH4+-N) was also measured by bulk samplers under Japanese cypress trees near the feedlot. The annual mean NH3 concentration measured inside the feedlot (322 ppbv) was lower than that expected from the cattle density, suggesting the requirement for monitoring the micrometeorological environment and management processes inside the feedlot. The results also indicated that the local-scale spatial distributions of the NH3 concentration may be influenced by not only horizontal wind directions but also air temperature and humidity, buildings, and trees. The annual throughfall deposition of NH4+-N (27.5 kgN/ha/yr) was clearly greater than those observed in the Japanese forests in past studies, suggesting the high impact of the dry deposition of NH3 volatilized from the feedlot. The deposition velocity of NH3 was estimated to be 3.4±2.5 cm/s, which was the highest range level of literature values for coniferous forests.
This study aimed to identify an association between risk of falling and various functions in 45 community-dwelling frail elderly people from the viewpoint of preventive care. The investigated items ...comprised fall risk, physical functions, cognitive and living functions, and fear of falling. We found that 11% of the elderly people had experienced falls. Factors involved in increasing risk of falling included dynamic and static balance ability, decreased walking speed and cognitive functions about body functions. In terms of cognitive function, decreased attention (selectivity) and living functions, the extent of fear of falling, movement such as the amount of the attention given to falling, leisure activities, the limit of in-home roles, and walking up and down stairs were associated with risk of falling. Fear of falling was also associated with the presence or absence of a domestic role. Fear of falling needs to be considered in addition to physical and cognitive functions when considering the efforts to prevent the fall of frail elderly. Intervention in areas such as the domestic role or leisure activities also seems particularly important.
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