Summary
We examined the effectiveness of coordinators’ interventions to prevent secondary fractures in patients with fragility fractures. These coordinator-based interventions improved bone density ...assessment implementation and treatment rates, and enhanced treatment persistence rates in the early stages following fractures.
Introduction
This study aimed to determine the efficiency of coordinator-based osteoporosis intervention in fragility fracture patients during a 2-year period.
Methods
A prospective intervention randomized control study was conducted at seven medical facilities from January 2015 to March 2017. Postmenopausal women and men over 50 years old with fragility fractures were randomly divided into the coordinator intervention (LI; 70 patients) and without intervention (non-LI; 71 patients) groups. The osteoporosis treatment rate, osteoporosis treatment persistence rate, fall rate, fracture incidence rate, and bone density measurement rate 3 months, 6 months, 1 year, and 2 years after registration were compared between the two groups. Non-parametric tests were used to analyze data at each inspection period.
Results
The osteoporosis treatment initiation rate was significantly higher in the LI group than in the non-LI group (85.7% vs. 71.8%;
p
= 0.04). The LI group had significantly higher bone density assessment implementation rates than the non-LI group at the time of registration (90.0% vs. 69.0%;
p
= 0.00) and 6 months after registration (50.0% vs. 29.6%;
p
= 0.01), but not 1 or 2 years after registration. In addition, no significant differences in fall or fracture incidence rates were found between the two groups.
Conclusion
The coordinator-based interventions for fragility fractures improved bone density assessment implementation and treatment rates and enhanced treatment persistence rates in the early stages following bone fractures. The findings suggest that liaison intervention may help both fracture and osteoporosis physicians for the evaluation of osteoporosis and initiation and continuation of osteoporosis medication.
Summary
We examined the effects of the coordinator-based intervention on quality of life (QOL) in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL. The ...coordinator-based interventions mitigated the decrease in QOL. Secondary fracture after primary fracture, however, was a significant predictor of lower QOL.
Purpose
This study aimed to determine the effects of the coordinator-based intervention on QOL in the aftermath of a fragility fracture, as well as factors predictive of post-fracture QOL, in an Asian population.
Methods
Patients with new fractures in the intervention group received the coordinator-based intervention by a designated nurse certified as a coordinator, within 3 months of injury. QOL was evaluated using the Japanese version of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) scale before the fracture (through patient recollections) and at 0.5, 1, and 2 years after the primary fracture.
Results
Data for 141 patients were analyzed: 70 in the liaison intervention (LI) group and 71 in the non-LI group. Significant intervention effects on QOL were observed at 6 months after the fracture; the QOL score was 0.079 points higher in the LI group than in the non-LI group (
p
=0.019). Further, the LI group reported significantly less pain/discomfort at 2 years after the fracture, compared to the non-LI group (
p
=0.037). In addition, secondary fractures were found to significantly prevent improvement and maintenance of QOL during the recovery period (
p
=0.015).
Conclusion
Short-term intervention effects were observable 6 months after the primary fracture, with the LI group mitigated the decrease in QOL. Few patients in the LI group reported pain/discomfort 2 years after the fracture, but there is uncertainty regarding its clinical significance. Secondary fracture after initial injury was a significant predictor of lower QOL after a fracture.
Abstract
A method to discriminate between green peaberry beans and normal beans was developed using an excitation and emission spectrometer that can be used to construct a simple optical system to ...save farm workers' labor. The excitation and emission matrix were obtained in the wavelength range of 300 - 800 nm using a hand-held spectrophotometer combined with a diffraction grating and a diode array. Light sources of 300, 375 nm were used to excite the samples by light-emitting diodes. The acquired spectral information was used to classify the coffee samples into peaberry and normal coffee using the chemometric method of partial least squares discriminant analysis (PLS-DA). The results showed that all coffee samples were discriminated as corresponding classes by PLS-DA. In the PLS-DA model, investigation of the main wavelengths contributing to classification using all sample VIP showed that excitation/emission wavelengths at 300/470, 300/670 375/470, 375/670 nm are important for coffee type determination. These wavelengths were closely related to the excitation-emission wavelengths of several important chemical components in raw coffee beans (caffeine, caffeic acid, and chlorogenic acid (CGA), tocopherol). These results will be useful as basic knowledge to contribute to the labor-saving and automation of coffee bean sorting in the future.
This study investigated the effects of marker placement (skin- vs shoe-mounted) on metatarsophalangeal joint (MTP) kinematics and kinetics during running. Fifteen trained men ran on a 15-m track at ...10 and 13 km/h with three (low, standard and high stiffness) shoe longitudinal bending stiffnesses (LBS). Reflective markers were fixed on the shoe upper, and on the skin using holes cut in the shoe. Three-dimensional marker positions and ground reaction forces were recorded at 200 and 2000 Hz, respectively. Kinematic and kinetic parameters were analyzed using one-dimensional metrics (statistical parametric mapping). MTP joint was less dorsiflexed at midstance (57% to 100% of braking phase and 0% to 48% of pushing phase), and the MTP joint plantarflexion moment was higher (22% to 55% of pushing phase) with the shoe markerset in comparison with the skin markerset. The effect of LBS on MTP angle was found to be significant for a larger percentage of each stride using the shoe markerset compared to the skin markerset. However, the effect of LBS on plantarflexion moment was significant with the shoe markerset only. The effect of running speed on MTP angle was significant for a larger percentage of each stride with the skin markerset. This study demonstrates that the placement of markers influences the measurement of MTP kinematics and kinetics and that these effects are mediated by other variables such as LBS or running speed. It is concluded that the shoe markerset does not fully reflect the movement of the MTP joint.
Although shoe friction has been widely studied in occupational ergonomics, information was lacking about friction in sport shoes. The purpose of the study was to examine the neuromechanical ...adaptations to different shoe-surface interface in an aerobic-gym specific movement. Sixteen females performed 10 change of direction movements in two shoe conditions differing by their outsoles (ethyl-vinyl-acetate: EVA and rubber: RB) to ensure significant differences in mechanical coefficients of friction (EVA = 0.73 ± 0.07 and RB = 1.46 ± 0.15). The kinematics, kinetics and muscle activities of the right lower-limb were analysed. Statistical parametric mapping was used to investigate the kinematics and kinetics adaptation to the different shoe-surface coefficients of friction. The participants had a longer stance duration in the EVA compared to the RB condition (526 ± 160 ms vs. 430 ± 151 ms, p < .001). The ankle and knee joints powers and works were lower during both the braking and the push-off phases in the EVA as compared to the RB condition. Preactivation of the agonist muscles (soleus, gastrocnemius medialis and vastus medialis) decreased in the EVA compared to the RB condition (−28.5%, −26.5% and −49.0%, respectively). Performing a change of direction movement with slippery shoes reduced the ankle and knee joints loadings, but impaired the stretch-shortening cycle performance. Participants demonstrated thus a different neuromechanical strategy to control their movement which was associated with a reduced performance.
In order to measure the longitudinal phase-space profile and transverse slice emittances of the electron beam, we are developing a compact measurement system that consists of a Cherenkov radiator and ...a streak camera. The Cherenkov radiator with the aerogel has been installed on the downstream side of the bending magnet in the beam transport, and the preliminary profile image of the electron beam in the longitudinal phase-space has been obtained.
Acute pulmonary embolism (PE) is a life-threatening disease, and several vasoconstrictors, including endothelin-1 (ET-1), play a key role in vasoconstriction and hypoxemia during the development of ...PE. Rho kinase is activated by various vasoconstrictors resulting in vascular contraction and remodeling. Recent evidence has revealed an important role of Rho kinase in the pathogenesis of systemic and pulmonary vascular diseases. However, contribution of Rho kinase in PE remains unclear. We thus investigated the role of Rho kinase in the PE rat model induced by intrajugular administration of polystyrene microspheres (mean diameter, 26 microm). At 6 h following the administration of microspheres (1.5 ml/kg), right ventricular systolic pressure (RVSP) was higher in the PE than in the control rats (15.8 +/- 1.6 vs. 32.9 +/- 7.5 mmHg). Arterial oxygen tension was lower (92.3 +/- 12.5 vs. 66.0 +/- 17.7 Torr), and alveolar-arterial difference in oxygen partial pressure was higher (3.9 +/- 3.8 vs. 36.5 +/- 26.9 Torr) in the PE rats. Western blotting analysis revealed upregulation and downregulation in expression of vascular cell adhesion molecule-1 and endothelial nitric oxide synthase in lungs from the PE rats, respectively, and radioimmunoassay demonstrated an increase in plasma ET-1 levels. Lung Rho kinase alpha expression was greater in the PE rats. At 5 h following administration of microspheres (0.75 ml/kg), intravenous Rho kinase inhibitors HA1077 and Y27632 (3 mg/kg each) attenuated elevation of RVSP (22.0 +/- 3.7, 17.1 +/- 3.2, 14.3 +/- 2.6 mmHg, PE, PE+HA1077, PE+Y27632) and the severity of hypoxemia (66.3 +/- 16.2, 94.9 +/- 23.0, 89.1 +/- 8.5 Torr, PE, PE+HA1077, PE+Y27632) in the PE rats. These results suggest that pulmonary endothelial dysfunction and activation of Rho kinase may contribute to the potentiation of vasoconstriction and hypoxemia in the PE rats.
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