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The zinc level improved with oral, enteral, peripheral parenteral, and total parenteral nutrition. While the nutritional status of patients at the time of discharge improved with oral and enteral nutrition, total parenteral nutrition without oral or enteral nutrition did not improve the status.

To discharge patients alive, efforts must be made to continue oral and enteral nutrition for as long as possible.

To discharge patients alive, efforts must be made to continue oral and enteral nutrition for as long as possible.

This study aimed to improve the understanding of the utilization rates and the characteristics of users of pulmonary rehabilitation (PR) among people with chronic obstructive pulmonary disease.

We used medical and long-term care claims data from between April 2012 and March 2013 from Kashiwa city in Chiba prefecture, Japan. The study participants included patients of ≥63 years of age, who had received outpatient treatment for COPD (ICD-10 codes J41-J44) two or more times during the study period, and who had been prescribed two or more COPD-related drugs. We extracted data on inpatient and outpatient PR using respiratory rehabilitation fee (I) (II) codes, and on home-based PR using home-care rehabilitation or nursing codes from medical insurance or long-term care insurance data.

The mean age of the patients was 76.8 years (total participation n = 2,708). There were 61 (2.3%) inpatient PR users, 25 (0.9%) outpatient PR users, and 101 (3.8%) home-based PR users. selleck products The median duration of usage by the inpatient, outpatient and home-based PR users was 1 month, 2 months, and 11 months, respectively. The mean age of non-PR and outpatient PR users was 76 years, while that of the inpatient PR users and home-based PR users was approximately 80 years. Approximately 20-30% of non-PR users and outpatient PR users were certified for long-term care. In contrast, approximately half of the inpatient users and almost all of the home-based PR users were certified for long-term care.

Since the PR utilization rates were low in both hospital-based and home-based settings, it is necessary to take measures to disseminate each PR based on the characteristics of the intervention duration and service users.

Since the PR utilization rates were low in both hospital-based and home-based settings, it is necessary to take measures to disseminate each PR based on the characteristics of the intervention duration and service users.

To investigate the longitudinal association between health literacy and frailty status at two-year follow-up in community-dwelling older adults.

A total of 218 older adults (mean age, 72.5±4.9 [range 65-86] years old; men, n=81) without frailty at baseline participated in this study. Functional health literacy was assessed using the Newest Vital Sign (NVS). Comprehensive health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). Comprehensive health literacy indices are constructed as a general health literacy index comprising all items along with the three sub-indices of health care, disease prevention, and health promotion domains. Demographic data and other potential confounding factors were also assessed. The total Kihon checklist score was used to monitor the presence of frailty based on a score of ≥8 at the 2-year follow-up (postal survey).

Of the 253 participants in the follow-up survey, 226 responded (response rate 89.3%). Excluding the 8 participants with missing values, 25 (11.5%) of the 218 were reported to be frail. A multiple logistic regression analysis indicated that comprehensive health literacy (total score of HLS-EU-Q47) was independently associated with a lower risk of frailty (odds ratio per standard deviation = 0.54, 95% confidence interval = 0.33-0.87) after adjusting for the covariates (age, gender, education, body mass index, gait speed, cognitive function, and comorbidities). The health care and disease prevention domain scores of the HLS-EU-Q47 were also independently associated with a lower risk of frailty. link2 Functional health literacy (NVS score) was not associated with frailty.

Older adults with higher comprehensive health literacy are less likely to be frail at two-year follow-up than those with a lower literacy.

Older adults with higher comprehensive health literacy are less likely to be frail at two-year follow-up than those with a lower literacy.Many dogs are relinquished worldwide, so it is important to enhance adoptions' success. We aimed at investigating factors associated with owners' satisfaction with adopted dogs, both in general and focusing on galgos. Data on 392 dogs (191 galgos) were gathered using an online survey, investigating dogs' and owners' demographics, satisfaction with the adopted dog and post-adoption behavior. Satisfaction was affected by different variables in galgos' owners as compared to non-sighthound non-podenco dogs' ones, with only the presence of disobedience on walks negatively affecting satisfaction in both samples. Depending on dogs' type, the presence of some behavioral problems was associated with decreased satisfaction with the dog (e.g., destructiveness for galgos, or separation problems for non-sighthound non-podenco dogs), whereas that of others increased it (e.g., not being interested in social interactions with dogs for galgos, and shadowing for non-sighthound non-podenco dogs). The variables most often being predictors of the behaviors influencing satisfaction were dog type, with being a galgo as a negative predictor, and dog's age, with being older as a negative predictor. Further studies on dog adopters' satisfaction are needed.

The risk prediction of incident atrial fibrillation (AF) is useful to prevent AF and its complications. The aim of this study is to develop a new risk prediction model for incident AF using the prospective longitudinal data from a general Japanese population.Methods and ResultsA total of 2,442 community-dwelling AF-free residents aged ≥40 years were followed up from 1988 to 2012 (46,422 person-years). The development of AF was confirmed by a standard 12-lead electrocardiogram at repeated health examinations and by medical records at clinics or hospitals. The risk prediction model for incident AF was developed using a Cox proportional hazards model. During the follow up, 230 AF events were confirmed. Age, sex, systolic blood pressure, waist circumference, estimated glomerular filtration rate, abnormal cardiac murmur, high R-wave amplitude, and arrhythmia other than AF were selected for inclusion in the model. This model showed good discrimination (Harrell's c statistics 0.785) and calibration (Greenwood-Nam-D'Agostino test P=0.87) for AF risk at 10 years.

The new risk prediction model showed good performance on the individual risk assessment of the future onset of AF in a general Japanese population. As this model included commonly used clinical parameters, it may be useful for determining the requirements for the careful evaluation of AF, such as frequent electrocardiogram examinations in clinical settings, and subsequent reductions in the risk of AF-related complications.

The new risk prediction model showed good performance on the individual risk assessment of the future onset of AF in a general Japanese population. As this model included commonly used clinical parameters, it may be useful for determining the requirements for the careful evaluation of AF, such as frequent electrocardiogram examinations in clinical settings, and subsequent reductions in the risk of AF-related complications.Arctigenin (ARG), a natural lignans compound isolated from Arctium lappa L. In this study, the anti-tumor effect of ARG on prostate cancer cell PC-3M and the mechanism of apoptosis and autophagy induced by phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling pathway were discussed, and further confirmed by the joint treatment of ARG and PI3K inhibitor LY294002. Here, the effect of ARG on cell viability was evaluated in PC-3M cells by Cell Counting Kit-8 reagent (CCK-8) assay. After the treatment of ARG, colony formation assay was used to detect the anti-proliferation effect. Annexin V-fluoresceine isothiocyanate/propidium iodide (FITC/PI) kit and 4',6-diamidino-2-phenylindole (DAPI) staining were used to detect the apoptosis level, and cell cycle changes were analyzed by flow cytometry. The expression of autophagy was detected by acridine orange staining. In addition, the expression levels of apoptosis and autophagy-related proteins were analyzed by Western blot. The result showed that different concentrations of ARG inhibited the proliferation of PC-3M cells. DAPI staining and flow cytometry showed that ARG induced PC-3M cell apoptosis and arrested cell in G0/G1 phase. Acridine orange staining showed that ARG induced autophagy in PC-3M cells. Western blot experiments showed that ARG inhibited the expression of Bcl-2, promoted the expression of Bax and cleaved caspase-3. At the same time, the expression of autophagy-related proteins LC3B-II and Beclin-1 increased after ARG treatment, but P62 decreased. link3 In addition, further studies have shown that treatment with LY294002 enhanced the effects of ARG on the expression of proteins associated with apoptosis and autophagy, indicating that ARG may induce apoptosis and autophagy through PI3K/Akt/mTOR pathway.

Traffic noise exposure is associated with adverse health effects such as environmental sleep disorder, ischaemic heart disease (IHD), stroke and diabetes. The health risks posed by traffic noise were estimated to be quite high in European countries. However, in Japan, no estimation has ever been conducted. In the present study, we estimated the health risk posed by road traffic noise in Japan.

We estimated the risks of environmental sleep disorder (high sleep disturbance) and IHD caused by road traffic noise in Japan as of 2015 on the basis of existing noise-exposure estimates, vital statistics of deaths, and patient survey with exposure-response relationships proposed by the Environmental Noise Guidelines for the European Region issued in 2018. We employed old information on noise exposure in 1994 because it is the only information currently available in Japan. We also estimated the health risks of noise exposure levels that were equivalent to the Japanese environmental quality standards.

The estimated numbers of patients with environmental sleep disorder and IHD caused by road traffic noise were approximately 1,200,000 and 9,000, respectively. The estimated number of mortalities from IHD was approximately 1,700. The noise exposure level equivalent to the Japanese noise standards caused a lifetime mortality rate of more than 10

, which was extremely high as an environmental health risk.

As in European countries, road traffic noise was one of the most important environmental risk factors in Japan. However, the current Japanese noise standards are insufficient for the protection of public health.

As in European countries, road traffic noise was one of the most important environmental risk factors in Japan. However, the current Japanese noise standards are insufficient for the protection of public health.