Can AI predict walking independence in patients with stroke upon admission to a recovery-phase rehabilitation ward?

Ono K, Takahashi R, Morita K, Ara Y, Abe S, Ito S, Uno S, Abe M, Shirasaka T. Can AI predict walking independence in patients with stroke upon admission to a recovery-phase rehabilitation ward? Jpn J Compr Rehabil Sci 2024; 15: 1-7. Objective: This study aimed to develop a prediction model for walking independence in patients with stroke in the recovery phase at the time of hospital discharge using Prediction One, an artificial intelligence (AI)-based predictive analysis tool, and to examine its utility. Methods: Prediction One was used to develop a prediction model for walking independence for 280 patients with stroke admitted to a rehabilitation ward-based on physical and mental function information at admission. In 134 patients with stroke hospitalized during different periods, accuracy was confirmed by calculating the correct response rate, sensitivity, specificity, and positive and negative predictive values based on the results of AI-based predictions and actual results. Results: The prediction accuracy (area under the curve, AUC) of the proposed model was 91.7%. The correct response rate was 79.9%, sensitivity was 95.7%, specificity was 62.5%, positive predictive value was 73.6%, and negative predictive value was 93.5%. Conclusion: The accuracy of the prediction model developed in this study is not inferior to that of previous studies, and the simplicity of the model makes it highly practical.

Dimerization processes for light-regulated transcription factor Photozipper visualized by high-speed atomic force microscopy.

Dimerization is critical for transcription factors (TFs) to bind DNA and regulate a wide variety of cellular functions; however, the molecular mechanisms remain to be completely elucidated. Here, we used high-speed atomic force microscopy (HS-AFM) to observe the dimerization process for a photoresponsive TF Photozipper (PZ), which consists of light-oxygen-voltage-sensing (LOV) and basic-region-leucine-zipper (bZIP) domains. HS-AFM visualized not only the oligomeric states of PZ molecules forming monomers and dimers under controlled dark-light conditions but also the domain structures within each molecule. Successive AFM movies captured the dimerization process for an individual PZ molecule and the monomer-dimer reversible transition during dark-light cycling. Detailed AFM images of domain structures in PZ molecules demonstrated that the bZIP domain entangled under dark conditions was loosened owing to light illumination and fluctuated around the LOV domain. These observations revealed the role of the bZIP domain in the dimerization processes of a TF.

Antibacterial Activity of Membrane-Permeabilizing Bactericidal Cyclodextrin Derivatives.

Antimicrobial peptides that act by disrupting bacterial membranes are attractive agents for treating drug-resistant bacteria. This study investigates a membrane-disrupting peptide mimic made of a cyclic oligosaccharide cyclodextrin scaffold that can be chemically polyfunctionalized. An antibacterial functional group on the peptide was simplified to an alkylamino group that combines cationic and hydrophobic moieties, the former to interact with the anionic bacterial membrane and the latter with the membrane interior. The cyclodextrins equipped with eight alkylamino groups on the molecules using a poly-click reaction exhibited antibacterial activity against Gram-positive and Gram-negative bacteria, including drug-resistant pathogens such as carbapenem-resistant Enterobacteriaceae. Several lines of evidence showed that these agents disrupt bacterial membranes, leading to rapid bacterial cell death. The resulting membrane perturbation was directly visualized using high-speed atomic force microscopy imaging. In Gram-negative bacteria, the membrane-permeabilizing action of these derivatives allowed the entry of co-treated traditional antibiotics, which were then active against these bacteria.

Oxidation of Anatase TiO2(001) Surface Using Supersonic Seeded Oxygen Molecular Beam.

We investigated the oxidation of oxygen vacancies at the surface of anatase TiO2(001) using a supersonic seeded molecular beam (SSMB) of oxygen. The oxygen vacancies at the top surface and subsurface could be eliminated by the supply of oxygen using an SSMB. Oxygen vacancies are present on the surface of anatase TiO2(001) when it is untreated before transfer to a vacuum chamber. These vacancies, which are stable in the as-grown condition, could also be effectively eliminated by using the oxygen SSMB.

Local states of chromatin compaction at transcription start sites control transcription levels.

The 'open' and 'compact' regions of chromatin are considered to be regions of active and silent transcription, respectively. However, individual genes produce transcripts at different levels, suggesting that transcription output does not depend on the simple open-compact conversion of chromatin, but on structural variations in chromatin itself, which so far have remained elusive. In this study, weakly crosslinked chromatin was subjected to sedimentation velocity centrifugation, which fractionated the chromatin according to its degree of compaction. Open chromatin remained in upper fractions, while compact chromatin sedimented to lower fractions depending on the level of nucleosome assembly. Although nucleosomes were evenly detected in all fractions, histone H1 was more highly enriched in the lower fractions. H1 was found to self-associate and crosslinked to histone H3, suggesting that H1 bound to H3 interacts with another H1 in an adjacent nucleosome to form compact chromatin. Genome-wide analyses revealed that nearly the entire genome consists of compact chromatin without differences in compaction between repeat and non-repeat sequences; however, active transcription start sites (TSSs) were rarely found in compact chromatin. Considering the inverse correlation between chromatin compaction and RNA polymerase binding at TSSs, it appears that local states of chromatin compaction determine transcription levels.

A helical amplification system composed of artificial nucleic acids.

Herein we report an amplification system of helical excess triggered by nucleic acid hybridization for the first time. It is usually impossible to prepare achiral nanostructures composed of nucleic acids because of their intrinsic chirality. We used serinol nucleic acid (SNA) oligomers for the preparation of achiral nanowires because SNA oligomers with symmetrical sequences are achiral. Nanowire formation was confirmed by atomic force microscopy and size exclusion chromatography. When a chiral nucleic acid with a sequence complementary to SNA was added to the nanostructure, helicity was induced and a strong circular dichroism signal was observed. The SNA nanowire could amplify the helicity of chiral nucleic acids through nucleobase stacks. The SNA nanostructures have potential for use as platforms to detect chiral biomolecules under aqueous conditions because SNA can be readily functionalized and is water-soluble.

The time domain numerical method of three-dimensional conductors including radiation with lumped parameter circuit.

We formulate a numerical method on the transmission and radiation theory of three-dimensional conductors starting from the Maxwell equations in the time domain. We include the delay effect in the integral equations for the scalar and vector potentials rigorously, which is vital to obtain numerically stable solutions for transmission and radiation phenomena in conductors. We provide a formalism to connect the conductors to any passive lumped-parameter circuits. We show one example of numerical calculations, demonstrating that the new formalism provides stable solutions to the transmission and radiation phenomena.

Role of tip apices in scanning force spectroscopy on alkali halides at room temperature-chemical nature of the tip apex and atomic-scale deformations.

We have revealed processes of the tip apex distortion in the measurements of non-contact scanning force microscopy. High-spatial-resolution two-dimensional force mapping on KCl(100) surfaces for a large number of tips, seven tips, enabled us to see the complex behavior of the tip apex distortion. The tips are from Si without additional coating, but are altered by the tip-sample interaction and show the behavior of different atomic species. On the KCl(001) surfaces, the tip apex, consisting of K and Cl atoms or of Si, distorted several times while changing the distance even in a weak attractive region. There are variations in rigidity of the tip apex, but all tips distorted in the small attractive region. This complex behavior was categorized in patterns by our analyses. We compare the experimental force-distance data to atomistic simulations using rigid KCl-terminated tips and KCl-terminated tips with an additional KCl-pair designed to perform atomic jumps. We also compare the experimental force-distance data to first principles simulations using Si tips. We mainly find K-terminated tips and Si-terminated tips. We find that Si tips show only one force minimum whereas KCl-terminated tips show two force minima in line with the stronger rigidity of Si compared to KCl. At room temperature, the tip apex atoms can perform atomic jumps that change the atomic configuration of the tip apex.

Arthroscopic superior capsule reconstruction with Teflon felt synthetic graft for irreparable massive rotator cuff tears: clinical and radiographic results at minimum 2-year follow-up.

BACKGROUND: Superior capsule reconstruction (SCR) was developed to improve shoulder function and relieve pain in patients with irreparable rotator cuff tears. Here, we investigated the clinical and radiographic outcomes and postoperative complications of SCR using a Teflon graft for reconstruction. METHODS: Thirty-five consecutive patients with irreparable rotator cuff tears underwent SCR with Teflon grafts. The American Shoulder and Elbow Surgeons score, active shoulder elevation, shoulder muscle strength, visual analog scale pain scores, acromiohumeral distance, and postoperative complications were investigated. Data obtained before and after surgery were compared by using a paired t-test, χ2 test, and 1-way analysis of variance, and data from 1-layer-graft SCR (15 patients; mean age, 75.1 years) and 3-layer-graft SCR (20 patients; mean age, 76.6 years) were compared by using an unpaired t-test. The average time to final follow-up was 42 months (range, 24-69 months). RESULTS: SCR using Teflon grafts of either 1 or 3 layers significantly improved the American Shoulder and Elbow Surgeons score (by 20.8, P = .001 for a 1-layer graft; and by 31.1, P < .0001 for a 3-layer graft), visual analog scale score for motion pain (by 3.2, P = .001; and by 3.0, P < .0001), and muscle strength in shoulder abduction (by 11.9 N, P = .02; and by 10.9 N, P = .008). Active elevation at final follow-up was significantly greater in the 3-layer-graft group (142° ± 27°) than in the 1-layer-graft group (107° ± 42°) (P = .006). One year after SCR, acromiohumeral distance in the 3-layer-graft group was significantly greater than preoperatively (P = .04), whereas in the 1-layer-graft group, it was not. On postoperative magnetic resonance imaging, none of the patients in the 3-layer-graft group had graft tears, whereas 2 patients had graft tears and 1 patient had severe synovitis after 1-layer-graft SCR. CONCLUSION: SCR using a Teflon graft-especially a 3-layer graft-significantly improved shoulder function and shoulder abduction strength, with pain relief and a low rate of postoperative complications. SCR using a Teflon graft can be a viable option for irreparable rotator cuff tears, especially when an autograft or allograft is not available.

Influence of back support shape in wheelchairs offering pelvic support on asymmetrical sitting posture and pressure points during reaching tasks in stroke patients.

Many poststroke hemiplegic patients have an asymmetrical wheelchair-sitting posture. This study aimed to investigate the impact of different back support shapes on asymmetrical sitting posture and pressure points among poststroke hemiplegic patients during an activities of daily living-related reaching task. This study included 23 poststroke hemiplegic patients who performed tasks that involved the movement of objects using the unaffected upper limb to the affected side while sitting in a conventional wheelchair (C-WC) with a flat back support or a wheelchair providing pelvic and thoracic support (P-WC). Body alignment angles from video images and pressure distribution on supporting surfaces were measured using a two-dimensional motion analysis software (Dartfish) and a pressure mapping system (FSA). Regarding movement performance, although postural asymmetry increased in both wheelchair types, the degree of postural variation was smaller with P-WC use than C-WC use (p < 0.05), with partly reduced postural asymmetry. With P-WC, one-sided ischial asymmetrical pressure was significantly less after the movement (p < 0.05). In conclusion, P-WC's back support shape contributed to a decrease in postural asymmetry for pelvic girdle support both at rest and during movement. This highlights the importance of a wheelchair back support shape and may help to increase the quality of activities of daily living movement in poststroke hemiplegic patients in wheelchairs.

Atomic-resolution imaging of rutile TiO2(110)-(1 × 2) reconstructed surface by non-contact atomic force microscopy.

The structure of the rutile TiO2(110)-(1 × 2) reconstructed surface is a phase induced by oxygen reduction. There is ongoing debate about the (1 × 2) reconstruction, because it cannot be clarified whether the (1 × 2) structure is formed over a wide area or only locally using macroscopic analysis methods such as diffraction. We used non-contact atomic force microscopy, scanning tunneling microscopy, and low-energy electron diffraction at room temperature to characterize the surface. Ti2O3 rows appeared as bright spots in both NC-AFM and STM images observed in the same area. High-resolution NC-AFM images revealed that the rutile TiO2(110)-(1 × 2) reconstructed surface is composed of two domains with different types of asymmetric rows.

Time-domain Formulation of a Multi-layer Plane Circuit Coupled with Lumped-parameter Circuits using Maxwell Equations.

We calculate electromagnetic phenomena in the multi-layer plane circuit starting from the Maxwell equations. We present a numerical method of potential and current density in two-dimensional conductors, where their time developments are treated as phenomena of wave propagation. We treat the plane conductors by dividing them into small finite-volume elements, similar to the case of the partial element equivalent circuit method, and the transport equations are then solved by the finite-difference time-domain method. Furthermore, we develop a calculation method for the boundary in a multi-layer plane by applying the method we have used in multi-transmission lines. We formulate the boundary conditions of a multi-layer plane coupled with lumped-parameter circuits and introduce an algorithm to reduce calculation costs that are largely associated with the two-dimensional extension from the multi-transmission-line case. We perform calculations of the wave propagation of potential, current density, and charge density in the time domain for a simple plane circuit. These calculations are presented as supplementary materials of the present paper.

Mechanism of Common-mode Noise Generation in Multi-conductor Transmission Lines.

The mechanism of common-mode noise generation in multi-conductor transmission lines is presented. Telegraphic equations, wave equations, and reflection coefficients in the normal and common modes are derived, which provide the mechanism of common-mode noise generation. In addition to coupling among transmission lines, the origin of the common-mode noise generation is elucidated by deriving the reflection coefficients in the normal and common modes.

Fermented product of rice with Lactobacillus kefiranofaciens induces anti-aging effects and heat stress tolerance in nematodes via DAF-16.

Rice kefiran is superior in functionality, has high concentration of mucilaginous polysaccharide, and low lipid content, compared to conventional kefiran. However, reports on its physiological functionality, especially studies on life expectancy and aging, in model organisms are rare. In this study, nematodes were used as model organisms that were fed rice kefiran, along with Escherichia coli OP50, as a result of which, the lifespan of nematodes was extended and age-related retardation of mobility was suppressed. It also increased the heat stress resistance in nematodes. Experiments using daf-16 deletion mutant revealed that rice kefiran functions via DAF-16. Thus, this study revealed the longevity, anti-aging and heat stress tolerance effects of rice kefiran in nematodes.

Bone union of the transferred coracoid graft is the key factor affecting the extent of postoperative graft changes and the clinical results following the modified Bankart and Bristow procedure: a computed tomography scan study.

BACKGROUND: The extent of postoperative changes in the coracoid process grafted during the modified Bankart and Bristow procedure remains unclear. The purpose of the present study was to quantify the postoperative changes in bone surface area as assessed on computed tomography, as well as to clarify the impact of such changes on the clinical results. METHODS: Twenty-three shoulders of 21 subjects who underwent the modified Bankart and Bristow procedure were retrospectively analyzed. Computed tomography images were obtained immediately after surgery and at the final follow-up. The changes in bone surface area of the grafted coracoid process were measured on computed tomography slices in the proximity of the screw bore. Clinical outcomes were evaluated in terms of the Rowe, Walch-Duplay, and simple shoulder test scores. RESULTS: Bone area increased in 15 shoulders (65.2%) and decreased in eight shoulders (34.8%). Bone area increased by 51.3% in shoulders with bone union in the superior part of the coracoid process graft, with no significant differences between the superior and inferior sides of the graft regarding the rate of change in bone surface area (41.4% vs. 68.9% increase). However, in shoulders with bone union in the inferior part of the coracoid process graft, the rate of change in bone area differed significantly between the superior and inferior sides of the graft, exhibiting a 42.3% decrease on the superior side and 39.8% increase on the inferior side. In shoulders with no bone union, bone area decreased by 29.5% (17.4% vs. 39.3% decrease on the superior and inferior side, respectively), whereas the Rowe and Walch-Duplay scores were significantly lower than those noted in shoulders with bone union. CONCLUSIONS: Postoperative bone formation and bone resorption in the coracoid process grafted during the modified Bankart and Bristow procedure depend on whether and where bone union occurs. Graft non-union is associated with inferior clinical results.

The discovery and characterization of K-563, a novel inhibitor of the Keap1/Nrf2 pathway produced by Streptomyces sp.

Keap1/Nrf2 pathway regulates the antioxidant stress response, detoxification response, and energy metabolism. Previous reports found that aberrant Keap1/Nrf2 pathway activation due to Kelch-like ECH-associated protein 1 (Keap1) mutations or Nuclear factor E2-related factor 2 (Nrf2) mutations induced resistance of cancer cells to chemotherapy and accelerated cell growth via the supply of nutrients. Therefore, Keap1/Nrf2 pathway activation is associated with a poor prognosis in many cancers. These previous findings suggested that inhibition of Keap1/Nrf2 pathway could be a target for anti-cancer therapies. To discover a small-molecule Keap1/Nrf2 pathway inhibitor, we conducted high-throughput screening in Keap1 mutant human lung cancer A549 cells using a transcriptional reporter assay. Through this screening, we identified the novel Keap1/Nrf2 pathway inhibitor K-563, which was isolated from actinomycete Streptomyces sp. K-563 suppressed the expression of Keap1/Nrf2 pathway downstream target genes or the downstream target protein, which induced suppression of GSH production, and activated reactive oxygen species production in A549 cells. K-563 also inhibited the expression of downstream target genes in other Keap1- or Nrf2-mutated cancer cells. Furthermore, K-563 exerted anti-proliferative activities in these mutated cancer cells. These in vitro analyses showed that K-563 was able to inhibit cell growth in Keap1- or Nrf2-mutated cancer cells by Keap1/Nrf2 pathway inhibition. K-563 also exerted synergistic combinational effects with lung cancer chemotherapeutic agents. An in vivo study in mice xenotransplanted with A549 cells to further explore the therapeutic potential of K-563 revealed that it also inhibited Keap1/Nrf2 pathway in lung cancer tumors. K-563, a novel Keap1/Nrf2 pathway inhibitor, may be a lead compound for development as an anti-cancer agent.

Imaging patterns of anatase TiO2(001) with non-contact atomic force microscopy.

Image patterns of anatase TiO2(001) with non-contact atomic force microscopy (NC-AFM) are presented. A combined system of NC-AFM with pulsed laser deposition, scanning tunneling microscopy (STM), and low energy electron diffraction (LEED) enables us to prepare clean surfaces of anatase TiO2 thin films and to perform measurements on them without breaking the vacuum or the need of cleaning the surface with sputtering and annealing cycles. Results from STM and LEED show that the anatase TiO2(001) films display a (1 × 4) surface pattern of row structures. At far distances, in which the frequency shift was relatively small, NC-AFM images show three different patterns (labeled as protrusion, hole, and neutral contrast, respectively) similar to the ones that have been reported before in the studies of the rutile TiO2 surface. At closer tip-sample distances, a periodic pattern consistent with the TiO2 lattice constant was observed along the higher-positioned TiO3 rows. We have also observed that energy dissipation is induced only with platinum tips, and not with other tip apexes.

Theoretical Study of Lumped Parameter Circuits and Multiconductor Transmission Lines for Time-Domain Analysis of Electromagnetic Noise.

In order to find the origins of electromagnetic noise in the time domain, we formulate a system of lumped parameter circuits and multiconductor transmission lines (MTL). We present a discretized approach to treat any lumped parameter circuits and MTL systems, and the boundary conditions between these systems, where the lumped parameter circuits are described by coupled differential equations, and the MTL systems by coupled partial-differential equations. The introduction of the time-domain impedance and the element matrices enables us to perform a time-domain analysis that includes dependent sources and the coupling devices in the framework of the circuit theory. For three-line systems, we are able to calculate the coupling of the normal, common, and antenna modes, and to find out methods to reduce the noise.

Bifacial Nucleobases for Hexaplex Formation in Aqueous Solution.

Although DNA can form triplex and quadruplex structures through hydrogen bonds, design and preparation of structures with more than five strands is difficult even when artificial nucleic acids are used. Herein we report a hexaplex formed by oligomers of artificial nucleic acids bearing bifacial molecules on d-threoninol. Aminopyrimidine and cyanuric acid derivatives were selected as bases because they have complementary hydrogen bonding patterns. The complex formed by aminopyrimidine and cyanuric acid decamers melted with large hysteresis. Hexaplex formation was indicated by gel electrophoresis, size exclusion chromatography and atomic force microscopy imaging, and proven directly through native mass spectrometry. CD measurements and molecular dynamics simulations indicated that the hexaplex adopts a helical structure. The hexaplex formation was highly dependent on pH and the presence of divalent cations. The hexaplex was stable in aqueous solution, and its unique structure and properties may lead to novel nanostructures, molecular assemblies, metal sensors, and ion channels.

Combined pulsed laser deposition and non-contact atomic force microscopy system for studies of insulator metal oxide thin films.

We have designed and developed a combined system of pulsed laser deposition (PLD) and non-contact atomic force microscopy (NC-AFM) for observations of insulator metal oxide surfaces. With this system, the long-period iterations of sputtering and annealing used in conventional methods for preparing a metal oxide film surface are not required. The performance of the combined system is demonstrated for the preparation and high-resolution NC-AFM imaging of atomically flat thin films of anatase TiO2(001) and LaAlO3(100).