Work engagement among older workers: a systematic review.

OBJECTIVES: Given current labor force conditions, including population aging, keeping older workers engaged in work and motivated is important. Aging may alter the effects that psychological and environmental factors have on work engagement. We conducted a systematic review to understand the features of work engagement among older workers. METHODS: A systematic search was conducted in July 2022 using 4 databases. The review included relevant articles that focused on participants aged 40 years and older. RESULTS: Fifty articles were selected for our review, which were grouped into 5 categories: (1) studies examining the relationship between chronological age and work engagement, (2) studies investigating the moderating effects of age on the relationship between job-related psychological factors and work environment factors and work engagement, (3) studies comparing the relationship of job-related psychological factors and work environment factors with work engagement across different age groups, (4) studies exploring the relationship between work engagement and retirement intentions or continued employment beyond retirement age, and (5) other studies discussing work engagement in the context of older workers. Most articles focused on workers in Europe and the United States and used observational study designs. CONCLUSIONS: Work engagement increases with age, and is mainly mediated by increased emotional regulation. In addition, age moderates the relationships between various job-related psychological and work-environmental factors and work engagement. Work engagement is associated with working beyond retirement age. Organizations should understand the characteristics of work engagement among older workers and make age-conscious efforts to support them in adapting to social changes.

Clinical assessment of efficacy of poly-L-lactide sternal pin on sternal stability and post-operative pain: a prospective randomized trial in cardiovascular surgery.

BACKGROUND: Although the incident rate is low, sternal dislocation and dehiscence due to unstable sternal fixation after cardiovascular surgery could cause potentially lethal complications. Thus, to enforce the stability of closed sternum, the sternal pins have been utilized at surgeon's discretion. However, there is no randomized clinical trial to test whether these pins are effective to stabilize a sternum. Hence, this study aimed to examine the clinical efficacy of bioabsorbable poly-L-lactide (PLLA) sternal pins in reinforcing sternal stability and preventing instability of the sternum after full sternotomy. METHODS: We conducted a single institutional, prospective, randomized, single-blinded clinical study involving 100 patients who underwent an initial cardiovascular surgery via sternotomy. Patients were randomly allocated into two groups: with (group P) and without (group N) PLLA sternal pins, at 1:1 ratio from November 2013 to April 2016. Sternal deviation and stability were assessed with postoperative computed tomography (CT) at two postures to put shear stress on the sternum. Additionally, information on patient demographic indices was obtained prospectively, and patient's pain intensity was assessed with numerical rating scoring system during rehabilitation. Furthermore, propensity score matching was performed for further comparative sub-analysis. RESULTS: Ninety-one patients (43 in group P and 48 in group N) were analyzed using the intention-to-treat method. Group N had a significantly higher proportion of males (P=0.015) and ischemic disease as a primary diagnosis (P=0.040) than group P. Postoperative CT showed that the degree of sternal deviation and stability were comparable between the groups. Similarly, the numerical rating score of pain during rehabilitation showed no difference between the groups. Even after adjusting for patient characteristics using propensity score matching method, no significant differences in sternal gaps, stability, and numerical rating score of pain were observed. Of note, no material-related adverse event such as wound infection was found. CONCLUSIONS: We could not identify the efficacy of the sternal pin in enforcing sternal stability based on CT measurements with mild shear stress on sternum after cardiovascular surgery. Nevertheless, our results with no adverse events might encourage further investigations with a more specific cohort who is susceptible to infection but requires an additional sternal fixation. TRIAL REGISTRATION: This study was registered in University Hospital Medical Information Network Clinical Trial Registry (UMIN000017357).

Effect of Anisotropic Hybridization in YbAlB_{4} Probed by Linear Dichroism in Core-Level Hard X-Ray Photoemission Spectroscopy.

We have probed the crystalline electric-field ground states of pure |J=7/2,J_{z}=±5/2⟩ as well as the anisotropic c-f hybridization in both valence fluctuating systems α- and ß-YbAlB_{4} by linear polarization dependence of angle-resolved core level photoemission spectroscopy. Interestingly, the small but distinct difference between α- and ß-YbAlB_{4} was found in the polar angle dependence of linear dichroism, indicating the difference in the anisotropy of c-f hybridization, which may be a key to understanding a heavy Fermi liquid state in α-YbAlB_{4} and a quantum critical state in ß-YbAlB_{4}.

A compact permanent-magnet system for measuring magnetic circular dichroism in resonant inelastic soft X-ray scattering.

A compact and portable magnet system for measuring magnetic dichroism in resonant inelastic soft X-ray scattering (SX-RIXS) has been developed at the beamline BL07LSU in SPring-8. A magnetic circuit composed of Nd-Fe-B permanent magnets, which realised ∼0.25 T at the center of an 11 mm gap, was rotatable around the axis perpendicular to the X-ray scattering plane. Using the system, a SX-RIXS spectrum was obtained under the application of the magnetic field at an angle parallel, nearly 45° or perpendicular to the incident X-rays. A dedicated sample stage was also designed to be as compact as possible, making it possible to perform SX-RIXS measurements at arbitrary incident angles by rotating the sample stage in the gap between the magnetic poles. This system enables facile studies of magnetic dichroism in SX-RIXS for various experimental geometries of the sample and the magnetic field. A brief demonstration of the application is presented.

Wide-angle display-type retarding field analyzer with high energy and angular resolutions.

Deployments of spherical grids to obtain high energy and angular resolutions for retarding field analyzers (RFAs) having acceptance angles as large as or larger than ±45° were explored under the condition of using commercially available microchannel plates with effective diameters of approximately 100 mm. As a result of electron trajectory simulations, a deployment of three spherical grids with significantly different grid separations instead of conventional equidistant separations showed an energy resolving power (E/ΔE) of 3200 and an angular resolution of 0.6°. The mesh number of the wire mesh retarding grid used for the simulation was 250. An RFA constructed with the simulated design experimentally showed an E/ΔE of 1100 and an angular resolution of 1°. Using the RFA and synchrotron radiation of 900 eV, photoelectron diffraction (PED) measurements were performed for single-crystal graphite. A clear C 1s PED pattern was observed even when the differential energy of the RFA was set at 0.5 eV. Further improvement of the energy resolution was theoretically examined under the assumption of utilizing a retarding grid fabricated by making a large number of radially directed cylindrical holes through a partial spherical shell instead of using a wire mesh retarding grid. An E/ΔE of 14 500 was predicted for a hole design with a diameter of 60 µm and a depth of 100 µm. A retarding grid with this hole design and a holed area corresponding to an acceptance angle of ±7° was fabricated. An RFA constructed with this retarding grid experimentally showed an E/ΔE of 1800. Possible reasons for the experimental E/ΔE lower than the theoretical values are discussed.

Modification of a Standard Thoracoabdominal Incision to Preserve Collaterals to Adamkiewicz Artery.

We report a case of a 35-year-old male who underwent thoracoabdominal aortic repair of a chronic dissecting aortic aneurysm, Crawford extent II. Preoperative computed tomography showed thrombosis of almost all intercostal arteries. Precise diagnostic assessment demonstrated the Adamkiewicz artery originating from the left lateral thoracic artery and subscapular artery, which would have been at risk after using a standard Stoney's incision, thus potentially causing paraplegia or paraparesis due to spinal cord ischemia. We modified the lateral thoracic incision anteriorly and successfully preserved the collateral arteries without impairing the spinal cord function.

Graft placement with an omental flap for ruptured infective common iliac aneurysm in a patient with a continuous flow left ventricular assist device: alternative surgical approach avoiding driveline injury and pathogen identification by 16S ribosomal DNA gene analysis.

Patients supported by mechanical circulatory support have to wait for longer periods for heart transplantation in Japan. Infective events are a major complication and influence survival. Here, we present the case of a patient with an implantable left ventricular assist device for 6 months who had the complication of ruptured infective common iliac aneurysm. Graft placement with an omental flap was successfully performed via the alternative surgical approach to avoid percutaneous driveline injury. In samples of aortic specimens, 16S ribosomal DNA gene analysis identified Helicobacter cinaedi. Complete removal of the infected tissue and correct pathogen identification may have been relevant to the good clinical course.

Polarized hard X-ray photoemission system with micro-positioning technique for probing ground-state symmetry of strongly correlated materials.

An angle-resolved linearly polarized hard X-ray photoemission spectroscopy (HAXPES) system has been developed to study the ground-state symmetry of strongly correlated materials. The linear polarization of the incoming X-ray beam is switched by a transmission-type phase retarder composed of two diamond (100) crystals. The best value of the degree of linear polarization was found to be -0.96, containing a vertical polarization component of 98%. A newly developed low-temperature two-axis manipulator enables easy polar and azimuthal rotations to select the detection direction of photoelectrons. The lowest temperature achieved was 9 K, offering the chance to access the ground state even for strongly correlated electron systems in cubic symmetry. A co-axial sample monitoring system with long-working-distance microscope enables the same region on the sample surface to be measured before and after rotation. Combining this sample monitoring system with a micro-focused X-ray beam by means of an ellipsoidal Kirkpatrick-Baez mirror (25 µm × 25 µm FWHM), polarized valence-band HAXPES has been performed on NiO for voltage application as resistive random access memory to demonstrate the micro-positioning technique and polarization switching.

[Issues in Coronary Artery Bypass Grafting for Kawasaki Disease].

Progressive narrowing at the entrance and exit of coronary artery aneurysm can develop at late phase of Kawasaki disease (KD). Evaluation and prediction of progressive coronary lesions remain a challenge in the treatment of post-KD coronary artery disease. We aimed to elucidate long-standing issues imposed on the patients who underwent coronary artry bypass grafting (CABG) for coronary artery lesions associated with KD. Between January, 2000 and December, 2013, CABG for coronary artery lesions associated with KD were performed in 6 patients (male/female: 5/1, mean age 14.5±10.0). There was no operative mortality. Follow-up for the 6 patients has been performed with the average period of 5 years (1~9 years). Cardiac events occurred in 2 patients during follow-up. In 1 patient, left internal thoracic artery (LITA) occluded due to flow competition between the native artery and LITA graft after LITA to LAD bypass grafting. The other patient required a re-do CABG using the free right internal thoracic artery to the circumflex branch because of occlusion at the coronary artery aneurysms after 4 years postoperatively. Meticulous preoperative diagnostic evaluations of coronary artery aneurysm may further improve the long-term outcome after surgical intervention for coronary lesions in conjunction with an aneurysm.

[Preoperative Use of Tolvaptan in a Patient with Constrictive Pericarditis].

Tolvaptan is a new selective vasopression V2-receptor antagonist. We report our experience with a use of tolvaptan for preoperative fluid management in a patient with severe constrictive pericarditis. A 66-year-old man presented with heart failure symptoms derived from constrictive pericarditis. Chest X-ray showed right pleural effusion and chest computed tomography demonstrated severe pericardial calcification. Despite that he received optimal conventional medical treatments, his hemodynamic condition further exacerbated during hospitalization. We administered tolvaptan in an attempt to optimize preoperative fluid management. Tolvaptan was found to be remarkably effective in that regard. The body weight decreased and the heart failure symptoms improved. Pericardiectomy was performed successfully, and he recovered uneventfully.

[Early Postoperative Outcomes and Evaluation of Hemodynamics after Mitral Valve Replacement with Epic Mitral Bioprosthesis].

BACKGROUND: In Guideline for Surgical and Interventional Treatment of Valvular Heart Disease, revised by Japanese Circulation Society in 2012, mitral valve replacement (MVR) with bioprosthesis is class II b recommendation for patients aged 70 years or older who have no risk factors for thromboembolism. The aim of this study was to evaluate the early postoperative surgical outcomes and the hemodynamic performance with the Epic mitral bioprosthesis. METHODS: Twenty-six consecutive patients underwent MVR with Epic mitral bioprostesis at Tohoku University Hospital between April 2011 and July 2014. Twenty-five cases of 26 were evaluated their hemodynamics at discharge, and of which 19 cases of 26 were evaluated at the outpatient clinic during follow-up period. RESULTS: There was 1 hospital death. Long-term mortality or reoperation for any valve abnormality was not observed in the median follow-up of 23.9 ± 11.3 months. Hemodynamic date at discharge obtained by transthoracic echocardiography included mean hemodynamics of mitral valve bioprosthesis as below. Effective orifice area (EOA):2.44 ± 0.62 cm², peak mitral pressure gradient (pMPG):15.8 ± 5.3 mmHg, mean mitral pressure gradient(mMPG):7.2 ± 2.4 mmHg. Hemodynamic parameters at follow-up were found to be stable as EOA:2.25 ± 0.64 cm², pMPG:17.3 ± 5.7 mmHg, mMPG:6.2 ± 2.3 mmHg, respectively. CONCLUSION: We have attempted to elucidate our preliminary postoperative outcomes and hemodynamics after MVR with Epic mitral bioprosthesis. These in vivo hemodynamic data can serves a clinical reference.

Soft X-ray angle-resolved photoemission with micro-positioning techniques for metallic V2O3.

Soft X-ray angle-resolved photoemission has been performed for metallic V2O3. By combining a microfocus beam (40 µm × 65 µm) and micro-positioning techniques with a long-working-distance microscope, it has been possible to observe band dispersions from tiny cleavage surfaces with a typical size of several tens of µm. The photoemission spectra show a clear position dependence, reflecting the morphology of the cleaved sample surface. By selecting high-quality flat regions on the sample surface, it has been possible to perform band mapping using both photon-energy and polar-angle dependences, opening the door to three-dimensional angle-resolved photoemission spectroscopy for typical three-dimensional correlated materials where large cleavage planes are rarely obtained.

[Leg amputation for severe lower limb ischemia caused by type A acute aortic dissection; report of a case].

A 41-year-old man underwent total arch replacement and aorto-bifemoral bypass owing to type A acute aortic dissection complicated by ischemia of both lower extremities. Just after the operation, he developed myonephropathic metabolic syndrome due to severe ischemia of the right leg, and hemodiafiltration was performed. However, the serum potassium was elevated to an uncontrollable level. Ligation of the right femoral artery and the right branch of the bypass graft was performed one hour after the transfer to intensive care unit (ICU), and the serum potassium dropped to a normal level. He underwent amputation of the right lower limb above the knee on the 13th postoperative day, and was discharged after long-term rehabilitation.

Oxidized arachidonic acid and hexanal enhance mouse taste perception of monosodium glutamate.

OBJECTIVE: Little is known about whether mammals use gustatory sense to detect compounds produced from oxidized oil as a taste or only use olfactory sense to detect the compounds as aroma. The present study examined the effects of oxidized arachidonic acid (AA) ethyl ester and hexanal, one predominant compound in oxidized AA, on mouse taste perception of monosodium glutamate (MSG). METHOD: We examined the effects of oxidized ethyl AA and hexanal on chorda tympani (CT) nerve response to MSG using mouse electrophysiological technique. In addition, we evaluated the effects of aliphatic aldehydes and alcohol which are compounds structurally related to hexanal with carbon chain lengths or a functional group different from hexanal on taste perception of MSG using behavioral and electrophysiological studies. RESULT: The CT nerve responses to 10, 20, and 50 mM MSG with water extracts of oxidized ethyl AA was higher than that to MSG alone. A total of 1000 µM hexanal and pentanal enhanced mouse taste response to MSG, but 1000 µM propanal and 1-hexanol failed to increase the responses. DISCUSSION: The products of oxidized ethyl AA and hexanal would enhance the taste sensation of MSG, which suggests that CT nerve input should be important for projection to the behavioral responses. The carbon chain length and the functional group of hexanal would be key factors of the hexanal effect on mouse taste perception of MSG.

Complete atrioventricular block subsequent to thrombosed-type acute aortic dissection.

We report a case of complete atrioventricular block subsequent to thrombosed-type acute aortic dissection. An 81-year-old woman with thrombosed-type acute aortic dissection experienced cardiopulmonary arrest and complete atrioventricular block 6 days after aortic dissection. After temporary pacing, a permanent pacemaker was implanted. Atrioventricular conductivity disorders that result in complete atrioventricular block are rare complications developing after aortic dissection, especially thrombosed-type aortic dissection. We discuss the cause of atrioventricular block subsequent to aortic dissection.

Procaterol inhibits rhinovirus infection in primary cultures of human tracheal epithelial cells.

ß(2) agonists reduce the frequency of exacerbations in patients with bronchial asthma and chronic obstructive pulmonary disease caused by respiratory virus infection. ß(2) agonists reduce the production of pro-inflammatory cytokines. However, the inhibitory effects of ß(2) agonists on the infection of rhinovirus, the major cause of exacerbations, have not been well studied. To examine the effects of a ß(2) agonist, procaterol, on rhinovirus infection and rhinovirus infection-induced airway inflammation, human tracheal epithelial cells were infected with a major group rhinovirus, type 14 rhinovirus. Rhinovirus infection increased viral titers and the content of pro-inflammatory cytokines, including interleukin-1ß and interlukin-6, in supernatant fluids and rhinovirus RNA in the cells. Procaterol reduced rhinovirus titers and RNA, cytokine concentrations, and susceptibility to rhinovirus infection. Procaterol reduced the expression of intercellular adhesion molecule-1 (ICAM-1), the receptor for type 14 rhinovirus, and the number of acidic endosomes in the cells from which rhinovirus RNA enters into the cytoplasm. Procaterol inhibited the activation of nuclear factor kappa-B (NF-κB) proteins including p50 and p65 in the nuclear extracts, while it increased the cytosolic amount of the inhibitory kappa B-α and intracellular cyclic AMP (cAMP) levels. A selective ß(2)-adrenergic receptor antagonist ICI 118551 [erythro-dl-1-(7-methylindan-4-yloxy)-3-isopropylaminobutan-2-ol] reversed the inhibitory effects of procaterol on rhinovirus titers and RNA, susceptibility to rhinovirus infection, pro-inflammatory cytokines production, ICAM-1 expression, acidic endosomes, and NF-κB. ICI 118551 also reversed the effects of procaterol on cAMP levels. Procaterol may inhibit rhinovirus infection by reducing ICAM-1 and acidic endosomes as well as modulate airway inflammation in rhinovirus infection.

Effect of oxidized arachidonic acid and hexanal on the mouse taste perception of bitterness and umami.

The oxidization of fatty acids generates many volatile compounds forming an aroma, but little is known whether mammals use gustatory sense to detect the oxidized products as a taste or only use olfactory sense to detect as an aroma. We examined in this study the effect of aqueous extracts of the compounds from autoxidized arachidonic acid (AA) ethyl ester or hexanal which is the predominant component generated from oxidized AA by the anosmic mouse licking performance to a tastant. The addition of the water extract from oxidized AA or hexanal to a quinine hydrochloride (QHCl) solution decreased the anosmic mice licking frequency at several concentrations of QHCl. Hexanal also reduced the licking frequency of anosmic mice conditioned to avoid MSG at several concentrations of monosodium glutamate (MSG). These results suggest that hexanal would affect mouse taste perception to QHCl and MSG via the gustatory sensation.

Modification of the descending thoracic aortic anastomotic site using biodegradable felt: study in a canine model with or without basic fibroblast growth factor.

OBJECTIVES: We investigated the outcomes of reinforcing anastomotic sites using (1) nonbiodegradable polytetrafluoroethylene (PTFE) felt, (2) biodegradable polyglycolic acid (PGA) felt, and (3) PGA felt with basic fibroblast growth factor (bFGF) in a canine descending thoracic aortic replacement model. METHODS: Thirty-seven beagles underwent descending thoracic aorta replacement using a prosthetic graft with one of the above-mentioned reinforcements or no reinforcement for controls. Histologic evaluations were carried out 1 month and 3 months after surgery. The biomechanical strength of the anastomosis was assessed along the longitudinal axis of the aortic segments using a tensile tester. Local compliance at the anastomotic site was also evaluated in the circumferential direction. RESULTS: The media was significantly thinner in the PTFE group than in the control group (65.8% +/- 5.1% vs 95.0% +/- 9.3% of normal thickness; P < .05). Relative to the control group, the adventitial layer was significantly thinner in the PTFE group (42.3% +/- 8.2% of control; P < .05) but significantly thicker in the PGA and the PGA + bFGF groups (117.2% +/- 11.3% and 134.1% +/- 14.2% of control, respectively; P < .05). There were more vessels in the adventitial layer in the PGA + bFGF group than in the control, PTFE, and PGA groups (29.2 +/- 2.1/mm(2) vs 13.8 +/- 0.8, 5.4 +/- 0.7, 17.0 +/- 1.3/mm(2), respectively; P < .01). There were no significant differences between the four groups in the failure force at anastomotic sites. Local compliance at the anastomotic site was higher in the PGA group than that in the PTFE group (11.6 +/- 1.6 10(-6) m(2)/N vs 5.6 +/- 1.9 10(-6) m(2)/N; P < .05). CONCLUSION: Reinforcement of the experimental aortic wall with PTFE felt resulted in thinning of the media and adventitia and fewer vessels at the anastomotic site. These histologic changes were not observed when biodegradable felt was used. The bFGF failed to augment the modification of the aortic wall with the exception of increased adventitial vessel number. Biomechanical strength of the anastomosis along the longitudinal axis was comparable in all four groups; however, local vascular compliance was better in the biodegradable PGA felt group.

Effect of low-dose landiolol, an ultrashort-acting beta-blocker, on postoperative atrial fibrillation after CABG surgery.

OBJECTIVE: Postoperative atrial fibrillation is the most common complication after coronary artery bypass grafting (CABG). This complication is associated with prolongation of the intensive care unit stay and hospitalization time with attendant increased hospitalization costs, and it is an important risk factor for perioperative cerebrovascular accidents. Landiolol is a newly developed ultrashort-acting beta-adrenoceptor antagonist with a half-life of 3 min that is eight times more cardioselective than esmolol. The purpose of this study was to investigate the prophylactic effect of continuous administration of low-dose landiolol on postoperative atrial fibrillation. METHODS: We reviewed all patients who underwent CABG alone at our hospital from April 2002 and September 2006. Patients with a previous history of atrial arrhythmias were excluded. The remaining patients were divided to two groups: landiolol group (n = 20), and control group (n = 35). Administration of landiolol started after cardiopulmonary bypass with a loading dose of 1.5-2.5 mug.kg(t-1).min(-1) and continued for the first 2 days after surgery. The incidence of postoperative atrial fibrillation was noted. Continuous variables were compared between groups by means of Student's t-test. Categorical variables were compared by means of the chi(2) test or Fisher's exact test. RESULTS: The occurrence of atrial fibrillation after CABG in the control group was statistically more than in the landiolol group (P = 0.04). There were no statistical differences between the groups regarding the cardiac index or the dose of inotropic agents during the perioperative period. CONCLUSION: Intraoperative and perioperative administration of low-dose landiolol has a preventive effect on the appearance of atrial fibrillation after CABG surgery.

Trial of new vascular clips for aortic anastomosis in a canine model.

OBJECTIVES: We created a new vascular clip designed for aortic surgery. The purposes of this investigation were to examine surgical applicability in a clinically relevant aortic replacement model and to assess biomechanical strength of the clipped anastomosis and serial histologic changes in the clipped anastomotic site. METHODS: Twenty-one beagles underwent descending thoracic aortic replacement. Distal anastomosis was performed with the new clips, mimicking the cuffed anastomosis technique, and proximal anastomosis was carried out by conventional suture anastomosis. Tissue specimens of the anastomotic sites were harvested at 1, 3, 6, and 12 months postoperatively for examination. RESULTS: There was no significant difference in the time required to carry out clip anastomosis (12.2 +/- 1.3 minutes) and suture anastomosis (13.7 +/- 0.9 minutes; P = .38). Neither type of anastomotic site was disrupted by raising the intraluminal pressure to 280 mm Hg. Microscopically, the areas of aortic wall compressed by vascular clips appeared as hyalinized areas adjacent to surrounding collagen fibers, with no significant infiltration of inflammatory cells. Identical histologic changes were observed at the site of the sutured anastomosis. The media at the clipped anastomosis site was significantly thinner than that at the sutured anastomosis site at 1 month after the operation. However, there was no significant difference in the thickness of the media at 3 months. CONCLUSIONS: The new vascular clips were effective in this clinically relevant model, with appropriate biomechanical strength, and the anastomotic sites underwent similar histologic changes to those observed after suture anastomosis.