Associations between patterns of participation in community activities and social support, self-efficacy, self-rated health among community-dwelling older adults.

Certain types of community-based social activities improve the health issues of older adults; however, the present patterns of participation in community activities remain unknown. This study aims 1) to identify community-dwelling older adults' patterns of participation in community-based activities and 2) to evaluate the relationships between social support, self-efficacy, self-rated health, and the patterns of participation in community activities. This cross-sectional study used data collected from 146 older adults aged ≥65 years who participated in community events in Japan in 2018. Cluster analysis was used to identify subjects' patterns of participation in community activities. In the multinomial logistic regression model, the participation pattern (dependent variable), and social support and self-efficacy (independent variables), were included, adjusting for age, sex, and years of residency. Three participation pattern clusters were identified: diverse activities (58%), municipal events (30%), and senior citizen club (12%). The proportion of participants reported themselves healthy were 93%, 88%, and 78% for diverse activities, municipal events, and senior citizen club clusters, respectively. Compared to those in the senior citizen club cluster, older adults in the diverse activities cluster were more likely to have self-efficacy (adjusted odds ratio (aOR): 1.19, p = .041) and social support (aOR: 2.35, p = .018), while participants in the municipal events cluster were associated with only social support (aOR: 3.29, p = .022). Increasing social support and self-efficacy may promote seniors' participation in diverse community activities, which would be beneficial for their healthy aging. Further studies are needed to evaluate the causal relationships.

Differences in characteristics of raters who use the visual estimation method in hospitals based on their training experiences.

BACKGROUND & AIMS: Despite a clinical need, only a few studies have provided information concerning visual estimation training for raters to improve the validity of their evaluations. This study aims to describe the differences in the characteristics of raters who evaluated patients' dietary intake in hospitals using the visual estimation method based on their training experiences. METHODS: We collected data from three hospitals in Tokyo from August to September 2016. The participants were 199 nursing staff members, and they completed a self-administered questionnaire on demographic data; working career; training in the visual estimation method; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity of and skills of visual estimation. We classified participants into two groups, experienced and inexperienced, based on whether they had received training. Square test, Mann-Whitney U test, and univariable and multivariable logistic regression analysis were used to describe the differences between these two groups in terms of their characteristics; knowledge, attitude, and practice associated with nutritional care; and self-evaluation of method validity and tips used in the visual estimation method. RESULTS: Of the 158 staff members (79.4%) (118 nurses and 40 nursing assistants) who agreed to participate in the analysis, thirty-three participants (20.9%) were trained in the visual estimation method. Participants who had received training had better knowledge (2.70 ± 0.81, score range was 1-5) than those who had not received any training (2.34 ± 0.74, p = 0.03). Score of self-evaluation of method validity of the visual estimation method was higher in the experienced group (3.78 ± 0.61, score range was 1-5) than the inexperienced group (3.40 ± 0.66, p < 0.01). Mean total scores of using tips in the visual estimation method in the experienced and inexperienced groups were 19.6 ± 1.76 and 17.9 ± 2.28, respectively (score range was 6-24), differing significantly between the two groups (p < 0.01). Multivariable logistic regression revealed that participants who had been trained had adequate knowledge (OR: 2.78, 95% CI: 1.05-7.35) and frequently used tips in visual estimation (OR: 1.85, 95% CI: 1.26-2.73). CONCLUSION: Trained participants had more required knowledge and they used visual estimation tips more frequently than participants who had not been trained in the visual estimation method. This study provides new evidence for the importance of training clinical staff members to use the visual estimation method appropriately and makes suggestions to improve the validity of the visual estimation method.

Differences in the validity of a visual estimation method for determining patients' meal intake between various meal types and supplied food items.

BACKGROUND & AIMS: The aim of this study was to examine differences in the validity of a visual estimation method for determining patients' meal intake between various meal types and supplied food items in hospitals and to find factors influencing the validity of a visual estimation method. METHODS: There are two procedures by which we obtained the information on dietary intake of the patients in these hospitals. These are both by visual assessment from the meal trays at the time of their clearing, by the attending nursing staff and by weighing conducted by researchers. The following criteria are set for the target trays: A) standard or therapeutic meals, which are monitored by a doctor, for energy and/or protein and/or sodium; B) regular, bite-sized, minced and pureed meal texture, and C) half-portion meals. Visual assessment results were tested for their validity by comparing with the corresponding results of weighing. Differences between these two methods indicated the estimated and absolute values of nutrient intake. RESULTS: A total of 255 (76.1%) trays were included in the analysis out of the 335 possible trays and the results indicated that the energy consumption estimates by visual or weighing procedures are not significantly different (412 ± 173 kcal, p = 0.15). However, the mean protein consumption was significantly different (16.3 ± 6.7 g/tray, p < 0.01) between the two procedures. Compared with standard meals (38 ± 45 kcal, 1.9 ± 2.5 g/tray), raters significantly misestimated the energy and protein intake of half-portion meals (78 ± 65 kcal, 2.8 ± 2.2 g/tray, p = 0.01) but accurately estimated the protein intake of protein controlled meals (0.5 ± 0.6 g/tray, p = 0.03). Trays adding supplied food items were significantly misestimated for energy intake (66 ± 58 kcal/tray) compared to trays with no additions (32 ± 39 kcal/tray, p < 0.01). Moreover, the results of multivariable analysis demonstrated that supplied food items were significantly associated with increased odds of a difference between the two methods (OR: 3.84; 95% confidence interval [CI]: 1.07-13.85). CONCLUSIONS: There were high correlations between the visual estimation method and the weighing method measuring patients' dietary intake for various meal types and textures, except for meals with added supplied food items. Nursing staff need to be attentive to supplied food items.

Association Between Interdialytic Weight Gain, Perception About Dry Weight, and Dietary and Fluid Behaviors Based on Body Mass Index Among Patients on Hemodialysis.

OBJECTIVE: This study aimed to identify dietary and fluid behaviors associated with relative interdialytic weight gain (RIDWG) (divided by the respective dry weight [DW]) by stratifying the patients according to body mass index (BMI). DESIGN AND METHODS: This was a cross-sectional, multicenter investigation. Between July 2016 and March 2017, data were collected from 4 Japanese dialysis centers in 3 cities. The patients (n = 577) were asked to reply to a self-completed questionnaire, including questions on perception about DW and dietary and fluid behaviors. The differences in perception about DW and dietary and fluid behaviors were compared between RIDWG nonadherence (average RIDWG ≥5％ a month) and adherence subgroups. RESULTS: The 360 participants were stratified into thin (<20; 28.6%), normal low (≥20 and <22; 22.5%), normal high (≥22 and <25; 31.7%), and overweight (≥25; 17.2%) groups on the basis of BMI. In the thin and normal low BMI groups, the RIDWG nonadherent patients were more likely to identify their DW as "looking to increase." Although the difference was less prominent between the adherence subgroups in the thin BMI group, the RIDWG nonadherent patients in normal low BMI group seemed to generally take less care to intentionally regulate their behaviors as a representative of sodium-intake/fluid management. Although patients with a larger body size (overweight and normal high BMI groups) were not associated with this perception about DW, they were associated with some demographic characteristics; regarding the normal high BMI group, a higher proportion of RIDWG nonadherent patients worked full-time, and they more frequently reported an irregular eating pattern. CONCLUSION: Dietary and fluid behaviors associated with RIDWG differed according to the BMI group. Assessing more specific types of patient behaviors, focusing on the underlying factors associated with dietary and fluid behaviors, and taking BMI into consideration are required.

Birbeck granules, worm-like bodies and "lupus erythematosus virus".

The origin of worm-like bodies and their relationship with Birbeck granules is poorly understood. To clarify the origin of worm-like bodies and their relationship with Birbeck granules. Over 800 electron micrographs of histiocytic disorders and several appendage tumours were reviewed in order to check for worm-like bodies and Birbeck granules. Worm-like bodies were most often encountered in mildly- to moderately-proliferative histiocytic tumours. Birbeck granules were observed in more malignant conditions. Narrow endoplasmic reticulum (Nrer), which resembles worm-like bodies, was abundant in worm-like body-rich cells and coexisted with Birbeck rods. Nrer is thought to be one of the candidates that gives rise to worm-like bodies. An ultrastructural similarity exists between worm-like bodies (and octopus body formation) and the so-called "lupus erythematosus virus". The presence of Nrer is often concomitant with other organelle markers, and could be a candidate for the origin of worm-like bodies.

A new high-pressure strontium germanate, SrGe2O5.

The Sr-Ge-O system has an earth-scientific importance as a potentially good low-pressure analog of the Ca-Si-O system, one of the major components in the constituent minerals of the Earth's crust and mantle. However, it is one of the germanate systems that has not yet been fully examined in the phase relations and structural properties. The recent findings that the SrGeO3 high-pressure perovskite phase is the first Ge-based transparent electronic conductor make the Sr-Ge-O system interesting in the field of materials science. In the present study, we have revealed the existence of a new high-pressure strontium germanate, SrGe2O5. Single crystals of this compound crystallized as a co-existent phase with SrGeO3 perovskite single crystals in the sample recovered in the compression experiment of SrGeO3 pseudowollastonite conducted at 6 GPa and 1223 K. The crystal structure consists of germanium-oxygen framework layers stacked along [001], with Sr atoms located at the 12-coordinated cuboctahedral site; the layers are formed by the corner linkages between GeO6 octahedra and between GeO6 octahedra and GeO4 tetrahedra. The present SrGe2O5 is thus isostructural with the high-pressure phases of SrSi2O5 and BaGe2O5. Comparison of these three compounds leads to the conclusion that the structural responses of the GeO6 and GeO4 polyhedra to cation substitution at the Sr site are much less than that of the SrO12 cuboctahedron to cation substitution at the Ge sites. Such a difference in the structural response is closely related to the bonding nature.

Gold-Catalyzed Anti-Markovnikov Selective Hydrothiolation of Unactivated Alkenes.

Despite the widespread use of transition-metal catalysts in organic synthesis, transition-metal-catalyzed reactions of organosulfur compounds, which are known as catalyst poisons, have been difficult. In particular, the transition-metal-catalyzed addition of organosulfur compounds to unactivated alkenes remains a challenge. A novel gold-catalyzed hydrothiolation of unactivated alkenes is presented, which proceeds effectively to give the anti-Markovnikov-selective adducts in good yields and in a regioselective manner.

Criterion validity of the visual estimation method for determining patients' meal intake in a community hospital.

BACKGROUND & AIMS: The accuracy of the visual estimation method is unknown, even though it is commonly used in hospitals to measure the dietary intake of patients. We aimed to compare the difference in the validity of visual estimation according to the raters' job categories and tray divisions, and to demonstrate associations between meal characteristics and validity of visual estimation in a usual clinical setting in a community hospital. METHODS: We collected patients' dietary intake data in usual clinical settings for each tray in 3 ways: visual estimation by nursing assistants, visual estimation by dietitians, and weighing by researchers (reference method). Dietitians estimated the dietary intake using 2 divisions, namely, whole tray and food items. Then we compared the weights and visual estimation data to evaluate the validity of the visual estimation method. RESULTS: Mean nutrient consumption of target trays was significantly different when using the visual estimation of target trays than when using the weighed method (visual estimation by nursing assistants [589 ± 168 kcal, 24.3 ± 7.0 g/tray, p < 0.01], dietitians' whole trays [561 ± 171 kcal, 23.0 ± 6.9 g/tray, p < 0.05], food items [562 ± 171 kcal/tray, p < 0.05], and dietitians' food items [23.4 ± 7.3 g/tray, p = 0.63]). Spearman's correlations for both methods were very high for energy (ρ = 0.91-0.98, p < 0.01) and protein intakes (ρ = 0.88-0.96, p < 0.01), respectively. The limits of agreement in the Bland-Altman plot for both dietary intake categories were -121 kcal to 147 kcal/tray and -6.4 g to 7.0 g/tray (nursing assistants, whole division), -122 kcal-106 kcal/tray and -6.7 g to 5.5 g/tray (dietitians, whole divisions), and -82 kcal to 66 kcal/tray and -4.3 g to 3.9 g/tray (dietitians, food items divisions). High intake rate of grains was significantly associated with decreased odds of a difference between two methods based on the nursing assistant's whole tray evaluation (odds ratio [OR]: 0.85; 95% confidence interval [CI]: 0.76-0.94) and the dietitians' whole tray (OR: 0.80; 95% CI: 0.72-0.89) and food items evaluations (OR: 0.64; 95% CI: 0.56-0.73), respectively. In addition, minced meals were also associated with a difference between two methods, for the nursing assistants' whole tray (OR: 3.53; 95% CI: 1.66-7.51) and dietitians' food items (OR: 2.92; 95% CI: 1.37-6.22). CONCLUSIONS: Visual estimation by nursing assistants and dietitians correlated highly with the weighing method although the limits of agreement were wide. Nursing assistants and dietitians should pay attention to low consumption and modified texture meals when evaluating dietary intake using the visual estimation method.

Crystal structure of post-perovskite-type CaIrO3 reinvestigated: new insights into atomic thermal vibration behaviors.

Single crystals of the title compound, the post-perovskite-type CaIrO3 [calcium iridium(IV) trioxide], have been grown from a CaCl2 flux at atmospheric pressure. The crystal structure consists of an alternate stacking of IrO6 octa-hedral layers and CaO8 hendeca-hedral layers along [010]. Chains formed by edge-sharing of IrO6 octa-hedra (point-group symmetry 2/m..) run along [100] and are inter-connected along [001] by sharing apical O atoms to build up the IrO6 octa-hedral layers. Chains formed by face-sharing of CaO8 hendeca-hedra (point-group symmetry m2m) run along [100] and are inter-connected along [001] by edge-sharing to build up the CaO8 hendeca-hedral layers. The IrO6 octa-hedral layers and CaO8 hendeca-hedral layers are inter-connected by sharing edges. The present structure refinement using a high-power X-ray source confirms the atomic positions determined by Hirai et al. (2009 ▸) [Z. Kristallogr. 224, 345-350], who had revised our previous report [Sugahara et al. (2008 ▸). Am. Mineral. 93, 1148-1152]. However, the displacement ellipsoids of the Ir and Ca atoms based on the present refinement can be approximated as uniaxial ellipsoids elongating along [100], unlike those reported by Hirai et al. (2009 ▸). This suggests that the thermal vibrations of the Ir and Ca atoms are mutually suppressed towards the Ir⋯Ca direction across the shared edge because of the dominant repulsion between the two atoms.

Crystal structure of SrGeO3 in the high-pressure perovskite-type phase.

Single crystals of the SrGeO3 (strontium germanium trioxide) high-pressure phase have been synthesized successfully at 6 GPa and 1223 K. The compound crystallizes with the ideal cubic perovskite-type structure (space group Pm-3m), which consists of a network of corner-linked regular GeO6 octa-hedra (point-group symmetry m-3m), with the larger Sr atoms located at the centers of cavities in the form of SrO12 cubocta-hedra (point-group symmetry m-3m) in the network. The degrees of covalencies included in the Sr-O and the Ge-O bonds calculated from bond valences are 20.4 and 48.9%, respectively. Thus, the Ge-O bond of the GeO6 octa-hedron in the SrGeO3 perovskite has a strong covalency, comparable to those of the Si-O bonds of the SiO4 tetra-hedra in silicates with about 50% covalency. The thermal vibrations of the O atoms in the title compound are remarkably suppressed in the directions of the Ge-O bonds. This anisotropy ranks among the largest observed in stoichiometric cubic perovskites.

A novel strategy for preparing nanoporous biphasic calcium phosphate of controlled composition via a modified nanoparticle-assembly method.

Biphasic calcium phosphate (BCP) consisting of hydroxyapatite (HAp) and ß-tricalcium phosphate is usually prepared by thermal decomposition of calcium-deficient HAp (CDHAp). However, the calcium deficiency and morphology of CDHAp are difficult to manipulate in parallel. In this study, we report a novel strategy for controlling the composition of nanoporous BCP by using only CDHAp nanoparticles with specific properties (Ca/P molar ratio, 1.61; particle size, 50 nm) as a building block and by adjusting the calcium deficiency of the nanoparticle-assembled CDHAp (Ca/P molar ratio, 1.50-1.67; pore size, 8 nm) with the addition of water-soluble Ca(NO3)2 or (NH4)2HPO4. After thermal treatment at 1000 °C, the composition of BCP could be predictably controlled by adjusting the Ca/P ratio of the nanoparticle-assembled CDHAp. Changes in the Ca/P ratio did not significantly affect the surface morphology of BCP, but the grain size (210-300 nm) and pore size (140-170 nm) tended to increase slightly as the Ca/P ratio decreased. The porosity significantly decreased upon the addition of Ca salts (porosity, 20%) or PO4 salts (porosity, 14%) compared with that of the sample without additives (porosity, 53%). In vitro tests demonstrated enhanced cell adhesion on nanoporous BCP compared with densely sintered pure HAp, and cell differentiation was promoted on the nanoporous pure HAp.

Change in albumin measurement method affects diagnosis of nephrotic syndrome.

BACKGROUND: Although serum albumin levels (sALB) have been quantified by the dye-binding method with bro- mocresol green (BCG) or bromocresol purple (BCP) on a routine basis, accurate measurement of sALB with these methods is difficult. The modified BCP method is highly specific to albumin without being affected by sample preservation to enable stable and accurate quantification of albumin concentrations. A change in the albumin measurement method may alter the diagnosis of nephrotic syndrome. METHODS: sALB was measured in 295 patients including 98 patients with chronic renal disease by the modified BCP method, BCG method, and immunonephelometry as the gold standard. RESULTS: sALB measured by the modified BCP method was well correlated with levels measured by immunonephelometry. sALB obtained by the BCG method was significantly higher than the levels measured by the modified BCP method (p < 0.001, Student's t-test). This tendency was more evident in patients with chronic renal disease than other patients. When the threshold value of sALB for the diagnosis criteria of nephrotic syndrome (≤ 25 g/L) and a high risk of thrombosis (≤ 20 g/L) in nephrotic syndrome was based on the BCG method, the revised criteria in the modified BCP method would be ≤ 20.5 and ≤ 14.9 g/L, respectively. CONCLUSIONS: Overestimation of sALB by the BCG method affected diagnosis of nephrotic syndrome. The method by which sALB is measured should be specified in both clinical and research settings in nephrology.

Expansion of nanosized pores in low-crystallinity nanoparticle-assembled plates via a thermally induced increase in solid-state density.

We investigated thermally induced changes in a low-crystallinity hydroxyapatite (HAp)-nanoparticle-assembled plate containing nanosized pores. We first prepared an aqueous dispersion of low-crystallinity HAp nanoparticles (particle size, 48 nm) via a wet chemical process and then prepared the nanoparticle-assembled plate by drying the dispersion on an oil substrate to prevent crack formation. Before the plates were subjected to heat treatments, they contained 7.9-nm-sized pores because of the gap between the nanoparticles, and their porosity was 60%. After the heat treatments (600-1100 °C) were performed for 1 h, the solid-state density determined using helium pycnometry increased from 2.85 to 3.21 g/cm(3), and the pore size increased from 7.9 to 250 nm. These results indicate that the pore size expanded because of increases in crystallinity and density, despite the large decrease in the total volume because of thermally induced sintering of the nanoparticles.

Induced radioactivity in the blood of cancer patients following Boron Neutron Capture Therapy.

Since 1990, Boron Neutron Capture Therapy (BNCT) has been used for over 400 cancer patients at the Kyoto University Research Reactor Institute (KURRI). After BNCT, the patients are radioactive and their (24)Na and (38)Cl levels can be detected via a Na-I scintillation counter. This activity is predominantly due to (24)Na, which has a half-life of 14.96 h and thus remains in the body for extended time periods. Radioactive (24)Na is mainly generated from (23)Na in the target tissue that is exposed to the neutron beam in BNCT. The purpose of this study is to evaluate the relationship between the radioactivity of blood (24)Na following BNCT and the absorbed gamma ray dose in the irradiated field. To assess blood (24)Na, 1 ml of peripheral blood was collected from 30 patients immediately after the exposure, and the radioactivity of blood (24)Na was determined using a germanium counter. The activity of (24)Na in the blood correlated with the absorbed gamma ray doses in the irradiated field. For the same absorbed gamma ray dose in the irradiated field, the activity of blood (24)Na was higher in patients with neck or lung tumors than in patients with brain or skin tumors. The reasons for these findings are not readily apparent, but the difference in the blood volume and the ratio of bone to soft tissue in the irradiated field, as well as the dose that leaked through the clinical collimator, may be responsible.

Prediction of groundwater contamination with 137Cs and 131I from the Fukushima nuclear accident in the Kanto district.

We measured the concentrations of (131)I, (134)Cs, and (137)Cs released from the Fukushima nuclear accident in soil and rainwater samples collected March 30-31, 2011, in Ibaraki Prefecture, Kanto district, bordering Fukushima Prefecture to the south. Column experiments revealed that all (131)I in rainwater samples was adsorbed onto an anion-exchange resin. However, 30% of (131)I was not retained by the resin after it passed through a soil layer, suggesting that a portion of (131)I became bound to organic matter from the soil. The (137)Cs migration rate was estimated to be approximately 0.6 mm/y in the Kanto area, which indicates that contamination of groundwater by (137)Cs is not likely to occur in rainwater infiltrating into the surface soil after the Fukushima accident.

Computed tomography enteroclysis for recurrent severe gastrointestinal bleeding in a patient with vascular malformation of the small bowel.

This is a case study of a 66-year-old woman who had a vascular malformation of the small bowel that was visualized on computed tomography enteroclysis (CTE). She presented with repeated tarry stool and severe anemia. Although the source of bleeding was not identified on upper and lower gastrointestinal endoscopy, active bleeding was revealed by capsule endoscopy in the deep jejunum. The cause of bleeding was not found on capsule endoscopy. CTE was requested as double-balloon endoscopy would have been difficult because of strong adhesion of the small intestine. A continual subtle vascular malformation of the jejunum, starting from the third jejunal branch end, was demonstrated on CTE with dynamic contrast enhancement. Because this vascular malformation was considered the cause of small intestinal bleeding, selective arterial coil embolization was performed. After embolization, the repeated tarry stool disappeared and the severe anemia dramatically improved. CTE may be a safe and useful method for determining the cause of small intestinal bleeding and for subsequent therapy.