Dysphagia is an independent predictor of hospital-acquired disability in older patients with heart failure: a propensity score-matched analysis : Predictors of HAD in older HF patients.

This study aims to identify the relationship between dysphagia and developing hospital-acquired disability (HAD) in older patients with heart failure (HF). This single-center retrospective cohort study included 360 patients (median age, 84 years: 58.1% female, 41.9% male) who had undergone rehabilitation and were aged 65 years and older. Patients were divided into dysphagia and non-dysphagia groups and compared based on the Functional Oral Intake Scale score. HAD was defined as a decline in the Barthel Index score (indication of daily activity levels) at discharge relative to that before admission. The relationship between dysphagia and HAD was analyzed using bivariate analysis after adjusting for age, sex, body mass index, medical history, clinical and laboratory data, short physical performance battery (SPPB), and cognitive function at the start of rehabilitation, using propensity score matching. HAD was observed in 38.1% of the patients. Patients with dysphagia were significantly older, and had lower body mass index and physical and cognitive function than those without. After propensity score matching, the prevalence of HAD was significantly higher in the dysphagia group than in the non-dysphagia group (61.9% vs. 42.9%, P = 0.032). Dysphagia at the start of rehabilitation was an independent predictor of HAD. The results of this study may contribute to risk stratification of HAD.

Topochemical Synthesis of LiCoF3 with a High-Temperature LiNbO3-Type Structure.

A novel perovskite fluoride, LixCoF3, which has an exceptionally low tolerance factor (0.81), has been synthesized via low-temperature lithium intercalation into a distorted ReO3-type fluoride CoF3 using organolithium reagents. Interestingly, this reaction is completed within 15 min at room temperature. Synchrotron X-ray diffractometry and optical second harmonic generation at room temperature have revealed that this compound shows a high-temperature LiNbO3-type structure (space group: R3̅c) involving Li-Co antisite defects and A-site splitting along the c direction. A-site splitting is consistent with the prediction based on hybrid Hartree-Fock density functional theory calculations. Co-L2,3 edge X-ray absorption spectroscopy, as well as bond valence sum analysis, has verified the divalent oxidation state of Co ions in the lithiated phase, suggesting that its composition is close to LiCoF3 (x ≈ 1). This compound exhibits a paramagnetic-to-antiferromagnetic transition at 36 K on cooling, accompanied by weak ferromagnetic ordering. The synthetic route based on low-temperature lithiation of metal fluorides host paves the way for obtaining a new LiNbO3-type fluoride family.

Dysphagia and malnutrition limit activities of daily living improvement in phase i cardiac rehabilitation: a prospective cohort study for acute phase heart failure patients.

Dysphagia and malnutrition combinations in hospitalized patients with acute heart failure (AHF) may affect activities of daily living (ADL) after hospital discharge more than dysphagia or malnutrition alone. The aim of the present study to clarify the impact of the combination of dysphagia and malnutrition on ADL in hospitalized patients with acute phase heart failure who have undergone cardiac rehabilitation (CR). Prospective cohort study. Acute care hospital. Participants were 224 AHF patients undergoing CR. Barthel index (BI), functional oral intake scale (FOIS), controlling nutritional status (CONUT), short physical performance battery (SPPB), and mini-mental state examination were evaluated at baseline. We examined primary effects of predictors (CONUT) and the moderator (FOIS) and the interaction effect of FOIS and CONUT (FOIS × CONUT) using hierarchical linear regression model and simple-slope tests. The ADL independence dropped in 29.5% of the patients on hospitalization; however, 82.6% of the patients successfully regained their independence at discharge. Based on the FOIS score and nutritional status on admission, 58.5% of the patients were classified into the non-dysphagia and non-malnutrition categories, 21.0% into non-dysphagia and malnutrition, 15.2% into dysphagia and non-malnutrition, and 5.3% into dysphagia and malnutrition. Lower FOIS and SPPB scores as well as the FOIS × CONUT interaction predicted a significantly lower BI but not CONUT. Simple slope test revealed a negative association between CONUT and BI with low-level FOIS (B = - 2.917, P < .001) but not with high-level FOIS (B = .476, P = .512). Thus, patients with dysphagia and malnutrition in combination had a greater risk of failed recovery of ADL after cardiac rehabilitation than those without this combination. In hospitalized AHF patients, FOIS and CONUT had an interactive effect on BI at hospital discharge in cases with low-level FOIS. Early detection of dysphagia might improve the accurate identification of hospitalized AHF patients at higher risk of ADL dependence at discharge.

Examination of independent predictors of discharge disposition in acute phase hospitalized heart failure patients undergoing phase I cardiac rehabilitation.

BACKGROUND: Increasing acute heart failure (HF) population is very common. Discharge disposition is one of the major cardiac rehabilitation (CR) outcomes. However, there were few data exist on home discharge criteria in acute phase HF patients who were underwent CR. AIM: The aim of this study was to clarify the predictors of home discharge in acute phase hospitalized HF patients who were underwent guideline-based CR. DESIGN: The study was designed as an intervention study. SETTING: This study took place in acute-hospital setting. POPULATION: Participants were 320 hospitalized acute phase HF patients who were underwent Japanese guideline-based CR. METHODS: Knee extension strength (KES), exercise tolerance, short physical performance battery (SPPB), Barthel Index (BI), mini-mental state examination (MMSE) and controlling nutritional status (CONUT) were evaluated on hospital admission and at hospital discharge, respectively. At hospital discharge, patients were divided into the home group (N.=255) and the non-home group (N.=65) based on discharge disposition. The independent predictors of home discharge and cut-off value were evaluated using logistic regression analysis and receiver operating curve. RESULTS: At the time of hospital admission, KES, exercise tolerance, SPPB, BI and MMSE is significantly higher in the home group. However, there were no significant differences in HF severity and CONUT on hospital admission between the groups. At hospital discharge, KES, exercise tolerance, SPPB, BI and MMSE were significantly higher and CONUT was significantly lower in the home group than in the non-home group. Multivariate analysis showed KES and SPPB on hospital admission, length of hospital stay and BI at hospital discharge were the independent predictors of home discharge. Cut-off values for predicting home discharge were KES on hospital admission ≥12.1 kg, SPPB on hospital admission ≥3 points, and BI at hospital discharge ≥80 points. CONCLUSIONS: The present study suggested that KES and SPPB on hospital admission may contributed to early detection of the patients who are difficult to return home. Additionally, there is a possibility that CR goal setting of BI ≥80 points is effective to home discharge in acute phase hospitalized HF patients. CLINICAL REHABILITATION IMPACT: This study may contribute to early detection of the patients who are predicted to be difficult to return home and to appropriate rehabilitation goals setting.

Gas sorption porosimetry for the evaluation of hard carbons as anodes for Li- and Na-ion batteries.

Hard carbons are promising candidates for high-capacity anode materials in alkali metal-ion batteries, such as lithium- and sodium-ion batteries. High reversible capacities are often coming along with high irreversible capacity losses during the first cycles, limiting commercial viability. The trade-off to maximize the reversible capacities and simultaneously minimizing irreversible losses can be achieved by tuning the exact architecture of the subnanometric pore system inside the carbon particles. Since the characterization of small pores is nontrivial, we herein employ Kr, N2 and CO2 gas sorption porosimetry, as well as H2O vapor sorption porosimetry, to investigate eight hard carbons. Electrochemical lithium as well as sodium storage tests are compared to the obtained apparent surface areas and pore volumes. H2O, and more importantly CO2, sorption porosimetry turned out to be the preferred methods to evaluate the likelihood for excessive irreversible capacities. The methods are also useful to select the relatively most promising active materials within chemically similar materials. A quantitative relation of porosity descriptors to the obtained capacities remains a scientific challenge.

Green tea polyphenol epigallocatechin gallate inhibits cell signaling by inducing SOCS1 gene expression.

Therapeutic effects of green tea involve an inhibitory function of its constituent polyphenol epigallocatechin gallate (EGCG) on cell signaling. The specificity and mechanism(s) by which EGCG inhibits cell signaling have remained unclear. Here, we demonstrate that green tea and EGCG induce suppressor of cytokine signaling 1 (SOCS1) gene expression, a negative regulator of specific cell signaling pathways. In mouse immune cells, EGCG induces SOCS1 expression via an oxidative (superoxide) pathway and activation of the signal transducer and activator of transcription 5 transcription factor. EGCG inhibited SOCS1-regulated cell signaling, but this inhibitory effect was abrogated in cells deficient in SOCS1. These findings identify a mechanism by which EGCG inhibits cell signaling with specificity, mediated by induction of the negative regulator SOCS1.

Association of adiponectin mutation with type 2 diabetes: a candidate gene for the insulin resistance syndrome.

Adiponectin, also referred to as AdipoQ or ACRP30, is a plasma protein produced and secreted exclusively from adipose tissue. The protein contains a collagen-like domain and a C1q-like globular domain. A protease-generated globular segment enhances fatty acid oxidation in muscles, thereby modulating lipid and glucose metabolism. Plasma adiponectin levels are inversely correlated with the severity of insulin resistance. A recent genome-wide scan study mapped a susceptibility locus for type 2 diabetes and the metabolic syndrome to chromosome 3q27, where the adiponectin gene is located. Here, we screened Japanese patients with type 2 diabetes and age- and BMI-matched nondiabetic control subjects for mutations in adiponectin gene. We identified four missense mutations (R112C, I164T, R221S, and H241P) in the globular domain. Among these mutations, the frequency of I164T mutation was significantly higher in type 2 diabetic patients than in age- and BMI- matched control subjects (P < 0.01). Furthermore, plasma adiponectin concentrations of subjects carrying I164T mutation were lower than those of subjects without the mutation. All the subjects carrying I164T mutation showed some feature of metabolic syndrome, including hypertension, hyperlipidemia, diabetes, and atherosclerosis. Our findings suggest that I164T mutation is associated with low plasma adiponectin concentration and type 2 diabetes.