Publications by authors named "Emi Watanabe"

33 Publications

Mild Hypertensive Retinopathy and Risk of Cardiovascular Disease: The Suita Study.

J Atheroscler Thromb 2022 Jan 15. Epub 2022 Jan 15.

Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Aims: This study aimed to investigate the association of mild hypertensive retinopathy with cardiovascular disease (CVD) risk.

Methods: A total of 7,027 residents aged 30-79 years without a history of CVD participated in the annual health checkups and retinal photography assessments. Retinal microvascular abnormalities were graded using the standard protocols and classified according to the Keith-Wagener-Barker classification. Mild hypertensive retinopathy was defined as grades 1 and 2. Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for total CVD and its subtypes according to the presence and absence of mild hypertensive retinopathy.

Results: During a median follow-up of 17 years, 351 incident stroke and 247 coronary heart disease (CHD) cases were diagnosed. After adjustment for traditional cardiovascular risk factors, mild hypertensive retinopathy was positively associated with risk of CVD (multivariable HR=1.24; 95% CI, 1.04-1.49) and stroke (1.28; 1.01-1.62) but not with risk of CHD (1.19; 0.89-1.58). Generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk, the multivariable HR (95% CI) was 1.24 (1.00- 1.54)and 1.33 (1.02-1.74), respectively. Moreover, mild hypertensive retinopathy was positively associated with stroke risk in normotensive participants.

Conclusion: Mild hypertensive retinopathy was positively associated with CVD and stroke risk in the urban Japanese population. Especially, generalized arteriolar narrowing and enhanced arteriolar wall reflex were positively associated with CVD risk. These findings suggested that retinal photography could be helpful for cardiovascular risk stratification in the primary cardiovascular prevention.
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http://dx.doi.org/10.5551/jat.63317DOI Listing
January 2022

Developing a Stroke Risk Prediction Model Using Cardiovascular Risk Factors: The Suita Study.

Cerebrovasc Dis 2021 Nov 29:1-8. Epub 2021 Nov 29.

Division of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.

Introduction: Stroke remains a major cause of death and disability in Japan and worldwide. Detecting individuals at high risk for stroke to apply preventive approaches is recommended. This study aimed to develop a stroke risk prediction model among urban Japanese using cardiovascular risk factors.

Methods: We followed 6,641 participants aged 30-79 years with neither a history of stroke nor coronary heart disease. The Cox proportional hazard model estimated the risk of stroke incidence adjusted for potential confounders at the baseline survey. The model's performance was assessed using the receiver operating characteristic curve and the Hosmer-Lemeshow statistics. The internal validity of the risk model was tested using derivation and validation samples. Regression coefficients were used for score calculation.

Results: During a median follow-up duration of 17.1 years, 372 participants developed stroke. A risk model including older age, current smoking, increased blood pressure, impaired fasting blood glucose and diabetes, chronic kidney disease, and atrial fibrillation predicted stroke incidence with an area under the curve = 0.76 and p value of the goodness of fit = 0.21. This risk model was shown to be internally valid (p value of the goodness of fit in the validation sample = 0.64). On a risk score from 0 to 26, the incidence of stroke for the categories 0-5, 6-7, 8-9, 10-11, 12-13, 14-15, and 16-26 was 1.1%, 2.1%, 5.4%, 8.2%, 9.0%, 13.5%, and 18.6%, respectively.

Conclusion: We developed a new stroke risk model for the urban general population in Japan. Further research to determine the clinical practicality of this model is required.
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http://dx.doi.org/10.1159/000520100DOI Listing
November 2021

Weight Change Since Age 20 and the Risk of Cardiovascular Disease Mortality: A Prospective Cohort Study.

J Atheroscler Thromb 2021 Nov 20. Epub 2021 Nov 20.

Division of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center.

Aim: Weight change could have many health outcomes. This study aimed to investigate the association between weight change and mortality risk due to total cardiovascular disease (CVD), ischemic heart disease (IHD), and stroke among Japanese.

Methods: We used Suita Study data from 4,746 people aged 30-79 years in this prospective cohort study. Weight change was defined as the difference between baseline weight and weight at age 20. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of total CVD, IHD, and stroke mortality for 1) participants with a weight change (>10, 5 to 10, -5 to -10, and <-10 kg) compared to those with stable weight (-4.9 to 4.9 kg) and 2) participants who moved from one body mass index category (underweight, normal weight, or overweight) to another compared to those with normal weight at age 20 and baseline.

Results: Within a median follow-up period of 19.9 years, the numbers of total CVD, IHD, and stroke mortality were 268, 132, and 79, respectively. Weight loss of >10 kg was associated with the increased risk of total CVD mortality 2.07 (1.29, 3.32) and stroke mortality 3.02 (1.40, 6.52). Moving from normal weight at age 20 to underweight at baseline was associated with the increased risk of total CVD, IHD, and stroke mortality: 1.76 (1.12, 2.77), 2.10 (1.13, 3.92), and 2.25 (1.05, 4.83), respectively.

Conclusion: Weight loss, especially when moving from normal to underweight, was associated with the increased risk of CVD mortality.
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http://dx.doi.org/10.5551/jat.63191DOI Listing
November 2021

Impact of an antimicrobial stewardship in a 126-bed community hospital with close communication between pharmacists working on post-prescription audit, ward pharmacists, and the antimicrobial stewardship team.

J Pharm Health Care Sci 2021 Aug 1;7(1):25. Epub 2021 Aug 1.

Division of Pharmacy, Tarumizu Chuo Hospital, Tarumizu Municipal Medical Center, Tarumizu, Japan.

Background: Antimicrobial stewardship (AS) is defined as coordinated interventions to improve and measure the appropriate use of antimicrobial agents. However, available resources for AS differ depending on the size of the clinical setting. Therefore, AS programs based on guidelines need to be selected in order to implement AS in small- to medium-sized hospitals. The present study compared the impact of AS in a 126-bed community hospital between pre- and post-AS periods.

Methods: The present study was retrospectively performed by selecting data on eligible patients from electronic medical records stored in the central database of the hospital. The roles of the AS team included weekly rounds and recommendations on the appropriate use of antimicrobials, and pharmacists working on post-prescription audits and pharmaceutical care at the bedside closely communicated with the AS team to assist with its implementation. As process measurements, the order rate of culture examinations, the conducting rate of de-escalation, antimicrobial use density (AUD), days of therapy (DOT), and the AUD/DOT ratio of carbapenems and tazobactam-piperacillin (TAZ/PIPC) were measured. Thirty-day mortality and recurrence rates were examined as clinical outcomes.

Results: A total of 535 patients (288 in the pre-AS period and 247 in the post-AS period) were enrolled in the present study. The recommendation rate to prescribers significantly increased (p < 0.01) from 10.4% in the pre-AS period to 21.1% in the post-AS period. The order rate of culture examinations increased from 56.3 to 73.3% (p < 0.01). The conducting rate of de-escalation increased from 10.2 to 30.8% (p < 0.05). The AUD of carbapenems and TAZ/PIPC significantly decreased (p < 0.05). The DOT of carbapenems (p < 0.01) and TAZ/PIPC (p < 0.05) also significantly decreased. The AUD/DOT ratio of carbapenem significantly increased from 0.37 to 0.60 (p < 0.01). Thirty-day mortality rates were 11.2 and 14.2%, respectively, and were not significantly different. The 30-day recurrence rate significantly decreased (p < 0.05) from 14.7 to 7.5%.

Conclusions: The implementation of AS in this hospital improved the appropriate use of antimicrobials without negatively affecting clinical outcomes. These results may be attributed to close communication between pharmacists working on post-prescription audits and pharmaceutical care at the bedside and the AS team.
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http://dx.doi.org/10.1186/s40780-021-00206-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8325832PMC
August 2021

Psychiatric Neural Networks and Precision Therapeutics by Machine Learning.

Biomedicines 2021 Apr 8;9(4). Epub 2021 Apr 8.

Laboratory of Molecular Neuroscience, Faculty of Pharmacy, Takasaki University of Health and Welfare, Gunma 370-0033, Japan.

Learning and environmental adaptation increase the likelihood of survival and improve the quality of life. However, it is often difficult to judge optimal behaviors in real life due to highly complex social dynamics and environment. Consequentially, many different brain regions and neuronal circuits are involved in decision-making. Many neurobiological studies on decision-making show that behaviors are chosen through coordination among multiple neural network systems, each implementing a distinct set of computational algorithms. Although these processes are commonly abnormal in neurological and psychiatric disorders, the underlying causes remain incompletely elucidated. Machine learning approaches with multidimensional data sets have the potential to not only pathologically redefine mental illnesses but also better improve therapeutic outcomes than DSM/ICD diagnoses. Furthermore, measurable endophenotypes could allow for early disease detection, prognosis, and optimal treatment regime for individuals. In this review, decision-making in real life and psychiatric disorders and the applications of machine learning in brain imaging studies on psychiatric disorders are summarized, and considerations for the future clinical translation are outlined. This review also aims to introduce clinicians, scientists, and engineers to the opportunities and challenges in bringing artificial intelligence into psychiatric practice.
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http://dx.doi.org/10.3390/biomedicines9040403DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068267PMC
April 2021

Identification of 5-Hydroxymethylfurfural (5-HMF) as an Active Component Citrus Jabara That Suppresses FcεRI-Mediated Mast Cell Activation.

Int J Mol Sci 2020 Apr 2;21(7). Epub 2020 Apr 2.

Laboratory of Immune Regulation, Graduate School of Pharmaceutical Sciences, Suzuka University of Medical Science, 3500-3 Minamitamagaki, Suzuka Mie 513-8607, Japan.

Jabara ( Hort. ex Y. Tanaka) is a type of citrus fruit known for its beneficial effect against seasonal allergies. Jabara is rich in the antioxidant narirutin whose anti-allergy effect has been demonstrated. One of the disadvantages in consuming Jabara is its bitter flavor. Therefore, we fermented the fruit to reduce the bitterness and make Jabara easy to consume. Here, we examined whether fermentation alters the anti-allergic property of Jabara. Suppression of degranulation and cytokine production was observed in mast cells treated with fermented Jabara and the effect was dependent on the length of fermentation. We also showed that 5-hydroxymethylfurfural (5-HMF) increases as fermentation progresses and was identified as an active component of fermented Jabara, which inhibited mast cell degranulation. Mast cells treated with 5-HMF also exhibited reduced degranulation and cytokine production. In addition, we showed that the expression levels of phospho-PLC1 and phospho-ERK1/2 were markedly reduced upon FcεRI stimulation. These results indicate that 5-HMF is one of the active components of fermented Jabara that is involved in the inhibition of mast cell activation.
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http://dx.doi.org/10.3390/ijms21072472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177689PMC
April 2020

CDC's Multiple Approaches to Safeguard the Health, Safety, and Resilience of Ebola Responders.

Prehosp Disaster Med 2020 Feb 10;35(1):69-75. Epub 2019 Dec 10.

US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Over 27,000 people were sickened by Ebola and over 11,000 people died between March of 2014 and June of 2016. The US Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) was one of many public health organizations that sought to stop this outbreak. This agency deployed almost 2,000 individuals to West Africa during that timeframe. Deployment to these countries exposed these individuals to a wide variety of dangers, stressors, and risks.Being concerned about the at-risk populations in Africa, and also the well-being of its professionals who willingly deployed, the CDC did several things to help safeguard the health, safety, and resilience of these team members before, during, and after deployment.The accompanying special report highlights innovative pre-deployment training initiatives, customized screening processes, and post-deployment outreach efforts intended to protect and support the public health professionals fighting Ebola. Before deploying, the CDC team members were expected to participate in both internally-created and externally-provided trainings. These ranged from pre-deployment briefings, to Preparing for Work Overseas (PFWO) and Public Health Readiness Certificate Program (PHRCP) courses, to Incident Command System (ICS) 100, 200, and 400 courses.A small subset of non-clinical deployers also participated in a three-day training designed in collaboration with the Center for the Study of Traumatic Stress (CSTS; Bethesda, Maryland USA) to train individuals to assess and address the well-being and resilience of themselves and their teammates in the field during a deployment. Participants in this unique training were immersed in a Virtual Reality Environment (VRE) that simulated deployment to one of seven different types of emergencies.The CDC leadership also requested a pre-deployment screening process that helped professionals in the CDC's Occupational Health Clinic (OHC) determine whether or not individuals were at an increased risk of negative outcomes by participating in a rigorous deployment at that time.When deployers returned from the field, they received personalized invitations to participate in a voluntary, confidential, post-deployment operational debriefing one-on-one or in a group.Implementing these approaches provided more information to clinical decision makers about the readiness of deployers. It provided deployers with a greater awareness of the kinds of challenges they were likely to face in the field. The post-deployment outreach efforts reminded staff that their contributions were appreciated and there were resources available if they needed help processing any of the potentially-traumatizing things they may have experienced.
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http://dx.doi.org/10.1017/S1049023X19005144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113416PMC
February 2020

Cooking Methods for a Soft Diet Using Chicken Based on Food Texture Analysis.

J Nutr Sci Vitaminol (Tokyo) 2017 ;63(4):256-262

Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts.

Undernutrition caused by difficulties in masticating is of growing concern among the elderly. Soft diets are often served at nursing homes; however, the styles differ with nursing homes. Improperly modified food texture and consistency may lead to further loss of nutritive value. Therefore, we developed a method to produce a soft diet using chicken. The texture-modified chicken was prepared by boiling a mixture of minced chicken and additive foodstuff that softened the meat. The best food additive was determined through testing cooking process, size after modification and texture. The optimum proportions of each component in the mixture were determined measuring food texture using a creep meter. Teriyaki chicken was cooked using the texture-modified chicken, and provided to a nursing home. The amount of food intake by elderly residents was subsequently surveyed. This study involved 22 residents (1 man and 21 women; mean age 91.4±5.3 y). Consequently, yakifu, which was made from wheat gluten, was the most suitable additive foodstuff. The hardness of the texture-modified chicken, with proportions of minced chicken, yakifu, and water being 50%, 10%, and 40% respectively, was under 40,000 N/m. The intake amount of the texture-modified chicken of subjects whose intake amount of conventional chicken using chicken thigh was not 100% was significantly higher. These findings suggest that properly modified food textures could contribute to improve the quality of meals by preventing undernutrition among the elderly with mastication difficulties.
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http://dx.doi.org/10.3177/jnsv.63.256DOI Listing
July 2018

The Criteria of Thickened Liquid for Dysphagia Management in Japan.

Dysphagia 2018 Feb 30;33(1):26-32. Epub 2017 Aug 30.

Department of Health Sciences, Prefectural University of Hiroshima, 1-1-71 Ujina-Higashi, Minami-ku, Hiroshima, 734-8558, Japan.

In Japan, the viscosity of thickened liquids is different among hospitals and nursing homes. In order to standardize viscosity of thickened liquids, the dysphagia diet committee of the Japanese Society of Dysphagia Rehabilitation developed the Japanese Dysphagia Diet 2013 (JDD2013). To decide on a definition of thickened liquids, the committee reviewed categories from other countries. Especially, the criteria of the USA and Australia were used as references. The definition had three levels: mildly thick, moderately thick, and extremely thick. Then a sensory evaluation by health care workers was carried out to decide the viscosity range of each level, and a draft document was made. After collecting public comments, follow-up experiments using thickened water with thickeners using xanthan gum were performed, and the JDD2013 (Thickened Liquid) was determined. The JDD2013 (Thickened Liquid) evaluated the drinking properties, visual properties, and viscosity values of each level. The shear rate of 50 s was adopted to measure the viscosity with a cone and plate type viscometer to duplicate the measurement criteria used by the USA. We also set the values of the JDD2013 with the Line Spread Test to promote the use of guidelines in clinical practice. We believe the JDD2013 standards help hospitals and other settings that care for people with dysphagia to use the same thickness level and the same labels. In the future, the JDD2013 levels will be compared with new international guidelines to help with international understanding of the JDD2013 levels.
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http://dx.doi.org/10.1007/s00455-017-9827-xDOI Listing
February 2018

Development of a simple and objective evaluation method for thickened liquids using funnels.

J Texture Stud 2017 Jun 7;48(3):198-204. Epub 2016 Dec 7.

Department of Health Sciences, Prefectural University of Hiroshima, 1-1-71 Ujina-Higashi, Minami-ku, Hiroshima, 734-8558, Japan.

Some patients with dysphagia are prone to aspiration of low-viscosity liquids. Thickened liquids are often used in attempts to prevent aspiration. The patients should be given thickened liquids with suitable thickness, and the thickness should be constant at all time. While rotational and cone-and-plate viscometers are used for the evaluation of thickened liquids, they are high-precision and expensive equipment. To control the thickness of liquids, a simple and objective evaluation method is thus necessary. We developed a method to evaluate thickened liquids using funnels, and verified the appropriateness of this method. We measured the outflow times of five thickened liquids through funnels. One of the thickened liquids was a commercially available nutritional supplement, another was made with a thickening agent that contained guar gum, and all others were made with a thickening agent that contained xanthan gum. Four funnels with different stem sizes were tested. We found that the outflow time of thickened liquids through a funnel depended on their viscosities at a shear rate between 10 and 50 s , when the average inner diameter of the stem was in the range of 5.3-9.0 mm, and the volume of the liquid poured into the funnel was 30 mL. The correlation coefficient between the value of the sensory evaluation and the outflow time of the funnel with an average stem ID of 5.3 mm was 0.946. Therefore, this method may be useful in hospital and nursing home kitchens for evaluating thickened liquids.

Practical Applications: The findings of this study will help develop a new method for the evaluation of thickened liquids. Funnels made from polypropylene, which are inexpensive and light, were used in this method. The process for measuring the outflow time of thickened liquids through a funnel is simple, and we can obtain quantitative data that are objective. Even though line spread test (LST) is well known as a simple measurement method, nutritional supplements and liquids thickened using a thickening agent containing guar gum have not been evaluated accurately. The funnel method was found to have a stronger correlation with sensory evaluation compared to LST. This method is useful in hospital and nursing home kitchens for evaluating thickened liquids.
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http://dx.doi.org/10.1111/jtxs.12235DOI Listing
June 2017

Symptom recognition and healthcare experiences of young women with acute myocardial infarction.

Circ Cardiovasc Qual Outcomes 2015 Mar 24;8(2 Suppl 1):S31-8. Epub 2015 Feb 24.

From the Department of Chronic Disease Epidemiology (J.H.L., E.C.L.-L., E.W.) and Department of Health Policy and Management (H.M.K., L.A.C.), Yale School of Public Health, New Haven, CT; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (N.B.A.); Cardiovascular Outcomes Research, Saint Luke's Mid America Heart Institute, Kansas City, MO (B.G., J.A.S.); School of Medicine (B.G., J.A.S.) and School of Pharmacy (L.S.G.), University of Missouri-Kansas City; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (H.M.K.); Section of Cardiovascular Medicine, Department of Internal Medicine (H.M.K.) and Robert Wood Johnson Clinical Scholars Program, Department of Internal Medicine (H.M.K., L.A.C.), Yale School of Medicine, New Haven, CT; and Global Health Leadership Institute, Yale University, New Haven, CT (L.A.C.).

Background: Prompt recognition of acute myocardial infarction symptoms and timely care-seeking behavior are critical to optimize acute medical therapies. Relatively little is known about the symptom presentation and care-seeking experiences of women aged ≤55 years with acute myocardial infarction, a group shown to have increased mortality risk as compared with similarly aged men. Understanding symptom recognition and experiences engaging the healthcare system may provide opportunities to reduce delays and improve acute care for this population.

Methods And Results: We conducted a qualitative study using in-depth interviews with 30 women (aged 30-55 years) hospitalized with acute myocardial infarction to explore their experiences with prodromal symptoms and their decision-making process to seek medical care. Five themes characterized their experiences: (1) prodromal symptoms varied substantially in both nature and duration; (2) they inaccurately assessed personal risk of heart disease and commonly attributed symptoms to noncardiac causes; (3) competing and conflicting priorities influenced decisions about seeking acute care; (4) the healthcare system was not consistently responsive to them, resulting in delays in workup and diagnosis; and (5) they did not routinely access primary care, including preventive care for heart disease.

Conclusions: Participants did not accurately assess their cardiovascular risk, reported poor preventive health behaviors, and delayed seeking care for symptoms, suggesting that differences in both prevention and acute care may be contributing to young women's elevated acute myocardial infarction mortality relative to men. Identifying factors that promote better cardiovascular knowledge, improved preventive health care, and prompt care-seeking behaviors represent important target for this population.
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http://dx.doi.org/10.1161/CIRCOUTCOMES.114.001612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801001PMC
March 2015

Use of footwear and foot condition among rural Ethiopian school children.

J Epidemiol Glob Health 2014 Dec 23;4(4):323-5. Epub 2014 Aug 23.

Brighten and Sussex Medical School, United Kingdom.

Objective: To evaluate whether shoe-wearing affords foot protection among school children living in southern Ethiopia.

Methods: Data collectors conducted a standardized foot assessment with children in an elementary school in southern Ethiopia (N=168).

Results: 54% reported wearing shoes consistently in the prior three days. Children wearing closed-toed shoes showed less adherent soil and toe nail dystrophy than those wearing open-toed sandals. There were no differences by shoe type with regard to signs of foot trauma or heel fissures.

Conclusions: Shoe wearing provided limited foot protection. Interventions are needed to build behavioral skills, including foot washing and wearing appropriate shoes that maximize foot protection.
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http://dx.doi.org/10.1016/j.jegh.2014.06.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320331PMC
December 2014

Fatty degeneration of gluteus minimus muscle as a predictor of falls.

Arch Gerontol Geriatr 2015 Jan-Feb;60(1):59-61. Epub 2014 Aug 1.

Department of Radiology, Saiseikai Yamagata Hospital, 79-1 Oki-machi, Yamagata 990-8545, Japan.

The cause of falls is multifactorial, however, hip fractures in elderly would be prevented if accidental falls are predictable. We assessed magnetic resonance images of 38 patients with groin pain after taking a fall whose fracture could not be detected by plain X-rays, and 45 patients with no episode of falls. Their ages were over 65 years. Fatty degeneration of muscles, gluteus maximus, gluteus medius, gluteus minimus, obturator externus, adductor longus, rectus femoris and iliopsoas muscles, were evaluated by Goutallier's staging. Odds ratio was calculated by a logistic regression analysis allocating dependent variable for falls and independent variables for Goutallier's stage, age and gender. The fatty degeneration of gluteus maximus muscle was generalized, while that of gluteus minimus muscle was unevenly distributed, especially in anterior area. Gluteus minimus muscle initiated its fatty degeneration earlier than gluteus medius muscle. Odds ratio of falling was 3.2 (95% confidence intervals: 1, 14, 8.94) for Goutallier' stage of the gluteus medius muscle. Fatty degeneration of gluteus medius muscle has a crucial role in providing stability of the pelvis including hip joint. Evaluating fatty streaks in the gluteus minimus muscle could help give early indication to those who have a higher risk of falling.
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http://dx.doi.org/10.1016/j.archger.2014.07.013DOI Listing
June 2015

A qualitative study exploring barriers related to use of footwear in rural highland ethiopia: implications for neglected tropical disease control.

PLoS Negl Trop Dis 2013 25;7(4):e2199. Epub 2013 Apr 25.

College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Background: The role of footwear in protection against a range of Neglected Tropical Diseases (NTDs) is gaining increasing attention. Better understanding of the behaviors that influence use of footwear will lead to improved ability to measure shoe use and will be important for those implementing footwear programs.

Methodology/principal Findings: Using the PRECEDE-PROCEED model we assessed social, behavioral, environmental, educational and ecological needs influencing whether and when children wear shoes in a rural highland Ethiopian community endemic for podoconiosis. Information was gathered from 242 respondents using focus groups, semi-structured interviews and extended case studies. Shoe-wearing norms were said to be changing, with going barefoot increasingly seen as 'shameful'. Shoes were thought to confer dignity as well as protection against injury and cold. However, many practical and social barriers prevented the desire to wear shoes from being translated into practice. Limited financial resources meant that people were neither able to purchase more than one pair of shoes to ensure their longevity nor afford shoes of the preferred quality. As a result of this limited access, shoes were typically preserved for special occasions and might not be provided for children until they reached a certain age. While some barriers (for example fit of shoe and fear of labeling through use of a certain type of shoe) may be applicable only to certain diseases, underlying structural level barriers related to poverty (for example price, quality, unsuitability for daily activities and low risk perception) are likely to be relevant to a range of NTDs.

Conclusions/significance: Using well established conceptual models of health behavior adoption, we identified several barriers to shoe wearing that are amenable to intervention and which we anticipate will be of benefit to those considering NTD prevention through shoe distribution.
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http://dx.doi.org/10.1371/journal.pntd.0002199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636134PMC
November 2013

The association of beliefs about heredity with preventive and interpersonal behaviors in communities affected by podoconiosis in rural Ethiopia.

Am J Trop Med Hyg 2012 Oct 23;87(4):623-30. Epub 2012 Jul 23.

College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Little is known about how beliefs about heredity as a cause of health conditions might influence preventive and interpersonal behaviors among those individuals with low genetic and health literacy. We explored causal beliefs about podoconiosis, a neglected tropical disease (NTD) endemic in Ethiopia. Podoconiosis clusters in families but can be prevented if individuals at genetically high risk wear shoes consistently. Adults (N = 242) from four rural Ethiopian communities participated in qualitative assessments of beliefs about the causes of podoconiosis. Heredity was commonly mentioned, with heredity being perceived as (1) the sole cause of podoconiosis, (2) not a causal factor, or (3) one of multiple causes. These beliefs influenced the perceived controllability of podoconiosis and in turn, whether individuals endorsed preventive and interpersonal stigmatizing behaviors. Culturally informed education programs that increase the perceived controllability of stigmatized hereditary health conditions like podoconiosis have promise for increasing preventive behaviors and reducing interpersonal stigma.
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http://dx.doi.org/10.4269/ajtmh.2012.12-0204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516310PMC
October 2012

Effect of an MCM4 mutation that causes tumours in mouse on human MCM4/6/7 complex formation.

J Biochem 2012 Aug 4;152(2):191-8. Epub 2012 Jun 4.

College of Science, Ibaraki University, 2-1-1 Bunkyo, Mito, Ibaraki 351-8511, Japan.

It has been reported that a point mutation of minichromosome maintenance (MCM)4 causes mammary carcinoma, and it deregulates DNA replication to produce abnormal chromosome structures. To understand the effect of this mutation at level of MCM2-7 interaction, we examined the effect of the same mutation of human MCM4 on the complex formation with MCM6 and MCM7 in insect cells. Human MCM4/6/7 complexes containing the mutated MCM4 were formed, but the hexameric complex formation was not evident in comparison with those containing wild-type MCM4. In binary expression of MCM4 and MCM6, decreased levels of MCM6 were recovered with the mutated MCM4, compared with wild-type MCM4. These results suggest that this mutation of MCM4 perturbs proper interaction with MCM6 to affect complex formation of MCM4/6/7 that is a core structure of MCM2-7 complex. Consistent with this notion, nuclear localization and MCM complex formation of forcedly expressed MCM4 in human cells are affected by this mutation. Thus, the defect of this mutant MCM4 in interacting with MCM6 may generate a decreased level of chromatin binding of MCM2-7 complex.
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http://dx.doi.org/10.1093/jb/mvs060DOI Listing
August 2012

Analysing breast cancer microarrays from African Americans using shrinkage-based discriminant analysis.

Hum Genomics 2010 Oct;5(1):5-16

Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC 27710, USA.

Breast cancer tumours among African Americans are usually more aggressive than those found in Caucasian populations. African-American patients with breast cancer also have higher mortality rates than Caucasian women. A better understanding of the disease aetiology of these breast cancers can help to improve and develop new methods for cancer prevention, diagnosis and treatment. The main goal of this project was to identify genes that help differentiate between oestrogen receptor-positive and -negative samples among a small group of African-American patients with breast cancer. Breast cancer microarrays from one of the largest genomic consortiums were analysed using 13 African-American and 201 Caucasian samples with oestrogen receptor status. We used a shrinkage-based classification method to identify genes that were informative in discriminating between oestrogen receptor-positive and -negative samples. Subset analysis and permutation were performed to obtain a set of genes unique to the African-American population. We identified a set of 156 probe sets, which gave a misclassification rate of 0.16 in distinguishing between oestrogen receptor-positive and -negative patients. The biological relevance of our findings was explored through literature-mining techniques and pathway mapping. An independent dataset was used to validate our findings and we found that the top ten genes mapped onto this dataset gave a misclassification rate of 0.15. The described method allows us best to utilise the information available from small sample size microarray data in the context of ethnic minorities.
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http://dx.doi.org/10.1186/1479-7364-5-1-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042882PMC
October 2010

Use of antithrombotic medications among elderly ischemic stroke patients.

Circ Cardiovasc Qual Outcomes 2011 Jan 23;4(1):30-8. Epub 2010 Nov 23.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520, USA.

Background: The use of antithrombotic medications after ischemic stroke is recommended for deep vein thrombosis prophylaxis and secondary stroke prevention. We assessed the rate of receipt of these therapies among eligible ischemic stroke patients age ≥65 years and determined the effects of age and other patient characteristics on treatment.

Methods And Results: The analysis included Medicare fee-for-service beneficiaries discharged with ischemic stroke (ICD 433.x1, 434.x1, 436) randomly selected for inclusion in the Medicare Health Care Quality Improvement Program's National Stroke Project 1998 to 1999, 2000 to 2001. Patients discharged from nonacute facilities, transferred, or terminally ill were excluded. Receipt of in-hospital pharmacological deep vein thrombosis prophylaxis, antiplatelet medication, anticoagulants for atrial fibrillation, and antithrombotic medications at discharge were assessed in eligible patients, stratified by age (65 to 74, 75 to 84, and 85+ years). Descriptive models identified characteristics associated with treatment. Among 31 554 patients, 14.9% of those eligible received pharmacological deep vein thrombosis prophylaxis, 83.9% antiplatelet drugs, 82.8% anticoagulants for atrial fibrillation, and 74.2% were discharged on an antithrombotic medication. Rates of treatment decreased with age and were lowest for patients ages 85 years or older. Admission from a skilled nursing facility and functional dependence were associated with lower treatment rates.

Conclusions: There was substantial underutilization of antithrombotic therapies among elderly ischemic stroke patients, particularly among the very elderly, those admitted from skilled nursing facilities, and patients with functional dependence. The reasons for low use of antithrombotic therapies, including the apparent underutilization of deep vein thrombosis prophylaxis in otherwise eligible patients, require further investigation.
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http://dx.doi.org/10.1161/CIRCOUTCOMES.109.850883DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073519PMC
January 2011

Predictors of hospital readmission after stroke: a systematic review.

Stroke 2010 Nov 7;41(11):2525-33. Epub 2010 Oct 7.

Yale University School of Medicine, New Haven, CT 06520-8088, USA.

Background And Purpose: Risk-standardized hospital readmission rates are used as publicly reported measures reflecting quality of care. Valid risk-standardized models adjust for differences in patient-level factors across hospitals. We conducted a systematic review of peer-reviewed literature to identify models that compare hospital-level poststroke readmission rates, evaluate patient-level risk scores predicting readmission, or describe patient and process-of-care predictors of readmission after stroke.

Methods: Relevant studies in English published from January 1989 to July 2010 were identified using MEDLINE, PubMed, Scopus, PsycINFO, and all Ovid Evidence-Based Medicine Reviews. Authors of eligible publications reported readmission within 1 year after stroke hospitalization and identified ≥ 1 predictors of readmission in risk-adjusted statistical models. Publications were excluded if they lacked primary data or quantitative outcomes, reported only composite outcomes, or had < 100 patients.

Results: Of 374 identified publications, 16 met the inclusion criteria for this review. No model was specifically designed to compare risk-adjusted readmission rates at the hospital level or calculate scores predicting a patient's risk of readmission. The studies providing multivariable models of patient-level and/or process-of-care factors associated with readmission varied in stroke definitions, data sources, outcomes (all-cause and/or stroke-related readmission), durations of follow-up, and model covariates. Few characteristics were consistently associated with readmission.

Conclusions: This review identified no risk-standardized models for comparing hospital readmission performance or predicting readmission risk after stroke. Patient-level and system-level factors associated with readmission were inconsistent across studies. The current literature provides little guidance for the development of risk-standardized models suitable for the public reporting of hospital-level stroke readmission performance.
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http://dx.doi.org/10.1161/STROKEAHA.110.599159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021413PMC
November 2010

Postendarterectomy mortality in octogenarians and nonagenarians in the USA from 1993 to 1999.

Cerebrovasc Dis 2010 Jan 1;29(2):154-61. Epub 2009 Dec 1.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA. judith.lichtman @ yale.edu

Background: Relatively little is known about trends in the utilization or outcomes of carotid endarterectomy (CEA) in the very elderly. We determined trends in the rates of CEA and perioperative (in-hospital and 30-day) and long-term (1-, 2-, 3-, 4- and 5-year) mortality in a US national sample of patients >or=80 years of age.

Methods: All fee-for-service Medicare patients (80-89 and >or=90 years of age) who had a CEA [ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification): 38.12] from 1993 to 1999 were identified using the Centers for Medicare and Medicaid Services Inpatient Standard Analytic Files. Demographic characteristics and comorbid conditions were determined using ICD-9-CM diagnostic codes within the year prior to the index hospitalization for CEA.

Results: A total of 140,376 CEA were performed in patients aged 80-89 years and 6,446 in those aged >or=90 years during this 7-year period. The annual number of operations increased from 13,115 in 1993 to 21,582 in 1999 for octogenarians, and from 481 in 1993 to 1,257 in 1999 for nonagenarians. Perioperative mortality was 2.2% in octogenarians and 3.3% in nonagenarians. Long-term mortality increased by approximately 10% per year after the operation, and was 43% in octogenarians and 56% in nonagenarians at 5 years. Perioperative mortality rates remained relatively stable over the 7-year period for both age groups although comorbidities increased.

Conclusions: The number of CEA performed in the very elderly in the USA increased from 1993 to 1999. Perioperative mortality rates were high compared with trial results, while long-term survivorship was comparable to that of similarly-aged peers in the USA.
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http://dx.doi.org/10.1159/000262312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813815PMC
January 2010

Hospital arrival time and intravenous t-PA use in US Academic Medical Centers, 2001-2004.

Stroke 2009 Dec 1;40(12):3845-50. Epub 2009 Oct 1.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA.

Background And Purpose: Prompt care-seeking behavior is a focus of US national public stroke educational campaigns. We determined whether the time between symptom onset and hospital arrival and the receipt of intravenous tissue-type plasminogen activator (IV t-PA) changed for ischemic stroke patients evaluated at US academic centers between 2001 and 2004.

Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted from the Emergency Department within 48 hours of symptom onset at 35 academic medical centers participating in the University HealthSystem Consortium Ischemic Stroke Benchmarking Project between January 1, 2001 and March 31, 2001, and 32 centers between January 1, 2004 and June 30, 2004. Demographic and clinical characteristics of patients who presented within and after 2 hours of symptom onset were compared. Multivariate logistic regression was used to compare time to arrival by year and to identify patient characteristics associated with earlier hospital arrival.

Results: The study included 428 patients from 2001 and 481 from 2004. Although there was no difference in the percentage of patients who arrived within 2 hours between the 2 periods (37% in 2001 vs 38% in 2004, P=0.63), the percentage of these patients treated with IV t-PA increased (14.0% to 37.5%, P<0.0001). In risk-adjusted analysis, black patients had a lower odds of arriving within 2 hours (odds ratio=0.55; 95% CI, 0.39 to 0.78), whereas those with severe strokes were more likely to arrive promptly (odds ratio=2.17; 95% CI, 1.49 to 3.15).

Conclusions: There was no change in the proportion of stroke patients arriving at hospitals within 2 hours of symptom onset between 2001 and 2004; however, the rate of IV t-PA use increased, indicating system-level improvements of in-hospital care.
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http://dx.doi.org/10.1161/STROKEAHA.109.562660DOI Listing
December 2009

Stroke patient outcomes in US hospitals before the start of the Joint Commission Primary Stroke Center certification program.

Stroke 2009 Nov 24;40(11):3574-9. Epub 2009 Sep 24.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale UniversitySchool of Medicine, New Haven, Conn 06520-8034, USA.

Background And Purpose: The Joint Commission (JC) began certifying Primary Stroke Centers in November 2003. Cross-sectional studies assessing the impact of certification could be biased if these centers had better outcomes before the start of the program. We determined whether hospitals certified within the first years of the JC program had better outcomes than noncertified hospitals before the start of the certification program.

Methods: The study sample included Medicare fee-for-service beneficiaries >or=65 years of age discharged with ischemic stroke in 2002 from 5070 hospitals, 317 of which were JC-certified by June 2007. Hierarchical logistic regression and Cox proportional hazards models were used to compare in-hospital mortality, 30-day mortality, and 30-day readmission for patients treated at future JC-certified versus noncertified hospitals.

Results: Among 366 551 patients, 18% (66 300) were treated at hospitals with centers that were JC-certified within the first few years of the program. These patients were younger, more likely to be white and male, and had fewer comorbidities and hospitalizations within the prior year. Unadjusted in-hospital mortality (4.7% versus 5.5%), 30-day mortality (9.8% versus 11.3%), and readmissions (13.8% versus 14.6%) were lower in the future JC-certified hospitals (all P<0.001). These differences remained after risk adjustment (in-hospital mortality: OR, 0.93; 95% CI, 0.90 to 0.96; 30-day mortality: OR, 0.92; 95% CI, 0.87 to 0.96; 30-day readmission: hazard ratio, 0.97; 95% CI, 0.95 to 0.99).

Conclusions: JC Primary Stroke Center-certified hospitals had better outcomes than noncertified hospitals even before the program began. Cross-sectional studies assessing the effects of stroke center certification need to account for these pre-existing differences.
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http://dx.doi.org/10.1161/STROKEAHA.109.561472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782858PMC
November 2009

Secondary structural change of bovine serum albumin in thermal denaturation up to 130 degrees C and protective effect of sodium dodecyl sulfate on the change.

J Phys Chem B 2008 Dec;112(51):16585-9

Department of Applied Chemistry and Biotechnology, Okayama University of Science, 1-1 Ridai-cho, Okayama 700-0005, Japan.

The secondary structure of bovine serum albumin (BSA) was first examined in the thermal denaturation up to 130 degrees C. The helicity (66%) of the protein decreased with rise of temperature. Half of the original helicity was lost at 80 degrees C, but the helicity of 16% was still maintained even at 130 degrees C. When the BSA solution was cooled down to 25 degrees C after heating at temperatures above 50 degrees C, the helicity was not completely recovered. The higher the thermal denaturation temperature was, the lower was the recovered helicity. On the other hand, upon the addition of sodium dodecyl sulfate (SDS), the secondary structure of BSA was partially protected against the thermal denaturation above 50 degrees C where the structural change became irreversible. A particular protective effect was observed below 85 degrees C upon the coexistence of SDS of extremely low concentrations. For example, the helicity was 34% at 80 degrees C in the absence of SDS, but it was maintained at 58% at the same temperature upon the coexistence of 0.75 mM SDS. Upon cooling down from 80 to 25 degrees C, the helicity of BSA was recovered to 62% in the presence of 0.75 mM SDS. Such a protective effect of SDS was not observed above 95 degrees C. In the interaction with the surfactant, this protein structure appeared likely to have a critical temperature between 90 and 100 degrees C in addition to the critical temperature in the vicinity of 50 degrees C. This protective effect of SDS, characterized by the specific amphiphilic nature of this anionic surfactant, is considered to be attained by building cross-linking bridges between particular nonpolar residues and particular positively charged residues in the protein molecule.
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http://dx.doi.org/10.1021/jp8067624DOI Listing
December 2008

Diagnostic evaluation for patients with ischemic stroke: are there sex differences?

Cerebrovasc Dis 2009 19;27(5):450-5. Epub 2009 Mar 19.

Section of Chronic Disease Epidemiology, Yale University School of Medicine, New Haven, Conn., USA.

Background And Purpose: Differences in the management of women and men with acute coronary symptoms are well documented, but relatively little is known about practices for patients with ischemic stroke. We sought to determine whether there are sex-associated differences in the utilization of diagnostic tests for ischemic stroke patients treated at academic hospitals in the United States.

Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 US academic medical centers from January through June, 2004, as part of the University HealthSystem Consortium Ischemic Stroke Benchmarking Project. We compared the utilization rates of diagnostic tests including neuroimaging (CT or MRI), electrocardiogram (ECG), ultrasound of the carotid arteries, and echocardiography (transthoracic or transesophageal) for women and men. Multivariate logistic regression was used to test for sex differences with adjustment for potential confounders.

Results: The study included 1,256 ischemic stroke patients (611 women; 645 men; mean age 66.6 +/- 14.6 years; 56% white). There were no differences between women and men in the use of neuroimaging (odds ratio, OR = 1.37; 95% confidence interval, CI = 0.58-3.24), ECG (OR = 1.00, 95% CI = 0.70-1.44), carotid artery ultrasound (OR = 0.93, 95% CI = 0.72-1.21) or echocardiography (OR = 0.70, 95% CI = 0.70-1.22). The results were similar after covariate adjustment.

Conclusions: Women and men admitted to US academic hospitals receive comparable diagnostic evaluations, even after adjusting for sociodemographic and clinical factors.
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http://dx.doi.org/10.1159/000209240DOI Listing
July 2009

Elderly women have lower rates of stroke, cardiovascular events, and mortality after hospitalization for transient ischemic attack.

Stroke 2009 Jun 19;40(6):2116-22. Epub 2009 Feb 19.

Department of Epidemiology and Public Health, Yale University School of Medicine, PO Box 208034, New Haven, CT 06520-8034, USA.

Background And Purpose: Patients with transient ischemic attack (TIA) are at increased risk for stroke, cardiovascular events, and death, yet little is known about whether these risks differ for men and women. We determined whether there are sex-based differences in these outcomes 30 days and 1 year after TIA using a national sample of elderly patients.

Methods: Rates of 30-day and 1-year hospitalization for TIA (International Classification of Diseases, 9th Revision Code 435), stroke (International Classification of Diseases, 9th Revision Codes 433, 434, and 436), coronary artery disease (International Classification of Diseases, 9th Revision Codes 410 to 414), all-cause readmission, and mortality were determined for fee-for-service Medicare patients >or=65 years of age discharged with a TIA in 2002. Cox proportional hazards models and random-effects logistic models compared outcomes with risk adjustment for demographics, medical history, comorbidities, and prior hospitalizations.

Results: The study included 122063 TIA hospitalizations (mean age, 79.0+/-7.6 years; 62% women; 86% white). Men were younger but had higher rates of cardiac comorbidities than women. Women had lower unadjusted rates of stroke, coronary artery disease, and mortality at 30 days and 1 year after TIA admission. These relationships persisted in risk-adjusted analyses at 30 days for stroke (hazard ratio, 0.70; 95% CI, 0.64 to 0.77), coronary artery disease (hazard ratio, 0.86; 0.74 to 1.00), and mortality (odds ratio, 0.74; 0.68 to 0.82) as well as at 1 year for stroke (hazard ratio, 0.85; 0.81 to 0.89), coronary artery disease (hazard ratio, 0.81; 0.77 to 0.86), and mortality (odds ratio, 0.78; 0.75 to 0.81).

Conclusions: These data suggest that women have a better prognosis than men within the first year after hospital discharge for a TIA. Additional research is needed to identify factors that may explain these sex-related differences in outcomes.
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http://dx.doi.org/10.1161/STROKEAHA.108.543009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757938PMC
June 2009

Utilization of intravenous tissue plasminogen activator for ischemic stroke: are there sex differences?

Cerebrovasc Dis 2009 29;27(3):254-8. Epub 2009 Jan 29.

Section of Chronic Disease Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn. 06520-8034, USA.

Background: We evaluated whether there were sex-related differences in the administration of intravenous tissue plasminogen activator (IV-tPA) to patients with acute ischemic stroke admitted to US academic medical centers.

Methods: Medical records were abstracted for consecutive ischemic stroke patients admitted to 32 academic medical centers from January through June, 2004, as part of the University HealthSystem Consortium Ischemic Stroke Benchmarking Project. Multivariate logistic models were used to test for sex-related differences in the receipt of IV-tPA with adjustment for demographic and clinical factors.

Results: The study included 1,234 patients (49% women; mean age 66.6 years; 56% white). IV-tPA was given to 7% (6.5% of women versus 7.5% of men, p = 0.49). Women and men were equally likely to receive IV-tPA in risk-adjusted analyses (OR 1.02, 95% CI 0.64-1.64). Approximately 77% of women and men who did not receive IV-tPA did not meet the 3-hour treatment window or their time of onset was unknown.

Conclusions: Women admitted to academic hospitals receive IV-tPA as often as men; however, a substantial percentage of both women and men are not arriving within the 3-hour time window required for diagnostic assessment and administration of intravenous thrombolytic therapy. Additional efforts are needed to improve the rapid identification, evaluation and treatment of stroke patients.
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http://dx.doi.org/10.1159/000196824DOI Listing
May 2009

Photoisomerization of 2-[3-(2-thioxopyrrolidin-3-ylidene)methyl]-tryptophan, a yellow pigment in salted radish roots.

Biosci Biotechnol Biochem 2008 Sep 7;72(9):2262-8. Epub 2008 Sep 7.

Department of Health and Nutrition, Takasaki University of Health and Welfare, Takasaki, USA.

The photostability of (E)-2-[3-(2-thioxopyrrolidin-3-ylidene)methyl]-tryptophan ((E)-TPMT), the main yellow pigment in salted radish, was studied. First we analyzed the photoproduct generated from (E)-TPMT under longwave UV irradiation. On the basis of NMR spectroscopy, the photoproduct was identified as Z-configurated TPMT, and isomerization from the Z- to the E-form was reversibly induced by Vis-light irradiation. The optimum wavelength for isomerization from the E- to the Z-form was 360-380 nm, and that for isomerization from the Z- to the E-form was 440-460 nm. The E/Z-ratios in the photostationary state under UV- and Vis-light irradiation conditions were approximately 0.95:1 and 26:1 respectively. The (Z)-isomer was more sensitive to light irradiation than the (E)-isomer in the quantum yield measurement. Yellowing was dependent on the ratio of the (Z)-isomer, because the b(*) and chroma value rose with increases in the (Z)-isomer by the colorimeters. Hence, it is possible that the formation of the (Z)-isomer contribute to the yellow color of takuan-zuke during long salting and fermentation.
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http://dx.doi.org/10.1271/bbb.80092DOI Listing
September 2008

Effects of ethinylestradiol on medaka (Oryzias latipes) as measured by sperm motility and fertilization success.

Arch Environ Contam Toxicol 2009 Feb 28;56(2):253-9. Epub 2008 May 28.

Institute for Environmental Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka 422-8526, Japan.

We investigated the effects of 30-480 ng/L 17alpha-ethinylestradiol (EE(2)) on the sperm motility and fertility of Japanese medaka (Oryzias latipes). Sperm motility was examined by computer-assisted image analysis. In male medaka, the velocity of sperm was found to have increased after 3 weeks of exposure at 60-480 ng/L. This result suggests that higher sperm velocities depleted sperm energy reserves more rapidly and shortened the time for which sperm were viable to fertilize eggs. In a separate experiment that studied whether EE(2) exposure of males affects the fertilization rate or hatchability, sexually mature male medaka were exposed for 3 weeks and subsequently evaluated for their reproductive ability after pairing with unexposed females for 7 days. Exposure of males to EE(2) exerted a potent inhibitory effect on a reproduction parameter (fertilization rate x hatchability), and the highest inhibition was observed at 60 ng/L. The results offer toxicological data for the assessment of EE(2 )exposure in medaka and suggest that short-term exposure to EE(2) might reduce sperm function and fertility in adult male medaka.
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http://dx.doi.org/10.1007/s00244-008-9183-9DOI Listing
February 2009

Stopped-flow kinetic study of the aroxyl radical-scavenging action of catechins and vitamin C in ethanol and micellar solutions.

J Agric Food Chem 2008 Jun 24;56(12):4406-17. Epub 2008 May 24.

Department of Chemistry, Faculty of Science, Ehime University, Matsuyama 790-8577, Japan.

Kinetic study of the aroxyl radical-scavenging action of catechins (epicatechin (EC), epicatechin gallate (ECG), epigallocatechin (EGC), and epigallocatechin gallate (EGCG)) and related compounds (methyl gallate (MG), 4-methylcatechol (MC), and 5-methoxyresorcinol (MR)) has been performed. The second-order rate constant ( k s) for the reaction of these antioxidants with aroxyl radical has been measured in ethanol and aqueous Triton X-100 micellar solution (5.0 wt %). The k s values decreased in the order of EGCG > EGC > MC > ECG > EC > MG >> MR in ethanol, indicating that the reactivity of the OH groups in catechins decreased in the order of pyrogallol B-ring > catechol B-ring > gallate G-ring > resorcinol A-ring. The structure-activity relationship in the free radical-scavenging reaction by catechins has been clarified by the detailed analyses of the pH dependence of k s values. From the results, the p K a values have been determined for catechins. The monoanion form at catechol B- and resorcinol A-rings and dianion form at pyrogallol B- and gallate G-rings show the highest activity for free radical scavenging. It was found that the free radical-scavenging activities of catechins are 3.2-13 times larger than that of vitamin C at pH 7.0.
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http://dx.doi.org/10.1021/jf703770mDOI Listing
June 2008

[Status of measures against angiography room infection as determined by questionnaire].

Nihon Hoshasen Gijutsu Gakkai Zasshi 2006 Nov;62(11):1566-74

Department of Radiology, Kanto Medical Center NTT EC.

Although the cleanliness of the angiography room and that of the operating room have long been equally attended to, the concept of Standard Precautions (including the basic measures and procedures to prevent infection) of the Centers for Disease Control and Prevention (CDC), 1996, as well as the introduction of transmission-based precautions, have been changing to preventive measures that are based on concrete measures. Therefore, a questionnaire was introduced in order to determine the actual status of countermeasures against infection used in the angiography room. The questionnaire was sent to 530 institutions, and 286 responded, a response rate of 54.0%. Its results significantly revealed the following: 1) unexpectedly low recognition of the need and importance for the CDC preventive measures against infection, 2) a considerable number of institutions continuing to perform the conventional preventive measures, 3) problems with education systems on preventive measures, and 4) handwashing, the most important measure against infection, failing to be adequately carried out noticeably among radiological technologists.
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http://dx.doi.org/10.6009/jjrt.62.1566DOI Listing
November 2006
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