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Assessing Interest and Educational Gaps in AI and Robotics Applications for Elderly Care Among Healthcare Students
Get PDFThe global integration of AI and robotics (AI/R) in elderly care has immense potential, but significant educational gaps persist, especially in developing countries. To address this, we surveyed 188 undergraduate healthcare students in Vietnam in June 2023. Our aim was to assess their interest in AI/R applications in elderly care and identify educational deficiencies. Using a Likert-style questionnaire with two scales (AI non-physical work and robotic physical work), we found that a majority of respondents showed keen interest in AI/R in elderly care, despite lacking formal education on these topics. Regarding AI non-physical work, the students found applications like communication support with medical staff (M=3.9, SD=0.83), controlling lights and devices (M=3.9, SD=0.81), and providing patient reminders (M=3.89, SD=0.84) highly applicable. Regarding robotic physical work, they considered applications such as heavy lifting assistance (M=3.88, SD=0.84), room/house cleaning (M=3.86, SD=0.84), and patient feeding (M=3.81, SD=0.83) highly relevant. These findings highlight the urgent need to address the lack of formal AI/R education for undergraduate healthcare students in Vietnam. Bridging this knowledge gap is crucial to equip future healthcare professionals with the skills to leverage AI/R technologies effectively in elderly care and enhance healthcare services in the country.journal articl
Study on methods of suppression of cell aggregation and utilization of pigs as cell source in mesenchymal stem cell therapy
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Full-endoscopic spine surgery in oldest old patients aged over 90 years : A case report
Get PDFBackground : Transforaminal full-endoscopic spine surgery (FESS) is the least invasive spinal surgery and can be performed under local anesthesia. In Japan, the population is rapidly aging and the number of spinal surgeries performed in the elderly is also increasing. Object : In this report, we describe 3 patients aged 90 years or older in whom we performed FESS under local anesthesia. Case : The first case was a 90-year-old man who presented with severe leg pain. He had multiple medical comorbidities and was unsuitable for general anesthesia. We performed FESS. After surgery, the leg pain resolved with full recovery of muscle strength. He was discharged with no perioperative complications. The second case was a 90-year-old man who presented with severe leg pain. MRI showed a herniated nucleus pulposus and foraminal stenosis at L4 / 5. We performed FESS. The leg pain improved immediately after surgery. The third case was a 91-year-old woman in whom we diagnosed left L5 radiculopathy due to foraminal stenosis at L5 / S1. After surgery, her leg pain was relieved. Conclusion : FESS is a good surgical procedure for elderly patients who are in a poor general condition because it is minimally invasive and can be performed under local anesthesia with early mobilization.journal articl
Associations between dietary diversity and dyslipidemia among Japanese workers : cross-sectional study and longitudinal study findings
Get PDFObjective: The aim of this study was to determine the associations between dietary diversity and risk of dyslipidemia in Japanese workers.
Methods: The cross-sectional study included 1,399 participants aged 20-63 years and the longitudinal study included 751 participants aged 20 to 60 years in 2012-2013 (baseline) who participated at least once from 2013 to 2017 with cumulative participation times of 4.9 times.
Dietary intake was assessed using a food frequency questionnaire, and dietary diversity score (DDS) was determined using the Quantitative Index for Dietary Diversity. Dyslipidemia was diagnosed when at least one of the following conditions was met: hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, high non-HDL-cholesterol, and a history of dyslipidemia.
Multivariable logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for dyslipidemia with control of confounding factors in cross-sectional analysis. Generalized estimating equations were used for calculating the ORs (95% CI) for dyslipidemia in the follow-up period according to the DDS at baseline with control of confounding factors in longitudinal analysis.
Results: Cross-sectional analysis showed that the highest DDS reduced the odds of dyslipidemia in men (OR [95% CI] in Tertile 3: 0.67 [0.48-0.95], p-value= 0.023). In longitudinal analysis, a moderate DDS reduced the risk of dyslipidemia (OR [95% CI] in Tertile 2: 0.21 [0.07-0.60], p-value= 0.003) in women.
Conclusions: The results of cross-sectional analysis in this study suggest that the higher diversity of diet might reduce the presence of dyslipidemia in men and the results of longitudinal analysis suggest that a moderate DDS might reduce the risk of dyslipidemia in women. Further studies are needed since the results of cross-sectional and longitudinal analyses in this study were inconsistent.doctoral thesi
Humoral immune response against SARS-CoV-2 and polyethylene glycol elicited by anti-SARS-CoV-2 mRNA vaccine, and effect of pre-existing anti-polyethylene glycol antibody in patients with hematological and autoimmune diseases
Get PDFBackground: The effects of vaccination are modified by hematological and autoimmune diseases and/or treatment. Anti-SARS-CoV-2 mRNA vaccine contains polyethylene glycol (PEG), it is largely unknown whether PEG influences the effects of vaccination or induces a humoral response. This study examined whether anti-PEG antibodies before vaccination (pre-existing) influenced the acquisition of SARS-CoV-2 antibodies and evaluated the relationship between the development of anti-SARS-CoV-2 antibodies and anti-PEG antibodies after SARS-CoV-2 vaccination in hematological and autoimmune diseases.
Methods: Anti-SARS-CoV-2 antibody IgG, anti-PEG IgG, and IgM titers were evaluated in patients with hematological and autoimmune diseases after the second dose of BNT162B2. Anti-PEG IgG and IgM titers were also measured before vaccination to examine changes after vaccination and the relationship with vaccine efficacy.
Results: In patients with hematological (n = 182) and autoimmune diseases (n = 96), anti-SARS-CoV-2 and anti-PEG antibody titers were evaluated after a median of 33 days from 2nd vaccination. The median anti-SARS-CoV-2 antibody titers were 1901 AU/mL and 3832 AU/mL in patients with hematological and autoimmune disease, respectively. Multiple regression analysis showed that age and days from 2nd vaccination were negatively associated with anti-SARS-CoV-2 antibody titers. Anti-CD20 antibody treatment was negatively correlated with anti-SARS-CoV-2 antibody titers in hematological disease, and C-reactive protein (CRP) was positively correlated with anti-SARS-CoV-2 antibody titers in autoimmune disease. Baseline anti-PEG antibody titers were significantly higher in patients with autoimmune disease but were not correlated with anti-SARS-CoV-2 antibody titers. Patients with increased anti-PEG IgG acquired higher anti-SARS-CoV-2 antibody titers in patients with autoimmune disease.
Conclusions: Anti-SARS-CoV-2 antibody acquisition was suboptimal in patients with hematological disease, but both anti-SARS-CoV-2 antibody and anti-PEG IgG were acquired in patients with autoimmune disease, reflecting robust humoral immune response. Pre-existing anti-PEG antibody titers did not affect anti-SARS-CoV-2 antibody acquisition.journal articl
A case of anterior open bite associated with idiopathic condylar resorption treated with miniscrew-assisted orthodontics
Get PDFWe successfully treated a Class II Division 1 patient with an anterior open bite accompanied by idiopathic condylar resorption (ICR) using miniscrew-assisted orthodontics. A female patient, aged 20 years 7 months, had a convex profile with retropositioned chin, a severe open bite, and an excessive overjet due to a skeletal Class II jaw-base relationship. Panoramic radiograph showed condylar atrophy with generalized sclerosis in the temporomandibular joints bilaterally, and cone-beam computed tomography (CBCT) revealed severe condylar resorption with avascular necrosis bilaterally. Segmental arches were placed on maxillary and mandibular premolars and molars. After leveling, titanium miniscrews were obliquely implanted between the maxillary first and second molars, and maxillary molar intrusion was initiated. At 11 months of treatment, a repeat CBCT was performed and we confirmed no active resorption. Maxillary first premolars were extracted bilaterally to reduce an excessive overjet. After 33 months of active orthodontic treatment, a proper facial profile and an acceptable occlusion were achieved with 2.0 mm intrusion of the maxillary molars. The resultant occlusion was stable throughout the 1-year retention period. In conclusion, we believe that correction of ICR-related anterior open bite by molar intrusion using titanium miniscrews is effective for the treatment of patients with severe degenerative joints.journal articl
Difference in the accuracy of the third-generation algorithm and the first-generation algorithm of FreeStyle Libre continuous glucose monitoring device
Get PDFBackground : FreeStyle Libre uses the algorithm to calculate the sensor glucose (SG) levels. The manufacturer announced that they had changed the algorithm from the first generation (Gen. 1) to the third generation (Gen. 3). To assess the difference, we conducted an observational study to analyze the characteristics of the measurements by these two algorithms compared to the capillary blood glucose (BG) levels. Methods : Participants with type 1 diabetes wore two FreeStyle Libre sensors, one on the left arm used with Gen. 3 algorithm, and another on the right arm used in combination with the FreeStyle Libre Reader with Gen. 1 algorithm. Results : Data were collected from 11 participants. The Bland-Altman analysis of the measurements by Gen. 3 algorithm showed bias of 7.4 mg/dl and no proportional bias was observed (r=0.130). In contrast, the Bland-Altman analysis of the measurements by Gen. 1 algorithm showed bias of 4.4 mg/dl and proportional bias was observed (r=0.424). The MARD of Gen. 3 algorithm and Gen. 1 algorithm was 11.9±9.0% and 9.7±8.3%, respectively (P=0.053). Conclusion : No proportional bias in the measurements by Gen. 3 algorithm was observed, but in those by Gen. 1 algorithm.journal articl
Successful dilation using a Non-Slip Element Percutaneous Transluminal Angioplasty Scoring Balloon to treat in-stent restenosis of carotid artery stenting with inadequate dilation during balloon angioplasty : A case report
Get PDFBackground : Carotid artery stenting (CAS) is commonly performed to treat internal carotid artery (ICA) stenosis ; however, it is associated with high recurrence rates. The treatment of in-stent restenosis (ISR) following CAS poses several challenges, and percutaneous transluminal angioplasty (PTA) is a possible treatment option. Scoring balloons used in the cardiovascular field can prevent slipping and plaque incisions during balloon expansion ; however, their efficacy in treating cervical ICA ISR remains uncertain. Case description : An 81-year-old man underwent CAS for carotid artery stenosis and subsequently developed ISR. Initial PTA with a noncompliant balloon failed to achieve sufficient dilation. However, the employment of a non-slip-element (NSE) PTA scoring balloon for additional expansion resulted in successful dilation, indicating its effectiveness in treating cervical ICA ISR. The patient was discharged postoperatively without any new neurological deficits, although magnetic resonance imaging revealed new ischemic lesions. Conclusion : The NSE PTA balloon could be considered as a valuable and effective treatment option for ISR when conventional balloon catheters face challenges in achieving dilation, although potential risks such as debris embolization should be considered.journal articl
両側乳腺に多発した乳腺原発神経内分泌腫瘍の1例
Get PDF【Introduction】 Breast neuroendocrine tumors can manifest in various organs of the body, but those with primary origin in mammary glands are rare. Here, we report a case of multiple breast neuroendocrine tumors in bilateral mammary glands. 【Case】 The patient was a 45-year-old woman with no significant medical, medication, or family history. One year ago, she noticed a lump in her left breast and visited a local doctor. Following thorough examination, she was initially diagnosed with bilateral breast cancer and subsequently referred to our hospital. Breast ultrasonography at our hospital also indicated bilateral breast cancer, and needle biopsy results suggested bilateral breast neuroendocrine tumors. Surgical intervention involved partial mastectomy with sentinel lymph node biopsy for the right breast tumor and mastectomy with axillary dissection for the left breast tumor. Final pathological examination results confirmed bilateral breast neuroendocrine tumors based on hematoxylin and eosin staining and immunostaining.【Conclusion】 This study reports a relatively rare case of multiple neuroendocrine tumors with primary origin in bilateral mammary glands.journal articl