Development of Simple, Objective Chair-Standing Assessment of Physical Function in Older Individuals Using a KinectTM Sensor

BACKGROUND

With increasing interest in addressing quality of life of older individuals, tests such as the Functional Independence Measure (FIM) are widely used measures of infirmity and burden of care. However, these scales are largely qualitative and especially problematic when assessing movement-based tasks. While effective, reliable analysis of human movement is technically complicated and expensive; an infrared depth sensor is potentially a low-cost, portable devise which may provide a quantitative aspect to clinical testing.

OBJECTIVE

to assess the utility of the KinectTM sensor in providing an objective evaluation of human movement using an oft measured ADL (chair stand).

DESIGN

Cross-sectional study.

SETTING

Community, geriatric day-care center in Japan.

PARTICIPANTS

Men (n=136) and women (n=266) between 50 and 93 years of age, consisting of healthy (HE; n=312) and physically frail (FR; n= 90) individuals.

MEASUREMENTS

Subjects completed two trials of the chair stand, conducted without assistance. Trials were timed and recorded with KinectTM v2. Coronal plane angle (CPA) was determined by a line transecting the shoulder-center and waist relative to the vertical axis and was used to assess quality of the chair stand movement pattern.

RESULTS

Age, height, and body mass were not different between groups. CPA was significantly greater in FR (29.3 ± 8.3°) than HE (19.5 ± 6.5°). CPA and age were significantly related (r=0.148, p<0.01). An optimal threshold for CPA identifying frailty was determined by a receiver-operator characteristic curve with a CPA of 23.1° providing the greatest combination of sensitivity (79%) and specificity (73%).

CONCLUSION

During the chair stand, frail older adults adopted a forward lean position (increased CPA) compared to healthy older adults. This compensatory posture appears to facilitate torso rotation while reducing lower-limb muscular effort during standing. As such, CPA serves as an indicator of reduced lower-body function in older, frail adults.

Meta-analysis of the association of extraintestinal manifestations with the development of pouchitis in patients with ulcerative colitis

Background

The presence of extraintestinal manifestations may be associated with the development of pouchitis in patients with ulcerative colitis after ileal pouch–anal anastomosis. The aim of this study was to assess this correlation.

Methods

A systematic literature search was performed using MEDLINE and the Cochrane Library. Studies published in English up to 22 May 2017 investigating the association between extraintestinal manifestations and development of pouchitis in adults with ulcerative colitis were included. Case reports were excluded. The association of extraintestinal manifestations with the development of overall and chronic pouchitis was investigated using a random‐effects model.

Results

Of 1010 citations identified, 22 observational studies comprising 5128 patients were selected for analysis. The presence of extraintestinal manifestations was significantly associated with both chronic pouchitis (odds ratio 2·28, 95 per cent c.i. 1·57 to 3·32; P = 0·001) and overall pouchitis (odds ratio 1·96, 1·49 to 2·57; P < 0·001).

Conclusion

The presence of extraintestinal manifestations is associated with development of pouchitis after ileal pouch–anal anastomosis.

Λp correlated production from low energy K−12C interactions by AMADEUS

The main steps for the analysis of the Λp correlated production in low-energy K− captures on Carbon nuclei, performed by the AMADEUS collaboration, are presented. The goal is to perform the first comprehensive study of the K− absorption on two, three and four nucleons, exploiting the lowmomentum K−s (pK ~ 127 MeV/c) produced at the DAΦNE collider, and to measure the low-energy cross sections and branching ratios of the K− multinucleon absorption processes in both the Λp and Σ0p channels. An integrated luminosity of 1.74 fb−1 collected during the KLOE 2004/2005 data campaign is analysed by reconstructing the Λp final state.

Spectroscopy of kaonic atoms at DAFNE and J-PARC

The interaction of antikaons (K−) with nucleons and nuclei in the low-energy regime represents a very active research field in hadron physics. A unique and rather direct experimental access to the antikaon-nucleon scattering lengths is provided by precision X-ray spectroscopy of transitions in low-lying states in the lightest kaonic atoms (i.e. kaonic hydrogen and deuterium). In the SIDDHARTA experiment at the electron-positron collider DAFNE of LNFINFN we measured the most precise values of the strong interaction observables in conic hydrogen. The strong interaction on the 1s ground state of the electromagnetically bound K-p atom causes an energy shift and broadening of the 1s state. SIDDHARTA will extend the spectroscopy to kaonic deuterium to get access to the antikaon-neutron interaction and thus the isospin dependent scattering lengths. At J-PARC a kaon beam is used in a complementary experiment with a different setup for spectroscopy of kaonic deuterium atoms. The talk will give an overview of the of the upcoming experiments SIDDHARTA and the complementary experiment at J-PARC.Furthermore, the implications of the experiments for the theory of low-energy strong interaction with strangeness will be discussed.

Low Energy Antikaon-nucleon/nuclei interaction studies by AMADEUS

The AMADEUS experiment at the DAΦNE collider of LNF-INFN deals with the investigation of the at-rest, or low-momentum, K− interactions in light nuclear targets, with the aim to constrain the low energy QCD models in the strangeness sector. The 0 step of the experiment consisted in the reanalysis of the 2004/2005 KLOE data, exploiting K− absorptions in H, 4He, 9Be and 12C, leading to the first invariant mass spectroscopic study with very low momentum (about 100 MeV) in-flight K− captures. With AMADEUS step 1 a dedicated pure Carbon target was implemented in the central region of the KLOE detector, providing a high statistic sample of pure at-rest K− nuclear interaction. The first measurement of the non-resonant transition amplitude $\left| {{A_{{K^ - }n \to \Lambda {\pi ^ - }}}} \right|$ at $\sqrt s = 33\,MeV$ below the K̄N threshold is presented, in relation with the Λ(1405) properties studies. The analysis procedure adopted in the serarch for K− multi-nucleon absorption cross sections and Branching Ratios will be also described.

The Development and Practical Use of Information Systems in the Pharmaceutical Industry

To provide information on the efficacy, safety, and quality of medicine promptly and accurately, we have developed two databases: a literature database with numerical data, and a Drug Information database. By an easy-to-use, company-wide information network system, over 1,000 medical representatives in more than 80 offices throughout Japan can retrieve information. Information derived from the system is displayed on the terminal and the original documents are automatically output through a facsimile.

Studies of low-energy K- nuclear interactions by AMADEUS

The goal of the AMADEUS experiment is to shed light on unsolved fundamental issues in the non-perturbative strangeness QCD sector through the study of lowenergy K- hadronic interactions with light nuclear targets. The main open questions are the controversial nature of the Δ(1405) state, which is investigated in hyperon-pion correlation studies, and the possible existence of exotic antikaon multi-nucleon clusters, whose search in K- induced reactions is intimately related to the studies of the K- multi-nucleon absorption processes in hyperon-nucleon/nucleus channels. The DAΦNE collider at the INFN-LNF provides unique monochromatic low-momentum kaons from the φ meson decay almost at-rest, suitable for the AMADEUS studies. The KLOE detector is exploited as an active target, in order to obtain excellent acceptance and resolution data for K- nuclear capture on H, 4He, 9Be and 12C, both at-rest and in-flight.

Low energy interaction studies of negative kaons in light nuclear targets by AMADEUS

The AMADEUS collaboration is performing experimental investigations in the sector of the low energy strangeness hadron physics by taking advantage of the DAΦNE collider, which provides a unique source of monochromatic low-momentum kaons and exploiting the KLOE detector as an active target. The K− single and multi-nuclear absorption on H, 4He, 9Be and 12C, both at-rest and in-flight, are studied with the aim to determine the nature of the controversial Λ(1405), the non-resonant hyperon pion formation amplitude below the K̅N threshold, the yield and cross sections of K− multi-nucleon absorptions intimately connected to the antikaon multi-nucleon clusters properties and the K− scattering cross sections on light nuclear targets.

These studies have a strong impact on the non-perturbative strangeness QCD with implications ranging from nuclear physics to the equation of state of neutron stars.

Significant augmentation of regulatory T cell numbers occurs during the early neonatal period

Regulatory T cells (T_regs ) control immune responses by suppressing various inflammatory cells. T_regs in newborn babies may play an important role in preventing excessive immune responses during their environmental change. We examined the number and phenotype of T_regs during the neonatal period in 49 newborn babies. T_regs were characterized by flow cytometry using cord blood (CB) and peripheral blood (PB) from the early (7-8 days after birth) and late (2-4 weeks after birth) neonatal periods. CD4⁺ forkhead box protein 3 (FoxP3⁺ ) T cells were classified into resting T_regs (CD45RA⁺ FoxP3^low ), activated T_regs (CD45RA^- FoxP3^high ) and newly activated T cells (CD45RA^- FoxP3^low ). Compared with CB and PB during the late neonatal period, the percentage of T_regs and all T_reg subpopulations in the CD4⁺ lymphocyte population were increased significantly during the early neonatal period. Furthermore, the proportion and absolute number of activated T_regs were increased markedly compared with other T_reg subpopulations, such as resting T_regs and newly activated T cells (non-T_regs ), in the early neonatal period. Increased T_regs concomitantly expressed the suppressive molecule cytotoxic T lymphocyte antigen-4 (CTLA-4). The up-regulated expression of chemokine receptor 4 (CCR4) and down-regulated expression of CCR7 were also observed in expanded T_regs . When cord blood cells were cultured in vitro with CD3 monoclonal antibodies (mAb) for 5 days, CD4⁺ CD45RA^- FoxP3^high cells were increased significantly during the culture. Thus, the presence of increased activated T_regs in early neonates may play an important role in immunological regulation by suppressing excessive T cell activation caused by the immediate exposure to ubiquitous antigens after birth.