BackgroundAccidental falls among inpatients are a substantial cause of hospital injury. A number of successful experimental studies on fall prevention have shown the importance and efficacy of multifactorial intervention, though success rates vary. However, the importance of staff compliance with these effective, but often time-consuming, multifactorial interventions has not been fully investigated in a routine clinical setting. The purpose of this observational study was to describe the effectiveness of a multidisciplinary quality improvement (QI) activity for accidental fall prevention, with particular focus on staff compliance in a non-experimental clinical setting.MethodsThis observational study was conducted from July 2004 through December 2010 at St. Luke’s International Hospital in Tokyo, Japan. The QI activity for in-patient falls prevention consisted of: 1) the fall risk assessment tool, 2) an intervention protocol to prevent in-patient falls, 3) specific environmental safety interventions, 4) staff education, and 5) multidisciplinary healthcare staff compliance monitoring and feedback mechanisms.ResultsThe overall fall rate was 2.13 falls per 1000 patient days (350/164331) in 2004 versus 1.53 falls per 1000 patient days (263/172325) in 2010, representing a significant decrease (p = 0.039). In the first 6 months, compliance with use of the falling risk assessment tool at admission was 91.5% in 2007 (3998/4368), increasing to 97.6% in 2010 (10564/10828). The staff compliance rate of implementing an appropriate intervention plan was 85.9% in 2007, increasing to 95.3% in 2010.ConclusionIn our study we observed a substantial decrease in patient fall rates and an increase of staff compliance with a newly implemented falls prevention program. A systematized QI approach that closely involves, encourages, and educates healthcare staff at multiple levels is effective.

Summary Most triacylglycerol-lowering fibrates have been developed in the 1960s–1980s before their molecular target, peroxisome proliferator-activated receptor alpha (PPARα), was identified. Twenty-one ligand-bound PPARα structures have been deposited in the Protein Data Bank since 2001; however, binding modes of fibrates and physiological ligands remain unknown. Here we show thirty-four X-ray crystallographic structures of the PPARα ligand-binding domain, which are composed of a “Center” and four “Arm” regions, in complexes with five endogenous fatty acids, six fibrates in clinical use, and six synthetic PPARα agonists. High-resolution structural analyses, in combination with coactivator recruitment and thermostability assays, demonstrate that stearic and palmitic acids are presumably physiological ligands; coordination to Arm III is important for high PPARα potency/selectivity of pemafibrate and GW7647; and agonistic activities of four fibrates are enhanced by the partial agonist GW9662. These results renew our understanding of PPARα ligand recognition and contribute to the molecular design of next-generation PPAR-targeted drugs.

ABSTRACT. A basic feature of the movement of eukaryotic flagella is oscillation. Although flagellar oscillation is thought to be regulated by a self-regulatory feedback system including the mechanical signal of bending itself, the mechanism regulating the dynein motile activity to produce oscillation is not well understood. To elucidate the mechanism, we developed a new experimental system which allowed us to analyze the conditions necessary for the induction of oscillation. When a mechanical signal of bending or a pulse was applied by micromanipulation to a demembranated motionless sea urchin sperm flagellar axoneme at very low ATP concentrations (1-3 µM), a localized pair of bends was induced. The bend formation was often followed by further responses including propagation of the distal bend of paired bends, growth and propagation of the paired bends, and cyclical beating. The beating was induced at 2.0 µM or higher concentrations of ATP, but appeared even at 1.5 µM ATP if a few µM of ADP was also present. When the proximal half of a flagellum was attached to a microneedle, beating could not be induced in the distal free region at 2 µM ATP. These results suggest that mechanical signal is involved in the mechanism regulating the motile activity of dynein to produce oscillation. Our results also showed that the presence of a small amount of ADP and the axial difference along the flagellum are factors essential for the induction of flagellar oscillation.

A series of 3-styrylchromone derivatives (4-20) were synthesized and the structure-activity relationships for α-glucosidase inhibition and antioxidant activities were analyzed. Among the synthesized compounds, compounds 15 and 20, which contain a catechol moiety, showed both potent 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging activity (15: EC 50 17 µM; 20: EC 50 23 µM) and α-glucosidase inhibitory activity (15: IC 50 16 µM; 20: IC 50 10 µM). Our data suggest that 3-styrylchromone derivatives are novel α-glucosidase inhibitors that have the potential to counteract diet-induced hyperglycemia in diabetes.Key words 3-styrylchromone; α-glucosidase inhibitor; antioxidant; structure-activity relationship Diabetes mellitus is a metabolic disorder characterized by hyperglycemia resulting from insufficiency of secretion or action of endogenous insulin. α-Glucosidase has been recognized as a therapeutic target for modulation of postprandial hyperglycemia. α-Glycosidase inhibitors act to delay glucose absorption, making them potent drugs to control blood glucose levels.1) On the other hand, antioxidants function as free radical scavengers, chelating agents for pro-oxidant metals, quenchers of singlet oxygen formation, and reducing agents. 2,3)Because of their antioxidant characteristics, antioxidants are important in the prevention of human diseases. The accumulated evidence suggests that diabetic patients are under oxidative stress and that oxidative stress plays a major role in the pathogenesis of diabetes mellitus. 4) Recently, several researchers have evaluated α-glucosidase inhibitors possessing free-radical scavenging activity. 5-11)4H-1-Benzopyran-4-ones (chromones) are an important class of oxygenated heterocyclic compounds, and have attracted the attention of organic chemists and biochemists due to their biological activities and occurrence in natural products. This chromone core structure is found in flavones, isoflavones, and 2-styrylchromones. Flavones and isoflavones are distributed in several species of plants. In contrast, 2-styrylchromones constitute a small group of naturally occurring chromones. Synthetic 2-styrylchromones possess a number of biological activities, including antioxidant, 12,13) anti-allergic, 14) anti-inflammatory, 15) antitumor, [16][17][18] and antiviral [19][20][21] effects. The synthesis and evaluation of biological activities of 2-styrylchromones has been extensively investigated, while studies dealing with 3-styrylchromones are few. Moreover, although there are some examples of the synthesis of 3-styrylchromones, [22][23][24][25][26][27] only a few studies have evaluated the biological activity of 3-styrylchromones. 22,28) In order to further explore novel biological activities, a series of 3-styrylchromone derivatives were synthesized, containing newly prepared compounds, and structure-activity relationships in regards to antioxidant activity and α-glycosidase inhibition were investigated. Results and DiscussionChemistry 3-Styrylchromone derivatives presented in this...

Regardless of the number of lesions, the existence of a genu lesion suggested disability 1 year after TBI in patients with DAI.

Alongside risk factors conventionally thought to be related to LH, underweight may also be a LH-related factor, specifically in the elderly.

In current orthodontic practice, miniscrew implants (MSIs) for anchorage and bone fixation plates (BFPs) for surgical orthodontic treatment are commonly used. MSIs and BFPs that are made of bioabsorbable material would avoid the need for removal surgery. We investigated the mechanical, degradation and osseointegration properties and the bone-implant interface strength of the AZ31 bioabsorbable magnesium alloy to assess its suitability for MSIs and BFPs. The mechanical properties of a Ti alloy (TiA), AZ31 Mg alloy (MgA), pure Mg and poly-L-lactic acid (PLA) were investigated using a nanoindentation test. Also, pH changes in the solution and degradation rates were determined using immersion tests. Three-dimensional, high-resolution, micro-computed tomography (CT) of implants in the rat femur was performed. Biomechanical push-out testing was conducted to calculate the maximum shear strength of the bone-implant interface. Scanning electron microscopy (SEM), histological analysis and an evaluation of systemic inflammation were performed. MgA has mechanical properties similar to those of bone, and is suitable for implants. The degradation rate of MgA was significantly lower than that of Mg. MgA achieved a significantly higher bone-implant bond strength than TiA. Micro-CT revealed no significant differences in bone density or bone-implant contact between TiA and MgA. In conclusion, the AZ31 Mg alloy is suitable for both MSIs and BFPs.

Desmoplastic mesothelioma is a rare subtype of diffuse malignant mesothelioma, and is often difficult to distinguish from reactive pleural fibrosis because of associated extensive collagen fibrosis. An 82‐year‐old woman with a severe cough was revealed to have pleural effusion and diffuse pleural thickening on the right side. Antibiotics were ineffective, and a compression fracture of the ninth and tenth thoracic vertebral bodies was recognized on X‐ray. Autopsy revealed a diffuse pleural thickening with hyalinized collagen tissue in the central part of the pleura. However, the peripheral part of the fibrous tissue was composed of spindle and polygonal cell proliferation that were immunohistochemically positive for antibodies against cytokeratin and vimentin. In addition, the ninth and tenth thoracic spines were infiltrated by similar cells. The condition was diagnosed as desmoplastic mesothelioma with bone metastases. Asbestos bodies were detected in the thickened pleura and fibrosed alveolar septa, and it was suggested retrospectively that the patient had been exposed to asbestos. Thus, autopsy analyses of fibrous pleurisy are necessary to detect a desmoplastic variant of mesothelioma of the pleura and its association with asbestos exposure.