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O objetivo do estudo foi identificar ferramentas educativas que promovam saúde bucal entre os pacientes da terceira idade. Trata-se de uma revisão de literatura, com uma busca sistematizada nas bases de dados, Biblioteca Virtual em Saúde, Scielo e Google Acadêmico, empregando os descritores: saúde bucal, idoso, promoção de saúde, jogos e brinquedos. Os critérios de inclusão foram: estudos qualitativos e relatos de experiências. A busca resultou em 1.108 artigos e após a verificação dos critérios de elegibilidade foram incluídos quatro artigos. Os resultados evidenciaram que as ferramentas educativas utilizadas na promoção da saúde bucal entre os idosos foram: atividades lúdico-educativas, palestras e rodas de conversas, orientação de higiene bucal e distribuição de escovas e cremes dentais. Assim, as ferramentas educativas podem capacitar e apoiar os idosos nas tomadas de decisões a fim de garantir um cuidado seguro, confiável e que promova longevidade com qualidade de vida, bem como auxiliar na manutenção da saúde geral e saúde bucal dos mesmos.

A inserção da Odontologia no Sistema Único de Saúde, como estratégia de transformação da prática, introduziu novas formas de organização na busca pela melhoria das condições de saúde bucal da população. O objetivo do trabalho foi identificar práticas adotadas pela Equipe de Saúde Bucal na prevenção e promoção da saúde bucal das comunidades assistidas pela Estratégia Saúde da Família. Trata-se de uma revisão de literatura, com uma busca sistematizada nas bases de dados Biblioteca Virtual em Saúde e Scielo, utilizando os descritores: programa saúde da família, estratégia saúde da família, saúde bucal e odontologia. Os critérios de inclusão foram: estudos qualitativos, surveys e mistos, que abordem práticas adotadas pela Equipe de Saúde Bucal da Estratégia Saúde da Família, na prevenção e promoção da saúde bucal. A busca resultou em 435 estudos, após remoção das duplicatas, leitura de títulos, resumos e verificação dos critérios de inclusão foram incluídos 18 artigos. As práticas identificadas foram: educação em saúde, visita domiciliar, humanização do cuidado, educação permanente em saúde e intersetorialidade. Os resultados mostraram que as práticas de prevenção e promoção de saúde adotadas pela Equipe de Saúde Bucal da Estratégia Saúde da Família foram viáveis, uma vez que emergiram de estratégias difundidas pelas políticas públicas, evidenciando a indissociabilidade entre saúde bucal e saúde geral dos usuários e comunidades, contribuindo no processo de consolidação do Sistema Único de Saúde.

We aimed to evaluate the relationship between hearing ability and cognitive domains and determine how the relationship changes after 6 months of introducing a hearing aid.We conducted a 6-month hearing aid lending study between September 2014 and March 2019, including 59 older participants who visited the Memory Clinic at the National Center for Geriatrics and Gerontology. The hearing level was assessed using pure tone audiometry. Speech intelligibility was measured using the monosyllabic word discrimination score. We assessed the relationship between hearing ability and cognitive domains using the Mini-Mental State Examination (MMSE) total score and four subscale scores (orientation, memory, attention, and language). Differences in the cognitive function between baseline (pre-) and 6 months later (post-) after introducing a hearing aid were also assessed.The pre-orientation score was significantly associated with the pure-tone average (p = 0.013), and the pre-language score was significantly associated with speech intelligibility (p = 0.006) after adjusting for confounders. None of the MMSE subscale scores were significantly different between pre- and post-scores, however, an expectation of improvement with continuous hearing aid use was implied in the attention domain.We found a significant association between hearing ability and cognitive domains in individuals whose cognitive functions were not considered healthy. The presence of a potential relationship between cognitive domains, hearing ability, and auditory compensation is suggested.

A Extensão Universitária é a ação da Universidade junto à comunidade. O objetivo do estudo foi identificar ações em saúde bucal realizadas por projetos de extensão de Instituições de Ensino Superior (IES) que assistem a população idosa no Brasil. Trata-se de uma revisão da literatura, realizada nas bases de dados PubMed, Biblioteca Virtual da Saúde e Google Acadêmico, empregando os seguintes descritores: idoso, odontologia e relações comunidade-instituição. Foram incluídos estudos realizados por IES brasileiras, que relacionem projetos de extensão, odontologia, saúde bucal e idoso. A busca resultou em 385 artigos científicos, após a remoção das duplicatas e conferência dos critérios de inclusão, dois artigos foram incluídos. O estudo identificou na literatura que as ações em saúde bucal realizadas por projetos de extensão de IES, que assistem a população idosa no Brasil, foram ações de promoção e prevenção da saúde geral e bucal. Assim, a relação universidade e comunidade é uma estratégia assertiva para a redução das desigualdades sociais e do acesso à saúde, sendo indispensáveis para o aumento da qualidade de vida e melhoria na saúde bucal dos idosos.

A 55-year-old woman with atopic dermatitis was admitted to the hospital with a diagnosis of septic shock. She had multiple cerebral and left renal infarctions. Transesophageal echocardiography revealed a 10 mm mobile verrucous lesion at the mitral valve. Emergency mitral valvuloplasty was performed, and the verrucous lesion was successfully removed. The patient was hemodynamically stable and was admitted to the postoperative intensive care unit (ICU) under ventilatory support. On postoperative day 3, anemia progressed, and on postoperative day 4, the patient went into shock. Emergency embolization was performed for hemostasis, and the patient’s circulation improved. This is the first report of a case of renal hemorrhage after surgery for infective endocarditis. This case is valuable for the treatment of this disease in which various complications occur.

It was found recently that the durability of Ni‒Co dispersed on a samaria-doped ceria (SDC) hydrogen electrode was improved remarkably via reversible cycling operation between steam electrolysis and fuel cell-modes. The microstructure was observed to be stabilized, with certainty, due to a strong interaction between Ni‒Co and SDC. Aiming to develop a durable, practical hydrogen electrode with such a stabilized microstructure, we prepared new Ni–SDC H2 electrodes by a convenient protocol by the use of Ni nanoparticles with uniform size. The initial performance of the Ni–SDC H2 electrode thus prepared was comparable or slightly higher than that of our Ni‒Co dispersed SDC electrode prepared by an impregnation method.

Background: Due to clinicoradiological similarities, including amnestic cognitive impairment and limbic atrophy, differentiation of argyrophilic grain disease (AGD) from Alzheimer’s disease (AD) is often challenging. Minimally invasive biomarkers, especially magnetic resonance imaging (MRI), are valuable in routine clinical practice. Although it is necessary to explore radiological clues, morphometry analyses using new automated analytical methods, including whole-brain voxel-based morphometry (VBM) and surface-based morphometry (SBM), have not been sufficiently investigated in patients with pathologically confirmed AGD and AD. Objective: This study aimed to determine the volumetric differences in VBM and SBM analyses between patients with pathologically confirmed AGD and AD. Methods: Eight patients with pathologically confirmed AGD with a lower Braak neurofibrillary tangle stage (

The minimally invasive approach of arthroscopic shoulder surgery is beneficial; however, for optimal outcomes, perioperative pain management is essential. This cross-sectional study aimed to examine the analgesic effectiveness of intra-articular injection (IA) versus interscalene brachial plexus block (ISPB) among patients treated with arthroscopic shoulder surgeries.We reviewed 100 consecutive patients who underwent shoulder arthroscopic surgery, of whom 50 each underwent IA (February 2019─January 2020; IA group) and ISPB (October 2018─July 2019; ISPB group). The primary outcome was the postoperative pain score measured using a Wong-Baker FACES Pain Rating Scale preoperatively and at 2, 6, 12, 24, and 48 h postoperatively. We performed multiple regression analysis to examine whether IA/ISPB selection is associated with acute-phase postoperative pain and adjusted for intra-articular injection, interscalene brachial plexus block, postoperative pain management, arthroscopic shoulder surgery, IA with 10 mg of morphine previously reported prognostic factors for postoperative pain (e.g., surgical procedures, operative time, older age, and preoperative pain). Furthermore, we examined induction time, total pentazocine dosage, and total postoperative nausea and vomiting (PONV) events.There were no significant differences between the IA and ISPB groups in perioperative pain control during the acute-phase periods (p = 0.12, repeated analysis of variance). The difference in anesthesia method was not a prognostic factor for acute-phase postoperative pain (p = 0.11). The IA group (15.06 ± 4.00 min) had a significantly shorter mean anesthesia induction time than the ISPB group (29.23 ± 9.22 min) (p = 0.0001). There was no significant between-group difference in the total pentazocine dosage during the first 7 days (p = 0.3934) postoperatively. PONV was observed in eight (17.0%) and two (4.2%) patients in the IA and ISPB groups, respectively. There was no significant between-group difference in the PONV incidence (p = 0.1582).There was no significant difference in acute-phase postoperative pain management between the IA and ISPB groups. The induction time was significantly shorter in IA. IRB: Approval number: UOEHCRB20-078, IRB approval date: September 9th, 2020; study duration: October 2018 to January 2020.

Background Amyloid plaques and neurofibrillary tangles, the molecular lesions that characterize Alzheimer’s disease (AD) and other forms of dementia, are emerging as determinants of proteinopathies ‘beyond the brain’. This study aims to establish tau’s putative pathophysiological mechanistic roles and potential future therapeutic targeting of tau in heart failure (HF). Methods and results A mouse model of tauopathy and human myocardial and brain tissue from patients with HF, AD, and controls was employed in this study. Tau protein expression was examined together with its distribution, and in vitro tau-related pathophysiological mechanisms were identified using a variety of biochemical, imaging, and functional approaches. A novel tau-targeting immunotherapy was tested to explore tau-targeted therapeutic potential in HF. Tau is expressed in normal and diseased human hearts, in contradistinction to the current oft-cited observation that tau is expressed specifically in the brain. Notably, the main cardiac isoform is high-molecular-weight (HMW) tau (also known as big tau), and hyperphosphorylated tau segregates in aggregates in HF and AD hearts. As previously described for amyloid-beta, the tauopathy phenotype in human myocardium is of diastolic dysfunction. Perturbation in the tubulin code, specifically a loss of tyrosinated microtubules, emerged as a potential mechanism of myocardial tauopathy. Monoclonal anti-tau antibody therapy improved myocardial function and clearance of toxic aggregates in mice, supporting tau as a potential target for novel HF immunotherapy. Conclusion The study presents new mechanistic evidence and potential treatment for the brain–heart tauopathy axis in myocardial and brain degenerative diseases and ageing.

Objetivo: avaliar a percepção dos profissionais de saúde em relação à prática da Educação Permanente em Saúde. Método: estudo descritivo, transversal, de abordagem qualitativa, realizada em 2019 numa cidade do interior do Paraná. Aplicaram-se questionários abertos, antes e após uma capacitação sobre Educação Permanente em Saúde, e as respostas foram analisadas pela técnica categorial de Bardin. Resultados: participaram 28 profissionais, com predominância do sexo feminino (89%) e com 30 a 39 anos (50%). Verificou-se como fatores facilitadores da Educação Permanente em Saúde: entendimento sobre conceito e prática (antes); importância para prática no serviço e melhoria no atendimento ao usuário (após), e como barreiras: compreensão incipiente do conceito e prática (antes) e dificuldades de implementação (após). Conclusão: os fatores relatados evidenciam a necessidade dos profissionais de saúde se capacitarem, sendo importante o apoio da gestão para que a Educação Permanente em Saúde possa ser inserida na rotina de trabalho do município, com melhorias no processo de trabalho, consolidação da interprofissionalidade e qualidade na atenção aos usuários.

Recently, demand for thin steel plates has increased. In the manufacturing of thin steel plates, surface quality deterioration due to contact between the rollers and steel plate involved is problematic. We are investigating magnetic levitation conveyance to propose a noncontact conveyance system using electromagnets. However, the magnetic levitation of thin steel plates is unstable because of the deflection in the range where the electromagnetic force is not affected. Therefore, to improve the levitation stability, we are investigating a bending magnetic levitation system in which a thin steel plate is bent during magnetic levitation but not deformed plastically. In this study, a dynamic analysis using the finite difference method is performed to understand the behavior of a thin steel plate during magnetic levitation. In the dynamic analysis, vibration is evaluated based on the displacement standard deviation. The dynamic simulation visualizes the dynamic behavior of a levitated flexible steel plate.

Background: Peutz-Jeghers syndrome (PJS) is a rare disease characterized by the presence of hamartomatous polyposis throughout the gastrointestinal tract, except for the esophagus, along with characteristic mucocutaneous pigmentation. It is caused by germline pathogenic variants of the STK11 gene, which exhibit an autosomal dominant mode of inheritance. Some patients with PJS develop gastrointestinal lesions in childhood and require continuous medical care until adulthood and sometimes have serious complications that significantly reduce their quality of life. Hamartomatous polyps in the small bowel may cause bleeding, intestinal obstruction, and intussusception. Novel diagnostic and therapeutic endoscopic procedures such as small-bowel capsule endoscopy and balloon-assisted enteroscopy have been developed in recent years. Summary: Under these circumstances, there is growing concern about the management of PJS in Japan, and there are no practice guidelines available. To address this situation, the guideline committee was organized by the Research Group on Rare and Intractable Diseases granted by the Ministry of Health, Labour and Welfare with specialists from multiple academic societies. The present clinical guidelines explain the principles in the diagnosis and management of PJS together with four clinical questions and corresponding recommendations based on a careful review of the evidence and involved incorporating the concept of the Grading of Recommendations Assessment, Development and Evaluation system. Key Messages: Herein, we present the English version of the clinical practice guidelines of PJS to promote seamless implementation of accurate diagnosis and appropriate management of pediatric, adolescent, and adult patients with PJS.

Objectives Dignity therapy (DT) was developed to help patients at their end of life to reframe and give meaning to their illness process. The DT question protocol focuses on personhood and important aspects of the individual’s life. This study aimed to translate and culturally adapt the Dignity Therapy Question Protocol (DTQP) to Brazilian Portuguese. Methods This was a descriptive and methodological study, and cross-cultural adaptation process comprised 4 stages: (1) translation and synthesis of English original version protocol into Brazilian Portuguese, (2) back translation, (3) experts committee, and (4) pretest. Results The Portuguese version of the DTQP – Protocolo de Perguntas sobre Terapia da Dignidade – demonstrated a content validity index of 1 for all equivalences. The initial sample consisted of 41 participants (9 [21.9%] refused to participate and 1 [2.43%] dropped out). The pretest was applied to 30 (73.1%) participants, 15 of them were female and the mean age was 53.4 years. The final version consisted of 10 questions that were approved by the original authors who affirmed that the DTQP Brazilian Portuguese version maintained the original English characteristics. Significance of results The Brazilian cultural adaptation of the DTQP was well understood by patients. It will be very useful in palliative care clinical practice for patients nearing end of life. The adapted version to Brazilian Portuguese will facilitate future studies using the DTQP.

In large hayfields belonging to intensive dairy systems, satellite remote-sensing data can be useful to determine the hayfield yield and quality efficiently. In this study, we compared the land survey data of hayfield yield, and its quality parameters such as crude protein and neutral detergent fiber digestibility (NDF), with the Sentinel-2 satellite image data for thirteen hayfield paddocks in Kamishihoro region, Hokkaido, Japan. Commonly used indices derived from the satellite image data, including the Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), were used to assess the hayfield yield and quality. In this region, hayfields are usually harvested twice yearly, in early summer (first harvest) and late summer (second harvest). As result, the Sentinel-2 data could predict the pasture growth and quality for the first harvest better than those for the second harvest. The EVI and the index based on the bands B8a and B7 were the best predictors for the biomass and NDF for the first harvest, respectively. However, the satellite-image-based predictors were not found for the second harvest. Towards the second harvest season, the color of the hayfield surface became more heterogeneous because of the flowering of weeds and uneven pasture growth, which made it challenging to predict pasture growth based on the remote-sensing data. Our land survey approach (quadrat-based sampling from a small area) should also be improved to compare the remote-sensing data and the pasture with uneven growth.

We deal with the change point problem in ergodic diffusion processes based on high frequency data. Tonaki et al. (2020, 2021) studied the change point problem for the ergodic diffusion process model. However, the change point problem for the drift parameter when the diffusion parameter changes is still open. Therefore, we consider the change detection and the change point estimation for the drift parameter taking into account that there is a change point in the diffusion parameter. Moreover, we examine the performance of the tests and the estimation with numerical simulations.