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Background: To identify the clinical factors affecting activities of daily living (ADL) at baseline and after 6 months. Methods: We conducted a single-centre observational study at two time points across 6 months (baseline and after 6 months) from April 2015 to March 2017. in a 270-bed rural recuperation hospital at Hyogo prefecture in Japan. The total number of participants was 131 (male 33, female 98; mean age: 87.0 ± 7.0; mild and moderate dementia, 38; severe dementia, 93). Measurement scales used were Personal Self-Maintenance Scale (PSMS) for assessing ADL, Mini-Mental State Examination and Cognitive Test in Severe Dementia (CTSD) for cognitive function, Neuropsychiatric Inventory- Nursing Home version and Cornell Scale for Depression in Dementia (CSDD) for behavioural/psychological symptoms of dementia, Mini Nutritional Assessment Short form (MNA-SF) for nutritional status, Pain Assessment in Advanced Dementia for pain, and Charlson comorbidity index (CCI) and the number of illness categories based on Cumulative Illness Rating Scale Geriatrics for comorbidities. Multiple regression analyses identified the association between PSMS score as the dependent variable and other variables as independent variables. Results: In participants with severe dementia, the PSMS scores at baseline were significantly associated with CTSD, CCI, MNA-SF, and CSDD scores. In the longitudinal analysis, only CTSD score was significantly associated with PSMS score after 6 months. It is noteworthy that for participants with severe dementia, the only factor associated with ADL after 6 months was cognitive function, as assessed by CTSD score. Conclusions: The most important factor predicting functional decline is cognitive function, even at the severe and profound stage. [ABSTRACT FROM AUTHOR]

Pyroclastic density currents (PDCs) are one of the most dangerous but least understood phenomena of volcanic eruptions. An open-source numerical depth-averaged model of dense granular currents controlled by physical processes such as energy dissipation, basal deposition, and erosion (faSavageHutterFOAM) was applied to investigate the basal concentrated region of a dome-collapse PDC generated on June 3, 1991 at Unzen volcano (Japan) to assess the effects of the physical processes (and their interplay) on the flow dynamics and run-out area of the PDC. Numerical simulations show that energy dissipation process decreases the flow velocity and increases the basal deposition rate, which reduces the run-out distance. The simulations also reveal that erosion process during flow propagation decreases the flow velocity and increases the run-out distance. The numerical results are sensitive to the parameters of energy dissipation (dry friction coefficient μ and collisional or turbulent friction coefficient χ) and erosion (specific erosion energy eb). The results are fitted to field data for run-out distance and flow velocity when μ is between 0.01 and 0.1 with χ∼103 m-1 s-2 (or when χ is between 104 and 105 m-1 s-2 with μ∼0.2) and eb∼102 m2 s-2. The estimated value of eb suggests that re-entrainment of deposit mass played an important role in controlling the flow dynamics and run-out area of the PDC. The estimated values of μ and χ are correlated, but the estimation of these parameters might be improved by further constraints from field data. The presented results serve as a basis to make further quantitative estimations of the model parameters (μ, χ, and eb) for applying the faSavageHutterFOAM model to hazard assessments of PDCs. [ABSTRACT FROM AUTHOR]

Background: A comprehensive understanding of the relevant factors involved in improving quality of life (QoL) is essential in patients with severe dementia; however, rating scales used in previous studies may not adequately reflect the factors that affect these patients. The purpose of this study was to identify factors that contribute to QoL using an evaluation scale suitable for patients with severe dementia. Methods: The current cross‐sectional study was conducted at a hospital for recuperation in Hyogo prefecture in Japan. The measurement scales included the QoL in Late‐Stage Dementia Japanese version (QUALID‐J), Cognitive Test for Severe Dementia, Neuropsychiatric Inventory‐Nursing Home (NPI‐NH), Physical Self‐Maintenance Scale (PSMS), Pain Assessment in Advanced Dementia (PAINAD), and Special Care Unit Environment Quality Scale (SCUEQS). Multiple regression analyses were performed. Results: We assessed a total of 105 patients with severe dementia (80 women; aged 87.3 ± 6.3 years). Multiple regression demonstrated that the QUALID‐J total score was significantly affected by the NPI‐NH and PAINAD scores. Factors 1 (expression of comfort) and 2 (expression of discomfort) of the QUALID‐J were significantly affected by the PSMS and PAINAD, and the NPI‐NH and PAINAD scores, respectively. Conclusion: Our results indicate that behavioural and psychological symptoms of dementia and pain are important factors in influencing the QoL of patients with severe dementia. [ABSTRACT FROM AUTHOR]

Background/Aims: Existing cognitive measures for moderate-to-severe dementia have shown floor effects and an inability to assess the remaining cognitive function, especially for profound dementia. Methods: We constructed the Cognitive Test for Severe Dementia (CTSD), which consists of 13 items covering 7 cognitive domains, and examined its reliability and validity. Results: Cronbach's α in severe dementia participants was 0.896. Interrater and test-retest reliability were 0.961 and 0.969, respectively. The CTSD showed a significant correlation with 3 other measures of cognitive function (Mini-Mental State Examination, Severe Cognitive Impairment Rating Scale, and Hasegawa Dementia Scale-Revised: r values = 0.870-0.922, p values <0.001). While the other measures showed floor effects, the CTSD did not. Conclusion: The CTSD was able to sensitively capture the remaining cognitive function in severe dementia patients when compared with other cognitive tests. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Kochi oxydol radiation therapy for unresectable carcinomas II (KORTUC II) is currently the most widely used radiosensitizer in Japan. This sensitizer is a solution consisting of 0.83% sodium hyaluronate and 0.5% hydrogen peroxide. The mixture is injected intratumorally just before radiation therapy (RT) several times. KORTUC II has the effect of neutralizing antioxidant enzymes, while increasing the oxygen tension into the tumor tissue, and achieves marked local effects without notable adverse events. The present report describes cases in which KORTUC II was used to treat patients with locally advanced breast cancer (LABC) or recurrent breast cancer (LRBC). The present study included 30 patients with LABC (n=9) or LRBC (n=21) aimed at local control of tumors, who were followed up for ≥3 months after treatment. The irradiation dose and extent fields were determined by the attending physicians considering various patient factors, such as a performance status, prognosis and presence or absence of adjuvant therapy. The median irradiation dose was 60.4 Gy3.5 (43.6-76.1 Gy3.5) based on the calculation of equivalents of 2 Gy fractions, and the median total number of sensitizer injections was 5 (2-7) times. The median maximum tumor shrinkage was 97.0% and 15 patients (50%) were assessed to have achieved a clinical complete response. The proportion with loco-regional control at 1, 2 and 3 years was 100, 94.7 and 75.4%, respectively, and progression free survival after RT at 1 and 2 years was 59.0 and 24.1%, respectively. KORTUC II exhibited high rates of local tumor control for LABC and LRBC. KORTUC II is expected to be an inexpensive and promising RT method because it is safe and has an excellent radio-sensitizing effect. [ABSTRACT FROM AUTHOR]