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Concrete structures are susceptible to corrosion especially when exposed to marine environment. In order to minimize the corrosion in reinforced concrete, reduction of dissolved Oxygen (DO) in mixing water is recommended. The DO is the measurement of the amount of free Oxygen that is dissolved in water which is proportional to the corrosion rate of steel bars inside concrete. In this paper, the use of industrial waste/by-products, agricultural waste, natural minerals, and green inhibitors as additive for cement in reducing the DO level of the mixing water was explored. Candidate materials from different types of agricultural waste, industrial waste, natural minerals, and green inhibitors. The percentage difference of DO were computed for all types of materials as ash or powder or extract in room temperature. This is the percentage difference of DO level in distilled water and the solution mixed with the candidate material having a mass ratio of 3 : 2 and/or 3 : 1. Results showed that more than 90% reduction of DO level were achieved when mixed with ginger extract, ginger powder, aloe vera extract, ginger pulp, and rice hull ash. Future experimental studies using the candidate materials producing reinforced concrete specimens with high reduction of DO level in mixing water is recommended.

This study aimed to determine which instrumental activities of daily living (IADL) are associated with health deterioration from the "support level" to the "care level" among users of the long-term care insurance system in Japan. From April 2017 to March 2020, we conducted a retrospective follow-up survey on 178 Japanese community-dwelling older adults (64 men, 114 women) newly certified as support level. Independent variable was 8 IADL items and the outcome defined as the "support level maintenance time." Cox models were used to assess the risk of health deterioration, with adjustments for age group, family composition, dementia status, and frailty status by gender. Dependence on 5 items, "laundry" (hazard ratio [HR] =2.5; 95% confidence interval [CI]: 1.1-5.8), "cooking" (HR = 3.7; 95% CI: 1.1-12.2), "telephone use" (HR = 2.4; 95% CI: 1.2-4.7), "financial management" (HR = 2.5; 95% CI: 1.2-5.0), and "medication management" (HR = 2.4; 95% CI: 1.2-4.8), was independently associated with a worse outcome among men, whereas dependence on "financial management" (HR = 2.6; 95% CI: 1.5-4.7) and "medication management" (HR = 2.0; 95% CI: 1.1-3.5) was independently associated with a worse outcome among women. These findings suggest that difficulties in "financial management" and "medication management" are common factors associated with health deterioration from the support to the care level among both genders. An association with household tasks was also seen among men, indicating that a paradigm shift is needed to increase the participation of men in household tasks. [ABSTRACT FROM AUTHOR]

Objective: The development of a dysphagia screening test is an urgent issue in the field of frailty prevention among community‐dwelling older people. The purpose of this study was to evaluate the screening performance of a 100‐mL water swallowing test (WST). Methods: The study employed a cross‐sectional design. Participants were 304 (65 men and 239 women, mean age = 80 years) Japanese community‐dwelling older adults aged over 65 years. We investigated swallowing disorder using the 10‐item Eating Assessment Tool (EAT‐10), and compared choking signs, swallowing time and number of swallows, and their combination in the 100‐mL WST. We calculated the sensitivity and specificity of these indices. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut‐off value of swallowing time and number of swallows in the 100‐mL WST based on the Youden Index among participants without choking signs. Results: The sensitivity and specificity of choking signs in the 100‐mL WST were 20% and 91%, respectively. The discriminating ability of swallowing time and number of swallows among participants without any choking signs was.76 and.72, respectively, in the area under the ROC curve. Diagnostic sensitivity and specificity to discriminate dysphagia from normal swallowing ability were 65% and 74% when the cut‐off was >10 s based on maximisation of the Youden Index. The 100‐mL WST performed best when the indices of choking signs and swallowing time were combined, with a sensitivity and specificity of 72% and 68%, respectively. Conclusions: The 100‐mL WST would be an adequate screening tool when compared to the EAT‐10. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the outcome of nonobstructive (or non-flow-limiting) residual dissection (RD) after percutaneous coronary intervention. Results of 124 consecutive native coronary lesions with angiographic nonobstructive RD in 97 patients (RD group) were compared with outcomes of 124 lesions without RD in 100 patients (non-RD group), whose characteristics were matched with those of the RD group. RD occurred after stent implantation (81 of 124 lesions, 65%) or balloon angioplasty (43 of 124 lesions, 35%). Angiographic types of RD were type A in 8 lesions (6%), B in 101 (82%), and C in 15 (12%). Stents were implanted in 65% of the lesions in each group. Clinical success (94% in RD group vs 95% in non-RD group, p = 0.77) and the in-hospital major adverse cardiac event rates were found to be similar in the 2 groups (6% vs 3%, respectively; p = 0.33). The late angiographic and clinical outcomes were also comparable. By intravascular ultrasound (IVUS) evaluation of the dissections in the RD group, area stenosis correlated with the incidence of in-hospital major adverse cardiac events (p = 0.023), whereas the final minimal lumen area correlated inversely with the occurrence of restenosis (p = 0.011). An area stenosis > or =58% was the best predictor for the incidence of in-hospital major adverse cardiac events (sensitivity 0.68, specificity 0.68). Most nonobstructive RDs are "favorable" and do not need stent implantation. IVUS evaluation identifies "unfavorable" nonobstructive (or non-flow-limiting) dissections that might be prone to acute occlusion. Nonobstructive dissections can be left untreated when final IVUS reveals an area stenosis of < 60% at the site of a dissection.

ObjectivesThe purpose of this study was to evaluate two different techniques of stent placement in bifurcation lesions.BackgroundAlthough stent placement with dedicated techniques has been suggested to be a useful therapeutic modality for bifurcation lesions, limited information is available if stent placement on the side branch and on the parent branch provides any advantage over a simpler strategy of stenting the parent vessel and balloon angioplasty of the side branch.MethodsBetween March 1993 and April 1999, we treated a total of 92 patients with bifurcation lesions with two strategies: stenting both vessels (group B, n = 53) or stenting the parent vessel and balloon angioplasty of the side branch (group P, n = 39). Paired angiograms were analyzed by quantitative angiography, and clinical follow-up was obtained.ResultsStent placement on both branches resulted in a lower residual stenosis (7.4 +/- 10.9% vs. 23.4% +/- 18.7%, p < 0.001) in the side branch. Acute procedural success was similar in the two groups (group B: 87% vs. Group P: 92%). In-hospital major adverse cardiac events (MACE) occurred only in group B (13% vs. 0%, p < 0.05). At the six-month follow-up, the angiographic restenosis rate (group B: 62% vs. Group P: 48%) and the target lesion revascularization rate (38% vs. 36%, respectively) were similar in the two groups. There was no difference in the incidence of six-month total MACE (51% vs. 38%).ConclusionsFor the treatment of true bifurcation lesions, a complex strategy of stenting both vessels provided no advantage in terms of procedural success and late outcome versus a simpler strategy of stenting only the parent vessel.