Bobath memorial hospital

Abstract Accurately estimating the thickness of Arctic multiyear sea ice is essential for understanding cryospheric dynamics and monitoring climate change. Ground-penetrating radar (GPR) is widely used in terrestrial geophysical applications, including subsurface imaging for geological mapping, permafrost investigations, and structural assessments of the lithosphere. In recent years, GPR has also been applied to sea ice studies, particularly for detecting the snow-ice and ice-seawater boundaries. However, accurately resolving the ice-seawater boundary remains challenging due to the presence of a transition zone, where brine drainage causes gradual changes in dielectric properties. This leads to significant signal attenuation and reflection ambiguities in GPR data. To improve GPR interpretation under such conditions, this study applies attribute analysis techniques specifically instantaneous amplitude, instantaneous phase, and instantaneous Q-factor. These attributes enhance the interpretability of GPR signals and assist in identifying boundaries within brine-affected transition zones. In addition, field data acquired from GPR systems were used to evaluate how attribute analysis contributes to the interpretation of sea ice structure, demonstrating the practical value of these attributes for delineating internal boundaries and transitions within multiyear sea ice. Comparison with direct ice thickness measurements and electromagnetic (EM) surveys conducted along the same transects was used to assess the performance of the attribute-based interpretation. The attribute-based interpretation provided supplementary information that improved the interpreter’s ability to resolve complex boundary conditions. Compared to traditional methods relying on empirical calibration or multi-frequency analysis, this approach offers improved support for ice thickness estimation in challenging sea ice environments.

We investigated the efficacy of a multidomain intervention (MI) via face-to-face and video communication platforms using a tablet personal computer application in patients with mild cognitive impairment (MCI). Three hundred participants with MCI and≥1 modifiable dementia risk factor, aged 60-85 years, were randomly assigned to either the MI group, who underwent a 24-week intervention, or the control group, who received usual care. The overall adherence rate to MI was 84.7%. The adjusted mean change from baseline at 24weeks in the total scale index score of the repeatable battery for the assessment of neuropsychological status was 8.43 in the MI group and 4.26 in the control group (difference, 4.17; 95% confidence interval, 1.92-6.43; p<0.001). MI showed significant beneficial effects on cognition in both apolipoprotein E (APOE) ε4 carriers and noncarriers. MI can exert beneficial effects on the cognition of patients with MCI. ClinicalTrials.gov identifier: NCT05023057 HIGHLIGHTS: Although the controls also demonstrated improved performance in cognition, multidomain interventions showed significantly greater benefits for cognition in MCI compared to the controls in a randomized controlled trial. Multidomain interventions improved depression and quality of life. Multidomain interventions significantly positively impacted cognition in both APOE ε4 carriers and noncarriers. Multidomain interventions may be more effective for amnestic than nonamnestic MCI.

BackgroundAntibiotic resistance threatens public health worldwide, and inappropriate use of antibiotics is one of the main causes. Antibiotic use for asymptomatic bacteriuria (ABU) has been defined as “antibiotics never events”, and urinary tract infection (UTI) is one of the most common infectious diseases for which antibiotics are prescribed in Korea. To establish an effective antimicrobial stewardship strategy, a qualitative assessment of antibiotic use in actual clinical syndrome is necessary.MethodsCases of positive urine cultures (≥105 CFU/ml), performed in inpatient, outpatient, and emergency departments in April 2021 were screened in 26 hospitals located throughout Korea. Cases were classified into ABU, lower UTI, and upper UTI. The appropriateness of antibiotic use was retrospectively evaluated by infectious disease specialists using quality indicators based on the domestic clinical guideline for ABU and UTI.Figure 1.Study flow diagramResultsA total of 2697 cases of ABU or UTI were included. The appropriateness of antibiotic use was assessed in 1157 cases with asymptomatic bacteriuria, 677 and 863 cases with lower and upper UTI (Figure 1). Antibiotics were prescribed in 21.7% (251 of 1157) of ABU without appropriate indication. Of 66 ABU cases with appropriate indication in which prophylactic antibiotics were prescribed, the duration of antibiotics was adequate in only 34.8% (Table 1). For lower UTI, the appropriateness of empirical and definite antibiotics was 77.8% (527 of 677) and 68.0% (353 of 519). In terms of upper UTI, 86.3% (745 of 863) and 78.2% (583 of 746) was appropriate, respectively. The duration of antibiotics was adequate in 65.7% (421 of 641) of lower UTI and 77.9% (592 of 760) in upper UTI (Table 2, 3).ConclusionThis nationwide qualitative assessment of antibiotic use in ABU and UTI revealed that a significant proportion of antibiotics were prescribed inappropriately and, furthermore the duration of antibiotics was prolonged unnecessarily. Interventions for appropriate antibiotic use in ABU and UTI at the national level are required.DisclosuresAll Authors: No reported disclosures.

Purpose The aim of this study was to investigate the effects of medial longitudinal arch mobility of paretic foot on balance and gait, and muscle activity in stroke patients. Methods Twelve stroke patients who were hospitalized at B hospital in Gyeonggido during the period from January 2022 to February 2022 were enrolled in this study. The subjects were divided into the medial longitudinal arch mobility training group of the paretic foot (n = 6) and the conventional physical therapy group (n = 6). The intervention was performed for 30 minutes a days, 5 times a weeks, and two weeks. The effectiveness of the intervention was assessed pre and postevaluated using the 10M Walk Test(10MWT), Berg Balance Scale(BBS), the BioRescue Platform(BRP) and the surface ElectroMyoGraphy(sEMG). Results As the result of the medial longitudinal arch mobility training on the paretic foot showed significantly improved balance and gait after exercise than before exercise in 10MWT, BBS and BRP. Conclusion Medial longitudinal arch mobility training of the paretic foot was effective in improving balance and gait speed through weightbearing on the paretic side in hemiplegic patients with stroke.

In the SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN), we evaluated the impact of a 24-week facility-based multidomain intervention (FMI) and home-based MI (HMI) on cortical thickness, brain volume, and the serum brain-derived neurotrophic factor (BDNF). Totally, 152 participants, aged 60–79 years without dementia but with ≥ 1 modifiable dementia risk factor, were randomly assigned to the FMI, HMI, or control groups. Among them, 55 participants (20 FMI, 19 HMI, and 16 controls) underwent brain MRI at baseline and 24 weeks. We compared changes in global/regional mean cortical thickness at the region-of-interest (ROI) between the intervention and control groups. The changes in the total cortical gray matter volume and global mean cortical thickness were compared using analysis of covariance with age, sex, and education as covariates. ComBat site harmonization was applied for cortical thickness values across the scanners. ROI-based analysis was controlled for multiple comparisons, with a false discovery rate threshold of p < 0.05. Serum BDNF levels were significantly higher in the FMI group than in the control group (p = 0.029). Compared with the control group, the mean global cortical thickness increased in the FMI group (0.033 ± 0.070 vs. − 0.003 ± 0.040, p = 0.013); particularly, cortical thickness of the bilateral frontotemporal lobes, cingulate gyri, and insula increased. The increase in cortical thickness and serum BDNF in the FMI group suggests that group preventive strategies at the facility may be beneficial through structural neuroplastic changes in brain areas, which facilitates learning and neurotrophic factors.

PURPOSE: Respiratory function can be adversely affected after a cerebrovascular accident. This study aimed to determine whether inspiratory muscle training (IMT) changes the respiration and balance abilities of patients with stroke.METHODS: Twelve patients with stroke were randomly assigned to the study (n=6) and control (n=6) groups. The study and control groups received IMT and general physical therapy, respectively for 6 weeks, five times a week for 30 min/day. Inspiratory and expiratory functions and balance were measured pre- and post-evaluation.RESULTS: After IMT intervention, the weight distribution ratio (WDR) for balance ability measurement was significantly decreased (p&lt;.05), and the maximum inspiratory pressure (MIP), maximum inspiratory flow rate (MIFR), maximum inspiratory capacity (MIC), peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and limits of stability (LOS) were significantly increased in the study group (p&lt;.05). A comparison of the study and control groups revealed statistically significant differences in MIP (p&lt;0.01), MIFR (p&lt;.01), MIC (p&lt;.05), PEF (p&lt;.05), FEV1 (p&lt;.05), WDR (p&lt;.01), and LOS (p&lt;.05).CONCLUSIONS: This study suggests that IMT is a useful and effective exercise intervention for patients with stroke.

〔目的〕回復期リハビリテーション病棟を退院した後の在宅生活におけるFunctional Independence Measure（FIM）運動下位項目の経時的変化を明らかにする．〔対象と方法〕対象は，退院直後から訪問リハビリを開始した41名の脳卒中患者とした．診療録から抽出したFIM運動項目合計と，その下位項目の点数を各時期（退院時，退院直後，退院後3ヵ月）で比較した．〔結果〕退院直後は排泄（排便）が向上，移動（歩行）が低下した．退院後3ヵ月はセルフケア（食事，清拭，更衣下半身，トイレ動作），排泄（排尿，排便），移乗（ベッド，トイレ，浴槽），移動（階段）が向上したが，整容，更衣上半身，歩行は変化しなかった．〔結語〕退院後3ヵ月におけるFIM運動下位項目の変化は，生活段階で異なることが示唆された．

Abstract BackgroundIn the South Korean study to prevent cognitive impairment and protect brain health through lifestyle intervention in at‐risk elderly people (SUPERBRAIN), we explored impact of baseline daily physical activity on cognitive and physical effects of 24‐week lifestyle multidomain intervention.MethodA total of 152 participants, aged 60‐79 years without dementia but with ≥ 1 modifiable dementia risk factor, were randomly assigned to the facility‐based multidomain intervention (FMI), and home‐based MI (HMI), or control groups. Among them, 82 participants (27 FMI, 34 HMI, and 21 control) took their physical activity for 7 days using the accelerometer (Actigraph GT3X+, FL, USA) at baseline. We divided 61 participants in the FMI or HMI into two groups according to their physical activity at baseline: Group I who met WHO physical activity guidelines for older adults (more than 150 minutes of moderate activity per week) and Group Ⅱ who did not meet the guidelines. We compared changes of cognitive and physical measures after 24‐week intervention between group I and Group Ⅱ. Cognitive function was measured using the total sale index score of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the physical fitness was measured by the hand grip strength test, 30 s sit‐to‐stand test, 3 m sit–walk‐and‐return test, sit‐and‐reach test, 2‐min stationary march, and Figure‐8‐walks. Due to not satisfying the normality test, the nonparametric tests Mann‐Whitney and Wilcoxon were analyzed using IBM SPSS Statistics25.ResultGroups I and II had no significant difference in the baseline total sale index score of the RBANS, whereas the group I had a higher physical fitness at baseline (sit‐and‐reach test and 3m sit‐walk‐and‐return test &lt;0.05; Figure‐8‐walks &lt;0.01). After the intervention, only Group I showed significant improvement in the total sale index score of the RBANS. Both groups were significantly improved in 30 s sit‐to‐stand test, 2‐min stationary march, and Figure‐8‐walks. However, hand grip strength was improved in only Group I.ConclusionSignificant improvement in both cognitive and physical function in at‐risk but active elderly without substantial impairment in the SUPERBRAIN suggest that preventive strategies may be more beneficial on cognitive and physical function in active older adults.

Abstract Purpose Few large-scale studies have focused on the prevalence of symptoms and signs during the last days of patients diagnosed with advanced cancer. Identifying the patterns of specific symptoms according to cancer type is helpful to provide end-of-life care for patients with advanced cancer. We investigated the prevalence and severity of symptoms and signs associated with impending death in patients with advanced cancer. Methods In this secondary analysis of an international multicenter cohort study conducted in three East Asian countries, we compared the severity of symptoms and signs among dying patients 3 days before death according to the type of primary cancer using one-way analysis of variance (ANOVA). Post hoc analysis was conducted for multiple comparisons of each symptom according to the type of primary cancer. Results We analyzed 2131 patients from Japan, Korea and Taiwan. Fatigue, dry mouth, drowsiness and dyspnea were present in nearly half of the patients, and edema of lower extremities was the most common sign in all dying patients. According to cancer type, edema of lower extremities was the most common symptom and fatigue/ ascites were the most severe symptoms in digestive tract cancer. For lung cancer, respiratory secretion was the most prevalent and dyspnea/ respiratory secretion were the most severe symptoms. Conclusion We demonstrated the prevalence and severity of symptoms and signs associated with impending death of patients with advanced cancer in East Asia. Our study can enable clinicians to recognize the specific symptoms and signs at the very end of life.