Ibaraki Prefectural University of Health Sciences

The combination of vessel wall imaging (VWI) and MR angiography (MRA) is useful for differentiating between intracranial atherosclerotic disease and arterial dissection. However, additional VWI scans increase total scan time. The purpose of this study was to develop and evaluate a simultaneous acquisition method for VWI and MRA using phase-sensitive inversion recovery (PSIR) in brain MRI. Imaging parameters were optimized using a phantom simulating cerebral blood flow, brain parenchyma, and plaque. The proposed method was validated in an in vivo study by comparing it with the conventional method (T1-turbo spin echo+time of flight-MRA). The proposed method achieved a higher contrast ratio than the conventional method. Additionally, the acquisition time was reduced to less than one-half (2 min 18 s vs 7 min 15 s). This simultaneous acquisition method using PSIR is useful for brain MRI.

Headaches are common in youth and can impact school and daily life. Data on headaches and care-seeking in Japanese schoolchildren are scarce. We investigated prevalence, impact, and consultation patterns. A school-based online survey was conducted between February and March 2025 among 3,766 students in seven elementary and three junior high schools in Ami-town, Ibaraki-prefecture, Japan. Two questionnaire versions were distributed: one for lower-grade students (grades 1-3) and one for upper-grade students (grades 4-9). The survey included items on headache frequency, triggers, associated symptoms, medication use, and consultation experiences. The prevalence of headaches was 29.1% in lower-grade and 37.6% in upper-grade students. The most common age of onset was 10 years. Students with Headaches that meet most of the diagnostic criteria for episodic migraine experienced more headache days and more school absences compared to students with other headache characteristics. Although nearly half of the students had taken medication, fewer than one-third had consulted a physician. Despite experiencing headaches, only a small number of children sought medical care, which may raise concerns about the potential overuse of over-the-counter medications. Therefore, collaboration between educational and medical institutions is essential to improve early recognition and intervention.

Postoperative C5 palsy is a common complication of cervical spine surgery. Inadequate recovery from C5 palsy can result in significant impairment of activities of daily living. However, no effective treatment has been established for persistent cases. In the present report, we describe a novel therapeutic approach using the Hybrid Assistive Limb (HAL) in a patient with severe, prolonged postoperative C5 palsy. The patient was a 46-year-old man who developed severe right C5 palsy following cervical spine surgery performed 41 months earlier. Despite undergoing conventional rehabilitation, no improvement was observed, and the muscle strength of the right deltoid and biceps remained at manual muscle testing (MMT) grade 2. HAL training, using both shoulder and elbow devices, was initiated at our institution. Training was conducted once weekly for a total of 106 sessions over 21 months. At baseline, the right shoulder range of motion was limited to 50° in flexion and 35° in abduction. With HAL-assisted training, flexion improved to 150° and abduction improved to 95° by the final (106th) session and further increased to 165° and 170°, respectively, at long-term follow-up. Deltoid strength, assessed using handheld dynamometry, increased from 3.5 Nm/kg at baseline to 28.5 Nm/kg after training. In this case, a long-term therapeutic program incorporating shoulder and elbow HAL training successfully improved severe and prolonged postoperative C5 palsy to a functionally useful level. This case highlights the potential effectiveness of HAL therapy for treatment-resistant postoperative C5 palsy.

Branch atheromatous disease (BAD) often progresses during the acute phase. During acute rehabilitation, clinicians should prioritize monitoring neurological symptom progression. We treated a patient with right-sided, finger-limited motor paralysis and frequent transient motor paralysis fluctuations due to BAD by implementing early upper-limb occupational therapy while maintaining rigorous risk management. Occupational therapy included standard upper limb functional training, continuous neuromuscular electrical stimulation, and repetitive facilitation exercises. During occupational therapy, blood pressure was carefully monitored, and neurological symptoms were regularly assessed. Any symptom changes were promptly communicated among occupational therapists, rehabilitation specialists, and neurosurgeons. Although transient motor paralysis occurred five times, timely treatment, including medication adjustments, prevented further neurological deterioration. Additionally, upper-limb function and object manipulation ability improved over time. Risk management is critically important in occupational therapy for acute BAD. This case demonstrated that repetitive facilitation exercises combined with continuous neuromuscular electrical stimulation can be safely initiated in the early stages of stroke, potentially improving upper limb dysfunction.

手指衛生は，感染拡大を予防するための重要な手段である．この度のCOVID-19感染禍で高齢者介護施設において感染拡大が報告された．手指衛生遵守状況改善には手指衛生教育が必須であることから，本研究は介護職員に特化した教育の効果を検証することを目的とした．2022年8～9月，北関東の高齢者介護施設4施設の介護職員を対象に，学習の動機づけの手段であるARCSモデルを活用した教育を行い，教育前後の知識確認調査と手指衛生遵守率を比較した．知識確認調査の点数は，研修前15.0±2.6点，研修後18.8±1.0点で研修後の点数が有意に上昇した（p＜.001）．手指衛生遵守率は「入所者に接触する前」「清潔/無菌操作の前」の遵守率に研修前後で差はなかったが，「体液曝露リスクの後」「入所者に接触した後」「入所者周辺の物品に触れた後」「手袋の使用後」の遵守率は研修後に上昇した．教育理論を取り入れた研修の構成は，対象者の学歴，実務経験年数などの属性に関係なく教育効果をもたらす可能性を示した．「入所者に触れる前」「清潔/無菌操作の前」の手洗いの必要性を認識できる教育の重要性が示唆された．

Abstract A professional diagnosis of the physiological status based on careful spatial observation is essential to maintain the healthy and sustainable conditions and desired quality of turfgrass areas. The objectives of this study were to demonstrate the capability of drone‐based physiological remote sensing and to analyze the spatial heterogeneity of putting greens using drone‐based maps. Multispectral and thermal imagery were acquired concurrently with in situ measurements of soil water content (θ) in an experimental turfgrass field and putting greens at a commercial golf course in Ibaraki, Japan, during 2020–2022. High‐resolution maps of the two physiological indicators, that is, canopy chlorophyll index (CCI) as a proxy for chlorophyll content and plant stress index (PSI) as an indicator of transpiration depression, were generated from the multispectral and thermal imagery, respectively. The CCI was closely regressed to the ground‐based dark green color index (DGCI) (r2 = 0.80, p < 0.01), suggesting that the CCI could be an alternative to the DGCI. The PSI (0–1) had a close relationship with θ expressed by an exponential equation (r2 = 0.92, p < 0.01), suggesting an intrinsic response pattern of transpiration depression to soil water deficit in creeping bentgrass (Agrostis stolonifera L.) turfgrass areas. A strong correlation was found between PSI and θ (r = −0.85, p < 0.01) in putting greens. The spatial pattern of θ was so consistent in both the horizontal and vertical axes (r = 0.8–0.9, p < 0.01) that the site‐specific variability would be persistent. The physiological maps before and after an adverse weather event suggested that these maps will be useful in identifying the vulnerable areas. The drone‐based physiological maps and their synergistic use with in situ θ would provide useful information for turfgrass diagnostics. Further experimental studies are needed to extend the applicability of the methods to different species and environmental conditions.

BackgroundThe Activities-specific Balance Confidence (ABC) scale lacks sufficient psychometric evidence for use in patients with subacute stroke.ObjectiveTo investigate the floor and ceiling effects, construct validity, responsiveness, and the minimal important change (MIC) of the ABC scale in patients with subacute stroke.MethodsThe cases of patients with subacute stroke (n = 62) were analyzed for floor/ceiling effects and construct validity at baseline; those of 39 of the patients were analyzed for responsiveness and MIC at baseline and after 4 weeks. Outcome measures included the ABC scale, Mini-Balance Evaluation Systems Test (Mini-BESTest), Timed Up and Go test (TUG), comfortable walking speed (CWS), and maximal walking speed (MWS) measured at both baseline and 4-week follow-up. The MIC was calculated using a ≥ 4-point improvement on the Mini-BESTest as the anchor.ResultsThe ABC scale's total score did not exhibit any floor or ceiling effects. The ABC scale was correlated with the Mini-BESTest (ρ = 0.74), TUG (ρ = -0.56), CWS (ρ = 0.60), and MWS (ρ = 0.64). The correlation of change score between the ABC scale and Mini-BESTest was ρ = 0.39. The MIC for the ABC scale was 15.6% (95%CI: 10.4%-21.1%).ConclusionsThe ABC scale may help assess self-efficacy in patients with subacute stroke.