Sarcopenic Dysphagia and Simplified Rehabilitation Nutrition Care Process: An Update

Kakehi Shingo,Isono Eri,Wakabayashi Hidetaka,Shioya Moeka,Ninomiya Junki,Aoyama Yohei,Murai Ryoko,Sato Yuka,Takemura Ryohei,Mori Amami,Masumura Kei,Suzuki Bunta 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.5

Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient’s pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.

Rehabilitation Nutrition and Exercise Therapy for Sarcopenia

Kakehi Shingo,Wakabayashi Hidetaka,Inuma Hayato,Inose Tomomi,Shioya Moeka,Aoyama Yohei,Hara Taiki,Uchimura Kosuke,Tomita Kazusa,Okamoto Mizuki,Yoshida Masato,Yokota Shohei,Suzuki Hayato 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.1

Sarcopenia is an age-related loss of skeletal muscle associated with adverse outcomes such as falls, fractures, disability, and increased mortality in older people and hospitalized patients. About half of older male nursing home residents have sarcopenia. The diagnostic criteria by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Asian Working Group for Sarcopenia (AWGS) have led to increased interest in sarcopenia. Exercise and nutritional management are crucial for the prevention and treatment of sarcopenia. Nutritional therapy for sarcopenia that includes 20 g of whey protein and 800 IU of vitamin D twice a day improves lower limb strength. Exercise therapy for sarcopenia, such as resistance training and 6 months of home exercises, improves muscle strength and physical function. Combination therapy that includes both nutritional and exercise therapy improves gait speed and knee extension strength more than either exercise alone or nutrition therapy alone. Excessive bedrest and mismanagement of nutrition in medical facilities can lead to iatrogenic sarcopenia. Iatrogenic sarcopenia is sarcopenia caused by the activities of health care workers in health care facilities. Appropriate nutritional management and exercise programs through rehabilitation nutrition are important for prevention and treatment of iatrogenic sarcopenia. Nutritional and exercise therapy should be started very early after admission and adjusted to the level of inflammation and disease status. Repeated assessment, diagnosis, goal setting, interventions, and monitoring using the rehabilitation nutrition care process is important to maximize treatment effectiveness and improve patients’ functional recovery and quality of life.

Reliability and Validity of Caregivers’ Fear of Falling Index When Caring for Home-Based Rehabilitation Patients With Fall-Related Fractures

Kakehi Tomohiro,Zenta Masashi,Ishimori Takuya,Tamura Naoki,Wada Hiromu,Bessho Masahiko,Kakuda Wataru 대한재활의학회 2023 Annals of Rehabilitation Medicine Vol.47 No.4

Objective: To evaluate the reliability and validity of this new measure, called the caregivers’ fear of falling index (CFFI).Methods: The study surveyed home-based rehabilitation patients with fall-related fracture, and their primary caregivers. The characteristics of these patients were evaluated, and the caregivers were surveyed using the CFFI and Falls Efficacy Scale-International (FES-I). The reliability of the CFFI was assessed using item-total correlation, while the validity of the CFFI was evaluated through correlation coefficients calculated between the CFFI and the FES-I.Results: The participants were 51 patient-caregiver pairs. The internal consistency of the CFFI showed an alpha coefficient of 0.904. No items were excluded in the corrected item-total correlations. The CFFI showed a moderate correlation with FES-I (r=0.432, p=0.002).Conclusion: This study found the CFFI to be a reliable and valid tool for measuring the primary caregivers’ fear. The CFFI may be a useful tool for healthcare professionals to identify and supporting these primary caregivers.

확률 접속표를 이용한 일본어 형태소 분석 결과의 후처리 기법

박철제(Chul-Jae Park),이종혁(Jong-Hyeok Lee),이근배(Geunbae Lee),Katsuhiko Kakehi(Katsuhiko Kakehi) 한국정보과학회 1997 정보과학회논문지(B) Vol.24 No.1

본 논문에서는 말뭉치로부터 얻은 통계정보를 이용한 일본어 형태소 분석 결과의 후처리 기법을 제안한다. 형태소 분석 과정은, 사전 검색을 통해 가능한 모든 형태소 분석 후보를 얻는 분할 단계와 확률 접속표를 이용하여 형태소 간의 결합 타당성 검사 및 분석 후보의 우선 순위를 결정하는 선택 단계로 구성된다. 확률 접속표는 단순히 형태소 간의 접소가능 유무만을 나타내던 기존의 접속정보표와는 달리 형태소 간의 접속강도를 확률값으로 나타냄으로써 형태소 간의 강한 접속 뿐만 아니라 문절과 문절 간의 약한 접속도 세밀하게 표현할 수 있다. 이는 띄여쓰기를 하지 않아 문장 단위의 처리가 불가피한 일본어 형태소 분석시 더욱 정확한 우선 순위 결정을 가능하게 한다. 형태소 간의 접속확률은 대상 언어에 대한 확률 모델로서 통계 정보 추출기를 통해 약 24만 단어의 일본어 말뭉치로부터 추출하였다. 확률 접속표를 이용한 일본어 형태소 분석기는 95.73%의 정확도를 보였으며, 그 결과는 기존 방식과 비교하여 문장의 길이 및 단어 품사별로 기술, 평가하였다. This paper proposes a statistical Postprocessing method of Japanese morphological analysis, which is carried out by two main stages: the first one is to segment a sentence into all possible morpheme chains by dictionary look-up, and the second is to check the morpheme-ordering constraint while ranking the chain candidates using a probabilistic connectivity matrix. Since, unlike the traditional binary matrix, the probabilistic connectivity matrix can distinguish in detail between the strong and the weak connectivities with probability values, the candidates can be ranked much accurately in Japanese analysis which is inevitably performed by a sentence unit. The probabilistic connectivity matrix was statistically constructed by a corpus analysis of 240,000 morphemes. In experimental evaluation, the morphological analyzer based on the probabilistic connectivity matrix shows an accuracy of 95.73%, and th experimental results classified by the sentence length and the word category are summarized being compared with those of traditional approach.

Interference of Accent System Variation with the Acquisition of Compound Accent Rule: A Cross-dialectal Study

Ayako Shirose,Kazuhiko Kakehi,Shigeru Kiritani 서울대학교 인지과학연구소 2001 Journal of Cognitive Science Vol.2 No.1

This study aims at investigating how Japanese compound accent rules (CAR) are acquired by native Japanese children. To better understand CAR acquisition, this study contrasts CAR acquisition in three dialects which vary in accent systems: Tokyo Japanese, Kyoto Japanese and Kagoshima Japanese. Our results reveal the following points: 1) Both Tokyo and Kyoto children tended to produce the pattern in which the nonfinal foot of the compound is accented more frequently than any of the other CA patterns. This finding agrees with the universal constraint-hierarchy of Optimality Theory. 2) Kyoto children showed the tendency to use the nonfinal-footed accent at a later developmental stage than the Tokyo children. The complex accent system of Kyoto Japanese may prevent the emergence of the unmarked characteristic at an early stage of acquisition. 3) With the Kagoshima Japanese experiment, most of the children`s answers followed the adult`s answers. This result suggests the simple accent system of Kagoshima Japanese may contribute to tuning children to the adults` accent system at an early stage of acquisition. These results raise the possibility that the accent system variation interferes with the acquisition of compound accent rule: the complex accent system suppresses CAR acquisition while the simple accent system promotes it.

Interval Reduced-order Switched Positive Observers for Uncertain Switched Positive Linear Systems

Naohisa Otsuka,Daiki Kakehi,Przemysław Ignaciuk 제어·로봇·시스템학회 2024 International Journal of Control, Automation, and Vol.22 No.4

In this paper, existence conditions and a design procedure of reduced-order switched positive observers for continuous- and discrete-time switched positive linear systems with uncertainty are established. In the analyzed class, arbitrary switching is permitted, whereas the uncertainty expressed via matrix inequalities concerns both the initial state and system parameters. Positive lower and positive upper interval switched observers are obtained. The proposed observers are of (n− p) order, where n is the dimension of the state vector and p is the rank of the output matrix, i.e., p-dimensional measurement information. Moreover, as a special case, existence conditions and a design procedure of reduced-order positive observers for uncertain positive linear systems without switching are provided. The theoretical findings are illustrated by two numerical examples for continuous- and discrete-time systems.

Oxidation behavior characteristics of an aluminized Ni-based single crystal superalloy CM186LC between 900 8C and 1100 8C in air

Fahamsyah H. Latief,Koji Kakehi,Yuma Tashiro 한국공업화학회 2013 Journal of Industrial and Engineering Chemistry Vol.19 No.6

Oxidation behavior of an aluminized Ni-based single crystal superalloy CM186LC was performed between 900 8C and 1100 8C in air. The oxidation kinetics approximately followed a parabolic oxidation law at 900 8C and 1100 8C. The mass gains were significantly increased owing to the formation of u-Al2O3during initial oxidation stage. After 100 h oxidation, the mass gain rates were then decreased due to the transformation from u-Al2O3 to a-Al2O3. The microstructures after 500 h oxidation at all temperatures generally consisted of scale, coating layer, interdiffusion zone (IDZ), substrate diffusion zone (SDZ)accompanied with the topologically close-packed (TCP) and substrate.

Quantification of Healthcare Works by Physical Activity at a Nursing Home for Long-term Care

Masato Takanokura,Masafumi Miyake,Masaru Kawakami,Seiko Taki,Tetsuo Yamada,Munenori Kakehi 대한산업공학회 2015 대한산업공학회 추계학술대회논문집 Vol.2015 No.11

Healthcare works were quantified by physical activity at a nursing home for long-term care in Japan. Physical activities were measured by using an activity meter from four healthcare workers. They were quantified by a high-intensity activity of 3.0 METs and more, a type of activity, and a relation between physical activity and healthcare works. A higher workload of healthcare worker could be quantified by the average physical activity and the cumulative time of highintensity activities of 3.0 METs and more. The healthcare worker with long experience had acquired efficient manners of elderly care from daily works, but the acquired manner had a high-intensity physical activity or a higher workload for the worker. In addition to observational methods, improvement of healthcare works should be considered by quantitative variables.

A NEW LIVER SCANNING AGENT IN A KIT TYPE FOR POSITRON TOMOGRAPHY

Takada, Tadahiro,Kuniyasu, Yoshio,Ishioka, Kuniaki,Higashi, Shizuka,Kakehi, Hirotake,Uchiyama, Katsuhiro,Yasuda, Hideki,Hasegawa, Hiroshi 대한핵의학회 1984 핵의학 분자영상 Vol.18 No.1