A 51-year-old man presented to our hospital with general fatigue and lower extremity edema due to right heart failure with severe coagulation disorder. He had undergone ascending aortic and total arch replacement for type A acute aortic dissection when he was 49 years old and had diagnosed with anastomotic pseudoaneurysm in the ascending aorta by computed tomography 1 year after the operation. Preoperative computed tomography showed an enlargement of the pseudoaneurysm. Since re-median sternotomy seemed to be high risk strategy for bleeding due to severe coagulation disorder, we decided to perform ascending aortic replacement through right thoracotomy. We opened the pseudoaneurysm and found an aorto-right atrium fistula. Redo ascending aortic replacement with direct closure of the fistula was successfully performed. The postoperative course was uneventful.

Increasing light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and decreasing sedentary behavior (SB) are important to maintain cognitive function in older adults. However, there is a lack of studies examining the influence of replacing time spent in SB, LPA and MVPA on cognitive function. Therefore, this study applied an isotemporal substitution (IS) model approach to examine the associations of objectively measured SB, LPA, and MVPA on multiple cognitive functions in older adults. We analyzed data from 145 older persons (mean age, 75.1 ± 4.5 years; 61.4% women) in Kasama City, Japan. We assessed SB, LPA, and MVPA for seven consecutive days with a triaxial accelerometer. To evaluate the cognitive function, we used the Five-Cog test (character position referencing task, category cued recall task, clock drawing task, animal name listing task, and analogy task). The IS model of the multiple regression analysis was used to examine the effects of replacing time spent on one activity type with 30 minutes per day of SB, LPA, and MVPA on multiple cognitive functions, adjusting for age, gender, body mass index, education, smoking, sleep duration, history of stroke, medication for hypertension, dyslipidemia, and diabetes and accelerometer wear time. The results showed that reallocation from SB to LPA was significantly related to the category cued recall task score (B = 0.69, 95% confidence interval 0.07 - 1.31). In contrast, other reallocations were not associated with any cognitive tasks. The results suggest that substituting SB with LPA is positively associated with verbal episode memory among older Japanese adults.

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.
Adult ; COVID-19/prevention & control* ; Contact Tracing/methods* ; Cross-Sectional Studies ; Female ; Humans ; Industry/classification* ; Japan/epidemiology* ; Male ; Middle Aged ; Mobile Applications/statistics & numerical data* ; SARS-CoV-2 ; Smartphone ; Workplace/statistics & numerical data*