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Kidney transplantation is the treatment of choice even for the elderly, as it improves quality of life and life expectancy, lowering the financial burden to the health care system compared to dialysis therapy. In Japan, kidney transplant recipients have become older due to the shift in demographics. Compared to community‐dwelling elderly adults, elderly kidney transplant recipients undergoing immunosuppressive therapy have a higher risk of age‐related outcomes including hospital readmissions, infections, dementia, malignancies, and fractures. In frailty, patients become vulnerable to adverse events after stressors due to a lack of physiologic reserve. Although it is often associated with aging, frailty can also occur in younger individuals with certain chronic illnesses or conditions including chronic kidney disease. Limited compensatory mechanisms result in functional impairment and adverse health outcomes, such as disability, falls, decreased mobility, hospitalization, and death. Although kidney transplant recipients can restore their kidney function after transplantation, most of them still have chronic kidney disease, as well as a gradual decline in graft function as a result of chronic allograft nephropathy. Wait‐listed candidates for kidney transplantation with frailty are more likely to experience wait‐list removal or death. Frailty at the time of transplantation is associated with complications after kidney transplantation such as delayed graft function, longer hospital stays, rehospitalizations, immunosuppression intolerance, surgical complications, and death. Nevertheless, kidney transplantation can be a viable intervention for frailty in dialysis patients. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is known to bring about adverse outcomes in elderly populations and dialysis patients. However, whether it is a risk factor in kidney transplant recipients (KTRs) has not yet been established. In the present study, the association of sarcopenia with mortality was investigated in KTRs. Methods: We conducted a single‐center prospective cohort study and recruited KTRs who were more than 1‐year posttransplant from August 2017 to January 2018. The participants were followed for 5 years, and the Kaplan–Meier method and Cox proportional hazards model were used to assess patient survival. Results: A total of 212 KTRs with a median age of 54 years and median transplant vintage of 79 months were enrolled in this study. Among them, 33 (16%) had sarcopenia according to the Asia Working Group for Sarcopenia 2019 at baseline. During the 5‐year follow‐up period, 20 (9.4%) died, 5 returned to dialysis after graft loss, and 4 were lost to follow‐up. The 5‐year overall survival rate was 90%. After 1:1 propensity score matching, a matched cohort with 60 KTRs was generated. The overall survival rate was significantly lower in the sarcopenia group compared to the non‐sarcopenia group (p = 0.025, log‐rank test). Furthermore, mortality risk was significantly higher in the sarcopenia group compared to the non‐sarcopenia group (hazard ratio = 7.57, 95% confidence interval = 0.94–62). Conclusion: Sarcopenia was a predictor of mortality in KTRs. KTRs with suboptimal muscle status who were at risk for poor survival could have a clinical benefit by interventions for sarcopenia. [ABSTRACT FROM AUTHOR]

Tribological properties of several kinds of polyoxymethylene (POM) composites were evaluated for the purpose of developing a polymeric tribomaterial especially suited for mating with aluminum parts having low surface hardness. POM composites containing small amounts of silicon carbide (SiC), POM/SiC; those containing a small amount of calcium octacosanonoate besides SiC, POM/SiC/Ca-OCA; and the one blended with 24 wt % of polytetrafiuoroethylene, POM/PTFE(24); were injection-molded into pin specimens and their tribological properties were tested by means of a pin-on-disk type wear apparatus using an aluminum (A5056) mating disk in comparison with a 303 stainless steel (SUS303) disk. Evaluation was focused on observation of the sliding surfaces of the pin specimens and the mating disks by a scanning electron microscope and an optical microscope together with the measurement of surface roughness. In the case of mating against a SUS303 disk having high surface hardness, all pin specimens did not roughen the disk surfaces even after long time of rubbing. Only POM/PTFE(24) composite obviously made a transfer film on the disk surface, while the other composites made an extremely thin one on it. POM/SiC(0.1)/Ca-OCA(1) composite, containing SiC 0.1 wt. % and Ca-OCA 1 wt. %, was found to show the lowest coefficient of friction and the lowest wear rate forming extremely thin transfer film on the mating disk. On the other hand, against an A5056 disk which has lower surface hardness than that of SUS303 disk, unfilled POM and POM composites except POM/SiC(0.1)/Ca-OCA(1) composite roughened the disk surfaces. However, the sliding surface of the A5056 disk rubbed with POM/ SiC(0.1)/Ca-OCA(1) composite was significantly smoother and that of the pin specimen was also quite smooth in comparison with other pin specimens. Further, when each POM composite was rubbed against the A5056 disk, formation of transfer film was not obvious on the disk surfaces. For POM/SiC(0.1)/Ca-OCA(1) composite, the wear rate was the lowest of all POM composites, and the coefficient of friction was as low level as 60 percent of that of unfilled POM, but slightly higher than that of POM/PTFE(24) composite. For POM/SiC(0.1)/Ca-OCA(1) composite, the nucleating effect of SiC and Ca-OCA, which accelerated the crystallization of POM during its injection molding to form a matrix containing fine spherulites, must have resulted in increasing the toughness of the matrix and lowering the wear rate. Also, the lubricant effect of Ca-OCA should have lowered the coefficient of friction of the same matrix for rubbing against aluminum mating disk. POM/SiC(0.1)/Ca-OCA(1) composite was concluded as an excellent tribomaterial for mating with aluminum parts. [DOI: 10.1115/1.1540123]

The election of 22 women to the Upper House of the Diet in 1990 has been dubbed 'the Madonna Boom' by the media, but may be a fluke rather than a trend. Despite a female majority in the electorate, the role of the politician is a traditionally male one and the political parties have no long term plans to support these new Diet members. The new female members see themselves as trying to maintain a female identity without taking advantage of that fact despite pressure from their parties. Female Diet members have crossed party lines more than once to back particular issues.