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Addressing how employment impacts older adults, including their psychological well-being, we contribute to the study of this topic by examining the association between paid work in community-dwelling older adults and their depressive mood, while considering the extent of their financial pressure. Methods: The data are from the Kashiwa longitudinal cohort study, with a 2014 baseline and a 2016 follow-up. Of the 1308 participants in the 2014 survey, 781 people were included. We conducted binary logistic regression analyses stratified by economic status with regard to the extent of the financial pressure experienced. The independent variable of interest was paid work in 2014, and the dependent variable was the extent of depressive mood (a score of 5 or more on the Geriatric Depression Scale 15) in 2016. Results: Paid work was associated with lower odds of depressive mood among those under financial pressure (odds ratio [OR] 0.46, 95% confidence interval [95%CI] 0.26, 0.81), whereas for those financially stable, we did not find an association between paid work and odds of depressive mood (OR 0.99, [95%CI] 0.26, 2.63). Discussion: We evidence that for older adults under financial pressure, employment supports the maintenance of their psychological well-being. We contribute to the literature by understanding when employment is beneficial for older adults, which is important in developing appropriate older adult employment social policies.

Abstract The placement of a jejunostomy catheter during esophagectomy may cause postoperative bowel obstruction. The proximity of the jejunostomy site to the midline might be associated with bowel obstruction, and we have introduced laparoscopic jejunostomy (Lap-J) to reduce jejunostomy’s left lateral gap. We evaluated 92 patients who underwent esophagectomy for esophageal cancer between February 2013 and August 2022 to clarify the benefits of Lap-J compared to other methods. The patients were classified into two groups according to the method of feeding catheter insertion: jejunostomy via small laparotomy (J group, n = 75), and laparoscopic jejunostomy (Lap-J group, n = 17). Surgery for bowel obstruction associated with the feeding jejunostomy catheter (BOFJ) was performed on 11 in the J group. Comparing the J and Lap-J groups, the distance between the jejunostomy and midline was significantly longer in the Lap-J group (50 mm vs. 102 mm; P

In natural microbiomes, microorganisms interact with each other and exhibit diverse functions. Microbiome engineering, which enables bacterial knockdown, is a promising method to elucidate the functions of targeted bacteria in microbiomes. However, few methods to selectively kill target microorganisms in the microbiome without affecting the growth of nontarget microorganisms are available. In this study, we focused on the host-specific lytic ability of virulent phages and validated their potency for precise microbiome engineering. In an artificial microbiome consisting of Escherichia coli, Pseudomonas putida, Bacillus subtilis, and Lactiplantibacillus plantarum, the addition of bacteriophages infecting their respective host strains specifically reduced the number of these bacteria more than 102 orders. Remarkably, the reduction in target bacteria did not affect the growth of nontarget bacteria, indicating that bacteriophages were effective tools for precise microbiome engineering. Moreover, a virulent derivative of the λ phage was synthesized from prophage DNA in the genome of λ lysogen by in vivo DNA assembly and phage-rebooting techniques, and E. coli-targeted microbiome engineering was achieved. These results propose a novel approach for precise microbiome engineering using bacteriophages, in which virulent phages are synthesized from prophage DNA in lysogenic strains without isolating phages from environmental samples.

AbstractImmune thrombocytopenia (ITP) is a thrombocytopenic condition induced by autoimmune mechanisms and includes secondary ITP with underlying diseases such as connective tissue diseases (CTD). In recent years, it has been elucidated that the subsets of the ITP are associated with complement abnormalities but much remains unclear. To perform a literature review and identify the characteristics of complement abnormalities in ITP. PUBMED was used to collect the literature published up to June 2022 related to ITP and complement abnormalities. Primary and secondary ITP (CTD-related) were examined. Out of the collected articles, 17 were extracted. Eight articles were related to primary ITP (pITP) and 9 to CTD-related ITP. Analysis of the literature revealed that the ITP severity was inversely correlated with serum C3, C4 levels in both ITP subgroups. In pITP, a wide range of complement abnormalities was reported, including abnormalities of initial proteins, complement regulatory proteins, or the end products. In CTD-related ITP, reported complement abnormalities were limited to the initial proteins. Activation of the early complement system, mainly through activation of C3 and its precursor protein C4, was reported for both ITPs. On the other hand, more extensive complement activation has been reported in pITP.

Abstract Background Clinical evidence demonstrating a longitudinal association between prescribed medications and sarcopenia onset is lacking. We investigated the association of polypharmacy (the use of five or more medications) and potentially inappropriate medications (PIMs) with sarcopenia risk in community-dwelling older adults. Methods In this longitudinal population-based cohort study, 2,044 older residents with no long-term care needs were randomly selected from a community in Kashiwa, Japan. Baseline data collection was conducted in 2012, with follow-ups in 2013, 2014, 2016, 2018, and 2021. Prescribed medications and PIMs (drugs listed in the Screening Tool for Older Person’s Appropriate Prescriptions for the Japanese or potentially muscle-wasting drugs) were identified through interviews. New-onset sarcopenia was identified according to the 2019 criteria of the Asian Working Group for Sarcopenia over a 9-year period and analyzed. We used Cox proportional hazards models to test the longitudinal association of prescribed medications with sarcopenia onset. Results Of the 1,549 participants without sarcopenia at baseline (mean age, 72.5 ± 5.5 years; 49.1% women; median and interquartile range, 6.0 [4.0–9.0] years), 230 experienced new-onset sarcopenia during the follow-up. After adjusting for confounders, polypharmacy combined with PIM use was strongly associated with new-onset sarcopenia (adjusted hazard ratio, 2.35; 95% confidence interval, 1.58–3.51; P

Abstract Background Restrictions on outdoor movements due to the coronavirus disease (COVID‐19) pandemic have led to a decreased physical activity; this can lead to sarcopenia and frailty in older adults. Our recent study has demonstrated a significant decrease in the trunk muscle mass immediately after the pandemic's first wave (April–May 2020) among Japanese community‐dwelling older women. In the present study, we further examined whether muscle mass recovery or deterioration occurs after 1 year of the pandemic's first wave by comparing physical measurements among the following assessment periods: before the first wave, immediately after the first wave, and at 1‐year follow‐up thereafter. Methods This study included 77 women (78.0 ± 5.7 years) who underwent physical measurements for muscle mass, grip strength, one‐leg stand‐up ability (3 s), and oral motor skills and answered questionnaires on sociality (social network, participation, and support) in the three assessment periods. Results The frequency of going out and the subjective vitality were significantly decreased immediately after the first wave; these recovered at the 1‐year follow‐up (P

Abstract Objective Maintaining a level of functional capacity is essential for healthy aging. In this research, the association between the change in the level of functional capacity and social network typology was explored over a two-year period. Participants were recruited from a community-based cohort study within Kashiwa City, Japan, and data from the years 2016 and 2018 were used. Cognitive functions, functional capacity, and social network typology were assessed using the Mini-Mental State Examination, the Japan Science and Technology Agency Index of Competence, and the Lubben Social Network Scale, respectively. Binomial logistic regression analysis was then conducted to evaluate the association of individuals’ personal network and their functional capacity. Results Results showed that, when compared to the group with both a high family and friend network, the group of community-dwelling older adults with both a low family and friend network (OR: 0.58, 95% CI: 0.34-1.00), and the group with a high family but low friend network demonstrated a lower functional capacity (OR:0.47, 95% CI: 0.26–0.85). Active social participation, facilitated by a friend network, could be a contributing factor to the maintenance of functional capacity.

Introduction Treatment strategy for castration‐resistant prostate cancer with neuroendocrine differentiation after radiation therapy has not been established. Case presentation We described a case of castration‐resistant prostate cancer with neuroendocrine differentiation after initial external beam radiotherapy followed by salvage androgen deprivation therapy. Magnetic resonance imaging detected recurrence of a suspicious lesion in the left lobe of the prostate, although the prostate‐specific antigen level was

Background: Oral frailty is defined as a slight decline in comprehensive oral function and can predict the onset of adverse health outcomes including morbidity in community-dwelling older adults. Previously, the number of remaining teeth and masticatory status had been suggested to be associated with cognitive decline. The effects of comprehensive oral condition on cognitive decline have not been adequately examined. In this study, we aimed to examine whether oral frailty is associated with new-onset mild cognitive impairment (MCI) among community-dwelling older adults. Methods: Two thousand and forty-four participants of a longitudinal cohort study in Kashiwa City, Chiba Prefecture, without cognitive decline who participated in at least one follow-up survey, were included. New-onset MCI was assessed using the Mini-Mental State Examination (score

The discrete logarithm problem (DLP) is the basis for several cryptographic primitives. Since Shor’s work, it has been known that the DLP can be solved by combining a polynomial-size quantum circuit and a polynomial-time classical postprocessing algorithm. The theoretical result corresponds the situation where a quantum device working with a medium number of qubits of very small errors can solve the DLP. However, all the quantum devices that we can use have a limited number of noisy qubits, as of the noisy intermediate-scale quantum (NISQ) era. Thus, evaluating the instance size that the latest quantum device can solve and giving a future prediction of the size along the progress of quantum devices are emerging research topics. This article contains two proposals to discuss the performance of quantum devices against the DLP in the NISQ era: 1) a quantitative measure based on the success probability of the postprocessing algorithm to determine whether an experiment on a quantum device (or a classical simulator) succeeded; and 2) a procedure to modify bit strings observed from a Shor’s circuit to increase the success probability of a lattice-based postprocessing algorithm. In this article, we conducted our experiments with the ibm_kawasaki device and discovered that the simplest circuit (7 qubits) from a 2-bit DLP instance achieves a sufficiently high success probability to proclaim the experiment successful. Experiments on another circuit from a slightly harder 2-bit DLP instance, on the other hand, did not succeed, and we determined that reducing the noise level by half is required to achieve a successful experiment. Finally, we give a near-term prediction based on required noise levels to solve some selected small DLPs and integer factoring instances.

Control modular addition is a core arithmetic function, and we must consider the computational cost for actual quantum computers to realize efficient implementation. To achieve a low computational cost in a control modular adder, we focus on minimizingKQ (where K is the number of logical qubits required by the algorithm, and Q is the elementary gate step), defined by the product of the number of qubits and the depth of the circuit. In this article, we construct an efficient control modular adder with small KQ by using relative-phase Toffoli gates in two major types of quantum computers: fault-tolerant quantum computers (FTQ) on the logical layer and noisy intermediate-scale quantum computers (NISQ). We give a more efficient construction compared with Van Meter and Itoh’s, based on a carry-lookahead adder. In FTQ, $T$ gates incur heavy cost due to distillation, which fabricates ancilla for running $T$ gates with high accuracy but consumes a lot of especially prepared ancilla qubits and a lot of time. Thus, we must reduce the number of $T$ gates. We propose a new control modular adder that uses only 20% of the number of $T$ gates of the original. Moreover, when we take distillation into consideration, we find that we minimize $\text{KQ}_{T}$ (the product of the number of qubits and $T$-depth) by running $\Theta (n / \sqrt{\log n})$ $T$ gates simultaneously. In NISQ, cnot gates are the major error source. We propose a new control modular adder that uses only 35% of the number of cnot gates of the original. Moreover, we show that the $\text{KQ}_{\text{CX}}$ (the product of the number of qubits and cnot-depth) of our circuit is 38% of the original. Thus, we realize an efficient control modular adder, improving prospects for the efficient execution of arithmetic in quantum computers.

It is necessary to optimize evacuation guidance to shelters in short evacuation time. The state-of-the-art method based on an idea of combinatorial optimization problems related to evacuees’ locations and the capacities of nearby shelters has been developed, while it cannot mitigate the effect of congestion on roads/streets after evacuation starts. In this study, to cover this problem, we develop a new method that utilizes simulations for estimating the effect of congestion on roads/streets during evacuation and reassigning shelters to evacuees based on the simulation results. By iterating this step, our method derives the congestion-aware solutions for shelter selection that can realize more smooth evacuation. To evaluate our method, we conducted multi-agent simulations assuming a disaster situation in a sightseeing spot. Specifically, we examined a hypothetical case scenario involving the evacuation of 30,000 visitors from the Gion Festival. We compared the proposed method with conventional methods, such as the nearest shelter selection method and our previous method. We found that our proposed method reduced average and total evacuation time and congestion on roads compared to the conventional methods including the nearest shelter selection method and our previous method that only employs combinatorial optimization without estimating congestion. From this result, our idea of simulation-based congestion estimation has an impact of easing congestion during evacuation and preventing overcapacity of shelters at the same time. It shows the possibilities of help in developing congestion-aware evacuation strategies in emergency situations of crowded areas like huge cities or sightseeing spots.

Presents corrections to the article “The Present and Future of Discrete Logarithm Problems on Noisy Quantum Computers”.

Abstract Background This study aimed to determine how increased muscle mass and athletic performance in adolescence contribute to the prevention of sarcopenia in old age, accounting for the type of sport and the continuation of exercise habits. We compared the prevalence of sarcopenia, its components (low appendicular skeletal muscle mass, low muscle strength, and low physical function), and musculoskeletal pain using data from two cohorts: former athletes who competed in the 1964 Tokyo Olympics and general community‐dwelling older adults living in Kashiwa City, Chiba Prefecture. Methods We analysed the data from 101 former Olympic athletes (mean age ± SD: 75.0 ± 4.4 years; 26% female) and 1529 general community‐dwelling older adults (74.1 ± 5.5 years; 49% women). We assessed sarcopenia (defined by the Asian Working Group for Sarcopenia revised in 2019) and musculoskeletal pain and considered potential confounding factors such as demographic characteristics, for example, sex and exercise habits. Results The prevalence of sarcopenia was significantly lower in former Olympic athletes than general older adults (odds ratios [OR], 0.49; 95% confidence interval [CI], 0.20–0.94), especially with regard to superior appendicular skeletal muscle mass and muscle strength. This effect was more pronounced in individuals who continued their exercise and in athletes whose sporting discipline was classified as having a high exercise intensity. Conversely, low physical function (OR, 2.60; 95% CI, 1.16–6.07) and musculoskeletal pain (OR, 2.22; 95% CI, 1.24–3.97) were more prevalent in former Olympic athletes and in athletes who competed in sports with physical contact. Conclusions We observed a lower prevalence of sarcopenia and superior appendicular skeletal muscle mass and strength in the former Olympic athletes, especially among those that continued their exercise habits and those in sports with high exercise intensity. Conversely, low physical function and higher musculoskeletal pain scores were more prevalent in former Olympic athletes, especially among athletes who competed in sports with physical contact. Our results warrant further promotion of exercise in adolescence and beyond as well as providing safety education, which is required to prevent the development of sarcopenia and musculoskeletal pain in old age.

Ageing is a global concern with major social, health, and economic implications. While individual countries seek to develop responses to immediate, pressing needs, international attention and collaboration is required to most effectively address the multifaceted challenges and opportunities an ageing global population presents in the longer term. The Ageing, Longevity and Health stream of the International Alliance of Research Universities (IARU-ALH) was built on a solid foundation of first-class interdisciplinary research and on innovative outreach and communication centres. This interdisciplinary network conducts projects that span biology, medicine, social sciences, epidemiology, public health, policy, and demography, and actively engages with the public and other societal stakeholders. Here we posit that such international interdisciplinary networks are needed and uniquely placed to address major challenges related to health and ageing and ultimately will produce new understanding and knowledge to promote the awareness of healthy ageing and encourage societal change via novel, science-informed interventions. Global interdisciplinary research presents great potential and opportunities to accelerate our understanding of human ageing and to produce new, more effective solutions to a pressing, complex problem. However, more focused, strategic efforts and investments are required in order to deliver on these potentials and reap maximum benefits for individuals and societies. IARU-ALH members are determined to contribute, in collaboration with others, to delivering on this vision.

Oral frailty, overlapping a decline in multi-faceted oral functions and often seen in older adults, increases risks of adverse health outcomes, thereby necessitating earlier measures. Tooth loss, a major element of oral frailty, is mainly caused by periodontal disease and is an irreversible event. Therefore, this study aimed to clarify whether advanced periodontal disease increases the risks of “new-onset” oral frailty through a longitudinal analysis based on the 2012 baseline survey of the Kashiwa cohort and the follow-up assessments conducted in 2013, 2014, 2016, and 2018. The participants were disability-free, non-orally frail older adults living in Kashiwa City. Of the 1234 participants (72.2 ± 5.1 years old; 50.8% men) analyzed in this study, oral frailty occurred in 23.1% within the six-year period. The group with Community Periodontal Index (CPI) ≥ 3 at baseline had no significant difference in the risk of oral frailty compared with CPI ≤ 2; however, CPI4 at baseline was related to the increased risk of oral frailty compared with CPI ≤ 3 (an adjusted hazard ratio (95% confidence interval): 1.42 (1.12–1.81). Conclusively, severe periodontitis (CPI4) might be associated with new-onset oral frailty, suggesting that prevention of periodontal disease could contribute to oral frailty prevention.

Objectives Functional ability, or the ability to live actively in older age, is essential for healthy ageing. This study assessed the association between the five types of lower urinary tract symptoms (LUTS) and functional ability among community-dwelling older adults (≥65 years old).Design A cross-sectional study.Setting Community-dwelling older adults (≥65 years old) randomly selected from the basic resident register of Kashiwa city as part of the Kashiwa study.Participants The study included 916 community-dwelling older adults (481 male participants) in Japan.Outcome measures A self-administered questionnaire was used to collect data regarding LUTS, which included frequency, nocturia, urgency, urinary incontinence and overactive bladder (OAB). Functional ability was measured using the Japan Science and Technology Agency Index of Competence. Sex-stratified logistic regression analyses were conducted, adjusting age, obesity, alcohol consumption, polypharmacy and comorbidities.Results Male participants experienced symptoms of frequency, nocturia, urgency, urinary incontinence and OAB at rates of 68.0%, 89.0%, 16.0%, 3.7% and 4.3%, respectively. Female participants experienced these symptoms at rates of 68.3%, 80.0%, 11.0%, 7.4% and 8.5%, respectively. Among male participants, lower functional ability was only associated with nocturia (≥3 times/night) (adjusted OR (AOR): 1.71, 95% CI 1.05 to 2.79). Contrarily, lower functional ability among female participants was significantly associated with frequency (AOR: 1.61, 95% CI 1.04 to 2.49), urgency (AOR: 2.06, 95% CI 1.08 to 3.95) and OAB (AOR: 2.43, 95% CI 1.15 to 5.11).Conclusion The different associations between LUTS and functional ability by sex might be related to differences in the effect of comorbidities and physical fatigue. Our results help clarify the multifaceted effects of LUTS in old age, the need for early detection and treatment of LUTS, and the importance of maintaining functional ability.

ObjectiveOur aim is to determine the strong predictors of the onset of instrumental activities of daily living (IADL) decline in community-dwelling older people.DesignA prospective cohort study with a two-year follow-up.SettingKashiwa City, Chiba Prefecture, Japan and Toshima Ward, Tokyo Metropolitan, Japan.ParticipantsThe data were acquired from two cohorts. The final sample comprised 1,523 community-dwelling older people aged 65-94 years (681 men, 842 women). They were individuals who were independent in IADL at baseline and participated in follow-up IADL assessments two years later.MeasurementsAt baseline, comprehensive assessments were performed including: health interview, gait function, hand-grip strength, skeletal muscle mass, balance function, oral function, dietary lifestyle, cognitive function, quality of life, mental status, and social network. When the two-year follow-up was performed, IADL declines were observed in 53 out of 1,523 people. The association of each Z-transformed parameter with the occurrence of IADL decline was examined by employing a binominal logistic regression model adjusting for age, gender, body weight, body height, and medical history. An odds ratio (OR) and a 95% confidence interval were calculated and compared between different parameters.ResultsA decrease in walking speed and one-legged stance time, whereas an increased timed up & go test time was associated with significant ORs for the occurrence of IADL decline.ConclusionGait-related parameters appear to be the strong predictors of the onset of IADL decline in community-dwelling older people.

Uterine adenomyosis often co-occurs with endometriosis or leiomyoma, but little is known about its molecular underpinnings. Here, the authors show that KRAS mutations are frequent in this disease, which might reduce sensitivity to progestin treatment via epigenetic silencing of the progesterone receptor.

Background: Sarcopenia is a major cause of frailty, which relates to nutrition-related, physical, and social factors. In this study, we aimed to discuss the cross-sectional association of sarcopenia with the above three factors both individually and comprehensively. Methods: Overall, 1257 older adults (≥65 years old) participated in this study. Sarcopenia was determined via the Asian Working Group for Sarcopenia 2019 criteria. The independent variables for nutrition-related, physical, and social factors and especially their criteria for health condition were defined separately. Binomial logistic regression analysis was carried out to testify the associations of sarcopenia with three factors individually and in combination. Results: The mean age was 74.6 (±5.5), and women were 47.7%. Sarcopenia prevalence was 7.5%. Participants who did not meet the criteria of nutritional health, physical fitness, or social robustness independently had significant associations with a higher adjusted odds ratio (aOR) of sarcopenia or its indices of lower grip strength, muscle mass, or gait speed. In comparison to participants meeting three criteria, those who met two, one, or none showed (marginally) significant association with increased aOR for sarcopenia (aOR (95% confidence interval)): two: 1.97 (0.84–4.64); one: 2.35 (1.00–5.23); none: 5.52 (2.30–13.23). Conclusions: Comprehensive countermeasures with the above three factors are indispensable for sarcopenia prevention.

Studies investigating the associations of oral function and dysphagia with frailty and sarcopenia in community-dwelling older adults are increasing; however, they have not been systematically summarized. We conducted a systematic review to investigate these associations. We searched electronic databases and synthesized relevant data using conventional (frequentist-style) and Bayesian meta-analyses. Twenty-four studies were found to be eligible for our review, including 20 cross-sectional and four prospective cohort studies. Older adults with frailty or sarcopenia had lower tongue pressure, according to the results of conventional meta-analysis (mean difference [95% confidence interval or credible interval]: −6.80 kPa [−10.22 to −3.38] for frailty and −5.40 kPa [−6.62 to −4.17] for sarcopenia) and Bayesian meta-analysis (−6.90 kPa [−9.0 to −4.8] for frailty, −5.35 kPa [−6.78 to −3.89] for sarcopenia). People with frailty had a higher odds ratio (OR) for dysphagia according to the results of conventional meta-analysis (3.99 [2.17 to 7.32]) and Bayesian meta-analysis (1.38 [0.77 to 1.98]). However, the results were inconclusive for people with sarcopenia. A prospective association could not be determined because of the lack of information and the limited number of studies. Decreased oral function and dysphagia can be important characteristics of frailty and sarcopenia in community-dwelling older adults.

Efficient methods for loading given classical data into quantum circuits are essential for various quantum algorithms. In this paper, we propose an algorithm called Approximate Amplitude Encoding that can effectively load all the components of a given real-valued data vector into the amplitude of quantum state, while the previous proposal can load only the absolute values of those components. The key of our algorithm is to variationally train a shallow parameterized quantum circuit, using the results of two types of measurement: the standard computational-basis measurement plus the measurement in the Hadamard-transformed basis, introduced in order to handle the sign of the data components. The variational algorithm changes the circuit parameters so as to minimize the sum of two costs corresponding to those two measurement basis, both of which are given by the efficiently computable maximum mean discrepancy. We also consider the problem of constructing the singular value decomposition entropy via the stock market data set to give a financial market indicator; a quantum algorithm (the variational singular value decomposition algorithm) is known to produce a solution faster than classical, which yet requires the sign-dependent amplitude encoding. We demonstrate, with an in-depth numerical analysis, that our algorithm realizes loading of time series of real stock prices on quantum state with small approximation error, and thereby it enables constructing an indicator of the financial market based on the stock prices.

Eating alone while living with family members is a risk factor for mental health decline in old age. However, little is known as to why older adults choose to eat alone, even with family present. This study therefore aimed to explore reasons for older adults eating alone despite living with family members, using a qualitative approach. Fifteen people aged 65 years and older (11 men and 4 women) who were eating alone while living with family members were included in the study. These individuals were selected from the participants of the Kashiwa cohort study conducted in 2016. Individual interviews were conducted using an open-ended format. All interviews were recorded and transcribed. The data were further thematically analyzed using a qualitative software package, NVivo 11. We extracted six themes as reasons for eating alone and hypothesized interactions among these themes. The extracted themes were: "age-related changes," "solo-friendly environment," "family structure changes," "time lag for eating," "bad relationships with family members" and "routinization." To assess interactions, the themes were categorized as "background factors," "triggers," and "stabilizers." The aforementioned themes could lead to the development and sustained behavior of eating alone among older adults living with family members. As most themes describe conditions that are likely to remain static, it may not be realistic to encourage such individuals to begin eating with family members. The promotion of meals with neighbors or friends could be effective in alleviating the negative consequences of eating alone.

Abstract Prostate‐specific antigen nadir (nPSA) after radiotherapy for localized prostate cancer has been investigated as a predictor. However, nPSA usually requires several years, limiting its clinical utility. We investigated the significance of nPSA within 12 months (nPSA12) after low‐dose‐rate prostate brachytherapy (LDR‐PB) or external beam radiotherapy (EBRT) on treatment outcomes. Between 2006 and 2014, 663 patients with prostate cancer were treated with LDR‐PB or EBRT at two institutions. Four hundred and seventy‐four men received LDR‐PB and 189 men received EBRT, without androgen deprivation therapy. The Kaplan–Meier method was used for biochemical failure (BF)‐free survival (BFFS) and distant metastasis (DM)‐free survival (DMFS) analyses, and multivariable Cox regression analysis was performed. The median follow‐up was 61.3 months. The median nPSA12 in the LDR‐PB and EBRT cohorts was 0.7 and 1.0 ng/mL, respectively. The 7‐year BFFS and DMFS rates in LDR‐PB patients with nPSA12 ≤ 0.7 ng/mL were 99.1% and 99.5%, respectively; when nPSA12 was >0.7 ng/mL, they were 90.2% and 94.8%, respectively. In EBRT patients with nPSA12 ≤ 1.0 ng/mL, BFFS and DMFS rates were 85.4% and 98.5%, respectively; when nPSA12 was >1.0 ng/mL, they were 67.1% and 87.2%, respectively. nPSA12 was an independent predictor of BF and DM in both cohorts (LDR‐PB, P = 0.004 and 0.020, respectively; EBRT, P = 0.005 and 0.041, respectively). The nPSA12 after LDR‐PB or EBRT is significantly associated with treatment outcomes of prostate cancer. Higher nPSA12 may identify patients at high risk of relapse who might benefit from salvage treatment.

In this paper, we propose a quantum amplitude estimation method that uses a modified Grover operator and quadratically improves the estimation accuracy in the ideal case, as in the conventional one using the standard Grover operator. Under the depolarizing noise, the proposed method can outperform the conventional one in the sense that it can in principle achieve the ultimate estimation accuracy characterized by the quantum Fisher information in the limit of a large number of qubits, while the conventional one cannot achieve the same value of ultimate accuracy. In general this superiority requires a sophisticated adaptive measurement, but we numerically demonstrate that the proposed method can outperform the conventional one and approach to the ultimate accuracy, even with a simple non-adaptive measurement strategy.

Recently, electrical welfare vehicles driven by two motors employing free casters are widely used by patients and elders. However, as the user is not able to drive the vehicle well on the uneven rough roads, it is necessary to apply a new mechanism to drive on the rough road in order to expand driving area. The skid steer vehicle (SSV) has been used because of its high traveling ability on the rough road. However, the SSV has disadvantage that is, the driving assistance is required because its steering is highly affected by the road condition. The aim of this study is to design a driving assistance system of SSV for patients and elders by using Model Error Compensator (MEC) that suppresses the modeling error. The proposed controller consists of MEC, Extended Kalman Filter (EKF) that reduces sensor noise and system noise, and estimator of on-line cornering power of SSV. The effectiveness of the proposed system using on-line cornering power estimator is confirmed by the outdoor driving experiments. And the improvement of the driving assistance is evaluated by the correlation of the joystick manipulation comparing the paved and the dirt roads.

The effects of sarcopenic obesity, the co-existence of sarcopenia and obesity, on mood disorders have not been studies extensively. Our objective was to examine the association of depressive symptoms with sarcopenia and obesity status in older Japanese adults. We analyzed data from 1731 functionally-independent, community-dwelling Japanese adults aged 65 years or older (875 men, 856 women) randomly selected from the resident register of Kashiwa city, Chiba, Japan in 2012. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. Obesity was defined as the highest sex-specific quintile of the percentage body fat. Depressive symptoms were defined as a Geriatric Depression Scale 15-item score ≥ 6. Multiple logistic regression was employed to examine the association of depressive symptoms with four groups defined by the presence/absence of sarcopenia and obesity. The prevalence of depressive symptoms was 10.1% and the proportions of sarcopenia/obesity, sarcopenia/non-obesity, non-sarcopenia/obesity, non-sarcopenia/non-obesity were 3.7%, 13.6%, 16.9% and 65.8%, respectively. After adjustment for potential confounders, sarcopenia/obesity was positively associated with depressive symptoms compared with non-sarcopenia/non-obesity, whereas either sarcopenia or obesity alone was not associated with depressive symptoms. The association was particularly pronounced in those aged 65 to 74 years in age-stratified analysis. We conclude that our findings suggest a synergistic impact exerted by sarcopenic obesity on the risk of depressive symptoms, particularly in those aged 65 to 74 years.

Recent epidemiological evidence suggests that effects of cardiovascular risk factors may vary depending on sex and age. In this study, we assessed the associations of metabolic syndrome (MetS) with sarcopenia and its components in older adults, and examined whether the associations vary by sex and age. We also tested if any one of the MetS components could explain the associations. We conducted a cross-sectional analysis of the baseline data from the cohort study conducted in Kashiwa city, Chiba, Japan in 2012 which included 1971 functionally-independent, community-dwelling Japanese adults aged 65 years or older (977 men, 994 women). Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel-III criteria. The prevalence of sarcopenia was 14.2% in men and 22.1% in women, while the prevalence of MetS was 43.6% in men and 28.9% in women. After adjustment for potential confounders, MetS was positively associated with sarcopenia in men aged 65 to 74 years (odds ratio 5.5; 95% confidence interval 1.9-15.9) but not in older men or women. Among the sarcopenia components, MetS was associated with lower muscle mass and grip strength, particularly in men aged 65 to 74 years. The associations of MetS with sarcopenia and its components were mainly driven by abdominal obesity regardless of sex or age. In conclusion, MetS is positively associated with sarcopenia in older men. The association is modified by sex and age, but abdominal obesity is the main contributor to the association across sex and age.

This article discusses a case of IgG4-related disease (IgG4-RD) with small intestinal involvement. The patient experienced gastrointestinal symptoms and was diagnosed with IgG4-RD based on elevated serum IgG4 levels and diffuse infiltration of IgG4+ plasmacytes in the gastrointestinal tract. Treatment with prednisolone improved the patient's symptoms and resolved the abnormalities seen on CT scans. The article emphasizes the importance of considering IgG4-RD in the diagnosis of chronic gastrointestinal symptoms and highlights the need for histopathological assessment to establish an accurate diagnosis and prevent complications. [Extracted from the article]

Objectives: We investigated the effect of belimumab (BEL) on achieving low disease activity (LDA) and remission as an additive molecular-targeting agent to standard of care (SoC) in patients with systemic lupus erythematosus (SLE). Methods: Clinical information was retrospectively collected from patients with SLE who received BEL additive to SoC (BEL + SoC), and from patients treated with SoC alone as a control arm. Disease activity was measured by SLE-disease activity score (SLE-DAS). The proportion of patients in LDA and remission at 12 months was compared after propensity score matching. The factors contributing to LDA and remission achievement were identified by Cox proportional hazard model. Results: BEL + SoC significantly reduced SLE-DAS at 6 months, with a significantly higher proportion of patients achieving LDA and remission at 12 months compared to SoC alone. The presence of arthritis at baseline was significantly associated with achieving LDA and remission. Additionally, both treatment groups experienced a significant reduction in daily glucocorticoid dose. Conclusions: Adding BEL to SoC was beneficial for patients with arthritis, leading to higher proportion of achieving LDA and remission, while also reducing their glucocorticoid dose. Our results indicate the utility of BEL in a treat-to-target approach for SLE patients in a real-world setting. [ABSTRACT FROM AUTHOR]

Aim: This cross-sectional study had two aims: to assess the prevalence of oral frailty (OF), according to the Oral Frailty 5-Item Checklist (OF-5), among community-dwelling older adults; and to examine the associations among oral frailty, dietary variety, social engagement, and physical frailty. Methods: We pooled data from two population-based studies (the Otassha Study and the Itabashi Longitudinal Study on Aging). With the OF-5, OF is characterized by the presence of two or more of the following: (i) fewer teeth, (ii) difficulty in chewing, (iii) difficulty in swallowing, (iv) dry mouth, and (v) low articulatory oral motor skills. We calculated the OF prevalence for each sex. We assessed dietary variety, social engagement, and physical frailty. Generalized structural equation modeling was employed to investigate the associations among oral frailty, low dietary variety (dietary variety score =3), social isolation (Lubben Social Network Scale score <12), and physical frailty (Japanese version of the Cardiovascular Health Study score =3). Results: A total of 1206 individuals (626 women and 580 men) with a mean age of 74.7 years were included. The prevalence of OF was 36.7%, and it increased with age; however, there was no significant sex difference. OF was significantly indirectly associated with physical frailty via low dietary variety (odds ratio, 1.43; 95% confidence interval, 1.04-1.97) and social isolation (odds ratio, 1.42; 95% confidence interval, 1.04-1.94). Conclusions: Two of five community-dwelling older adults exhibited OF. Low dietary variety and social isolation are potential underlying mechanisms through which OF is indirectly associated with physical frailty. [ABSTRACT FROM AUTHOR]