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Key summary points: Aim: The associations between food groups and changes in sarcopenia parameters were analyzed in older adults attending a frailty clinic. Findings: Higher sugar, sweetener, and beverage consumption is associated with a higher risk of worsening sarcopenia parameters. On the other hand, higher legume, fruit, and green yellow vegetables consumption was associated with a decreased risk of worsening muscle mass and physical function. Message: The importance of nutritional management, with emphasis on food group, in the prevention and management of sarcopenia in older patients is suggested. Purpose: This study investigated the relationship between food group and the changes in sarcopenia parameters in 1 year among older outpatients. Methods: A prospective cohort study conducted between July 2017 and April 2021 included patients aged ≥ 65 years attending a frailty clinic. Food group consumption adjusted for energy and body weight was conducted using a self-administered dietary history questionnaire. Ordinal logistic regression analysis was used to examine the association between tertiles of adjusted food group consumption and outcomes, including a handgrip strength decline, prolonged five-time chair stand test (5CST), decreased skeletal muscle mass index (SMI), and decreased gait speed in 1 year. Covariates included age, sex, height, energy intake, number of comorbidities, and the Baecke activity score. Results: In the analysis of 165 participants (mean age 77.6 ± 6.1 years, 107 women), individuals with higher consumption of sugar and sweeteners had a significantly increased risk for handgrip strength decline (OR 2.46, 95% CI 1.15–5.23, P = 0.020) and prolonged 5CST (OR 3.14, 95% CI 1.38–7.13, P = 0.006). Higher consumption of beverages increased the risk of handgrip strength decline (OR 2.30, 95% CI 1.11–4.76, P = 0.025). Conversely, higher legume consumption decreased the risk of SMI reduction (OR 0.35, 95%CI 0.16–0.76, P = 0.008), higher fruit consumption reduced the risk of prolonged 5CST time (OR 0.29, 95% CI 0.13–0.67, P = 0.004), and higher green yellow vegetables consumption decreased the risk of reduced gait speed (OR 0.38, 95% CI 0.17–0.84, P = 0.017). Conclusion: Sugar, sweeteners, and beverages are associated with worsened sarcopenia parameters, whereas consumption of legumes, vegetables, and fruits is associated with a lower risk. [ABSTRACT FROM AUTHOR]

Reduced muscle mass is one of the diagnostic components for Global Leadership Initiative on Malnutrition (GLIM), with various assessment methods proposed. Calf circumference (CC), a representative anthropometric marker of skeletal muscle mass, is now recommended to adjustment based on body mass index (BMI). This study aimed to evaluate the validity and efficacy of BMI-adjusted CC in very older adults, compared with other methods of assessing muscle mass. This prospective cohort study included 284 patients aged 65 years and older who were admitted to the Department of Geriatric Medicine at the National Center for Geriatrics and Gerontology Hospital. Health indicators, including nutritional status, were assessed upon admission. Three months after discharge, a telephone survey was conducted to assess patients' living conditions and survival status. Skeletal muscle mass was estimated using a dual-energy X-ray absorptiometry (DXA); moreover, anthropometric measurements (unadjusted and BMI-adjusted CC) were used as markers of muscle mass. Logistic regression analysis was performed to examine the association between mortality and GLIM-based malnutrition, using each muscle mass assessment method. The mean age of the patients was 86.2 ± 6.2 years, and 60.9 % were women. The prevalence of GLIM-based malnutrition ranged from 55.3 % to 58.8 % across the three methods used to assess reduced muscle mass. Three months after discharge, 244 patients were followed up, of whom 29 (11.9 %) died. Multivariate logistic regression analysis, adjusted for age, sex, and comorbidities, showed that all methods significantly predicted 3-month mortality, with odds ratios of 5.67, 5.44, and 4.90 for unadjusted CC, BMI-adjusted CC, and appendicular skeletal muscle mass index using DXA, respectively. The prevalence and survival-predictive ability were similar across all methods. GLIM-based malnutrition, diagnosed using different methods for assessing muscle mass, similarly predicted 3-month mortality in patients admitted to an acute geriatric ward. These results suggest that BMI-adjusted CC are sufficient alternatives when technical measurements such as DXA are not feasible. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: To evaluate the effectiveness of body mass index-adjusted calf circumference for muscle mass estimation, sarcopenia diagnosis, and fall prediction. Findings: The utility of BMI-adjusted CC in assessing skeletal muscle mass was not confirmed. The potential value of BMI-adjusted CC has been suggested regarding falls. Message: Improving the accuracy of predicting muscle mass by measuring calf circumference is a critical issue in the assessment of sarcopenia and malnutrition that requires further research. Purpose: This study aims to evaluate the utility of body mass index (BMI)-adjusted calf circumference (CC) in estimating skeletal muscle mass and diagnosing sarcopenia, as well as its association with falls, a common adverse event in sarcopenia. Methods: This study used cross-sectional and longitudinal designs. The CC cut-off values and the diagnosis of sarcopenia were based on valid diagnostic criteria. BMI-adjusted CC was based on previous studies, with muscle mass measured by dual-energy X-ray absorptiometry. To evaluate the diagnostic performance of BMI-adjusted CC for low muscle mass and sarcopenia, receiver operating characteristic curves were generated, and the area under the curve (AUC) values were compared using DeLong's test. Over a 1 year follow-up period, factors associated with falls were examined using logistic regression analysis. Results: In the study of 901 older adults (77.6 ± 6.1 years, 63.6% women), 38.1% of men and 42.1% of women had a BMI outside the 18.5–24.9 kg/m2 range. BMI-adjusted CC significantly lowered the AUC values for diagnosing low skeletal muscle mass and sarcopenia in both sexes (P < 0.001). Longitudinal univariate logistic regression analysis in women revealed that unadjusted CC was not significantly associated with fall risk, whereas BMI-adjusted CC significantly reduced fall risk at higher values. However, this association was no longer present in the multivariate analysis. Conclusion: The utility of BMI-adjusted CC in assessing skeletal muscle mass was not confirmed. The potential value of BMI-adjusted CC has been suggested regarding falls. Further research is warranted to better elucidate these findings. [ABSTRACT FROM AUTHOR]

Introduction: Among super-microsurgical techniques, the anastomosis of vessels smaller than 0.5 mm is very difficult to perform due to the small diameter and thinness of the blood and lymphatic vessel walls. In this article, we report on the main points of super microsurgery, particularly on the anastomosis of veins and lymphatic vessels with diameters smaller than 0.5 mm. Methods and Results: Details of anastomosis of vessels smaller than 0.5 mm. (1) The outer wall of the first blood vessel near the abrupt end hook with the tip of the needle in the needle holder. The entire abrupt end of the first blood vessel was supported by forceps in the surgeon's left-hand. (2) The surgeon decided the entry point and angle of the needle while moving the tip. After the needle was fixed, a force was applied so that the needle could pass through to the vascular wall. (3) After the needle passed through, the tip was confirmed to be located in the lumen of the first blood vessel. (4) The tip of the needle was inserted into the lumen of the second blood vessel, and the bite was adjusted while touching the second blood vessel through the endometrium. (5) Once the tip was properly positioned, counter-traction was applied by holding the entire outer wall with a left-hand forceps. (6) The needle was held near the tip and pulled out along its curvature. The anastomosis time was 11.35 minutes on average (9 to 14 minutes). The patency rate for all 20 anastomosis procedures was also 100%. Conclusion: The important points of LVA for lymphatic vessels and veins smaller than 0.5 mm were reported. Once the surgeons are familiarized with this anastomosis procedure, they can typically perform one anastomosis in about 10 minutes. [ABSTRACT FROM AUTHOR]

Simulated bone is widely used for surgical simulation, medical training, and especially for medical cutting device testing due to its mechanical properties similar to those of natural bone. However, studies on its cutting characteristics are still limited, especially for the simulated cortical bone. The cutting characteristics of natural cortical bone are often influenced by viscoelasticity and bone fiber structure that affect chip formation, as well as the variation of cutting forces at different cutting speeds or different depths of cut. In this work, orthogonal cutting experiments were performed on simulated cortical bone to investigate chip formation with cutting force variations and compared with bovine cortical bone. Experimental results show that the simulated cortical bone is similar to bovine cortical bone in viscoelasticity. Simulated bone has a relatively homogeneous composition with a simple hierarchy. Therefore, the difference in cutting force at small and large cutting depths is less significant than in natural cortical bone. In addition, because the glass fibers in simulated bone are randomly distributed, they do not accurately reflect the anisotropic properties of natural cortical bone. These findings can contribute to an in-depth understanding of the behavior of simulated bone during the cutting process and guide the improvement of simulated bone to better emulate the cutting characteristics of cadaveric bone for better application in the medical field. [ABSTRACT FROM AUTHOR]

The unified synthesis of the NOPQ and STUV rings of brevisulcenal-F was achieved from a common intermediate based on a convergent strategy via 2-ring construction. The STUV ring was synthesized via radical reduction of an O,S-acetal, and the NOPQ ring was constructed via ring expansion giving a 7-membered ring ketone, methylation of an O,S-acetal, and introduction of the c/s-1,2-diol moiety at C60-C61. [ABSTRACT FROM AUTHOR]

Key summary points: Aim: To examined the potential association between intrinsic capacity (IC) and oral functional decline in older adult population. Findings: This study highlights the potential relationship between the number of IC domain deficits and oral functional decline, with the most significant domain being locomotion. Furthermore, it suggests a possible link between sensory and oral function. Message: Future longitudinal studies are required to elucidate the dynamic nature of the relationships examined in the present study. Purpose: This study aimed to investigate how intrinsic capacity (IC) deficit is associated with oral functional decline. Methods: This cross-sectional study enrolled older adults at a research hospital frailty clinic between July 2021 and May 2023. IC evaluation included the locomotion, cognition, vitality, psychology, and sensory domains. Criteria for deficits were established within each domain, and the number of IC deficit domains was calculated for each patient. Oral function assessment included oral hygiene, oral dryness, occlusal force, tongue–lip motor function, tongue pressure, masticatory function, and swallowing function. Patients who met three or more criteria were classified into the oral hypofunction (OHF) group. Univariate and multivariate logistic regression analyses were performed to investigate the relationship between IC deficit and OHF. Results: Of 222 included patients (mean age 78.3 ± 6.3 years; 39.6% men), 105 (47.3%) met the criteria for OHF. This OHF group showed a significantly higher prevalence of locomotion, cognition, psychology, and sensory domain deficits than the normal oral function group. Multivariate analysis adjusted for age and sex revealed a significant association between IC deficits and OHF (odds ratio [OR], 1.33; 95% confidence interval [CI] 1.04–1.70). A significant association was also observed between the locomotion domain and OHF (OR, 2.06; 95% CI 1.13–3.76). Conclusion: This study highlights the potential relationship between the number of IC domain deficits and oral functional decline, with the most significant domain being locomotion. Furthermore, it suggests a possible link between sensory and oral function. [ABSTRACT FROM AUTHOR]

A new lipopeptide, N -desmethylmajusculamide B (1), was isolated from the Okinawan cyanobacterium Okeania hirsuta along with 2 known compounds majusculamide A (2) and majusculamide B (3). The planar structure of (1) was elucidated by a detailed analysis of mass spectrometry and nuclear magnetic resonance spectra. The absolute configurations of the amino acid residues were determined using Marfey's analysis. The configuration of C-16 in the α-methyl-β-keto-decanoyl moiety was determined unambiguously to be S by conducting a semisynthesis of N -desmethylmajusculamide B from 3. The cytotoxicity against mouse L1210 leukemia cells was evaluated for majusculamides (1-3). [ABSTRACT FROM AUTHOR]

The edge shape of a silicon wafer is crucial for optimal device manufacturing. In polishing processes, it is necessary to form wafers into either a flat or roll-up shape, depending on the specific requirements of the process. However, the conventional process typically results in a roll-off shape. This study identifies the factors that influence a change in the edge shape during polishing. Polishing experiments were conducted to examine the effects of the initial edge shape and contact state between the wafer and polishing pad on the removal distribution. An approach for adjusting the resulting edge shapes was proposed. [ABSTRACT FROM AUTHOR]

Background: Lymphaticovenular anastomosis (LVA) has recently become a mainstream surgical treatment for lymphedema and is a useful treatment option in addition to conservative therapies such as compression therapy, exercise therapy, and lymphatic drainage. We performed LVA with the goal of stopping compression therapy and report the effect of LVA on secondary lymphedema of the upper extremities. Methods and Results: The participants were 20 patients with secondary lymphedema of the upper extremities categorized as stage 2 or 3 according to the International Society of Lymphology classification. We measured and compared the upper limb circumference at six locations before and 6 months after LVA. Significant decreases in circumference after surgery were observed at 8 cm proximal to the elbow, the elbow joint, 5 cm distal to the elbow, and the wrist joints, but not at 2 cm distal to the axilla or the dorsum of the hand. At more than 6 months postoperatively, eight patients who had been wearing compression gloves were no longer required to wear them, and three patients who had been wearing both sleeves and gloves were no longer required to wear them. Conclusions: LVA is effective in the treatment of secondary lymphedema of the upper extremities, particularly in improving elbow circumference, and is one of the treatments that contributes significantly to the improvement of quality of life. For severe cases with limited range of motion of the elbow joint, LVA should be performed first. Based on these results, we present an algorithm for upper extremity lymphedema treatment. [ABSTRACT FROM AUTHOR]

Web-based post-bereavement survey systems for specialized palliative care will enable obtaining timely results on the care quality from more participants at a lower cost. The primary aim of the study was to develop a web-based post-bereavement survey system and to compare response rates for different number of items. The secondary aim was to examine response bias between web-based and mail survey in post-bereavement surveys. Between January and April 2019, two cross-sectional web-based questionnaire surveys were conducted among the bereaved families from six inpatient palliative care units in Japan. Measurements included structure and process of end-of-life (EOL) care, overall care satisfaction, achievement of a good death, depression, grief status, web survey usability, and participant and bereaved family member characteristics. The long survey included 34 items, and the short survey included 16 items. There were no significant differences in the response rates between the long and short surveys (24% and 27%, respectively, p = 0.376). Compared with a previous nationwide post-bereavement mail survey, more children responded; however, the quality rating scores was unchanged. Despite low response rate, no apparent response bias was observed, indicating its feasibility. This survey method is low-cost, less burdensome to the institution, and allows for ongoing quality assurance. [ABSTRACT FROM AUTHOR]

The 1923 Taisho Kanto earthquake-an interplate event along the Sagami trough where the Philippine Sea plate subducts beneath the Kanto region-produced ground shaking, crustal deformation, landslides, and tsunamis, and caused the worst earthquake disaster in Japan. Based on seismological and geodetic data, many fault models have been proposed, extending ∼100 km from the epicenter, with a moment magnitude (⁠Mw ⁠) of 7.8-8.2, and large slips of ∼8 m located near the epicenter and beneath the Miura Peninsula. The penultimate 1703 Genroku Kanto earthquake produced similar macroseismic effects around Sagami Bay and the Miura Peninsula, but larger coastal uplift and tsunami in the Boso Peninsula. The proposed fault models extend off the Boso Peninsula with Mw of 8.1-8.5. In 2004, the Earthquake Research Committee (ERC) classified the Kanto earthquakes as "Taisho type" and "Genroku type" with recurrence intervals of 200-400 yr and 2300 yr, respectively. In 2014, the ERC revised the long-term evaluation to a recurrence interval of 180-590 yr and a 30 yr probability of 0%-5% based on the Brownian passage time model. With the Cabinet Office, the ERC considered the source area of the maximum possible earthquake of Mw 8.6-8.7. The recent historiographical and paleoseismological studies have identified other candidates for the past Kanto earthquakes in 1495, 1433, 1293, and 878. Various combinations of these candidates give a mean recurrence interval of 210-315 yr, an aperiodicity parameter of 0.04-0.76, and a 30 yr probability of 0.0%-19%. The Cabinet Office has calculated the seismic intensity and tsunami heights of various types of Kanto earthquakes. National and local governments estimate the damage from these hazards. For the Tokyo metropolitan area, the estimated damage and occurrence probability are more significant for M ∼7 earthquakes with various types and depths, and most mitigation efforts are directed at such events. [ABSTRACT FROM AUTHOR]

The most versatile recipient vessels for breast reconstruction are the internal mammary artery and vein. For microvascular anastomosis, one or two costal cartilages are often dissected to increase the length of the vessel and the degree of freedom. In some cases, the resection of the rib cartilage causes long-term depression at the dissected site, compromising its cosmetic appearance. A total of 101 patients were examined, with 111 sides in which the internal mammary artery and vein were used as the recipient vessels. The patients were followed up for at least 6 months. A total of 37 of 38 patients with complete rib cartilage preservation had no depression, and 1 patient had a slight depression. In the case of partial resection of the rib cartilage, 37 of the 46 sides had no depression, 8 sides had mild depression, and 1 side had an obvious depression. When more than one rib cartilage was removed, 11 of the 27 sides had no depression, 11 had mild depression, and 5 had an obvious depression. The Spearman rank correlation coefficient was 0.4911936. This study reported the relationship between rib cartilage resection and postoperative concave deformity in breast reconstruction surgery using free flap transfer and the internal mammary artery and vein as the recipient vessels. A strong correlation was found between the extent of rib cartilage resected and the degree of depression. Minimizing rib cartilage resection when using the internal mammary artery and veins may minimize postoperative chest recession deformity and provide a well-dressed breast reconstruction. [ABSTRACT FROM AUTHOR]

Poor prognostic cardiac function is known among some patients with primary aldosteronism (PA). However, studies with echocardiograms on whether the normalization of aldosterone after laparoscopic adrenalectomy (LADX) improves myocardial hypertrophy and diastolic cardiac dysfunction have been inadequate. Between August 2009 and December 2021, 147 patients with unilateral PA who underwent pre- and post-LADX echocardiography at a single center were enrolled in this retrospective study. We evaluated the cardiac impact of LADX by comparing patients who demonstrated complete clinical success (CS) with those who demonstrated partial or absent CS. Adjusted odds ratios (ORs) for not obtaining complete CS were calculated using binomial logistic regression analysis for clinically significant items among the pre- and postoperative clinical and echocardiographic markers. Overall, 47 (29%) and 104 (71%) patients had complete and partial or absent CS, respectively. Compared to patients with complete CS, patients with partial CS or without CS tended to have preoperative low early to late diastolic transmitral flow velocity (E/A) (< 0.8 cm/s) (41% vs. 21%, P < 0.05) and postoperative supranormal left ventricular ejection fraction (LVEF) (> 70%) (37% vs. 21%, P < 0.05). Furthermore, laparoscopic adrenalectomy improved the low and high echocardiographic values of E/A and LVEF, respectively, in both groups. The risk factors for not reaching complete CS were male sex (OR 3.42), low preoperative E/A (OR 3.11), and postoperative supranormal LVEF (OR 3.17). Although low preoperative E/A and postoperative supranormal LVEF are associated with poor clinical outcomes, LADX can improve diastolic cardiac function in patients with PA. [ABSTRACT FROM AUTHOR]

Microbiota have been reported to influence the development of various gastrointestinal neoplasms through the mechanism of sustained inflammation; however, few data are available regarding their influence on intraductal papillary mucinous neoplasms. The aim of this study was to assess the association between specific microbiota and the clinicopathologic characteristics of intraductal papillary mucinous neoplasms of the pancreas. DNA was extracted from formalin-fixed, paraffin-embedded samples of 30 patients who underwent pancreatectomy for intraductal papillary mucinous neoplasm, and polymerase chain reaction was used to create sequence libraries using the primer set for the V3 and V4 region of 16S recombinant DNA. Filtered sequence reads were then processed into operational taxonomic units with a 97% identity threshold and the relative abundance of bacteria compared between the 2 groups using operational taxonomic units. There was a trend toward fewer Firmicutes and more Proteobacteria and Fusobacteria in the relative abundance of main duct operational taxonomic units than in branch duct operational taxonomic units. The relative abundances of Bacteroidetes (P <.01) and Fusobacteria (P =.04) were significantly higher in invasive intraductal papillary mucinous neoplasms than in noninvasive intraductal papillary mucinous neoplasms. The relative abundance of the intestinal type was significantly lower in Firmicutes than the relative abundance of the nonintestinal type (P =.04). Notably, main duct operational taxonomic units with the intestinal subtype were affected by increased proportions of Proteobacteria and Fusobacteria, and Fusobacteria were abundant in the intestinal type of invasive main duct operational taxonomic units. Intratumoral microbiota may be involved in the progression of operational taxonomic units. [ABSTRACT FROM AUTHOR]

Silicon wafer geometry is stringently controlled at present in the semiconductor industry. In particular, surface flatness must comply with strict standards because it can affect the success of various downstream manufacturing processes. A double-sided polishing (DSP) process serves as the standard finishing process in the industrial manufacture of large diameter silicon wafers. However, nonuniformities in the removal distribution on a wafer in DSP processes cause deterioration of surface flatness of the wafer. In this study, we derive the relation between DSP conditions and the uniformity of the removal distribution and propose better DSP conditions via kinematic modeling of a DSP process. [ABSTRACT FROM AUTHOR]

Due to the inevitable, nonuniform relative speed distribution between a workpiece and polishing pads, double-sided polishing (DSP) faces the challenge of nonuniform removal distributions. Hence, maintaining workpiece flatness while perfecting surface finishing remains a challenge in the DSP process. This study controlled the pressure distribution on a workpiece using a polishing pad design to compensate for the nonuniformity. An analytical model of the removal distribution was proposed considering the impact of pressure distribution. Experiments confirmed the proposed model's capability to evaluate the compensating effect of the polishing pad design. Finally, design guidelines for uniform removal distributions were established. [ABSTRACT FROM AUTHOR]

Background: Diet-induced inflammation may be associated with sarcopenia; however, few reports have examined this relationship. Aim: To examine the association between the dietary inflammatory index (DII) and sarcopenia in older adults who visited a frailty clinic in Japan. Methods: This cross-sectional study used outpatient data from the Frailty Registry Study. The DII is an index of diet-induced inflammation, and a dietary assessment was performed using a brief self-administered diet history questionnaire to calculate the DII score. We classified DII scores by quartiles (Q1–Q4), and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 consensus. Logistic regression analyses for sarcopenia were performed. Age, sex, comorbidities, and physical activity were entered as confounding factors (Model 1) and Models 2, 3, and 4 with BMI, protein intake, and energy intake added to Model 1. Results: We included 304 patients in the analysis (mean age, 77.6 ± 6.3 years; female, 67.4%). The prevalence of sarcopenia was 14.5%. Logistic regression analyses showed that DII scores were significantly associated with sarcopenia in Model 1 and 2 (Model 1, reference: Q1, Q4: OR 3.10, P = 0.020; Model 2, Q4: OR 3.40, P = 0,022) but not in Model 3 and 4. Discussion: Diet-induced inflammation is associated with a higher likelihood of sarcopenia; however, this association disappeared after confounding for protein and energy intake. Conclusions: The results demonstrated that dietary protein and energy parameters were the main drivers for muscle health in medical patients. [ABSTRACT FROM AUTHOR]