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Aim: The serum creatinine/cystatin C ratio (CCR) or sarcopenia index is considered a useful marker of muscle mass. However, its usefulness in late‐stage older adults remains unclear. We aimed to determine the usefulness of CCR as an indicator of sarcopenia in community‐dwelling Japanese adults aged >75 years. Methods: Our study recruited participants aged 70, 80, and 90 ± 1 years during the baseline years, and included a 3‐year follow‐up in the Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians study. From 2015 to 2018, 955 participants were eligible: 367 in their 70s, 304 in their 80s, and 284 in their 90s. The diagnostic components of sarcopenia, including "low muscle mass, plus low muscle strength, and/or low physical performance," were evaluated using the bioelectrical impedance analysis‐measured skeletal muscle mass index (SMI), handgrip strength, and short physical performance battery (SPPB) score, respectively, in accordance with the Asia Working Group for Sarcopenia 2019 criteria. Separate analyses were performed between each component and CCR, adjusting for sex, body mass index, and other blood biomarkers in each group. Results: The relationship between CCR and sarcopenia components was significant for handgrip strength (β = 0.21, 0.13, 0.19, and P < 0.0001, =0.0088, <0.0001, for the 70s, 80s, and 90s age groups, respectively); however, it was limited for SMI (β = 0.14; P = 0.0022, only for the 90s) and not significant for the SPPB score. Conclusion: CCR is a limited indicator of sarcopenia in late‐stage older adults. Although its association with muscle strength was significant, its relationship with muscle mass and physical performance was less pronounced. Geriatr Gerontol Int 2024; 24: 529–536. [ABSTRACT FROM AUTHOR]

Aim: To examine the actual conditions of older patients receiving home medical care after hospitalization over a period of 2 years in Japan. Methods: The study population included 102 participants, aged ≥65 years, receiving home medical care, who consented to participate in the Osaka Home Care Registry (OHCARE) study in Japan over a period of 2 years. We investigated the actual conditions for returning home after hospitalization. Results: The median age of the 102 participants was 84 years, and 61 (59.8%) were women. In the group that returned home, 42 (55.3%) of the respondents desired to recuperate in a familiar place, as in advanced care planning (ACP). During the 2‐year follow‐up period, the group that did not return home had significantly more deaths. A multivariate analysis showed the association in the presence of ACP (odds ratio: 4.72, 95% confidence interval: 1.60–13.86) and cardiac disease (odds ratio: 0.25, 95% confidence interval: 0.08–0.76). The lack of ACP in the medical records when the patient was admitted to the hospital may have prevented the return home. Conclusion: In older patients who had difficulty returning home after hospitalization, the lack of ACP in home medical care may have been an influencing factor. ACP could help continue with home medical care. Geriatr Gerontol Int 2024; 24: 320–326. [ABSTRACT FROM AUTHOR]

In recent years, the increasing number of obese individuals in Japan has made transplant teams sometimes forced to select candidates with a high body mass index (BMI) as marginal donors in living donor liver transplantation. However, data are lacking regarding the impact of a high BMI on the outcome for liver donors, particularly over the long term. Here, we aimed to clarify the impact of a high BMI on postoperative short- and long-term outcomes in liver donors. We selected 80 cases that had complete 5-year data available from hepatectomies performed in 2005 to 2015 in our institute. We divided donors into overweight (BMI ≥ 25 kg/m2, n = 16) and normal-weight (BMI < 25, n = 64) groups. Preoperatively, the overweight group had significantly higher preoperative levels of serum alanine aminotransferase and γ-glutamyl transpeptidase and a larger liver volume than the normal-weight group. Although the overweight group had significantly greater intraoperative blood loss (660 ± 455 vs 312 ± 268 mL, P =.0018) and longer operation times (463 ± 88 vs 386 ± 79 min, P =.0013), the groups showed similar frequencies of postoperative complications. At 1 year post hepatectomy, liver regeneration and spleen enlargement ratios did not significantly differ between the 2 groups. Remarkably, the overweight group showed significantly higher serum γ-glutamyl transpeptidase levels over the long term. Overweight status alone was not a risk factor for either short- or long-term postoperative outcomes after a donor hepatectomy. However, donors with elevated γ-glutamyl transpeptidase levels, which was frequent among overweight donors, may require special attention. [ABSTRACT FROM AUTHOR]

• An approach for estimating the relationship between V eq and RS pv was developed. • Effects of magnitude, distance, and site conditions on V eq / RS pv were clarified. • A practical formulation for V eq / RS pv was constructed using real seismic records. The input energy spectrum is useful information for determining the hysteretic energy demand in energy-based seismic design. The input energy spectrum commonly expressed in terms of the energy equivalent velocity spectrum, V eq , can be easily established from the code-specified response spectra (RS) based on the relationship between V eq and RS. Several formulations for the V eq -RS relationship have been developed; however, all of them ignore the influences of magnitude, distance, and site conditions. The aim of this study is to propose a practical formulation for the relationship between V eq and the pseudo-velocity response spectrum, RS pv , incorporating the influences of magnitude, distance, and site conditions. Firstly, to explore the influences of magnitude, distance, and site conditions on the V eq - RS pv relationship, an approach for estimating V eq / RS pv is proposed based upon random vibration theory and verified by comparison with the values calculated by traditional time-series analysis. It is found that the magnitude influences V eq / RS pv the most among these parameters by changing the frequency content of the ground motion, and the V eq / RS pv values at long oscillator periods decrease significantly with an increasing magnitude. Then, based on these conclusions, a practical V eq / RS pv formulation incorporating the influences of magnitude, distance, and site conditions was developed using 16,660 real seismic ground motions in Japan. [ABSTRACT FROM AUTHOR]

The elevated serum glutamic-oxaloacetic transaminase (GOT) and glutamic-pyruvic transaminase (GPT) rate among people with intellectual disabilities (ID) is unknown and have not been sufficiently studies. The present paper aims to provide the profile of GOT and GPT, and their associated relationship with other biochemical levels of children or adolescents with ID. A cross-sectional design was conducted in three Taiwanese public special schools to analyze annual health examination chart of students with ID. There were 1041 aged 3-21 years children and adolescents with ID participated in the study. The results show elevated rate of GOT and GPT were 3.7% and 7.2%, the study indicates the elevated GPT in children and adolescents with ID is higher than the general school aged children in Taiwan. In multiple linear regression models show that the factors of BMI, HBsAg, TC and UA can significantly explain the GOT value (R(2)=0.275). Those factors of gender, BMI, HBsAg, TC and UA can significantly explain 44.4% variation of GPT value (R(2)=0.444). To prevent the further liver disease burden in people with ID, the study highlights that the health care professionals should assess liver functions of this group of people, and to inform their caregivers the importance of implement regular liver health check-up.