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BACKGROUND/OBJECTIVES: To clarify the association of serum docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) levels with cognitive decline over 10 years. SUBJECTS/METHODS: This study was part of the National Institute for Longevity Sciences--Longitudinal Study of Aging, and was conducted with 232 male and 198 female Japanese community-dwelling subjects aged 60-79 years in the second wave (2000-2002). Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in both the second and seventh (2010-2012) waves. Fasting venous blood samples were collected in the morning, and serum DHA and EPA levels were measured. Multiple logistic regression analysis was performed among participants with an MMSE score ≥ 24 in the second wave (n = 430) to estimate the odds ratio (OR) and 95% confidence interval (CI) for MMSE score [less than or equal to] 23 or MMSE score decline ≥ 4 10 years later. These estimates were based on baseline tertiles of serum DHA or EPA levels, and controlled for age, sex, education, MMSE score at baseline, alcohol consumption, current smoking, body mass index and disease history. RESULTS: Fifteen (3.5%) subjects whose MMSE score was [less than or equal to] 23 and 36 (8.3%) subjects whose MMSE score declined to [greater than or equal to] 4 showed cognitive decline. Multivariate-adjusted OR (95% CI) for the lowest through highest tertiles of serum DHA to MMSE score [less than or equal to] 23 or decline ≥ 4 were 1.00 (reference), 0.11 (0.02-0.58) and 0.17 (0.04-0.74), or 1.00 (reference), 0.22 (0.08-0.61) and 0.31 (0.12-0.75), respectively (P for trend = 0.01 or 0.04). Serum EPA was not associated with cognitive decline. CONCLUSIONS: The study gives some indication that a moderately high level of serum DHA might prevent cognitive decline among community-dwelling elderly Japanese individuals. European Journal of Clinical Nutrition (2014) 68, 503-509; doi:10.1038/ejcn.2013.264; published online 8 January 2014 Keywords: DHA; EPA; serum; cognition; Japanese; elderly, INTRODUCTION An estimated two million people in Japan suffer from dementia and this number will likely increase as the population ages. (1) The essential n-3 polyunsaturated fatty acids (PUFA), docosahexaenoic [...]

Purpose: To analyze the surgical outcomes of petalloid multilayered inverted internal limiting flap using perfluorocarbon liquid (PFCL) in extra-large macular holes (MHs) (minimum linear diameter >550 μm and basal diameter [BD] >1000 μm). Methods: This was a prospective interventional series of 103 eyes of 99 patients with extra-large MHs which were treated with 25-gauge pars plana vitrectomy, petalloid multilayered inverted internal limiting membrane flaps under PFCL and 15% perfluoropropane (C3F8) gas tamponade. Intraoperative optical coherence tomography (i-OCT) was used to confirm correct positioning of flaps. Follow-up was at 1 week, 1 month, and 3 months postoperatively. Results: Mean age of patients was 58.282 ± 16.3 years. Mean preoperative best corrected visual acuity (BCVA) was logarithm of minimum angle of resolution (logMAR) 1.206 ± 0.384, and the value at the third month was logMAR 0.793 ± 0.337. Mean minimum linear diameter (MLD) was 711.96 ± 270.744 μm. MLD ranged from 557μm (minimum MLD) to 2657 μm (maximum MLD). Mean BD was 1301.165 ± 425.914 μm. Type 1 closure was seen in 92.2% eyes, 5.8% eyes had type 2 closure, and 1.9% eyes had type 3 closure. Eyes with both type 1 closure (P = 0.001) and type 2 closure (P = 0.009) showed a significant improvement in BCVA postoperatively at 3 months. Conclusion: Petalloid multilayered inverted internal limiting membrane flap under PFCL technique with adjunctive use of i-OCT showed improved morphological and functional outcomes in the treatment of extra-large MHs. We present here a large series of extra-large MHs, in which a novel technique of petalloid multilayered inverted ILM flaps was used.

A 59 years male presented with painless diminution of vision in right eye for 4 months. His vision was 20/100 in right eye and 20/30 in left eye. Fundus examination revealed epiretinal membrane in right eye with central macular thickness of 747 μm for which he underwent 25 guage pars plana vitrectomy. Intraoperatively after internal limiting membrane peeling, during removal of the pieces of the membrane from the forceps with the endoilluminator pipe, accidentally one blade from the tip of ILM peeling forceps broke. In this report, we describe first case of inadvertent intraoperative fracture of 25- gauge Grieshaber DSP End-Grasping ILM forceps in a case of ERM who underwent vitrectomy and removal of ERM with successful removal of fractured tip of ILM forceps.

A 22-year-old female with severe headache was referred to eye outpatient department for fundus examination with a possibility of intracranial space-occupying lesion. On fundus examination, we found bilateral disc edema with creamy white elevated lesion in the left eye suggestive of retinal astrocytoma which was confirmed by spectral-domain optical coherence tomography. Hence, the patient underwent magnetic resonance imaging brain, ultrasonography abdomen, and dermatological workup which confirmed it to be the case of tuberous sclerosis. This case report exemplifies the systemic manifestations of tuberous sclerosis complex and its specific expression in the eye. Hence, in turn, to establish an appropriate diagnosis, retinal manifestations of the disorder must not be overlooked.

The Bombyx mori silkworm's homologue of the Broad-Complex gene ( BmBR- C) is transcribed from two promoters: a distal promoter ( Pdist) and a proximal promoter ( Pprox). As determined by a luciferase assay, the transcriptional activity of Pdist, but not Pprox, was activated by ecdysone. Further analyses using reporters driven by sequential deletion Pdist mutants indicated that two regions, ecdysone responsive element ( EcRE)- D and EcRE- P, −4950 bp and −3480 bp upstream from the distal transcription start site, respectively, were important in the responsiveness of Pdist to 20-hydroxyecdysone (20 E); however, no significant sequence similarities were found between the canonical EcRE and the EcRE- D or EcRE- P regions. Electrophoretic mobility shift assays showed that both the EcRE- D and - P sequences specifically bound to Bombyx protein(s). Sequence analyses and competition assays suggested that the protein(s) bound to EcRE- P might include components other than the ecdysone receptor ( EcR), suggesting that BmBR- C transcription was indirectly activated by ecdysone through the EcRE- P. Remarkably, protein binding to the mid-region of the EcRE- D, EcRE- Db, was competitively inhibited by an oligonucleotide containing the Drosophila hsp27 EcRE sequence. Furthermore, an anti- EcR antibody interfered with the formation of the protein- EcRE- Db complex. These results indicated that a functional Bombyx ecdysone receptor binds to EcRE- D and activates the expression of BmBR- C. [ABSTRACT FROM AUTHOR]

Pulmonary sclerosing pneumocytoma is a rare benign neoplasm typically seen in middle-aged women. The exact preoperative diagnosis is quite challenging considering its nonspecific clinical and radiologic features along with complex histology. Moreover, obtaining an exact histopathological diagnosis can be difficult especially with the small biopsy specimens. Most patients are generally asymptomatic with incidental detection of peripheral, homogenous, solitary pulmonary nodule. It is essential to differentiate it from other mimickers including malignant lesions as limited surgical resection is curative in these cases without adjuvant therapy. We present a rare giant cystic variant of pneumocytoma, in a young male, which was initially mimicking inflammatory myofibroblastic tumor even on preoperative histology.

Background: Although diets rich in carotenoids are associated with muscle health and a reduced risk of disability, the relationship between carotenoids and low lean body mass has not been fully elucidated., Objectives: This study aimed to clarify the relationship between serum carotenoid concentrations and low lean body mass over 4 y in older Japanese community-dwellers., Methods: A total of 750 adults aged ≥60 y participated in the National Institute for Longevity Sciences-Longitudinal Study of Aging. Individuals with a low lean body mass and muscle strength or gait speed at baseline were excluded. Baseline serum α-carotene, β-carotene, β-cryptoxanthin, zeaxanthin, lutein, and lycopene were measured. Low lean body mass was defined as appendicular lean mass relative to the measured height (ALM/ht 2 ) of <7.0 kg/m 2 in males and <5.4 kg/m 2 in females, according to the criteria of the Asian Working Group for Sarcopenia 2019. A generalized estimating equation was used to estimate the odds ratio and 95% confidence interval for low lean body mass according to tertiles of total and individual carotenoids at baseline, adjusted for sex, age, season, follow-up months, education years, economic status, current smoking status, a history of ischemic heart disease, stroke, hypertension, dyslipidemia, diabetes mellitus, and metabolic equivalents., Results: Low serum total carotenoids were associated with low ALM/ht 2 , and the odds ratios of low ALM/ht 2 in the third tertile of total carotenoids were significantly lower than those in the first tertile after adjusting for covariates. The odds ratios of low ALM/ht 2 in the third tertile of β-cryptoxanthin were significantly associated with those in the first tertile after adjusting for covariates (P = 0.03); however, no trend was observed for this relationship., Conclusions: These findings indicate that low serum total carotenoids and serum β-cryptoxanthin are associated with low lean body mass in older Japanese community-dwellers., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Considering that a multifactorial lifestyle approach may prove more effective than a single factor approach to improve or maintain brain health, we evaluated the association of exercise (open skill exercise [OSE] or closed skill exercise [CSE]) combined with long-chain polyunsaturated fatty acid (LCPUFAs) (docosahexaenoic acid [C22:6n-3, DHA], eicosapentaenoic acid [C20:5n-3, EPA], and arachidonic acid [C20:4n-6, ARA]) intake with brain atrophy among older Japanese individuals (n = 795, aged 60-88 years) without a self-reported history of dementia based on the datasets of a two-year longitudinal study. Brain volumes were measured using three-dimensional T1-weighted brain magnetic resonance imaging for follow-up periods of two years. The associations between multivariate-adjusted changes in brain volumes and OSE or CSE frequency (≥ once/month and < once/month) along with LCPUFA intake (≥ median and < median) at the baseline were assessed using a general linear model. Subgroup analysis was performed by restricting DHA and EPA intakes (n = 263; median, 323 mg/d), which represented levels similar to those in countries with low fish consumption. Higher OSE frequencies, ARA intakes, and their combination were inversely associated with decreases in total gray matter and frontal cortex volumes. In subgroup analysis, a combination of higher OSE frequencies and DHA intakes was also associated with a smaller decrease in total gray matter volume. Overall, our findings suggest that regular OSE engagement and appropriate LCPUFA intake may contribute to preventing brain volume decreases in older individuals., Competing Interests: Declaration of competing interest HT, CH, YK, TI, and YN are employees of Suntory Wellness Ltd., which markets health food products that include LCPUFAs. The other authors declare no conflicts of interest regarding this study., (Copyright © 2024. Published by Elsevier B.V.)

Multifactorial lifestyle approaches could be more effective than a single factor for maintaining cognitive function. This study investigated the association of combining cognitively stimulating leisure activities (CSLAs), including puzzles, quizzes, and cognitive training games, with intake of long-chain polyunsaturated fatty acids (LCPUFAs), including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA), on cognitive function in the older Japanese individuals without dementia. Participants were community-dwelling Japanese individuals without a self-reported history of dementia ( n = 906, aged 60-88 years) from datasets of a 2-year longitudinal study (baseline: 2006-2008 and follow-up: 2008-2010). CSLA engagement and LCPUFA intake were divided into high and low groups according to frequency (≥once/week and

Background: Nutritional profiling system (NPS) holds promise as a public health tool for companies to measure product healthiness and for individuals in making healthier food choices. The Meiji NPS for adults specifically targets lifestyle-related diseases prevalent among Japan's adult population, including overweight/obesity, hypertension, diabetes, and dyslipidemia. This study examined the cross-sectional association between the Meiji NPS for adults Dietary Index (MNfA-DI) and indicators of lifestyle-related diseases in a population., Methods: The study comprised 1,272 middle-aged individuals (40-64 years, 50.1% male) who participated in the seventh wave (2010-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging project, with no missing data on three-day dietary records. The MNfA-DI was computed at the individual diet level (accounting for the whole diet) using arithmetic energy-weighted means. A higher MNfA-DI indicated a greater nutritional quality of an individual's overall diet. Lifestyle-related disease indicators included body mass index (BMI, kg/m 2 ), body fat (%), systolic and diastolic blood pressure (mmHg), fasting plasma glucose (mg/dL), HbA1c (%), triglyceride levels (mg/dL), LDL, and HDL cholesterol levels (mg/dL). A multiple regression model was used to assess the association between the MNfA-DI and lifestyle-related disease indicators, adjusting for demographics, socioeconomic status, lifestyle factors, disease history, and energy intake as covariates, depending on the outcome., Results: The median (interquartile range) age and MNfA-DI were 53.0 (46.0, 59.0) years and 10.1 (6.0, 14.0) points, respectively. MNfA-DI was negatively associated with body fat [partial regression coefficient (95% confidence interval) -0.04 (-0.07, -0.01)], diastolic blood pressure [-0.08 (-0.17, -0.002)], fasting plasma glucose [-0.18 (-0.33, -0.01)], and triglyceride [-1.36 (-2.16, -0.55)]. Additionally, MNfA-DI was also associated with almost indicators (except for LDL and HDL cholesterol) among participants with a BMI between 18.5 and 24.9 kg/m 2 ., Conclusion: These findings suggest that the Meiji NPS for adults could be associated with a lower risk of lifestyle-related diseases. In addition, from a public health nutrition perspective, the Meiji NPS for adults may be useful to assess the food healthiness of the adult population., Competing Interests: TY, RW, and TH are full-time employees of R&D Division Meiji Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yu, Zhang, Wakayama, Horimoto, Tange, Nishita and Otsuka.)

Objectives: Frailty is a significant cause of adverse health events including long-term care and hospitalization. Although information and communication technology (ICT) has become an integral part of modern life, it remains unclear whether ICT use is associated with frailty., Design: A cross-sectional study (Integrated Longitudinal Studies on Aging in Japan, ILSA-J)., Setting and Participants: Aged 75 and older data from the ILSA-J in 2017 (n = 2893)., Methods: ICT use was measured using the technology usage sub-items of the Japan Science and Technology Agency Index of Competence. Specifically, the use of mobile phones, ATMs, DVD players, and sending e-mails were rated as "yes" (able to do) or "no" (unable to do), with the first quintile (≤1 point) defined as ICT non-users. Frailty was assessed using the Japanese version of the Cardiovascular Health Study criteria based on the phenotype model (e.g., weight loss, slowness, weakness, exhaustion, and low activity). Further, multivariate logistic regression analysis analyzed its association with ICT use. Subgroup analyses were stratified according to gender, years of education, and living arrangements., Results: Higher ICT use was not associated with frailty after adjusting for covariates (odds ratio [OR]: 0.53; 95%CI 0.39-0.73). Similar associations were found in the sub-groups of women (OR 0.45, 95%CI 0.30-0.66), <13 years of education (OR 0.48, 95%CI 0.34-0.67), living alone (OR 0.46, 95%CI 0.27-0.79), and living together (OR 0.57, 95%CI 0.38-0.85). No association existed between using ICT and frailty in the sub-groups of men and ≥13 years of education., Conclusions and Implications: Higher ICT use is associated with the absence of frailty in individuals 75 years and older. Such benefits may be particularly pronounced in women, those with lower levels of education, and older adults living alone or with others., (© 2024. The Author(s).)

Aim: This study aimed to examine the relationships between levels of competence and impaired physical and cognitive functions in older adults., Methods: We used a data set of the Integrated Longitudinal Studies on Aging in Japan for 2017 including 5475 community-dwelling older adults. Levels of competence were assessed using the Japan Science and Technology Agency Index of Competence (JST-IC). Grip strength (low grip strength: <28 kg for men and <18 kg for women) and gait speed (slow gait speed: <1.0 m/s for both sexes) were evaluated as physical function measurements, and the Mini-Mental State Examination (cognitive decline: <24 on the Mini-Mental State Examination) was used to assess cognitive function., Results: The JST-IC had areas under the curve estimated from receiver operating characteristic analysis ranging from 0.65 to 0.73 for detecting low function as assessed by these tests. Restricted cubic spline curves showed that the shape of the association between the JST-IC and impaired function depended on sex and the test used. The comparison between perfect and imperfect JST-IC scores showed significant differences in the prevalence of low grip strength in both sexes, slow gait speed in women, and cognitive decline in men., Conclusions: It may be insufficient to identify those with impaired physical or cognitive function using the JST-IC. The shape of the association with the JST-IC varies across their measurements. Our findings can help interpret JST-IC scores in the context of low physical and cognitive functions. Geriatr Gerontol Int 2024; 24: 352-358., (© 2024 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.)