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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.
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BACKGROUND AND OBJECTIVES: Study aim was to determine the levels and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support. METHODS AND STUDY DESIGN: Delegate of registered dietitians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of screening, assessment, intervention (including planning), and monitoring (components of the NCP). RESULTS: Of 5,378 institutions contacted, 905 (16.8%) responded. For Screening, 80.0% screened all inpatients: primary personnel in charge were RDs (57.6%); the most used screening tool was Subjective Global Assessment (SGA) (49.2%). For Assessment, 66.1% assessed all inpatients: food intake (93.3%) was most evaluated whereas muscle mass and strength (13.0%, 8.8%) were least evaluated. For Intervention, 43.9% did so within 48h of hospital admission: oral nutritional supplement (92.9%) was the most common RDs intervention and parenteral nutrition (29.9%) was used less. For Monitoring, 18.5% of institutions had monitoring frequency of ≥ 3 times/week whilst 23.0% had monitoring less than once a week for severely malnourished patients. Energy and protein intake (93.7%, 84.3%) were most monitored and lipid intake (30.1%) was less monitored. CONCLUSIONS: Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate fre-quency and lack of important evaluation items in Monitoring. An increase in RDs staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items utilized in nutritional management are possible solutions.
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Apoyo Nutricional , Humanos , Encuestas y Cuestionarios , Japón , Apoyo Nutricional/métodos , Terapia Nutricional/métodos , Hospitales , Internet , Evaluación Nutricional , Nutricionistas , Desnutrición/diagnóstico , Desnutrición/prevención & control , Estado Nutricional , Pueblos del Este de AsiaRESUMEN
BACKGROUND: Oral and social problems can exacerbate long-term care. Understanding the relationship between social aspects and oral hypofunction can help identify high-risk factors for long-term care. OBJECTIVE: This study aimed to investigate the social aspects of oral hypofunction among medical outpatients. METHODS: This retrospective cross-sectional study included patients who visited an outpatient clinic for frailty. The oral function was assessed using seven items: oral hygiene, occlusal force, masticatory function, tongue-lip motor function, tongue pressure, oral dryness and swallowing function. Participants with three or more functional declines were classified as having 'oral hypofunction'. Social aspects were assessed using 21 items in four categories: general resources, basic social needs, social resources and social behaviours/activities. We analysed the relationship between oral hypofunction and each social aspect. RESULTS: A total of 316 participants (age 78.5 ± 6.4 years) were included, and 128 (41%) had oral hypofunction. Participants with oral hypofunction were significantly more likely to have limited education, require long-term care, not use transportation, depend on others for shopping, not participate in events, lack association membership and not engage in charity or volunteer work. After logistic regression analysis, 'long-term care' and 'no association membership' remained significantly associated with oral hypofunction (odds ratios 2.3, 2.3; 95% CI 1.1-5.0, 1.1-4.7, respectively). CONCLUSION: Participants with oral hypofunction faced challenges in 'general resources' and 'social behaviour/activities', which were linked to oral function issues. Future longitudinal studies are necessary to further investigate this relationship.
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Background: The effect of sarcopenia on depressive mood during geriatric rehabilitation remains unclear. This study investigated the potential influence of sarcopenia on depressive mood among geriatric patients in a rehabilitation setting. Methods: This observational cohort study enrolled 204 patients aged ≥65 years (mean: 78.8±7.6 years, 45.1% women) admitted to a rehabilitation unit between April 2020 and July 2021. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment (AWGS2019) criteria, which include low handgrip strength and muscle mass. Depressive mood was defined as a 15-item Geriatric Depression Scale score of ≥6 points. We applied logistic regression models to examine the influence of sarcopenia on depressive mood at discharge. Results: We observed sarcopenia in 58.3% of patients. The logistic regression model showed that sarcopenia negatively influenced depressive mood at discharge (odds ratio, 5.460; 95% confidence interval, 2.344-13.415). Of the 68 patients without depressive mood at admission, those with sarcopenia (n=31) had a significantly higher incidence of depressive mood at discharge compared with patients without sarcopenia (n=37) (41.9% vs. 16.2%, p=0.037). Conclusion: Sarcopenia at admission negatively affected depressive mood at discharge from geriatric rehabilitation. Thus, early and routine assessment of sarcopenia is vital for patients undergoing geriatric rehabilitation.
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PURPOSE: Feeding assistance should be safe and improve the assisted individual's ability to feed, yet objective tools for evaluating these skills are lacking. This study focuses on developing a tool for assessing feeding assistance skills. METHODS: A group consisting of 25 experts employed the Delphi method to achieve a consensus on the essential items necessary for assessing feeding assistance skills. Subsequently, a draft score using a three-point scale was developed. To test the reliability of the draft scores, a group of 20 patients and 20 nurses was matched to record a meal assistance scene, which were independently evaluated by three raters. We computed the AC1 statistic to assess both intra- and inter-rater reliability, and further examined correlations between the Feeding Assistance Skill Score (FASS) scores and outcome items to verify validity. RESULTS: Initially, an 18-item draft score was generated using the Delphi method. Subsequently, seven items were omitted from the intra- or inter-rater reliability analysis. Furthermore, after discussion, researchers removed one item that assessed food cognition, because the agreement score between the two items was 91%. Finally, the 10-item FASS was developed, showing a correlation with dietary intake upon validation. CONCLUSIONS: We successfully developed a scoring system for peer evaluation of feeding assistance skills. Future studies should aim to validate the FASS. The implementation of the FASS aims to assess the effectiveness of feeding assistance training and care quality, potentially improving safety and satisfaction for those receiving feeding assistance.
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BACKGROUND & AIMS: Sarcopenia, characterized by loss of muscle mass and decreased muscle strength, significantly affects adults but also influences pediatric health. However, definitions for low muscle mass, decreased strength, and sarcopenia in children are less established, impacting interventions for improving health outcomes. The objective of this scoping review is synthesize the existing literature on the diagnostic criteria, prevalence and clinical outcomes of sarcopenia. METHODS: A scoping review, following the PRISMA extension for scoping reviews, examined pediatric sarcopenia literature until June 2023. The literature search was performed using MEDLINE and the Cochrane Central Register of Controlled Trials with the last search conducted on June 30, 2023. Criteria included studies on aged 0-20 years, covering healthy subjects, acutely ill patients, and chronic disease cases excluding specific conditions like neuromuscular diseases or prematurity. RESULTS: Initial search found 503 studies, finally, we included 56 studies. Most studies diagnosed sarcopenia using skeletal muscle mass indicators like total psoas muscle area from Computed Tomography or Magnetic Resonance Imaging. Around half of the longitudinal studies highlighted sarcopenia as a risk factor for various clinical outcomes, predominantly in hospitalized patients. However, cutoff values for sarcopenia indicators lacked consistency, with studies employing diverse percentile-based measurements or z-scores. CONCLUSION: Pediatric sarcopenia diagnosis primarily relies on skeletal muscle mass, with identified links to future clinical outcomes in specific conditions. The lack of standardized cutoffs for sarcopenia indicators underscores the necessity for age, gender, and race-specific cutoff values derived from studies establishing reference values for muscle mass and strength across diverse pediatric populations.
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Sarcopenia , Humanos , Sarcopenia/diagnóstico , Sarcopenia/epidemiología , Niño , Prevalencia , Preescolar , Adolescente , Lactante , Fuerza Muscular , Músculo Esquelético/fisiopatología , Músculo Esquelético/diagnóstico por imagen , Masculino , Femenino , Recién Nacido , Factores de RiesgoRESUMEN
This paper proposes a multimodal Transformer model that uses time-series data to detect and predict winter road surface conditions. For detecting or predicting road surface conditions, the previous approach focuses on the cooperative use of multiple modalities as inputs, e.g., images captured by fixed-point cameras (road surface images) and auxiliary data related to road surface conditions under simple modality integration. Although such an approach achieves performance improvement compared to the method using only images or auxiliary data, there is a demand for further consideration of the way to integrate heterogeneous modalities. The proposed method realizes a more effective modality integration using a cross-attention mechanism and time-series processing. Concretely, when integrating multiple modalities, feature compensation through mutual complementation between modalities is realized through a feature integration technique based on a cross-attention mechanism, and the representational ability of the integrated features is enhanced. In addition, by introducing time-series processing for the input data across several timesteps, it is possible to consider the temporal changes in the road surface conditions. Experiments are conducted for both detection and prediction tasks using data corresponding to the current winter condition and data corresponding to a few hours after the current winter condition, respectively. The experimental results verify the effectiveness of the proposed method for both tasks. In addition to the construction of the classification model for winter road surface conditions, we first attempt to visualize the classification results, especially the prediction results, through the image style transfer model as supplemental extended experiments on image generation at the end of the paper.
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BACKGROUND: The purpose of this study was to clarify (1) the differences in cortical bone thickness (CBT) of the tibial diaphysis between healthy and osteoarthritic knees and (2) the influences of the femorotibial angle (FTA) and inclination of the medial compartment of the proximal tibia (MCT) on tibial CBT. METHODS: The study assessed 60 subjects with varus knee osteoarthritis (OA) (22 males and 38 females; mean age, 74 ± 7 years) and 53 healthy elderly subjects (28 males and 25 females; mean age, 70 ± 6 years). Three-dimensional estimated CBT of the tibial diaphysis was automatically calculated for 2752-11,296 points using high-resolution measurements from CT. The standardized CBT was assessed in 24 regions by combining six heights and four areas. Additionally, the association between the CBT, each FTA, and MCT inclination was investigated. RESULTS: The OA group showed a thicker CBT in the medial areas than in the lateral areas of the proximal tibia, while the healthy group had a thicker lateral CBT. The medial-to-lateral ratio of the proximal tibia was significantly higher in the OA group than in the healthy group. The proximal-medial CBT correlated with FTA and MCT inclinations in the OA group. CONCLUSIONS: This study demonstrated that varus osteoarthritic knees showed a different trend of proximal-medial CBT with associations in FTA and MCT inclination from healthy knees, possibly due to medial load concentration.
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Hueso Cortical , Diáfisis , Osteoartritis de la Rodilla , Tibia , Humanos , Masculino , Femenino , Tibia/diagnóstico por imagen , Tibia/patología , Anciano , Osteoartritis de la Rodilla/diagnóstico por imagen , Osteoartritis de la Rodilla/patología , Hueso Cortical/diagnóstico por imagen , Hueso Cortical/patología , Diáfisis/diagnóstico por imagen , Diáfisis/patología , Anciano de 80 o más Años , Tomografía Computarizada por Rayos X , Extremidad Inferior/diagnóstico por imagen , Persona de Mediana EdadRESUMEN
The need for improved nutrition in older adults requiring care has been acknowledged, but, to the best of our knowledge, there is a lack of systematic review and integration of nutritional care studies with older adults in nursing homes. This scoping review aimed to examine the scope and nature of nutritional care research for older adults in nursing homes and to identify research gaps, following the guidelines of the Joanna Briggs Institute. We found varied nutritional care for older adults living in nursing homes, including individualized sessions, such as nutrition counseling, the addition of foods and preparations for increased nutritional intake, and the maintenance of an eating environment, such as feeding assistance and calling. The nutritional care identified in this scoping review also included studies that have improved the nutritional status of older adults in nursing homes by implementing educational programs for care staff. For future research on effective nutritional care for older adults in nursing homes, we suggest evaluating both short- and long-term intervention effects with an adequate sample size.
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Casas de Salud , Estado Nutricional , Humanos , Anciano , Terapia NutricionalRESUMEN
This study presents a trial analysis that uses brain activity information obtained from mice to detect rheumatoid arthritis (RA) in its presymptomatic stages. Specifically, we confirmed that F759 mice, serving as a mouse model of RA that is dependent on the inflammatory cytokine IL-6, and healthy wild-type mice can be classified on the basis of brain activity information. We clarified which brain regions are useful for the presymptomatic detection of RA. We introduced a matrix completion-based approach to handle missing brain activity information to perform the aforementioned analysis. In addition, we implemented a canonical correlation-based method capable of analyzing the relationship between various types of brain activity information. This method allowed us to accurately classify F759 and wild-type mice, thereby identifying essential features, including crucial brain regions, for the presymptomatic detection of RA. Our experiment obtained brain activity information from 15 F759 and 10 wild-type mice and analyzed the acquired data. By employing four types of classifiers, our experimental results show that the thalamus and periaqueductal gray are effective for the classification task. Furthermore, we confirmed that classification performance was maximized when seven brain regions were used, excluding the electromyogram and nucleus accumbens.
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In our digitally driven society, advances in software and hardware to capture video data allow extensive gathering and analysis of large datasets. This has stimulated interest in extracting information from video data, such as buildings and urban streets, to enhance understanding of the environment. Urban buildings and streets, as essential parts of cities, carry valuable information relevant to daily life. Extracting features from these elements and integrating them with technologies such as VR and AR can contribute to more intelligent and personalized urban public services. Despite its potential benefits, collecting videos of urban environments introduces challenges because of the presence of dynamic objects. The varying shape of the target building in each frame necessitates careful selection to ensure the extraction of quality features. To address this problem, we propose a novel evaluation metric that considers the video-inpainting-restoration quality and the relevance of the target object, considering minimizing areas with cars, maximizing areas with the target building, and minimizing overlapping areas. This metric extends existing video-inpainting-evaluation metrics by considering the relevance of the target object and interconnectivity between objects. We conducted experiment to validate the proposed metrics using real-world datasets from Japanese cities Sapporo and Yokohama. The experiment results demonstrate feasibility of selecting video frames conducive to building feature extraction.
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The advancements in deep learning have significantly enhanced the capability of image generation models to produce images aligned with human intentions. However, training and adapting these models to new data and tasks remain challenging because of their complexity and the risk of catastrophic forgetting. This study proposes a method for addressing these challenges involving the application of class-replacement techniques within a continual learning framework. This method utilizes selective amnesia (SA) to efficiently replace existing classes with new ones while retaining crucial information. This approach improves the model's adaptability to evolving data environments while preventing the loss of past information. We conducted a detailed evaluation of class-replacement techniques, examining their impact on the "class incremental learning" performance of models and exploring their applicability in various scenarios. The experimental results demonstrated that our proposed method could enhance the learning efficiency and long-term performance of image generation models. This study broadens the application scope of image generation technology and supports the continual improvement and adaptability of corresponding models.
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OBJECTIVES: In this study, we aimed to investigate the prevalence of oral frailty and explore its relationship with oral function and sarcopenia among older outpatients. MATERIALS AND METHODS: In this cross-sectional study, we retrospectively included older patients who visited a frailty outpatient clinic. We assessed total oral frailty employing, among other measures, oral diadochokinesis (/ta/ sound) for tongue-lip movement and tongue pressure. Patients who did not meet the cut-off values for three or more of these were classified as having oral frailty. Sarcopenia was assessed according to Asian Working Group for Sarcopenia 2019 criteria and analyzed for the relationship with oral function. RESULTS: The mean ± standard deviation age of the 111 patients was 77.2 ± 5.7 y; 63 were women (57%). Fifteen patients (14%) had either sarcopenia or dynapenia. The overall prevalence of oral frailty was 38%, with no significant difference in its prevalence between the sarcopenia/dynapenia group (44%) and the robust (no sarcopenia/dynapenia) group (35%). The following oral function assessments significantly differed between the sarcopenia/dynapenia group and the robust group: median (interquartile range) total oral frailty score, 2 (2-4) and 2 (1-3) (P = 0.019); tongue-lip motor function, 5.4 ± 1.2 and 5.9 ± 1.2 times/s (P = 0.049); and tongue pressure, 27.3 ± 8.5 kPa and 31.7 ± 8.0 kPa (P = 0.009). CONCLUSIONS: Approximately 40% of patients exhibited a decline in oral function regardless of the presence of sarcopenia. Sarcopenia and dynapenia may particularly affect tongue function. Although assessing patients for sarcopenia is crucial, separate evaluations of oral function should also be considered.
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Anciano Frágil , Fragilidad , Evaluación Geriátrica , Pacientes Ambulatorios , Sarcopenia , Lengua , Humanos , Sarcopenia/epidemiología , Sarcopenia/complicaciones , Estudios Transversales , Femenino , Masculino , Anciano , Fragilidad/epidemiología , Fragilidad/complicaciones , Estudios Retrospectivos , Prevalencia , Pacientes Ambulatorios/estadística & datos numéricos , Anciano de 80 o más Años , Lengua/fisiopatología , Evaluación Geriátrica/métodos , Evaluación Geriátrica/estadística & datos numéricos , Anciano Frágil/estadística & datos numéricos , Salud Bucal/estadística & datos numéricosRESUMEN
Thioredoxin-interacting protein (TXNIP) plays an important role in glucose metabolism, and its expression is regulated by DNA methylation (DNAm). Although the association between TXNIP DNAm and type 2 diabetes mellitus has been demonstrated in studies with a cross-sectional design, prospective studies are needed. We therefore examined the association between TXNIP DNAm levels and longitudinal changes in glycemic traits by conducting a longitudinal study involving 169 subjects who underwent two health checkups in 2015 and 2019. We used a pyrosequencing assay to determine TXNIP DNAm levels in leukocytes (cg19693031). Logistic regression analyses were performed to assess the associations between dichotomized TXNIP DNAm levels and marked increases in glycemic traits. At four years, the TXNIP DNA hypomethylation group had a higher percentage of changes in fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) compared to those in the hypermethylation group. The adjusted odds ratios for FPG and HbA1c levels were significantly higher in the TXNIP DNA hypomethylation group than in the hypermethylation group. We found that TXNIP DNA hypomethylation at baseline was associated with a marked increase in glycemic traits. Leukocyte TXNIP DNAm status could potentially be used as an early biomarker for impaired glucose homeostasis.
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Glucemia , Proteínas Portadoras , Metilación de ADN , Hemoglobina Glucada , Humanos , Proteínas Portadoras/genética , Masculino , Femenino , Estudios Longitudinales , Persona de Mediana Edad , Glucemia/metabolismo , Glucemia/análisis , Hemoglobina Glucada/metabolismo , Hemoglobina Glucada/análisis , Adulto , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/metabolismo , Anciano , Leucocitos/metabolismoRESUMEN
BACKGROUND: The association of the combination of body mass index (BMI) and weight change at admission with prognoses in patients with heart failure (HF) is unclear. Therefore, we investigated whether BMI and weight changes at admission affect mortality in patients with HF. METHODS: This retrospective cohort study lasted 99 months, starting in April 2014, and included 4,862 patients with HF from a Japanese real-world database. Cubic and thin-plate smoothing spline analyses were performed to investigate the association of BMI and weight changes with mortality. The percentage weight change was calculated every 6 months. The study outcome was the presence or absence of death. RESULTS: The patients' mean age was 81.5±9.6 years, and 1,239 (25.5%) patients died. Cubic spline analysis revealed a negative correlation of BMI with mortality hazard ratio (HR) (BMI of 18.5 kg/m2 and 25 kg/m2; HR=1.3 [1.2-1.4] and 0.8 [0.7-0.9], respectively). Cubic spline analysis of weight change showed that weight loss tended to increase the mortality HR (each 6% decrease in weight change rate was associated with a 1.1 times higher mortality risk (95% CI [1.0-1.2]) Thin-plate smoothing spline analysis showed that the odds ratio (OR) negatively correlated with BMI (1-year mortality: BMI of 18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.5, 1.0, and 0.7, respectively; 2-year mortality: BMI=18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.4, 0.9, and 0.7, respectively). CONCLUSION: A low BMI in patients with HF was associated with a higher risk of mortality. Weight loss in patients, regardless of BMI, was associated with a higher OR for mortality.
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Índice de Masa Corporal , Insuficiencia Cardíaca , Pérdida de Peso , Humanos , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/fisiopatología , Masculino , Pérdida de Peso/fisiología , Femenino , Estudios Retrospectivos , Anciano , Anciano de 80 o más Años , Japón/epidemiología , Pronóstico , Factores de Riesgo , Medición de Riesgo , Modelos de Riesgos Proporcionales , Hospitalización/estadística & datos numéricosRESUMEN
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.
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Evaluación Geriátrica , Salud Bucal , Humanos , Masculino , Femenino , Anciano , Estudios Transversales , Anciano de 80 o más Años , Fragilidad , Anciano Frágil , Cognición/fisiologíaRESUMEN
PURPOSE: Frailty and hospitalization-associated disabilities (HAD) are geriatric conditions that should be managed in older patients undergoing pancreatectomy. The Hospital Frailty Risk Score (HFRS) can evaluate frailty based on medical records and could predict postoperative activities of daily living (ADL) decline. This study aimed to investigate whether HFRS affects the postoperative incidence of HAD in older patients who underwent pancreatectomy. METHODS: This retrospective, observational study used data from a nationwide hospital-based database. We included consecutive patients aged ≥ 65 years who were diagnosed with pancreatic cancer (International Statistical Classification of Diseases, 10th revision code C25) and underwent curative pancreatectomy between April 2014 and August 2020. We evaluated preoperative frailty using HFRS. The primary outcome was HAD following pancreatectomy. Logistic regression analysis was performed for analyzing the impact of frailty on HAD following pancreatectomy. RESULTS: We included 671 patients for the analysis (mean age 74.3 ± 5.6, male 54.8%). The prevalence of intermediate and high risk of frailty with HFRS ≥ 5 was 2.7%. The incidence of HAD was significantly higher in the intermediate- and high-risk groups compared to that in the low-risk group (33.3% vs. 8.4%, p < 0.001). Logistic regression analysis demonstrated that intermediate and high risks of frailty increased the likelihood of HAD (odds ratio, 3.55; 95% confidence interval: 1.12-11.2). CONCLUSIONS: The risk of frailty evaluated using the HFRS increased the likelihood of developing HAD in older patients undergoing pancreatectomy. Future research on effective perioperative interventions for preventing postoperative HAD and enhancing postoperative ADL recovery is warranted.
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Actividades Cotidianas , Fragilidad , Evaluación Geriátrica , Hospitalización , Pancreatectomía , Neoplasias Pancreáticas , Humanos , Masculino , Anciano , Femenino , Estudios Retrospectivos , Fragilidad/epidemiología , Fragilidad/diagnóstico , Anciano de 80 o más Años , Hospitalización/estadística & datos numéricos , Medición de Riesgo , Neoplasias Pancreáticas/cirugía , Neoplasias Pancreáticas/epidemiología , Evaluación Geriátrica/métodos , Anciano Frágil/estadística & datos numéricos , Factores de Riesgo , Complicaciones Posoperatorias/epidemiología , Modelos LogísticosRESUMEN
Text-guided image editing has been highlighted in the fields of computer vision and natural language processing in recent years. The approach takes an image and text prompt as input and aims to edit the image in accordance with the text prompt while preserving text-unrelated regions. The results of text-guided image editing differ depending on the way the text prompt is represented, even if it has the same meaning. It is up to the user to decide which result best matches the intended use of the edited image. This paper assumes a situation in which edited images are posted to social media and proposes a novel text-guided image editing method to help the edited images gain attention from a greater audience. In the proposed method, we apply the pre-trained text-guided image editing method and obtain multiple edited images from the multiple text prompts generated from a large language model. The proposed method leverages the novel model that predicts post scores representing engagement rates and selects one image that will gain the most attention from the audience on social media among these edited images. Subject experiments on a dataset of real Instagram posts demonstrate that the edited images of the proposed method accurately reflect the content of the text prompts and provide a positive impression to the audience on social media compared to those of previous text-guided image editing methods.