Impacts of probiotics on the efficacies of immune checkpoint inhibitors with or without chemotherapy for patients with advanced non-small-cell lung cancer.

The relationships between the therapeutic effects of immune checkpoint inhibitors (ICIs) and the intestinal flora have attracted increasing attention. However, the effects of oral probiotics on the efficacies of ICIs used to treat non-small-cell lung cancer (NSCLC) remain unclear. We investigated the effects of probiotics on the efficacies of ICIs in patients treated with and without chemotherapy. We investigated patients with advanced NSCLC on ICI monotherapy or combination ICI and chemotherapy using the Okayama Lung Cancer Study Group Immunotherapy Database (OLCSG-ID) and the Okayama Lung Cancer Study Group Immunochemotherapy Database (OLCSG-ICD). In total, 927 patients (482 on ICI monotherapy, 445 on an ICI + chemotherapy) were enrolled. Most were male, of good performance status, smokers, and without epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) mutations. Probiotics were administered to 19% of patients on ICI monotherapies and 17% of those on ICIs + chemotherapy. Of the former patients, progression-free survival (PFS) and overall survival (OS) were significantly better in the probiotics group (PFS 7.9 vs. 2.9 months, hazard ratio [HR] 0.54, p < .001; OS not attained vs. 13.1 months, HR 0.45, p < .001). Among patients receiving ICI and chemotherapy, there were no significant differences in PFS between those on probiotics and not but OS was significantly better in the probiotics group (PFS 8.8 vs. 8.6 months, HR 0.89, p = .43; OS not attained vs. 22.6 months, HR 0.61, p = .03). Patients on probiotics experienced better outcomes following ICI treatment.

Efficacy of gilteritinib in comparison with alectinib for the treatment of ALK-rearranged non-small cell lung cancer.

Gilteritinib is a multitarget tyrosine kinase inhibitor (TKI), approved for the treatment of FLT3-mutant acute myeloid leukemia, with a broad range of activity against several tyrosine kinases including anaplastic lymphoma kinase (ALK). This study investigated the efficacy of gilteritinib against ALK-rearranged non-small cell lung cancers (NSCLC). To this end, we assessed the effects of gilteritinib on cell proliferation, apoptosis, and acquired resistance responses in several ALK-rearranged NSCLC cell lines and mouse xenograft tumor models and compared its efficacy to alectinib, a standard ALK inhibitor. Gilteritinib was significantly more potent than alectinib, as it inhibited cell proliferation at a lower dose, with complete attenuation of growth observed in several ALK-rearranged NSCLC cell lines and no development of drug tolerance. Immunoblotting showed that gilteritinib strongly suppressed phosphorylated ALK and its downstream effectors, as well as mesenchymal-epithelial transition factor (MET) signaling. By comparison, MET signaling was enhanced in alectinib-treated cells. Furthermore, gilteritinib was found to more effectively abolish growth of ALK-rearranged NSCLC xenograft tumors, many of which completely receded. Interleukin-15 (IL-15) mRNA levels were elevated in gilteritinib-treated cells, together with a concomitant increase in the infiltration of tumors by natural killer (NK) cells, as assessed by immunohistochemistry. This suggests that IL-15 production along with NK cell infiltration may constitute components of the gilteritinib-mediated antitumor responses in ALK-rearranged NSCLCs. In conclusion, gilteritinib demonstrated significantly improved antitumor efficacy compared with alectinib against ALK-rearranged NSCLC cells, which can warrant its candidacy for use in anticancer regimens, after further examination in clinical trial settings.

Association Between Procrastination in Childhood and the Number of Remaining Teeth in Japanese Older Adults.

BACKGROUND: Procrastination is associated with stress and unhealthy behaviors. The oral condition reflects the long-term history of an individual's stress exposure and oral health behaviors; however, empirical studies on the association of procrastination in childhood with remaining teeth in older age are limited. We investigated the association of procrastination in childhood with the number of remaining teeth among community-dwelling older Japanese adults. METHODS: In total, 1,616 community-dwelling senior residents of Wakuya City (Miyagi Prefecture, Japan) who were enrolled in the National Health Plan & the Medical Care System for the Elderly completed a self-administered questionnaire on the number of teeth. Procrastination was measured using a single binary question about timing of holiday homework completion in childhood. The number of remaining teeth was assessed via a questionnaire with response options of ≥20, 10-19, 1-9, and 0 teeth. Ordered logistic regression models with potential confounders (sex, age, maternal education, childhood socioeconomic status [SES], childhood maltreatment, conscientiousness trait) and mediators (adulthood SES, smoking history, alcohol use history) were estimated. RESULTS: Forty-six percent of participants reported a higher tendency to procrastinate in childhood. The proportions of participants with ≥20, 10-19, 1-9, and 0 teeth were 39.6%, 22.7%, 24.0%, and 13.7%, respectively. After adjusting for all covariates, a higher tendency to procrastinate in childhood was significantly associated with having fewer remaining teeth (odds ratio 1.28; 95% confidence interval, 1.05-1.57). CONCLUSION: A higher tendency to procrastinate in childhood was associated with having fewer remaining teeth in later life.

Association between childhood socioeconomic status and subjective memory complaints among older adults: results from the Japan Gerontological Evaluation Study 2010.

BACKGROUND: Subjective memory complaints (SMC) have been suggested as an early marker of mild cognitive impairment and dementia. However, there is a paucity of evidence on the effects of early life conditions on the development of SMC in old age. This study is aimed at investigating the association between childhood socioeconomic status (SES) and SMC in community-dwelling older adults. METHODS: We used the data of the Japan Gerontological Evaluation Study, a population-based cohort study of people aged 65 years or older enrolled from 28 municipalities across Japan. Childhood SES and SMC in everyday life were assessed from the self-report questionnaire administered in 2010 (n = 16,184). Poisson regression was performed to determine their association, adjusted for potential confounders and life-course mediators and examined cohort effects. RESULTS: We identified SMC in 47.4% of the participants. After adjusting for sex, age, and number of siblings, low and middle childhood SES were associated with 29% (prevalence ratio [PR]: 1.29, 95% confidence interval [CI]: 1.22, 1.36) and 10% higher prevalence of SMC (PR: 1.10, 95%CI: 1.04, 1.17), respectively, compared with high childhood SES (p for trend <.001). The interaction terms between childhood SES and age groups were not statistically significant. CONCLUSION: Childhood SES is significantly associated with SMC among community-dwelling older adults. Efforts to minimize childhood poverty may diminish or delay the onset of SMC and dementia in later life.

The family planning conundrum in Afghanistan.

INTRODUCTION: In Afghanistan, despite the high awareness levels of contraceptive methods, the contraceptive prevalence is low and short birth spacing is common. The aim of this study was to understand the perception about family planning and contraceptive utilization among reproductive-aged married women, their husbands, their mothers-in-law, religious leaders and healthcare providers. METHODS: Focus group discussions and semi-structured interviews were conducted among married women of reproductive age (n = 482), their husbands (n = 133), their mothers-in-law (n = 194), their religious leaders (n = 16), and healthcare providers (n = 36) in rural and urban areas in five provinces. RESULTS: Bigger family size was generally considered as desirable for emotional, economic and social well-being. The majority endorsed contraception. However, some religious scholars and their followers argued that contraception is a sinful act in Islam by interpreting contraception as equivalent to infanticide and suppression of the increase of the Muslim population. Healthcare providers attempted to disseminate health benefits of modern contraception on a family basis. However, fear of various side effects and doubts about their effectiveness due to irregular supply were prevalent in communities. DISCUSSION: It is important to increase awareness on the health benefits of appropriate birth spacing at community level. Public health campaigns supported by Islamic religious scholars and a system that ensures appropriate counselling and a steady supply of contraceptives are likely to increase contraceptive utilization.

MR elastography of the liver at 3.0 T in diagnosing liver fibrosis grades; preliminary clinical experience.

OBJECTIVES: To clarify the usefulness of 3.0-T MR elastography (MRE) in diagnosing the histological grades of liver fibrosis using preliminary clinical data. MATERIALS AND METHODS: Between November 2012 and March 2014, MRE was applied to all patients who underwent liver MR study at a 3.0-T clinical unit. Among them, those who had pathological evaluation of liver tissue within 3 months from MR examinations were retrospectively recruited, and the liver stiffness measured by MRE was correlated with histological results. Institutional review board approved this study, waiving informed consent. RESULTS: There were 70 patients who met the inclusion criteria. Liver stiffness showed significant correlation with the pathological grades of liver fibrosis (rho = 0.89, p < 0.0001, Spearman's rank correlation). Areas under the receiver operating characteristic curve were 0.93, 0.95, 0.99 and 0.95 for fibrosis score greater than or equal to F1, F2, F3 and F4, with cut-off values of 3.13, 3.85, 4.28 and 5.38 kPa, respectively. Multivariate analysis suggested that grades of necroinflammation also affected liver stiffness, but to a significantly lesser degree as compared to fibrosis. CONCLUSIONS: 3.0-T clinical MRE was suggested to be sufficiently useful in assessing the grades of liver fibrosis. KEY POINTS: MR elastography may help clinicians assess patients with chronic liver diseases. Usefulness of 3.0-T MR elastography has rarely been reported. Measured liver stiffness correlated well with the histological grades of liver fibrosis. Measured liver stiffness was also affected by necroinflammation, but to a lesser degree. 3.0-T MRE could be a non-invasive alternative to liver biopsy.

Association between sex inequality in animal protein intake and economic development in the Papua New Guinea highlands: The carbon and nitrogen isotopic composition of scalp hair and fingernail.

OBJECTIVES: People in the Papua New Guinea Highlands consume sweet potatoes as their dietary staple; consumption of animal protein is limited. In such societies with marginal protein intake, the intra-household allocation of animal protein in terms of sex or age is of importance. The objective of this study was to investigate how the allocation pattern of protein-rich foods by sex and age is associated with economic development in the Papua New Guinea Highlands. METHODS: The carbon and nitrogen isotopic compositions of fingernails, collected in 1995 in two areas (Tari and Port Moresby [the national capital where Tari migrants resided]), and of scalp hair, collected in 2007, 2012, and 2013 in three areas of different degree of economic development (Levani, Tari, and Goroka) were analyzed. RESULTS: Analysis of fingernail samples showed that δ(15)N was lower in rural communities than in the urban migrant community, while a sex difference in δ(15)N (higher in males than in females) was found in the former but not in the latter community. Age was not associated with either δ(15)N or δ(13)C values. The analysis of scalp hair samples showed that δ(15)N values were lowest in Levani, the least developed area. Furthermore, there were statistically significant sex differences in δ(15)N values in Levani but not in Tari and Goroka. Age was not associated with either δ(15)N or δ(13)C values. DISCUSSION: The sex inequality in animal protein consumption seems to have decreased as the communities in the Papua New Guinea Highlands have experienced economic development.

Reduced morning cortisol concentration in saliva was associated with obesity: Evidence from community-dwelling adults in papua new guinea.

OBJECTIVES: This study investigated morning salivary cortisol concentration in relation to total body fat composition among community-dwelling Papua New Guinean adults. METHODS: In addition to demographic and anthropometric measurements, saliva was collected in a single morning from 478 residents in Eastern Highlands Province and Madang Province. RESULTS: After adjusting for age, region, and occupation, the morning salivary cortisol concentration was significantly negatively correlated with body mass index among men (B = -0.01, P < 0.05) and women (B = -0.013, P < 0.05), and waist circumference (B = -0.007, P < 0.05), waist-to-hip-ratio (B = -1.214, P < 0.05), and subscapular-to-triceps skinfold-thickness ratio (B = -0.045, P < 0.05) among men. Men with total or abdominal body fat mass known for elevated risk of non-communicable diseases displayed lower cortisol compared to men without such risk. CONCLUSIONS: Papua New Guinean adults with increased accumulation of body fat showed reduced cortisol concentration in morning saliva. Am. J. Hum. Biol. 28:587-590, 2016. © 2016 Wiley Periodicals, Inc.

Association of protein intakes and variation of diet-scalp hair nitrogen isotopic discrimination factor in Papua New Guinea highlanders.

OBJECTIVES: We present new nitrogen isotopic discrimination factor between diets and scalp hairs (Δ(15) NHair-Diet : δ(15) NHair - δ(15) NDiet ) for indigenous residents in three communities in the Papua New Guinea Highlands who consumed various amounts and qualities of protein. The Δ(15) N is important for precise evaluation of the dietary habits of human populations; in both contemporary and traditional lifestyles. Several hypotheses have been proposed regarding factors that affect Δ(15) N values, based largely on observations from animal feeding experiments. However, variations and factors controlling Δ(15) N in humans are not well understood, mainly due to the difficulty of controlling the diets of participants. MATERIALS AND METHODS: These residents were studied because they have maintained relatively traditional dietary habits, which allow quantitative recording of diets. Δ(15) N was estimated by comparing hair δ(15) N values to mean dietary δ(15) N values calculated from the recorded intake of each food item and their δ(15) N values. RESULTS: The results showed that: i) there was a significant difference in Δ(15) N among study locations (3.9 ± 0.9‰ for most urbanized, 5.2 ± 1.0‰ for medium and 5.0 ± 0.9‰ for least urbanized communities; range = 1.2-7.3‰ for all participants); and ii) estimated Δ(15) N values were negatively correlated with several indicators of animal protein intake (% nitrogen in diet: range = 0.9-7.6%). DISCUSSION: We hypothesize that a combination of several factors, which presumably included urea recycling and amino acid and protein recycling and/or de novo synthesis during metabolic processes, altered the Δ(15) N values of the participants.

Development, validation, and use of a semi-quantitative food frequency questionnaire for assessing protein intake in Papua New Guinean Highlanders.

OBJECTIVES: The aim of this article was to develop a semi-quantitative food frequency questionnaire (FFQ) and evaluate its validity to estimate habitual protein intake, and investigate current dietary protein intakes of Papua New Guinea (PNG) Highlanders. METHODS: A 32-item FFQ was developed and tested among 135 healthy male and female volunteers. The FFQ-estimated daily total and animal protein intakes were compared with biomarkers and 3-day Weighed Food Records (WFR) by correlation analyses, Bland-Altman plot analyses and joint classification analyses. RESULTS: The FFQ-estimated total protein intake significantly correlated with urinary nitrogen in the first morning void after adjusting urinary creatinine concentration (r = 0.28, P < 0.01) and the FFQ-estimated animal protein intake significantly correlated with the hair δ(15) N (Spearman's r = 0.34, P < 0.001). The limits of agreement were ±2.39 Z-score residuals for total protein intake and ±2.19 Z-score for animal protein intake, and intra-individual differences increased as protein intake increased. The classification into the same and adjacent quartiles was 66.0% for total protein intake and 73.6% for animal protein intake. Median daily total and animal protein intake estimates from the FFQ and the 3-day WFR showed a good agreement with differences of 0.2 and 4.9 g, respectively. None of the studied communities in the PNG Highlands met the biologically required protein intake; although the community closer to an urban center showed higher protein intake than the more remote communities. CONCLUSIONS: The newly developed 32-item FFQ for PNG Highlanders is applicable for evaluation of protein intake at the individual level. Am. J. Hum. Biol. 27:349-357, 2015. © 2014 Wiley Periodicals, Inc.

Nitrite formation from organic nitrogen by Streptomyces antibioticus supporting bacterial cell growth and possible involvement of nitric oxide as an intermediate.

The actinomycete Streptomyces antibioticus was shown to produce nitrite (NO-(2)) and ammonium (NH+(4)]) when aerobically incubated in an organic nitrogen-rich medium. The production of NO-(2) was synchronized with rapid cell growth, whereas most NH+(4)] was produced after cell proliferation had ceased. Intracellular formation of nitric oxide (NO) was also observed during the incubation. The production of these inorganic nitrogen compounds along with cell growth was prevented by several enzyme inhibitors (of nitric oxide synthase or nitrate reductase) or glucose. Distinct, membrane-bound nitrate reductase was induced in the NO-(2)-producing cells. Tungstate (a potent inhibitor of this enzyme) prevented the NO-(2) production and cell growth, whereas it did not prevent the NO formation. These results revealed the occurrence of novel nitrogen metabolic pathway in S. antibioticus forming NO-(2) from organic nitrogen by which rapid cell growth is possible. NO synthase, NO dioxygenase (flavohemoglobin), and dissimilatory nitrate reductase are possible enzymes responsible for the NO-(2) formation.

Therapeutic amnioinfusion for chronic abruption-oligohydramnios sequence: a possible prevention of the infant respiratory disease.

Chronic abruption-oligohydramnios sequence (CAOS), characterized by chronic vaginal bleeding and oligohydramnios, is associated with adverse pregnancy outcomes, including preterm delivery and lung problems in the infant. Fetal lung damage may be induced by not only oligohydramnios but also iron-induced oxidative stress through chronic aspiration of bloody substances in amniotic fluid. We describe a pregnancy complicated with CAOS that was managed with repeated amnioinfusions. This is the first report showing that amnioinfusions succeeded in a significant reduction in high concentrations of iron, lactose dehydrogenase, and 8-hydroxy-2'-deoxyguanosine, a marker of oxidative DNA damage, in the amniotic fluid complicated by CAOS. The baby, born at 26 weeks' gestation via cesarean, was discharged home without supplemental oxygen 116 days after birth.

Evaluation of a rapid immunochromatographic assay for the detection of rotavirus, norovirus and adenovirus from children hospitalized with acute watery diarrhea.

We evaluated the IP-Triple I immunochromatographic rapid test for the detection of rotavirus, norovirus and adenovirus using stool samples from children with diarrhoea. The detection of norovirus and adenovirus was poor compared to polymerase chain reaction assays. However, high sensitivity (92%) and specificity (99%) were obtained for the detection of rotavirus.

Association of revision of Money Lending Business Act and suicide rate in Japan: An interrupted time series analysis.

OBJECTIVE: Debt problems are associated with suicide. In Japan, the Money Lending Business (MLB) Act was revised in December 2006 and fully enforced in June 2010 to reduce multiple debt problems. This study aimed to examine the association between the full enforcement of the revised act and suicide rates. METHODS: An interrupted time series analysis was used to the national registry data of death records between January 2000 and December 2016. Stratified analysis was conducted to assess the differences between gender and age groups. RESULTS: The effects of the full enforcement on the suicide rate were the greatest among men aged 40-64 years; after the enforcement, there was a significant decrease of -0.3085 per 100,000 persons in the level of the suicide rate (95% confidence interval [CI] -0.529 to -0.0881) and -0.0165 per 100,000 persons (95% CI -0.0215 to -0.0115) in the trend. Among women aged 40-64 and ≥65 years, an increase in the level of the suicide rate was observed after the enforcement. CONCLUSIONS: The full enforcement of the revised MLB Act was associated with decreased suicide rates, particularly among middle-aged men. Policy interventions for addressing debt problems may have the potential to prevent suicide.

Association between the social network of medical students and their academic performance on the anatomy written examination.

Although medical students learn human anatomy within a social network of friends/classmates, limited research has examined how social network structure is related to student's performance in human anatomy examinations. This study aimed to examine the association between centrality (i.e., the degree to which a student is connected to other students in class) before the start of the anatomy laboratory and changes in centrality owing to the start of the laboratory and failing the written examination taken on the last day of the course. Data included all 211 medical students at Tokyo Medical and Dental University who took anatomy classes in 2018 and 2019. The in-class social network before the laboratory was defined as "connected" if the student had more than one connection to the same individual in terms of the type of club activity, high school, and affiliation with an extracurricular program. The laboratory group adds the connection to the prelaboratory network, resulting in a postlaboratory network. Logistic regression models were used to estimate the association of degree and eigenvector centrality and changes in centrality after the laboratory with failing the written examination. Of the 211 students, 38 failed the examination. A one standard deviation increase in eigenvector centrality before the laboratory was significantly associated with a 44% decrease in odds of failing the examination (OR: 0.56, 95% CI: 0.34, 0.92). Changes in centrality measures were not associated with the performance of students in the examination. Higher in-class network centrality was associated with lower odds of failing the written examination.

Association between trajectory of socioeconomic position and regional brain volumes related to dementia: Results from the NEIGE study.

BACKGROUND: Low socioeconomic position (SEP) has been linked to an increased risk of dementia. However, little is known about the association between SEP trajectory and regional brain volumes related to dementia. METHODS: A random sample of community-dwelling older adults (n = 428, age = 73.1 ± 5.5) living in Tokamachi City (Niigata Prefecture, Japan) without medical histories of dementia, Parkinson's disease, and depression who underwent automated assessment of brain volumes on magnetic resonance imaging and responded to a self-administered questionnaire survey in 2017. We measured SEP in childhood (household SEP at age 15), young adulthood (education), mid-adulthood (the longest occupation), and late adulthood (current wealth), and further performed group-based trajectory analysis to identify lifetime trajectory patterns on SEP. Multivariate regression models were employed to investigate the association between SEP trajectories and four regional brain volumes related to the development of Alzheimer's Disease (AD) (i.e., entorhinal cortex, hippocampus, amygdala, and the parahippocampus), the most common type of dementia. RESULTS: We found three distinct SEP trajectories [stable middle-class (68%), downward (23%), and upward (9%)]. Compared to those who experienced stable middle-class, older adults who experienced the upward SEP mobility had significantly larger hippocampus (ß: 213.2, 95%CI: 14.7, 411.8). On the other hand, older adults who experienced downward SEP mobility showed no significant differences in any of the four brain structural volumes. CONCLUSION: Our findings indicate that upward life-course SEP mobility is associated with larger volumes of hippocampus in old age. SEP trajectory may offer us a useful lens to enhance our understanding of the etiology of dementia.

CDK4/6 signaling attenuates the effect of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors in EGFR-mutant non-small cell lung cancer.

Background: Epidermal growth factor receptor (EGFR) mutations, such as exon 19 deletion and exon 21 L858R, are driver oncogenes of non-small cell lung cancer (NSCLC), with EGFR tyrosine kinase inhibitors (TKIs) being effective against EGFR-mutant NSCLC. However, the efficacy of EGFR-TKIs is transient and eventually leads to acquired resistance. Herein, we focused on the significance of cell cycle factors as a mechanism to attenuate the effect of EGFR-TKIs in EGFR-mutant NSCLC before the emergence of acquired resistance. Methods: Using several EGFR-mutant cell lines, we investigated the significance of cell cycle factors to attenuate the effect of EGFR-TKIs in EGFR-mutant NSCLC. Results: In several EGFR-mutant cell lines, certain cancer cells continued to proliferate without EGFR signaling, and the cell cycle regulator retinoblastoma protein (RB) was not completely dephosphorylated. Further inhibition of phosphorylated RB with cyclin-dependent kinase (CDK) 4/6 inhibitors, combined with the EGFR-TKI osimertinib, enhanced G0/G1 cell cycle accumulation and growth inhibition of the EGFR-mutant NSCLC in both in vitro and in vivo models. Furthermore, residual RB phosphorylation without EGFR signaling was maintained by extracellular signal-regulated kinase (ERK) signaling, and the ERK inhibition pathway showed further RB dephosphorylation. Conclusions: Our study demonstrated that the CDK4/6-RB signal axis, maintained by the MAPK pathway, attenuates the efficacy of EGFR-TKIs in EGFR-mutant NSCLC, and targeting CDK4/6 enhances this efficacy. Thus, combining CDK4/6 inhibitors and EGFR-TKI could be a novel treatment strategy for TKI-naïve EGFR-mutant NSCLC.

Investigation of Age-Associated Cognitive Functional Homophily in Community-Dwelling Older Adults' Confidant Social Networks Using Exponential Random Graph Model.

One of the prominent interventions to tackle loneliness and social isolation in older adults is social facilitation. The present study investigated whether similarities in cognitive functions that are sensitive to age play a role in confidant social networks among older adults. We analyzed the data of 252 community-dwelling older adults in Wakuya City, Miyagi Prefecture, Japan, who responded to a self-administered questionnaire and cognitive health checkups provided by the city in 2017. We performed Exponential Random Graph Model and investigated educational attainment, orientation, word registration, clock drawing, delayed recall, verbal fluency and logical memory homophily while adjusting for density, reciprocity, age, sex living arrangement, presence of disability in instrumental activities of daily living, educational attainment and cognitive impairment status. The probability of a confidant tie with an older adult was significantly reduced by 6% (odds ratio (OR): 0.94, 95% confidence interval (CI): 0.90-0.99) for one score difference in logical memory, and marginally increased by 5% (OR: 1.05; 95% CI: 1.00-1.11) for one score difference in delayed recall. There was no significant association between educational attainment and other age-associated cognitive functional scores. Our findings suggest that similar logical memory functions play a role in strong social network building among community-dwelling older adults in Japan.

Depressive symptoms homophily among community-dwelling older adults in japan: A social networks analysis.

Late-life depression is one of the most common mental illnesses that cause serious consequences, but the majority do not reach out for mental health services and relapses are common. The present study investigated profiled similarity of older adults' social networks in terms of depressive symptoms. In 2017, we distributed questionnaires inquiring about confidants in the community, depressive symptoms based on the 15-item Geriatric Depression Scale (GDS-15), and demographic and functional characteristics to all the community-dwelling older adults under the national insurance system in Wakuya City (Miyagi prefecture, Japan). Applying the Exponential Random Graph Model, we estimated the likelihood of a confidant relational tie by the similarity of overall and specific depressive symptoms within 217,470 potential ties among 660 respondents eligible for analysis. The overall depressive symptom homophily was marginally significant (p < 0.10), indicating that the likelihood of a confidant relational tie between two community-dwelling older adults was decreased by 5%, with one point increase in their difference in the total number of depressive symptoms (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.90-1). Focusing on specific domains of depressive symptoms, we found significant apathy homophily (p < 0.05) but no significant suicidal ideation of homophily. The results indicated that there is a 19% decrease in the likelihood of a confidant relational tie between two community-dwelling older adults by one point increase in their difference in the total number of apathy symptoms (OR, 0.81; 95%CI, 0.67-0.98) but no change by increasing the difference in their total number of suicidal ideation symptoms (OR, 1; 95%CI, 0.87-1.14). These findings suggest depressive symptom homophily, particularly with respect to apathy domains, in confidant social networks of community-dwelling older adults, and the importance of network intervention in preventing late-life depression.

The frequency of job participation and well-being of older people in Japan: Results from JAGES study.

We investigated the association between the frequency of job participation and well-being among older people in Japan, using data from a prospective nation-wide survey, the Japan Gerontological Evaluation Study (JAGES). The frequency of work was classified into "not working," "sometimes or less" (≤3 times/week), and "often or more" (≥4 times/week), and we conducted binary and continuous outcome analyses using logistic or Poisson regression and linear regression. After adjusting for covariates, we have found that participants who worked "often or more" and "sometimes or less" were less likely to display poor subjective health (often or more = odds ratio (OR): 0.55, 95% confidence interval (CI): 0.48 to 0.62; sometimes or less = OR: 0.57, 95% CI: 0.49 to 0.67) and depression (often or more = OR: 0.62, 95% CI: 0.53 to 0.73; sometimes or less = OR: 0.58, 95% CI: 0.47 to 0.71), and more likely to be happy (often or more = prevalence ratio (PR): 1.05, 95% CI: 1.03 to 1.07; sometimes or less = PR: 1.03, 95% CI: 1.00 to 1.05). Linear regression analysis of ordinal discrete outcomes showed similar trends, and furthermore suggested that more work conferred more benefits. The participants who worked "often or more" were less likely to have poor subjective health and were happier than those who worked "sometimes or less" (linear coefficients of -0.04 and 0.15 respectively). Further research is required to investigate possible explanations for the association between frequent job participation and health and well-being at older ages.