Field-free spin-orbit torque switching in ferromagnetic trilayers at sub-ns timescales.

Current-induced spin torques enable the electrical control of the magnetization with low energy consumption. Conventional magnetic random access memory (MRAM) devices rely on spin-transfer torque (STT), this however limits MRAM applications because of the nanoseconds incubation delay and associated endurance issues. A potential alternative to STT is spin-orbit torque (SOT). However, for practical, high-speed SOT devices, it must satisfy three conditions simultaneously, i.e., field-free switching at short current pulses, short incubation delay, and low switching current. Here, we demonstrate field-free SOT switching at sub-ns timescales in a CoFeB/Ti/CoFeB ferromagnetic trilayer, which satisfies all three conditions. In this trilayer, the bottom magnetic layer or its interface generates spin currents with polarizations in both in-plane and out-of-plane components. The in-plane component reduces the incubation time, while the out-of-plane component realizes field-free switching at a low current. Our results offer a field-free SOT solution for energy-efficient scalable MRAM applications.

Genetic specificity study using next-generation sequencing (NGS) of peritoneal metastatic colorectal cancer compared to primary colorectal cancer.

BACKGROUND: In patients with colorectal cancer, peritoneal metastases are the second most frequent metastatic lesion after liver metastases. Peritoneal metastases have a very poor prognosis, with a median survival time of 5-7 months. Currently, there is a lack of research on the genetic differences between primary colorectal cancer and peritoneal metastases. Therefore, we aimed to identify their genetic characteristics through a cancer panel test using next-generation sequencing. OBJECTIVE: We aim to investigate the specificity of genetic variants in primary colorectal cancer and peritoneal metastases. METHODS: We recruited patients with stage I, II, and III primary colorectal cancer and peritoneal metastases for genetic analysis using NGS. Samples were collected from patients who underwent surgery at Dankook University Hospital and consented to genetic testing. NGS was performed using a cancer panel. RESULTS: Among 36 patients with primary cancer, TP53 gene mutation was identified the most in 25 patients (69%), followed by APC gene mutation in 19 patients (53%), and KRAS gene mutation in 17 patients (47%). In the peritoneal metastasis patient group, unlike the primary cancer patient group, KRAS gene mutations were the most common 6 patients (55%), followed by TP53 gene mutations in 4 patients (36%) and PIK3CA gene mutations in 2 patients (18%). CONCLUSION: The small number of surgical cases of peritoneal metastases was a limitation of our sample size. Nevertheless, we identified differences in the alterations of specific genes between primary and peritoneal metastases. Acquiring additional cases and collecting more data will provide deeper insights into these cancers.

Features of optical coherence tomography angiography in age-related macular degeneration with residual fluid after three loading doses of aflibercept.

BACKGROUND: To identify the macular neovascularization (MNV) features in exudative age-related macular degeneration (AMD) patients who exhibited residual fluid after receiving three loading doses of aflibercept. METHODS: Patients were classified into two groups: Group 1, which did not exhibit intraretinal fluid (IRF) and subretinal fluid (SRF), and Group 2, which did exhibit IRF and/or SRF. Optical coherence tomography angiography (OCTA) features were assessed and compared between the groups. RESULTS: A total of 101 eyes were enrolled; 65 for Group 1 and 36 for Group 2. No significant differences were found in baseline MNV size (2.94 ± 2.51 µm2 vs. 2.22 ± 2.26 µm2, P = 0.178) or vessel density (47.1 ± 15.4 % vs. 41.3 ± 10.5%, P = 0.052) between Groups 1 and 2. There were significant differences in the presence of loops (52.3% vs. 75%, P = 0.026) and peripheral arcades (29.2% vs. 55.6%, P < 0.001) at baseline between the two groups. In Group 1, there was a significant reduction in the presence of branching (P < 0.001) and loops (P = 0.016) after treatment. In Group 2, only the presence of branching decreased significantly (P < 0.001) after treatment. Multivariable analysis revealed that the presence of a peripheral arcade (B = 4.77, P = 0.001) was significantly associated with residual fluid. CONCLUSIONS: Although responding to treatment, the presence of loops and peripheral arcades in exudative AMD patients may contribute to residual fluid following the three loading doses of aflibercept. The peripheral arcade, in particular, may play a more significant role in the presence of residual fluid.

Enhancing Industrial Communication with Ethernet/Internet Protocol: A Study and Analysis of Real-Time Cooperative Robot Communication and Automation via Transmission Control Protocol/Internet Protocol.

This study explores the important task of validating data exchange between a control box, a Programmable Logic Controller (PLC), and a robot in an industrial setting. To achieve this, we adopt a unique approach utilizing both a virtual PLC simulator and an actual PLC device. We introduce an innovative industrial communication module to facilitate the efficient collection and storage of data among these interconnected entities. The main aim of this inquiry is to examine the implementation of Ethernet/IP (EIP), a relatively new addition to the industrial network scenery. It was designed using ODVA's Common Industrial Protocol (CIP™). The Costumed real-time data communication module was programmed in C++ for the Linux Debian platform and elegantly demonstrates the impressive versatility of EIP as a means for effective data transfer in an industrial environment. The study's findings provide valuable insights into Ethernet/IP's functionalities and capabilities in industrial networks, bringing attention to its possible applications in industrial robotics. By connecting theoretical knowledge and practical implementation, this research makes a significant contribution to the continued development of industrial communication systems, ultimately improving the efficiency and effectiveness of automation processes.

A scalable second order optimizer with an adaptive trust region for neural networks.

We introduce Tadam (Trust region ADAptive Moment estimation), a new optimizer based on the trust region of the second-order approximation of the loss using the Fisher information matrix. Despite the enhanced gradient estimations offered by second-order approximations, their practical implementation requires sizable batch sizes to estimate the second-order approximation matrices and perform matrix inversions. Consequently, integrating second-order approximations entails additional memory consumption and imposes substantial computational demands due to the inversion of large matrices. In light of these challenges, we have devised a second-order approximation algorithm that mitigates these issues by judiciously approximating the pertinent large matrix, requiring only a marginal increase in memory usage while minimizing the computational burden. Tadam approximates the loss up to the second order using the Fisher information matrix. Since estimating the Fisher information matrix is expensive in both memory and time, Tadam approximates the Fisher information matrix and reduces the computational burdens to the O(N) level. Furthermore, Tadam employs an adaptive trust region scheme to reduce approximate errors and guarantee stability. Tadam evaluates how well it minimizes the loss function and uses this information to adjust the trust region dynamically. In addition, Tadam adjusts the learning rate internally, even if we provide the learning rate as a fixed constant. We run several experiments to measure Tadam's performance against Adam, AMSGrad, Radam, and Nadam, which have the same space and time complexity as Tadam. The test results show that Tadam outperforms the benchmarks and finds reasonable solutions fast and stably.

CHARACTERISTICS OF THE MACULAR MICROVASCULATURE IN IDIOPATHIC EPIRETINAL MEMBRANE PATIENTS WITH AN ECTOPIC INNER FOVEAL LAYER.

PURPOSE: To identify the characteristics of the retinal microvasculature in epiretinal membrane patients with ectopic inner foveal layer (EIFL). METHODS: Patients were classified into two groups: those without EIFL (Group 1) and those with EIFL (Group 2). The vessel density (VD), perfusion density (PD), and the foveal avascular zone (FAZ) parameters were compared using optical coherence tomography angiography. Linear regression analysis was performed to identify the optical coherence tomography angiography parameters associated with best-corrected visual acuity. RESULTS: The VD of the central area in Group 1 and Group 2 was 11.6 ± 3.3 and 17.2 ± 2.8 mm -1 , respectively ( P < 0.001), the PD of the central area was 21.7 ± 6.2 and 32.0 ± 5.5%, respectively ( P < 0.001), and the FAZ area was 0.24 ± 0.11 and 0.09 ± 0.08 mm 2 , respectively ( P < 0.001). Based on the linear regression analysis, the VD of the central area (B = 0.018, P = 0.003), the PD of the central area (B = 0.009, P = 0.004), and FAZ area (B = -0.489, P = 0.013) were significantly associated with best-corrected visual acuity in patients with epiretinal membrane. CONCLUSION: The VD and PD of the foveal area were significantly higher in patients with EIFL, and the FAZ area was lower in patients with EIFL than in those without EIFL. In addition, the VD and PD of the foveal area were negatively associated with best-corrected visual acuity, and the FAZ area was positively associated with best-corrected visual acuity in patients with epiretinal membrane.

Impact of high myopia on inner retinal layer thickness in type 2 diabetes patients.

To investigate the impact of the combination of type 2 diabetes (DM) and high myopia on inner retinal layer thickness of the macular area. The patients were divided into four groups: control (group 1), patients with DM without high myopia (group 2), patients with high myopia without DM (group 3), and patients with DM and high myopia (group 4). Ganglion cell complex (GCC) thickness was compared among the groups. Linear regression analysis was performed to identify factors associated with GCC thickness. A total of 194 eyes were enrolled: 59 in group 1, 52 in group 2, 49 in group 3, and 34 in group 4. The average parafovea GCC thicknesses were 113.9 ± 10.4, 112.4 ± 11.2, 112.2 ± 7.8, and 102.6 ± 15.1 µm (P < 0.001), and the average perifovea GCC thicknesses were 104.8 ± 13.2, 103.5 ± 10.8, 103.6 ± 8.8, and 93.9 ± 15.5 µm in groups 1, 2, 3 and 4, respectively (P = 0.001). In multivariate analyses, age (ß = - 0.20, P = 0.007), DM duration (ß = - 0.34, P = 0.023), and axial length (ß = - 1.64, P < 0.001) were significantly associated with parafoveal GCC thickness. The GCC was significantly thinner when high myopia and DM were combined, compared to either condition alone. Additionally, age, DM duration, and axial length were significant factors associated with GCC thickness. The combination of mechanical stretching and neurodegeneration would accelerate neural damage to the retina, resulting in greater inner retinal layer thinning.

Reproducibility of each retinal layer thickness measurement in epiretinal membrane patients with ectopic inner foveal layers.

BACKGROUND: To identify the reliability of each retinal layer thickness measurement in epiretinal membrane (ERM) patients with ectopic inner foveal layers (EIFLs). METHODS: Subjects were divided into two groups: ERM patients with EIFLs (Group 1) and without EIFLs (Group 2). The retinal layer thickness was measured twice, and intraclass correlation coefficient (ICC) and coefficient of variation (CV) values were calculated. RESULTS: In Group 1, the CVs of the nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL) were 22.39%, 13.12%, 13.37%, 13.21%, 15.09%, and 11.94%, while the ICCs were 0.431, 0.550, 0.440, 0.286, 0.279, and 0.503, respectively. In Group 2, the CVs were 18.20%, 10.59%, 10.65%, 13.27%, 14.75%, and 10.37%, while the ICCs were 0.788, 0.834, 0.830, 0.715, 0.226, and 0.439, respectively. The average central macular thickness (CMT) was significantly correlated with the CVs of NFL (coefficient = 0.317; P < 0.001), GCL (coefficient = 0.328; P < 0.001), and IPL (coefficient = 0.186; P = 0.042) in Group 1. CONCLUSIONS: The reproducibility of the inner retinal layer thickness measurements in ERM patients with EIFLs was low compared to those without EIFLs. The reproducibility of the outer retinal layer thickness measurements, including OPL and ONL, was poor regardless of the presence of EIFLs in ERM patients. Additionally, the thicker the CMT in patients with EIFLs, the lower the reproducibility of the inner retinal layer thickness measurements.

Multiscale Architectured Membranes, Electrodes, and Transport Layers for Next-Generation Polymer Electrolyte Membrane Fuel Cells.

Over the past few decades, considerable advances have been achieved in polymer electrolyte membrane fuel cells (PEMFCs) based on the development of material technology. Recently, an emerging multiscale architecturing technology covering nanometer, micrometer, and millimeter scales has been regarded as an alternative strategy to overcome the hindrance to achieving high-performance and reliable PEMFCs. This review summarizes the recent progress in the key components of PEMFCs based on a novel architecture strategy. In the first section, diverse architectural methods for patterning the membrane surface with random, single-scale, and multiscale structures as well as their efficacy for improving catalyst utilization, charge transport, and water management are discussed. In the subsequent section, the electrode structures designed with 1D and 3D multiscale structures to enable low Pt usage, improve oxygen transport, and achieve high electrode durability are elucidated. Finally, recent advances in the architectured transport layer for improving mass transportation including pore gradient, perforation, and patterned wettability for gas diffusion layer and 3D structured/engineered flow fields are described.

CHARACTERISTICS OF AGE-RELATED MACULAR DEGENERATION SHOWING A POOR RESPONSE TO THREE LOADING DOSES OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR.

PURPOSE: To analyze the clinical features of refractory age-related macular degeneration patients associated with the response to three consecutive loading doses of anti-vascular endothelial growth factor. METHODS: A retrospective chart review was performed on typical exudative age-related macular degeneration patients treated by three consecutive anti-vascular endothelial growth factor injections. The patients were divided into a group without residual fluid on optical coherence tomography images (Group 1) and a group with residual fluid (Group 2). We analyzed qualitative and quantitative morphologic features of optical coherence tomography and optical coherence tomography angiography. We performed univariate and multivariate logistic regression analyses to identify factors associated with the treatment response. RESULTS: We enrolled a total of 90 patients (Group 1: n = 60, Group 2: n = 30). Under optical coherence tomography, the choroidal thickness differed significantly between groups 1 and 2 (246.60 ± 67.67 vs. 286.90 ± 40.92 µ m, P = 0.001). Under optical coherence tomography angiography, the presence of branching (48.3% vs. 73.3%, P = 0.024), loops (31.7% vs. 66.7%, P = 0.002), and a peripheral arcade (40.0% vs. 76.7%, P = 0.001) differed significantly. Logistic regression analysis showed that the initial CT (B = 0.012; P = 0.007), presence of loops (B = 1.289; P = 0.015), and peripheral arcade (B = 1.483; P = 0.008) significantly affected the anti-vascular endothelial growth factor treatment response. CONCLUSION: A thicker choroid and the presence of loops and a peripheral arcade were significantly associated with a poorer response to three loading anti-vascular endothelial growth factor injections in typical exudative age-related macular degeneration patients.

Retinal microvasculature and choriocapillaris impairments according to the stage of dry age-related macular degeneration.

BACKGROUND: We aimed to analyse the retinal microvasculature and choriocapillaris according to the dry age-related macular degeneration (AMD) stage and to identify factors associated with their microvasculatures. METHODS: Patients were divided into four groups: normal controls, early, intermediate and advanced AMD groups. The vessel density (VD) of superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris was compared using optical coherence tomography angiography among the groups. Linear regression analysis was performed to identify factors associated with the VD. RESULTS: The VDs of the SCP were 22.1 ± 5.7, 19.1 ± 5.4, 18.0 ± 6.4 and 12.2 ± 6.4% (p < 0.001); the VDs of the DCP were 22.4 ± 4.5, 20.7 ± 4.3, 18.1 ± 5.3 and 14.6 ± 5.8% (p < 0.001); the VDs of the choriocapillaris were 29.4 ± 3.7, 26.4 ± 4.8, 24.5 ± 4.9 and 24.2 ± 3.7% (p < 0.001) in the control, early, intermediate, and advanced groups, respectively. AMD stage and age were significantly associated with the VDs of all layers, and the VDs of the SCP and DCP were associated with visual acuity (both p < 0.001). Additionally, hypertension was associated with the VDs of the DCP (p = 0.027) and choriocapillaris (p = 0.024). CONCLUSIONS: The retinal microvasculature and choriocapillaris tended to become more impaired as the AMD stage progressed. Age was significantly associated with the microvasculature impairments of all layers, and hypertension was significantly associated with impairments of the DCP microvasculature and choriocapillaris.

Peritoneal metastatic mixed adenoneuroendocrine carcinoma treated with cytoreduction surgery and hyperthermic intraperitoneal chemotherapy: a case report.

A 61-year-old man presented with abdominal distension without any symptoms. On colonoscopy and computed tomography findings, it was clinically diagnosed as peritoneal metastasis of sigmoid colon cancer, and diagnostic laparoscopy was performed. Only the peritoneum was partially resected, and the pathology was signet ring cell carcinoma with predominantly local mucinous carcinoma component. However, the patient complained of persistent symptoms and, despite the progress of chemotherapy, the peritoneal dissemination worsened, and additional cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) was performed. Mixed adenoneuroendocrine carcinomas (MANECs) were reported in the appendix with perforated visceral peritoneum. After additional chemotherapy, the patient was discharged. Patients with advanced MANEC with peritoneal spreading may benefit from aggressive treatment by cytoreduction surgery with HIPEC, followed by intravenous chemotherapy.

Comparison of retinal layer thickness and microvasculature changes in patients with diabetic retinopathy treated with intravitreous bevacizumab vs panretinal photocoagulation.

To compare changes in retinal layers and microvasculature in diabetic retinopathy (DR) patients after bevacizumab therapy and panretinal photocoagulation (PRP). This prospective study divided patients into two groups: patients treated with bevacizumab and those treated with PRP. Patients visited our retinal clinic at 1, 3, and 6 months after treatment. Retinal layer thickness and vessel density (VD) using optical coherence tomography angiography were analyzed. 37 eyes in the bevacizumab group and 36 eyes in the PRP group were enrolled. In the bevacizumab group, the parafoveal RNFL, GCL, and IPL thicknesses significantly decreased (P < 0.001, P = 0.013, and P = 0.017, respectively), whereas the thicknesses in the PRP group showed an increasing tendency over time (P = 0.087, P = 0.005, and P = 0.003, respectively). The VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the bevacizumab group did not show significant changes, whereas the VD in the PRP group significantly increased over time (both P < 0.001). Additionally, RNFL (P = 0.001) and GCL thicknesses (P = 0.035) were significant factors affecting changes in BCVA, whereas the VDs of SCP and DCP did not. Patients who received bevacizumab therapy did not show a significant change in macular VD, whereas the VD of patients after PRP significantly increased after treatment. The increased macular VD in patients after PRP would be associated with the increased inner retinal layer thickness after treatment, which was significantly related to the impairment in visual acuity.

Measurement of Human Walking Movements by Using a Mobile Health App: Motion Sensor Data Analysis.

BACKGROUND: This study presents a new approach to measure and analyze the walking balance of humans by collecting motion sensor data in a smartphone. OBJECTIVE: We aimed to develop a mobile health (mHealth) app that can measure the walking movements of human individuals and analyze the differences in the walking movements of different individuals based on their health conditions. A smartphone's motion sensors were used to measure the walking movements and analyze the rotation matrix data by calculating the variation of each xyz rotation, which shows the variables in walking-related movement data over time. METHODS: Data were collected from 3 participants, that is, 2 healthy individuals (1 female and 1 male) and 1 male with back pain. The participant with back pain injured his back during strenuous exercise but he did not have any issues in walking. The participants wore the smartphone in the middle of their waistline (as the center of gravity) while walking. They were instructed to walk straight at their own pace in an indoor hallway of a building. The walked a distance of approximately 400 feet. They walked for 2-3 minutes in a straight line and then returned to the starting location. A rotation vector in the smartphone, calculated by the rotation matrix, was used to measure the pitch, roll, and yaw angles of the human body while walking. Each xyz-rotation vector datum was recalculated to find the variation in each participant's walking movement. RESULTS: The male participant with back pain showed a diminished level of walking balance with a wider range of xyz-axis variations in the rotations compared to those of the healthy participants. The standard deviation in the xyz-axis of the male participant with back pain was larger than that of the healthy male participant. Moreover, the participant with back pain had the widest combined range of right-to-left and forward-to-backward motions. The healthy male participant showed smaller standard deviation while walking than the male participant with back pain and the female healthy participant, indicating that the healthy male participant had a well-balanced walking movement. The walking movement of the female healthy participant showed symmetry in the left-to-right (x-axis) and up-to-down (y-axis) motions in the x-y variations of rotation vectors, indicating that she had lesser bias in gait than the others. CONCLUSIONS: This study shows that our mHealth app based on smartphone sensors and rotation vectors can measure the variations in the walking movements of different individuals. Further studies are needed to measure and compare walking movements by age, gender, as well as types of health problems or disease. This app can help in finding differences in gait in people with diseases that affect gait.

Development of a High-Density Piezoelectric Micromachined Ultrasonic Transducer Array Based on Patterned Aluminum Nitride Thin Film.

This study presents the fabrication and characterization of a piezoelectric micromachined ultrasonic transducer (pMUT; radius: 40 µm) using a patterned aluminum nitride (AlN) thin film as the active piezoelectric material. A 20 × 20 array of pMUTs using a 1 µm thick AlN thin film was designed and fabricated on a 2 × 2 mm2 footprint for a high fill factor. Based on the electrical impedance and phase of the pMUT array, the electromechanical coefficient was ~1.7% at the average resonant frequency of 2.82 MHz in air. Dynamic displacement of the pMUT surface was characterized by scanning laser Doppler vibrometry. The pressure output while immersed in water was 19.79 kPa when calculated based on the peak displacement at the resonant frequency. The proposed AlN pMUT array has potential applications in biomedical sensing for healthcare, medical imaging, and biometrics.

Psychological and Environmental Correlates of Moderate-to-Vigorous Physical Activity and Step Counts Among Older Adults With Cognitive Decline.

Promoting physical activity (PA) among older adults with cognitive decline is important for maintaining and improving their health. Identifying psychological and environmental PA correlates in this population can help develop effective strategies for PA promotion. Since past findings with healthy older adults may not generalize to those with cognitive decline, this study offers data on how self-efficacy, self-regulation, and social-environmental factors were associated with PA among a group of older adults with cognitive decline. We report secondary analysis of baseline data from a randomized control study of 262 older participants (M = 76.2 years) who showed a decline in global cognitive function as defined by Mini-Mental State Examination scores between 21 and 24. The participants' PA was measured by an accelerometer, and participants completed questionnaires measuring self-efficacy, self-regulation, social support, social network, and demographic variables. In this study, we evaluated the participants' neighborhood environment with a geographic information system and found through stepwise multiple regression analyses that self-efficacy, gender, and age were associated with PA variables, while self-regulation and environmental factors were not. Thus, perceived self-efficacy was an important psychological correlate of PA in this group of older adults with cognitive decline. PA promotion interventions for this population should attend to self-efficacy, gender, and age.

Environmental predictors of objectively measured out-of-home time among older adults with cognitive decline.

BACKGROUND: Older adults with cognitive decline are vulnerable to various health problems. Going out of home for longer time could be beneficial for their health. Identifying modifiable predictors is essential for developing effective strategies that would increase time spent out-of-home by older adults. This study examined social and physical environmental predictors of objectively measured out-of-home time spent among older adults with cognitive decline. METHODS: This study was a secondary analysis of a randomized controlled trial (n = 147). Out-of-home time per day was measured by a Global Positioning System at baseline and 1-year follow-up. Baseline data of social environment (living alone, social network [Japanese version of the Lubben Social Network Scale]), objective physical environment (road network distance from each home address to nearest supermarket store, convenience store, and public transportation), and demographic factors (gender, age, education, driving status, fear of falling) were examined as potential predictors. RESULTS: After adjusting main effects of allocation group, time of measures, and their interactive effect, a mixed model showed that younger age (p = 0.044), current driving status (p = 0.039), and stronger social network (p = 0.003) were predictors of out-of-home time. However, none of the physical environmental factors significantly predicted outdoor time. CONCLUSIONS: The present study found that social network was a predictor of objectively measured out-of-home time among older adults with global cognitive decline. A sufficient social network might help increase out-of-home time among them. However, the influence of physical environment on out-of-home time might be small.

The effect of a multicomponent intervention to promote community activity on cognitive function in older adults with mild cognitive impairment: A randomized controlled trial.

OBJECTIVES: This study aimed to examine the effectiveness of a multicomponent intervention combining physical, cognitive, and social activities developed to promote community activity in improving cognitive function in older adults with mild cognitive impairment (MCI). DESIGN: Single-blind randomized controlled trial. SETTING: A total of 83 Japanese older adults with MCI participated in the study from April to September 2017. INTERVENTIONS: Participants were randomly assigned to either the multicomponent intervention group (n = 41), attending 90-minute physical, cognitive, or social activity sessions using community resources twice weekly, or the health education control group (n = 42). OUTCOMES: The primary outcomes were cognitive functions, and the secondary outcomes were grip strength, walking speed, depressive symptoms, physical activities, number of outdoor activities, and conversation time. RESULTS: Analysis using linear mixed models revealed significantly greater improvements in the intervention group in spatial working memory (p = 0.024) following intervention compared with the control group. Time spent in moderate-to-vigorous physical activity (p = 0.048) and step count (p = 0.059) decreased from the baseline post-intervention in the control group, whereas the baseline was maintained in the intervention group. No significant between-group differences were found post-intervention in the other primary and secondary outcomes. CONCLUSIONS: This study showed that a 24-week multicomponent intervention program was effective in improving spatial working memory and maintaining physical activity in older adults with MCI. A follow-up investigation is required to determine whether continuation of physical, cognitive, and social activity can prevent dementia or reverse MCI in older adults.

Daily Physical Activity and Functional Disability Incidence in Community-Dwelling Older Adults with Chronic Pain: A Prospective Cohort Study.

OBJECTIVE: This study examined the association between daily physical activity and functional disability incidence in community-dwelling older adults with chronic pain. DESIGN: Prospective cohort study. SETTING: Japanese community. SUBJECTS: Of the 5,257 participants enrolled for baseline assessment, data on the 693 participants who had chronic lower back or knee pain and underwent daily physical activity assessment using an accelerometer were analyzed. METHODS: Participants were assessed for regular physical activity (step counts, moderate- to vigorous-intensity physical activity duration, and light-intensity physical activity duration) using an accelerometer at baseline and were followed up for monthly functional disability incidence, based on the national long-term care insurance system, for approximately two years. We determined the effect of physical activity cutoff points on functional disability incidence using receiver operating characteristic curves and Youden index. Cox proportional hazards regression models were used to analyze associations between the cutoff points and disability incidence. RESULTS: Among the 693 participants with chronic pain, 69 (10.0%) developed functional disability during the follow-up period. Participants with lower physical activity levels showed significantly higher risk of disability. After adjusting for all covariates, functional disability was associated with step counts (hazard ratio [HR] = 1.79, 95% confidence interval [CI] = 1.02-3.14) and moderate- to vigorous-intensity physical activity duration (HR = 2.02, 95% CI = 1.16-3.51) but had no relationship with light-intensity physical activity duration (HR = 1.72, 95% CI = 0.97-3.05). CONCLUSIONS: Maintenance of physical activity with at least moderate intensity may be effective in preventing disability even among older adults with chronic pain.