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Nanostructure control is of fundamental and technological importance because various properties such as vortex pinning in superconductors are determined by the nanostructure. While the nanostructure in superconducting oxides is well controlled, the nanostructure control of iron-based superconductors is required. The nanostructure has not yet been well controlled even in Fe(Te,Se) with the simplest structure among Fe-based superconductors because the anion may be non-stoichiometric and anionic substitution is possible. In this study, we observed the compositional inhomogeneity originating from phase separation in Fe(Te,Se) films, which were prepared by pulsed laser deposition. The films deposited at lower temperature do not show nanoscale compositional inhomogeneity. On the other hand, the high-temperature deposited films contain an inhomogeneous anion distribution with the size of ∼8 nm due to phase separation. The spacing of the compositional inhomogeneity is ∼16 nm. This structure obtained by phase separation is expected to be an effective pinning center in high magnetic fields after further optimization. Thus, the method of nanostructure control other than nanocomposite formation in oxides is demonstrated for Fe(Te,Se). [ABSTRACT FROM AUTHOR]

Background/Objectives: Chronic kidney disease (CKD) and anemia are independent prognostic factors for heart failure. In recent years, hypoxia-inducible factor-prolyl hydroxylase (HIF-PH) inhibitors have become available for the treatment of renal anemia. This prospective randomized controlled study aimed to investigate the effects of switching from a continuous erythropoietin receptor activator (CERA) to one of four HIF-PH inhibitors in patients with chronic heart failure and renal anemia. Methods: Forty patients were randomized by the envelop method to receive treatment with roxadustat, daprodustat, vadadustat, or molidustat. The primary endpoint was the change in the hemoglobin (Hb) level. Secondary endpoints included changes in erythropoietin, changes in free T3, free T4, and thyroid-stimulating hormone (TSH), adverse effects, and drug dose increases and decreases. This study was preregistered in the University Hospital Medical Information Network Clinical Trials Registry (study ID: UMIN000041651). Results: We found no statistically significant difference between Hb levels with HIF-PH inhibitors and CERA, but at month 6, the Hb level was significantly higher with roxadustat than with vadadustat and daprodustat. Erythropoietin decreased significantly after switching to HIF-PH inhibitors. HIF-PH inhibitors had various significant effects on free T3, free T4, and TSH. No adverse events occurred. The doses of some drugs had to be increased or decreased. Conclusions: In patients with heart failure and renal anemia receiving CERA, Hb, NT-ProBNP, and renal function were similar after switching from CERA to HIF-PH inhibitors. The individual HIF-PH inhibitors appear to have different effects on anemia and thyroid function. However, because this was a single-center study with a limited sample size, the efficacy and potential limitations of HIF-PH inhibitors need to be further clarified. [ABSTRACT FROM AUTHOR]

Key Clinical Message: A woman with a single coronary artery underwent aortic valve replacement due to aortic stenosis. Two years later, she developed an aortic annular abscess around the right coronary cusp and non‐coronary cusp. Significant adhesions to the right coronary artery (RCA) resulted from the abscess, making artery separation challenging, and raising concerns about potential future RCA stenosis. The patient subsequently underwent aortic root replacement and coronary artery bypass grafting. Utilizing a freestyle valve and a saphenous vein graft for the RCA. Following the procedure, the patient was discharged and has remained symptom‐free without any recurrence of infection for 2 years. [ABSTRACT FROM AUTHOR]

Introduction: Frailty is a crucial health issue among older adults. Growth differentiation factor 15 (GDF15) is associated with inflammation, oxidative stress, insulin resistance, and mitochondrial dysfunction, which are possible pathogeneses of frailty. However, few longitudinal studies have investigated the association between GDF15 and the incidence of frailty. Therefore, we investigated whether high serum GDF15 levels are associated with the incidence of frailty. Methods: A total of 175 older adults (mean age: 77 ± 6 years; 63% women) with cardiometabolic diseases and no frailty out of the two criteria at baseline participated. Individuals with severe renal impairment or severe cognitive impairment were excluded. Serum GDF15 levels were measured at baseline. Patients were asked to assess frailty status at baseline and annually during follow-up using the modified version of the Cardiovascular Health Study (mCHS) and the Kihon Checklist (KCL). We examined the association between GDF15 tertiles and each frailty measure during follow-up (median 38–39 months). In the multivariate Cox regression analysis, with the GDF15 tertile groups as the explanatory variables, hazard ratios (HRs) and 95% confidence intervals (CIs) for incident frailty were calculated after adjusting for covariates and using the lowest tertile group as the reference. Results: During the follow-up period, 25.6% and 34.0% of patients developed frailty, as defined by the mCHS and KCL, respectively. The highest GDF15 tertile group had a significantly higher incidence of mCHS- or KCL-defined frailty than the lowest GDF15 tertile group. Multivariate Cox regression analysis revealed that the adjusted HRs for incident mCHS- and KCL-defined frailty in the highest GDF15 tertile group were 3.9 (95% CI: 1.3–12.0) and 2.7 (95% CI: 1.1–6.9), respectively. Conclusion: High serum GDF15 levels predicted the incidence of frailty among older adults with cardiometabolic diseases and could be an effective marker of the risk for frailty in interventions aimed at preventing frailty, such as exercise and nutrition. [ABSTRACT FROM AUTHOR]

Impella (Abiomed Inc., Danvers, MA, USA) assisted off-pump coronary artery bypass has been increasingly reported in recent years. However, there have been no reports of the procedures performed for acute myocardial infarction in which the patient is hemodynamically unstable. We report a case of a 73-year-old man with cardiogenic shock due to extensive ST elevation acute myocardial infarction that worsened despite Impella CP® support. Because of the fragile myocardium in the acute phase of myocardial infarction, Impella assisted off-pump coronary artery bypass graft causes a high risk of myocardial injury, but we were able to safely perform the procedure by ingenious techniques. When performing Impella-assisted off-pump coronary artery bypass for extensive acute myocardial infarction patients, the high risk of mechanical complications due to myocardial fragility must be considered. The position of Impella should be carefully monitored intraoperatively, and elevation of cardiac apex should be kept to a minimum to prevent myocardial damage caused by Impella. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is an epidemiological risk factor for dementia and has been implicated in multifactorial pathologies, including neuroinflammation. In the present study, we aimed to elucidate the potential anti-inflammatory effects of imeglimin, a novel antidiabetic agent, on high-glucose (HG)-stimulated microglia. Mouse microglial BV2 cells were stimulated with HG in the presence or absence of imeglimin. We examined the effects of imeglimin on the levels of proinflammatory cytokines, intracellular reactive oxygen species (ROS), mitochondrial integrity, and components related to the inflammasome or autophagy pathways in these cells. Our results showed that imeglimin suppressed the HG-induced production of interleukin-1beta (IL-1β) by reducing the intracellular ROS levels, ameliorating mitochondrial dysfunction, and inhibiting the activation of the thioredoxin-interacting protein (TXNIP)–NOD-like receptor family pyrin domain containing 3 (NLRP3) axis. Moreover, the inhibitory effects of imeglimin on the TXNIP–NLRP3 axis depended on the imeglimin-induced activation of ULK1, which also exhibited novel anti-inflammatory effects without autophagy induction. These findings suggest that imeglimin exerted novel suppressive effects on HG-stimulated microglia through the ULK1–TXNIP–NLRP3 axis, and may, thereby, contribute to the development of innovative strategies to prevent T2DM-associated cognitive impairment. [ABSTRACT FROM AUTHOR]

This article discusses the emergence of Mpox (monkeypox) as an emerging viral disease that has spread beyond Africa since May 2022. The first case in Japan was reported in July 2022, and the peak of the outbreak in Japan was observed between January and May 2023. Mpox is mainly transmitted through sexual contact, particularly among men who have sex with men (MSM). The clinical presentation of Mpox varies widely and can be easily mistaken for other sexually transmitted infections (STIs). This study aimed to screen for overlooked cases of Mpox in patients with suspected syphilis in Japan. The study found one case of Mpox that was initially missed, highlighting the need for increased awareness and timely diagnosis of Mpox. Saliva was found to be a useful sample for retrospective screening, and future outbreaks of Mpox could benefit from its use. The study acknowledges the limitations of its small sample size and suggests that additional specimens from different sites could detect more overlooked cases. [Extracted from the article]

Key Clinical Message: Some cases of left ventricular pseudoaneurysms (LVPAs) are asymptomatic. While cardiac magnetic resonance imaging is important, a chest x‐ray can easily be performed and is also crucial for the detection of LVPA during the first outpatient visit. [ABSTRACT FROM AUTHOR]

Transcatheter aortic valve implantation (TAVI) for patients with aortic stenosis is a less invasive alternative to surgical aortic valve replacement. Despite this, careful anesthetic management, especially strict control of blood pressure and fluid management, is necessary. During TAVI, normalization of left ventricular afterload due to aortic balloon valvuloplasty and prosthetic valve deployment is expected to result in rapid improvement of systolic function and consequent improvement in diastolic function. However, the early effect of TAVI on left ventricular diastolic function is less clear. We hypothesized that TAVI induces a rapid decrease in left ventricular end-diastolic pressure (LVEDP) after valve deployment. This retrospective observational study included 71 patients who had undergone TAVI using the transfemoral approach with a balloon-expandable valve under general anesthesia. Intraoperative LVEDP was measured using an intracardiac catheter. The severity of residual aortic regurgitation (AR) was assessed using the Sellers criteria. The mean (SD) LVEDP was 17.8 (5.3) mmHg just before TAVI and increased significantly to 27.3 (8.2) mmHg immediately after prosthetic valve deployment (p < 0.0001). The change in LVEDP was 8.7 (8.6) mmHg in patients with low residual AR (Sellers [less than or equal to]1) and 11.0 (7.1) mmHg in those with high residual AR (Sellers [greater than or equal to]2); however, this difference was not significant. No correlation was found between the LVEDP change and intraoperative fluid balance. In conclusion, LVEDP increased significantly in the early period after valve deployment during TAVI, regardless of residual AR severity. It was suggested that the tolerability of fluid load could be reduced at that time., Author(s): Kosaku Toyota[sup.1] , Takashi Ota[sup.1] , Katsutoshi Nagamine[sup.1] , Yasuhiro Koide[sup.1] , Takeshi Nomura[sup.2] , Futoshi Yamanaka[sup.3] , Koki Shishido[sup.3] , Masashi Tanaka[sup.4] , Shigeru Saito[sup.3] Author Affiliations: (1) [...]