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Cloning of murine glycosyl phosphatidylinositol anchor attachment protein, GPAA1. Am J Physiol Cell Physiol 279: C205-C212, 2000.--Glycosyl phosphatidylinositols (GPIs) are used to anchor many proteins to the cell surface membrane and are utilized in all eukaryotic cells. GPI anchoring units are attached to proteins via a transamidase reaction mediated by a GPI transamidase complex. We isolated one of the components of this complex, mGPAA1 (murine GPI anchor attachment), by the signal sequence trap method. mGPAA1 cDNA is about 2 kb in length and encodes a putative 621 amino acid protein. The mGPAA1 gene has 12 small exons and 11 small introns, mGPAA1 mRNA is ubiquitously expressed in mammalian cells, and in situ hybridization analysis revealed that it is abundant in the choroid plexus, skeletal muscle, osteoblasts of rib, and occipital bone in mouse embryos. Its expression levels and transamidation efficiency decreased with differentiation of embryonic stem cells. The 3T3 cell lines expressing antisense mGPAA1 failed to express GPI-anchored proteins on the cell surface membrane. GPAA1; GAA1; glycosyl phosphatidylinositol; anchor; transamidase

The effect on pregnant rats of individual amino acids added excessively to the diet or intermittently administered in excess directly with a stomach tube was examined. When methionine was excessively added to the diet at a 5% level, amino acid imbalance in plasma was induced and food intake decreased remarkably to approximately one-fifth of that of control rats. However, when administered directly into the stomach, food intake remained almost normal, except for excess of methionine, tryptophan or threonine, and an adverse effect of excess amino acid was not observed. However, in the case of a decrease in food intake, various adverse effects were observed. This was especially so for the group that was administered methionine and whose food intake was far below that of the control group: decrease in maternal body weight, delayed growth of products of conception, and further, significant decrease in brain and liver cells of the fetus were observed. In addition, the changes in nitrogen balance were well correlated with the changes in bodyweight in all groups. In the methionine group, in particular, nitrogen balance was negative throughout the period because of a decrease in food intake, and utilization of dietary nitrogen was inferior. The majority of the various lesions observed with excess administration of individual amino acids were not due to a direct effect of excess amino acid but were mainly caused by the remarkable decrease in food intake. [ABSTRACT FROM AUTHOR]

We propose HaptoFloater, a low-latency mid-air visuo-haptic augmented reality (VHAR) system that utilizes imperceptible color vibrations. When adding tactile stimuli to the visual information of a mid-air image, the user should not perceive the latency between the tactile and visual information. However, conventional tactile presentation methods for mid-air images, based on camera-detected fingertip positioning, introduce latency due to image processing and communication. To mitigate this latency, we use a color vibration technique; humans cannot perceive the vibration when the display alternates between two different color stimuli at a frequency of 25 Hz or higher. In our system, we embed this imperceptible color vibration into the mid-air image formed by a micromirror array plate, and a photodiode on the fingertip device directly detects this color vibration to provide tactile stimulation. Thus, our system allows for the tactile perception of multiple patterns on a mid-air image in 59.5 ms. In addition, we evaluate the visual-haptic delay tolerance on a mid-air display using our VHAR system and a tactile actuator with a single pattern and faster response time. The results of our user study indicate a visual-haptic delay tolerance of 110.6 ms, which is considerably larger than the latency associated with systems using multiple tactile patterns.

Aim: Estrogen exerts beneficial cardiovascular effects by binding to specific receptors on various cells to activate nuclear and non-nuclear actions. Estrogen receptor α (ERα) non-nuclear signaling confers protection against heart failure remodeling, involving myocardial cyclic guanosine monophosphate (cGMP) - cGMP-dependent protein kinase G (PKG) activation; however, its tissue-specific role remains elusive. Herein, we examined the cell type-specific role of ERα non-nuclear signaling in estrogen-conferred protection against heart failure., Methods and Results: We first assessed the tissue-specific impacts of ERα in estrogen's cardiac benefits, utilizing endothelial ERα deletion (ERαf/f/Tie2Cre+) and myocyte ERα deletion (ERαf/f/αMHCCre+) female mice. Female mice were ovariectomized and the effect of estradiol (E2) was assessed in hearts exposed to 3week pressure-overload (TAC). E2 failed to improve cardiac function in ERαf/f/Tie2Cre+ TAC hearts but provided benefits in ERαf/f/αMHCCre+ TAC hearts, indicating that endothelial ERα is essential. We next assessed the role of non-nuclear signaling in endothelial cells, employing animals with endothelial-specific inactivation of ERα non-nuclear signaling (ERαKI/KI/Tie2Cre+). Female OVX mice were supplemented with E2 and subjected to 3-week TAC. ERαKI/KI/Tie2Cre+ TAC hearts revealed exacerbated cardiac dysfunction and reduced myocardial PKG activity as compared to littermate TAC hearts, which was associated with attenuated myocardial induction of vascular endothelial growth factor (VEGF) and angiogenesis as assessed with CD31-stained capillary density. This phenotype of ERαKI/KI/Tie2Cre+ was rescued by myocardial PKG activation from chronic treatment with soluble guanylate cyclase (sGC) stimulator. We performed co-culture experiments to determine endothelial-cardiomyocyte interactions. VEGF induction by E2 in cardiac myocytes required co-existence of intact endothelial ERα signaling in a NOS-dependent manner. On the other hand, VEGF was induced in myocytes directly with an sGC stimulator in the absence of endothelial cells., Conclusions: An endothelial estrogen - myocardial cGMP axis stimulates angiogenic response and improves cardiac performance during pressure-overload., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Introduction: Cardiovascular diseases (CVD) that require long-term anticoagulant and antiplatelet therapy presents a problem in people with haemophilia (PWH) who receive factor replacement therapy to reduce bleeding risk. Currently, there are no Japanese guidelines for the management of PWH with CVD., Aim: To develop expert guidance on managing CVD in PWH in Japan., Methods: A steering committee of four experts (two haemophilia specialists, one thrombosis specialist, one cardiologist) identified 44 statements related to five key themes. An online questionnaire was produced comprising a mix of 4-point Likert scale and multiple-choice questions that was sent to specialists in the management of PWH with CVD in Japan. Consensus was defined as high or very high if a respective ≥75% or ≥90% of respondents agreed with a statement., Results: Of 16 potential respondents, responses were received from 15 specialists. Of the Likert scale questions, 71% (29/41) achieved ≥90% agreement (very strong agreement), 17% (7/41) achieved 75%-89% agreement (strong agreement) and 15% (6/41) did not achieve consensus agreement. The three multiple-choice questions failed to identify a strong preference. Agreement on specific target trough clotting factor levels for managing certain clinical situations, such as when in the presence of non-valvular atrial fibrillation or myocardial infarction, was also achieved., Conclusion: The results of this consensus study provide a framework for cardiologists and haematologists to manage PWH who are at risk of, or who have, CVD. Implementation of the recommendations provided herein may improve outcomes for PWH with CVD., (© 2024 John Wiley & Sons Ltd.)

A 55-year-old man presented to the emergency department with worsening shortness of breath 1 month after a gastrointestinal bleed. He had congestive heart failure, and an electrocardiogram suggested ischemic heart disease involvement. Echocardiography revealed a ventricular septal defect complicated by a left ventricular aneurysm in the inferior-posterior wall. Conservative treatment was started, but hemodynamic collapse occurred on the third day of admission and coronary angiography revealed a revascularizing lesion in the right fourth posterior descending coronary artery. Subsequently, his hemodynamic status continued to deteriorate, even with an Impella CP ® heart pump, so ventricular septal defect patch closure and left ventricular aneurysm suture were performed. His condition improved and he was discharged on day 23 of admission and was not readmitted within 6 months after the procedure. Hemodynamic management of ventricular septal defects requires devices that reduce afterload, and clinicians should be aware of the risk of myocardial infarction after gastrointestinal bleeding.

Background: Late lumen enlargement (LLE) - a positive remodelling phenomenon - after drug-coated balloon (DCB) angioplasty for stable coronary disease contributes to a lower restenosis rate. However, lesion characteristics promoting LLE remain unclear., Aims: This study aimed to investigate predictive lesion characteristics for LLE using serial optical frequency domain imaging (OFDI) following DCB angioplasty for de novo coronary artery lesions., Methods: This retrospective, single-centre observational study included patients with angina pectoris who underwent paclitaxel-coated balloon angioplasty without stenting under OFDI guidance as well as follow-up OFDI. OFDI endpoints were lumen volume, plaque phenotype, and procedure-associated dissection. LLE was defined as a ≥10% increase in the lumen volume of the treated lesion at follow-up., Results: Between August 2016 and December 2019, among patients with successful DCB angioplasty, 108 lesions (83 patients) had available follow-up imaging after a median of 6.1 months. LLE was detected in 44 (40.7%) lesions. Fibrous/fibrocalcific and layered plaques had significantly larger lumen volumes at follow-up than immediately after the index procedure, whereas lipid plaques exhibited no significant difference. Medial dissection with an arc >90° revealed an increased lumen volume. Multivariate analysis showed that layered plaques (odds ratio [OR] 8.73, 95% confidence interval [CI]: 1.92-39.7; p=0.005) and medial dissection with an arc >90° (OR 4.65, 95% CI: 1.63-13.3; p=0.004) were independent LLE predictors., Conclusions: Layered plaques and extensive medial dissection after DCB angioplasty were associated with higher LLE occurrence in de novo coronary lesions. These findings may be clinically applicable to DCB therapeutic strategies based on plaque features.

Existing near-eye displays (NEDs) have trade-offs related to size, weight, computational resources, battery life, and body temperature. A recent paradigm, beaming display, addresses these trade-offs by separating the NED into a steering projector (SP) for image presentation and a passive headset worn by the user. However, the beaming display has issues with the projection area of a single SP and has severe limitations on the head orientation and pose that the user can move. In this study, we distribute dual steering projectors in the scene to extend the head orientation and pose of the beaming display by coordinating the dual projections on a passive headset. For cooperative control of each SP, we define a geometric model of the SPs and propose a calibration and projection control method designed for multiple projectors. We present implementations of the system along with evaluations showing that the precision and delay are 1.8 ∼ 5.7 mm and 14.46 ms, respectively, at a distance of about 1 m from the SPs. From this result, our prototype with multiple SPs can project images in the projection area ($20\ \text{mm} \times 30\ \text{mm}$) of the passive headset while extending the projectable head orientation. Furthermore, as applications of cooperative control by multiple SPs, we show the possibility of multiple users, improving dynamic range and binocular presentation.

Light Attenuation Displays (LADs) are a type of Optical See-Through Head-Mounted Display (OST-HMD) that present images by attenuating incoming light with a pixel-wise polarizing color filter. Although LADs can display images in bright environments, there is a trade-off between the number of Spatial Light Modulators (SLMs) and the color gamut and contrast that can be expressed, making it difficult to achieve both high-fidelity image display and a small form factor. To address this problem, we propose StainedSweeper, a LAD that achieves both the wide color gamut and the variable intensity with a single SLM. Our system synchronously controls a pixel-wise Digital Micromirror Device (DMD) and a nonpixel polarizing color filter to pass light when each pixel is the desired color. By sweeping this control at high speed, the human eye perceives images in a time-multiplexed, integrated manner. To achieve this, we develop the OST-HMD design using a reflective Solc filter as a polarized color filter and a color reproduction algorithm based on the optimization of the time-multiplexing matrix for the selected primary color filters. Our proof-of-concept prototype showed that our single SLM design can produce subtractive images with variable contrast and a wider color gamut than conventional LADs.

An extremely high prevalence (12.2%) of moderate-to-severe coronary artery stenosis (CAS) was documented in asymptomatic Japanese haemophiliacs living with HIV-1 (JHLH) in our previous study. The cause of this phenomenon remains unknown. We conducted the CAS screening in people living with HIV-1 without haemophilia (PLWH without haemophilia) to compare the prevalence of CAS in JHLH and PLWH without haemophilia and to identify the risk factors including inflammation markers. Ninety-seven age-matched male PLWH without haemophilia who consulted our outpatient clinic between June and July 2021 were randomly selected, and 69 patients who provided informed consent were screened for CAS using coronary computed tomography angiography (CCTA). The number of JHLH cases was 62 in this study. The prevalence of moderate (> 50%) to severe (> 75%) CAS was significantly higher in JHLH [14/57 (24.6%) vs. 6/69 (8.7%), p = 0.015], and the ratio of CAS requiring urgent interventions was significantly higher [7 (12.3%) vs. 1 (1.4%), p = 0.013] in JHLH than in PLWH without haemophilia. Among the inflammatory markers, serum titres of intercellular adhesion molecule-1 ( p < 0.05) and interleukin-6 ( p < 0.05) in JHLH were significantly higher than those in PLWH without haemophilia. Although some patient demographics were different in the age-matched study, it might be possible to speculate that intravascular inflammation might promote CAS in JHLH., Competing Interests: The authors have no conflicts of interest to disclose., (2024, National Center for Global Health and Medicine.)

This paper proposes a novel tour guide robot, "ASAHI ReBorn", which can lead a guest by hand one-on-one while maintaining a proper distance from the guest. The robot uses a stretchable arm interface to hold the guest's hand and adjusts its speed according to the guest's pace. The robot also follows a given guide path accurately using the Robot Side method, a robot navigation method that follows a pre-defined path quickly and accurately. In addition, a control method is introduced that limits the angular velocity of the robot to avoid the robot's quick turn while guiding the guest. We evaluated the performance and usability of the proposed robot through experiments and user studies. The tour-guiding experiment revealed that the proposed method that keeps distance between the robot and the guest using the stretchable arm enables the guests to look around the exhibits compared with the condition where the robot moved at a constant velocity.

Background: Patients with atrial fibrillation (AF) and heart failure (HF) have high stroke risk owing to left atrial dysfunction. However, anticoagulation is a concern in patients with high bleeding risk. We aimed to identify independent predictors of stroke in HF patients with AF., Methods: We retrospectively examined 320 patients (mean age 79 ± 12 years, 163 women) hospitalized with acute HF complicated by AF between January 2014 and December 2018. Patients were followed from admission until ischemic stroke or systemic embolism (SSE) onset or death or were censored at the last contact date or September 2023., Results: SSE occurred in 40 patients (median follow-up of 528 days). Multivariate Cox regression analysis identified age (hazard ratio [HR] 1.04, 95% confidence interval [CI] 1.00-1.07, p  = .034), direct oral anticoagulant (DOAC) use (HR 0.26, 95% CI 0.11-0.60, p  = .002), and early diastolic peak flow velocity to early diastolic peak annular velocity (E/e'; HR 1.05, 95% CI 1.02-1.08, p  < .001) to be independent predictors of SSE, whereas left atrial reservoir strain was not. After determining an appropriate E/e' cutoff by receiver-operating characteristic curve analysis and adjusting the multivariate Cox model, E/e' ≥17.5 (HR 3.30, 95% CI 1.56-6.83, p  = .001) independently predicted SSE. The results were consistent with no interaction in the subanalysis except for gender., Conclusion: Elderly patients not on DOACs with elevated E/e' may be at higher risk of stroke, suggesting that DOACs should be the first choice for patients with elevated E/e' and aggressive additional prophylaxis and careful follow-up are needed., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)

Although long-QT syndrome (LQTS) with a normal range QT interval at rest leads to fatal ventricular arrhythmias, it is difficult to diagnose. In this article, we present a rare case of a patient who suffered a cardiac arrest and was recently diagnosed with LQTS and coronary vasospasm. A 62-year-old man with no syncopal episodes had a cardiopulmonary arrest while running. During coronary angiography, vasospasm was induced and we prescribed coronary vasodilators, including calcium channel blockers. An exercise stress test was performed to evaluate the effect of medications and accidentally unveiled exercise-induced QT prolongation. He was diagnosed with LQTS based on diagnostic criteria. Pharmacotherapy and an implantable cardioverter defibrillator were used for his medical management. It is extremely rare for LQTS and coronary vasospasm to coexist. In cases of exercise-induced arrhythmic events, the exercise stress test might be helpful to diagnose underlying disease.

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the urinary albumin-to-creatinine ratio (UACR) in patients with elevated levels of albuminuria in the presence or absence of heart failure (HF) or type 2 diabetes mellitus (T2D). However, these effects have not yet been reported in the presence of both HF and T2D. This lack of evidence prompted us to conduct a clinical trial on the effects of dapagliflozin on UACR in patients with HF and T2D., Methods: DAPPER is a multicentre, randomised, open-labeled, parallel-group, standard treatment-controlled trial that enrolled patients at 18 medical facilities in Japan. Eligible participants with both HF and T2D and aged between 20 and 85 years were randomly assigned to a dapagliflozin or control (anti-diabetic drugs other than SGLT 2 inhibitors) group with a 1:1 allocation. The primary outcome was changes in UACR from baseline after a two-year observation, and secondary endpoints were cardiovascular (CV) events and parameters related to HF. This trial was registered with the UMIN-CTR registry, UMIN000025102 and the Japan Registry of Clinical Trials, jRCTs051180135., Findings: Between 12 May 2017 and 31 March 2020, 294 patients were randomly assigned to the dapagliflozin group (n = 146) or control group (n = 148). The mean age of patients was 72.1 years and 29% were female. The mean glycated hemoglobin value was 6.9%, mean NT-proBNP was 429.1 pg/mL, mean estimated GFR was 65.7 mL/min/1.73 m 2 , and median UACR was 25.0 (8.8-74.6) mg/g Cr in the dapagliflozin group and 25.6 (8.2-95.0) mg/g Cr in the control group. Of the 146 patients in the dapagliflozin group, 122 completed the study, and 107 (87.7%) were taking 5 mg of dapagliflozin daily at the end of the observation period. The primary outcome did not significantly differ between the dapagliflozin and control groups. Among the secondary endpoints, the mean decrease in left ventricular end-diastolic dimensions as one of the echocardiographic parameters was larger in the dapagliflozin group than in the control group. The composite endpoint, defined as CV death or hospitalisation for CV events, hospitalisation for HF events, hospitalisation for all causes, and an additional change in prescriptions for heart failure in a two-year observation, was less frequent in the dapagliflozin group than in the control group., Interpretation: Although dapagliflozin at a dose of 5 mg daily did not reduce urinary albumin excretion in patients with HF and T2D from that in the controls, our findings suggest that dapagliflozin decreased CV events and suppressed left ventricular remodeling., Funding: AstraZeneca KK, Ono Pharmaceutical Co., Ltd., Competing Interests: FY reports grants and personal fees from AstraZeneca K.K. and Ono Pharmaceutical Co., LTD., during the conduct of the study. FY also has received grants from the Japanese government (KAKENHIPROJECT-17K09002, 20K07819, 23K09616) and personal fees from Daiichi Sankyo, National Agricultural Insurance Association, AstraZeneca, Kyowa-Kirin, Bayer, Astellas, Mochida, Teijin, Otsuka, Sumitomo Dainippon, Terumo, Novartis, Akahata, Tanabe Mitsubishi, Boehringer Ingelheim, and Sumitomo, outside the submitted work. MI has nothing to disclose. IS 3) reports grants and personal fees from the National Cerebral and Cardiovascular Centre during the conduct of the study. IS 3) also received grants from Ryukyu University, Soiken Co., Res. Inst. for Production Development and Nexis Co., and personal fees from Daiichi Sankyo, Kowa, AstraZeneca, Kyowa-Kirin, Bayer, Astellas, Mochida, Nipro, Otsuka, Sumitomo Dainippon, Eisai, Novartis, Glaxo Smith Kline, Toa Eiyo, Boehringer Ingelheim, Novo Nordisk, Bristol Myers Squibb, and Sanwa Kagaku, outside the submitted work. YH received grants from the Japanese government (AMED JP20ek0210152, and JP22ek21065) from the National Centre for Global Health and Medicine (21A1001, 21A2004, 21A2007, and 23A1019) and personal fees from AstraZeneca, Daiichi Sankyo, Bayer, Otsuka, Novartis, Tanabe Mitsubishi, Roche, Novo Nordisk, Mochida, Viatris, Kowa, Chugai, MSD, Boehringer Ingelheim, Takeda, Eisai, and Edwards Lifesciences outside the submitted work. HH reports grants and personal fees from AstraZeneca Plc. and Ono Pharmaceutical Co., LTD., during the conduct of the study. HH also received personal fees from Daiichi Sankyo, AstraZeneca, Bayer, and Terumo outside the submitted work. OO has nothing to disclose. CI 6) author, has nothing to disclose. CI 7) author reports grants from the Japanese government (KAKENHIPROJECT-22K08118), AMED (22ek0109539h0002, and 23ek0109629h0001), Daiichi Sankyo, Cannon Medical Systems, Teijin, Pfizer, Idorsia Pharmaceuticals Japan, LSI Medience and Shin Nippon PPD as well as personal fees from Daiichi Sankyo, Edwards Lifesciences, AstraZeneca, Cannon Medical Systems, Bayer, Astellas, Mochida, Teijin, Otsuka, Sumitomo Dainippon, Pfizer, Novartis, Bristol-Myers Squibb, Tanabe Mitsubishi, Boehringer Ingelheim, Tsumura, and MSD outside the submitted work. TN received grants from the Japanese government (KAKENHIPROJECT-22K08223, 22H03191, 21K08044, 20K08483, 20H03681, and 19K08571) and the Japan Agency for Medical Research and Development (AMED: 23811571, 20314990, 21453332, 21472516, and 17930494). TN received personal fees from AstraZeneca, Kyowa-Kirin, Bayer, Astellas, Mochida, Takeda, Otsuka, Sumitomo Dainippon, Boston-Scientific, Novartis, Daiichi Sankyo, Tanabe Mitsubishi, Boehringer Ingelheim, Kowa, Toaeiyo, Bristol Myers Squibb, Gwangju International Interventional Cardiology Symposium (GICS 2023), and Gwangju International Interventional Cardiology Symposium (GICS 2022) outside the submitted work. TS has nothing to disclose. NN has nothing to disclose. KF has nothing to disclose. KI reports honoraria from AstraZeneca, Ono Pharmaceutical, Boehringer Ingelheim, Eli Lilly and Company, Novo Nordisk A/S, Sumitomo Pharma, Amgen, Kowa Company, Bayer, Kyowa-Kirin, Daiichi Sankyo, Astellas, Mochida, Otsuka Pharmaceutical, Novartis, and Tanabe Mitsubishi, and support for attending meetings and travel from Novo Nordisk A/S. OT has nothing to disclose. KK receives personal fees from Otsuka, AstraZeneca, Kyowa-Kirin, Novartis, Amgen, and Abbott. MT received honoraria for lectures from AstraZeneca, Ono Pharmaceutical Co., Kyowa-Kirin, Kowa Company Limited, Sanofi K.K., Daiichi Sankyo, TAISHO PHARMACEUTICAL, Takeda Pharmaceutical, Tanabe Mitsubishi, Boehringer Ingelheim, Novo Nordisk Pharma, Sumitomo Dainippon, MSD, Astellas, Eli Lilly, KISSEI PHARMACEUTICAL, Teijin, Novartis, Mochida, Otsuka, SANWA KAGAKU KENKYUSHO, Sumitomo Pharma, NIPRO CORPORATION, and Bayer. KY received personal fees from Mochida Pharmaceutical Co., Ltd., Eisai Co., Ltd., Otsuka Pharmaceutical, Sanofi, Boston Scientific, Abbott Diagnostics Medical Co., Ltd., Bristol Myers Squibb, DAIICHI SANKYO COMPANY, LIMITED, Nippon Boehringer Ingelheim Co., Ltd., Janssen Pharmaceutical K.K., Kowa Company, Limited, Amgen K.K., Novartis Pharma K.K., AstraZeneca K.K., Edwards Lifesciences, and Mitsubishi Tanabe Pharma Corporation. HT receives personal fees from AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Kowa, Mochida, Nippon Shinyaku, Novartis, Omron, Otsuka, PDRadiopharma, and Sumitomo Dainippon outside the submitted work. TH 16) has nothing to disclose. IS 17) reports honoraria from Kyowa-Kirin Terumo, Sumitomo, Novo Nordisk, Eli Lilly, AstraZeneca, Boehringer Ingelheim Sanofi, Otsuka, and MSD. TM receives grants from the Japanese government (KAKENHIPROJECT 18K15864, and 21K16068) and personal fees from Daiichi Sankyo, AstraZeneca, Bayer, Astellas, Mochida, Otsuka, Novartis, and Boehringer Ingelheim outside the submitted work. KW reports consulting fees from Terumo, Gadelius Medical, and ITI Co., LTD., during the conduct of the study. KW also received personal fees from OrbusNeich, Japan Medtronic, Ono Pharmaceutical Co., Daiichi-Sankyo, Dainihon Sumitomo, Amgen, Kowa, Japan Lifeline, Novartis, Toaeiyo, Otsuka Pharma, Mochida, Sumitomo Pharma, Fuji Yakuhin, and AstraZeneca outside the submitted work. KS has nothing to disclose. TH 21) has nothing to disclose. SA has nothing to disclose. SH receives personal fees from Daiichi Sankyo, AstraZeneca, Novartis, Nippon Boehringer Ingelheim, Kowa, Viatris, Actelion, Bayer, Amgen, Bristol Myers, Takeda, Termo, Ono, Janssen, Novo Nordisk, Tanabe, Otsuka, Astellas, and Edwards Lifesciences outside the submitted work. MA received grants from Daiichi Sankyo, Otsuka, Boehringer Ingelheim, and personal fees from AstraZeneca, Tanabe Mitsubishi, Daiichi Sankyo, Novartis, Byer, Boehringer Ingelheim, Nippon Shinyaku, Viatris, Janssen, Astellas, Eli Lilly, and Otsuka outside the submitted work. TK receives Grants-in-Aid for Scientific Research (KAKENHI 22K10547). KO receives personal fees from Nippon Boehringer Ingelheim Co., Ltd., outside the submitted work. SI reports a grant from the Japan Society for the Promotion of Science outside the submitted work. MK reports grants from the Japanese government, grants from the Japan Heart Foundation, grants from the Japan Cardiovascular Research Foundation, personal fees from Daiichi-Sankyo, personal fees from Viatris, grants and personal fees from Ono, grants from Novartis, grants and personal fees from Tanabe-Mitsubishi, grants from Takeda, grants and personal fees from Astra Zeneca, grants and personal fees from Boehringer-Ingelheim, grants from Kowa, and personal fees from Otsuka, and personal fees from Eli Lilly outside the submitted work., (© 2023 The Author(s).)

This paper presents a low-latency Beaming Display system with a 133 μs motion-to-photon (M2P) latency, the delay from head motion to the corresponding image motion. The Beaming Display represents a recent near-eye display paradigm that involves a steerable remote projector and a passive wearable headset. This system aims to overcome typical trade-offs of Optical See-Through Head-Mounted Displays (OST-HMDs), such as weight and computational resources. However, since the Beaming Display projects a small image onto a moving, distant viewpoint, M2P latency significantly affects displacement. To reduce M2P latency, we propose a low-latency Beaming Display system that can be modularized without relying on expensive high-speed devices. In our system, a 2D position sensor, which is placed coaxially on the projector, detects the light from the IR-LED on the headset and generates a differential signal for tracking. An analog closed-loop control of the steering mirror based on this signal continuously projects images onto the headset. We have implemented a proof-of-concept prototype, evaluated the latency and the augmented reality experience through a user-perspective camera, and discussed the limitations and potential improvements of the prototype.

Background: Patients with atrial fibrillation (AF) and heart failure (HF) have elevated left ventricular end-diastolic pressure in addition to decreased left atrial (LA) function, but there are few reports of useful prognostic indices that can be seen on echocardiography. In this study, we investigated the association between LA reservoir strain (LARS) and prognosis in this group of patients., Methods and results: We retrospectively enrolled patients with acute HF complicated by AF who were consecutively admitted to hospital between January 2014 and December 2018. A total of 320 patients (mean age 79±12 years, 163 women) were included in the analysis. During a median follow-up of 473 days, 92 cardiovascular deaths and 113 all-cause deaths occurred. In the multivariate analysis, LARS was an independent predictor of all-cause death (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90-0.99, P=0.016). Multivariate analysis also showed that the patients in the lowest LARS tertile (<7.16%) had a significantly increased risk of cardiovascular death (HR 1.76, 95% CI 1.05-2.96; P=0.033) and all-cause death (HR 1.90, 95% CI 1.17-3.08; P=0.009) in comparison with patients in the highest LARS tertile (>10.52%)., Conclusions: We found a significant association between LARS and death in patients with AF and HF. Patients with reduced LARS had poor prognosis, suggesting the need for aggressive therapy to improve their LA dysfunction.

Constipation has been reported to increase the risk of cardiovascular mortality. Patients with atrial fibrillation (AF) and heart failure (HF) have more comorbidities and an increased bleeding risk. However, it remains unclear whether constipation is associated with an increased risk of incident bleeding complications in AF with HF. Here, we investigated the association between constipation requiring laxatives and major bleeding in AF and HF. We retrospectively analyzed the medical records of 370 consecutive patients hospitalized for AF and congestive HF. Constipation was defined as regularly taking laxatives or having at least two prescriptions for a ≥ 30-day supply of laxatives. Sixty patients experienced major bleeding events during a median follow-up of 318 days. The most common sites of bleeding were lower gastrointestinal (28%, 17/60), upper gastrointestinal (27%, 16/60), and intracranial (20%, 12/60). There were 33 (55%) patients with constipation in the bleeding group and 107 (35%) in the non-bleeding group (P = 0.004). Multivariate Cox regression analysis adjusted for HAS-BLED score, hemoglobin, and direct oral anticoagulant use showed that constipation (hazard ratio [HR] 1.85, 95% confidence interval [CI] 1.11-3.08; p = 0.019) was a significant risk factor for major bleeding. We found a significant association between constipation requiring laxatives and major bleeding in patients with AF and HF. These findings indicate the need for constipation prevention in these patients to avoid reliance on invasive defecation management, including laxatives., (© 2023. The Author(s).)

Aim: To compare the characteristics and clinical course of patients with coronavirus disease (COVID-19) according to the healthcare level of the admitted hospital, to provide an insight into determining the appropriate level of care for each patient., Methods: This retrospective, observational study utilized data from the COVID-19 Registry Japan (COVIREGI-JP), the largest Japanese registry of hospitalized patients with COVID-19. Datasets were obtained from reports filed as of May 31, 2022., Results: A total of 59,707 patients (2004 in the primary care group, 41,420 in the secondary care group, and 16,283 in the tertiary care group) from 585 facilities were included in the analysis. Patients with established risk factors for severe disease, such as old age and the presence of comorbidities, were treated at higher care facilities and had poorer initial conditions and in-hospital clinical course, as well as higher mortality. Analysis of the fatality rates for each complication suggested that patients with complications requiring procedures (e.g. pleural effusions, myocardial ischemia, and arrhythmia) may have better survival rates in facilities with specialist availability. The number of deaths and severe COVID-19 cases in this study were notably less than those reported overseas., Conclusion: Our results showed that more difficult COVID-19 cases with poor outcomes were treated at higher care level facilities in Japan. Attending to possible complications may be useful for selecting an appropriate treatment hospital. Healthcare providers need to maintain a broad perspective on the distribution of medical resources., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)

Purpose: Paretic side collisions frequently occur in stroke patients, especially while walking through narrow spaces. We determined whether training for walking through an opening (T-WTO) while entering from the paretic side would improve collision avoidance behavior and prevent falls after 6 months., Materials and Methods: Thirty-eight adults with moderate-to-mild hemiparetic gait after stroke who were hospitalized in a rehabilitation setting were randomly allocated to the T-WTO ( n  = 20) or regular rehabilitation (R-Control; n  = 18) program. Both groups received five sessions of 40 min per week, for three weeks total. T-WTO included walking through openings of various widths while rotating with the paretic side in front, and R-Control involved normal walking without body rotation. Obstacle avoidance ability, 10-m walking test, timed Up and Go test, Berg Balance Scale, Activities-specific Balance Confidence, the perceptual judgment of passability, and fall incidence were assessed., Results: Collision rate and time to passage of the opening in obstacle avoidance task significantly improved in the T-WTO group compared with those in the R-Control group. Contrast, T-WTO did not lead to significant improvements in other outcomes., Conclusions: T-WTO improved efficiency and safety in managing subacute stroke patients. Such training could improve patient outcomes/safety because of the paretic body side during walking., Clinical Trial Registration No.: R000038375 UMIN000033926.

Background: Gait impairment is common in people with multiple sclerosis (MS), but less is known about gait differences between MS disease progression subtypes. The objective here was to examine differences in spatiotemporal gait in MS and between relapsing-remitting and progressive subtypes during the timed-25-ft-walk test. Our specific aims were to investigate (1) spatiotemporal, (2) spatiotemporal variability, and (3) gait modulation differences between healthy controls and MS subtypes at preferred and fast walking speed., Methods: This study included 27 controls, 18 relapsing-remitting MS, and 13 progressive MS participants. Participants wore six inertial sensors and walked overground without walking aids at preferred and fast-as-possible speeds., Findings: Both MS groups had significantly lower walking speed than controls, with a trend towards lower preferred gait speed in progressive compared to relapsing-remitting MS (ES = 0.502). Although most spatiotemporal gait parameters differed between controls and MS groups, differences were not significant between MS subtypes in these parameters and their variability, with low to moderate effect sizes during preferred and fast walking. Both MS groups showed reduced modulation in gait compared to controls and no significant differences between MS subtypes., Interpretation: Gait in MS is altered compared to controls. Although gait may change with progressive MS, the overall small differences in the gait parameters between the MS subtypes observed in this sample suggests that those with the progressive form of MS who are independently ambulatory and without further clinically meaningful changes in gait speed may not show gait decrements greater than the relapsing-remitting form of the disease., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Using the Cre-loxP system, we generated the first mouse model in which estrogen receptor-α non-nuclear signaling was inactivated in endothelial cells. Estrogen protection against mechanical vascular injury was impaired in this model. This result indicates the pivotal role of endothelial estrogen receptor-α non-nuclear signaling in the vasculoprotective effects of estrogen., Competing Interests: This work was supported by the Japan Foundation for Applied Enzymology, Japan Heart Foundation Research Grant, SENSHIN Medical Research Foundation, Kobayashi Foundation (Dr Takimoto), Takeda Science Foundation (Drs Ueda and Takimoto), National Institutes of Health HL 052233, National Institutes of Health HL 136962, DK 062729 (Dr Liao), AHA Northeast Research Consortium Postdoctoral Fellowship, Uehara Research Fellowship (Dr Hiroi), and Tri-Service General Hospital Medical Research Foundation Grant TSGH-PH-E-111017 (Dr Liu). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2023 The Authors.)

We propose a spatial calibration method for wide field-of-view (FoV) near-eye displays (NEDs) with complex image distortions. Image distortions in NEDs can destroy the reality of the virtual object and cause sickness. To achieve distortion-free images in NEDs, it is necessary to establish a pixel-by-pixel correspondence between the viewpoint and the displayed image. Designing compact and wide-FoV NEDs requires complex optical designs. In such designs, the displayed images are subject to gaze-contingent, non-linear geometric distortions, which explicit geometric models can be difficult to represent or computationally intensive to optimize. To solve these problems, we propose neural distortion field (NDF), a fully-connected deep neural network that implicitly represents display surfaces complexly distorted in spaces. NDF takes spatial position and gaze direction as input and outputs the display pixel coordinate and its intensity as perceived in the input gaze direction. We synthesize the distortion map from a novel viewpoint by querying points on the ray from the viewpoint and computing a weighted sum to project output display coordinates into an image. Experiments showed that NDF calibrates an augmented reality NED with 90° FoV with about 3.23 pixel (5.8 arcmin) median error using only 8 training viewpoints. Additionally, we confirmed that NDF calibrates more accurately than the non-linear polynomial fitting, especially around the center of the FoV.

In mid-September 2019, a teenage Chinese male student and part-time waiter in Tokyo was diagnosed with multidrug-resistant (MDR) sputum smear-positive pulmonary tuberculosis (TB). This study describes the outbreak investigation of his friends and colleagues at the restaurant. We investigated 6 friends and 15 colleagues; 5 friends and 13 colleagues underwent interferon-γ release assay (IGRA). Of these, 3 friends (60.0%) and 4 colleagues (30.8%) were IGRA-positive. Each of the friends and colleagues was found to have MDR-TB (20% and 7.7%, respectively). Challenges during the investigation were the unavailability of regimens for latent TB infection (LTBI) for contacts with MDR-TB, budgetary constraints concerning implementing computed tomography (CT) scans for the contacts, frequent address changes of foreign-born patients and contacts, investigation during the coronavirus disease pandemic, and variations of alphabetical expression of the names of the patients and contacts, particularly for those from China. It is recommended that the national government officially adopt prophylaxis regimens for LTBI with MDR-TB, address the budgetary constraints regarding CT scans, and deploy liaison officers for coordinating investigations involving many foreign-born patients and contacts scattered in multiple municipalities. The names of foreign-born persons could more accurately be identified using both the alphabet and Chinese characters.

Repellent coatings are critical for the development of biomedical and analytical devices to prevent nonspecific protein and cell adhesion. In this study, prevelex (polyampholytes containing phosphate and amine units) was synthesized for the fine coating of microdevices for cell culture. The dip-coating of the prevelex on hydrophobic substrates altered their surfaces to be highly hydrophilic and electrically neutral. The range of prebake temperature (50-150 °C) after dip-coating was moderate and within a preferable range to treat typical materials for cell culture such as polystyrene and polydimethylsiloxane. Scanning electron microscopy revealed a conformal and ultra-thin film coating on the micro/nano structures. When compared with poly(2-hydroxyethyl methacrylate) and poly(2-methacryloyloxyethyl phosphorylcholine), prevelex exhibited better characteristics for coating on microwell array devices, thereby facilitating the formation of spheroids with uniform diameters using various cell types. Furthermore, to examine cellular functionalities, mouse embryonic epithelial and mesenchymal cells were seeded in a prevelex-coated microwell array device. The two types of cells formed hair follicle germ-like aggregates in the device. The aggregates were then transplanted to generate de novo hair follicles in nude mice. The coating material provided a robust and fine coating approach for the preparation of non-fouling surfaces for tissue engineering and biomedical applications., (© 2022. The Author(s).)