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Seiko Miyata,1,* Kunihiro Iwamoto,1,* Ippei Okada,1,* Akihiro Fujimoto,2 Yuki Kogo,2 Daisuke Mori,1,3,4 Manabu Amano,5 Nao Matsuyama,5 Kazuki Nishida,5 Masahiko Ando,5 Toshiaki Taoka,6 Shinji Naganawa,7 Norio Ozaki1,4 1Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan; 2Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan; 3Brain and Mind Research Center, Nagoya University, Nagoya, Japan; 4Pathophysiology of Mental Disorders, Nagoya University, Graduate School of Medicine, Nagoya, Japan; 5Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan; 6Department of Innovative Biomedical Visualization (Ibmv), Nagoya University, Graduate School of Medicine, Nagoya, Japan; 7Department of Radiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan*These authors contributed equally to this workCorrespondence: Seiko Miyata, Department of Psychiatry, Nagoya University, Graduate School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan, Tel +81 52 744 2282, Fax +81 52 744 2293, Email miyata.seiko.v4@f.mail.nagoya-u.ac.jpPurpose: Both subjective and objective evaluations are essential for the treatment of insomnia. Lemborexant has been shown to be effective in the long-term based solely on a subjective basis, and no long-term objective measures have been evaluated under natural sleep conditions. Small, lightweight sleep electroencephalogram (EEG) monitor was used, instead of polysomnography, to objectively evaluate sleep at home 4 and 12 weeks after lemborexant treatment.Patients and Methods: Adults and elderly subjects with insomnia disorder, per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, were enrolled in this open-label, single-arm, single-center trial. Objective and subjective measures of sleep were prospectively assessed. Sleep disturbance, excessive sleepiness, and depressive symptoms were assessed using questionnaires.Results: A total of 45 subjects were screened, of which 33 were enrolled. Paired t-tests were conducted to evaluate changes in sleep variables and compared with the baseline; subjects showed significant improvements in objective sleep efficiency (SE) and subjective sleep parameters at weeks 4 and 12 following treatment with lemborexant. When baseline values were taken into account, a repeated-multivariate analysis of variance (MANOVA) revealed statistically significant changes in the objective measures. Sleep disturbance, excessive sleepiness, and depressive symptoms improved after three months of lemborexant treatment.Conclusion: Furthermore, lemborexant therapy improved nocturnal sleep, when measured objectively using sleep EEG monitoring at home, and improved daytime sleepiness and depressive symptoms in older adults with insomnia disorder.Keywords: insomnia, lemborexant, objective sleep evaluation, portable sleep EEG monitoring, subjective sleep evaluation

Background and Objectives CD36 antibody ( Ab) causes several disorders: neonatal alloimmune thrombocytopenia, platelet transfusion refractoriness and non-haemolytic transfusion reactions. However, there is no gold-standard test for CD36 Ab. Materials and Methods We developed a transfectant panel cell line-based Mo Ab-independent antigen capture assay system for detection of CD36 Ab and compared it with the monoclonal antibody-specific immobilization of platelet antigens ( MAIPA) system in terms of sensitivity and specificity. Results Our new system was characterized by (1) gene-transfected cell lines, but not panel platelets; (2) not being hampered by HLA Abs; and (3) no need to use CD36 Mo Abs to ensure the antigen specificity of this detection system. In addition, it showed a much better receiver operating characteristic curve than the MAIPA system. Conclusions The present results indicate that our new system permits highly sensitive and specific detection of CD36 Ab. [ABSTRACT FROM AUTHOR]

Background: Ventricular late potentials (VLPs) have been known to be a predictor of lethal ventricular arrhythmias (L-VAs); however, detection of other arrhythmogenic signals within the QRS complex remains obscure.Objective: The aim of this study was to evaluate whether abnormal intra-QRS high-frequency powers (IQHFP) within the QRS complex become a new predictor of L-VAs in addition to VLPs.Methods: Both 12-lead electrocardiograms (ECG) and VLPs were recorded from 142 subjects, including 37 patients without heart diseases, 97 patients post-myocardial infarction (MI), and 45 post-MI patients with L-VAs. Time-frequency analysis of ECG (leads V(1) or II) using wavelet transform with the Morlet function was performed. After the time-frequency powers were calculated, the ratios of the peak of signal power during the QRS complex in high-frequency bands against the peak power at 80 Hz (b/a ratio; P100, P150, P200, P250, or P300Hz/P80Hz) were measured. Abnormal IQHFP was defined when the b/a ratio exceeded the optimal cut-off values estimated by receiver-operator characteristic curves.Results: The combination of abnormal IQHFP appearing at 200, 250, and 300 Hz with positive VLPs increased the sensitivity for prediction of L-VAs from 53.3% by VLPs to 89.5%, and the negative predictive value from 74.7% by VLPs to 87.7%.Conclusion: The combined use of VLPs and IQHFP hidden within the QRS complex improved the prediction of L-VAs in post-MI patients. [ABSTRACT FROM AUTHOR]