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Abstract Background Whether human T-lymphotropic virus type 1 (HTLV-1) carriers can develop sufficient humoral immunity after coronavirus disease 2019 (COVID-19) vaccination is unknown. Methods To investigate humoral immunity after COVID-19 vaccination in HTLV-1 carriers, a multicenter, prospective observational cohort study was conducted at five institutions in southwestern Japan, an endemic area for HTLV-1. HTLV-1 carriers and HTLV-1-negative controls were enrolled for this study from January to December 2022. During this period, the third dose of the COVID-19 vaccine was actively administered. HTLV-1 carriers were enrolled during outpatient visits, while HTLV-1-negative controls included health care workers and patients treated by participating institutions for diabetes, hypertension, or dyslipidemia. The main outcome was the effect of HTLV-1 infection on the plasma anti-COVID-19 spike IgG (IgG-S) titers after the third dose, assessed by multivariate linear regression with other clinical factors. Results We analyzed 181 cases (90 HTLV-1 carriers, 91 HTLV-1-negative controls) after receiving the third dose. HTLV-1 carriers were older (median age 67.0 vs. 45.0 years, p

Aims: The longitudinal effect of personality traits on glycemic control is unclear. This prospective observational study explored the relationship between personality traits and glycemic control in patients with uncontrolled diabetes after inpatient diabetes education. Methods: Patients with diabetes mellitus (HbA1c ≥ 7.5%, measured by high-performance liquid chromatography) who received inpatient diabetes education were scored on the Big Five personality traits: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Multiple linear analysis was used to determine whether any personality traits were independently associated with HbA1c on admission and HbA1c change from admission to 1, 3, and 6 months after discharge. Results: One hundred seventeen participants (mean age 60.4 ± 14.5 years; 59.0% male) were enrolled. HbA1c values on admission and 1, 3, and 6 months after discharge were 10.2 ± 2.1%, 8.3 ± 1.4%, 7.6 ± 1.4%, and 7.7 ± 1.5%, respectively. Multiple linear analysis showed that no personality traits were associated with HbA1c on admission. Neuroticism was negatively associated with the HbA1c change from admission to 3 months (β = −0.192, P = 0.025) and 6 months after discharge (β = −0.164, P = 0.043). Conclusions: Neuroticism was associated with good long-term glycemic control after inpatient diabetes education.

ABSTRACT Aims/Introduction The Japanese diabetes treatment guidelines do not specify the first choice of hypoglycemic agents, unlike those of Western countries. Furthermore, the current situation in diabetes treatment is that the choice of hypoglycemic agents is determined by each physician. Therefore, we aimed to determine the current situation in Miyazaki Prefecture, Japan, in this context. For this, we carried out a questionnaire survey among physicians twice regarding the target value of glycated hemoglobin and the choice of hypoglycemic agents in various cases. Materials and Methods We administered an unsigned questionnaire to physicians in Miyazaki Prefecture, Japan, in July 2016 and March 2020. We divided responses into those of diabetologists and those of non‐diabetologists, and analyzed each response. We then compared the results between both years. Results In total, 18 diabetologists and 142 non‐diabetologists responded in 2016, and 21 diabetologists and 134 non‐diabetologists responded in 2020. Many diabetologists chose biguanide as the first‐line drug for obese type 2 diabetes patients. In addition, the rate of choice of sodium–glucose cotransporter 2 inhibitor (SGLT2i) among physicians almost increased in 2020. Some non‐diabetologists, and even a few diabetologists, inappropriately chose SGLT2i and biguanide for patients with severe renal dysfunction. Conclusions Because SGLT2i became available in 2016 and a few years have passed, both diabetologists and non‐diabetologists seemed to refrain from prescribing SGLT2i. However, with the emergence of various lines of firm evidence regarding the use of SGLT2i, physicians started to prescribe it. However, some diabetologists and non‐diabetologists chose hypoglycemic agents inadequately; therefore, there is a need for novel and precise information.

Abstract Met gene amplification has been found in a subset of malignant carcinomas, including diffuse-type gastric carcinoma (DGC), which has a poor prognosis owing to rapid infiltrative invasion and frequent peritoneal dissemination. Met is considered a promising therapeutic target for DGC. However, DGC cells with Met gene amplification eventually acquire resistance to Met inhibitors. Therefore, identification of alternate targets that mediate Met signaling and confer malignant phenotypes is critical. In this study, we conducted a phosphoproteomic analysis of DGC cells possessing Met gene amplification and identified Pleckstrin Homology Domain Containing A5 (PLEKHA5) as a protein that is tyrosine-phosphorylated downstream of Met. Knockdown of PLEKHA5 selectively suppressed the growth of DGC cells with Met gene amplification by inducing apoptosis, even though they had acquired resistance to Met inhibitors. Moreover, PLEKHA5 silencing abrogated the malignant phenotypes of Met-addicted DGC cells, including peritoneal dissemination in vivo. Mechanistically, PLEKHA5 knockdown dysregulates glycolytic metabolism, leading to activation of the JNK pathway that promotes apoptosis. These results indicate that PLEKHA5 is a novel downstream effector of amplified Met and is required for the malignant progression of Met-addicted DGC.

A 54-year-old woman was referred to our hospital with a cervical tumor. CT revealed a cervical tumor extending to the upper mediastinum, tracheal deviation and tumor infiltration in the cervical vessels. She was followed-up because no diagnosis of malignancy was made by cytology. However, 2 months later, a CT scan showed enlargement of the tumor and tracheal stenosis, and a surgical biopsy was performed and she was diagnosed with anaplastic thyroid cancer (ATC). The tracheal tube with tracheal stenosis could not be removed due to the rapid growth of the tumor, necessitating management by mechanical ventilation. Due to the difficulty of surgical resection, she was treated with lenvatinib. A lenvatinib solution was made and administered via a nasogastric tube. After lenvatinib treatment, the tumor volume decreased and the tracheal stenosis improved. The tracheal tube was removed and oral intake became possible. She was discharged and received ambulatory lenvatinib therapy. The tumor was significantly reduced in size, but gradually grew and was exposed through the cervical wound 6 months later. Esophageal perforation occurred 10 months after the start of treatment. Lenvatinib was re-administered via a nasogastric tube. Eleven months later, the patient died of massive bleeding from the exposed cervical tumor. Patients with advanced ATC may require management with mechanical ventilation for airway stenosis or with a nasogastric tube for esophageal stenosis and perforation. We experienced a case in which lenvatinib was safely administered via a nasogastric tube while performing mechanical ventilation.

We report the case of a 48-year-old man with thyroid storm associated with fulminant hepatitis and elevated levels of soluble interleukin-2 receptor (sIL-2R). Fatigue, low-grade fever, shortness of breath, and weight loss developed over several months. The patient was admitted to the hospital because of tachycardia-induced heart failure and liver dysfunction. Graves’ disease with heart failure was diagnosed. He was treated with methimazole, inorganic iodide, and a β-blocker. On the day after admission, he became unconscious with a high fever and was transferred to the intensive care unit. Cardiogenic shock with atrial flutter was treated with intra-aortic balloon pumping and cardioversion. Hyperthyroidism decreased over 10 days, but hepatic failure developed. He was diagnosed with thyroid storm accompanied by fulminant hepatitis. Laboratory investigations revealed elevated levels of sIL-2R (9770 U/mL). The fulminant hepatitis was refractory to plasma exchange and plasma filtration with dialysis, and no donors for liver transplantation were available. He died of hemoperitoneum and gastrointestinal hemorrhage due to fulminant hepatitis 62 days after admission. Elevated circulating levels of sIL-2R might be a marker of poor prognosis in thyroid storm with fulminant hepatitis.

We report a case of rapid pleural effusion after discontinuation of lenvatinib. A 73-year-old woman was diagnosed with poorly differentiated thyroid cancer with right pleural metastasis. Weekly paclitaxel treatment was performed for 18 weeks, but it was not effective. Oral administration of lenvatinib, a multi-target tyrosine kinase inhibitor, reduced the size of cervical and thoracic tumors and lowered serum thyroglobulin levels. Lenvatinib was discontinued on day 28 because of Grade 2 thrombocytopenia and Grade 3 petechiae. Seven days after discontinuation of lenvatinib, the patient was hospitalized because of dyspnea and right pleural effusion. Pleural effusion rapidly improved with drainage and re-initiation of lenvatinib and did not recur. Anorexia caused by lenvatinib led to undernutrition, which resulted in death 13 months after initiation of lenvatinib. Autopsy revealed extensive necrosis with primary and metastatic lesions, suggesting that the patient responded to lenvatinib. Physicians should be aware of the possibility of flare-up in patients with thyroid cancer treated with lenvatinib.

A retrospective chart survey of the clinical features of indolent adult T-cell leukemia/lymphoma (ATL) was conducted in the Miyazaki Prefecture, Japan. This study enrolled 24 smoldering-type ATLs, 10 favorable chronic-type ATLs, and 20 unfavorable chronic-type ATLs diagnosed between 2010 and 2018. Among them, 4, 3, and 10 progressed to acute-type ATLs during their clinical course. The median survival time (MST) in smoldering-type ATL and favorable chronic-type ATL was not reached, and their 4-year overall survival (OS) was 73% and 79%, respectively. Compared with this, the prognosis of unfavorable chronic-type ATL was poor. Its MST was 3.32 years, and the 4-year OS was 46% (p = 0.0095). In addition to the three features that determine the unfavorable characteristics of chronic-type ATL, namely, increased lactate dehydrogenase, increased blood urea nitrogen, and decreased albumin, the high-risk category by the indolent ATL-Prognostic Index, which was defined by an increment of soluble interleukin-2 receptor (sIL2-R) of >6000 U/mL, could explain the poor prognosis in indolent ATL patients. The level of sIL-2R might be an indicator of the initiation of therapy for indolent ATL.

This paper shows the performance evaluation of the variable refrigerant flow (VRF) air-conditioning system subjected to very low outdoor air temperature at which the heating-defrosting cyclic operation occurred. The objectives of the study are to know the effect of the heating-defrosting cyclic operation in the VRF air-conditioning performances and of the indoor environment thermal conditions. The one outdoor unit's and two indoor units' VRF air-conditioning system was used as a test specimen in the controlled testing chambers in which temperature and humidity were controlled. Several test cases were done covering from constant dry bulb temperature with different wet bulb temperature and for both dry bulb temperature and wet bulb temperature different. The results of the study show that the heating-defrosting cyclic operation affected the performance of the VRF air-conditioning system. It shows that the heating time changes depend on both dry bulb and wet bulb temperatures. It shows that the defrosting time is almost the same for different dry bulb and wet bulb temperatures for different heating times. The cyclic heating-defrosting operation affected the indoor air temperature by lowering the indoor air temperature during defrosting. Based on the results, necessary measures are needed to address the effect of the defrosting in the VRF air-conditioning system performance and of the indoor thermal environment conditions. The heating-defrosting cyclic operation is expected to occur when the VRF air-conditioning system is installed in an actual building in a temperate climate, and in the performance evaluation of the different VRF air-conditioning systems under these conditions, it is important to know how it affects the system's operation behavior, energy consumption and support of the indoor environment thermal conditions.

This paper shows the performance evaluation of the variable refrigerant flow (VRF) air-conditioning system at different outdoor air temperatures during cooling and heating operations. The purpose of this study is to determine the real performance of the system when operating at different outdoor temperatures. The one outdoor unit's and two indoor units' VRF system was used as a test specimen in the controlled testing chambers in which temperature and humidity were controlled. Several test cases were done covering from partial to full thermal loadings for the different outdoor air temperatures. The results showed that the outdoor air temperature much affected the performance of the VRF air-conditioning system. It showed that during the cooling operation, as the outdoor air dry bulb temperature increases, the coefficient of the performance ratio decreases. In the heating operation, as the outdoor air dry bulb with corresponding wet bulb temperature decreases, the coefficient of the performance ratio decreases. The defrosting mode, which occurs during the heating operation, affects the indoor chamber's temperature as the air temperature becomes very low due to the indoor units having become an evaporator. The results of the study showed the importance of the VRF air-conditioning system performances at different outdoor air dry bulb and wet bulb temperatures. Hence, it is important to consider the outdoor air temperatures when calculating the energy consumption of the VRF air-conditioning system to be installed in new and/or retrofitted buildings as they affect the electric energy consumption.

This paper shows the performance evaluation of the variable refrigerant flow (VRF) air-conditioning system subjected to partial and unbalanced thermal (cooling and heating) loadings. The one outdoor unit's and two indoor units' VRF system was used as a test specimen in the controlled outdoor chamber in which temperature and humidity were controlled. The indoor chamber thermal loading was controlled from full to partial thermal loadings and from balanced to unbalanced thermal loadings with respect to the specified rated capacity of the test specimen. The purpose of this study is to determine the real performance of the system when it is operating under actual operating situations. The general results show that the system coefficient of performance much depends on the partial and unbalanced thermal loadings. It is shown that the system maximum coefficient of performance occurred at around 50% of the rated thermal loadings. It is shown that as the load balance ratio decreases, the system coefficient of performance decreases, particularly for the cooling operation, due to the increase of compressor speed to support the refrigerant sub-cooling. In the heating operation, the compressor speed increase is very minimal which results in a very small decrease of the system coefficient of performance as the load balance ratio decreases. Based on this study, the system coefficient of performance becomes much different as the system is operating at partial thermal loadings. Also, during the unbalanced thermal loadings, the system coefficient of performance further decreases, particularly during the cooling operation. With the results of the study and analyses of the system operation, it is important to consider how the VRF system operates in an actual building when estimating the energy consumption of the VRF air-conditioning system to be installed in a new or in a retrofitted building.

Scirrhous gastric carcinoma (SGC) has the worst prognosis of all gastric cancers, owing to its rapid expansion by invasion and frequent peritoneal dissemination. Due to the increased proliferation of stromal fibroblasts (SFs) that occurs within SGC lesions and the peritoneal metastatic sites, SFs have been proposed to support the progression of this disease. However, the biological and molecular basis and the pathological role of the intercellular interaction between SGC cells and SFs remain largely unknown. In this study, we investigated the role of SFs in the invasion of the extracellular matrix (ECM) by SGC cells. When SGC cells were cocultured with SFs derived from SGC tissue on three-dimensional (3D) Matrigel, they were attracted together to form large cellular aggregates that invaded within the Matrigel. Time-lapse imaging revealed that this process was associated with extensive contraction and remodeling of the ECM. Immunofluorescence and biochemical analysis showed that SGC cells stimulate phosphorylation of myosin light chain and actomyosin-mediated mechanical remodeling of the ECM by SFs. By utilizing this assay system for inhibitor library screening, we have identified several inhibitors that potently suppress the cooperation between SGC cells and SFs to form the invasive structures. Among them, a Src inhibitor dasatinib impaired the interaction between SGC cells and SFs both in vitro and in vivo and effectively blocked peritoneal dissemination of SGC cells. These results indicate that SFs mediate mechanical remodeling of the ECM by SGC cells, thereby promoting invasion and peritoneal dissemination of SGC.

It is required to obtain chromaticity and luminance distribution of the natural scene with a digital camera. One of the problem to measure with the digital camera is that it has low dynamic range. The purpose of this study is to derive relational expressions between pixel values of several images with different exposure times and chromaticity or luminance. The prediction functions are derived by using the multiple regression analysis from XYZ obtained by measured values and pixel values (log10Y=αR+βG+γB+δ(Δt)). The coefficients of RGB of the prediction function were constant regardless of exposure time, in contrast, the δ value was represented by the exposure time function. Therefore, the prediction function moves parallel by the exposure times. The error between the actual measurement values and the predictive values were 8%, 6%, 5% in X,Y,Z. Therefore, it was able to acquire the chromaticity and the luminance distribution with a digital camera. There is problem that amount of light of the surrounding imaging area decreases more than center imaging area actual measured values. We construct a model of calibrate prediction function by the eccentricity from damping rate of the center of the lens.

The objective is to develop a method of defining color confusion lines in the display RGB color space through color discrimination tasks. In the experiment, reference and test square patches were presented side by side on a CRT display. The subject's task is to set the test color where the color difference from the reference is just noticeable to him/her. In a single trial, the test color was only adjustable along one of 26 directions around the reference. Thus 26 colors with just noticeable difference (JND) were obtained and made up a tube-like or an ellipsoidal shape around each reference. With color-anomalous subjects, the major axes of these shapes should be parallel to color confusion lines that have a common orientation vector corresponding to one of the cone excitation axes L, M, or S. In our method, the orientation vector was determined by minimizing the sum of the squares of the distances from JND colors to each confusion line. To assess the performance the method, the orientation vectors obtained by pseudo-dichromats (color normal observers with a dichromat simulator) were compared to those theoretically calculated from the color vision model used in the simulator.

Cataract is one of the most typical age-related eye diseases. As a cataract progress, the crystalline lens becomes hazier and visual ability deteriorates. Since the main cause of visual impairment is light scattered by the hazy lens, both brighter environments and hazier lenses worsen visual ability. In this study, error scores of 50 Hue test were measured for pseudo-cataract subjects (young observer with foggy filters of known as haze factor) when the intensity of scattering light was increased. The rate of increase in error score of 50 Hue test was larger with higher haze factor. We propose, as an easy method for assessing the progress of a cataract, the haze estimation of elderly crystalline lens using the obtained error scores of 50 Hue test as a function of the intensity of scattering light.

One of the most important problems for lighting design is how to reduce an electric energy. One way to solve this problem is use of daylight, but little is known how to perceive a brightness of a room illuminated by daylight come in through a window and artificial light. Although the horizontal illuminance increases because of daylight, we would not perceive the room as bright as brightness estimated by the illuminance. The purpose of this study is to measure the space brightness for daylit room and to propose a evaluation method. The experiment was conducted with a couple of miniature office rooms, standard room and test room. Test room has several types of windows and standard room has no window. Subject was asked to evaluate the brightness of the test room relative to the standard room with method of magnitude estimation. It was found that brightness of daylit room did not increase simply with horizontal illuminance. Subject perceived a daylit room darker than a room illuminated only by the artificial light even if horizontal illuminance of these room was same. The effect of daylight on space brightness would vary with the window size and intensity of daylight or artificial light.

To design a lighting environment, horizontal illuminance is generally used as the brightness of a room. But it is reported that a subjective brightness does not always match the horizontal illuminance. For example, the room furnished with high saturated colored objects is perceived brighter than the room furnished with achromatic objects, even though the horizontal illuminance is the same. To investigate a effect of interior chromaticness on space brightness, we conducted the experiment in four miniature rooms that were different in terms of chromaticness of interior decorating surfaces, but kept lightness of surfaces constant. Subjects were asked to set the illuminance of reference room, that is furnished with achromatic objects, to equate the brightness of the test room, that is with chromatic objects. Four of seven subjects needed less illuminance to get the equality of space brightness if the test room had a saturated objects. The illuminance ratio of test to reference room was about 1.4. Other three subjects set the illuminance of reference room almost equal to test room. Thus, there are differences between individuals so further work would be needed to estimate the quantitative effect of interior chromaticness on space brightness.

Our previous study has shown that blur adaptation through a foggy filter temporarily improved visual acuity (VA). Here we report the influence on VA from the adaptation to blurred images by a defocusing lens. In the experiment, a subject adapted to the blurred visual field by observing motion pictures through a trial lens either of 2.5D, 3.0D, 4.0D, or 5.0D. The visual acuity was measured in the periods of pre- and post-adaptation by a quick and simplified staircase method with Landolt C. The moment the lens was removed, subject's VA was obviously higher than the original VA and then gradually returned to the original level in a few minutes. However the degree of transient improvement in VA was not necessarily larger with longer period of adaptation. The enhancement in VA demonstrated here is presumably caused by blur adaptation and its aftereffect. The usual VA might not be the optimum performance of the hardware of an eye, or rather, be suppressed by the visual system in the level of the cortex.