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Objectives Previous research has suggested cross-national differences in the association between living alone and well-being among older adults. This study examined whether the association varied across social contexts within the country, Japan, in terms of varying degree of urbanization and differential time periods. Methods Data were obtained from a nine-wave nationwide longitudinal survey with a probability sample of Japanese adults aged 60 years and over. Respondents belonged to one of the three periods (around 1990, 2000, and 2015) according to the year they commenced participation. As many as 4,655 individuals from 575 municipalities provided 9,016 observation sets of two consecutive waves (t − 1 and t). Within a framework of the Hierarchical Generalized Linear Model, depressive symptoms at t were predicted based on changes in living arrangements from t − 1 to t and their cross-level interactions with gender, level of urbanization, and time period, controlling for various covariates at t − 1. Results In general, older adults living alone continuously as well as those who started living alone between the waves showed more depressive symptoms than those coresiding with someone continuously. However, this tendency was more prominent among rural residents than their urban counterparts, especially for men. Moreover, the effect of continuously living alone on depressive symptoms became smaller in Period 2015 than that in Period 1990, because of the increase in depressiveness in coresident older adults. Discussion Our findings indicate that living alone has a differential effect on older adults’ well-being depending on the social context where residents’ preferences for living arrangements and availability of formal services could vary.

Background: Fulminant myocarditis presentation (FMP) is a rare and severe presentation of myocarditis. The natural history of FMP and its clinical features associated with poor outcomes are incompletely understood because there is a lack of generalizable evidence. Methods: This multicenter retrospective cohort study included patients hospitalized with histologically proven myocarditis who underwent catecholamine or mechanical support from 235 cardiovascular training hospitals across Japan between April 2012 and March 2017. Clinical features and the prognostic predictors of death or heart transplantation within 90 days on the basis of clinical and pathologic findings were determined using the Kaplan-Meier method, log-rank test, and Cox regression analysis. Results: This study included 344 patients with histologically proven FMP (median age, 54 years; 40% female). The median follow-up was 600 days (interquartile range, 36 to 1599 days) and the cumulative risk of death or heart transplantation at 90 days was 29% (n=98). Results from multivariable Cox regression analysis showed that older age, nonsinus rhythm, low left ventricular wall motion ( Conclusions: The results from analyses of data from this multicenter registry demonstrated that patients with FMP are at a higher risk of death or heart transplantation in real-world settings. These observations inform which clinical and pathologic findings may be useful for prognostication in FMP. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000039763.

Little evidence is available regarding the long-term outcome in elderly patients after deferral of revascularization based on fractional flow reserve (FFR).Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), 1,262 patients were divided into 2 groups according to age: elderly and younger patients (aged ≥75 or75 years, respectively). The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), defined as a composite of cardiac death, target vessel-related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR). Cumulative 5-year incidence of TVF was not significantly different between elderly and younger patients (14.3% vs. 10.8%, P=0.12). Cardiac death occurred more frequently in elderly patients than younger patients (4.4% vs. 0.8%, P0.001), whereas TVMI and CDTVR did not differ between groups (1.3% vs. 0.9%, P=0.80; 10.7% vs. 10.1%, P=0.80, respectively). FFR values in lesions with diameter stenosis50% were significantly higher in elderly patients than in younger patients (0.88±0.07 vs. 0.85±0.07, P=0.01), whereas this relationship was not observed in those with diameter stenosis ≥50%.Elderly patients had no excess risk of ischemic events related to the deferred coronary lesions by FFR, although FFR values in mild coronary artery stenosis were modestly different between elderly and younger patients.

Background: The cardiopulmonary response to exercise in patients with heart failure exhibiting a mildly reduced ejection fraction (41% ≤ EF ≤ 49%) remains unclear. Materials & methods: A total of 193 consecutive patients with heart failure (excluding those with coronary artery disease) who underwent cardiopulmonary exercise (CPX) tests were examined. CPX variables were compared among patients with reduced, mildly reduced, and preserved EF. Results: The CPX test responses of patients with mildly reduced EF were similar to those of patients with reduced or preserved EF; however, increases in systolic blood pressure during exercise differed significantly (32 ± 26, 50 ± 24, and 41 ± 31 mmHg, respectively; p = 0.016). Grip strength and an increase in systolic blood pressure during exercise were independently associated with peak oxygen uptake in patients with mildly reduced EF (β = 0.41, 0.35, respectively; p < 0.05). Conclusion: Measurements of grip strength and blood pressure during exercise are useful predictors of prognoses in patients with non-ischemic and mildly reduced EF.

The aim of this study was to evaluate the impact of thrombotic risk on the occurrence of cardiovascular events in patients with coronary artery disease with deferred revascularization after fractional flow reserve (FFR) measurements.Deferral of revascularization on the basis of FFR is generally considered to be safe, but after deferral, some patients have cardiovascular events over time.From J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), 1,263 patients with deferral of revascularization on the basis of FFR were evaluated. The association between thrombotic risk as assessed by CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) thrombotic score and 5-year target vessel failure (TVF) and major adverse cardiac and cerebrovascular events (MACCE) was investigated.FFR and high thrombotic risk (HTR) were associated with increased risk for 5-year TVF (FFR per 0.01-unit decrease: HR: 1.08; 95% CI: 1.05-1.11; P 0.001; HTR: HR: 2.16; 95% CI: 1.37-3.39; P 0.001) and MACCE (FFR per 0.01-unit decrease: HR: 1.05; 95% CI: 1.02-1.06; P 0.001; HTR: HR: 2.11; 95% CI: 1.56-2.84; P = 0.001). Patients with HTR had higher risk for 5-year TVF (HR: 2.30; 95% CI: 1.45-3.66; P 0.001) and MACCE (HR: 2.34; 95% CI: 1.75-3.13; P 0.001) than those without HTR, even when they had negative FFR.Assessment of thrombotic risk provides additional prognostic value to FFR in predicting 5-year TVF and MACCE in patients with deferral of revascularization after FFR measurements. (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry; UMIN000014473).

Time-resolved electron holography was implemented in a transmission electron microscope by means of electron beam gating with a parallel-plate electrostatic deflector. Stroboscopic observations were performed by accumulating gated electron interference images while applying a periodic modulation voltage to a specimen. Electric polarization in an ionic liquid specimen was observed under applied fields. While a static electric field in the specimen was reduced by the polarization of the material, an applied field modulated at 10 kHz was not screened. This indicates that time-resolved electron holography is capable of determining the frequency limit of dynamic response of polarization in materials. Graphical Abstract

Soft magnetic materials have low coercive fields and high permeability. Recently, nanocrystalline alloys obtained using annealing amorphous alloys have attracted much interest since nanocrystalline alloys with small grain sizes of tens of nanometers exhibit low coercive fields comparable to that of amorphous alloys. Since nanocrystalline soft magnetic materials attain remarkable soft magnetic properties by controlling the grain size, the crystal grains’ microstructure has a substantial influence on the soft magnetic properties. In this research, we examined the magnetic properties of Fe-Si-B-P-Cu nanocrystalline soft magnetic alloys obtained by annealing amorphous alloys. During crystallization, the observation findings reveal the correlation between the generated microstructures and soft magnetic properties.

This study examines the mediating effect of social network size on depression among older adults in Japan in association with the Big Five personality traits: extraversion, agreeableness, conscientiousness, neuroticism, and openness. Cross-sectional data were obtained from 739 older adults (Mean age = 75.13, SD = 6.86) residing in Tokyo. Multiple mediation analyses estimated total, indirect, and direct effects between personality and depression. Extraversion was associated with the number of kin and friend networks and agreeableness with the number of kin networks. Moreover, these social networks partially mediated the effects of extraversion and agreeableness on depression. The findings show that personality traits such as extraversion and agreeableness are associated with social network size, which contributes to better mental health in old age.

Background Epicardial adipose tissue (EAT) is considered to play a critical role in vascular endothelial function. Coronary artery spasm has been postulated to be a causal factor in vascular endothelial abnormalities and atherosclerosis. This study aimed to investigate the relationship between coronary artery spasm and EAT volume, total abdominal adipose tissue (AAT) area, and abdominal visceral adipose tissue (AVAT) area. Method Among patients undergoing coronary computed tomography (CT) to evaluate coronary artery disease, we identified 110 patients who did not have significant coronary artery stenosis and underwent a coronary spasm provocation test with cardiac catheterization. They were divided into two groups according to the results of the spasm provocation test: spasm-positive and spasm-negative. EAT volume, total AAT area, and AVAT area were evaluated using CT images. Results Seventy-seven patients were included in the spasm-positive group and 33 patients in the spasm-negative group. There were no significant differences in baseline clinical characteristics between the two groups, except for the prevalence of current smoking (48% vs. 27%, p = 0.04). EAT volume was significantly higher in the spasm-positive group (108 ± 38 mL vs. 87 ± 34 mL, p = 0.007), while no significant difference was seen in total AAT area (280 ± 113 cm2 vs. 254 ± 128 cm2, p = 0.32) or AVAT area (112 ± 54 cm2 vs. 98 ± 55 cm2, p = 0.27). Multivariate logistic analysis indicated that EAT volume (per 10 cm3) (odds ratio, 1.198; 95% confidence interval, 1.035–1.388; p = 0.016) was a significant predictor of coronary artery spasm. Conclusion Our results suggest that EAT has a strong association with coronary artery spasm, while AAT may not.

3 formulated etchants were prepared and their etch rates were measured using blanket wafers in order to confirm that the etching reactions on Si1-XGeX and Si are controllable. Si1-XGeX selective etching with those formulations was also verified using the wafers which had Si1-XGeX and Si multi-stacked structures. Cross-sectional transmission electron microscope (TEM) images suggested that the formulations were usable for Si1-XGeX selective etching processes.

It is well known that two DNA molecules are wrapped around histone octamers and folded together to form a single chromosome. However, the nucleosome fiber folding within a chromosome remains an enigma, and the higher-order structure of chromosomes also is not understood. In this study, we employed electron diffraction which provides a noninvasive analysis to characterize the internal structure of chromosomes. The results revealed the presence of structures with 100–200 nm periodic features directionally perpendicular to the chromosome axis in unlabeled isolated human chromosomes. We also visualized the 100–200 nm periodic features perpendicular to the chromosome axis in an isolated chromosome whose DNA molecules were specifically labeled with OsO4 using electron tomography in 300 keV and 1 MeV transmission electron microscopes.

We have developed an amplitude-division type Mach-Zehnder electron interferometer (MZ-EI). The developed MZ-EI is composed of single crystals corresponding to amplitude-division beam splitters, lenses corresponding to mirrors and an objective aperture. The spacings and azimuth angles of interference fringes can be controlled by single crystal materials and their orientations and by diffraction spots selected by the objective aperture. We built the MZ-EI on a 1.2-MV field-emission transmission electron microscope and tested its performance. Results showed that interference fringes were created for various spacings and azimuth angles, which demonstrates the practicability of the MZ-EI as an amplitude-division type electron interferometer.

This paper reviews the basics of electron holography as an introduction of the holography part of this special issue in Microscopy. We discuss the general principle of holography and interferometry regarding measurements and analyses of phase distributions, first using the optical holography. Next, we discuss physical phenomena peculiar to electron waves that cannot be realized by light waves and principles of electromagnetic field detection and observation methods. Furthermore, we discuss the interference optical systems of the electron waves and their features, and methods of reconstruction of the phase information from electron holograms, which are essential for realization of practical electron holography. We note that following this review application of electron holography will be discussed in detail in the papers of this special issue.

Lensless Fourier transform holography has been developed. By treating Bragg diffraction waves as object waves and a transmitted spherical wave as a reference wave, these two waves are interfered and recorded as holograms away from the reciprocal plane. In this method, reconstruction of holograms requires only one Fourier transform. Application of this method to analyze vortex beams worked well and their amplitude and phase distributions were obtained on the reciprocal plane. By combining the conventional holography with the developed lensless Fourier transform holography, we can reconstruct and analyze electron waves from the real to reciprocal space continuously.

The magnetism of a narrow (~1.6 nm) grain boundary phase produced in a 0.1 at% Ga-doped Nd–Fe–B sintered magnet was examined using electron holography. The magnetic flux density was determined to be 0.8 ± 0.1 T, which was smaller than that for a commercial magnet free from Ga doping (~1.0 T). The presence of a ferromagnetic grain boundary phase reasonably explained the functionality of the 0.1 at% Ga-doped system, such as the improvement in the squareness of the demagnetization curve. The observations provide useful information for deeper understanding of the coercivity mechanism in Ga-doped Nd–Fe–B sintered magnets.

Hidehiro Sugisawa,1 Ken Harada,2 Yoko Sugihara,3 Shizuko Yanagisawa,4 Masaya Shinmei5 1International Graduate School for Advanced Studies, J. F. Oberlin University, Machida-shi, Tokyo, Japan; 2Department of Humanities and Social Sciences, Jissen Women’s University, Shibuya-ku, Japan; 3Department of Urban Science and Policy, Tokyo Metropolitan University, Hachioji-shi, Japan; 4Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University, Tokushima-shi, Japan; 5Faculty of Human Welfare, Den-En Chofu University, Kawasaki Shi, JapanCorrespondence: Hidehiro Sugisawa, International Graduate School for Advanced Studies, J. F. Oberlin University, 3758, Machida-shi, Tokyo, 194-0294, Japan, Tel/Fax +81(0)02-797-9847, Email sugisawa@obirin.ac.jpPurpose: Few studies have examined together the psychosocial mediators of how life-course and late-life socioeconomic status (SES) influence late-life health. This study explored psychosocial mediators of influences of not only life-course but also late-life financial strain on late-life health in Japan, using a cross-sectional survey. It was hypothesized that: 1) both life-course and late-life financial strain will influence late-life health through common mediators, and 2) such mediating influences will be large on health indicators strongly related to psychosocial resources, such as depressive tendencies and self-rated health.Methods: The participants (N = 739) were aged 65 years and older and lived in metropolitan Tokyo, Japan. Life-course financial strain was measured retrospectively by the number of financially strenuous experiences over the participants’ life-courses. Possible mediators included stressors (life-course and late-life major traumatic life events) and psychosocial resources (self-esteem, sense of control, health literacy, social networks, and social support). Health indicators included multimorbidity, disabled activities of daily living (ADL), depressive tendency, and poorer self-rated health.Results: Having a sense of control mediated the significant influences of both life-course and late-life financial strain on disabled ADL. Furthermore, self-esteem significantly mediated the influences of both life-course and late-life financial strain on depressive tendencies and poorer self-rated health. All such mediating influences were significant at p < 0.05. Psychosocial resources did not mediate significant influences of life-course and financial strain on multimorbidity.Conclusion: The results support our hypotheses and make three main contributions on the mechanism through which SES influences late-life health: 1) psychosocial resources mediate the effect of life-course SES on late-life health; 2) the influence differs depending on health type; and 3) these results can generalize to older adults in not only Japan but also Western countries.Keywords: accumulative effects model, multiple health indicators, multiple mediation, social class, self-concept

Background: Little large-scale data is available about the long-term (beyond 3 years) clinical outcomes after fractional flow reserve (FFR)–based deferral of revascularization in clinical practice. We sought to assess the 5-year outcomes after deferral of revascularization based on FFR. Methods: The J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry) prospectively enrolled 1263 patients with 1447 lesions in whom revascularization was deferred based on FFR from 28 Japanese centers. The primary study end point was the cumulative 5-year incidence of target vessel failure (TVF), including cardiac death, target vessel–related myocardial infarction, and clinically driven target vessel revascularization. Results: Five-year follow-up was completed in 92.2% of patients. The 5-year TVF rate was 11.6% in deferred lesions, mainly driven by clinically driven target vessel revascularization (9.8%). Cardiac death and target vessel–related myocardial infarction were 1.9% and 0.95%, respectively. Cumulative 5-year incidence of TVF was similar between the FFR 0.75 to 0.80 and 0.81 to 0.85 groups even after adjustment for baseline characteristics (12.2% versus 13.0%, inverse probability–weighted hazard ratio, 0.86 [95% CI, 0.46–1.60]; P =0.63). Compared with the almost normal FFR (0.86–1.00) group, the significant (P Conclusions: The 5-year TVF rate was 11.6% in deferred lesions, mainly driven by clinically driven target vessel revascularization. Notably, cardiac death and target vessel–related myocardial infarction rarely occurred during the follow-up. Our findings highlight the long-term safety of FFR-based deferral of revascularization in patients with chronic coronary syndrome. Registration: URL: https://www.umin.ac.jp/ctr ; Unique identifier: UMIN000014473.

Guideline-directed medical therapy (GDMT) is essential to prevent future cardiovascular events in chronic coronary syndrome (CCS) patients. However, whether achieving optimal GDMT could improve clinical outcomes in CCS patients with deferred lesions based on fraction flow reserve (FFR) remains thoroughly investigated. We sought to evaluate the association of GDMT adherence with long-term outcomes after FFR-based deferral of revascularization in a real-world registry.This is a post-hoc analysis of the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicentre registry). Optimal GDMT was defined as combining four types of medications: antiplatelet drug, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker, beta-blocker, and statin. After stratifying patients by the number of individual GDMT agents at 2 years, landmark analysis was conducted to assess the relationship between GDMT adherence at 2 years and 5-year major adverse cardiac events (MACEs), defined as a composite of all-cause death, target vessel-related myocardial infarction, clinically driven target vessel revascularization. Compared with the suboptimal GDMT group (continuing ≤3 types of medications, n = 974), the optimal GDMT group (n = 139) showed a lower 5-year incidence of MACE (5.2% vs. 12.4%, P = 0.02). The optimal GDMT was associated with a lower risk of MACE (hazard ratio: 0.41; 95% confidence interval: 0.18 to 0.92; P = 0.03).Patients with optimal GDMT were associated with better outcomes, suggesting the importance of achieving optimal GDMT on long-term prognosis in CCS patients after FFR-guided deferral of revascularization.

We have developed an observation and measurement method for spatial electromagnetic fields by using scanning electron/ion microscopes, combined with electron holography reconstruction technique. A cross-grating was installed below the specimen, and the specimens were observed under the infocus condition, and the grating was simultaneously observed under the defocus condition. Electromagnetic fields around the specimen were estimated from grating-image distortions. This method is effective for low and middle magnification and resolution ranges; furthermore, this method can in principle be realizable in any electron/ion beam instruments because it is based on the Lorentz force model for charged particle beams.

In this study, the spatial counting statistics of free electron beams, which were released via field emission from cold metal and propagated through a vacuum region, were investigated to examine the normal functioning of the counting equipment for electron correlation spectroscopy. The beam electrons were recorded separately according to the locations of individual events as they reached the direct detection transmission Complementary Metal Oxide Semiconductor (CMOS) sensor. We examined the spatial point patterns arising from the locations of the individual events of each primary electron being detected in the case of electrons in a state in which the wave function is constant on the sensor. The quadrat method, which compares the observed frequencies of the number of electron counts in the subsets of the study region with the predicted frequencies from a Poisson distribution, indicates a clustering-type departure from complete spatial randomness. To explore some of the basic principles governing the location of coherent electrons being counted, Ripley’s K-function and the corresponding L-function of a stationary spatial point process were used to test the complete spatial randomness from the data. The maximum peak in the average of the L-functions was sensitive only to the mean counts per frame. Thus, clustering of spatial point patterns may result from abnormalities in the direct detection camera. When the interaction of the beam electrons with the sensor is included in the simulation, there is a reasonable match between the average of the L-functions and the experimental curves with the theoretically simulated curves.

Polyhydroxyalkanoate (PHA) synthases catalyze the polymerization reaction of the acyl moiety of hydroxyacyl-coenzyme A into polyester. The catalytic subunit PhaC of PHA synthase has the PhaC box sequence at the active site that is typically described as G-X-C-X-G-G (X is an arbitrary amino acid), and cysteine is an active center. In this study, an amino acid replacement was introduced into the PhaC box of the PHA synthase derived from Ralstonia eutropha (PhaCRe ) to investigate the importance of highly conserved residues in polymerizing activity. Point mutagenesis revealed that PhaCRe mutants with the expanded PhaC box sequence ([GAST]-X-C-X-[GASV]-[GA]) are functional PHA synthases. These findings highlight the low mutational robustness of the last glycine residue in the PhaC box as well as that of the active center cysteine.

Objective: Few studies have used time perspective (TP) theory to examine the factors mediating the association between socio-economic status (SES) and health behaviours (i.e. the psychological mech...