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T cell receptor rearrangement excision circles (TRECs) and immunoglobulin κ-deleting recombination excision circles (KRECs) represent the lymphopoiesis capacity, widely used for newborn screening of inborn errors of immunity. To clarify the significance of TRECs and KRECs as immune indicators in patients with systemic autoimmune diseases, we prospectively evaluated TREC and KREC levels with qPCR, lymphocyte phenotypes with flow cytometry, along with lymphocyte counts and serum immunoglobulin levels in peripheral blood samples from newly diagnosed patients. Each variable was assessed before immunosuppressive treatments (baseline), 3-, 6-, and 12-months after the treatment. Severe infections were recorded until 6 months after treatment. Among 35 patients, TREC and KREC levels were associated positively with the proportion of recent thymic emigrants, naïve T and B cells at all the timepoints. TREC and KREC levels decreased after treatment. The ratios of TREC and KREC levels under treatment to baseline were significantly lower in patients with severe infection than those without. In conclusion, TREC and KREC levels reflect peripheral blood immunophenotypes, specifically recent-emigrated T and B cells, in patients under treatment-naïve and immunosuppressive conditions. The longitudinal changes in TREC and KREC levels were beneficial markers for predicting the risk of severe infection during immunosuppressive treatments.

Waterlogging is a common environmental constraint that inhibits soybean growth and reduces its yield. The aim of the present study was to evaluate the alleviating effect of crack treatment during mid-term tillage on waterlogging stress in soybean using field and pot trials. In the field experiments, crack treatment significantly increased both biomass and seed production under a waterlogging condition by a short-term flood stress during the early growth stage. In the pot experiment, three factors, namely root cutting, nodule bacteria, and aeration, were separately evaluated using a double root chamber system. The results indicated that aeration significantly enhanced soybean yield in the waterlogged treatment. In addition, root cutting inhibited soybean growth, and nodule bacteria application had no significant effect. The findings suggest that the crack treatment mitigated waterlogging stress in field-grown soybeans, and that aeration is a key factor that mitigates waterlogging stress and influences soybean growth and yield.

Abstract Background A wearable cardioverter defibrillator (WCD) is indicated for a limited period in patients at high risk of sudden cardiac death (SCD). Nonischemic heart failure (HF) is common among Japanese patients with HF. The aim of this study was to evaluate the incidence of fatal arrhythmias during WCD use and the clinical outcomes after WCD withdrawal in Japanese patients with HF. Methods We retrospectively studied 105 hospitalized HF patients who were discharged with a WCD. The main outcome was SCD/ventricular arrhythmias during WCD use and the other outcomes were implantation of an implantable cardioverter‐defibrillator (ICD), SCD/ventricular arrhythmias after WCD withdrawal, and changes in left ventricular ejection fraction (LVEF). Results Eighty‐seven (83%) patients received a WCD for primary prevention of SCD, of whom 60 (69%) were new‐onset HF patients with an LVEF ≤35%. The median daily wear time was 22.1 h. Two patients experienced sustained ventricular tachycardia and one patient experienced atrioventricular block with asystole while on WCD. After WCD withdrawal, 81 (77%) patients decided not to receive ICD implantation. The percentage of patients with an LVEF ≥35% increased from 20% at baseline to 70% at 1 year after discharge. During the median follow‐up of 50 months, 78 (96%) of the 81 patients who did not have an ICD were free of SCD/ventricular arrhythmias. Conclusions The use of a WCD is useful for determining the appropriate indication for ICD implantation in Japanese patients with new‐onset HF, a low LVEF, and a risk of SCD.

Abstract To design a wooden satellite and select the appropriate wood species, we conducted a space exposure test of wood on the International Space Station (ISS). The space exposure test used the Japanese Experiment Module “Kibo” on the Exposed Experiment Bracket Attached on i-SEEP (ExBAS), which is connected to the exposed facility of the ISS. Three wood species considered candidates for the structure of a wooden satellite were used in the exposure test: honoki (Magnolia obovata), yamazakura (Cerasus jamasakura), and dakekanba (Betula ermanii). In the outgassing test conducted in preparation for the space exposure test, the collected volatile condensable materials (CVCM) of the three wood species were below the critical value; however, the total mass loss (TML) exceeded the critical value. However, this was not a problem, because most of the mass loss was due to water evaporation. A space exposure test was conducted for 10 months in 2022. Consequently, no change was observed in the weight of the exposed specimen, and no erosion due to atomic oxygen (AO) was observed. The exposure test was scheduled to be carried out in the forward direction of the ISS travel; however, owing to equipment trouble, it was installed in the opposite direction. This is because an insufficient AO flux collided with the specimen. In terms of wood color, the brightness of the three species decreased owing to space exposure, and saturation increased in two wood species, except for yamazakura. A thin-film layer was observed on the surface of the aluminum cover to which the exposed specimen was fixed, which may have also formed on the surface of the wood specimen, reducing its brightness. However, because the hue angle did not change significantly, only a slight deterioration of the surface layer owing to vacuum ultraviolet was observed. The results confirmed that the wood had hardly deteriorated in space for approximately 10 months.

Background/purpose: Cognitive flexibility is a personality trait, which can influence how effectively a healthcare professional can manage a challenging clinical situation. This study explored the cognitive flexibility of undergraduate dental hygiene students at two universities in Asia to gather baseline information in order to consider whether there was an educational need for pre-clinical students with regards to this personality factor. Materials and methods: Participants were all undergraduate dental hygiene students in the 2022 academic year at Tokyo Medical and Dental University (TMDU; n = 79) and Taipei Medical University (TMU; n = 88). An anonymous questionnaire was distributed, which included questions on demographic information and the Cognitive Flexibility Inventory (CFI). Results: The response rates were 97.5% (TMDU) and 89.8% (TMU). The CFI total scores were 91.77 for TMDU and 95.87 for TMU, and there was no significant difference between the two schools. The Alternatives scores were significantly higher in TMU than TMDU (P = 0.044), but there were no significant differences in the Control scores between the two schools. There were also no significant differences between school years of both universities. Conclusion: The dental hygiene students from both dental schools exhibit moderate cognitive flexibility. The educators in both dental schools may consider whether they should investigate and develop this personality factor further during the undergraduate training of their dental hygiene students.

Abstract Background Various surgical procedures have employed microporous polysaccharide hemosphere (MPH) hemostatic agents. However, data regarding their effectiveness in preventing pocket hematomas (PHs) during the implantation of cardiac implantable electronic devices (CIED) among the Asian population are limited. Therefore, this study aimed to investigate the potential benefits of using MPH hemostatic agents during CIED implantations as a preventive measure against post‐procedural PHs. Methods We conducted a retrospective, single‐center, observational study involving 255 consecutive Japanese patients who underwent CIED implantation between November 2017 and April 2021. We compared PH occurrences within 28 days after CIED implantation between patients who received MPH hemostatic agents (n = 145) and those who did not (n = 110). Results PH development was observed in nine (6.2%) patients who received MPH hemostatic agents and in 13 (11.8%) patients without MPH hemostatic (p = .111). Kaplan–Meier analysis of PH development revealed no significant difference between the two groups (log‐rank p = .102). However, utilizing MPH hemostatic agents among patients taking antithrombotic drugs, including antiplatelet medications, direct oral anticoagulants, and warfarin, significantly reduced PH incidence (log‐rank p = .03). The multivariate Cox proportional hazards model demonstrated that MPH hemostatic agent utilization independently correlated with a decreased PH risk (hazard ratio 0.22, 95% confidence interval 0.08–0.63, p = .004). Conclusions The findings of this study suggest that the incorporation of MPH hemostatic agents into standard practice may benefit to mitigate PH risk during CIED implantations in patients on antithrombotic therapy. This simple and practical measure may be valuable, especially in high‐risk patients, such as those taking antithrombotic medications.

Abstract Candida parapsilosis is an opportunistic fungal pathogen commonly isolated from the environment and associated with nosocomial infection outbreaks worldwide. We describe here the construction of a large collection of gene disruptions, greatly increasing the molecular tools available for probing gene function in C. parapsilosis. We use these to identify transcription factors associated with multiple metabolic pathways, and in particular to dissect the network regulating the assimilation of sulphur. We find that, unlike in other yeasts and filamentous fungi, the transcription factor Met4 is not the main regulator of methionine synthesis. In C. parapsilosis, assimilation of inorganic sulphur (sulphate) and synthesis of cysteine and methionine is regulated by Met28, a paralog of Met4, whereas Met4 regulates expression of a wide array of transporters and enzymes involved in the assimilation of organosulfur compounds. Analysis of transcription factor binding sites suggests that Met4 is recruited by the DNA-binding protein Met32, and Met28 is recruited by Cbf1. Despite having different target genes, Met4 and Met28 have partial functional overlap, possibly because Met4 can contribute to assimilation of inorganic sulphur in the absence of Met28.

Abstract Background The association between corrected QT (QTc) interval and life‐threatening cardiac events in patients with hypertrophic cardiomyopathy (HCM) remains unclear. This study sought to investigate whether the prolonged QTc was associated with HCM‐related death in patients with HCM. Methods We included 445 patients with HCM (mean age 51 ± 16 years, 67% men). The QTc interval was measured at the time of the initial evaluation and the patients were classified into those with and without QTc prolongation, which was defined as a QTc interval >450 ms. HCM‐related death was defined as a combined endpoint of sudden death or potentially lethal arrhythmic events, heart failure‐related death, and stroke‐related death. Results Prolonged QTc interval was found in 120 patients (26.4%) at the time of enrollment. Over a median (IQR) follow‐up period of 8.1 (4.6–11.9) years, a total of 67 patients (15.1%) experienced HCM‐related deaths including 57 (12.8%) with the endpoint of sudden death or potentially lethal arrhythmic events. In a multivariable analysis that included prolonged QTc interval and the risk factors for life‐threatening events, prolonged QTc interval was independently associated with an HCM‐related death (adjusted hazard ratio [HR]: 1.91; 95% confidence interval [CI]: 1.16–3.16; p = .011) and this trend also persisted for the combined endpoint of sudden death or potentially lethal arrhythmic events (adjusted HR: 2.01: 95% CI: 1.17–3.46; p = .012). Conclusions In this cohort of patients with HCM, QTc prolongation may be associated with HCM‐related death, including the endpoint of sudden death or potentially lethal arrhythmic events.

Background Ongoing debates question the harm of internet use with the evolving technology, as many individuals transition from regular to problematic internet use (PIU). The habenula (Hb), located between the thalamus and the third ventricle, is implicated in various psychiatric disorders. In addition, personality features have been suggested to play a role in the pathophysiology of PIU.Aims This study aimed to investigate Hb volumetry in individuals with subclinical PIU and the mediating effect of personality traits on this relationship.Methods 110 healthy adults in this cross-sectional study underwent structural magnetic resonance imaging. Hb segmentation was performed using a deep learning technique. The Internet Addiction Test (IAT) and the NEO Five-Factor Inventory were used to assess the PIU level and personality, respectively. Partial Spearman’s correlation analyses were performed to explore the relationships between Hb volumetry, IAT and NEO. Multiple regression analysis was applied to identify personality traits that predict IAT scores. The significant trait was then treated as a mediator between Hb volume and IAT correlation in mediation analysis with a bootstrap value of 5000.Results Relative Hb volume was negatively correlated with IAT scores (partial rho=−0.142, p=0.009). The IAT score was positively correlated with neuroticism (partial rho=0.430, p

Kodamaea ohmeri is an emerging and opportunistic yeast associated with a high mortality rate in humans. As it is commonly found in the environment, it is possible that environmental conditions and agricultural practices contribute to the adaptation of this yeast and the selection of antifungal resistance. During a multicentric study in Brazil, conducted under a One Health perspective, 14 isolates of K. ohmeri were identified from different sources: three from blood cultures, three from animals (swine and poultry), and eight from animal environments (swine and poultry). Yeasts were isolated using CHROmagar® Candida medium and identified by MALDI-TOF MS and ITS rDNA barcoding. Minimum inhibitory concentration (MIC) was determined using the broth microdilution method for clinical (azoles, echinocandins, pyrimidine analogs, and polyenes), and environmental antifungals (tebuconazole, pyraclostrobin, carbendazim, and mancozeb), and hospital disinfectants (quaternary ammonium compounds). Of note, color variations of K. ohmeri were noted on CHROmagar® depending on the incubation time, which is likely to complicate its identification. Following polyphasic identification and taxonomic confirmation, all isolates demonstrated low MIC values for clinical antifungals, disinfectants, and tebuconazole. However, all isolates were able to grow in the presence of carbendazim, mancozeb, and pyraclostrobin. Together, these findings highlight the risks associated with the use of environmental azoles, such as tebuconazole, as they may impact non-target fungi of medical importance, but other fungicides do not present the same risk. This is the first study to demonstrate that K. ohmeri, an important emerging yeast in human medicine, can be isolated from various sources, including patients. Although the isolates exhibited low MIC values for clinical antifungals, it is crucial to monitor changes in sensitivity patterns over time in emerging microorganisms to prevent the development of multidrug resistance, which may originate in the environment.

Elderly patients with pulmonary arterial hypertension (PAH) exhibit distinct features and outcomes compared to classical patients. Cardiopulmonary comorbidities are common and likely contribute to the development of pulmonary hypertension (PH). However, solid evidence for treating elderly PAH patients with these comorbidities remains lacking, complicating management. We report a case of a 74-year-old male with PAH and cardiopulmonary comorbidities who responded transiently to initial combination therapy with pulmonary vasodilators.

Cardiac physiologic pacing (CPP), encompassing cardiac resynchronization therapy (CRT) and conduction system pacing (CSP), has emerged as a pacing therapy strategy that may mitigate or prevent the development of heart failure (HF) in patients with ventricular dyssynchrony or pacing-induced cardiomyopathy. This clinical practice guideline is intended to provide guidance on indications for CRT for HF therapy and CPP in patients with pacemaker indications or HF, patient selection, pre-procedure evaluation and preparation, implant procedure management, follow-up evaluation and optimization of CPP response, and use in pediatric populations. Gaps in knowledge, pointing to new directions for future research, are also identified.

Abstract Objective To reveal the clinical features and assess risk factors linked to brain fog and its societal implications, including labor productivity, providing valuable insights for the future care of individuals who have experienced coronavirus disease 2019 (COVID‐19). Methods We analyzed a comprehensive cohort dataset comprising 1,009 patients with COVID‐19 admitted to Japanese hospitals. To assess brain fog, we analyzed patients who responded to a questionnaire indicating symptoms such as memory impairment and poor concentration. Results The prevalence of brain fog symptoms decreased 3 months posthospitalization but remained stable up to 12 months. Neurological symptoms such as taste and smell disorders and numbness at hospitalization correlated with a higher frequency of identifying brain fog as a long COVID manifestation. Our findings indicated that advanced age, female sex, a high body mass index, oxygen required during hospitalization, chronic obstructive pulmonary disease, asthma, and elevated C‐reactive protein and elevated D‐dimer levels were risk factors in patients exhibiting brain fog. Additionally, we demonstrated the negative impact of brain fog on labor productivity by presenteeism scores. Interpretations This study clarified the clinical characteristics of patients experiencing brain fog as a long COVID manifestation, specifically emphasizing neurological symptoms during hospitalization and their correlation with brain fog. Additionally, the study identified associated risk factors for its onset and revealed that the emergence of brain fog was linked to a decline in labor productivity.